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Yangming transforms its qi into dryness within the Metal element. Yangming is the meridian of the Stomach, and the Stomach is the fu-organ of Yangming. Yangming disease includes both meridian (jing) and fu-organ syndromes: the meridian primarily governs transmission and circulation, while the fu-organ primarily governs reception and storage. If the pathogen remains in the Taiyang meridian and the patient's Stomach Yang is not vigorous, then after two days it reaches Yangming, after three days Shaoyang, and after six days the meridian cycle completes; sweating can resolve the condition without the pathogen entering the Yangming fu-organs. This situation is collectively categorized under the Taiyang meridian syndrome. Regardless of whether it is the second or third day, it belongs to Guizhi Tang (Cinnamon Twig Decoction) or Mahuang Tang (Ephedra Decoction) syndromes. Even during the Yangming time frame on the second day, it cannot be called Yangming disease, because by the next day it will transmit to Shaoyang, and by the day after to Taiyin. This does not constitute a syndrome where "the central Earth of Yangming has nowhere else to transmit."

If the patient's Stomach Yang is inherently vigorous, and the exterior meridian pathogen transmits inward, this is termed Yangming disease. This occurs because when Yangming is in command, Taiyang and Shaoyang lose their authority, and the Three Yin meridians retreat. The pathogen remains permanently in the Stomach fu-organ, never shifting, which is referred to as "the central Earth of Yangming has nowhere else to transmit." When the fu-organ heat is not yet solidified but the exterior meridian pathogen has not resolved, this is a Gegen Tang (Kudzu Root Decoction) syndrome. Once the Stomach heat steams and condenses, sweat appears, the exterior resolves, and tidal fever with abdominal pain and fullness occur, one should simply use Chengqi Tang formulas (Gut-Purging Decoctions) to purge downward, with no other treatments needed. Provided that purgation was not administered too early causing interior deficiency, there would rarely be unexpected complications. Treating diseases with such precision, resulting in near-perfect outcomes, is indeed something to be celebrated and comforted by.

However, things are忌 (averse to) being overly full; hyperactivity brings harm. If the condition is prolonged and purgation is delayed, over time Yin fluids are consumed by Yang, essence and fluids are depleted, the Earth becomes scorched, and water sources dry up, leading inevitably to death. Zhang Zhongjing therefore issued warnings for early purgation and established guidelines for urgent purgation. Early purgation causes Yang to recede into Yin; delayed purgation causes Yin to exhaust while Yang hyperacts. Both delay and haste result in failure. Thus, the subtlety of the Chengqi Tang method lies in balancing slowness and urgency appropriately, ensuring the disease is eliminated while the person survives; this depends on the skill of the physician.

The Stomach is Dry Earth; dryness generates heat. In diseases of the Three Yang meridians, regardless of which meridian is affected, if internal stagnation generates Stomach heat, the Stomach disease arises due to the solidity of Stomach Yang. However, Yin tends to flourish while Yang tends to decline. Therefore, although the Stomach may have excess heat, it is not devoid of cold deficiency. When there is excess heat, Yang spirit dominates, merging Yin into Yang; when there is deficiency cold, Yin pathogens take control, moving from Yang into Yin. These states are not uniform. Nevertheless, it is named Yangming because it represents the convergence of two Yangs reaching extreme prosperity. If one bears the name of Yang excess but possesses the reality of Yang deficiency, Yangming fails to be true Yangming, holding only an empty reputation. Therefore, Stomach excess can be called "Yangming zhi wei bing" (the manifestation of Yangming disease), but Stomach deficiency, though nominally Yangming, is actually Taiyin. Can this still be called "Yangming zhi wei bing"? Zhang Zhongjing presents both cold/heat and deficiency/excess in his discussion of "Yangming zhi wei bing," yet his summary statement is "Wei jia shi ye" (Stomach house excess). His intention to revere Yang and dismiss Yin is evident beyond the text itself.

Yangming zhi wei bing is Wei jia shi ye (The manifestation of Yangming disease is Stomach excess).
The Stomach is the fu-organ of Yangming. Yangming disease arises entirely from the solidity of Stomach Yang. Solidity leads to disease at Yangming, where fu-organ heat stagnates and manifests; the pathogen enters the Stomach fu-organ and does not transmit elsewhere. This does not mean other meridians do not get sick. Among the Three Yang meridians, none possess more Yang than Yangming. The pathogen in Yangming is uniquely prosperous and cannot be attributed to other meridians. Because Stomach excess causes the pathogen to remain in the Stomach fu-organ without shifting, it is said that "Yangming zhi wei bing." If Stomach Yang were not excessive, today it might be in the Yangming meridian, tomorrow already transmitted to the Shaoyang meridian, and the day after to the Taiyin meridian. In such cases, one could not exclusively name a single meridian as "Yangming zhi wei bing."