The natures[qi] of warm and heat are in ascending mechanism. Warm half-ascends and heat ascends.
The natures[qi] of cool and cold are in descending mechanism. Cool half- descends and cold descends.
But how about sour flavor which is connected with wood?
Does sour flavor make qi to ascend? Of course not. The flavors of sour and bitter are in descending mechanism. The flavors of sweet and pungent are in ascending mechanism.
The sour of Bai Shao Yao supplies yin to the liver, in other words, it supplements liver yin or liver blood. The sour of Wu Wei Zi supplies yin to the lungs. Rising of yin causes [vacuous] fire to descend.
The pungent and sweet of Ma Huang disperses in exterior.
Si Qi [四氣. Four qi] of warm, heat, cool, and cold is in engendering relationship with Wu Xing, but Wu Wei [五味, five flavor] is in restraining relationship with Wu Xing.
So when one studies Ben Cao [herbs], one should think and consider whether the qi and flavor descend or ascend in which part or to which part.
This method can be applied to our diet. Someone who suffers from gastritis which belongs to stomach heat pattern should avoid eating the foods which has pungent and heat nature.
10. The three yin and three yang of the Earlier Heaven. 先天的 三陰三陽.
One yang (lesser yang) grows up to three yang (greater yang) and rises up to the place highest. And then the yang has to descend. (陽極生陰).
The fleshy exterior is the outermost place of the body .
So greater yang governs the exterior such as flesh, skin, and fur.
Therefore the pulse is floating, the head and nape are stiff and painful.
In the place that greater yang governs, both functions of rising and falling happens.
11. The three yin and three yang of the Later Heaven (The function diagram).
後天(作用圖)의 三陰三陽
In a plant, as it grows, the sap of it also rises up.
Yang is separating yin while yang rises up.
If expaining with water vapor, water vaporizes into steam going up to the ceiling, the steam accumulates on the ceiling and changes back into water, and then the water falls downward.(升降)
Korea has four seasons. Generally, rainy season follows after summmer, and then hot and damp whether (long summer) starts again. So lesser yin, greater yin, and lesser yang which belong to hot whether, are charaterized by much qi and a little blood. And greater yang and reverting yin belong to a little bit cold whether, so they are charaterized by much blood and a little qi. Autumn is the season when cool and hot climates counter each other. The more daily temperature range is wide, the more delicious the fruit is. So yang brightness are charaterized by much blood and much qi.
12. The nornalizing and adverse (順逆) of the three yin and three yang.
Normalizing (順)
Reverting yin, Lesser yin, Greater yin, Lesser yang, Yang brightness, Greater yang.
Adverse (逆)
Greater yang, Yang brightness, Lesser yang, Greater yin, Lesser yin, Reverting yin.
.
This is the order of Shanghanlun.
(Adverse mutation makes disease, death)
13. Greater yang disease. Tai yang bing. 太陽病
太陽之爲病, 脈浮, 頭項强痛而惡寒.
In disease of the greater yang,1) the pulse is floating, the head and nape are stiff and painful, and there is aversion to cold.
This lins is a general outline of the pulse and signs of greater yang disease.
What is greater yang?
Where dose greater yang stand for?
In Huang Di nei jing suwon,
太陽之上 寒氣治之
The upper of the greater yang is governed by the cold qi.
太陽爲開
The greater yang is the opening
太陽從標從本
The greater yang conform to the root and the tip.
太陽主表
The greater yang governs the exterior.
Greater yang is the channel of Cold Water.
If greater yang get an attack from the cold evil(寒邪), the body will resists against it. The general pattern of the greater yang is as follows
- The floating pulse
- Aversion to cold
- Body pain (especially in head and nape which belong to the foot greater yang bladder channel)
Cinnamon Twig Decoction. Gui Zhi Tang. 桂枝湯
1) Lines on Guizhitang
a. 太陽病, 發熱汗出, 惡風, 脈緩者, 名爲中風.
When in greater yang disease there is heat effusion, sweating, aversion to wind, and a pulse that is moderate, it is called wind strike.
b. 太陽中風, 陽浮而陰弱. 陽浮者, 熱自發. 陰弱者, 汗自出, 嗇嗇惡寒, 淅淅惡風, 翕翕發熱, 鼻鳴乾嘔者, 桂枝湯主之.
When in greater yang wind strike, the pulse is floating in yang level and weak in yin level. Patients with floating pulse in yang level are prone to have spontaneous heat effusion. Patients with weak pulse in yin level are prone to sweat spontaneously. If there is huddled aversion to cold, wetted aversion to wind, feather-warm heat effusion, noisy nose, and dry retching. Cinnamon Twig Decoction (gui zhi tang) governs.
c. 太陽病 發熱汗出 此爲營弱衛强 故使汗出 欲救邪風 桂枝湯主之
When in greater yang disease there is heat effusion and sweating, this means weakness in the construcrion and strength in the defense, which consequently causes sweat to issue. To eliminate the evil wind, Cinnamon Twig Decoction (gui zhi tang) governs
2) What kind of constitution is easy to contract greater yang wind strike?
Greater yang wind strike also reffered to as a greater yang exterior vacuity pattern. Exterior vacuity refers to the constitution of the patient. The patient has a slack quality in the fleshy exterior and interstices.
d. 風傷衛 開太過
The wind belongs to yang. The wind evil damages the defense, the opening of the sweat pores is too severe. Gui Zhi Tang pattern belongs to "the excessive opening"(開太過). The patient's constitution in this formula patterns tends to be weak rather than strong. (The flesh tends to be thinner than thick.)
This case can be explained with a rice-pot uncoverd or covered but not tightly over a weak fire. This patient is in deficiency condition of yang-qi and also the defense-qi. So the defense-qi is hard to secure the exterior and that leads to sweat issue. As long as the sweat issues, the qi, (whatever yang qi or the defense qi, as you already knew, the defense qi is originated from the yang qi in life gate) becomes weak. On the contrary, the yin cold qi is exurberant. So this greater yang exterior vacuity pattern will be able to transmute into the yin cold pattern of the greater yin or lesser yin directly.
e. The compositon of the Cinnamon Twig Decoction
This decoction is kind of supplement formula to treat the exterior vacuity pattern.
In the rice-pot uncoverd over a weak fire, the rice will be unable to be cooked well. To make rice well, the pot should be covered tightly and the firepower should be raised. The covering of the pot is compare to peony (shao yao), and the raising of the firepower is compare to cinnamon twig (gui zhi) and (fresh ginger) sheng jiang.
Peony (shao yao) is also almost used in the formula that contains aconite (fu zi). This means closing the cover is to reinforce the fire qi.
2. Ephedra Decoction. Ma Huang Tang. 麻黃湯
ephedra (麻黃 ma hunag Ephedrae Herba) 3 liang
cinnamon twig (桂枝 gui zhi, Cinnamon Ramulus) 2 liang
mix-fried licorice (甘草 gan cao, Glycyrrhizae Radix) 1 liang
apricot kernel (杏仁 xing ren, Armeniacae Semen) 70 pieces
1
1).太陽病, 或已發熱, 或未發熱, 必惡寒, 體痛, 嘔逆, 脈陰陽俱緊者, 名爲傷寒.
1). Greater yang disease, whether heat has effused or not, as long as there is aversion to cold, with generalized pain , retching counterflow, and yin and yang pulse both tight, is called cold damage
2). 太陽病, 頭痛發熱, 身疼腰痛, 骨節疼痛, 惡風, 無汗而喘者, 麻黃湯主之.
2). When in greater yang disease, there is headache, heat effusion, generalized pain, lumbar pain, joint pain, aversion to wind, and absence of sweating with panting. Ephedra Decoction (ma huang tang) governs.
Nei Jing says that (太陽爲開) Greater yang is[governs] the opening. Greater yang controls skin and fur in the fleshy exterior. Greater yang makes yang-qi spread and apply on the fleshy exterior with the help of pivot activity of lesser yang(少陽樞). So the opening funcrion of greater yang leads to protect the exterior and the defense part. The yang-qi which warms and defenses the exterior is originated from life gate fire(命門火). So (foot) lesser yang and greater yang are in the relationship of mutual exterior and interior.
Ma Huang Tang belongs to "the deficient opening"(開不及). The patient's constitution in this formula patterns tends to be strong rather than weak. (The flesh tends to be thicker than thin.) The people who looks like Rambo may be easier to have cold damage exterior repletion patterns (Ma Huang Tang) when contracted disease externally than wind strike exterior vacuity patterns (Gui Zhi Tang)
The cold evil invades the exterior, depressing and fettering the defense qi. The defense qi is unable to warm the fleshy exterior and this causes aversion to cold.
Because the cold evil fetters the exterior, sweat pore is closed(寒傷營 , 開不及), so the yang qi and the yang heat are unable to be effused, they get exuberant interior. If it is not treated, the disease will shift into yang brigntness, lesser yang or three yin. And the accumulated yang heat will damage yin-humor. This situation can be compared with a rice-pot over a fire. If a rice pot is covered tightly over a strong fire, the pot will be burned. To solve the problem, the fire should be turned low or off and the lid should be off. Ma Huang Tang is similar with this. Mahuang looks like tiny and thin straw. Imagine that a straw is through the skin so the heat can be effused. MaHunag is acrid, slight warm, and light in nature, these kind of natures are easy to asend, so Ma Huang works in skin. Gui Zhi resolves the evil in the flesh. Gan Cao supplements the original qi(元氣) of the central palace(中宮) and help the other ingredients to harmonize. Xing Ren is bitter, sweet, and acrid in flavour. Bitter and sweet nature of Xing Ren drains the evil in the Lung aspect and promotes the effusing function of Mahuang, Gui Zhi, and Gan Cao. Bitter nature give qi advantage to descend. And Xing Ren has a function of moistening dryness that also make it to desend after effusing. This is an excellent method in order to promote sweating and preserve the humor and fluids at the same time.
The fettered exterior is resolved through root(primary)-cold(本寒) and fever in the exterior is resolved through tip(secondary)-yang(標陽). This is to protect fluid and humor belonging to cold-water(寒水). This means “太陽之上 寒氣治之”(Greater yang is governed by the cold qi and "太陽從標從本“(greater yang can be treated by both way of according to tip or root)
If Ma Huang Tang pattern is not resolved, this pattern can shift to yang brightness . The Formulas of yang brightness tend to be 갈근탕 백호탕 승기탕. If shift to lesser yang, the formuals tend to be 대시호탕 시호가망초탕. If shift to lesser yin, 승기탕 황련아교탕 저부탕. If shifting to reverting yin, the formuals tend to be 백두옹탕 승기탕. These formulas belongs to replete pattern.
Greater yang governs skin and fur, and the bladder, yang brightness governs the fleshy and the stomache, lesser yang governs half-exterior and half interior, greater yin governs greater abdomen and below the heart, lesser yin governs umbilical resion, reverting yin governs the lesser abdomen.
Understading well of Shanghanlun makes one to know where the disease is located in.
Cautions
As soon as the illness is cured, this formula should be withdrawn immediately. Prolongation of intake is of no benefit.
Patient with blood vacuity or slow pulse in cubit is not appropriate to apply it. If people feels palpitations after drinking coffee, Mahuang should be used carefully.
In Shang Han Lun, "when in cold damage, the pulse is floating and moderate, and there is no generalized pain, only generalized heaviness, with sudden periords of lightness, and there is no lesser yin disease, Major Green-Blue Dragon Decoction will promte sweating and resolve the disease''. Greater yang is linked to lesser yin. If Mahunag is used too long, that could influence to lesser yin.
(summary of shang han lun)
xiao chai hu tang
