After purgation, followed by sweating, there is dysphoria during the day and inability to sleep, but quietness at night, without vomiting or thirst, and no exterior pattern. The pulse is deep and faint, and there is no high fever. Dried Ginger and Aconite Decoction is the main treatment.

bubble_chart Note

• This follows the previous section to elaborate on the pulse and symptoms, and to propose the treatment.
• After purgation, which weakens the interior, and sweating, which weakens the exterior, there is a deficiency of both yin and yang. Yang has nothing to attach to, hence quietness at night, without vomiting or thirst, indicating no yang pattern internally; no exterior pattern, no high fever, and a deep and faint pulse, indicating no yang pattern externally.
• With no yang in the exterior or interior, and yin prevailing both internally and externally, the only yang pattern is dysphoria during the day and inability to sleep. This is a case of yin governing itself in the yin aspect, and yang disturbing itself in the yang aspect, not a case of mutual conquest but of separation. Therefore, Dried Ginger and Aconite Decoction is used to assist yang to match yin.
• Although yin is strong, it does not oppose yang; yang qi is weak and does not attach itself.

bubble_chart Collected Annotations

• Yu Chang said: "The previous section only mentioned chills and a faint pulse, without specifying the disease, as deficiency syndromes vary. However, chills and a faint pulse already indicate yang deficiency. If there is dysphoria during the day and inability to sleep, it is clear that deficient yang is causing disturbance; quietness at night, without vomiting or thirst, indicates that the disturbance of deficient yang is not accompanied by external pathogens. A deep and faint pulse and no high fever indicate that dysphoria is a sign of yang exhaustion, and Dried Ginger and Aconite Lateral Root are essential. From this, it can be inferred that if there is quietness during the day and dysphoria at night, it is a yin disease without yang disease."
• Cheng Yingmao said: "After purgation and sweating, dysphoria during the day and inability to sleep indicate that deficient yang is causing disturbance, showing false heat externally. Quietness at night, without vomiting or thirst, no exterior pattern, a deep and faint pulse, and no high fever indicate that yin qi is governing alone, with true cold internally. Dried Ginger and Aconite Decoction should be used to restore yang from within yin, and one should not be misled by the false heat pattern of dysphoria during the day."

bubble_chart Formula

Dried Ginger and Aconite Decoction
Dried Ginger 1 liang, Aconite Lateral Root 1 piece (peeled, used raw, broken into 8 pieces)
The above two ingredients are boiled in 3 sheng of water until 1 sheng remains. The dregs are removed, and the decoction is administered at draught.