Inheriting the legacy of Qi Huang, a public account with substance and warmth.
Ai Yu Xiang Tang
1. Harmonizing Yin and Yang is the Method of Treating Diseases
Take example 29. Example 29 refers to the Shao Yao Gan Cao Tang syndrome of Yin deficiency, not the deficiency of both Yin and Yang. The deficiency of both Yin and Yang is described in example 68: “If the sweating disease does not resolve and there is a return of aversion to cold, it is due to deficiency; Shao Yao Gan Cao Fu Zi Tang is the main treatment for it.”
Example 29 shows symptoms of “frequent urination, irritability, and leg cramps,” which are interconnected symptoms and evidence of Yin deficiency. Yin deficiency leads to internal heat; internal heat forces Yin to leak, resulting in frequent urination. Internal heat disturbs the heart, causing irritability, and frequent urination exacerbates the Yin deficiency, leading to muscle cramps, manifesting as leg cramps. Although there may be a floating pulse (indicating strong Wei Yang), spontaneous sweating (indicating weak Ying Yin), and slight aversion to cold (indicating an exterior syndrome) consistent with Gui Zhi Tang syndrome, it should not be treated with Gui Zhi to attack the exterior. Because the Ying Yin is already deficient, the Wei Yang lacks support, and attacking the exterior with Gui Zhi will lead to the loss of Yang, resulting in symptoms of counterflow, dry throat, irritability, and vomiting, which are indicative of the deficiency of both Yin and Yang. This syndrome cannot be treated with Shao Yao to support Yin, as supporting Yin will not restore counterflow and will not stop vomiting. Therefore, we use Gan Cao Gan Jiang Tang to first restore Yang.
Conversely, if treated with Gui Zhi, it leads to counterflow, which is clear evidence of Gui Zhi damaging Yang. The pulse of Gui Zhi Tang syndrome is floating and weak, with spontaneous sweating, and there must be no frequent urination or leg cramps indicative of Ying Yin deficiency. Therefore, the formula of Gui Zhi Tang is used to promote the excess Wei Yang and to nourish the weak Ying Yin with Shao Yao, facilitating the harmony of Ying and Wei, leading to recovery. As stated in the classics, “In Tai Yang disease, if there is fever and sweating, this indicates weak Ying and strong Wei, hence the sweating occurs.” How to resolve this? Gui Zhi Tang is appropriate to “restore the sweating; when Ying and Wei are harmonized, recovery occurs.” How do Ying and Wei harmonize? It is through Shao Yao and Gan Cao nourishing the insufficient Ying Yin, and Gui Zhi promoting the excess Wei Yang, assisting the body in achieving harmony between Ying and Wei, leading to recovery. The Gui Zhi series of formulas for treating deficiency and fatigue also harmonizes Yin and Yang: for acute deficiency and fatigue, Xiao Jian Zhong Tang is a representative formula. Xiao Jian Zhong Tang syndrome shows manifestations of strong Yang Qi, such as palpitations, limb pain, and hot hands and feet; it also shows manifestations of Yin deficiency, such as nosebleeds, abdominal pain, nocturnal emissions, and dry throat and mouth. Therefore, Gui Zhi promotes the excess and outwardly exuberant Yang Qi, while Shao Yao and Gan Cao nourish the insufficient and inwardly restrained Yin Qi, promoting internal and external harmony, leading to recovery.
For chronic deficiency and fatigue, Shu Yu Wan is a representative formula. Shu Yu Wan similarly uses herbs like Gui Zhi, Chai Hu, Da Dou Huang, Ju Hong, Jie Geng, Xing Ren, and Fang Feng to promote the excess Yang Qi, while using Dang Gui, Di Huang, Gan Cao, Ren Shen, Shao Yao, Mai Dong, E Jiao, and Da Zao to nourish the insufficient Yin Qi. A hundred pills are used as a dose for long-term conditioning.
Deficiency and fatigue can involve both acute and chronic diseases. Not all deficiency and fatigue are chronic diseases, nor are they all cases of deficiency of both Yin and Yang. If acute deficiency and fatigue can receive timely and correct treatment, it can prevent the development into chronic disease. The principle of treating all diseases is to observe their Yin and Yang, to drain what is excessive and to supplement what is insufficient, in order to achieve harmony between Yin and Yang, leading to recovery.
2. Disharmony of Yin and Yang, Focus on Hands and Feet
Looking at medical cases, one often sees records such as: “Four limbs are cold, cold beyond the knees, cold beyond the elbows, body feels cool.”Touching a normal person’s body, it often feels cool. Elderly people often say: “Good child, cool as a coin,” meaning that touching the skin of a healthy child feels as cool as touching a coin. Therefore, when medical records describe the body as feeling cool, is it cold or cool? It is not clear. A normal person’s body is usually warmer in the upper limbs and cooler in the lower limbs, with the elbow cooler than the arm and the knee cooler than the leg. The knees are the coolest part of the body. Therefore, when medical records describe the four limbs as cold, cold beyond the knees, and cold beyond the elbows, it is also not standardized. Because it is common to find cold knees and warm feet, and cold elbows and warm hands.
In the “Shang Han Lun,” it only states, “Hands and feet are cold, hands and feet are warm, hands and feet are hot”; it does not mention “four limbs are cold, cold beyond the knees, cold beyond the elbows.” In the “Jin Gui Yao Lue,” it also mentions “body cool and harmonious.” Body cool and harmonious means that body temperature has returned to normal. The harmony of body coolness means normality.
The temperature of the hands and feet is a very important basis for judging whether a person’s Yin and Yang Qi are harmonious or not. Typically, when the hands and feet change from hot to warm or from cold to warm, it indicates harmony of Yin and Yang. Hot hands and feet indicate strong Yang Qi. Cold hands and feet indicate Yang stagnation and cold, blood deficiency and cold, or Yang deficiency and cold. Commonly, cold hands and feet are often due to Yang stagnation and cold or blood deficiency and cold. Yang deficiency and cold indicate a more severe condition.
Common diseases with hot hands and feet:Strong Wei Qi and stagnant heat in the stomach.
Strong Wei Qi and stagnant heat indicate conditions such as Tai Yang cold damage, Tai Yang wind stroke, and Yang strong deficiency and fatigue.In Tai Yang cold damage, the pulse is floating and tight or floating and rapid, with no sweating, aversion to wind and cold, and pain in the head and body, with stiffness in the neck and back. The treatment should induce sweating and release the exterior, with formulas like Ma Huang Tang or Ge Gen Tang.
In Tai Yang wind stroke, the pulse is floating and weak or floating and rapid, with sweating, aversion to wind and cold, headache, and stiffness in the neck and back. The treatment should induce sweating and release the muscles, with formulas like Gui Zhi Tang or Gui Zhi Jia Ge Gen Tang.
Yang strong deficiency and fatigue present with lower abdominal tightness, palpitations, nosebleeds, abdominal pain, nocturnal emissions, limb pain, dry throat, and dry mouth, with Xiao Jian Zhong Tang as the selected formula. Lower abdominal tightness, cold in the Yin region, dizziness, hair loss, male nocturnal emissions, female nocturnal intercourse, with a pulse that is wiry or moving or weak or tight. The selected formula is Gui Zhi Long Gu Mu Li Tang.
Stomach strong stagnant heat presents with abdominal distension, frequent urination, hard stools, and a red tongue with yellow coating, treated by draining heat and unblocking the bowels, with formulas like Cheng Qi Tang.
Common diseases with cold hands and feet:Shaoyang Qi stagnation, Shaoyang heat stagnation, blood deficiency with internal cold, and Yang deficiency with internal cold.
Shaoyang Qi stagnation presents with fullness in the chest and ribs, belching, vomiting, diarrhea, or coughing, palpitations, or difficulty urinating, with a white tongue coating and wiry pulse. The treatment should unblock Yang and resolve stagnation, with the selected formula being Si Ni San.
Shaoyang heat stagnation presents with body heat and sweating, facial dirtiness, dry and thick tongue coating, and slippery and rapid pulse. The treatment should clear heat and drain fire, with the selected formula being Bai Hu Tang.
Blood deficiency with internal cold presents with cold body and pain, alleviated by warmth, pale red tongue, thin white and moist coating, and thin pulse. The treatment should warm and nourish the blood vessels, expel cold and harmonize Ying, with the selected formula being Dang Gui Si Ni Tang. If there is internal long-standing cold, with cold pain in the lower abdomen, or dry retching, or vomiting foamy saliva, add Wu Zhu Yu and Sheng Jiang to warm the liver and stomach, dispel cold and reduce counterflow.
Yang deficiency with internal cold presents with cold pain in the lower back and knees, or clear diarrhea, or joint pain, pale tongue with thin white coating, and deep pulse. The treatment should restore Yang and rescue counterflow or warm Yang and dispel cold, with the selected formulas being Si Ni Tang or Fu Zi Tang.
3. Excessive Yang Qi is a Pathological State
Excessive Yang Qi is a pathological state, not a normal state. For example, in example 247, it states: “The pulse of the foot Yang is floating and rough; floating indicates strong stomach Qi, and rough indicates frequent urination; floating and rough interacting leads to hard stools, indicating the spleen is constrained.” The floating pulse of the foot Yang indicates strong stomach Qi, and strong stomach Qi indicates weak spleen Qi; when the stomach is strong and the spleen is weak, it leads to disharmony between the spleen and stomach. “The spleen governs the stomach in transporting its fluids” (from the Huang Di Nei Jing). If the spleen and stomach are not harmonious, the spleen cannot transport the fluids of the stomach, leading to frequent urination and hard stools.
Similarly, when Ying and Wei are not harmonious, Ying Qi is relatively weak; “the weak Yin leads to spontaneous sweating, while the floating Yang leads to heat spontaneously occurring,” which is the pathogenesis described in the “Shang Han Lun,” indicating that the floating pulse, fever, and sweating are due to weak Ying and strong Wei. When Ying Yin is weak, spontaneous sweating occurs, which is similar to the situation of weak spleen Yin leading to frequent urination; spontaneous sweating and frequent urination are both pathological phenomena of “Yang being strong and unable to contain, leading to the exhaustion of Yin Qi” (from the Huang Di Nei Jing), indicating that excessive Yang Qi leads to the forced leakage of Yin Qi, and the pathogenesis is weak Yin and strong Yang, leading to disharmony between Yin and Yang.
The basic definitions of Yin and Yang are: internal is Yin, external is Yang; downward is Yin, upward is Yang. Therefore, excessive diarrhea indicates loss of Yin, and excessive sweating indicates loss of Yang. Loss of Yang indicates Yang deficiency. For example, in example 286, it states: “In Shao Yin disease, the pulse is weak; sweating cannot be induced, as it is due to loss of Yang. When Yang is already deficient, if the pulse at the wrist is weak and rough, it cannot be purged.” The manifestations of loss of Yang (Yang deficiency) include the following two types:
One is deficiency cold, as in example 38: “If there is no sweating and irritability, Da Qing Long Tang is the main treatment; if the pulse is weak and sweating occurs with aversion to wind, it cannot be taken. If taken, it will lead to counterflow, muscle spasms, and trembling, which is a reversal.” Taking Da Qing Long Tang when sweating leads to loss of Yang, resulting in the cold syndrome of Yang deficiency and counterflow.
The other is excess heat, as in example 111: “In Tai Yang disease with wind stroke, fire consumes sweating. The evil wind is heated by fire, and blood and Qi overflow, losing their normal balance, leading to mutual burning of both Yangs, resulting in yellowing of the body. When Yang is excessive, it leads to nosebleeds, and when Yin is deficient, it leads to difficulty in urination. When both Yin and Yang are exhausted, the body becomes dry, with only head sweating, and the sweat returns to the neck. Abdominal fullness, slight wheezing, dry mouth, sore throat, or constipation, if prolonged, leads to delirium, and in severe cases, to hiccups, restlessness of hands and feet, and fidgeting with clothes and bed. If there is frequent urination, the person can be treated.” In Tai Yang wind stroke, fire consumes sweating, leading to loss of Yang, resulting in the excess heat syndrome of Yang and deficiency of Yin.
Yang deficiency (loss of Yang) is easily understood as deficiency cold; Yang deficiency (loss of Yang) as excess heat is not easily understood. In fact, as long as one understands what Yang is, then the two states of Yang deficiency manifesting as deficiency cold and excess heat become easy to understand.
What is Yang? External is Yang, upward is Yang. As the classics say, “Ying is in the pulse, Wei is in the pulse exterior,” Ying Qi in the pulse is Yin, and Wei Qi in the pulse exterior is Yang. “If the complexion is bright red, it indicates that Yang Qi is stagnant at the surface,” and “if the complexion is bright red, it indicates that blood is stagnant at the surface,” meaning that blood at the surface is Yang.
In example 46: “In Tai Yang disease, the pulse is floating and tight, with no sweating, fever, and body pain, and if it does not resolve after eight or nine days, the exterior syndrome still exists, it is necessary to induce sweating. If the medication has slightly alleviated the condition, and the person becomes irritable and has closed eyes, in severe cases, there will be nosebleeds, which will resolve the condition. This is because Yang Qi is heavy.” The irritability and closed eyes, in severe cases leading to nosebleeds, indicate heavy Yang Qi, which is also blood stagnation at the surface. From the original text of the “Shang Han Lun,” it can be seen that the blood at the surface is Yang Qi. Therefore, loss of Yang indicates the loss of blood at the surface.
Loss of blood at the surface leads to blood deficiency at the surface, losing the ability to return to the interior to rescue the Qi and blood of the interior, then the interior becomes colder, leading to increased coldness, resulting in Shao Yin deficiency cold syndrome, as in example 38; if the interior is hot, it leads to increased heat, resulting in Yang Ming excess heat syndrome, as in example 111. Due to the different physical conditions of patients, if the interior is colder, inducing sweating and losing Yang will lead to Shao Yin deficiency cold syndrome; if the interior is hotter, inducing sweating and losing Yang will lead to Yang Ming excess heat syndrome. For example, in example 124, the pulse is “weak and deep” indicating Yang deficiency, and the person becomes manic, with a hard and full lower abdomen, and frequent urination indicates internal heat.
The “Jin Gui Yao Lue” states, “When Yang Qi declines, it leads to mania,” which is also a Yang deficiency with internal heat syndrome. The “Huang Di Nei Jing” states, “When Yang Qi is heavy above, it is excessive above; moxibustion will lead to Yang Qi entering Yin, and if it enters, it will lead to stupor; if it is bled, it will lead to Yang Qi deficiency, and if it is deficient, it will lead to mania.” Bleeding with stone needles or stone pieces leads to deficiency of surface Qi, losing the ability to return to the interior’s Qi and blood, leading to increased internal heat, resulting in mania.
From the discussions in the “Shang Han Lun” and the “Huang Di Nei Jing,” it can be seen that Yang Qi is the Qi of the surface, which is the Qi that moves outward from the interior, including the Qi that rushes upward; Yin Qi is the Qi of the interior, which is the Qi that moves inward from the exterior, including the Qi that sinks downward. Therefore, strong stomach Qi indicates an abundance of internal Qi, leading to stagnation and blockage in the interior; strong Wei Qi indicates an abundance of surface Qi, leading to stagnation and blockage at the surface.
Thus, formulas like Gui Zhi Tang and Ma Huang Tang are used to release the Qi of the surface, relieving surface stagnation. When surface stagnation is removed, Wei Qi changes from strong to balanced. The mechanism of action of Gui Zhi and Ma Huang is to deplete the external Qi, which is to reduce the excess Yang at the surface. Therefore, those with surface deficiency should be cautious when using Gui Zhi and Ma Huang formulas. For example, in the “Jin Gui Yao Lue,” Gui Ling Wu Wei Gan Cao Tang removes Gui Zhi and adds Gan Jiang and Xi Xin, because “when the Qi rushes low, it leads to more coughing and fullness in the chest.” When the Qi rushes low, it leads to more coughing and fullness in the chest, indicating that the upper is deficient and cold, hence Gui Zhi is removed and Gan Jiang and Xi Xin are added.
Example 111 states, “When Yang is excessive, it leads to nosebleeds,” which is due to fire consuming sweating, leading to excessive Yang evil, not excessive Yang Qi. As the “Huang Di Nei Jing” states, “When the strong fire Qi declines, the weak fire Qi becomes strong. Strong fire consumes Qi, and Qi consumes weak fire. Strong fire disperses Qi, while weak fire generates Qi.”
The content of this article is for reference only,not for professionaldoctorsto try needles or medicines.