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14. Pathogenic factors entering the interior must first affect the chest, then spread from the chest to the hypochondrium, involving the Shaoyang (Lesser Yang) channel. If the Taiyang (Greater Yang) disease presents with a floating pulse and only chest fullness, but the disease persists beyond its proper period, it may involve the Yangming (Yang Brightness) disease. Symptoms such as dry retching, tidal fever, and chest-hypochondriac fullness should be treated with Da Chai Hu Tang (Major Bupleurum Decoction) plus Mangxiao (Natrii Sulfas) to resolve both exterior and interior pathogens simultaneously. If there is hard, full pain in the heart and abdomen radiating to the hypochondrium, accompanied by dry retching and urinary retention, Shizao Tang (Ten Jujube Decoction) should be used to purge fluid retention.

[Annotation] Pathogenic factors entering the interior must start from the chest. If the pulse is floating and there is only chest fullness without involvement of the hypochondrium, the pathogen still resides in the exterior aspect of the Taiyang channel, and Mahuang Tang (Ephedra Decoction) is appropriate. If the condition spreads from the chest to the hypochondrium causing fullness in both areas, it belongs to the Shaoyang channel, and Xiaochaihu Tang (Minor Bupleurum Decoction) is appropriate. If the disease remains unresolved for more than ten days, presenting with chest-hypochondriac fullness, dry retching, and tidal fever, this indicates a combination of Shaoyang and Yangming diseases; Da Chaihu Tang (Major Bupleurum Decoction) plus Mangxiao (Natrii Sulfas) should be used to resolve both aspects. If the exterior syndrome has resolved, but there is hard, painful fullness in the epigastrium and abdomen radiating to the hypochondrium, accompanied by dry retching and difficulty urinating, this indicates internal fluid retention and excess; Shizao Tang (Ten Jujube Decoction) should be used to purge it.

15. Why does vomiting belong to the Shaoyang? It is because pathogenic factors enter from the exterior into the interior, where the interior Qi resists and blocks, causing upward rebellion and vomiting, thus becoming a calamity belonging to the Shaoyang. Vomiting due to Taiyang disease results from an unresolved exterior syndrome; desire to vomit after eating relates to Stomach Yang; the Taiyin disease involves spitting but not retching; the Jueyin (Terminal Yin) disease often features vomiting of saliva/phlegm or roundworms; Shaoyin (Lesser Yin) vomiting with diarrhea indicates the presence of water Qi; drinking and vomiting reciprocally indicate fluid retention.

[Annotation] Vomiting can occur in all channels; why is it specifically attributed to Shaoyang? Because pathogenic factors enter from the exterior into the interior, the interior Qi resists and blocks, causing upward rebellion and vomiting, thus becoming a calamity attributed to Shaoyang, and Xiaochaihu Tang (Minor Bupleurum Decoction) is appropriate. If there is hardness and irritability in the epigastrium, or constipation, Da Chaihu Tang (Major Bupleurum Decoction) is appropriate. Vomiting due to an unresolved exterior syndrome belongs to Taiyang, and Chaigui Tang (Bupleurum and Cinnamon Twig Decoction) is appropriate. Desire to vomit after eating relates to Stomach Yang: if it belongs to Middle Jiao cold, Wuzhuyu Tang (Evodia Decoction) is appropriate; if vomiting worsens after taking the decoction, it belongs to exterior heat, and Gegen Banxia Tang (Pueraria and Pinellia Decoction) is appropriate. Vomiting of saliva/phlegm or vomiting of roundworms belongs to Jueyin disease; Wuzhuyu Tang (Evodia Decoction) is appropriate; if roundworms are vomited, Wu Mei Wan (Mume Pill) is appropriate. Vomiting accompanied by diarrhea indicates the presence of water Qi and belongs to Shaoyin disease; Zhenwu Tang (True Warrior Decoction) is appropriate. Drinking followed by vomiting, or vomiting followed by thirst for drinking, where drinking and vomiting reciprocally persist, indicates fluid retention; Wuling San (Five-Ingredient Powder with Poria) is appropriate.