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Any warm disease pattern chiefly characterized by take the form of (a) stomach channel patterns with vigorous fever, great thirst, and sweating; (b) large intestine channel patterns with constipation and abdominal distension and pain; or (c) spleen channel patterns with generalized heat effusion failing to surface unresolved by sweating, glomus and oppression in the stomach duct and abdomen, and upwelling and nausea.

Pathogenesis: Center-burner patterns arise when warm heat evil invades the spleen and stomach, transforming into dryness or dampness, depending on pre-existing conditions. The stomach likes moistness and is averse to dryness. When evils invade the yáng brightness (yáng míng), they easily transform into dryness and damage liquid, giving rise to dryness-heat patterns. The spleen, by contrast, likes dryness and is averse to dampness. When evils enter the greater yīn (tài yīn), they repress the spleen and engender dampness, giving rise to damp-heat patterns.

Patterns: There are three patterns each associated with different channels:

• Intense heat in the yáng brightness (yáng míng) (yáng míng) stomach channel: Vigorous heat effusion with aversion to heat rather than aversion to cold, great thirst, sweating, and red eyes. The tongue is red with yellow fur. The pulse is floating and surging.
• Heat binding in the yáng brightness (yáng míng) (yáng míng) large intestine channel: When the dryness heat binds in the interior, the signs are late afternoon tidal heat, distension, fullness, hardness, and pain that refuses pressure in the abdomen, and constipation. The tongue is prickly and bears a burnt-yellow fur. The pulse is sunken and replete.
• Greater yīn (tài yīn) (tài yīn) damp-heat: Generalized heat effusion failing to surface that sweating fails to resolve, glomus and oppression in the stomach duct and abdomen, and upwelling and nausea. The tongue is red with a slimy yellow fur. The pulse is soggy and rapid.

Analysis of signs:

• Stomach channel: When intense yáng brightness (yáng míng) dryness-heat is located in the stomach channel, it blasts outward to the outer body, manifesting in vigorous fever, thirst, sweating, and a pulse that is floating and surging.
• Large intestine channel: When the dryness-heat binds in the interior, it causes stoppage of bowel qì; hence there is abdominal distension, fullness, hardness, and pain, constipation, and a pulse that is sunken and replete. Because yáng brightness (yáng míng) channel qì is strongest at 3–5 p.m. (traditionally called the late afternoon watch), late afternoon tidal heat also features.
• Spleen channel: When greater yīn (tài yīn) damp-heat lies depressed and steaming, it gives rise to generalized heat effusion failing to surface that is not resolved by sweating, to a slimy yellow tongue fur, and to a pulse that is soggy and rapid. When damp-heat obstructs the qì dynamic, there is glomus and oppression in the stomach duct and abdomen and heavy cumbersome limbs. When splenic movement and transformation fails and the stomach’s harmony and downbearing is impaired as a result, there is upwelling and nausea as well as sloppy stool and diarrhea.

Treatment

Medicinal therapy: For foot yáng brightness (yáng míng) stomach heat, clear the stomach and discharge heat, engender liquid and allay thirst, using bái hǔ tāng (白虎汤 White Tiger Decoction). For hand yáng brightness (yáng míng) patterns, use offensive precipitation with cold bitter agents using dà chéng qì tāng (大承气汤 Major Qì-Coordinating Decoction) and related formulas. For foot greater yīn (tài yīn) spleen channel damp-heat pattern, clear heat and transform dampness to free the qì dynamic, using sān rén tāng (三仁汤 Three Kernels Decoction) and similar formulas.

Acumoxatherapy: LI-4 (hé gǔ), LI-11 (qū chí), BL-47 (cháng shān), and ST-40 (fēng lóng).

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