太阳症兼见阳明,名曰太阳阳明合病;太阳症兼见少阳,名曰太阳少阳合病;阳明症兼见少
阳,名曰阳明少阳合病。以上两阳经合病也。若三阳皆见症者,名三阳经合病。夫曰合病,
初起一齐发病之谓。若一经先病,先病之经未解,又见一经起者,名并病。若先起之经病
解,又见一经病起者,名传经病,皆非合病也。若太阳与阳明合病,先治太阳,兼治阳明;
太阳少阳合病,先治太阳,兼治少阳。凡治外感,先重太阳表症,故见太阳症,多用羌活汤
为君。兼阳明症,加葛根;兼少阳症,加柴胡。三阳皆见,三经之药俱用,而太阳之药倍之。
三阳合病,多发春夏秋三时。三阳合病,多下利。按《伤寒论》合病,言太阳有二条,不言合
病,然用方一以KT KT 有汗,用桂枝葛根汤以解肌,一以KT KT 项背强无汗,用葛根汤以发汗,
则暗合阳明合病矣。又明言太阳与阳明合病三条,一以不下利但呕者,葛根加半夏汤;一以
不呕下利者,但用葛根汤;一以喘而胸满者,麻黄汤。其太阳与少阳合病者二条。一以自下
利者,黄芩汤;一以下利兼呕者,黄芩汤加半夏生姜。阳明少阳合病者一条,以下利脉滑而
数者,有宿食,用大承气汤。三阳合病二条,一曰脉浮大,上关上,但欲眠睡,目合则汗,不
立方治;一曰腹满身重,难以转侧,口不仁,面垢,谵语,遗尿,发汗则谵语,下之额上生
汗,手足逆冷,若自汗者,白虎汤主之。前言三阳合病,一见太阳病,重用太阳表症之药,
再视何经有合病,再加某经药治之。此言太阳表邪为重,故以太阳经络而分轻重也。又云合
病并病,要看症之多少轻重,舍少从多,舍轻从重主治,未可尽执经络上分轻重。又见仲景
于太阳阳明合病,见呕加半夏,不加太阳药。太阳阳明合病,见喘满用麻黄汤,不用阳明
药。下文太阳阳明合病,见下利用黄芩汤清少阳,不用太阳药。下利见呕,加半夏、生姜,
不加少阳药。此又在症上分轻重缓急而言。此告戒经络病症,互相参治,方无遗漏。
When Taiyang disease manifestations are accompanied by Yangming disease manifestations, it is termed Taiyang-Yangming Hebing (Combined Disease); when Taiyang disease manifestations are accompanied by Shaoyang disease manifestations, it is termed Taiyang-Shaoyang Hebing; when Yangming disease manifestations are accompanied by Shaoyang disease manifestations, it is termed Yangming-Shaoyang Hebing. The above refer to combined diseases involving two Yang meridians. If disease manifestations of all three Yang meridians appear simultaneously, it is termed San Yang Jing Hebing (Combined Disease of Three Yang Meridians). The term "Hebing" refers to the simultaneous onset of symptoms from different meridians at the beginning of the disease. If one meridian is affected first, and before its pathogen is resolved, symptoms of another meridian appear, it is termed Bingbing (Concurrent Disease). If the initially affected meridian's pathology resolves, and then pathology of another meridian appears, it is termed Chuanjing Bing (Transmission Disease). These do not constitute Hebing. In cases of Taiyang-Yangming Hebing, treatment should prioritize the Taiyang meridian while concurrently addressing the Yangming meridian; in Taiyang-Shaoyang Hebing, treatment should prioritize the Taiyang meridian while concurrently addressing the Shaoyang meridian. Generally, in treating exogenous febrile diseases, priority is given to Taiyang exterior syndromes. Therefore, upon observing Taiyang syndrome, Qianghuo Tang (Notopterygii Rhizoma et Radix Decoction) is often used as the principal formula. If Yangming syndrome is concurrent, Puerariae Radix (Kudzu Root) is added; if Shaoyang syndrome is concurrent, Bupleuri Radix (Thoroughwort Root) is added. If manifestations of all three Yang meridians are present, herbs for all three meridians are employed, with the dosage for Taiyang herbs doubled.
San Yang Hebing frequently occurs during spring, summer, and autumn. It is often characterized by Xiali (Diarrhea). According to *Shanghan Lun* (*Treatise on Cold Pathogenic Diseases*), there are two clauses regarding Taiyang that imply Hebing without explicitly naming it: for those with sweating, Guizhi Gegen Tang (Cinnamon Twig and Kudzu Root Decoction) is used to relieve the muscle layer; for those with stiffness in the nape and back without sweating, Gegen Tang (Kudzu Root Decoction) is used to induce sweating. This implicitly aligns with the treatment of Yangming Hebing. Furthermore, there are three explicit clauses on Taiyang-Yangming Hebing: one where diarrhea is present but no vomiting, treated with Gegen Banxia Tang (Kudzu Root and Pinellia Decoction); one where there is no vomiting but diarrhea, treated solely with Gegen Tang; and one featuring panting and chest fullness, treated with Mahuang Tang (Ephedra Decoction). There are two clauses on Taiyang-Shaoyang Hebing: one presenting spontaneous diarrhea, treated with Huangqin Tang (Scutellaria Decoction); and one with diarrhea accompanied by vomiting, treated with Huangqin Tang plus Pinelliae Rhizoma and Zingiberis Rhizoma et Recens (Fresh Ginger). There is one clause on Yangming-Shaoyang Hebing: characterized by diarrhea, a slippery and rapid pulse, and Su Shi (Retained Food), treated with Da Chengqi Tang (Major Order the Qi Decoction). There are two clauses on San Yang Hebing: one describes a floating and large pulse, prominent at the Guan position, somnolence, and sweating upon closing the eyes, for which no formula is prescribed; the other presents abdominal fullness, body heaviness, difficulty turning over, inability to taste properly, facial greasiness, Shenjing (Delirium), and urinary incontinence. If sweating is induced erroneously, delirium worsens; if purgation is induced erroneously, sweat appears only on the forehead and cold extremities occur. If spontaneous sweating is present, Baihu Tang (White Tiger Decoction) is the primary treatment. The previous text stated that for San Yang Hebing, once Taiyang disease is identified, heavy emphasis is placed on Taiyang exterior herbs, followed by adding herbs for any other concurrent meridians. This emphasizes that when Taiyang exterior pathogen is predominant, severity is distinguished via the Taiyang meridian. Conversely, it is also stated that for Hebing and Bingbing, treatment should be based on the quantity and severity of symptoms, prioritizing the majority over the minority and the severe over the mild, rather than rigidly adhering to meridian hierarchy. Observations of Zhang Zhongjing show that in Taiyang-Yangming Hebing with vomiting, Banxia (Pinelliae Rhizoma) is added without Taiyang-specific herbs; in Taiyang-Yangming Hebing with panting and fullness, Mahuang Tang is used without Yangming-specific herbs; in subsequent Taiyang-Yangming Hebing with diarrhea, Huangqin Tang is used to clear Shaoyang heat without Taiyang herbs; and in diarrhea with vomiting, Banxia and Shengjiang (Zingiberis Rhizoma et Recens) are added without specific Shaoyang herbs. This approach distinguishes severity and urgency based on symptoms. This serves as a warning to integrate meridian and symptom-based treatments to avoid omissions.