并病者,一经先病未愈,又起一经病者。如先见太阳病未解,又见阳明病,此太阳与阳明并
病。如先见太阳病未解,又见少阳病,此太阳与少阳并病。《伤寒论》言二阳并病两条,一曰
面赤色,不足言,阳气怫郁在表,烦躁不知痛处,但坐以汗出不彻,更发汗则愈。此言宜汗
也,虽不立方,然北方冬月麻黄汤,南方羌活汤跃跃矣。二曰太阳症罢,潮热汗出,大便难
而谵语者,宜大承气汤。此言宜下也。其论太阳少阳并病三条,第一言头项强痛,眩冒如结
胸,心下痞硬,当刺大椎,慎不发汗。脉弦谵语,当刺期门,此言不可汗也。第二言心下
硬,颈项强而眩者,当刺大椎、肺俞、肝俞、此言慎勿下也。第三言反下之,成结胸,下利
不止,水浆不入,其人心烦,此言误下变症也。
汗吐下温针诸法皆用过而病不解,名坏症。又有汗吐下诸法,颠倒误用而病不解,亦名坏
症。言坏症,非言必坏之症,言无经络表里,无汗吐下诸法可治者,故曰坏症。按《伤寒论》
坏症两条,上条言太阳病,汗吐下温针用过,桂枝汤又不中用;下条言太阳病,已吐下发汗,
温针反见谵语,此为坏症。自此详之,则太阳病用不得发表解肌,少阳病用不得柴胡和解,
阳明症用不得葛根汤,即是坏病。总之,此经之病,用不得此经之方法正治者,亦名坏症。
故曰看其脉症,知犯何逆,随症治之,而不立方法。
Bingbing (Concurrent Disease) refers to a condition where the disease in one meridian has not yet resolved, and a disease in another meridian arises. For example, if Taiyang disease (Disease of the Taiyang Meridian) appears first and remains unresolved, followed by Yangming disease (Disease of the Yangming Meridian), this is called Taiyang-Yangming Bingbing. Similarly, if Taiyang disease appears first and remains unresolved, followed by Shaoyang disease (Disease of the Shaoyang Meridian), this is called Taiyang-Shaoyang Bingbing.
The *Shanghan Lun* (Treatise on Cold Pathogenic Diseases) contains two clauses discussing Er Yang (Dual Yang: Taiyang and Yangming) Bingbing. The first states: "Facial redness indicates that Yang Qi is constrained at the exterior. The patient experiences irritability and restlessness without knowing the specific location of pain; this is due to incomplete sweating. Re-administering diaphoresis will lead to recovery." This indicates that diaphoresis (sweating therapy) is appropriate. Although no specific formula is prescribed, the implication points to Mahuang Tang (Ephedra Decoction) for winter in the north, or Qianghuo Tang (Notopterygium Decoction) for the south. The second clause states: "If Taiyang symptoms have ceased, but there is tidal fever, sweating, difficulty in defecation, and delirium, Da Chengqi Tang (Major Order the Qi Decoction) is indicated." This indicates that purgation (downward-draining therapy) is appropriate.
There are three clauses discussing Taiyang-Shaoyang Bingbing. The first states: "Stiffness and pain in the head and neck, dizziness and vertigo resembling Jie Xiong (Chest Binding), and fullness and hardness in the epigastrium indicate need for acupuncture at Dazhui (GV14). Caution against diaphoresis. If the pulse is wiry and delirium occurs, acupuncture at Qimen (LR14) is indicated." This indicates that diaphoresis is contraindicated. The second states: "Fullness and hardness in the epigastrium, stiffness in the neck, and dizziness indicate need for acupuncture at Dazhui (GV14), Feishu (BL13), and Ganshu (BL18)." This indicates that purgation is strictly contraindicated. The third states: "If purgation is mistakenly used, it results in Jie Xiong (Chest Binding), incessant diarrhea, inability to take food or fluids, and mental restlessness." This describes complications arising from erroneous purgation.
When diseases remain unresolved after the use of diaphoresis, emesis, purgation, and warm needle moxibustion, it is termed Huai Zheng (Ruined Disease/Malpractice Sequelae). Similarly, if these methods are applied incorrectly or in the wrong sequence, leading to unresolved disease, it is also termed Huai Zheng. The term "Huai Zheng" does not necessarily mean a disease destined to deteriorate fatally, but rather a state where the disease no longer follows clear meridian exterior-interior patterns, and standard therapies (diaphoresis, emesis, purgation) are ineffective. Hence, it is called Huai Zheng.
Reviewing the two clauses on Huai Zheng in the *Shanghan Lun*: The first describes Taiyang disease where diaphoresis, emesis, purgation, and warm needle moxibustion have been used, and Guizhi Tang (Cinnamon Twig Decoction) is ineffective. The second describes Taiyang disease where emesis and purgation were used, followed by erroneous warm needle moxibustion, resulting in delirium; this constitutes Huai Zheng. From this detailed analysis, we understand that if Taiyang disease cannot be treated with exterior-releasing and muscle-relaxing methods, if Shaoyang disease cannot be treated with Chai Hu (Bupleurum) harmonizing methods, or if Yangming disease cannot be treated with Gegen Tang (Kudzu Decoction) [Note: Contextually referring to appropriate Yangming exterior/interior resolution], it becomes a Huai Bing (Ruined Disease). In summary, when the disease of a specific meridian cannot be treated with the standard correct method for that meridian, it is named Huai Zheng. Therefore, the principle is: "Observe the pulse and symptoms, determine what error was made, and treat according to the current presentation," without establishing fixed treatment protocols.