问曰。何以识为少阳病。答曰。少阳之为病。口苦咽干目眩也。少阳之脉。起于目锐
。从耳
后。入耳中。挟咽出颐颔中。其支者。会缺盆。下胸中。循胁。以足少阳胆。与三焦相火合
化。此经受邪。多从升处而走所络之空窍。故仲景以口苦咽干目眩。括少阳病之提纲。至若
往
来寒热。胸胁苦满。默默不欲饮食。心烦。喜呕。皆邪入少阳当然之证。其或胸中烦而不呕
。
或渴。或腹中痛。或胁下痞硬。或心下悸。小便不利。或不渴。身有微热。或咳。此又少阳
病中或然或不然之证。总不离一小柴胡汤加减之法。故又曰伤寒中风。有柴胡证。但见一证
即是。不必悉具。又少阳受病。其脉尺寸俱弦。故仲景言伤寒脉弦细。头痛发热者属少阳。
此又不从证而从脉。虽见头痛发热之表证。不责太阳而责少阳。则可见弦为少阳之定脉。有
此定脉定证。以审实少阳之为病。自不至误汗误下。犯少阳之大禁矣。
问曰。少阳病。尽传自阳明乎。答曰。此不尽然。内经谓三阳之离合。太阳为开。阳明
为阖。
少阳为枢。凡邪中太阳。有阳明以为之迎。正赖有少阳以为之拒。伤寒以出表为顺。入里为
逆。设非少阳之枢居中拦截。则外来之邪长驱直入而无所御。是少阳一经。关系甚钜。太阳
病往
往有初得之二三日。不传阳明。迳传少阳者。有太阳与少阳同时病见者。正不必尽俟阳明经
尽。
始传少阳。且邪入三阴之后。亦有还返少阳而解者。总以定证定脉为据。就脉证上审实其为
少阳病。即可主用少阳之治法而无疑矣。
问：如何识别少阳病？
答：少阳病的典型症状是口苦、咽干、目眩。少阳经脉，起始于目外角，从耳后进入耳中，挟行于咽喉，出于下颌部。其分支，会合于缺盆，下行至胸中，沿胁肋走行。足少阳胆经与三焦相火合并化生。此经受邪，多从升发之处走向其所联络的空窍。因此，张仲景以口苦、咽干、目眩作为少阳病的提纲证。至于往来寒热、胸胁苦满、神情默默不欲饮食、心烦、喜呕等症状，都是邪气侵入少阳的必然证候。或者出现心中烦闷但不呕吐，或者口渴，或者腹中疼痛，或者胁下痞塞硬满，或者心下悸动、小便不利，或者不渴、身体有轻微发热，或者咳嗽。这些又是少阳病中可能出现也可能不出现的兼证。总的原则不离小柴胡汤加减运用的方法。所以说，伤寒或中风，只要有柴胡证，只要见到其中一个证候即可确诊，不必所有症状都具备。另外，少阳受病，其脉象尺寸两部皆呈弦脉。所以张仲景说，伤寒脉象弦细，伴有头痛发热的，属于少阳病。这是不从症状而从脉象判断的方法。虽然见到头痛发热这类表证，不归属于太阳病而归属于少阳病，由此可见弦脉是少阳病的定型脉象。有了这定型的脉象和证候，来审察确认少阳病，就不会误用汗法或下法，从而触犯少阳病的大禁忌了。
问：少阳病是否全部由阳明病传变而来？
答：这不完全是这样。《内经》说，三阳经的开合枢关系，太阳为开，阳明为阖，少阳为枢。凡是邪气侵犯太阳，有阳明作为迎接（指阳明主里，太阳主表，二者相邻），正依赖少阳作为拒守（拦截）。伤寒病以邪气外出体表为顺，入里为逆。如果不是少阳之枢机在中间拦截，那么外来的邪气就会长驱直入而无法抵御。因此，少阳一经的关系非常重大。太阳病往往在初得的两三天内，不传阳明，直接传入少阳；也有太阳与少阳同时发病的情况。正不必非要等到阳明经的病邪传尽之后，才开始传入少阳。而且，邪气侵入三阴经之后，也有返回少阳而解体的情况。总之，要以确定的证候和脉象为依据，在脉证上审察确认其为少阳病，就可以确定使用少阳的治疗方法而没有疑问了。
Question: How to identify Shaoyang disease?
Answer: The typical symptoms of Shaoyang disease (Lesser Yang disease) are bitter taste in the mouth, dryness of the throat, and vertigo/dizziness. The Shaoyang meridian (Gallbladder Meridian of Foot-Shaoyang) originates at the outer canthus of the eye, enters the ear from behind it, runs alongside the pharynx, and emerges at the mandible. Its branch meets at the supraclavicular fossa (Quepen), descends into the chest, and follows the hypochondrium. The Foot-Shaoyang Gallbladder channel combines with the Ministerial Fire of the Sanjiao (Triple Burner). When this channel is invaded by pathogenic factors, the pathogens tend to move from the ascending aspect to the orifics connected to it. Therefore, Zhang Zhongjing uses bitter taste in the mouth, dryness of the throat, and vertigo as the guiding syndrome (Tigang) for Shaoyang disease. As for alternating chills and fever, fullness and distension in the chest and hypochondrium, silence with lack of appetite, irritability, and frequent vomiting, these are inevitable syndromes when pathogens enter the Shaoyang. Alternatively, there may be vexation in the chest without vomiting, thirst, abdominal pain, hardness and stuffiness under the costal margin, palpitations in the epigastrium with inadequate urination, absence of thirst with slight fever on the body, or coughing. These are optional or conditional syndromes within Shaoyang disease. The general principle does not deviate from the method of modifying Xiao Chai Hu Tang (Minor Bupleurum Decoction). Thus, it is said that in Shanghan (Cold Damage) or Fengzhong (Wind Strike), if there are Chaihu syndromes, observing just one symptom is sufficient for diagnosis; it is not necessary for all symptoms to be present. Furthermore, in Shaoyang disease, the pulse at both the Cun (inch) and Chi (cubit) positions is wiry (Xian). Therefore, Zhang Zhongjing stated that in Shanghan, a wiry and fine pulse accompanied by headache and fever belongs to Shaoyang. This is a judgment based on pulse rather than symptoms. Although superficial symptoms like headache and fever are present, they are attributed to Shaoyang rather than Taiyang (Greater Yang). This shows that the wiry pulse is the definitive pulse for Shaoyang. With this definitive pulse and syndrome, one can examine and confirm Shaoyang disease, thereby avoiding erroneous use of sweating or purging methods, which would violate the major contraindications of Shaoyang disease.
Question: Does Shaoyang disease always transmit from Yangming disease?
Answer: This is not entirely true. The Neijing (Inner Canon) states the relationship of opening, closing, and pivoting among the Three Yang channels: Taiyang is the opening, Yangming is the closing, and Shaoyang is the pivot. Whenever pathogens invade Taiyang, Yangming serves as an advance guard, and it relies on Shaoyang as a defensive barrier. In Shanghan disease, the expulsion of pathogens to the exterior is favorable, while their entry into the interior is unfavorable. If the pivot mechanism of Shaoyang did not intercept in the middle, external pathogens would march straight in without resistance. Thus, the Shaoyang channel plays a crucial role. In Taiyang disease, often within two or three days of onset, the disease may not transmit to Yangming but directly to Shaoyang; there are also cases where Taiyang and Shaoyang diseases occur simultaneously. It is not necessary to wait until the Yangming channel's pathology is exhausted before transmitting to Shaoyang. Moreover, after pathogens enter the Three Yin channels, there are instances where they return to Shaoyang to resolve. In summary, one must rely on definitive syndromes and pulses. By examining the pulse and symptoms to confirm Shaoyang disease, one can confidently apply the treatment methods for Shaoyang without doubt.