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14. Chest fullness with heat and vexation: treat with Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction). Chest fullness, epigastric stiffness, and Qi rushing to the throat causing dyspnea: treat with Goudi San (Melon Seed Powder) to induce vomiting. Fever, aversion to cold, vexatious pain in the limbs, slight vomiting, and "Zhi Jie" (supporting knotting below the heart): treat with Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) to harmonize. Depressed mild vexation, incessant vomiting, pain and hardness below the heart: treat with Da Chaihu Tang (Major Bupleurum Decoction) for gentle purgation. If the Chaihu syndrome persists after erroneous purgation, administer Chaihu Tang again; the patient will experience shaking sweating and recover.
[Note] The preceding text discusses contraindications to prevent inappropriate treatment; this section discusses permissible methods, emphasizing flexibility. Chest fullness and vexatious heat indicate light pathogenic factors of Taiyang and Shaoyang; Zhizi Chi Tang is suitable to induce vomiting. Chest fullness, epigastric stiffness, and Qi rushing to the throat causing respiratory difficulty indicate heavy pathogenic factors of Taiyang and Shaoyang; Goudi San is suitable to induce vomiting. Fever, aversion to cold, vexatious limb pain, slight vomiting, and supporting knotting below the heart are exterior syndromes of Taiyang and Shaoyang; Chaihu Guizhi Tang is suitable to resolve both via mild sweating. Depressed mild vexation, incessant vomiting, and pain/hardness below the heart are interior-exterior syndromes of Shaoyang and Yangming; Da Chaihu Tang is suitable for gentle purgation to resolve both. If erroneous purgation does not cause adverse reactions and the Chaihu syndrome persists, re-administer Chaihu Tang to harmonize. Recovery will manifest as steaming shaking sweat due to post-purgation deficiency. See Taiyang and Shaoyang chapters for details.

15. He Bing (Combined Disease) involves two or three meridians affected simultaneously; Bing Bing (Consecutive Disease) involves transmission merging into one meridian. Er Yang (Two Yangs) combined disease presenting with abdominal fullness, wheezing, or spontaneous diarrhea: Gegen Tang (Kudzu Decoction) is primary; add Banxia (Pinellia Tuber) if vomiting occurs. Tai Shao (Taiyang-Shaoyang) combined disease with spontaneous diarrhea: Huangqin Tang (Scutellaria Decoction); add Banxia if vomiting. Pulse Xian (Wiry) indicates unfavorable prognosis (Fu), while Chang (Long) indicates favorable prognosis (Sheng/Chang Sheng). Pulse Hua Shuo (Slippery-Rapid) indicates retained food: Dachengqi Tang (Major Order to Yield Decoction). San Yang (Three Yangs) combined disease presents with abdominal distension, dry mouth, heavy body, delirium, desire to sleep with eyes closed accompanied by steaming hot sweat, enuresis, and greasy facial complexion: Renshen Baihu Tang (Ginseng White Tiger Decoction). If pulse is Fu (Floating), profuse sweating is prohibited; if pulse is Da (Large), purgation is prohibited. Er Yang consecutive disease with incomplete sweating and flushed face indicating pathogenic stagnation: Da Qinglong Tang (Major Green Dragon Decoction). After exterior resolution, tidal fever, sweaty hands/feet, difficult defecation, and delirium indicate Yangming Fu excess: Dachengqi Tang for purgation. Tai Shao consecutive disease with head/neck pain, dizziness, epigastric stiffness resembling Jie Xiong (Chest Binding): prohibit sweating, vomiting, and purgation; only acupuncture is suitable. Delirium, fright, anorexia, and diarrhea indicate poor prognosis.
[Note] When a syndrome in one meridian has not resolved and transmits to another, affecting two or three meridians without merging into one, it is called He Bing. When two or three meridians are affected but subsequently merge into one meridian's independent pathology, it is called Bing Bing. Er Yang refers to Taiyang and Yangming. Taiyang presents with headache, fever, aversion to cold, and anhidrosis; Yangming presents with muscle heat, aversion to heat, mental restlessness, and insomnia. Abdominal fullness and wheezing in Er Yang He Bing require Mahuang Tang (Ephedra Decoction) for sweating if no diarrhea; Gegen Tang if spontaneous diarrhea occurs; Gegen Tang plus Banxia if vomiting occurs without diarrhea. Tai Shao refers to Taiyang and Shaoyang. Taiyang presents with headache, fever, aversion to cold, anhidrosis; Shaoyang presents with alternating chills and fever, bitter taste, deafness, vertigo, and hypochondriac pain. Spontaneous diarrhea in Tai Shao He Bing requires Huangqin Tang; add Banxia if vomiting occurs without diarrhea. If neither vomiting nor diarrhea is present, it is not He Bing; use Chaihu Guizhi Tang to resolve both. Ming Shao refers to Yangming and Shaoyang combined disease with diarrhea. Xian (Wiry) pulse indicates Wood overacting on Earth (unfavorable/Fu leading to death); Chang (Long) pulse indicates Earth flourishing (favorable/Sheng leading to life). Slippery-rapid pulse with sticky/foul diarrhea indicates retained food: Dachengqi Tang. Sour/bitter vomiting indicates Da Chaihu Tang. San Yang refers to Taiyang, Yangming, and Shaoyang combined disease. "Peng Peng" describes abdominal distension. "Kou Zao" is dry mouth. "Shen Zhong" is heaviness of the body making turning difficult. "Zhan Yu" is delirious speech. "Yu Mian" is somnolence. "He Mu Han Zheng Zheng" is steaming hot sweat when closing eyes. "Yi Niao" is enuresis. "Mian Gou" is a greasy facial appearance. These are signs of excessive Three Yang heat and depletion of Jin Ye (Body Fluids). If pulse is Floating, sweating is strictly prohibited; if Large, purgation is prohibited. Use Baibu Jia Renshen Tang (White Tiger Plus Ginseng Decoction) to tonify Qi, generate fluids, and clear heat. If no prior sweating/purgation and fluids are intact, mild San Yang He Bing may be treated with Chaige Jieji Tang (Bupleurum and Kudzu Relieving Muscle Decoction) to clear and resolve Three Yang. Er Yang Bing Bing refers to Taiyang-Yangming consecutive disease. "Han Bu Che" means incomplete sweating from Taiyang transmitting to Yangming. Flushed face indicates pathogenic stagnation at the exterior of Taiyang/Yangming, not yet entering Yangming Fu; use Da Qinglong Tang. "Biao Ba" means Taiyang exterior syndrome has ceased. Tidal fever, sweaty extremities, difficult stool, and delirium indicate merger into Yangming Fu; use Dachengqi Tang to purge Yangming Excess Heat. Tai Shao Bing Bing refers to Taiyang-Shaoyang consecutive disease. Head/neck stiffness, vertigo, epigastric stiffness resembling Jie Xiong indicates symptoms have not merged; pathogen is unsettled. Prohibit sweating, vomiting, purgation; only acupuncture at Dazhui (GV14), Ganshu (BL18), Feishu (BL13) to drain heat is suitable. Erroneous sweating causes delirium; erroneous vomiting/purgation causes mental restlessness, fright, inability to swallow, and persistent diarrhea. These adverse conditions indicate fatal prognosis. See He Bing and Bing Bing chapters for detailed principles.