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11. Alternating chills and fever, fullness in the chest and hypochondrium, wiry pulse, dizziness, deafness, bitter taste in the mouth, taciturnity with anorexia, vexation and frequent vomiting.
Shaoyang (Lesser Yang) channel diseases may present with thirst, cough with slight fever, hardness and pain in the hypochondrium or abdominal pain, palpitations without vomiting, difficult urination, and a slippery white tongue coating; these all fall under the scope of Xiao Chai Hu Tang (Minor Bupleurum Decoction).
[Note] A wiry pulse refers to the pulse characteristic of Shaoyang disease. Alternating chills and fever, fullness in the chest and hypochondrium, dizziness, deafness, bitter taste, taciturnity with anorexia, vexation, and frequent vomiting are the principal manifestations of Shaoyang channel disease. Thirst, cough with slight fever, hardness and pain in the hypochondrium or abdominal pain, palpitations without vomiting, difficult urination, and a slippery white tongue coating are all possible accompanying symptoms of Shaoyang disease. All should be primarily treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction), with modifications according to specific symptoms. See the Shaoyang Chapter for details.

12. If there is vexation in the chest but no vomiting, remove Ren Shen (Ginseng Radix et Rhizoma) and Ban Xia (Pinelliae Tuber), add Gua Lou Shi (Trichosanthis Fructus); if thirsty, replace Ban Xia (Pinelliae Tuber) with Gua Lou Gen (Trichosanthis Radix); if abdominal pain, remove Huang Qin (Scutellariae Radix) and add Bai Shao (Paeoniae Radix Alba); if palpitations and urinary difficulty, add Fu Ling (Poria) and remove Huang Qin (Scutellariae Radix); if subcostal distension and hardness, replace Da Zao (Jujubae Fructus) with Mu Li (Ostreae Concha); if not thirsty but with slight external heat, remove Ren Shen (Ginseng Radix et Rhizoma) and add Gui Zhi (Cinnamomi Ramulus) to induce slight sweating; if coughing, remove Ren Shen (Ginseng Radix et Rhizoma) and Da Zao (Jujubae Fructus), add Gan Jiang (Zingiberis Rhizoma) and Wu Wei Zi (Schisandrae Fructus). When applying Xiao Chai Hu Tang (Minor Bupleurum Decoction), clinical judgment must be exercised carefully.
[Note] The principal manifestations of Shaoyang channel disease are suitably treated primarily with Xiao Chai Hu Tang (Minor Bupleurum Decoction). For possible accompanying symptoms, modifications must be considered based on clinical presentation. If there is vexation in the chest but no vomiting, remove Ban Xia (Pinelliae Tuber) and Ren Shen (Ginseng Radix et Rhizoma), add Gua Lou Shi (Trichosanthis Fructus). If thirsty, replace Ban Xia (Pinelliae Tuber) with Gua Lou Gen (Trichosanthis Radix). If abdominal pain, remove Huang Qin (Scutellariae Radix) and add Bai Shao (Paeoniae Radix Alba). If epigastric palpitations and difficult urination, add Fu Ling (Poria) and remove Huang Qin (Scutellariae Radix). If subcostal distension and hardness, add Mu Li (Ostreae Concha) and remove Da Zao (Jujubae Fructus). If not thirsty but with slight external heat, remove Ren Shen (Ginseng Radix et Rhizoma) and add Gui Zhi (Cinnamomi Ramulus) to induce slight sweating. If coughing, remove Ren Shen (Ginseng Radix et Rhizoma) and Da Zao (Jujubae Fructus), add Gan Jiang (Zingiberis Rhizoma) and Wu Wei Zi (Schisandrae Fructus). The rationale is detailed under the entry for Xiao Chai Hu Tang (Minor Bupleurum Decoction) in the Shaoyang Chapter.

13. The three prohibitions for Shaoyang disease must be clearly understood: misusing sweating leads to delirious speech, misusing emesis or purging leads to palpitations and fright; severe cases may result in intractable diarrhea, inability to take food or fluids, and death.
[Note] The "three prohibitions" refer to the prohibition of emesis, sweating, and purging in Shaoyang disease. If sweating is mistakenly induced, delirious speech will occur. If emesis or purging is mistakenly used, palpitations and fright will result. In Shaoyang channel disease, even if there is hardness below the heart, purging must not be used; if forced, it may lead to intractable diarrhea. Even if there is fullness in the chest, emesis must not be used; if forced, it may lead to the inability to ingest food or fluids, becoming a critical condition where life is hard to save. See the Shaoyang Chapter for details.