Question: There are diseases transmitted from Greater Yang to Yang Brightness, Yang Brightness disease due to direct attack, and transmission from Shaoyang to Yang Brightness. What do these mean? Answer: Transmission from Greater Yang to Yang Brightness refers to splenic constipation; Yang Brightness disease due to direct attack refers to excess of stomach and intestine; transmission from Shaoyang to Yang Brightness refers to the condition where after inducing sweating and promoting urination, there is dryness, irritability, and fullness in the stomach, leading to difficulty in defecation.

bubble_chart Note

• Yang Brightness can be treated with purgation, not limited to excess of stomach and intestine. There are three main categories, hence the question and answer to clarify.
• When the pathogenic factors of Greater Yang take advantage of stomach dryness-heat and transmit to Yang Brightness, it is called transmission from Greater Yang to Yang Brightness, characterized by not changing clothes without discomfort, known as splenic constipation.
• When the pathogenic factors of Greater Yang take advantage of retained food in the stomach and combine with dryness-heat, it is called Yang Brightness disease due to direct attack, characterized by constipation, internal fullness and pain, known as excess of stomach and intestine.
• When the pathogenic factors of Greater Yang have reached Shaoyang, the method should be harmonization, but instead, sweating and promoting urination are induced, damaging body fluids. The pathogenic factors of Shaoyang then take advantage of stomach dryness and transmit to Yang Brightness, called transmission from Shaoyang to Yang Brightness, characterized by difficult and astringent defecation, known as difficulty in defecation.

bubble_chart Collected Annotations

• Cheng Zhi said: "This explains that all three Yang channels can lead to diseases in the stomach. Yang Brightness is the sea of water and grain, and the middle earth is where all things return, hence all three Yang channels can enter its fu-organ. When pathogenic factors transmit from Greater Yang to the stomach fu-organ, it is called transmission from Greater Yang to Yang Brightness, as described in the classics where Taiyang disease, after vomiting, purging, or sweating, leads to slight irritability, frequent urination, and hard stools, due to the spleen's astringency, hence a mild purgative like Minor Chengqi Decoction is used to harmonize. When pathogenic factors transmit from the Yang Brightness channel to the stomach fu-organ, it is called Yang Brightness disease due to direct attack, as described in the classics where fever and sweating lead to dryness and hardness in the stomach with delirium, indicating an excess of pathogenic factors in the stomach, hence a strong purgative like Major Chengqi Decoction is used for purgation. When pathogenic factors transmit from Shaoyang to the stomach fu-organ, it is called transmission from Shaoyang to Yang Brightness, as described in the classics where Shaoyang should not be treated with sweating, as it leads to delirium, indicating a transmission to the stomach, due to exhaustion of body fluids, hence Hemp Seed Pill is used for moistening purgation to harmonize body fluids. If the external symptoms of the three Yang channels are not resolved, the standard treatment methods for Yang Brightness should not be applied."