3. Incorporating several perspectives from the Three Jiao differentiation

3. Incorporating several perspectives from the Three Jiao differentiation

Upper jiao syndromes represent the early clinical manifestations of febrile diseases. The upper jiao includes the heart and lungs, which are closely related and mutually influential. Wu Jutong pointed out that upper jiao syndromes include both external heat affecting the lung defense and internal heat causing pericardial confusion, thus aligning the concept of "warm pathogens initially attack the lungs and then spread to the pericardium"^⑧^ with clinical practice. For acute febrile diseases such as meningitis, sepsis, and bacillary dysentery, the initial presentation often involves both external heat and confusion, making them typical upper jiao syndromes when observed through the Three Jiao differentiation. Wu Jutong said: "The heart is the master of the body and does not directly suffer from pathogenic factors because it is protected by the pericardium. Therefore, when pathogenic factors invade, the pericardium takes the hit instead." "^⑨^ This shows that "pericardial invasion" refers to the spread of lung heat to the pericardium. In the "six-stage differentiation," after listing the three types of wind-cold, cold damage, and warm diseases under the Sun section, the author adds the pericardial invasion type as the fourth type (see diagram).

The middle jiao syndromes involve the spleen and stomach. Here, there is the fire of the Foot Yangming Stomach, the dampness of the Foot Taiyin Spleen, and the combination of dampness and heat between the two organs. The stomach governs dryness, while the spleen governs dampness. When pathogenic factors enter the middle jiao and favor the stomach, it manifests as Yangming real heat; when they favor the spleen, it manifests as Taiyin cold dampness; and when both the spleen and stomach are heavily affected, it manifests as damp-heat syndrome. Given that the Yangming syndrome in the Six Meridians only emphasizes the aspect of stomach fire, the author adds the damp-heat syndrome under the Yangming section after the meridian and腑syndromes, making it the third type in this section (see diagram).