Introduction

Among the Six Conformations described in the Shang Han Lun, Yang Ming stands at the height of disease transformation. If Tai Yang represents the beginning of externally contracted illness, Yang Ming represents its consolidation, when the struggle between righteous qi and pathogenic influence has moved inward and gathered strength at the center.

In the cosmology of the Huang Di Nei Jing, dryness rules Yang Ming. It is the Dry Metal of the West, associated with gathering, collecting, and descending. Physiologically, Yang Ming encompasses the Stomach and Large Intestine, also known as, the “Stomach household” (胃家). This is the great domain of reception and transformation. When this domain functions harmoniously, fluids are distributed, turbidity descends, and clarity is maintained. When dryness exceeds its proper measure, heat arises, fluids are damaged, and repletion forms.

Thus Yang Ming disease is not simply “heat in the stomach.” It is a failure of the center to regulate moisture and descent. The classical signs, great heat, great sweating, great thirst, great pulse, reflect an interior that has become excessively dry. Tidal heat at ribu time, abdominal fullness, delirious speech, and difficult defecation all express the same underlying principle: the Earth has lost its ability to transform and transport.

This study approaches Yang Ming not as a static category of symptoms, but as a living conformation with its own physiology, timing, and strategic methods of restoration. Through careful reading of the classical lines and formulas, we seek to understand how dryness transforms into heat, how repletion develops, and how treatment restores the descending mandate of the center.

Signs

Aversion to heat

The energetic nature of Yang ming is one of cooling, collecting, and descending. Yang ming disease is a failure of this nature, which give rise to heat. This excess heat causes a person to avoid heat sources.

Aversion to cold may be seen in the early stages of Yang ming disease. 

Heat effusion

Heat effusion is the radiating of heat from the body. This is not the western idea of fever. In Yang ming channel patterns there will be strong heat effusion and sweat will be flowing freely. It is much more present than in a Tai yang pattern. In a Tai yang pattern the heat effusion is considered feather-warm heat effusion.

In Yang ming organ patterns the heat effusion is called afternoon tidal heat effusion.

Tidal heat effusion

Tidal heat effusion has momentum and comes in waves and in the late afternoon. A tidal fever has momentum, just like the tides of the ocean. The late afternoon is the time period of Yang ming.

The late afternoon is the time period and called ribuso in Chinese.

日晡所 – rì bū suǒ

·        日 (rì) – sun / day

·        晡 (bū) – late afternoon period

·        所 (suǒ) – place / time / the point at which 

The Jade Discourse describes Ribuso this way, This is the time of shen, 3-5 pm.

Explaining Writing and Analyzing Characters, The sun is yang and therefore male, thus this describes the beauty of the sun. When the sun begins to disappear, it is the most beautiful time of the day, thus the time of sundown is also referred to as ribu.

Where does the sun in the human body set. In yang ming. Yang ming rules the Earthly Branches of Shen, You, and Xu, and corresponds with the time period from 15:00-21:00. 

Remember, When the Yin fails to contain the Yang, the flow in the channels will become rapid, causing the Yang qi to become excessive and reckless. 

Spontaneous Sweating

In Yang ming channel patterns the sweat is abundant and streams outward over the whole body. In a Tai yang pattern the sweat is scant or light and flows slowly.

In Yang ming organ patterns the sweat is on the limbs. If there is enough fluids to sweat. Fluids may become damaged and then only observed on small part of the body, like the head. 

Thirst with desire to drink

Thirst occurs in both Yang min channel and Yang ming organ patterns because the heat damages fluids. In Yang ming excess patterns there will be a dry mouth and tongue with desire to drink water.

Thirst in general

The thirst of the three yang conformation is accompanied by distinctive symptoms.

Tai yang thirst accompanies tai yang bowel disease, and is caused by the inhibition of the tai yang transformation of Yin fluids.

Yang ming thirst is due to excess heat damaging the fluids. Yang ming thirst is part of the four great symptoms.

Shao yang thirst results from a failure of the pivot, and affects the opening and closing mechanisms as well as the three burners. Shao yang thirst is accompanied by symptoms of the pivot, alternating chills and fever, unpleasant fullness of the chest and rib sides, a fine wiry pulse, bitter taste, dry throat, and blurry vision. 

Tai yin disease is not characterized by thirst. If thirst is present, there is no desire to drink.

Shao yin disease is characterized by thirst, abundant clear urine and yin cold signs.

Jue yin disease is characterized by thirst with the ability to drink, and with the ability to disperse the fluids which causes more thirst.  

Plain Questions Chapter 5, The heart rules the tongue, the spleen rules the mouth.

Thirst results from the mouth and tongue being dry, from the spleen and heart, from the earth and fire elements.

Thirst and drought are analogous. In the macrocosm, there is drought, and in the microcosm of the human body, there is thirst. Both are the result of insufficient fluids moisturizing and nourishing the environment.

The water found in rivers, streams, lakes, and seas are by nature yin. They cannot moisten the myriad of things on their own. It requires the action of yang to transform them. One of the most important transformers is jue yin wood. 

Wood is generated by water, it is the child of water.

Yi and gui stem from the same source.

This is referring to the ten heavenly stems. Yi wood, the second heavenly stem, and gui water the tenth heavenly stem.

The heart is associated with the fire element, and it is the child of wood, and is generated by wood. In order for the tongue to receive moisture, wood must first draw this nourishment upward, and thus fire is dependent upon the yang of wood.

Because the liver belongs to wood and the pericardium to fire, this indicates that it is jue yin that most readily affects the mouth and tongue, the spleen and heart, and the earth and fire of the body. Which is why in jue yin disease there is dispersion thirst. The heat damages the fluids and there is thirst.

Abdominal fullness, distension, and pain

Abdominal fullness, distension, and pain occur in Yang ming organ patterns and these are usually severe and persistent. This is usually painful to touch. 

Inability to defecate

This includes absence of defecation, difficult defecation, and hard stools. This manifests from excessive dryness in Yang ming bowel patterns.

Heat bind with circumfluence

Diarrhea can be observed in Yang ming bowel patterns. Heat bind with circumfluence is when soft watery stool passes hard stool that is obstructing the intestines.

Spleen constraint

Spleen constraint is Tai yang Yang ming disease.

The signs of Spleen constraint are dryness of the intestines and hardening of the feces. It can be easily understood in the context of dryness and dampness. Spleen constraint means that the dampness related to the Tai yin is bound up. Once the Spleen dampness is bound, the Stomach’s dryness naturally increases, and constipation arises.

Why is Tai yang Yang ming called spleen constraint?

The following text comes from the Shang Han Lun.

247 When the instep pulse is floating and rough, floating means strong qi in the stomach, and rough means urination is frequent. The floating and rough qualities of the pulse indicate contention and the stool is hard, which means the spleen is strained; therefore ma zi ren wan governs.

An increase in urination leads to dryness in the intestines and the feces become hard. The bladder belongs to tai yang, thus it is called tai yang yang ming disease. 

Yellowing

Yellowing is divided into two types, Yang and Yin yellowing.

Yang Yellowing

Heat and dampness combine in the interior with signs of bright yellowing, inhibited urination, generalized heat, dry mouth, Heart vexation, glomus, possible blocked stool, and rapid pulse.

Yin Yellowing

Cold and dampness combine in the interior with signs of dark dull yellowing, aversion to cold, and desire for warmth, no heat effusion, sloppy stool, sunken and slow pulse. 

Delirious Speech

Delirious speech can occur in both Yang ming channel and Yang ming bowel patterns. It is the result of heat rising upwards. The voice is heavy and forceful.

In excess heat patterns the Heart mind may be clouded causing hallucinations.

In deficiency patterns the Heart mind may be clouded, but then the voice is faint and forceless, and this is called muttering. 

Basic Yang Ming Patterns

Heat Patterns

Yang ming channel pattern with great heat, great sweating, great thirst with desire to drink, great vexation, and a surging large long pulse, bai hu tang

Heart vexation, zhi zi chi tang

Damage to Tai yin Qi and fluids, bai hu jia ren shen tang

Warm water accumulation, zhu ling tang

Bowel Excess Patterns

Mild dryness excess with hard stool or inability to defecate, steaming heat effusion, sweating, heart vexation, tiao wei cheng qi tang

Heat bind excess with hard stool or inability to defecate, abdominal distension and fullness, tidal heat effusion, xiao cheng qi tang

Severe bowel excess with inability to defecate, heat bind with circumfluence, abdominal fullness hardness and pain, tidal heat effusion, da cheng qi tang

Strained Spleen, Tai yang Yang ming, ma zi ren wan

Transmuted Patterns

Damp Heat Yellowing Patterns

Yellowing, inhibited urination absence of sweating, thirst, and abdominal fullness, yin chen hao tang

Yellowing, heat effusion, heart vexation, and thirst, zhi zi bai pi tang

Yellowing, inhibited urination, heat effusion, and aversion to cold, and itching, ma huang lian qiao chi xiao dou tang

Blood Heat Patterns

Possible spontaneous external bleeding, dry mouth, heat effusion, delirious speech, black stool that is easy to pass, pus or blood in the stool, di dang tang

Deficiency Cold

Retching, inability to eat, hiccup, wu zhu yu tang

Yang Ming Patterns

Yang Ming Conformation of the Dry Metal of the West

The organs involved are the Stomach and Large intestine.

In the Shang Han Lun the Yang ming bowel is called the Stomach family and includes the Stomach, Small and Large Intestine.

胃家實

胃家實 Wèi jiā shí

·        胃 (wèi) – Stomach

·        家 (jiā) – household, domain, residence

·        實 (shí) – replete, full, excess (as opposed to deficiency)

家 (jia) does not simply mean “organ.” It means:

·        household

·        family

·        that which belongs to

·        the sphere or domain under governance 

In the flowing text the way that each of the Conformations manifests as disease is described. Each of the Conformations has a different way of manifesting. I used two different texts from The Yellow Emperor’s Classic to illustrate this manifesting.

Chapter 66

These are what is called Root; these are the so-called six principal qi.

What is above in jue yin, the wind rules it.

What is above in shao yin, the heat rules it.

What is above in tai yin, dampness rules it.

What is above in shao yang, the ministerial fire rules it.

What is above in yang ming, the dryness rules it.

What is above in tai yang, cold rules it. 

Wang Bing

The three yin and yang constitute the Tip.

Cold, dryness, fire, dampness, heat, wind constitute the Root. 

Chapter 74

Qi Bo,

The shao yang and the tai yin conform to the root.

The shao yin and the tai yang conform to the tip and root.

The yang ming and the jue yin conform to neither the tip nor the root, they conform to the center.

The shao yang and the tai yin conform to the root.

Wang Bing, The root of shao yang is fire, the root of tai yin is dampness. Root and tip agree, hence the text states, they confirm to their root.

The shao yin and the tai yang conform to the tip and root.

Wang Bing, The root of shao yin is heat, its tip is yin. The root of the tai yang is cold, its tip is yang.

The yang ming and the jue yin conform to neither the tip nor the root, they conform to the center.

Wang Bing, Within the yang ming is tai yin and within the jue yin is shao yang. Root and tip differ from what is in the center.

Yang ming

Within the yang ming is tai yin center

26 When, after gui zhi tang is taken and a great sweat has issued, there is great vexation and thirst, and the disease is unresolved and the pulse is surging and large, bai hu jia ren shen tang governs.

The center dampness is excessively dry. 

176 When in cold damage the pulse is floating and slippery, this means there is heat in the exterior and cold in the interior, bai hu tang governs.

The center dampness is excessively dry and cold. 

180 In disease of yang ming the stomach domain is replete.

The center is dry causing excess. 

181 Question: Why does one get yang ming disease? Answer: In tai yang disease, if sweating is promoted, if precipitation is used, or if urination is disinhibited, this causes liquid and humor collapse and dryness in the stomach; hence there is a shift to the yang ming. No changes of clothes, internal repletion, and difficult defecation; these are signs of yang ming.

The center is dry causing difficult defecation.

Heat Patterns

Zhi zi chi tang

Line 221 When in yang ming disease, the pulse is floating and tight, the throat is dry and there is a bitter taste in the mouth, abdominal fullness, panting, heat effusion, sweating, absence of aversion to cold, and instead, aversion to heat is present and there is generalized heaviness, if sweating is promoted, there will be agitation, restiveness of the heart but delirious speech. If one adds a warm needle, there will be apprehensiveness and vexation and agitation with inability to sleep. If one precipitates, there will be empty vacuity in the stomach, visiting qi stirring the diaphragm, anguish in the heart, and if fur arises on the tongue zhi zi chi tang governs.

zhi zi 9 dan dou chi 9

Line 228 When in yang ming disease, precipitation is used and there is heat in the exterior, warm extremities, no chest bind, anguish in the heart, hunger with inability to eat, and sweating only from the head, zhi zi chi tang governs.

After sweating, vomiting or purging, there is deficiency vexation and inability to attain sleep, if it gets worse, there will be continuous tossing and turning, with anguish in the heart, and zhi zi chi tang governs. If there is shortness of breath, zhi zi gan cao chi tang governs. If there is retching, zhi zi sheng jiang chi tang governs.

Bai hu tang

Line 176 When in cold damage the pulse is floating and slippery, this means there is heat in the exterior and cold in the interior, bai hu tang governs.

Line 219 In combination disease of the three yang, there is abdominal fullness, generalized heaviness, difficulty turning sides, insensitivity of the mouth, grimy face, delirious speech and enuresis. If sweat spontaneously issues, bai hu tang governs. If sweating is promoted, there will be delirious speech and if precipitation is used, sweat will arise on the forehead and there will be reversal cold of the extremities.

shi gao 48 zhi mu 18 geng mi 18 zhi gan cao 6 

Bai hu jia ren shen tang

Line 169 When in cold damage great heat effusion is absent and there is a dry mouth, thirst, heart vexation, and a slight aversion to cold in the back, bai hu jia ren shen tang governs.

Line 168 When in cold damage, if vomiting is used, or if precipitation is used and after seven or eight days there is no resolution, the heat is bound in the interior, with heat in the exterior and interior, frequent aversion to wind, great thirst, dry tongue, vexation, and a desire to drink several sheng of water, then bai hu jia ren shen tang governs.

Line 222 If there is thirst with desire to drink water, dry mouth, and a dry tongue, then bai hu jia ren shen tang governs.

shi gao 48 zhi mu 18 geng mi 12 zhi gan cao 6 ren shen 9

Zhu ling tang

Line 223 If the pulse is floating and there is heat effusion, thirst with a desire to drink water, and inhibited urination, then zhu ling tang governs.

This may occur due to mistreatment. Not urinating is the key.

Line 224 When in yang ming disease, there is copius sweating and thirst, one cannot give zhu ling tang because with copious sweat the stomach is dry and zhu ling tang disinhibits the urine.

Here urinating is not a problem so do not use zhu ling tang because it will make the fluid loss worse.

zhu ling 9 fu ling 9 ze xie 9 e jiao 9 hua shi 9

Excess Patterns 

Tiao wei cheng qi tang

Line 248 When tai yang disease has lasted for three days, and sweating is promoted but there is no resolution of the disease and there is steaming heat effusion, this belongs to the stomach, and tiao wei cheng qi tang governs.

Line 249 When in cold damage, if after vomiting is used, there is abdominal distension and fullness, give tiao wei cheng qi tang. 

Line 207 When in yang ming disease, neither vomiting nor precipitation was used and there is heart vexation, one can give tiao wei cheng qi tang.

da huang 12 mang xiao 12 zhi gan cao 6

Xiao cheng qi tang

Line 213 When in yang ming disease the person is sweating copiously, because liquid and humor are issuing outwards, the stomach becomes dry and the stool will be hard. With hard stool, delirious speech will follow, and xiao cheng qi tang governs. If after one dose the delirious speech stops, no more should be taken.

Line 214 When in yang ming disease there is delirious speech, tidal heat effusion, and a pulse that is slippery and racing, xiao cheng qi tang governs. When, as a result of using one sheng of xiao cheng qi tang there is a shifting of qi in the abdomen, again take one sheng; if there is no shifting of qi, do not give it again. The next day, if there is again inability to defecate, but the pulse is faint and rough, this indicates internal vacuity. This is difficult to treat and one cannot give xiao cheng qi tang again.

Line 250 When in tai yang disease, if after vomiting, precipitation, or the promotion of sweating, there is mild vexation, frequent urination, and as a result, hard stool, give xiao cheng qi tang to harmonize and bring about recovery.

hou po 6 da huang 12 zhi shi 3

Da cheng qi tang

Line 220 When in drag over disease of the two yang, the tai yang disease has ceased and there is only tidal heat effusion, sweat streaming from the extremities, difficult defecation and delirious speech, precipitation will bring about recovery and therefore da cheng qi tang is appropriate.

Line 241 When after great precipitation there is inability to defecate for six or seven days, unresolved vexation, and abdominal fullness and pain, this means there is dry stool. Why this is so is because the root is abiding food for which da cheng qi tang is appropriate.

Line 242 When the person has inhibited urination, intermittently difficult and easy stool, periodic mild heat, panting and veiling, and is unable to sleep, this means that there is dry stool, and therefore da cheng qi tang is appropriate.

Line 252 When in cold damage that has lasted for six or seven days, there is unclear vision, disharmony of the eyes, neither an exterior or interior pattern, difficult defecation, and mild generalized heat, this indicates repletion, so precipitation is urgent and therefore da cheng qi tang is appropriate.

Line 253 When in yang ming disease there is heat effusion and copious sweating, precipitation is urgently required and therefore, da cheng qi tang is appropriate.

Line 254 When sweating is promoted, but brings no resolution, and there is abdominal fullness and pain, precipitation is urgent, and therefore da cheng qi tang is appropriate.

Line 255 When abdominal fullness does not decrease, or decreases insufficiently to speak of, one should precipitate, and in such cases da cheng qi tang is appropriate.

Line 256 In yang ming and shao yang combination disease, there will be diarrhea and when the pulse is not contrary, it means that the disease is in favorable sequence. When the pulse is contrary, it means deviation from the normal sequence and mutual restraining and robbing, so it is called contrary. When the pulse is slippery and fast it means there is abiding food. One should precipitate and therefore da cheng qi tang is appropriate.

Line 215 When in yang ming disease, there is delirious speech and tidal heat effusion, but inability to eat, this means that there must be five or six pieces of dry stool in the stomach. Da cheng qi tang is appropriate for precipitation.

Line 217 When there is sweating and delirious speech because of dry stool in the stomach, this indicates wind. One must precipitate, and since there has been channel passage, one can precipitate. Precipitation if used to early, will result in deranged speech, this being because of exterior vacuity and interior repletion. Precipitation will bring about recovery and therefore da cheng qi tang is appropriate.

Line 238 When in yang ming disease, precipitation is used and there is anguish and vexation in the heart and dry stool in the stomach, one can attack. If there is mild abdominal fullness, and stool that is hard at the beginning and then sloppy, one cannot attack. If there is dry stool, da cheng qi tang is appropriate.

hou po 6 da huang 12 mang xiao 9 zhi shi 3

Comparison Da cheng qi tang and Xiao cheng qi tang

While da cheng qi tang is used for glomus, fullness and repletion, xiao cheng qi tang is used for dry stool, glomus, and fullness where the dryness heat is less severe. Therefore there is no need for mang xiao. The difference is the presence of heat.

Line 208 When in yang ming the pulse is slow, even though there is sweating, and aversion to cold is absent, there will be generalized heaviness, shortness of breath, abdominal fullness, panting, and tidal heat effusion, which means the exterior is about to resolve and one can attack the interior. Sweat streaming from the extremities indicates the stool is already hard and therefore da cheng qi tang governs. If there is copious sweating, mild heat effusion and aversion to cold, the exterior has not yet resolved, and given that this heat is not tidal, one cannot give cheng qi tang. If there is great abdominal fullness and the stool is blocked, one can give xiao cheng qi tang to harmonize the stomach qi mildly, but must not cause great discharge and precipitation. 

Line 209 When in yang ming disease, there is tidal heat effusion and slightly hard stool, one can give da cheng qi tang, but if there is no hardness, one cannot give this formula. If the patient has not been able to defecate for six or seven days and one fears there is dry stool, the way to find out is to give a small amount of xiao cheng qi tang. When the decoction enters the abdomen, passing of fecal qi indicates dry stool and one can attack. But if there is no passing of fecal qi, only hard first, then sloppy stool, one cannot attack, for if one attacks, there will be abdominal fullness and inability to eat. There is a desire to drink water and when water is given, there is immediate hiccupping. After this, there is heat effusion and the stool will again be hard and scant, so use xiao cheng qi tang to harmonize. If there is no passing of fecal qi, one should be cautious and cannot attack.

Line 251 When in an illness that the person has had for two or three days, the pulse is weak, there is neither a tai yang nor a chai hu tang pattern, and there is vexation and agitation, and hardness below the heart, then at four or five days, although the person is able to eat, one can give a very small amount of xiao cheng qi tang to harmonize and quiet. At six days, give one sheng of xiao cheng qi tang. If there is inability to defecate for six or seven days and scant urination, although the person will not accept food and there is only stool that is hard at the beginning and then sloppy, it is not yet formed and hard, and if one attacks, there will be sloppy stool. There must be uninhibited urination and hard formed stool, then one can attack and therefore da cheng qi tang is appropriate.

Ma zi ren wan

Line 247 When the instep pulse is floating and rough, floating means strong qi in the stomach, and rough means urination is frequent. The floating and rough qualities of the pulse indicate contention and the stool is hard, which means the spleen is strained; therefore ma zi ren wan governs.

hou ma ren 12 da huang 12 hou po 9 xing ren 6 bai shao 6 zhi shi 6

Transmuted patterns 

Yin chen hao tang 

Line 236 When in yang ming disease, there is heat effusion and sweating, this means that the heat is straying, and unable to cause yellowing. Sweating only from the head, not from the body, and stopping at the neck, as well as inhibited urination and thirst with intake of fluids, indicates stasis heat in the interior. Hence there will be generalized yellowing and therefore yin chen hao tang governs. 

Line 260 When in cold damage that has lasted for seven or eight days, there is generalized yellowing the color of tangerine, inhibited urination, and mild abdominal fullness, yin chen hao tang governs. 

yin chen hao 18 zhi zi 15 shu da huang 6 

Zhi zi bai pi tang 

Line 261 In cold damage with generalized yellowing and heat effusion, zhi zi bai pi tang governs. 

zhi zi 15 huang bai 6 zhi gan cao 6 

Ma huang lian qiao chi xiao dou tang 

Line 262 In cold damage with stasis heat in the interior, there will be generalized yellowing, ma huang lian qiao chi xiao dou tang governs.

ma huang 6 lian qiao 6 chi xiao dou 24 xing ren 6 sheng jiang 6 da zao 6 zhi gan cao 6 yin chen hao 24

Blood Heat Patterns 

Blood aspect patterns are the result of one of the following.

• Dryness heat entering the Blood layer.
• Enduring static Blood combining with heat

Di dang tang 

Line 237 When in yang ming disease the person is forgetful, there will be blood amassment. Why this is so is because originally there was enduring blood amassment, thus causing forgetfulness and stool, that although hard, is nevertheless easy to pass, and that will be black in color. It is appropriate to precipitate with di dang tang. 

Line 257 When the person has neither an exterior nor an interior pattern and has heat effusion for seven days, although the pulse is floating and rapid, one can precipitate. If precipitation has already been used and the pulse is still rapid, having not resolved, the heat has combined with the blood, so there is swift digestion and rapid hungering, and inability to defecate for six or seven days, which means that there is static blood, therefore di dang tang is appropriate. 

jiu da huang 9 tao ren 3 shui zhi 9 di bie chong (originally mang chong 9)

Patterns Identification 

Line 190 In yang ming disease, if the person is able to eat, it is called wind strike, if unable to eat, it is called cold strike.

Line 191 In yang ming disease, if it is cold strike and there is inability to eat, uninhibited urination, and sweat streaming from the extremities, this means that there is about to be a firm conglomeration and there will be stool first hard and then sloppy. Why this is so is because there is cold in the stomach and no separation of water and grain.

Line 197 When there is yang ming disease, but sweating is absent and the urine is uninhibited, and there have been two or three days of retching and coughing and reversal of the extremities, the person will suffer from a head ache. If cough, retching, and reversal of the limbs are absent, head ache will also be absent.

Line 198 When in yang ming disease, there is dizzy head only without aversion to cold, and consequently, the person is able to eat, and coughs, there will be sore throat. If cough is absent, the throat will not be sore.

Line 226 If there is vacuity cold in the stomach and inability to eat, drinking water will result in hiccup.

Wu zh yu tang

Line 243 A desire to retch after eating belongs to yang ming, wu zhu yu tang governs. But when taking the decoction makes the retching more severe, this pattern belongs to the upper burner.

Wu zhu yu is a warm formula which when taken the retching worse means that there is heat in the Stomach and upper burner.

wu zhu yu 24 sheng jiang 18 ren shen 9 da zao 6

Main Yang Ming Herbs 

All herbs are described according to how they interact with one or more of the Six Conformations. It is my intent to keep the description short, and mainly address the best qualities of each herb, not all its characteristics.

Shi gao, Gypsum

Shi gao Yang ming disperses and cools yang ming channel and cools stomach heat

Shi gao Tai yin cools lung heat

Zhi mu, Anemarrhenae rhizome

Zhi mu Jue yin nourishes and cools blood

Geng mi, Semen Oryzae, nonglutinous rice

Geng mi Yang ming tonifies stomach while moistening

Geng mi Tai yin tonifies spleen while moistening

Zhi gan cao, Glycyrrhizae radix prep stir fried with honey

Zhi gan cao Yang ming tonifies stomach while moistening

Zhi gan cao Tai yin tonifies spleen while moistening

Zhi gan cao Shao yin nourishes heart blood

Ren shen, Ginseng radix

Ren shen Tai yin tonifies spleen and lung while moistening and raising clear qi

Ren shen Shao yin tonifies original qi

Zhi zi, Gardeniae fructus

Zhi zi Shao yang clears heat in the san jiao

Dan dou chi, Sojae semen praeparatum 

Dan dou chi Tai yang surface warming 

Dan dou chi Yang ming stomach qi moving and warming 

Zhu ling, Polyporus sclerotium

Zhu ling Shao yin move water

Fu ling, Poria

Fu ling Shao yin moves water

Ze xie, Alismatis rhizome

Ze xie Yang ming promotes water separation

Ze xie Shao yin move water

E jiao, Asini corii colla

E jiao Jue yin nourishes yin and blood

Hua shi, Talcum

Hua shi Shao yin moves and cools water

Da huang, Rhei rhizoma

Da huang Yang ming clears accumulations of stool and heat

Zhi Da Huang, Rhei rhizoma praep, steamed with rice wine, also known as Shu Da Huang, Zhi or Shu Chuan Jun, Zhi or Shu Jin Wen This refers to Rhubarb which has been steamed or stewed in rice wine. Warmer than da huang.

Shu da huang Yang ming clears accumulations of stool

Jiu da huang, Rhei rhizoma praep, wine mixed fried aka jiu xi da huang

Jiu da huang Yang ming accumulation clearing of the upper burner

Mang xiao, Natrii sulfas

Mang xiao Yang ming moistening and descending

Hou po, Magnoliae cortex

Hou po Yang ming tonifies and transforms dampness while descending qi

Zhi shi, Aurantii fructus immaturus

Zhi shi Yang ming descends excess accumulation in stomach domain

Zhi shi Shao yang drains accumulations and moves qi in liver and gallbladder

Huo ma ren, Cannabis semen

Huo ma ren Yang ming moistening

Huo ma ren Jue yin nourishes blood

Xing ren, Armeniacae semen

Xing ren Tai yin disperses and descends lung

Bai shao, Paeoniae radix lactiflora

Bai shao Jue yin nourishes and moves blood

Yin chen hao, Artemisiae scopariae herba

Yin chen hao Tai yang clears damp and heat on the surface

Yin chen hao Shao yang damp and heat clearing in san jiao

Yin chen hao Tai yin clears heat and percolates dampness 

Huang bai, Phellodendri cortex

Huang bai Shao yang clears heat and damp in lower burner

Huang bai Jue yin clears heat to cool blood

Ma huang, Ephedrae herba

Ma huang Tai yang warms the surface

Ma huang Tai yin disperses and descends the lung

Ma huang Shao yin strongly increases heart yang

Lian qiao, Forsythiae fructus

Lian qiao Tai yang clears the surface of heat and dampness

Chi xiao dou, Phaseoli semen

Chi xiao dou Tai yang drains dampness

Chi xiao dou Yang ming drains damp heat in stomach domain

Sheng jiang, Zingiberis rhizoma recens

Sheng jiang Tai yang warms the surface

Sheng jiang Yang ming tonifies and disperses excess fluids in stomach

Sheng jiang Tai yin tonifies and warms spleen and lung and sends clear qi upwards

Da zao, Jujubae fructus

Da zao Tai yin tonifies spleen while moistening

Da zao Jue yin nourishes blood

Tao ren, Persicae semen

Tao ren Yang ming descends, moistens and drains to break stagnations

Tao ren Jue yin moves and breaks blood

Shui zhi, Hirudo, leech

Shui zhi Jue yin blood breaking

Di bie chong, Eupolyphaga, aka tu bie chong, wingless cockroach

Di bie chong Jue yin blood breaking

Wu zhu yu, Evodiae fructus

Wu zhu yu Yang ming warms and dries the stomach

Wu zhu yu Tai yin warms and dries the spleen

Wu zhu yu Jue yin warms ministerial fire

Formulas According to Conformations

The following formulas are listed and described for reference. I only describe the Conformations influenced by the herbs in the formulas to express the normal physiology of the body.

bai hu tang

shi gao 48 zhi mu 18 geng mi 18 zhi gan cao 6 

yang ming, tai yin, shao yin

bai hu jia ren shen tang

shi gao 48 zhi mu 18 geng mi 12 zhi gan cao 6 ren shen 9 

Modified bai hu tang yang ming, tai yin, shao yin, ren shen extra tai yin, shao yin

zhi zi chi tang

zhi zi 9 dan dou chi 9

tai yang, yang ming, shao yang

zhu ling tang

zhu ling 9 fu ling 9 ze xie 9 e jiao 9 hua shi 9 

yang ming, shao yin, jue yin

tiao wei cheng qi tang

da huang 12 mang xiao 12 zhi gan cao 6 

yang ming, tai yin, shao yin

xiao cheng qi tang

hou po 6 da huang 12 zhi shi 3 

yang ming, shao yang

da cheng qi tang

hou po 6 da huang 12 mang xiao 9 zhi shi 3

yang ming, shao yang

ma zi ren wan

hou ma ren 12 da huang 12 hou po 9 xing ren 6 bai shao 6 zhi shi 6

yang ming, shao yang, tai yin, jue yin

Yin chen hao tang 

yin chen hao 18 zhi zi 15 shu da huang 6 

tai yang, yang ming, shao yang, jue yin 

zhi zi bai pi tang

zhi zi 15 huang bai 6 zhi gan cao 6 

yang ming, shao yang, shao yin, jue yin

ma huang lian qiao chi xiao dou tang

ma huang 6 lian qiao 6 chi xiao dou 24 xing ren 6 sheng jiang 6 da zao 6 zhi gan cao 6 yin chen hao 24 

tai yang, yang ming, tai yin, shao yin, jue yin

di dang tang

jiu da huang 9 tao ren 3 shui zhi 9 di bie chong (originally mang chong 9)

yang ming, jue yin

wu zhu yu tang

wu zhu yu 24 sheng jiang 18 ren shen 9 da zao 6

tai yang, yang ming, tai yin, shao yin, jue yin

Conclusion

Yang Ming is not merely a stage of blazing heat or hardened stool; it is the revelation of dryness at the center. Where Tai Yang begins at the surface, Yang Ming consolidates in the interior. It is the moment when fluids have been taxed, when the pivot of moistening and descending has failed, and when the Stomach domain - wei jia 胃家 - becomes replete.

To understand Yang Ming is to understand the responsibility of the center. Dryness is its root qi, yet when dryness exceeds its mandate, heat arises, fluids are consumed, and repletion forms. The four greats, great heat, great sweat, great thirst, and a great pulse are not random symptoms, but the signature of a center that has lost its capacity to gather and descend. Tidal heat at ribu time, delirious speech, abdominal fullness, and difficult defecation all testify to the same principle: the Earth has become too dry to transform and transport.

The classical formulas do not simply purge or cool; they restore order to the domain. Bai Hu Tang clears channel heat while protecting the center. The Cheng Qi Tang formulas descend and free what has bound. Ma Zi Ren Wan moistens where dryness has strained the Spleen. Even in yellowing or blood heat patterns, the strategy remains consistent: regulate the center so that the conformation may resume its proper function.

The Huang Di Nei Jing and Wang Bing remind us that Yang Ming conforms neither to root nor tip, but to the center. Within Yang Ming is Tai Yin. This is its secret. Excess dryness is always in relationship to dampness; heat is always in relationship to Earth. When treatment respects this relationship, transformation resumes, fluids return, and the Stomach household regains harmony.

Thus Yang Ming teaches us that disease at its height is also an opportunity. When the interior is full and the signs are clear, the method is decisive. To recognize Yang Ming is to recognize the clarity of repletion, to act at the proper moment, and to restore the descending mandate of the West—the Dry Metal that gathers, collects, and completes the cycle.

In this way, Yang Ming is not only the culmination of heat, but the restoration of balance at the center of life itself.