（胃实不大便 自汗 不得卧 潮热 谵语 狂乱 循衣摸床 渴 呕）
黄 阳明之为病胃家实是也谓之正阳阳明属下证轻则大柴胡汤重则大小承气汤此邪自阳明经传入腑者经曰阳
明病
脉迟虽汗出不恶寒者其身必重短气腹满有潮热者此欲解可攻里也手足 然汗出者此是大便已硬也大承气汤主之若汗多
微发热恶寒者外未解也其热不潮未可与承气汤若腹满不通者可与小承气汤微和胃气勿令大泄下谓阳明亦有在经者未全
入腑犹宜解外纵有大满大府不通亦不过小承气汤微下之入胃在经犹宜两审也其阳明一证少有自病多因太阳传入兼与太
阳阳明合病用葛根汤者是也少阳阳明合病用黄芩芍药汤者是也自少阳传入阳明及未合并病者亦然阳明经治法有汗吐下
温和解刺
汗 桂枝汤 麻黄汤 五苓散（此亦作汗剂） 麻黄连翘赤小豆汤
吐 栀子豉汤
下 调胃承气汤 大承气汤 抵当汤 麻仁丸 茵陈蒿汤 小承气汤
温 吴茱萸汤 四逆汤
和解 白虎汤 白虎加人参汤 猪苓汤 小柴胡汤 蜜导煎 猪胆汁 土瓜根 栀子柏皮汤
刺 热入血室刺期门
问曰病有太阳阳明有正阳阳明有少阳阳明何谓也答曰太阳阳明者脾约是也（经曰趺阳脉浮而涩浮则胃气强涩则小便
数浮涩相搏大便则难其脾为约麻仁丸主之 太阳病三日发汗不解蒸蒸发热者属胃也调胃承气汤主之）正阳阳明者胃家实
是也少阳阳明者发汗利小便已胃中躁烦热大便难是也（宜小承气汤微溏之盖少阳复不可下也按本草大黄酒浸入太阳经酒
洗入阳明经病之高下全在酒之多少以引之耳又按太阳阳明正阳阳明承气汤中俱用酒浸惟少阳阳明为下经故小承气汤中
不用酒浸也以此推之则太阳阳明当用调胃承气汤盖以调胃承气既附在太阳篇中而大黄下注曰酒浸正阳阳明当用大承气
其大黄注曰酒洗少阳阳明当用小承气汤不惟大黄不用酒浸洗而少阳禁汗下故去芒硝之峻剂而且当少少与之也书此以驳
成氏之误又须识太阳阳明脾约丸少阳阳明又可大柴胡也又有说在不大便之条）问曰何缘得阳明病答曰太阳病发汗若下若
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此名阳明也（成 本太阳病不解因发汗利小便亡津液胃中干燥
太阳之邪入腑转属阳明古人登厕必更衣不更衣者通为不大便不更衣则胃中物不得泄故为内实胃无津液加之蓄热大便则
难为阳明里实也）伤寒脉浮而缓手足自温者是系在太阴太阴者身当发黄若小便自利者不能发黄至七八日大便硬者为阳明
病也（成 浮为阳邪缓为脾脉伤寒脉浮缓太阴客热邪在三阳则手足热邪在太阴则手足温邪在少阴厥阴则手足寒今手足自
温是知系在太阴也太阴土也为邪蒸之则色见于外当发身黄小便自利者热不内蓄不能发黄至七八日大便硬者即太阴之邪
入腑转属阳明也）阳明病若能食名中风不能食名中寒（成 阳明病以饮食别受风寒者以胃为水谷之海风为阳邪阳气杀谷
故中风者能食寒为阴邪阴邪不杀谷故伤寒者不能食）阳明病但头眩不恶寒故能食而咳其人必咽痛若不咳者咽不痛（按目
眩之眩其字从目从玄谓其眼中黑暗也头眩之眩当作若药不瞑眩之眩训之谓眩愦乱也谓其头岑岑然愦乱而不宁也凡书皆
当活看不可拘执成 阳明病身不重痛但头眩而不恶寒者阳明中风而风气上攻也经曰阳明病若能食名中风风邪攻胃胃气
上逆则咳咽门者胃之系咳甚则咽伤故必咽痛若胃气不逆则不咳其咽亦不痛也 胃气主呕肺气主咳成氏以胃气上逆则咳
恐非盖风邪侵肺也肺虽不为足经肺主气风为气类）阳明病不能食攻其热必哕所以然者胃中虚冷故也以其人本虚故攻其热
必哕（成 不能食胃中本寒攻其热复虚其胃虚寒相搏故令哕也经曰关脉弱胃气虚有热不可大攻之热去则寒起此之谓也）
阳明病脉迟食难用饱饱则微烦头眩必小便难此欲作谷疸虽下之腹满如故所以然者脉迟故也（成 阳明病脉迟则邪方入里
未化为热也胃中有寒食难用饱饱则微烦而头眩者谷气与寒气相搏也寒热相搏必小便难利者不能发黄言谷热得泄也小便
不利则谷气酝酿成热不得泄出身必发黄胆黄也以其发于谷气之热故名谷疸热实者下之则愈脉迟为寒故虽下之只益其寒
腹满亦不减也经曰脉迟尚未可攻）阳明病欲解时从申至酉止（阳明燥 金旺于申酉戌向旺时是为欲解）伤寒呕多虽有阳
明证不可攻也（见呕）阳明病面合赤色不可攻攻必发热色黄小便不利也（成 合通也阳明病面色通赤者热在经也不可下
之下之虚其胃气耗其津液经中之热乘虚入胃必发热色黄小便不利也 张 夫阳明病理必近于可下但以面赤其热犹在经
故云不可攻若攻之则经中之热悉入于胃郁蓄而发黄色譬如下之太早成结胸之类）阳明病心下硬满者不可攻之攻之利遂不
止者死利止者愈（阳明病腹满者为邪气入腑可下之心下硬满则邪气尚浅未全入腑不可便下之得利止者为邪气去正气安正
气安则愈若因下利不止者为正气脱而死 尚浅浅字不如高字）
（胃中实热导致的大便不通、自汗、无法安卧、潮热、说胡话、狂乱、抓摸衣被床沿、口渴、呕吐）
阳明病的特征，就是“胃家实”，这被称为正阳阳明。它属于里证（腑证）。病情轻的，用大柴胡汤；病情重的，用大承气汤。这是邪气从阳明经传入腑的情况。经文说：阳明病，脉迟，虽然有汗出但不恶寒，身体必定沉重，短气，腹部胀满，有潮热的，这是可以攻里的时机。如果手足濈然汗出，这是大便已经硬结的表现，用大承气汤主治。如果汗多，微发热且恶寒，说明表证未解，不可攻里。如果发热不呈潮热状，也不可给予承气汤。如果腹部胀满不通，可以给予小承气汤，轻微调和胃气，不要令其剧烈泻下。这说明阳明病也有在经的情况，尚未完全入腑，仍宜解表。即使有大满大腑不通的情况，也不过是用小承气汤轻微通下。邪气入胃或在经，都应当仔细审察。阳明病这一类，很少是自身直接发病，多因太阳病传入所致。兼与太阳病合病的，用葛根汤治疗；兼与少阳病合病的，用黄芩芍药汤治疗。从少阳传入阳明以及尚未合并其他病证的，情况也是如此。阳明经的治疗方法包括汗、吐、下、温、和、解、刺等法。
汗法：桂枝汤、麻黄汤、五苓散（这也作为发汗剂使用）、麻黄连翘赤小豆汤。
吐法：栀子豉汤。
下法：调胃承气汤、大承气汤、抵当汤、麻仁丸、茵陈蒿汤、小承气汤。
温法：吴茱萸汤、四逆汤。
和解法：白虎汤、白虎加人参汤、猪苓汤、小柴胡汤、蜜导煎、猪胆汁、土瓜根、栀子柏皮汤。
刺法：热入血室，针刺期门穴。
问：病有太阳阳明、正阳阳明、少阳阳明，这是什么意思？
答：太阳阳明，是指脾约证。（经文说：趺阳脉浮而涩，浮则胃气强，涩则小便数，浮涩相搏，大便则难，其脾为约，用麻仁丸主治。太阳病经过三天，发汗后病不解，蒸蒸发热的，属于胃实证，用调胃承气汤主治。）
正阳阳明，就是胃家实。
少阳阳明，是指发汗或利小便后，胃中躁扰烦热，大便困难的情况。（宜用小承气汤轻微通便。因为少阳病也不可妄用下法。按本草记载，大黄酒浸则入太阳经，酒洗则入阳明经。病位的高下全在于酒的多少来引导。又按，太阳阳明和正阳阳明在承气汤中都使用酒浸大黄，唯独少阳阳明因为是下经，所以小承气汤中不用酒浸大黄。以此推断，太阳阳明应当用调胃承气汤，因为调胃承气汤附在太阳篇中，且大黄注解说酒浸；正阳阳明应当用大承气汤，其大黄注解说酒洗；少阳阳明应当用小承气汤，不仅大黄不用酒浸洗，而且少阳禁汗下，所以去掉芒硝这种峻烈之品，并且应当少量给予。写下这些以驳斥成无己的错误。另外必须知道，太阳阳明的脾约丸，少阳阳明也可以用大柴胡汤。另有说法见於不大便的条目中。）
问：为什么会得阳明病？
答：太阳病发汗，或者误下，或者利小便，导致津液亡失，胃中干燥，因而转属阳明。如果不解大便，内实，大便困难的，这就叫阳明病。（成无己注：本为太阳病，因发汗、利小便导致津液亡失，胃中干燥。太阳之邪入腑，转属阳明。古人上厕所必更衣，不更衣就是指通常的大便不通。不更衣则胃中的食物残渣不得排泄，故为内实。胃中无津液，加之蓄积热邪，大便则难，成为阳明里实证。）
伤寒病，脉浮而缓，手足自然温暖，这是病系在太阴。太阴病的人应当发黄，如果小便自利，则不能发黄。到了七八天，大便变硬的，就转为阳明病了。（成无己注：浮为阳邪，缓为脾脉。伤寒脉浮缓，若客热在三阳，则手足热；邪在太阴，则手足温；邪在少阴、厥阴，则手足寒。如今手足自温，可知病系在太阴。太阴属土，被邪气蒸迫，颜色见于外，应当发身黄。如果小便自利，热不内蓄，不能发黄。到了七八天大便硬，即是太阴之邪入腑，转属阳明。）
阳明病，如果能进食，名叫中风；如果不能进食，名叫中寒。（成无己注：阳明病通过饮食情况辨别受风寒者，因为胃是水谷之海。风为阳邪，阳气能消化谷物，所以中风者能食。寒为阴邪，阴邪不能消化谷物，所以伤寒者不能食。）
阳明病，仅头眩，不恶寒，所以能食且咳嗽，其人必定咽痛。如果不咳嗽，咽就不痛。（按：目眩的“眩”字从目从玄，指眼中黑暗。头眩的“眩”应当作如药物瞑眩之“眩”，解释为昏愦混乱。指头部岑岑然昏乱而不安宁。凡书籍都应灵活看待，不可拘执。成无己注：阳明病身体不重痛，仅头眩且不恶寒，这是阳明中风，风气上攻。经文说阳明病若能食名中风。风邪攻胃，胃气上逆则咳。咽门是胃的系联，咳甚则咽伤，所以必定咽痛。如果胃气不逆，则不咳，咽也不痛。胃气主呕，肺气主咳。成氏认为胃气上逆则咳，恐怕不对，应该是风邪侵肺。虽然肺不是足经，但肺主气，风为气类。）
阳明病不能进食，如果攻其热，必定发生哕逆。之所以这样，是因为胃中虚冷。因为病人原本体虚，所以攻其热必定导致哕逆。（成无己注：不能食是因为胃中本寒，攻其热又使胃更虚，虚寒相搏，所以令哕逆。经文说：关脉弱，胃气虚，有热不可大攻。热去则寒起，说的就是这个道理。）
阳明病，脉迟，吃东西难以吃饱，饱了则轻微心烦、头眩，必定小便难，这是将要发作谷疸。即使用了下法，腹部胀满依然如故。之所以这样，是因为脉迟的缘故。（成无己注：阳明病脉迟，说明邪气刚入里，尚未化为热。胃中有寒，食物难以吃饱。饱了则轻微心烦头眩，是谷气与寒气相搏。寒热相搏，必定小便难。如果小便通利，则不能发黄，说明谷热得以泄出。小便不利，则谷气酝酿成热，不得泄出，身体必定发黄，即胆黄。因其发于谷气之热，故名谷疸。如果是热实证，下之则愈。但脉迟为寒，所以即使下之，只会增加其寒，腹满也不会减少。经文说：脉迟，尚未可攻。）
阳明病欲缓解的时间，是从申时到酉时止。（阳明燥金旺于申、酉、戌时，向旺之时是为欲解。）
阳明病，面色通红，不可攻下。攻下必定发热、色黄、小便不利。（成无己注：合即通。阳明病面色通赤，说明热在经，不可下。下之则虚其胃气，耗其津液，经中之热乘虚入胃，必定发热、色黄、小便不利。张元素注：夫阳明病理必近于可下，但以面赤，其热犹在经，所以说不可攻。若攻之，则经中之热悉入于胃，郁蓄而发黄色，譬如下之太早而成结胸之类。）
阳明病，心下硬满的，不可攻下。攻下后利遂不止的，死；利止的，愈。（阳明病腹部胀满是邪气入腑，可下。心下硬满则是邪气尚浅，未全入腑，不可便下。得利止者为邪气去，正气安，正气安则愈。若因下法导致利不止，为正气脱而死。尚志斋注：浅字不如高字好。）
(Stomach excess with constipation, spontaneous sweating, inability to sleep, tidal fever, delirium, mania, grasping at clothes and bedrails, thirst, vomiting)
The characteristic of Yangming disease is "stomach family excess" (Wei Jia Shi), which is called Zheng Yang Yangming. It belongs to the interior syndrome (Fu organ syndrome). For mild cases, Da Chai Hu Tang (Major Bupleurum Decoction) is used; for severe cases, Da Cheng Qi Tang (Major Order the Qi Decoction) is used. This occurs when pathogenic factors transmit from the Yangming meridian to the Fu organs. The classic text states: In Yangming disease, if the pulse is slow, there is sweating but no aversion to cold, the body will be heavy, there is shortness of breath, abdominal fullness, and tidal fever. This indicates that the interior can be purged. If there is continuous sweating on the hands and feet, this indicates that the feces have hardened; Da Cheng Qi Tang (Major Order the Qi Decoction) should be administered. If there is profuse sweating, slight fever, and aversion to cold, the exterior has not yet resolved, and purgatives should not be used. If the fever is not tidal, Cheng Qi Tang formulas should not be given. If there is abdominal fullness and obstruction, Xiao Cheng Qi Tang (Minor Order the Qi Decoction) may be given to mildly harmonize the stomach qi, avoiding drastic purgation. This shows that Yangming disease can also remain in the meridian stage before fully entering the Fu organs, and exterior resolution is still appropriate. Even with significant fullness and obstruction, only a mild purgation with Xiao Cheng Qi Tang (Minor Order the Qi Decoction) is needed. Whether the pathogen is in the stomach or the meridian, careful examination is required. Yangming disease rarely arises spontaneously but is often transmitted from Taiyang disease. When combined with Taiyang disease, Ge Gen Tang (Kudzu Decoction) is used; when combined with Shaoyang disease, Huang Qin Shao Yao Tang (Scutellaria and Peony Decoction) is used. The same applies to transmission from Shaoyang to Yangming or cases without combined syndromes. Treatment methods for Yangming meridian diseases include diaphoresis, emesis, purgation, warming, harmonizing, resolving, and acupuncture.
Diaphoresis: Gui Zhi Tang (Cinnamon Twig Decoction), Ma Huang Tang (Ephedra Decoction), Wu Ling San (Five-Ling Powder) [also used as a diaphoretic], Ma Huang Lian Qiao Chi Xiao Dou Tang (Ephedra, Forsythia, and Red Bean Decoction).
Emesis: Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction).
Purgation: Tiao Wei Cheng Qi Tang (Regulate the Stomach and Order the Qi Decoction), Da Cheng Qi Tang (Major Order the Qi Decoction), Di Dang Tang (Wait-Until-It-Settles Decoction), Ma Ren Wan (Hemp Seed Pill), Yin Chen Hao Tang (Capillaris Decoction), Xiao Cheng Qi Tang (Minor Order the Qi Decoction).
Warming: Wu Zhu Yu Tang (Evodia Decoction), Si Ni Tang (Reverse the Cold Decoction).
Harmonizing/Resolving: Bai Hu Tang (White Tiger Decoction), Bai Hu Jia Ren Shen Tang (White Tiger Plus Ginseng Decoction), Zhu Ling Tang (Polyporus Decoction), Xiao Chai Hu Tang (Minor Bupleurum Decoction), Mi Dao Jian (Honey Suppository), Pig Gallbladder Juice, Tu Gua Gen (Trichosanthes Root), Zhi Zi Bo Pi Tang (Gardenia and Phellodendron Bark Decoction).
Acupuncture: For heat entering the blood chamber, puncture Qi Men (LR 14).
Question: There are Taiyang Yangming, Zheng Yang Yangming, and Shaoyang Yangming. What do these mean?
Answer: Taiyang Yangming refers to Pi Yue (Spleen Constriction) syndrome. (The classic text states: At the foot yang position, the pulse is floating and choppy. Floating indicates strong stomach qi; choppy indicates frequent urination. The interaction of floating and choppy pulses leads to difficult defecation, constraining the spleen; Ma Ren Wan (Hemp Seed Pill) is indicated. After three days of Taiyang disease, if sweating fails to resolve the condition and there is steaming fever, it belongs to the stomach; Tiao Wei Cheng Qi Tang (Regulate the Stomach and Order the Qi Decoction) is indicated.)
Zheng Yang Yangming is Wei Jia Shi (Stomach Family Excess).
Shaoyang Yangming occurs after sweating or diuresis, leading to dryness, restlessness, heat in the stomach, and difficulty in defecation. (Xiao Cheng Qi Tang (Minor Order the Qi Decoction) should be used to mildly induce stool, as Shaoyang disease contraindicates harsh purgation. According to Materia Medica, Rhubarb soaked in wine enters the Taiyang meridian, while Rhubarb washed in wine enters the Yangming meridian. The depth of the disease is guided by the amount of wine. Furthermore, Taiyang Yangming and Zheng Yang Yangming use wine-soaked Rhubarb in their Cheng Qi Tang formulas, whereas Shaoyang Yangming does not, as it is a lower meridian. Thus, Taiyang Yangming should use Tiao Wei Cheng Qi Tang (Regulate the Stomach and Order the Qi Decoction), as noted in the Taiyang chapter where Rhubarb is wine-soaked. Zheng Yang Yangming should use Da Cheng Qi Tang (Major Order the Qi Decoction), where Rhubarb is wine-washed. Shaoyang Yangming should use Xiao Cheng Qi Tang (Minor Order the Qi Decoction); since Shaoyang contraindicates sweating and purging, Scutellaria is removed along with the harsh Magnolia Bark, and it should be given in small doses. This refutes Cheng Wuji's errors. Note that Taiyang Yangming's Pi Yue can be treated with Pi Yue Wan, and Shaoyang Yangming can use Da Chai Hu Tang (Major Bupleurum Decoction). Further discussion is found under the section on constipation.)
Question: How does one contract Yangming disease?
Answer: If Taiyang disease is treated with sweating, purgation, or diuresis improperly, body fluids are depleted, the stomach becomes dry, and the disease transforms into Yangming. If one does not defecate, internal excess develops, and defecation is difficult; this is named Yangming disease. (Cheng Wuji notes: Originally Taiyang disease, improper sweating or diuresis depletes fluids, causing stomach dryness. The Taiyang pathogen enters the Fu organs and transforms into Yangming. Ancients changed clothes when using the toilet; "not changing clothes" implies general constipation. Without defecation, stomach contents cannot be expelled, leading to internal excess. Lack of stomach fluids plus accumulated heat makes defecation difficult, resulting in Yangming interior excess.)
In Shanghan (Cold Damage), if the pulse is floating and slow, and the hands and feet are naturally warm, the disease is associated with Taiyin. Taiyin patients typically develop jaundice; however, if urination is normal, jaundice will not occur. By the seventh or eighth day, if the stool hardens, it has transformed into Yangming disease. (Cheng Wuji notes: Floating indicates pathogenic heat; slow indicates the Spleen pulse. In Shanghan, a floating-slow pulse suggests external heat. If in the Three Yang meridians, hands and feet are hot; if in Taiyin, they are warm; if in Shaoyin or Jueyin, they are cold. Warm hands and feet indicate association with Taiyin. Taiyin is Earth; when steamed by pathogenic heat, yellow color appears externally, causing jaundice. Normal urination prevents heat accumulation and jaundice. By day seven or eight, hard stool indicates Taiyin pathogen entering the Fu organs and transforming into Yangming.)
In Yangming disease, if the patient can eat, it is called Zhong Feng (Wind Strike); if they cannot eat, it is called Zhong Han (Cold Strike). (Cheng Wuji notes: Food intake distinguishes wind vs. cold in Yangming because the stomach is the sea of water and grain. Wind is a Yang pathogen that aids digestion, so those struck by wind can eat. Cold is a Yin pathogen that hinders digestion, so those struck by cold cannot eat.)
In Yangming disease, if there is only dizziness, no aversion to cold, ability to eat, and coughing, the throat will surely hurt. If there is no coughing, the throat will not hurt. (Note: "Xuan" in eye dizziness implies darkness in vision. "Xuan" in head dizziness implies confusion/disorientation, like drug-induced vertigo. The head feels heavy and unsettled. Texts should be interpreted flexibly. Cheng Wuji notes: Yangming disease with no body heaviness, only dizziness and no aversion to cold, is Yangming Zhong Feng, with wind pathogen attacking upward. The classic text says Yangming patients who can eat have Zhong Feng. Wind attacks the stomach, causing stomach qi to rebel upward, leading to coughing. The throat is connected to the stomach; severe coughing injures the throat, causing pain. If stomach qi does not rebel, there is no cough and no throat pain. Stomach qi governs vomiting; Lung qi governs coughing. Cheng's view that stomach rebellion causes coughing is likely incorrect; it is probably wind invading the Lung. Although the Lung is not a Foot meridian, it governs Qi, and wind is related to Qi.)
If a Yangming patient cannot eat and heat is attacked/purged, hiccups (Yue) will certainly occur. This is because the stomach is deficient and cold. Since the patient is originally deficient, attacking the heat will cause hiccups. (Cheng Wuji notes: Inability to eat indicates original stomach cold. Attacking heat further damages the stomach; deficiency and cold interact, causing hiccups. The classic text states: A weak Guan pulse indicates deficient stomach qi; even with heat, harsh purgation is forbidden. Removing heat leaves cold behind, which is what this describes.)
In Yangming disease, if the pulse is slow, the patient finds it difficult to eat until full. Upon eating too much, there is slight irritability, dizziness, and difficulty urinating. This is about to become Gu Dan (Grain Jaundice). Even if purged, abdominal fullness remains unchanged. This is due to the slow pulse. (Cheng Wuji notes: A slow pulse in Yangming indicates pathogen entering the interior but not yet transforming into heat. Cold in the stomach makes overeating difficult. Overeating causes slight irritability and dizziness due to interaction between grain qi and cold. Interaction of cold and heat leads to difficult urination. If urination is free, jaundice does not occur as grain heat is released. If urination is obstructed, grain heat brews and cannot escape, causing jaundice (Dan Huang). Named Grain Jaundice due to heat from grain. If it were heat excess, purgation would cure it. But a slow pulse indicates cold; purgation increases cold, so abdominal fullness does not decrease. The classic text states: With a slow pulse, purgation is not yet indicated.)
Yangming disease tends to resolve from Shen hour (3-5 PM) to You hour (5-7 PM). (Yangming Dry Metal is prosperous during Shen, You, and Xu hours; resolution occurs as it approaches prosperity.)
In Shanghan, if vomiting is frequent, even if Yangming symptoms are present, purgation is contraindicated. (See Vomiting section.)
In Yangming disease, if the face is completely red, purgation is contraindicated. Purgation will lead to fever, yellow complexion, and difficulty urinating. (Cheng Wuji notes: "He" means complete. Complete facial redness indicates heat in the meridian, not suitable for purgation. Purgation damages stomach qi and depletes fluids, allowing meridian heat to enter the stomach, causing fever, yellow color, and urinary difficulty. Zhang Yuansu notes: Yangming pathology usually approaches the need for purgation, but facial redness indicates heat remains in the meridian, hence purgation is forbidden. Purgation drives meridian heat into the stomach, causing郁accumulation and yellow color, similar to early purgation leading to Jie Xiong (Chest Binding).)
In Yangming disease, if there is hardness and fullness in the epigastrium (Xin Xia), purgation is contraindicated. If purgation is performed and diarrhea continues unceasingly, death ensues; if diarrhea stops, recovery occurs. (Abdominal fullness indicates pathogen in the Fu organs, suitable for purgation. Epigastric hardness/fullness indicates pathogen is shallow and not fully in the Fu organs, so purgation is premature. If diarrhea stops, pathogen is gone and healthy qi is restored, leading to recovery. If diarrhea continues after purgation, healthy qi collapses, leading to death. Shang Zhi Zhai notes: "Shallow" is better understood as "high" or superior.)