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Shaoyang disease (Disease of the Shaoyang channel) presents with a floating pulse, fever, and absence of sweating. If the exterior syndrome remains unresolved, Baihu Tang (White Tiger Decoction) must not be administered. If there is thirst desire to drink water and no exterior syndrome, Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) is the primary treatment.

Baihu Tang is a formula for treating heat binding in the interior. The text first indicates contraindications and then clarifies indications, demonstrating that Baihu Tang is potent and should not be used lightly. Floating pulse, fever, and absence of sweating indicate that Mahuang Tang syndrome (Exterior Excess Syndrome treated by Ephedra Decoction) persists; this constitutes an unresolved exterior. Coupled with thirst desire to drink, it signifies heat entering the interior. This situation involves both exterior and interior syndromes; Wuling San (Five-Ingredient Powder with Poria) should be used, along with drinking warm water to induce sweating. If external heat has resolved, there is no exterior syndrome. Thirst desire to drink alone indicates pathogenic heat attacking inward. Pathogenic heat and healthy Qi cannot coexist; urgent rescue of the interior is required, hence Baihu Jia Renshen Tang is indicated. If the exterior is unresolved and this formula is misused, heat may retreat causing cold to arise, leading to imminent death.

After taking Guizhi Tang (Cinnamon Twig Decoction), if profuse sweating occurs followed by severe restlessness, unrelenting thirst, and a flooding pulse, Baihu Jia Renshen Tang is the primary treatment.

The previous clause details symptoms; this clause details pulses. Full annotations are found in the Guizhi Tang chapter.

In Shaoyang disease, if there is no significant fever, dry mouth and thirst, mental irritability, and slight aversion to cold on the back, Baihu Jia Renshen Tang is the primary treatment.

In Shaoyang disease lasting six or seven days, absence of significant fever accompanied by restlessness and irritability indicates Yang departing and entering Yin. Although here there is no restlessness but rather thirst and irritability, it clearly shows Yang pathogen entering the interior. "No significant fever" refers to the exterior, indicating slight heat remains; "slight aversion to cold on the back" indicates aversion to cold is about to cease. Although there are exterior and interior signs, the exterior pathogen is light while interior heat is severe. Urgent administration of Baihu Jia Renshen Tang is needed; once the interior harmonizes, the exterior resolves spontaneously.

Following purgation or emesis in Shaoyang disease, if after seven or eight days the condition remains unresolved, with heat binding in the interior and heat present in both exterior and interior, occasional aversion to wind, extreme thirst, dry tongue with irritability, and desire to drink several liters of water, Baihu Jia Renshen Tang is the primary treatment.

If Shaoyang disease persists for seven or eight days without resolution, failing to sweat when one should, and instead undergoing emesis or purgation, this is incorrect treatment. Emesis causes loss of body fluids above; purgation causes loss below. Although the exterior remains unresolved, heat has entered the interior. Taiyang governs the exterior; Yangming governs the interior. Heat in both exterior and interior indicates concurrent illness of two Yang channels. Aversion to wind is an unresolving Taiyang exterior sign; however, "occasional" aversion implies periods without it, suggesting the exterior is resolving, similar to slight aversion on the back. Irritability, dry tongue, and extreme thirst are Yangming signs. Desire to drink several liters indicates interior heat binding and dispersion failure; urgent interior rescue to nourish fluids is required. Harmonizing the interior also resolves the exterior, so dual exterior-interior resolution is unnecessary.

In Yangming disease, if there is thirst desire to drink water, dry mouth, and dry tongue, Baihu Jia Renshen Tang is the primary treatment.

Baihu Tang treats all Yangming dryness syndromes; designating it as the principal formula for Yangming demonstrates profound insight.

In concurrent illness of the three Yang channels, presenting with abdominal fullness, heavy body, difficulty turning over, insensitivity around the mouth, greasy facial complexion, and urinary incontinence: inducing sweating leads to delirious speech; purging leads to sweating on the forehead and cold hands and feet. If spontaneous sweating occurs, Baihu Tang is the primary treatment.

This is fundamentally a Yangming disease slightly involving Taiyin and Shaoyang. Stomach Qi obstruction causes abdominal fullness. Yangming governs flesh; lack of Qi movement causes heaviness. Difficulty turning reflects Shaoyang channel distribution along the sides of the body. The mouth is the gateway of the stomach. Stomach pathology prevents fluid ascent, causing oral insensitivity. Yangming disease darkens the face; Shaoyang disease causes a dusty appearance due to lack of Yang Qi nourishment, resulting in a greasy look. Urinary incontinence due to bladder laxity is a fundamental Taiyang disease. Despite concurrent three-Yang illness, Yangming signs predominate, warranting exclusive focus on Yangming. Without exterior syndrome, sweating is inappropriate; without excess in the stomach, purging is inappropriate. This is a half-exterior/half-interior Yangming syndrome. Interior heat without interior excess requires Baihu Tang, not Chengqi Tang formulas. Incorrect sweating depletes fluids causing delirium; incorrect purging destroys Yang causing forehead sweating and cold extremities. Spontaneous sweating here refers to severe internal heat, following the mention of urinary incontinence. If spontaneous sweating exists without severe restlessness/thirst or flooding-floating-slippery pulse, treat as deficiency; do not misuse Baihu Tang. If forehead sweating and cold extremities occur alongside restlessness/thirst, delirium, and slippery-flooding pulse, Baihu Tang may still be used.

In concurrent illness of the three Yang channels, with floating-large pulse at the Guan position, drowsiness, and sweating upon closing eyes:

The previous clause discusses symptoms and treatment; this clause details pulse, probes pathology, and investigates mechanism. Both clauses must be referenced together to grasp the essence of concurrent illness. Large pulse indicates Yang; Guan position governs Yang, representing excessive Yang. Drowsiness indicates Yang entering Yin. Closing eyes allows Wei Qi to enter Yin, accompanied by sweating, indicating heat rampant within. This resembles the aforementioned spontaneous sweating but differs from Shaoyin disease's fine-weak pulse and drowsiness.

In Shaoyang disease, floating-slippery pulse indicates heat in the exterior and pathogen in the interior; Baihu Tang is the primary treatment.

This clause discusses pulse without symptoms, inferring pulse from Baihu Tang syndrome. Do not rely solely on pulse without examining symptoms. Floating-slippery pulse is Yang, governing heat. *Neijing* states: "Slow and slippery pulse indicates heat in the center." Floating indicates exterior; slippery indicates interior. Old texts stating "cold in interior" are erroneous. Although mentioning both exterior and interior, emphasis is on interior heat—heat binding in the interior, appearing as heat in both layers.

In Shaoyang disease, slippery pulse with cold extremities indicates heat in the interior; Baihu Tang is the primary treatment.

Micro-pulse with cold extremities is Cold Jue (Reversal); slippery pulse with cold extremities is Heat Jue. Extreme Yang resembling Yin syndromes are distinguished entirely by pulse. However, symptoms like irritability/thirst with drinking preference, ability to eat but difficult defecation must confirm interior heat.

Baihu Tang:
Shigao (Gypsum Fibrosum, 1 jin, crushed, wrapped in muslin) Zhimu (Anemarrhenae Rhizoma, 6 liang) Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang) Jingmi (Oryza Sativa, 6 he)
Boil in 10 dou of water until rice is cooked and decoction ready. Take 1 sheng warm, three times daily.

Baihu Jia Renshen Tang:
Add Renshen (Panacis Ginseng Radix, 3 liang) to the above formula. Preparation method same as above.

*Jing* states: "Fire generates bitter." Also: "Use bitter to dry dampness." Also: "Excessive bitterness impairs Spleen moisture and thickens Stomach Qi." Thus, bitter transforms via Fire. Fire generates Earth; if Earth is dry and Fire blazes, bitter-cold flavors cannot treat it. *Jing* states: "Sweet enters Spleen first." Also: "Use sweet to drain." Also: "Water entering Stomach, essence transported to Spleen, ascending to Lung, fluids distributed four directions, five meridians parallel." Thus, sweet-cold herbs are superior for draining Stomach Fire and generating fluids. Shigao is extremely cold, overcoming heat; sweet flavor enters Spleen; rigid nature descends; embodies Earth generating Metal; white color connects to Lung; heavy texture contains grease, possessing Metal generating Water function. Hence, it is the Sovereign herb. Zhimu is cold and descending; bitter drains Lung Fire; pungent moistens Lung dryness; inner white fleshy part with outer skin represents Lung Metal image and Water source. Hence, it is the Minister herb. Gancao has red skin and yellow center, draining fire in Earth, acting as a vessel in the Central Palace; combined with cold herbs, it moderates their chill. As Assistant, its sinking nature lingers in Spleen/Stomach. Jingmi is sweet from cultivation, mild-warm in aroma/flavor, possessing balanced nature, providing postnatal nourishment. As Assistant, it prevents cold herbs from damaging Spleen/Stomach. Decoction enters Stomach, transports to Spleen/Lung, distributes fluids, relieving severe restlessness/thirst. Baihu governs Western Metal; named after autumn metal season when summer heat clears, reflecting seasonal order. Adding Renshen tonifies Middle Qi and generates fluids, harmonizing Gancao/Jingmi tonification, controlling Shigao/Zhimu coldness, draining fire without injuring正气 (Zheng Qi), ensuring complete safety.