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。
（阳明胃也。邪自太阳经。传之入府者。谓之太阳阳明。经曰。太阳病。若吐若下。若
发汗
正阳阳明者。胃家实是也。
（邪自阳明经。传入腑者。谓之正阳、阳明。经曰。阳明病脉迟。虽汗出。不恶寒。其
身
也
少阳阳明者。发汗。利小便。已。胃中燥烦。实。大便难是也。
（邪自少阳经。传之入腑者。谓之少阳、阳明。经曰。伤寒脉弦细。头痛发热者。属少
阳。
阳明之为病。胃家实也。
（邪传入胃。热毒留结。则胃家为实。华佗曰。热毒入胃。要须下去之。不可留于胃中。
是
问曰。何缘得阳明病。答曰。太阳病发汗。若下。若利小便。此亡津液。胃中干燥。因
转属
（本太阳病不解。因汗利小便。亡津液。胃中干燥。太阳之邪入腑。转属阳明。古人登
厕必
蓄热
问曰。阳明病。外证云何。答曰。身热。汗自出。不恶寒。反恶热也。
（阳明病。为邪入腑也。邪在表。则身热。汗出而恶寒。邪既入腑。则表证已罢。故不
恶寒
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
（邪客在阳明。当发热而不恶寒。今得一日。犹不发热而恶寒者。即邪未全入腑。尚带
表邪
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
（胃为水谷之海。主养四旁。四旁有病。皆能传入于胃。入胃则更不复传。如太阳传之
入胃
本太阳。初得病时。发其汗。汗先出不彻。因转属阳明也。
（伤寒传经者。则一日太阳。二日阳明。此太阳传经。故曰转属阳明。）
伤寒发热。无汗。呕不能食。而反汗出 然者。是转属阳明也。
（伤寒发热无汗。呕不能食者。太阳受病也。若反汗出 然者。太阳之邪。转属阳明
也。
伤寒三日。阳明脉大。
（伤寒三日。邪传阳明之时。经曰。尺寸俱长者。阳明受病。当二三日发。阳明气血俱
多。
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
（浮为阳邪。缓为脾脉。伤寒脉浮缓。太阴客热。邪在三阳。则手足热。邪在三阴。则
手足
小
伤寒转系阳明者。其人 然微汗出也。
（伤寒则无汗。阳明法多汗。此以伤寒兼邪转系阳明。故 然微汗出。）
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。
（脉浮在表。紧为里实。阳明中风。口苦咽干。腹满微喘者。热传于里也。发热恶寒者。
表
阳明病。若能食。名中风。不能食。名中寒。
（阳明病。以饮食别受风寒者。以胃为水谷之海。风为阳邪。阳杀谷。故中风者能食。
寒为
阳明病。若中寒。不能食。小便不利。手足 然汗出。此欲作痼瘕。必大便初硬后溏。
所以
（阳明中寒。不能食者。寒不杀谷也。小便不利者。津液不化也。阳明病。法多汗。则
周身
欲
便
阳明病。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
（阳病客热。初传入胃。胃热则消谷而欲食。阳明病热为实者。则小盒饭数。大盒饭硬。
今
长气于阳。谷多则阳气胜。热消津液则水少。经曰。水入于经。其血乃成。水少则阴血弱。
金匮要略曰。阴气不通。即骨疼。其人骨节疼者。阴气不足也。热甚于表者。翕翕发热。热
甚于里者。蒸蒸发热。此热气散漫。不专着于表里。故翕翕如有热状。奄忽也。忽然发狂者
。阴不胜阳也。内经曰。阴不胜其阳者。则脉流薄疾。并乃狂。阳明蕴热为实者。须下之愈
热气散漫。不为实者。必待汗出而愈。故云 然而汗出解也。水谷之等者。阴阳气平也。水
不胜谷气。是阴不胜阳也。汗出。则阳气衰。脉紧则阴气生。阴阳气平。两无偏胜。则愈。
故云与汗共并。脉紧则愈。）
阳明病。欲解时。从申至戌上。
（四月为阳。土旺于申酉戌。向旺时。是为欲解。）
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。
（不能食。胃中本寒。攻其热。复虚其胃。虚寒相搏。故哕也。经曰。关脉弱。胃气虚。
有
阳明病。脉迟。食难用饱。饱则微烦。头眩。必小便难。此欲作谷疸。虽下之。腹满如
故。
（阳明病。脉迟。则邪方入里。热未为实也。食入于阴。长气于阳。胃中有热。食难用
饱。
黄。
谷疸
攻。
阳明病。法多汗。反无汗。其身如虫行皮中状者。以此久虚故也。
（胃为津液之本。气虚津液少。病则反无汗。胃候身之肌肉。其身如虫行皮中者。知胃
气久
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
（阳明病。法多汗。反无汗而小便利者。阳明伤寒。而寒气内攻也。至二三日呕而咳支
厥者
亦不
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。
（阳明病。身不重痛。但头眩而不恶寒者。阳明中风。而风气内攻也。经曰。阳明病。
若能
胃气
阳明病。无汗。小便不利。心中懊 者。身必发黄。
（阳明病。无汗而小便不利者。热蕴于内而不得越。心中懊 者。热气郁蒸。欲发于外
而为
阳明病。被火。额上微汗出。小便不利者。必发黄。
（阳明病。则为内热。被火。则火热相合而甚。若遍身汗出。而小便利者。热得泄越。
不能
阳明病。脉浮而紧者。必潮热。发作有时。但浮者。必盗汗出。
（浮为在经。紧者里实。脉浮而紧者。表热里实也。必潮热。发作有时。若脉但浮而不
紧者
阳明病口燥。但欲漱水。不欲咽者。此必衄。
（阳明之脉。起于鼻。络于口。阳明里热。则渴欲饮水。此口燥。但欲漱水。不欲咽者。
是
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。
不久
（先亡津液。使大便硬。小便数少。津液分别。大便必自下也。）
伤寒呕多。虽有阳明证。不可攻之。
（呕者。热在上焦。未全入腑。故不可下。）
阳明病。心下硬满者。不可攻之。攻之利遂不止者。死。利止者。愈。
（阳明病。腹满者。为邪气入腑。可下之。心下硬满。则邪气尚浅。未全入腑。不可便
下之
阳明病。面合赤色。不可攻之。必发热色黄。小便不利也。
（合。通也。阳明病。面色通赤者。热在经也。不可下之。下之虚其胃气。耗其津液。
经中
阳明病。不吐不下。心烦者。可与调胃承气汤。
（吐后心烦。谓之内烦。下后心烦。谓之虚烦。今阳明病。不吐不下。心烦。即是胃有
郁热
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
外
泄
（阳明病。脉迟。若汗出多。微发热恶寒者。表未解也。若脉迟。虽汗出而不恶寒者。
表证
则
胃热。经曰。潮热者。实也。其热不潮。是热未成实。故不可便与大承气汤。虽有腹大满不
通
大承气汤方
大黄（四两苦寒酒洗） 浓朴（半斤苦温炙去皮） 枳实（五枚苦寒炙） 芒硝（三合
咸寒）
（内经曰。燥淫所胜。以苦下之。大黄、枳实之苦。以润燥除热。又曰。燥淫于内。治
以苦温。浓
味。以水一
一两沸。
小承气汤方
大黄（四两） 浓朴（二两炙去皮） 枳实（三枚大者炙）
（大热结实者。与大承气汤。小热微结者。与小承气汤。以热不大甚。故于大承气汤去
芒硝
滓。
阳明病。潮热。大便微硬者。可与大承气汤。不硬者。不与之。若不大便六七日。恐有
燥屎
者
热者
（潮热者。实。得大便微硬者。便可攻之。若不硬者。则热未成实。虽有潮热。亦未可
攻。
不能
攻之
哕。
微
夫实则谵语。虚则郑声。郑声重语也。
（内经曰。邪气盛则实。精气夺则虚。谵语由邪气盛而神识昏也。郑声由精气夺。而声
不全
声。
若声
直视。谵语。喘满者死。下利者亦死。
（直视。谵语。邪胜也。喘满为气上脱。下利为气下脱。是皆主死。）
发汗多。若重发汗者。亡其阳。谵语。脉短者死。脉自和者不死。
（亡阳胃燥谵语者。脉短。津液已绝。不可复治。脉自和。为主气未衰。而尤可生也。）
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。独语见
鬼状
但
（若吐若下。皆伤胃气。不大便五六日。上至十余日者。亡津液。胃气虚。邪热内结也。
阳明旺于申酉戌。日晡所发潮热者。阳明热甚也。不恶寒者。表证罢也。独语如见鬼状者。
阳
至
为
复
下
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
（亡津液。胃燥。大便硬而谵语。虽无大热内结。亦须与小承气汤。和其胃气。得一服。
谵
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。腹中转气者。
更服
承气
（阳明病。谵语。发潮热。若脉沉实者。内实者也。则可下。若脉滑疾。为里热未实。
则未
除之
是
大
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。但硬尔。宜
大承
（谵语潮热。为胃热。当消谷引食。反不能食者。胃中有燥屎。而胃中实也。若能食者。
胃
胃中虚热甚者。能食。与杂病为异也。大承气汤以下燥屎。逐结热。）
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
（阳明病。热入血室。迫血下行。使下血谵语。阳明病。法多汗。以夺血者。无汗。故
但头
通。
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。
（胃中有燥屎。则谵语。以汗出为表未罢。故云风也。燥屎在胃。则当下。以表未和。
则未
为
伤寒四五日。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
（邪气入内之时。得沉脉而喘满。里证具也。则当下之。反发其汗。令津液越出。胃中
干燥
三阳合病。腹满。身重。难以转侧。口不仁而面垢。谵语。遗尿。发汗则谵语。下之则
额上
（腹满身重。难以反侧。口不仁。谵语者。阳明也。针经曰。少阳病甚。则面微尘。此
面垢
邪。
冷。
内外
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
（本太阳病。并于阳明。名曰并病。太阳证罢。是无表证。但发潮热。是热并阳明。一
身汗
出者
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
膈。
（脉浮发热。为邪在表。咽燥口苦。为热在经。脉紧腹满而喘。汗出不恶寒。反恶热。
重身
而愦
表里
表中
于胃
若渴欲饮水。口干舌燥者。白虎加人参汤主之。
（若下后。邪热客于上焦者。为虚烦。此下后。邪热不客于上焦。而客于中焦者。是为
干躁
若脉浮。发热。渴欲饮水。小便不利者。猪苓汤主之。
（此下后。客热客于下焦者也。邪气自表入里。客于下焦。三焦俱带热也。脉浮发热者。
上
利
猪苓汤方
猪苓（去皮甘平） 茯苓（甘平） 阿胶（甘平） 滑石（碎甘寒） 泽泻（甘咸寒各
一两）
（甘甚而反淡。淡味渗泄为阳。猪苓、茯苓之甘。以行小便。咸味涌泄为阴。泽泻之咸。
以
升
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。
（针经曰。水谷入于口。输于肠胃。其液别为五。天寒衣薄。则为溺。天热衣浓。则为
汗。
脉浮而迟。表热里寒。下利清谷者。四逆汤主之。
（浮为表热。迟为里寒。下利清谷者。里寒甚也。与四逆汤。温里散寒。）
若胃中虚冷。不能食也。饮水则哕。
（哕者。咳逆是也。千金曰。咳逆者。哕逆之名。胃中虚冷。得水。则水寒相搏。胃气
逆而
脉浮。发热。口干鼻燥。能食者。则衄。
（脉浮发热。口干鼻燥者。热在经也。能食者。里和也。热甚于经。迫血为衄。胃中虚
冷。
阴。
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
（表未罢而下者。应邪热内陷也。热内陷者。则外无热。而手足寒。今外有热而手足温
者。
自胸
阳明病。发潮热。大便溏。小便自可。胸胁满不去者。小柴胡汤主之。
（阳明病。潮热为胃实。大便硬。而小便数。今大便溏。小便自可。则胃热未实。而水
谷不
Q: There are Taiyang Yangming, Zhengyang Yangming, and Shaoyang Yangming in diseases. What does this mean?
A: Taiyang Yangming refers to Pi Yue (Spleen Constraint, constipation due to insufficient Spleen Yin and intestinal dryness).
(Yangming refers to the Stomach Fu organ. When pathogenic factors transmit from the Taiyang channel into the Stomach Fu, it is called Taiyang Yangming. The Classics state: In Taiyang disease, if emesis, purgation, or sweating methods are used...)
Zhengyang Yangming refers to Wei Jia Shi (Stomach House Excess, gastrointestinal dry-heat accumulation).
(When pathogenic factors transmit directly from the Yangming channel into the Fu, it is called Zhengyang Yangming. The Classics state: In Yangming disease, the pulse is slow; although there is sweating, there is no aversion to cold, and the body...)
Shaoyang Yangming refers to the syndrome where, after sweating and promoting urination, the stomach becomes dry, vexed, and solid, with difficulty in defecation.
(When pathogenic factors transmit from the Shaoyang channel into the Fu, it is called Shaoyang Yangming. The Classics state: In Cold Damage disease, with a wiry and thin pulse, headache, and fever, it belongs to Shaoyang disease.)
The general principle of Yangming disease is Wei Jia Shi (Stomach House Excess).
(When pathogenic factors enter the Stomach and heat-toxins remain and knot, the Stomach presents as an excess pattern. Hua Tuo said: If heat-toxin enters the Stomach, it must be removed by purgation; it cannot be allowed to remain in the Stomach.)
Q: Why does one contract Yangming disease?
A: If Taiyang disease is treated with sweating, purgation, or promoting urination, it leads to fluid depletion, dryness in the Stomach, and thus transforms into Yangming disease.
(The original Taiyang disease has not resolved. Due to sweating and promoting urination, fluids are depleted, the Stomach becomes dry, Taiyang pathogenic factors enter the Fu, and transform into Yangming. When ancients went to the toilet... accumulating heat...)
Q: What are the external manifestations of Yangming disease?
A: Fever, spontaneous sweating, no aversion to cold, but aversion to heat.
(Yangming disease involves pathogenic factors entering the Fu. When pathogens are at the Exterior, there is fever, sweating, and aversion to cold; once pathogens have entered the Fu, the Exterior syndrome has ceased, so there is no aversion to cold...)
Q: Some patients, on the first day of illness, do not have fever but have aversion to cold. Why?
A: Although it is only the first day, the aversion to cold will soon cease spontaneously, followed immediately by spontaneous sweating.
(Pathogens lodging in Yangming should present with fever and no aversion to cold. Now, on the first day, there is still no fever but aversion to cold, indicating that pathogens have not fully entered the Fu and still carry Exterior pathogens...)
Q: Why does the aversion to cold stop spontaneously?
A: Yangming resides in the center and corresponds to the Earth element; it is where all things return, and there is nowhere else for pathogens to transmit. Initially, there may be aversion to cold, but it stops spontaneously on the second day.
(The Stomach is the Sea of Water and Grain, nourishing the four peripheries. Diseases in the peripheries can all transmit to the Stomach. Once in the Stomach, they no longer transmit further, e.g., Taiyang disease transmitting to the Stomach...)
Originally Taiyang disease, when first contracted, sweating was induced, but the sweat was not thorough, leading to transformation into Yangming disease.
(In Cold Damage disease transmission, typically Day 1 is Taiyang, Day 2 is Yangming. This is Taiyang channel transmission, hence it is said to transform into Yangming.)
In Cold Damage with fever, no sweating, vomiting, inability to eat, but instead profuse sweating, this is transformation into Yangming disease.
(Cold Damage with fever, no sweating, vomiting, and inability to eat indicates Taiyang channel involvement. If instead there is profuse sweating, it means Taiyang pathogens are transforming into Yangming...)
Three days into Cold Damage, the Yangming pulse is large.
(Three days into Cold Damage is when pathogens transmit to Yangming. The Classics state: If the pulse is long at Cun, Guan, and Chi positions, it is Yangming disease, which should manifest on Days 2-3. Yangming has abundant Qi and Blood...)
Cold Damage with a floating and moderate pulse, and warm hands and feet, indicates the disease is tied to Taiyin. In Taiyin disease, the body should become jaundiced; however, if urination is free, jaundice will not occur.
(A floating pulse indicates Yang pathogens; a moderate pulse relates to the Spleen. Cold Damage with a floating-moderate pulse indicates Taiyin guest-heat. If pathogens are in the Three Yang channels, hands and feet are hot; if in the Three Yin channels, hands and feet...) Small...
When Cold Damage transforms into Yangming, the patient will have slight sweating.
(Cold Damage usually presents with no sweating, while Yangming disease usually presents with much sweating. Here, because Cold Damage involves pathogens transforming into Yangming, there is slight sweating.)
Yangming Wind Strike, with bitter taste in the mouth, dry throat, abdominal fullness, slight wheezing, fever, aversion to cold, and a floating-tight pulse. If purgation is used, abdominal fullness will worsen, and urination will become difficult.
(A floating pulse indicates the Exterior; a tight pulse indicates Interior Excess. In Yangming Wind Strike, bitter taste, dry throat, abdominal fullness, and slight wheezing indicate heat transmitting to the Interior. Fever and aversion to cold indicate...)
In Yangming disease, if the patient can eat, it is called Wind Strike; if unable to eat, it is called Cold Strike.
(In Yangming disease, the type of wind or cold invasion is distinguished by dietary intake. Since the Stomach is the Sea of Water and Grain, and Wind is a Yang pathogen that aids digestion, those with Wind Strike can eat. Cold is...)
In Yangming disease, if it is Cold Strike, the patient cannot eat, has difficulty urinating, and has slight sweating on the hands and feet. This desires to form a Guo Zha (chronic mass), and there will definitely be hard stool initially followed by loose stool. Therefore...
(In Yangming Cold Strike, inability to eat is because Cold cannot digest food. Difficulty urinating is because fluids are not transformed. Yangming disease usually has much sweating, so the whole body... Desire... Stool...)
In Yangming disease, the patient desires to eat, but urination is unexpectedly difficult, stool is normal, bones and joints ache, there is a feeling of mild fever, sudden madness occurs, and there is profuse sweating.
(Yang disease with guest-heat, just transmitted to the Stomach; Stomach heat causes digestion and desire to eat. In Yangming disease, if heat becomes Excess, urine is frequent, and stool is hard. Now... Long Qi grows in Yang; abundant grain leads to victorious Yang; heat consumes fluids, leading to less water. The Classics state: When water enters the meridians, blood is formed. Less water means weak Yin Blood. The *Jin Gui Yao Lue* states: If Yin Qi is blocked, there is bone pain. Bone and joint pain indicate insufficient Yin Qi. Heat severe at the Exterior manifests as mild fever; heat severe at the Interior manifests as steaming fever. Here, heat is scattered, not fixed solely on Exterior or Interior, hence the feeling of mild fever. Yan Hu means suddenly; sudden madness is Yin failing to overcome Yang. The *Nei Jing* states: When Yin fails to overcome Yang, pulses flow rapidly, leading to madness. If Yangming accumulates heat becoming Excess, purgation is required for cure. If heat is scattered and not Excess, recovery depends on sweating. Hence, profuse sweating leads to resolution. Equal water and grain mean balanced Yin and Yang Qi. Water failing to overcome Grain Qi means Yin failing to overcome Yang. Sweating reduces Yang Qi; a tight pulse generates Yin Qi. Balanced Yin and Yang Qi, without dominance, leads to cure. Hence, "combining with sweat," a tight pulse indicates cure.)
Yangming disease resolves from Shen hour to Xu hour.
(The fourth month is Yang; Earth prospers at Shen, You, and Xu hours. Approaching prosperity is when resolution occurs.)
In Yangming disease, if the patient cannot eat, attacking the heat will definitely cause hiccups. The reason is cold deficiency in the Stomach. Because the person is originally deficient, attacking heat will definitely cause hiccups.
(Inability to eat indicates original Cold in the Stomach. Attacking heat further weakens the Stomach; deficiency and Cold contend, causing hiccups. The Classics state: Weak Guan pulse indicates deficient Stomach Qi... Have...)
In Yangming disease, with a slow pulse, inability to eat until full, slight vexation after eating, dizziness, and definite difficulty urinating, this desires to form Gu Dan (Grain Jaundice). Even with purgation, abdominal fullness remains.
(Yangming disease with a slow pulse indicates pathogens just entered the Interior, and heat has not yet become Excess. Food enters Yin, nourishes Yang. Heat in the Stomach makes one unable to eat until full... Yellow... Grain Jaundice... Attack...)
Yangming disease usually has much sweating; if there is no sweating, and the skin feels like insects crawling, this is due to chronic deficiency.
(The Stomach is the root of fluids. Qi deficiency and low fluids lead to no sweating when ill. The Stomach governs muscles; skin feeling like insects crawling indicates chronic Stomach Qi deficiency...)
Yangming disease, with no sweating but free urination, vomiting and coughing after two to three days, and cold hands and feet, will definitely suffer from headache. If there is no coughing or vomiting, and hands and feet are not cold...
(Yangming disease usually has much sweating; no sweating with free urination indicates Cold Damage to Yangming with internal Cold attack. By Day 2-3, vomiting and coughing... Branch... Cold limbs... Also not...)
Yangming disease, with only dizziness, no aversion to cold, ability to eat, and coughing, will definitely have a sore throat. If there is no coughing, the throat will not hurt.
(Yangming disease without heavy body pain, only dizziness and no aversion to cold, is Yangming Wind Strike with internal wind attack. The Classics state: Yangming disease... If able... Stomach Qi...)
Yangming disease, with no sweating, difficulty urinating, and mental restlessness, will definitely develop jaundice.
(Yangming disease with no sweating and difficulty urinating means heat is trapped internally and cannot vent. Mental restlessness indicates heat stagnation and steaming, attempting to emerge... To become...)
Yangming disease treated with fire therapy, with slight sweating on the forehead and difficulty urinating, will definitely develop jaundice.
(Yangming disease implies internal heat. Fire therapy combines fire and heat, making it worse. If the whole body sweats and urination is free, heat vents... Cannot...)
Yangming disease with a floating and tight pulse will definitely have tidal fever occurring at specific times. If only the pulse is floating, there will definitely be night sweating.
(Floating indicates the Meridian; tight indicates Interior Excess. Floating and tight pulse indicates Exterior heat and Interior Excess. Definitely tidal fever, occurring at times. If only floating without tight...)
Yangming disease with dry mouth, desiring to rinse with water but not swallow, will definitely result in epistaxis.
(The Yangming meridian starts at the nose and connects to the mouth. Interior heat in Yangming causes thirst and desire to drink. Here, dry mouth, desiring to rinse but not swallow, indicates...)
Yangming disease, originally with sweating, treated with excessive sweating by the physician; although the illness has improved, slight vexation and unclear consciousness persist. This is because the stool must be hard. Due to fluid depletion... Soon...
(First, fluids are depleted, making stool hard and reducing urination frequency. Fluids separate, and stool will naturally pass down.)
In Cold Damage, if there is much vomiting, even if there are Yangming signs, purgation is contraindicated.
(Vomiting indicates heat in the Upper Jiao, not fully entered the Fu, so purgation is contraindicated.)
In Yangming disease, hardness and fullness in the epigastrium are contraindications for purgation. If purged and diarrhea continues uncontrollably, death ensues. If diarrhea stops, recovery occurs.
(Yangming disease with abdominal fullness indicates pathogens entered the Fu, allowing purgation. Hardness and fullness in the epigastrium indicate pathogens are shallow, not fully in the Fu, so purgation is contraindicated...)
Yangming disease with a completely red face is contraindicated for purgation. It will definitely result in fever, yellow complexion, and difficulty urinating.
(He means connected/complete. A completely red face in Yangming disease indicates heat in the Meridian. Purgation is contraindicated. Purging weakens Stomach Qi and depletes fluids. The Classics...)
In Yangming disease, without prior emesis or purgation, if there is vexation, Tiao Wei Cheng Qi Tang may be given.
(Vexation after emesis is called Internal Vexation. Vexation after purgation is called Deficient Vexation. Now, in Yangming disease, without prior emesis or purgation, vexation indicates stagnant heat in the Stomach...)
Yangming disease with a slow pulse, sweating, no aversion to cold, heavy body, shortness of breath, abdominal fullness, wheezing, and tidal fever indicates the Exterior is resolving, and purgation may be used... Exterior... Vent...
(Yangming disease with a slow pulse, if sweating is profuse with slight fever and aversion to cold, the Exterior is unresolved. If the pulse is slow, sweating occurs, and there is no aversion to cold, the Exterior syndrome... Then... Stomach Heat. The Classics state: Tidal fever indicates Excess. If heat is not tidal, Excess has not formed, so Da Cheng Qi Tang is contraindicated. Even with significant abdominal fullness and obstruction...)
Da Cheng Qi Tang Formula
Da Huang (4 liang, bitter-cold, washed with wine) Hou Po (8 qian, bitter-warm, stir-fried, bark removed) Zhi Shi (5 pieces, bitter-cold, stir-fried) Mang Xiao (3 he, salty-cold)
(The *Nei Jing* states: For dryness invading, use bitter purgatives. The bitterness of Da Huang and Zhi Shi moistens dryness and clears heat. It also states: For internal dryness, treat with bitter-warm. Hou... Flavor, with one sheng of water... Boil for one tael...)
Xiao Cheng Qi Tang Formula
Da Huang (4 liang) Hou Po (2 liang, stir-fried, bark removed) Zhi Shi (3 large pieces, stir-fried)
(For great heat and solid accumulation, give Da Cheng Qi Tang. For minor heat and slight accumulation, give Xiao Cheng Qi Tang. Because heat is not severe, Mang Xiao is removed from Da Cheng Qi Tang... Dregs.)
In Yangming disease, with tidal fever and slightly hard stool, Da Cheng Qi Tang may be given. If not hard, do not give. If no bowel movement for six to seven days, fearing dry stool... Person... Heat...
(Tidal fever indicates Excess. With slightly hard stool, purgation is permissible. If not hard, Excess has not formed; even with tidal fever, purgation is not permitted... Cannot... Attack... Hiccups... Slight...)
Excess patterns present with delirious speech; Deficient patterns present with Zheng Sheng (repetitive speech). Zheng Sheng is repetitive speech.
(The *Nei Jing* states: Pathogenic excess constitutes Excess; essence depletion constitutes Deficiency. Delirious speech arises from pathogenic excess confusing the spirit. Zheng Sheng arises from essence depletion, causing incomplete voice... Sound... If sound...)
Fixed gaze, delirious speech, wheezing and fullness indicate death. Diarrhea also indicates death.
(Fixed gaze and delirious speech indicate pathogenic victory. Wheezing and fullness indicate Qi escaping upward; diarrhea indicates Qi escaping downward. All indicate death.)
Profuse sweating, or repeated sweating, leads to Yang loss, delirious speech. A short pulse indicates death. A harmonious pulse indicates survival.
(Yang loss with Stomach dryness and delirium, with a short pulse, indicates exhausted fluids, untreatable. A harmonious pulse indicates unweakened Main Qi, suggesting potential for survival.)
In Cold Damage, if emesis or purgation fails to resolve symptoms, and there is no bowel movement for five to six days, up to ten-plus days, with evening tidal fever, no aversion to cold, and solitary speech as if seeing ghosts... But...
(Emesis and purgation both damage Stomach Qi. No bowel movement for five to six days, up to ten-plus days, indicates fluid depletion, deficient Stomach Qi, and internal binding of pathogenic heat. Yangming prospers at Shen, You, Xu hours; evening tidal fever indicates severe Yangming heat. No aversion to cold indicates Exterior syndrome has ceased. Solitary speech as if seeing ghosts indicates... Until... Is... Repeat... Down...)
In Yangming disease, if the patient sweats much, fluids exit externally, the Stomach becomes dry, stool becomes hard, and hard stool causes delirium. Xiao Cheng Qi Tang is the primary treatment. If after one dose delirium...
(Fluid depletion, Stomach dryness, hard stool, and delirium require Xiao Cheng Qi Tang even without severe internal heat binding, to harmonize Stomach Qi. After one dose, delirium...)
In Yangming disease, with delirium and tidal fever, if the pulse is slippery and rapid, Xiao Cheng Qi Tang is the primary treatment. Give one sheng of Cheng Qi Tang; if gas turns in the abdomen, administer more... Cheng Qi...
(Yangming disease with delirium and tidal fever: if the pulse is deep and solid, it is Interior Excess, allowing purgation. If the pulse is slippery and rapid, Interior heat has not formed Excess, so... Remove... Is... Big...)
In Yangming disease, with delirium and tidal fever, if the patient cannot eat, there must be dry stool (five to six pieces) in the Stomach. If the patient can eat, the stool is merely hard; Da Cheng Qi Tang is appropriate.
(Delirium and tidal fever indicate Stomach heat, which should aid digestion and appetite. Inability to eat indicates dry stool in the Stomach and Stomach Excess. Ability to eat indicates... Stomach deficiency heat being severe allows eating, differing from miscellaneous diseases. Da Cheng Qi Tang purges dry stool and removes knotted heat.)
In Yangming disease, with bleeding and delirium, this is Heat Entering the Blood Chamber. Only head sweating occurs; puncture Qi Men to drain excess. Profuse sweating then indicates resolution.
(Yangming disease, Heat Entering the Blood Chamber forces blood downward, causing bleeding and delirium. Yangming disease usually has much sweating; since blood loss precludes sweating, only head sweats... Pass... Sweat...)
Sweating with delirium indicates dry stool in the Stomach; this is Wind. Purgation is required. Wait until the meridian cycle passes before purging. Premature purging will cause chaotic speech.
(Dry stool in the Stomach causes delirium. Sweating indicates the Exterior is unresolved, hence called Wind. Dry stool in the Stomach requires purgation. Since the Exterior is not harmonized, purging is delayed... For...)
Cold Damage at four to five days, with a deep pulse and wheezing/fullness. Deep indicates Interior. Releasing sweat erroneously causes fluids to escape, making stool difficult. Exterior deficiency and Interior Excess, lasting long...
(When pathogens enter internally, a deep pulse with wheezing/fullness indicates complete Interior syndrome, requiring purgation. Erroneous sweating causes fluid escape and Stomach dryness...)
San Yang He Bing (Combined Disease of Three Yangs), with abdominal fullness, heavy body, difficulty turning, insensitivity in the mouth, dirty complexion, delirium, and urinary incontinence. Sweating causes delirium; purging causes forehead...
(Abdominal fullness, heavy body, difficulty turning, oral insensitivity, and delirium belong to Yangming. The *Zhen Jing* states: Severe Shaoyang disease presents with a dusty face; this dirty complexion... Pathogen... Cold... Internal and External...)
Er Yang Bing Bing (Concurrent Disease of Two Yangs), with Taiyang symptoms resolved, only tidal fever, profuse sweating on hands and feet, difficult stool, and delirium. Purging leads to cure; Da Cheng Qi Tang is appropriate...
(Original Taiyang disease merging into Yangming is called Concurrent Disease. Resolved Taiyang symptoms mean no Exterior syndrome. Tidal fever indicates heat merging into Yangming. Whole body sweat... Out...)
Yangming disease with a floating and tight pulse, dry throat, bitter mouth, abdominal fullness, wheezing, fever, sweating, no aversion to cold, aversion to heat, and heavy body. If sweating is induced... Diaphragm...
(Floating pulse and fever indicate pathogens at the Exterior. Dry throat and bitter mouth indicate heat in the Meridian. Tight pulse, abdominal fullness, wheezing, sweating, no aversion to cold, aversion to heat, heavy body... And confused... Table and Interior... Table Inside... To Stomach...)
If there is thirst for drinking water, dry mouth, and dry tongue, Bai Hu Jia Ren Shen Tang is the primary treatment.
(If after purgation, pathogenic heat lodges in the Upper Jiao, it is deficient vexation. Here, after purgation, pathogenic heat does not lodge in the Upper Jiao but in the Middle Jiao, causing dryness...)
If the pulse is floating, with fever, thirst for drinking water, and difficulty urinating, Zhu Ling Tang is the primary treatment.
(This is post-purgation, with guest-heat lodging in the Lower Jiao. Pathogens enter from the Exterior to the Interior, lodging in the Lower Jiao, involving heat in all three Jiaos. Floating pulse and fever indicate... Upper... Benefit... Zhu Ling Tang Formula
Zhu Ling (skin removed, sweet-neutral) Fu Ling (sweet-neutral) E Jiao (sweet-neutral) Hua Shi (crushed, sweet-cold) Ze Xie (sweet-salty-cold, each 1 liang)
(Sweetness is extreme but appears bland; bland flavor promotes drainage, belonging to Yang. The sweetness of Zhu Ling and Fu Ling promotes urination. Salty flavor induces vomiting and drainage, belonging to Yin. The salinity of Ze Xie... Ascend...)
In Yangming disease, with profuse sweating and thirst, Zhu Ling Tang is contraindicated. Because profuse sweating causes Stomach dryness, and Zhu Ling Tang further promotes urination.
(The *Zhen Jing* states: Water and grain enter the mouth, transport through the intestines and stomach, and fluids separate into five types. In cold weather with thin clothing, it becomes urine. In hot weather with thick clothing, it becomes... Sweat...)
Pulse floating and slow, Exterior heat and Interior cold, with diarrhea of undigested food, Si Ni Tang is the primary treatment.
(Floating indicates Exterior heat; slow indicates Interior cold. Diarrhea of undigested food indicates severe Interior cold. Si Ni Tang warms the Interior and dispels Cold.)
If the Stomach is cold and deficient, unable to eat, drinking water causes hiccups.
(Hiccups are ke ni. The *Qian Jin Fang* states: Ke ni is another name for yue ni. Stomach cold and deficiency, meeting water, causes water and Cold to contend, Stomach Qi rebelling... Reverse and...)
Pulse floating, fever, dry mouth and nose, ability to eat, results in epistaxis.
(Pulse floating and fever, dry mouth and nose, indicate heat in the Meridian. Ability to eat indicates Interior harmony. Heat severe in the Meridian forces blood, causing epistaxis. Stomach cold and deficiency... Yin...)
Yangming disease, after purgation, with exterior heat, warm hands and feet, no chest binding, mental restlessness, hunger but inability to eat, and only head sweating, Zhi Zi Chi Tang is...
(Exterior unresolved with purgation should lead to internal sinking of pathogenic heat. Internal sinking means no exterior heat and cold hands. Now, exterior heat with warm hands indicates... From Chest...)
Yangming disease, with tidal fever, loose stool, normal urination, and persistent chest-hypochondriac fullness, Xiao Chai Hu Tang is the primary treatment.
(Yangming disease with tidal fever indicates Stomach Excess, hard stool, and frequent urination. Now, loose stool and normal urination indicate Stomach heat has not formed Excess, and water... Grain not...)