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In Yangming disease, if there is profuse sweating accompanied by thirst, Zhu Ling Tang (Polyporus Decoction) must not be administered. This is because excessive sweating causes dryness in the Stomach; administering Zhu Ling Tang to promote urination would further deplete body fluids.

Chapter 65 states that if there is thirst with difficulty in urination, Zhu Ling Tang should be given. However, if there is profuse sweating and thirst, Bai Hu Tang (White Tiger Decoction) should be used instead of Zhu Ling Tang. Since profuse sweating has already caused dryness in the Stomach, Zhu Ling Tang would further promote urination, leading to the loss of Jin-Ye (body fluids). This clarifies the rationale for using Zhu Ling Tang mentioned in the previous chapter and Chapter 65.

In Yangming disease, if the mouth feels dry and the patient desires to rinse water in the mouth but does not wish to swallow it, epistaxis (nosebleed) will certainly occur.
Dryness in the mouth with a desire to rinse but not swallow indicates that the Heat pathogen is in the Channels and Collaterals rather than in the Fu organs. Since the Channel Heat cannot dissipate, epistaxis is inevitable.

If the pulse is floating, accompanied by fever, dry mouth, dry nose, and the ability to eat, epistaxis will occur.
A floating pulse and fever indicate external constraint by Cold pathogen on the exterior. Dry mouth and nose indicate internal steaming of Heat within the Channels. The ability to eat suggests that the Heat is not in the Fu organs. Since the Channel Heat cannot vent laterally, it must vent upwards through epistaxis.

In Yangming disease, if the pulse is floating and tight, tidal fever (chaore) occurring at specific times will definitely occur. If the pulse is only floating without being tight, night sweats will definitely occur.
A floating and tight pulse is characteristic of Taiyang disease. When Yangming disease presents this pulse, tidal fever occurring at fixed times is certain, caused by external Cold constraining the internal Fu Heat. If the pulse is only floating and not tight, there is no external Cold and no internal Repletion Heat. During sleep, Wei Qi (Defensive Qi) fails to enter the Yin aspect, causing the skin pores to lose their closure. The Channel Heat steams and vents outwards, resulting in night sweats. Individuals suffering from night sweats generally have excess Yin and cold Zang organs, preventing Yang from interacting internally.

In early Yangming disease, if the patient initially desires food, yet urination is obstructed while bowel movements remain normal, and they experience pain in the bone joints, a slight feeling of heat as if feverish, followed suddenly by mania, and then resolving with copious sweating, this indicates that the Water-Dampness pathogen is overcome by Gu Qi (Grain Qi), which exits together with sweat. A return to a tight pulse signifies recovery.
Initial desire to eat indicates the presence of Gu Qi. Obstructed urination with normal stools and joint pain (due to Dampness flowing into the joints) indicate Spleen Earth Dampness and Water retention. When Gu Qi is strong, sweating occurs; when Water-Dampness is strong, sweating does not occur. At this stage, the body feels slightly hot, and sudden mania occurs before resolving with copious sweating. This happens because Gu Qi attempts to disperse, but the Heat constrained by Water-Dampness cannot disperse, leading to restlessness and mania. Ultimately, since Water-Dampness is inferior to Gu Qi, copious sweating ensues. Upon sweating, the Water-Dampness is excreted along with the sweat, combining to exit via the exterior. Both the external Cold and internal Water are eliminated, and a tight pulse indicates self-healing.

In Yangming disease, if the face appears red or flushed, purgative methods must not be used. Otherwise, fever, yellow complexion, and difficulty in urination will certainly occur.
External Cold constrains the Channel Heat, causing the face to appear red. This condition can be treated with diaphoresis (sweating method) but not with purgation. The redness on the face indicates Channel Heat, not Fu organ Heat. If it were Fu organ Heat, the pores would steam, sweat would be excreted, and Yang Qi would vent outward, resulting in no facial redness. Purgation would damage Yang, generate Dampness, fail to resolve the external Cold, and cause Dampness to stagnate in the channels and collaterals, inevitably leading to fever, yellow complexion, and urinary difficulty.