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Those with dryness of the throat and pharynx should not be treated with diaphoresis (sweating therapy).
Patients suffering from cold pathogens generally require diaphoresis to resolve the pathogen, yet there are cases where diaphoresis is contraindicated; this must be carefully examined.
The throat and pharynx are the gathering point of all Yin meridians. Dryness here indicates a deficiency of Yin fluids.
Sweat is generated by the vaporization of Yang Qi but originates from Yin fluids.
Therefore, for those with dryness of the throat and pharynx, even if external pathogens are present, one must not use warm-natured herbs to force diaphoresis.
If forced, the dryness will worsen, leading to cough, sore throat, and even vomiting of pus and blood, with various adverse transformations potentially occurring.
The phrase "should not be treated with diaphoresis" refers to conditions that theoretically warrant sweating but should not be forcibly induced, not to conditions that inherently do not require sweating.
This is referred to as an "adverse transformation." The following cases follow this pattern.

Patients with strangury (a syndrome characterized by frequent, urgent, and painful urination) should not be treated with diaphoresis.
If diaphoresis is induced, hematuria (blood in urine) will inevitably occur.
Chao Yuan-fang stated: Strangury arises from Kidney deficiency and Bladder heat.
Inducing sweat further damages Zang organ Yin and exacerbates Fu organ heat, inevitably leading to hematuria.
This is analogous to the case of forcibly inducing sweat in Shaoyin disease and disturbing the blood.

Patients with chronic sores and ulcers, although experiencing body pain, should not be treated with diaphoresis.
If diaphoresis is induced, spasm (tetany or convulsions) will occur.
Body pain indicates the presence of pathogenic factors on the exterior.
Patients with sores have lost pus and blood, thereby damaging their Yin Qi.
Even with exterior pathogens, diaphoresis is contraindicated.
Inducing sweat leads to Blood deficiency generating Wind, inevitably causing spasm.

Patients prone to epistaxis (nosebleeds) should not be treated with diaphoresis.
If diaphoresis is induced, depression of the temporal arteries, tense pulse, fixed gaze, inability to move the eyes, and insomnia will occur.
Depression of the temporal arteries and tense pulse refer to the sunken or rigid, non-pliable nature of the arteries on both sides of the forehead.
The *Ling Shu* states: Sunken and erect pulses on the dorsum of the foot indicate the Foot-Yangming Stomach meridian; "sunken" means depressed, and "erect" means tense. This perfectly elucidates the current text.
Fixed gaze, inability to move the eyes, and insomnia are all signs of Yin fluid exhaustion.

Patients who have suffered significant blood loss should not be treated with diaphoresis.
If diaphoresis is induced, chills and trembling will occur.
When Yin fluids are exhausted, Yang Qi cannot remain anchored.
Following blood loss with diaphoresis results in chills and trembling because Yin Qi was previously deficient, followed by the exhaustion of Yang Qi.
Note: Patients with chronic sores and those prone to epistaxis both fall under the category of blood loss.
However, this specific clause reiterates "patients with blood loss" to encompass other conditions such as hematemesis, hematochezia, traumatic injuries, surgical wounds, and postpartum hemorrhage.

Patients who habitually sweat, if subjected to further diaphoresis, will suffer from mental confusion and restlessness, along with penile pain after urination. They should be administered Yu Yu Liang Wan (Hematitum Pill).
The five fluids transform into sweat within the Heart.
When Heart fluids are depleted, Heart Yang has no anchor, resulting in mental confusion and restlessness.
Heart deficiency generates internal heat, which flows downward to affect the genitalia, causing penile pain after urination.
The formula for Yu Yu Liang Wan is missing.
Chang Qizhi stated: Using only Hematitum (Yu Yu Liang), calcined and taken orally, is also effective.
Note: Hematitum is heavy in nature and can dispel fright; it is sweet and cold, clearing heat; and it is astringent, treating various disorders of the lower Jiao anterior and posterior orifices.

Patients with interior cold, if subjected to diaphoresis, will develop coldness in the Stomach and inevitably vomit roundworms.
"Having cold" refers to interior cold.
In cases of interior cold, even if exterior pathogens exist, the interior must first be warmed before addressing the exterior, as demonstrated by the Si Ni Tang (Frigid Extremities Decoction) method later in the text.
Failing to warm the interior and instead inducing sweat damages Yang Qi, leading to Stomach deficiency-cold and the vomiting of roundworms.

A condition presenting like Taiyang Cold Damage (Shanghan) but with a pulse that is neither wiry-tight nor floating-superficial, but rather weak.
A weak pulse indicates thirst. If fire therapy is applied to induce sweat, delirium will ensue.
If the pulse is weak, accompanied by fever and floating qualities, resolution through diaphoresis should result in sweating and recovery.
A presentation resembling Shanghan with a pulse that should be wiry-tight but is actually weak indicates excess pathogen and deficient healthy Qi.
A weak pulse signifies insufficient Yin; pathogens exploit this deficiency, generating heat and damaging Yin, thus causing thirst.
Applying fire therapy to劫 (rob) sweat combines two heats, causing dryness and irritability in the Stomach. Sweat will not emerge, and delirium will immediately follow.
If fever and a floating pulse are present, the pathogen desires to exit via the exterior. Although Yin is deficient, it can be resolved by promoting sweating, similar to the Guizhi Er Yuebi Yi Tang (Cinnamon Twig Twice, Green Ginger Once Decoction) method mentioned below.
If the pulse is not floating, the pathogenic heat disturbs the interior; rescuing Yin is already urgent enough, let alone inducing sweat.

A floating and rapid pulse typically indicates that sweating should lead to recovery.
If purgation is used instead, resulting in heaviness of the body and palpitations, diaphoresis is contraindicated. Recovery occurs when spontaneous sweating happens.
This is because a faint pulse at the Chi position indicates interior deficiency. The interior and exterior must become solid, and once fluids harmonize naturally, spontaneous sweating will occur, leading to recovery.
A floating and rapid pulse indicates the disease is on the exterior, where diaphoresis is the standard treatment for recovery ("Floating and rapid pulses may be treated with diaphoresis, appropriate for Mahuang Tang").
If purgation is used, pathogens enter the interior causing heaviness, and Qi deficiency causes palpitations. Even if the exterior syndrome persists, pharmacological diaphoresis is contraindicated. One must wait for spontaneous sweating to resolve the pathogen.
This is because a faint Chi pulse indicates interior deficiency. Further diaphoresis would deplete the exterior Qi as well, leaving the interior unprotected and leading to collapse.
Thus, one must wait for the restoration of exterior and interior Qi and the harmony of fluids before sweating occurs. How could one force it with medication?

A floating and tight pulse typically presents with body pain and is suitable for resolution via diaphoresis.
However, if the pulse at the Chi position is slow, diaphoresis is contraindicated. Why? Because Ying Qi is insufficient and Blood is scant.
A floating and tight pulse indicates Cold pathogens on the exterior, typically causing body pain, treated with diaphoresis.
If the Chi pulse is slow, it indicates deficiency of Ying and insufficiency of Blood.
Even with body pain, diaphoresis is contraindicated.
This is because sweat emerges from Yang but originates from Yin. Forcing sweat when Ying-Blood is insufficient will prevent sweating.
If sweat does occur, it leads to muscle twitching and tremors, followed by the dissipation of healthy Qi. Can one not be cautious?