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The pulse is floating and slow, accompanied by exterior heat and interior cold, with diarrhea of undigested food; Si Ni Tang (Four Counterflow Decoction) should be administered (formula found in Taiyin Chapter 3). If the stomach is deficient and cold, unable to accept food, drinking water will induce hiccups.

Water-cold insulting Earth causes deficiency and cold in the stomach, making it unable to accept food. Drinking water at this time adds water to water, inevitably triggering hiccups.

In Yangming disease, inability to eat is common. Attacking the heat must induce hiccups. The reason is deficiency and cold in the stomach; because the person is originally deficient, attacking the heat will inevitably cause hiccups.

Exterior heat and interior cold, mistakenly perceived as interior heat and attacked, lead to the failure of Spleen Earth and reversal of Stomach Qi, inevitably causing vomiting and hiccups.

After severe purging and emesis in Cold Damage, extreme deficiency occurs, followed by extreme sweating. Because the person's exterior Qi is stagnant and depressed, giving water to induce sweating results in hiccups. The reason is coldness in the stomach.

Purging and emesis deplete Yang, leaving Middle Qi extremely deficient. Wei Qi leaks and loses its containment, resulting in extreme sweating. Because the person's Exterior Yang is stagnant and detached from its root, floating outwardly, mistaking this for exterior pathogenic factors and giving water to induce sweating leads to the failure of Spleen Earth and reversal of Stomach Qi, thus causing vomiting and hiccups.

In Cold Damage, if hiccups occur with abdominal fullness, observe the anterior and posterior orifices to determine which part is obstructed; unblocking it will lead to recovery.

Hiccups with abdominal fullness indicate that turbid Qi of Yangming does not descend and clear Qi of Taiyin does not ascend. One of the two orifices must be obstructed. If the anterior orifice is obstructed, unblock the water pathway; if the posterior orifice is obstructed, unblock the grain pathway. The pathology of abdominal fullness lies merely in the stagnation of Qi and Water.

Yangming disease typically presents with profuse sweating; conversely, if there is no sweating and the body feels itchy as if insects are crawling under the skin, this is due to long-standing deficiency.

Qi deficiency fails to penetrate and diffuse, stagnating in the skin and interstices, causing itching as if insects are crawling.

Yangming disease presents with no sweating and free urination. After two or three days, if coughing, vomiting, and cold extremities occur, headache must be suffered. If there is no coughing, no vomiting, and no cold extremities, the head will not hurt.

No sweating indicates internal deficiency of Yang; free urination indicates downward deficiency of Yang. As the Classics state, "unrestrained flow of spring water" refers to the Bladder's failure to store (a quote from Suwen). Two or three days later, Stomach Yang becomes more deficient, Qi reverses causing cough and vomiting, cold extremities appear, and turbid Qi congests upward, inevitably causing painful headache. If there is no cough, no vomiting, and no cold extremities, turbid Qi has not reversed, so the head does not hurt.

Yangming disease presents only with dizziness, without aversion to cold, ability to eat, and coughing; such a person will inevitably have sore throat. If there is no cough, the throat will not hurt.

Yangming disease follows the principle that descending is smooth and ascending is adverse. Reversal of Stomach Earth Qi and failure of Yang to descend, leading to floating and rootless Yang, causes dizziness. With the exterior resolved, there is no aversion to cold. Since Stomach Yang is not yet exhausted, eating is possible. Reversal of Stomach Earth causes congestion of Lung Metal, leading to coughing. Coughing causes counterflow of Ministerial Fire, resulting in sore throat. Without coughing, Ministerial Fire does not rush upward, so the throat does not hurt.