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Taiyang disease (Disease of the Taiyang/Bladder channel) with exterior symptoms unresolved, and the pulse floating and weak, should be resolved by sweating; Guizhi Tang (Cinnamon Twig Decoction) is appropriate.

In Taiyang disease, if the exterior is not released in time, internal heat cannot vent out, leading to transmission from the exterior to the interior. Although interior symptoms have formed, the exterior symptoms cannot resolve spontaneously. Whenever the pulse is floating and weak, it should still be resolved by sweating; Guizhi Tang (Cinnamon Twig Decoction) is appropriate. After the exterior is resolved, carefully examine whether there are interior symptoms before discussing the use of purgation. The pulse floating and weak refers to the meaning of "floating Yang and weak Yin" mentioned in the previous chapter.

When Taiyang disease has exterior symptoms unresolved, purgation must not be used; doing so is a contraindication (adverse treatment). To resolve the exterior, Guizhi Tang (Cinnamon Twig Decoction) is the primary formula. Only after the exterior is resolved can one discuss whether to use purgation for the interior symptoms.

Although Taiyang disease has exterior symptoms unresolved and interior symptoms exist, purgation must not be used. If purgation is used, Wei Yang (Defensive Yang) will sink inward, which is called a contraindication (adverse treatment). To resolve the exterior, one cannot go beyond Guizhi Tang (Cinnamon Twig Decoction). Only after the exterior is resolved can one consider using purgation for the interior symptoms.

The patient's pulse is floating and large. Asking the patient, they say only that their stool is hard. If purgation is used at this time, it is a major contraindication. Stool hardness indicates interior excess, but if sweating resolves the condition, why? Because the pulse is floating, indicating the exterior syndrome remains, and it should be resolved by sweating.

Yangming Fu-organ disease presents with a floating and large pulse (refer to *Shanghan Lun*, Yangming Chapter: "Two Yang combined disease, pulse floating and large at Guan position"). A floating and large pulse indicates Fu-organ excess, yet asking the patient reveals only a sensation of hard stool, without pain or fullness, so it is not an indication for urgent severe purgation. If purgation is rashly applied, it is a major contraindication. Although stool hardness implies interior excess, if exterior symptoms remain, resolution through sweating is still required; purgation is inappropriate. Why? Although a large pulse may suggest interior excess, a floating pulse dictates that resolution should be achieved through sweating.

If the disease is to resolve spontaneously, vexation (fan) must occur first, followed by sweating and resolution. How do we know this? Because the pulse is floating, we know it will resolve through sweating.

Note: The Wanlin edition originally omitted this passage; it is supplemented here. This text comes from the Taiyang Chapter. Huang Yuanyu's commentary is lost. It essentially conveys the same meaning as the preceding paragraph.

In Taiyang disease where the condition has not resolved, if the pulse at all three positions (Cun, Guan, Chi) stops and becomes motionless, chills and tremors (zhen li) will necessarily occur first, followed by sweating and resolution. If only the Yang pulse (Cun/inch) is faint, resolution occurs through sweating first; if only the Yin pulse (Chi/cubit) is faint, resolution occurs through purgation. If purgation is desired, Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) is appropriate (formula recorded in Yangming Chapter 20).

When Taiyang exterior symptoms are unresolved, and the pulse suddenly stops at both Cun and Chi positions without movement, this is due to Qi deficiency failing to emit outward, causing stagnation and closure of Ying (Nutrient) and Wei (Defensive) Qi. After a while, chills and tremors will necessarily occur, followed by sweating and resolution. Before the pulse stopped, the Cun and Chi pulses were likely unequal in size. If only the Cun pulse is faint, this indicates Yang Qi stagnating below; resolution requires Yang Qi to ascend and sweat to emerge, resulting in chills and tremors followed by sweating. If only the Chi pulse is faint, this indicates Yin deficiency with intestinal dryness and blockage of the lower orifices; sweating alone will not resolve it. Purgation is necessary to unblock the dryness, allowing Stomach heat to drain downward for resolution. In Yangming disease, Fu-organ heat evaporation leads to sweating and exterior resolution. However, in current Taiyang disease, the exterior symptoms are unresolved, indicating interior heat is not yet solidified. At this time, if purgation is desired, it should be administered after sweating, using Tiaowei Chengqi Tang (containing Mangxiao/Rhizoma Imperatae, Dahuang/Rhei Radix et Rhizoma, Gancao/Glycyrrhizae Radix) to harmonize the dryness and heat of the Stomach organ.