shanghanlun

Greater Yang & Yang Brightness Combination Disease (line 32 and 33)

By Fornia ⋅ March 11, 2008 ⋅  Print This Post ⋅ Post a comment

There is another line where we see a Greater Yang and Young Brightness Combination Disease (太阳与阳明合病), but over there, precipitation is not recommended because the patient also suffers from panting and a tight chest (喘而胸满).

On Diarrhea with exterior symptoms:

太阳与阳明合病者必自下利，葛根汤主之。 (line 32)

Not here in line 32. This is where the illness in the Greater Yang has moved into the Yang Brightness, but is still straddling both. The way to solve this is to bring it back out. This is termed bring the ship back against the tide (逆流挽舟). This terms is associated with 人参败毒散, which is used to treat diarrhea with exterior symptoms (痢疾有表证). That said, Pueraria Decoction (葛根汤) was created long before the advent of 人参败毒散, to do just that.

On Vomiting:

太阳与阳明合病，不下利但呕者，葛根加半夏汤主之。 (line 33)

This line says that during a Greater Yang and Yang Brightness Combination Disease, when there isn’t diarrhea but vomiting instead, we should use Pueraria Plus Pinella Decoction (根根加半夏汤). Note thought that this decoction is more accurately called Pueraria Decoction Plus Pinella. In any case, we can infer from this line that Pinella (半夏) is anti-emetic.

Remember though that line 33 is suggesting we use Pueraria Decoction for a situation of no diarrhea. This is interesting.

The Takeaway:

1. If there’s diarrhea: use Pueraria Decotion (葛根汤).
2. If there’s vomiting and no diarrhea: use Pueraria Plus Pinella Decoction (葛根加半夏汤).

The Bigger Summary:

Pueraria Decotion (葛根汤) is used for two type of problems:

1. Pain, especially stiffness in the nape.
2. Gastrointestinal problems, especially diarrhea.

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