【Original Text】Article 1: The disease of Taiyang manifests as a floating pulse, stiffness and pain in the head and neck, and aversion to cold.
【Translation】The disease characterized by a floating pulse, stiffness and pain in the head and neck, and aversion to cold can be diagnosed as Taiyang disease.
The author believes that understanding symptoms is key to learning and applying this classic text. If one does not grasp the symptoms well, it will be difficult to understand the patient’s manifestations, leading to a disconnect when encountering patients, and one will be unable to effectively apply the classic teachings to solve clinical problems. Therefore, the author has taken great pains to explain the symptoms in detail, hoping to assist fellow practitioners in understanding and applying the classics.
【Explanation of Symptoms】
1. Floating Pulse: It can be felt with light pressure, but diminishes with heavy pressure.
The floating pulse refers to a pulse that is superficial, which is a symptom in itself. A floating pulse means that the pulse can be felt at a shallow level beneath the skin; thus, it can be detected with light pressure, but it weakens with heavy pressure, though it does not disappear.
Principle: The pulse reflects the Qi, and the pulse diagnosis senses the body’s Zheng Qi (correct Qi). Taiyang governs the body’s exterior, which can be understood as the outermost layer of the body. When this outer layer is invaded by pathogenic Qi, the Zheng Qi rises to resist the pathogenic Qi, resulting in a struggle between Zheng and Xie (pathogenic) Qi at the body’s surface, hence the manifestation of a floating pulse. The Zheng Qi is at the outer layer of the body, which is why it can be felt with light pressure; the internal Qi is weakened, thus it diminishes with heavy pressure.
2. Stiffness and Pain in the Head and Neck: A feeling of tightness and pain in the head and neck.
Explanation: Understanding this symptom requires some imagination. Taiyang disease has both systemic and localized manifestations; the systemic aspect is like the sky surrounding the earth, while the localized aspect is like the sun rising and setting. In the human body, it primarily affects the head, neck, and back. In Taiyang disease, both systemic and localized aspects are obstructed, leading to pain, hence the stiffness and pain in the head and neck.
3. Aversion to Cold: A feeling of being cold.
Explanation: The term ‘aversion’ means to dislike; aversion to cold indicates a fear of cold, manifested as a dislike for cold, which cannot be alleviated even with additional clothing or blankets. Aversion to cold is a core symptom of Taiyang disease and a specific manifestation that distinguishes between exterior cold, interior cold, excess cold, and deficiency cold. Therefore, the ancients believed that ‘for every degree of aversion to cold, there is a corresponding degree of exterior syndrome.’
【Expansion】
1. The Significance of Knowing the Normal and the Abnormal
During the teaching process, it was found that many students do not understand ‘normal.’ Normal refers to the manifestations of a healthy person. To help students recognize the importance of understanding ‘normal,’ it is necessary to remind them to engage deeply in clinical practice and to experience the manifestations of normal individuals.
Learning Traditional Chinese Medicine (TCM) requires knowing the normal to understand the abnormal. The so-called ‘normal’ refers to what is typical; ‘abnormal’ refers to what is not typical. Only by knowing the characteristics of normal can we discern the abnormal. To know the normal, one must engage in clinical practice to enhance diagnostic skills. Establishing a sensory system within one’s own experience allows for the internalization of book knowledge into personal knowledge, which is also the process of constructing one’s own perceptual awareness. Completing this construction of perceptual awareness is the process of enlightenment.
2. The Spirit of Believing with Certainty
Constructing one’s own perceptual awareness requires opening the door to ‘faith.’ Faith means unconditionally believing in the theories presented in textbooks, considering them absolute truths, which is essential for constructing this system. Otherwise, even with extensive knowledge, one cannot enter the door of Zhang Zhongjing’s teachings and will remain an outsider. Without faith, one’s perceptual awareness will close, preventing entry into the realm of understanding. The normal pulse of a person typically has a frequency of 4-5 beats per breath and is characterized by being calm, smooth, neither too strong nor too weak, neither floating nor sinking; these are manifestations of having Qi, spirit, and root.
3. Integrating TCM Physiology into Clinical Practice Daily
Understanding the normal state of the human body is extremely important; hence, the ancients said that treating diseases without understanding the organs will lead to mistakes. One reason modern medicine is so dominant is that it incorporates knowledge of anatomy, physiology, and pharmacology into daily rounds. For example, cardiology studies the distribution of coronary arteries daily; neurology studies the brain cortex’s regional functions daily. This continuous analysis of the objective structure of the human body helps in understanding organic diseases. TCM has been weak in this aspect of teaching rounds; very few can comprehensively explain TCM’s physiological functions. In fact, TCM also derives from objective anatomy, such as the distinctions between zang (organs) and fu (hollow organs). The ancients discovered that organs have common characteristics, and so do hollow organs, and their functions also share commonalities. Understanding individuality within commonality is often a necessary path in TCM. Moreover, TCM further elevates tangible and visible concepts to develop theories of Qi, which leads to the emergence of purely rational concepts. These purely rational concepts are relatively difficult to understand, which limits the learning of TCM. In clinical practice, treating constipation involves theories such as the spleen governing ascent, the stomach governing descent, the five organs storing essence without leaking, and the six fu transmitting and transforming substances without storing. When a patient presents with constipation and also experiences dizziness and numbness of the skin, it may be explained as Qi stagnation or blood not flowing, or simply as a concept of insufficient Yang Qi. However, there is no discussion of the flow of meridians, which is where Qi and blood run at certain times to certain channels, leading to issues. Although many skilled TCM practitioners can treat diseases based on local theories, this broad approach is not easily understood by everyone, resulting in significant disparities in TCM achievements. In terms of ‘knowing the normal,’ the current mainstream TCM model has its shortcomings.
Due to limited insights, any inaccuracies are welcome for correction by fellow practitioners!!!