Taiyang disease, after purgation, if the pulse is rapid and there is chest fullness, Cinnamon Twig minus Peony Decoction is prescribed. If there is slight aversion to cold, remove Peony Root from the formula and add Aconite Decoction to treat it.

Note: If there is slight aversion to cold, it should be accompanied by sweating and slight aversion to cold to be appropriate. If the words "sweating" are absent, it indicates that the exterior has not been resolved, and there is no need to add Aconite Lateral Root.

bubble_chart Annotation

• Taiyang disease, if the exterior is not resolved and purgation is applied, the chest excess pathogen sinks, leading to chest fullness, rising of qi to the throat causing difficulty in breathing, Muskmelon Base Powder is the appropriate treatment. If the chest deficiency-type pathogen sinks, leading to rising of qi, Cinnamon Twig Decoction is the appropriate treatment.
• Now, after purgation, the pathogen sinks into the chest, causing chest fullness and a rapid pulse. It seems like chest excess but without the symptom of qi rising to the throat causing difficulty in breathing, and it seems like chest deficiency but with the symptom of chest fullness. Therefore, Muskmelon Base Powder is not used to treat excess, nor is Cinnamon Twig Decoction used to treat deficiency. Only the sweet and pungent Cinnamon Twig is used to harmonize the exterior of the taiyang, and Peony Root is removed to avoid chest fullness.
• If there is sweating and slight aversion to cold, remove Peony Root and add Aconite Lateral Root to the formula to prevent yang exhaustion.

Note: In the previous passage, a rapid pulse, panting, sweating without aversion to cold, and persistent diarrhea indicate excess heat. In this passage, a rapid pulse, chest fullness, sweating with slight aversion to cold, without panting or diarrhea, indicate deficiency cold. Why? In the previous passage, the sweating without aversion to cold is due to interior heat steaming out, hence it is yang excess, and panting with diarrhea are both signs of heat. In this passage, the sweating with slight aversion to cold is due to the exterior yang not being secure, hence it is yang deficiency, and even without panting or diarrhea, it is still cold. It is important to know that Zhang Zhongjing's method of establishing principles often distinguishes in the most subtle details, fearing that people may easily overlook the subtle points. Now, using slight aversion to cold to elucidate the meaning, the distinction of cold and heat is not based on sweating, but on sweating with aversion to cold or without aversion to cold; Not based on the rapid pulse, but on the strength or weakness of the rapid pulse to distinguish cold and heat. From this, it can also be understood that the distinction of deficiency and excess is not only based on chest fullness, but also on whether the chest fullness is constant or intermittent, and whether it is constantly full without reduction to distinguish deficiency and excess.

• Yu Chang said: "The slight aversion to cold in this passage, when compared with the previous passage, shows that within the rapid pulse, chest fullness, panting, and sweating, there is originally a hidden mechanism of yang deficiency on the verge of collapse. Therefore, Zhang Zhongjing in this passage specifically uses the phrase 'slight aversion to cold' to elucidate the meaning, showing that yang deficiency causes aversion to cold. It also shows that aversion to cold without sweating is not yang deficiency."
• Cheng Yingmao said: "There is yang exuberance that shows a rapid pulse, and there is also yang deficiency that shows a rapid pulse. It should be distinguished by strength or weakness, and still needs to be distinguished by external symptoms."
• Shen Mingzong said: "Misapplying purgation disturbs the yin-yang qi, causing a rapid pulse. The pathogen enters the chest and diaphragm, almost forming thoracic accumulation, but only causing fullness without pain! Therefore, Cinnamon Twig Decoction is used alone to lift the pathogen from the chest and diaphragm, allowing it to resolve through the exterior. Peony Root is removed to avoid its sour and astringent nature, which would draw the pathogen inward. If there is a rapid pulse, chest fullness, and slight aversion to cold, it is deficiency and constraint, with yang qi on the verge of collapse, which is not comparable to yang excess. Therefore, Aconite Lateral Root is added to protect the true yang. However, the aversion to cold after common cold and purgation is distinctly different from aversion to cold without purgation. And the aversion to cold after sweating is also different from aversion to cold without sweating."

bubble_chart Formula

Cinnamon Twig minus Peony Decoction Formula
Remove Peony Root from Cinnamon Twig Decoction, and follow the previous method for the rest.
Cinnamon Twig Decoction minus Peony Root plus Aconite Decoction
Remove Peony Root from Cinnamon Twig Decoction Formula, add one piece of Aconite Lateral Root, roasted and peeled, broken into eight pieces, and follow the previous method for the rest.