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This is a moniker created by our Shanghan teacher, whose lectures are enthralling, to say the least.

First, let’s look at line 91:

“伤寒，医下之，续得下利，清谷不止，身疼痛者，急当救里；

后身疼痛，清便自调者，急当救表。

救里宜四逆汤，救表宜桂枝汤。” (line 91)

Here we have a case of some kind of infection, let’s say a typical virus infection, that is wrongly treated (by precipitating instead of by resolving the exterior. The patient goes into a diarrheatic release, and don’t stop oozing undigested shit. His body is aching… What do we do? We first treat the interior - using 四逆汤.Then when the diarrhea self-regulates (i.e. he recovers from diarrhea), the patient only feels an aching body. This is when you treat the exterior correctly - using 桂枝汤.

Next, let’s look at lines 301 and 302:

“少阴病，始得之，反发热，脉沉者，麻黄细辛附子汤主之。” (line 301)

“少阴病，得之二三日，麻黄附子甘草汤微发汗。以二三日无证，故微发汗也。” (line 302)

Here are two 少阴病 situations. Remember that “少阴病，脉微细，但欲寐也。” To me it’s a 里虚寒证, but it’s more like a chronic illness than what we have in line 91, where the patient is also 里虚寒, and exhibiting it in a stronger fashion, i.e. through diarrhea. Line 91’s patient is a healthy guy whose body is just reacting to pathogens and wrong treatment.

Conclusion:

I would conclude that 四逆汤 can be used to treat acute cases of internal weakness, say from loss of fluids and minerals in repeated diarrhea. It probably can get the body’s system up and running again.

As for these strong 解表剂 (麻黄细辛附子汤 & 麻黄附子甘草汤), we see that Mr. Zhang uses them to treat a  weak guy who exhibits exterior symptoms. Why?

My take is that 附子 represents 四逆汤 here in helping the body get back on track, while 麻黄 is here to clear the exterior, BUT also can turn up the sympathetic nervous system, perhaps in this manner, give the body some extra ooomph. 细辛 is there to turn up the heat, both warming a weak body AND clearing an unresolved exterior. According to the textbooks, the reason why 细辛 is present in the line 301 formula is because “始得之” （meaning, pathogen is very much in the exterior), while it’s not present in the line 302 formula. The 麻黄甘草 herb-pair is seen here in line 302, which makes sense if we don’t want such a strong effect, also since it’s “得之二三日”.

Books compared line 91 with lines 301&302, say that the 里虚寒 is less pronouned in line 91, while it’s more pronounced in lines 301&302. I think it’s just a different category of 里虚寒 -  a very broad one albeit.

Summary:

太少两感证 is a 少阴病 stage of illness where 太阳病 characteristics are expressed. To treat, we use very strong exterior resolving prescriptions to clear out the pathogen. And we don’t do much to treat the 少阴病, because the focus is on the exterior. So in this situation, 先治标, and may along the way, we can indirectly treat the root - 后治本.