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The variations of Shaoyin disease are omitted. Here, the significance of Shaoyin as the "pivot" (Zhu Shu) is supplemented. Let us examine this in detail now. Section 34 states that for Shaoyin disease presenting with diarrhea, Baotong Tang (White Tongue Decoction) is the primary treatment. This indicates that Baotong Tang is the specific formula for Shaoyin diarrhea. Section 35 states that for Shaoyin disease with diarrhea and a faint pulse, Baotong Tang is administered; if diarrhea persists, accompanied by cold extremities, absence of pulse, dry retching, and irritability, Baotong Tang plus Porcine Bile Decoction (Baotong Jia Zhudan Huang Tang) is used. If the pulse suddenly emerges violently after taking the decoction, it indicates death; if the pulse slowly resumes, it indicates survival. This explains that when cold pathogenic factors are extreme, sudden administration of hot herbs causes rejection (Ge Ju), necessitating the method of "using heat for cold" (Re Yin Han Yong). Section 36 states that if Shaoyin disease does not improve after two or three days, and by the fourth or fifth day presents with abdominal pain, dysuria, heaviness and pain in the four limbs, and spontaneous diarrhea, this is due to the presence of water qi (Shui Qi). The patient may also have cough, clear urination, diarrhea, or vomiting; in such cases, Zhenwu Tang (True Warrior Decoction) is indicated. This describes a condition where there is no fire (Yang Qi) within the water, leading to Spleen Earth deficiency and an inability to control water dampness. The phrase "presence of water qi" is most critical; it represents the lateral aspect of Shaoyin disease, distinct from the frontal aspects represented by Baotong Tang and Sini Tang. Section 37 states that for Shaoyin disease with diarrhea of undigested food, internal cold with external false heat, cold extremities, and a pulse so faint it is nearly imperceptible, yet the body feels no aversion to cold and the face appears red, or if accompanied by abdominal pain, dry retching, sore throat, or cessation of diarrhea without pulse recovery, Tongmai Sini Tang (Pulse-Reviving Sini Decoction) is used. This describes true internal cold with false external heat, representing the frontal aspect of Shaoyin disease and a progression of the Sini syndrome. From Section 31 to here, following the discussion on diarrhea in Section 30, this serves as a summary for water-related disorders in Shaoyin syndrome.

Section 38 states that for Shaoyin disease presenting with cold extremities, and optionally cough, palpitations, dysuria, abdominal pain, or tenesmus during diarrhea, Sini San (Four Counterflow Powder) is used. This follows up by indicating that cold extremities are not exclusively due to deficiency-cold, thereby establishing a harmonizing method to demonstrate the dynamic nature of the disease. Thus, it implicitly supplements the significance of Shaoyin as the pivot. Section 39 states that for Shaoyin diarrhea persisting for six or seven days, accompanied by cough, vomiting, thirst, irritability, and insomnia, Zhu Ling Tang (Polyporus Decoction) is used. This follows the principle that although diarrhea originates in the lower jiao, after six or seven days the cold transforms into heat, and the qi moves upward again, manifesting as cough, vomiting, thirst, irritability, and insomnia—what is termed "descending to the extreme leads to ascending." A clearing and draining method is established, adhering to the classic principle that pathogens moving upward from below should still be guided out from below. This also implicitly supplements the significance of Shaoyin as the pivot, aligning with the main theme of Section 30 regarding the pivot. This is because Shaoyin is the root of life and destiny; diseases are divided into water and fire types, and treatment must be as urgent as rescuing someone from fire or drowning, for any delay renders it irretrievable.

Section 40 states: "For Shaoyin disease developing over two or three days, with dry mouth and tongue, immediate purgation is required, using Da Chengqi Tang (Major Order the Qi Decoction)." This explains that when Minister Fire (Jun Huo) of Shaoyin is hyperactive above, failure to restrain it will lead to self-burning. Section 41 states: "For Shaoyin disease with spontaneous discharge of clear watery stool, purely green in color, with必 (must) pain in the epigastrium and dry mouth/throat, immediate purgation is required, using Da Chengqi Tang." This explains that Shaoyin Minister Fire is hyperactive above, exacerbated by Wood-Fire stirring, causing Kidney Water to fail against the two Fires and collapse immediately. Section 42 states: "For Shaoyin disease lasting six or seven days, with abdominal distension and constipation, immediate purgation is required, using Da Chengqi Tang." This explains that Shaoyin Minister Fire fails to exit via the pivot, reversing into the earth element causing distension. As stated in the *Neijing*: "If movement ceases for a breath, the efficacy of acupuncture ends." One must urgently purge to move the Shaoyin pivot and restore its rotation. The three urgent purgation syndromes of Shaoyin should be carefully studied in shallow annotations. There are also two urgent warming syndromes. Section 43 states: "For Shaoyin disease with a deep and slow pulse, urgent warming is required, using Sini Tang." This emphasizes that Shaoyin is the root of life; a deep pulse at the onset predicts the latent mechanism of cold extremities, vomiting, diarrhea, and irritability, akin to the meaning of "treading on frost implies hard ice is coming." It highlights focusing on what others easily overlook and treating it urgently. Section 44 states: "For Shaoyin disease, if food is vomited upon entering the mouth, and there is a warm sensation in the heart with a desire to vomit but inability to do so... (indicating Yin-Cold rejection revealing pivot symptoms), and initially presenting with cold extremities and a string-taut, slow pulse, this is excess in the chest; purgation is contraindicated, but emesis is indicated. (Using the chest-excess emesis case to narrate the urgent warming syndrome.) If there is cold-fluid retention above the diaphragm causing dry retching, emesis is contraindicated; urgent warming is required, using Sini Tang." This describes Shaoyin Yin-Qi rising with cold-fluid retention, differing from chest excess. In moments of hesitation, one must make a unique decision to treat urgently. Ultimately, Shaoyin focuses on saving Yang, while True Yin must not be damaged. Section 45 states: "For Shaoyin disease with diarrhea, a faint (Yang deficiency) and choppy (Yin deficiency) pulse, vomiting and sweating... (Yang deficiency leads to Yin-Cold counterflow causing vomiting; Yin deficiency leads to insecure Yin causing sweating), frequent trips to the toilet but scant output... (these seven characters are the key: Yang deficiency causes Qi sinking; Yin deficiency causes straining). One should warm the upper part with moxibustion." This means moxa should be applied to Baihui (GV20) to warm the upper region, avoiding excessive warming of the lower part which could scorch True Yin. The implication is that opposing Yin and Yang divide into two, while mutually rooting Yin and Yang unite as one. The text of the Shaoyin chapter is ethereal and变幻 (transformative), indescribable; Laozi was perhaps like a dragon.