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[General Principle] Zhang Zhongjing stated: If it was originally a Taiyang disease (Disease of the Taiyang Channel), and at the onset, diaphoresis (sweating method) was applied, but the sweat was not thorough, the pathogen may transfer to the Yangming channel. In cases where Shanghan (Cold Damage) transfers to Yangming, the patient exhibits continuous, slight sweating (Ji Ran Wei Han Chu).

When Taiyang and Shaoyang diseases occur simultaneously (Bing Bing), with a wiry pulse (Xian Mai), stiffness and pain in the head and neck, occasional dizziness or vertigo, and sensations resembling Jie Xiong (Chest Binding Syndrome) with epigastric fullness and hardness, one should needle the first interspace of the Dazhui (GV14) point, Feishu (BL13), and Ganshu (BL18). Diaphoresis must be strictly avoided; inducing sweat may lead to delirious speech (Zhen Yu). If delirium persists, Qimen (LR14) should be needled. In cases of Taiyang and Shaoyang simultaneous disease presenting with epigastric hardness, stiffness, and pain in the head and neck, Dazhui (GV14), Feishu (BL13), and Ganshu (BL18) should be needled. Purging methods must be strictly avoided. If purgatives are incorrectly used for Taiyang and Shaoyang simultaneous disease, it results in Jie Xiong syndrome, characterized by epigastric hardness, incessant diarrhea, inability to take food or fluids, and mental restlessness.

[Detailed Commentary] Xu Shuwei said: When asked about the difference between He Bing (Combined Disease) and Bing Bing (Simultaneous Disease) among the Three Yang channels, the answer is as follows: A floating and large pulse, headache, lower back pain, muscle heat, eye pain, and nasal dryness indicate He Bing. If Taiyang disease is treated with diaphoresis at onset, but the sweat is not thorough, leading to a transfer to Yangming, followed by continuous slight sweating and absence of aversion to cold, this is Bing Bing.

He Bing occurs in all Three Yang channels, whereas Bing Bing does not occur in the Three Yin channels; this distinction must be understood.

Li [Gao] explained that "Bing" implies forcing or pressing together. Initially, there is a combined disease of two Yang channels. Later, if one Yang qi becomes excessive and the other deficient, the pathology consolidates into one channel, becoming predominant, while initial symptoms remain unresolved. For Yangming combining with Taiyang, where Taiyang symptoms persist and Yangming symptoms emerge, Mahuang Tang (Ephedra Decoction) combined with Shengma (Cimicifugae Rhizoma) may be used. If Taiyang symptoms are heavier, add herbs for the Taiyang channel; if Yangming symptoms are heavier, add herbs for the Yangming channel, following this pattern. For Shaoyang combining with Taiyang, where Taiyang symptoms persist and Shaoyang symptoms emerge, Mahuang Tang combined with Xiaochaihu Tang (Minor Bupleurum Decoction) is appropriate. For symptoms such as headache, neck stiffness, dizziness, and a sensation resembling chest binding, Jiwei Qianghuo Tang (Nine-Ingredient Notopterygia Decoction) is also suitable. For Shaoyang combining with Yangming, representing Wood overacting on Earth, the condition is difficult to treat. Xiaochaihu Tang combined with Shengma Gegen Tang (Cimicifuga and Pueraria Decoction) or Chaihu Shengma Tang may be used. Such simultaneous diseases in the exterior can be treated with diaphoresis. However, if Taiyang symptoms have resolved and the pathogen has entered the stomach fu organ, it is termed a transmitted disease (Chuan Jing Zheng), not a simultaneous disease, and purging should be considered cautiously. Ancient texts state that Three Yin channels do not have He Bing, yet they can have internal combinations, though these are not Liang Gan (Double Invasion) patterns, and there is no principle of Yin and Yang channels combining to form disease.

Tao Hua stated: In Taiyang-Yangming simultaneous disease, if an original Taiyang disease is treated with diaphoresis resulting in incomplete sweating, causing a transfer to Yangming, followed by continuous slight sweating and absence of aversion to cold, the pathology has consolidated into Yangming. If Taiyang symptoms persist, Guizhi Mahuang Banxia Tang (Modified Cinnamon Twig and Ephedra Half-Dose Decoction) addresses the Taiyang aspect, while Da Chengqi Tang (Major Order the Qi Decoction) or Xiao Chengqi Tang (Minor Order the Qi Decoction) addresses the Yangming aspect.

Ke Qin stated: Simultaneous disease differs from combined disease. Combined disease presents simultaneously, whereas simultaneous disease progresses sequentially. For instance, if Taiyang symptoms of head and neck stiffness persist, followed by a strong pulse, dizziness, and epigastric fullness/hardness, it is a combination with Shaoyang. If delirium subsequently appears, it becomes a simultaneous disease of all three Yang channels. In Taiyang-Yangming simultaneous disease, if Taiyang symptoms persist, mild diaphoresis targeting Taiyang is indicated; if Taiyang symptoms have resolved, purging targeting Yangming is indicated. The differentiation lies in the presence or absence of aversion to cold and fever. However, Yangming disease involves excess in the stomach-intestines. In Taiyang-Yangming combined disease presenting with wheezing and chest fullness, purging is contraindicated, as the stomach-intestine excess may not yet be established.