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Although the condition is slightly milder, it is still referred to as sweating (Fa Han), but it actually involves herbs that release the muscle layer (Jie Ji). Therefore, Zhang Zhongjing stated in the discussion of Guizhi Tang syndrome that after taking the medicine, there should be a slight sweat over half of the body, not profuse sweating like pouring water; otherwise, the pathogenic factor will certainly not be eliminated. From this, we know that Wind-stroke (Zhong Feng) cannot be treated with heavy sweating. If sweating is excessive, it will disturb Ying Blood (Ying Xue), and the pathogenic factor will take advantage of the deficiency to invade, resulting in the disease not being cured. Cold damaging Ying (Shang Rong) means cold pathogen enters the Yin blood, while Ying Qi circulates within the vessels. When cold pathogen resides in the vessels, not only does Ying suffer from the pathogen, but it also generates internal disturbances, subsequently affecting Wei Qi. Over time, it infiltrates and reaches the bones. Thus, symptoms such as anhidrosis, fever, dry teeth, and inner vexation occur. Zhang Zhongjing used Mahuang to induce sweating, and combined it with Guizhi and Gancao to assist dispersion, aiming to cleanse both internal and external pathogens and treat the disorders of Ying and Wei. Generally speaking, both types of herbs induce sweating; Guizhi disperses Wei-level pathogens, while Mahuang treats both Ying and Wei levels, naturally having differences in depth. How can this be verified? In the 19th clause regarding Guizhi Tang, Zhang Zhongjing said: "The patient often sweats spontaneously. This indicates Ying Qi is harmonious. The disharmony lies externally because Wei Qi does not harmonize with Ying Qi. Ying circulates in the vessels, and Wei circulates outside the vessels. Re-inducing sweating will harmonize Ying and Wei, leading to recovery; Gui Zhi Tang is appropriate." In the 47th clause, he said: "Fever and sweating indicate weak Ying and strong Wei, causing sweating. To rescue from wind pathogen, Gui Zhi Tang is appropriate." From this, we know that sweating in Wind-stroke indicates harmonious Ying but disharmonious Wei. In Volume 1, it is stated: "Cun Kou pulse is floating and tight. Floating indicates Wind, tight indicates Cold. Wind damages Wei, Cold damages Ying. When Ying and Wei are both diseased, bone joints are painful and restless; sweating should be induced." Thus, a floating-tight pulse in Cold damage indicates simultaneous disease of Ying and Wei. The use of Guizhi in Mahuang Tang reflects Zhang Zhongjing's intent. As for Da Qing Long Tang, although it treats Wind-stroke presenting with Cold pulse or Cold damage presenting with Wind pulse, Zhang Zhongjing also stated: "If there is sweating and aversion to wind, it must not be taken; doing so may lead to limb reversal coldness and muscle twitching (Jin Ti Rou Tiao)." Therefore, the prescription of Da Qing Long Tang is particularly difficult, requiring precise matching of signs and symptoms before administration. Wang Shifu only used Gui Zhi Ma Huang Ge Ban Tang for treatment, demonstrating caution.

Tao Hua believed: High heat with vexation and warm hands/feet with a floating-tight pulse indicates Wind-stroke presenting with Cold pulse; lack of vexation, slight heat, slightly cold limbs, and a floating-slow pulse indicate Cold damage presenting with Wind pulse. Both conditions involve simultaneous disease of Ying and Wei, and theoretically, Da Qing Long Tang is suitable. However, this decoction is dangerous and should only be used when both Wind and Cold are severe and accompanied by vexation; otherwise, Gui Zhi Ma Huang Ge Ban Tang is more stable, and even better, Jiu Wei Qiang Huo Tang added with Shi Gao, Zhi Mu, and Zhi Ke.

Wen Fen Formula: Bai Zhu, Ben Cao, Chuan Xiong, Bai Zhi (equal parts), ground into fine powder. For every one liang of powder, mix with three liang of rice flour, and apply to the whole body to stop sweating. If sweating is excessive, risking Yang collapse leading to reversal coldness, aversion to wind, vexation, and insomnia, this powder is suitable to stop sweating.

In Taiyang disease, if the neck and back feel stiff and uncomfortable (Jin Jin Jin), accompanied by spontaneous sweating and aversion to wind, Gui Zhi Jia Ge Gen Tang should be administered. (Note: According to the *Book of Songs*, "Chi Xi Jin Jin," the annotation explains "Jin Jin" as a state of being constrained, referring to the tight fit of shoes at the toe, symbolizing restraint. This imagery helps visualize the stiffness and constraint of the neck and back. Interpreting it as bird feathers would make the pronunciation 'Shu', which does not fit the meaning of constraint. The later Ge Gen Tang consists of Gui Zhi Tang plus Mahuang and Ge Gen. It is used for anhidrosis to induce sweating with Mahuang. This case has sweating, so Mahuang is removed, hence called Gui Zhi Jia Ge Gen Tang. If Mahuang were included, it would be Ge Gen Tang. Cheng Wuji should not have created doubt in his commentary, confusing future students, hence this clarification.)

Gui Zhi Jia Ge Gen Tang Formula: Ge Gen (4 liang), Shao Yao (2 liang), Gancao (2 liang), Sheng Jiang (3 liang, sliced), Guizhi (2 liang, bark removed), Da Zao (12 pieces, split). These seven ingredients are boiled in ten dou of water to obtain three sheng. Strain and take one sheng warm.

In Taiyang disease, if the neck and back are stiff and uncomfortable (Jin Jin Jin), with anhidrosis and aversion to wind, Ge Gen Tang should be administered.

Ge Gen Tang Formula: Ge Gen (4 liang), Mahuang (3 liang, nodes removed), Guizhi (2 liang, bark removed), Shao Yao (2 liang, sliced), Gancao (2 liang, honey-fried), Sheng Jiang (3 liang, sliced), Da Zao (12 pieces, split). These seven ingredients are chewed/crushed, boiled in ten dou of water. First boil Mahuang and Ge Gen, reduce by two sheng, skim off foam, then add other herbs. Boil to obtain three sheng, strain, and take one sheng warm. Cover to induce slight sweating; no need to drink porridge. Rest and dietary restrictions follow the method of Gui Zhi Tang. (*Ben Cao* states: Light substances can remove excess; Mahuang and Ge Gen are examples. This formula adds these two to Gui Zhi Tang because of exterior excess due to Wind-stroke.)

In Taiyang disease, after eight or nine days, resembling malaria with fever and aversion to cold, where heat predominates over cold, and the patient does not vomit, and bowel/bladder functions are relatively normal, occurring two or three times a day, if the pulse is slightly slow and moderate, recovery is imminent. If the pulse is faint and there is aversion to cold, this indicates deficiency of both Yin and Yang, and sweating, purging, or vomiting should not be attempted. If the face appears flushed, the disease has not resolved because small sweating could not be achieved, leading to itching of the skin; Gui Zhi Ma Huang Ge Ban Tang is appropriate. (Cheng Wuji notes: After eight or nine days of Cold Damage, the pathogen transmits through meridians again, covering all three Yang meridians and approaching the two Yin meridians. Transmission sequence: Day 3 completes Yang transmission; Day 4 enters Yin. If it doesn't enter Yin, it resolves. Transmission to Yin completes on Day 6. If unresolved, it re-transmits Yang on Day 9. Resolving like malaria occurs at specific times. More cold indicates progression; more heat indicates regression. Classics say: Less Jue (cold extremities) and more heat means cure; more cold and less heat means regression/progression. Here, more heat than cold indicates advancing Yang Qi and declining pathogen. No vomiting or diarrhea indicates interior harmony. Intermittent fever indicates deep pathogen; daily occurrence indicates returning pathogen; twice daily indicates shallow pathogen; two to three times daily indicates mild pathogen. *Nei Jing* says: Large pulse indicates pathogen arrival, small pulse indicates peace. Many days with faint-moderate pulse indicates mild/slow pathogen, hence impending cure. Slow pulse with aversion to cold indicates exterior-interior deficiency. Yang is exterior, Yin is interior. Faint pulse indicates interior deficiency; aversion to cold indicates exterior deficiency. With both deficient, further sweating/purging/vomiting is contraindicated. Deficiency of Yin/Yang usually causes pale/blue face; red flush indicates unresolved exterior. Red color is heat color. Small sweating brings harmony; without it, pathogen scatters externally, causing itching. Gui Zhi Ma Huang Ge Ban Tang induces slight sweating to remove exterior pathogen. The first section describes current symptoms; the rest predicts changes. Divide into three parts: 'impending cure' requires no treatment; 'vomiting' suggests warming; the end suggests slight sweating. Mahuang induces, Guizhi stops; alternating prevents profuse sweating.)

Gui Zhi Ma Huang Ge Ban Tang Formula: Guizhi (1 liang 16 zhu, bark removed), Shao Yao, Sheng Jiang (sliced), Gancao (honey-fried), Mahuang (nodes removed, each 1 liang), Da Zao (4 pieces, split), Xing Ren (24 pieces, soaked in hot water, skin and tips removed, double kernels discarded). These seven ingredients are boiled in five sheng of water. First boil Mahuang for one or two boils, skim foam, add other herbs, boil to obtain 1.8 sheng, strain, and take 0.6 sheng warm.

In Taiyang disease, with fever, aversion to cold, heat predominating over cold, and a faint pulse, this indicates absence of Yang (Wu Yang), and sweating is contraindicated. Gui Zhi Er Yue Bi Yi Tang is appropriate. (Previous case had faint-moderate pulse, flushed face, itching, treated with slight sweating via Gui Zhi Ma Huang Ge Ban Tang, which was not too weak. Here, the faint pulse worsens, indicating greater deficiency than before. Even slight sweating is unsuitable, hence 'contraindicated'. However, since the disease is in Taiyang and exterior syndrome persists, dispersing herbs like Guizhi are necessary, just avoid inducing sweat.)

Gui Zhi Er Yue Bi Yi Tang Formula: Guizhi (bark removed), Shao Yao, Gancao (each 0.75 qian), Sheng Jiang (1 liang 2 zhu, sliced), Da Zao (4 pieces, split), Mahuang (nodes removed, 0.75 qian), Shi Gao (1 liang, crushed, wrapped in silk). These seven ingredients are crushed, boiled in five sheng of water. First boil Mahuang for one or two boils, skim foam, add other herbs, boil to obtain two sheng, strain, and take one sheng warm. Originally, this formula was divided into Yue Bi Tang and Gui Zhi Tang, mixed to drink one sheng. Now combined into one formula, named Gui Zhi Er Yue Bi Yi. The Stomach is the master of the twelve meridians; the Spleen manages water and grain, considered a humble organ like a maid (Bi). *Nei Jing* states: The Spleen transports fluids for the Stomach. Hence, this decoction is called Yue Bi, meaning to promote the 'maid's' function to circulate fluids externally. *Waitai Mi Yao* calls it Yue Pi Tang, reflecting this meaning. Whenever Zhang Zhongjing refers to Taiyang disease, it implies exterior syndrome with fever, aversion to cold, and head/neck stiffness. If the pulse is floating and large, it matches the syndrome, and sweating is indicated. Here, exterior signs exist but the pulse is faint, mismatching the syndrome, so sweating is contraindicated. Harmonizing formulas like Ge Ban Tang should be used.

If Taiyang Zhong Yue (Sunstroke) presents with fever, aversion to cold, faint pulse, cold extremities, and thirst, Bai Hu Jia Ren Shen Tang should be administered. (Formula theory see Sunstroke.)

In Taiyang disease, after six or seven days, if exterior signs persist, the pulse is faint and sinking, and there is no chest binding, but the patient experiences mania, it is due to heat in the lower jiao. The lower abdomen should be hard and full. If urination is free, bleeding will lead to recovery. This is because Taiyang pathogen followed the meridians, causing blood stasis in the interior. Di Dang Tang is appropriate. (Formula theory see Blood Accumulation.) In Taiyang disease, if there is yellowing of the body, sinking-knotted pulse, hard lower abdomen, and difficulty urinating, it is not blood stasis. If urination is free and the patient resembles mania, blood stasis is confirmed. Di Dang Tang is also appropriate. (See Blood Accumulation for details.) Whenever Zhang Zhongjing mentions Taiyang syndrome with a sinking pulse, it refers to fever, aversion to cold, head/neck stiffness, but the pulse is unexpectedly sinking. Accompanied by mania and hard lower abdomen, it indicates Blood Accumulation, as seen in this Di Dang Tang case.

Accompanied by joint pain, difficulty urinating, and yellowing of the body, it is Wet Bi (Shi Bi). (Theory see Dampness.)

Accompanied by sudden lockjaw and opisthotonos, it is Jing (Spasm). If there is anhidrosis and aversion to cold, it is Gang Jing (Rigid Spasm), treated with Ge Gen Tang. If there is sweating and no aversion to cold, it is Rou Jing (Soft Spasm), treated with Gua Lou Gui Zhi Tang. (See Spasm in Miscellaneous Diseases.)

If fever and headache present with a contrary sinking pulse, and if the disease does not resolve, with body pain, the interior should be rescued with Si Ni Tang. In Shaoyin disease, upon onset, if there is contrary fever and sinking pulse, Ma Huang Fu Zi Xi Xin Tang is appropriate.

Zhao Sizhen commented: Detailed analysis shows Taiyang disease with fever and headache should have a floating pulse, but here it is sinking; Shaoyin sinking pulse should have no fever, but here there is fever. Zhang Zhongjing uses "contrary" to denote abnormality. Taiyang pulse resembles Shaoyin, and Shaoyin pulse resembles Taiyang, hence both are called "contrary," yet treatments differ. Investigating the essence: both have sinking pulse and fever. With headache, it is Taiyang (Yang syndrome), expecting floating pulse. Failure to float is due to interior deficiency, chronic cold, and衰弱 Zheng Qi. Body pain necessitates rescuing the interior to restore Zheng Qi, forcing pathogen out; Gan Jiang and Sheng Fu Zi can also induce sweating and resolution. If interior were not deficient/cold, pulse would be floating, fitting Taiyang Mahuang syndrome. Without headache, it is Shaoyin (Yin syndrome), expecting no fever. Contrary fever indicates cold pathogen is in the exterior, not transmitted to interior, causing heat via pore closure, while interior lacks heat. Thus, Mahuang and Xi Xin release exterior heat, and Fu Zi warms Shaoyin meridians. If cold entered interior, exterior would lack heat, showing vomiting, diarrhea, reversal coldness, fitting Shaoyin Si Ni Tang syndrome. Thus, superficial exterior pathogen with fever is lighter than Zheng Qi collapse with sinking pulse. Si Ni Tang is crucial compared to Ma Huang Fu Zi Xi Xin Tang. Also, cooked Fu Zi with Mahuang provides supplementation during dispersion; raw Fu Zi with Gan Jiang provides dispersion during supplementation. Zhang Zhongjing's intent is subtle.

Ma Huang Fu Zi Xi Xin Tang Formula: Mahuang (2 liang, nodes removed), Xi Xin (2 liang), Fu Zi (1 piece, soaked, bark removed, broken into 8 slices). These three ingredients are boiled in ten dou of water. First boil Mahuang, reduce by two sheng, skim foam, add other herbs, boil to obtain three sheng, strain, and take one sheng warm, twice daily.

Cheng Wuji noted: *Nei Jing* states: Treat internal cold with sweet-hot, assisted by bitter-pungent. Use pungent to moisten. Mahuang's sweetness resolves Shaoyin cold; Xi Xin and Fu Zi's pungency warms Shaoyin meridians.

Zhao Sizhen commented: Zhang Zhongjing's sweating formulas vary in weight. Mahuang Tang, Gui Zhi Tang, Da Qing Long Tang, Ge Ban Tang, Yue Bi Tang, etc., have gradations. The two Shaoyin sweating formulas both use Mahuang and Fu Zi but differ in dosage. Adding Xi Xin is heavier; adding Gancao is lighter, reflecting pungent dispersion and sweet moderation. In the first case, Shaoyin originally lacks heat; inducing sweating makes it "contrary." Fever indicates exterior pathogen requiring sweating; sinking pulse indicates Yin requiring warming. Thus, Fu Zi warms meridians, Mahuang disperses cold, and heat requires sweating, so Xi Xin is added, making it a heavy sweating agent. In the second case, lacking interior cold to warm and interior heat to purge, using Mahuang and Fu Zi requires sinking pulse to qualify as Shaoyin disease and fever to justify sweating. Onset of 2-3 days indicates shallow disease, lighter than the previous case. Hence, pulse/signs are not emphasized, only "slight sweating" is mentioned. Removing Xi Xin and adding Gancao makes it a light sweating agent. Whenever Zhang Zhongjing says Taiyang disease without aversion to cold, it implies fever, head/neck stiffness, floating pulse, but unexpectedly no aversion to cold. Accompanied by thirst, it is Wen Bing (Warm Disease); accompanied by sweating, it is Rou Jing (Soft Spasm). (Formulas see Warm Disease, Soft Spasm.)

In Cold Damage, after six or seven days, with slight fever and aversion to cold, painful joints, slight vomiting, and subcostal fullness/constraint, with exterior signs unresolved, Chai Hu Jia Gui Zhi Tang is appropriate. (Cheng Wuji notes: Day 6-7 is when pathogen should transmit inward. 'Zhi' means scatter. Vomiting and subcostal constraint are interior signs, suggesting purging. However, slight fever/aversion to cold and joint pain indicate unresolved exterior, prohibiting purging. Chai Hu Gui Zhi Tang harmonizes. Note: 'Zhi' as 'scatter' is unclear. 'Zhi Jie' and 'Zhi Jie' differ. 'Zhi Jie' is like 'branch segments' (ancient variant). 'Zhi Jie' means supporting and knotting. Interpret flexibly. Nanyang says: Unresolved exterior with subcostal oppression is not Pi (blockage) but Zhi Jie.)

Chai Hu Jia Gui Zhi Tang Formula: Guizhi (bark removed), Huang Qin, Ren Shen (each 1.5 liang), Gancao (honey-fried, 1 liang), Shao Yao, Sheng Jiang (sliced, each 1.5 liang), Da Zao (6 pieces, split), Chai Hu (4 liang), Ban Xia (2.5 he). These nine ingredients are boiled in seven sheng of water to obtain three sheng. Strain and take warm. Whenever Zhang Zhongjing says "exterior unresolved," it refers to Taiyang fever, aversion to cold, head/neck stiffness, floating pulse. Although Taiyang exterior syndrome exists, if interior signs accompany it, he says "exterior unresolved" rather than "Taiyang disease." Subcostal constraint is addressed by this Chai Hu Gui Zhi Tang.

Accompanied by fluid retention in the epigastrium, dry retching, and cough, Xiao Qing Long Tang is used. (Formula see Cough.) Accompanied by hypochondriac pain, warm hands/feet, and thirst, Xiao Chai Hu Tang is used. Accompanied by epigastric blockage (Pi), first resolve exterior with Gui Zhi, then treat Pi with Xie Xin Tang. (Formula see Pi.) Accompanied by diarrhea and abdominal fullness/bloating, first warm interior with Si Ni Tang, then attack exterior with Gui Zhi Tang. (Formula see Diarrhea.)

Taiyang disease resolves between Si and Wei hours (9 AM - 3 PM). If Taiyang disease is unresolved and both Yin and Yang pulses stop, chills and sweating will precede resolution. If only the Yang pulse is slightly active, sweating leads to resolution; if only the Yin pulse is slightly active, purging leads to resolution. If purging is desired, Tiao Wei Cheng Qi Tang is appropriate. In Taiyang disease, with floating-tight pulse, fever, anhidrosis, spontaneous nosebleed leads to recovery.

If Taiyang exterior signs are unresolved, purging is contraindicated and constitutes error. To resolve the exterior, Gui Zhi Tang is appropriate. (Classics state: Inducing sweating then purging is error; purging after sweating is not error.)

Hai Zang commented: Da, Xiao, and Tiao Wei Cheng Qi Tangs must only be used when floating pulse, headache, aversion to wind/cold, and all exterior signs have ceased, replaced by fever, aversion to heat, delirium, and constipation. If floating-tight pulse is purged, Jie Xiong (Chest Binding) results; if floating-slow pulse is purged, Pi (Blockage) results.

Xu Shimwei recalled a relative with Cold Damage: fever, headache, anhidrosis, constipation for four to five days. The physician prescribed Da Huang and Po Xiao to purge. I said: Wait, let me examine. Pulse was floating-slow; he felt very cold in a closed room. I said: Exterior signs are evident. Constipation for days without abdominal distension or other discomfort warrants immediate purging? Zhang Zhongjing's method requires complete resolution of exterior signs before purging. Otherwise, pathogen enters via deficiency, causing Jie Xiong or Heat Diarrhea. I prepared Gui Zhi Ma Huang Ge Ban Tang, followed by Xiao Chai Hu Tang. Sweating occurred, bowels moved, and the patient recovered.

Zhang Zhongjing stated: Most Cold Damage arises from Wind-Cold. Initially, Wind-Cold is in the exterior; if it enters the interior, it does not dissipate. To attack it, first resolve the exterior, then purge. If exterior is resolved and interior accumulation remains (severe fullness, hardness, dry feces), purging is safe even after four to five days without harm. If purging is inappropriate and performed anyway, interior deficiency allows heat invasion, leading to Heat-carrying Diarrhea and Vexation, with countless variations. Mild cases become critical; severe cases die. The original text had repetitions; I corrected them. The logic is clear: Wind-Cold entering interior without dissipation causes dry feces or constipation. Purging is only safe when pulse is not floating, no aversion to wind, and exterior signs cease. Constipation for four to five days is harmless. Ignoring exterior and purging leads to Heat-carrying Diarrhea. Gui Zhi and Mahuang are Zhang Zhongjing's primary formulas, yet careless practitioners kill with them. The Yi Shui school replaced them with other drugs. Ignorants claim Zhang Zhongjing left out cleverness; I believe this is where Yi Shui fell short, despite their good intentions. Adhering to Chinese Medicine ensures safety. I present these exterior syndrome treatment examples and two categories (supplementing/nourishing combined with dispersion) for future scholars. Practitioners should study them carefully.