Library

The *Classic of Medicine* (Huangdi Neijing) states: On the second day, the Yangming channel is affected. The Yangming channel governs the flesh and its vessels run alongside the nose and connect to the eyes. Therefore, symptoms include fever, eye pain, dryness of the nose, and inability to lie down comfortably. On the third day, the Shaoyang channel is affected. The Shaoyang channel governs the Gallbladder, and its vessels follow the hypochondrium and connect to the ears. Therefore, symptoms include pain in the chest and hypochondrium, and deafness. Although both are caused by cold pathogenic factors, the text specifies the second and third days rather than the first because this usually indicates transmission of pathogens from one channel to another (transmission disease), whereas direct contraction (self-infection) is less common. Direct contraction manifests as cold syndromes, while transmitted pathogens tend to transform into heat. Zhang Zhongjing used Gegen Tang (Kudzu Decoction) and Xiaochaihu Tang (Minor Bupleurum Decoction) to treat diseases of these two channels. Jie'an (Dai Yuanli) stated that one method resolves the muscle layer (jieji), while the other harmonizes the pivot (hejie). He also mentioned treating according to the "middle" rather than following the root or branch strictly. This indeed indicates that these conditions do not heal simply through sweating like Taiyang diseases. Can students of medicine be dogmatic? However, there are cases of direct infection in these two channels. For instance, when the Yangming channel is invaded, massive swelling of the head and face occurs; when the Shaoyang channel is invaded, swelling occurs around the ears. These cases do not transmit from the Taiyang channel, yet the fever is indistinguishable from Shanghan (cold damage). Li Dongyuan treated such conditions with Puji Xiaodu Yinzi (Universal Benefit Detoxification Decoction) and Shuniuzi Tang (Arctostaphyli Seed Decoction). This is because the Yangming channel governs dryness, and the Shaoyang channel governs fire, unlike the Taiyang channel which is governed by cold water. Thus, treatments differ accordingly.

Note: When cold pathogens enter the interior, they invariably transmit to the Yangming, but this refers to Yangming Fu-organ disease, not Yangming Jing-channel disease. The Yangming channel corresponds to the Stomach. The Stomach is the sea of water and grain. Once invaded by cold pathogens, the digestion and transportation of water and grain stagnate, leading to heat, thirst, abdominal distension, and in severe cases, delirium and manic speech. These are all manifestations of the pathogen. In treatment, one must not induce excessive sweating to deplete fluids (Taboo 1); one must not use purgatives too early to injure Yin (Taboo 2); and one must not use overly cold and bitter substances to obstruct physiological transformation (Taboo 3). It is appropriate to regulate using Gegen Pingwei San (Pueraria and Stomach-Ping Powder) with modifications. As for the Shaoyang channel, it belongs to Wood and contains Ministerial Fire. Symptoms include vomiting, abnormal sounds, and alternating chills and fever. The primary formula should be Xiaochaihu Tang (Minor Bupleurum Decoction). If a woman contracts the pathogen during her menstrual period, it is termed "Heat Entering the Blood Chamber," which may lead to delirium in severe cases. Adding Shengdihuang (Rehmanniae Radix) and Mudanpi (Moutan Cortex) constitutes orthodox treatment. Sweating and purging are particularly contraindicated.

Yangming diseases have numerous variations, so treatment must be appropriate. Cold causes stagnation and indigestion; heat causes dryness and further fluid loss. Therefore, using Gegen Fen (Puerariae Radix Powder) to quench thirst and stimulate Stomach Qi is superior to Huafen (Trichosanthis Radix) and Zhimu (Anemarrhenae Rhizoma). To calm the stomach, Houpo (Magnoliae Officinalis Cortex) is used to warm the middle jiao, differing from Muxiang (Aucklandiae Radix) and Doukou (Amomi Fructus Rotundus). For upper body issues, Jiegeng (Platycodonis Radix) and Zhike (Aurantii Fructus Immaturus) are used; for lower body issues, Zhishi (Aurantii Fructus Immaturus) and Qingpi (Citri Reticulatae Pericarpium Viride) are used. Gancao (Glycyrrhizae Radix et Rhizoma) harmonizes the center, Chenpi (Citri Reticulatae Pericarpium) regulates Qi, and ShanZha (Crataegi Fructus) and Laifuzi (Raphani Semen) eliminate food stagnation. Although these methods are extremely mild, they represent sound and unchangeable principles. However, some patients have food retention hidden in the middle jiao without obvious pulse or symptom manifestations. Conversely, some pulse and symptom patterns resemble food retention but are actually caused by deficiency of Middle Qi. In such cases, one must carefully inquire about the cause, observe the pulse, complexion, and tongue coating, palpate the chest and abdomen for tenderness, and check bowel movements. Based on these findings, decide whether to tonify or purge, forming a definitive judgment to treat the patient. This is the correct approach.

Gegen Tang (Kudzu Decoction)
Gegen (Puerariae Radix) (1.5 qian) Mahuang (Ephedrae Herba) (1 qian) Guizhi (Cinnamomi Ramulus) Shaoyao (Paeoniae Radix) Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.6 qian)
Decoct with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus) in water. This formula treats Taiyang syndrome with no sweat and aversion to wind, as well as combined Taiyang-Yangming disease. It should not be used indiscriminately for Yangming Fu-organ disease.

Xiaochaihu Tang (Minor Bupleurum Decoction)
Chaihu (Bupleuri Radix) (2 qian) Huangqin (Scutellariae Radix) Renshen (Ginseng Radix) Banxia (Pinelliae Rhizoma) (each 1 qian) Gancao (Glycyrrhizae Radix et Rhizoma) (0.5 qian)
Decoct with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus) in water and take orally.

Jiawei Xiaochaihu Tang (Modified Minor Bupleurum Decoction)
(Add Shengdihuang (Rehmanniae Radix) and Mudanpi (Moutan Cortex) each 1 qian to the above formula)

Puji Xiaodu Yinzi (Universal Benefit Detoxification Decoction)
Huangqin (Scutellariae Radix) (wine-fried) Huanglian (Coptidis Rhizoma) (each 0.8 qian, roasted) Renshen (Ginseng Radix) Juhong (Citri Reticulatae Pericarpium Rubrum) Xuanshen (Scrophulariae Radix)
Gancao (Glycyrrhizae Radix et Rhizoma) (raw) Lianqiao (Forsythiae Fructus) Niubangzi (Arctostaphyli Fructus) (fried and crushed) Jiegeng (Platycodonis Radix) Chaihu (Bupleuri Radix)
Jiangcan (Bombyx Batryticatus) (fried) Bohe (Menthae Haplocalycis Herba) (each 0.5 qian) Banlangen (Isatidis Radix) Mapibo (unknown, likely a local herb variant) Shengma ( Cimicifugae Rhizoma) (each 0.2 qian)
Decoct in water and take orally. (If constipated, add Dahuang (Rhei Radix et Rhizoma) fried with wine, 1 qian).

Shuniuzi Tang (Arctostaphyli Seed Decoction)
Niubangzi (Arctostaphyli Fructus) (roasted and crushed) Zhike (Aurantii Fructus Immaturus) Gancao (Glycyrrhizae Radix et Rhizoma) (honey-fried) Chaihu (Bupleuri Radix) Lianqiao (Forsythiae Fructus) Huangqin (Scutellariae Radix) Jiegeng (Platycodonis Radix) (each 1 qian) Boheye (Menthae Haplocalycis Herba) (2 qian)
Decoct in water.