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19. Cold invasion causing vomiting of food and inability to eat; absence of thirst with cold extremities and vomiting indicates a cold-deficiency pattern; vomiting after eating with thirst indicates rebellious fire; vomiting immediately after drinking, where vomiting and drinking cause each other, indicates water retention disease.
[Note] "Cold invasion causing vomiting of food" refers to vomiting food and inability to eat due to cold invasion. Whenever there is an absence of thirst accompanied by cold extremities and vomiting, it is a cold-deficiency type of vomiting, for which Lizhong Tang (Regulate the Middle Decoction) or Wuzhuyu Tang (Evodia Decoction) are appropriate. Whenever there is thirst accompanied by immediate vomiting after eating, it is a fire-type vomiting; for heat-excess patterns, Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity) is suitable; for heat-deficiency patterns, Ganjiang Huanglian Huangqin Renshen Tang (Dried Ginger, Coptis, Scutellaria, and Ginseng Decoction) or Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) are suitable. If one feels thirsty and drinks, vomits after drinking, and then feels thirsty again, this is Water Reversal Disease (Shui Ni), for which Wuling San (Five-Ingredient Powder with Poria) is appropriate.

20. Heat dysentery presents with red urine, thirst, and sticky, foul-smelling discharge; cold dysentery presents with clear, watery stools and clear white urine. If Lizhong Tang yields no effect, astringent methods should be used; if there is still no effect, draining methods should be used, and the disease will heal.
[Note] Spontaneous diarrhea without thirst belongs to Taiyin cold syndrome. Diarrhea accompanied by desire to drink water is due to heat. Here, the presence or absence of thirst is used to distinguish between cold and heat. Yellow-red urine with foul odor and sticky consistency all indicate heat dysentery. Clear-white urine with clear stools containing undigested food (Wan Gu Bu Hua) all indicate cold dysentery. For heat dysentery with exterior signs, mild cases use Shengma Gegen Tang (Kudzu and Cimicifuga Decoction), and severe cases use Gegen Tang (Kudzu Decoction) to induce sweating. For those with interior signs, San Chengqi Tangs (Three Major Purging Formulas) should be used appropriately to purge. For those without exterior or interior signs, mild cases use Huangqin Tang (Scutellaria Decoction), and severe cases use Gegen Huanglian Huangqin Tang (Kudzu, Coptis, and Scutellaria Decoction) to clear heat. Cold dysentery should be treated with Lizhong Tang to warm and tonify. If Lizhong Tang yields no effect, this belongs to slipping and uncontrolled descent of the Lower Jiao, for which Chishizhi Yuyuliang Tang (Red Halloysite and Hematite Decoction) is appropriate to astringe. If there is still no effect, this is due to the failure to separate clear from turbid, with water flowing into the Large Intestine; Wuling San (Five-Ingredient Powder with Poria) or Zhu Ling Tang (Polyporus Decoction) should be used to promote urination, and the disease will heal.

21. Shaoyin disease involves lethargy and desire to lie down without exterior or interior signs; waking up only to fall back asleep requires no alarm. Wind-warmth disease presents with floating pulse, fever, sweating, excessive sleepiness, heavy body, and snoring breath.
[Note] The desire to sleep and lethargy in Shaoyin disease are manifestations of Shaoyin syndrome. If one desires to sleep and is lethargic but has neither exterior nor interior signs, and the body is harmonious with a fine pulse, it indicates that the disease has resolved. However, sleep after resolution, where one wakes upon being called and falls back asleep, indicates the recovery of Yin Qi, not Yin excess confining Yang, so there is no need for alarm. Wind-warmth disease also involves desire to sleep and excessive sleepiness, but it is distinguished by floating pulse, fever, sweating, heavy body, and snoring breath.