典藏书目

In combined disease of the three yang channels, the pulse is floating and large, rising above the Guan position; the patient desires sleep, and sweating occurs when the eyes are closed.

This occurs when pathogenic factors from the Taiyang channel transmit to the Yangming and Shaoyang channels. The Yangming fu-organ pathology has formed, yet the pathogenic factors in the Taiyang and Shaoyang channels have not been resolved; this is termed combined disease of the three yang channels. The pulse of the Taiyang channel manifests as floating; regarding the Yangming channel, the Qi of the Gallbladder (Dan) presents at the left Guan position, and the Qi of the Stomach (Wei) presents at the right Guan position. Because the Qi of the Gallbladder and Stomach fails to descend, the two qi mechanisms reverse and ascend, causing the pulse to rise above the Guan position. Heat in the Gallbladder causes Jia Wood (Gallbladder) to overact on Earth (Spleen/Stomach), leaving the Earth qi exhausted and weak, hence the desire for sleep. In healthy individuals, during sleep, Yang Qi is stored internally. However, in combined disease of the three yang channels, Yang Qi is excessive on the exterior. During sleep, Yang Qi cannot be contained; it stagnates, steams, and opens the skin and hair pores, resulting in sweating when the eyes are closed.

If the pulse at the Yang position (Cun/Inch) is faint and sweating is slight, this indicates self-harmonization. If sweating is excessive, it indicates excess or over-treatment. If the pulse at the Yang position is solid, and sweating is profuse due to excessive diaphoresis, this also indicates excess. "Excess" here refers to Yang Qi being extremely hyperactive within the interior without opposition, leading to the loss of body fluids and consequent hardening of the stool.

The pulse is floating and Kou (hollow). Floating indicates Yang excess; Kou indicates Yin deficiency. When floating and Kou pulses interact, stomach Qi generates heat, and its Yang Qi becomes severed.

Floating indicates Yang excess failing to store; Kou indicates Yin deficiency with internal emptiness (external fullness with central hollowing is called Kou). The combination of floating and Kou signifies the external loss of Yang and the exhaustion of Yin, inevitably leading to stomach heat generation and the solitary severance of Yang Qi.

If the condition remains unresolved after inducing sweating, accompanied by abdominal fullness and pain, urgent purgation is required; Da Cheng Qi Tang (Major Order the Qi Decoction) is indicated.

Unresolved condition after sweating indicates this is not a exterior syndrome, but an excess of Yang heat in the Stomach. Sweating further depletes Yin; dry feces obstruct, and stomach fire injures the Taiyin Spleen, causing abdominal fullness and pain. Hyperactive Yang and depleted Yin lead to death; therefore, urgent purgation is necessary. These three chapters correspond mutually with the three chapters on urgent purgation in Shaoyin disease: if Yang hyperactivity in Yangming injures Yin, purging too early before Yang peaks will cause loss of Yang; purging too late after Yang has peaked will cause loss of Yin. Thus, there are methods for gentle purgation and provisions for urgent purgation. This shares the same principle as the chapter in Shaoyin disease regarding "abdominal distension and inability to defecate after six or seven days."

In Yangming disease, if fever and profuse sweating occur, urgent purgation is required; Da Cheng Qi Tang (Major Order the Qi Decoction) is indicated.

The Kidney governs the five fluids, which transform into sweat upon entering the Heart. Fever with profuse sweating leads to the withering of Liver Wood and drying of Spleen Earth, subsequently injuring the Shaoyin Kidney water; therefore, urgent purgation is required. This shares the same principle as the chapter in Shaoyin disease regarding "dry mouth and throat."