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Spring-warmth disease presents with aversion to cold and fever, headache, and body aches. Suddenly, there is profuse sweating that does not stop, or vomiting, or diarrhea, cold limbs, a faint pulse, coma, and irritability. This indicates the transformation of a Yang syndrome into a Yin syndrome. It is appropriate to use Shisiwei Da Jianzhong Tang (Fourteen-Ingredient Major Constructing the Middle Decoction) to attend to both Yin and Yang.

Initially, body aches, fever, and aversion to cold belong to exterior syndromes. Due to excessive use of ascending and dispersing methods, or forced sweating through heavy covering, sudden profuse sweating occurs, or severe vomiting and diarrhea ensue. This leads to cold limbs, a faint pulse, coma, and irritability. The exterior pathogenic factor has been completely dispersed, and Yang Qi follows in collapse, transforming into a Yin syndrome. If Shisiwei Da Jianzhong Tang is not used to tonify both Yin and Yang simultaneously, danger lies imminent. This is not the typical presentation of warmth disease, but a critical complication arising from pathological changes.

Spring-warmth disease presents with headache, fever, mental restlessness, frequent vomiting, cough with counterflow qi, chest tightness, and impending eruption of sand-rash (sha zhen). It is appropriate to use herbs such as Bohe (Menthae Haplocalycis Herba), Niu Bang Zi (Arctii Fructus), Xingren (Armeniacae Semen Amarum), Lianqiao (Forsythiae Fructus), Dan Chi (Sojae Semens Praeparatum), Hei Zhi (Gardeniae Fructus), Zhike (Aurantii Fructus), Jiegeng (Platycodonis Radix), Shengjiang (Zingiberis Rhizoma Recens), and Zhuru (Bambusae Caulis in Taenia) to clear and drain heat from the Lung and Stomach.

Headache and fever indicate the pathogen is initially at the exterior; mental restlessness, cough, vomiting, and chest discomfort involve the Lung and Stomach. Heat in the Lung transforms into rash, while heat in the Stomach transforms into macules. If not opened and drained, the pathogen will inevitably enter the Ying (Nutritive) level. Therefore, Bohe, Niu Bang Zi, Dan Chi, and Xingren are used to disperse exterior pathogens; Lianqiao and Hei Zhi clear internal heat; Zhike and Jiegeng lift and open the chest and diaphragm; Shengjiang and Zhuru harmonize the Stomach and resolve phlegm. This ensures the phlegm above the diaphragm is properly transformed, clearing heat from Lung and Stomach Qi and preventing pathogen stagnation. Such usage avoids bias and side effects.

Spring-warmth disease presents with headache, body fever, aversion to cold without sweat, chest tightness, and diarrhea. This indicates the transmission of exterior pathogens to the interior. It is appropriate to use Huangqin Tang (Scutellaria Decoction) supplemented with Gegen (Puerariae Lobatae Radix), Bohe, Xingren, Houpo (Magnoliae Officinalis Cortex), Chishao (Paeoniae Radix Rubra), and Zexie (Alismatis Rhizoma) to unblock and drain the Sanjiao (Triple Burner).

Headache, body fever, absence of sweat, and aversion to cold indicate the pathogen remains at the exterior, which should be resolved by sweating. If accompanied by chest tightness and diarrhea, it means the pathogen is not dispersing outward but moving inward. Failure to distinguish this may lead to pi-jie (glomus obstruction). Thus, following Zhang Zhongjing’s example for combined Three-Yang diseases with heat-collapsing diarrhea, Huangqin Tang is used. Huangqin’s bitter cold clears heat; Baishao (Paeoniae Radix Alba) and Gancao (Glycyrrhizae Radix et Rhizoma) with sweet and sour flavors generate Yin; Gegen and Bohe penetrate the exterior; Xingren and Houpo soothe the Spleen; Chishao and Zexie promote differentiation and drainage. This allows exterior, interior, and Sanjiao pathogens to be decomposed simultaneously, achieving precise efficacy.