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[Combined Disease of Exterior and Interior Must Present with Diarrhea]
When the Taiyang (Taiyang Channel) and Yangming (Yangming Channel) channels are simultaneously affected (He Bing), spontaneous diarrhea will inevitably occur; Gegen Tang (Kudzu Decoction) should be administered. If there is no diarrhea but vomiting occurs, Gegen Jia Banxia Tang (Gegen plus Pinellia Decoction) should be administered.
When the Taiyang (Taiyang Channel) and Shaoyang (Shaoyang Channel) channels are simultaneously affected (He Bing), if spontaneous diarrhea occurs, Huangqin Tang (Scutellaria Decoction) should be administered; if accompanied by vomiting, Huangqin Jia Banxia Shengjiang Tang (Huangqin plus Pinellia and Fresh Ginger Decoction) should be administered.
When the Yangming (Yangming Channel) and Shaoyang (Shaoyang Channel) channels are simultaneously affected (He Bing), diarrhea will inevitably occur. If the pulse is slippery and rapid, it indicates retained food stagnation; purgative therapy should be employed, and Dachengqi Tang (Major Order the Qi Decoction) is appropriate. (For detailed discussions on diarrhea, see the "Diarrhea" section.)

[Bing Bing - Sequential Affection of Channels]
Taiyang (Taiyang Channel) and Yangming (Yangming Channel) sequential affection: After sweating treatment for Taiyang channel pathogen, if not thorough, the pathogen transfers to the Yangming channel. The patient presents with spontaneous sweating, aversion to cold has ceased, yet Taiyang symptoms persist, manifesting as facial redness, restlessness, shortness of breath. Re-sweating therapy should be applied to achieve cure.
Taiyang (Taiyang Channel) and Yangming (Yangming Channel) sequential affection: When Taiyang symptoms have resolved, presenting with tidal fever and delirium, purgative therapy should be applied to achieve cure. (See "Delirium" section for related discussion.)
Taiyang (Taiyang Channel) and Shaoyang (Shaoyang Channel) sequential affection: Manifesting with neck stiffness, dizziness, and epigastric hardness resembling Jie Xiong (Chest Binding Syndrome). Acupuncture at Xionshu (BL-17) and Ganshu (BL-18) points should be performed. (See "Neck Stiffness" section for related discussion.)

[Analysis of Combined and Sequential Affections]
Simultaneous affection of two channels is called He Bing (Combined Disease); when symptoms of one channel resolve and merge into another, it is called Bing Bing (Sequential Affection).
Taiyang and Yangming He Bing presents in three patterns. Due to differences in the depth of pathogen invasion, treatments vary between sweating, purging, and harmonizing. Refer to respective sections for specific treatments.
San Yang (Three Yang Channels: Taiyang, Yangming, Shaoyang) He Bing presents in two patterns: one pattern is treated with Baihu Tang (White Tiger Decoction); the other lacks a fixed standard treatment, with later practitioners often using Xiaochaihu Tang (Minor Order the Qi Decoction) or Baihu Tang. This is because both patterns exhibit signs of all three Yang channels, thus neither simple sweating nor purging is appropriate.
Er Yang (Two Yang Channels: Taiyang, Yangming) Bing Bing presents in two patterns: if exterior syndrome is unresolved, sweating therapy is indicated; if exterior is resolved and interior excess exists, purging therapy is indicated.
Taiyang and Shaoyang Bing Bing presents in three patterns:
1. Caused by erroneous purging leading to epigastric hardness forming Jie Xiong (Chest Binding Syndrome).
2. Neck stiffness resembling Rou Jing (Soft Spasm), with epigastric hardness like Jie Xiong. Acupuncture at Feishu (BL-13) and Ganshu (BL-18) is indicated. Sweating must be strictly avoided, otherwise delirium will persist; Qimen (LR-14) acupuncture is suitable.
3. Epigastric hardness, neck stiffness, and dizziness. Dazhui (GV-14) and Feishu (BL-13) acupuncture is indicated. Purging is contraindicated.

[Detailed Explanation of He Bing]
Taiyang and Yangming He Bing, if presenting with chest fullness and wheezing, cannot be purged; Mahuang Tang (Ephedra Decoction) should be used.
Taiyang and Yangming He Bing, if presenting with spontaneous diarrhea, use Gegen Tang (Kudzu Decoction); if no diarrhea but vomiting occurs, use Gegen Jia Banxia Tang (Gegen plus Pinellia Decoction). (Alternatively explained: Taiyang exterior remains unresolved while Yangming interior pathogen arrives. Heat from combined Yang pathogens is intense on the exterior and attacks the interior via deficiency, causing diarrhea. If no diarrhea but vomiting occurs, the pathogen attacks the interior but has not entered the Stomach, causing Qi rebellion and vomiting; thus Banxia (Pinellia) is added to stop vomiting. Pang Shi stated: Exterior signs necessarily include headache, lower back pain, muscle heat, eye pain, and nasal dryness. Floating-large pulse indicates Taiyang disease; long pulse indicates Yangming disease. Head and waist belong to Taiyang; muscles, eyes, and nose belong to Yangming.)
Taiyang and Shaoyang He Bing, if presenting with spontaneous diarrhea, use Huangqin Tang (Scutellaria Decoction); if accompanied by vomiting, use Huangqin Jia Banxia Tang (Huangqin plus Pinellia Decoction). (Alternatively explained: This is exterior excess and interior deficiency, with heat invading and attacking the interior, causing spontaneous diarrhea. If phlegm-fluid retention is present, vomiting occurs.)
Yangming and Shaoyang He Bing inevitably presents with diarrhea. A long pulse is a favorable sign (Shun); dizziness indicates an unfavorable sign (Fu/Negative), representing overcoming and harming. A slippery and rapid pulse indicates retained food; Dachengqi Tang (Major Order the Qi Decoction) should be used for purging. (Alternatively explained: Yangming belongs to Earth, Shaoyang to Wood. A string-like pulse indicates Wood overacting on Earth; without string-like quality, it is not overcoming. Overcoming leads to death. If slippery and rapid with retained food, it is not overcoming, hence purging is suitable.)
San Yang (Three Yang Channels) He Bing presents with abdominal fullness, body heaviness, difficulty turning, numbness of the mouth and face, greasy complexion, delirium, and urinary incontinence. Neither sweating nor purging is allowed. If spontaneous sweating occurs, Baihu Tang (White Tiger Decoction) should be used. San Yang He Bing with floating-large pulse seen at Guan position, somnolence, and sweating upon closing eyes, treat with Xiaochaihu Tang (Minor Order the Qi Decoction) or Baihu Tang (White Tiger Decoction). (Alternatively explained: Both patterns exhibit San Yang signs; thus sweating and purging are contraindicated.)

[Detailed Explanation of Bing Bing]
Taiyang and Yangming Bing Bing (Muscle-Releasing Method): Initial Taiyang disease treated with sweating was incomplete, transferring to Yangming. Continued mild spontaneous sweating and absence of aversion to cold indicate Dachengqi Tang (Major Order the Qi Decoction) [Note: Text says Da Chai Hu Tang here]. If Taiyang symptoms persist, purging is contraindicated; slight sweating may be attempted. If the face is entirely red, Yang Qi is constrained on the exterior due to incomplete sweating, causing restlessness, shortness of breath, and unknown pain locations. Re-sweating with Gegen Tang (Kudzu Decoction) is required.
Taiyang and Yangming Bing Bing (Purgative Method): When Taiyang symptoms resolve, presenting with tidal fever, sweating on hands and feet, difficult defecation, and delirium, Dachengqi Tang (Major Order the Qi Decoction) should be used.
Taiyang and Shaoyang Bing Bing, if erroneously purged, forms Jie Xiong (Chest Binding Syndrome), with epigastric hardness, incessant diarrhea, inability to take fluids, and irritability. Shengjiang Xiexin Tang (Fresh Ginger Decoction to Drain the Epigastrium) or Xiaoxianzhong Tang (Minor Trap-in-the-Center Decoction) should be used.
Taiyang and Shaoyang Bing Bing, presenting with neck stiffness and pain, or dizziness, sometimes resembling Jie Xiong (Chest Binding Syndrome), with epigastric stuffiness and hardness. Acupuncture at Dazhui (GV-14), Feishu (BL-13), and Ganshu (BL-18) is indicated. Sweating is contraindicated; if done, delirium will persist. Qimen (LR-14) acupuncture is indicated.
Taiyang and Shaoyang Bing Bing, with epigastric hardness, neck stiffness, and dizziness. Acupuncture at Dazhui (GV-14) and Feishu (BL-13) is indicated. Purging must be strictly avoided.

Zhao Sizhen long doubted the clarity of He Bing and Bing Bing concepts. Let us explain: He Bing refers to simultaneous affliction of two or three Yang channels without transmission. Bing Bing refers to prior affliction of one Yang channel followed by transmission to another.
For example, in Taiyang-Yangming Bing Bing, if the merging is incomplete, transmission is blocked, and exterior signs remain (as Zhongjing described: "Taiyang signs unresoved, facial redness, Yang Qi constrained on exterior, unable to vent, restlessness, shortness of breath"). In this case, Ge Ban Tang (Half-Half Decoction) should still be used for sweating. If merging is complete, transmission has occurred (as Zhongjing described: "Taiyang signs resolved, tidal fever, hand/foot sweating, hard stool, delirium"). In this case, Chengqi Tang (Order the Qi Decoction) should be used for purging. Thus, transmission enters the Fu organs; non-transmission does not. Therefore, Zhongjing lists only three patterns for Taiyang-Yangming He Bing as above, while describing Taiyang-Yangming Bing Bing emphasizes its transmissive nature.
Furthermore, mutual He Bing among Yang channels invariably presents with spontaneous diarrhea. Zhongjing uses Gegen Tang for Taiyang-Yangming He Bing, Huangqin Tang for Taiyang-Shaoyang He Bing, and Chengqi Tang for Shaoyang-Yangming He Bing. For Taiyang-Shaoyang Bing Bing, symptoms include head/neck stiffness, dizziness, resemblance to Jie Xiong, and epigastric stuffiness/hardness; acupuncture at Dazhui, Feishu, Ganshu is indicated, avoiding sweating and purging. Taiyang-Yangming Bing Bing is discussed above. However, for San Yang He Bing, Zhongjing does not mention aversion to cold on the back. Although cases exist with dry mouth/thirst, irritability, and slight back aversion to cold, these belong to Taiyang signs, not San Yang He Bing. *Huoren Shu* states San Yang He Bing includes back aversion to cold, which is incorrect. If San Yang combines with San Yin, it becomes Liang Gan (Double Cold), so San Yin has no He Bing cases.

Zhang Yuansu argued that "Bing" implies urging or supervising, not swallowing or merging. "Cu Bing" (urging) is pronounced with a departing tone, while "Tun Bing" (swallowing) is pronounced with an upper tone. *Records of the Grand Historian* states Qin Shi Huang initially "Bing" (unified/conquered) the world, illustrating this principle. The logic of "Bing" is that the previous illness is unresolved while the new illness arrives, creating a sense of coercion and combination, hence "Bing Bing". The classic states "Taiyang and Shaoyang Bing Bing, head/neck stiffness or dizziness," etc. If they were truly merged into one entity, Zhongjing would not list signs of both channels separately. This proves it is not merely the character "Bing".
Another view: Some ask if San Yang He Bing involving Taiyang-Yangming, Zheng Yang Yangming, and Shaoyang-Yangming is repetitive. I reply: Each has specific reference, differing only by exterior/interior distinction. San Yang He Bing is exterior; San Yang Yangming disease is interior. They are distinct paths, not repetitive. Exterior conditions require dispersing resolution; interior conditions require purging. Since exterior and interior treatments differ significantly, they only appear repetitive in indexing.