According to the principles of Yangming, the focus is on interior symptoms. Although there may be exterior symptoms, Zhang Zhongjing’s intention is not on the exterior, as it is said that various internal conditions manifest externally. There may also be concurrent channel diseases, but Zhang Zhongjing’s focus is not on the channels, as the exterior is in the channels but rooted in the stomach. The Taiyin and Yangming share the central region, with Taiyin being expansive and Yangming being consolidative. Therefore, Yangming must primarily focus on disease. Whether there is constipation or not, whether there is urination or not, inability to eat, difficulty in feeling full, initial desire to eat but then unable to, all these are symptoms. Spontaneous sweating and night sweats indicate that the exterior is open while the interior is affected. Conversely, if there is no sweating, both interior and exterior are involved. Various diseases may occur, some likely and some unlikely.Thus, the principle is solely based on the fullness of the stomach. Stomach fullness does not merely refer to dry stools and hardness; it is specifically related to diarrhea. Diarrhea indicates that the stomach is not full. Therefore, if sweating occurs after resolution, and the stomach is not harmonious, then diarrhea does not indicate Yangming disease. If the stomach is deficient and there is no diarrhea, it belongs to Yangming. This means initially hard stools followed by loose stools, where food and drink are not differentiated, even if death occurs without diarrhea, it is still considered Yangming disease. The Yangming and Taiyin both serve as the granaries, but their functions are distinct. The stomach is responsible for receiving, hence Yangming governs fullness, while the spleen is responsible for transporting, hence Taiyin governs diarrhea. Although they share the same stomach organ, their treatments are thus differentiated, which is how the two channels are divided.Yangming is the residence of transformation, thus it must alternate between fullness and emptiness. When food enters, if the stomach is full and the intestines are empty, or if food descends and the intestines are full while the stomach is empty, if there is only fullness without emptiness, it becomes the root of Yangming disease. Stomach fullness is not Yangming disease, but the disease of Yangming arises entirely from stomach fullness.Therefore, the fullness of the stomach is the general principle of Yangming. However, the causes of fullness should be examined in detail.There are those who are full before becoming ill, and those who are full after becoming ill. There are external wind-cold invasions, heat that cannot be surpassed leading to fullness, excessive sweating, vomiting, and purging that depletes body fluids leading to fullness, and there are those who transition from other channels leading to fullness. This only highlights the root of the disease being in fullness, and one must not hastily conclude that stomach fullness is a condition that can be purged.Body heat with spontaneous sweating, not fearing cold but rather fearing heat, is the principle of Yangming exterior symptoms.Thus, if the stomach is deficient and cold, it can also be termed Yangming disease due to such exterior symptoms. However, this is an internal heat reaching the exterior, not the exterior symptoms of wind-cold. At this time, the exterior cold has dispersed, hence not fearing cold, while internal heat is closed and bound, thus fearing heat instead. This is due to the root of the disease being in stomach fullness, which manifests as body heat and spontaneous sweating without fearing cold but rather fearing heat. However, this only describes the mechanism of the disease’s manifestation, not a condition that can be purged.Only when there are symptoms of tidal heat, irritability, and distension can purging be considered.The Taiyang serves as the general principle, presenting the front, while Yangming serves as the general principle, revealing the underside. The front of Yangming’s symptoms is the same as that of Taiyang, yet one must also observe that Yangming’s symptoms differ from those of Taiyang.For instance, in Yangming disease, if the pulse is slow and there is much sweating with slight aversion to cold, this is the symptom of Yangming’s Gui Zhi. If the pulse is floating without sweating and there is wheezing, this is the symptom of Yangming’s Ma Huang.This text states that if the disease is present for one day without fever but with aversion to cold, this is already established. Later generations see that Taiyang has this pulse symptom and thus claim that Yangming should not have this pulse symptom, leading to the notion that it is still in Taiyang and about to enter Yangming. They do not know that Zhang Zhongjing’s writings often do not mention this point, while other points reveal it. For example, initially, there may be aversion to cold, and phrases like ‘no sweating’ are also present, as Yangming’s exterior symptoms are primarily characterized by sweating without aversion to cold, hence the addition of ‘no sweating’ is noted. There are points in the original text that have not been declared, but are revealed in other texts.If Taiyang has a stiff neck and pain, and Shaoyang has a thin and wiry pulse, this is also the case. However, if there is headache without stiff neck, and the pulse is large and not thin, then it is Yangming’s exterior symptoms. After Taiyang has passed through the body, Yangming precedes the body, and the wind-cold received is all in the Yingwei exterior. Taiyang’s Yingwei has both deficiency and excess, and Yangming’s Yingwei also has both deficiency and excess. If deficient, it is Gui Zhi; if excessive, it is Ma Huang. This is Zhang Zhongjing’s established method for treating exterior pathogens.Zhang Zhongjing’s formulas are set according to symptoms, not according to channels. When this symptom is seen, it corresponds with this formula, which is Zhang Zhongjing’s flexible method.Later generations mistakenly categorize formulas by channels, not only do they dare not use two formulas for Yangming, but they have also long abandoned Taiyang.Yangming’s exterior has two types: one is the exterior caused by initial invasion of external pathogens, and the other is the exterior heat reaching outward. The exterior caused by external pathogens lasts only one or two days, with symptoms of slight aversion to cold, much sweating, or no sweating but wheezing. The exterior heat appears one or two days later, with symptoms of body heat, spontaneous sweating, not fearing cold, but rather fearing heat.Because the exterior is due to wind-cold, Zhang Zhongjing also uses Ma Huang and Gui Zhi to induce sweating. When the exterior is due to internal heat, Zhang Zhongjing formulates Zhi Zi and Bo He Decoction.This is due to the heat causing vomiting. Later generations fail to recognize Yangming’s exterior symptoms, and after one or two days do not dare to use Ma Huang, and after two or three days do not know to use Zhi Zi and Bo He Decoction.They do not recognize Zhang Zhongjing’s initial method for treating Yangming, thus abandoning Yangming’s method of inducing vomiting, waiting until the heat is deep and excessive, to use Bai Hu and Cheng Qi to treat it, which is to nurture a tiger and leave hidden dangers.Among the six channels of Shanghan, only Yangming is the lightest, as Yangming is the sea of food and drink.The qi of food is sufficient to overcome the evil qi.Yangming is the leader of the twelve meridians.The qi and blood are sufficient to resist cold qi.Yangming resides in the place where the two Yangs converge and illuminate.The Yang qi is sufficient to resist Yin qi.When Yangming is invaded, for one day there is aversion to cold, similar to Taiyang. After two days, there is no aversion to cold, but rather aversion to heat. Thus, the Inner Canon states that after two days, Yangming is affected, and Yangming’s symptoms appear on the second day, not to say that Yangming’s disease is in the intersection of Taiyang. Zhang Zhongjing states that after three days of Shanghan, the Yangming pulse is large. It is important to know that Yangming’s Shanghan is only on the first and second day when the cold departs and heat arises. On the third day, the Yangming pulse is large, indicating that there is no cold qi, and this is Yangming’s disease heat, not a return to the previous day’s Shanghan. Although it initially arises from Shanghan, it is no longer referred to as Shanghan, and thus it is treated with Shanghan’s formulas.Yangming’s aversion to cold ceases after two days, which is different from other channels. Its aversion to cold is slight, and it is not as severe as Taiyang. Yangming’s heat steams and evaporates within the muscles, but there is heat without cold, which differs from Taiyang’s heat that is bound to the skin. Yangming’s spontaneous sweating is also different from Taiyang’s spontaneous sweating due to wind.Taiyang may have spontaneous sweating, but it is not beneficial.There is an intention to hold on, hence its condition is described as such.Yangming’s spontaneous sweating often has a wave-like and fluctuating appearance.Thus, it is named as such. The pulse of Taiyang is floating and tight, which must indicate tidal heat.The pulse of Taiyang is merely floating, which must indicate no sweating.The pulse of Yangming is merely floating, which must indicate spontaneous sweating.The exterior symptoms of the two channels and their exterior pulses differ in this way.Now, the Shanghan text divides headache into three Yangs. Yangming’s pain is in the forehead, which is indeed the case. However, Yangming governs the interior, and headache is not its primary symptom. The Inner Canon states that on the first day of Shanghan, the major Yang is affected, hence the pulse connects to the Wind Mansion, causing headache and stiff neck. On the seventh day, Taiyang disease declines, and headache slightly improves. On the second day, Yangming is affected, and its pulse connects to the nasal network at the eyes, hence body heat and eye pain, dry nose, and inability to lie down.This indicates that the Inner Canon attributes headache to Taiyang, not to Yangming.Zhang Zhongjing has two entries for Yangming headache: one day of Yangming disease, with no sweating and slight diarrhea; two to three days of vomiting and coughing, with hands and feet cold, must be accompanied by severe headache. If there is no cough or vomiting, and hands and feet are not cold, there is no headache. This headache occurs on the second or third day, not on the first day of illness, and is due to vomiting and coughing, not due to external pathogens. On the first day of Shanghan, if there is no bowel movement, and on the sixth or seventh day, if there is headache without heat, it corresponds with Cheng Qi Decoction. This headache occurs during the decline of Taiyang, and is due to lack of bowel movement, which is as the Inner Canon states, distension and headache are not due to wind-cold.Among the various wind-cold entries, none address headache symptoms, thus Yangming headache is distinctly different from Taiyang. This text states that Yangming disease has a floating and tight pulse, dry throat, bitter mouth, abdominal fullness, and wheezing, fever, sweating, not fearing cold but rather fearing heat, and heaviness of the body. This should directly correspond to Zhi Zi and Bo He Decoction. If sweating is induced in three stages, and this formula is not used, it leads to erroneous treatment.It should still be Zhi Zi and Bo He Decoction that governs it. Zhang Zhongjing only mentions it in the concluding sentence, which is a concise writing style. Later generations mistakenly recognize Zhi Zi and Bo He Decoction as a remedy for reversing after sweating and purging. One must ask, before sweating and purging, what method did Zhang Zhongjing use to treat it? It is important to know that dry throat, bitter mouth, abdominal fullness, and wheezing are Yangming’s internal heat, while fever and sweating, not fearing cold but rather fearing heat, are Yangming’s exterior heat. Due to Yangming’s heat reaching the exterior, the internal symptoms are more severe, hence this section describes symptoms, listing internal symptoms before exterior symptoms. Zhi Zi is used to clear internal heat, while the exterior heat is also resolved. Bo He is used to relieve abdominal fullness, while heaviness of the body is also alleviated. Later generations cannot find Yangming’s exterior in Zhang Zhongjing’s writings, and they mistakenly reference the Inner Canon’s discussion of heat diseases, such as eye pain and dry nose, to address it. They do not understand Zhang Zhongjing’s method for treating Yangming’s exterior symptoms, and they mistakenly reference the formulas for measles, such as Ge Gen and Sheng Ma, to govern it, not knowing thatthe Inner Canon discusses heat diseases, only addressing one aspect of Yangming channel diseases.Zhang Zhongjing established Yangming as a channel that encompasses the treatment of both internal and external symptoms, and they do not realize that eye pain and dry nose indicate Yangming’s excess Yang and deficient Yin, which should be treated by nourishing Yin and clearing fire, rather than inducing Yangming’s sweating. If there is bleeding from the nose above and difficulty in bowel movements below, it is akin to inviting thieves into the home.It is important to know that if the three Yin channels are affected, the relationship does not lie in Shaoyang or Taiyang, but entirely relates to Yangming.Yangming is the interior of Taiyin, referring to the female organs, while Taiyin also regards Yangming as the interior, referring to the transition of channels.The kidneys are the gate of the stomach, and wood is the thief of earth, hence the three Yin channels can also regard Yangming as the interior. The three Yin channels are the interior of the three Yang channels, and the three Yin channels can also transition to Yangming as the interior, thus all three Yin channels can descend from Yangming, making Yangming a crucial pathway for the three Yin channels to expel pathogens. It serves as the exterior of the three Yin channels to resist pathogens, and also as the interior of the three Yin channels to expel pathogens.The relationship between Yangming and the three Yin channels is significant.Previous Articles:
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