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Wei Qi (Defensive Qi) circulates in the Yang aspect (exterior/surface) during the day and in the Yin aspect (interior/viscera) at night. When circulating in Yang, one is awake; when circulating in Yin, one sleeps. If Yang Qi is deficient and Yin Qi is excessive, the eyes close (Mu Ming), resulting in hypersomnia (excessive sleepiness). This occurs because the pathogenic factor has transmitted to the Yin aspect rather than remaining in the Yang aspect. The drowsy state with closed eyes reflects the closing nature of Yin; silence reflects the quiet nature of Yin. The Classics state: In Taiyang disease (disease pattern caused by pathogenic invasion of the Taiyang channel), after ten days, if the pulse is floating and fine, and the patient desires to lie down/sleep, it indicates that the exterior pathogen has been resolved. If there is dryness of the nose, inability to sweat, and hypersomnia, this indicates internal attack by wind-heat; the pathogen is not on the exterior, so heat qi lingers in the interior, leading to a preference for sleep. In San Yang combined disease (simultaneous involvement of Taiyang, Yangming, and Shaoyang channels), where the patient only desires sleep, sweats upon closing the eyes, and speaks deliriously with fever, this indicates the presence of heat. The appearance of nocturnal sweating (Dao Han) indicates stomach heat, which also leads to hypersomnia. Feng Wen (Wind-Warmth disease) and Hu Huo (Fox-Huo disease) may present with similar symptoms and must be differentiated.

In Taiyang disease, after ten days, if the pulse is floating and fine and the patient is hypersomnolent, the exterior has been resolved. However, if chest fullness, hypochondriac pain, dry nose, and inability to sweat are present, Xiao Chai Hu Tang (Minor Bupleurum Decoction) should be used. If the pulse is merely floating, Ma Huang Tang (Ephedra Decoction) should be used.

In Shaoyin disease (disease pattern caused by pathogenic invasion of the Shaoyin channel), where the patient only desires sleep and both the Cun (inch) and Chi (cubit) pulses are deep and fine, Si Ni Tang (Frigid Extremities Decoction) should be used. In Shaoyin disease, where the patient feels nausea but cannot vomit, experiences mental restlessness, and hypersomnolence, with both Cun and Chi pulses being deep and fine, Si Ni Tang should also be used. In Shaoyin disease, where the patient feels nausea but cannot vomit, experiences mental restlessness and hypersomnolence, and after five or six days develops spontaneous diarrhea with thirst and white urine, the condition reaches its limit (or implies a specific prognosis/stopping point).

In Shi Huo Luan (Wet Cholera, characterized by vomiting and diarrhea), death is less common; in Gan Huo Luan (Dry Cholera, characterized by obstruction without vomiting or purging), death is more common. If one cannot vomit from above nor defecate from below, the ingested food cannot be expelled, causing stagnation and closure of Zheng Qi (Upright Qi), leading to separation of Yin and Yang, resulting in death due to panting and abdominal distension. The Su Wen states: If eating and drinking are regulated, and daily routines are regular, how can Huo Luan occur?

For Huo Luan presenting with headache, fever, and body pain: if heat signs predominate and there is desire to drink water, use Wu Ling San (Five-Ingredient Powder with Poria); if cold signs predominate and there is no desire to drink water, use Li Zhong Tang (Regulate the Middle Decoction).

If vomiting and diarrhea are accompanied by sweating, faint pulse, aversion to cold, cold limbs, and muscle cramping/tethering, use Si Ni Tang. If abdominal fullness and pain are present, along with tethering of the four limbs, muscle twitching/cramping, and diarrhea, use Li Zhong Tang plus Fuzi (Prepared Aconite Root) and Guigui (Cinnamon Bark). For detailed modifications, refer to the formula description.

If vomiting and diarrhea cease but body pain persists, use Guizhi Tang (Cinnamon Twig Decoction). If vomiting and diarrhea occur simultaneously, followed by free urination, profuse sweating, diarrhea of undigested food, internal cold with external heat, and a faint pulse nearly imperceptible, use Si Ni Tang. If vomiting and diarrhea cease, but sweating and cold limbs persist, with unresolved tethering of the four limbs and a faint pulse nearly imperceptible, use Tong Mai Si Ni Jia Zhu Dan Jiang (Pulse-Restoring Frigid Extremities Decoction with Pig Gallbladder Bile).