故也。（此系胃中冷实之证。阳明中寒者。谓寒邪初入于经。未全入胃。不作郁热也。胃为阳。主气。胃中阳气胜。则能
营运水谷。使出入不失其常度。今者。胃中寒。遏其阳气。以故谷不能入。水不能出。所以不能食。而小便亦不利也。
手足 然汗出者。四肢为诸阳之本。又阳明胃府。复主四肢胃府之阳。既为寒气所遏。不得内发。郁蒸于外。以故手足
然而汗出也。固瘕者。寒气固结。犹如瘕聚而不散。故云。此欲作固瘕。非真欲成瘕聚也。其人大便。虽初硬而后必
溏。盖手足 然汗出者。其人必大便硬。其所以初硬后溏者。以胃中所入之寒气。已固结而成冷。中焦阳气不运。不能
泌别水谷。以故小便不利。而大便必溏也。按此条论。仲景无治法。补亡论常器之云。可理中汤。愚以寒气固瘕。水谷
不别。此为冷实之证。理中汤太补。不宜用也。又云。猪苓汤。推常氏之意。以小便不利。故用此汤。但仲景既云胃中
冷。水谷不别。以致小便不利。复用猪苓泽泻滑石等寒药何也。盖胃中虽冷而实。胃实必作郁热。故常氏用猪苓汤。以
利其小便。俟小便利则大便自硬。然后议用承气等下药。）
阳明病初欲食。小便反不利。大便自调。其人骨节疼。翕翕如有热状。奄然发狂。 然汗出而解者。此水不胜谷气。
与汗共并。脉紧则愈（此系阳明经热未全入府之证。阳明病欲食者。谓风邪初传入胃。胃气本强。不为病夺也。胃强。
则能游溢精气。通调水道。是小便宜利矣。今反不利者。以胃气挟邪热而过强。水气升发于表。势欲作汗。故不下而为
溺也。大便自调。知非水谷不别。胃中冷实之证可比。其人骨节疼。翕翕如有热状者。风邪郁于阳明之表也。但此骨节
疼。非比太阳伤寒。寒气拘急而疼。乃阳明中风。热气蒸发而疼。以故热伏于肌肉之间。在表则但翕翕然如有热。而又
若无热之状也奄忽也。奄然发狂者。乃邪热初入于胃。胃气强。不受热邪所困。正与邪争。邪气还表。以故发狂汗出而
解也。 然义注已见前。水以小便言。谷气以欲食言胃能食。则谷气胜。水气不胜谷气。必相与作汗而共并于表。则前
此未汗而脉紧者。至此则紧脉去。而阳明经病必自愈。按脉紧则愈。补亡论阙疑常器之云。一本作脉去则愈。郭白云云。
千金作坚者。则愈无脉字。是误以脉紧为去为坚者。或漏脉字。或漏者字。当云。脉紧者则愈愚今校正。当云脉紧去则
愈。或云脉紧宜用麻黄汤。愚以仲景法。太阳病脉紧者。宜麻黄汤。此条系阳明病。当改用葛根汤也。况上正文云。汗
出而解。以故不及治法。）
阳明病欲解时从申至戌上。（注已见前第三卷太阳上编）
阳明病不能食。攻其热必哕。所以然者。胃中虚冷故也。以其人本虚。故攻其热必哕。（寒中阳明。胃中虚冷。无热
可攻。成注云。热去寒起。竟认作有热之证。其误甚矣。其人虽不能食。以胃气本虚。故不食。非胃中实而食不下也。
此条系真寒证。正文与注俱见中寒论中。）
阳明病脉迟。食难用饱。饱则微烦。头眩。必小便难。此欲作谷疸。虽下之腹满如故。所以然者。脉迟故也。（此系
阳明中风。初入于胃。里未全实之证。脉迟者为阴。主里。阳明病。至脉迟。则邪已离经。渐入于府。但府中郁热未甚。
故其脉尚迟。食难用饱者。以中风证。其初本能食。至此。则邪已入胃。势必于于难用饱矣。饱则谷气与热邪相搏。郁
蒸成湿湿热之气。上攻则微烦而头眩。小便必难者。湿热上攻。则水道必不下顺也。湿热郁于中焦。上不得越。下不得
泄。此其势又必至蒸发于外。欲作谷疸之证。疸黄病也。以此证。本因阳明中风。不能禁其食。故成谷疸。而身发黄色
也。湿热内积而成谷疸。则其人腹满可知。腹满者。下之则愈。今下之而腹满如故。何也。所以然者。以脉迟。则表邪
未全入里。热气尚未敛实。故其病不因下而少衰。成注引经云。脉迟尚未可攻。正此谓也。按此条论。仲景无治法。补
亡论常器之云。宜猪苓汤。五苓散。愚以上二方未成谷疸时加减出入。可随证选用。郭白云云。已发黄者。茵陈蒿汤。
此为不可易之剂。）
阳明病法多汗。反无汗其身如虫行皮中状者。此以久虚故也。（此系阳明经有寒邪。郁热不能透发。可见阳明之为病。
亦以无汗为伤寒也。阳明多气多血。寒中阳明热郁肌肉法当多汗。今反无汗者。此以经中阳气虚。不能升发于表。以故
皮中如虫行之状也。如虫行者。痒也。皮中者。肌肉之间。汗欲出而不得。以故肌肉作痒。如虫行皮中状。犹之太阳病。
得之八九日。以其不得小汗出。身必痒。当用桂枝麻黄各半汤。以小发其汗。故尚论篇云。言久虚者。此明汗所以不能
透出于肌表之故。非谓当用补也。按此条论。仲景无治法。补亡论。常器之云。可桂枝。加黄 汤。郭白云云。以无汗
故如虫行皮中状。须小汗乃解。宜桂枝麻黄各半汤。以此汤解身痒。能小汗故也。愚以上二汤。皆太阳经药。今系阳明
无汗证。仲景法。还当用葛根汤主之。）
阳明病反无汗而小便利。二三日呕而咳。手足厥者必苦头痛若不咳不呕。手足不厥者头不痛。（此亦阳明经伤寒也。小便
利者邪不在里也。此为阳明经初得之病至二三日。经中郁热不得外泄。渐入于胃则呕而咳。或以咳为肺病。然肺之系。
与胃口相附。胃热既上冲而作呕。则肺气亦上逆而为咳也。四肢者。诸阳之本。阳明受寒邪所伤。经中阳气不能外达肌
肤而为汗。焉能横走手足而温其四肢邪。厥逆也冷也。逆冷既甚。则郁热愈深。热气上攻。必苦头痛若不咳。不呕。不
厥者。经中郁热。尚未深也。故头不痛盖诸阳之经。皆上头。即头痛一候。可见手足厥之为热厥。而非真寒证矣。按此
条论仲景无治法。补亡论常器之云。类要用小建中汤。误矣。可小柴胡汤。推常氏之意。以呕而咳。建中为呕家。所禁
故改用小柴胡。殊不知此系阳明病胃口郁热作呕。气逆作咳。与柴胡证之喜呕。或咳者。实无与。郭白云云。手足厥者。
宜小建中汤。要之此证。非中气虚寒而发厥。乃表寒郁其经中阳热之气而发厥也。愚以仲景法。还当用葛根汤加减。以
发其汗。）
阳明病但头眩不恶寒。故能食而咳。其人必咽痛。若不咳者咽不痛（此系阳明经中风也。风主动摇故头眩。眩者。
头旋而目运也。风为阳邪。故不恶寒能食而咳。其义见前。凡风寒之邪。皆能郁热而作咳。风比寒邪其热尤甚。故其人
必咽痛。咽门者。胃之系也。咳甚。则咽伤而痛。若不咳。则咽不伤。故不痛或问云。咳出于肺。其人当病喉痛。何以
伤咽。余答云。经云。脏腑皆令人咳。今者。阳明病当是胃有风热而咳。故云。必咽痛也。按此条论。仲景无治法。补
亡论常器之云。可服茯苓甘草白术生姜汤。愚以头眩而咳。纯是风热。反用茯苓白术等补气之药。其误甚矣。又云。咽
痛者。宜桔梗汤。此本少阴病咽痛之药。盖少阴之脉。循喉咙。咽痛者胃热。甚侵及少阴之经。上汤可相借用之。）
阳明病无汗。小便不利。心中懊 者身心发黄（此系阳明经有郁热兼入于府之证。无汗而小便不利。则热郁湿停。
湿热内积其气上熏。则心中懊 。此为土郁之证可知。身必发黄者。盖言湿热郁蒸势所必至也。）
阳明病被火。额上微汗。出小便不利者必发黄（此条病与上条大同小异阳明无汗。因以火强迫其汗。热邪被火。周身之
气燥极。而热不外越。但上攻于额而微汗出。此与太阳病。但头汗出同义。经中邪热。既不得外越又不得下泄。而小便
不利。此为湿热交蒸。身亦必至发黄也。按上二条论。仲景无治法。补亡论常器之皆云。可与茵陈蒿汤。调下五苓散。
愚以茵陈蒿汤固宜用。但五苓散。乃太阳经利小便。兼解表之药。今阳明经无汗。
若用五苓。宜去桂枝。加葛根为妥。又白术一味。当改用苍术。缘上二条证。皆湿胜发黄湿热内盛故也。）
阳明病脉浮而紧者。必潮热。发作有时。但浮者。必盗汗出（此系太阳风寒之邪。传入阳明之证。阳明病当见目
疼鼻干。不得卧矣。其脉浮而紧者。仍见太阳伤寒之脉也。阴寒之邪。束其经中之阳气。阳气被郁。不得发。故乘其经
气王时。必潮热发作也。若其脉但浮者。此是太阳经风邪。传于阳明。其人必盗汗出盗汗者。睡而汗出也。阳邪入于阴
分。以故睡则汗出。愚按此条论当分作两截看。脉浮紧。潮热。此是阳明伤寒。仲景法。宜葛根汤主之。脉浮。盗汗出。
此是阳明中风。仲景法。宜桂枝加葛根汤主之。补亡论与柴胡桂枝汤误矣。）阳明病口燥。但欲漱水。不欲咽者。此必衄
（此系阳明经燥热之证成注云。阳明之脉起于鼻络于口。阳明里热。则渴欲饮水。此口燥。但欲饮水。不欲咽者。是热
在经。而里无热也。阳明气血俱多经中热甚。迫血妄行。必作衄也。按此条论。仲景无治法。补亡论常器之云。可黄芩
芍药地黄汤。一云当作黄芩芍药甘草汤。愚以此二汤。乃衄后之药于未衄时还宜用葛根等汤。加减主之。）
阳明病。本自汗出。医更重发汗。病已瘥尚微烦不了了者。此大便必硬故也。以亡津液胃中干燥。故令大便硬。当
问其小便日几行。若本小便日三四行。今日再行。故知大便不久出。今为小便数少。以津液当还入胃中。故知不久必。
大便也。（当还二字。作还当其义乃顺。此条病。可见阳明府实大便硬之证。亦有不必下
者。医人不可以不知也。阳明病。本自汗出者。表中风也。医更重发汗。谓过用葛根汤。以大发其汗。阳明经表病
已瘥。瘥者。病小愈也。病虽小愈。必尚微烦。烦者里有热也。病已瘥而尚烦。是即谓不了了。若此者。大便必硬。其
所以大便硬之故。以重发汗亡津液。津液者。为胃所主。胃亡津液而干燥。则大肠无以滋养。故令大便硬也。大便虽硬。
其人但微烦。而无躁渴谵语狂乱等急证。故无可下之法。当问其小便之多少。以候其津液之自回。若其人于自汗出之日。
小便本三四行。今于微烦之日。小便止再行。知大便不久将出。何也。盖汗与小便皆津液所化。汗虽重发而津液亡矣。
今者小便药。之次数。得少于前。其时津液。不偏渗于膀胱。胃中得以少留。故云。还当入胃。非云。既渗于膀胱以内。
当还而入于胃中也。胃有津液。则大肠得以充润。故知不久。必大便下也。愚按此条阳明病。当兼手足而言。盖大便硬。
不尽属胃。实出之大肠府也。病家如欲用药宜少与麻仁丸。）
伤寒呕多。虽有阳明证。不可攻之。（此承上文而言。不可攻之证。复有数条。医人不可以不知也。此条伤寒。当是
太阳证。呕多者。风寒之邪方盛于表。胸中阳气。为寒所郁。于是上逆而作呕。故云虽有阳明胃家实。不大便之证。不
可攻之。成注云。呕者。热在上焦。未全入府。故不可下。按此条论。仲景无治法。补亡论常器之云。小柴胡汤。愚以
呕而口苦者。为少阳经证方。宜用小柴胡汤。今者太阳伤寒未罢。呕多。兼有阳明证。仲景法。还宜用葛根加半夏汤也。）
阳明病。心下硬满者。不可攻之。攻之利。遂不止者死。利止者愈。（阳明病心下硬满。心下者。胸膈之间也。此为
邪气初聚。府未全实慎不可攻。攻之。则肠胃中真气受伤。利遂不止。成注云。正气脱而死者此也。利止者。成注云邪
气去正气安则愈。或问云。同是误攻。何以其利。有止与不止之分。愚答云。其不止者。必其人肠胃素虚。或医反用大
承气。故利不止而死。其止者。必其人肠胃素实。或医止用小承气。故利止而愈。或又问云。结胸证同是心下硬满。又
属可下。何也。余答云。结胸当是虚硬虚满。与半夏泻心汤证。心下痞满略同故云不可攻也。补亡论常器之云。未攻者。
可与生姜泻心汤即是此意。又云。利不止者。四逆汤愚意云。止须以理中汤救之。）
阳明病面合赤色。不可攻之。攻之必发热。色黄小便不利也。（此条言阳明病。必胃家实。不大便之证。合。通也。
成注云。阳明病。面色通赤者。风热之邪。犹在经也。如误下之。则表邪不解。胃气徒虚。津液大耗。表不解。故其发
热。必愈盛。胃气虚。以故面色赤者。转而为黄。此系燥热。但致面色微黄。非若湿热之通身发黄也。津液燥。以故小
便不利。此系水竭而不利。非水瘀而不利也。后条辩云。一误攻之。截热于外。耗液于里。胃气燥而成黄者。此之谓欤。
按此条论。仲景无治法。补亡论郭白云云。既不可攻。但茵陈蒿汤。调五苓散服之。推郭氏之意。以发热为里热。小便
不利为停湿。竟认作湿热发黄。大谬之极。况此发热色黄。小便不利。系误攻以后变证。方其面合赤色之时。未必先有
是证也。愚意以面合赤色。与二阳并病。面色缘缘正赤相同。此为阳气怫郁于表。可小发汗。仲景法。还宜桂枝加葛根
汤。以微汗之。）
This is a syndrome of cold and excess in the stomach. Yangming disease with cold indicates that cold pathogenic factors have just entered the meridians but have not fully entered the stomach, thus failing to generate stagnant heat. The stomach belongs to Yang and governs Qi movement. If stomach Yang Qi is abundant, it can properly transform food and fluids, maintaining normal intake and excretion. Now, cold in the stomach inhibits Yang Qi, preventing food from entering and water from exiting, resulting in an inability to eat and difficulty urinating.
Sustained sweating on the hands and feet occurs because the four limbs are the root of all Yang meridians, and the Yangming stomach also governs the limbs. Since the stomach's Yang Qi is inhibited by cold and cannot diffuse inward, it stagnates and steams outward, causing sustained sweating on the hands and feet. "Gu Jia" (solidified mass) refers to cold qi condensing and not dispersing, resembling a fixed accumulation; thus, it is said that this condition "wants to form Gu Jia," meaning it has not truly formed a fixed mass. The patient's stool may be hard at the beginning but loose later. Generally, patients with sustained hand and foot sweating tend to have hard stools; the reason for initial hardness followed by looseness is that the cold qi entering the stomach has condensed into cold, middle Jiao Yang Qi fails to transport, and clear turbid separation is impaired, leading to difficult urination and loose stools. Regarding this clause, Zhang Zhongjing provides no treatment method. Chang Qizhi in *Bu Wang Lun* suggests Lizhong Tang. I believe that for cold excess with indistinguishable food and fluids, Lizhong Tang is too tonifying and inappropriate. Another suggestion is Zhu Ling Tang; inferring Chang's intent, he used it for difficult urination. However, since Zhang stated that cold stomach and indistinguishable food/fluids cause difficult urination, why use cold herbs like Zhu Ling, Ze Xie, and Shi Gao? Likely, although the stomach is cold, there is excess, which inevitably generates stagnant heat. Thus, Chang used Zhu Ling Tang to promote urination, waiting for urine flow to restore before considering Chengqi Decoction or similar purgatives.
In early Yangming disease, if the patient desires food, yet urination is unexpectedly difficult while stool remains normal, accompanied by bone joint pain, slight feverish sensation, sudden mania, followed by sustained sweating and resolution, this indicates that Water Qi cannot overcome Grain Qi, and both exit via sweat. A tight pulse resolving signifies recovery. This represents Yangming meridian heat not fully entering the fu organs. Desire for food implies wind pathogen just entered the stomach, where stomach Qi is strong and not depleted. Strong stomach Qi should regulate water passages, making urination smooth. Difficulty here arises because stomach Qi, carrying pathogenic heat, is overly strong, causing Water Qi to rise to the exterior, attempting to sweat rather than become urine. Normal stool rules out cold-excess syndromes. Bone joint pain and slight fever indicate wind pathogen stagnating in the Yangming exterior. Unlike Taiyang cold-stagnation pain, this is Yangming wind-heat evaporation pain. Heat lies in muscles; externally, it feels slightly warm, almost without heat. Sudden mania occurs when pathogenic heat enters the stomach; strong stomach Qi resists, righteous Qi fights pathogen, driving it back to the exterior, causing mania resolved by sweating. "Water" refers to urine; "Grain Qi" refers to appetite. When stomach eats well, Grain Qi prevails over Water Qi, forcing them together as sweat. Previously tight pulse disappears, indicating self-recovery. *Bu Wang Lun* notes variations: some texts say "pulse leaves then recovers"; Guo Baiyun cites *Qian Jin Fang* as "firmness leads to recovery," missing "pulse." Correction suggests "tight pulse leaving leads to recovery" or "tight pulse warrants Mahuang Tang." However, per Zhang's method, Taiyang tight pulse uses Mahuang Tang; this Yangming case requires Gegen Tang. Since text says "resolved by sweating," no specific treatment is given.
Yangming disease resolves between Shen (3-5 PM) and Xu (7-9 PM). Note seen previously.
Yangming disease with inability to eat, attacking heat causes hiccups (Yue). This is due to deficiency-cold in the stomach. Because the person is originally deficient, attacking heat induces hiccups. Cold strikes Yangming, causing deficiency-cold with no heat to attack. Cheng Wuji notes error in treating as heat. Inability to eat stems from weak stomach Qi, not excess blocking food. This is a true cold syndrome.
Yangming disease with slow pulse, difficulty eating full meals, slight vexation and dizziness after eating, and difficult urination indicates impending Gu Dan (grain jaundice). Purging will not relieve abdominal fullness because of the slow pulse. This is Yangming wind-strike entering stomach, interior not fully solid. Slow pulse indicates Yin/interior. Pathogen moves from meridian to fu, but heat is not severe, hence slow pulse. Fullness exacerbates heat-dampness interaction. Damp-heat attacks upward causing vexation/dizziness and blocks water passages. Stagnant damp-heat in Middle Jiao steams outward, forming yellow disease (Dan Jaundice). Due to uncontrolled eating in Yangming wind-strike, grain jaundice forms. While purging usually treats fullness, here it fails because slow pulse means exterior pathogen hasn't fully entered interior, and heat isn't consolidated. Cheng note cites: "Slow pulse, do not attack." Chang Qizhi suggests Zhu Ling Tang or Wu Ling San. Guo Baiyun recommends Yinchen Hao Tang for established jaundice.
Yangming disease typically involves profuse sweating; lack thereof with a sensation like insects crawling on skin indicates chronic deficiency. Cold pathogen in Yangming meridian traps heat. Yangming has abundant Qi and Blood; cold trapping heat should cause sweating. Lack of sweating implies deficient meridian Yang Qi failing to reach exterior. Itching/crawling sensation results from sweat trying to emerge but failing. Similar to Taiyang 8-9 day syndrome requiring Guizhi Mahuang Banxia Tang for mild sweating. *Shanglun Pian* clarifies "chronic deficiency" explains failure of sweat to emerge, not indication for tonification. Chang Qizhi suggests Guizhi plus Huangqi Tang. Guo Baiyun suggests Guizhi Mahuang Banxia Tang. I argue these are Taiyang formulas; for Yangming non-sweating, Gegen Tang is appropriate.
Yangming disease with no sweating but free urination, progressing over 2-3 days to vomiting, cough, and cold extremities, implies severe headache. Absence of these symptoms means no headache. This is Yangming cold-strike. Free urination indicates pathogen not in interior. After 2-3 days, trapped meridian heat enters stomach, causing vomiting/cough. Lung connects to stomach; stomach heat rising affects lung Qi. Limbs are root of Yang; Yangming cold prevents Yang Qi from warming limbs, causing cold extremities (Jue). Severe cold deepens heat, which attacks head causing pain. All Yang meridians ascend to head. Thus, cold extremities indicate heat-Jue, not true cold. Chang Qizhi wrongly suggests Xiaojianzhong Tang. Guo Baiyun suggests Xiaochaihu Tang. I argue this is stomach heat/qi rebellion, unrelated to Shaoyang. Ge Gen Tang modification is correct.
Yangming disease with only dizziness, no aversion to cold, ability to eat, and cough implies sore throat. Wind moves, causing dizziness. Wind is Yang pathogen, so no aversion to cold. Cough and sore throat result from wind-heat damaging throat (stomach connection). If no cough, no sore throat. Question: Why throat instead of larynx? Answer: Zang-Fu all cause cough; here stomach wind-heat causes cough and throat pain. Chang Qizhi suggests Fuling Gancao Baizhu Shengjiang Tang, which is wrong for wind-heat. For sore throat, Jiegeng Tang (Shaoyin formula) might be borrowed if heat invades Shaoyin meridian.
Yangming disease with no sweating, difficult urination, and mental restlessness (Ao Nao) leads to yellowing of body and eyes. Heat stagnation and damp retention accumulate internally, steaming upward. This is Earth stagnation. Yellowing is inevitable outcome of damp-heat steaming.
Yangming disease treated with fire therapy, with slight forehead sweating and difficult urination, leads to yellowing. Similar to previous clause. Fire forces sweat; heat becomes dry, unable to escape except slightly on forehead (similar to Taiyang head-only sweat). Heat trapped internally and externally, combined with difficult urination, causes damp-heat steaming and yellowing. Chang Qizhi suggests Yinchen Hao Tang plus Wu Ling San. I agree with Yinchen Hao Tang but advise modifying Wu Ling San: remove Guizhi, add Gegen. Replace Baizhu with Cangzhu due to damp-heat excess.
Yangming disease with floating-tight pulse implies tidal fever at regular times. Floating pulse alone implies night sweats. This is Taiwind-wind-cold transmitting to Yangming. Floating-tight resembles Taiyang cold-strike; Yin-cold constrains Yang Qi, causing tidal fever during peak meridian time. Floating pulse indicates wind-transmission, causing night sweats (sweating during sleep due to Yang pathogen entering Yin). Analysis splits clause: Floating-tight/tidal fever = Yangming cold-strike, treat with Gegen Tang. Floating/night sweat = Yangming wind-strike, treat with Guizhi plus Gegen Tang. Chaihu Guizhi Tang is incorrect.
Yangming disease with dry mouth, desire to rinse mouth but not swallow, implies epistaxis (nosebleed). Cheng note: Yangming vessel starts at nose/mouth. Interior heat causes thirst/drinking. Dry mouth/rinsing-not-swallowing indicates heat in meridian, not interior. Abundant Yangming Qi/Blood with intense meridian heat forces blood recklessly, causing bleeding. Chang Qizhi suggests Huangqin Shaoyao Dihuang Tang or Huangqin Shaoyao Gancao Tang. These are post-bleeding formulas; pre-bleeding should use Gegen modifications.
Yangming disease originally with spontaneous sweating, further induced sweating by physician, residual mild vexation and confusion indicates hard stool. Loss of fluids and dry stomach cause hardness. Check urine frequency. If urine drops from 3-4 times/day to 2 times, stool will pass soon as fluids return to stomach. Fluids transform into sweat and urine. Reduced urine means fluids stay in stomach/intestines, moistening colon. Mild vexation without severe agitation means no immediate purging needed. Monitor fluid recovery. If medication desired, small dose of Maren Wan.
Taiyang disease with frequent vomiting, even with Yangming signs, prohibits purging. Vomiting indicates pathogen still in exterior/chest, obstructing Yang Qi upward. Even with Yangming excess constipation, do not purge. Cheng note: Heat in upper Jiao, not fully in fu. Chang Qizhi suggests Xiaochaihu Tang. I argue Xiaochaihu is for Shaoyang (vomiting + bitter taste). Here Taiyang cold persists with Yangming signs; Gegen plus Banxia Tang is indicated.
Yangming disease with epigastric hardness/fullness prohibits purging. Purging causing unceasing diarrhea leads to death; stopping diarrhea indicates recovery. Epigastric area is chest/diaphragm. Early pathogen aggregation, not full fu-solidity. Purging damages true Qi. Unceasing diarrhea = Qi collapse. Stopping = pathogen gone, Qi restored. Difference depends on original constitution (deficient vs. solid) and severity of purgative used. Jie Xiong (knotted chest) also has epigastric hardness but is "false fullness," treated with Banxia Xiexin Tang. Chang Qizhi suggests Shengjiang Xiexin Tang. For unceasing diarrhea, Sini Tang suggested, but I prefer Lizhong Tang.
Yangming disease with flushed face prohibits purging. Purging causes fever, yellow face, difficult urination. Flushed face indicates wind-heat still in meridian. Incorrect purging fails to resolve exterior, empties stomach Qi, depletes fluids. Exterior unresolved causes fever. Empty stomach Qi turns red face yellow (dry heat, not damp-heat jaundice). Depleted fluids cause difficult urination (water exhaustion, not obstruction). Guo Baiyun suggests Yinchen Hao Tang plus Wu Ling San, mistaking post-purging complications for primary damp-heat. I compare flushed face to Two-Yang concurrent disease (continuous redness), indicating Yang Qi stagnation in exterior. Mild sweating with Guizhi plus Gegen Tang is appropriate.