今以一圈分为六层，是将一元真气分为六气。六气，即六经也。气机自下而上，自内而外，真气充满周身，布护一定不易。外邪入内，先季外之第一层。第一层乃太阳寒水气化出路，故畏风恶寒，法宜宣散。治之不当，邪不即去，渐至第二层。二层乃阳明所主，阳明主燥，外邪至此，化为燥邪，故恶热，法宜清凉，不可妄用温燥。治之不当，邪不即去，渐至第三层。三层乃少阳所主，居半表半里之间，法宜和解。治之不当，邪不即去，渐至第四层。四层乃太阴所主，太阴主湿，邪与湿合，化成湿邪，湿多成泻，故吐泻病居多，法宜温中。治这不当，邪不即去，渐至第五层。五层乃少阴所主。少阴有两法，一邪从少阴心火为病，则火症居多，法宜清润。一邪从少阴肾水为病，则阴寒为重，法宜温经散寒。治之不当，邪不即云，渐至第六层。六层乃厥阴所主。厥阴有两法，一邪从风化为病，风为阳邪，故曰热深厥深，下攻而便脓血，上攻而为喉痹，法宜养阴清热。一从阴化为病，多见爪甲青黑，腹痛，法宜回阳。
仲景分配六经，标出六经，提纲病情，为认邪之法。又立出六经主方，为治邪之法。其间随邪变化，亦难尽举。学者细读三百九十七法，一百一十三方，便得步步规矩之道。兹再将六经主方，圆通活泼之妙，略言一二。庶学者不执于方，明理为要，则得矣。
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太阳用药图
风为阳邪，善动，从毛窍而入。风动于中，血液不藏，毛窍疏而不实，故见自汗出，恶风。
桂枝汤圆通应用法
按桂枝汤一方，乃调和阴阳，彻上彻下，能内能外之方，非仅治仲景原文所论病条而已。想仲景立法之日，当是邪在太阳卫分时说法，就未言及别证皆可以用得。今人不明圣意，死守陈法，不敢变通，由其不识阴阳之妙，变化之机也，予亦粗知医，常于临症时多用此方，应手辄效。因思仲景之方，原不仅治伤风证，凡属太阳经地面之病，皆可用得。兹特将经验病形略举一二于左，以便参究。
一治胸腹痛背亦彻痛者。盖太阳之气，由下而上至胸腹，寒邪逆于太阳，则气机不畅，故胸腹痛而背亦彻痛。太阳行
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身之背，因腹中之气不畅，而背亦受之，故桂枝汤治之而愈，
一治通身寒冷。寒为太阳之本气，今见通体恶寒，是邪犯太阳之本气也。桂枝汤能扶太阳之气，故治之而愈。
一治小儿角弓反张，手足抽掣。太阳行身之背，因风中于背，太阳之经气不舒，经气卒闭，故见角弓反张。桂枝汤力能宣太阳之风邪，故治之而愈。
一治脑后生疮。脑后者，太阳经脉之所贯注者也。风寒之邪逆于脑后，抑郁而成疮。桂枝汤宣散太阳之邪，故治之而愈。
一治周身皮肤作痒，时而恶风。周身毛窍乃太阳寒水气化出路，风寒之邪外干而不得入，逆于皮肤，抑郁生热，故周身作痒。桂枝汤能宣太阳抑郁之气，故治之而愈。
一治足跟痛，痛彻腰股。足跟与腰背，皆太阳经循行之道，因寒客［1］之，邪闭之，故见以上病形。桂枝汤力能输太阳之气，故治之而愈。
一治小儿两腮肿，发热恶风。夫两腮近耳下，乃少阳阳明地面，似不可与桂枝汤，今竟以此方治之而愈者，因其发热恶风，知太阳之邪逆于此也。
一治小儿发热痘出。盖痘本胎毒，欲出于外，必得太阳真气鼓动，方能引痘外出。桂枝汤扶助太阳之气，气伸而毒尽越于外，不遗于内，故此方又能治痘也。
一治妇人妊娠恶阻。妇人初妊，经气卒然不舒，营卫之气不畅，故见恶阻。桂枝汤能宣营卫，协和阴阳，故治之而愈。
一治发热恶风、下痢，日数十次。风邪犯于太阳，则表气不通，表气不通，则里气不顺，邪陷于下，故见下痢。桂
[1] 客 原本作"容"，据文义改。
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枝汤宣风外出，表气顺则太阳之气升而不陷，故痢可愈。
按此方，伤寒门尚有数症可用，至于加减变通，实多奇异，仲景已言之矣。学者细读仲景《伤寒》书，明其理而通其变，则得活泼之妙，内外兼备之道也。
太阳经腑用药图
寒为阴邪，从毛窍而入，寒主静而不动，毛窍密而不疏，故见无汗恶寒。
邪不传经而传腑，故见口渴，小便不利。五苓散功专利水，水道利则太阳气舒，邪亦从此而解。
桂麻二方，是祛邪从上出者也。五苓散是祛邪从下出者。惟此三方，可称太阳首尾专主之方也。
一治痘初出而忽隐，壮热，无汗者。盖痘之初出，全借
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太阳一点真气鼓动，运毒外出，今壮热而痘忽隐，是因其感受外寒，闭束气机，抑郁生热。麻黄汤能开腠理，祛寒外出，邪云则正安，痘自外出，而人自平安。若壮热太热，烦躁饮冷者，又可于方内加石膏。
一治肩背沉重，觉内冷者。盖肩背之沉重，寒之滞也。寒滞于内，故觉内冷。麻黄汤轻清属阳，力能祛寒外出，肩背正属太阳所主，故治之而愈。
一治两脚弯发起红块痛甚。脚弯地面，乃太阳经循行之道，今为寒邪闭束，阻其气机，遏郁而起红块痛甚。麻黄汤力能散太阳之寒，故治之而愈。
一治大便泻水，而小便全无者。此病夏月居多，由暑邪拂郁，扰乱正气，以致阑［1］门失职，津液不行于膀胱，而直趋大肠。五苓散力能化膀胱之气，故治之而愈。
一治头晕咳嗽，呕吐腹胀，小便短。病形虽现头晕、咳嗽、呕吐，总缘膀胱气化不运，水湿之气不得下降，气机必返于上，上干清道，故现以上病形。五苓散功专利水，水气下降，气机自顺，故病自愈。
一治霍乱吐泻，思饮冷水者。此病上吐下泻，理应着重太阴，其所以用五苓者，盖以吐泻之病，无小便也。又见渴而思水，正是太阳腑症提纲，故五苓为要药。其所以致吐泻者，皆由太阳气化失运。中宫失职，此刻先治太阳，然后理中，庶为正治，亦经权之道也。
二方伤寒门尚有数症当用，至于加减变通，仲景言之甚详，兹不赘。
[1] 阑 原本作"闻"，据文义改。
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阳明经证用药图
盖太阳主开，阳明主阖。今阳明为太阳之邪所逼，不从本经之阖，而从太阳之开，开于下，故下利也。
葛根汤圆通应用法
一治周身发热，发现斑点，呕吐。夫周身肌肉皆属阳明，阳明主发热，不恶寒，今为外邪抑郁，壅于阳明，故发热而现斑、呕吐者，皆邪毒上壅外出之故。葛根汤力能祛邪外出，随其邪之所向而祛之，故愈。
一治两眼皮红肿痛甚。眼皮上下皆阳明所主，今为风热所闭，抑郁而为红肿痛甚。葛根汤力能解阳明风热，故治之而愈。
一治两乳红肿发热。两乳地面，乃阳明所主。今外感之
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邪，伏于两乳间，故见红肿痛甚。葛根汤专祛阳明之邪，治之故愈。
一治小儿痘初现点。夫痘毒自内出外，既在现点，此刻毒邪尽在肌肉之间，肌肉属阳明，葛根汤力能宣通肌肉之邪，不使痘毒遗留于内，发透为佳。然后另行养浆之法。若已发透，即不可用此。
此方功用颇多，加减法亦多，仲景《伤寒》书言之甚详，兹不复赘。
阳明经用药图
此方本列于太阳篇中，而又曰治阳明腑症者，盖以太阳之邪，服桂枝汤大发汗，表邪既解，而阳明之血液已伤。阳明乃气多血多之腑。今血液骤伤，阳明之内热立作。若不急用白虎以清热，人参以养血液，邪火益盛，即有不要扑灭之势，故白虎又是阳阴之腑方也。
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白虎汤圆通应用法
一治上消证。夫上消者，渴而多饮也。由邪火在胃，血液大伤。血为阴，阴伤而引水以救者，阴与阴相亲也。白虎汤力能灭火以有阴，故治之而愈。
一治心下一寸间发生疮疾，红肿痛甚。按心下一寸，乃胃之上口也。因邪热结于胃之上口间，故发生疮疾。白虎汤专清胃热，故治之而愈。
一治牙龈红肿痛甚，饮冷。夫牙龈乃阳明所主，今胃火聚于上，故见红肿痛甚，又见饮冷，知其邪火伤阴。白虎汤力能清胃热，故治之而愈。
一治两乳红肿痛甚。两乳乃阳明脉过之所，今见红肿痛甚，是胃中之邪热壅滞所致也。白虎汤专清胃热，热邪去而肿自消，故治之而愈。
一治谵语遗尿，口不仁而面垢，三阳并病。谵语者，邪热入于阳明之府也；遗尿者，邪热合于太阳之府也；口不仁而面垢者，邪热合于少阳之腑也。白虎汤力能清热，一热清而三病立解，故治之而愈。
此方功用颇多，加减变通亦多，《伤寒》书言之甚详，其中尚有背寒一证，亦用之。学者当辩而明之。
阳明里症用药图
凡用此方，必须审察的确，总要知道胃家实三字提纲。何谓胃家实？如大小便不通是也；大便硬，腹满是也；狂妄奔走，叫骂不避亲疏是也；潮热谵语是也。种种不一，务宜
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斟酌，不可猛浪。
大承气汤圆通就用法
一治咳嗽，声如洪钟。夫咳嗽之病，似不可以与此方。其所以必用此方者，诚以咳嗽声洪，乃邪火旺极之征，火刑于肺。若不亟用此方，以扑灭其火，肺有立坏之势，故不得不用之也。
一治食入即吐。夫食入而出，亦非可下之候，其所以可下者，疬以吐则为逆，非寒即火。今食入而出，是胃中之火逆行于上，其食故不得下降也。但寒与火虽辩明，方可用此。
一治头晕，人昏乱无主，三五日一发，夫头晕之症，原非应下之候。其所以应下者，盖以阴血虚极，不能制其亢龙，龙奔于上，则浊火乱其神明，故昏昏无主。大承气汤力能制其亢龙，故治之而愈。
此方吴又可《温疫论》条中，可用此方有三十余症，《伤
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寒》阳明本篇可用六七症，少阴篇急下可用有三症，兹不备举。学者务宜熟读仲景《伤寒》书，但得圆通应用变化之道，切不可死守原文，当以明理为要。
少阳经用药图
此方虽名为少阳方，究意总是太阳经所感受的这一占点邪气种子，不能从胸出去，逆于胸胁之间，阻其少阳升降之机，故少阳之经症作。其方治少阳，实是治太阳也。
小柴胡汤圆通应用法
一治两胁胀痛。夫两胁乃少阳所主，今见胀痛，是少阳之气抑郁不舒也。柴胡汤力能舒少阳之气，故治之而愈。
一治头响两侧胀。夫头之两侧，乃少阳所主。今见胀而响，是少阳之火浮于上也。柴胡汤力能治少阳之经，倍黄芩
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力能清少阳之火，故治之而愈。
一治两耳红肿痛甚。夫两耳前后。俱属少阳所主。今见红肿痛甚，是风热之邪，聚于少阳也。柴胡汤力能治少阳之风热，故治之而愈。
一治疟疾。夫疟之为病，多缘外邪伏于少阳，不能从转输而出，少阳居半表半里，邪欲从阳明而出则热，欲从太阴而入则寒。诸书云疟不离少阳，皆是明少阳之经气不舒，转枢失职，邪故伏而不去。小柴胡汤力能伸少阳之气，少阳之气伸，转枢复运，邪自从此而出，病自愈而人自安也。
一治吐酸不食。夫不食而吐之症，属于太阴，理宜温中健脾，今见不食吐酸，明是木气不舒，上克脾土，土畏木克，故不食。酸属木，乃是禀少阳热气所化，土木相凌，故见以上症形。小柴胡力能舒少阳之气，少阳之气舒，即不克制脾土，两经之气平，而病自不作矣。
一治妇女热入血室谵语。夫肝乃藏血之所，肝与胆相为表里，胆移热于肝，热入血室，故见谵语。柴胡汤力能治肝胆邪热，故治之而愈。
按此方功用颇多，加减变化亦无穷，《伤寒》书言之甚详，兹不赘。
太阴经用药图
太阴篇内有桂枝加芍药汤，桂枝加大黄汤，皆是太阳误治，邪陷于太阴而设，不得谓为太阴主方。学者须知。
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理中汤圆通应用法
一治吐血。夫吐血之症，多由中州答失运，阴血遂不归经，瘀滞闭塞清道，以致清阳不升，阳血僭上，便成血逆。理中汤才能调中州之气，中州健运，血自归经，其病自己。
一治四肢浮肿。夫四肢属土，土虚则元气发泄，不能潜藏，故见四肢浮肿。理中汤力能温暖脾胃，脾胃有权，元气不致漫散，故治之而愈。
一治心下嘈杂吐水。夫心下一寸，乃胃之上口。胃主纳，而脾主运。脾气衰而不运，津液上逆于胃口，以致心气不宁，故嘈杂吐水，即是明验。理中汤力能温暖中宫，脾土健运，水气下行，嘈杂、吐水自己。
一治咳嗽吐清水。夫咳唾之病，属于肺经，理应从肺于治。今独用理中者，原由中州失运，水聚于上，肺气欲下降而不能，故咳唾清水。理中汤力能健脾，脾土健而水湿下趋，
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肺气降而咳唾自己。
一治唾水不休。夫唾水之病，多属胃冷。理中汤能温暖中宫，土暖而水湿自消 病立愈。
一治呃逆不休。夫呃逆之病，原有寒热之分。果属胃寒而呃逆不休。理中汤能温中，中寒云而呃逆自己。
一治手足微冷少神。夫四肢逆冷之症，原有四逆之法。此乃微冷、少神。明系中州气衰，不能充周四肢。理中汤大能温暖中宫。中州气旺，肢冷自愈。
按此方功用最多，加减变通更多，姑举数知，以便学者参悟。
少阴经用药图
Now, dividing the circle into six layers is equivalent to dividing the One Yuan True Qi (Yi Yuan Zhen Qi) into Six Qi. The Six Qi are, in fact, the Six Channels (Liu Jing). The Qi mechanism moves from below upwards and from inside outwards; True Qi fills the entire body, distributing and protecting it in a fixed and unchanging manner. When external pathogens enter the interior, they first invade the outermost first layer. The first layer is the pathway for the Qi transformation of Taiyang Cold Water, hence symptoms such as aversion to wind and cold manifest; the treatment principle should be to disperse and vent. If treated improperly and the pathogen does not depart immediately, it gradually advances to the second layer. The second layer is governed by Yangming; Yangming governs Dryness. When external pathogens reach this stage, they transform into Dryness Pathogen, resulting in aversion to heat; the treatment principle should be cooling, and warm-drying agents must not be used recklessly. If treated improperly and the pathogen does not depart immediately, it gradually advances to the third layer. The third layer is governed by Shaoyang, located between the exterior and interior; the treatment principle should be harmonization. If treated improperly and the pathogen does not depart immediately, it gradually advances to the fourth layer. The fourth layer is governed by Taiyin; Taiyin governs Dampness. The pathogen combines with dampness to form Damp Pathogen; excessive dampness often leads to diarrhea, so vomiting and diarrhea are common; the treatment principle should be warming the middle. If treated improperly and the pathogen does not depart immediately, it gradually advances to the fifth layer. The fifth layer is governed by Shaoyin. There are two approaches for Shaoyin: if the pathogen manifests as Heart Fire disease, fire syndromes predominate, and the treatment principle should be clearing and moistening; if the pathogen manifests as Kidney Water disease, yin-cold is severe, and the treatment principle should be warming the meridians and dispersing cold. If treated improperly and the pathogen does not depart immediately, it gradually advances to the sixth layer. The sixth layer is governed by Jueyin. There are also two approaches for Jueyin: if the pathogen transforms via Wind, since Wind is a Yang pathogen, it is said that "the deeper the heat, the deeper the cold limbs"; attacking downwards causes pus and blood in the stool, while attacking upwards causes throat obstruction; the treatment principle should be nourishing Yin and clearing heat. If transforming via Yin, symptoms such as cyanotic and black fingernails and abdominal pain are common; the treatment principle should be restoring Yang.
Zhang Zhongjing allocated the Six Channels, outlined their提纲 (guidelines) to describe conditions, which serves as the method for recognizing pathogens. He also established main formulas for the Six Channels, which serve as the method for treating pathogens. The variations arising from changes in the pathogen are difficult to list completely. Students who carefully study the 397 methods and 113 formulas will obtain the way of following rules step by step. Here, I will briefly mention the subtleties of applying the main formulas of the Six Channels flexibly and vivaciously. It is hoped that students will not stick rigidly to formulas but prioritize understanding principles, thus achieving success.
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Medication Diagram for Taiyang
Wind is a Yang pathogen, prone to movement, entering through the hair pores. When wind moves internally, blood fails to be contained, the pores become loose and not dense, leading to spontaneous sweating and aversion to wind.
Versatile Application Method of Guizhi Tang (Cinnamon Twig Decoction)
Regarding Guizhi Tang, it is a formula that harmonizes Yin and Yang, penetrates from top to bottom, and acts both internally and externally; it is not merely for treating the disease clauses discussed in Zhang Zhongjing's original text. When Zhang Zhongjing established this method, he was likely speaking when the pathogen was in the Wei (Defensive) level of Taiyang, without mentioning that other syndromes could also use it. Modern people, failing to understand the sage's intent, rigidly adhere to old methods and dare not adapt, because they do not recognize the subtleties of Yin and Yang and the mechanisms of change. I have a rudimentary knowledge of medicine and often use this formula in clinical practice, achieving immediate efficacy. Thus, I realize that Zhang Zhongjing's formulas were originally not only for treating wind-strike syndromes but can be used for any disease belonging to the territory of the Taiyang Channel. Here, I specifically list a few experienced symptom patterns below for reference and study.
One: Treating chest and abdominal pain extending thoroughly to the back. Generally, Taiyang Qi rises from below to the chest and abdomen. When Cold Pathogen rebels against Taiyang, the Qi mechanism becomes obstructed, causing chest and abdominal pain that extends thoroughly to the back. Taiyang runs along the back of the body; due to the obstruction of Qi in the abdomen, the back is also affected. Therefore, Guizhi Tang cures it.
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One: Treating generalized coldness. Cold is the fundamental Qi of Taiyang. Now, seeing generalized aversion to cold indicates that the pathogen has invaded the fundamental Qi of Taiyang. Guizhi Tang can support the Qi of Taiyang, thus curing it.
One: Treating opisthotonos and convulsions of hands and feet in children. Taiyang runs along the back of the body. Since wind attacks the back, the Jing Qi of Taiyang fails to flow smoothly, and sudden closure of Jing Qi leads to opisthotonos. Guizhi Tang has the power to disperse Wind Pathogen of Taiyang, thus curing it.
One: Treating sores on the back of the head. The back of the head is where the Taiyang Meridian passes through. Cold-Wind Pathogen rebels against the back of the head, stagnating and forming sores. Guizhi Tang disperses the pathogen of Taiyang, thus curing it.
One: Treating generalized skin itching with intermittent aversion to wind. The hair pores of the whole body are the exit pathways for the Qi transformation of Taiyang Cold Water. When Cold-Wind Pathogen disturbs externally but cannot enter, it rebels against the skin, stagnates, and generates heat, causing generalized itching. Guizhi Tang can disperse the stagnant Qi of Taiyang, thus curing it.
One: Treating heel pain extending to the waist and thighs. The heels and lower back are pathways traversed by the Taiyang Channel. Because Cold Pathogen invades and blocks them, the above symptom patterns appear. Guizhi Tang has the power to distribute the Qi of Taiyang, thus curing it.
One: Treating swollen cheeks, fever, and aversion to wind in children. The cheeks near the ears belong to the territory of Shaoyang and Yangming, seemingly unsuitable for Guizhi Tang. However, it cured them because the fever and aversion to wind indicated that Taiyang pathogen had rebelled there.
One: Treating fever and eruption of smallpox in children. Smallpox originates from fetal toxin. To erupt outward, it requires the stirring of Taiyang True Qi. Guizhi Tang supports the Qi of Taiyang; as Qi extends, the toxin is driven entirely outward without remaining inside, so this formula can also treat smallpox.
One: Treating nausea and vomiting during pregnancy in women. When a woman first becomes pregnant, her Jing Qi suddenly fails to flow smoothly, and Ying (Nutritive) and Wei (Defensive) Qi are obstructed, leading to nausea and vomiting. Guizhi Tang can circulate Ying and Wei Qi and harmonize Yin and Yang, thus curing it.
One: Treating fever, aversion to wind, and dysentery occurring dozens of times a day. Wind Pathogen invading Taiyang causes exterior Qi obstruction; exterior Qi obstruction leads to interior Qi disharmony, and the pathogen sinks downward, causing dysentery. Guizhi Tang disperses Wind Pathogen outward; when exterior Qi flows smoothly, Taiyang Qi ascends without sinking, so dysentery heals.
[1] Ke (invade) was originally written as Rong (contain), corrected according to context.
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Regarding this formula, several syndromes in the Shanghan (Cold Damage) section can also use it. As for modifications and adaptations, there are truly many wonders, as Zhang Zhongjing stated. Students who carefully read Zhang Zhongjing's *Shanghan Lun* and understand its principles while mastering its variations will achieve flexibility and a comprehensive approach covering both interior and exterior.
Medication Diagram for Taiyang Organ and Channel
Cold is a Yin pathogen, entering through the hair pores. Cold governs stillness and lacks movement; the pores are tight and not loose, leading to anhidrosis (no sweat) and aversion to cold.
When the pathogen transmits to the organ rather than the channel, symptoms such as thirst and difficulty urinating appear. Wuling San (Five-Ingredient Powder with Poria) specializes in promoting urination; once the water passages are clear, Taiyang Qi relaxes, and the pathogen resolves from here.
Mahuang Tang (Ephedra Decoction) and Guizhi Tang are methods for expelling pathogens from above. Wuling San is a method for expelling pathogens from below. Only these three formulas can be called the primary formulas for the beginning and end of Taiyang.
Versatile Application Method of Mahuang Tang and Wuling San
One: Treating smallpox that initially appears but suddenly disappears, accompanied by high fever and anhidrosis. The initial eruption of smallpox relies entirely on a spark of Taiyang True Qi to stir and transport the toxin outward. Now, high fever with sudden disappearance of smallpox is due to external cold contracting and binding the Qi mechanism, causing stagnation and heat generation. Mahuang Tang opens the interstices and expels cold outward; when the pathogen departs, Zheng Qi is safe, smallpox naturally erupts, and the person remains safe. If the high fever is extreme with irritability and desire for cold drinks, Gypsum (Shigao) can be added to the formula.
One: Treating heaviness in the shoulders and back with a sensation of internal cold. The heaviness in the shoulders and back is caused by stagnation of Cold. Cold stagnating internally causes the sensation of internal cold. Mahuang Tang is light, clear, and belongs to Yang; its power can expel Cold outward. The shoulders and back are governed by Taiyang, thus curing it.
One: Treating painful red patches appearing behind the knees. The area behind the knees is the pathway of the Taiyang Channel. Now, being closed by Cold Pathogen, its Qi mechanism is blocked, causing stagnation and painful red patches. Mahuang Tang has the power to disperse Cold of Taiyang, thus curing it.
One: Treating watery diarrhea with complete absence of urine. This condition is common in summer, caused by Summerheat Pathogen disturbing and disrupting Zheng Qi, leading to failure of the Lan Gate (sphincter/valve function) to perform its duty, preventing fluids from reaching the Bladder and directing them straight to the Large Intestine. Wuling San has the power to transform Bladder Qi, thus curing it.
One: Treating dizziness, cough, vomiting, abdominal distension, and scanty urine. Although symptoms include dizziness, cough, and vomiting, the root cause is the failure of Bladder Qi transformation, preventing Dampness-Qi from descending. Consequently, Qi mechanism rebounds upward, disturbing the clear orifices, presenting the above symptoms. Wuling San specializes in promoting urination; as Water-Qi descends, Qi mechanism flows smoothly, and the disease heals itself.
One: Treating cholera-like vomiting and diarrhea with craving for cold water. This disease involves upper vomiting and lower diarrhea, which should theoretically focus on Taiyin. The reason for using Wuling San is that in vomiting and diarrhea, there is no urine. Furthermore, thirst and craving for water constitute the guideline for Yangming Organ Syndrome (specifically Taiyang Organ Syndrome in this context implies Bladder involvement affecting fluid metabolism). Thus, Wuling San is a crucial herb/formula. The cause of vomiting and diarrhea lies in the failure of Taiyang Qi transformation. With the Central Palace (Spleen/Stomach) failing in its duties, treating Taiyang first and then regulating the Middle is the correct approach, representing both standard and flexible methods.
There are several syndromes in the Shanghan section suitable for these two formulas. Regarding modifications and variations, Zhang Zhongjing explained them in detail, so I will not repeat them here.
[1] Lan (intestine gate) was originally written as Wen (hear), corrected according to context.
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Medication Diagram for Yangming Channel Syndrome
Taiyang governs opening, while Yangming governs closing. Now, Yangming is pressured by Taiyang pathogen, failing to follow its own closing function and instead following Taiyang's opening, opening downwards, hence diarrhea.
Versatile Application Method of Gegen Tang (Kudzu Decoction)
One: Treating generalized fever, appearance of macules, and vomiting. The muscles of the whole body belong to Yangming; Yangming governs fever and lack of aversion to cold. Now, oppressed by external pathogen and congested in Yangming, fever appears along with macules and vomiting, all due to pathogen toxin congesting upward and seeking exit. Gegen Tang has the power to expel pathogen outward, following the direction of the pathogen to expel it, thus healing.
One: Treating severely swollen, red, and painful eyelids. Both upper and lower eyelids are governed by Yangming. Now, closed by Wind-Heat, stagnation results in severe swelling, redness, and pain. Gegen Tang has the power to resolve Wind-Heat of Yangming, thus curing it.
One: Treating swollen, red, and hot breasts. The area of the breasts belongs to Yangming. Now, the pathogen of external contraction hides between the breasts, causing severe swelling, redness, and pain. Gegen Tang specifically expels pathogen of Yangming, thus curing it.
One: Treating the initial appearance of smallpox spots in children. Smallpox toxin emerges from within to without. Once spots appear, the toxic pathogen is entirely within the muscles. Muscles belong to Yangming. Gegen Tang has the power to circulate pathogen in the muscles, preventing smallpox toxin from remaining inside, aiming for full eruption. Afterwards, nourishing the pus phase is performed separately. If already fully erupted, this formula should not be used.
This formula has many functions and modification methods, explained in detail in Zhang Zhongjing's *Shanghan Lun*, so I will not repeat them here.
Medication Diagram for Yangming Channel
This formula was originally listed in the Taiyang chapter but is also said to treat Yangming Organ Syndrome. The reason is that after the Taiyang pathogen takes Guizhi Tang for heavy sweating, the exterior pathogen is resolved, but the Blood of Yangming is damaged. Yangming is an organ abundant in Qi and Blood. Now, with sudden blood damage, internal heat in Yangming arises immediately. If Baibu Tang (White Tiger Decoction) is not urgently used to clear heat, and Ginseng (Renshen) to nourish blood, the evil fire will intensify, becoming unstoppable. Thus, Baibu Tang is also a formula for Yangming Organ.
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Versatile Application Method of Baibu Tang (White Tiger Decoction)
One: Treating Upper Xiao (Upper Wasting-Thirst). Upper Xiao refers to thirst with excessive drinking. It is caused by evil fire in the Stomach damaging Blood significantly. Blood is Yin; when Yin is damaged, drawing water to rescue it represents Yin attracting Yin. Baibu Tang has the power to extinguish fire to preserve Yin, thus curing it.
One: Treating sores occurring one cun below the heart, with severe swelling, redness, and pain. One cun below the heart is the upper opening of the Stomach. Because evil heat knots at the upper opening of the Stomach, sores occur. Baibu Tang specifically clears Stomach Heat, thus curing it.
One: Treating severely swollen, red, and painful gums with desire for cold drinks. The gums are governed by Yangming. Now, Stomach Fire gathers above, causing severe swelling, redness, and pain, along with desire for cold drinks, indicating evil fire damages Yin. Baibu Tang has the power to clear Stomach Heat, thus curing it.
One: Treating severely swollen, red, and painful breasts. The breasts are where Yangming meridians pass. Now, severe swelling, redness, and pain are caused by congestion of evil heat in the Stomach. Baibu Tang specifically clears Stomach Heat; as heat pathogen leaves, swelling subsides, thus curing it.
One: Treating delirium, urinary incontinence, insensitivity of the mouth, greasy face, and concurrent illness of the Three Yang channels. Delirium indicates evil heat entering the Yangming Fu (Organ); urinary incontinence indicates evil heat combining with the Taiyang Fu; insensitivity of the mouth and greasy face indicate evil heat combining with the Shaoyang Fu. Baibu Tang has the power to clear heat; once heat is cleared, the three illnesses are resolved immediately, thus curing it.
This formula has many functions and variations, explained in detail in the *Shanghan Lun*. There is also a syndrome of cold in the back where it is used. Students should distinguish and understand clearly.
Medication Diagram for Yangming Interior Syndrome
Whenever using this formula, one must examine accurately, always knowing the guideline "Wei Jia Shi" (Stomach Family Excess). What is Wei Jia Shi? It includes inability to pass stool or urine; hard stool and abdominal fullness; madness, running about, cursing without avoiding relatives or strangers; tidal fever and delirium. There are various types; one must deliberate carefully and not act rashly.
Versatile Application Method of Dachengqi Tang (Major Order the Qi Decoction)
One: Treating cough with a voice like a bell. Cough seems unsuitable for this formula. The reason for necessarily using it is that a loud cough is a sign of extreme evil fire, punishing the Lung. If this formula is not urgently used to extinguish the fire, the Lung faces imminent destruction, so it must be used.
One: Treating vomiting immediately after eating. Vomiting after eating is not typically a indication for purgation. The reason it can be purged is that vomiting is rebellious Qi, either Cold or Fire. Now, vomiting after eating indicates Stomach Fire rebelling upward, preventing food from descending. Only after distinguishing between Cold and Fire can this be used.
One: Treating dizziness, confusion, and loss of control, occurring every three to five days. Dizziness is originally not an indication for purgation. The reason it should be purged is that Yin Blood is extremely deficient, unable to restrain the Hyperactive Dragon. When the Dragon rushes upward, turbid fire disrupts the Spirit, causing confusion. Dachengqi Tang has the power to restrain the Hyperactive Dragon, thus curing it.
In Wu Youke's *Wenyi Lun* (Treatise on Pestilential Diseases), over thirty syndromes can use this formula; in the Yangming chapter of *Shanghan*, six or seven syndromes can use it; in the Shaoyin chapter, three syndromes requiring urgent purgation can use it. I will not list them all here. Students must熟读 (read熟熟) Zhang Zhongjing's *Shanghan Lun*; obtaining the way of versatile application and variation is key. One must never rigidly stick to the original text but prioritize understanding principles.
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Medication Diagram for Shaoyang Channel
Although this formula is named a Shaoyang formula, it ultimately addresses the seed of pathogen received by the Taiyang Channel that cannot exit through the chest, rebelling in the hypochondrium, obstructing the ascending and descending mechanism of Shaoyang, thus causing Shaoyang channel symptoms. Treating Shaoyang with this formula is essentially treating Taiyang.
Versatile Application Method of Xiaochaihu Tang (Minor Bupleurum Decoction)
One: Treating distending pain in the hypochondrium. The hypochondrium is governed by Shaoyang. Now, distending pain indicates Shaoyang Qi is depressed and unsmooth. Chaihu Tang has the power to soothe Shaoyang Qi, thus curing it.
One: Treating head noise and distension in the sides. The sides of the head are governed by Shaoyang. Now, distension and noise indicate Shaoyang Fire floating upward. Chaihu Tang treats Shaoyang channels; doubling Huangqin (Scutellaria Root) enhances the power to clear Shaoyang Fire, thus curing it.
One: Treating severely swollen, red, and painful ears. The areas before and after the ears belong to Shaoyang. Now, severe swelling, redness, and pain indicate Wind-Heat Pathogen gathering in Shaoyang. Chaihu Tang treats Wind-Heat of Shaoyang, thus curing it.
One: Treating Malaria. Malaria often occurs because external pathogens hide in Shaoyang and cannot exit via transmission and distribution. Shaoyang resides between exterior and interior; when pathogen seeks to exit via Yangming, heat occurs; when seeking to enter via Taiyin, cold occurs. Various books state malaria is inseparable from Shaoyang, clarifying that Shaoyang Jing Qi is unsmooth, the pivot function fails, and the pathogen hides and does not depart. Xiaochaihu Tang has the power to extend Shaoyang Qi; as Shaoyang Qi extends, the pivot function resumes operation, the pathogen exits from here, the disease heals, and the person becomes safe.
One: Treating sour regurgitation and anorexia. Anorexia with vomiting belongs to Taiyin, ideally treated by warming the middle and strengthening the Spleen. Now, anorexia with sour regurgitation clearly indicates Wood Qi is unsmooth, attacking Earth (Spleen) from above. Earth fears Wood attack, hence anorexia. Sour belongs to Wood, transformed from Shaoyang Hot Qi. Wood and Earth clash, causing the above symptoms. Xiaochaihu Tang has the power to soothe Shaoyang Qi; as Shaoyang Qi soothes, it no longer suppresses Spleen Earth, the Qi of both channels balances, and the disease ceases.
One: Treating delirium in women due to Heat entering the Blood Chamber. The Liver stores Blood, and the Liver and Gallbladder are exterior-interior pairs. Gallbladder transfers heat to the Liver, Heat enters the Blood Chamber, causing delirium. Chaihu Tang treats Evil Heat of Liver and Gallbladder, thus curing it.
Regarding this formula, functions are numerous, and variations are infinite, explained in detail in the *Shanghan Lun*, so I will not repeat them.
Medication Diagram for Taiyin Channel
In the Taiyin chapter, Guizhi Jia Shaoyao Tang (Guizhi Decoction plus Peony Root) and Guizhi Jia Dahuang Tang (Guizhi Decoction plus Rhubarb) are set for cases where Taiyang was mistreated, causing pathogen to sink into Taiyin; they cannot be considered main formulas for Taiyin. Students must know this.
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Versatile Application Method of Lizhong Tang (Regulate the Middle Decoction)
One: Treating hematemesis (vomiting blood). Hematemesis is mostly caused by failure of the Central Palace (Spleen/Stomach) to transport, causing Yin Blood to fail to return to its vessels, leading to stasis blocking the clear pathways, preventing Clear Yang from ascending, and allowing Yang Blood to rebel upward, resulting in blood rebellion. Only Lizhong Tang can regulate Qi of the Central Palace; as the Central Palace functions healthily, Blood returns to its vessels, and the disease heals itself.
One: Treating edema of the four limbs. The four limbs belong to Earth. When Earth is deficient, Yuan Qi leaks and cannot submerge, causing edema of the four limbs. Lizhong Tang warms the Spleen and Stomach; when Spleen and Stomach have authority, Yuan Qi does not scatter, thus curing it.
One: Treating epigastric discomfort and vomiting of water. One cun below the heart is the upper opening of the Stomach. The Stomach governs receiving, and the Spleen governs transporting. When Spleen Qi declines and fails to transport, fluids rebel upward to the stomach opening, causing restlessness of Heart Qi, hence epigastric discomfort and vomiting of water, which is clear evidence. Lizhong Tang warms the Central Palace; as Spleen Earth functions healthily, Water-Qi descends, and discomfort/vomiting heal themselves.
One: Treating cough with expectoration of clear fluid. Cough and expectoration belong to the Lung Channel, ideally treated from the Lung. The reason for exclusively using Lizhong is that failure of the Central Palace to transport causes Water to gather above; Lung Qi desires to descend but cannot, hence coughing up clear fluid. Lizhong Tang strengthens the Spleen; as Spleen Earth strengthens, Dampness-Water trends downward,
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Lung Qi descends, and cough/expectoration heal themselves.
One: Treating continuous expectoration of saliva/water. Diseases of continuous expectoration mostly belong to Cold Stomach. Lizhong Tang warms the Central Palace; as Earth warms, Dampness-Water dissipates, and the disease heals immediately.
One: Treating continuous hiccups. Hiccups have distinctions between Cold and Heat. If it is indeed Stomach Cold causing continuous hiccups, Lizhong Tang warms the middle; as Middle Cold departs, hiccups heal themselves.
One: Treating slightly cold hands and feet with lethargy. Diseases of reversed cold limbs have the Sini (Four Reversals) method. This case involves slight cold and lethargy, clearly indicating decline of Central Palace Qi, unable to fill the four limbs. Lizhong Tang greatly warms the Central Palace; as Central Palace Qi prospers, cold limbs heal themselves.
Regarding this formula, functions are most numerous, and variations are even more so. I briefly list a few for students to ponder.
Medication Diagram for Shaoyin Channel