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Taiyang disease presenting with a faint pulse and cold extremities, progressing to cold skin after seven or eight days, where the patient is restless without any moment of peace, is termed Zang Jue (Visceral Cold Reversal), not Hui Jue (Roundworm Reversal). Patients with Hui Jue typically vomit roundworms. The current patient is mostly quiet but occasionally irritable, indicating this is not due to visceral cold. The irritability arises because the roundworms move upward into the diaphragm; they stop after a short while. Vomiting occurs after eating, and subsequent irritability happens because the roundworms are stirred by the smell of food, causing the patient to vomit them. For patients vomiting roundworms, Wumei Wan (Mume Pill) is the primary formula; it also treats chronic diarrhea.

In Taiyang disease, if a patient presents with a faint pulse, cold extremities, and irritability within six or seven days, moxibustion on the Jueyin meridian should be urgently applied to rescue the condition. However, if after seven or eight days the skin becomes cold and the patient is restless without irritability, this indicates pure Yin without Yang, a reversal caused by visceral cold, which is an untreatable condition. Nevertheless, Hui Jue can also present with a faint pulse and cold skin; this represents internal heat with external cold. One should not hastily diagnose it as Zang Jue and deem it untreatable. The obvious sign is vomiting roundworms, while the subtle distinction lies in differentiating between irritability (fan) and restlessness (zao). Visceral cold manifests as restlessness without irritability, whereas internal heat manifests as irritability without restlessness. A patient who is quiet but occasionally irritable is distinctly different from one who is constantly restless without peace. This corresponds mutually with symptoms such as Qi rushing up to the heart, pain and heat in the epigastrium, hunger without desire to eat, and vomiting roundworms upon eating. Roundworms are parasites formed by the combination of consumed raw/cold foods and damp-heat qi in the stomach. Due to Wind-Liver pathogenic factors and Ministerial Fire attacking upward, the worms do not descend through the intestines but ascend to the throat. Therefore, treatment requires the simultaneous use of cold and hot herbs. This case involves chest irritability with vomiting roundworms, not gastric cold causing vomiting, so Huanglian (Coptis Rhizome) and Huangbai (Phellodendron Bark) can be used. It must be understood that Huanglian and Huangbai are cold herbs used in a hot context, not merely for their bitter taste to pacify roundworms. Observing various Jueyin syndromes matching this formula, and noting that purgation leads to unceasing diarrhea (aligning with "also treats chronic diarrhea"), Wumei Wan is the master formula for Jueyin diseases, not just a remedy for Hui Jue.

Wumei Wan:
Wumei (Fructus Mume, 200 pieces), Xixin (Asari Radix et Rhizoma, 6 liang), Ganjiang (Zingiberis Rhizoma Recens, 10 liang), Huanglian (Coptidis Rhizoma, 16 liang), Danggui (Angelicae Sinensis Radix, 4 liang), Fuzi (Aconiti Lateralis Radix Praeparata, 6 liang, processed and peeled), Shujiao (Sichuan Pepper Fruit, 4 liang, stir-fried until oil appears), Guizhi (Cinnamomi Ramulus, 6 liang, bark removed), Renshen (Ginseng Radix, 6 liang), Huangbai (Phellodendri Cortex, 6 liang).

The above ten ingredients are separately pounded and sifted, then mixed. Soak Wumei in vinegar overnight, remove pits, and steam over five sheng of rice. Once the rice is cooked, pound the Wumei into a paste, mix thoroughly with the other medicines, place in a mortar, add honey, and pound three thousand times to form pills the size of tung tree seeds. Take ten pills before meals with warm water, three times daily, gradually increasing to twenty pills. Avoid raw/cold, slippery, and foul-smelling foods.

Roundworms move with wind; they become quiet with sour flavors, dormant with pungent flavors, and descend with bitter flavors. Thus, Wumei and vinegar, being extremely sour, serve as the Sovereign herb. Ganjiang, Shujiao, Xixin, Fuzi, Huanglian, and Huangbai, being strongly pungent and bitter, serve as Ministers. Renshen and Danggui assist in regulating Qi and Blood, while Guizhi disperses Wind pathogens. The Qi of rice harmonizes the Stomach, and the flavor of honey guides the roundworms. Administering small amounts and gradually increasing them will gradually cease irritability and dissolve the roundworms. Consuming raw/cold food agitates the roundworms, and consuming slippery food causes them to ascend to the diaphragm; hence, these are prohibited.