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泄之 然汗出而愈
心藏神而神之魂藏于血血热则心神昏乱而作谵语但头汗出者阳盛于上而表不能闭也头上无汗则热郁血分不得外泄宜
刺期门以泄血热刺其实处而泄之令其 然汗出则愈也期门肝脉之穴在于乳上肝藏血故刺厥阴之期门（此妇人病金匮入妇
人杂病中）
阳明病欲解时从申至戍上
申酉戍阳明得令之时故解于此
阳明从燥金化气是为燥土太阴以湿土主令是为湿土脾胃以膜相连（素问语）感应最捷胃家实则燥土司气而湿以化燥
胃中虚则湿土主令而燥土亦化湿燥则阳明之证也湿则太阴之证也而化气之燥究不敌主令之湿杂证湿居其九而燥不得一盖
胃家之阳实非风寒郁为内热则不病也惟伤寒有胃家实证乃胃家之实者未能强半而胃中之虚者不止十三实则始终于阳明所
谓阳明中土无所复传承气之的证也虚则病在阳明而阳衰气退太阴脾脏将起而代秉其权是名为阳明而实则太阴无所复传者
自此而传变无穷四逆真武之证悉伏于此矣阳明为阳盛之经犹且虚实之相半况乎太阳为三阳之终少阳为三阳之始此将盛方
长之气则动入三阴未可屈指也盖脾阴胃阳胜负之机在乎中气临病而不知中气见阳明之经热昧阳明之腑冷汗下烧针孟浪错
缪中气一败祸生不测虽胃家之实攻泄之早犹且阳去而入阴矧胃中之虚汗下一误有不亡神失国而登鬼录者哉老子有言治人
事天莫若啬医家宝啬中气不肯孟浪轻泄则燥湿移易虚实贸迁金书玉诀尽在此矣
阳明病出现下血、说胡话的症状，这是热邪侵入血室的表现；如果只有头部出汗，应当针刺期门穴，随着邪气的实盛而进行泻法治疗。待患者周身濈然汗出，疾病即可痊愈。
心主藏神，而神的魂寄居于血中。血分有热会导致心神昏乱，从而产生谵语（胡言乱语）。只有头部出汗，是因为阳气亢盛于上部，导致体表毛孔不能闭合。如果头上没有汗，则热邪郁结在血分中，无法向外宣泄，适宜针刺期门穴以泄去血分之热，刺其实盛的部位进行泻法，使患者周身濈然汗出，疾病即可痊愈。期门穴是肝经的穴位，位于乳头上方。肝主藏血，所以针刺厥阴肝经的期门穴（此条原文本属于妇人病，收录于《金匮要略》妇人杂病篇中）。
阳明病欲解除的时间段是从申时到戌时。
申时、酉时、戌时是阳明经当令旺盛的时段，所以病情在此时得以缓解。
阳明经从燥金化气，表现为燥土的特性；太阴经由湿土主令，表现为湿土的特性。脾胃通过膜相连（出自《素问》），相互感应最为迅速。胃家实（胃肠实证）时，燥土之气司权，湿气转化为燥；胃中虚时，湿土之气主令，燥土之气也转化为湿。燥则表现为阳明的证候，湿则表现为太阴的证候。而在化气产生的燥性终究敌不过主令的湿性，杂病中湿证占十分之九，燥证不足一分。大概因为胃中的阳气，如果不是被风寒郁遏化为内热，就不会发病。只有伤寒病中有胃家实证，这才是真正的胃家实证，但这类情况尚不到一半，而胃中虚证却超过十三种。实证始终归属于阳明，所谓“阳明为中土，无所复传”，这是承气汤证的典型表现。虚证则病在阳明，但阳气衰微、气机退却，太阴脾脏将兴起并代替行使职权，这名义上是阳明病，实际上却是太阴病。“无所复传”的情况，从此开始变得传变无穷。四逆汤证和真武汤证都潜伏于此了。阳明是经脉中阳气极盛的经络，尚且虚实各半，何况太阳是三阳的终结，少阳是三阳的开始，这些正处于生长旺盛阶段的气机，很容易转入三阴，不可用屈指计算来预估其变化。大概脾阴与胃阳胜负的关键在于中气。临证时如果不了解中气的重要性，面对阳明经的热象或阳明腑的实证，误用冷汗法、烧针法等孟浪错误的疗法，一旦中气败坏，祸患便不可测度。即使是胃家的实证，攻下泄热过早，也会导致阳气离去而陷入阴证，更何况胃中的虚证，若误用发汗、攻下之法，岂有不导致精神丧失、如同亡国般死亡并进入鬼录（死亡）的道理吗？老子曾说：治理人事、顺应天道，没有比爱惜（啬）更好的了。医生应以爱惜中气为宝，不肯孟浪轻率地耗泄，那么燥湿就会转化，虚实就会变动，所有的珍贵医诀都包含在这个“啬”字之中了。
In Yangming disease, if there is bleeding from the lower orifice accompanied by delirium, this indicates that heat has entered the Blood Chamber (Xue Shi). If only the head sweats, puncture Qimen (LR14) and drain according to the excess. When a generalized sweating occurs, the disease will be cured.
The Heart stores the Spirit (Shen), and the Ethereal Soul (Hun) of the Spirit resides in the Blood. Heat in the Blood causes the Heart Spirit to become confused, resulting in delirium. Sweating only on the head indicates that Yang Qi is excessive in the upper part, causing the exterior pores to fail to close. If there is no sweat on the head, the heat is constrained within the Blood aspect and cannot vent outward; it is appropriate to puncture Qimen to drain the heat from the Blood, targeting the site of excess to drain it, so that generalized sweating occurs and the disease is cured. Qimen (LR14) is an acupoint of the Liver Meridian, located above the nipple. The Liver stores Blood; therefore, puncturing Qimen of the Jueyin Liver Meridian drains the Liver's stored blood heat. (This clause originally belongs to diseases in women and is included in the "Miscellaneous Diseases of Women" chapter of *Jin Gui Yao Lue*).
The time when Yangming disease tends to resolve is from Shen hour to Xu hour.
Shen, You, and Xu hours are the times when Yangming receives its command; thus, resolution occurs during these periods.
Yangming transforms qi from Dryness Metal, manifesting as Dry Earth. Taiyin is governed by Damp Earth, manifesting as Damp Earth. The Spleen and Stomach are connected by membranes (*Su Wen*), and their mutual induction is most rapid. When the Stomach House is Excess (Wei Jia Shi), Dry Earth governs the qi, and Dampness transforms into Dryness. When the Stomach Middle is Deficient, Damp Earth governs the command, and Dryness also transforms into Dampness. Dryness manifests as Yangming syndromes, while Dampness manifests as Taiyin syndromes. However, the Dryness generated by transforming qi ultimately cannot overcome the Dampness governing the command. In miscellaneous diseases, Dampness accounts for nine-tenths, while Dryness accounts for less than one-tenth. Generally, unless the Yang Qi of the Stomach House is constrained by Wind-Cold and transformed into internal heat, illness does not occur. Only in Cold Damage are there true cases of Stomach House Excess. These constitute less than half of all cases, whereas Stomach Middle Deficiency accounts for more than thirteen out of twenty. Excess conditions always remain within Yangming. This is referred to as "Yangming being the Central Earth, having nowhere further to transmit," which represents the definitive syndrome for Chengqi Decoction treatments. Deficiency conditions involve Yangming, but with declining Yang Qi and retreating energy, the Taiyin Spleen rises to assume authority. Although named Yangming, it is actually Taiyin. From this point, transmission becomes infinite. The syndromes of Sini Decoction and Zhenwu Decoction are latent here. Yangming is the meridian of extreme Yang abundance, yet it presents with both excess and deficiency equally. How much more so for Taiyang, the end of the Three Yang, and Shaoyang, the beginning of the Three Yang? These energies, just beginning to flourish, easily enter the Three Yin; their changes cannot be counted on fingers. The balance between Spleen Yin and Stomach Yang hinges on the Middle Qi. At the bedside, failing to understand the importance of Middle Qi, and treating Yangming Meridian heat or Yangming Fu-organ excess with reckless errors such as cold sweat methods or moxibustion on needles, once the Middle Qi collapses, disaster becomes unpredictable. Even if it is Stomach House Excess, purging too early may cause Yang to depart and enter Yin. How much worse, then, if the Stomach Middle is Deficient and sweating or purging is mistakenly applied? Would this not lead to the loss of Spirit, akin to the fall of a nation, resulting in death? Laozi said: "To manage human affairs and serve Heaven, nothing is better than frugality (Se)." Physicians should treasure the preservation of Middle Qi and refuse to recklessly deplete it. Then Dryness and Dampness will shift, and Excess and Deficiency will interchange. All golden books and jade secrets lie within this concept of "frugality."