Shaoyang stage, its condition and treatment

少阳主春，其气半出地外，半在地中，人身之气亦如之，故主半表半里也。半表者，谓在外之太阳也；半里者，谓在内之太阴也。邪入其间，阴阳相移，寒热交作，邪正相持，进退互拒，此际汗、吐、下三法俱在所禁，故立小柴胡汤和解法，加减施治。然小柴胡加减法中，又有：口不渴身有微热者，加桂枝以取汗，及下後胸胁满微结，小便不利，渴而不呕，头汗出往来寒热者，用柴胡桂枝乾姜汤汗之。又有柴胡证具，而反下之，心下满而硬痛者，此为结胸也，大陷胸汤主之；及柴胡证仍在者，先与小柴胡汤；呕不止心下急，郁郁微烦者，为未解也，与大柴胡汤下之。更有本柴胡证，医以丸药，下之微利，胸胁满而呕，日晡潮热者，小柴胡加芒硝汤下之等法。是仲景亦有汗、下之法，惟在临证详察，因病施治，不可执一也。

Shaoyang is associated to spring season. The Yangqi in the nature in Shaoyang peroid is half in the out of the earth and half inside the earth. Similarly in the body, body Yangqi in the Shaoyang stage is half in the surface of the body and half in the inside of the body. Whenever a Xieqi comes in the Shaoyang stage, it is easy to shift between the surface Taiyang and inside Taiyin stage, causing cold-hot shift. In this stage, the sweat therapy, vomiting therapy and bowel-cleansing therapy are all forbidden. The main therapy used for this stage is a harmonizing therapy by using Xiao Chaihu Tang. Further more, if the person, after a bowel-cleansing therapy, has mild hot feeling but no thirsty, add Guizhi into the Xiao Chaihu Tang; if the person feels mild fullness in the chest and side of the upper stomach, difficulty in urine, thirsty but no nausea, sweat on head and the cold-hot shift syndrome, Chaihu Guizhi Ganjiang Tang is used; if there are evidence for the Chaihu Tang conditions, but a bowel-cleansing therapy is mis-used, the person feels fullness, hard and pain in the upper stomach, e.g. the Jiexiong syndrome, use Da Xiangxiong Tang; if there is the condition to the use of the Chaihu Tang, give Xiao Chaihu Tang first; if the person feels continuous nausea, urgent feeling in the upper stomach, mild annoyed/impatience, it suggests the disease remains, Da Chaihu Tang is indicated; if there is Chaihu Tang condition originally, but a bowel-cleansing therapy is used (in pill form), the person has slight diarrhea, full in chest and side of upper stomach, nausea, hot around sunset time, Xiao Chaihu Tang jia Mangxiao Tang is used. All means that the Xiao Chaihu Tang needs to be modified according to the variations of clinic conditions.

Bitter taste in mouth, dry throat and dizziness feeling in eyes, all suggest that the disease is in the Shaoyang stage.[1]

02 少阳中风，两耳无所闻，目赤，胸中满而烦者，不可吐下，吐下则悸而惊。(小柴胡汤主之).

In Wind-invasion Shaoyang stage, if the person feels deafness in the ear, red eyes, fullness in chest and annoyed/impatience, vomiting therapy or bowel-cleansing therapy should not be used. Other wise, he will have palpitation and panic syndrome.[2] (Xiao Chaihu Tang should be used.)

03 伤寒，脉弦细，头痛发热者，属少阳，少阳不可发汗，发汗则谵语，此属胃，胃和则愈，胃不和，则烦而悸。

In Cold-invasion in the Shaoyang stage, the person has string pulse, and feels headache and hot[3]. In this case, sweat therapy shouldn’t be used. Other wise, he will have Chattering syndrome. The problem is in the stomach, since the Weiqi in stomach is not in harmony, the person will feel annoyed/impatience and palpitation.

04 伤寒五、六日，中风，往来寒热，胸胁苦满，默默不欲饮食，心烦，喜呕，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，或咳者，小柴胡汤主之。

If the Cold-invasion Shanghan disease lasts for five to six days, and if it is a Wind-invasion type, the person feels cold-hot shift, fullness in chest and side of the upper stomach, no-willing silent[4] and no appetite, annoyed/impatience, easy to nausea, or annoyed feeling in chest but no nausea, or feels thirsty, or pain in Stomach, or hard and full in the side of upper stomach, or palpitation in the upper stomach with difficulty in urine, or no thirst but hot, or cough. For all, use Xiao Chaihu Tang. [5]

柴胡半斤，黄芩三两，人参三两，半夏（洗）半升，甘草（炙）三两，生姜（切）三两，大枣（擘）十二枚．

Chaihu 90 gram, Huangqin 45 gram, Renshen 45 gram, Banxia (washed) 124 gram, Gancao (processed) 45 gram, Fresh ginger 45 gram, Chinese date 62 gram.

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。

Add the herbs and 3000 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is 1500 ml liquid in the pot left. Remove the herbal residue, continue the cook until there is about 750 ml left. Collect the herbal tea. Drink one third of the tea each time, three times a day.

(1). If the person is with annoyed in chest but no nausea: remove Banxia and Renshen, add Gualushi 45 gram;

(2). If with thirsty, remove Banxia, add additional Renshen 23 gram, and add Gualougen 60 gram;

(4). If with fullness and hard on the side of upper stomach, remove Chinese date, but add Muli 60 gram;

(5). If with palpitation and hard in urine, remove Huangqing, but add Fuling 60 gram;

(6). If with mild hot but no thirsty, remove Renshen, but add Guizhi 45 gram, drink the tea when it is warm;

(7). If with cough, remove Renshen, fresh ginger and date, but add Ganjiang 30 gram, and Wuweizi 25 gram.

To diagnose the Wind-invasion or Cold-invasion Shaoyang stage, one symptoms above is enough, no need to have more conditions ready. [6]

With the Cold-invasion Shanghan disease for three days, if the person’s pulse is small, it means that the disease will cure by itself.

07 伤寒四、五日，身热恶风，颈项强，胁下满，手足（他觉）温而渴者，小柴胡汤主之。

With Cold-invasion Shanghan disease for four to five days, if the person feels hot and dislike wind, has stiff in neck (back and side of the neck), fullness in the side of the upper stomach, thirsty and warm hands and feet (when touch), Xao Chaihu Tang is to be used. [7]

08 阳明病，发潮热，大便溏，小便自可，胸胁满不去者，与小柴胡汤。

When in Yangming stage and Shaoyang stage, if the person has wave-hot, loss bowel movement and easy urine, and has fullness in the chest and side of the upper stomach, use Xiao Chaihu Tang. [8]

09 阳明病，胁下硬满，不大便而呕，舌上白苔者，可与小柴胡汤，上焦得通，津液得下，胃气因和，身濈然汗出而解。

When in Yangming stage and Shaoyang stage, if the person has no bowel movement (Yangming stage), but also has hard and fullness in the side of the upper stomach (not in whole Stomach area), has nausea and white tongue covering, use Xiao Chaihu Tang. [9]　This herb harmonize the Upper Jiao (the chest part), so the Jingye can move down to humidify the bowel tract, and to create sweat to solve the disease.

10 凡柴胡汤病证而下之，若柴胡证不罢者，复与柴胡汤，必蒸蒸而振，却发热汗出而解。

If it is originally a Chaihu Tang condition, but a bowel-cleansing therapy is given and the Chaihu Tang condition remains, give the Chaihu Tang again. The person will have continuous and mild sweat to cure.

11 得病六、七日，脉迟浮弱，恶风寒，手足温，医二、三下之，不能食，而胁下满痛，面目及身黄，颈项强，小便难者，与柴胡汤後，必下重，本渴而饮水呕者，柴胡汤不中与也。

If the disease lasts for six to seven days, the pulse is slow and floating and weak, the person feels chilly but warm in hands. A bowel-cleansing therapy has been given so the person loses appetite, feels fullness in the side of upper stomach, has jaundice in the body and eyes, has stiff neck, hard urine. Since there is the stiff in the side of the upper stomach, the Chaihu Tang was given. The person will have diarrhea and heavy pressure feeling in the anus. Though the person has thirsty, and vomiting after drinking water, such thirsty and vomiting is not the condition to the Chaihu Tang, so its use does not work.

12 伤寒六、七日，发热微恶寒，支节烦疼，微呕，心下支结，外证未去者，柴胡桂枝汤主之。

When Cold-incation Shanghan has been for six to seven days, the person feels hot and slight chilly, continuous pain in the joints, mild nausea, little fullness in the upper stomach. Chaihu Guizhi Tang should be used. [10]

柴胡四两, 桂枝一两半, 人参一两半, 甘草（炙）一两, 半夏（洗）二合半, 黄芩一两半, 芍药一两半, 大枣（擘）六枚, 生姜（切）一两半.

Chaihu 60 gram, Guizhi 23 gram, Renshen 23 gram, Gancao (processed) 15 gram, Banxia (washed) 50 gram, Huangqin 23 gram, Shaoyao 23 gram, Chinese date 30 gram, Fresh ginger 23 gram.

Add the herbs and 1750 ml water into a herbal pot. Bring to boil and keep in mild boiling until the liquid in the pot is about 750 ml. Collect the herbal tea. Drink one third of the tea each time, three times a day.

13 伤寒五、六日，已发汗而复下之，胸胁满微结，小便不利，渴而不呕，但头汗出，往来寒热，心烦者，此为未解也，柴胡桂枝乾姜汤主之。

With Cold-invasion Shanghan disease for five to six days, the person has had sweat therapy, had sweat, but given bowel-cleansing therapy again. He now feels fullness in the side of the upper stomach, difficulty in urine, thirsty (no nausea), sweat only on head, cold-hot shift, annoyed/impatience. Chaihu Guizhi Ganjiang Tang is used. [12]

柴胡半斤，桂枝三两，乾姜二两，栝蒌根四两，黄芩三两，牡蛎二两，甘草（炙）二两

Chihu 90 gram, Guizhi 45 gram, Ganjiang 30 gram, Gualugen 60 gram, Huangqin 45 gram, Muli 30 gram, Gancao (processed) 30 gram.

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。

Add the herb and 3000 ml water into a herb pot. Bring to boil and keep in mild boiling until the liquid in the pot is about half. Remove the residue, continue in mild boiling until there is about 750 ml left. Drink one third of the herbal tea each time, three times a day. With the first drink, the person may feel little annoyed/impatience, later drinking will cause a sweat to cure.

After drinking Chaihu Tang, if the person feels thirsty, his condition is in Yangming stage.

15 伤寒五、六日，头汗出，微恶寒，手足冷，心下满，口不欲食，大便硬，脉沉细者[13]，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。脉虽沉细[14]，不得为少阴病，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。

In the Cold-invasion Shanghan disease for five to six days, if the person has sweat but only on the head, feels mild chilly, cold in hands and feet, fullness in the upper stomach, no appetite, and has hard bowel movement and deep and thin pulse, his condition belongs to mild Yangjie condition. It indicates the Xieqi moves from the surface into the inside, so the pulse becomes deep, deep pulse suggesting the disease is in inside of the body. Sweat is due to short of Yangqi. On the other hands, if the condition belongs to a pure Yinjie condition, the person should have no surface symptoms and the person’s symptoms all indicate an inside condition. Now the symptoms suggest the condition half in the surface and half in the inside. It should not be regarded as Shaoyin stage, though the pulse is deep and thin, since there should have no sweat in Shaoyin stage. In this Shaoyang condition, use Xiao Chihu Tang. If this herbal formula work not so satisfied, try bowel-cleaning therapy to remove dead stool in the stomach. [15]

16 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。

With Shanghan disease, if the pulse is harsh when pressed slight, but string when pressed deeper, the person should have acute pain in stomach. Xiao Jianzhong Tang should be used first. If it does not work, try Xiao Chaihu Tang.

17 伤寒胸中有热，胃中有邪气，腹中痛，欲呕吐者，黄连汤主之。

With Cold-invasion Shanghan disease, if the person has Fire in chest but Cold in stomach, he will have stomach pain and tends to vomit. Huangliang Tang should be used. [16]

黄连三两，甘草（炙）三两，乾姜三两，人参二两，桂枝三两，半夏（洗）半升，大枣（擘）十二枚.

Huanglian 45 gram, Gancao (processed) 45 gram, Ganjiang 45 gram, Renshen 30 gram, Guizhi 45 gram, Banxia (washed) 62 gram, Chinese date 62 gram.

Add the herbs and 2500 ml water into a herbal pot. Bring to boil then keep it in mild boiling until there is about 1500 ml liquid left. Remove the herbal residue, collect the herbal tea. Separate the tea into five parts. Drink three parts during the day time, and two parts in the night.

18 太阳病，十日以去，脉浮细而嗜卧者，外已解也。设胸满胁痛者，与小柴胡汤；脉但浮者，与麻黄汤。

With Shanghan disease in Taiyang stage for more than ten days, the person has a willingness to lie down, has floating and thin pulse, suggesting the surface Xieqi has been released. If the person still feels fullness and pain in the chest and in the side of upper stomach, use Xiao Chaihu Tang. If the person has floating pulse and has a willingness to lie down, use Mahuang Tang. [17]

19伤寒发热，汗出不解，心中痞硬，呕吐而不下利者[18]，大柴胡汤主之。(太阳病发热汗出不解，心下痞硬，下利不呕吐者，此表里俱虚，桂枝人参汤证也。)

With Cold-invasion Shanghan disease, the person feels hot and sweat but the symptoms remains, and he feels fullness and hard in the stomach, nausea and vomiting with difficult bowel movement[19], use Da Chaihu Tang.

20太阳病，过经十馀日，反二、三下之，後四、五日，柴胡证仍在者，先与小柴胡汤。呕不止，心下急，郁郁微烦者，为未解也，与大柴胡汤下之则愈。

Previously in Taiyang stage, the disease has passed for more than ten days, the bowel-cleansing therapy has been repeated two to three times. After additional four to five days, if the Chinhu Tang condition remains, use Xiao Chaihu Tang. If the person has continuous vomiting, feels urgent feeling in the upper stomach, mild but continuous annoyed/impatience, use Da Chaihu Tang.

柴胡　半斤，黄芩　三两，半夏（洗）半升，芍药　三两，枳实（炙）四枚，大黄　二两，生姜（切）五两，大枣（擘）十二枚．

Chaihu 90 gram, Huangqin 45 gram, Banxia (washed) 62 gram, Shaoyao 45 gram, Zhishi (processed) 60 gram, Dahuang 30 gram, Fresh ginger 75 gram, Chinese date 62 gram.

右八味，以水一斗二升，煮取六升，去滓再煎，温服一升，日三服。

Add the herbs and 3000 ml water into a herbal pot. Bring to boil and keep in mild boiling until the liquid in the pot is about 1500 ml. Remove the herb residue, continue to boiling until there is about 250 ml left. Collect the herbal tea. Drink one third of the tea each time, three times a day.

21 太阳病，过经十馀日，心中温温欲吐，而胸中痛，大便反溏，腹微满，郁郁微烦，先此时，自极吐下者，与调胃承气汤，若不尔者，不可与。但欲呕，胸中痛，微溏者，此非柴胡证。以呕，故知极吐、下也。

Previously in Taiyang stage, the disease has passed for more than ten days, the person feels a mild feeling of wiling to vomit, has chest pain, loss bowel movement, mild fullness in stomach, mild and slight annoyed/impatience, if asked, he admits that he has had strong vomiting therapy before. In this case, use Tiaowei Chengqi Tang. If the conditions are not due to vomiting, this herb should not be used. The condition of willingness to nausea, has chest pain but mild diarrhea, all together is not a Chaihu Tang condition, so Chaihu Tang should not be given either. The nausea here is caused by heavy vomiting or bowel-cleansing therapy.[20] (This is a combined condition of Taiyang and Shaoyang. If the person has diarrhea with vomiting, Huangqin jia Banxia Shengang Tang can be used.)

22 伤寒十三日不解，胸胁满而呕，日晡所发潮热，已而微利，此本柴胡证，下之而不得利。今反利者，知医以丸药下之，非其治也。潮热者，实也，先宜小柴胡汤以解外，後以柴胡加芒硝汤主之。

With a Cold-invasion Shanghan disease for thirteen days, the person feels fullness in the chest and side of upper stomach, nausea, wave-hot around sunset time, followed by a mild diarrhea. This is condition for Chaihu Tang. If he is given bowel-cleansing therapy, he will have clear diarrhea. It is a wrong treatment. Wave-hot suggests a Shi condition, Xiao Chaihu Tang should be used to release Xieqi from body surface, then use Chaihu jia Manxiao Tang to deplete it through bowel movement.

23 伤寒十三日不解，过经谵语者，以有热也，当以汤下之。若小便利者，大便当硬，而反下利，脉调和者，知医以丸药下之，非其治也。若自下利者，脉当微厥，今反和者，此为内实也，调胃承气汤主之。

With a Cold-invasion Shanghan disease for thirteen days, the person has Chattering syndrome. This indicates he has Fire in the body. Bowel-cleansing therapy should be used. If he has easy urine, his bowel movement should be hard. If his bowel movement is unexpectedly easy, and his pulse is pretty normal, he must have had a bowel-cleaning therapy before, which is a wrong medication. If he was not given a bowel-cleansing therapy, his diarrhea will suggest a weakness condition inside, so his pulse should be weak and has Jue condition. If he has no cold hands and/or feet, the condition will suggests a Shi condition inside. Tiaowei Chengqi Tang is to be used.

24 伤寒三日，三阳为尽，三阴当受邪，其人反能食而不呕，此为三阴不受邪也。

With Cold-invasion Shanghan disease for three days, the Xieqi should pass all the three Yang meridian/stages and move into the Yin meridians/stages. The patient will then feel nausea and hard to eat. Now he has no nausea and feels normal appetite, suggesting that the Xieqi is not going to develop deeper into the Yin conditions.[21]

25 伤寒六、七日，无大热，其人躁烦者，此为阳去入阴故也。

With Cold-invasion Shanghan for six to seven days, the person has no heavy hot, but feels annoyed/impatience emotionally and physically, it suggesting that the Xieqi is to develop further deeper into the Yin conditions. [22]

26 妇人中风，发热恶寒，经水适来，得之七、八日，热除而脉迟身凉，胸胁下满，如结胸状，谵语者，此为热入血室也，当刺期门，随其实而泻之。

If a woman got Wind-invasion, feels hot and chilly, when she has period. After seven to eight days, she feels no hot, but cold in the body and has slow pulse, feels fullness in the chest and side of upper stomach (similar to a Jiexiong condition), and has Chattering syndrome, indicating that she has Fire in the uterus. Acupuncture should be applied, using Qimen point with depletion manner. [23]

27 妇人中风，七、八日续得寒热，发作有时，经水适断者，此为热入血室，其血必结，故使如疟状，发作有时，小柴胡汤主之。

If a woman got Wind-invasion, after seven to eight days, she feels hot and chilly again and again, and the period stops. This condition suggests that the invaded Fire has invaded into the uterus. The blood must be clotted[24], so to make the hot-cold repeat as a malaria. Xiao Chaihu Tang is to be used. [25]

28 妇人伤寒，发热，经水适来，昼日明了，暮则谵语，如见鬼状者，此为热入血室，无犯胃气及上二焦，必自愈。

If a woman has Cold-invasion, feels hot. At this movement, her period comes. She is normal during the day time, but has Chattering syndrome at night, seeming to meet a ghost. This condition suggests a Fire into the uterus too, no any meaning to the Weiqi or The Upper and Middle Jiao Cavity. This condition can cure by itself.

29 血弱气尽，腠理开，邪气因入，与正气相抟，结於胁下，正邪分争，往来寒热，休作有时，默默不欲饮食，藏府相连，其痛必下，邪高痛下 (一云：藏府相连，其病必下，胁膈中痛)，故使呕也，小柴胡汤主之。

If a person has weakness in blood, short in Qi, his out defense system is weak too. This allows Xieqi come in, stick in the side of the upper stomach. The body defense Qi and the Xieqi combat each other, making the person feels hot-cold repeatedly with a fixed pattern. The person feels silent/quiet/no desire to eat. The Xieqi comes down into the stomach, makes him feel nausea. In this case, use Xiao Chaihu Tang.

30 呕而发热者，小柴胡汤主之（衍文，已见太阳中篇半夏泻心汤条上）。少阳病，欲解时，从寅至辰上。

For a disease in the Shaoyang stage, it may be improved from any time between 3 am and 9 am, or it may be worse from any time of this time period.[26]

With a proper treatment, or if the disease is in cure by itself, or if the disease belongs to a weak condition, the disease is improved from any time during this time period[27]. With an improper treatment, or if the disease is progressing, or if the nature of the disease belongs to a Shi condition, it will be worse from any time during this time period.[28]

[1] Shaoyang stage is associated with the Shaoyang meridian. Shaoyang meridian is the Gall bladder meridian, which goes from outside of the eyes, back to the side of the head, to the back of the ear, into the ear, down to the throat and mouth. Therefore, disease in the Shaoyang meridian level will cause bitter taste, dry mouth and dizziness in eyes. No matter it is Cold-invasion or Wind-invasion in the Shaoyang stage, if the person has more than two of the signs, the diagnosis of the Shaoyang stage is more possible.

[2] Panic syndrome: one feels scared, panic, convulsion, thunder, or thrilling.

[3] Feeling hot and headache can also be seen in Taiyang and Yangming stages. In the Shaoyang stage, the pulse is string and thin. It is floating and tight in Taiyang and big in Yangming.

[4] In TCM, if a person is quiet or silent, his condition may belong to different disorders. Here, the person in the Shaoyang stage may appear as quiet, silent and no willing to do anything including to eat, to contact people, to talk, to work and so on. It is not a depression condition. The one simply has no desire for anything.

[5] It is said that the Shaoyang is in between surface and inside layer of the body, so it is explained that it is between the Taiyang (the surface layer) and the Yangming (the inside layer). It is also explained that the Shaoyang is between the Yang stages (the Taiyang and Yangming) and the three Yin stages (the Taiyin, Shaoyin and Jueyin). Therefore, depending on the position of the Xieqi in the body, the person will have different, various and shifting symptoms. For the treatment, it will be difficult to fix a herbal formula to cover so much variable stages. In practice, the Xiao Chaihu Tang is used as a stem formula, which is modified according to the exact conditions of an individual patients. To diagnose the Shaoyang stage, one of the way is to exclude the pure Taiyang and Yangming stage, as well as no evidence for the three Yin stages (see below), or think about the possibility of the Shaoyang stage when the treatments for other stages have been tried but failed.

[6] However, we should be careful to exclude the possibility to the disease in other stages. Other wise if we make the Shaoyang stage diagnosis taking only one symptom here, say, only a cough, or only cold-hot shift, the clinic success rate is low.

[7] This is a combination condition for the Taiyang, Shaoyang and Yangming stages: hot and dislike wind is Taiyang; stiff neck is Taiyang and Shaoyang; thirsty and warm hands and feet when touch is Shaoyang and Yangming. To treat, start with harmonizing the Shaoyang stage.

[8] In Yangming stage, the person should feel hard in stool with frequent urine even if he has wave-hot. Here the condition is wave-hot that is similar to the Yangming but the person has loss bowel movement, not frequent urine, and the fullness is in the chest and side of upper stomach, not in the full Stomach, suggesting the presence of Shaoyang stage. When the Xieqi in both Shaoyang and Yangming, solve the Xieqi from the Shaoyang first.

[9] No bowel movement is Yangming stage, but the fullness and hard in the side of the upper stomach, and nausea suggests either Da Chaihu Tang or Xiao Chaihu Tang. For Da Chihu Tang, the tongue covering is yellow, and for the Xiao Chihu Tang, it is white in color. Again the co-exist of Yangming and Shaoyang stages, solve the Xieqi in the Shaoyang first.

[10] Hot, chilly, pain in the joints suggest Taiyang stage, and fullness in the upper stomach, nausea suggest Shaoyang stage. So, the herb here is the combination of the Chaihu Tang and Guizhi Tang.

[11] Hot, chilly, and pain in the joints all suggest a Taiyang stage, and fullness in the upper stomach, nausea suggest Shaoyang stage. So, the herb here is the combination of the Chaihu Tang and Guizhi Tang.

[12] This condition needs to be distinguished with Wuling San, for the hot, thirsty and difficulty in urine.

[13] In original version, the pulse here is thin.

[14] In original version, the pulse here is deep and tight.

[15] This is a condition which needs to be distinguished with Shaoyin stage, since both has cold feeling in hands and feet, chilly, no appetite and have deep and tight or thin pulse. The Mater pointed out the sweat is the main point to separate these two conditions.

[16] This is a mixed Fire and Cold condition. The Fire is in the chest but the Cold in the stomach. The herbal formula then should also a Yin and Yang in nature to harmonize the co-exist of Fire and Cold in the body.

[17] Some one explained that if there are floating pulse, as well s headache, hot, chilly, no sweat, use the Mahuang Tang.

[18] In original version, it is diarrhea.

[19] In one version, it is diarrhea. If the person feels hot, sweat, fullness and hard in the stomach, no nausea but has diarrhea, use Guizhi jia Renshen Tang.

[20] If there is diarrhea or lose bowel movement, the stomach should not be full. If it is full, it suggests that there is something in the Stomach to block the release of Xieqi through the bowel movement. The disease should belong to Yangming stage.

[21] When the Xieqi is in the Shaoyang stage, the person should feel nausea and cannot eat. Now he becomes no nausea and can eat, suggesting the improvement of the disease, so it said that the Xieqi is not going to develop further deeper.

[22] For a Taiyang condition, annoyed/impatience may suggests release of Xieqi out of the body: (When in the Taiyang stage) and if the disease is to cure by itself, one will feel annoyed (irritable in emotion) first, then has sweat. Why this way? It is because the pulse is floating, indicating that a sweat will follow to remove the Xie Qi out of the body. Therefore, annoyed/impatience during the Taiyang and in the Shaoyang stage has different meaning.

[23] For women, the period is associated with the development of a disease. If the period comes, the Xieqi could move down into the uterus causing complex clinic conditions. Here, the condition of cold body, slow pulse, should be distinguished with Xiao Chaihu Tang (Shaoyang paragraph 15) and Sini San conditions. Note: this condition is pretty much seen in patients with hysteria.

[24] But not develops into typical Jiexiong condition yet.

[25] When treat a menopause syndrome, be careful to exclude this condition.

[26] This is a time period which corresponding to the production of a Yangqi in the nature and in the body. The trends of the Yangqi in the Nature helps, vibrates with the Yangqi in the body, so to cause corresponding trends of the Yangqi in the body: to increase the Yangqi in the body, or to activate the body function. This is a time period of Sun rise. Therefore in winter, it starts close to the 9 am and in summer, it starts close to 3 am. It therefore is also vary from the location of city on the earth.

[27] Proper treatment plus the Yangqi movement in the Nature helps the cure of the disease.

[28] It is a very important way to distinguish the Shaoyang stage from other stages by checking its improvement time period or a worse period.