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Zhang Zhongjing said: There are diseases of Taiyang-Yangming, Zhengyang-Yangming, and Shaoyang-Yangming. What does this mean? The answer is: Taiyang-Yangming refers to Pi Yue (Splee Confinement). Zhengyang-Yangming refers to Wei Jia Shi (Stomach House Excess). Shaoyang-Yangming refers to the condition where, after sweating or promoting urination, there is dryness, irritability, excess in the stomach, and difficulty in defecation. Question: How does one contract Yangming disease? Answer: When a Taiyang disease is treated with sweating, purgation, or promoting urination, body fluids are depleted, leading to dryness in the stomach. Consequently, it transforms into Yangming, characterized by internal excess and difficulty in defecation; this is called Yangming disease. Question: What are the external manifestations of Yangming disease? Answer: Fever of the body, spontaneous sweating, aversion to cold is absent but aversion to heat is present.

Commentary: These three types of Yangming syndromes all result from the transmission from meridians to fu-organs, representing excess patterns of the Stomach House. "Taiyang-Yangming" implies that pathogenic factors transmit from the Taiyang meridian to the Stomach; its name is Pi Yue (Splee Confinement), characterized by frequent urination and hard stools. "Zhengyang-Yangming" implies that pathogenic factors transmit from the primary Yangming meridian to the fu-organ, resulting in pathogenic excess in the Stomach. "Shaoyang-Yangming" implies that pathogenic factors transmit from the Shaoyang meridian to the Stomach. The Stomach, as a fu-organ, is like a storehouse; the term "Fu" means gathering. Since the Stomach belongs to Earth and is the destination for all things, once pathogens enter the Stomach, they do not transmit further. They stagnate and generate heat. This arises from the depletion of body fluids and dryness in the stomach, or from unresolved heat pathogens of the Three Yang meridians transmitting from meridians to fu-organs, forming heat accumulation. Therefore, pathogens entering the Yangming Stomach fu-organ are called excess pathogens. The Qi of Earth (Spleen and Stomach) is affected by pathogens and is vigorous during the Wei (1-3 PM) and Shen (3-5 PM) hours; thus, tidal fever at dusk belongs to Yangming. The Treatise states: Tidal fever indicates excess; this is a syndrome suitable for purgation. It also states: Tidal fever indicates that the exterior is resolving, and the interior can be attacked. It further states: If the fever is not tidal, Chengqi Decoction should not be administered. From this, it is known that such tidal fever belongs to the Stomach. However, although tidal fever is an indication for attack, if the pulse is floating and tight, or if urination is difficult, stools are loose, and there is fever without sweating, it indicates that the heat pathogen has not fully entered the fu-organ and still belongs to the exterior pattern; harmonization should still be employed. If pathogens are in the exterior and wrongly purged, disaster will follow immediately.

Cheng Wuji said: The Stomach is the sea of water and grain, primarily nourishing the surrounding organs. Therefore, diseases in surrounding organs can all transmit to the Stomach; once in the Stomach, they do not transmit further. For example, if Taiyang disease transmits to the Stomach, it does not transmit to Yangming; if Yangming disease transmits to the Stomach, it does not transmit to Shaoyang; if Shaoyang disease transmits to the Stomach, it does not transmit to the Three Yin meridians.