The significance of Shaoyang meridian/stage

按少阳一经，以火为本（少阳之上，相火主之，故也），厥阴为中气（肝与胆为表里），少阳为标（主外，是本经之标、本、中三气也）。有经症，有腑症，有半表半里症，不可不知也。

The Shaoyang meridian is dominated by the Fire, or it dominates the Fire (It is the Fire that dominates the Shaoyang meridian/stage). Yueyin is its middle Qi (The liver and the gallbladder is the couple system. The Liver belongs to the Yueyin.). The Shaoyang is its surface layer. The disease can happen in its meridian, inside organs, or in between the surface and the inside (half-surface and half inside).

（以下承接阳明经）如阳明之邪未罢，势必传于少阳，则治少阳，必兼治阳明；如全不见阳明之经症、腑症，而独见少阳之经、腑症者，则专治少阳，方为合法。

If the disease is not solved in the Yangming stage, it will pass into the Shaoyang. To solve the disease in the Shaoyang stage, the Yangming stage should also be treated. If there is only the evidence for the disorder in the Shaoyang stage, but no evidence for the Yangming stage, only treat the Shaoyang stage.

经症者何？头痛在侧，耳聋喜呕，不欲食，胸胁满，往来寒热是也。夫寒邪之客气，每至阳明燥地而化为燥邪，燥邪之客气未尽，遂传入少阳（客寒至阳明，从燥而化为燥邪，燥邪入少阳，为病机主脑）。盖少阳主枢，有枢转阴阳之道，今因燥邪之客气干之，阻其少阳条达之气机，正邪相击，故两侧头痛作矣（耳前后两侧，俱属少阳），胆脉入耳，燥邪干之，清窍闭塞，耳遂骤聋；木原喜乎条达，呕则气动，木气稍泄，病故喜呕；木气不舒，上克脾土，土畏木克，故不欲食；胸胁者，肝胆所主之界限也，肝胆不舒，胀满并作（即此便可悟客气之过也。客气详附解）。少阳与太阴接壤，系阴阳交界之区，故曰半表半里。邪附于胆，出与阳争则热，入与阴争则寒（阳指阳明，阴指太阴），故有寒热往来也。主以柴胡汤，专舒木气，木气得舒，枢机复运，邪自从枢转而出，此本经浅一层立法也。

What is the evidence for the disease in the meridian level of the Shaoyang stage? The patient has headache in the side of the head, has deaf, tends to nausea or gag, no desire to eat, fullness in the chest and upper-side of abdomen, hot-cold shift feeling. The Cold Xie Qi passes into the Yangming stage, it will turn into the Dryness Xie Qi. If the Dryness Xie Qi is not solved or depleted out completely, it will pass into the Shaoyang stage and turn into the Fire Xie Qi. The Function of the Shaoyang in the body is as the pivot to transform the Yin and the Yang. Now, the Dryness Xie Qi invades in the Shaoyang stage, blocks its pivot function, the original normal body Qi and the invaded Qi struggle each other to cause the head pain in the side of the head (the Shaoyang meridian distributes in the side of the head.). The Shaoyang Gall bladder meridian distributes into the ear, so the Xie Qi causes deafness. The Wood likes to have free stretch. If the Shaoyang Qi is blocked, no free stretch, it tends to save energy to push off the block, to cause nausea. It Wood Qi is in disorder. It will insult the Soil, the Spleen system, causing the reduction of the Spleen, so the patient has no desire to eat. The chest and the upper and side of the abdomen is the zone dominated by the Gall bladder and the Liver. The Liver Qi is in a depressed condition, so there is fullness feeling in the chest and its side. The Shaoyang connected with the Taiyin stage. It is the boarder of the Yang and the Yin stages, so called half Yang and half Yin. The Xie Qi attached in the Gall bladder. If it follows the Gall bladder Qi to move out, it causes hot; if it moves along with the Yin, it causes cold feeling. (The Yang means Yangming, and the Yin refers to the Taiyin). Therefore the patient feels hot-cold shift feeling. The main herb formula for the Shaoyang stage is the Xiao Chaihu Tang, to release the depress in the Shaoyang stage. This is the treatment principle for the mild disease in the Shaoyang stage.

用药未当，邪不即出，则必入腑，即现口苦、咽干、目眩（六字乃本经腑症提纲），此际燥邪入腑，合本经标阳，燥与热合成一家，热甚则胆液泄，故口苦、咽干；肝开窍于目，与胆为表里，表病及里，里热太甚，必伤肝中所藏之血液，故目眩。主以黄芩汤，清其里热，里热一解，邪自灭亡，此本经深一层法也。

If the treatment does not work, the Xie Qi is not depleted out of the body, it will move into the inside organ, showing bitter taste in mouth, dry throat, dizziness in eyes. These are the principle parameter to diagnose the Shaoyang stage. At this movement, the Dry Xie moves in the organ, mixed with the original Hot in the Shaoyang stage. If the Fire is overwhelming, it will press the gall bladder to spill, to cause bitter taste in mouth, and dry throat. The eyes are the opening place for the Liver, and the gall bladder the Liver is the surface-inside relationship, the disease in the gall bladder affects the Liver too, the Fire so also burns the Liver blood, causing the dizzy in eyes. In this condition, use HuangQin Tang to clear the inside Fire. This is the treatment principle for the relatively severe conditions in the Shaoyang stage.

所谓半表半里症者何？即其所处之界，分而言之也。邪在三阳，俱以表称；邪在三阴，俱以里论。半表者从阳分（少阳与阳明太阳为一家也），半里者从阴分（少阳与太阴接壤，太阴与少阴厥阴为一家也），故诸书言疟病不离少阳，因其寒热之往来而决之于少阳也（表邪之为病，寒热无定候；疟邪之为病，寒热有定候。以此别之）。邪在少阳，不能从枢转而出，直趋阳明地界。阳明主燥，故病者发热（即热疟也）；邪苟不趋阳明，而专趋太阴。太阴主寒，故病者发寒（即寒疟也）。学者能于寒热二字，探其轻重，则治疟不难也。

What means the half surface and half inside condition? It is due the location of the Shaoyang. It is in between the Yang meridian/stage and the Yin meridian/stage. When the Xie Qi is in the Yang stages (Taiyang, Yangming or the Shaoyang), it is called surface. When it is in the Yin meridian/stage (Taiyin, Shaoyin or the Jueyin stage), it is called inside condition. Half surface means the Xie Qi is relatively more in the Yang stages, and half inside means it is more in the Yin stages. This is the reason in many book in discussion of malaria, they talked the Shaoyang, since one of the main clinic manifestation for the Shaoyang is the hot-cold shift. (It should be known that, the hot-cold shit in the ordinary disease, the shift is not in a fixed time pattern. But in the malaria, the onset has regular time pattern.). When the Xie Qi is in the Shaoyang, unable to deplete out of the body, it will move into the Yangming stage. The Yangming dominates Dry, so the disease shows fever (e.g. the Fever malaria). If the Xie Qi does not move to the Yangming, but to the Taiyin, the Taiyin dominates Cold, so the disease shows cold (e.g. the Cold malaria). If the beginner can understand the meaning and the mechanism of the hot and the cold, pay attention to the severity of the cold or the hot, the treatment of the malaria should not be so difficult.

附解：有少阳经症初见，而合三阴为病者，即合三阴之法治之。

Appendix: if the Shaoyang stage happens for not long time, and there are also evidences for the three Yin conditions, all of the conditions should be treated the same time.

须知伤寒有传经不传腑，传腑即不传经的，更有直中太阴、少阴、厥阴，切切不可拘于一日太阳，二日阳明上搜寻，总在这六经提纲病情上体会，即误治变逆，亦可知也。即本经自受之风，自受之寒，自受之热，皆可以辨也。

It should be known that there are conditions in the Shanghan disease, in which the disease passes into the meridian but not in the organ, or into the organ but not in the meridian. The disease can also invade the Taiyin, or the Shaoyin, or the Jueyin straight forwards without staying in the Yang stages. We should not stick the surface meaning of the sentence in the book “The first day, the Xie Qi is in the Taiyang, second day, it is in the Yangming…”. Keeping the characteristics of the evidences of the Xie Qi in each of the six meridian/stage. By this way, even if the clinic condition is caused by doctor’s mistake in the treatment, it would be easier to identify it. In another words, if each of the meridian is attacked by out coming Wind Xie, Cold Xie, or Hot Xie, can also be known.

伤寒一书，通体就在这邪正二字。正气乃六经之本气也，寒为太阳之本气，燥为阳明之本气，火为少阳之本气，湿为太阴之本气，热为少阴之本气，风为厥阴之本气。六经之本气，乃一定不易之气也。六经只受得先天之真气，受不得外来之邪气，邪气即客气也。客气者何？风、寒、暑、湿、燥、火是也。此六客者，天地常有之客也，正气旺者，客气不得而干之，正气弱者，客气即得而入之。六客皆能损人之气血，戕人之性命，故仲景首以寒客立论，先提出六经本气，后指出寒邪之客气，或在三阳、或在三阴，或病于经、或病于腑，或病于卫、或病于营，或随燥化、或随热化、或随湿化、或从火化、或从风化。或邪在表，误下而入内；或邪在里，误汗而变逆。出入变化、往来盛衰，皆客气流行自然之道，实因人身五脏六腑之偏盛致之也。学者务要识得六经本气、病情、提纲，即能明客气之所在，而用药有据，则不惑也。仲景虽未将六客，逐位立论，举伤寒一端，而六客俱在也。即外之尸气、瘴气、疫气、四时一切不正之气，亦皆可仿此而推也。

The whole book <<Shang Han Lun>> talks about the Xie Qi and the Zheng Qi. The Zheng Qi is the body own Qi in the six meridian/stages. The Cold is the original Qi of the Taiyang; Dry is the original Qi of the Yangming; Fire is the original Qi of the Shaoyang; Wet is the original Qi of the Taiyin; Hot is the original Qi of the Shaoyin; and the Wind is the original Qi of the Jueyin meridian/stage. This is the truth for ever. The six meridians can only associate and harmony with the original Qi, not at all with the out-coming Xie Qi. The Xie Qi is also called as a quest Qi. The quest Qi is the Wind, the Cold, the Hot, the Wet, the Fire, and the Dry. However, the six quest Qi is also the natural Qi in the nature. If the body Zheng Qi is strong, the quest Qi wouldn’t be able to invade. If the body Zheng Qi is weak or in a deficient condition, the quest Qi can invade to cause a disease. All the quest Qi can damage body Qi and Blood, to cause death, so the Master Zhang Zhongjing first introduced the effect of the Cold Qi on the body, then pointed out the six original Qi, then told us the Cold Qi can either be in the three Yang stages, or three Yin stages, or in the meridians, or in the organs, or in the Wei layer, or in the Ying layer, or following the Dry, the Hot, the Wetness, the Fire, or the Wind. The Xie Qi may be in the surface but go down to the inside; or it is in the inside, but a sweat therapy brings it in a much complex condition. The movement and the transform of the quest Qi follows the natural movement rule of the Qi in the nature, depending on the strong or weak of the body original Qi. The Mater though did not tell the rule of all the quest Qi movement in the body, but only the Cold Qi, implies actually the same rule for all of the Qi. Even for some other special Qi in the nature, such as the corpse Qi, the miasma Qi, or the infectious Qi, when invade into the body, will follow the same rule in affecting the body.