Bright Yang Stage Also called Yangming Stage

Jonathan Clogstoun-Willmott

April 14, 2020

The Bright Yang stage (Yangming stage) of disease is when your body mounts a massive attack on an invader, such as an invasion by Wind-Cold or Cold.

… by the way … if you’ve arrived here, all innocent, from somewhere respectable, be prepared. There’s a lot of Chinese medicine theory on this page. Maybe not the best place if you’re wondering how Chinese medicine may help you! Why not limber up first with our page on yin and yang? … Otherwise, to carry on …

An Ancient theory

In this ancient theory, first set down in AD220, there are Six Stages your body can go through in its defence against Cold. The stage on this page is the third of them. Each stage shows the attacker getting closer to destroying the host, ie your body’s health.

But at this stage, your body has a huge ambush up its sleeve.

Another theory, developed to deal not with Wind-Cold but with invasion by Wind-Heat, found that your body used this same defence at its Qi level – see Four Levels.

House in the snow: resisting Cold, like the Bright yang stage — House in the snow – Photo by Greg Rakozy on Unsplash

Ideally, your body stops the invasion in its tracks at the outermost, or most Yang, level. Read more about that here.

If the body now manages to stop the disease at this Bright Yang stage – Yangming stage – it does it by producing a high fever, profuse sweat, great thirst and a pulse described as ‘overflowing’ – see below for more symptoms.

The fever can be so high that it leads to delirium. Worrying though these symptoms are, they are, for your body, highly effective.

They stop the disease in its tracks. The fever is such that, although unpleasant for you, it’s a good deal more unpleasant for the disease process, the ‘cold’ invasion.

The ‘Cold’ that was trying to penetrate inwards is, in effect, burned out. Indeed, the fever is such that you may welcome cool things: quite different from your reaction at the Tai Yang stage, the first and outermost level or the alternating states in the second stage, the Lesser Yang stage.

But sometimes, your body hasn’t got the wherewithal to ambush the invader at this stage so the invader marches on to the next level, that of the Greater Yin Tai Yin level.

Why might your body skip this Bright Yang stage?

Here are some reasons why your body might allow the attacker past this Bright Yang stage without mounting a defence here:

Can’t muster the energy for it. A high fever uses a lot of energy. If you put a pan of water on a fire, how long does it take before the water boils? While you wait, you can watch the fire burning away underneath as it tries to raise the temperature. Think how much energy is needed to raise your body, all 8 gallons or 30 litres of it, by just a few degrees.
Doesn’t know how to do it. If your body was never allowed to produce a fever in childhood, perhaps to combat a childhood disease, you/it may fear what happens. So you may try to stop it by taking medicines that prevent fevers, or that can quickly ameliorate them. The kind of medicines that do this are pain-killers and antibiotics.

white and orange medication pill — Photo by Michał Parzuchowski

Connected with the first reason above, your body might be weakened in some way, or its response might be compromised by the effect of other things going on, such as great stress, or taking other forms of medication eg for asthma.
You might be doing something that prevents a good response. This could include taking a host of supplements that, in effect, finesse the situation away. On the face of it, these are great! But, in effect, they may suppress your body’s best way of dealing with the attacker. Read Suppression and the many ways there are to block a reaction. If you prevent your body from deploying its best defence, it has to fall back on its next-best defence.
Connected with the last reason, you might be using cooling ploys so effectively that it prevents the proper fever. See below.

Or a history of Vaccination?

Or, connected with the reason just given, you may have been vaccinated as a child. Often vaccinations are given before your immune system is thought to have matured around two (2) years old. This may have prevented you developing such illnesses in the first place, but in so doing it prevents your parents and you from learning how to accept and deal with a high fever, confident in its successful outcome.

A Cooling Ploy for Bright Yang stage

What might be a COOLING ploy?

Cool moist flannels on the brow are very pleasant for most people in a fever, and rarely make much difference to how it proceeds.

Chinese medicine noticed some time ago that putting lots of cold or iced water on the back of the knees (the poplitea) had a pronounced cooling effect on the body.

Immersing the body in cold or freezing water also reduces the temperature.

If you can contain yourself, however, your feverish body will nearly always emerge healthier, with a better circulation and immune function if allowed to proceed through its own system, unpleasant at the time though this is.

Symptoms of Bright Yang stage

There are two types of Bright Yang stage (you can get both at the same time!):

Channel type
Organ type

1/ The ‘Channel’ type of Bright Yang stage

In this Bright Yang stage, the body confronts the attacking Cold with Heat: like bringing an icicle into your house and putting it into a hot oven until it evaporates.

So your body has allowed the invader in, but for a good reason. In a way, it knows it has the upper hand once it gets the Cold inside.

Another way of thinking about it is that your immune system and the invader are equally matched, so there is a tremendous struggle between them, generating a lot of heat. In this way of thinking, the invader has indeed pushed his way indoors, but you are putting up a huge fight to push him out. The heat is the sign of the struggle, so is very important.

Fever and Heat conditions

Fever, usually high, usually worse in the afternoon. If neither you nor your parents had experience of this, you may worry about it, and admittedly where small children are concerned, they quite often get delirious and – very occasionally – some may even pass out or have a fit. This is rare in healthy children, and does not usually prevent a full recovery. So if you are the parent, keep calm! This reaction is fierce but beneficial. Also, if your child sees that you are alarmed, it will make your child more alarmed too. That adds to the anxiety all round, each feeding the other. If you have parents or grandparents who grew up in ‘undeveloped’ countries, they almost certainly experienced this condition. So too do people born before the mid-nineteen sixties when, increasingly, vaccination and pharmaceutical suppressive means began to be used in ‘developed’ countries.
Perspiration – eventually, heavy – so make sure you have lots available to drink. Changes of clothes may be necessary.
Thirst – considerable. Because of the Heat, you will almost certainly prefer cold or iced fluids. Usually Chinese medicine counsels against giving sick people cold drinks but here there is so much heat around that it probably doesn’t matter. Exceptions? Small children because their small bodies can ‘rev’ up very quickly, producing a splendid fever, (they have plenty of Yang, but at that stage of life, not much of a Yin body to counteract it) but can lose it again because they don’t have a body big enough to store the Yang heat. In other words, too much cold or iced water could extinguish the heat before it’s done its job.

Behavioural changes

Emotional disturbance, meaning impatience, anger, agitation, easily annoyed.
Sometimes delirium.
Likes cold and cold conditions. This shows the pattern is no longer at the Great Yang stage where you are averse cold.
Other signs of Heat include the sensation of heat, a red face and the pulse and tongue symptoms below.
Tongue: colour is red, coating is yellow: these are both signs of heat
Pulse: fast – rapid; over-flowing or ‘big’

Why is it called the ‘Bright Yang’ or ‘YangMing’ stage?

The above symptoms of great thirst, heat and redness, eg on face and tongue, show that the ‘disease-process’ is in the Stomach.

In Chinese medicine the Stomach and Large Intestine channels are called, when combined, the Yang Ming or Bright Yang channel.

Very often acupuncturists use points along the Large Intestine or Stomach channels to treat this Bright Yang stage syndrome.

What does your acupuncturist do for the Bright Yang stage?

Acupuncture at shoulder for bright yang stage treatment — Acupuncture on the shoulder

If your body has successfully produced the above symptoms, you can be fairly confident that by the time you reach your acupuncturist the Cold will have been vanquished.

In that case, your acupuncturist will use points that help your body to clear Stomach-Heat. Some of these points will be along the Yangming or Bright Yang channels, and might include points like LI 11, St 21, 34, 43 and 44, Du 14, P 3.

He might also prescribe a herbal recipe containing at least one very ‘cold’ type herb, balanced with other herbs to prevent damage and to provide nutrition.

Examples of traditional recipes that might form the basis of the recipe for you include Bai Hu Tang.

What can YOU do for yourself?

1. Let the fever run

For your best Bright Yang stage response, don’t stop the fever – it is your body’s best ploy!

Keep going with it for at least a day, if not two. Fever burns out not just the cold but also any remaining traces of other old diseases you harbour, including phlegm and catarrh.

Indeed, if you stop a fever too soon, you may retain the cold in some form, to return another day when least expected. This is more likely to happen if you use Western medicine to stop it.

That is because, unlike Chinese herbal recipes which are well-balanced in their action, Western science prides itself on extracting and using ‘pure’ active ingredients. Consequently the medicine lacks the other nutritive and supportive substances that your body needs to recover healthfully.

2. After a few days …

Once you’ve allowed your body to deploy this great fever etc, for at least a day, if it continues to the point where you are weakening (yes, yes, I know, you ask, what does this mean, well tough, you’ll have to decide yourself or seek advice: can’t put everything here, it would take a book!) you could try to reduce the Heat in your Stomach by using herbs such as fresh Aloe Vera juice.

You may need quite a lot of it and don’t complain if you don’t like the taste. Find a source that is as close to raw as possible. Avoid it if it is contaminated with sweeteners and other things to make it more palatable. Aloe Vera has a very cold energy, so don’t use for more than a few days. Probably you should take it with some warm boiled water in which you’ve stewed a piece of ginger root: this herb counteracts the cold in Aloe without preventing it from working. (However, if you are pregnant or menstruating, don’t take Aloe.)

Then cool yourself with cold water, on the backs of your knees and even by taking cold showers and baths.

3. As the fever reduces …

As the fever reduces, don’t go so far as to get cold! For example, don’t walk around outside in cold air to the point where you start shivering again. You are still fragile! Allow your body to recover its energy over the ensuing days with rest, plenty of sleep and gradually increasing amounts of well-chewed nutritious food; and fluids, of course.

2/ The Bright Yang ‘Organ’ stage

In this kind of Bright Yang stage condition, the Heat produced by your body goes not just to your Stomach, but reaches down into your Intestines. Consequently, as well as the symptoms above you get extra symptoms as follows:

Abdominal distension and pain, from build up of dry stools
Constipation
Stools are dry, hard to pass, and may smell
Urine is dark
Other symptoms are mostly the same as above, but the fever may be unremitting, even worse in the afternoon, and you may sweat more on your arms and legs;
Thirst – great
Tongue: red, but the yellow covering is not moist but dry
Pulse: rapid, full, deep, may be slippery

What is going on at this Bright Yang organ stage?

You could say that here the body has gone overboard with its Heat, almost got out of control, to the point where its fluids are drying out, hence the dry stools, dry tongue and even greater thirst.

Note: people sometimes go straight to this stage, or something very like it, when on holiday in hot countries, perhaps after eating spicy food and sunbathing and burning before they have acclimatised. In this case, their bodies reached this stage from Heat, not cold.

What is the correct treatment?

What you should not do is to prevent bowel movement. That results in the Heat being retained, only to destroy Yin fluids all the more.

The right treatment, the Chinese classics say, is first to purge, in other words to get the body to pass the stools, taking much of their heat with them.

Choose Chinese Herbs for Purging — Chinese herbal recipes can help purge, so expelling Heat

There are herbs for this Bright Yang stage, but modern medicine has ways of treating it too, and there are many supplements for constipation which can be properly employed here without much danger. Herbs used in Chinese medicine for this include senna and aloe vera.

However, such supplements or medicines should not become habitual. You need, after recovering, to make sure you eat foods that provide natural bowel movements without worry. Also to moderate stress levels so that it does not bind you up. (Read my book on the subject of stress, “Qi Stagnation – Signs of Stress”.)

But purging has its dangers.

Purging too often (ie when no longer needed) prevents the natural flow of food along your alimentary canal. That stops your body from absorbing food’s nutritional qualities, so you eventually weaken, making yourself susceptible to the next invader.
Frequent use of anti-constipation laxatives can make you dependent on them. Any medicine can compromise your health and immunity, and all have secondary effects that you may not be aware of at the time.

Acupuncture and herbs for this

Your acupuncturist will probably use similar points to those for the ‘Channel’ kind of Bright Yang stage, with additional points for constipation. For example: LI 11, St 43 and 44, Du 14, P 3, St21 & 25 and Sp 15, Du 14, St 37, and Sp 6.

The herb recipe they use will also be purging. The right recipe for you will contain herbs that nourish Yin and so help combat the excess Yang situation your body has been in. Da Cheng Qi Tang and Tiao Wei Cheng Qi Tang could be recipes on which your recipe might be based.

What is the next stage as the invader penetrates further inwards?

The next stage is called the Greater Yin stage. If someone’s body can’t produce this Bright Yang stage ambush on the invader, the invader may get past it to the Greater Yin stage.

If you have read this far, you’ll realise that to mount a Bright Yang stage you need to be fairly young or fit. It is not so common amongst older people, or people weighed down by chronic conditions. They usually pass the invading disease straight on to the Greater Yin stage.