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The methods for expelling pathogenic factors consist only of two categories: releasing the exterior (Jie Biao) and purging the interior (Gong Li). Releasing the exterior aims to open the pores, allowing pathogens to exit through sweat. One should employ substances that are extremely light, bland, aromatic, and cooling, so that pathogenic factors slowly permeate out from the skin and hair without invading the Middle Jiao (Middle Burner) or damaging Body Fluids (Jin Ye). The formulas such as Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction) by Zhang Zhongjing exemplify this approach. However, there is still a concern that the Yin Qi within the Ying (Nutritive) level may be fanned by Wind-Fire, leading to internal consumption, failing to moisten and nourish, and thus unable to support the expulsion of pathogens outward. Therefore, drinking thin congee (porridge) is recommended to assist Stomach Qi and replenish Body Fluids; this is an excellent method for taking Guizhi Tang. This principle can be extrapolated to all formulas primarily intended for inducing sweating. Inducing sweating necessarily relies on Body Fluids, as demonstrated here.

Later generations, unaware of this, often exclusively use warm and drying herbs such as Houpo (Magnolia Bark), Gegen (Kudzu Root), Qianghuo (Notopterygium Rhizome), Baizhi (Angelica Dahurica), Cangzhu (Atractylodes Rhizome), and Doukou (Black Cardamom) in sweating formulas. Even if a patient's Body Fluids were not initially deficient, having already been simmered internally by Wind-Fire, they are further dried by these warming-drying drugs. Consequently, where would sweat come from? If fluids cannot be generated, pathogens have no medium to attach to and exit. Instead of expelling pathogens, the drying drugs agitate them, causing them to become more rampant; they mix with Healthy Qi (Zheng Qi), spreading Pathogenic Fire everywhere, further injuring Body Fluids, resulting in symptoms such as a scorched tongue, dry lips, constipation, and red eyes. Various fire-like manifestations arise spontaneously, causing the body temperature to rise further and consciousness to gradually cloud, leading to the emergence of various severe syndromes. If sweating is induced again at this stage, Yang-Fire reaches its peak, disturbing the True Yang (Zhen Yang). Kidney Water comes to rescue, and Yuan Yang (Original Yang) follows it out; excessive sweating ensues, giving rise to critical conditions of Yang Collapse (Wang Yang). In milder cases, it may develop into Jing Syndrome (Spasm/Convulsion), eventually becoming a Huai Bing (Ruined Disease/Difficult-to-Treat Condition). Thus, countless deaths have occurred due to the use of drying drugs to induce sweating.

This trend originated with Li Dongyuan. The formulas he prescribed in his writings were methods for treating Dampness Pathogens, unrelated to Shanghan (Cold Damage) or miscellaneous external infections. Later generations followed his theory, applying it to all external infection syndromes, and the harm has intensified to this day. Moreover, the method for treating Dampness primarily involves bland leaching/draining agents, such as Zhuling Tang (Polyporus Decoction) and Wuling San (Five-Ingredient Powder with Poria), none of which rely on drying drugs to overcome dampness. Generally, Dampness is also an external pathogen; it should always be driven outwards, possibly combined with damp-drying agents. It is absolutely inadvisable to exclusively use strong damp-resisting drugs, which would cause inward attack, leading to conflict between Pathogens and Healthy Qi, thereby damaging Original Qi.

Regarding Cold Invasion (Zhong Han), treatment should first focus on releasing the exterior. There is no rationale for solely using hot drugs to overcome cold. Only when Cold Qi sinks into the interior due to deficiency and lacks an outlet should one use Jiang (Zingiberis Rhizoma) and Fu Zi (Aconiti Lateralis Radix Praeparata) to restore Yang. This is the principle behind Zhang Zhongjing’s use of Lizhong Fa (Regulating the Middle Method). Today, however, drying drugs are used to induce sweating for miscellaneous external infections. This is not only contrary to the methods of ancient sages but also a misuse of Li Dongyuan’s methods. The medical Dao has been lost; if even such superficial principles are unknown, how much more so the profound and subtle theories?