Taiyang and Shaoyang concurrent disease, but instead of purgation, it leads to thoracic accumulation, hardness below the heart, incessant diarrhea, inability to ingest water or gruel, and the person feels vexed.

bubble_chart Note

• This follows from the previous passage, discussing the changes due to mistaken purgation.
• In the concurrent disease of Taiyang and Shaoyang, instead of needling the lung and liver shu points, purgation is mistakenly applied. The pathogens of the two yangs take advantage of a deficiency to invade internally, leading to symptoms resembling thoracic accumulation, which eventually becomes actual thoracic accumulation. Hardness below the heart transforms into incessant diarrhea, and the inability to ingest water or gruel.
• When nothing enters from above and there is constant outflow from below, the middle becomes empty and devoid of substance, causing the person to feel vexed and frantic, leading to a deteriorated condition. Even with the needling methods mentioned in the previous passage, they are of no use.

bubble_chart Collected Annotations

• Cheng Zhi said: "This is a case of concurrent disease of the two yangs, with changes due to mistaken purgation. The exterior pathogen of Taiyang takes advantage of deficiency to enter the interior, leading to thoracic accumulation and hardness below the heart. The semi-interior pathogen of Shaoyang takes advantage of deficiency to enter the interior, leading to incessant diarrhea. With both upper and lower parts affected, the Yangming in the middle is unable to ingest water or gruel, causing vexation."
• Yu Chang said: "Even without mistakenly using sweating or purgation, the concurrent disease already resembles thoracic accumulation and hardness below the heart, how much more so with mistaken purgation? Thus, compared to the changes due to mistaken purgation in Taiyang alone, this is even more severe. The person's vexation seems like an incomplete statement, but the classics say that with thoracic accumulation, agitation and vexation indicate death. Does this mean that the person's vexation indicates death?"
• Wang Hu said: "In Taiyang disease in the meridians, purgation should not be used, and in Shaoyang disease, purgation is also prohibited. Therefore, purgation is considered contrary."