Differentiation of syndromes according to the 6 channels originally appeared in the Traditional Chinese Medicine classic called the "Shang Han Lun", which can be loosely translated as "On Cold Damage". It was written by Zhang Zhong Jing in the late Han Dynasty, circa 20-200 A.D.

The original text was then divided into two texts, one being the "Shan Han Lun" which focused on external conditions, and the other being the "Jin Kui Yao Lue" which focuses on internal conditions. Many of the herbal formulas from these two texts are not only very elegant, but still useful today.

Tai Yang (Initial Yang) Syndromes

The Tai Yang syndrome corresponds to the initial invasion of the external Cold Evil through the pores and interstices of the skin.

General symptoms:

The stiff neck and headache will be located in the Tai Yang (Bladder and Small Intestine Channel) areas of the body. The floating (superficial) pulse is located in the exterior, and with the finger raised, it has a surplus, when pressing down it is insufficient, weak, or disappears. When pressure is released, it regains full strength.

A fever ensues when the strong Zheng (Upright) Qi of the body engages the Wind-Cold invasion (Cold Evil) at the surface level of the body. Tai Yang syndrome fevers are relatively mild because the invading cold is weak compared to the body's Wei (Defensive) Qi, as it is in the initial stage of entering the body.

If the cold evil becomes stronger because the Wei (Defensive) Qi is weak or easily depleted, the fever will increase as the pathogen penetrates deeper into the Yang Ming or Shao Yang channels. The Tai Yang fever is generally accompanied by chills, at least in the initial stages of the invasion.

Nasal discharge and sneezing are not included in the general symptoms for the Tai Yang syndrome.

A. Tai Yang Zhong Feng Syndrome

Febrile Disease caused by Wind (External Deficiency)

Symptoms:

Treatment

Formula: Gui Zhi Tang (Cinnamon Twig Decoction)

Function: Releases the pathogenic influences from the muscle layer and harmonizes the nutritive (Ying) and defensive (Wei) Qi.

Contents:

B. Tai Yang Shang Han Syndrome

Febrile Disease caused by Cold (External Excess)

Symptoms:

Treatment

Formula: Ma Huang Tang (Ephedra Decoction)

Function: Releases the Exterior Cold and arrests wheezing. Opens the Lung Qi and induces sweating.

Contents:

Acupuncture Points: (Appropriate for both external deficiency and external excess syndromes) Zhong Feng and Shang Han

Yang Ming (Greater Yang) Syndromes

As the pathogenic factor invades the interior of the body in the Yang Ming stage, both the Zheng (Upright) Qi and the Evil (Xie) Qi are strong, turning the excess pathogen in to heat within the body. Yang Ming fevers are therefore more severe than fevers in the Tai Yang stage. In the Yang Ming Syndrome, there are no chills. There are two types of Yang Ming Syndromes, one that involves the channel, and the other involves the related Zang Fu (Stomach and Large Intestine organs). Both of these syndromes can occur at the same time.

A. Yang Ming Jing (Channel) Syndrome

Symptoms (The Four Big's):

Treatment

Formula: Bai Hu Tang (White Tiger Decoction)

Function:Clears Qi Stage and Yang Ming Channel Heat; Drains Stomach Fire, generates body fluids and alleviates thirst.

Contents:

B. Yang Ming Fu (Organ) Syndrome

Symptoms:

Treatment

Formula: Da Cheng Qi Tang (Major Order the Qi Decoction)

Function: Vigorously purges the Heat Accumulation (induces defecation).

Contents:

Shao Yang (Lesser Yang) Syndrome

The Tai Yang stage involves Evil pathogens (Cold, Wind) on the exterior of the body which need to be released or "sweated out." The Yang Ming stage involves pathogenic Heat in the Interior which need to be purged through the bowels. In between these two stages is the Shao Yang syndrome where the pathogen is between Internal and External.

Although the Shao Yang symptoms include both chills and fever, these symptoms alternate from one to the other. The related channels of the Shao Yang syndrome are the San Jiao, Gallbladder, Pericardium, and Liver.

Symptoms:

Treatment

Formula: Xiao Chai Hu Tang (Minor Bupleurum Decoction)

Function: Harmonizes and releases Shao Yang (lesser yang) channel disorders.

Contents:

Acupuncture Points:

Tai Yin (Initial Yin) Syndrome

The invasion into the Tai Yin can occur from a chronic Tai Yang syndrome progressing into the Tai Yin, inappropriate treatment of a Tai Yang disease whcih forces it into the Tai Yin, or if the pathogen is strong enough, it can bypass the exterior and immediately invade the Tai Yin stage. Food poisoning, for example, can cause sudden diarrhea and Cold-Damp in the body (symptoms of Tai Yin syndrome). In all cases, the Spleen and Stomach Zang Fu will be deficient and there will be Internal Cold and Dampness present.

Symptoms:

Treatment

Formula: Li Zhong Wan (Regulate the Middle Pill)

Function: Warms the Middle Jiao and strengthens the Spleen and Stomach.

Contents:

Acupuncture Points:

Note: Comparison of Tai Yin and Yang Ming Abdominal Pain

In Tai Yin syndromes, the diarrhea and lack of thirst are both a product of Cold-Damp inside the body. In Yang Ming syndromes, the constipation and strong thirst are both products of the Internal Heat. In the Yang Ming syndrome, the abdominal pain is aggravated by pressure and heat because it is an excess condition. In the Tai Yin syndrome, the abdominal pain is alleviated by pressure and heat because it is a deficiency syndrome.

Starting with a common cold (Tai Yang syndrome), invasions can progress into more complicated internal/external Shao Yang conditions, as well as expressing into full Heat conditions as the body mounts all it's defenses against the invading Cold. If the pathogenic factor is too strong, the fever will subside, and this is an ominous sign (accompanied by cold digestive problems) that the situation is getting worse. This is already a serious situation, if allowed to progress further, the condition may be life threatening.

Shao Yin (Lesser Yin) Syndromes

Shao Yin syndrome affects the Kidneys and the Heart. There are two types of Shao Yin syndromes: One involves a deficiency of Yang Qi and Cold, and the other involves a deficiency of Yin and Heat. Both involve a serious disruption of the body's basic Yin and Yang balance.

A. Yang Deficient Shao Yin Syndrome

Symptoms:

Treatment

Formula: Si Ni Tang (Frigid Extremities Decoction)

Function: Rescues devastated Yang, warms the Middle Jiao, and stops the diarrhea.

Contents:

Acupuncture Points:

B. Yin Deficient Shao Yin Syndrome

Symptoms:

Treatment

Formula: Huang Lian E Jiao Tang (Coptis and Ass-Hide Gelatine Decoction)

Function: Nourishes the Yin, causes the Deficient Fire to descend, eliminates irritability and calms the Shen (Spirit).

Contents:

Jue Yin (Greater Yin) Syndrome

Jue Yin is the last yin stage. Starting with the initial Tai Yang stage, we progress through the stages until the Jue Yin Stage. This syndrome is the last stage of disease caused by Cold Evil. It chief attribute is the weakness of the Zheng Qi.

Symptoms:

Treatment

Formula: Wu Mei Wan (Mume Pill)

Function: Warms the organs (intestines), calms worms and stops chronic diarrhea.

Contents:

At this stage of disease, the patient may be in shock. The Yang Qi needs to be revitalized or the patient may die. Roundworms may migrate to another part of the GI tract that is more suitable if the gastrointestinal tract environment is altered from illness. They may move into and lodge themselves in the hepato-pancreatic ampulla, producing extreme colicky pain. In this situation, the ingestion of a sour solution such as vinegar or Wu Mei Wan, may alleviate the pain.