Significance of Yangming Stage/meridian

按阳明一经，以燥为本（阳明之上，燥气主之，故也），太阴为中气（脾与胃为表里），阳明为标（主外，是本经之标、本、中三气也）。有经症，有里症、有腑症，不可不知也。

The nature of the Yangming stage/meridian is Dryness (In the Yangming layer of the body, it is the Dryness dominates). Taiyin is its middle Qi (since the Yangming is the Stomach area. The Spleen, which belongs to Taiyin, and the stomach are surface-inside couple). Yangming is the surface layer of the Yangming stage. In the Yangming stage, there are disease in the meridian, in the inside organ, in their hollow organ (Stomach) too.

（以下承接上太阳经）太阳之寒邪未尽，势必传于阳明，则治阳明，必兼治太阳，若全不见太阳之经症、腑症病情，独见阳明之经症、腑症，则专治阳明，方为合法。

If the Cold invader remains in the Taiyang stage and not solved soon, it must pass into the Yangming stage. In this case, to solve the invader in the Yangming, the Cold invader in the Taiyang should also be treated. If there is no any evidence for the invader in the Taiyang stage, but only in the Yangming stage, treat the Yangming stage only.

当知寒邪走入燥地，即从燥而化为燥邪，乃气机势时之使然也（寒邪化燥，乃本经病机主脑）。

It should be known that, when the Cold invader comes into the Dryness stage, it will change into the Dryness invader. This is the rule due to the natural Qi circle. (The change of the Cold into the Dryness is the mechanism for the disease in the Yangming stage).

经症者何？前额连眼眶胀痛，鼻筑气而流清，发热不恶寒，此际寒邪初入阳明之经，寒气尚有一线未化尽，故还见筑气流清涕之寒形，渐渐发热不恶寒（不恶寒三字，便是寒邪俱化为热也）。邪在经尚可解肌，故用葛根汤以解肌，俾邪从肌肉而出（阳明主肌肉，故也），此本经浅一层立法也。

What’s the evidence for the disease in the meridian part of the Yangming stage? The patient has headache in the front head, pain in the eye frame, with fever (or hot feeling) but not chilly feeling. This is the early stage of the disease showing in the Yangming stage. Since the Cold Xie has not been completely turned into the Dryness, there is still plug feeling in the nose, with running nose too (suggesting the Cold remaining). The body feels gradual hot, but no chilly anymore (once there is not chilly, it suggests that the Cold Xie has been changed into the Dryness). The Xie Qi is in the meridian, so the muscle-loss therapy can be used, using Gegen Tang, to expel the Xie Qi out of the muscle (the Yangming dominates and associates with the muscle in the body). This is the treatment principle for the early stage disease in the Yangming stage.

服此方而邪若解，则病愈。设若不解，有传少阳之经，而不传本经之腑，有传本经之腑，而不传少阳之经者出矣（便是分途处）。

After taking the Gegen Tang, if the Xie Qi has been solved, the disease will be solved. If not, the Xie Qi may pass into the Shaoyang stage, but not to the inside organ (Abdomen) of the Yangming stage; or the Xie Qi may move into the inside organ of the Yangming stage, but not to the Shaoyang stage.

若本经经症，合少阳之经症，名二阳合病，即以二阳之法治之，如葛根汤合柴胡汤是也。

If the disease in the Yangming meridian is accompanied by the disease in the Shaoyang stage, it is called two Yang stages. The two stages should be treated same time, using the Gegen Tang plus the Chaihu Tang.

若本经经症，而传入本经之里，则现口燥心烦，汗出恶热，渴欲饮冷（这便是里症情形）。此刻全无一点寒形，尽是一团燥热之邪气，盘据胃中，兼之胃乃多气多血之府，邪热之气，又合胃中之气，二火交煽于中，则邪热炽矣。热甚则血亏，故口燥心烦，热蒸于外，故汗出，内热太甚，则乞救于外之水而欲为之扑灭，故大渴饮冷，仲景用白虎汤以救之，有不使邪热归腑之意，深一层立法也。服此方而若解，则病愈。

If the meridian disorder passes into the inside of the Yangming, the patient show dryness in the mouth, annoyed in heart, sweat, dislike hot, thirsty and likes to drink cold water (all suggest that the disease is in the inside of the Yangming stage). At this movement, there is no any sign of Cold. All are as a fire burning. The Fire stagnated and occupied in the stomach area. Since the stomach originally has more Qi and more Blood, together with the invasion of the outside fire, the two fire met in the stomach to make the fire more overwhelming. When the fire is overwhelming, the blood will be depleted, so the patient has dry mouth and annoyed in heart. The fire steams, to cause sweat. The fire in too much in the inside, so body needs water to save, so the thirsty is strong and the person wants to drink huge amount of cold water. In this case, Master Zhang Zhongjing uses Baihu Tang, to prevent the fire go further into the inside.

设若白虎力轻，未能扑灭其邪热，邪即入腑，便见张目不眠，声音响亮，口臭气粗，身轻恶热，大便闭塞等情，此际邪已归腑。邪至腑中，热已过盛，热盛必将肠胃中之血液灼尽，即肠胃中所存宿谷糟粕中之津液，亦必灼尽。胃中枯槁，阴气不得上交，所以张目不眠，胃火旺极，故声音响亮，口臭气粗，身轻恶热，肠胃此际，无一毫血液运其糟粕，故大便闭塞，通身上下不啻一盆烈火。若不急为扑灭，顷刻将周身血液灼尽，脏腑有立坏之势也，主以大、小承气汤，苦寒陡进，推荡并行，火邪一灭，正气庶可复生。即有痞满实燥坚谵语狂走等情，皆缘热邪所致，俱当以此法为主，不可因循姑惜，酿成脱症之祸矣（阳旺极，而阴必立消）。

If the Baihu Tang is not strong enough to solve the fire, the Xie Qi will move into the inside organ. The patient has eyes open all night without sleep, has sound voice, bad odor in mouth, strong breath, light body but hate hot, and constipation. All of these symptoms suggest the Xie Qi has moved into the organ. Once the Xie Qi is in the organ, the overwhelming fire burns the blood in the stomach, as well as the liquid in the food in the stomach. The inside of the stomach becomes dry and withered, the Yin Qi cannot move up, causing opened eyes and no sleep. The stomach fire is overwhelming, so the sound is loud, the mouth odor is strong, the breath is strong, the body is light and hates hot. Since there is not blood in the abdomen to move the food dross, the stool blocks the intestine, causing stop of bowel movement. Now the whole body is as a big fire. If it is not cooled down, it will burns off the blood in the whole body to cause death. In this case, use Da Chengqi Tang, Xiao Chengqi Tang. Use the cold and bitter herbs together to cool down the fire and open the intestine. With the clearance of the fire, the body normal Qi can be produced again. In clinic, the patient can also have other symptoms, such as fullness, delirious speech, madness and so on. All are due to the Xie Fire. The treatment principle is the same, by using the Da Chengqi Tang and Xiao Chengqi Tang. At this movement, the treatment should be decided and started as soon as possible. Any hesitate will be dangerous to the life. (Once the Yang is overwhelming, the Yin will disappear pretty soon).

附解：病缘是伤寒为本，至于用大黄、芒硝、石膏之药，全不见伤寒面目，学者至此，每多茫然莫解，由其不知化机与六经所主耳。

Appendix: the reason for the disease is the Cold-invasion. Upon to the use of herb Dahuang, Mangxiao, Shigao, etc., no any evidence of the Cold-invasion, new student usually feels confused at this time, because they do not know the nature change of the Xie Qi in each stage and the domitating Qi in each stage.

万病不出阴阳两字，阳极化阴，阴极化阳，自然之理。阴阳分布六经，六经各有所主之气，寒主太阳，燥主阳明，火主少阳，湿主太阴，热主少阴，风主厥阴。须知寒邪至燥地，寒气即化为燥邪，一定不易之理也（譬如一团冷物，放于热物之中，顷刻冷物亦化为热物。一团热物而放于冷物之中，顷刻热物亦化为冷物。知此化机，便得伤寒一贯之旨，庶可识仲景步步立法之苦心也）。他经化机仿此。

All diseases can be summarized into simply the Yin or the Yang, the two words. When the Yang is overwhelming to extreme, it will turn, become or transform into the Yin. Similarly if the Yin is overwhelming to extreme, it will turn, become and transform into the Yang. This is the nature rule of the universe. The Yin and the Yang distributes into the six meridian/stage. Each meridian/stage has its own dominating Qi. The Cold dominates he Taiyang meridian/stage; the Dryness Qi dominates the Yangming; the Fire dominates the Shaoyang; the Wetness dominates the Taiyin; the Warm dominates the Shaoyin; and the Wind dominates the Jueyin. It should know that, once the Cold Xie moves into the Yangming, the Cold Qi will become into the Dryness Xie Qi. This is true for ever. (This is as to put a mass of cold stuff into warm stuff. The cold stuff becomes warm soon. A mass of warm stuff, when put into a cold stuff, it will also turn into cold too. If you understand this rule, you will understand the natural path way of the Shanghan disease and understand how careful and how much effort the Master Zhang Zhongjing has spend to write his great book.). When the Xie Qi moves into other stage, it will turn and transform in the similar way, depending on the dominating Qi in that stage.

仲景以伤寒二字冠首者，寒居正冬子令，一阳初生，为一岁之首，一年分六气，六气配六经，一岁之气机，可以六日括之，六日之气机，又可以一日尽之，生生化化，循环不已，学者宜知。

Master Zhang Zhongjing uses the Shanghan (Shang means invasion. Han means Cold in Chinese) as the title of his book << Shanghan Lun >>. The Cold located in the Zi zong of time (between 11 pm and 1 am). It is the time period in which the Yang just born. The new born Yang Qi is the first of the year. One year holds six Qi. The six Qi match the six meridian/stage. So the movement of the Qi in one year can be also shrunk in six days. The Qi movement in a day can also be shrunk and summarized in one day. The Qi is in a circle within small or bigger and more big time circles. The beginner should know this.