太阳经证解

Significance of Taiyang meridian

按太阳一经，以寒为本（太阳之上，寒气主之，故也）。少阴为中气（肾与膀胱为表里），太阳为标（主外，是本经之标、本、中三气也）。太阳一经为病，有经病（本经自病），有伤风症（经症中之兼证），有伤寒症（经症中之兼症），有两感症（经症中之兼症），有腑症（太阳中之里症）。腑症之中，又有蓄尿症、蓄热症、蓄血症、癃闭症（腑症中恒有之病也）。不可不知也。

The nature of the Taiyang meridian is Cold (In the Taiyang layer, it is the Cold dominates). Shaoyin is its Middle Qi (The Kidney belongs to the Shaoyin layer, and the Urine bladder belongs to the Taiyang. The Kidney and the Urine Bladder is the couple relationship). The Taiyang is the surface layer. When the Taiyang meridian is in disorder, the disorder might be in the meridian (this meridian per se is in disorder), Wind-invasion condition, Cold-invasion condition, or the disorder can be in both the Taiyang and in other meridian, or it is in its hollow organ (the Urine Bladder). Among the Urine bladder, there might be either the urine-accumulation condition, hot-accumulation condition, blood-accumulation condition, or the urine-block conditions. The readers should know this.

经症者何？脉浮、头项强痛、恶寒，发热是也。

What is the disorder in the meridian per se? It is the floating pulse, pain and stiff in the head and neck, chilly and fever.

（经病情形）兼自汗而恶风者，则为伤风症，是太阳之卫分为风邪所伤也，主以桂枝汤，协和营卫，驱风邪外出，浅一层立法也，服此方而若解则病愈（此刻节令之气寒，客风亦寒，故曰风寒。寒气即是风气，风气即是寒气。仲景以风寒冠旨（旨字应是首字、校正），一示厥阴循环之意，一示风轮主持大世界之意，风字宜活看）。

If the meridian disorder is accompanied by self-sweat and dislike wind (or air conditioning), it is the Wind-invasion syndrome/condition. It means that the Taiyang layer of the body has been invaded by the Wind factor (the disease-causing factor). The main herbs need to be used is the Guizhi Tang, to harmony the Ying Qi and the Wei Qi in and out of the blood. This is the principle for a mild disorder. (At this movement, the sub-step of the season is the Cold, the invading Wind factor is also Cold, so it is called Wind-Cold invation. The Cold Qi is the Wind Qi, so the Wind Qi is the Cold Qi. Master Zhang Zhongjing use the Wind-Cold on the top title, first he means that the Yueyin is in a circle (the Yueyin dominates the Wind); second, he means the Wind turns the world to run. The word “Wind” should be understood as such, in a dynamic and flexible way.

经症而兼无汗者，则为伤寒症，是太阳之营分为寒邪所伤也，主以麻黄汤，大开腠里，俾营分之寒邪，尽从汗出，深一层立法也。服此方而若解，则病愈（此际若不知发汗，则病进从实；若过发汗，则症变从虚；若妄下，则症变从误）。

If the meridian disorder is not accompanied by self-sweat, it is called Cold-invasion condition. It means that the Taiyang layer is invaded by the disease-causing Cold factor. The main herbs needed are the Mahuang Tang, to open the hole in the skin, to create sweat, to let the invaded Cold factor out of the body through the sweat. This is the principle for a relatively severe condition. (At this movement, if the sweat therapy is not used, the disease will go deeper and becomes severe; if the sweat therapy is overdone, the body will become weak; if the bowel-cleansing therapy is used, it is a big mistake, a lot of bad conditions will happen.).

经症而兼壮热烦躁脉浮紧者，则为两感症，是太阳之营卫，为风邪寒邪所伤也。主以大青龙汤，营卫两解，风寒并驱，又深一层立法也。服此方而若解，则病愈（两感症，又有一日太阳，而与少阳同病，亦名两感症。三阳症与三阴症同见，亦名两感，用药即当解表温经，再看表里重轻。以上兼症三法，系本经恒有之候，非传经之谓也。传经法详附解）。设若不解，不传经则必传腑（传经则现经症，传腑则现腑症）。

If the meridian disorder is accompanied by high fever, highly annoyed, irritable, with floating and tight pulse, it is called coupled common-cold. It is due to the Ying Qi and the Wei Qi of the Taiyang layer has been invaded by the Wind and the Cold factors. In such condition, the herbs used would be mostly the Da Qinglong Tang, to solve the disorder in both the Ying and the Wei Qi and to remove both the Wind and the Cold out of the body. The is treatment principle for more severe conditions. (In the literature, the coupled common-cold can also refer to the following conditions: when the disorders are in both the  Taiyang and the Shaoyang stages; when the three Yang conditions, e.g. the Taiyang, Shaoyang and the Yangming stages, is accompanied by either of the three Yin conditions, such as the Taiyin, Shaoyin or the Jueyhin stages. For such various coupled common-cold, the treatment principle should be to solve the surface invasion, and warm the meridian, depending on the severity of the surface and the inside disorders. The Wind-invasion, the Cold-invasion and this coupled common cold are the fixed and specially associated conditions for the Taiyang stage. It does not mean that they are passed from other meridians or other stages of the disease. The rule of the disorders passing from other meridian will be introduced later. If the disorder is not solved, it will not pass to the other meridians but to its own hollow organ (the Urinary bladder).

腑症者何？口渴而小便不利是也。是邪由太阳之经，而转入太阳之腑也，主以五苓散，化太阳之气。气化一行，小便亦利，邪亦可从此而出，病亦可从此解矣（此处便是太阳首尾界限）。

What’s the clinic manifestation for the invasion into the Urinary bladder? It will show thirsty and non-smooth urination (difficult in urination). This is the disease-causing Cold turns from the meridian into the inside associated organ. . In this case, main herbal formula needed is the Wuling San. This herbs work to warm and support the Taiyang Qi. Once the Qi is enough in the Taiyang layer, the Qi would move forward to guide the urine out of the body. At the same time, the disease-causing Cold Qi will also move out of the body along with the urine. The disease is then solved. (Here is the end of the Taiyang layer).

至于腑症之中，另有蓄尿一症（病形小腹满，便短赤不利，口渴），盖膀胱乃储水之区，今为寒气所束，太阳之气微，不足以胜其寒邪之气，气机于是乎不运矣，气机一刻不运，则所储之水，即不能出，势必上涌，而小腹作满，故名之曰蓄尿，主以五苓倍桂。桂本辛温，力能化太阳之寒气，气化一行，小便得出，病亦立解，此法中之法也。

Among the inside organ disorders, there is one called urine-accumulation syndrome. (The patient has fullness in the lower abdomen, the urine is short, harsh, with strong red-brown color and thirsty). This is because the Urinary bladder is the space to hold the water. It is now suppressed, folded by the Cold factor, which makes the Taiyang Qi weak. The water accumulated cannot go out, will spill up, causing fullness in the lower abdomen. In this case, the herb Wuling San (plus more Guizhi in it) is used. The herb Guizhi belongs to warm in herbal nature. It works to dissolve the Cold invaded. Once the Taiyang is released from the Cold, the Taiyang Qi is moving again, the urine will go out of the body and the disorder is then solved.

另有蓄热一症（病形小腹不满，口渴溺赤），由寒邪入腑，从太阳之标阳而化为热。热甚则必涸其所注之水，故小腹不满而便不利，故名之曰蓄热，主以五苓去桂，加滑石以清利其热。热邪一去，腑自立安，亦法中之法也。

Another inside organ disorder is called hot-accumulation syndrome in the Urinary bladder. (The patient has no fullness in the lower abdomen, but has thirsty and the urine is red in color.). It is due to the invasion of the Cold into the Urinary bladder. The Cold turns, following the surface hot nature of the Taiyang layer, into hot and fire. If the fire is overwhelming, it will burn off the water in the Urinary bladder, so that the lower abdomen is not in fullness but the urine is harsh to pass, so it is called Hot-accumulation syndrome in the Taiyang stage. The Main herbs are still the Wuling San, but the Guizhi in it should be taken away, but add Huashi to deplete the accumulated hot. Once the Hot is removed, the Urinary bladder is relaxed.

另有蓄血一症（病形小腹硬满），缘由寒邪入腑，阻其太阳之气机，而循行本经之血液，失其常度，不得归经，流入腑中，聚而不散，少腹硬满，故名之曰蓄血，主以五苓散中，加桃仁、红花、当归、万年霜之类，从小便以逐其瘀，即可移危为安，皆不易之法也。

For the Blood-accumulation syndrome in the Taiyang stage, the patient has fullness and hard lower abdomen. It is due the invasion of the Cold, which blocks the Taiyang Qi movement, causing the blood that circulates in the Taiyang layer loses its normal way of circulation, fails to return to the meridian, so flows into the inside Urinary bladder. It is accumulated in the Urinary bladder without moving out, so the lower abdomen is full and hard. So it is called the Blood-accumulation syndrome. The main herbs used are also the Wuling San, but need to add some other herbs, such as Taoren, Honghua, Dangui, Wannianshuang, etc. to move the stagnated blood out of the Urinary bladder.

另有癃闭一症，与热结膀胱不同。热结者，尿常可出一二点，此则胀翻出窍，尿不得出，由三焦气机不运，水道壅塞太甚，法宜升提，俾壅者立开（此下陷从上治法也），尿即得出，病亦可解，此皆不易之法也（此太阳一经，经腑症形如是，至于传经，详附解）。

Another clinic syndrome in the Taiyang disorders is the Urine-stop syndrome. It is different from the Hot-accumulation syndrome above. In the Hot-accumulation syndrome, the patient can still urinate little urine. In this Urinary-stop syndrome, the lower abdomen is very full, there is no any urine out. This condition is due to the block of the whole three Jiao, the water pathway is fully blocked. The principle in the treatment should be to increase the Qi (This mean to solve the shrinking condition by using the rising therapy).

附解：太阳经，有经症初见，不传本经之腑，而传阳明、少阳，三阳经症同见者，名三阳并病，即以三阳之法治之，如桂枝汤加葛根、柴胡是也。

Appendix: For disorders in the Taiyang stage, if the disorder shows just in the meridian level, not passes into its own inside (the urinary bladder), but passes into other meridian layer, such as in the Yangming or Shaoyang layers, or the disorders show in all of the three Yang meridians, it would be called the Three-Yang meridian disease. It should be treated as the three Yang stages, using herbs, such as the Guizhi Tang, plus Gegeng and/or Chaihu.

有经症初见，传阳明而不传少阳者，名二阳为病，即以二阳之法治之，如桂枝加葛根汤是也。又有三阳经症同见，而见太阴之腹满自利，即于三阳表药中，合理中之法治之。

If the disease is just shown in the Taiyang meridian, it passes into the Yangming stage, but not to the Shaoyang stage, it is called Two-Yang disease. It should be treated with the special herbs for the two Yang stages, such as Guizhi jia Gegeng Tang. In another condition, there are the evidence for the three Yang stages, but also that for Taiyin (one of the Yin stages), it is needed to add some herbs, such as the Lizhong Tang, for the Yin condition, among the herbs for the Yang conditions.

有经症初见，转瞬而见少阴之身重欲寐者，肾与膀胱为表里，表病而及里也，当从少阴之法治之，如麻黄附子细辛汤是也。至于当汗而不汗，表里不通，壮热烦躁者，大青龙是也。

There is clinic condition, in which the evidence for the Taiyang stage just showing up, soon there is the evidence for the Shaoyin stage, such as heavy body, like to lie down for rest. This is the passing of the surface disease (the Taiyang stage) into the inside layer (the Shaoyin stage), since the Kidney and the Urine bladder is the surface-inside couple system. In this case, the treatment principle is to solve the Shaoyin stage, using herbs, such as Mahuang Fuzi Xixin Tang. If the patient should have sweat, but not sweat, showing block from the surface and the inside, use herbs such as Da Qinglong Tang.

经症误下遂利者，桂枝加葛根汤是也（误下邪陷于内，故加葛根以举之）。过汗而至汗不止者，桂枝加附子汤是也。下后而至脉促胸满者，桂枝去芍药汤是也。

If the bowel-cleansing therapy is misused, causing diarrhea, use Guizhi jia Gegen Tang (the bowel-cleansing therapy causes shrink of the Yang Qi, so use the Gegen to rise the Yang Qi). If the sweat therapy has been used improperly, causing over-sweat, use Guizhi jia Fuzi Tang. If the bowel-cleansing therapy causes fullness in the chest and fast pulse, use Guizhi qui Shaoyao Tang.

仲景之法，总在活法圆通，并无死法，方方皆有妙义，轻重大有经权，学者先将六经提纲病情熟记于心，方能见病知源。六经所主气机乃为本，客气所生乃为病，客气往往随主气而化为病，故一经一经病形不同，虽云伤寒二字冠首，因寒在子，故也。

The principle introduced by Master Zhang Zhongjing, is very flex and reasonable, not at all fixed. Every formula has smart idea in it. The ingredient, the dose of each herbs, and how to give the herbs for drink, all bear big meaning. Readers need to remember and study the Six-stage theory carefully, so to know the reason upon seeing a disease. The Qi that each meridian/stage dominates is the root, and the base. A disease is caused by invasion of disease-causing factor/Qi from outside to each stage. The out-coming Qi usually follows the nature of the original Qi in each stage to cause different clinic manifestation. Therefore, the clinic manifestations in each meridian/stage are different. Though in the book Shanghan Lun, it is titled Shanghan, simply because the Cold starts in the Zi zone (11 pm to 1 am). 

【阐释】癃闭症只说法宜升提，未有处方，宜用补中益气汤治之。癃闭还有由于湿热下注，或瘀血内结，膀胱气化不利而致之实症；亦有因肾气亏损、膀胱气化无权，水液不能下注之虚症。实症小便量少、热赤、频急、而滴沥不畅，甚至尿闭不通，小腹胀满，或疼痛、口渴、便秘、苔黄腻、脉滑、数，宜清利湿热，宜猪苓汤或八正散加减治之。虚症小便滴沥不爽，排出无力，甚或不通，面白、腰冷、舌质淡、脉沉细，宜补肾温阳通窍，以济生肾气丸加减治之。

Explanation: In the urine-stop syndrome (in the Taiyang stage), it has mentioned to solve the problem by rising therapy, but did not give herb formula. It might need the herb Buzhong Yiqi Tang. Other reasons can also cause the urine-block syndrome, such as the flowing down into the bladder the Wet-Hot; the blood stagnation; the urine bladder Qi fails to dominate the urine, the water cannot flow out of the body (belongs to a weak condition). For a real condition, the urine is short, hot, red in color, frequent and hurry to go to washroom, drop by drop, even block completely, the lower abdomen is full or pain, thirsty, constipation, yellow tongue cover, slipper and frequent pulse. The principle of the treatment should be to clear hot and wetness, using Zhuling Tang or Bazhen San (plus or minus some herb ingredients). For weakness condition, the patient has harsh urine, weak to pass the urine, or even no energy to pass the urine at all. The face is pale, the lower back is cold, the tongue is light white in color, the pulse is deep and thin. The principle for the treatment should be to support the kidney, warm Yang Qi and open the urine, using Jishen ShenQi Wan.