Library

Shaoyang disease manifests as bitter taste in the mouth, dryness of the throat, and dizziness.
This involves the Foot-Shaoyang Gallbladder Meridian (Zu Shao Yang Dan Jing). The *Neijing* states: "A person suffering from bitter taste in the mouth is diagnosed with Dan Fan (Gallbladder Heat)." The *Jiayi Jing* states: "The Gallbladder is the storehouse of essence; the decisions of the five zang organs depend on the Gallbladder, and the pharynx serves as its conduit." The Shaoyang meridian originates at the outer canthus of the eye. When the Shaoyang meridian is invaded by pathogenic factors, symptoms such as bitter taste in the mouth, dryness of the throat, and dizziness occur.

In Shaoyyang wind-strike syndrome, there is deafness in both ears, redness of the eyes, fullness in the chest accompanied by vexation. Purging or emesis must not be used; if employed, palpitations and fright will ensue.
The Shaoyang meridian originates at the outer canthus of the eye and enters the ear; its branch descends through the chest, piercing the diaphragm. Wind pathogens damage qi, and wind transforms into heat. In Shaoyang wind-strike, qi becomes congested and generates heat, resulting in deafness, red eyes, chest fullness, and vexation. The pathogen resides in the Shaoyang stage, which is a half-exterior, half-interior condition. Using emesis to remove vexation damages qi; qi deficiency leads to palpitations. Using purgatives to remove fullness depletes blood; blood deficiency leads to fright.

In cold damage, if the pulse is wiry and fine, accompanied by headache and fever, it belongs to Shaoyang disease. Shaoyang disease should not be treated with sweating methods; if sweated, delirium may occur. This condition involves the Stomach; if the Stomach harmonizes, recovery occurs; if the Stomach does not harmonize, vexation and palpitations result. (Zhao's edition notes: "Alternatively described as restlessness.")
The classic states: "When the pulses at all three positions are wiry, the Shaoyang is diseased." A fine pulse indicates that the pathogen is gradually transmitting inward. Although headache and fever persist, indicating the exterior is not yet resolved, because the pathogen lodges in the Shaoyang stage—half-exterior, half-interior—sweating is contraindicated. Sweating depletes body fluids, causing dryness in the Stomach. The Shaoyang pathogen, having transmitted to the Stomach, inevitably causes delirium. Tiaowei Chengqi Decoction (Regulate the Stomach and Downbear Excess Pill) should be administered to purge; if the Stomach harmonizes, recovery occurs. If not purged, the Stomach will be constrained by the Wood pathogen of Shaoyang, leading to vexation and palpitations.

If a pre-existing Taiyang disease fails to resolve and transmits to Shaoyang, presenting with hardness and fullness below the costal margin, dry retching, inability to eat, alternating chills and fever, and if no emesis or purging has yet been performed, but the pulse is deep and tight, Xiaochaihu Tang (Minor Bupleurum Decoction) should be given. (Zhao's edition includes the formula for Xiaochaihu Tang, detailed in Volume 3.)
Transmission from Taiyang to Shaoyang signifies the exterior pathogen entering the interior. Hardness and fullness below the costal margin, inability to eat, and alternating chills and fever indicate the pathogen is between the exterior and interior. If emesis or purging has already been performed and the pulse is deep and tight, the pathogen has sunk into the fu organs, constituting an interior excess syndrome. If emesis or purging has not yet been performed, and the pulse is deep and tight, although transmission to the interior has occurred, it has not fully entered the fu organs, and the exterior remains unresolved. Xiaochaihu Tang (Minor Bupleurum Decoction) should be given to harmonize.

If emesis, purging, sweating, or warm needle therapy have already been applied, resulting in delirium, and the indications for Chaihu Tang (Bupleurum Decoction) have ceased, this is termed a damaged disease. One must determine the nature of the iatrogenic error and treat accordingly.
The Shaoyang pathogen resides between the exterior and interior. Improper use of emesis, purging, sweating, or warm needles depletes body fluids, causing dryness in the Stomach. The Wood pathogen then constrains the Stomach, inevitably causing delirium. If the Chaihu indications persist, it is not considered an adverse reaction; if they cease, it is a damaged disease. One must investigate the cause of the therapeutic error and apply appropriate remedial methods.

In combined disease of the three yang meridians, the pulse is floating and large, prominent at the Guan position. The patient desires sleep, and sweating occurs when closing the eyes.
The Guan pulse reflects Shaoyang qi; the Taiyang pulse is floating, and the Yangming pulse is large. A floating and large pulse, prominent at the Guan position, indicates combined disease of the three yang meridians. Gallbladder heat causes somnolence. In Shaoyin disease, the patient also desires sleep, but there is no sweating upon closing the eyes, as yin conditions do not typically present with sweating. Desire for sleep accompanied by sweating upon closing the eyes indicates combined disease of the three yang meridians and heat in the Gallbladder.

In cold damage lasting six or seven days, with no significant external heat, yet the patient exhibits restlessness and vexation, this indicates the departure of yang and entry into yin.
The exterior is yang, and the interior is yin. When the pathogen is in the exterior, there is external heat. At six or seven days, it is the time for the pathogen to enter the interior. The absence of significant external heat, coupled with internal restlessness and vexation, indicates that the exterior pathogen has transmitted to the interior. Thus, it is said that yang departs and enters yin.

In cold damage after three days, the three yang meridians' pathogenic influence is exhausted, and the three yin meridians should be affected. However, if the patient can eat and does not vomit, this indicates that the three yin meridians are not affected by the pathogen.
On the fourth day of cold damage, if the exterior pathogen transmits to the interior and the interior is disharmonious, the patient cannot eat and will vomit. The fact that the patient can eat and does not vomit indicates that the pathogen does not transmit to the yin meridians but remains in the yang meridians.

In cold damage after three days, if the Shaoyang pulse becomes small, the disease is about to resolve.
The *Neijing* states: "A large pulse indicates the presence of pathogenic factors; a small pulse indicates peace/health." After three days of cold damage, when the pathogen transmits to Shaoyang, the pulse should be wiry and tight. A small pulse now indicates that the pathogenic factor is weak and the disease is nearing resolution.

Shaoyang disease tends to resolve during the hours of Yin to Chen (03:00–07:00).
The *Neijing* states: "Shaoyang among the yang meridians corresponds to the Qi of Spring." The hours of Yin, Mao, and Chen are when the Wood energy of Shaoyang is prosperous.