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Fire pathogen is governed by the Ministerial Fire of Shaoyang (Lesser Yang). Its manifestations include sudden death, fever with aversion to cold, severe pain outbreaks, transformation into edema, yellow complexion with physical emaciation, purulent bloody diarrhea, dysentery with red and white discharge, carbuncles, ulcers, toxic sores, erysipelas, rashes, pediatric malnutrition diarrhea, abdominal distension, sudden watery diarrhea, heat in the chest and epigastrium, severe cases presenting with nasal congestion and epistaxis, pain in the chest and hypochondrium, deafness, bitter taste in the mouth, dry tongue, visceral toxicity with lower bleeding, undigested food in stool, borborygmus with cutting pain, wasting-thirst with upper asthma, indicating lung metal pathology.
Available formulas: Liangge San (Cool the Diaphragm Powder), Huanglian Jiedu Tang (Coptis Decoction for Detoxification), Xiexin San (Drain the Heart Powder), Shenxiong Wan (Divine Xiong Pill), Bazheng San (Eight Upright Powder), Tiaowei San (Regulate the Stomach Powder), Tiaoweichengqi Tang (Regulate the Stomach and Direct Downward Decoction).

Dryness pathogen is governed by the Dry Metal of Yangming (Bright Yang). Its manifestations include various qi stagnation and depression, dryness and depletion of the intestines and stomach, wrinkling and peeling of the skin, hypochondriac pain, cold malaria, asthma and cough, borborygmus in the abdomen, urgent diarrhea with loose stools, sudden severe pain in the hypochondrium making turning difficult, dry throat, dusty face, muscle wasting with poor complexion, hernia in men, lower abdominal pain and red/white leukorrhea in women, sores, acne, furuncles, asthma with tidal fever, dry and constipated stool, and sores like "horse knife" and "clenched goiter", indicating liver wood pathology.
Available formulas: Shengong Wan (Divine Merit Pill), Pi Yue Wan (Spley Restriction Pill), Maren Wan (Hemp Seed Pill), Runti Wan (Moisten Body Pill), Sisheng Wan (Four Generations Pill).

Cold pathogen is governed by the Cold Water of Taiyang (Greater Yang). Its manifestations include various cold-damp bi syndrome, spasm and stiffness of elbows and arms, cold cough due to autumn dampness, phlegm-jue heart pain, palpitations in the heart, pain in the chest, hypochondrium, and epigastrium preventing eating, lack of appetite after eating, vomiting and diarrhea with foul-smelling excreta, difficulty in flexion and extension, incontinence of urine and feces, blindness, hard masses, sallow/dark complexion, thirst craving cold water with fluid retention, swollen feet, retracted scrotum, cold limbs, cyanotic nails, indicating heart fire pathology (due to cold damaging yang).
Available formulas: Jiangfu Tang (Ginger and Aconite Decoction), Sini Tang (Reverse the Yin Decoction), Erjiang Tang (Two Gingers Decoction), Zhufu Tang (Atractylodes and Aconite Decoction), Da Yihan Wan (Great Cold-Resolving Pill), Lizhong Tang (Regulate the Middle Decoction).

For conditions such as wind-capture, seasonal qi disorders, warm diseases, and cold damage within three days of onset, presenting with headache, fever, and aversion to cold, Tongsheng San (Unimpeded Holy Powder) and Yiyuan San (Benefit Origin Powder) can be used, five to seven qian each, boiled in one large bowl of water with over ten slices of fresh ginger, over ten stalks of green onion whites with roots, and a pinch of fermented soybeans. After boiling three to five times, strain the dregs, warm slightly, and administer more than half first; after some time, induce vomiting by probing the throat with a hairpin, without rinsing the mouth; then administer the remaining small portion, also warmed, followed by green onion vinegar spicy soup, cover with blankets, and cure upon sweating. If encountering chaotic times, as stated in *Neijing*: when annual fire is excessive, hot summer heat prevails, fire qi is too strong, and lung metal is attacked, corresponding to the bright appearance of Mars; using acrid-cool agents to resolve it ensures success. In peaceful times, Shengma Tang (Cimicifuga Decoction), Gegen Tang (Pueraria Decoction), and Baidu San (Defend Against Poison Powder), which are acrid-warm agents, can be used to resolve the exterior. Adding green onion roots/whites and fermented soybeans allows for resolving via vomiting and sweating. As *Neijing* states: "Treat light pathogens by dispersing them." Dispersing means uplifting. Vomiting and sweating disperse cold and heat pathogens. After vomiting and sweating, strict rest is required; after ten days, the pathogen will not recur. Another method: if no medicine is available, use one large bowl of sour vinegar juice, boil three to five times, remove vegetable leaves, drink rapidly; after a while, induce vomiting by probing the throat with a hairpin, repeat three times; then drink green onion vinegar spicy soup, cover with blankets, and cure upon sweating. As *Neijing* states: "Acid and bitter promote upward and downward discharge, belonging to Yin." Upward refers to vomiting. Cold damage within three days with headache and fever indicates pathogen in the upper jiao. Pathogens in the upper jiao should be treated with vomiting, followed by nourishment with thin rice gruel; recovery occurs in one or two days.
Another method: use Buwo San (Do Not Sleep Powder) by insufflating powder into both nostrils, inducing thirty to twenty sneezes, then cover with blankets. Use this medicine in a warm room; after sneezing, drink spicy sour rice gruel, sweating profusely. Sneezing is a form of vomiting therapy. This method corresponds internally and externally to Shuangjie San (Double Resolution Powder).
Another guiding exercise method can be used in a quiet place. Teach the patient to sit cross-legged, interlock fingers, grasp the Fengchi (Wind Pool) and Fengfu (Wind Court) acupoints at the back of the head, which are gates of wind; bow forward until nearly touching the ground, repeating one hundred and twenty times; immediately drink spicy green onion vinegar porridge, and recover upon sweating.
Cold damage, warm plague, seasonal qi, wind-capture, and heatstroke are all improper qi of the four seasons. Initial infection presents with headache, aversion to cold, fever, alternating chills and fever, and stiff waist/spine, indicating Taiyang channel involvement. As *Neijing* states: "Treat the exterior first, then the interior." First use Shuangjie San (Double Resolution Powder) decocted with ginger, green onion whites, and fermented soybeans to resolve via vomiting and sweating. If unresolved, on day five or six, with constipation, asthma/fullness, delirium, excess heat, and deep pulses in both hands, use Tiaoweichengqi Tang (Regulate the Stomach and Direct Downward Decoction), Dachengqi Tang (Major Direct Downward Decoction), or Xiaochengqi Tang (Minor Direct Downward Decoction) to purge. Strictly avoid silver powder, croton seed frost, apricot kernels, and genkwa root (hot purgatives); purging with these leads to death. This is treating the exterior first, then the interior. After heavy sweating, strictly avoid mallow soup, huoxiang vegetables, and meats of sheep, pig, chicken, dog, fish, rabbit. Ignorance of this leads to severe distress and difficult treatment later. On day seven or eight of cold damage, with jaundice, spots, tidal fever, and abdominal fullness, or intermittent phlegm-excess, even if previously purged with Chengqi Decoctions, Zhang Zhongjing states: if Cun Kou pulse is floating and slippery, Gouti San (Melon Seed Powder) can be used to vomit. However, for cold damage, floating-slippery Cun Kou pulse allows this; for miscellaneous diseases, sinking Cun Kou pulse allows vomiting. Wang Shuhe said: "Sinking Cun pulse indicates phlegm in the chest." Qixuanzi said: "Excessive upper fullness requires vomiting to drain the pathogen."