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Shaoyin is the interior of Taiyang. It resides between Jueyin and Taiyin. Therefore, there are cases where pathogenic factors are in Taiyang but have already affected Shaoyin internally; cases where cold directly strikes Shaoyin but still connects externally to Taiyang; and cases where pathogenic factors are in Shaoyin, either complicating with Jueyin or complicating with Taiyin. Generally, those complicating with Taiyin often present with fever, while those complicating with Jueyin often present with cold limbs and diarrhea. Besides transmission through meridians (Chuanjing) and direct strike (Zhizhong), there are such differences. Moreover, cold from direct strike may transform into heat over time, and heat from transmission may generate Yin deficiency when extreme. This chapter first lists pulse and symptoms, then discusses clearing methods (Qingfa), followed by warming methods (Wenfa), and subsequently methods for determining life and death. The aim is to enable learners to clearly distinguish the practical application of clearing versus warming, rather than merely adhering to the names of "transmission" or "direct strike." Finally, it covers contraindications for Shaoyin disease. Since Shaoyin disease involves principles of sweating and purging, contraindications for these methods must also be noted. There are forty-five clauses in total, forming one volume.

The manifestation of Shaoyin disease is a faint and fine pulse, and a desire only to sleep.
Regarding meridians, Yang channels are superficial and Yin channels are deep; Yang pulses are large and Yin pulses are small. When pathogens transmit to Shaoyin, floating pulses become faint, and large pulses become fine. Furthermore, those with abundant Yang are often awake, while those with abundant Yin are often sleepy. When pathogens transmit to Shaoyin, the state of being unable to close the eyes transforms into a desire only to sleep. Shaoyin is the pivot of the three Yin channels; Yang enters here, and Yin exits here. Thus, although Taiyin and Jueyin are both Yin organs, their pathological manifestations are uniquely characteristic of Shaoyin. Moreover, Shaoyin disease is not limited to just faint/fine pulses and somnolence. Zhang Zhongjing specifically highlights these two aspects to illustrate that at the juncture of transitioning from Yang to Yin, pulse and symptom changes manifest in this manner.

In Shaoyin disease, if the patient desires to vomit but cannot, feels irritability, and desires only to sleep; after five or six days, if spontaneous diarrhea occurs accompanied by thirst, it belongs to Shaoyin. This is due to internal deficiency causing the patient to draw water to self-rescue. If the urine is white, the signs of Shaoyin disease are fully present. White urine indicates deficiency-cold in the Lower Jiao, which fails to control water metabolism, resulting in white coloration.
This represents Shaoyin contracting cold pathogens directly, not transmitted from Yang channels. When cold initially reaches the channel, the body struggles to accept or reject it, leading to the desire to vomit without success, irritability, and a desire to sleep (though actual sleep is difficult). By the fifth or sixth day, spontaneous diarrhea and thirst indicate the pathogen has entered the Shaoyin Zang organ. However, Shaoyin is a Yin Zang, and cold is a Yin pathogen; receiving Yin with Yin should theoretically not cause thirst. The presence of thirst here is not due to heat, but because the Zang is deficient and cold, prompting the patient to seek water for self-rescue. Further examination of the urine: if white, the nature of Shaoyin cold disease is unmistakably revealed. Why? In cases where heat transmits to Shaoyin with spontaneous diarrhea and thirst, the pathogenic heat consumes fluids, making the urine red. In cases where cold directly strikes Shaoyin with spontaneous diarrhea and thirst, although the patient can drink, they cannot metabolize/transform it, making the urine white. Such is the precision of Zhang Zhongjing’s differentiation.

If a patient’s pulse is tight in all positions (Yin and Yang), yet sweat appears spontaneously, this indicates loss of Yang. This belongs to Shaoyin disease, and according to the law, should present with sore throat accompanied by vomiting and diarrhea.
A tight pulse in all positions is typical of Taiyang Cold Damage, which should present without sweat. Spontaneous sweating indicates exterior deficiency and loss of Yang. The disease thus shifts from Taiyang to Shaoyin.
The Shaoyin meridian ascends through the diaphragm and follows the throat. The Shaoyin Zang serves as the gate of the Stomach and governs the two lower orifices. Direct invasion by cold pathogens affects both the meridian and the Zang, hence the occurrence of sore throat, vomiting, and diarrhea. This is a case where cold damages Taiyang, Yang Qi becomes too weak to resist, and the condition transitions into Shaoyin. Taiyang is the exterior of Shaoyin, akin to lips and teeth; if the lips are gone, the teeth suffer cold; if Yang is lost, Yin is implicated. Hence, it is said that many Shaoyin pathogens transfer from Taiyang.

In Shaoyin disease, after eight or nine days, if the entire body and hands and feet become hot, it is because heat resides in the Bladder, and hematochezia (blood in stool) will inevitably occur.
This represents heat transmitting to Shaoyin and then returning to enter the Bladder. The Bladder corresponds to Taiyang. Taiyang is the exterior of the three Yang channels and is characterized by abundant blood and scarce Qi. Heat residing in the Bladder causes heat throughout the body and extremities. Excessive heat forces blood to scatter and flow downward, inevitably resulting in hematochezia.