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The Qi transformation of the Shaoyang (Lesser Yang) channel relies on the Ministerial Fire (Xiang Huo). Its meridian runs from the head down to the feet. When diseased, Qi rebels and the fire flares upward, scorching the throat and burning the head and eyes. Although Shaoyang diseases have various accompanying syndromes, bitter taste in the mouth (Kou Ku), dryness of the throat (Yan Gan), and vertigo/dizziness (Mu Xuan) are the principal manifestations, due to the stagnation of Ministerial Fire in the upper jiao. Although the clinical condition evolves continuously, these three symptoms remain unchanged; although the pathological signs shift frequently, these three remain fixed. This is because the Ministerial Fire fails to descend and secure itself, detaching from its root and floating upward, thus causing bitter taste, dry throat, and restless spinning of the head and eyes. Therefore, other syndromes of Shaoyang exist within the realm of "possible" (huoran) variations, whereas these three symptoms represent the necessary pattern. The outline presents these three symptoms to summarize Shaoyang disease. Although Shaoyang pathology is变幻无常 (changeable and unpredictable), even if there are unique presentations, there is always an underlying rationale.

Disease of the Shaoyang channel manifests as bitter taste in the mouth, dryness of the throat, and vertigo.

The Foot-Shaoyang Gallbladder Channel originates at the outer canthus of the eye, descends along the neck, and converges at the Quepen (LI 15) point. The mouth, pharynx, and eyes are all areas traversed by the Shaoyang meridians. The normal direction of Shaoyang Qi is downward; when diseased, the meridian Qi becomes obstructed and rebels upward toward the head, causing the Ministerial Fire to flare, resulting in the aforementioned symptoms. "Bitter" is the flavor associated with Fire, which has a flaming-upward nature. "Vertigo" is the manifestation of Ministerial Fire detaching from its root and floating/spinning upward. (Su Wen: Chapter on Origin, Terminal, and Transmission of Diseases states that Liver diseases cause dizziness of the head and eyes, as the Liver and Gallbladder share the same Qi.)

In Taiyang disease, after five or six days, if Wind-Cold strikes again, this originally belongs to the Taiyang stage, specifically the Guizhi Mahuang Banxia Decoction syndrome where both Wind and Cold are present. The pathogenic factors in the exterior constrain the Shaoyang meridian Qi, thereby triggering Shaoyang disease. The Shaoyang meridian lies interior to the Taiyang and Yangming, and exterior to the Three Yin channels. Being exterior involves the Two Yangs, hence it is called "Half-Exterior"; being interior involves the Three Yins, hence it is called "Half-Interior". The "Half-Exterior" resides below the Two Yangs, transforming Qi from Yang to generate Heat; the "Half-Interior" resides above the Three Yins, transforming Qi from Yin to generate Cold. If human meridian Qi does not stagnate, it does not become excessive; if it stagnates, Yang excess generates Heat, and Yin excess generates Cold. Due to the constraint and pressure of meridian Qi, the Wei (Defensive) Qi of the Half-Exterior desires to emit outward but is bound by Ying (Nutritive) Qi, preventing penetration, thus leading to closure and generating Exterior Cold. The Ying Qi of the Half-Interior desires to emit outward but is blocked by Wei Qi, preventing penetration, thus leading to stagnation and steaming, generating Interior Heat. Generally, when Cold injures the Ying, Ying constrains Wei, generating Exterior Cold; when Ying declines, Cold recedes and Heat returns. When Wind injures the Wei, Wei blocks Ying, generating Interior Heat; when Wei declines, Heat recedes and Cold returns. This back-and-forth fluctuation, with uncertain victory or defeat, is what is termed "alternating chills and fever" (Wanglai Hanre).

The Shaoyang meridian descends through the chest, pierces the diaphragm, passes through the stomach opening, and follows the costal region. When diseased, meridian Qi stagnates and obstructs, attacking the Stomach Earth (Wu Tu). The Stomach becomes distended and obstructs the descending pathway of the Gallbladder meridian, causing congestion, leading to fullness and distress in the chest and hypochondrium (Xiong Xie Ku Man). The Stomach Earth is weakened and congested by the Wood (Liver/Gallbladder), leading to listlessness and lack of desire for food (Heihei Buyu Yinzshi). Since Jia Wood (Gallbladder) has rebelled and Ministerial Fire scorches upward, while Wu Earth rises and fills, leaving no path for Jun Fire (Heart Fire) to descend, mental restlessness (Xin Fan) occurs. Stomach Qi rebels upward, turbid Qi fails to descend, leading to frequent vomiting (Xi Ou). Alternatively, if Ministerial Fire harasses the Heart but Stomach Qi does not severely rebel, there is mental restlessness without vomiting. If Ministerial Fire insults the Lung, thirst arises. If Spleen Earth is cold and Liver Wood is dry, the pressure between Wood and Earth causes abdominal pain. If meridian Qi is knotted and obstructed, there is epigastric hardness (Xia Piying). If Spleen Dampness and Liver Stagnation cause palpitations under the heart (Xin Xia Ji) and dysuria (Xiao Bian Bu Li). If Lung fluids are not yet depleted, there is no internal thirst. If the Taiyang exterior syndrome has not resolved, there may be slight heat in the heart/chest. If Stomach Qi rebels and Lung Qi is obstructed, coughing may occur. All these conditions stem from Shaoyang internal stagnation and disharmony between the interior and exterior. Xiao Chaihu Tang uses Chaihu (Bupleuri Radix) and Huangqin (Scutellariae Radix) to clear the Half-Exterior and drain Jia Wood; Renshen (Ginseng Radix), Gancao (Licorice Root), and Dazao (Jujubae Fructus) warm and tonify the Half-Interior and supplement Ji Earth (Spleen); Shengjiang (Zingiberis Rhizoma Recens) and Banxia (Pinelliae Tuber) descend Stomach Qi to stop vomiting.

Shaoyang resides between the Half-Exterior and Half-Interior. If Yin deficiency exists in the Half-Interior, pathogens enter the Yangming Meridian and then the Yangming Fu organs. If Yang deficiency exists in the Half-Interior, pathogens enter the Taichyin Meridian and then the Taichyin Zang organs. Xiao Chaihu Tang uses Chaihu and Huangqin to clear the Half-Exterior, preventing entry into Yangming; it uses Renshen and Gancao to warm and tonify the Half-Interior, preventing entry into Taichyin. Thus, the pathogen is resolved in the original channel without entering the Yin or Yang stages. This is termed "harmonizing the interior and exterior" (Hejie Biaoli). As stated in Su Wen: "When Wood is diseased, it transmits to Earth," meaning "disease transmits to what it overcomes." Since Shaoyang is adjacent to Yangming and Taichyin, to prevent Wood overcoming Earth and transmitting to Yangming, Chaihu and Huangqin are used to drain the Half-Exterior and clear Yangming. To prevent Wood overcoming Earth and transmitting to Taichyin, Renshen and Gancao are used to tonify the Half-Interior and warm Taichyin. Thus, both the exterior and interior are simultaneously resolved.