典藏书目

After six or seven days of Taiyang disease (Disease of the Bladder and Small Intestine channels), if the eyes are blurry and unable to see clearly, and the eyeballs lack flexibility, without exterior syndrome (symptoms indicating pathogenic factors on the body surface) or interior syndrome (symptoms indicating pathogenic factors within the organs), with difficult defecation and slight fever, this is an excess pattern. Urgent purgation is required, and Da Cheng Qi Tang (Major Order the Yellow Decoction) is indicated.

The liver opens into the eyes. Blurry vision and inflexible eyeballs indicate that Stomach fire has damaged the blood of the Jueyin Liver channel, causing liver blood depletion and drying up the eye system (the meridians connecting the eyes to the brain), resulting in stiff eyeballs fixed in one direction. In the absence of exterior signs (such as aversion to cold and fever) and interior signs (such as abdominal fullness and pain), although the body heat is slight, the heat in the fu organs is severe; therefore, urgent purgation is necessary. The principle here is identical to that of Shaoyin disease (Disease of the Kidney and Heart channels) characterized by spontaneous diarrhea of clear water, purely green in color. Yangming disease (Disease of the Stomach and Large Intestine channels) is characterized by "fullness and excess in the stomach." The text mentions using purgatives when the pulse is excess because of deficiency at the exterior and excess at the interior. Here, it states internal excess and simply excess, both elucidating the meaning of "fullness and excess in the stomach."

In Yangming disease, if a patient suffers from forgetfulness, there must be accumulation of blood (stasis). This occurs because there is long-standing blood stasis, which causes forgetfulness. Although the stool is hard, it is surprisingly easy to pass, and its color must be black. Di Dang Tang (Di Dang Decoction) is indicated for purging (the formula is found in Chapter 45 of the Taiyang section).

Hun (Ethereal Soul) knows what comes next, while Po (Corporeal Soul) stores what has passed. The Lung governs Po and generates Water; Kidney Water hibernates and secures the Yang Spirit, allowing past events to be stored and remembered. Dry-heat damages the blood, causing stasis and obstruction, blocking the path for the Yang Spirit to descend and hibernate. As Yang leaks and the spirit flies away, and Water Essence loses its storage, forgetfulness ensues. This indicates blood stasis in the lower jiao (lower burner), damaging the winter-storage function of the Kidney. The heat is in the Blood Sea (Uterus/Blood reservoir) and does not affect the Large Intestine directly, hence defecation is easy. Black represents the depression of Water Qi; Kidney Water is depressed in the lower jiao, causing feces to appear black. Di Dang Tang is indicated to purge the accumulated blood.

If a patient presents with neither exterior nor interior syndromes but has had fever for seven to eight days, even if the pulse is floating and rapid, purgation may be used. If purgation has been administered but the rapid pulse persists, and combined heat leads to efficient digestion and frequent hunger, followed by no bowel movement for six or seven days, this indicates blood stasis. Di Dang Tang is indicated (the formula is found in Chapter 45 of the Taiyang section). If the pulse remains unresolved and diarrhea becomes incessant, it will likely result in pus and blood in the stool due to heat forcing the bleeding.

The patient lacks the aversion to cold of an exterior syndrome and the abdominal fullness/pain of an interior syndrome, yet has had fever for seven to eight days, indicating definite interior heat. Even if the pulse is floating and rapid, purgation can be employed. Although floating and rapid pulses typically indicate exterior patterns, the absence of exterior symptoms means they should not be interpreted as such. If purgation has been used but the rapid pulse persists, and combined exterior-interior heat causes efficient digestion and hunger, leading to no bowel movement for six or seven days, this is not Stomach heat but blood stasis. The rapid pulse indicates interior heat; since purgation failed to resolve the rapid pulse, the interior heat was not cleared. This heat resides not in the Qi aspect of the Middle Jiao but in the Blood aspect of the Lower Jiao. Di Dang Tang is indicated to purge the blood stasis. If, after taking Di Dang Tang, the rapid pulse persists and is accompanied by incessant diarrhea, it signifies deep injury to the Blood aspect, which will combine with external heat to cause dysentery with pus and blood.