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Pain in the Hypochondrium and Deafness
The Shaoyang (Lesser Yang) channel is governed by Ministerial Fire (Xiang Huo, a physiological fire that warms the organs). The Foot-Shaoyang Gallbladder Channel transforms Qi into Ministerial Fire via Jia Wood. Under normal conditions, it should submerge to warm Kidney Water; if rebellious, it flares upward and scorches Lung Metal. Therefore, the Shaoyang channel is most susceptible to Fire pathogens. In plague diseases, Cold Water fails to store properly, causing Ministerial Fire to flare and steam, becoming excessive during a time of deficient and depleted healthy Qi. Contracting disease in spring and summer leads to closure of Defensive Qi (Wei Qi) and stagnation of Nutritive Qi (Ying Qi), resulting in intense heat and fire eruption. This occurs when the pathogen is in its season of dominance, making the condition extremely severe and fierce. Regarding Shaoyang Cold Damage (Shanghan), Taiyang and Yangming are at the exterior, while the Three Yin channels are at the interior. Excess Yang causes heat, excess Yin causes cold. Since Shaoyang resides halfway between the exterior and interior, it presents with alternating chills and fever. However, in plague diseases, the Qi of the Three Yin channels transforms into heat following Yang, presenting only with fever and no chills. The Shaoyang channel descends from the head to the neck, connects with the ear, follows the hypochondrium, and runs along the side of the body; thus, it causes chest and hypochondriac pain and deafness. Fire has the nature of flaming upward, and upward flaming produces a bitter taste; hence, there is dryness of the throat and a bitter taste in the mouth. Internal stagnation of Ministerial Fire scorches Lung Metal; internal stagnation of Jia Wood overacts on Stomach Earth. With no external outlet for release, the pathogenic fire will inevitably scorch Spleen Earth, flow into Lung Metal, and enter the Yangming channel. At this stage, a cooling and harmonizing method should be employed to disperse the fierce inflammation. Hongyu Dan (Red Rain Pill) is indicated.

Hongyu Dan: Treats chest and hypochondriac pain, deafness, bitter taste in the mouth, and dry throat caused by Shaoyang channel pathology.
Chai Hu (Bupleuri Radix, 2 qian), Huang Qin (Scutellariae Radix, 1 qian), Shao Yao (Paeoniae Radix Alba, 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian), Dan Pi (Moutan Cortex, 1 qian), Yuan Shen (Scrophulariae Radix, 1.5 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 2 qian).
Decoct with flowing water until half a cup remains. Take hot, then cover with clothing to induce slight sweating.

When the meridians of the Three Yang channels are affected but the pathogen has not yet entered the Fu organs, the treatment principle should be diaphoresis (sweating). However, plague diseases differ from Cold Damage and Wind Strike due to different climatic influences; acrid-warm herbs like Ephedrae Herba (Ma Huang) and Cinnamomi Ramulus (Gui Zhi) are unsuitable. Instead, one should supplement with clearing and moistening agents to cool and drain the dry-heat in the meridians. This constitutes the diaphoretic method for plague diseases. The pathogen injures Wei Qi and enters Ying Blood; Ying Qi stagnation causes fever. Therefore, Moutan Cortex (Dan Pi) and Paeoniae Radix Alba (Shao Yao) are used to drain heat and cool the Ying level.

Vertigo, Deafness, Bitter Taste in Mouth, Dry Throat, Chest Pain, Hypochondriac Fullness, Vomiting, Diarrhea/Dysentery
If the heat in the Yangming channel of plague does not resolve, it transmits to the Shaoyang channel. Shaoyang lies interior to the Two Yang channels (Taiyang and Yangming) and exterior to the Three Yin channels. Excess Yin transmits to the Taiyin Zang organs, while excess Yang transmits to the Yangming Fu organs. Shaoyang serves as the gateway for transmission into the Fu and Zang organs. In plague, Ying Qi stagnation and excessive heat cause Fire to flourish and Wood to wither; thus, transmission usually occurs to the Stomach Fu organ rather than the Spleen Zang organ. Transmission to the Stomach means Wood pathogen oppresses Earth, leading to stagnation of Fu Qi and resulting in vomiting and diarrhea/dysentery. It is appropriate to clear and disperse the pathogen in the channels to block its entry into the Fu organs.

Xiao Chai Hu Tang plus Tian Hua Fen and Shao Yao Decoction: Treats vertigo, deafness, bitter taste in the mouth, dry throat, and chest pain caused by Shaoyang channel pathology.
Chai Hu (Bupleuri Radix, 3 qian), Huang Qin (Scutellariae Radix, 2 qian), Ban Xia (Pinelliae Rhizoma Preparatum, 1.5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 2 qian), Shao Yao (Paeoniae Radix Alba, 2 qian), Tian Hua Fen (Trichosanthis Radix, 2 qian).
Decoct with flowing water until half a cup remains. Take hot, then cover with clothing to induce slight sweating.

Da Chai Hu Tang plus Xuan Shen and Di Huang Decoction: Treats vomiting and diarrhea/dysentery when Shaoyang pathology transmits to the Yangming Stomach Fu organ.
Chai Hu (Bupleuri Radix, 3 qian), Huang Qin (Scutellariae Radix, 1 qian), Ban Xia (Pinelliae Rhizoma Preparatum, 2 qian), Shao Yao (Paeoniae Radix Alba, 2 qian), Zhi Shi (Aurantii Fructus Immaturus, 1 qian, bran-fried), Da Huang (Rhei Radix et Rhizoma, 2 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 2 qian), Da Zao (Jujubae Fructus, 2 pieces, split), Xuan Shen (Scrophulariae Radix, 1 qian), Sheng Di Huang (Rehmanniae Radix Praeparata, 2 qian).
Decoct with flowing water until half a cup remains. Take warm.

Transmission of Three Yang Pathology to the Stomach Fu Organ
If the heat in the channels of plague does not resolve and there is no external outlet for release, it is impossible for the pathogen to remain solely in the meridians without transmitting to the Stomach Fu organ. This is a natural hierarchical progression, necessitating purgative and draining methods. Dry-heat in Stomach Earth inevitably scorches the Yin fluids of the Zang organs. The essence and fluids of the Lungs, Spleen, Liver, and Kidneys have long been simmered by Ministerial Fire; compounded by blazing dry-heat, the Zang Yin will inevitably become exhausted. One must nourish the Zang Yin and drain the Fu heat to prevent Yang hyperactivity and Yin depletion. Baiying Dan (White Herb Pill) is indicated.

Baiying Dan: Treats Yangming Fu organ disease presenting with delirium, abdominal fullness, tidal fever, and thirst.
Da Huang (Rhei Radix et Rhizoma, 3 qian), Mang Xiao (Natrii Sulfas, 1 qian), Zhi Cao (Prepared Glycyrrhizae Radix et Rhizoma, 1 qian), Zhi Shi (Aurantii Fructus Immaturus, 1 qian, fried), Hou Po (Magnoliae Officinalis Cortex, 1.5 qian, ginger juice-fried), Xuan Shen (Scrophulariae Radix, 2 qian), Mai Dong (Ophiopogonis Radix, 4 qian, heart removed), Dan Pi (Moutan Cortex, 2 qian), Shao Yao (Paeoniae Radix Alba, 2 qian), Sheng Di Huang (Rehmanniae Radix Praeparata, 3 qian).
Decoct with flowing water until half a cup remains. Take hot.

Yangming corresponds to Wu Earth and ranks first among the Three Yang channels. When Yang Qi reaches its peak, it ultimately returns to Yangming and enters the Stomach Fu organ. The root cause of all Three Yin Zang diseases in plague is Stomach Heat. Although it is said that all five Zang and six Fu organs may be diseased, the Yangming Stomach Fu organ acts as the general guideline. Regardless of which Zang or Fu organ exhibits internal heat, the primary treatment is to drain Stomach heat, supplemented by clearing the respective channel. If the intestines and stomach have not reached a state of dry impaction, one should merely nourish the Zang Yin without using Cheng Qi Decoctions. Even if dry impaction is not severe, one should wait until the meridian cycle concludes and the Fu pathogen becomes internally solid before employing heat-draining and Yin-nourishing methods; a single purge will clear the heat. If dry-heat is extremely vigorous, one should not adhere to the number of days; purgatives can be used immediately. In such cases, the urgent purgative method of Cold Damage should be adopted, rather than the slow attack guidelines, because the internal heat is stagnant and latent, fundamentally differing from Cold Damage.

Transmission of Three Yang Pathology to the Stomach Fu Organ Manifesting as Macules/Rashes
In plague diseases affecting the Three Yang channels, Ying Qi stagnation and excessive heat inevitably transmit internally to the Stomach Fu organ. The Stomach Yang is naturally vigorous; dry-heat is triggered. The channels and Fu organs share the same Qi, affecting both exterior and interior. Internal pressure from Fu heat consumes Zang Yin. If the disease persists beyond the conclusion of the meridian cycle, it becomes critical. The greatest taboo in plague is the inability of Ying heat to vent externally. This occurs because Defensive Qi is excessive while Nutritive Qi is deficient, and Spleen Yin is deficient while Stomach Yang is vigorous. If Spleen Yin is not deficient and Stomach Yang is not vigorous, after the Six Channels have circulated, if the pathogen desires to transmit internally but the Zang Qi repels it, defending against the channel pathogen, the heat will have no gap to sink inward. Instead, it will vaporize and vent through the skin and hair, manifesting as macules/rashes, resulting in a milder disease. However, once the pathogen enters the Stomach Fu organ, Fu Yang increases daily, causing Zang Yin to wither daily. Purging becomes necessary. For a mild course, purge after the meridian cycle concludes; for an acute course, purge before the meridian cycle concludes. Once the Fu heat is cleared, the channel heat will reach the exterior, and red macules/rashes will appear.