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Shaoyang disease (Disease of the Shaoyang channel) is characterized by bitter taste in the mouth, dryness of the throat, and dizziness. (The *Ren Shu* states: Xiao Chai Hu Tang [Minor Bupleurum Decoction] is appropriate.)

When Shaoyang is affected by wind pathogen, symptoms include bilateral hearing loss, redness of the eyes, fullness and irritability in the chest. Purging (Purgation) or emesis (Emetic therapy) are contraindicated; if mistakenly used, they will lead to palpitations (Palpitation) and fright. (Mistaken emesis leads to Qi deficiency causing palpitations; mistaken purging leads to Blood deficiency causing fright.)

In cold damage (Shanghan), if the pulse is wiry and fine, accompanied by headache and fever, it belongs to Shaoyang. Shaoyang disease prohibits sweating therapy (Diaphoresis); if mistakenly induced, it leads to delirious speech (Delirium), indicating the pathogen has entered the Stomach organ (Stomach). If the Stomach harmonizes, recovery occurs; if not, irritability and palpitations ensue.

Three days after the onset of cold damage, if the Shaoyang pulse becomes small, the disease is about to resolve. The time when Shaoyang disease tends to resolve is from Yin hour to Chen hour (03:00–09:00).

Yangming disease presents with abdominal fullness, a floating and tight pulse, bitter taste, dry throat, and wheezing. If the patient has fever and aversion to cold, and is mistakenly purged, abdominal fullness and difficult urination result. If the patient has fever without aversion to cold but rather aversion to heat, and is mistakenly purged, the Stomach becomes empty, leading to vexation (Vexation/Regret); mistaken purging leads to delirious speech; mistaken application of burning needle therapy leads to insomnia. (See discussion on Abdominal Fullness. Xu Xueshi states: Xiao Chai Hu Tang [Minor Bupleurum Decoction] is appropriate.)

Dizziness with bitter taste and dry tongue belongs to Shaoyang. (See discussion on Bitter Taste.) Dizziness with hardness below the heart and neck stiffness belongs to concurrent Taiyang and Shaoyang disease; Da Zhui and Fei Shu acupoints should be needled. Sweating and purging are contraindicated. (See discussion on Neck Stiffness.)

Dizziness with excess in the Stomach, where the patient can eat and has no aversion to cold, indicates wind strike; dizziness after eating and difficult urination indicate Grain Jaundice. Both belong to Yangming. (See discussion on Stomach Excess.)

After sweating therapy for Taiyang disease, if fever persists, accompanied by palpitations, dizziness, and body tremors as if falling to the ground, Zhen Wu Tang [True Warrior Decoction] is the primary treatment. (See discussion on Tremors/Shivering.)

If "moving qi" is on the left, mistaken sweating leads to dizziness and continuous sweating with muscle twitching. (See discussion on Moving Qi. *Ren Shu* states: Xiao Jian Zhong Tang [Minor Construct the Middle Decoction] is appropriate.) In various counterflow conditions, mistaken sweating leading to confused speech and dizziness indicates a fatal prognosis. (See discussion on Delirium.) Dizziness with a deep and tight pulse; mistaken sweating disturbs the channels, leading to body tremors and swaying. (See discussion on Tremors/Shivering.)

[From *Ben Cao Yan Yi*] If Taiyang disease does not resolve and transfers to Shaoyang, presenting with hardness and fullness under the hypochondrium, dry retching, inability to eat, and alternating chills and fever, and if emesis, purging, sweating, or warm needle therapy have not yet been used, and the pulse is deep and wiry, administer Xiao Chai Hu Tang [Minor Bupleurum Decoction]. If emesis, purging, sweating, or warm needle therapy have already been used, leading to delirious speech and the cessation of Chai Hu syndrome, this is termed a damaged disease (Bad Disease). Determine what error was made and treat accordingly.

In cold damage or wind strike lasting five to six days, presenting with alternating chills and fever, oppression and fullness in the chest and hypochondrium, silence with lack of desire for food, irritability, and frequent vomiting, or alternatively, chest vexation without vomiting, thirst, abdominal pain, hypochondriac痞 (stagnation/hardness), subcostal palpitations, difficult urination, absence of thirst with slight external fever, or cough, Xiao Chai Hu Tang [Minor Bupleurum Decoction] is the primary treatment. When Blood is deficient and Qi is exhausted, the pores open, allowing the pathogen to enter and contend with the healthy Qi, knotting at the hypochondrium. The contention between healthy and pathogenic factors causes alternating chills and fever with regular intervals. Silence and lack of desire for food occur because the organs are connected, and the disease inevitably moves downward. The pathogen is high, but the manifestation is low, hence vomiting occurs; Xiao Chai Hu Tang [Minor Bupleurum Decoction] is appropriate.

Chai Hu (2 liang), Huang Qin (Scutellaria Root), Ren Shen (Ginseng Root), Gan Cao (Licorice Root) (each 3 qian), Ban Xia (Pinellia Tuber, processed with ginger) (6 qian).
Crush the herbs. Take 5 qian per dose, add 5 slices of fresh ginger and 2 jujubes, decoct together, and take warm. Three doses daily.
If there is chest vexation without vomiting, remove Ban Xia and Ren Shen, add one Gua Lou Shi (Trichosanthes Fruit).
If severe thirst, remove Ban Xia, add Ren Shen 3 qian and Gua Lou Gen (Trichosanthes Root) 1 liang.
If abdominal pain, remove Huang Qin, add Bai Shao (White Peony Root) 3 fen.
If hypochondriac stagnation/hardness, remove Da Zao (Jujube), add Mu Li (Oyster Shell) 1 liang.
If subcostal palpitations and difficult urination, remove Huang Qin, add Fu Ling (Poria) 1 liang.
If no thirst but slight external fever, remove Ren Shen, add Gui Zhi (Cinnamon Twig) 3 fen, cover with blankets to induce slight sweating for recovery.
If cough, remove Ren Shen, Da Zao, and fresh ginger, add Wu Wei Zi (Schisandra Berry) 0.5 liang and Gan Jiang (Dried Ginger) 3 fen.

For Chai Hu disease that does not resolve after purging, administering Xiao Chai Hu Tang [Minor Bupleurum Decoction] again will likely cause intense internal heat and shivering, followed by fever and sweating, leading to resolution. In cold damage or wind strike, if Chai Hu syndrome is present, the appearance of even one symptom is sufficient; all symptoms need not be present.

In cold damage lasting more than ten days, with heat knotting internally and recurring alternating chills and fever, Da Chai Hu Tang [Major Bupleurum Decoction] is appropriate. (See discussion on Chest Binding.)

Da Chai Hu Tang [Major Bupleurum Decoction]
Chai Hu (2 liang), Huang Qin (Scutellaria Root), Bai Shao (White Peony Root) (each 0.5 liang), Ban Xia (Pinellia Tuber, processed) (6 qian), Sheng Jiang (Fresh Ginger) (1 liang), Zhi Shi (Immature Bitter Orange) (0.5 liang), Da Huang (Rhubarb Root and Rhizome) (1 liang).
Crush the herbs. Take 5 qian per dose, add 3 jujubes, decoct in water, and take warm. Stop when bowel movement is achieved; if not achieved, take again.

[Xu Shumi] A patient suffered from cold damage with irritability, frequent vomiting, and alternating chills and fever. The physician administered Xiao Chai Hu Tang [Minor Bupleurum Decoction], but the illness did not resolve. I said: The pulse is surging and large yet firm, indicating heat knotting internally; how can Xiao Chai Hu Tang eliminate it? Zhang Zhongjing stated: In cold damage lasting more than ten days, with heat knotting internally and recurring alternating chills and fever, administer Da Chai Hu Tang [Major Bupleurum Decoction]. After three doses, the illness resolved. This is because Da Huang (Rhubarb Root and Rhizome) sweeps away accumulated heat and is a crucial herb for treating cold damage. Wang Shuhe stated: Without Da Huang, it cannot be called a Chai Hu formula; it must be raw and wine-washed for efficacy.

In cold damage lasting five to six days, after sweating and mistaken purging, presenting with chest and abdominal fullness with slight knotting, difficult urination, thirst without vomiting, only head sweating, alternating chills and fever, and irritability, the disease is unresolved.
Hu Ge Gui Zhi Gan Jiang Tang [Bupleurum, Cinnamon Twig, and Dried Ginger Decoction] is appropriate.

Hu Ge Gui Zhi Gan Jiang Tang [Bupleurum, Cinnamon Twig, and Dried Ginger Decoction]
Chai Hu (2 liang), Gui Zhi (Cinnamon Twig), Gan Jiang (Dried Ginger) (each 0.5 liang), Gua Lou Gen (Trichosanthes Root), Huang Qin (Scutellaria Root) (each 1 liang), Mu Li (Oyster Shell), Gan Cao (Licorice Root, honey-fried) (each 0.5 liang).
Crush the herbs. Take 5 qian per dose, decoct, and take warm. If slight vexation remains, take again; sweating indicates recovery.

If the patient's pulse is faint and choppy, this is iatrogenic injury caused by excessive sweating and repeated severe purging, leading to blood loss. The patient should feel aversion to cold, which later turns into ceaseless fever. In midsummer heat, they desire thick clothing; in midwinter cold, they desire to be naked. The reason is that faint Yang causes aversion to cold, and weak Yin causes fever. The physician’s sweating depleted Yang Qi, and purging depleted Yin Qi. In May, Yang Qi is on the exterior, and the Stomach is cold due to internal Yang deficiency, unable to overcome cold, hence desiring thick clothing. In November, Yang Qi is interior, and the Stomach is vexed with heat due to internal Yin deficiency, unable to overcome heat, hence desiring to be naked. Additionally, a slow and chopping Yin pulse confirms blood loss.

The faint pulse resulted from excessive sweating; thus, during aversion to cold, even in midsummer, thick clothing is desired. The choppy pulse resulted from severe purging; thus, during fever following aversion to cold, even in midwinter, nakedness is desired. These are due to blood loss, weak Yang, and weak Yin, unable to resist cold or heat, not implying that midsummer extends into midwinter.