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Taiyang disease persisting for two to three days, with the patient unable to lie down and desiring only to sit up, indicates that there must be a knotting in the epigastrium. If the pulse is faint, this originally stems from an internal cold pathogen. If purgation is erroneously applied, and if diarrhea ceases, Jie Xiong (Chest Binding) will inevitably develop; if diarrhea does not cease, and purgation is again applied on the fourth day, Xie Re Li (Heat-Colluding Diarrhea) will result.

When Taiyang disease persists for two to three days, it is the time when the pathogen transmits to Yangming and Shaoyang. The patient desires to sit up but cannot lie down, accompanied by external vexation. From this, it can be known that there is knotting in the epigastrium. This is because the pathogen has entered Yangming and Shaoyang, causing Stomach Qi to rebel upward and Gallbladder Qi to become stagnant, leading to depression and pressure of the channel Qi, thus resulting in hardness and knotting in the epigastrium.

Ministerial Fire flares upward, generating vexation. If the pulse appears faint, it indicates the presence of internal Cold, which repels the Yang Fire. If purgation is erroneously applied at this stage, the Cold becomes excessive and the Spleen weakens, inevitably leading to diarrhea. If the diarrhea stops, the Spleen Qi does not sink, but the Cold pathogen remains in the Middle Jiao without being able to drain downward. It must then rebel upward, causing stagnation in the Gallbladder and Stomach, resulting in Jie Xiong (Chest Binding). If the diarrhea has not stopped, it indicates that Spleen Qi is sinking. On the fourth day, if the external heat is seen to be more severe, yet purgation is applied again, the internal Cold increases further, and the external heat becomes more intense. As the Cold increases, the diarrhea worsens; this is termed Xie Re Li (Heat-Colluding Diarrhea). Both Jie Xiong (Chest Binding) and Xie Re Li (Heat-Colluding Diarrhea) involve an internal Cold pathogen. When the Cold pathogen rushes upward, it causes Stomach Qi to rebel, forming Jie Xiong (Chest Binding); when the Cold pathogen drains downward, it causes Spleen Qi to sink, forming Xie Re Li (Heat-Colluding Diarrhea). Their clinical manifestations differ, but their root cause is the same. Xie Re Li (Heat-Colluding Diarrhea) refers to diarrhea caused by the combination of internal Cold and external Heat.

Pi Zheng (Epigastric Fullness Syndrome) is a complication of Taiyin disease, resulting from erroneous purgation today. Yang Qi is characterized by deficiency and emptiness, while Yin Qi is characterized by excess and solidity. The emptiness in the epigastrium exists because Clear Yang ascends and Turbid Yin descends. The authority over the ascending and descending of Clear and Turbid substances lies in the Middle Qi. If the Middle Qi is damaged, its ascending and descending functions fail: Turbid Qi rebelling upward generates distension, while failure of Clear Qi to descend generates Sundun (Undigested Food Diarrhea). Therefore, Pi Zheng (Epigastric Fullness Syndrome) occurring simultaneously with diarrhea is entirely due to the collapse of Middle Qi. Taiyin disease presents with abdominal fullness and spontaneous diarrhea. Abdominal fullness is the root of Pi Zheng (Epigastric Fullness Syndrome); however, if purgation is applied before Pi Zheng (Epigastric Fullness Syndrome) fully forms, causing hardness and knotting below the chest, Pi Zheng (Epigastric Fullness Syndrome) is then established. Thus, Pi Zheng (Epigastric Fullness Syndrome) is a Huai Bing (Complication/Deteriorated Disease) of Taiyin. For Taiyin Organ Cold, Si Ni Tang (Frigid Extremities Decoction) is appropriate for warming; once Yang Qi is vigorous, the Cold dissipates, and no other issues remain. However, once Pi Zheng (Epigastric Fullness Syndrome) forms, there is Lower Cold combined with Upper Heat, making Si Ni Tang (Frigid Extremities Decoction) unsuitable. Therefore, Xi Xin Tang (Heart-Draining Decoctions) are used instead, clearing the Upper and warming the Lower, combining Cold and Heat therapies. This demonstrates ingenious thinking and infinite variations.

In Taiyang disease, if the exterior syndrome is unresolved but purgation is applied multiple times, it leads to Xie Re Li (Heat-Colluding Diarrhea) with unremitting diarrhea, epigastric hardness and fullness, and simultaneous interior and exterior pathology. Gui Zhi Ren Shen Tang (Cinnamon Twig and Ginseng Decoction) should be administered.

In Taiyang disease, if the exterior syndrome is unresolved and purgation is applied multiple times, the external heat does not recede, and the internal cold increases. The internal cold colludes with the external heat to cause diarrhea, which does not stop. Since the Clear Yang has sunk, the Turbid Yin rebels upward, filling the stomach opening and causing epigastric hardness and fullness. This is because the Middle Qi is deficient and collapsed, failing to regulate the Yin and Yang, causing the ascending and descending mechanisms to reverse, and the positions of Clear and Turbid substances to swap. This means the interior syndrome is unresolved, and the external heat persists, meaning the exterior syndrome is also unresolved. When both interior and exterior are involved, both must be treated internally and externally. In Gui Zhi Ren Shen Tang (Cinnamon Twig and Ginseng Decoction), Gui Zhi (Cinnamomi Ramulus) unblocks the channels to resolve the exterior heat, while Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Jiang (Zingiberis Rhizoma), and Gan Cao (Glycyrrhizae Radix et Rhizoma) warm and tonify the Middle Qi to restore the mechanism of ascending and descending. The hardness and knotting below the chest in Taiyin disease is Pi Zheng (Epigastric Fullness Syndrome); increasingly severe spontaneous diarrhea is unremitting diarrhea. When the Middle Qi is injured and collapsed, Pi Zheng (Epigastric Fullness Syndrome) and diarrhea occur together. Ren Shen Tang (Ginseng Decoction), which is Li Zhong Tang (Regulate the Middle Decoction), assists the movement of the Middle Qi: descending the Turbid Yin within Yang resolves the epigastric fullness, and ascending the Clear Yang within Yin stops the diarrhea. This is the standard method for treating Pi Zheng (Epigastric Fullness Syndrome). The various Xi Xin Tang (Heart-Draining Decoctions) are modifications based on the condition of Lower Cold and Upper Heat.