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Formulas for harmonizing the shaoyang are suitable for alternating cold and heat, fullness in the chest and hypochondria, vexation and vomiting, with bad appetite, bitter taste in the mouth, dry throat, dizziness and wiry pulse caused by cold damage or warm disease with evil in the shaoyang . The shaoyang lies in the half-interior and half-exterior, being the hinge of the moving of the qi dynamic, thus evil in the shaoyang comes and goes, is changeable, has never had a fixed position, and the symptoms are varied. This kind of formula can be applied when one or part of the main symptoms of the shaoyang disease is found in clinic. It was stated by Zhang Zhong-jing that: “ Cold damage and wind stroke can be diagnosed by only one of the patterns of Xiăo Chái Hú Tāng (Minor Bupleurum Decoction) without finding all of the patterns ” (伤寒中风，有柴胡证，但见一证便是，不必悉具) ( Discussion on Cold Damage ).Formulas for harmonizing the shaoyang are usually composed of light and clear medicinals with the function of eliminating the evil heat from the interior to the exterior, and harmonizing the shaoyang such as chái hú (Radix Bupleuri) and qīng hāo (青蒿, Herba Artemisiae Annuae). Analyzing the established formulas in the past, the combination includes the following aspects:
For example, huáng qín (Radix Scutellariae), qīng dài (Indigo Naturalis). The shaoyang belongs to the gallbladder, containing the ministerial fire, it is located half-interiorly and half-exteriorly, it is the hinge for the ascending and descending, entering and exiting of the three yang. Therefore, invasion of the shaoyang by pathogens leads to the incoordination between interior and exterior, disorder of channel qi, and ministerial fire of the shaoyang being depressed into heat, which flames upward along the channel, causing symptoms such as bitter taste in the mouth, dry throat, dizziness, fullness in the chest and rib-side, etc. Moreover, the san jiao also belongs to the yang, it being the passage of the ascending and descending, entering and exiting of the qi dynamic for the entire body, in charge of the free circulation and draining of fluid. Thus, pathogen lingering in the san jiao will cause non-smoothness of the qi dynamic, and water-dampness brewing and transforming into heat, causing dampness-heat patterns in the shaoyang . It was indicated by He Xiu-shan that: “ The foot shaoyang gallbladder channel is combined with the hand shaoyang san jiao channel into one channel. The unified qi lies in the gallbladder to transform food essence, generating in the san jiao to move into the interstitial space. When stagnated by dampness and heat, the qi dynamic of the san jiao is unsmooth, so then the ministerial fire in the gallbladder is intense ” (足少阳胆，与手少阳三焦，合为一经. 其气化一寄于胆中以化水谷，一发于三焦以行腠理. 若受湿遏热郁，则三焦之气机不畅，胆中之相火乃炽), cited from Revised Popular Guide to the Discussion on Cold Damage . It not only emphasized the pathogenic interrelation between the foot shaoyang gallbladder channel and the hand shaoyang san jiao channel, but also revealed the characteristics of the pathomechanism in qi dynamic stagnation by dampness and heat. Therefore, according to different disease patterns resulting from heat stagnation or concurrent dampness and heat in the shaoyang , formulas for harmonization and resolution are usually combined with medicinals for clearing heat and for clearing heat and dispelling dampness to achieve the effects of clearing and discharging the shaoyang and rectifying the exterior and interior. For example, Xiăo Chái Hú Tāng (Minor Bupleurum Decoction) recorded in Discussion on Cold Damage is for symptoms of alternating cold and heat, fullness in the chest and hypochondria, with no desire to eat, vexation and vomiting, bitter taste in the mouth, dry throat, and dizziness caused by evil invading the shaoyang in cold damage, the pathomechanism is the qi dynamic in the shaoyang depression and stagnation with the evil half-interior and half-exterior, which causes unrelieved heat and ministerial fire. In these formulas, chái hú (Radix Bupleuri) with the light and clear property is used as the chief medicinal for not only dispelling evils in the shaoyang from the interior to exterior, but also for smoothing the qi dynamic, diffusing the evils in the half-exterior; meanwhile, bitter and cold huáng qín (Radix Scutellariae) is combined as the deputy medicinal for clearing depressed heat in the shaoyang , eliminating the heat between the exterior and interior thoroughly from the interior. By the combination of the chief and deputy medicinals, this formula can diffuse externally and clear internally, harmonize the exterior and interior, and compliment each other; it is the typical formula for harmonizing the shaoyang . Many of the formulas for harmonization and resolution in later generations are established by imitating and modifying this method. Chái Hú Zhĭ Jú Tāng (Bupleurum Decoction Plus Bitter Orange and Platycodon, 柴胡枳桔汤) and Hāo Qín Qīng Dăn Tāng (Sweet Wormwood and Scutellaria Gallbladder-Clearing Decoction)recorded in Popular Guide to the Discussion on Cold Damage are examples. The former is for the shaoyang channel disease leaning towards the disease being more in the exterior, which is formulated by deleting rén shēn (Radix et Rhizoma Ginseng), gān căo (Radix et Rhizoma Glycyrrhizae) and dà zăo (Fructus Jujubae)from Xiăo Chái Hú Tāng (Minor Bupleurum Decoction), and adding zhĭ qiào (Fructus Aurantii), jié gĕng (Radix Platycodonis), chén pí (Pericarpium Citri Reticulatae) and yŭ qián chá , the tea collected before the season of April 20 th . The yŭ qián chá is for clearing heat and descending fire, in order to reinforce the effect of huáng qín (Radix Scutellariae) for clearing heat and purging by its bitter flavor; the latter, Hāo Qín Qīng Dăn Tāng (Sweet Wormwood and Scutellaria Gallbladder-Clearing Decoction) has developed further in combinations. This formula is for gallbladder heat in the shaoyang diseases with concurrent patterns of damp-heat and turbid phlegm blocking in the middle jiao . Thus, while bitter, cold, and aromatic qīng hāo (Herba Artemisiae Annuae) is used for transforming dampness and eliminating the dirty, dispelling evil heat in the shaoyang , medicinals for clearing heat and dispelling dampness such as huáng qín (Radix Scutellariae), qīng dài (Indigo Naturalis), huá shí (Talcum) and chì fú líng (Poria Rubra)are combined to not only clear and relieve the gallbladder fire in the shaoyang but also to purge dampness heat in the san jiao , they “ purge all the damp-heat from the bladder ” (俾湿热下出，均从膀胱而去), cited from Revised Popular Guide to the Discussion on Cold Damage .
For example, bàn xià (Rhizoma Pinelliae), chén pí (Pericarpium Citri Reticulatae), zhú rú (竹茹, Caulis Bambusae in Taenia), shēng jiāng (Rhizoma Zingiberis Recens), etc.
Generally speaking, the invasion of the gallbladder heat to the stomach due to irregulation of the shaoyang often causes stomach qi counterflow and vomiting, or burns body fluid into phlegm, then symptoms of qi counterflow in the gallbladder-stomach with concurrent turbid phlegm such as frequent vomiting and no desire to eat, or concurrent spitting of sour and bitter fluid, vomiting sticky yellow saliva, even dry retching and hiccough. It was noted by the Divine Pivot - Qi of the Four Seasons, Chapter 19 (四时气第十九, Sì Shí Qì Dì Shí Jiŭ ) that: “ Evil is in the gallbladder, and counterflow of qi is in the stomach, thus upward overflow of bile gives rise to a bitter taste in the mouth, and upward counterflow of stomachqi causes biliary vomiting ” (邪在胆，逆在胃，胆液泄则口苦，胃气逆则呕苦). He Xiu-shan indicated further that: “ Intense gallbladder fire will certainly invade the stomach and cause fluid to be depressed and form phlegm ” (胆火炽，必犯胃而液郁为痰) (recorded from Revised Popular Guide to the Discussion on Cold Damage ). It deeply explored the pathomechanism characteristics of simultaneous disease of the gallbladder-stomach in the shaoyang , and of phlegm-heat and qi counterflow. Therefore, formulas for harmonization and resolution are always combined with medicinals for transforming phlegm and harmonizing the stomach for simultaneously treating the branch. For example, Xiăo Chái Hú Tāng (Minor Bupleurum Decoction) recorded in Discussion on Cold Damage is for the concurrent symptom of “ vexation and frequent vomiting ” (心烦喜呕) due to gallbladder heat invading the stomach, it is combined with bàn xià (Rhizoma Pinelliae) and shēng jiāng (Rhizoma Zingiberis Recens) as the assistant medicinal to harmonize the stomach, descend counterflow and stop vomiting. The indications of Dà Chái Hú Tāng (Major Bupleurum Decoction) include severe counterflow of stomach qi with symptoms of“ unceasing vomiting, depression, and slight anxiety ” (呕不止，郁郁微烦). Therefore, the combination of bàn xià (Rhizoma Pinelliae) and shēng jiāng (Rhizoma Zingiberis Recens) is used in this formula at twice the dosage to reinforce the effect of descending counterflow of qi and stopping vomiting. In addition, the acrid and dispersing properties of bàn xià (Rhizoma Pinelliae) and shēng jiāng (Rhizoma Zingiberis Recens) can strengthen the function of harmonizing and dispelling evil, so when analyzing Xiăo Chái Hú Tāng (Minor Bupleurum Decoction), Ke Qin indicated:“ The acrid and dispersing properties of shēng jiāng (Rhizoma Zingiberis Recens) and bàn xià (Rhizoma Pinelliae) are combined to assist chái hú (Radix Bupleuri) and huáng qín (Radix Scutellariae) to dispel evil on the one hand, and to move the otherwise stagnating properties of gān căo (Radix et Rhizoma Glycyrrhizae) and dà zăo (Fructus Jujubae) on the other ” (引用姜、半之辛散, 一以佐柴、芩而逐邪，一以行甘、枣), cited from Collected Writings on Renewal of the Discussion on Cold Damage - Further Appendices to the Discussion on Cold Damage ). Hāo Qín Qīng Dăn Tāng (Sweet Wormwood and Scutellaria Gallbladder-Clearing Decoction)recorded in the Popular Guide to the Discussion on Cold Damage is indicated for severe heat in the shaoyang with concurrent phlegm dampness stagnating internally. Qīng hāo (Herba Artemisiae Annuae) and huáng qín (Radix Scutellariae) are used in this formula for clearing the pathogenic heat in the shaoyang , and bàn xià (Rhizoma Pinelliae), chén pí (Pericarpium Citri Reticulatae), and zhú rú (Caulis Bambusae in Taenia) are combined for harmonizing the stomach and descending the counterflow of qi, and transforming phlegm, therefore, the effects of harmonizing the stomach and transforming phlegm are more prominent.
Regarding the choice of medicinals for harmonizing the stomach and transforming phlegm in this kind of combination, it is better to choose medicinals with the concurrent effects of transforming phlegm and harmonizing the stomach and descending the counterflow of qi. For example, bàn xià (Rhizoma Pinelliae) is acrid and bitter in flavor, and warm in property, it can, not only dry dampness and eliminate phlegm, but also can descend the counterflow of qi and stop vomiting, thus it is the first choice in formulas for harmonizing the shaoyang . Five crude medicinals, i. e. chái hú (Radix Bupleuri), bàn xià (Rhizoma Pinelliae), dà zăo (Fructus Jujubae), huáng qín (Radix Scutellariae), and shēng jiāng (Rhizoma Zingiberis Recens), the shared components in Dà Chái Hú Tāng (Major Bupleurum Decoction), Xiăo Chái Hú Tāng (Minor Bupleurum Decoction) and Chái Hú Guì Zhī Tāng (Bupleurum and Cinnamon Twig Decoction, 柴胡桂枝汤) were taken by Japanese scholars to compose the basic formula (BASE), while other medicinals in these formulas were taken as additional medicinals (additional group). It was found that the BASE showed a notable resisting effect on the ex vivo ileum contraction of mice caused by acetylcholine, barium chloride and histamine, the resistance being more obvious when the additional group is combined; the experiment on ex vivo colon attained a similar result. After the analysis, BASE is the bulk of the complex of decoctions of chái hú (Radix Bupleuri) in resisting acetylcholine and barium chloride, where chái hú (Radix Bupleuri), huáng qín (Radix Scutellariae), and especially bàn xià (Rhizoma Pinelliae) produce the effects( Journal of Pharmacy, 药学杂志, 1983, 4:466;1984, 5:516 (in Japanese)). It demonstrated the comprehensive compatible significance of bàn xià (Rhizoma Pinelliae) in formulas for harmonization and resolution. Moreover, medicinals for harmonizing the stomach and transforming phlegm should be chosen properly according to the different natures of concurrent phlegm in the counterflow of the gallbladder-stomach qi. For relatively cold phlegm, bàn xià (Rhizoma Pinelliae) is mostly used; while for relatively warm phlegm, zhú rú (Caulis Bambusae in Taenia) is often used. The proportion between medicinals for harmonizing the stomach and that for transforming phlegm should be decided according to the degree of the concurrent phlegm counterflowing in the gallbladder-stomach. Chái Hú Xiàn Xiōng Tāng (Bupleurum Chest Bind Decoction, 柴胡陷胸汤) recorded in the Popular Guide to the Discussion on Cold Damage is indicated for phlegm heat chest bind due to the evil sunken into the shaoyang , it is formulated by deleting the medicinals for supporting the right qi, namely rén shēn (Radix et Rhizoma Ginseng), gān căo (Radix et Rhizoma Glycyrrhizae), and dà zăo (Fructus Jujubae), and adding medicinals for clearing heat and transforming phlegm such as guā lóu (Fructus Trichosanthis), huáng lián (Rhizoma Coptidis), jié gĕng (Radix Platycodonis) and zhĭ shí (Fructus Aurantii Immaturus) from Xiăo Chái Hú Tāng (Minor Bupleurum Decoction), so it is a classic formula paying equal attention to both harmonizing the shaoyang and clearing heat and transforming phlegm.
For example, rén shēn (Radix et Rhizoma Ginseng), dăng shēn (Radix Codonopsis), zhì gān căo (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle), dà zăo (Fructus Jujubae). “ Where pathogen is aggregated, the qi is certainly deficient ” (邪之所凑，其气必虚) ( Basic Questions - Treatise Discussing Heat Disease , Sù Wèn - Píng Rè Bìng Lùn , 素问·评热病论). It is the same case with diseases of the shaoyang invaded by evil. It is indicated in the Discussion on Cold Damage that “ because of blood weakness and qi exhaustion, and the opening interstitial space, the pathogenic qi enters and is accumulated under the hypochondria after fighting with the right qi. ” (血弱气尽，腠理开，邪气因入，与正气相搏，结于胁下) It reflected that deficiency of the right qi is the pathogenic premise of the pathogenic invading the shaoyang . Moreover, regarding the shaoyang being located in the halfinterior and half-exterior, pathogenic qi is likely to take advantage of the right qi deficiency after the fighting between the right and pathogenic qi, when the shaoyang is invaded by pathogenic qi. Therefore, aiming at the pathomechanism of right qi insufficiency in the shaoyang diseases, medicinals for supplementing qi should be reasonably combined in the formulas for harmonization and resolution to support the right qi to dispel pathogen directly from the exterior on the one hand, and to boost qi and prevent pathogen moving into the interior from the exterior, achieving right qi flourishing while leaving no chance for pathogen moving into the interior from the exterior on the other, which has the significance of cutting off the pathogenic force and reinforcing the strength of dispelling pathogen into the exterior. Such examples can be found in the Discussion on Cold Damage where Xiăo Chái Hú Tāng (Minor Bupleurum Decoction) is combined with medicinals for supplementing qi and fortifying the spleen such as rén shēn (Radix et Rhizoma Ginseng), zhì gān căo (Radix et Rhizoma Glycyrrhizae Praeparata cum Melle) and dà zăo (Fructus Jujubae). Wu Kun stated in his analysis of Xiăo Chái Hú Tāng (Minor Bupleurum Decoction)that: “ The pathogen invades the body often by taking advantage of right qi deficiency. The reason for the application of rén shēn (Radix et Rhizoma Ginseng) and gān căo (Radix et Rhizoma Glycyrrhizae) is to prevent middle qi deficiency, thus preventing the evil from being transmitted into the interior. Therefore, for patients without middle qi deficiency, although all of the indications of chái hú (Radix Bupleuri)may be found, rén shēn (Radix et Rhizoma Ginseng) can still be deleted ” (邪之伤人，常乘其虚. 用人参、甘草者欲，中气不虚，邪不得复传入里耳. 是以中气不虚之人，虽有柴胡证俱，而人参在可去也), cited from Investigations of Medical Formulas ( Yī Fāng Kăo , 医方考). Wu Qian, et al also held that: “ Once the right qi in the taiyin in the interior is deficient, the evil will advance and invade the shaoyang channel. Thus, shēng jiāng (Rhizoma Zingiberis Recens), dà zăo (Fructus Jujubae), and rén shēn (Radix et Rhizoma Ginseng) are applied to harmonize the middle and strengthen the internal qi, keeping the interior harmonized without the invasion of evils, dispelling the evil, and resolving the exterior ” (犹恐在里之太阴，正气一虚，在经之少阳，邪气乘之，故以姜、枣、人参和中而预壮里气，使里不受邪而和，还表以作解也), cited from Golden Mirror of the Medical Tradition - Corrections of Discussion on Cold Damage ( Yī Zōng Jīn Jiàn - Dìng Zhèng Shāng Hán Lùn Zhù , 医宗金鉴·订正伤寒论注). These statements are very enlightening for the correct comprehension of the compatible significance, of combining medicinals for supplementing qi, in formulas for harmonizing the shaoyang . The combination of rén shēn (Radix et Rhizoma Ginseng), dà zăo (Fructus Jujubae), or gān căo (Radix et Rhizoma Glycyrrhizae) in Chái Hú Guì Zhī Tāng (Bupleurum and Cinnamon Twig Decoction, 柴胡桂枝汤) and Chái Hú Jiā Lóng Gŭ Mŭ Lì Tāng (Bupleurum Decoction Plus Dragon Bone and Oyster Shell, 柴胡加龙骨牡蛎汤) recorded in the Discussion on Cold Damage also belongs to this kind of combination.
It should be noted that the combination with medicinals for supplementing qi in formulas for harmonization and resolution is embodied in Xiăo Chái Hú Tāng (Minor Bupleurum Decoction) and its categorized formulas, it is hardly found in those formulas for harmonization and resolution established by experts in warm disease in later generations. This is because the Discussion on Cold Damage focused on the uncertain disease tendency due to the state of rising and falling between right qi and the evils in conflict with each other after external cold evil moved into the foot shaoyang gallbladder channel, so rén shēn (Radix et Rhizoma Ginseng), gān căo (Radix et Rhizoma Glycyrrhizae), and dà zăo (Fructus Jujubae) are combined to protect the right qi and resist evils, and to turn the tendency of the disease instead of simply supplementing deficiency, as was noted by Ke Qin: “ Supplement the right qi in advance, harmonize the internal qi and external evil cannot enter ” (预补其正气，使里气和，而外邪勿入也), cited from Collected Writings on the Renewal of the Discussion on Cold Damage - Further Appendices to the Discussion on Cold Damage . Most experts in warm disease held that the theory was as follows: For external warm evils with concurrent damp-heat and turbid phlegm which will stagnate the qi dynamic of the shaoyang san jiao , the fire and heat are intense, but without deficiency of the right qi, the pathogenic evils should be resolved only by clearing instead of using medicinals for supplementing qi and supporting the right qi, which otherwise have the disadvantage of retaining evils. Therefore, there was no need to combine the supplementing medicinals in formulas. Actually, this kind of compatible method of choosing the proper medicinals is reflected completely in the Discussion on Cold Damage . As it was noted beneath the formula of Xiăo Chái Hú Tāng (Minor Bupleurum Decoction), “ for symptoms of vexation in the chest without vomiting, this formula may be used after removing bàn xià (Rhizoma Pinelliae)and rén shēn (Radix et Rhizoma Ginseng)while adding one piece of guā lóu shí (Fructus Trichosanthis) ” ; “ for symptoms with slight exterior heat without thirst, this formula may be used after removing rén shēn (Radix et Rhizoma Ginseng) and adding three liang of guì zhī(Ramulus Cinnamomi), cover the patient and create slight perspiration ” ; “ for symptoms with cough, this formula may be used after removing rén shēn (Radix et Rhizoma Ginseng), dà zăo(Fructus Jujubae) and shēng jiāng (Rhizoma Zingiberis Recens) while adding half liang of wŭ wèi zĭ (Fructus Schisandrae Chinensis) and two liang of gān jiāng (Rhizoma Zingiberis) ” (胸中烦而不呕者，去半夏、人参，加栝蒌实一枚；若不渴，外有微热者，去人参，加桂枝三两，温覆取微汗；若咳者，去人参、大枣、生姜，加五味子半升、干姜二两). The reasons for all of these combinations are as follows:
① The heat accumulates in the chest without qi deficiency;
② Pay attention to the external evil in case of retention of evils;
③ For lung cold and qi counterflow one should avoid stagnation of the qi dynamic.
All of these revealed the flexibility of application and modification of the original formulas from different aspects. Moreover, the indications of Dà Chái Hú Tāng (Major Bupleurum Decoction) are evil heat that has reached the interior and formed the combined disease of the shaoyang and yangming , and the opportunity for stopping the progression of the disease has been lost. Thus, the main therapy is to resolve the shaoyang , and combine with purgation of interior heat accumulation, without the combination of medicinals for supplementing qi. Accordingly, the combination of medicinals for supplementing qi and supporting the right in formulas for harmonization and resolution should be decided according to specific conditions, such as, the rise and fall of the right and evil qi, the amount of concurrent evil qi, and the degree of the disease; and inflexibility in formulation should be avoided.
For example, dà huáng (Radix et Rhizoma Rhei), máng xiāo (Natrii Sulfas). The invasion of the shaoyang by evils causes dysfunction of its ability to act as the pivot and the struggle between the healthy and evil qi between the exterior and interior. The disease can be cured by therapy for rectifying the interior and exterior, while the method of effusing, emesis, and purgation are forbidden. Although evil in the shaoyang enters the yangming at the beginning with partial yangming symptoms, the evil entering the interior should be eliminated to the exterior by rectifying the shaoyang , for the pathogenic transformation of activities has the tendency of penetrating outward. The purgation or the combination of purgating medicinals in the formulas for harmonization and resolution are usually not applied. It was once noted in the Discussion on Cold Damage that “ cold damage with much spitting cannot be eliminated although it has symptoms of the yangming ” (伤寒呕多，虽有阳明证，不可攻之). However, the complicated disease of the shaoyang and yangming has not only symptoms of the shaoyang such as alternating cold and heat, fullness in the chest and hypochondria, but also has symptoms of heat accumulation of the yangming such as fullness and pains or hard glomus below the heart, constipation or dysentery and diarrhea, yellow and thick tongue coating, wiry and forceful pulse. Thus, simply harmonizing the shaoyang has the potential problems of attending to one thing and losing sight of the other; only when consideration is given to both the exterior and the interior through the combination of purgating medicinals in formulas for harmonizng the shaoyang , the pathogens of the shaoyang and yangming can both be eliminated with one application. Based on clinical practice, this combination is suitable for the objective reality of the symptoms of the shaoyang with heat, and concurrent heat accumulation in the yangming, while it doesn’t deviate from the treatment principle that purgation is forbidden for the shaoyang disease. Thus, it further enriched and developed the treatment method of the concurrent patterns in the shaoyang diseases and the compatible methods in formulas for harmonization and resolution. ” Wang Ang indicated that: “ Although the shaoyang cannot be treated by purgation, the concurrent patterns of the yangming fu should be treated by purgation ” (少阳固不可下，然兼阳明腑证则当下), cited from Medical Formulas Collected and Analyzed . It emphasizes the direction of the combination of purgating medicinals in formulas for harmonizing the shaoyang . Dà Chái Hú Tāng (Major Bupleurum Decoction) recorded in the Discussion on Cold Damage was formulated by deleting rén shēn (Radix et Rhizoma Ginseng), and gān căo (Radix et Rhizoma Glycyrrhizae) from Xiăo Chái Hú Tāng (Minor Bupleurum Decoction) to specialize in harmonizing the shaoyang by clearing, and adding in dà huáng (Radix et Rhizoma Rhei), zhĭ shí (Fructus Aurantii Immaturus), and sháo yào (Radix Paeoniae Alba) to discharge internal yangming heat bind and quickly stop pain, thus it is the representative formula mainly for harmonizing combined with purgation. He Xiushan noted reasonably in his analysis of the combination in this formula that: “ Although the shaoyang patterns should not be purgated, this method combines mild purgation in harmonization, because evil comes from the shaoyang and is accumulated gradually in the yangming. While the shaoyang pattern is still not eliminated, marked by alternating cold and heat, and chest vexation and vomiting, thus chái hú (Radix Bupleuri) and shēng jiāng (Rhizoma Zingiberis Recens) have to be combined for resolving the exterior, and bàn xià (Rhizoma Pinelliae) and huáng qín (Radix Scutellariae) for harmonizing the interior. But for acute interior patterns such as abdominal fullness and pain, or red face with extreme thirst, or constipation and dark urine, so chì sháo (Radix Paeoniae Alba) is added to break acute interior patterns, zhĭ shí (Fructus Aurantii Immaturus) and raw dà huáng (Radix et Rhizoma Rhei) are added to purgate potential accumulated heat in the yangming by relaxing the bowels, and dà zăo(Fructus Jujubae) is added as the assistant medicinal to mitigate the drastic effect of chái hú (Radix Bupleuri) and dà huáng (Radix et Rhizoma Rhei) in resolving the exterior and attacking the interior, thus it is the effective formula for harmonizing the shaoyang and yangming and treating the exterior and interior moderately ” (少阳证本不可下，而此于和解中兼以缓下者，以邪从少阳而来，渐结于阳明. 而少阳证未罢，或往来寒热，或胸痛而呕，不得不借柴胡、生姜以解表，半夏、黄芩以和里，但里证已急，或腹满而痛，或面赤燥渴，或便秘溺赤，故加赤芍以破里急，枳实、生军以缓下阳明将结之热，佐以大枣，以缓柴胡、大黄发表攻里之烈性，而为和解少阳阳明，表里缓治之良方), cited from Revised Popular Guide to the Discussion on Cold Damage . For the shaoyang with concurrent excess patterns of the yangming fu but with right qi deficiency and only minor interior excess, Xiăo Chái Hú Jiā Máng Xiāo Tāng (Minor Bupleurum Decoction Plus Marabilite, 小柴胡加芒硝汤) recorded in the Discussion on Cold Damage is more suitable. One third of the dosage of Xiăo Chái Hú Tāng (Minor Bupleurum Decoction) is used to harmonize the pivot of the shaoyang , máng xiāo (Natrii Sulfas)is added for clearing heat and eliminating excess, and softening hardness to loosen the bowels, gently purgating heat accummulation in the yangming , which also belongs to this kind of combination.
For example, shēng jiāng (Rhizoma Zingiberis Recens) and dà zăo (Fructus Jujubae). The exterior belongs to defensive qi and the interior to ying qi, therefore the evils invading the shaoyang will cause an imbalance between the exterior and interior and also cause incoordination of the ying and defensive qi. Wang Ang indicated that: “ Pathogen lying between the exterior and interior will cause fighting between the ying qi and defensive qi ”(邪在半表半里，则营卫争), cited from the Medical Formulas Collected and Analyzed . He revealed the pathogenic characteristics of the shaoyang disease with disorder between the ying and defensive qi. On the contrary, rectifying ying qi and defensive qi can, not only resolve the exterior and interior, but also strengthen the force of harmonizing the shaoyang , which is the basis of the medicinal property for the combination with medicinals for rectifying ying and defensive qi in formulas for harmonizing the shaoyang .Such examples can be found in the Discussion on Cold Damage where most of the formulas for harmonizing the shaoyang such as Dà Chái Hú Tāng (Major Bupleurum Decoction), Xiăo Chái Hú Tāng (Minor Bupleurum Decoction), Xiăo Chái Hú Jiā Máng Xiāo Tāng (Minor Bupleurum Decoction Plus Marabilite), Chái Hú Jiā Lóng Gŭ Mŭ Lì Tāng (Bupleurum Decoction Plus Dragon Bone and Oyster Shell) are combined with shēng jiāng (Rhizoma Zingiberis Recens)and dà zăo (Fructus Jujubae) for rectifying the ying and defensive qi. Cheng Wu-ji stated in his analysis of the combination with shēng jiāng (Rhizoma Zingiberis Recens) and dà zăo (Fructus Jujubae) in Xiăo Chái Hú Tāng (Minor Bupleurum Decoction) that: “ Shēng jiāng (Rhizoma Zingiberis Recens) is acrid in flavor, and dà zăo (Fructus Jujubae) is sweet in flavor and warm in property. It is stated in the Inner Classic: acrid and sweet flavor can diffuse and is yang. Unresolved external evil will wind its way inward. Resolving both the interior and exterior should be complete before the evil forms an excess pattern. The external evil should be dispelled with medicinals acrid and sweet in flavor, thus shēng jiāng (Rhizoma Zingiberis Recens) and dà zăo (Fructus Jujubae)are applied as the envoy medicinals ” (生姜味辛，大枣味甘温. 《内经》曰：辛甘发散为阳.表邪未已，迤逦内传，既未作实，宜当两解.其在外者，必以辛甘之物发散，故生姜、大枣为使), cited from the Clarification of the Theory of Cold Damage . Wu Kun also noted that Dà Chái Hú Tāng (Major Bupleurum Decoction) was combined with “ shēng jiāng (Rhizoma Zingiberis Recens) and dà zăo (Fructus Jujubae) for rectifying the middle and the ying and defensive qi ” ( Investigations of Medical Formulas ). Thus it can be seen, the combination of medicinals for rectifying the ying and defensive qi can be applied, not only in formulas for resolving the exterior, but also in formulas for harmonization and resolution.