Library

22. Sore throat with dryness and swelling indicates a Yang-heat syndrome; absence of dryness and swelling indicates a Yin-cold syndrome. The Yang-heat syndrome is treated with formulas such as Ganjie Tang (Licorice and Platycodon Decoction), while the Yin-cold syndrome is treated with Ganjie Fuzi Jiangxin San (Licorice, Platycodon, Aconite, and Dried Ginger Powder).
[Note] Sore throat can be caused by both cold and heat pathogens. Dryness, swelling, and pain in the throat indicate a heat syndrome of the Three Yang meridians, which should be regulated with formulas such as Ganjie Tang (Licorice and Platycodon Decoction), Banxia Kujiu Tang (Pinellia and Vinegar Decoction), or Zhufu Tang (Pig Skin Decoction). Absence of dryness and mild pain indicate a cold syndrome of the Three Yin meridians, which should be primarily treated with Sini Tang (Frigid Extremities Decoction) added with Jiegeng (Platycodon Root).

23. Qi counterflow striking upward accompanied by vomiting of roundworms is the primary syndrome of the Jueyin (Terminal Yin) meridian. If no roundworms are vomited, it indicates the pathogen remains in the exterior of the Yang level, treated with Guizhi Tang (Cinnamon Twig Decoction). Urgent pulling pain in the lower abdomen is treated with Shao Kun San (Burnt Underwear Powder). Qi rushing to the throat causing difficult breathing is effectively treated with Gouti San (Melon Seed Powder).
[Note] "Qi counterflow striking upward accompanied by vomiting of roundworms" refers to the primary syndrome of the Jueyin meridian. "No roundworms vomited" means there is Qi counterflow but no vomiting of roundworms, indicating the pathogen is still in the Yang exterior, for which Guizhi Tang (Cinnamon Twig Decoction) is appropriate. "Urgent pulling pain in the lower abdomen" refers to Qi rushing upward combined with severe pulling pain from the lower abdomen to the genital region, known as the disease of exchange between Yin and Yang, for which Shao Kun San (Burnt Underwear Powder) is appropriate. "Qi rushing to the throat causing difficult breathing" refers to Qi rushing to the throat with chest fullness and difficulty in respiration, indicating excess cold pathogen stagnating in the chest, for which Gouti San (Melon Seed Powder) is appropriate.

24. Hunger without desire to eat, vomiting of roundworms, and cold extremities constitute the primary syndrome of the Jueyin meridian. Inability to eat after purgation belongs to the Yangming meridian. Mental restlessness (Ao Nao) and sweating on the head are treated with Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction). Cold extremities with a tight pulse and irritability indicate pathogen stagnation in the chest.
[Note] "Hunger without desire to eat, vomiting of roundworms, and cold extremities" refers to the primary syndrome of the Jueyin meridian. Feeling hungry but unable to eat after purgation belongs to the Yangming meridian. Yangming disease manifests as mental restlessness (Ao Nao), extreme irritability, and sweating on the head, indicating heat in the stomach, which should be treated with Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) to induce vomiting. Jueyin disease manifests as vomiting of roundworms, cold extremities, and a faint pulse. If the pulse is not faint but tight, accompanied by increased irritability, this is not due to cold deficiency but to excess cold pathogen stagnating in the chest, which should be treated with Gouti San (Melon Seed Powder) to induce vomiting.

25. The Taiyin (Greater Yin) meridian presents with warm hands and feet without cold extremities (Jue Ni). The Shaoyin (Lesser Yin) meridian presents with cold extremities that cannot be warmed. The Jueyin meridian’s cold extremities vary in severity, and its heat-induced cold extremities require differentiation based on depth.
[Note] The Taiyin meridian does not present with cold extremities but rather naturally warm hands and feet. The Shaoyin meridian presents with cold extremities (Han Jue) but not heat-induced cold extremities (Re Jue). The Jueyin meridian presents with both cold and heat-induced cold extremities. Cold extremities refer to coldness without heat. Heat-induced cold extremities involve alternating cycles of heat leading to cold extremities and cold extremities transforming into heat, occurring continuously without cessation. One must differentiate the depth of Yin and Yang pathology and treat accordingly with formulas such as Danggui Sini Tang (Angelica Sinensis Decoction for Frigid Extremities) or Chengqi Tang (Descending Qi Decoction). For details, see the Jueyin chapter.