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If there is pain in the chest and hypochondrium, deafness, and both the Cun (inch) and Chi (cubit) pulses are wiry (Xian), it indicates a disease of the Shaoyang (Lesser Yang) channel (As discussed in *Huo Ren Shu*, Chaihu Tang is indicated).

When pathogenic factors accumulate as excess in the chest, causing depression and pain, inability to eat, and if pressing on the chest induces salivation accompanied by diarrhea more than ten times, yet the pulse is surprisingly slow with a slightly slippery Cun pulse, this condition can be treated with emesis (vomiting), after which the diarrhea will cease.

After vomiting or purging, if there is a desire to vomit, chest pain, loose stools, abdominal fullness, and irritability, Tiaowei Chengqi Tang is appropriate (see detailed discussion under "Vomiting").

Deafness has two causes: one results from excessive sweating leading to deficiency, and the other arises from Shaoyang wind-strike. If there is chest and hypochondriac pain, deafness, and wiry pulses at both Cun and Chi positions, it signifies a Shaoyang disease.

Before taking the pulse, if the patient covers their heart with their hands, and when asked to cough does not do so, this must be due to deafness preventing them from hearing the command. This occurs because excessive sweating has caused deficiency (Huangqi Jianzhong Tang may be used). In Shaoyang wind-strike, with bilateral deafness, red eyes, chest fullness, and irritability, emesis and purgation are contraindicated; misusing them leads to palpitations and fright (Xiao Chaihu Tang may be used).

Simultaneous disease of the Shaoyang and Jueyin channels presents with deafness, retraction of the testicles, and cold limbs, known as a Lianggan syndrome. If Jueyin Ying and Wei qi fail to circulate, resulting in deafness, testicular retraction, and unconsciousness, the condition is critical. For Damp-Warmth syndrome, treatment focuses on the Taiyin channel; sweating is contraindicated. If sweated, the patient may become mute, deaf, unaware of their illness, with bluish skin and altered complexion, termed "Zhong" (Baitu Jia Cangzhu Tang is indicated).

Yang Du (Yang Toxin) syndrome, upon initial onset, involves deep and heavy pathogenic toxins. If sweating should have been induced but was not, or purgation should have been used but was not, or if after vomiting/purging heat pathogens enter due to deficiency, or if hot medicines are mistakenly taken causing toxic heat to spread like adding firewood to a fire, symptoms include six pulses being deep and solid, tongue rolling and scorched black, nostrils resembling soot, rash patterns like brocade on the body and face, delirious speech, running and jumping, climbing walls and roofs, singing while standing high, discarding clothes and running. These are all manifestations. Treatable within five days; untreatable after six to seven days.

Shengma Biejia Tang: Treats Yang Du disease with red face, brocade-like rashes, sore throat, and expectoration of pus and blood.
Ingredients: Shengma (2 liang), Danggui, Shujiao (stir-fried to remove moisture), Gancao (each 1 liang), Biejia (one piece the size of a finger), Xionghuang (half a liang, ground). The above six ingredients are boiled in four sheng of water to yield one sheng, taken in one dose. Sweating indicates cure. *Zhouhou Beiji Fang* and *Qianjin Fang* contain Guizhi but no Biejia in Yang Du Shengma Tang; Yindu Gancao Tang contains no Xionghuang.

Appendix:
*Huo Ren Shu* Yang Du Shengma Tang: Treats Shanghan becoming Yang Du within one or two days, or transforming into Yang Du after vomiting/purgation. Symptoms include back pain, restlessness, red face, delirium, running, hallucinations, diarrhea, floating-large-rapid pulses, red face with brocade-like rashes, sore throat, and expectoration of pus and blood. Treatable within five days; untreatable after six to seven days.
Ingredients: Shengma, Xijiao (sliced), Shegan, Huangqin, Renshen, Gancao (equal parts). Crushed, decocted in water, taken again after a meal duration, covered warmly to induce sweat in hands and feet. Repeat if unresolved.

Yang Du Zhizi Tang: Treats Yang Du Shanghan with fever and pain in all joints.
Ingredients: Shengma, Huangqin, Xingren, Shigao (each 2 qian), Zhizi, Chishaoyao, Zhimu, Daqing (each 1 qian), Gancao (5 fen), Chaihu (1.5 qian). Crushed, take half a liang per dose with five slices of Shengjiang and one hundred grains of Chishao, decocted together.

Dahuang San: Treats unresolved Yang Du Shanghan with internal heat, mental confusion resembling mania.
Ingredients: Dahuang (1.5 liang), Guixin (7.5 qian), Gancao (roasted), Mangxiao, Dafupi, Mutong (each 1 liang), Taoren (21 pieces). Crushed, decocted in water, stop when bowels move freely.

Haizang Ge Gen San: Treats Yang Du with intense body heat, headache, restlessness, thirst, dry and painful throat.
Ingredients: Gegen (7.5 qian), Huangqin, Dahuang (vinegar-fried), Gancao, Zhizi, Puxiao (each half liang). Crushed, decocted in water.

*Huo Ren Shu* Hei Nu Wan: Treats epidemic diseases where no sweat has occurred after six to seven days, with large or rapid pulses, red face, eye pain, intense body heat, restlessness, delirium, urge to run, extreme thirst. Also treats lingering heat in the chest after five to six days, jaw stiffness preventing speech, classified as damaged Shanghan deemed incurable by physicians, or where vital essence is exhausted but warmth remains in the epigastrium; administering medicine can revive the patient. Also treats Yang Du and macules.
Ingredients: Mahuang (deprived of joints, soaked, 3 liang), Dahuang (2 liang), Fudi Mei (ground), Huangqin, Mangxiao, Zaotu Mo (ground), Liangshang Chen, Xiaomai Nu (each 1 liang). Powdered, honey-pilled to the size of a bullet. Dissolve one pill in fresh well water and administer. Give cold water if thirsty. Cold chills followed by sweating indicate recovery. If no sweat, administer another pill; slight diarrhea is effective. Xiaomai Nu refers to immature wheat spikes that fail to develop grain, turning black when rubbed. This medicine is only suitable for patients with extreme thirst and severe restlessness; administering it to non-thirsty patients causes harm.
For large pulses, internal/external heat accumulation, curled scorched-black tongue, and soot-like nostrils, apply wet cloth compresses to the chest, replacing with cold water repeatedly. For severe heat, immerse the patient in water until heat subsides. This is also a good method.

Dansha Wan: Treats critical conditions of Yin and Yang Du in Shanghan.
Ingredients: Boshang Liuhuang, Shuiyin, Taiyin Yuanjing Shi, Taiyang Shi (each 1 liang), Xiaoshi (half liang). Powdered, stir-fried evenly in a clean pot over mild heat until gray, then ground finely. Mix with fresh ginger juice and steamed bread dough to form mung-bean-sized pills. Take five pills per dose with Longnao, ginger, and honey water to suppress agitation. For Yang Du, use jujube soup; for Yin Du, use plain water. Do not roast under the eaves.
Baitu Jia Renshen Tang is also called Huaban Tang. For severe macules, Qingdai Yi Wu Tang. For sore throat, Xuanshen Shengma Tang.

Qingdai Yi Wu Tang:
Ingredients: Qingdai (date-sized), ground in fresh well water and taken.

Xuanshen Shengma Tang:
Ingredients: Shengma, Xuanshen, Gancao (each half liang), decocted in three zhan of water to yield one and a half zhan, strained and taken.

Tao Hua: If medication fails for Yang Du Shanghan with peeling skin on hands and feet, body red as cinnabar, eyes fiery, extreme thirst and agitation, strong large pulses, and unconsciousness, Sanhuang Shigao Tang is indicated.
Alternatively, use Shengma Zhizi Tang to induce vomiting. If heat causes alternating mania and coma with jaw clenching where oral medication cannot be swallowed, use water compresses. Wait for jaw relaxation and reduced agitation before administering medicine, such as Hei Nu Wan, which should not be used lightly.

Li Dongyuan: Yang depends on Yin, Yin depends on Yang. Without Yang, Yin cannot transform; without Yin, Yang cannot generate. They cannot exist independently. Zhang Zhongjing stated: If Yang qi fails first and Yin qi later, death ensues with blue complexion; if Yin qi fails first and Yang qi later, death ensues with red complexion. Thus, Yin and Yang qi in the body must not be excessively deficient. Extinction means no return to life. *Huo Ren Shu* discusses Yin Du as Yang qi failure and Yang Du as Yin qi failure. Once extinct, it is incurable. These are severe cases involving toxic vapors, hence medicines like Shengma, Xijiao, Xionghuang, and Daqing are used to resolve toxicity. Once Yang Du resolves, Yin qi recovers; once Yin Du resolves, Yang qi recovers, leading to resolution via profuse sweating. Why does *Huo Ren Shu* not define Yang Du as extreme Yang excess and minimal Yin, and Yin Du as extreme Yin excess and minimal Yang, to avoid implying total extinction?