this is yang ming organ-stage disorder characterized by heat accumulation which can be due to externally-contracted heat. when heat enters this stage it injures the fluids, which become viscous and turbid. the heat and turbidity of the fluids cause the stool to dry out. the heat and dry stool then combine to form clumps, which obstruct the orderly, downward movement of qi through the intestines. this results in severe constipation and flatulence, focal distention, a sensation of fullness in the abdomen, and the other abdominal symptoms mentioned. a dry, yellow tongue coating indicates dryness in the interior. in severe cases the coating will become black with prickles. dryness also accounts for the deep, excessive pulse.