Library

The *Huoren* (Book of Living People) states: Restlessness, manic running, delirious speech, red face, sore throat, mottled skin eruptions resembling brocade, or yellow-red diarrhea are classified as Yang Toxicity. This is because the pulse is surging and excess, or slippery or rapid; therefore, sour and bitter medicines are used for treatment.

Cheng Wuji stated: There is delirium following sweating, delirium following diarrhea, delirium following bloody stool, delirium due to heat entering the Blood Chamber, delirium due to concurrent disease of the Three Yang meridians, and delirium due to unresolved pathogen after passing through its designated period; all these are Yang syndromes. Only when excessive sweating leads to the loss of Yang Qi causing delirium should purgation be avoided; instead, Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) should be administered. This refers to delirium caused by the loss of Yang Qi due to excessive sweating in exogenous diseases.

Haizang (Zhang Yuansu) stated: Internal injury from cold pathogens can cause disordered speech. The world suspects this as delirium, but it is actually the spirit failing to reside in its abode; this is merely a Yin syndrome, characterized only by a deficient and non-excess pulse!

The *Neijing* (Classic of Internal Medicine) states: Delirium, madness, sorrow, and laughter all belong to Heat. The *Nanjing* (Classic of Difficult Issues) asserts: Red face, fondness for laughter, and vexation also belong to Heat. Generally, the pulses for such syndromes are surging and excess, with strength upon deep palpation. If the pulse for such syndromes lacks strength upon deep palpation, it indicates that Yin Qi is充盈 (abundant) internally, while Yang Qi floats externally between the skin and hair follicles; this is Fire without roots. When Yang Qi and Heart Fire float into the interstices of the skin, since the Lung governs the skin and hair, symptoms such as delirium, madness, sorrow, laughter, red face, fondness for laughter, and vexation occur. Is it merely so?

For cases involving eruptions on the chest, back, and both hands, blood-streaked saliva, or slight epistaxis, one should not treat them as Yang syndromes, but rather as Yin syndromes. Therefore, in the *Huoren*, differentiation does not rely on other factors but exclusively on the pulse; nothing is more effective than this. His words can be said to be perfectly complete and beautiful!

The *Bencao* (Materia Medica) records: Ganjiang (Dried Ginger) stops hemoptysis/sputum with blood; Liuhuang (Sulfur) treats epistaxis. Sun Simiao used Guixin (Cinnamon Bark) to treat sputum with blood.

Passing blood resembling pig liver occurs because excessive consumption of cold drinks causes extreme cold in the Spleen and Stomach, cold in the Lungs, and stagnation and coagulation in the Pericardium. The toxicity permeates and infiltrates into the Stomach and also flows downward into the Intestines. Thus, the blood passed resembles pig liver, unlike the bright red blood resulting from extreme Heat forcing blood to move recklessly. This involves the Middle Qi descending, leading to hematochezia. If the Middle Qi rebels and ascends, it leads to hematemesis or vomiting blood. This is also distinct from the bright red blood overflowing upward seen in Yang syndromes. Generally, for both Yin and Yang syndromes, upward movement manifests as vomiting, spitting, or overflowing, while downward movement manifests as defecation, bowel movements, or diarrhea. Although the names differ, the essence is the same.