Shaoyin disease, with vomiting and diarrhea, cold extremities, dysphoria, and a desire to die, is treated with Evodia Decoction.

bubble_chart Note

• It is called Shaoyin disease, and the main treatment for Jueyin is because Shaoyin and Jueyin often have combined diseases, with similar symptoms but different conditions, thus requiring different treatments.
• Shaoyin has vomiting and diarrhea, Jueyin also has vomiting and diarrhea; Shaoyin has cold extremities, Jueyin also has cold extremities; Shaoyin has dysphoria, Jueyin also has dysphoria. This is a combination of diseases with similar symptoms.
• The coldness in Shaoyin can be mild or severe, while in Jueyin it can be cold or hot; the dysphoria in Shaoyin is often restless, while in Jueyin it is often irritable.
• Generally, Shaoyin disease is often due to exuberant yin repelling yang, so the main treatment is with ginger and aconite in the Sini Decoction, to expel yin and restore yang; Jueyin disease is often due to yin exuberance and yang stagnation, so the main treatment is with the pungent and strong Evodia Fruit, to quickly disperse and unblock yang. This is the difference in condition and treatment.
• Now, with vomiting but no vomiting of worms, and cold extremities, it is named Shaoyin disease.
• The coldness does not extend beyond the elbows and knees, with much irritability and a desire to die, so it is treated as Jueyin disease. Therefore, Cold-Extremities Decoction is not used, but Evodia Decoction is used instead.

bubble_chart Collected Annotations

• Cheng Zhi said: "Vomiting and diarrhea indicate yin pathogen in the interior, affecting the spleen and stomach; cold extremities indicate yang not warming the limbs; irritability and restlessness indicate extreme yin exuberance, leading to yang qi exposure and disturbance, nearing danger. Without the pungent warmth of Evodia, it is impossible to subdue the rising yin qi; without the sweet warmth of Ginseng, ginger, and jujube, it is impossible to nourish the middle earth and control kidney evil. Restlessness and dysphoria are different; restlessness is yin restlessness, dysphoria is yang dysphoria. Restlessness means self-restlessness and dysphoria, indicating yin pathogen externally pressing; dysphoria means self-dysphoria and restlessness, indicating yang qi internally struggling. The difference in severity and depth should be carefully examined by scholars."
• Cheng Yingmao said: "The warming method is originally for pudendal coldness, so true cold often appears as false heat. All cases of exuberant yin repelling yang, yin syndrome resembling yang, etc., are Shaoyin deceiving the senses. One must discern the true from the false to avoid being misled. For example, vomiting and diarrhea with cold extremities indicate stomach yang decline and kidney yin invasion. Who does not know it is cold? Yet, dysphoria and a desire to die appear to deceive, as yang is repelled by yin and has no place, hence this appearance. Evodia Decoction uses wood strength to enhance fire, warming the earth and dispelling water cold."

bubble_chart Formula

Evodia Decoction Formula
Evodia Fruit one sheng, Ginseng three liang, Fresh Ginger Rhizome one liang, Chinese Date twelve pieces
The above four ingredients are boiled in seven sheng of water to obtain two sheng, taken warm in seven ge, three times a day.

bubble_chart Collected Explanations

• Luo Tian-yi said: "The method of Zhongjing emphasizes the consolidation of primordial yang in the Shaoyin and the consolidation of vital qi in the Jueyin. Although the Jueyin liver wood is the margence of double yin, the vital qi of a single yang actually arises within it. If this vital qi becomes deficient, the turbid qi of the three yin will directly press upon the middle and upper regions, not only manifesting all the symptoms of the meridian but also causing the Yangming's healthy transportation to fail, leading to the exposure of the true yang of the Shaoyin, resulting in vomiting, diarrhea, cold extremities, dysphoria, a desire to die, and nausea upon eating. The Evodia Fruit, imbued with the qi of the east, is acrid, bitter, and extremely hot, capable of relieving wood stagnation and directly entering the Jueyin to reduce the turbid qi of yin exuberance, thus serving as the sovereign. Ginseng, with its balanced and healthy qi, sweet and warm, greatly tonifies, able to connect with the heavenly true qi and save lives, raising the nearly extinguished vital qi, thus serving as the minister. Assisted by ginger and jujube to harmonize the stomach and circulate to the four extremities. Thus, the divine power of the east combines with virtue, wood and earth do not harm each other, the marvelous function of a single yang is achieved, and the space of the three yin is filled with the qi of life. How can the various symptoms not retreat?"
• Fang You-zhi said: "Vomiting damages yang, while diarrhea harms yin. Cold extremities indicate yin deficiency and counterflow, while dysphoria suggests yang injury and disorder. Evodia is pungent and warm, dispersing cold, warming the stomach, and stopping vomiting; Ginseng is sweet and warm, benefiting yang, consolidating the foundation, and tonifying the middle; Chinese Date assists the stomach and benefits the spleen; Fresh Ginger Rhizome is a sacred medicine for those who vomit. Therefore, these four substances are essential for warming the middle and descending counterflow."