典藏书目

Combined disease (He Bing) and concurrent disease (Bing Bing) are alternative terms for the transmission of meridians in Shanghan (Cold Damage). When two meridians are diseased simultaneously, or three meridians are diseased simultaneously, it is called Combined Disease; if a disease in one meridian has not yet resolved and subsequently involves another meridian, it is called Concurrent Disease. Shanghan texts state: "There are Combined and Concurrent diseases in the Three Yang meridians, but none in the Three Yin meridians." Is this true? Must Taiyin never be diseased concurrently with Shaoyin? Must Shaoyin never be diseased concurrently with Jueyin? Moreover, if Taiyin disease is not cured, must it necessarily involve Shaoyin? If Shaoyin disease is not cured, must it necessarily involve Jueyin? If so, how can the syndromes of the Three Yin meridians appear jointly and simultaneously? And why do pathogens of the Three Yang and Three Yin meridians interweave to cause disease? Thus, we know that there are Combined diseases involving Yang, just as there are those involving Yin; there are Concurrent diseases involving Yang, just as there are those involving Yin. Zhang Zhongjing stated that in Combined disease of the Three Yang meridians, symptoms include sweating when eyes are closed, facial grime, delirium, and urinary incontinence, treated with Baihu Tang (White Tiger Decoction). This is because the exterior combines with the meridians of the Three Yang, and the interior combines with the Fu organs of Yangming; hence, acrid-cool harmonizing methods are used. If the pathogen does not enter the Fu organs, where would Baihu Tang be applicable? In treatment, whether concerning the Three Yang or Three Yin meridians, if two meridians are combined, medications from both meridians are used together; if three meridians are combined, medications from all three are used together. If a disease in one meridian persists and then involves another, one should observe the sequence, urgency, and severity to prescribe medication accordingly, thus avoiding errors. Therefore, are Combined and Concurrent diseases not merely alternative terms for the transmission of Shanghan!

Direct invasion (Zhi Zhong) refers to the initial onset of disease bypassing the Yang meridians and directly attacking the Three Yin meridians. Invasion of Taiyin is suitable for Lizhong Tang (Regulate the Middle Decoction); invasion of Shaoyin is suitable for Sini Tang (Frigid Extremities Decoction); invasion of Jueyin is suitable for Baitong Tang with Pig Bile (Scallion White Decoction with Pig Bile). Generally, when Zang organs are invaded by cold, failure to warm them leads to peril; urgent administration of acrid-hot drugs is required without delay.

For treating cold pathogen invading Taiyin, presenting with vomiting of clear saliva and froth, cold pain in the abdomen, or diarrhea with undigested food, vomiting of roundworms, and a deep pulse, the prescription is as follows: Ganjiang (Dried Ginger), Fuzi (Prepared Aconite Root), Zhi Gancao (Honey-fried Licorice Root) (each 1 qian), Renshen (Ginseng Root) (2 qian), Baizhu (Atractylodes Rhizome) (2 qian). Decoct in water and take orally. For severe cold, add Ganjiang 2 qian; for thirst with desire to drink water, add Renshen and Baizhu each 1 qian; for pulsation at the navel (Dongqi), remove Baizhu and add Rougui (Cinnamon Bark) 1 qian; for frequent vomiting, add Shengjiang (Fresh Ginger) 1.5 qian; for frequent diarrhea, double the dosage of Baizhu; for palpitations, add Fuling (Poria) 1.5 qian; for abdominal fullness, remove Renshen and Baizhu, and add Chenpi (Tangerine Peel), Banxia (Pinellia Tuber), and Sharen (Amomum Fruit) each 0.8 fen, and Fuzi 1.5 qian; essentially, warming constitutes tonification.