The essential symptom indicating that the pathogenic factor is in between the Exterior and
Interior, is the alternation of chills and fever (or feeling of heat). This is due to the fact that the
pathogenic factor "bounces" in between the Exterior and Interior: the patient feels cold when it is
on the Exterior, hot when it is in the Interior. It should be noted, however, that there need not be
an actual fever, as it may just be a feeling of heat. In fact, the temperature may be normal or in
some cases even subnormal, and still the person feels hot. In many cases of ME when patients
experience alternation of chills and fever for months or years, the temperature is very often
subnormal. When the temperature becomes normal the person feels better.4(511)
The Lesser-Yang pattern, characterized by alternation of chills and feeling of heat, is quite
commonly seen in patients suffering from ME: as was explained above, this pattern is, in itself, a
type of residual pathogenic factor just as Damp-Heat is. The Lesser-Yang pattern can even last
for years. The longer it goes on, of course, the more it is associated with some deficiency. In
these cases, it is necessary to clear the Lesser Yang before tonifying.
Apart from the alternation of chills and heat, another essential sign of this condition is the pulse
being Wiry. It may be Wiry only on the left side, or it may be slightly Wiry at the same time as
being Fine, but it should have some Wiry quality.
As mentioned above, the Lesser-Yang patterns from the 6 Stages and the 4 Levels are essentially
the same. The main difference is that in the 4-Level Lesser Yang pattern there is more Heat
(hence the thirst, more pronounced feeling of heat, yellow tongue coating and Rapid pulse).
Treatment Principle
Clear the Lesser Yang.
Acupuncture
General Prescription
T.B.-5 Waiguan, Du-14 Dazhui. Even method.
Explanation
These two points clear the Lesser Yang and release the pathogenic factor. They should be used
several times in succession, obviously combined with some other points according to the
condition.
Herbal Treatment
There are three prescriptions for the Lesser Yang pattern, the first for the one from the 6 Stages,
the second and third for the one from the 4 Levels.