典藏书目

( Bitter taste in the mouth, dryness of the throat, dizziness, alternating chills and fever, pain in the chest and hypochondrium, fullness in the chest, chest pain, deafness )

Although the treatment methods for the Shaoyang (Lesser Yang) channel all belong to harmonizing methods, if there is a case where improper sweating leads to delirium due to Stomach excess, it should be treated with Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction) to purge. Although the Shaoyang channel has no direct method for releasing the exterior through sweating, there is the formula Xiaochaihu Tang (Minor Chaihu Decoction) added with Shengjiang (Zingiberis Rhizoma Recens, Fresh Ginger) and Guizhi (Cinnamomi Ramulus, Cinnamon Twig), which also implies warming and harmonizing to induce slight sweating.

Furthermore, the primary syndromes of this channel include pain in the chest and hypochondrium, deafness, alternating chills and fever, dry retching, or vomiting bitter fluid; these are suitable for harmonization using Xiaochaihu Tang (Minor Chaihu Decoction). If the condition does not resolve after taking this medicine, Daxiehu Tang (Major Chaihu Decoction) for purging is appropriate. If there is excessive phlegm-fluid retention in the chest and hypochondrium, Gouti San (Melon Seed Powder) should be used to induce vomiting. This is the profound intent of Zhang Zhongjing.

Harmonizing method: Xiaochaihu Tang (Minor Chaihu Decoction), Xiaochaihu Jia Guizhi Tang (Minor Chaihu Decoction Added with Cinnamon Twig).
Vomiting method: Gouti San (Melon Seed Powder).
Purging method: Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction), Daxiehu Tang (Major Chaihu Decoction).

The guideline for Shaoyang disease is bitter taste in the mouth, dryness of the throat, and dizziness. (The Foot-Shaoyang Gallbladder Channel is the Gallbladder meridian. The *Neijing* states that those who suffer from bitter taste in the mouth have a disease named Dan Dan (Gallbladder Heat). The *Jiayi Jing* states that the Gallbladder is the residence of pure essence, and the Qi of the five Zang organs depends on the Gallbladder; the pharynx serves as its envoy. The Shaoyang channel originates at the outer canthus. When the Shaoyang channel is invaded by pathogenic factors, bitter taste in the mouth, dryness of the throat, and dizziness occur. The *Huoren Shu* states that Xiaochaihu Tang (Minor Chaihu Decoction) is appropriate.) When both the Cun (inch) and Chi (cubit) pulses are wiry, it indicates disease in the Shaoyang channel. Because the channel courses along the hypochondrium and connects with the ears, pain in the chest and hypochondrium and deafness occur. (Checking the Shaoyang chapter, there are syndromes of chest and hypochondrial fullness without pain. Some say that deafness, red eyes, chest fullness, and irritability in Shaoyang disease belong to Wind Strike, while bitter taste in the mouth, dryness of the throat, and dizziness belong to Cold Damage.) In Shaoyang Wind Strike syndrome, where hearing is lost in both ears, eyes are red, and there is fullness and irritability in the chest, neither vomiting nor purging should be used. Improper vomiting causes palpitations due to Qi deficiency, and improper purging causes fright due to Blood deficiency.

In Cold Damage, if the pulse is wiry and fine, accompanied by headache and fever, it belongs to Shaoyang. Shaoyang disease must not be treated with sweating; if sweated, delirium will occur. This belongs to Stomach excess. If the Stomach Qi harmonizes, the patient recovers; if the Stomach Qi does not harmonize, irritability and palpitations occur. (Cheng Wuji in his commentary states that when the pulses in all three positions are wiry, it is Shaoyang disease; a fine pulse indicates the pathogen gradually transmitting inward. Although headache and fever suggest the exterior is not yet resolved, the wiry and fine pulse indicates the pathogen resides in the Shaoyang, half-exterior and half-interior, thus sweating is contraindicated. Sweating consumes body fluids, leading to dryness in the Stomach, allowing the Shaoyang pathogen to transmit into the Stomach, inevitably causing delirium. At this point, Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction) should be administered to purge; once the Stomach harmonizes, recovery ensues. If not purged, the Stomach will be attacked by the Wood pathogen of Shaoyang, resulting in irritability and palpitations. Generally, headaches indicate an exterior condition, but why is this headache considered Shaoyang? Because the pulse is wiry and fine. Whether to sweat or not should be determined by this criterion. If this is a severe Shaoyang-Yangming combined disease, Xiao Chengqi Tang (Minor Chengqi Decoction) is appropriate; if mild, Daxiehu Tang (Major Chaihu Decoction) is appropriate. Since Shaoyang cannot be purged and Yangming must be purged, Xiao Chengqi Tang is given in small amounts to achieve mild laxation. Cheng Wuji’s preference for Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction) is erroneous; Tiaowei Chengqi Tang is a formula for Taiyang-Yangming diseases and must be examined carefully.)

In the third day of Cold Damage, if the Shaoyang pulse becomes smaller, the disease is about to resolve. (Cheng Wuji cites the *Neijing*: a large pulse indicates abundant pathogen, a small pulse indicates peace/normality. On the third day of Cold Damage, when the pathogen transmits to Shaoyang, the pulse should be wiry and tight. Now that the pulse is small, the pathogen is weak and the disease is resolving.)

Shaoyang disease tends to resolve between Yin (03:00-05:00) and Chen (07:00-09:00) hours. (The *Neijing* states that Shaoyang within Yang corresponds to Spring Qi. Yin, Mao, and Chen hours are when Shaoyang Wood energy is prosperous.)

Haizang analyzed the theories of Exterior, Interior, and Middle: Suppose there are Shaoyang symptoms; if only one of the following three signs is present—headache, alternating chills and fever, floating pulse—it is classified as an Exterior syndrome. If any one of the following is present—loss of taste, abdominal discomfort, constipation or diarrhea with irregular bowel movements—it is classified as an Interior syndrome. If there are no Exterior or Interior signs above or below, the remaining conditions are deficient heat, indicating the disease is in the Middle Jiao.

Zhang Yuansu said: If one claims that the Shaoyang Gallbladder channel winds and twists more than other channels, and observes that the treatments in the Shaoyang chapter are very simple, and furthermore, no specific herb is mentioned as the principal method for this channel, why is this? Regarding the location of meridians: Taiyang is posterior, serving as the Exterior; Yangming is anterior, serving as the Interior; Shaoyang is lateral, sandwiched between the Exterior and Interior, hence called Half-Exterior Half-Interior. Treatment for the Exterior involves sweating; treatment for the Interior involves purging. Since it resides between the two, neither sweating nor purging is suitable, so there is no fixed standard treatment method. The classic states that in Shaoyang Wind Strike, with deafness, red eyes, chest fullness, and irritability, vomiting and purging are contraindicated; improper use leads to palpitations and fright. The previous clause also states that sweating is contraindicated. Thus, the three methods of sweating, purging, and vomiting are all taboo for Shaoyang. The formulas merely employ harmonizing methods. Therefore, Zhang Zhongjing correctly used only Xiaochaihu Tang (Minor Chaihu Decoction) as the most appropriate method. However, although the branch meridians are numerous, their pathways do not follow the main routes, so the diseases they cause are not numerous either.