Lesser yáng (shào yáng) disease

Also midstage pattern. Disease of the hand lesser yáng (shào yáng) triple burner and the foot lesser yáng (shào yáng) gallbladder channels. Because the lesser yáng (shào yáng) is located between the greater yáng (tài yáng) and yáng brightness (yáng míng), lesser yáng (shào yáng) disease is often referred to as a midstage disease pattern. The essential signs are alternating heat and cold, chest and rib-side pain and fullness, bitter taste in the mouth, and vomiting. Other signs include no desire for food and drink, heart vexation, desire to vomit, dizzy vision, painful hard glomus under the rib-side, and a stringlike pulse. Lesser yáng (shào yáng) disease occurs when, owing to debilitation of right qì, an evil invades the body through the interstices and binds in the gallbladder, impeding qì dynamic and disrupting upbearing and downbearing. Bitter fullness in the chest and rib-side is explained by the lesser yáng (shào yáng) gallbladder channel that traverses this area. Alternating heat effusion and aversion to cold are explained by the struggle between the evil and right. Heart vexation, bitter taste in the mouth, dry pharynx, dizzy vision, as well as vomiting and no desire for food and drink, are the result of gallbladder heat rising counterflow up the channel, disturbing the harmony and downbearing of stomach qì. A stringlike pulse is classically associated with the gallbladder. Lesser yáng (shào yáng) disease is different from greater yáng (tài yáng) and yáng brightness (yáng míng), lying midway between the two. Greater yáng (tài yáng) disease can pass to both yáng brightness (yáng míng) and lesser yáng (shào yáng). Lesser yáng (shào yáng) disease may resolve in an exterior pattern through a constant sweat, or may pass to the yáng brightness (yáng míng) to form an interior pattern. It may pass to the yīn channels, causing vacuity patterns. Consequently, lesser yáng (shào yáng) disease is commonly termed a midstage pattern. However, it may occur in combination with an exterior pattern characterized by heat effusion, aversion to cold, and vexing pain in the joints of the limbs, or with a yáng brightness (yáng míng) interior pattern characterized by abdominal fullness and constipation.

Medicinal therapy: Lesser yáng (shào yáng) is treated by the method of harmonization and resolution. This involves outthrusting the evil and clearing the interior, and regulating qì dynamic, in accordance with the principle of supporting right and dispelling evil. The chief formula used is Minor Bupleurum Decoction (小柴胡汤 xiǎo chái hú tāng). However, where an exterior pattern is also present, causing a greater yáng (tài yáng) and lesser yáng (shào yáng) combination, sweat-effusing action is needed. In such cases, Bupleurum and Cinnamon Twig Decoction (柴胡桂枝汤 chái hú guì zhī tāng) is used. Where an interior pattern is present, forming a lesser yáng (shào yáng) and yáng brightness (yáng míng) combination, an appropriate formula is Major Bupleurum Decoction (大柴胡汤 dà chái hú tāng), which possesses an additional precipitant effect.