Lesser yáng (shào yáng) disease pattern

Any pattern of lesser yáng (shào yáng) disease, chiefly characterized by alternating cold and heat; fullness in the chest and rib-sides.

Description: Alternating cold and heat (aversion to cold alternating with heat effusion), fullness in the chest and rib-side, taciturnity and no desire to eat or drink (默默不欲饮食 mò mò bù yù yǐn shí), heart vexation, frequent retching, bitter taste in the mouth, dry throat, and dizzy vision. The pulse is stringlike.

Pathogenesis: Disturbance of the lesser yáng (shào yáng)’s pivot action by evils invading from the greater yáng (tài yáng), directly from outside the body, or from the reverting yīn (jué yīn).

Lesser yáng (shào yáng) disease is called half exterior half interior (半表半里 bàn biǎo bàn lǐ) disease. The disease is no longer in the exterior and has not yet entered the interior. The idea is that the disease is halfway between the exterior and interior, which can therefore also be referred to as mid-stage penetration.

Lesser yáng (shào yáng) disease most commonly arises when greater yáng (tài yáng) disease fails to resolve and evil qì encroaches inward, becoming depressed in the gallbladder and the triple burner. It can also arise when reverting yīn (jué yīn) disease passes outward into the lesser yáng (shào yáng) or when external evils directly invade the lesser yáng (shào yáng). Right and evil struggle with each other, prevailing in turns, half-way between the exterior and interior. This struggle inhibits what is called the pivot mechanism so that the evil neither advances into the interior nor can be repelled to the exterior.

The pivot mechanism (枢 shū) is the tendency for lesser yáng (shào yáng) to allow evils to pass into the interior. When it is inhibited, evils cannot advance.

Analysis of signs

• Impaired pivot action: Alternating cold and heat is attributable to the fact that the evil has invaded lesser yáng (shào yáng), inhibiting the pivot. The evil is fighting with right qì, each prevailing in turns. When right overcomes evil, there is heat effusion; when evil overcomes right, there is aversion to cold.
• Evil inhibiting lesser yáng (shào yáng) channel qì: Fullness in the chest and rib-side.
• Gallbladder heat harassing the upper body: Bitter taste in the mouth, dry throat, and dizzy vision.
• Gallbladder heat invading the stomach: The taciturnity and no desire to eat and drink. Note that the interpretation of 默默 mò mò as taciturnity is disputed. Some says it means revulsion at the sight of food.
• Pulse: Stringlike.

Treatment

Medicinal therapy: Harmonization and resolution using xiǎo chái hú tāng (小柴胡汤 Minor Bupleurum Decoction). If there is an unresolved exterior pattern, use chái hú guì zhī tāng (柴胡桂枝汤 Bupleurum and Cinnamon Twig Decoction). If there is an interior pattern, use dà chái hú tāng (大柴胡汤 Major Bupleurum Decoction).

Acumoxatherapy: Clear liver, gallbladder, and pericardium heat and resolve depression using PC‑5 (jiān shǐ), CV‑13 (shàng wǎn), GB‑41 (zú lín qì), and GB‑34 (yáng líng quán). For alternating cold and heat, use TB‑10 (tiān jǐng), GB‑34 (yáng líng quán), GV‑14 (dà zhuī), and PC‑5 (jiān shǐ). Fullness in the chest and rib-side, TB‑6 (zhī gōu) and GB‑34 (yáng líng quán).