Shaoyang apoplexy, with deafness in both ears, red eyes, fullness and irritability in the chest, should not be treated with emesis or purgation, as these methods will cause palpitations and fright.

bubble_chart Note

• Shaoyang refers to the symptoms described in the first section: bitter taste in the mouth, dry throat, and dizziness.
• Apoplexy refers to this Shaoyang disease, which is transmitted from the pathogen of apoplexy.
• The Shaoyang meridian starts from the outer canthus, enters the ear from behind, and its branch meets at the Quepen, descends to the chest, and follows the ribs. When an exterior pathogen invades this meridian, it causes red eyes, deafness, and fullness and irritability in the chest.
• However, this is the fullness and irritability in the chest due to the Shaoyang half-exterior and half-interior condition, not comparable to the fullness and irritability in the chest due to the Taiyang pattern with pathogen sinking. Therefore, emesis and purgation should not be used. If emesis and purgation are used, it will weaken the interior, leading to mental weakness, and thus palpitations and fright.
• This reveals the general principle of apoplexy pathogen transmitting to Shaoyang.

bubble_chart Collected Annotations

• Cheng Zhi said: Shaoyang should only be treated with harmonization. If emesis is used, it will weaken the Yang and cause palpitations; if purgation is used, it will weaken the Yin and cause fright.
• Wang Hu said: "Shaoyang has prohibitions against emesis and purgation, only because of irritability and fullness, hence the mistaken use of emesis and purgation. The commentary states: 'Emesis harms the Qi, leading to Qi deficiency and palpitations; purgation depletes the blood, leading to blood deficiency and fright.' However, it is not understood that fright and palpitations are both related to the heart. Mistaken emesis and purgation deplete the body fluids, leading to mental weakness, hence palpitations and fright."
• Shen Ming-zong said: "Fullness and irritability in the chest may seem treatable with emesis, but in Shaoyang, the pathogen has already descended to the chest and follows the ribs. Emesis only harms the Qi in the chest, causing the pathogen to internally combine and press on mental activity, leading to palpitations and fright."
• Wei Li-tong said: "This section does not provide a prescription from Zhongjing. In the section on Minor Bupleurum, there are symptoms of heart vexation and palpitations below the heart, suggesting that no other treatment is needed. Since the three methods of sweating, emesis, and purgation are not applicable, harmonization should be used. Minor Bupleurum is the appropriate medicine for Shaoyang, and its use should be decisive!"