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Taiyin (Greater Yin) corresponds to the Earth element. In the zang-fu organs, it corresponds to the Spleen (Pi); in terms of qi and pathogenic factors, it corresponds to Dampness (Shi). When the heat from a cold damage disease transmitted through the meridians enters the interior and contends with Dampness, it results in symptoms such as abdominal fullness, vomiting, and diarrhea. When cold pathogen directly invades the interior and contends with Dampness, it similarly presents with abdominal fullness, vomiting, and diarrhea. The distinction lies only in whether the limbs are cold or warm, the pulse is slow or rapid, and whether there is thirst or not. Furthermore, the Three Yin meridians (Taiyin, Shaoyin, Jueyin) are the interior counterpart to the Three Yang meridians, yet the Three Yin themselves possess their own exterior-interior relationship. Therefore, wind-cold pathogens do not necessarily enter all the way to the zang organs; they may also linger in the meridians. Hence, there are clauses regarding "Taiyin Wind-Strike" and the method of inducing sweating using Guizhi Tang (Cinnamon Twig Decoction). Additionally, cases involving diarrhea with abdominal fullness and body pain represent simultaneous disease of both the meridians and the zang organs; thus, the treatment principle is to address the interior first and the exterior subsequently. However, contemporary discussions on Three Yin diseases often mention only direct invasion and meridian transmission, knowing only of the interior aspect of the Three Yin but ignoring their exterior aspect. This chapter first lists zang organ diseases, then meridian diseases, and finally simultaneous meridian-zang diseases, comprising ten clauses in one volume.

The defining syndrome of Taiyin disease includes abdominal fullness, vomiting, inability to eat, worsening spontaneous diarrhea, and occasional spontaneous abdominal pain. If purgatives are incorrectly applied, it will inevitably lead to hardness and binding below the chest.
This is the definitive syndrome of Foot-Taiyin Spleen disease. The Taiyin meridian enters the abdomen, connects with the Spleen, and links with the Stomach; it ascends through the diaphragm and flanks the throat. Consequently, its manifestations include abdominal fullness, vomiting, food retention, spontaneous diarrhea, and abdominal pain. However, Taiyin pathology is not limited to meridian transmission; it occurs similarly in direct invasion, and applies not only to Cold Damage but also to miscellaneous diseases. The differentiation lies merely in whether the condition belongs to Yin or Yang, excess or deficiency. Since Taiyin is a Zang organ, characterized by "fullness without solidity," purgation is contraindicated according to medical principles. Incorrect purgation damages the Middle Qi, allowing pathogenic factors to bind, resulting in hardness below the chest.

In a case originally presenting as Taiyang disease, if the physician erroneously applies purgation, leading to abdominal fullness and intermittent pain, this indicates involvement of the Taiyin system. It should be treated primarily with Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction plus Peony Root).
When the pathogen remains in the Taiyang stage, failure to resolve the exterior and instead attacking the interior allows the pathogen to sink into the Taiyin position due to deficiency, causing abdominal fullness and intermittent pain. This corresponds to what Tao described as transmission caused by erroneous purgation. Since the etiology involves pathogen sinking, recovery requires resolving the pathogen; since the Zang Yin has been injured by drugs, it requires medicinal harmonization for peace. Thus, Guizhi Jia Shaoyao Tang is indicated. Guizhi disperses the externally invading pathogen, while Shaoyao soothes the Yin injured by purgation. According to the *Jingui Yaolue*: "In cold damage, if the Yang pulse is choppy and the Yin pulse is string-taut, abdominal cramping pain is expected; administer Xiao Jianzhong Tang. If ineffective, administer Xiao Chaihu Tang." This is also due to pathogen sinking into the Yin. Guizhi Jia Shaoyao Tang shares the intent of Xiao Jianzhong Tang but omits Yitang (Maltose) because the patient has abdominal fullness and should not receive sweet substances that might exacerbate fullness.

Formula: Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction plus Peony Root)
Add three liang of Shaoyao (Peony Root) to the original Guizhi Tang formula, totaling six liang of Shaoyao. Follow the preparation and administration methods of Guizhi Tang for the remainder.

In cases of severe excess and intense pain ("Da Shi Tong"), Guizhi Jia Dahuang Tang (Cinnamon Twig Decoction plus Rhubarb) is indicated.
This follows the previous clause. If abdominal fullness is present but not solid, and pain is not severe, Guizhi Jia Shaoyao Tang can harmonize and resolve the condition. However, in cases of severe excess and intense pain, pathogenic factors have aggregated into excess; thus, Guizhi Jia Dahuang Tang must be used to disperse the sunken pathogen and eliminate stagnation. Taiyin is the Spleen Zang; how can a Zang organ present with excess requiring purgation? Yangming (Stomach) is the exterior counterpart to Taiyin, connected by membranes. When the Zang receives pathogen and the Fu organ fails to transport, excess results. Therefore, the Spleen does not generate excess independently but becomes affected by Stomach excess. Dahuang (Rhubarb) is used to purge the Stomach, not the Spleen. Shaoyin and Jueyin conditions also utilize Chengqi formulas; see respective chapters for cross-reference.

Formula: Guizhi Jia Dahuang Tang (Cinnamon Twig Decoction plus Rhubarb)
Guizhi (Cinnamon Twig, 3 liang, bark removed), Gancao (Licorice Root, 3 liang, honey-fried), Dahuang (Rhubarb Root and Rhizome, 1 liang), Shengjiang (Fresh Ginger, 3 liang, sliced), Dazao (Jujube Fruit, 12 pieces), Shaoyao (Peony Root, 6 liang).
These six ingredients are boiled in seven sheng of water to yield three sheng. Strain the dregs. Take one sheng warm, three times daily.

In Taiyin disease, if the pulse is weak and the patient continues to have spontaneous loose stools, even if Dahuang or Shaoyao were indicated, their dosages should be reduced. This is because the person's Stomach Qi is weak and easily disturbed.
This also follows the previous clause. Dahuang and Shaoyao are applicable when there is Stomach excess and hard stool. If the pulse is weak and spontaneous loose stools continue, these methods are contraindicated even in cases of severe pain. If used, dosages must be carefully reduced. The reason is that weak Stomach Qi cannot rally, and pathogens do not aggregate firmly but move easily; thus, a gradual approach is suitable, whereas aggressive attack is difficult.

In cold damage, if the pulse is floating and moderate, and the hands and feet are naturally warm, the disease is associated with Taiyin. In Taiyin involvement, jaundice should develop. However, if urination is free and easy, jaundice will not occur. By the seventh or eighth day, sudden irritability followed by diarrhea occurring more than ten times a day will necessarily stop spontaneously. This is because the Spleen's righteous Qi is sufficient ("Spleen Home Excess"), and foul turbidity is being expelled.

A floating and moderate pulse in cold damage indicates the disappearance of the tight pulse becoming moderate, signaling a transformation of cold into heat, similar to Clause 47 of Taiyang. Naturally warm hands and feet are not a fixed sign of Taiyin; in Taiyin cold, hands and feet are cold; in Taiyin heat, they are naturally warm. Yangming heat causes fever in the whole body and extremities, whereas Taiyin heat causes no body fever but warm extremities. Here, cold has transformed into heat, and extremities are warm, indicating the pathogen has moved from Taiyang to Taiyin rather than Yangming. The persistent floating pulse suggests the pathogen has not fully entered the interior. Hence, it is said to be "associated with Taiyin," meaning connection from Taiyang to Taiyin. According to protocol, Taiyin heat with anhidrosis leads to heat-contending-with-dampness and jaundice. If urination is free, heat dissipates and cannot steam to cause jaundice. By days 7-8, sudden irritability and diarrhea indicate internal righteous Qi activity and pathogen expulsion. Although occurring ten-plus times daily, it will cease spontaneously. This occurs because the Spleen naturally contains foul turbidity to be expelled, causing spontaneous diarrhea. Once turbidity is cleared, diarrhea stops.

Spontaneous diarrhea without thirst indicates Taiyin involvement, due to cold in the Zang organs. Treatment should employ warming methods, preferably Si Ni Tang (Frigid Extremities Decoction) or similar formulas.
Spontaneous diarrhea without thirst indicates inherent Taiyin cold compounded by Yin pathogen invasion. Identifying it as Taiyin confirms internal cold, distinct from Yang meridian diarrhea or transmitted heat diseases. The method should warm the Zang and dispel cold, using formulas like Si Ni Tang. Bitter-cold herbs for clearing heat and consolidating Yin, such as those in Huangqin Tang (Scutellaria Decoction), are contraindicated.