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Differentiation of syndromes according to the theory of the six meridiansDifferentiation of syndromes according to the theory of the six meridians and subsequent determination of treatment belong to the theoretical system expounded in the book On Febrile Diseases Due to Invasion of Cold. It represents the development and application of the theory of meridians and collaterals from The Internal Classic. This method is mainly used in the differentiation of exogenous diseases. The pathological manifestations of these exogenous diseases at different stages of development are classified into six syndromes according to their characteristics. These are Taiyang, Yangming and Shaoyang syndromes, and Taiyin, Shaoyin and Jueyin syndromes. The former three are known as the three yang syndromes, while the latter three are referred to as the three yin syndromes. Differentiation of syndromes according to the theory of six meridians is closely related to the meridians and zang - fu organs. In terms of the meridians, the Taiyang, Yangming and Shaoyang Meridians traverse the posterior, anterior and lateral aspects of the body respectively. Consequently Taiyang syndrome may exhibit neck rigidity and pain in the posterior aspect of the head and neck ; Yangming syndrome may manifest as flushed face, and fullness and pain in the abdomen ; and in Shaoyang syndrome, fullness and distension in the costal and hypochondriac regions are present. As for the three yin syndromes, the abdominal pain and diarrhea of Taiyin syndrome, the dryness of the mouth and throat of Shaoyin syndrome, and the pain and heat sensation in the heart, and vertical pain of Jueyin syndrome all relate to areas the three yin meridians traverse. When correlated to the zang - fu organs, the three yang syndromes identify pathological changes of the six fu organs. The bladder, for example, is the fu organ of Taiyang. When pathogenic factors are transmitted from the meridian to the fu organ, hence affecting the function of the bladder, retention of harmful water and dysuria may appear. The downward transmission of dryness and heat of the stomach, the fu of Yangming, may lead to symptoms and signs of the gastrointestinal tract such as constipation, and abdominal pain which is aggravated by pressure. Pathogenic invasion of the gallbladder, the fu of Shaoyang, may give rise to a bitter taste in the mouth and hypochondriac pain. Similarly, differentiation of the three yin syndromes is based upon pathological changes of the five zang organs. Examples are deficiency of the spleen yang in Taiyin syndrome, deficiency of the heart and kidney is Shaoyin syndrome and disturbance of the liver qi in Jueyin syndrome. Thus, it can be seen that differentiation of syndromes according to the theory of the six meridians reflects pathological changes of the meridians and zang - fu organs. Integral to this method of differentiation is the analysis of the stages of pathological development, including rules governing the transmission and transformation of diseases that result from the invasion of exogenous pathogenic cold. In this context it cannot be equated with differentiation of syndromes according to the theories of meridians and collaterals, and zang - fu organs. Differentiating syndromes according to the six meridians entails making an analysis and synthesis of various pathological manifestations of exogenous diseases and their development in terms of the strength of resistance to the disease, the virulence of the pathogenic factors and the depth of disease. In this way, the pathology is determined, which subsequently serves as a guide to treatment. In the three yang syndromes, the antipathogenic qi is strong and the pathogenic factor is hyperactive ; the disease tends to be active, manifesting syndromes of heat and excess nature. Treatment is aimed at eliminating the pathogenic factors. In the three yin syndromes, the pathogenic factor is hyperactive, while resistance to the disease is weak ; the disease tends to be inactive manifesting syndromes of cold and deficiency nature. In this case the emphasis of the treatment is laid on promoting the antipathogenic qi. Although syndromes of the six meridians differ, they are interrelated. Generally, exogenous diseases develop from the exterior to the interior. However, there are exceptions such as concurrent diseases in which there is a simultaneous onset of disease in two or three meridians ; overlapping of diseases in which another meridian is affected even before the previously affected meridian has been cured ; direct invasion of one of the six meridians by exogenous pathogenic factors ; and transmission of diseases between a pair of externally and internally related meridians. In order to arrive at a correct diagnosis and hence to obtain the anticipated results from treatment, a good command of the basic and complicated syndromes is required. |
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