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The *Yellow Emperor's Inner Canon* states: "Yang qi, when pure, nourishes the spirit; when soft, it nourishes the sinews." Excessive sweating leads to withered and scanty body fluids, causing severe deficiency of yang qi. As a result, the muscles and sinews lose their nourishment, leading to twitching and jumping sensations (muscle fasciculations). Immediate treatment should focus on warming the meridians and benefiting yang qi. Zhenwu Tang (True Warrior Decoction) is the primary prescription.

Zhenwu Tang is indicated for muscle fasciculations following excessive sweating in Shanghan (Cold Damage) syndrome, as well as for diarrhea caused by middle-jiao cold, cough or vomiting accompanied by abdominal pain due to water retention within, and other related symptoms. It is prepared by decocting in water.
If cough is present, add ten grains of Wuweizi (Schisandrae Fructus) and 1.5 qian of Ganjiang (Zingiberis Rhizoma); if urination is smooth, remove Fuling (Poria); if diarrhea is present, remove Shaoyao (Paeoniae Radix Alba); if vomiting occurs, remove Fuzi (Aconiti Lateralis Radix Praeparata) and double the amount of Shengjiang (Zingiberis Rhizoma Recens).

When excessive sweating causes the patient to cover the heart area with both hands, experiencing palpitations that are relieved by pressure, Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction) is the primary prescription.

"Xin Song" refers to a feeling of fright or unease in the heart, while "Ti Ti Ran" describes the sensation of violent heartbeat. This condition may arise from qi deficiency, damage to body fluids due to excessive sweating or purging, or the presence of water qi. Treatment should be administered according to the accompanying symptoms.

There are several types of difficult urination. When difficult urination results from sweating or purging, it is due to insufficient body fluids. In cases of jaundice and heat disease where urination is difficult, it is due to stagnant heat accumulating internally. When wind-dampness combats each other, or in Yangming wind-stroke cases where urination is difficult, it is due to the invasion of cold qi. Furthermore, difficult urination caused by qi deficiency requires careful differentiation.

Enuresis (involuntary urination) in Shanghan syndrome is a critical sign. Due to deficiency-cold in the lower jiao, the inability to control water leads frequently to enuresis. Lizhong Tang (Regulate the Middle Decoction) and Sini Tang (Four Reversal Decoction) are primarily used. However, in San Yang He Bing (combined disease of the three yang meridians), this symptom often accompanies the condition; Baihu Tang (Tiger Powder Decoction) may be used when the heat is extreme and yin function fails. Generally speaking, cases with extreme heat and confusion of the spirit are treatable, whereas those with deficiency-cold and cold reversal are difficult to treat. For enuresis arising from miscellaneous diseases, it mostly belongs to qi deficiency, treated with herbs such as Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), and Baizhu (Atractylodis Macrocephalae Rhizoma).

E Ni (hiccups) refers to the phenomenon where qi rushes directly from below the navel to the chest. Some claim that Ke Ni (cough-reversal) is synonymous with E Ni, which is incorrect; Ke Ni refers to coughing, which has no relation to hiccups. According to general principles, in Shanghan syndrome, if purgation was indicated but not performed, stomach fire rushing upward causes hiccups. The symptoms include dryness, thirst, internal heat, and constipation. Daxiehu Tang (Major Bupleurum Decoction) is used to purge. If the stool is not hard, Xiexin Tang (Drain the Epigastrium Decoction) is the primary prescription. In cold affecting the three yin meridians, where stomach qi is about to exhaust, hiccups occur with symptoms of cold extremities, aversion to cold, and diarrhea with undigested food. Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) combined with Dingxiang San (Clove Powder) is used to warm the interior. If the hiccups stop, the prognosis is good; if they persist, the prognosis is poor.