Chapter 2, Jing, Wetness, Ye, their pulse, clinic manifestations

Chapter 2, Jing, Wetness, Ye, their pulse, clinic manifestations and treatment

病者，身热足寒，颈项强急，恶寒，时头热，面赤，目赤，独头动摇，卒口噤，背反张者，痉病也。若发其汗者，寒湿相搏，其表益虚，即恶寒甚，发其汗已，其脉如蛇。[1]

It is called a Jing disease, if the person feels hot in the body, but cold in feet, strong tightness on the neck, chilly, and from time to time he feels hot on the head and red in the face, with red blood vesicles in the eyes, shaking on the head (only on the head), sudden tight jaw so that it is hard to open the mouth, the back reverse bend.

The pulse suggests the Jing disease: tight as string from the Chun to Chi position.

太阳病发热无汗，反恶寒者，名曰刚痉。太阳病发热汗出，而不恶寒，名曰柔痉。

In Taiyang stage, if the person has fever and sweat, and chilly, it is called Roujing[2] disease.

太阳病，无汗而小便反少，气上冲胸，口噤不得语，欲作刚痉，葛根汤主之。

In Taiyang stage, the person has no sweat and the urine is unexpectedly short, he has air pushing-up feelin to the chest, the mouth is tight and hard to open to speak, all of the conditions suggests the onset of a Gangjing disease, use Gegen Tang.

痉为病，胸满口噤，卧不着席，脚挛急，必齘齿，可与大承气汤。

For the Jing disease, the person feels fullness in the chest, tight in mouth, the body bends so it is hard to lie in a platen body condition on the bed, spasm in the feet. He will also bit his teetch. Use Da Chengqi Tang.

大黄（四两，酒洗）厚朴（半斤，炙，去皮）枳实（五枚，炙）芒硝（三合）

Dahuang (washed with liquor) 60 gram, Houpo (processed, remove skin), 60 gram, Zhishi (processed) 72 gram, Manxiao 30 gram.

右四味，以水一斗，先煮二物，取五升，去滓，内大黄，煮取二升，去滓，内芒硝，更上火微一二沸。分温再服，得下止服。

Add Houpo, Zhishi, and 2500 ml water into a herbal pot. Bring to boil then keep in mild boiling until there is 1250 ml water in it left. Remove the residue, add the Dahuang continue to boiling until there is 500 ml left. Add the Manxiao in, bring to mild boiling for minutes until it is dissolved. Separate it into several parts. Drink one part. Wait for one to two hours see if there is bowel movement. If yes, stop to drink. If not, drink another part until there is bowel movement.

太阳病其证备，身体强，几几然，脉反沉迟，此为痉，栝蒌桂枝汤主之。

In Taiyang stage, the clinic conditions meet the need for the diagnosis of the Taiyang stage, the person’s body is tight, and his pulse is deep and slow, it is a Jing condition. Use Gualu Guizhi Tang.

栝蒌根（二两），桂枝（三两），芍药（三两），甘草（二两），生姜（三两），大枣（十二枚）

Guolugen 30 gram, Guizhi 45 gram, Shaoyao 45 gram, Gancao 30 gram, fresh ginger 45 gram, Chinese date 12 badges.

右六味，以水九升，煮取三升。分温三服，取微汗。汗不出，食顷，啜热粥发之。

Add the herbs and 2250 ml of water into a herbal pot. Bring to boil and keep in mild boiling until there is about 750 ml liquid left. Collect the herbal tea. Drink one third of the tea each time, three times a day, to create a mild sweat. If there is no sweat after half to one hour, eat a bowl of rice soup to help the sweat.

In Taiyang stage, if the person has fever and if his pulse is deep and thin, it is called Jing disease, it is hard to treat.

If a disease is caused by Wind -invasion, the person is given a bowel-cleansing therapy, followed by a sweat therapy, he will have muscle spasm.

In Taiyang stage, if the person is given a sweat therapy and he sweats a lot, he will have the Jing condition.

~~暴腹胀大者~~，若发其汗者，寒湿相搏，其表益虚，即恶寒甚，发其汗已，其脉如蛇为欲解，脉如故，反伏弦者，痉。[3]

No only with the Wind disease, but also with the Cold and Wetness disease, more sweat therapy will deplete the defense Qi from the body to cause the Jing disease. After sweat, if the pulse is as snake moving, it indicates an improvement of the Jing disease. IF the pulse is the same, or even deep and string, he is to have the Jing disease.

For a person with ulcer in skin, he should not be given sweat therapy even if he has pain in the body, otherwise he will has the Jing condition.

If the person has Jing disease and an ulcer due to a moxibustion, it is hard to treat his Jing disease.

It is the Wetness disease, if the person has pain in whole body, has fever and the skin is dark yellow.

湿家，病身疼发热，面黄而喘，头痛鼻塞而烦，其脉大，自能饮食，腹中和无病，病在头中寒湿，故鼻塞，纳药鼻中则愈。

For Wetness people[4], if he has sweat on head[5], stiffness in back, likes to be covered and likes to face fire, to early application of bowel-cleansing therapy will cause burping and fullness in chest and difficulty in urine. If his tongue covering is thick and white in color, it furthermore indicates Fire in his lower stomach area but Cold in the chest[6]. This makes him feel very thirsty but cannot actually drink water[7], again this makes him very dry in mouth and annoyed.

湿家，身烦疼，可与麻黄加术汤，发其汗为宜，慎不可以火攻之。

For the Shi person with continuous pain in the body, use Mahuang jia Baishu Tang to create a sweat therapy. Do not use fire-roasting therapy.

麻黄（三两，去节）, 桂枝（二两，去皮） ,甘草（一两，炙） ,杏仁（七十个，去皮尖） ,白朮（四两）

Mahuang 45 gram, Guizhi 30 gram, Gancao (processed) 15 gram, Xinren 70 (remove skin and tips), Baishu 60 gram.

右五味，以水九升，先煮麻黄，减二升，去上沫，内诸药，煮取二升半，去滓。温服八合，覆取微似汗。

Add the Mahuang and 2250 ml water into a herbal pot. After the liquid is evaporated for about 500 ml, remove the upper floating herbal residue, ad the remaining herbs in. Continue to cook until the liquid in the pot is about 600 ml. Collect the herbal tea. Drink one third of the herbal tea, cover the body to create a sweat.

太阳病，关节疼痛而烦，脉沉而细者，此名湿痹，湿痹之候，小便不利，大便反快，但当利其小便。

In Taiyang stage, if the person has pain in the (big) joints, and his pulse is deep and thin, it is a Wetness Bi Condition. In the Shi Bi condition, the person has difficult in urine but a lose bowel movement (tends to be a diarghea). For the treatment, use urine therapy.

湿家，其人但头汗出，背强，欲得被覆向火，若下之蚤则哕，或胸满，小便不利，舌上如胎者，以丹田有热，胸中有寒，渴欲得水，而不能饮，则口燥烦也。

For Wetness people[8], if he has sweat on head[9], stiffness in back, likes to be covered and likes to face fire, to early application of bowel-cleansing therapy will cause burping and fullness in chest and difficulty in urine. If his tongue covering is thick and white in color, it furthermore indicates Fire in his lower stomach area but Cold in the chest[10]. This makes him feel very thirsty but cannot actually drink water[11], again this makes him very dry in mouth and annoyed.

湿家下之，额上汗出，微喘，小便利者，死；下利不止者，亦死。

If such Wetness people has sweat on front head, has slight asthma, and has too frequent urination[12], they tend to die, so as they have too much and heavy diarrhea.

病者一身尽疼，发热，日晡所剧者，名风湿。此病伤于汗出当风，或久伤取冷所致也，可与麻黄杏仁薏苡甘草汤。

If the person has pain all of the body, has fever that is sever especially on the evening, it indicates Wind-wetness disease[13]. The reason for this illness is either because he catch wind when he had sweat before[14], or when he touched cold repeatedly before[15]. Use Mahuang Xinren Yiyiren Gancao Tang

麻黄（去节，半两，汤泡）甘草（一两，炙）薏苡仁（半两）杏仁（十个，去皮尖，炒）

Mahuang (remove the stem joints) 8 gram, Gancao (processed) 15 gram, Yiyiren 8 gram, Xinren 10 badges (remove skin and tips, fried).

右剉麻豆大，每服四钱匕，水盏半，煮八分，去滓。温服，有微汗，避风。

Prepre the herbs into powder, take 7 gram, mix with 300 ml water, bring to boil until there is about 200 ml liquid left. Drink it when warm to create mild sweat. Avoid wind.

For the Wind-wetness disease, if the pulse is floating, the body feels heavy and has sweat, and the person dislike wind environment, use Fangji Huangqi Tang

防己（一两）, 甘草（半两，炒）, 白朮（七钱半）, 黄芪（一两一分，去芦）

右剉麻豆大，每抄五钱匕，生姜四片，大枣一枚，水盏半，煎八分，去滓。温服，良久再服。

Prepare the herbs into powder, take 9 gram, mix it with fresh ginger 4 pieces, Chinese date one badge, and 300 ml water. Bring to boil until there is abou 200 ml liquid left. Collect the herbal tea. Drink it when it is warm. Repeat it once after 2 to 3 hours.

喘者，加麻黄半两；胃中不和者，加芍药三分；气上冲者，加桂枝三分；下有陈寒者，加细辛三分。服后当如虫行皮中，从腰下如冰，后坐被上，又以一被绕腰以下，温，令微汗，差。

If the person has asthma, add Mahuang 8 gram; with discomfort in stomach, add Shaoyao 4 gram; with air pushing-up feeling, add Guizhi 8 gram, with chronic cold in the lower abdomen, add Xixing 8 gram. The person should feel as worm moving in the skin and cold from down the lower back. Let the person sit on the soft covering and with another covering to cover his lower part of the body. Keep warm to create mild sweat.

风湿相搏，一身尽疼痛，法当汗出而解，值天阴雨不止，医云此可发汗，汗之病不愈者，何也？盖发其汗，汗大出者，但风气去，湿气在，是故不愈也。若治风湿者，发其汗，但微微似欲汗出者，风湿俱去也。

Asked: with the Wind-wetness in the body, the person should feel pain all of the body. The principle for the treatment of such condition is to use sweat therapy[16] but it does not work in a cloudy and raining weather. From medical book, it is said that indeed sweat therapy should be used, but it doesn’t work. Why? Master: With the Shi body condition (the Fengshi condition), sweat therapy will remove its Wind but left the Shi behind in the body. This counts the failure for the treatment. You should control the extent of the sweat during the sweat therapy, not let the sweat heavily, but keep it mildly[17].

伤寒八、九日，风湿相搏，身体疼烦，不能自转侧，不呕不渴，脉浮虚而涩者，桂枝附子汤主之；若大便坚，小便自利者，去桂枝加白术汤主之。
For eight to nine days of a disease similar to Shanghan[18], the person has Wind-wetness in the body and he feels pain in whole of the body[19] and annoyed, hard to turn the body, no nausea or thirsty. If his pulse is floating, weak and harsh[20], use Guizhi Fuzi Tang. (If the pulse is floating and strong, use Mahuang jia Baishu Tang). If he has hard stool but frequent urine, use Guizhi Fuzi que Guizhi jia Baishu Tang.

桂枝（四两，去皮）, 生姜（三两，切）, 附子（三枚，炮，去皮，破八片）, 甘草（二两，炙）, 大枣（十二枚，擘）

Guizhi 60 gram, fresh ginger 45 gram, Fuzi (processed, remove skin, cut into pieces)3 badges, Gancao (processed) 30 gram, Chinese date 12 badges.

Add the herbs and 1500 ml water into a herbal pot. Bring to boil and keep it in mild boiling until there is 500 ml liguid left. Collect the herbal tea. Drink one third each time, three times a day.

白朮（二两）, 附子（一枚半，炮，去皮）, 甘草（一两，炙）, 生姜（一两半，切）, 大枣（六枚）

Baishu 30 gram, fresh ginger 23 gram, Fuzi (processed, remove skin, cut into pieces) 1.5 badges, Gancao (processed) 15 gram, Chinese date 6 badges.

右五味，以水三升，煮取一升，去滓，分温三服。一服觉身痹，半日许再服，三服都尽，其人如冒状，勿怪，即是朮、附并走皮中逐水气，未得除故耳。

Add the herbs and 750 ml water into a herbal pot. Bring to boil and keep it in mild boiling until there is 250 ml liguid left. Collect the herbal tea. Drink one third of the herbal tea. After the first drinking the body should feel pain and tight. Repeat the second and the last one third drinking after every 4 hours. If the person feels cloudiness in mind or some kind of nausea-like feeling, no worry. This phenomenon suggests that the Baishu and Fuzi work in the skin to remove the Shuiqi (the Shiqi, or the water-like Xieqi).

风湿相搏，骨节疼烦，掣痛不得屈伸，近之则痛剧，汗出短气，小便不利，恶风不欲去衣，或身微肿者，甘草附子汤主之。
If the person has Wind and Wetness, he will feel continuous and annoying pain in the (small) joints. It is so painful that the points cannot be touch and the joints are hard to bend or strech. The person feels short of breath, sweat, hard in urine, dislikes wind and tends to keep covering on the body, or has slight swelling. In this case, use Gancao Fuzi Tang.

甘草（二两，炙）附子（二枚，炮，去皮）白朮（二两）桂枝（四两，去皮）

Gancao (processed) 15 gram, Fuzi (processed, remove skin, cut into pieces) 2 badges, Baishu 30 gram, Guizhi 60 gram,

右四味，以水六升，煮取三升，去滓。温服一升，日三服。初服得微汗则解。能食，汗出复烦者，服五合。恐一升多者，服六七合为妙。

Add the herbs and 1500 ml water into a herbal pot. Bring to boil and keep it in mild boiling until there is 750 ml liquid left. Collect the herbal tea. Drink one third of the herbal tea each time, three times a day. After the first drinking, if the person has mild sweat, the pain will be cured. If the person has pretty good appetite, and feels annoyed/impatience after the sweat, drink half mount of tea thereafter. If it is worried the original one third of the tea is too much, drink only 60% to 70% of the one third tea.

太阳中热者，暍是也，汗出恶寒，身热而渴，白虎加人参汤主之。

If the Taiyang stage is caused by invasion of Hot (weather, or environment), it is called Ye disease. The person feels sweat and chilly, hot in the body and thirsty. Use Baihu jia Renshen Tang.

知母（六两）, 石膏（一斤，碎）, 甘草（二两）, 粳米（六合）, 人参（三两）

Zhimu 90 gram, Shigao (grind into small pieces) 248 gram, Gancao 30 gram, Gengmi 124 gram, Renshen 45 gram.

右五味，以水一斗，煮米熟汤成，去滓。温服一升，日三服。

Add the herbs and 2500 ml water into a herbal pot. Bring to boil and keep it in mild boiling until the Gengmi is ready to eat. Collect the herbal tea. Drink one third of the herbal tea each time, three times a day.

太阳中暍，发热恶寒，身重而疼痛，其脉弦细芤迟，小便已，洒洒然毛耸，手足逆冷，小有劳，身即热，口开前板齿燥；若发其汗，则恶寒甚；加温针，则发热甚；数下之，则淋甚。

With the Ye disease, the person feels fever and chilly, feels pain and heavy in the body. Pulse feels string, thin, and slow. After urination, he could feel as the hair on the body straight and has cold feeling in the hands and feet. Little bit labor work could make him more hot feeling. With mouth open, the front teeth feel very dry. In this condition, sweat therapy could make him more chilly; hot needle acupuncture makes him more hot; and repeated bowel-cleansing therapy makes him feel pain and hot in the urine. [21]

太阳中暍，身热疼重，而脉微弱，此以夏月伤冷水，水行皮中所致也，一物瓜蒂汤主之。

For the Ye disease in the Taiyang stage, the person feels fever and very much pain, but the pulse is weak. It is due to the touch of cold water in hot summer season, so the water (the Shiqi) moves in the skin. Use Yiwu Guadi Tang

Add the herbs and 250 ml water into a herbal pot. Bring to boil and keep it in mild boiling until the liquid is half. Collect the tea, drink all once.

[1]诸家以刚、柔二痉，列为首条，今以此为第一条者，盖刚、柔之辨，俱从此条分出，痉病之最备者，宜冠诸首。再痉病也之下，「若发其汗…」六句，与上文义不属，与后之十一条中「为欲解，脉如故，反伏弦者痉」句，文义相属，宜分于彼。

[2] Rou here means soft, not hard.

[3]本门首条痉病也之下「若发其汗…」六句，当移于此条之首，文义始属。此条「暴腹胀大者」句，衍文也，当删之。

[4] People who is easy to suffer from the Wetness syndrome is called Wetness people or Shi people. They are usually those who are over-weighted with white color in skin and easy to sweat. In Shanghan Lun, other kind of body constitution mentioned are: Wine people, e.g. those who addictive to wane and liquor drinking; and Lipido-depleting people, e.g. those who have too much sexual life or sexual stimulation so to lose lot of liquid from the sex system of the body. Surely such kind of people tends to have more specific body disorders, compared with ordinary people. It is very important to realize the difference among people so to choose the proper treatment principle for each kind of body constitution.

In TCM, people are separated into different subgroups by other means for their body constitution: Wet people, Water people, Fire people, Wood people, Soil people and so on. It is also separated based on the kinds of herbs that are suitable to them, such as Chaihu people, Guizhi people, Dahuang people, Shigao people, Ganjiang people, etc. The words Chaihu, Guizhi, Dahuang, Shigao, Ganjiang here is the names of various herbs. However, body constitution is a reference in the establish of the clinic diagnosis, not the obligation factors.

[5] For Shanghan, the person has no sweat. Shi person has sweat but cannot have sweat all over the body but only on the head.

[6] Overwhelming Shi condition will cause Cold inside of the body.

[7] For Fire condition, the person feels thirsty and drinks lots of water/cold water. For Shi-Fire condition, the person can also feel thirsty, but cannot drink actually.

[8] People who is easy to suffer from the Shi syndrome is called Wet people or Shi people. They are usually those who are over-weighted with white color in skin and easy to sweat. In Shanghan Lun, other kind of body constitution mentioned are: Wine people, e.g. those who addictive to wane and liquor drinking; and Lipido-depleting people, e.g. those who have too much sexual life or sexual stimulation so to lose lot of liquid from the sex system of the body. Surely such kind of people tends to have more specific body disorders, compared with ordinary people. It is very important to realize the difference among people so to choose the proper treatment principle for each kind of body constitution.

[9] For Shanghan, the person has no sweat. Shi person has sweat but cannot have sweat all over the body but only on the head.

[10] Overwhelming Shi condition will cause Cold inside of the body.

[11] For Fire condition, the person feels thirsty and drinks lots of water/cold water. For Shi-Fire condition, the person can also feel thirsty, but cannot drink actually.

[12] Shi people tend to have abnormal or difficulty in urination, if they have no any problem in the urination, or even have too often urination, or have often diarrhea, they may die. This is a prediction told by the Master. It is indicated before that the principle for the treatment of such Shi condition is urine therapy to deplete Shixie from the urine. Here, the frequent and large amount of urination is due to bowel-cleansing therapy. It is a wrong treatment. The frequent urine now is a sign of Yinqi depletion!

[13] Feng means Wind. Shi means Wetness.

[14] Such as when one has sport, so has lots of sweat in wind weather or in strong air conditioning rooms.

[15] Such as one had been using cold ice patch on the body (when he has sport damage on the body), or use ice bath to reduce body temperature (such as seen in hospital to reduce high fever condition). Just as an example. Readers should be reminded that some paragraphs are talking about Shi body, some about Fire and Cold in the Shi body, some about the Fengshi condition. Exposure to cold usually causes Coldshi where as exposure to wind causes Fengshi condition.

[16] Use Mahuang jia Shu Tang.

[17] For the treatment of Fengshi syndrome, use the mild sweat therapy on a clear sunshine day is the best way.

[18] On the day of eight to nine, the person has no nausea (Shaoyang stage) or thirsty (Yangming stage), suggesting that he has no Shanghan disease.

[19] Pain in whole body suggests Wind invasion.

[20] Harsh pulse means Coldshi and the Xieqi is in the meridian.

[21] Sweat, warm needle acupuncture, bowel cleansing therapy, all are commonly used therapies in Shanghan disease. Here the Master warms us to be careful in the distinguishment between the Shanghan disease and the Ye disease. They need different treatment principle.