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Yáng brightness (yáng míng) disease pattern
阳明病证 〔陽明病證〕yáng míng bìng zhèng
Any pattern of yáng brightness (yáng míng) disease.
Yáng brightness (yáng míng) disease patterns arise when, in the process of externally contracted disease, a powerful struggle between right and evil occurs so that the evil transforms into heat and enters the interior. They are characterized by intense yáng heat and are classed as interior repletion heat patterns.
Yáng brightness (yáng míng) has copious qì and copious blood; its yáng qì is exuberant. So, when evils enter yáng brightness (yáng míng), they easily transform into heat and give rise to dryness.
Yáng brightness (yáng míng) patterns mostly arise when greater yáng (tài yáng) or lesser yáng (shào yáng) disease is treated inappropriately or not treated effectively, resulting in damage to liquid that gives rise to dryness. This causes the evil to transform into heat and enter the interior. They can also occur when a patient habitually suffering from depletion of fluids and exuberance of yáng qì contracts an external evil. In such cases, the constitutional bias encourages the evil to transform into heat and enter the interior.
A distinction is made between channel and bowel patterns. Channel patterns are characterized principally by heat signs and therefore are sometimes referred to as heat patterns.
Bowel patterns are marked by constipation and are often referred to as repletion patterns.
Strictly speaking, however, both are repletion heat patterns.
Heat effusion: Yáng brightness (yáng míng) patterns are characterized by heat effusion with aversion to heat rather than with aversion to cold seen in greater yáng (tài yáng) disease patterns. Yáng brightness (yáng míng) heat effusion is explained by interior heat steaming outward. Bowel patterns tend to be characterized by late afternoon tidal heat effusion,
which denotes heat effusion that peaks during the late afternoon watch (日晡所 rì bū suǒ, 3–5 p.m.), that is, is the time at which the yáng qì of yáng brightness (yáng míng) is most exuberant.
Spontaneous sweating: Sweating is copious. The volume is usually significantly greater than in greater yáng (tài yáng) patterns. Channel patterns are characterized by generalized sweating. Bowel patterns are often marked by sweating on the limbs. When sweating is not pronounced, it is because of damage to yīn liquid or attributable to a complication of dampness.
Thirst with desire to drink: In yáng brightness (yáng míng) patterns, thirst is usually pronounced and is associated with a desire to drink. This is different from the thirst in greater yáng (tài yáng) water amassment patterns, where the patient may vomit ingested fluids after drinking copious amounts of water.
Abdominal distension and pain: Abdominal distension and fullness with pain that refuses pressure is a sign of yáng brightness (yáng míng) bowel patterns. It is attributable to repletion evil binding in the interior. These signs are usually severe and persistent, differing from the mild and intermittent abdominal fullness observed in greater yīn (tài yīn) vacuity cold patterns.
Constipation: Constipation, hard stool, and difficult defecation are attributable to dryness repletion in yáng brightness (yáng míng) bowel patterns. Constipation is also observed in other cold-damage patterns, but in yáng brightness (yáng míng) bowel patterns it constitutes the main feature. Furthermore, yáng brightness (yáng míng) bowel patterns may be characterized by diarrhea, when fluid passes around the impacted stool. This is called heat bind with circumfluence
(热结旁流 rè jié páng liú).
Delirious speech: Delirious speech may occur in channel or bowel patterns when repletion heat ascends to the upper body and harasses the spirit.
Yáng brightness (yáng míng) Channel Pattern
Yáng brightness (yáng míng) channel pattern (阳明经证 yáng míng jīng zhèng) is a disease pattern chiefly characterized by great heat effusion; great sweating; great thirst; a pulse that is surging and large. These signs are often referred to as the four greats.
Description: Great generalized heat; great sweating; vexing thirst with taking of fluids; red face; rough breathing; heart vexation; a dry yellow tongue fur; a pulse that is surging and large.
Pathogenesis: Exuberant evil heat filling the yáng brightness (yáng míng) channel and spreading over the whole body.
Analysis of signs
- Heat signs: Great heat effusion with aversion to heat (rather than the aversion to cold of greater yáng (tài yáng)), great sweating, great thirst.
- Spirit: Heart vexation.
- Heat distressing the lung: Rough breathing.
- Facial complexion: Red.
- Tongue fur: Yellow and dry, reflecting the effect of heat on the fluids. Although the Shāng Hán Lùn does not mention the tongue body, it is known to be red.
- Pulse: Surging and large, reflecting repletion heat.
Treatment
Medicinal therapy: Clear heat and drain fire using bái hǔ tāng (白虎汤 White Tiger Decoction).
Acumoxatherapy: Clear heat with
Yáng brightness (yáng míng) Bowel Pattern
Also:
- Large intestine heat bind (大肠热结 dà cháng rè jié)
- Large intestine repletion heat (大肠实热 dà cháng shí rè)
- Large intestine bowel repletion (肠热腑实 cháng rè fǔ shí)
Yáng brightness (yáng míng) bowel pattern (阳明腑证 yáng míng fǔ zhèng) is a disease pattern chiefly characterized by late afternoon tidal heat; abdominal fullness and pain; constipation; a pulse that is sunken and replete.
Description: Generalized heat effusion or late afternoon tidal heat; streaming sweat
on the extremities; distension, fullness, and hardness in the abdomen that refuses pressure; constipation; vexation and agitation, in severe case delirious speech, picking at bedclothes, forward-staring eyes; yellow or burnt-yellow tongue fur, with prickles; a pulse that is sunken, replete, and forceful, or else slippery and rapid.
Pathogenesis: Evil heat passing into the interior, binding with waste in the intestines, resulting in dry stool and stoppage of bowel qì.
Analysis of signs
- Heat: Generalized heat effusion, late afternoon tidal heat,
streaming sweat
on the extremities reflect repletion heat. Late afternoon tidal heat is explained by the fact yáng brightness (yáng míng) channel qì is most effulgent in the late afternoon watch (3–5 pm). - Repletion: Distension, fullness, and hardness that refuses pressure in the abdomen, constipation.
- Spirit: Vexation and agitation and in severe cases delirious speech, picking at bedclothes, and forward-staring eyes reflect dryness-heat carrying turbid qì upward to harass the heart spirit.
- Tongue fur: Thick, yellow, and dry, possibly burnt yellow, with prickles at the margins. This reflects the drying effect of repletion heat. Although the Shāng Hán Lùn does not mention the tongue body, it is known to be red.
- Pulse: Sunken, replete, and forceful, or else slippery and rapid. Sunken indicates disease of the interior. The other pulse conditions indicate repletion heat.
Treatment
Medicinal therapy: Offensive precipitation using dà chéng qì tāng (大承气汤 Major Qì-Coordinating Decoction).
Acumoxatherapy: Clear heat with