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28. Grasping at clothes and bedrails (involuntary finger movements touching clothing and bed) has two etiologies: one is the damage to Yin fluids caused by heat pathogen due to improper fire therapy forcing sweat in Taiyang disease; the other involves Yangming disease where extreme heat penetrates deeply into the body. In the former case, if urination is free, prognosis is good; if difficult, prognosis is poor. These conditions arise from the failure or mishandling of the three therapeutic methods: sweating, vomiting, and purging. If the pulse is excess (Shi), purging may be considered; if the pulse is deficient (Ruo), it cannot withstand purging. When differentiation between deficiency/excess and Yin/Yang is difficult, Dushen Tang (Single Ginseng Decoction) or Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) can be used to restore vitality.

[Annotation] Grasping at clothes and bedrails is a critical and malignant syndrome. One etiology is that Taiyang disease was treated with fire therapy to force sweating, leading to hyperactive Yang damaging Yin. If Yin fluids are not exhausted, urination will be free, and survival is likely; if Yin fluids are exhausted, urination will be difficult, and death is likely. The other etiology is extreme heat in Yangming disease resulting from improper use of sweating, vomiting, and purging methods, leading to "Huai Zheng" (complicated/ruined syndrome). The heat penetrates deeper. If the pulse is excess, purging is feasible and treatable; if the pulse is weak, purging is contraindicated and difficult to treat. This has become a critical Huai Zheng, often making differentiation of Yin/Yang and deficiency/excess impossible for physicians. Large doses of Dushen Tang (Single Ginseng Decoction), Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), or Gan Shengdi Huang Tang (Fresh Rehmannia Root Decoction) should be administered frequently, often resulting in recovery.

29. Taiyang disease with Yang pathogen combined with internal water retention presents as Shui Ni (Water Regurgitation) syndrome, characterized by Xiao Ke (wasting-thirst/polydipsia), fever, sweating, irritability, difficulty in urination, vomiting immediately after drinking, and a floating and rapid pulse. Wuling San (Five-Ingredient Poria Powder) is indicated.

[Annotation] The Shui Ni and Xiao Ke diseases caused by Yang pathogens in Taiyang disease refer to cases in Taiyang Wind Strike syndrome where there is thirst and desire to drink, but vomiting occurs immediately after ingestion, termed Shui Ni (Water Regurgitation); and cases with excessive drinking but scanty urination, termed Xiao Ke (Wasting-Thirst). Fever and sweating indicate Wind pathogen. Irrability indicates Heat pathogen. Difficulty in urination and vomiting after drinking indicate stagnation of fluid retention. A floating and rapid pulse indicates Wind-Heat. All these symptoms are suitable for treatment with Wuling San (Five-Ingredient Poria Powder). Patients should drink plenty of warm water to induce slight sweating, thereby releasing the exterior Taiyang pathogen and promoting diuresis of retained water internally, leading to cure. If the patient cannot tolerate warm water and desires cold water, it indicates intense heat. In this case, Han Shui Shi (Halloysitum Rubrum), Shi Gao (Gypsum Fibrosum), and Hua Shi (Talcum) can be added to Wuling San. See Volume 1 of the Taiyang Chapter in detail.