问曰何缘得阳明病答曰太阳病若发汗若下若利小便此亡津液胃中干燥因转属阳明不更衣内实大便难者是名阳明也
阳明病来自太阳者多少阳者少阳盛之人太阳病感汗下利水亡其津液以致胃中干燥因而转属阳明燥热内实大便坚硬此
名为阳明也
本太阳病初得时发其汗汗先出不彻因转属阳明也
太阳病汗出透彻则表解而里气亦达若汗出不彻表邪未解腑热郁生因而转属阳明也
二阳并病太阳初得病时发其汗汗先出不彻因转属阳明续自微汗出不恶寒若太阳病证不罢者不可下下之为逆如此可小
发汗设面色缘缘正赤者阳气拂郁在表当解之薰之若发汗不彻不足言阳气拂郁不得越当汗不汗其人烦躁不知痛处乍在腹中
乍在四肢按之不可得其人短气但坐以汗出不彻故也更发汗则愈何以知汗出不彻以脉涩故知也
病传阳明之腑而太阳表证未罢谓之二阳并病以太阳初病发汗不彻经热内蒸因而转属阳明续自微汗出而不恶寒便是腑
热作矣腑热宜下若太阳表证不罢者不可下下则表阳内陷此之谓逆如此可小发汗以泄其表设表邪外盛面色缘缘正赤者此阳
气拂郁在表不得出路郁蒸头面之故当内解外薰令其透彻不得小汗以致邪留若发汗不彻阳气拂郁不得外越其人胃气内遏必
至烦躁又觉疼痛其痛不知其处或在腹中或在四肢按之绝不可得而且隧路壅阻呼吸短气凡此诸证皆坐以汗出不彻故也更发
其汗则愈此何以知是汗出之不彻以其脉涩故知之也涩者阳郁而不滑利也拂郁抑郁之意汉书邹阳传太后拂郁泣血楚辞七谏
沉江心拂郁而内伤 薰法以盆盛滚水入被热薰取汗最捷宜于下部用之
问：为什么会得阳明病？
答：太阳病如果经过发汗、攻下或利小便治疗，导致津液耗损，胃中干燥，从而转化为阳明病；如果不解大便，体内实热积聚，大便困难，这就叫做阳明病。
阳明病来自太阳病的，是因为少阳之气旺盛的人，在患太阳病时，经过发汗、攻下、利水等治疗，耗伤了津液，致使胃中干燥，因而转化为阳明病，出现燥热内盛、大便坚硬的证候，这称为阳明病。
原本患有太阳病，刚发病时就进行发汗，但汗出得不透彻，因而转化为阳明病。
太阳病若汗出透彻，则表邪解除，里气也能通达；如果汗出不透彻，表邪未解，腑热郁结而生，因而转化为阳明病。
二阳并病（太阳与阳明同时患病），太阳病初起时发汗，但汗出不透彻，因而转化为阳明病；随后持续有微汗出，且不恶寒。如果太阳病的证候尚未完全消除，不可使用攻下法，误用攻下属于逆治。这种情况下，可以小量发汗。假如病人面色通红，这是阳气拂郁在体表，应当采用解表熏蒸的方法。如果发汗不彻底，不足以使阳气拂郁得以宣发，本该发汗而未发透，病人会出现烦躁，不知道疼痛的具体位置，有时在腹部，有时在四肢，按压也找不到痛点，并且呼吸短气，只能静卧。这都是因为汗出不透彻的缘故。再次发汗就会痊愈。怎么知道是汗出不透彻呢？通过脉象涩滞就可以知道。
病邪传入阳明之腑，而太阳表证仍未消除，称为“二阳并病”。因太阳病初起发汗不彻底，经热内蒸，因而转化为阳明病；随后持续微汗出且不恶寒，这就是腑热发作的表现。腑热适宜用攻下法，但如果太阳表证未除，不可攻下，否则会导致表阳内陷，这叫作逆治。这种情况可以小量发汗以泄其表。假设表邪外盛，面色通红，这是阳气拂郁在体表，没有出路，郁积蒸腾于头面所致，应当内外兼治（内服解表药配合外部熏蒸）使其透彻，不能仅靠小汗以免邪气滞留。如果发汗不彻底，阳气拂郁不能向外宣越，病人的胃气受到内部遏制，必然导致烦躁，又感觉疼痛，疼痛部位不确定，或在腹中，或在四肢，按压也找不到，而且经络阻塞，呼吸短气。所有这些症状都是因为汗出不透彻造成的。再次发汗就会痊愈。怎么知道这是汗出不透彻呢？因为脉象涩滞所以知道。涩脉意味着阳气郁结而不滑利。“拂郁”即抑郁之意，《汉书·邹阳传》中有“太后拂郁泣血”，《楚辞·七谏·沉江》中有“心拂郁而内伤”。熏法是用盆盛装滚水，让人在被子里受热熏蒸以取汗，效果最快，适宜用于下部病症。
Q: What is the cause of Yangming disease?
A: If Taiyang disease (disease of the Taiyang channel) is treated with sweating, purging, or promoting urination, it may lead to the depletion of body fluids and dryness in the stomach. Consequently, it transforms into Yangming disease. If the patient fails to defecate, internal excess heat accumulates, and defecation becomes difficult, this is termed Yangming disease.
Yangming disease originating from Taiyang disease occurs because individuals with vigorous Shaoyang qi (vital energy of the Shaoyang channel), when suffering from Taiyang disease and undergoing sweating, purging, or water-draining treatments, lose their body fluids, causing stomach dryness. This leads to a transformation into Yangming disease, characterized by internal dryness-heat and excess, resulting in hard stools; this is called Yangming disease.
In original Taiyang disease, if sweating is induced at the very beginning but the sweat is not thorough, it may transform into Yangming disease.
If sweating in Taiyang disease is thorough, the exterior pathogen is resolved, and the interior qi flows freely. However, if sweating is incomplete, the exterior pathogen remains unresolved, and heat stagnates in the fu organs, leading to a transformation into Yangming disease.
When both Yang channels are involved (Er Yang Bing - simultaneous Taiyang and Yangming disease), and sweating was attempted at the onset of Taiyang disease but was incomplete, transforming into Yangming disease, followed by continuous slight sweating and absence of aversion to cold: if the Taiyang exterior syndrome has not yet ceased, purging must not be used; using purging in this case is a contraindicated error (ni). In such situations, mild sweating should be induced. If the patient's face is persistently red, it indicates that yang qi is constrained and stagnant in the exterior. Treatment should involve resolving the exterior through fumigation. If sweating was incomplete, failing to allow the constrained yang qi to vent, and the necessary sweating was not achieved, the patient will experience irritability, pain with no fixed location (sometimes in the abdomen, sometimes in the limbs), which cannot be pinpointed by pressure, along with shortness of breath and an inability to lie down comfortably. All these symptoms result from incomplete sweating. Re-inducing sweating will lead to recovery. How do we know the sweating was incomplete? We know this from the choppy pulse (se mai).
When the disease transmits to the Yangming fu organs while the Taiyang exterior syndrome persists, it is called "Er Yang Bing." Due to incomplete sweating at the onset of Taiyang disease, meridian heat steams inward, transforming into Yangming disease. Continuous slight sweating without aversion to cold indicates the manifestation of fu-organ heat. Fu-organ heat is suitable for purging; however, if the Taiyang exterior syndrome is not resolved, purging is forbidden, as it causes the exterior yang to sink inward, which is termed a contraindicated error. Mild sweating can be used to release the exterior. If the exterior pathogen is strong and the face is persistently red, it signifies yang qi constrained in the exterior with no outlet, steaming upward to the head and face. Internal medication combined with external fumigation should be used to ensure thorough resolution, avoiding mere slight sweating that might leave pathogens behind. If sweating is incomplete, preventing the constrained yang qi from venting outward, the stomach qi is internally obstructed, leading to irritability and wandering pain (in the abdomen or limbs) that cannot be located by pressure, accompanied by blocked meridians and shortness of breath. All these conditions stem from incomplete sweating. Re-inducing sweating will cure the condition. How do we know it is due to incomplete sweating? Because the pulse is choppy. A choppy pulse indicates yang qi constraint and lack of smooth flow. "Fuyu" means depression or stagnation. The *Book of Han* mentions "The Empress Dowager was depressed and wept blood," and the *Chu Ci* states "Heart depressed and internally injured." The fumigation method involves placing boiling water in a basin and allowing the patient to sit under a blanket to be heated by the steam to induce sweat; this is most effective and suitable for lower-body conditions.