Yin Yang Exchange Pattern
The following is an excerpt from ‘Shang Han Lun Explained Vol.2’ by Greta Young and Christopher Zaslawski (working draft; Purple Cloud Press forthcoming), giving insight into a rather unusual formula:
Section Two
5.2 YIN YANG EXCHANGE PATTERN
Shao Ku San
Clause 392
伤寒阴阳易之为病，其人身体重、少气、少腹里急，或引阴中拘挛，热上冲胸，头重不欲举，眼中生花，膝胫拘急者，烧裈散主之。
Shang han yin yang exchange disease: If the person feels heavy in the body, there is shortness of breath, and interior urgency in the lesser abdomen, or cramping in the genitals, heat surges upward to the chest, the head feels heavy and there is an unwillingness to raise it, there is blurred vision, cramps in the knees and lower leg, Shao Ku San governs.
Shao Kun San: The crotch of a woman’s pants scorched and charred.
Directions: Take a square inch spoonful of the ashes with water, three times a day. daily. When urination is uninhibited and the glans penis is slightly swollen, this indicates recovery. When a woman has this disease, use the charred crotch of men’s pants.
Discussion: This clause describes a person (either man or woman) who, during their convalescence from an illness with residual heat, has had sexual intercourse and become infected by a toxic pathogen. According to the theory of Chinese medicine, sexual intercourse has the potential to exhaust the kidney essence. The heaviness in the body and shortness of breath is the result of damage to qi and essence. The depleted essence is unable to nourish the sinews, and there is abdominal urgency, accompanied by genital cramping.
Toxic damp heat has entered via the lower yin orifice, and has not only affected the lower jiao, but has surged upward, to harass the chest and head manifest as heaviness in the head and blurred vision. The root of this disorder is deficiency of qi and essence combined with an attack of toxic damp heat. The treatment for this disorder is to descend and expel the pathogen. Yi Zong Jin Jian explained: the part of pants closest to the genital area is associated with turbidity and if this is charred and turn to ashes, it can be used to dissipate and disperse. After taking this, there is sweating, urine is passed, and there is recovery. The swelling of the glans penis is a manifestation of the toxic heat being vented outward.
There is little information in literary records on the disorder of yin yang exchange; however, it generally is thought to refer to infection resulting from sexual contact. It could be a sexually transmitted disease or could be a localised infection caused by friction and subsequent micro-fissures. In either case, in the convalescent stage, the poor state of the zheng qi has not been strong enough to overcome the pathogen, and residual heat has laid a foundation for the generation of toxic heat.
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