（仲景） 治厥阴伤寒。手足厥寒，脉细欲绝。
当归 桂枝 芍药 细辛（三两） 甘草（炙） 通草（即木通二两） 大枣（二十五
枚） 仲景又
名四逆加吴茱萸生
四逆之名多矣，而有因寒因热之不同。此则因风寒中血脉而逆，故以当归辛温血中之气
药为
未
藉
（仲景） 治少阴伤寒腹痛，小便不利，四肢沉重疼痛，自下利者，此为有水气。或咳
或呕，或小便利。（伤寒脉沉细，欲吐不吐，心烦，但欲寐，五六日自利而渴者，为少阴证。
凡人寤则气行于阳，寐则气行于阴，然必自少阴始，故少阴证但欲寐，阴气胜也。一有阳
扰，则反是矣。周扬俊曰∶但欲寐，非能寐，昏昏如梦尔。少阴属肾，肾病不能制水，水饮
停为水气。腹痛者，寒湿内甚也。四肢沉重疼痛，寒淫外甚也。小便不利，自下利者，湿胜
而水谷不别也。或咳或呕，皆停饮也。）及太阳病发汗，汗出不解，仍发热，心悸，头眩，
筋惕肉 ，振振欲擗地。气虚恶寒。（汗出过多，则心悸。汗为心液，汗去心虚，如鱼失水
则跃也。水停心下，亦心悸。心属火，火畏水，故悸也。虚阳内动，故头眩。汗多则液少
不能荣养筋肉，故筋惕惕而跳，肉 而动也。振振欲擗地者，亡阳无奈，欲擗地而入也。程
郊倩曰∶汗多亡阳，夫人知之。然有卫外之阳，为周身营卫之主。此阳虚，遂有汗漏不止，
，恶寒身痛之证。有膻中之阳，为上焦心肺之主。此阳虚，遂有叉手冒心，及奔豚之证。有
肾中之阳，为下焦真元之主。此阳虚，遂有发热眩悸 振擗地之证。有胃中之阳，为中焦水
谷生化之主。此阳虚
逆，以法治之。肾之
泛滥为病。故上凌心
曰∶汗虽出而热不退
无往而非亡阳之
附子（一枚炮） 白术（二两炒） 茯苓 白芍 生姜（三两） 水寒相搏咳者，加五
味子细辛干
小便利，去茯苓。（以其渗利。）下利去芍药，加干姜。（芍药酸寒，干姜辛热。）呕去附
子，
茯苓白术，补上利水，能伐肾邪，而疗心悸。生姜附子，回阳益卫，能壮真火，而逐虚
寒。芍药酸收，能敛阴和营，而止腹痛。（补阳必兼和阴，不欲偏胜。经曰∶寒淫所胜，治
以辛
方济
阳从
水，
按青
法，
才见
以消
去生姜，加人参二两，名附子汤。（仲景）治少阴病，身体痛，手足寒，骨节痛，脉沉
者。（
感之痛
病，得
阳，腹
有阴气
背微恶
病，内
当以
（张仲景）治疗厥阴伤寒。症状为手脚冰凉，脉搏细微几乎摸不到。
当归、桂枝、芍药、细辛（各三两）、甘草（炙过的）、通草（即木通，二两）、大枣（二十五枚）。
张仲景又将其命名为四逆加吴茱萸生姜汤。
“四逆”这个名字有很多，但病因有寒证和热证的不同。这里是因为风寒侵入血脉导致四肢逆冷，所以用当归这味辛温、入血分的行气药作为主药。
（张仲景）治疗少阴伤寒引起的腹痛，小便不通畅，四肢沉重疼痛，自发腹泻的，这是体内有水气。或者咳嗽，或者呕吐，或者小便通畅。（《伤寒论》中提到：脉象沉细，想吐又吐不出来，心烦，只想睡觉，过了五六天出现自发性腹泻且口渴的，属于少阴证。人清醒时阳气运行于体表，睡眠时阳气运行于体内，但必须从少阴开始，所以少阴证表现为只想睡觉，这是因为阴气盛。一旦有阳热扰动，情况就会相反。周扬俊说：只想睡觉，并不是真的能睡着，而是昏昏沉沉像在做梦一样。少阴属肾，肾病不能控制水液，水饮停滞形成水气。腹痛，是因为寒湿在体内严重。四肢沉重疼痛，是因为寒邪在体表严重。小便不通畅，自发腹泻，是因为湿气胜而水谷不分。）以及太阳病发汗后，汗出后病未解，仍然发热，心悸，头晕，肌肉跳动，身体颤抖想要倒地。气虚怕冷。（出汗过多，会导致心悸。汗是心的体液，汗流失则心虚，就像鱼离开了水就会跳跃一样。水停在心下，也会引起心悸。心属火，火畏惧水，所以会悸动。虚阳在内扰动，所以头晕。汗多则津液少，不能滋养筋肉，所以肌肉跳动，皮肤抽动。身体颤抖想要倒地的，是因为亡阳无奈，想要趴在地上。程郊倩说：汗多亡阳，人们都知道。但是有护卫体表的阳，它是周身营卫的主宰。这种阳虚，就会出现汗漏不止，恶寒身痛的病症。有膻中的阳，它是上焦心肺的主宰。这种阳虚，就会出现双手交叉护住心胸，以及奔豚病的症状。有肾中的阳，它是下焦真元的主宰。这种阳虚，就会出现发热、眩晕、悸动、颤抖想要倒地的症状。有胃中的阳，它是中焦水谷生化之源的主宰。这种阳虚……逆乱，按法治之。肾之阳虚泛滥成病。所以上凌于心……曰：虽然出汗但热不退……无处不是亡阳的表现……
附子（一枚，炮制过）、白术（二两，炒过）、茯苓、白芍、生姜（三两）。如果因水寒相搏导致咳嗽，加五味子、细辛、干姜。如果小便通畅，去掉茯苓（因为它有利尿作用）。如果腹泻，去掉芍药，加干姜（因为芍药酸寒，干姜辛热）。如果呕吐，去掉附子，保留茯苓、白术，以补脾利水，能祛除肾邪，治疗心悸。生姜、附子，回阳益卫，能壮真火，驱逐虚寒。芍药酸收，能敛阴和营，治疗腹痛。（补阳必须兼调和阴，不希望偏胜。经书说：寒邪胜，用辛味药治疗……方剂济助……阳从……水……按青……法……才见……以消……
去掉生姜，加人参二两，名为附子汤。（张仲景）治疗少阴病，身体痛，手脚凉，骨节痛，脉沉的。（感之痛……病，得……阳，腹……有阴气……背微恶……病，内……当以……
(Zhang Zhongjing) Treats Jueyin Cold Damage (Jueyin Shaohang). Symptoms include coldness of the hands and feet, and a fine pulse that is nearly imperceptible.
Danggui (Angelicae Sinensis Radix), Guizhi (Cinnamomi Ramulus), Shaoyao (Paeoniae Radix), Xixin (Asari Radix et Rhizoma) [each 3 liang], Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Tongcao (Tetrapanacis Medulla, i.e., Mutong [Akebiae Caulis]), Dazao (Zizyphi Fructus) [25 pieces].
Zhang Zhongjing also named it Sini Decoction with Evodia and Ginger.
The name "Sini" (Reversal Cold) has many variations, but the etiology differs between cold and heat syndromes. This case is due to wind-cold invading the blood vessels causing reversal coldness; therefore, Danggui, a pungent-warm herb that moves qi within the blood, is used as the principal agent.
(Zhang Zhongjing) Treats Shaoyin Cold Damage presenting with abdominal pain, difficulty in urination, heaviness and pain in the four limbs, and spontaneous diarrhea, indicating the presence of water qi. There may also be cough or vomiting, or conversely, free urination. (In the Shanghan Lun: A deep and fine pulse, a sensation of wanting to vomit but unable to do so, irritability, and a desire only to sleep, along with spontaneous diarrhea and thirst after five or six days, constitute a Shaoyin syndrome. When awake, qi circulates in the yang aspect; when asleep, qi circulates in the yin aspect. However, this process must begin from Shaoyin; thus, the Shaoyin syndrome manifests as a desire only to sleep, caused by an excess of yin qi. If disturbed by yang heat, the situation reverses. Zhou Yangjun stated: "Desire only to sleep" does not mean one can actually fall asleep, but rather feels drowsy and dream-like. Shaoyin belongs to the Kidney; kidney disease fails to control water, leading to stagnation of fluid and formation of water qi. Abdominal pain indicates severe internal cold-dampness. Heaviness and pain in the four limbs indicate severe external invasion by cold. Difficulty in urination and spontaneous diarrhea result from dampness prevailing, causing failure to separate clear turbid fluids.) Furthermore, after treating Taiyang syndrome with sweating, if the illness persists despite sweating, accompanied by persistent fever, palpitations, vertigo, muscle twitching, and trembling as if about to collapse, this indicates deficiency of qi and aversion to cold. (Excessive sweating leads to palpitations. Sweat is the fluid of the Heart; loss of sweat causes Heart deficiency, akin to a fish jumping out of water. Water stagnating below the heart also causes palpitations. The Heart belongs to Fire, and Fire fears Water, hence palpitations. Internal movement of deficient yang causes vertigo. Excessive sweating depletes fluids, failing to nourish muscles and sinews, leading to twitching and tremors. Trembling as if about to collapse indicates desperate loss of yang, where the patient wishes to lie prostrate. Cheng Jiaoqian said: Everyone knows that excessive sweating leads to loss of yang. However, there is the defensive yang, which is the master of the body's wei and ying. Deficiency of this yang leads to unceasing leakage of sweat, aversion to cold, and body pain. There is the yang of the Danzhong (chest), which is the master of the upper jiao Heart and Lungs. Deficiency of this yang leads to crossing hands over the heart and Ben Tun (fleeing pig) syndrome. There is the true yang of the Kidney, master of the lower jiao. Deficiency of this yang leads to fever, vertigo, palpitations, and trembling as if collapsing. There is the stomach yang, master of the transformation and transportation of food and fluids in the middle jiao. Deficiency of this yang... leads to rebellion, treated according to method. Kidney yang deficiency leads to flooding disorders. Thus, it overwhelms the Heart... It is said: Although sweating occurs, fever does not subside... everywhere indicates loss of yang...
Fuzi (Aconiti Lateralis Radix Praeparata, 1 piece, processed), Baizhu (Atractylodis Macrocephalae Rhizoma, 2 liang, stir-fried), Fuling (Poria), Shaoyao (Paeoniae Radix), Shengjiang (Zingiberis Rhizoma Recens, 3 liang). If cough arises from water-cold clashing, add Wuweizi (Schisandrae Fructus), Xixin (Asari Radix et Rhizoma), and Ganjiang (Zingiberis Rhizoma). If urination is free, remove Fuling (due to its diuretic nature). If diarrhea occurs, remove Shaoyao and add Ganjiang (because Shaoyao is sour and cold, while Ganjiang is pungent and hot). If vomiting occurs, remove Fuzi, retain Fuling and Baizhu to tonify spleen and promote urination, thereby expelling kidney pathogenic factors and treating palpitations. Shengjiang and Fuzi restore yang and benefit defensive qi, strengthening true fire and driving away deficient cold. Shaoyao is sour and astringent, able to consolidate yin and harmonize the nutritive level, treating abdominal pain. (Tonifying yang must simultaneously harmonize yin, avoiding excess. The Classics state: When cold prevails, treat with pungent herbs... Formula assists... Yang follows... Water... According to Qing... method... just see... to eliminate...
Remove Shengjiang, add Renshen (Panax Ginseng Radix et Rhizoma, 2 liang), named Fuzi Tang. (Zhang Zhongjing) Treats Shaoyin disease with body pain, cold hands and feet, joint pain, and a deep pulse. (Pain from contraction... Disease, obtaining... Yang, abdomen... Has yin qi... Back slightly aversive to cold... Disease, interior... Should use...)