Classica Sinica Medica

瘀熱在裏 简体 瘀热在里

yū rè zài lǐ

Stagnant heat within · yu re zai li

Also rendered: Stagnant heat within (This site) · Accumulated heat inside (Literal) · Heat bound in static blood (Clinical)

Pathology

Reviewed · 2026-10-31

At a glance

Pinyin
yū rè zài lǐ
Simplified
瘀热在里
Literal
瘀 yū is blood that has stopped and clotted — the old dictionary defines it as accumulated blood; 熱 is heat; 在裏 is within. The phrase says that heat is not simply inside but caught in blood that will not move, and it is this pairing that produces yellowing, madness, or both.
Shuowen
**《說文》：「瘀，積血也。」「熱，溫也。」「裏，衣内也。」** 引申爲內。**六至十篇三見**：第六篇行291（太陽隨經，瘀熱在裏，抵當湯）、第八篇行570（瘀熱在裏，身必發黄，茵蔯湯）、第八篇行627（瘀熱在裏，身必發黄，麻黄連軺赤小豆湯）。**同語而兩歸**：在太陽則蓄血，少腹鞕滿、小便自利、其人如狂，治以抵當；在陽明則濕熱發黄，但頭汗出、小便不利、渴引水漿，治以茵蔯。**一在血，一在濕，而其爲「鬱而不通」則同**。

In brief

Heat held in blood that has stalled, so that it cannot disperse. The chapters use the phrase twice over, and the difference is instructive. In taiyang it produces blood accumulation: a hard full lower abdomen, urine passed freely, and a patient as if mad — the heat is in the blood and the treatment is to break the blood with the resisting decoction. In yang brightness it produces jaundice: sweat on the head alone, scanty urine, thirst for great draughts, the body yellowing like the colour of a tangerine — the heat is bound with damp and the treatment is capillaris. The common element is stagnation: heat that has somewhere to go is harmless, and heat that is held turns into something visible.

Senses in the classical corpus

1
太陽隨經瘀熱 瘀熱在裏故也
太陽六七日表證仍在而脉微沉、反不結胸、其人發狂、少腹鞕滿、小便自利，是太陽隨經瘀熱在裏，抵當湯
Seven days into taiyang the exterior sign remains, yet the pulse is faint and deep, there is no knotted chest, the patient is as if mad, the lower abdomen is hard and full, and urine passes freely: blood along the channel has stalled and heat is within. The resisting decoction governs.
太陽病六七日，表證仍在，脉微而沉，反不結胸，其人發狂者，以熱在下焦，少腹當鞕滿，小便自利者，下血乃愈。所以然者，以太陽隨經，瘀熱在裏故也。 — 辨太陽病脉證并治中第六
2
陽明濕熱發黄 此爲瘀熱在裏，身必發黄
發熱汗出而身無汗、但頭汗出、劑頸而還、小便不利、渴引水漿，是瘀熱在裏，身必發黄，茵蔯湯主之
Fever and sweat, yet the body does not sweat — the head does, and it stops at the neck — urine will not pass, and the patient drinks great draughts: stagnant heat within, the body will yellow, and capillaris decoction governs.
但頭汗出，身無汗，劑頸而還，小便不利，渴引水漿者，此爲瘀熱在裏，身必發黄，茵蔯湯主之。 — 辨陽明病脉證并治第八
3
濕熱在裏而黄 傷寒，瘀熱在裏，身必發黄
傷寒而瘀熱在裏，身必發黄，無汗小便不利者，以麻黄連軺赤小豆湯解表而利濕
Cold damage with stagnant heat within: the body will yellow. Where there is no sweat and urine will not pass, ephedra, forsythia and red bean decoction releases the exterior and drains the damp.
傷寒，瘀熱在裏，身必發黄，麻黄連軺赤小豆湯主之。 — 辨陽明病脉證并治第八

Occurrences in the classics

Passages where the term does real work, with the original, pinyin and English on the same line.

Display
3 passages
辨太陽病脉證并治中第六·辨太陽病脉證并治中第六 Read in context →
太陽病六七日，表證仍在，脉微而沉，反不結胸，其人發狂者，以熱在下焦，少腹當鞕滿，小便自利者，下血乃愈。所以然者，以太陽隨經，瘀熱在裏故也。抵當湯主之。 太阳病六七日，表证仍在，脉微而沉，反不结胸，其人发狂者，以热在下焦，少腹当硬满，小便自利者，下血乃愈。所以然者，以太阳随经，瘀热在里故也。抵当汤主之。
tài yáng bìng liù qī rì biǎo zhèng réng zài mài wēi ér chén fǎn bù jié xiōng qí rén fā kuáng zhě yǐ rè zài xià jiāo shào fù dāng yìng mǎn xiǎo biàn zì lì zhě xià xuè nǎi yù suǒ yǐ rán zhě yǐ tài yáng suí jīng yū rè zài lǐ gù yě dǐ dāng tāng zhǔ zhī
In taiyang disease of six or seven days, with the exterior signs still present, the pulse faint and deep, and no binding in the chest but madness instead, the heat is in the lower burner. The lower abdomen should be hard and full, and if urination is free, the illness resolves only when blood is passed below. The reason is that the taiyang evil has followed its channel and stagnant heat is within. Resisting Decoction governs it.
「隨經」二字，說瘀熱之所從來；「小便自利」則是蓄血之證。
辨陽明病脉證并治第八·辨陽明病脉證并治第八 Read in context →
陽明病，發熱汗出，此爲熱越，不能發黄也。但頭汗出，身無汗，劑頸而還，小便不利，渴引水漿者，此爲瘀熱在裏，身必發黄，茵蔯湯主之。 阳明病，发热汗出，此为热越，不能发黄也。但头汗出，身无汗，剂颈而还，小便不利，渴引水浆者，此为瘀热在里，身必发黄，茵𫈟汤主之。
yáng míng bìng fā rè hàn chū cǐ wéi rè yuè bù néng fā huáng yě dàn tóu hàn chū shēn wú hàn jì jǐng ér huán xiǎo biàn bù lì kě yǐn shuǐ jiāng zhě cǐ wéi yū rè zài lǐ shēn bì fā huáng yīn chén tāng zhǔ zhī
In yangming disease with fever and sweat, the heat is escaping and cannot make yellow. If sweat appears on the head alone, the body is dry, and it stops at the neck, with difficult urine and thirst drawing on water and broth, this is stagnant heat within; the body will surely turn yellow, and Yinchen Decoction governs it.
與「熱越」對舉：越則不黄，瘀則必黄，一字之反，病機盡露。
辨陽明病脉證并治第八·辨陽明病脉證并治第八 Read in context →
傷寒，瘀熱在裏，身必發黄，麻黄連軺赤小豆湯主之。 伤寒，瘀热在里，身必发黄，麻黄连轺赤小豆汤主之。
shāng hán yū rè zài lǐ shēn bì fā huáng má huáng lián yáo chì xiǎo dòu tāng zhǔ zhī
In cold damage with stagnant heat within, the body will surely turn yellow, and Ephedra, Forsythia Root, and Adzuki Decoction governs it.
同是瘀熱在裏，此用麻黄連軺，以無汗而表未解，故兼解表。

Compounds built on this term

瘀熱在裏
yū rè zài lǐ
stagnant heat within
辨陽明病脉證并治第八
瘀血
yū xuè
static blood
辨陽明病脉證并治第八
抵當湯
dǐ dāng tāng
resisting decoction
辨太陽病脉證并治中第六
茵蔯蒿湯
yīn chén hāo tāng
capillaris decoction
辨陽明病脉證并治第八

How it has been translated

Every rendering below is a decision about which reader is being addressed. There is no neutral option.

This sitestagnant heat withinkeeps 瘀 as stasis of blood
Literalclotted heat insideexact, but suggests a clot
Clinicalheat bound in static bloodexplains the mechanism, narrows the damp cases

Entry status

Review pending — who reviews this?

2026-10-31

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Reading path

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