柴胡半筋 桂枝三两 干姜二两 栝蒌根四两 黄芩三两 牡蛎二两 甘草（炙）二
两
右七味，以水一斗二升，煮取六升，去滓，再煎，取三升，温服一升，日三服，初服
微烦，复服汗出便愈。
【方解】
少阳表里未解，故以柴胡桂枝合剂而主之，即小柴胡汤之变法也。去人参者，因其正
气不虚；减半夏者，以其不呕，恐助燥也。加栝蒌根，以其能止渴兼生津液也；倍柴
胡加桂枝，以主少阳之表；加牡蛎，以耎少阳之结。干姜佐桂枝，以散往来之寒；黄
芩佐柴胡，以除往来之热，且可制干姜不益心烦也。诸药寒温不一，必需甘草以和之
。初服微烦，药力未及；复服汁出即愈者，可知此证非汗出不解也。
@@@
服柴胡汤已，渴者，属阳明，以法治之。
【注】
风寒之邪从阳明而传少阳，起初不渴，今服柴胡汤已，反渴者，是少阳转属阳明也。
以法治之，谓当分其经府见证而治之也，葛根、白虎、谓胃间，各从其宜而用之可耳
！
【集注】
方有执曰：已，毕也。服柴胡汤已毕而渴，则非暂渴，其为热已入胃亡津液而渴可知
，故曰：属阳明也。
沈明宗曰：服柴胡汤已渴者，乃少阳之邪不传三阴，而转入阳明矣，即当随阳明现证
而治，故谓以法治之。
郑重光曰：少阳、阳明之病机，在呕渴中分，渴则转属阳明，呕则仍在少阳。如呕多
虽有阳明证，不可攻之，因病未离少阳也，服柴胡汤渴当止。若服柴胡汤已加渴者，
是热入胃府，耗津消水，此属阳明胃病也。
@@@
伤寒五、六日，头汗出，微恶寒，手足冷，心下满，口不欲食，大便□，脉细者，此
为阳微结，必有表复有里也，脉沉亦在里也。汗出为阳微，假令纯阴结，不得复有外
证，悉入在里，此为半在里半在外也。脉虽沉紧，不得为少阳病，所以然者，阴不得
有汗，今头汗出，故知非少阴也，可与小柴胡汤，设不了了者，得屎而解。
【按】
脉细，当是「脉沉细」，观本条下文，脉沉亦在里也之「亦」字，自知。脉虽沉紧之
「紧」字，当是「细」字。本条上文并无「紧」字，如何说脉虽沉紧，「虽」字何所
谓耶？必是传写之误。
【注】
伤寒五、六日，虽表有头汗出，微恶寒之阳邪未罢，里有心下满，口不欲食，大便□
之阳结已形，但手足冷脉沉细，则阳邪所结殊微也，故曰：此为阳微结，必有表复有
里也。然脉沉细，似乎里阴盛，而头汗出，则为表阳郁也。假令纯阴结，则不得复有
头汗出之外证，始合悉入在里之纯阴结矣。夫既非悉入在里之纯阴结，此必为半在里
、半在表之阳微结也，故脉虽沉细，不得为少阴病。所以然者，三阴不得有汗，今头
汗出，故知非少阴也。可与小柴胡汤者，和其不通身汗出微恶寒也。设不了了者，必
大便之□未除，自宜利其大便使得屎而解也。
【集注】
喻昌曰：阳微结者，阳邪微结未尽散也。旧注作阳气衰微，故邪气结聚大差。果尔，
则头汗出为亡阳之证，非半表半里之证矣；果尔，则阴结又是阴气衰微矣。玩本文假
令纯阴结，及阳邪若不微结，是纯阴邪内结，则不得复有外证等语，其义甚明。
程知曰：此言少阳病有似少阴者，当细辨其脉证也。
程应旄曰：凡脉细、脉沉，皆阴脉也。今与阳证同见，则为阳热郁结之诊，无关少阴
也。可见阳气一经郁结，不但阳证似阴，并阳脉亦似阴矣。
沈明宗曰：得屎而解，当用大柴胡之法也。
吴人驹曰：此证常见有误作阴寒而施温热以致大逆者，盖因其恶寒，手足冷，脉细而
沉，不究其证之始末由来也。
周扬俊曰：此条恶寒肢冷不欲食，脉细或沉，有似乎阴，最难辨晰，仲景特出「阳微
结」三字，昭示千古。以头汗出为阳，阴不得有汗也。至五、六日头痛发热，证原属
阳也，故纵见少阴之脉，不得为少阴之病。然独未见少阳一证，何遽得为少阳病耶？
此仲景所以又明言半在表半在里也。尔时里证既多，不得纯以表药汗之；外证似阴，
不得复以里药温之，故取小柴胡提出其邪于表里之半，而大便□不了了者，则当下之
得屎无疑也。仲景恐人未明，自为详辨，然后知手足冷微恶寒者，正因阳邪郁结，不
外通于肢体，故独头汗出也。
@@@
伤寒阳脉涩，阴脉弦，法当腹中急痛者，先与小建中汤，不差者，与小柴胡汤主之。
【注】
伤寒脉得浮涩，荣卫不足也；脉得沉弦，木入土中也。荣卫不足则表虚，木入土中则
里急。惟表虚里急，腹中急痛，所以先用小建中汤，以其能补荣卫兼缓中急，则痛可
差也。或不差，必邪尚滞于表。知涩为荣卫不通，弦为少阳本脉，故与小柴胡汤，按
法施治也。成无己去黄芩加芍药，疏外调中，其说亦是。
【集注】
汪琥曰：弦脉不除，痛犹未止者，为不差，此为少阳经有留邪也。
@@@
伤寒胸中有热，胃中有邪气，腹中痛，欲呕吐者，黄连汤主之。
【注】
伤寒未解欲呕吐者，胸中有热邪上逆也；腹中痛者，胃中有寒邪内攻也。此热邪在胸
，寒邪在胃，阴阳之『气不和』，失其升降之常，故用黄连汤，寒温互用，甘苦并施
，以调理阴阳而和解之也。然此属外，因上下寒热之邪，故有如是之证；若内因杂病
，呕吐而腹痛者，多因宿食。由此推之，外因、内因，证同而情异，概可知矣。
【集注】
程知曰：阴邪在腹，则阳不得入而和阴，为腹痛；阳邪在上，则阴不得入而和阳，为
欲呕逆。
汪琥曰：『尚论篇』皆以风寒二邪，分阴阳寒热。殊不知风之初来未必非寒，寒之既
入亦能化热，不可拘也。
郑重光曰：此热邪中于上焦，寒邪中于下焦，阴阳不相入，失其上下升降之常也。
【方解】
少阳经表里之邪均未解除，因此使用柴胡桂枝汤合方来主治，这是小柴胡汤的变通用法。去掉人参，是因为患者正气并未虚弱；减少半夏用量，是因为患者没有呕吐症状，担心其助长燥热。加入栝蒌根（天花粉），是因为它能止渴并兼能生津液；加倍柴胡并加入桂枝，是为了主治少阳经在表的病证；加入牡蛎，是为了软化消散少阳经的气机郁结。干姜辅助桂枝，以发散往来寒热中的寒邪；黄芩辅助柴胡，以清除往来寒热中的热邪，并且可以制约干姜以免加重心烦。各种药物寒温性质不一，必须用甘草来调和它们。初次服药后出现轻微烦躁，说明药力尚未到达病所；再次服药后汗出，病症随即痊愈，由此可知此证并非不出汗就不能治愈。
@@@
服用柴胡汤之后，如果出现口渴症状，说明病邪已归属于阳明经，应当按照治疗阳明病的方法进行处理。
【注】
风寒之邪从阳明经传入少阳经，起初并不口渴，现在服用柴胡汤之后，反而出现口渴，这是少阳病转属阳明经的表现。所谓“按照方法治疗”，是指应当根据阳明经和腑的具体见证分别进行治疗，葛根汤、白虎汤等方剂，应根据具体情况适宜选用即可。
【集注】
方有执说：已，意为完毕。服用柴胡汤完毕后出现口渴，则不是暂时性的口渴，可以知道这是热邪已经入胃，耗伤津液而导致的口渴，所以说病邪归属于阳明经。
沈明宗说：服用柴胡汤后出现口渴，说明少阳经的病邪没有传入三阴经，而是转入阳明经了，就应当随着阳明经现出的证候进行治疗，所以说按照方法治疗。
郑重光说：少阳病和阳明病的病机区别，在于呕吐和口渴的区分上，出现口渴则转属阳明经，出现呕吐则仍在少阳经。如果呕吐多，即使有阳明经证候，也不可攻下，因为病邪未离开少阳经，服用柴胡汤后口渴应当停止。如果服用柴胡汤后反而更加口渴，说明热邪进入胃腑，耗伤津液和水湿，这属于阳明胃腑病。
@@@
伤寒病五到六天，出现头部出汗，轻微怕冷，手脚发凉，心下部胀满，口中不想进食，大便不通畅，脉象细弱的，这称为阳微结（阳气轻微郁结），一定既有表证又有里证，脉沉也说明病位在里。头部出汗是阳气轻微郁结的表现，假如是纯阴结（阴寒内结），就不会再有头汗出这样的外证，病邪完全陷入在里，这属于半在里半在表的情况。脉象虽然沉紧，但不能诊断为少阳病，之所以这样判断，是因为阴证不应该有汗，现在头部出汗，所以知道这不是少阴病，可以给予小柴胡汤治疗，如果服药后病情仍不缓解，通过通便排便即可痊愈。
【按】
原文中的“脉细”，应当是“脉沉细”，看本条下文提到的“脉沉亦在里也”中的“亦”字，自然可知。原文中“脉虽沉紧”的“紧”字，应当是“细”字。本条上文并没有“紧”字，怎么能说“脉虽沉紧”呢？“虽”字又从何说起呢？这一定是传抄过程中的错误。
【注】
伤寒病五到六天，虽然表证有头部出汗、轻微怕冷的阳邪未罢，里有心下部胀满、口中不想进食、大便不通畅的阳结已形成，但手脚发凉、脉象沉细，说明阳邪郁结的程度非常轻微，所以说：这是阳微结，一定既有表证又有里证。然而脉象沉细，看似里阴盛，但头部出汗，则是表阳被郁遏的表现。假如是纯阴结，就不会再有头部出汗这样的外证，这才符合完全陷入在里的纯阴结特征。既然不是完全陷入在里的纯阴结，这必定是半在里、半在表的阳微结，所以脉象虽然沉细，不能诊断为少阴病。之所以这样判断，是因为三阴病不应该有汗，现在头部出汗，所以知道这不是少阴病。可以给予小柴胡汤治疗，是为了调和气机，解决不通身出汗、轻微怕冷的问题。如果服药后病情仍不缓解，一定是大便不通畅的症状未除，自然应当通利大便，使大便通畅而痊愈。
【集注】
喻昌说：阳微结，是指阳邪轻微郁结未尽散。旧注将其解释为阳气衰微，导致邪气结聚，这与原意大相径庭。果真如此，那么头部出汗就是亡阳的证候，而不是半表半里的证候了；果真如此，那么阴结又是阴气衰微了。仔细玩味本文“假令纯阴结”以及“阳邪若不微结，是纯阴邪内结，则不得复有外证”等语句，其含义非常明显。
程知说：这里说的是少阳病有类似少阴病的情况，应当仔细辨别其脉象和证候。
程应旄说：凡是脉细、脉沉，都是阴脉。现在与阳证同时出现，就是阳热郁结的诊断，与少阴病无关。可见阳气一经郁结，不但阳证像阴证，连阳脉也像阴脉了。
沈明宗说：得屎而解，应当采用大柴胡汤的方法。
吴人驹说：此证常见被误认为是阴寒证而施用温热药，从而导致严重逆乱的后果，这是因为只看到恶寒、手脚冷、脉细而沉，却不探究病证的始末由来。
周扬俊说：此条文中出现的恶寒、肢冷、不欲食、脉细或沉，看起来像阴证，最难辨别清晰，张仲景特意提出“阳微结”三个字，昭示千古。以头部出汗为阳的特征，因为阴证不应该有汗。到了五到六天出现头痛发热，证候原本属于阳，所以即使见到少阴病的脉象，也不能诊断为少阴病。然而唯独没有见到少阳经的典型证候，怎么就能断定是少阳病呢？这就是张仲景所以要明确说明“半在表半在里”的原因。此时里证既多，不能单纯用解表药发汗；外证似阴，不能再单纯用治里药温补，所以取用小柴胡汤将邪气提引至表里之间。如果大便不通畅、病情不缓解，则应当用下法，通过排便而痊愈无疑。张仲景恐怕人们不明白，自己进行了详细辨析，然后才知道手脚发凉、轻微怕冷，正是因为阳邪郁结，不能通达于肢体，所以只有头部出汗。
@@@
伤寒病脉象阳部涩、阴部弦，按照法度应当出现腹中急痛的症状，先给予小建中汤治疗，如果不愈，再给予小柴胡汤主治。
【注】
伤寒病脉象浮涩，说明营卫不足；脉象沉弦，说明木气侵入土位（肝木乘脾土）。营卫不足则表虚，木气侵入土位则里急。正因为表虚里急，导致腹中急痛，所以先用小建中汤，因为它能补益营卫兼缓和中焦之急，疼痛就可以痊愈。如果服药后疼痛不缓解，必定是邪气仍然滞留于表。已知涩脉代表营卫不通，弦脉是少阳经的本脉，所以给予小柴胡汤，按照法度施治。成无己主张去掉黄芩加入芍药，以疏解外邪、调和中焦，这种说法也是正确的。
【集注】
汪琥说：弦脉不除，疼痛仍未停止的，称为不差，这说明少阳经有留滞的邪气。
@@@
伤寒病胸中有热邪，胃中有寒邪，出现腹中痛，想要呕吐的症状，主治方剂为黄连汤。
【注】
伤寒病未解欲呕吐，是因为胸中有热邪上逆；腹中痛，是因为胃中有寒邪内攻。此证热邪在胸，寒邪在胃，阴阳之气不和，失去了升降的正常规律，所以使用黄连汤，寒温药物互用，甘苦味道并施，以调理阴阳并和解之。然而这属于外感病，因上下寒热之邪所致，故有此证；如果是内伤杂病，呕吐而腹痛者，多因宿食停滞。由此推断，外因和内因，证候相同但病因情状不同，概可知道了。
【集注】
程知说：阴邪在腹部，则阳气不得入而调和阴气，导致腹痛；阳邪在上部，则阴气不得入而调和阳气，导致欲呕逆。
汪琥说：《尚论篇》都用风寒二邪来区分阴阳寒热。殊不知风邪初起未必不是寒，寒邪入体之后也能化热，不可拘泥于此。
郑重光说：此证是热邪中于上焦，寒邪中于下焦，阴阳不相交入，失去了上下升降的正常规律。
[Formula Analysis]
Shaoyang (Lesser Yang) exterior and interior pathogenic factors are both unresolved; therefore, the combination of Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) is used as the primary treatment. This is a modified version of Xiaochaihu Tang (Minor Bupleurum Decoction). Ren Shen (Ginseng Radix) is omitted because the patient's healthy Qi (Zhengqi) is not deficient. The dosage of Banxia (Pinelliae Rhizoma) is reduced because there is no vomiting, and its use might aggravate dryness. Gualougen (Trichosanthis Radix), also known as Tianhuafen, is added because it can relieve thirst and generate body fluids. Doubling the dosage of Chaihu (Bupleuri Radix) and adding Guizhi (Cinnamomi Ramulus) aims to treat the Shaoyang exterior syndrome. Mu Li (Ostreae Concha) is added to soften and dissipate Shaoyang stagnation. Ganjiang (Zingiberis Rhizoma) assists Guizhi to disperse the cold component of alternating chills and fever; Huangqin (Scutellariae Radix) assists Chaihu to clear the heat component of alternating chills and fever, and it also constrains Ganjiang to prevent exacerbating mental restlessness. Since the herbs possess varying cold and warm properties, Gancao (Glycyrrhizae Radix et Rhizoma) is necessary to harmonize them. Mild irritability after the first dose indicates that the medicinal force has not yet reached the disease site. Sweating and subsequent recovery after the second dose indicate that this syndrome cannot be resolved without sweating.
@@@
If thirst occurs after administering Chaihu Tang (Bupleurum Decoction), the pathogen has transferred to the Yangming (Yang Brightness) stage, and treatment should follow the protocols for Yangming diseases.
[Annotation]
Wind-cold pathogens transmit from the Yangming channel to the Shaoyang channel. Initially, there is no thirst. If thirst appears after taking Chaihu Tang, it signifies that the Shaoyang disease is transferring to Yangming. "Treating according to method" means one must differentiate between channel and fu-organ manifestations and treat accordingly. Ge Gen Tang (Puerariae Radix Decoction) or Bai Hu Tang (White Tiger Decoction) should be selected based on specific indications.
[Collected Annotations]
Fang Youzhi stated: "Yi" (already/completed) means finished. Thirst appearing after completing the administration of Chaihu Tang indicates it is not transient thirst but rather thirst caused by heat entering the stomach and consuming body fluids. Thus, it is said to belong to Yangming.
Shen Mingzong stated: Thirst after taking Chaihu Tang indicates that the Shaoyang pathogen did not transmit to the Three Yin channels but instead transferred to Yangming. One should then treat according to the current Yangming manifestations, hence "treating according to method."
Zheng Zhongguang stated: The differentiation between Shaoyang and Yangming pathology lies in vomiting versus thirst. Thirst indicates transfer to Yangming; vomiting indicates retention in Shaoyang. Even if Yangming symptoms exist, if vomiting is predominant, purgatives should not be used because the pathogen remains in Shaoyang. Thirst should cease after taking Chaihu Tang. If thirst intensifies after taking Chaihu Tang, it indicates heat entering the Stomach fu-organ, consuming fluids and water, which belongs to Yangming Stomach disease.
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In Taiyang (Greater Yang) cold damage occurring five to six days later, presenting with sweating only on the head, slight aversion to cold, cold hands and feet, fullness in the epigastrium, anorexia, constipation, and a fine pulse, this is termed "Yang Wei Jie" (Minor Yang Stagnation). There is both an exterior syndrome and an interior syndrome; a deep pulse also indicates an interior location. Head sweating reflects minor Yang stagnation. If it were pure Yin stagnation (Pure Yin Knot), there would be no exterior signs like head sweating, and all pathogenic factors would be interior. This represents a condition half-exterior and half-interior. Although the pulse may be deep and tight, it cannot be diagnosed as Shaoyang disease. The reason is that Yin syndromes typically do not present with sweating. Since there is head sweating, it is known not to be Shaoyin (Lesser Yin) disease. Xiaochaihu Tang (Minor Bupleurum Decoction) may be administered. If the patient remains uncomfortable afterward, relief will come with defecation.
[Commentary]
The text "fine pulse" should likely read "deep and fine pulse," as indicated by the word "also" in the subsequent phrase "a deep pulse also indicates an interior location." The character "tight" in "although the pulse is deep and tight" should likely be "fine." Since "tight" does not appear earlier in the text, the usage of "although" makes no sense. This is likely a transcription error.
[Annotation]
In Taiyang cold damage at five to six days, although there are exterior signs of head sweating and slight aversion to cold indicating unresolved Yang pathogens, and interior signs of epigastric fullness, anorexia, and constipation indicating formed Yang stagnation, the cold extremities and deep-fine pulse suggest that the Yang stagnation is very mild. Hence, it is called "Yang Wei Jie," involving both exterior and interior aspects. While a deep-fine pulse suggests interior Yin excess, head sweating indicates exterior Yang depression. If it were pure Yin stagnation, there would be no head sweating, fitting the description of pure interior Yin stagnation. Since it is not purely interior, it is a case of Yang Wei Jie, half-exterior and half-interior. Thus, despite the deep-fine pulse, it is not Shaoyin disease. The rationale is that Three Yin diseases do not typically present with sweating; head sweating confirms it is not Shaoyin. Xiaochaihu Tang is given to harmonize the lack of generalized sweating and slight aversion to cold. If discomfort persists, it is due to unresolved constipation, requiring purgation to achieve relief through defecation.
[Collected Annotations]
Yu Chang stated: "Yang Wei Jie" refers to minor residual Yang pathogen stagnation. Old annotations interpreting it as Yang Qi deficiency leading to pathogen aggregation are significantly incorrect. If that were true, head sweating would be a sign of Yang collapse, not a half-exterior/half-interior syndrome; and Yin stagnation would imply Yin Qi deficiency. Careful reading of phrases like "suppose pure Yin stagnation" and "if Yang pathogen is not minorly stagnated, it is pure Yin pathogen internally stagnated, thus no exterior signs" clarifies the meaning.
Cheng Zhi stated: This passage discusses Shaoyang diseases that resemble Shaoyin diseases, emphasizing the need to carefully differentiate pulses and symptoms.
Cheng Yingmao stated: Fine and deep pulses are Yin pulses. When seen with Yang symptoms, they indicate Yang heat stagnation, unrelated to Shaoyin. Once Yang Qi stagnates, not only do Yang symptoms resemble Yin, but Yang pulses also resemble Yin.
Shen Mingzong stated: Relief upon defecation suggests using the method of Da Chaihu Tang (Major Bupleurum Decoction).
Wu Renju stated: This syndrome is often misdiagnosed as Yin-cold and treated with warming agents, causing severe adverse reactions. This error arises from observing chills, cold extremities, and a deep-fine pulse without investigating the origin and progression of the disease.
Zhou Yangjun stated: The chills, cold limbs, anorexia, and fine or deep pulse in this passage resemble Yin syndromes, making differentiation difficult. Zhang Zhongjing specifically coined "Yang Wei Jie" to clarify this for posterity. Head sweating is a Yang sign because Yin syndromes do not sweat. By day five or six, headache and fever indicate a Yang syndrome; thus, even with Shaoyin-like pulses, it is not Shaoyin disease. However, lacking typical Shaoyang signs, how can it be definitively Shaoyang? This is why Zhang Zhongjing explicitly states "half-exterior, half-interior." With numerous interior signs, simple diaphoresis is inappropriate; with exterior signs resembling Yin, simple warming tonification is inappropriate. Therefore, Xiaochaihu Tang is used to extract the pathogen from the half-exterior/half-interior boundary. If constipation and discomfort persist, purgation is required for relief via defecation. Zhang Zhongjing provided detailed differentiation to prevent misunderstanding, explaining that cold extremities and slight chills result from Yang pathogen stagnation failing to circulate to the limbs, resulting in isolated head sweating.
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In Taiyang cold damage, if the Yang-position pulse is choppy and the Yin-position pulse is wiry, abdominal cramping pain is expected according to protocol. First, administer Xiao Jianzhong Tang (Minor Construct the Middle Decoction). If ineffective, administer Xiaochaihu Tang (Minor Bupleurum Decoction).
[Annotation]
A floating-choppy pulse in Taiyang cold damage indicates insufficiency of Ying (Nutritive) and Wei (Defensive) Qi. A deep-wiry pulse indicates Wood invading Earth (Liver overacting on Spleen/Stomach). Insufficient Ying and Wei lead to exterior deficiency; Wood invading Earth leads to interior tension. Due to exterior deficiency and interior tension causing abdominal cramping pain, Xiao Jianzhong Tang is used first to tonify Ying and Wei and soothe the middle jiao urgency, resolving the pain. If ineffective, the pathogen likely remains stagnant in the exterior. A choppy pulse indicates blocked Ying and Wei circulation; a wiry pulse is the characteristic pulse of Shaoyang. Thus, Xiaochaihu Tang is administered according to protocol. Cheng Wuji suggested removing Huangqin and adding Shaoyao (Paeoniae Radix) to release the exterior and harmonize the middle, which is also a valid perspective.
[Collected Annotations]
Wang Hu stated: If the wiry pulse persists and pain continues ("not improved"), it indicates lingering pathogen in the Shaoyang channel.
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In Taiyang cold damage, with heat in the chest and cold qi in the stomach, presenting with abdominal pain and a desire to vomit, the primary formula is Huanglian Tang (Coptis Decoction).
[Annotation]
Unresolved Taiyang cold damage with a desire to vomit indicates heat pathogens in the chest reversing upward. Abdominal pain indicates cold pathogens in the stomach attacking inward. Here, heat is in the chest and cold is in the stomach. The disharmony of Yin and Yang Qi disrupts their normal ascending and descending functions. Therefore, Huanglian Tang is used, combining cold and warm herbs and bitter and sweet flavors to regulate Yin and Yang and harmonize the condition. This belongs to external contraction, where upper heat and lower cold cause these symptoms. In contrast, internal miscellaneous diseases presenting with vomiting and abdominal pain are often due to retained food. From this, we can infer that while external and internal causes may present similar symptoms, their etiologies differ.
[Collected Annotations]
Cheng Zhi stated: Yin pathogens in the abdomen prevent Yang from entering to harmonize Yin, causing abdominal pain. Yang pathogens in the upper region prevent Yin from entering to harmonize Yang, causing nausea and reversal.
Wang Hu stated: *Shanglun Pian* distinguishes Yin-Yang and Cold-Heat using Wind and Cold pathogens. However, Wind initially may not be cold, and Cold can transform into Heat once inside; one should not be rigid.
Zheng Zhongguang stated: This involves heat pathogens affecting the Upper Jiao and cold pathogens affecting the Lower Jiao, causing Yin and Yang to fail to interact and disrupting normal ascending-descending dynamics.