2a. Six Jing diagnosis –Taiyang
Dr. Martin Wang
The Six Jing
diagnosis system was introduced from book
Shanghan Lun, more than 2000 years ago by Dr. Zhang Zhongjing. In
Traditional Chinese medicine (TCM), he is called the Master in
Shanghan Lun describes
the principle in the diagnosis and treatment of Wind- and
Cold-attacked disease. The word Shanghuan means a disease that
is caused by the Wind and the Cold. (The external factors that
cause a disease is called
Xieqi in TCM. Here, the Wind, the Cold is such
Xieqi). It actually also discussed, though not indicated clearly,
the principle in the diagnosis and treatment of a Wen disease (Wen
here means an epidemic disease with fever).
The Six Jing
diagnosis system separates a disease into six stage, step,
phase, or level. From the beginning, the shallow and light stage
of the disease to its later stage, they are named Taiyang Bing,
Yangming Bing, Shaoyang Bing, Taiyin Bing, Shaoyin Bing, and
Jueyin Bing. The word Bing here means a disease. We can
understand it as a stage, a step, a phase, and a level.
to diagnose the Taiyang Bing is: floating pulse, strong pain in
the head and on the neck, and chilly feeling.
The pulse is
floating. The Xieqi
attacks the body surface layer, so that the pulse is floating.
If the patient feels chilly, and has headache, but the pulse is
deep, it will not belong to the Taiyang stage, it is in the
Shaoyin stage. We should be careful with this distinguish. The
floating pulse needs to be distinguished with the big pulse.
has strong headache and pain on the neck. In fact, the pain can
be also on the lower back, on the back of the leg, all along the
distribution of Taiyang meridian. Sometimes, the pain is on the
heel. For College style doctor, they would tend to consider the
heel pain is due to kidney deficiency. In the Jing Fang style,
especially when the patient has floating pulse and chilly, they
will consider it as Taiyang disease.
patient feels cold, dislikes cold and wants to cover more for
warm. In this case, even if his/her body temperature reaches 40
ºC, we still pay attention to the chilly feeling, not the fever.
The patient may feel chilly or cold on the whole body, or only
on and around the shoulder, or only on the back of the body
somewhere. It can last for several hours or only several
seconds. In clinic, as a TCM doctor, we must remember to ask the
patient if he/she has such chilly feeling.
the Taiyang stage of the Shanghan disease, we must remember to
exclude the Wen disease, especially its early stage too.
Patients in the early stage of the Wen disease, such as SARS,
H1N1 flue, etc., have fever very soon after get the sick. The
patient feels hot, very thirsty, and has strong sweat. The
patient likes to stay in cold room, or drink cold water, but
hate hot or warm. If a patient has such feelings, we should
consider that the patient must
has a Wen disease. Actually, the clinic manifestations of the
Wen disease is pretty much same as the second stage of the
Shanhan disease: the Yangming stage, in which the patient also
feels hot, has fever, strong sweat, thirsty, not dislikes cold
but dislikes hot. For the treatment, the herbs used for the
Yangming stage can also be used for the treatment of Wen
disease. For this reason, we believe that the idea is not
correct that the Jing Fang style (the
Shanghan Lun style)
cannot be used for the treatment of Wen disease.
stage of Shanghan disease can be further more separate into a
Cold-attacked Taiyang syndrome (we also call it Mahuang Tang
syndrome), Wind-attacked Taiyang stage (Guizhi Tang syndrome),
Xiao Qinglong Tang syndrome, Da Qinglong Tang syndrome, and
Gegen Tang syndrome, and so on. This is because the difference
in the body reaction to the same kind and same level of
In the Mahuang
Tang syndrome, the patient has no sweat (the person usually is
hardly to have sweat), while the Wind-attacked Guizhi Tang
syndrome, the patient sweat easily. For the former, we use
Mahuang Tang, while for the later; we use Guizhi Tang for the
treatment. The person who can be treated with Mahuang Tang is
those who do not sweat easily, but easy to have local floating
phenomenon in the body surface, such as swelling in the lips of
the eyes, in the hands or feet.
The person who
should be treated with Guizhi Tang is usually slim in body
shape, easy to sweat.
The person who
should be treated with Xiao Qinglong Tang (Xiao means small) is
those who has poor digestive function, easy to have bloating in
stomach, has nausea, fever and cough. He/she may have diarrhea,
stock feeling in throat, difficulty in urination, bloating in
lower stomach, or has asthma.
For the Da
Qinglong Tang syndrome, the patient usually has hot-fire feeling
inside the body. The person feels hot in the body and likes to
drink cold or ice water. Such person can be found easily among
western people. For them, after getting the Shanghan disease,
they feel thirsty and annoyed, such inside fire phenomenon, as
well body surface syndromes.
who should be treated with Gegen Tang is those who are strong in
muscle mass, such as labor workers and athletics. Upon attacked
by the Shanghan disease, they frequently have pain in front of
head, onset of sinus problem, and pain on the back of the neck.
of Taiyang stage:
accumulation in urinary bladder.
In the Taiyang
stage, patient has chilly feeling and headache. The patient also
feels bloating in the lower stomach area and has difficulty in
urination. This is due to the
Xieqi invasion into
the urinary bladder. For the treatment, the sweat therapy is
still the first thing needed to release the
Xieqi out of the body.
After that, if the patient still feel bloating in the lower
stomach, and has difficulty in urination, use Taohe Cheng Qi
Tang to expel remaining Hotness
Xieqi from the urinary
(2). Blood accumulation in the
If the patient has chilly, headache, panic, bloating feeling in the lower
stomach, but no difficulty in urination, and his/her pulse feels
deep-weak, or deep-entangled, this condition belongs to blood
accumulation in the urinary bladder. In this case, Di Dang Tang
is used for the treatment.
The above is the principle for the diagnosis and treatment of
the Taiyang stage of Shanhan disease. The reader only needs to
remember the point for the diagnosis: floating pulse and dislike
cold feeling, no matter the patient has fever or not. The
floating pulse and the cold-dislike feeling fixes the diagnosis
on the Taiyang stage already. For those of doctors who graduated
from TCM schools may pay attention to whether the fever is more
or the cold-dislike feeling is more severe or intense. In the
Six meridian diagnosis systems here, it is not needed at all.
For how to tell the pulse is floating, reader has to consult an
experienced TCM doctor and to practice to feel it by himself. It
is hard to learn TCM only from the book or the seminar.
If the disease is in the Taiyang stage and if the diagnosis is
correct and the treatment is proper, the recovery is very fast.
The patient could feel much better after even several hours.
Such recovery means radical and complete. Not like the healing
by the use of antibiotics or cortisone products, which could
delay the recovery and the recovery usually
needs several days.
We use herbal granules. That means the herbs have been cooked,
extracted and dried into powder form. Upon use, you only need to
add water to the granules to dissolve and to drink it on spot.
We normally let client drink the herbal tea first, then use
acupuncture. If the herbal formula is the right one, the patient
can tell the healing effect of the herbs after 20 min. This can
be repeated by reader yourself. If you have a patient who
suffers from hot feeling, heavy sweat and thirsty, you can let
him/ her drink herbal tea of Baihu Jia Rensheng Tang. You can
see if he/she feels cooler, less sweat and less thirsty after 20
The main therapies for the Taiyang stage, the body surface
syndrome, are the sweat therapy (using Mahuang Tang series), the
Yin-Wei Harmony therapy (Guizhi Tang series), the
surface-releasing and inside water-expelling therapy (Xiao
Qinglong Tang series), the muscle-relaxing therapy (Gegeng Tang
series) and surface-releasing and inside fire-reducing therapy (Da
Qinglong Tang series). For the ingredients or the herbal
formulae, and the function of each ingredient in the formulae,
we will discuss later. In addition, there are special
requirements for the use of each herbal formula in clinic. If
the herbs are used improperly, there definitely will be side
effects or even make the disease worse – Healthcare is not easy
industry. This will also be discussed later.
If the Xieqi (the
disease-causing energy entity) invades the Shaoyang and Yangming
phases the same time, or if the
Xieqi has already
invaded into the deeper phase, which is
the Yangming or the Shaoyang phase, but there are still
some left in the Taiyang phase, there would be the co-exist of
the Taiyang-Shaoyang, the Taiyang-Yangming, or even the
Taiyang-Shaoyang-Yangming phases. For the diagnosis and
treatment of the two Yang phases, or the three Yang phases, we
will also discuss in later articles.
This series of articles introduce the
Shanghan Lun after re-organize its chapters, not introduce
or explain it according to its original paragraph. It can also
be regarded as simplified introduction of
Shanghan Lun. Readers
who have studied Shanghan
Lun before should not feel strange for this. Some
paragraphs, though introduced in a chapter for a given disease,
function there as for a distinguish aim. It actually does not
belong to that given chapter. For example, herbal Si Ni San was
listed in the Jueyin chapter (for the Jueyin disease), but it
actually should belong to Shaoyang chapter. It was listed in the
Jueyin chapter for distinguish with Si Ni Tang and Danggui Si Ni
Tang – we believe so. Sometimes, a paragraph tells about the
treatment of conditions that were due to improper treatment with
suggested original herb formula. For example, herbal formula
Zhizi Chi Tang was listed in the chapter for Taiyang stage, but
it is for the treatment of annoyed feeling and poor sleep that
happened after a sweat therapy, vomiting therapy or
colon-cleansing therapy. Or, it is for the treatment of annoying
hotness feeling with choking feeling in chest. Such choking
feeling in chest apparently belongs to Yangming stage. We will
talk about the reason for this later too.
In next articles, we will discuss the diagnosis and treatment of
Yangming stage of Shanghan disease. Thanks very much for your
patience and interest to our seminar.
Millwoods Acupuncture Center is
located in Edmonton, Alberta, Canada and serves Edmonton
surrounding area, including: St. Albert, Big
Lake, Spruce Grove, Stony Plain, Devon, Beaumont, Sherwood Park,
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