仲景曰。尺寸俱长者。阳明受病也。当二三日发。以其脉侠鼻。
络于目。故身热。目疼。鼻干。不得卧。庞氏曰。此证恶寒。可发汗。若
恶寒罢。反自汗恶热者。为胃家实。属正阳阳明。宜调胃承气汤。
仲景问曰。病有太阳阳明。有正阳阳明。有少阳阳明。何谓也。
答曰。太阳阳明者。脾约是也。正阳阳明者。胃家实是也。少阳阳明
者。发汗利小便已。胃中燥烦实。大便难是也。庞氏曰。本太阳病。若
发汗。若下。若利小便。此亡津液。胃中干燥。因转属阳明。名曰太阳
阳明也。本传到少阳。因发汗。利小便。胃中燥。大便难者。名曰少阳
阳明也。病患本风盛气实。津液消烁。或始恶寒。汗出后。恶寒既罢。
而反发热。或始得病。便发热狂言者。名曰正阳阳明也。凡阳明证。
俱宜下。唯中寒恶寒为病在经。与太阳合病属表。可发其汗。
又曰。阳明之为病。胃家实是也。千金作胃中寒者非。
又问曰。何缘得阳明病。答曰。太阳病。若发汗。若下。若利小
便。此亡津液。胃中干燥。因转属阳明。不更衣。内实。大便难者。此
名阳明也。
又问曰。阳明病。外证云何。答曰。身热。汗自出。不恶寒。反恶热也。
又问曰。病有得之一日。不发热而恶寒者。何也。答曰。虽得之一日。恶寒将自罢。即自汗出而恶热也。
又问曰。恶寒何故自罢。答曰。阳明居中土也。万物所归。无所复传。始虽恶寒。二日自止。此为阳明病也。
又曰。本太阳。初得病时发其汗。汗先出不彻。因转属阳明也。
又曰。伤寒。发热无汗。呕不能食。而反汗出 然者。是转属阳明也。
又曰。伤寒三日。阳明脉大。
又曰。伤寒脉浮而缓。手足自温者。是为系在太阴。太阴者。身
当发黄。若小便自利者。不能发黄。至七八日。大便硬者。为阳明病也。
又曰。伤寒转系阳明者。其人 然微汗出也。
又曰。阳明中风。口苦咽干。腹满微喘。发热恶寒。脉浮而紧。若
下之。则腹满小便难也。常氏云。可桂枝麻黄各半汤、小柴胡汤。
又曰。阳明病。若能食。名中风。不能食。名中寒。
又曰。阳明病。若中寒者。不能食。小便不利。手足 然汗出。此
欲作固瘕。必大便初硬后溏。所以然者。以胃中冷。水谷不别故也。
常氏云。可理中汤、猪苓汤。
又曰。阳明病。初欲食。小便反不利。大便自调。其人骨节疼。翕
翕如有热状。奄然发狂。 然汗出而解者。此水不胜谷气。与汗共
并。脉紧则愈。常氏云。疑阙麻黄汤一法。又一本云。脉去则愈。雍
曰。千金翼作坚者则愈。无脉字。证既有误。未可便用麻黄汤也。若
脉浮而紧无汗者。则可用。三书之误。是误以紧为坚。者为去。或漏
脉字。或漏者字。当云脉紧者则愈。
又曰。阳明病欲解时。从申至戌上。
又曰。阳明病。不能食。攻其热必哕。所以然者。胃中虚冷故也。
以其人本虚。故攻其热必哕。常云。可温中汤。金匮方小半夏汤亦
可。
又曰。阳明病。脉迟。食难用饱。饱则微烦。头眩。必小便难。此
欲作谷瘅。虽下之。腹满如故。所以然者。脉迟故也。常氏云。茯苓
汤、五苓散。雍曰。已发黄者。茵陈蒿汤。
又曰。阳明病。法多汗。反无汗。其身如虫行皮中状者。此以久
虚故也。常氏云。可桂枝加黄 汤。雍曰。以无汗。故如虫行皮中状。
须小汗乃解。宜桂枝麻黄各半汤。此汤解身痒。能小汗故也。
又曰。阳明病。反无汗而小便利。二三日。呕而咳。手足厥者。必
苦头痛。若不咳不呕。手足不厥者。头不痛。常氏云。类要用小建中
汤误也。可小柴胡汤。雍曰。手足厥者。宜小建中汤。
又曰。阳明病。但头眩。不恶寒。故能食而咳。其人必咽痛。若不
咳者。咽不痛。常氏云。可服茯苓甘草白术生姜汤。（未见方）咽痛
者。宜桔梗汤。
又曰。阳明病。无汗。小便不利。心中懊 者。身必发黄。常氏
云。可茵陈蒿汤调五苓散。
又曰。阳明病。被火。额上微汗出。而小便不利者。必发黄。常氏
云。可与茵陈蒿汤调五苓散。
又曰。阳明病。脉浮而紧者。必潮热。发作有时。但浮者。必盗汗
出。常氏云。可与柴胡桂枝汤。
又曰。阳明病。口燥。但欲漱水不欲咽者。此必衄。常氏云。可黄
芩芍药地黄汤。（当作黄芩芍药甘草汤此句后增非郭氏语）
又曰。阳明病。本自汗出。医更重发汗。病已瘥。尚微烦不了了
者。此大便必硬故也。以亡津液。胃中干燥。故令大便硬。当问其小
便日几行。若本小便日三四行。今日再行。故知大便不久出。今为小
便数少。以津液当还入胃中。故知不久必大便也。
又曰。伤寒呕多。虽有阳明证。不可攻之。常云。可小柴胡汤。
又曰。阳明病。心下硬满者。不可攻之。攻之。利遂不止者死。利
止者愈。常氏云。未攻者。可与生姜泻心汤。利不止者。四逆汤。
又曰。阳明病。面合赤色。不可攻之。必发热色黄。小便不利也。
常氏云。可五苓散。雍曰。既不可攻。则调胃承气不可用。但煎茵陈
蒿汤调五苓散服之。
又曰。阳明病。不吐不下。心烦者。可与调胃承气汤。
又曰。阳明病。脉迟。虽汗出。不恶寒者。其身必重。短气。腹满
而喘。有潮热者。此外欲解。可攻里也。手足 然汗出者。此大便已
硬也。大承气汤主之。若汗多。微发热恶寒者。外未解也。其热不潮。
未可与承气汤。若腹大满不通者。可与小承气汤微和胃气。勿令大泄下。
又曰。阳明病。潮热。大便微硬者。可与大承气汤。不硬者。不可
与之。若不大便六七日。恐有燥屎。欲知之法。少与小承气汤。汤入
腹中。转失气者。此有燥屎也。乃可攻之。若不转失气者。此但初头
硬。后必溏。不可攻之。攻之必胀满不能食也。欲饮水者。与水则哕。
其后发热者。必大便复硬而少也。以小承气汤和之。不转失气者。慎
不可攻也。
又曰。夫实则谵语。虚则郑声。郑声者。重语也。直视谵语。喘满
者死。下利者亦死。
又曰。发汗多。若重发汗者。亡其阳。谵语。脉短者死。脉自和者
不死。
又曰。伤寒。若吐若下后。不解。不大便五六日上至十余日。日
晡所发潮热。不恶寒。独语如见鬼状。若剧者。发则不识人。循衣摸
床。惕而不安。微喘直视。脉弦者生。涩者死。微者但发热谵语者。大
承气汤主之。若一服利。止后服。
又曰。阳明病。其人多汗。以津液外出。胃中燥。大便必硬。硬则
谵语。小承气汤主之。若一服谵语止者。更莫复服。
又曰。阳明病。谵语。发潮热。脉滑而疾者。小承气汤主之。因与
承气汤一升。腹中转失气者。更服一升。若不转失气者。勿更与之。
明日又不大便。脉反微涩者。里虚也。为难治。不可更与承气汤也。
常氏云。可用黄 人参建中汤。
又曰。阳明病。谵语。有潮热。反不能食者。胃中必有燥屎五六
枚也。若能食者。但硬耳。宜大承气汤下之。
又曰。阳明病。下血谵语者。此为热入血室。但头汗出者。刺期
门。随其实而泻之。 然汗出则愈。雍曰。此是妇人证。
又曰。汗出谵语者。以有燥屎在胃中。此为风也。须下之。过经
乃可下之。下之若早。语言必乱。以表虚里实故也。下之则愈。宜大
承气汤。
又曰。伤寒四五曰。脉沉而喘满。沉为在里。而反发其汗。津液
越出。大便为难。表虚里实。久则谵语。常氏云。喘满无大热者。可麻
黄杏仁甘草石膏汤。里实谵语者。调胃承气汤。
又曰。三阳合病。腹满身重。难以转侧。口不仁面垢。谵语遗尿。
发汗则谵语。下之则额上生汗。手足逆冷。若自汗出者。白虎汤主
之。（庞氏在少阳证）
又曰。二阳并病。太阳证罢。但发潮热。手足 汗出。大便难
而谵语者。下之则愈。宜大承气汤。
又曰。阳明病。脉浮而紧。咽燥口苦。腹满而喘。发热汗出。不恶
寒。反恶热。身重。若发汗则躁。心愦愦。反谵语。若加烧针。必怵惕
烦躁。不得眠。若下之。则胃中空虚。客气动膈。心中懊 。舌上苔
者。栀子豉汤主之。（庞氏云。脉浮紧。当无汗。反有汗。咽燥腹满恶
热。法当下之。而反脉浮紧。不可下。此恐变风湿。宜细详之。）
又曰。若渴欲饮水。口干舌燥者。白虎加人参汤主之。
又曰。若脉浮发热。渴欲饮水。小便不利者。猪苓汤主之。
又曰。阳明病。汗出多而渴者。不可与猪苓汤。以汗多。胃中燥。
猪苓汤复利其小便故也。常氏云。可与白虎加人参汤。雍曰。宜柴胡
桂枝汤和营卫。通津液也。
又曰。脉浮而迟。表热里寒。下利清谷者。四逆汤主之。
又曰。若胃中虚冷。不能食者。饮水则哕。常氏云。可温中汤。
（金匮方二物）
又曰。脉浮发热。口干鼻燥。能食者则衄。常氏云。可黄芩汤。
又曰。阳明病。下之。其外有热。手足温。不结胸。心中懊 。饥不能食。但头汗出者。栀子豉汤主之。
又曰。阳阴病。发潮热。大便溏。小便自可。胸胁满不去者。与小柴胡汤主之。
又曰。阳明病。胁下硬满。不大便而呕。舌上白苔者。可与小柴
胡汤。上焦得通。津液得下。胃气因和。身 然而汗出解也。
又曰。阳明中风。脉弦浮大而短气。腹都满。胁下及心痛。久按
之。气不通。鼻干不得汗。嗜卧。一身及目悉黄。小便难。有潮热。时
时哕。耳前后肿。刺之小瘥。外不解。病过十日。脉续浮者。与小柴胡
汤。
又曰。脉但浮。无余证者。与麻黄汤。若不尿。腹满加哕者。不
治。雍曰。千金通续前证为一证。似当理。
又曰。阳明病。自汗出。若发汗。小便自利者。此为津液内竭。虽
硬不可攻之。当须自欲大便。宜蜜煎导而通之。若土瓜根及大猪胆
汁。皆可为导。
又曰。阳明病。脉迟。汗出多。微恶寒者。表未解也。可发汗。宜
桂枝汤。
又曰。阳明病。脉浮。无汗而喘者。发汗则愈。宜麻黄汤。
又曰。阳明病。发热汗出。此为热越。不能发黄也。但头汗出。身
无汗。剂颈而还。小便不利。渴饮水浆者。此为瘀热在里。身必发黄。
茵陈蒿汤主之。
又曰。阳明证。其人喜忘者。必有蓄血。所以然者。本有久瘀血。
故令喜忘。屎虽硬。大便反易。其色必黑。宜抵当汤下之。
又曰。阳明病。下之。心中懊 而烦。胃中有燥屎者。可攻。腹微
满。初头硬。后必溏。不可攻之。若有燥屎者。宜大承气汤。
又曰。病患不大便五六日。绕脐痛。烦躁。发作有时者。此有燥
屎。故使不大便也。常氏云。可小承气汤。
又曰。病患烦热。汗出则解。又如疟状。日晡所发热者。属阳明
也。脉实者。宜下之。脉浮虚者。宜发汗。下之。与大承气汤。发汗。宜
桂枝汤。
又曰。大下后。六七日不大便。烦不解。腹满痛者。此有燥屎也。
所以然者。本有宿食故也。宜大承气汤。
又曰。病患小便不利。大便乍难乍易。时有微热。喘冒不能卧
者。有燥屎也。宜大承气汤。
又曰。食谷欲呕者。属阳明也。吴茱萸汤主之。得汤反剧者。属
上焦也。常氏云。可桔皮汤。（类要云。橘皮一两。甘草一两。生姜四
两。人参三两。为末。水煎服。）
又曰。太阳病。寸缓。关浮。尺弱。其人发热汗出。复恶寒。不呕。
但心下痞者。此以医下之也。如其不下者。病患不恶寒而渴者。此转
属阳明也。小便数者。大便必硬。不更衣十日。无所苦也。渴欲饮水
者。少少与之。但以法救之。渴者。宜五苓散。
又曰。阳脉微而汗出少者。为自和也。汗出多者为太过。阳脉
实。因发其汗。出多者。亦为太过。太过为阳绝于里。亡津液。大便因
硬也。常氏云。可与小柴胡汤和其津液。如便益坚。可调胃承气汤。
雍曰。通津液。用柴胡桂枝汤尤稳。如不得已。至用承气汤。防下后
变作狐惑。宜小小通之。
又曰。脉浮而芤。浮为阳。芤为阴。浮芤相搏。胃气生热。其阳则
绝。常氏云。可柴胡汤。
又曰。趺阳脉浮而涩。浮则胃气强。涩则小便数。浮涩相搏。大
便则硬。其脾为约。麻仁丸主之。
又曰。太阳病三日。发汗不解。蒸蒸发热者。属胃也。调胃承气
汤主之。
又曰。伤寒吐后。腹胀满者。与调胃承气汤。
又曰。太阳病。若吐若下若发汗后。微烦。小便数。大便因硬者。
与小承气汤和之愈。
又曰。得病二三日。脉弱。无太阳柴胡证。烦躁。心下硬。至四
五日。虽能食。以小承气汤少少与微和之。令小安。至六日。与承
气汤一升。若不大便六七日。小便少者。虽不能食。但初头硬。后必
溏。未定成硬。攻之必溏。须小便利。屎定硬。乃可攻之。宜大承气
汤。
又曰。伤寒六七日。（千金作七八日）目中不了了。睛不和。无表
里证。大便难。身微热者。此为实也。急下之。宜大承气汤。
Zhang Zhongjing said: When both the Cun (inch) and Chi (cubit) pulses are long, it indicates that the Yangming channel is affected. This typically manifests two or three days after onset. Because the Yangming meridian runs alongside the nose and connects to the eyes, symptoms include fever, eye pain, nasal dryness, and inability to sleep. Pang Shi stated: If this syndrome presents with aversion to cold, diaphoretic therapy may be used. If the aversion to cold ceases and is replaced by spontaneous sweating and aversion to heat, it constitutes "Stomach Fullness" (Wei Jia Shi), belonging to Zhengyang Yangming. Tiaowei Chengqi Decoction is appropriate.
Zhang Zhongjing asked: There are Taiyang-Yangming, Zhengyang-Yangming, and Shaoyang-Yangming conditions. What do these mean?
The answer is: Taiyang-Yangming refers to Pi Yue (Spleen Constraint); Zhengyang-Yangming refers to Wei Jia Shi (Stomach Fullness); Shaoyang-Yangming refers to cases where, after diaphoresis or promoting urination, the stomach becomes dry, irritable, and solid, resulting in difficult defecation. Pang Shi explained: Originally a Taiyang disease, if treated with diaphoresis, purgation, or promoting urination, leading to fluid depletion and stomach dryness, thereby transferring to Yangming, it is called Taiyang-Yangming. If the pathogen originally transmitted to Shaoyang, and due to diaphoresis and promoting urination, the stomach became dry with difficult defecation, it is called Shaoyang-Yangming. Patients who inherently have strong wind qi and robust constitution, with consumed fluids, or who initially had aversion to cold but after sweating the aversion ceased and fever appeared; or those who immediately upon illness developed fever and delirium, are called Zhengyang-Yangming. Generally, all Yangming syndromes are suitable for purgation. Only when accompanied by interior cold and aversion to cold, with the pathogen in the channels and combining with Taiyang as an exterior syndrome, can diaphoresis be used.
It is also said: The general principle of Yangming disease is Wei Jia Shi (Stomach Fullness). Qianjin Fang's assertion of "Stomach Cold" is incorrect.
Another question: How does one contract Yangming disease?
Answer: In Taiyang disease, if treated with diaphoresis, purgation, or promoting urination, causing fluid loss and stomach dryness, the condition transfers to Yangming. If there is no bowel movement, internal fullness, and difficulty passing stool, this is named Yangming disease.
Another question: What are the external manifestations of Yangming disease?
Answer: Fever, spontaneous sweating, no aversion to cold, but aversion to heat.
Another question: Some patients on the first day of illness have no fever but have aversion to cold. Why?
Answer: Although it has been one day, the aversion to cold will soon cease spontaneously, followed by spontaneous sweating and aversion to heat.
Another question: Why does the aversion to cold cease spontaneously?
Answer: Yangming resides in the center and corresponds to Earth, the gathering place of all things, where the pathogen does not transmit further. Although it begins with aversion to cold, it stops spontaneously on the second day; this is Yangming disease.
It is also said: Originally Taiyang disease, at the onset, diaphoresis was applied but the sweat was not thorough, leading to transfer to Yangming.
It is also said: In Shanghan (Cold Damage), with fever, no sweat, vomiting, inability to eat, yet profuse sweating occurs, this indicates transfer to Yangming.
It is also said: After three days of Shanghan, the Yangming pulse becomes large.
It is also said: In Shanghan, if the pulse is floating and slow, and the hands and feet are naturally warm, the disease is associated with Taiyin. Taiyin patients should develop jaundice; however, if urination is free, jaundice will not occur. By the seventh or eighth day, if the stool becomes hard, it is Yangming disease.
It is also said: When Shanghan transfers to Yangming, the patient exhibits slight continuous sweating.
It is also said: Yangming Fengzhong (Wind Strike), characterized by bitter taste in the mouth, dry throat, abdominal fullness, slight wheezing, fever, aversion to cold, and a floating-tight pulse. If purged incorrectly, abdominal fullness and difficult urination will result. Chang Shi suggested Guizhi Mahuang Ban Tang (Half-Guizhi Half-Mahuang Decoction) or Xiaochaihu Tang (Minor Bupleurum Decoction).
It is also said: In Yangming disease, if the patient can eat, it is named Fengzhong (Wind Strike); if unable to eat, it is named Zhonghan (Cold Strike).
It is also said: In Yangming disease, if caused by Cold Strike, the patient cannot eat, has difficult urination, and slight sweating on the hands and feet. This desires to form Gujia (a chronic accumulation/diarrhea condition), and the stool will likely be hard at the beginning and loose at the end. This is because the stomach is cold, failing to separate water and grain. Chang Shi suggested Lizhong Tang (Regulate the Middle Decoction) or Zhuling Tang (Polyporus Decoction).
It is also said: In Yangming disease, if the patient initially desires food, but urination is unfavorable while stool is normal, and experiences joint pain, feeling slightly hot, then suddenly goes mad, followed by profuse sweating and recovery, this is because Water Qi fails to overcome Grain Qi, which exits with the sweat. A tight pulse indicates recovery. Chang Shi suspected a missing method involving Mahuang Tang (Ephedra Decoction). Another version states "pulse departure leads to recovery." Guo Yong noted that Qianjin Yi reads "firmness leads to recovery," omitting the word "pulse." Given the error in the syndrome description, Mahuang Tang should not be used lightly. It can only be used if the pulse is floating-tight and there is no sweat. The errors in these texts stem from confusing "tight" with "firm," or "departure" with "one," or omitting characters. It should read "if the pulse is tight, then recovery."
It is also said: The time when Yangming disease resolves is from Shen hour to Xu hour (3 PM to 7 PM).
It is also said: In Yangming disease, if the patient cannot eat and heat is cleared, hiccups will inevitably occur. This is due to deficiency-cold in the stomach. Because the person is inherently deficient, clearing heat causes hiccups. Chang Shi suggested Wenzhong Tang (Warm the Middle Decoction). Xiao Banxia Tang (Minor Ginger and Pinellia Decoction) from Jin Gui Ye Fan is also applicable.
It is also said: In Yangming disease, with a slow pulse, the patient finds it difficult to eat until full; upon being full, they feel slightly vexed and dizzy, and urination becomes difficult. This desires to form Gu Dan (Grain Jaundice). Even if purged, abdominal fullness remains. This is due to the slow pulse. Chang Shi suggested Fuling Tang (Poria Decoction) or Wuling San (Five-Ingredient Powder with Poria). Guo Yong added: If jaundice has already occurred, Yinchen Hao Tang (Artemisia Capillaris Decoction) should be used.
It is also said: Yangming disease typically involves much sweating. If there is no sweat, and the body feels like insects crawling under the skin, this is due to prolonged deficiency. Chang Shi suggested Guizhi Jia Huangqi Tang (Guizhi Decoction plus Astragalus). Guo Yong stated: Due to lack of sweat, the sensation resembles insect crawling; slight sweating is required for resolution. Guizhi Mahuang Ban Tang is appropriate. This decoction relieves body itching because it induces slight sweating.
It is also said: In Yangming disease, if there is no sweat but urination is free, and after two or three days, vomiting and coughing occur with cold extremities, severe headache must ensue. If there is no coughing or vomiting, and extremities are not cold, the head will not hurt. Chang Shi criticized the use of Xiaojianzhong Tang (Minor Construct the Middle Decoction) in Lei Yao. Xiaochaihu Tang should be used. Guo Yong stated: For cold extremities, Xiaojianzhong Tang is appropriate.
It is also said: In Yangming disease, if there is only dizziness, no aversion to cold, so the patient can eat and cough, the throat must hurt. If there is no cough, the throat will not hurt. Chang Shi suggested Fuling Gancao Baizhu Shengjiang Tang (Poria, Licorice, Atractylodes, and Fresh Ginger Decoction) [formula not seen]. For throat pain, Jiegeng Tang (Platycodon Decoction) is appropriate.
It is also said: In Yangming disease, with no sweat and unfavorable urination, and mental restlessness (Ao Nao), jaundice will definitely occur. Chang Shi suggested Yinchen Hao Tang combined with Wuling San.
It is also said: In Yangming disease, if fire therapy is applied, slight sweating on the forehead with unfavorable urination leads to jaundice. Chang Shi suggested Yinchen Hao Tang combined with Wuling San.
It is also said: In Yangming disease, if the pulse is floating and tight, tidal fever will occur at specific times. If only the pulse is floating, night sweats will occur. Chang Shi suggested Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction).
It is also said: In Yangming disease, dry mouth with desire to rinse water but not swallow indicates impending epistaxis. Chang Shi suggested Huangqin Shaoyao Dihuang Tang (Scutellaria, Peony, and Rehmannia Decoction) [should be Huangqin Shaoyao Gancao Tang; this addition is not by Guo Yong].
It is also said: Yangming disease originally involved spontaneous sweating. If the physician induces heavy sweating again, although the illness has improved, slight vexation and confusion remain. This is because the stool must be hard. Due to fluid loss and stomach dryness, the stool becomes hard. One should ask how many times the patient urinates daily. If previously urinating three or four times a day, but now only twice, it is known that stool will pass soon. Now, with reduced urination frequency, fluids return to the stomach, indicating stool will pass shortly.
It is also said: In Shanghan, if vomiting is frequent, even if Yangming signs exist, purgation is contraindicated. Chang Shi suggested Xiaochaihu Tang.
It is also said: In Yangming disease, if the epigastrium is hard and full, purgation is contraindicated. If purged and diarrhea persists uncontrolled, death results; if diarrhea stops, recovery occurs. Chang Shi stated: Before purging, Shengjiang Xiexin Tang (Fresh Ginger Heart-Draining Decoction) can be given. If diarrhea is uncontrolled, Sini Tang (Frigid Extremities Decoction) is indicated.
It is also said: In Yangming disease, if the face is completely red, purgation is contraindicated. Fever, yellow complexion, and difficult urination will result. Chang Shi suggested Wuling San. Guo Yong stated: Since purgation is contraindicated, Tiaowei Chengqi Tang cannot be used. Instead, Yinchen Hao Tang combined with Wuling San should be decocted and taken.
It is also said: In Yangming disease, without vomiting or purgation, if there is mental vexation, Tiaowei Chengqi Tang can be given.
It is also said: In Yangming disease, with a slow pulse, sweating, and no aversion to cold, the body will be heavy, short of breath, abdomen full and wheezy. If there is tidal fever, the exterior is resolving, and interior purgation is possible. If hands and feet sweat continuously, the stool is hard; Dachengqi Tang (Major Order the Qi Decoction) governs this. If sweating is excessive with slight fever and aversion to cold, the exterior is unresolved, and fever is not tidal; Chengqi Tang should not be given. If the abdomen is greatly full and obstructed, Xiao Chengqi Tang (Minor Order the Qi Decoction) can be given to gently harmonize Stomach Qi, avoiding drastic purgation.
It is also said: In Yangming disease, with tidal fever and slightly hard stool, Dachengqi Tang can be given. If not hard, do not give. If no bowel movement for six or seven days, suspecting dry feces, the method to verify is to give a small amount of Xiao Chengqi Tang. If gas passes after ingestion, dry feces are present, and purgation is allowed. If no gas passes, the stool is hard at the start and loose at the end; do not purge. Purging will cause abdominal fullness and inability to eat. Thirst with water intake causes hiccups. Subsequent fever indicates stool becomes hard again but scanty; harmonize with Xiao Chengqi Tang. If no gas passes, absolutely do not purge.
It is also said: Excess leads to delirious speech (Zhanyu); deficiency leads to repetitive speech (Zhengsheng). Zhengsheng is repetitive talking. Fixed gaze with delirium and wheezing/fullness indicates death; diarrhea also indicates death.
It is also said: Excessive sweating or repeated sweating causes Yang collapse and delirium. A short pulse indicates death; a harmonious pulse indicates survival.
It is also said: In Shanghan, after vomiting or purgation, if unresolved, and no bowel movement for five to ten days, with evening tidal fever, no aversion to cold, and solitary speech resembling seeing ghosts: if severe, loss of recognition, grasping clothes and bed, fearfulness, slight wheezing, fixed gaze. A string-like pulse indicates life; a choppy pulse indicates death. Mild cases with only fever and delirium are governed by Dachengqi Tang. If one dose causes relief, stop subsequent doses.
It is also said: In Yangming disease, if the patient sweats much, fluids exit externally, stomach becomes dry, and stool becomes hard, leading to delirium. Xiao Chengqi Tang governs this. If delirium stops after one dose, do not administer more.
It is also said: In Yangming disease, with delirium and tidal fever, if the pulse is slippery and rapid, Xiao Chengqi Tang governs. Give one sheng of Chengqi Tang. If gas passes in the abdomen, give another sheng. If no gas passes, do not give more. If no bowel movement the next day and the pulse becomes faint and choppy, this is interior deficiency, difficult to treat; do not give Chengqi Tang again. Chang Shi suggested Huangqi Renshen Jianzhong Tang (Astragalus and Ginseng Construct the Middle Decoction).
It is also said: In Yangming disease, with delirium and tidal fever, if the patient cannot eat, there must be dry feces (five or six pieces) in the stomach. If able to eat, it is merely hardness; Dachengqi Tang is suitable for purgation.
It is also said: In Yangming disease, with blood discharge and delirium, this is Heat entering the Blood Chamber. If only the head sweats, puncture Qimen (LR14) and drain according to excess. Profuse sweating leads to recovery. Guo Yong noted: This is a female syndrome.
It is also said: Sweating with delirium indicates dry feces in the stomach due to Wind. Purging is necessary, but only after the pathogen has passed the meridians (exterior phase). Premature purging causes confused speech due to exterior deficiency and interior excess. Purging leads to recovery; Dachengqi Tang is appropriate.
It is also said: In Shanghan on the fourth or fifth day, if the pulse is deep with wheezing and fullness, deep indicates interior. Incorrectly inducing sweating causes fluid leakage and difficult defecation, exterior deficiency and interior excess, eventually leading to delirium. Chang Shi stated: For wheezing/fullness without high heat, Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) can be used. For interior excess with delirium, Tiaowei Chengqi Tang is indicated.
It is also said: In San Yang He Bing (Combined Disease of Three Yangs), with abdominal fullness, body heaviness, difficulty turning, oral insensitivity, facial grease, delirium, and enuresis. Sweating worsens delirium; purging causes sweating on the forehead and cold extremities. If spontaneous sweating occurs, Baihu Tang (White Tiger Decoction) governs. (Pang Shi placed this in Shaoyang syndromes.)
It is also said: In Er Yang Bing Bing (Concurrent Disease of Two Yangs), if Taiyang signs cease, leaving only tidal fever, hand-foot sweating, difficult defecation, and delirium, purging leads to recovery; Dachengqi Tang is appropriate.
It is also said: In Yangming disease, with floating-tight pulse, dry throat, bitter taste, abdominal fullness, wheezing, fever, sweating, no aversion to cold, aversion to heat, and body heaviness. Sweating causes irritability, mental confusion, and delirium. Adding fire needle therapy causes terror, restlessness, and insomnia. Purging empties the stomach, allowing hostile qi to disturb the diaphragm, causing mental restlessness (Ao Nao) and tongue coating. Zhiizi Chi Tang (Gardenia and Fermented Soybean Decoction) governs. (Pang Shi noted: Floating-tight pulse implies no sweat, yet here there is sweat; dry throat, full abdomen, aversion to heat suggest purgation is indicated, but floating-tight pulse prohibits it; this may transform into Wind-Dampness, requiring careful consideration.)
It is also said: If thirsty for water with dry mouth and tongue, Baihu Jia Renshen Tang (White Tiger plus Ginseng Decoction) governs.
It is also said: If floating pulse with fever, thirst for water, and unfavorable urination, Zhuling Tang (Polyporus Decoction) governs.
It is also said: In Yangming disease, with much sweating and thirst, Zhuling Tang is contraindicated. Because sweating depletes fluids and dries the stomach, Zhuling Tang would further promote urination. Chang Shi suggested Baihu Jia Renshen Tang. Guo Yong stated: Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) is suitable to harmonize Ying and Wei and circulate fluids.
It is also said: With floating-slow pulse, exterior heat and interior cold, and diarrhea with undigested food, Sini Tang (Frigid Extremities Decoction) governs.
It is also said: If stomach deficiency-cold prevents eating, drinking water causes hiccups. Chang Shi suggested Wenzhong Tang. (Jin Gui formula consists of two herbs.)
It is also said: With floating pulse and fever, dry mouth and nose, if the patient can eat, epistaxis will occur. Chang Shi suggested Huangqin Tang (Scutellaria Decoction).
It is also said: In Yangming disease, after purgation, if exterior heat remains, hands and feet are warm, no Chest Bind (Jie Xiong), mental restlessness (Ao Nao), hunger but inability to eat, and only head sweating, Zhiizi Chi Tang (Gardenia and Fermented Soybean Decoction) governs.
It is also said: In Yangming disease, with tidal fever, loose stool, normal urination, and persistent chest-hypochondriac fullness, Xiaochaihu Tang (Minor Bupleurum Decoction) governs.
It is also said: In Yangming disease, with hardness/fullness under the hypochondrium, constipation, vomiting, and white tongue coating, Xiaochaihu Tang (Minor Bupleurum Decoction) can be given. Once the Upper Jiao is unblocked and fluids descend, Stomach Qi harmonizes, and the body recovers through profuse sweating.
It is also said: Yangming Fengzhong (Wind Strike), with string-floating-large pulse and shortness of breath, generalized abdominal fullness, hypochondriac and heart pain, unrelieved pressure, nasal dryness, inability to sweat, lethargy, whole-body and eye yellowing, difficult urination, tidal fever, occasional hiccups, and swelling around ears. Acupuncture brings slight improvement. If exterior signs persist beyond ten days and the pulse remains floating, Xiaochaihu Tang (Minor Bupleurum Decoction) is given.
It is also said: If only the pulse is floating with no other signs, Mahuang Tang (Ephedra Decoction) is given. If there is no urination, abdominal fullness, and added hiccups, the condition is incurable. Guo Yong noted: Qianjin combines previous syndromes into one, which seems reasonable.
It is also said: In Yangming disease, with spontaneous sweating, if sweating is induced and urination is free, this is internal exhaustion of fluids. Although stool is hard, purgation is contraindicated. Wait for the desire to defecate; use Honey Suppository (Mi Jian Dao) to guide passage. Melon root or large pig bile can also serve as guides.
It is also said: In Yangming disease, with slow pulse, much sweating, and slight aversion to cold, the exterior is unresolved. Diaphoresis is appropriate; Guizhi Tang (Cinnamon Twig Decoction) is indicated.
It is also said: In Yangming disease, with floating pulse, no sweat, and wheezing, diaphoresis leads to recovery; Mahuang Tang (Ephedra Decoction) is indicated.
It is also said: In Yangming disease, fever and sweating indicate heat venting outward, preventing jaundice. If only the head sweats, body has no sweat up to the neck, urination is unfavorable, and thirst for liquids exists, this is stagnant heat in the interior, leading to jaundice. Yinchen Hao Tang (Artemisia Capillaris Decoction) governs.
It is also said: In Yangming syndrome, if the patient suffers from forgetfulness, there must be Blood Stasis. This is due to pre-existing old blood stasis causing forgetfulness. Stool may be hard, but defecation is easy, and color is black. Didang Tang (Di Dang Decoction) is suitable for purgation.
It is also said: In Yangming disease, after purgation, if mental restlessness (Ao Nao) and vexation occur, and dry feces are in the stomach, purgation is possible. If abdomen is slightly full, hard at start and loose at end, purgation is contraindicated. If dry feces are present, Dachengqi Tang (Major Order the Qi Decoction) is appropriate.
It is also said: If a patient has no bowel movement for five or six days, periumbilical pain, vexation, and periodic发作, this indicates dry feces causing constipation. Chang Shi suggested Xiao Chengqi Tang (Minor Order the Qi Decoction).
It is also said: If a patient has vexing heat, resolving with sweat, or malarial-like symptoms with evening fever, it belongs to Yangming. If the pulse is excess, purgation is appropriate (Dachengqi Tang). If the pulse is floating-deficient, diaphoresis is appropriate (Guizhi Tang).
It is also said: After severe purgation, if six or seven days pass without bowel movement, vexation persists, and abdominal fullness/pain exists, this indicates dry feces due to retained food. Dachengqi Tang (Major Order the Qi Decoction) is appropriate.
It is also said: If a patient has unfavorable urination, alternating hard/loose stool, slight fever, wheezing, dizziness, and inability to lie down, dry feces are present. Dachengqi Tang (Major Order the Qi Decoction) is appropriate.
It is also said: If eating grain induces vomiting, it belongs to Yangming; Wuzhuyu Tang (Evodia Decoction) governs. If symptoms worsen after taking the decoction, it belongs to the Upper Jiao. Chang Shi suggested Jupi Tang (Tangerine Peel Decoction) [Lei Yao recipe: Tangerine Peel 1 liang, Licorice 1 liang, Fresh Ginger 4 liang, Ginseng 3 liang, powdered, decocted in water].
It is also said: In Taiyang disease, with slow Cun pulse, floating Guan pulse, and weak Chi pulse, if the patient has fever, sweating, and aversion to cold, no vomiting, but only epigastric stagnation, this is due to physician-induced purgation. If not purged, and the patient has no aversion to cold but thirst, it transfers to Yangming. Frequent urination leads to hard stool. Ten days without bowel movement causes no distress. If thirsty for water, give small amounts and treat according to principles. For thirst, Wuling San (Five-Ingredient Powder with Poria) is appropriate.
It is also said: If Yang pulse is fine and sweating is slight, it is self-harmonization. Excessive sweating is too much. If Yang pulse is excess and sweating is induced excessively, this is also too much. Too much leads to Yang extinction in the interior, fluid loss, and hard stool. Chang Shi suggested Xiaochaihu Tang (Minor Bupleurum Decoction) to harmonize fluids. If stool becomes harder, Tiaowei Chengqi Tang can be used. Guo Yong stated: To circulate fluids, Chaihu Guizhi Tang is safer. If Chengqi Tang is unavoidable, use mildly to prevent transformation into Huo Huo (Aphthous/Ulcerative syndrome) post-purgation.
It is also said: With floating-kou pulse, floating indicates Yang, kou indicates Yin. Floating and kou interacting generates Stomach heat, leading to Yang extinction. Chang Shi suggested Chaihu Tang (Bupleurum Decoction).
It is also said: With Duyang pulse floating and coarse, floating indicates strong Stomach Qi, coarse indicates frequent urination. Interaction leads to hard stool and Spleen constraint. Maren Wan (Honey Pill of Hemp Seed) governs.
It is also said: In Taiyang disease on the third day, if diaphoresis fails and steaming fever occurs, it belongs to the Stomach. Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction) governs.
It is also said: After Shanghan vomiting, if abdominal fullness occurs, Tiaowei Chengqi Tang is given.
It is also said: In Taiyang disease, after vomiting, purgation, or sweating, if slight vexation, frequent urination, and hard stool occur, Xiao Chengqi Tang (Minor Order the Qi Decoction) harmonizes and cures.
It is also said: On the second or third day of illness, with weak pulse, no Taiyang or Shaoyang signs, vexation, and epigastric hardness: by the fourth or fifth day, even if able to eat, give small amounts of Xiao Chengqi Tang to gently harmonize and bring slight relief. By the sixth day, give one sheng of Chengqi Tang. If no bowel movement for six or seven days and urination is low, even if unable to eat, the stool is hard at start and loose at end, not definitively hard; purging causes diarrhea. Wait for free urination and definitive hard stool before purging with Dachengqi Tang (Major Order the Qi Decoction).
It is also said: In Shanghan on the sixth or seventh day (Qianjin says seventh or eighth), if vision is unclear and eyes are unresponsive, with no exterior-interior signs, difficult defecation, and slight body heat, this is excess. Urgent purgation is required; Dachengqi Tang (Major Order the Qi Decoction) is appropriate.