The Dynamics of Shang Han Lun ⑩ Particulars-Part 1
Commentary (2)
At the end of the sentence, the world ‘Wuling Power’ is written in Gui Lin Gu Ben (桂林古本), even though not written in Song Version (Song Ben, 宋本) and its interpretation is as follows:
In case of no chest bind (Jie Xiong Xheng, 结胸症), the severity of sickness is mild according to the symptoms, then use Wuling Powder to treat some symptoms of yellow. No mention about the clear state of the region below the heart appears.
While in Shang Han Lun there are many sentences and formulas which are mentioned to be connected with the state of below the heart.
We can find a few sentences about Wuling Powder treating glomus below the heart in Song Version. Next provision gives an explanation about it.
Sentence (2)
When, because originally precipitation was used, therefore, a glomus below the heart, give Xie Xin Decoction. If the glomus does not resolve and the person is thirsty, has a dry mouth, vexation and inhibited urination Wuling Powder governs (『Shang Han Lun』 Line 156, p244, PPV; Line 244 also can be referred.). Wuling Powder does not contain Huangjin or Renshen and has only herbs which drain water: Zhuling, Fuling, Zhexie, Baizhu and Guizhi.
Sign symptoms of Wuling Powder are watery sound below the heart or palpitation below the heart, but sometimes glomus below the heart is its sign symptom.
In Shang Han Lun, the region of below the heart is understood as a place where rising yang qi and descending yin qi must meet to be harmonious.
Sometimes exterior pathogenic qi and inner normal qi confront against each other and cause imbalance between water and fire. This imbalance appears with various types of glomus below the heart.
Some examples of different types of glomus below the heart in Shan Han Lun are: glomus of qi (『Shang Han Lun』 Line 151), glomus of visiting qi(ibid. Line 158), glomus of water-qi (ibid. Line 40, 41) or glomus of complex types (ibid Line 152, hard glomus and fullness below the heart and pain extending under the rib-side).
In some cases, the texture of glomus were describes in the sentences as hard glomus like a stone (ibid, Line 135), sogginess below the heart (ibid, Line 375) or fullness below the heart (ibid. Line 355) with the exception given as hard glomus only.
In practice many times, the differentiation between hard glomus below the heart and glomus below the heart is not clear. The practitioner has to observe and palpate the condition of below the heart and analyze with other symptoms such as rumbling sound, palpitation or hypertonicity.
According to great doctor Yoshimasu, todo’s teaching, one of the most important aspects for beginners of abdominal diagnosis is to connect sign symptom to a designated herb. For example, if you find hard glomus below the heart then one should be able to connect to sign symptom of Huangjin or Renshen or both of them.
In addition, another important idea is that sign symptoms’ need to be explained in relationship to a movement of water and fire or liquid and energy, to understand dynamics included in sign symptom.
Especially below the heart is a place where two categories are met and connected, i.e. the middle burner of the three burners and the lung meridian, which is the beginning channel; as one of twelve channels.
Therefore, theoretically, the state of below the heart has a dynamic relationship with other symptoms and sign symptoms, so we need to observe from around below the heart to every palpable portion of the abdomen, from the view point of the relation between water and fire or liquid and energy.
Sentence (3)
When cold damage has lasted for five or six days and is marked by retching and heat effusion and Shao Caihu Decoction signs are present, if other medicinals are used to precipitate and the Small Caihu Decoction signs still present, one can still give Shao Caihu Decoction. Although precipitation has already been used, it is not an adverse treatment and after the formula is given there will be steaming and quivering, then heat effusion and sweating by which the disease resolves. If there is fullness, hardness and pain below the heart, this indicates chest bind; therefore Da Xian Xiong Decoction governs. If there is fullness only, without pain, this indicates a glomus; therefore one should not give Shao Caihu Decoction and Banxia Xie Xin Decoction (ibid. Line 149, p.234, PPV).
