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During the Han Dynasty, Zhang Zhongjing authored the “Shang Han Lun“, which comprehensively analyzes the various syndromes that evolve from exogenous diseases, categorizing them based on the affected locations, the tendencies of cold and heat, and the strength of pathogenic and righteous qi, distinguishing them into Taiyang、Yangming、Shaoyang、Taiyin、Jueyin、Shaoyin six meridian diseases. For thousands of years, it has effectively guided the differentiation and treatment in Traditional Chinese Medicine.
Taiyang Disease Diagnosis and Treatment
Clinical Manifestations
“Shang Han Lun states: “Taiyang disease is characterized by a floating pulse, stiffness and pain in the head and neck, and aversion to cold.” “In Taiyang disease, if there is fever with sweating and aversion to wind, with a slow pulse, it is called a wind attack.” “In Taiyang disease, whether there is fever or not, there must be aversion to cold, body aches, nausea, and a tight pulse in both yin and yang, it is called Shang Han (cold damage).”
Summary: Any occurrence of fever, aversion to cold, headache, stiffness in the neck, and a floating pulse is called Taiyang disease. Taiyang disease is divided into two categories: meridian syndrome and organ syndrome. Meridian syndrome refers to the pathogenic changes at the muscle surface; organ syndrome is caused by the unresolved Taiyang pathogen transferring internally to the bladder.
Pathological Mechanisms
1. Taiyang Meridian Syndrome: Divided into three types:
(1) The person has disharmony between nutritive and defensive qi, with the defensive qi losing its ability to open and close, resulting in a floating pulse and muscle surface leakage, which is a wind attack (not a stroke).
(2) The person has defensive yang obstructed, with stagnation of nutritive and defensive qi, resulting in a tight muscle surface, which is Shang Han.
(3) The person is externally attacked by warm pathogens, injuring fluids and causing internal heat, which is a warm disease.
Wind Attack: Fever, sweating, aversion to wind, and a slow pulse (defensive deficiency syndrome).
Shang Han: Fever, no sweating, aversion to cold, tight pulse, body aches (defensive excess syndrome).
Warm Disease: Fever, thirst, no aversion to cold (internal heat syndrome).
Wind attack, Shang Han, and warm disease all belong to surface syndromes, thus all have “fever, headache, and floating pulse,” but their distinguishing points are:
Wind Attack: Floating and slow pulse, with sweating, and a thin white tongue coating.
Shang Han: Floating and tight pulse, no sweating but wheezing, and a thin white tongue coating.
Warm Disease: Floating and rapid pulse, fever, slight thirst, slight aversion to cold, and a red tongue tip.
2. Taiyang Organ Syndrome: Divided into two types:
(1) Pathogenic qi enters the bladder, affecting the bladder’s qi transformation function, leading to qi stagnation and water retention, resulting in water retention syndrome.
(2) Heat accumulation in the lower jiao, with blood stasis, leading to fullness and urgency in the lower abdomen, with self-initiated urination, resulting in blood retention syndrome.
Water Retention Syndrome: Fever, aversion to wind, difficulty urinating, thirst, vomiting when drinking, and a floating and rapid pulse.
Blood Retention Syndrome: Urgent fullness in the lower abdomen or fullness like madness, self-initiated urination, yellowing of the body, and a deep and tight pulse.
The distinguishing point: Water retention is due to the pathogen entering the bladder qi aspect, hence only difficulty urinating without mental symptoms. Blood retention is due to the pathogen entering the bladder blood aspect, hence only mental symptoms without difficulty urinating.
Treatment Principles and Formulas
1. Taiyang Meridian Syndrome Treatment:
(1) Wind Attack: It is a Taiyang surface deficiency syndrome, with strong defensive qi and weak nutritive qi. To treat wind attack, it is sufficient to harmonize the nutritive and defensive qi, induce sweating to resolve the disease, and can use Gui Zhi Tang.
(2) Shang Han: It is a Taiyang surface excess syndrome, with tight pores preventing sweating; thus, it is necessary to open the surface and induce sweating to expel the pathogen, and can use Ma Huang Tang.
(3) Warm Disease: It is due to internal heat injuring fluids. The “Shang Han Lun” does not provide a formula for treatment, as the causes of internal heat are numerous. Any injury to fluids is often due to excessive yang generating fire and consuming yin. Additionally, the cooling nature of yin blood is insufficient, often starting from the liver and stomach, thus it should not be treated externally. If treated externally, it would be seeking distant remedies for nearby issues. The treatment should focus on replenishing the consumed fluids and cooling the blood to clear heat. If the surface symptoms are resolved and internal consumption is replenished, the righteous qi will not be lost; and one should seek the location of the six meridian pathogens, assisting with attacking and treating them, achieving internal transformation effects. The path for the pathogen’s exit should be to open the turbid door with cold to relieve diarrhea, allowing the middle jiao to cool, and the remaining yang to return through the meridians, thus resolving the heat in the middle jiao, achieving the effect of borrowing arrows with a straw boat, cleverly bringing peace to the world.
2. Taiyang Organ Syndrome Treatment:
(1) Water Retention: This is due to the bladder’s qi transformation not functioning, leading to water stagnation. Wu Ling San (Fu Ling, Zhu Ling, Gui Zhi, Ze Xie, Bai Zhu) has the function of transforming qi and promoting urination, thus it is the main formula for water retention syndrome.
(2) Blood Retention: This is due to blood stasis not moving, with heat accumulation in the lower jiao. It should attack the stasis and promote blood flow, and can select Tao He Cheng Qi Tang based on the severity of the condition.
3. Treatment for Concurrent Taiyang Disease:
(1) If Taiyang wind attack is accompanied by qi counterflow causing wheezing, use Gui Zhi Tang with additional Hou Po and Xing Ren.
(2) If Taiyang disease is accompanied by stiffness in the neck and back (i.e., rigidity and discomfort), with sweating indicating surface deficiency, use Gui Zhi Jia Ge Gen Tang for deficiency, and Ge Gen Tang for excess.
(3) If Taiyang disease is accompanied by internal heat stagnation (internal heat, irritability, thirst), with sweating indicating surface deficiency, use Gui Zhi Er Yao Bi Yi Tang for deficiency, and Da Qing Long Tang for excess.
(4) If Taiyang disease is accompanied by water retention (dry vomiting, soft phlegm), if there is surface excess with no sweating, and water qi is present below the heart, with symptoms of fever, aversion to cold, no sweating, wheezing, and dry vomiting, treat with Xiao Qing Long Tang. If Taiyang wind attack leads to water qi accumulating in the chest and ribs, with symptoms of fever, aversion to cold, sweating, headache, fullness and pain in the chest and ribs, dry vomiting, and shortness of breath, after the surface symptoms are resolved, use Shi Zao Tang (Yuan Hua, Gan Sui, Da Ji, Da Zao) to attack it.
(5) If Taiyang disease is accompanied by internal deficiency, such as yin and yang deficiency causing palpitations and irritability, treat with Xiao Jian Zhong Tang. If there is deficiency of qi and blood, with palpitations and a knotty pulse, treat with Zhi Gan Cao Tang.
Yangming Disease Diagnosis and Treatment
Clinical Manifestations
“Shang Han Lun states: “Yangming disease is characterized by fullness in the stomach.”
“After three days of Shang Han, the Yangming pulse is large.”
“What are the external symptoms of Yangming disease? The answer is: “Body heat with spontaneous sweating, no aversion to cold, but aversion to heat.”
“If Shang Han leads to vomiting or diarrhea and does not resolve, with no bowel movement for five to six days, up to ten days, with tidal fever in the afternoon, no aversion to cold, and speaking as if seeing ghosts, if severe, the person does not recognize others, feels anxious and restless, with slight wheezing and staring, a wiry pulse indicates life, a clear pulse indicates death, and slight fever with delirium indicates treatment with Da Cheng Qi Tang. If one dose induces a bowel movement, stop further doses.”
“In Yangming disease, if there is excessive sweating and wheezing, do not use Zhu Ling Tang, as excessive sweating leads to dryness in the stomach, and Zhu Ling Tang promotes urination.”
Summary: Any occurrence of body heat, spontaneous sweating, no aversion to cold but aversion to heat, and a large pulse is called Yangming disease. Yangming disease is divided into two categories: meridian syndrome and organ syndrome; Yangming meridian syndrome is the pathogenic change in the stomach; Yangming organ syndrome is the pathogenic change in the large intestine.
Pathological Mechanisms
1. Yangming Meridian Syndrome: External pathogens enter the interior and transform into heat, combining with dryness in the stomach, leading to the consumption of fluids, resulting in body heat, spontaneous sweating, thirst, and a large pulse.
2. Yangming Organ Syndrome: External pathogens enter the interior and transform into heat, combining with the dryness and heat of the large intestine, leading to the consumption of fluids, forming dryness and obstruction in the interior, resulting in tidal fever, delirium, constipation, abdominal fullness and pain, and a deep and solid pulse.
Treatment Principles and Formulas
When there is high fever and diffuse symptoms, use cold and cooling herbs to clear heat. Therefore, Yangming meridian syndrome primarily uses clearing methods, and one can select pungent and cold herbs to clear internal heat; if heat and obstruction are present in the large intestine, use cold purgatives to treat, urgently purging to preserve yin, striving for time to prevent the consumption of fluids. Thus, organ syndrome primarily uses purging methods, and one can select bitter and cold purgative formulas.
1. Yangming Meridian Syndrome Treatment: Yangming meridian syndrome is caused by internal heat vaporizing, with both surface and interior heat, thus treatment should use Shi Gao Tang.
2. Yangming Organ Syndrome Treatment: Yangming organ syndrome is characterized by pathogenic heat having congealed with the large intestine’s waste into a solid heat syndrome. The treatment aims to eliminate dryness and clear internal heat. Due to the varying severity of the condition, there are three formulas for Yangming organ syndrome: Tiao Wei Cheng Qi Tang is a mild purgative for treating initial organ obstruction, where the obstruction is not yet solid, or where fluids are damaged and dryness is the main symptom; Xiao Cheng Qi Tang is for treating organ obstruction with fullness as the main symptom; Da Cheng Qi Tang is for treating organ obstruction with fullness and dryness as the main symptoms.
“If it is solid, it is Yangming; if it is deficient, it is Taiyin,” this is a saying based on practical experience in Traditional Chinese Medicine. Yangming disease can transform into Taiyin disease, indicating a decline in resistance; the prognosis is poor; Taiyin disease can also transform into Yangming disease, indicating an increase in resistance; the prognosis is good.
Shaoyang Disease Diagnosis and Treatment
Clinical Manifestations
“Shang Han Lun states: “Shaoyang disease is characterized by bitter taste in the mouth, dry throat, and dizziness.”
“If Shang Han lasts five to six days, with wind attack, alternating chills and fever, fullness in the chest and ribs, reluctance to eat, irritability with a preference for vomiting, or fullness and vomiting in the chest, or thirst, or abdominal pain, or fullness in the lower ribs, or palpitations, or difficulty urinating, or no thirst, with slight fever or cough.”
“If the original Taiyang disease does not resolve and transforms into Shaoyang, there will be fullness in the lower ribs, dry vomiting, inability to eat, alternating chills and fever, and a tight pulse.”
Summary: Any occurrence of bitter taste in the mouth, dry throat, dizziness, alternating chills and fever, fullness in the chest and ribs, reluctance to eat, irritability with a preference for vomiting, and a wiry and thin pulse is called Shaoyang disease. Shaoyang syndrome is the pathogenic change in the liver and gallbladder.
Pathological Mechanisms
External pathogens invade the liver and gallbladder, causing the qi of the liver and gallbladder to rise and become excessive, leading to bitter taste, dry throat, and dizziness. The pathogen in the gallbladder reverses (affecting) the stomach, hence the preference for vomiting and reluctance to eat, indicating digestive dysfunction. If the qi mechanism is not smooth, it leads to fullness in the chest and ribs. The struggle between the pathogen and the righteous qi, with the righteous qi being weak and unable to expel the pathogen, results in alternating chills and fever.
Treatment Principles and Formulas
1. Shaoyang Standard Treatment:
Shaoyang disease does not have the surface symptoms of Taiyang, and the pathogen is not on the surface, thus sweating is not allowed (if sweating occurs, it will consume fluids and cause the pathogen to enter the interior); it does not have the solid symptoms of Yangming, and the pathogen is not in the interior, thus purging is not allowed (if purging occurs, it will easily cause fright due to the movement of yin); there is no solid obstruction in the chest, thus vomiting is not allowed (if vomiting occurs, it will harm yang and cause palpitations). Therefore, there are three prohibitions in Shaoyang (prohibition of sweating, purging, and vomiting). The treatment principle for Shaoyang disease should focus on harmonizing and resolving both the surface and interior (i.e., a non-sweating method to relieve heat), however, Shaoyang disease often has both surface and interior symptoms, so on the basis of harmonization, one can also use Taiyang sweating methods or Yangming purging methods, treating according to the symptoms.
Because Shaoyang disease is half surface and half interior, the formula Xiao Chai Hu Tang is the standard treatment for Shaoyang disease.
2. Shaoyang Concurrent Syndrome Treatment:
(1) If there is slight fever with aversion to cold, joint pain, and fullness below the heart, with slight vomiting, it is Shaoyang concurrent with Taiyang disease, and can use Chai Hu Gui Zhi Tang.
(2) If there is Shaoyang syndrome with abdominal fullness and pain, slight irritability, and difficulty with bowel movements, with a dry yellow tongue coating, it is Shaoyang concurrent with Yangming solid syndrome, and can use Da Chai Hu Tang.
(3) If Shaoyang disease has abdominal cramping and pain, with a floating and thin pulse, it indicates Shaoyang disease concurrent with insufficient interior qi. First use Xiao Jian Zhong Tang to replenish deficiency, and after taking the medicine, if the interior deficiency is restored but the Shaoyang disease does not diminish, then use Xiao Chai Hu Tang to harmonize.
(4) If there is fullness in the chest and ribs, slight fullness, difficulty urinating, thirst without vomiting, but sweating, alternating chills and fever, irritability, etc., it indicates that the pathogenic heat is trapped in Shaoyang, and water and fluids are not transformed, thus use Chai Hu Gui Zhi Gan Jiang Tang to harmonize and promote fluid transformation.
(5) If there is fullness and anxiety in the chest, difficulty urinating, delirium, and body pain that prevents turning, it indicates that the pathogen has entered Shaoyang, with righteous qi being weak, and can use Chai Hu Jia Long Gu Mu Li Tang.
(6) If there is heat qi (stomach heat) rising, causing vomiting, and cold pathogens invading the stomach causing abdominal pain, it indicates upper heat and lower cold, and can use Huang Lian Tang to clear the upper and warm the middle.
Taiyin Disease Diagnosis and Treatment
Clinical Manifestations
“Shang Han Lun states: “Taiyin disease is characterized by abdominal fullness and vomiting, inability to eat, and frequent diarrhea, with occasional abdominal pain. If purged, there will definitely be fullness below the chest.”
Summary: Clinically, any occurrence of abdominal fullness and vomiting, inability to eat, frequent diarrhea, and a weak pulse is called Taiyin disease. It is characterized by spleen deficiency and excessive dampness, with the disease located in the spleen meridian.
Pathological Mechanisms
Cold dampness obstructs, damaging spleen yang, or cold pathogens directly invade the spleen meridian, damaging the spleen and stomach, affecting the digestion and excretion of food and fluids, leading to abdominal pain. Cold dampness invades the stomach, causing vomiting. Stomach qi stagnation leads to inability to eat. Cold dampness not transformed, spleen qi not rising, hence frequent diarrhea.
Treatment Principles and Formulas
1. Standard Treatment for Taiyin Disease:
Taiyin disease is due to interior deficiency and cold syndrome (spleen and stomach deficiency cold), thus the treatment principle should focus on warming and replenishing, with emphasis on warming the interior and dispersing cold. If the surface symptoms are prominent, first resolve the surface; if the interior symptoms are urgent, first treat the interior. The “Shang Han Lun Taiyin chapter” does not provide a definitive formula, but based on the interior deficiency and cold syndrome, it should primarily focus on warming the interior, thus Li Zhong Tang is the main formula for Taiyin disease.
2. Treatment for Concurrent Taiyin Disease:
(1) If there is both diarrhea and abdominal fullness (Taiyin interior deficiency syndrome), along with body pain (Taiyang surface syndrome), it indicates interior deficiency with surface symptoms, and should first use Li Zhong Tang to warm the interior, then use Gui Zhi Tang to treat the surface.
(2) If the surface symptoms have not resolved, but there is abdominal fullness and pain, use Gui Zhi Jia Shao Yao Tang (increased dosage of Shao Yao in Gui Zhi Tang). If the surface symptoms have not resolved and there is food retention leading to solid fullness and pain, use Gui Zhi Jia Da Huang Tang.
Jueyin Disease Diagnosis and Treatment
Clinical Manifestations
“Shang Han Lun states: “Jueyin disease is characterized by thirst, qi rising to the heart, heat in the heart, hunger without desire to eat, and if food is ingested, it leads to vomiting of roundworms, with persistent diarrhea.”
“If Shang Han has a weak pulse and cold extremities, after seven or eight days, the skin will be cold, and the person will be restless without a moment of peace; this is called hidden Jue.”
“If Shang Han has fever for four days, and Jue reverses for three days, with fever for four days, and Jue has less heat and more cold, the disease will recover; if the heat does not resolve from four to seven days, there will definitely be pus and blood in the stool.”
“If Shang Han has Jue for four days, heat reverses for three days, and then Jue for five days, the disease is progressing, with more cold and less heat, indicating a retreat of yang qi.”
Summary: Jueyin disease can be categorized into four types:
(1) Upper heat and lower cold syndrome: thirst, qi rising to the heart, heat in the heart indicates upper heat syndrome; hunger without desire to eat, vomiting of roundworms, and persistent diarrhea indicate lower cold syndrome.
(2) Jue heat victory reversal syndrome: characterized by alternating cold extremities and fever.
(3) Reversal syndrome: characterized by cold extremities, with mild cases only affecting the wrists and ankles, while severe cases can extend beyond the elbows and knees.
(4) Persistent diarrhea and vomiting: heat leads to persistent diarrhea; delirium leads to persistent diarrhea; clear diarrhea indicates cold deficiency. Dry vomiting, vomiting of saliva, and headache indicate cold drink vomiting; vomiting with fever indicates fever vomiting; and vomiting with fullness indicates solid vomiting.
Pathological Mechanisms
When the disease reaches Jueyin, the liver wood is disordered, and the pericardium is also invaded by pathogens, with fire rising causing heat, while heart fire cannot descend leading to cold, hence the presence of upper heat and lower cold. In the struggle between the righteous and the evil, if yang prevails and yin declines, there will be more heat and less cold; if yin prevails and yang declines, there will be more cold and less heat, leading to reversal. The internal invasion of pathogens causes qi and blood disturbances, and yin and yang cannot connect smoothly, resulting in various reversal syndromes. Liver and stomach qi rising or damp heat descending or solid heat obstructing or spleen and stomach deficiency cold can all lead to vomiting and diarrhea.
Treatment Principles and Formulas
Jueyin disease is characterized by interior deficiency and mixed cold and heat symptoms, thus the treatment methods: Upper heat and lower cold should be treated with both cold and heat; Jueyin cold syndrome should be treated with warming the interior and cold; Jueyin heat syndrome should be treated with clearing heat; if there is more heat and less cold, treatment should focus on warming yang. If there is less heat and more cold, it can self-resolve.
1. Treatment for Jueyin Disease:
(1) Thirst, qi rising to the heart, heat in the heart, hunger without desire to eat, and vomiting of roundworms, with persistent diarrhea, indicates mixed cold and heat syndrome. The treatment should also involve both cold and heat, and Wu Mei Wan is the main formula for Jueyin disease with mixed cold and heat syndrome, also effective for roundworm reversal syndrome and persistent diarrhea.
(2) If there is vomiting and persistent diarrhea, with food intake leading to vomiting, the symptoms are complex, thus both cold and heat should be used. For upper heat, clear; for lower cold, warm; for deficiency, replenish, using Gan Jiang Huang Qin Huang Lian Ren Shen Tang (medicinal ingredients as per the formula name).
(3) If there is persistent diarrhea with sticky pus and blood, abdominal pain, urgency in the lower abdomen, burning sensation in the anus, thirst, and a rapid and strong pulse, it indicates heat-type persistent diarrhea, thus use Bai Tou Weng Tang for effective treatment.
(4) If there is blood deficiency with cold, righteous qi being obstructed, with cold extremities, a thin pulse, use Dang Gui Si Ni Tang as the most suitable treatment.
(5) If there is dry vomiting, vomiting of saliva, and headache, indicating cold drink vomiting, use Wu Zhu Yu Tang.
Shaoyin Disease Diagnosis and Treatment
Clinical Manifestations
“Shang Han Lun states: “Shaoyin disease is characterized by a weak and thin pulse, with a desire to sleep.”
“In Shaoyin disease, aversion to cold, body curled up, and cold extremities indicate that it is not treatable.”
Summary: Shaoyin disease is the final and most critical stage among the six meridians, often presenting with extreme fatigue, a desire to sleep but unable to, resembling a comatose state. Shaoyin disease is the pathogenic change in the heart and kidney, divided into cold transformation and heat transformation.
Pathological Mechanisms
Insufficient yin qi leads to a weak pulse. Insufficient yin blood leads to a thin pulse. Weakness and lethargy lead to a desire to sleep. The heart and kidney water and fire are not in harmony, with the disease transforming into cold from water, leading to internal cold symptoms. If the disease transforms into heat from fire, it leads to internal heat symptoms.
Treatment Principles and Formulas
The treatment principle for Shaoyin disease focuses on supporting yang and nourishing yin. If it is cold transformation, support yang with warming methods; if it is heat transformation, nourish yin while also clearing heat. For Shaoyin concurrent with surface symptoms, use warming and sweating methods; for solid heat obstructing the interior, use urgent purging methods to preserve yin.
1. Cold Transformation Syndrome:
This syndrome is more common in the process of Shaoyin disease, with symptoms including: no heat, aversion to cold, weak pulse, a desire to sleep, cold extremities, frequent clear diarrhea, inability to eat. The treatment should focus on returning yang and rescuing the reverse, thus use Si Ni Tang.
2. Heat Transformation Syndrome:
Characterized by yin deficiency and yang excess, and yin deficiency with heat:
① Irritability, inability to sleep, dry mouth, dry throat, red tongue tip, thin and rapid pulse, indicating yin deficiency and yang excess, should use Huang Lian Er Jiao Tang to clear heat and nourish yin.
② Frequent diarrhea, difficulty urinating, cough, vomiting, thirst, irritability, and inability to sleep, use Zhu Ling Tang to nourish yin and clear heat, and promote fluid transformation.
3. Shaoyin Concurrent with Taiyang Surface Excess Syndrome:
If there is fever, aversion to cold, no sweating, cold extremities, and a deep pulse, use Ma Huang Fu Zi Xi Xin Tang or Ma Huang Fu Zi Gan Cao Tang (medicinal ingredients as per the formula name).
4. Shaoyin Concurrent with Yangming Organ Excess Syndrome:
If there is dry mouth and throat, abdominal fullness, and pain, with no bowel movement or clear diarrhea, use Da Cheng Qi Tang for urgent purging to preserve yin.
One of the methods of differentiation in Traditional Chinese Medicine. It uses Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin to classify the depth of diseases and the differentiation of the strength of the righteous and the evil. During the Han Dynasty, Zhang Zhongjing summarized this based on the characteristics of the transmission of Shang Han disease in the “Su Wen: Re Lun” and other chapters. It is applicable for the differentiation of exogenous diseases.
The Six Meridians are Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, and Jueyin. The syndromes of the six meridians are Taiyang disease, Yangming disease, Shaoyang disease, Taiyin disease, Shaoyin disease, Jueyin disease, which reflect the pathological changes of the meridians and organs in clinical practice. The differentiation of the six meridians uses the syndromes of the six meridians as the guiding principle for differentiation and treatment, summarizing the physiological functions and pathological changes of the organs, meridians, qi, and blood, to explain the location, nature, and strength of the disease, the trends of the righteous and evil, and the transmission relationships between the six meridian diseases.
The syndromes of the six meridians reflect the pathological changes of the meridians and organs, and the meridians and organs are interconnected as a whole. Therefore, the disease of one meridian can likely affect another meridian. Thus, the six meridian diseases have inter-transmissive syndromes. The rules of transmission include transmission through meridians, combined diseases, concurrent diseases, and direct transmission.
Pathogens invade from the outside and gradually spread inward, transforming from the symptoms of one meridian to those of another, which is called transmission through meridians. Whether transmission occurs mainly depends on the severity of the invasion, the strength of the body, and the appropriateness of treatment.
The general rules of transmission are:
① Transmission through meridians. This follows the order of the six meridians, such as Taiyang → Yangming → Shaoyang → Taiyin → Shaoyin → Jueyin, or Taiyang → Shaoyang → Yangming → Taiyin → Shaoyin → Jueyin.
② Skipping meridians. This does not follow the above order, but skips one or two meridians, such as if Taiyang disease does not resolve, it may not transmit to Shaoyang but to Yangming or Taiyin.
③ Surface and interior transmission. This is when two meridians that are mutually surface and interior transmit to each other, such as Taiyang transmitting to Shaoyin.
Using the differentiation of the six meridians can accurately grasp the development and changes of exogenous diseases, providing important guidance for treatment. The treatment principles for the six meridian diseases emphasize expelling pathogens for the three yang diseases and supporting the righteous for the three yin diseases.
Source: Jing Fang Da Yi Chuan Cheng
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