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Taiyang cold damage (Taiyang Cold Damage) with fever, absence of sweating, vomiting, and inability to eat, yet conversely presenting with continuous sweating, indicates a transmission to the Yangming stage.

The exterior syndrome of Taiyang cold damage has not yet resolved, manifesting as fever, absence of sweating, vomiting, and inability to eat. This is due to cold pathogenic factors constraining and forcing the stomach qi to become stagnant and rebellious, resulting in absence of sweating and vomiting, preventing food from descending. If conversely there is continuous sweating, it must be because heat in the Yangming fu-organ steams and薰zes the skin and hair; this constitutes a transmission to Yangming.

In cold damage, if the pulse is floating and slow, and the hands and feet are naturally warm, the disease is associated with the Taiyin stage. In Taiyin diseases, the body should turn yellow; however, if urination is free and easy, jaundice will not occur. After seven or eight days, if the stool becomes hard, it is classified as a Yangming disease. When cold damage transmits to the Yangming stage, the patient presents with slight, continuous sweating (Hanhan).

In Taiyang cold damage, if yang qi is vigorous, the disease transmits to Yangming; if yin qi is vigorous, it transmits to Taiyin. A floating and slow pulse with naturally warm hands and feet are common signs of both Yangming and Taiyin, but here it associates with Taiyin. However, Taiyin diseases typically present with jaundice because damp-earth is constrained, inevitably showing yellow coloration. Although both spleen and stomach can exhibit jaundice, the jaundice of the stomach is transmitted from Taiyin damp-earth. If urination is free and easy, dampness is eliminated, and jaundice cannot develop. How then to distinguish between Taiyin and Yangming? One must examine the stool: Taiyin stools are loose (Li), while Yangming stools are hard. After seven or eight days, if the stool is hard, this is a Yangming disease. Furthermore, Taiyin typically has no sweat; when cold damage transmits to Yangming, the patient exhibits slight, continuous sweating (this passage mutually illuminates the clause regarding Taiyin sudden irritability and diarrhea after seven or eight days).

Question: There are Taiyang-Yangming, Zhengyang-Yangming, and Shaoyang-Yangming in diseases. What does this mean? Answer: Taiyang-Yangming refers to Pi Yue (Spleen Constraint); Zhengyang-Yangming refers to Wei Jia Shi (Stomach Fullness/Excess); Shaoyang-Yangming refers to dryness, irritability, and heat in the stomach with difficult defecation following diaphoresis or promotion of urination.

Yangming diseases may transmit from Taiyang, from Shaoyang, or arise directly from the meridian itself. Those coming from Taiyang are called Taiyang-Yangming. Taiyang-Yangming manifests as frequent urination and difficult defecation, caused by the depletion of bladder fluids leading to loss of moistening in the spleen and stomach, causing spleen qi to constrain and form small, hard fecal pellets. Those arising directly from the meridian are called Zhengyang-Yangming. Zhengyang-Yangming is characterized by excess yang in the stomach-fu, which does not require transmission from other meridians; once external exterior pathogens constrain, internal fu-heat spontaneously arises. Those coming from Shaoyang are called Shaoyang-Yangming. Shaoyang-Yangming results from the exhaustion of gallbladder fluids following diaphoresis or water-draining therapies, leading to dryness and heat in the stomach and difficult defecation. Taiyang-Yangming stems from the depletion of Cold-Water; Shaoyang-Yangming stems from the exuberance of Ministerial Fire; Zhengyang-Yangming stems from the predominance of Dry-Metal.