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Disperse and resolve. If there are indications for purgation (indications requiring the use of purgative methods), treatment should primarily focus on promoting diuresis to leach out dampness. If one erroneously employs methods to induce normal sweating or normal purgation, the aforementioned adverse reactions will occur.

In cold damage with fever, headache, and slight sweating, forcibly inducing sweating leads to confusion and inability to recognize people; applying moxibustion or heat fumigation causes asthma, urinary retention, and fullness in the heart and abdomen; purgation leads to shortness of breath, difficult urination, headache, and stiffness of the neck; adding warm needle therapy results in epistaxis (nosebleed).

Individuals with Yin deficiency and excessive fire, upon merely contracting external pathogens, experience fever and headache more severely than usual. At this time, within the use of acrid-cool dispersing herbs, care must be taken to nourish and protect Yin blood. If acrid-hot strong diaphoretic drugs are mistakenly used, body fluids will immediately wither, and pathogenic fire will become even more rampant, leading to restlessness, confusion, and inability to recognize people. If one errs in using fumigation, purgation, or warm needles, would these adverse reactions not inevitably occur?

The above discusses the injury of the Ying (Nutrient) level by Cold.

The pulse at the Cun Kou (radial artery) is floating and tight. Floating indicates Wind, while tight indicates Cold. Wind injures the Wei (Defensive) Qi, and Cold injures the Ying (Nutrient) Blood. When both Ying and Wei are diseased, causing bone and joint irritation and pain, sweating should be induced.

In Taiyang Wind Strike (Taiyang Zhong Feng), if the pulse is floating and tight, accompanied by fever, aversion to cold, body pain, absence of sweating, and irritability, Da Qing Long Tang (Major Blue Green Dragon Decoction) is indicated. However, if the pulse is faint and weak, with sweating and aversion to wind, it must not be administered. Administration would lead to cold extremities (Jue Ni) and muscle twitching/tremors (Jin Ti Rou Tiao). This constitutes a therapeutic error. It should be rescued with Zhen Wu Tang (True Warrior Decoction).

The Zongyin edition omits the six characters "Da Qing Long Tang Zhu Zhi" (Mainly treated with Da Qing Long Tang). The Shichuan edition includes them. This text corrects it based on *Shang Lun*. ○ When heaven and earth are stagnant and steaming, rain brings harmony; when the human body is irritable, sweating brings relief. Da Qing Long Tang is precisely for this condition. The body originally has slight sweating, but it is blocked by Cold pathogens and cannot emerge from the muscle surface, thus generating irritability. This is distinctly different from the Ma Huang Tang syndrome characterized by complete absence of sweating. Therefore, Da Qing Long Tang is used to induce sweating to resolve the irritability. Thus, acute illness presenting with irritability confirms without doubt that both Ying and Wei are injured. This formula was originally intended to induce sweating in those who could not sweat. If the irritability arises after sweating has already occurred, it is completely unlike stagnation and steaming; its resolution does not rely on sweating is clear. Furthermore, with aversion to wind and a faint/weak pulse, this indicates a Shaoyin pattern of Yang deficiency. If the pulse is floating and weak, with sweating, aversion to wind, but no irritability, it is a Taiyang Wind Strike pattern. Neither of these relates to this formula. Mistakenly using this formula would inevitably cause cold extremities and muscle twitching, accelerating the loss of Yang. Note: In cases of Yang collapse due to mistaken use of Da Qing Long Tang, Si Ni Tang (Four Reversal Decoction) should be used to restore Yang. Yet, it is set aside, and preference is given to Zhen Wu Tang for rescue. What is the rationale? Zhen Wu is the deity governing water in the North. The Dragon can only transform by relying on water. If Zhen Wu does not provide water, the Qing Long cannot ascend to heaven vigorously, which is obvious. Therefore, the formula uses Fu Ling (Poria), Bai Zhu (Atractylodes Macrocephala Rhizome), Shao Yao (Peony Root), and Fu Zi (Aconite Lateralis Preparata) to promote water metabolism, collect Yin, awaken the Spleen, and strengthen Earth. Its功效 in gathering water and consolidating Yin outweighs its Yang-restoring function. Named Zhen Wu Tang, it gathers scattered and separated Yin and Yang, stabilizing them mutually in the Northern position of Shaoyin. The key lies in gathering the Water Qi so that the Dragon remains submerged and unseen. If even a trace of Water Qi rebels upward, the Dragon will ascend and transform. Even if one solely uses Fu Zi and Gan Jiang (Zingiberis Rhizoma) to restore Yang, what can be done about the incessant profuse sweating? Human Yang is rooted in Yin. The syndrome of Yang collapse refers to the True Yang of the Kidney in Shaoyin flying away. True Yang flying away urgently requires sedation and anchoring, returning it to its root in Yin. Once Yang returns to Yin, it naturally follows. When Yin follows, Water does not rebel, and Yang is no longer isolated. How could it fly away again?

In cold damage, if the pulse is floating and slow, the body is not painful but feels heavy, occasionally becoming lighter, and there are no Shaoyin signs, Xiao Qing Long Tang (Minor Blue Green Dragon Decoction) should be used to disperse.

The Shichuan edition reads "Da Qing Long Tang Fa Zhi". Corrected from the Internal Compilation. ○ Regarding the previous clause: floating-tight pulse, body pain, no sweating, and irritability are all signs of Cold injuring Ying. Only irritability is caused by Wind injuring Wei. Yet, the term "Wind Strike" is used to encompass the Cold syndrome. The prescription uses Ma Huang Tang plus Shi Gao (Gypsum Fibrosum) to resolve internal irritability, and Ginger/Jujube to harmonize Ying Qi. In this clause, floating-slow pulse and lack of body pain are signs of Wind injuring Wei. Only body heaviness is caused by Cold injuring Ying/Blood. However, the occasional lightness differs from the constant heaviness and painful irritability of bone/joints/lower back in cold damage, and also differs from the constant day-and-night heaviness and desire to sleep seen in Shaoyin. Heaviness is due to Cold; occasional lightness is due to Wind. Although both Ying and Wei are injured, Wind predominates over Cold. Yet, the term "Cold Damage" is used to encompass the Wind syndrome. The prescription uses Gui Zhi Tang (Cinnamon Twig Decoction) plus Ma Huang (Ephedrae Herba) to disperse Cold. Since Ying-Wei stagnant heat causes thirst and desire to drink, but early in the disease pathogenic heat is not substantial enough to consume fluids, fluid retention occurs. Therefore, Ban Xia (Pinelliae Rhizoma) is used first to wash away phlegm-fluids, Xi Xin (Asari Radix et Rhizoma) and Gan Jiang (Zingiberis Rhizoma) to dissipate knots, and Wu Wei Zi (Schisandrae Fructus) to astringe fluids. One fears that Sheng Jiang (Zingiberis Rhizoma Recens) acridly disperses and guides fluids upward, and Da Zao (Jujubae Fructus) sweet-warm gathers fluids preventing dispersion, so they are removed. "Fa Zhi" means dispersing the knot of Wind-Water, not inducing heavy sweating. Zhang Zhongjing further clarifies "without Shaoyin signs" because Taiyang and Shaoyin are exterior-interior pairs. In individuals with innate essence deficiency, exterior pathogens may invade the Kidney via the Bladder before transmission occurs. Moreover, complex patterns like simultaneous contraction of exterior and interior or Yin-collapsing patterns require careful examination. If Shaoyin is not deficient, how can exterior pathogens cross over to present with heaviness and desire to sleep? Therefore, if Shaoyin signs exist, and exterior dispersal is不得已 (unavoidable), there are methods to warm the meridians and scatter pathogens simultaneously. One cannot simply use Qing Long Tang to uproot solitary Yang.

In cold damage, if the exterior syndrome is unresolved, and there is fluid retention in the Heart region, accompanied by dry retching, fever, and cough, or alternatively thirst, diarrhea, choking sensation, dysuria with lower abdominal fullness, or asthma, Xiao Qing Long Tang is indicated.

This is a delayed onset of the previous syndrome, leading to fluid retention. Water and Cold bind together, damaging the Lung. Accumulated fluids in the body vary—some upper, some lower, some hot, some cold—but the Lung is the master. If any one or two symptoms appear, it indicates fluid rebellion. Xiao Qing Long Tang should be promptly used to scatter pathogens and expel water, unlike Da Qing Long Tang which aims to raise clouds and bring rain.

If there is mild diarrhea, remove Ma Huang and add Yuan Hua (Genkwa Flos) the size of an egg, roasted until red. If thirsty, remove Ban Xia and add Gua Lou Gen (Trichosanthis Radix) 3 liang. If choking, remove Ma Huang and add one prepared Fu Zi (Aconiti Lateralis Preparata Radix). If dysuria with lower abdominal fullness, remove Ma Huang and add Fu Ling (Poria) 4 liang. If asthmatic, remove Ma Huang and add Xing Ren (Armeniacae Semen Amarum) half sheng, peeled and tipped.

The main action of this formula is dispersing, hence Ma Huang is used. If the main action is promoting diuresis, Ma Huang is mostly removed and replaced with diuretic herbs. Yuan Hua promotes diuresis; once water is gone, diarrhea stops. Choking is caused by Water-Cold binding internally, hence Ma Huang is removed and Fu Zi added.

In cold damage, if there is fluid retention in the Heart region, with cough, slight asthma, fever, but no thirst, Xiao Qing Long Tang is indicated. If thirst occurs after taking the decoction, this indicates Cold is departing and the disease is resolving.

The Shichuan edition misplaces "Zai Han Qu Yu Jie Ye" under "Xiao Qing Long Tang Zhu Zhi". ○ Wind-Cold carrying fluid rebellion upward obstructs fluids without immediately injuring them, hence no thirst. After taking the decoction, fluids and Yin are depleted, hence thirst arises. Thirst indicates sudden injury to fluids without recovery, signaling Cold departure and impending resolution. Thus, although thirsty, no further medication is needed; one should wait quietly for fluids to return. ○ Cough and slight asthma indicate fluid overflow. Now, thirst after water removal differs from thirst due to fluid rebellion.

The above discusses injuries to both Ying and Wei.

If the throat is dry, sweating should not be induced.

The person’s Stomach fluids are inherently deficient, causing dryness in the throat. If one imprudently induces sweating, further depleting fluids, it will result in throat bi (obstruction) and expectoration of pus and blood. This differs from throat closure. The former becomes ill due to sweating depleting Yangming fluids; the latter warns against sweating to avoid depleting Shaoyin blood.

Patients with stranguria (Lin Syndrome) should not be sweated. Sweating will necessarily cause hematuria.

Stranguria patients have inherent Bladder injury. Further sweating disturbs the blood, causing it to exit through urine.

Patients with sores/ulcers (Chuang Jia), despite body pain, should not be sweated. Sweating will lead to tetany/spasm (Jing).

Sores/ulcer patients have inherently deficient exterior and hidden consumption of Ying blood. Further sweating allows exterior Wind to attack deficiency and internal blood to fail to nourish, inevitably leading to spasm.

Patients prone to nosebleeds (Nu Jia) should not be sweated. Sweating will cause depression of arteries in the forehead, tight pulse, fixed gaze unable to move, and insomnia.

Long-term nosebleed patients have damaged Clear Yang Qi. Further sweating exacerbates deficiency, causing arterial depression in the temples, tight pulse, inability to look suddenly, and insomnia. This is because eyes and forehead belong to the Yangming aspect.

This differs significantly from cold damage with floating-tight pulse where failure to sweat causes nosebleed; the deficiency/excess disparity must be distinguished.

Patients with blood loss (Wang Xue Jia) should not be sweated. Sweating will cause chills and tremors.

Blood loss leaves Yang isolated without partner. Sweating causes Yang to escape with sweat, resulting in chills rather than fever.

Persons prone to sweating (Han Jia) who are sweated again will suffer mental confusion and restlessness. After urination, there will be genital pain.

Chronic sweaters subjected to further sweating injure Heart blood, causing mental confusion. Bladder blood is also injured, causing genital pain after urination.

Throat closure should not be sweated. Sweating will cause hematemesis, near-death Qi, cold extremities, and a desire to curl up unable to self-warm.

These patients have inherent Kidney True Yang deficiency causing throat closure. Sweating depletes Yang, leaving blood without support, resulting in hematemesis, cold limbs, and curling up. This cannot be matched by Si Ni Tang alone.

Cough with urinary incontinence should not be sweated. Sweating will cause cold extremities.

Cough with urinary incontinence indicates Bladder empty heat. Sweating transmits to Shaoyin, causing cold extremities.

Any pulse that is rapid, active, yet weak/faint should not be sweated. Sweating will cause difficult defecation, dry abdomen, dry stomach, and irritability.

Although the pulse is rapid and active, weakness indicates exterior deficiency with spontaneous sweating. Sweating exhausts fluids, causing dry stomach and irritability.

For various rebellious conditions, mistaken sweating makes mild cases hard to cure, severe cases delirious, and those with dizziness die. (Cha is synonymous with Cui, meaning cured/healed).

Mistaken sweating in rebellious conditions means: For persons with chronic diseases and innate Yin-blood deficiency, mistaken diaphoretics further deplete blood. Mild cases become severe, severe cases worsen. Severe cases deliriate and feel dizzy because empty heat generates Wind, and Wind governs dizziness.

Throat dryness prohibits sweating. Chang Qizhi suggests Xiao Chai Hu Tang (Minor Bupleurum Decoction). Shi Wen suggests Xiao Jian Zhong Tang (Minor Construct the Middle Decoction). Stranguria prohibits sweating; Chang says Zhu Ling Tang (Polyporus Decoction); Shi Wen says Huang Qi Jian Zhong Tang before sweating. Sores prohibit sweating; Wang says Xiao Jian Zhong Tang plus Dang Gui. Chang says mistaken sweating causes spasm, use Gui Zhi Jia Ge Gen Tang (Cinnamon Twig Plus Kudzu Root Decoction). Shi Wen says leaky wind spasm, use Gui Zhi Jia Fu Zi Tang (Cinnamon Twig Plus Aconite Decoction). Nosebleed prohibits sweating; Xu Shumi says Huang Qi Jian Zhong Tang plus Xi Jiao (Rhinocerotis Cornu) for bleeding from sweating. Lv Cangzhou says Xiao Jian Zhong Tang plus Cong Chi (Scallion and Soybean). Uncontrollable fixed gaze after mistaken sweating is incurable. Blood loss prohibits sweating; Chang says Xiao Chai Hu Tang plus Shao Yao; Shi Wen says Huang Qi Jian Zhong Tang. Trembling after mistaken sweating uses Ling Gui Zhu Gan Tang plus Dang Gui. Throat closure prohibits sweating; An Chang says Gan Cao Gan Jiang Tang (Licorice and Dried Ginger Decoction). Sun Zhao says Huang Qi Jian Zhong Tang plus Cong Chi. Hematemesis after mistaken sweating uses Zhi Gan Cao Tang (Honey-Fried Licorice Decoction). Cold extremities use Dang Gui Si Ni Tang (Angelica Four Reversal Decoction). Cough with urinary incontinence prohibits sweating; Guo Baiyun says Gan Cao Gan Jiang Tang Dang Gui Si Ni Tang. Shi Wen says before sweating Gan Cao Gan Jiang plus Cong Chi; after mistaken sweating cold extremities use Dang Gui Si Ni Tang. Post-sweating frequent urination uses Fu Ling Gan Cao Tang (Poria and Licorice Decoction). Rapid-active-weak pulse prohibits sweating; Guo says Xiao Jian Zhong Tang; Wang says post-mistake irritability/difficult stool uses Zhi Gan Cao Tang. Chronic sweaters re-sweated with post-urination genital pain; Chang says Yi Yu Liang San (Halloysitum Powder). Wang says Yi Yu Liang, Chi Shi Zhi, Sheng Zi Bai Pi, Chi Xiao Dou equal parts, honey pills, boiled water twice daily.

The above lists examples of contraindications for sweating in chronic conditions.

Taiyang syndrome resolves between Si and Wei hours (9 AM to 3 PM).

Whenever a disease resolves, it follows the peak time of its meridian Qi. Taiyang is盛 Yang. Therefore, it resolves during the peak times of Si, Wu, and Wei.

The previous clause discusses the self-resolution signs of the Taiyang Meridian.