Library

Taiyang disease (disease of the Taiyang channel) exterior syndrome is not resolved, water qi (pathogenic fluid accumulation) stagnates in the epigastrium, presenting with dry retching, fever, and cough; or thirst, or diarrhea, or belching, or dysuria with hypogastric fullness, or wheezing. These are primarily treated with Xiao Qing Long Tang (Minor Blue Dragon Decoction).

When the exterior syndrome of Taiyang disease is not resolved, water retention in the epigastrium obstructs the descending pathways of the Lung and Stomach. Stomach Qi rebels upward causing dry retching, and Lung Qi rebels upward causing cough. Fire rises and Metal dries causing thirst; Qi obstruction causes Lung distension leading to wheezing; turbid Qi rebels upward causing belching; clear Qi descends downward causing diarrhea; or dysuria leads to hypogastric urgency and fullness. All these conditions result from the stasis and blockage of water qi. It is appropriate to use Xiao Qing Long Tang: Gan Cao (Licorice Root) to nourish Middle Qi; Ma Huang (Ephedrae Herba) and Gui Zhi (Cinnamon Twig) to disperse Ying Wei (Nutritive and Defensive Qi); Shao Yao (Paeoniae Radix Alba) to clear Wind Wood (Liver Wood); Ban Xia (Pinelliae Rhizoma) to descend rebellion and stop retching; Wu Wei Zi (Schisandrae Fructus), Xi Xin (Asari Radix et Rhizoma), and Gan Jiang (Zingiberis Rhizoma) to descend rebellion and stop cough.

Ma Huang (Ephedrae Herba, 3 liang) Gui Zhi (Cinnamomi Ramulus, 3 liang) Shao Yao (Paeoniae Radix Alba, 3 liang) Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 liang, honey-fried) Ban Xia (Pinelliae Rhizoma, 3 liang, washed) Wu Wei Zi (Schisandrae Fructus, half sheng) Xi Xin (Asari Radix et Rhizoma, 3 liang) Gan Jiang (Zingiberis Rhizoma, 2 liang)

Take the above eight herbs, add one dou of water, first boil Ma Huang until the volume reduces by two sheng, remove the foam on the surface, then add the remaining herbs. Boil until three sheng remain, strain, and take one sheng warm. If there is slight diarrhea, remove Ma Huang and add Yuan Hua (Daphnes Genkwa Flos) the size of a chicken egg, stir-fried until red (Diarrhea indicates Water Evil insulting Earth; Yuan Hua is added to drain water). If there is thirst, remove Ban Xia and add Gua Lou Gen (Trichosanthis Radix, 3 liang) (Gua Lou Gen clears Metal and stops thirst). If there is belching, remove Ma Huang and add Fu Zi (Aconiti Lateralis Radix Praeparata, one piece, processed) (Cold Water insulting Earth and turbid Qi rebelling upward causes belching; Fu Zi warms Water and descends rebellion). If there is dysuria and hypogastric fullness, remove Ma Huang and add Fu Ling (Poria, 4 liang) (Fu Ling drains fullness). If there is wheezing, add Xing Ren (Armeniacae Semen Amarum, half jin), skin and tips removed (Xing Ren benefits the Lung and stops wheezing).

In Taiyang disease, if urination is free, drinking too much water will certainly cause palpitations in the epigastrium; if urination is scanty, there will certainly be distressing internal urgency.

This clarifies the meaning of dysuria and hypogastric fullness mentioned in the previous chapter: If urination is free, body fluids seep away, inevitably causing dry thirst. Those who drink heavily due to thirst suffer from Spleen Earth dampness and Liver Wood depression, leading to palpitations in the epigastrium. If Liver Wood depression fails to vent water, urination becomes scanty, water accumulates in the hypogastrium, and there is distressing abdominal internal urgency and fullness.

In Taiyang disease, if there is water qi in the epigastrium, cough with slight wheezing, fever but no thirst, treat with Xiao Qing Long Tang. If thirst occurs after taking the decoction, this indicates that cold has departed and the disease is about to resolve.

Thirst after taking the medicine indicates that exterior cold has resolved and interior water has gone; body fluids are temporarily consumed, hence the thirst. Thirst signifies that the exterior is resolved, cold has left, and accumulated water transforms into sweat and exits outward. Da Qing Long Tang (Major Blue Dragon Decoction) syndrome represents excess Yang at the exterior with Fire inside; Xiao Qing Long Tang syndrome represents deficiency of Interior Yang with Water inside. When Yin and Yang become biased, they manifest upon obstruction. Both Major and Minor Blue Dragon Decoctions can release Wind-Cold from the exterior and drain Water-Fire from the interior; they are indispensable for treating such pathogenic patterns.