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Yangming disease, after purgation, presents with restlessness and vexation in the heart, and dry feces in the stomach; this is a case for attack (purgation). If there is only slight fullness in the abdomen, and the stool is hard at the beginning but loose later, it is not suitable for attack. If there are dry feces, Da Cheng Qi Tang (Major Order the Qi Decoction) is appropriate.

After purgation, if restlessness and vexation in the heart persist, and dry feces remain in the stomach, a second attack may be performed. In healthy individuals, dry feces accumulate in the large intestine. In Yangming disease, heat is excessive and body fluids are depleted; residues in the stomach have already formed hardened knots and do not need to reach the intestines. Hence, it is said that "dry feces are in the stomach." If there are no dry feces internally, the Stomach Qi has not yet reached a state of stagnation and constraint, so the abdomen is not significantly full.

In Yangming disease, if delirium (speaking nonsense), tidal fever (fever that rises at a specific time), and an inability to eat are present, it indicates that there must be five or six pieces of dry feces in the stomach. Da Cheng Qi Tang (Major Order the Qi Decoction) should be used to purge. If the patient can eat, it merely indicates hard stool.

Dry feces causing blockage lead to turbid Qi rushing upward, resulting in an inability to eat.

If a patient has difficulty urinating, bowel movements that are alternatively difficult and easy, occasional slight fever, wheezing, dizziness, and an inability to lie down, this indicates the presence of dry feces. Da Cheng Qi Tang (Major Order the Qi Decoction) is appropriate. Dry earth and depleted water cause difficulty urinating. The flow of Qi being obstructed or patent causes bowel movements to be alternatively difficult and easy. Internal Stomach heat blazing causes occasional slight fever on the body surface. Stagnant and constrained Stomach Qi leads to wheezing obstruction, dizziness, and insomnia. This is due to the blockage by dry feces. *Su Wen: Fu Zhong Lun* states: "Inability to lie down with audible breathing" is caused by the rebellion of Yangming. The Qi of the three Foot-Yang meridians normally descends; now it rebels and ascends, hence the audible breathing. Yangming is the meridian of the Stomach; the Stomach is the sea of the six fu organs, and its meridian Qi also descends. When Yangming Qi rebels and cannot follow its proper pathway, one cannot lie down.

If a patient has not had a bowel movement for five or six days, experiences pain around the umbilicus, restlessness, and irritability that occurs at specific times, this indicates the presence of dry feces, which causes the constipation.

Stagnant and constrained Stomach Qi, lacking an outlet for excretion, causes pain around the umbilicus.

After severe purgation, if seven or more days pass without a bowel movement, accompanied by persistent restlessness, abdominal fullness, and pain, this indicates the presence of dry feces. The reason is that there was originally retained food. Da Cheng Qi Tang (Major Order the Qi Decoction) is appropriate.

Originally retained food, undigested, is refined into dry feces by Stomach fire, blocking the orifices of the intestines and stomach. Stomach Qi follows the downward direction as normal; when the lower orifice is blocked, Stomach Qi becomes congested and constrained, unable to descend and excrete, instead rebelling and ascending, thus generating restlessness, fullness, and pain.

When Yangming disease combines with Shaoyang disease, diarrhea inevitably occurs. A pulse that does not show mutual overcoming is called "not losing" (bu fu) and is a favorable sign (shun); showing mutual overcoming is called "losing" (fu) and is an unfavorable sign (shi). Mutual overcoming and harming is named "losing." A slippery and rapid pulse indicates retained food, which requires purgation; Da Cheng Qi Tang (Major Order the Qi Decoction) is appropriate.

In the combination of Yangming and Shaoyang diseases, Gallbladder Qi stagnation forces Stomach Qi to become congested and constrained, causing it to lose its function of receiving and containing, thus inevitably leading to diarrhea. Jia Wood (Gallbladder) overacting on Wu Earth (Stomach): if Earth Qi is not defeated, the pulse shows "not losing," which is favorable; if "losing," it means Wood overacts on Earth, causing Earth to fail, which is termed "loss." "Losing" refers to the name of mutual overacting and harming. Retained food obstructs meridian Qi, causing it to fluctuate, resulting in a slippery and rapid pulse. The Stomach governs receiving and containing; the Spleen governs digestion. When food and drink enter the Stomach, Spleen Earth dampness moistens Stomach Earth dryness. The interaction of dryness and dampness, and the steaming of Yin and Yang, allows for the decomposition and transformation of food. If there is no retained food in the center, there is no issue. In Yangming disease, Stomach strength is high while Spleen weakness prevails; dryness deprives dampness before decomposition can occur, forming hardened knots. Although this retained food is technically a fault of Taiyin (Spleen), it is essentially the fault of Yangming (Stomach).