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9. Continuous sweating of the hands and feet, with hard stool and free urination indicates that purgation is indicated; if cold invades the interior causing cold sweat and difficult urination, purgation will lead to chronic diarrhea with clear, unformed stools.

[Annotation] The Stomach governs the four limbs and is the master of body fluids. When heat accumulates in the Stomach, it steams the body fluids, which then diffuse to the four limbs, resulting in continuous sweating of the hands and feet. Since urination is free, the fluids in the Stomach must be dry, leading to hard stool. In such cases, purgation is indicated. However, if Cold invades the interior, causing deficiency of Stomach Yang and Spleen Qi failing to constrain fluids, fluids may overflow excessively. The limbs may resemble a heavy downpour during Yin excess, resulting in cold sweat due to Yang deficiency and failure of transformation caused by Cold. If stool is hard but accompanied by hand and foot sweating, this is not due to Heat venting outward. Purgation must be strictly avoided; otherwise, complications such as *Gu Jia* (chronic abdominal masses or diarrhea) and persistent clear, watery diarrhea will arise.

10. Tidal fever occurring once in the afternoon, unremitting fever with profuse sweating, intermittent fever with spontaneous sweating without interior signs: administer Guizhi Tang (Cinnamon Twig Decoction) at the appropriate time.

[Annotation] Tidal fever (*Chao Re*) is a manifestation of Yangming Fu-organ syndrome. The Yangming channel is vigorous during Shen and You hours (3 PM to 7 PM); thus, tidal fever occurs in the afternoon, arriving like the tide without fail, hence the name. It is an indication for purgation. "Unremitting fever with profuse sweating" refers to fever without cessation, where heat penetrates the surface with abundant sweat, termed "steaming fever" (*Zheng Zheng Fa Re*). This also belongs to Yangming internal excess and is an indication for purgation. "Intermittent fever with spontaneous sweating" refers to fever that fluctuates in intensity accompanied by spontaneous sweating. This resembles tidal fever in frequency but differs from steaming fever by having intervals. Fever patterns of tidal fever and steaming fever are invariably accompanied by indications for purgation. Conversely, intermittent fever is invariably not accompanied by indications for purgation; hence, it is stated: "without interior signs." Since there are no interior signs, and fever is accompanied by sweating, it indicates that Wind pathogen remains lingering on the exterior. Therefore, Guizhi Tang (Cinnamon Twig Decoction) should be used. However, it must be administered precisely when the fever and sweating occur. Guizhi Tang (Cinnamon Twig Decoction) is not prescribed for simple intermittent fever with spontaneous sweating, but specifically for cases presenting with exterior signs and absence of interior signs. The emphasis here is on the absence of interior signs; it does not imply that all cases of intermittent fever with spontaneous sweating can be treated with Guizhi Tang (Cinnamon Twig Decoction).