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[Table-Interior Combined Disease Must Present with Diarrhea]
When the Taiyang (Taiyang Channel) and Yangming (Yangming Channel) channels are affected simultaneously (Combined Disease), spontaneous diarrhea will inevitably occur; Gegen Tang (Kudzu Root Decoction) should be administered. If there is no diarrhea but vomiting occurs, Gegen Jia Banxia Tang (Gegen Decoction with Added Pinellia) should be administered.
When the Taiyang (Taiyang Channel) and Shaoyang (Shaoyang Channel) channels are affected simultaneously (Combined Disease), if spontaneous diarrhea occurs, Huangqin Tang (Scutellaria Decoction) should be used; if vomiting accompanies it, Huangqin Jia Banxia Shengjiang Tang (Huangqin Decoction with Added Pinellia and Fresh Ginger) should be administered. (Note: The original text says "Huangqin Jia Ban Tang Shengjiang Tang", corrected here to Huangqin Jia Banxia Shengjiang Tang based on Shanghan Lun and medical logic).
When the Yangming (Yangming Channel) and Shaoyang (Shaoyang Channel) channels are affected simultaneously (Combined Disease), diarrhea will inevitably occur. If the pulse is slippery and rapid, it indicates retained food stagnation; purgative therapy should be employed, and Dachengqi Tang (Major Order the Qi Decoction) is appropriate. (For details on these conditions, see the section on "Diarrhea").

[Bing Disease - Sequential Involvement]
Taiyang (Taiyang Channel) and Yangming (Yangming Channel) Bing Disease: After treating Taiyang channel pathogen with sweating method, if the sweat was incomplete, the pathogen transfers to the Yangming channel. At this time, the patient sweats spontaneously, has no aversion to cold, but Taiyang symptoms have not completely resolved. Manifestations include facial redness, irritability, shortness of breath. In this case, sweating therapy should be applied again to cure.
Taiyang (Taiyang Channel) and Yangming (Yangming Channel) Bing Disease: When Taiyang symptoms have ceased, tidal fever (periodic fever) and delirium appear. Purgative therapy should be employed to cure. (See the section on "Delirium" for related discussions).
Taiyang (Taiyang Channel) and Shaoyang (Shaoyang Channel) Bing Disease: Manifesting as neck stiffness, dizziness, and hardness in the epigastrium resembling Jie Xiong (Chest Binding Syndrome), acupuncture at Xiongyu (BL-17) and Ganshu (BL-18) points should be performed. (See the section on "Neck Stiffness" for related discussions).

[Analysis of Simultaneous and Sequential Channel Involvement]
"Bing Disease" refers to a condition where symptoms of one channel cease, and the pathogen merges into another channel.
Taiyang and Yangming Combined Disease has three syndromes. Due to differences in the depth of pathogen invasion, treatment methods vary between sweating, purging, and harmonizing. Specific treatments are found in respective clauses.
San Yang (Taiyang, Yangming, Shaoyang) Combined Disease has two syndromes. One syndrome uses Baihu Tang (White Tiger Decoction); the other has no fixed specific treatment, and later practitioners often use Xiaochaihu Tang (Minor Order the Qi Decoction) or Baihu Tang. This is because both syndromes exhibit signs of all three Yang channels, so pure sweating or purging methods are contraindicated.
Er Yang (Taiyang, Yangming) Bing Disease has two syndromes: If the exterior syndrome is unresolved, sweating therapy should be used; if the exterior is resolved and interior syndrome exists, purging therapy should be used.
Taiyang and Shaoyang Bing Disease has three syndromes: First, mistaken purging leads to hardness in the epigastrium forming Jie Xiong Syndrome. Second, manifestations include neck stiffness resembling Rou Jing (Soft Spasm) and hardness in the epigastrium like Jie Xiong; acupuncture at Feishu (BL-13) and Ganshu (BL-18) points is indicated. Sweating must be strictly avoided, otherwise delirium will persist; Qimen (LR-14) point should be acupunctured. Third, hardness in the epigastrium, neck stiffness, and dizziness indicate acupuncture at Dazhui (GV-14) and Feishu (BL-13) points; purging is inappropriate.

[Detailed Discussion on Combined Disease]
Taiyang and Yangming Combined Disease presenting with chest fullness and wheezing should not be purged; Mahuang Tang (Ephedra Decoction) should be used.
Taiyang and Yangming Combined Disease presenting with spontaneous diarrhea uses Gegen Tang; if no diarrhea but vomiting occurs, Gegen Jia Banxia Tang (Gegen Decoction with Added Pinellia) is used. (Alternatively: Since Taiyang exterior is unresolved and Yangming interior pathogen arrives, the heat of two Yangs is strong on the exterior and attacks the interior due to deficiency, causing diarrhea. If vomiting occurs without diarrhea, the pathogen attacks the interior but has not entered the Stomach, causing only Qi rebellion and vomiting; thus Banxia is added to stop vomiting. Pang Shi stated: Exterior symptoms must include headache, lower back pain, muscle heat, eye pain, and nasal dryness. A floating and large pulse indicates Taiyang involvement; a long pulse indicates Yangming. Head and lower back belong to Taiyang; muscles, eyes, and nose belong to Yangming.)
Taiyang and Shaoyang Combined Disease presenting with spontaneous diarrhea uses Huangqin Tang (Scutellaria Decoction); if vomiting occurs, Huangqin Jia Banxia Shengjiang Tang (Huangqin Decoction with Added Pinellia and Fresh Ginger) is used. (Alternatively: This is exterior excess and interior deficiency, with heat entering and attacking the interior, causing spontaneous diarrhea; if phlegm-fluid retention is present, vomiting occurs.)
Yangming and Shaoyang Combined Disease inevitably presents with diarrhea. A long pulse is favorable; dizziness with a certain pulse quality is unfavorable ("Fu"), indicating mutual overcoming and harm. If the pulse is slippery and rapid, it indicates retained food stagnation, and Dachengqi Tang (Major Order the Qi Decoction) should be used for purging. (Alternatively: Yangming belongs to Earth, Shaoyang to Wood. A wiry pulse indicates Wood overcoming Earth; if not wiry, it is not unfavorable. Unfavorable cases result in death. If slippery and rapid, it indicates retained food, not an unfavorable pattern, hence purging is suitable.)
San Yang Combined Disease presents with abdominal fullness, body heaviness, difficulty turning over, numbness of the mouth/tongue, greasy complexion, delirium, and urinary incontinence. Sweating and purging are contraindicated. If spontaneous sweating occurs, Baihu Tang (White Tiger Decoction) should be used.
San Yang Combined Disease with a floating and large pulse visible at the Guan position, somnolence, and sweating upon closing the eyes can be treated with Xiaochaihu Tang (Minor Order the Qi Decoction) or Baihu Tang (White Tiger Decoction). (Alternatively: These two syndromes both possess San Yang signs; sweating and purging are contraindicated.)

[Detailed Discussion on Bing Disease]
Taiyang and Yangming Bing Disease (Muscle-Releasing Method): When Taiyang disease is first acquired and sweating is incomplete, the pathogen transfers to Yangming. Continued mild spontaneous sweating and absence of aversion to cold indicate Dachengqi Tang (Major Order the Qi Decoction) or potentially Da Chaihu Tang (Major Order the Qi Decoction? Note: Text says Da Chaihu Tang). If Taiyang symptoms do not cease, purging is contraindicated; slight sweating may be attempted. If the face is uniformly red, Yang Qi is constrained in the exterior, and incomplete sweating causes irritability, shortness of breath, and unknown pain locations, sweating therapy should be reapplied using Gegen Tang (Kudzu Root Decoction).
Taiyang and Yangming Bing Disease (Purgative Method): When Taiyang symptoms cease, tidal fever, sweating of hands and feet, difficult defecation, and delirium indicate Dachengqi Tang (Major Order the Qi Decoction).
Taiyang and Shaoyang Bing Disease: Mistaken purging leads to Jie Xiong Syndrome, hardness in the epigastrium, incessant diarrhea, inability to take fluids, and irritability. Shengjiang Xiexin Tang (Fresh Ginger Decoction to Drain the Epigastrium) or Xiao Xianxiong Tang (Minor Chest-Binding Decoction) should be used.
Taiyang and Shaoyang Bing Disease presenting with neck stiffness and pain, or dizziness, feeling like Jie Xiong Syndrome, with epigastric stuffiness and hardness, requires acupuncture at Dazhui (GV-14), Feishu (BL-13), and Ganshu (BL-18) points. Sweating is contraindicated; otherwise, delirium will persist. Qimen (LR-14) point should be acupunctured.
Taiyang and Shaoyang Bing Disease presenting with hardness in the epigastrium, neck stiffness, and dizziness requires acupuncture at Dazhui (GV-14) and Feishu (BL-13) points. Purging must be strictly avoided.

Zhao Sizhen had long doubted the clarity of Combined and Bing diseases. He explained: Combined Disease refers to two or three Yang channels being affected simultaneously without transmission; Bing Disease refers to one Yang channel being affected first, then transmitting to another, representing disease progression. For example, in Taiyang-Yangming Bing Disease, if the merging is incomplete, transmission is not thorough, and exterior signs remain (as described by Zhang Zhongjing: "Taiyang signs not ceased, face red, Yang Qi constrained in exterior, unable to vent, irritability, shortness of breath"). Sweating therapy with Ge Ban Tang (Ge Gen Tang combined with Gui Zhi Tang?) or similar formulas should still be used. If merging is complete, transmission has passed (as described by Zhang Zhongjing: "Taiyang signs ceased, tidal fever, hand/foot sweating, hard stool, delirium"). Purgative therapy with Chengqi Tang should be used. Thus, transmission enters the Fu organs; non-transmission does not. Therefore, Zhang Zhongjing lists only three syndromes for Taiyang-Yangming Combined Disease as above, while discussing Taiyang-Yangming Bing Disease emphasizes its transmissive nature. Furthermore, when Yang channels combine, they all present with spontaneous diarrhea. Zhang Zhongjing treats Taiyang-Yangming Combined Disease with Gegen Tang, Taiyang-Shaoyang Combined Disease with Huangqin Tang, and Shaoyang-Yangming Combined Disease with Chengqi Tang. Regarding Taiyang-Shaoyang Bing Disease, symptoms include head/neck stiffness, dizziness, Jie Xiong-like sensation, and epigastric stuffiness; acupuncture at Dazhui, Feishu, Ganshu is indicated, and sweating/purging are contraindicated. Taiyang-Yangming Bing Disease is discussed above. However, in San Yang Combined Disease, Zhang Zhongjing does not mention "aversion to cold on the back." Although "dry mouth/thirst, irritability, slight aversion to cold on the back" exists, that belongs to Taiyang syndrome, not San Yang Combined Disease. Cheng Wuji (Huoren) stated that San Yang Combined Disease includes aversion to cold on the back, which is incorrect. If San Yang combines with San Yin, it becomes Liang Gan (Dual Cold), so San Yin has no Combined Disease cases.

Zhang Yuansu argued that "Bing" implies urging or supervising, not swallowing or merging. However, "Cu Bing" (urge merge) uses the falling tone, while "Tun Bing" (swallow merge) uses the level tone. The Records of the Grand Historian states: "The First Emperor initially merged the world," illustrating this principle. The logic of "Bing" is that the previous illness is unresolved, and the new illness arrives, creating a sense of coercion and merging, hence "Bing Disease." The classic states: "Taiyang and Shaoyang Bing Disease, head/neck stiffness or dizziness..." If they were truly merged into one entity, Zhang Zhongjing would not list symptoms of both channels separately, clarifying that "Bing" does not mean simple combination.
Furthermore, some ask: In San Yang Combined Disease, there are Taiyang-Yangming, Zheng Yang-Yangming, and Shaoyang-Yangming, which seems repetitive. I reply: Each has specific indications, differing only by exterior vs. interior. San Yang Combined Disease is in the exterior; San Yang Yangming Disease is in the interior. They are distinct paths, not repetitive. Exterior conditions require dispersing methods for recovery; interior conditions require purging. Since exterior and interior treatments are vastly different, they only appear repetitive in the index.