程知曰∶并病者，一经证多，一经证少，有归并之势也。太阳证罢，而归并阳明，但手足 汗出，是大
便已硬也，与大承气汤以下胃热可也。
太阳与少阳并病，头项强痛，或眩冒，时如结胸，心下痞硬者，当刺大椎、第一间、肺俞、肝俞。慎不可
发汗，发汗则谵语，脉弦。五六日谵语不止，当刺期门。
【注】太阳与少阳并病，故见头项强痛，或眩冒，时如结胸，心下痞硬之证。而曰或、曰时如者，谓两阳
归并未定之病状也。病状未定，不可以药，当刺肺俞，以泻太阳，以太阳与肺通也；当刺肝俞，以泻少阳，以
肝与胆合也。故刺而俟之，以待其机也。苟不知此，而以头项强痛为太阳之邪，目眩胸满
为少阳之邪，发其汗，两阳之邪乘燥入胃，则发谵语。设脉长大，则犹为顺，可以下之，今脉不大而弦，五六
日谵语不止，是土病而见木脉也，名曰负。负者，克贼也。慎不可下，当刺期门，以直泻其肝可也。
【集注】方有执曰∶并，犹合也。彼此相兼合，而有轻重多寡之不同，谓之并。盖少阳间隔阳明，去太阳
远，故但兼并也。
喻昌曰∶少阳之脉，络胁肋间，并入太阳之邪，则与结胸证似是而实非也。肝与胆合，刺肝俞所以泻胆也。
膀胱不与肺合，然肺主气，刺肺俞以通其气，斯膀胱之气化行，而邪自不能留矣。发汗则谵语，与合病木盛克
土之意同。脉弦亦即合病内少阳胜而阳明负之互词，刺期门以泻木邪之盛也。
林澜曰∶大椎即百劳穴，一椎上陷中，主泻胸中诸热气。第一间疑即商阳，在手食指内侧，主胸中气满，
热病汗不出。肝俞在九椎下，肺俞在三椎下，各去脊中二寸，二穴并主泻五脏之热。期门在乳根二肋端，主伤
寒，胸中烦热，过经汗不出。
太阳少阳并病，心下硬，颈项强而眩者，当刺大椎、肺俞、肝俞，慎勿下之。
【注】此承上条，戒不可下之义也。太阳、少阳并病，心下硬而眩者，少阳也；颈项强者，太阳也。当刺
肺俞、肝俞，以泻太阳、少阳之邪，慎不可下也。若以心下硬，而误下之，必变逆候矣。
【集注】成无己曰∶慎勿下之。攻少阳之邪，太阳之邪乘虚入里，必作结胸。经曰∶太阳、少阳并病，而
反下之，成结胸。
程知曰∶上言不可汗，此言不可下也。不可汗，恐其谵语；不可下，恐其结胸也。
程应旄曰∶此并病心下硬居首，颈项强而眩次之，似尚可下，不知少阳三法有禁，只可刺而慎勿下也。
汪琥曰∶大椎一穴，实合太、少而齐泻。诸家注皆不明用针之理，竟置大椎而不论，大误之极。
太阳少阳并病，而反下之，成结胸，心下硬，下利不止，水浆不下，其人心烦。
【注】此承上条，而言误下之变也。太阳、少阳并病，不刺肺俞、肝俞，而反下之，两阳之邪，乘虚陷里，
则时如结胸，竟成结胸矣。心下硬，变为下利不止，水浆不入矣。上不入而下常出，则中空无物，其人心烦忙
乱，而变成坏证，虽有前条刺法，亦无所用矣。
【集注】程知曰∶此二阳并病，误下之变也。太阳表邪乘虚入里，则为结胸，心下硬；少阳半里之邪，乘
虚入里，则为下利不止。上下俱病，而阳明之居中者，遂至水浆不入，而心烦也。
喻昌曰∶并病即不误用汗、下，已如结胸，心下痞硬矣，况又误下乎？故比太阳一经，误下之变殆有甚焉。
其人心烦似不了之语，然经谓结胸证具，躁烦者死，意此亦谓其人心烦者死乎？
汪琥曰∶太阳病在经者，不可下，少阳病，下亦在所当禁，故以下之为反也。
程知说：并病，是指一经的症状多，另一经的症状少，有归并的趋势。太阳证已罢，而归并于阳明经，仅手足出汗，这是大便已经硬结的表现，可以给予大承气汤来泻除胃中的热邪。
太阳与少阳并病，出现头项强痛，或者头晕目眩，有时感觉像结胸证（邪热与水饮互结于胸膈），心下痞塞坚硬者，应当针刺大椎穴、第一间穴、肺俞穴、肝俞穴。千万不要发汗，如果发汗则会出现谵语（神志不清，胡言乱语），脉象弦。到了五六天谵语仍不止，应当针刺期门穴。
【注】太阳与少阳并病，所以出现头项强痛，或者头晕目眩，有时感觉像结胸，心下痞塞坚硬的证候。文中用“或”、“时如”等词，是说两阳经的病势归并尚未确定的症状。病状未定，不可以用药治疗，应当针刺肺俞穴，以泻太阳经之邪，因为太阳经与肺脏相通；应当针刺肝俞穴，以泻少阳经之邪，因为肝脏与胆腑相合。所以通过针刺来等待时机。如果不知道这一点，而把头项强痛当作太阳经的邪气，把目眩胸满当作少阳经的邪气，使用发汗法，两阳经的邪气乘着燥热入胃，就会引发谵语。假如脉象长大，那还是顺证，可以用下法；现在脉象不大而且弦，五六天谵语不止，这是土（脾胃）有病却见到木（肝胆）的脉象，名叫“负”。负，就是克贼（相克）。千万不可用下法，应当针刺期门穴，以直接泻除肝经的邪气即可。
【集注】方有执说：并，就像合一样。彼此相互兼合，而有轻重多寡的不同，叫做并。大概因为少阳经间隔在阳明经之外，距离太阳经远，所以只是兼并而已。
喻昌说：少阳经的经脉，联络胁肋之间，并入太阳经的邪气，那么与结胸证看起来相似但实际上不同。肝脏与胆腑相合，针刺肝俞是为了泻胆腑的邪气。膀胱不与肺相合，但是肺主气，针刺肺俞以通调肺气，这样膀胱的气化功能才能运行，邪气自然不能停留。发汗导致谵语，与合病中木盛克土的意思相同。脉弦也是合病中少阳胜而阳明负的另一种说法，针刺期门是为了泻除木邪的亢盛。
林澜说：大椎穴即百劳穴，在第一椎骨上方的凹陷中，主治泻除胸中各种热气。第一间穴怀疑就是商阳穴，在手食指内侧，主治胸中气满，热病汗不出。肝俞穴在第九椎骨下方，肺俞穴在第三椎骨下方，各距脊柱中线二寸，这两个穴位都主治泻除五脏的热邪。期门穴在乳根穴旁第二肋骨端，主治伤寒，胸中烦热，过经汗不出。
太阳少阳并病，心下硬，颈项强并且眩晕者，应当针刺大椎穴、肺俞穴、肝俞穴，千万不要用下法。
【注】这是承接上一条，告诫不可用下法的意义。太阳、少阳并病，心下硬并且眩晕，属于少阳经；颈项强，属于太阳经。应当针刺肺俞、肝俞，以泻除太阳、少阳经的邪气，千万不可用下法。如果把心下硬误用下法，必然变成逆乱的证候。
【集注】成无己说：千万不要用下法。攻伐少阳经的邪气，太阳经的邪气乘虚入里，必然形成结胸。经文说：太阳、少阳并病，反而用下法，会形成结胸。
程知说：上面说不可发汗，这里说不可用下法。不可发汗，是担心引起谵语；不可用下法，是担心引起结胸。
程应旄说：这条并病中心下硬排在首位，颈项强且眩晕排在其次，似乎还可以用下法，但不知道少阳病有三禁，只可针刺而千万不要用下法。
汪琥说：大椎这一穴，实际上同时合泻太阳、少阳两经。各家注解都不明白用针的道理，竟然忽略大椎穴而不讨论，错误极大。
太阳少阳并病，反而用下法，形成结胸，心下硬，下利不止，水浆不入，其人心中烦乱。
【注】这是承接上一条，说明误用下法后的变证。太阳、少阳并病，不针刺肺俞、肝俞，反而用下法，两阳经的邪气乘虚陷入体内，那么有时感觉像结胸，最终竟成了结胸。心下硬，变成了下利不止，水浆不能入口。上边不能进，下边一直出，那么中空无物，其人心中烦乱忙迫，从而变成坏证，即使有前条的刺法，也没有用处了。
【集注】程知说：这是两阳经并病，误用下法后的变证。太阳表邪乘虚入里，就形成结胸，心下硬；少阳半里之邪，乘虚入里，就形成下利不止。上下都有病，而居中的阳明经，以至于水浆不能进入，而心烦。
喻昌说：并病即使不误用汗、下法，也已经像结胸，心下痞硬了，何况又误用下法呢？所以比太阳一经误用下法的变证几乎更严重。其人心烦这句话似乎语意未尽，然而经文说结胸证具备，躁烦者死，意思是这里也说其人心中烦乱的是死证吗？
汪琥说：太阳病在经者，不可用下法，少阳病，用下法也在所当禁，所以以下法为反治。
Cheng Zhi stated: Bingbing (concurrent disease) refers to a condition where one meridian presents with more symptoms and another with fewer, showing a tendency to merge. When the Taiyang syndrome resolves and merges into the Yangming meridian, manifesting only as sweating of the hands and feet, this indicates that the stool has become hard; Da Cheng Qi Tang (Great Order the Qi Decoction) can be administered to purge the heat from the stomach.
In concurrent disease of Taiyang and Shaoyang, presenting with stiffness and pain in the head and neck, or dizziness and vertigo, sometimes resembling Jie Xiong (chest binding syndrome), and hardness and fullness below the heart, one should puncture Dazhui (GV14), Diyi Jian (LI11, assumed here as Shangyang LI1 based on context or specific lineage interpretation, but standard is LI11 for elbow crease, text says "First Intercalation" likely referring to a specific point location description or typo for Shangyang/He Gu area, however strictly translating the text's "Diyi Jian"), Feishu (BL13), and Ganshu (BL18). One must be cautious not to induce sweating; if sweating is induced, delirium (Chan Yu) will occur, and the pulse will be Wiry (Xian). If delirium persists for five to six days, Qimen (LR14) should be punctured.
[Annotation] In concurrent disease of Taiyang and Shaoyang, symptoms such as stiffness and pain in the head and neck, or dizziness and vertigo, sometimes resembling chest binding, and hardness and fullness below the heart appear. The use of words like "or" and "sometimes resembling" indicates that the pathological trend of the two Yang meridians merging is not yet fixed. Since the symptoms are undetermined, medication should not be used; instead, Feishu (BL13) should be punctured to drain the Taiyang pathogen, because the Taiyang meridian connects with the Lung; Ganshu (BL18) should be punctured to drain the Shaoyang pathogen, because the Liver and Gallbladder are internally-externally related. Thus, puncturing allows one to wait for the opportune moment. If this is not understood, and stiffness/pain in the head/neck is treated as a Taiyang pathogen while dizziness/chest fullness is treated as a Shaoyang pathogen, inducing sweating will cause the pathogens of both Yang meridians to enter the Stomach driven by dryness, resulting in delirium. If the pulse were large and long, it would still be a favorable sign, allowing for purgation; however, since the pulse is neither large nor wiry, and delirium persists for five to six days, this represents Earth (Spleen/Stomach) pathology manifesting with Wood (Liver/Gallbladder) pulses, termed "Fu" (Defeat). Fu means being overcome or attacked. Purgation must absolutely be avoided; instead, Qimen (LR14) should be punctured to directly drain the Liver pathogen.
[Collected Annotations] Fang Youzhi stated: "Bing" (merge) is similar to "He" (combine). They mutually combine, differing in severity and quantity, which is called "Bing". Generally, because the Shaoyang meridian is separated by the Yangming meridian and is far from Taiyang, it merely merges.
Yu Chang stated: The Shaoyang meridian networks the costal region. When its pathogen merges with the Taiyang pathogen, it appears similar to but is essentially different from Jie Xiong (Chest Binding) syndrome. The Liver and Gallbladder are paired; puncturing Ganshu (BL18) drains the Gallbladder. Although the Bladder does not pair with the Lung, the Lung governs Qi. Puncturing Feishu (BL13) unblocks Qi, thereby facilitating the Qi transformation of the Bladder, so that pathogens cannot remain. Sweating leading to delirium aligns with the concept of Wood overacting on Earth in Hebing (combined disease). A wiry pulse is also an alternative expression of Shaoyang excess and Yangming deficiency within combined disease; puncturing Qimen (LR14) drains the excess Wood pathogen.
Lin Lan stated: Dazhui (GV14) is also known as Bailao (EX-BN1), located in the depression above the first thoracic vertebra, primarily draining various types of heat from the chest. Diyi Jian (First Intercalation) is suspected to be Shangyang (LI1), located on the medial side of the index finger, treating chest Qi fullness and inability to sweat in febrile diseases. Ganshu (BL18) is below the ninth thoracic vertebra, Feishu (BL13) below the third, each 1.5 cun lateral to the spine; both treat draining heat from the Five Zang organs. Qimen (LR14) is at the end of the second rib near Rupen, treating cold damage, chest irritability and heat, and inability to sweat after the disease has passed through its stages.
In concurrent disease of Taiyang and Shaoyang, with hardness below the heart, stiffness in the neck, and dizziness, one should puncture Dazhui (GV14), Feishu (BL13), and Ganshu (BL18), and absolutely avoid purgation.
[Annotation] This follows the previous clause, warning against purgation. In concurrent disease of Taiyang and Shaoyang, hardness below the heart and dizziness belong to Shaoyang; stiffness in the neck belongs to Taiyang. One should puncture Feishu (BL13) and Ganshu (BL18) to drain the pathogens of Taiyang and Shaoyang, and absolutely avoid purgation. If purgation is mistakenly applied due to hardness below the heart, adverse conditions will inevitably result.
[Collected Annotations] Cheng Wuji stated: Absolutely avoid purgation. Attacking the Shaoyang pathogen allows the Taiyang pathogen to enter the interior due to deficiency, inevitably forming Jie Xiong (Chest Binding). The Classic states: In concurrent disease of Taiyang and Shaoyang, applying purgation results in Jie Xiong.
Cheng Zhi stated: The previous section said sweating is forbidden; this section says purgation is forbidden. Sweating is forbidden to prevent delirium; purgation is forbidden to prevent Jie Xiong.
Cheng Yingmao stated: Here, hardness below the heart is listed first, followed by neck stiffness and dizziness, which might seem suitable for purgation. However, knowing the three prohibitions of Shaoyang disease, only puncturing is allowed, and purgation must be avoided.
Wang Hu stated: The single point Dazhui (GV14) actually simultaneously drains both Taiyang and Shaoyang. All other commentators fail to understand the rationale of acupuncture, ignoring Dazhui entirely, which is extremely erroneous.
In concurrent disease of Taiyang and Shaoyang, if purgation is mistakenly applied, Jie Xiong (Chest Binding) forms, characterized by hardness below the heart, incessant diarrhea, inability to take fluids, and mental restlessness.
[Annotation] This follows the previous clause, describing the complications of mistaken purgation. In concurrent disease of Taiyang and Shaoyang, failing to puncture Feishu (BL13) and Ganshu (BL18) and instead using purgation causes the pathogens of both Yang meridians to sink into the interior due to deficiency. What was previously "resembling chest binding" becomes actual Jie Xiong (Chest Binding). Hardness below the heart transforms into incessant diarrhea and inability to ingest fluids. With nothing entering from above and constant loss from below, the center becomes empty, causing mental restlessness and agitation, transforming into a ruined syndrome. Even if the puncturing methods from the previous clause were available, they would be useless.
[Collected Annotations] Cheng Zhi stated: This is the complication of mistaken purgation in concurrent disease of the two Yang meridians. The Taiyang exterior pathogen enters the interior due to deficiency, forming Jie Xiong (Chest Binding) and hardness below the heart; the Shaoyang semi-interior pathogen enters the interior due to deficiency, causing incessant diarrhea. With pathology above and below, the central Yangming meridian is affected to the point of inability to ingest fluids and mental restlessness.
Yu Chang stated: Even without mistaken sweating or purgation, Bingbing (concurrent disease) already resembles Jie Xiong (Chest Binding) with hardness and fullness below the heart; how much worse is it when purgation is mistakenly applied? Thus, the complications are almost more severe than those of a single Taiyang disease mistakenly purged. The phrase "mental restlessness" seems incomplete, but the Classic states that in complete Jie Xiong (Chest Binding), irritability and restlessness indicate death; does this imply that mental restlessness here also indicates death?
Wang Hu stated: For Taiyang disease in the meridians, purgation is contraindicated; for Shaoyang disease, purgation is also prohibited. Therefore, applying purgation is considered a contrary treatment.