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Introduction:

It sounds like a hideous name, but to me the outstanding characteristic of this pattern is maculae and no pus - think “SKIN PROBLEM.” And while it’s called Yin-yang poison, we can just think of this as pattern as “poison.” The yin-yang refers to the usual method of sub-categorizing. Note that both yin poison and yang poison are just as heaty in nature, one just slightly less than the other.

On 阳毒：阴毒之为病，面赤斑斑如锦文，咽喉痛，唾脓血 …

On 阴毒：阳毒之为病，面目青，身痛如被枚，咽喉痛 …

Note that yin or yang here refers to the character of the symptoms exhibited. We can use the color of the face as well as whether the patient is coughing blood and pus to be the differentiator. The similarity is that ubiquituous sore throat present in both.

Treatment:

• For 阳毒，use 升麻鳖甲汤
• For 阴毒，use the same, but take away 雄黄 and 蜀椒.

I personally see the yin and yang as indicators of the severity of the heat in the body. Because the heat isn’t as intense in 阴毒, we can take out some of the heaty and poisonous drugs, which to me are there to counter the poisons.

Of course, another take on this is that a mistake was made in the original text, that we should take away 雄黄 and 蜀椒 for 阳毒 since the body is already in a state of intense heat, you don’t want to add oil to the furnace.