胁痛耳聋
少阳经以相火主令，足少阳以甲木而化气于相火，须则下蛰而温肾水，逆则上
炎而刑肺金，故少阳经最易病火。瘟病寒水失藏，相火炎蒸，已旺于衰废之时。春夏感病，卫闭
营郁，热盛火发，势当得令之候，愈极重赫。彼少阳伤寒，二阳在表，三阴在里，阳盛则热，阴盛
则寒，少阳居表里之半，是以往来寒热。至于瘟病，三阴经气从阳化热，故但热而无寒也。其经
自头下项，络耳循胁，行身之侧，故胸胁痛而耳聋。火曰炎上，炎上作苦，故咽干而口苦。相火
内郁，则刑肺金。甲木内郁，则克胃土。外无泄路，势必焦土流金而入阳明。当以清凉和解之法，
散其炎烈。红雨丹主之。
红雨丹 治少阳胸胁疼，耳聋，口苦咽干。
柴胡（二钱） 黄芩（一钱） 芍药（一钱） 甘草（一钱） 丹皮（一钱） 元参（钱半）
生姜（二钱）
流水煎大半杯，热服，覆衣取微汗。
三阳经络皆受其病，而未入于腑者，法应汗之，但瘟病与伤寒、伤风，寒暄异气，不宜麻桂辛
温，滋以清润之剂，凉泄经络燥热，方是瘟病汗法。其伤在卫气，而病在营血，营郁发热，故用
丹皮、芍药，泄热而凉营也。
目眩耳聋口苦咽干胸痛胁痞呕吐泄利
瘟疫阳明经热不解，则入少阳之经，少阳在二阳之里，三阴之表，阴盛则传太阴之脏，阳盛
则传阳明之腑。少阳者，入腑入脏之门户，瘟疫营郁热盛，火旺木枯，故但传胃腑，而鲜入脾脏。
传胃则木邪逼土，腑气郁遏而生吐利，是宜清散经邪，杜其入腑之路也。
小柴胡加花粉芍药汤 治少阳经目眩耳聋，口苦咽干，胸痛。
柴胡（三钱） 黄芩（二钱） 半夏（钱半，制） 甘草（一钱） 生姜（二钱） 芍药（二钱）
天花粉（二钱）
流水煎大半杯，热服，覆衣取微汗。
大柴胡加元参地黄汤 治少阳经传阳明胃腑，呕吐泄利。
柴胡（三钱） 黄芩（一钱） 半夏（二钱，制） 芍药（二钱） 枳实（一钱，麸炒）
大黄（二钱）
生姜（二钱） 大枣（二枚，劈） 元参（一钱） 生地（二钱）
流水煎大半杯，温服。
三阳传胃
瘟病经热不解，外泄无路，断无但在经络，不传胃腑之理。此自然之层次，则宜用攻泄。盖胃
土燥热，必烁脏阴，其肺脾肝肾精液，久为相火煎熬，益以燥热燔蒸，脏阴必至枯竭。是当滋其脏
阴，泄其腑热，勿令阳亢而阴亡也。白英丹主之。
白英丹 治阳明腑病，谵语腹满，潮热作渴。
大黄（三钱） 芒硝（一钱） 炙草（一钱） 枳实（一钱，炒） 浓朴（钱半，姜汁炒） 元
参（二钱） 麦冬（四钱，去心） 丹皮（二钱） 芍药（二钱） 生地（三钱）
流水煎大半杯，热服。
阳明戊土，位居三阳之长，阳盛之极，必皆归宿阳明而入胃腑。瘟疫三阴脏病，悉以胃热为之
根本，虽曰五脏六腑皆受病，而阳明胃腑实其纲领也。其里热发作，不拘在何脏腑，总以泄胃为
主，而兼清本部。但肠胃未至燥结，则第滋脏阴，不
须承气。即燥结未甚，亦当俟之经尽之后，腑邪内实，始用泄热滋阴之法，一下而清矣。若燥热
隆盛，则不拘日数，俱可泄下，是当用伤寒急下之法，不可循伤寒缓攻之条，以其内热郁伏，原
与伤寒不同也。
三阳传胃发斑
瘟疫三阳经病，营郁热盛，势必内传胃腑，胃阳素旺，燥热感发，经腑同气，表里俱病，腑
热内逼，而脏阴消烁，过经不解则危。瘟疫所最忌者，营热不能外泄。盖以卫盛而营衰，脾阴虚而
胃阳旺也。若脾阴不衰，胃阳不旺，六经既遍，邪欲内传，而脏气 格，外御经邪，热无内陷之
隙，则蒸泄皮毛，发为斑点，而病轻矣。若一入胃腑，腑阳日盛，则脏阴日枯，不得不用泄法，
缓则泄于经尽之后，急则泄于经尽之前。腑热一清，则经热外达而红斑发矣。
胁痛与耳聋
少阳经由相火主持其功能，足少阳胆经以甲木之气在相火中化生。正常情况下，相火应潜藏于下以温煦肾水；若逆乱则向上炎蒸，灼伤肺金。因此，少阳经最容易发生火邪为病。瘟疫病中，寒水失于封藏，相火炎上蒸腾，已在正气衰废之时变得旺盛。春夏季节感受病邪，卫气闭塞、营气郁滞，热盛火发，正值得令之时，病情会极其严重猛烈。至于少阳伤寒，二阳（太阳、阳明）在表，三阴在里，阳气盛则发热，阴气盛则恶寒，少阳位于表里之间，所以表现为往来寒热。而瘟疫病中，三阴经的气机从阳化热，所以只发热而不恶寒。少阳经脉从头下行至颈部，联络耳朵，沿胁肋行走，经过身体侧面，所以出现胸胁疼痛和耳聋。火性炎上，炎上则味苦，所以咽喉干燥且口苦。相火内郁，会灼伤肺金；甲木内郁，会克制胃土。由于外部没有宣泄的途径，火势势必焦灼脾土、流注肺金并传入阳明经。此时应当采用清凉和解的方法，来疏散其猛烈之火。使用红雨丹主治。
红雨丹：治疗少阳经引起的胸胁疼痛、耳聋、口苦咽干。
柴胡（二钱） 黄芩（一钱） 芍药（一钱） 甘草（一钱） 丹皮（一钱） 元参（钱半） 生姜（二钱）
用流动的水煎取大半杯，热服，覆盖衣物以取得微汗。
三阳经络都受到病邪侵袭，但尚未传入腑脏的，治法应当发汗。但是瘟疫病与伤寒、伤风不同，寒暖异气，不宜使用麻黄、桂枝等辛温药物，而应辅以清润之剂，凉泄经络中的燥热，这才是瘟疫病的发汗法。病邪伤及卫气，进而深入营血，营气郁滞导致发热，所以使用丹皮、芍药，以泄热并凉营。
目眩、耳聋、口苦、咽干、胸痛、胁部痞闷、呕吐、泄泻痢疾
瘟疫阳明经的热邪不解，就会传入少阳经。少阳位于二阳（阳明、太阳）之里，三阴之表。阴气盛则传变至太阴脏，阳气盛则传变至阳明腑。少阳是病邪入腑入脏的门户。瘟疫营气郁滞、热势亢盛，火旺导致木枯，所以病邪多传变至胃腑，很少传入脾脏。病邪传入胃腑，则木邪逼迫脾土，腑气郁遏而产生呕吐和泄利，此时适宜清散经邪，杜绝其传入腑脏的路径。
小柴胡加花粉芍药汤：治疗少阳经引起的目眩、耳聋、口苦咽干、胸痛。
柴胡（三钱） 黄芩（二钱） 半夏（钱半，制过） 甘草（一钱） 生姜（二钱） 芍药（二钱） 天花粉（二钱）
用流动的水煎取大半杯，热服，覆盖衣物以取得微汗。
大柴胡加元参地黄汤：治疗少阳经病邪传入阳明胃腑，出现呕吐、泄利。
柴胡（三钱） 黄芩（一钱） 半夏（二钱，制过） 芍药（二钱） 枳实（一钱，麸炒） 大黄（二钱） 生姜（二钱） 大枣（两枚，劈开） 元参（一钱） 生地（二钱）
用流动的水煎取大半杯，温服。
三阳经病邪传入胃腑
瘟疫病经热不解，外部没有宣泄途径，绝不可能仅在经络停留而不传入胃腑。这是自然的传变层次，因此适宜使用攻下泄热之法。因为胃土燥热，必然灼烧脏腑之阴液，肺、脾、肝、肾的精液，长期被相火煎熬，再加上燥热燔蒸，脏腑之阴必至枯竭。此时应当滋养脏腑之阴，泄除腑中之热，防止阳气亢盛而阴液亡失。使用白英丹主治。
白英丹：治疗阳明腑病，出现谵语、腹满、潮热、口渴。
大黄（三钱） 芒硝（一钱） 炙甘草（一钱） 枳实（一钱，炒） 浓朴（钱半，姜汁炒） 元参（二钱） 麦冬（四钱，去心） 丹皮（二钱） 芍药（二钱） 生地（三钱）
用流动的水煎取大半杯，热服。
阳明戊土，位居三阳之首，阳气盛极，最终都会归宿于阳明并进入胃腑。瘟疫三阴脏的病证，都以胃热为根本原因，虽然说是五脏六腑都受病，但阳明胃腑实际上是纲领所在。体内的热邪发作，不论在哪个脏腑，总以泄胃热为主，兼清本经之热。但如果肠胃尚未达到燥结程度，则只需滋养脏阴，不需要使用承气汤类方剂。即使燥结不严重，也应当等待经尽之后，待腑邪内实，才使用泄热滋阴的方法，一次攻下即可清除热邪。如果燥热非常隆盛，则不拘泥于日数，都可以使用泄下法，这时应当采用伤寒急下之法，不可遵循伤寒缓攻的条文，因为其内热郁伏，原本就与伤寒不同。
三阳经病邪传入胃腑并发斑疹
瘟疫三阳经的病证，营气郁滞、热势亢盛，势必内传胃腑。胃阳素来旺盛，燥热感发，经与腑同气，表里俱病，腑热内逼，导致脏阴消烁，如果超过经尽之日仍不解则危险。瘟疫最忌讳的是营热不能向外宣泄。这是因为卫气盛而营气衰，脾阴虚而胃阳旺。如果脾阴不衰，胃阳不旺，六经遍行后，邪气欲内传，但脏气格拒，抵御经邪，热邪没有内陷的空隙，就会蒸泄于皮毛，发为斑点，这样病情就轻了。如果病邪一旦进入胃腑，腑阳日益强盛，则脏阴日益枯竭，不得不使用泄法。缓则泄于经尽之后，急则泄于经尽之前。腑热一旦清除，经热就会外达而发出红斑。
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.