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After five or six days of Taiyang disease (Taiyang syndrome), following a severe purgative treatment, if the body heat persists and there is a sensation of knotting and pain in the heart region, it indicates that the pathogenic factor has not been completely resolved; Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) should be administered.

In Yangming disease, with a pulse that is wiry, floating, large, and full (indicating stomach excess), accompanied by shortness of breath, abdominal fullness, pain in the hypochondrium and epigastrium, dry nose without sweat, lethargy, jaundice, difficulty in urination, tidal fever, and frequent hiccups, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is indicated. (See "Stomach Excess" for the discussion; see "Alternating Chills and Fever" for the formula.)

[From *Yi Lin Zhai Xuan*] If a patient with Taiyang disease drinks too much water, leading to abdominal distension, asthma, and unbearable pain in the epigastrium, moxibustion on Zhongwan (CV12) and Qihai (CV6) acupoints is appropriate. If there is a sensation of qi rushing upward from the lower abdomen, moxibustion on Tianshu (ST25), Qichong (ST30), Zusanli (ST36), and Sanyinjiao (SP6) acupoints is recommended. (If these symptoms are absent, only the previous acupoints should be used.)

In Taiyang disease, if the pulse is slow and the course lasts six or seven days, but one mistakenly administers Huang Qin Tang (Scutellaria Decoction) to clear heat: since a slow pulse indicates cold, using Huang Qin Tang to further remove heat should make the abdomen cold and result in an inability to eat. However, if the patient can eat, this condition is called Chu Zhong (Elimination of the Middle), which is fatal. If the eyes are dull, speech is inhibited, yet food intake increases, this is also Chu Zhong. Although the mouth desires to speak, the tongue cannot articulate. In cases where hands and feet are cold accompanied by diarrhea, if the patient desires food when they should not, it may be Chu Zhong. One may test this by offering Suo Bing (noodle-like food); if fever ensues after eating, it is Chu Zhong; if no fever occurs, it is not. (See the "Jue Syndrome" section for the discussion.)

For dysentery with a feeling of heaviness in the rectum, if it presents as Shaoyin disease with drowsiness and cold extremities (Si Ni pattern), Si Ni Tang (Frigid Extremities Decoction) added with Xie Bai (Macrostemon Bulb) is used; if it is a heat pattern, Bai Tou Weng Tang (Pulsatilla Decoction) is used. (See "Diarrhea/Dysentery" for the formula discussion.)

A floating pulse indicates that sweating should be used to resolve the exterior. If moxibustion is applied instead, the pathogen has no outlet and becomes exacerbated by fire. This will cause heaviness and numbness from the waist down, a condition known as Fire Reversal (Huo Ni).

A pulse that is slow, floating, and weak, accompanied by aversion to wind and cold, indicates an exterior pattern. If the physician mistakenly uses purgation, it leads to loss of appetite, hypochondriac pain, jaundice, neck stiffness, and difficulty in urination. Administering Chai Hu Tang again will inevitably cause rectal heaviness. (See "Hypochondriac Pain" for the discussion.)

In diarrhea/dysentery, a deep and wiry pulse indicates rectal heaviness. (See "Rectal Heaviness" for the discussion.)

When a patient has high body heat but desires to wrap themselves in clothes, it indicates heat at the skin level and cold in the bone marrow. (*Qin Ren Shu* states: First treat the cold with Gui Zhi Tang (Cinnamon Twig Decoction), then use Xiao Chai Hu Tang plus Gui Zhi (Cinnamon Twig) to warm the exterior.) When a patient has severe cold sensations but does not desire to wrap themselves in clothes, it indicates cold at the skin level and heat in the bone marrow. (*Qin Ren Shu* states: First administer Bai Hu Tang plus Ren Shen (Ginseng) to clear heat, then use Gui Zhi Ma Huang Ge Ban Tang (Half-Size Decoction of Cinnamon Twig and Ephedra) to resolve the exterior.)