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Original text from *Shanghan Lun* (Treatise on Cold Damage Disorders): Shaoyin disease (a syndrome caused by pathogenic invasion of the Shaoyin meridians), with diarrhea of undigested food, internal cold and external heat, coldness of the hands and feet, a faint pulse nearly imperceptible, yet the body does not feel aversion to cold, the patient's face is red, abdominal pain, occasional dry retching, occasional sore throat, or cessation of diarrhea with an unpalpable pulse; Tongmai Sini Decoction (Pulse-Reviving Four-Reversal Decoction) is the primary treatment.

[Tongmai Sini Decoction] Prepared Glycyrrhizae Radix et Rhizoma (Gancao, Licorice Root) 2 liang, raw Fuzi (Aconiti Lateralis Radix Preparata, prepared lateral root of Aconite) one large piece, peeled and broken into eight slices, dried Ginger Root (Ganjiang, Dried Ginger) 3 liang.
Take the above three ingredients, add three sheng of water, boil to obtain one sheng and two he of liquid, remove the dregs, and divide into two warm doses. If the pulse gradually becomes palpable after administration, recovery occurs (unlike a sudden appearance from nothing followed by disappearance again, like a lamp flame flaring up). For those with a red face, add nine stalks of Scallion White (Congbai, White part of Allium fistulosum); for abdominal pain, remove Scallion White and add Paeoniae Radix Alba (Baishao, White Peony Root) 2 liang; for vomiting, add fresh Ginger (Shengjiang, Fresh Ginger) 2 liang; for sore throat, remove Paeoniae Radix Alba and add Platycodonis Radix (Jiegeng, Balloon Flower Root) 1 liang; for cessation of diarrhea with an unpalpable pulse, remove Platycodonis Radix and add Ginseng Radix (Renshen, Ginseng Root) 2 liang.

In the Taiyang chapter, the Sini Decoction contains 1.5 liang of dried Ginger, used to treat conditions where excessive sweating leads to Yang collapse. In Tongmai Sini Decoction, the ingredients are the same as before, but the amount of dried Ginger is doubled. This is because severe cold causes pulse obstruction, and the pungent-hot power is needed to open congealed cold and unblock the vessels. For a red face, adding nine stalks of Scallion White (roughly cut white parts of thick scallions, each about nine cun long) is prescribed. The red face indicates Yin cold below forcing Yang to float upward, known as Daiyang syndrome (False Yang floating upwards). Adding Scallion White facilitates the circulation of Qi between the upper and lower bodies. Moreover, using a larger quantity aligns with the number of Old Yang, allowing Yang to return to its residence. In my experience with such cases, I often add a few qian of Paeoniae Radix Alba, as the combination of Paeoniae Radix Alba and Fuzi is most effective in converging floating Yuan Yang (Primordial Yang) and guiding it downward.

Original text from *Shanghan Lun*: Shaoyin disease, spontaneous purgation of clear water, purely green in color, accompanied by inevitable pain in the epigastrium and dryness of the mouth, requires urgent purgation; Da Chengqi Decoction (Great Order the Qi Decoction) is appropriate.
This condition arises from latent heat pathogens invading the Liver and Kidney meridians. The Kidney governs closure and storage, while the Liver governs dispersion and drainage. The Kidney acts as the gate for urination and defecation, and the Liver assists the Kidney in regulating Qi flow. Due to the latent heat pathogen invading the Kidney and simultaneously affecting the Liver, the Liver’s dispersive force becomes excessive due to the heat, thereby excessively assisting the Kidney’s Qi movement. This causes the Kidney to lose its function of closure and storage, resulting in the purgation of clear water. Furthermore, Liver heat affects the Gallbladder, causing bile to flow recklessly due to heat and exit as purely green water along with the Liver’s excessive dispersion. Consequently, Kidney Water is nearly exhausted due to excessive dispersion and cannot ascend to nourish and suppress Heart Fire. Additionally, Liver Wood fails to receive the moistening nourishment of Water, leading to excessive dispersion below and rampant aggression above, causing epigastric pain and oral dryness. Urgent purgation is indicated here; by purging to stop diarrhea, the True Yin within the Kidney can recover, naturally ascending to cure oral dryness and epigastric pain.

Prior to this section, there is: "Shaoyin disease, two to three days after onset, with dry mouth and throat, requires urgent purgation; Da Chengqi Decoction is appropriate." And in the following section: "Shaoyin disease, six to seven days after onset, with abdominal fullness and constipation, requires urgent purgation; Da Chengqi Decoction is appropriate." It is presumed that Master Zhang Zhongjing also emphasized urgent purgation in these sections. If urgent purgation is not performed, the danger would be imminent, similar to the case of passing purely green water. Such being Zhang Zhongjing, he truly deserves to be called the Sage of Medicine.

Note: Medical texts mention Qiheng Dysentery. Zhang Yinan stated that this occurs when pathogens of the Three Yang meridians converge, overwhelming the Three Yin meridians, blocking all nine orifices, and causing Yang Qi to overflow sideways. Symptoms include dry throat, blocked and painful throat, and erratic movement into the Yin meridians, leading to intestinal dysentery. The pulse is slow, small, delayed, and choppy. Death ensues if the blood feels warm and the body is hot, or if the heat persists for seven days. Generally, this is due to excessive Yang Qi injuring Yin Qi, resulting in a small, delayed, and choppy pulse. This condition requires urgent use of Da Chengqi Decoction to purge Yang and nourish Yin; delay renders it ineffective. Regarding Qiheng Dysentery, although the nature of the excrement is unknown, the pulse characteristics of being slow, small, delayed, and choppy are identical to the faint and fine pulse of Shaoyin disease. The symptoms of dry throat, blocked throat, and pain merging into the Yin correspond to the epigastric pain and oral dryness in this section. Zhang Yinan’s recommendation for urgent administration of Da Chengqi Decoction aligns with the urgent purgation indicated here. Thus, Qiheng Dysentery falls within the scope of Shaoyin diarrhea; it may be named Qiheng Dysentery or simply Shaoyin diarrhea without issue.

Original text from *Shanghan Lun*: Shaoyin disease, with diarrhea, a faint and choppy pulse, vomiting and sweating, frequent bowel movements but scant output, should be treated by warming the upper part with moxibustion.
Commentators suggest: Moxibustion at Baihui GV20 (Convergence of Yang) is appropriate.