Inheriting the legacy of Qi Huang, a public account with substance and warmth.
Ai Yu Xiang Tang
Author: Liu Du Zhou
During the Ming and Qing dynasties, some outstanding physicians, such as Zhang Jingyue, Cheng Zhongling, and Jiang Bihua, extracted the two principles of Yin and Yang from the Six Meridians differentiation to govern the differentiation of exterior-interior, cold-heat, and deficiency-excess, which was highly valued and welcomed by physicians at that time. Later, it was further developed and perfected, becoming the current Eight Principles differentiation. From Jiang’s “Differentiation of Exterior-Interior, Deficiency-Excess, Cold-Heat,” we can see that the terminology at that time only referred to Yin and Yang as principles, while the differentiation of exterior-interior, deficiency-excess, and cold-heat had not yet reached the level of principles.Jiang stated: “All human diseases are nothing but Yin and Yang. The distinction of Yin and Yang is always related to the six words: exterior-interior, deficiency-excess, cold-heat. The interior is Yin, the exterior is Yang, deficiency is Yin, excess is Yang, cold is Yin, and heat is Yang. A good physician saves people by distinguishing this Yin and Yang; a mediocre physician harms people by misidentifying this Yin and Yang.” His statement is fundamentally similar to Zhang Jingyue’s concepts of “Two Principles” and “Six Transformations.” It can be said that this was the embryonic stage of the Eight Principles differentiation system. Today, revisiting the development and clinical application of the Eight Principles differentiation system is necessary for our reference and learning.However, it must be pointed out that the thought of Eight Principles differentiation originates from the Six Meridians differentiation in the “Shang Han Lun” (Treatise on Cold Damage). In the “Shang Han Lun,” the Six Meridians and the Eight Principles are closely linked and inseparable. This is because the Six Meridians are material, summarizing the organs and meridians, and differentiation must be based on this material foundation; thus, diseases cannot exceed the scope of the Six Meridians. However, the symptomatic manifestations of the Six Meridians cannot deviate from the rules of the Eight Principles differentiation, so the two must be combined to be effectively used in clinical differentiation. The specific methods of combining the Eight Principles differentiation with the Six Meridians differentiation are introduced as follows:
1. Yin and YangThe “Nei Jing” states: “To treat a disease, one must seek the root, which is based on Yin and Yang.” Therefore, the two principles of Yin and Yang serve as the principles of the Six Meridians and also as the principles of the Eight Principles, used to govern various symptoms and their developmental changes.1. Tai Yang DiseaseTai Yang and Shao Yin are exterior and interior, respectively, and have distinctions of Yin and Yang. If the pulse is floating, with fever and aversion to cold, it indicates a disease occurring in Tai Yang, called Yang syndrome. If the pulse is deep, with no fever but aversion to cold, it indicates a disease occurring in Shao Yin, called Yin syndrome.2. Yang Ming DiseaseYang Ming and Tai Yin are exterior and interior, respectively, thus having distinctions of Yin and Yang. If there is body heat with sweating, and aversion to heat rather than cold, it indicates a disease occurring in Yang Ming, called Yang syndrome; if there is cold in Yang Ming, with inability to eat, difficulty in urination, cold sweat on hands and feet, and initially hard but later loose stools, it indicates a disease occurring in Tai Yin, called Yin syndrome.3. Shao Yang DiseaseShao Yang and Jue Yin are exterior and interior, respectively, thus having changes of Yin and Yang. If a person experiences alternating chills and fever, fullness in the chest and hypochondria, irritability, and nausea, it indicates a disease occurring in Shao Yang, called Yang syndrome. If there is deafness, retraction of the scrotum, and inability to take in water, with a black and slippery tongue coating, it indicates a disease occurring in Jue Yin, called Yin syndrome.All diseases of the Six Meridians have both Yin and Yang aspects. Viewing the problem with a perspective of oppositional development is called the dichotomy thought. If one can distinguish, one can discern, thus governing the Six Meridians and clarifying the differentiation of exterior-interior, cold-heat, and deficiency-excess.From the above, it can be seen that diseases of the Yang Meridians often occur in the six fu organs, as the fu organs are Yang, with abundant Qi and blood, strong resistance to pathogens, thus characterized by various heat manifestations; while diseases of the Yin Meridians often occur in the five zang organs, as the zang organs are Yin, with deficient Qi and blood, weak resistance to pathogens, thus characterized by various cold manifestations. Broadly speaking: if the body is light, with shortness of breath, hot breath from the mouth and nose, bright eyes, and inability to sleep; or if there is extreme heat with blurred vision; or if the eyes are red with excessive tearing; or if there is body heat with a red face and lips; or if there is thirst with yellow-red urine, these all reflect Yang syndrome. If the body is heavy, with cold breath from the mouth and nose, dull eyes, a desire to lie down, pale complexion, cold extremities, blue nails, and diarrhea with white urine, these all reflect Yin syndrome.Ancient people said: “When Yang reaches its extreme, it resembles Yin; when Yin reaches its extreme, it resembles Yang,” so when distinguishing between Yin and Yang syndromes, one must differentiate their authenticity to avoid being misled by their appearances. The “Shang Han Lun” states: “If a patient has a high fever but desires to be close to clothing, the heat is in the skin, and the cold is in the marrow; if the body is very cold but does not want to be close to clothing, the cold is in the skin, and the heat is in the marrow.” It indicates that the “syndrome” has authenticity, while the “condition” is credible. Therefore, one can observe the truth through “desire” and “non-desire.” In clinical practice, if one follows this method, they will be closer to the truth.2. Exterior and InteriorThe Yin and Yang Six Meridians have a problem of disease location. Therefore, recognizing the location of exterior and interior diseases allows for the appropriate use of sweating and purging methods.1. Tai Yang Disease Exterior Syndrome(1) Tai Yang Disease Exterior Syndrome: Among the Six Meridians, only Tai Yang disease can represent exterior syndrome, which is inseparable from the physiological characteristics of Tai Yang. The Tai Yang Meridian connects to the Fengfu point, governing all Yang Qi, thus it governs the exterior and the defensive Qi of the body, making Tai Yang the master of the exterior. Additionally, each of the Six Meridians has its own meridian and fu organ distinction; when the meridian suffers from pathogens, compared to the fu organ, the meridian is external, thus having the meaning of exterior syndrome.The “Shang Han Lun” states: “If both pulses are floating, it indicates a disease in Tai Yang, which will manifest in one or two days. Because its pulse connects to the Fengfu point, it causes headache and stiffness in the neck and back.” The symptoms in the first section of the “Shang Han Lun” stating that “Tai Yang disease is characterized by a floating pulse, headache, stiffness in the neck, and aversion to cold” all illustrate that the pathogen harms the exterior of the Tai Yang Meridian, and the Qi of the Tai Yang Meridian is obstructed, leading to disease characteristics.(2) Tai Yang Disease Interior Syndrome: The fu organ of Tai Yang is the bladder, located in the lower jiao. If the pathogen in the Tai Yang Meridian does not resolve, the pathogenic Qi follows the meridian into the fu organ, leading to water and blood accumulation. We call this the interior (fu) syndrome of Tai Yang disease.Tai Yang Water Accumulation Syndrome: characterized by a floating pulse, slight fever, thirst with a desire to drink, and difficulty in urination, even vomiting after drinking, is called “water reversal.”Tai Yang Blood Accumulation Syndrome: In Tai Yang disease, a weak and deep pulse reflects the exterior pathogen entering the interior, leading to hardness and fullness in the lower abdomen, and mental agitation; or sudden abdominal pain with a sense of urgency, but urination is smooth, indicating heat and blood stasis, unrelated to water.2. Yang Ming Disease Exterior and Interior Syndrome(1) Yang Ming Disease Exterior Syndrome: The “Shang Han Lun” states: “If both pulses are long, it indicates a disease in Yang Ming, which will manifest in two or three days. Because its pulse connects to the nose and is linked to the eyes, it causes body heat, eye pain, and dry nose, making it impossible to sleep.” Cheng Wuji’s commentary states: “The Yang Ming pulse rises from the nose, connects to the eyes. The Yang Ming pulse, when it reaches the jaw, exits at the eye system… Eye pain and dry nose indicate the presence of pathogens in the meridian.” This syndrome also includes fever, aversion to cold, no sweating, a flushed face, headache, and a long floating pulse.(2) Yang Ming Disease Interior Syndrome: If the stomach and intestines are affected by pathogens, it is called Yang Ming Disease Interior Syndrome. The “Shang Han Lun” states: “If the cold damage lasts four to five days, the pulse is deep and there is shortness of breath. The deep pulse indicates the disease is in the interior, and if sweating is induced, the fluids will be lost, leading to difficulty in defecation…” This indicates the interior syndrome of Yang Ming’s stomach and intestines. Interior syndromes cannot be treated with sweating; inducing sweating will harm the fluids, leading to difficulty in defecation.3. Shao Yang Disease Exterior and Interior Syndrome(1) Shao Yang Disease Exterior Syndrome: Shao Yang is half exterior and half interior, located in the two sides of the body, yet it also has exterior and interior syndromes based on the meridian and fu organ.The “Shang Han Lun” states: “If both pulses are wiry, it indicates a disease in Shao Yang, which will manifest in three to four days. Because its pulse circulates in the sides and connects to the ears, it causes pain in the sides and deafness.” Cheng Wuji’s commentary states: “Pain in the chest and sides with deafness indicates obstruction in the meridian, leading to dysfunction.” The “Shang Han Lun” also records that “Shao Yang wind causes both ears to be unable to hear, red eyes, fullness in the chest, and irritability…” indicating the Shao Yang meridian syndrome.(2) Shao Yang Disease Interior Syndrome: Refers to the Shao Yang fu syndrome. The “Shang Han Lun” states: “Shao Yang disease is characterized by bitter mouth, dry throat, and dizziness.” This indicates that the pathogenic heat enters the gallbladder fu organ, forcing the bile to overflow, resulting in a bitter mouth, thus termed the interior syndrome of Shao Yang disease.4. Tai Yin Disease Exterior and Interior Syndrome(1) Tai Yin Disease Exterior Syndrome: The “Shang Han Lun” states: “If both pulses are deep and thin, it indicates a disease in Tai Yin, which will manifest in four to five days. Because its pulse spreads in the stomach and connects to the throat, it causes fullness in the abdomen and dryness in the throat.” The “Shang Han Lun” states: “Tai Yin wind causes pain in the four limbs…”; and “If Tai Yin disease has a floating pulse, sweating can be induced…” all reflect the fact that the Tai Yin spleen meridian is diseased.(2) Tai Yin Disease Interior Syndrome: The “Shang Han Lun” states: “If it is originally a Tai Yang disease, and the physician mistakenly purges it, leading to abdominal fullness and pain, it belongs to Tai Yin…” indicating that after purging, the exterior pathogen enters the interior of Tai Yin, resulting in abdominal fullness and pain in the Tai Yin interior syndrome.5. Shao Yin Disease Exterior and Interior Syndrome(1) Shao Yin Disease Exterior Syndrome: The “Shang Han Lun” states: “If both pulses are deep, it indicates a disease in Shao Yin, which will manifest in five to six days. Because its pulse penetrates the kidney and connects to the lung, it causes dry mouth, dry tongue, and thirst.” This discusses the heat syndrome of the Shao Yin meridian. The “Shang Han Lun” states: “If Shao Yin disease is first contracted, and there is a subsequent fever, the pulse is deep, it is treated with Ma Huang, Xi Xin, and Fu Zi decoction,” discussing the cold syndrome of Shao Yin’s Yang deficiency and the exterior receiving cold syndrome.(2) Shao Yin Disease Interior Syndrome: Refers to the diseases of the heart and kidney of Shao Yin. For example, the “Shang Han Lun” states: “Shao Yin disease, with a deep pulse, should be urgently warmed, and it is advisable to use Si Ni Tang.” Another section states: “Shao Yin disease, with a fine and deep pulse, indicates the disease is in the interior…” These two sections indicate that Shao Yin disease has both Yang deficiency cold syndrome and Yin deficiency heat syndrome in the interior.6. Jue Yin Disease Exterior and Interior Syndrome(1) Jue Yin Disease Exterior Syndrome: The “Shang Han Lun” states: “If both pulses are weak and slow, it indicates a disease in Jue Yin, which will manifest in six to seven days. Because its pulse circulates in the Yin organs and connects to the liver, it causes fullness and retraction of the scrotum.” The “Shang Han Lun” states: “If the hands and feet are cold, and the pulse is thin and about to disappear, it is treated with Dang Gui Si Ni Tang.” The above two sections reflect the characteristics of Jue Yin disease with both heat and cold syndromes.(2) Jue Yin Disease Interior Syndrome: The “Shang Han Lun” states: “If a person has had prolonged cold internally, it is advisable to use Dang Gui Si Ni Tang with Wu Zhu Yu and Sheng Jiang.” “Prolonged cold internally” refers to the cold syndrome of the Jue Yin organ in the interior.In the above, we use the principles of exterior and interior to reflect the diseases of the Six Meridians, which can embody the system and completeness of TCM differentiation. If we only discuss the interior syndromes of the organs without mentioning the exterior syndromes of the meridians, we lose the purpose of the Six Meridians differentiation. Therefore, the Eight Principles differentiation must be combined with the Six Meridians differentiation to avoid being one-sided.
3. Cold and HeatThe two principles of cold and heat are established to reflect the cold and heat conditions of the Six Meridians diseases. They serve as the basis for differentiation in clinical treatment, as they encompass the specific conditions of exterior-interior and Yin-Yang diseases. 1. Tai Yang Disease Cold and Heat Syndrome(1) Tai Yang Disease Cold Syndrome: Tai Yang governs the exterior, yet there are distinctions of cold and heat in exterior diseases that cannot be overlooked. For example, the “Shang Han Lun” states: “In Tai Yang disease, whether there is fever or not, there must be aversion to cold, body pain, nausea, and both Yin and Yang pulses are tight, which is called cold damage.” This reflects the characteristics of exterior cold as a disease, thus it can be termed the exterior cold syndrome of Tai Yang disease.(2) Tai Yang Disease Heat Syndrome: Where there is cold, there must be heat; this arises relatively. However, the exterior heat syndrome of Tai Yang disease can be classified into two forms: one is the invasion of warm pathogens, as stated in the “Shang Han Lun”: “In Tai Yang disease, if there is fever and thirst, but no aversion to cold, it is a warm disease.” Since the warm pathogen is still in Tai Yang and has not fully entered the interior, it is called the exterior heat syndrome of Tai Yang disease. The other is due to wind-cold binding the exterior, which, if unresolved for a long time, leads to cold stagnation transforming into heat, with the pulse changing from tight to relaxed, body pain changing to heaviness, no sweating, and irritability, which can also be termed the exterior heat syndrome of Tai Yang disease; additionally, there is the 27th section stating: “In Tai Yang disease, if there is fever and aversion to cold, with more heat than cold… it is advisable to use Gui Zhi Er Yao Yi Tang,” which also belongs to the exterior heat syndrome of Tai Yang disease.2. Yang Ming Disease Cold and Heat Syndrome(1) Yang Ming Disease Interior Cold Syndrome: Yang Ming governs the interior, and the interior syndrome has distinctions of cold and heat. The interior cold syndrome of Yang Ming disease is discussed in the “Shang Han Lun”: “If there is virtual cold in the stomach, leading to inability to eat, drinking water causes belching.” This discusses the interior cold causing belching. The 243rd section states: “If there is a desire to vomit after eating grains, it belongs to Yang Ming, and Wu Zhu Yu Tang is the main treatment.” This discusses the interior cold causing vomiting and proposes a treatment method.(2) Yang Ming Disease Interior Heat Syndrome: The interior heat syndrome of Yang Ming disease has different manifestations in the upper, middle, and lower parts. Heat in the upper part, stagnating in the diaphragm, leads to discomfort in the heart and a coating on the tongue; heat in the middle leads to thirst and a desire to drink water, with a dry mouth; heat in the lower part leads to a floating pulse with fever, a desire to drink water, and difficulty in urination.3. Shao Yang Disease Cold and Heat Syndrome(1) Shao Yang Disease Cold Syndrome: The symptoms include fullness and discomfort in the chest and sides, difficulty in urination, thirst without vomiting, but sweating from the head, abdominal distension, and loose stools, with a wiry and slow pulse.(2) Shao Yang Disease Heat Syndrome: The symptoms are primarily bitter mouth, irritability, dry throat, and dizziness.4. Tai Yin Disease Cold and Heat Syndrome(1) Tai Yin Disease Cold Syndrome: The “Shang Han Lun” states: “If there is diarrhea without thirst, it belongs to Tai Yin, due to cold in the organs…” “Cold in the organs” refers to cold in the spleen, thus the symptoms of diarrhea without thirst.(2) Tai Yin Disease Heat Syndrome: The “Shang Han Lun” states: “In cold damage, if the pulse is floating and relaxed, and the hands and feet are warm, it is in Tai Yin. Tai Yin should cause yellowing of the body; if urination is smooth, it cannot cause yellowing.”Tai Yin is damp earth, thus diseases can manifest as damp-heat and cold-damp, which must be clearly distinguished and not confused.5. Shao Yin Disease Cold and Heat Syndrome(1) Shao Yin Disease Cold Syndrome: The cold syndrome of Shao Yin disease is extensive. The “Shang Han Lun” states: “Shao Yin disease, with a desire to vomit but unable to, irritability but wanting to sleep, and self-limiting diarrhea with thirst, belongs to Shao Yin…” The white urine indicates that the lower jiao is deficient and cold, unable to control water, thus leading to white color.(2) Shao Yin Disease Heat Syndrome: The “Shang Han Lun” states: “Shao Yin disease, contracted for two to three days, with irritability and inability to sleep…” indicating the irritability of the heat syndrome of Shao Yin disease.6. Jue Yin Disease Cold and Heat Syndrome(1) Jue Yin Disease Cold Syndrome: The “Shang Han Lun” states: “If a person has had prolonged cold internally, it is advisable to use Dang Gui Si Ni Tang with Wu Zhu Yu and Sheng Jiang.” This indicates that the person has prolonged cold in the liver, manifesting as cold accumulation in the lower jiao, cold pain in the lower abdomen, or vomiting.(2) Jue Yin Disease Heat Syndrome: The heat syndrome of Jue Yin disease may arise from the invasion of warm pathogens; or Yang Qi being obstructed, transforming into heat over time; or excessive Yang in Jue Yin, leading to excess heat, as illustrated in the example of heat Jue: The “Shang Han Lun” states: “If cold damage occurs from one to two days to four to five days, there must be fever; if there is prior heat, there must be subsequent cold. The deeper the cold, the deeper the heat; the milder the cold, the milder the heat. If the cold is to be expelled, but sweating is induced, it must lead to mouth sores and redness.” This indicates the internal heat of Jue Yin leading to cold.4. Deficiency and ExcessThe two principles of deficiency and excess often reflect the struggle between the righteous and the evil in the Six Meridians diseases. Generally speaking, diseases of the three Yang meridians are primarily excess syndromes, while diseases of the three Yin meridians are primarily deficiency syndromes.1. Tai Yang Disease Deficiency and Excess(1) Tai Yang Disease Exterior Deficiency Syndrome: Tai Yang disease is an exterior syndrome; if there is sweating from the exterior syndrome, it is called exterior deficiency syndrome. For example, the “Shang Han Lun” states: “In Tai Yang wind, if Yang is floating and Yin is weak, Yang floating indicates heat is self-generated; Yin weak indicates sweating occurs. If there is aversion to cold, aversion to wind, and fever, with a tight pulse, Gui Zhi Tang is the main treatment.” This discusses the deficiency syndrome of the exterior pathogen of Tai Yang disease.(2) Tai Yang Disease Exterior Excess Syndrome: If there is no sweating but shortness of breath, it is called exterior excess syndrome. For example, the “Shang Han Lun” states: “In Tai Yang disease, with headache, fever, body pain, waist pain, and joint pain, with aversion to wind, no sweating, and shortness of breath, Ma Huang Tang is the main treatment,” discussing the excess syndrome of the exterior pathogen of Tai Yang.2. Yang Ming Disease Deficiency and Excess(1) Yang Ming Disease Interior Deficiency Syndrome: Yang Ming governs the interior, and there are distinctions of deficiency and excess. The interior deficiency syndrome of Yang Ming disease is discussed in the “Shang Han Lun”: “Yang Ming disease, with much sweating but no sweating, and the body feels like insects crawling under the skin, indicates prolonged deficiency.” Cheng Wuji’s commentary states: “The stomach is the reservoir of fluids; if Qi is deficient and fluids are few, the disease will lead to no sweating. The stomach governs the muscles of the body, and if the body feels like insects crawling under the skin, it indicates prolonged deficiency of stomach Qi.”Note: Tai Yang governs the exterior, thus having sweating as deficiency and no sweating as excess. Yang Ming governs the interior, thus having sweating as excess and no sweating as deficiency, illustrating the differentiation of deficiency and excess between exterior and interior.(2) Yang Ming Disease Interior Excess Syndrome: The interior excess syndrome of Yang Ming disease is characterized by “not changing clothes” and “difficulty in defecation” as the main clinical manifestations. The “Shang Han Lun” states: “Yang Ming disease is characterized by fullness in the stomach,” discussing the characteristics of Yang Ming as a disease. The specific symptoms of interior excess include: no defecation, abdominal fullness and pain, or pain around the navel; or persistent abdominal fullness, leading to inability to eat, with a deep and tight pulse, or a deep and slow pulse with strength, and a yellow and dry tongue coating.3. Shao Yang Disease Deficiency and Excess(1) Shao Yang Disease Deficiency Syndrome: The deficiency syndrome of Shao Yang disease is discussed in the “Shang Han Lun”: “In cold damage, the Yang pulse is thin, and the Yin pulse is wiry; it should be treated with Xiao Jian Zhong Tang first; if not effective, Xiao Chai Hu Tang is the main treatment.” The Shao Yang disease pulse is originally wiry; now it is taken as thin and wiry, reflecting the deficiency of Qi and blood in Shao Yang disease. First, use Xiao Jian Zhong Tang to support the deficiency of righteous Qi, then use Xiao Chai Hu Tang (seemingly removing Huang Qin and adding Shao Yao) to harmonize the Shao Yang pathogen.In today’s hepatitis patients, if they experience persistent pain in the sides and the medication is ineffective, with a wiry and thin pulse, I often use Xiao Jian Zhong Tang with good results. This is the method of “the liver suffers from urgency, urgently eat sweet to alleviate it,” which has been used since ancient times, not a new practice.(2) Shao Yang Disease Excess Syndrome: Refers to the symptoms of fullness in the chest and sides, urgency in the heart, slight irritability, persistent vomiting, constipation, bitter mouth, and irritability, with a wiry and slippery pulse.4. Tai Yin Disease Deficiency and Excess(1) Tai Yin Disease Deficiency Syndrome: The deficiency syndrome of Tai Yin disease often correlates with cold syndrome, as the “Shang Han Lun” states: “Tai Yin disease is characterized by abdominal fullness and vomiting, inability to eat, self-limiting diarrhea, and abdominal pain. If purged, there will be a binding sensation in the chest.” This fully reflects the vomiting and diarrhea syndrome due to deficiency and cold in the spleen Qi. However, in clinical practice, the cold syndrome of Jue Yin disease is primarily characterized by vomiting, while the cold syndrome of Tai Yin disease is primarily characterized by diarrhea, with vomiting being secondary; this must be understood.(2) Tai Yin Disease Excess Syndrome: The “Shang Han Lun” states: “If it is originally a Tai Yang disease, and the physician mistakenly purges it, leading to abdominal fullness and pain, it belongs to Tai Yin…”; “If there is severe pain, Gui Zhi Jia Da Huang Tang is the main treatment.” This indicates that the excess syndrome of the spleen can be treated with purging. However, if the pulse is weak, it should not be used.5. Shao Yin Disease Deficiency and Excess(1) Shao Yin Disease Deficiency Syndrome: The deficiency syndrome of Shao Yin disease should analyze both Yin deficiency and Yang deficiency, as the “Shang Han Lun” states: “Shao Yin disease, with a weak pulse, should not induce sweating, as it is due to Yang deficiency.” This indicates that the weak pulse and Yang deficiency prohibit the use of sweating methods. The 285th section states: “Shao Yin disease, with a fine and deep pulse, indicates the disease is in the interior, and sweating should not be induced.” This reflects the deficiency syndrome of Shao Yin disease with distinctions of Yin and Yang.(2) Shao Yin Disease Excess Syndrome: It is said that “the kidney has no excess syndrome, and the liver has no deficiency syndrome,” which is a rough statement and insufficient as a guideline. However, how does the excess syndrome of Shao Yin disease arise? It often forms through the “middle organ leaking into the fu.” For example, the “Shang Han Lun” states: “Shao Yin disease, with self-limiting clear water diarrhea, pure blue color, and pain in the heart, dry mouth,” indicating that dryness and heat in the interior force the Yin down, leading to the excess syndrome of Shao Yin disease.6. Jue Yin Disease Deficiency and Excess(1) Jue Yin Disease Deficiency Syndrome: The deficiency syndrome of Jue Yin disease has distinctions of Yang Qi deficiency and blood deficiency. For Yang deficiency, the “Shang Han Lun” states: “If there is excessive sweating, heat does not dissipate, internal tension, pain in the four limbs, and diarrhea with cold aversion, Si Ni Tang is the main treatment.” This discusses the cold syndrome of Jue Yin Yang deficiency. For blood deficiency, the “Shang Han Lun” states: “If the hands and feet are cold, and the pulse is thin and about to disappear, Dang Gui Si Ni Tang is the main treatment.” This discusses the cold syndrome of Jue Yin blood deficiency.(2) Jue Yin Disease Excess Syndrome: The excess syndrome of Jue Yin disease may involve phlegm obstruction and water retention, heat accumulation causing the liver’s discharge to be obstructed, leading to Qi stagnation and the occurrence of cold reversal. For example, the “Shang Han Lun” states: “If a patient has cold hands and feet, and the pulse is suddenly tight, the pathogen is obstructed in the chest, causing fullness and irritability, and inability to eat, the disease is in the chest, and it must be expelled, using Gua Di San.” This discusses the phlegm pathogen obstructing the chest, leading to cold hands and feet due to Jue Yin Qi stagnation. The 356th section states: “If there is cold damage and palpitations in the heart, it is advisable to treat the water first, using Fu Ling Gan Cao Tang, then treat the cold. Otherwise, if water enters the stomach, it will lead to diarrhea.” This indicates that water stagnation in the stomach leads to liver obstruction, causing Qi stagnation and cold hands and feet due to internal water pathogens, thus termed the excess syndrome.ConclusionThrough the above combination of Eight Principles differentiation and Six Meridians differentiation, in each meridian, there are changes in Yin and Yang, exterior and interior, cold and heat, and deficiency and excess, reflecting the symptomatic rules of the Six Meridians diseases. Therefore, it has the significance of differentiation principles. However, the Eight Principles differentiation is also an objective reflection based on the diseases of the Six Meridians. Thus, the Eight Principles and the Six Meridians are a unified organic whole, inseparable. If they are artificially separated, it will inevitably destroy the material spirit of the Eight Principles differentiation and the objective existence of the Six Meridians differentiation.At the same time, TCM differentiation theory is embodied in the physiological and pathological changes of the meridians and organs. Therefore, only by using the Eight Principles differentiation method can we govern the diseases of the meridians and organs, the nature of the diseases of Yin and Yang organs, as well as the cold and heat, righteous and evil, deficiency and excess, all of which are interconnected, allowing for clear understanding. For this reason, I humbly present the practical situation of combining the Eight Principles and Six Meridians, discussing the methods of Zhang Zhongjing’s differentiation and treatment. If there are any omissions, please provide guidance.This is for clinical reference only; non-professional doctors should not attempt acupuncture or medication.
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Ai Yu Xiang Tang
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