Library

Shaoyin disease complicated by wind-pathogen. If the pulse is slightly superficial at the cun position (radial artery proximal part) and floating at the chi position (radial artery distal part), it indicates that the disease is about to heal.

Shaoyin wind-pathogen refers to the Shaoyin meridian directly contracting wind-pathogen, rather than transmitting from Yang meridians. A slightly superficial pulse at the cun position indicates that the pathogenic factor is mild; a floating pulse at the chi position indicates that the pathogen is superficial and the interior qi is harmonious. Therefore, it is judged as impending recovery. This also illustrates the principle that when Yin diseases present with Yang pulses, there is still vitality.

The time when Shaoyin disease tends to resolve is from Zi hour (23:00–01:00) to Yin hour (03:00–05:00).

Shaoyin belongs to the Water zang organ. Diseases of Shaoyin involve Yin pathogens. Water qi peaks at Zi hour, while Yang qi begins to grow at Yin hour. Shaoyin disease tends to resolve from Zi to Yin hours because Yin qi becomes prosperous at Zi hour, and Yin pathogens dissipate upon encountering Yang qi.

In Shaoyin disease, if the pulse is tight, and after seven or eight days, spontaneous diarrhea occurs, the pulse suddenly becomes faint, the hands and feet become warm instead, and the tightness of the pulse disappears, this indicates that the disease is about to resolve. Although accompanied by irritability and diarrhea, the diarrhea will certainly stop spontaneously.

Cold pathogen damaging the Shaoyin meridian causes cold extremities and a tight pulse. After seven or eight days, if the pathogen transmits from the meridian to the zang organs, resulting in spontaneous diarrhea and a faint pulse, the condition is relatively deep. However, if the hands and feet become warm and the tight pulse disappears, it indicates that internal Yang qi is充盈 (full/abundant), and the Yin pathogen cannot remain. Thus, it is judged as impending resolution. Although accompanied by irritability and diarrhea, it will certainly stop spontaneously because the pathogen is turning to exit from below, consistent with the mechanism of Taiyin disease where foul matter should be expelled via diarrhea. Assuming the pathogen is completely exhausted, both irritability and diarrhea will cease.

In Shaoyin disease, if diarrhea occurs but stops spontaneously, and although there is aversion to cold and curling up in bed, the hands and feet are warm, the condition is treatable.

In Shaoyin disease, if there is aversion to cold and curling up in body, but occasional irritability with a desire to remove clothing and blankets, the condition is treatable.

In Shaoyin disease, if vomiting and diarrhea occur, but the hands and feet are not cold, and instead there is fever, death is unlikely. If the pulse is imperceptible, moxibustion should be applied to the Shaoyin points for seven moxa cones.

Cold striking Shaoyin may manifest as diarrhea, or aversion to cold with curling up, or simultaneous vomiting and diarrhea with an imperceptible pulse; these are signs of excessive Yin pathogen and deficient Yang qi. If diarrhea stops spontaneously, hands and feet are warm, or there is self-induced irritability with a desire to remove coverings, or there is contrary fever, it indicates that Yang qi has recovered and Yin pathogens are retreating. Thus, these conditions are not fatal and are treatable. An imperceptible pulse results from sudden deficiency of Yuan qi due to severe vomiting and diarrhea, causing the pulse to temporarily vanish. Moxibustion on Shaoyin points guides Yang qi back, and the pulse will likely return. In general, diseases transmitted through meridians depend on the survival of Yin qi for life or death, while diseases striking directly depend on the waxing and waning of Yang qi.

In Shaoyon disease, if there is aversion to cold, curling up, diarrhea, and cold extremities, it is incurable.

In Shaoyin disease, if there is four-yin (cold extremities), aversion to cold, curling up, an imperceptible pulse, no irritability but restlessness, death ensues.

Aversion to cold, curling up, diarrhea, and cold extremities indicate excessive Yin qi and depressed Yang qi, which is the exact opposite of the previous symptoms where diarrhea stopped and hands/feet were warm. When hands and feet are warm with irritability and fever, it signifies the growth of Yang Dao and the decline of Yin Dao. When hands and feet are cold with no irritability but restlessness, it signifies the growth of Yin qi and the decline of Yang qi. Furthermore, four-yin with an imperceptible pulse differs from warmth with an imperceptible pulse. The latter involves temporary Yang collapse which can be guided back; the former involves absolute exhaustion of Yang qi which cannot be summoned back. Also, irritability (fan) and restlessness (zao) differ. Irritability is heat-driven disturbance; restlessness is chaotic movement not necessarily associated with heat. Both irritability and restlessness indicate Yang anger fighting Yin, expecting victory, leading to survival. No irritability but only restlessness indicates Yang cannot fight nor remain stable, leading to dispersion and death.

In Shaoyin disease, vomiting, diarrhea, irritability, and four-yin (cold extremities) indicate death.

Cold striking Shaoyin with simultaneous vomiting and diarrhea means the Yin pathogen is excessively strong. However, if there is self-induced irritability and fever, or if hands and feet are not cold, it indicates Yang qi is still present; despite strong Yin pathogens, treatment might still be possible. This aligns with the earlier statement: "vomiting and diarrhea, hands and feet not cold, contrary fever, no death." If accompanied by irritability and four-yin, it shows signs of Yang qi scattering and perishing, with no hope of Yin pathogen receding. Even wishing for survival, it is impossible.

In Shaoyin disease, if diarrhea stops but dizziness occurs, with frequent sensations of head heaviness or obscuration, death ensues.

Diarrhea stopping does not mean spontaneous healing, but rather the exhaustion of Zang Yin. Dizziness (xuan) refers to blackening of vision and spinning; obsuration (mao) refers to mental clouding. With Yin qi exhausted, solitary Yang has no attachment and floats chaotically upward, causing dizziness and head heaviness. Since Yin qi is hard to restore quickly and solitary Yang easily scatters upward, even good medicine cannot save the patient. Therefore, in Shaoyin disease, diarrhea stopping due to Yang recovery leads to life, while diarrhea stopping due to Yin exhaustion leads to death.

In Shaoyin disease, if after six or seven days, respiration becomes shallow and rapid (xi gao), death ensues.

Xi gao refers to air rushing upward with panting. Shaoyin is the source of true qi and the root of respiration. If after six or seven days the disease persists and xi gao appears, it means the pathogen remains in the body while true qi has detached from its root. Hence, death.

In Shaoyin disease, if the pulse is faint, thin, and deep, with a desire only to sleep, sweating without irritability, and a desire to vomit, progressing to spontaneous diarrhea after five or six days, followed by irritability and inability to lie down or sleep, death ensues.

Faint, thin, deep pulse with a desire to sleep is the primary syndrome of pathogen transmission to Shaoyin, as described in the first article of this chapter. Sweating without irritability indicates Qi leaking outward while the pathogen does not exit with it. Desire to vomit followed by spontaneous diarrhea indicates the pathogen moving up and down while Zheng qi fails to expel it. By the stage of irritability and insomnia, both Yin and Yang are extremely deficient, the pathogen is dominant, Zheng qi cannot overcome the pathogen, leading to restless agitation and eventual dispersion and death. This is what is meant by "when the disease overcomes the Zang, death occurs."