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[General Principle] Zhang Zhongjing said: In Taiyang disease (disease of the Taiyang channel), if purgation is performed but the condition does not resolve, and sweating is subsequently induced, this results in deficiency of both the exterior and interior. Consequently, the patient experiences Mao (a sensation of mental cloudiness or dizziness). For those suffering from Mao, spontaneous sweating indicates recovery.
The reason for this is that sweating harmonizes the pathogenic factors. If the interior remains disharmonious, purgation may be applied again. After vomiting or purgation in Shanghan (cold damage) disease, there may be a sensation of fullness and rebellion in the epigastrium, Qi rushing up to the chest, dizziness upon rising, and a deep, tight pulse. If sweating is induced at this stage, it will disturb the meridians, causing tremors and shaking of the body. This should be treated with Fuling Guizhi Baizhu Gancao Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala and Licorice Decoction).
After vomiting and purgation in Shanghan disease, followed by sweating, there may be empty irritability (Xu Fan) and a very faint pulse. By the eighth or ninth day, there may be hardness and fullness in the epigastrium, pain in the hypochondrium, Qi rushing up to the throat, dizziness, Mao (cloudiness), and twitching of the meridians; if prolonged, this develops into Wei syndrome (flaccidity syndrome).
In Taiyang disease, excessive sweating can lead to Jing syndrome (spasm syndrome). The pulse is deep and fine, the body is hot while the feet are cold, the head and neck are stiff and rigid, sometimes with heat in the head, red face, and red eye vessels. Only the head and face tremble, sudden lockjaw occurs, and the back arches backward (opisthotonos); this is Jing syndrome.

[Commentary] Cheng Wuji stated: "Mao" refers to blurred vision, while "Xuan" refers to darkness before the eyes. Xuan, Yun (vertigo), and Mao have similar manifestations. Some refer to "Xuan Yun," others to "Xuan Mao." "Yun" implies rotation, commonly known as vertigo or spinning sensation. "Mao" implies covering or obscuring, commonly known as coma or confusion. Shaoyang disease (disease of the Shaoyang channel) presents with visual disturbances because Shaoyang resides between the exterior and interior; as exterior pathogens transmit inward, leading to deficiency of Yang in the exterior, frequent visual disturbances occur. In Bingbing (concurrent diseases) of two Yang channels, or when presenting with Xuan Yun or Xuan Mao, it is due to concurrent Shaoyang and Taiyang diseases; thus, Xuan is attributed to deficiency. In Shanghan disease, dizziness upon rising and Xuan Mao are caused by improper sweating, vomiting, or purgation, indicating Yang deficiency. Therefore, the *Zhen Jing* states: Deficiency above causes dizziness; deficiency below causes Jue (reversal cold). Although dizziness is often due to deficiency, wind-pattern patients also experience dizziness because Wind governs movement. Yangming Fengzhong (Wind-stroke in Yangming) also presents with dizziness. Such cases are not adverse conditions. However, after various mis-treatments involving sweating, severe cases may present with disordered speech and dizziness, which are fatal signs.
Wu Shou stated: In Taiyang Fengzhong, dizziness and head trembling present with a floating, wiry, and rapid pulse. Qianghuo Shenzhu Tang added with Tianma (Gastrodia Rhizome) and Fangfeng (Saposhnikovia Root) may be used. If dizziness is due to Blood deficiency, Siwu Tang added with Renshen (Ginseng) and Tianma is indicated. If Phlegm-Fire attacks upward, Huangqin (Scutellaria Root) and Zhuli (Bamboo Sap) are added. If internal injury from overwork leads to Yin-deficiency dizziness, Buzhong Yiqi Tang added with Chuanxiong (Ligusticum Chuanxiong), Tianma, Fangfeng, and Manjingzi (Vittex Seed) is indicated. If Yuanqi (Original Qi) deficiency in the Lower Jiao causes dizziness, Renshen Yangrong Tang or Dajianzhong Tang added with Tianma is used.
Yi Lao stated: For dizziness and blackening of vision, only Tianma can eliminate it; therefore, it must be included.
Shen Jin'ao commented: Improper sweating or purgation depletes Body Fluids, leading to deficiency of both exterior and interior, while Yang pathogens remain. Thus, exterior and interior pathogens do not resolve, resulting in Mao. Mao feels like being covered or obscured, signaling impending sweating. Therefore, once sweating occurs, Mao resolves. Improper vomiting and purgation lead to exterior Yang deficiency, causing dizziness upon rising. Subsequent improper sweating damages the meridians, causing whole-body tremors.
When vomiting, sweating, and purgation are all improperly applied, resulting in a faint pulse and empty irritability, Xuan Mao and meridian twitching arise from this empty irritability. This is also an indication for Banxia Xiexin Tang (Pinellia, Scutellaria, Ginger, Jujube, Ginseng, Coptis and Licorice Decoction). Excessive sweating depletes fluids without transforming into Yangming disease, instead forming Jing syndrome, manifesting as head/facial tremors, lockjaw, and opisthotonos. At this time, Stomach fluids are not yet exhausted, so the manifested symptoms remain Taiyang exterior patterns, such as head and neck stiffness. One should nourish Yin to harmonize the interior and avoid warm drugs. Zhigancao Tang (Prepared Licorice Decoction) is indicated.

[General Principle] Zhang Zhongjing said: In concurrent diseases of Taiyang and Shaoyang, presenting with stiffness and pain in the head and neck, occasional dizziness or Mao, sensations resembling Jiexiong (Chest Binding syndrome), and hardness/fullness in the epigastrium, one should needle Da Zhui (GV14), Fei Shu (BL13), and Gan Shu (BL18). When Cold pathogens invade, Jue (reversal) occurs, accompanied by Yu Mao (depressed cloudiness) and numbness.

[Commentary] Cheng Wuji stated: "Yu" means stagnation and lack of free flow of Qi; "Mao" means cloudiness due to deficiency and unclear spirit. Yu Mao arises from deficient Heat combined with Cold invasion. The *Jin Gui Yao Lue* states: Postpartum women suffer from three diseases: Jing syndrome, Yu Mao, and difficulty with bowel movements. Due to blood loss, subsequent sweating, and excess Cold, Yu Mao occurs. It further states: In postpartum Yu Mao, the pulse is faint, there is vomiting and inability to eat, and hard stools. This is because Blood deficiency leads to Jue, and Jue inevitably leads to Mao. For Yu Mao to resolve, profuse sweating must occur. From this, we know Yu Mao is a pattern of deficiency and Cold.
Yu Chang stated: The Shaoyang meridian connects the hypochondrium and merges with Taiyang pathogens; thus, the presentation resembles Jiexiong but is distinct. Liver and Gallbladder are internally-externally related; needling Gan Shu (BL18) drains the Gallbladder. Bladder does not directly connect with Lung, but Lung governs Qi; needling Fei Shu (BL13) unblocks Lung Qi, thereby facilitating Bladder Qi transformation, preventing pathogen retention.
Wei Litong stated: According to acupoint charts, Da Zhui (GV14) is a Du Meridian point located on the posterior aspect. Fei Shu (BL13) and Gan Shu (BL18) belong to the Foot-Taiyang Bladder Meridian. They are arranged sequentially downward from Da Zhui on the back, representing the pathway of the Taiyang meridian along the back. Needling these three points drains exterior pathogens from the Taiyang meridian and has no direct relation to the Zang-Fu organs of Lung, Liver, and Bladder. Previous commentators forced interpretations due to ignorance of the principle that needling these points drains meridian pathogens. The original text specifies needling the first interstice of Da Zhui. Charts show Da Zhui is located in the depression between the first thoracic vertebrae, being the first point of the Du Meridian descending from the neck.
Shen Jin'ao commented: Wei's statement that needling these three points drains Taiyang exterior pathogens is indeed accurate. Although the disease involves concurrent Taiyang and Shaoyang, treatment must focus on one meridian. Following the instruction to needle Da Zhui, Fei Shu, and Gan Shu, Zhongjing adds: Do not induce sweating. If sweating is induced, delirium ensues, and the pulse becomes wiry. If delirium persists for five to six days, Qimen (LR14) should be needled. Qimen is also a Taiyang meridian point. Zhongjing states this because in concurrent Taiyang-Yangming disease, sweating is appropriate; however, in concurrent Taiyang-Shaoyang disease, sweating is contraindicated due to the presence of Shaoyang pathology. Even in concurrent Three-Yang disease, sweating is not indicated. Thus, Zhongjing strictly warns against sweating. Sweating fails to remove Taiyang meridian pathogens and injures Yangming Fu, causing delirium. Therefore, despite the wiry pulse indicating Shaoyang, since Shaoyang prohibits sweating, needling Qimen (a Taiyang point) substitutes for sweating, sparing Yangming and Shaoyang while treating Taiyang. This illustrates using needling as a treatment for concurrent diseases.
Stiffness/pain in head/neck, occasional dizziness/Mao, sensations resembling Jiexiong, and epigastric hardness/fullness are entirely Taiyang symptoms. Shaoyang dizziness/Mao is also encompassed within Taiyang presentations. Therefore, treatment focuses entirely on the Taiyang meridian.