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If the Taiyang disease involves heat in the lower jiao (Lower Burner), there will inevitably be fullness in the lower abdomen and difficulty in defecation. If urination is instead free and unobstructed, this is a definitive sign of the Dandang Tang syndrome (blood stasis obstruction). In Yangming disease, spontaneous sweating occurs with scanty or obstructed urination. Once urination becomes frequent, it indicates exhaustion of body fluids; the stool becomes hard and dry, making purgative therapy inadvisable. In such cases, honey suppositories should be used; this is a crucial principle. One may ask why urination is frequent? This is caused by deficient-heat in the Kidney and Bladder. Deficiency alone does not typically cause frequent urination; rather, heat causes sluggishness and astringency in urine flow, creating a combative interaction. If sweating is present, Guizhi Tang (Cinnamon Twig Decoction) must not be administered. A floating and choppy pulse at the Yuyang position indicates Splee Constraint (Pi Yue, where weak Spleen Yin fails to distribute fluids due to strong Stomach heat). When the Stomach Qi is disharmonious, delirium may occur; in such instances, Tiaowei Chengqi Tang (Harmonizing the Stomach and Directing Downward Decoction) should be considered with caution.

For hard stools or constipation, Dachaihu Chengqi Tang (Minor Bupleurum and Major Purging Decoction) can achieve success. However, there are cases where purgatives are contraindicated, as recorded in the chapters on interior syndromes. Cold pathogens lead to loose stools, while heat pathogens lead to turbid excrement; one can infer the patterns of Yin-Yang deficiency and excess from these signs. If the internal fire is insufficient and severe cold prevails, the people may suffer from loose stools and gastrointestinal disorders.

Yin syndromes present with a cool body and clear urine and stools. At the onset, there may be spontaneous sweating without headache. There is no irritability or thirst. The pulse is deep and faint, which clarifies the diagnosis.

Yang syndromes present with fever, headache, generalized body pain, dry throat, and restlessness (difficulty lying still or turning over). Delirium or unconscious grasping at bedclothes may occur. The pulse is urgent, flooding, and long; appropriate treatment should be applied after careful examination.

What characterizes exterior syndromes of Shanghan (Cold Damage)? They manifest as absence of sweating, aversion to cold, and significant body heat. Pain in the head and neck is common, and the pulse is superficial upon light palpation. Formulas should be selected based on careful pattern differentiation, employing diaphoresis (sweating method) to harmonize the exterior.

Interior syndromes of Shanghan manifest as heart and abdominal pain. There is aversion to heat rather than aversion to cold. The pulse is deep and rapid, accompanied by spontaneous sweating. When both urine and stool are obstructed and scanty, purgative therapy leads to recovery.

Yin Jue (Cold Extremities) presents with a cool body, where heat is not internally generated; urine and stools are clear and slippery, without irritability. The pulse is distinct in both deep and superficial positions. Sanjian Tang (Three Establishments Decoction) combined with Sini Tang (Frigid Extremities Decoction) is suitable.

Yang Jue presents with warmth in the fingers and toes at times, irritability, constipation, and dry mouth. The pulse is deep and thin but rapid in the middle position. Chengqi Tang or Chaihu formulas are most appropriate for administration.

Yin syndromes mimicking Yang present with a red face, clear and slippery urine, and normal bowel movements. There is slight whole-body heat, and the pulse is deep and slow. Zhenwu Tang (True Warrior Decoction) combined with Lizhong Tang (Regulate the Middle Decoction) is indicated.

Yang syndromes mimicking Yin present with a cool body and cold limbs, scanty dark urine, and loose stools. There is irritability and dry mouth, and the pulse is deep and rapid. Baihu Tang (White Tiger Decoction) combined with Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) yields remarkable results.

When women contract this disease, differentiation is essential, as heaviness and lightness of the body represent different conditions. During pregnancy, if the body feels heavy, fetal calming should be prioritized. After childbirth, due to blood deficiency, tonifying blood should be the first step. Only by using Chaihu Siwu Tang (Bupleurum and Four Substances Decoction) can the Qi and Blood be harmonized, leading to peace and comfort.