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Add three liang of Radix Puerariae (Gegen, 葛根) to the Guizhi Tang (Cinnamon Twig Decoction). For the remainder, follow the preparation and administration method of the Guizhi Tang.

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In Taiyang disease (a syndrome caused by pathogenic factors invading the Taiyang meridian), excessive sweating may lead to Jing disease (a syndrome characterized by stiffness of the neck and back, trismus, and opisthotonos).
[Annotation]
The above discussions on Jing disease all refer to illnesses caused by external contraction of Wind, Cold, and Dampness. If Taiyang disease is treated with excessive sweating, leading to a massive loss of Body Fluids and insecurity of the Exterior Qi, allowing Pathogenic Wind to enter due to deficiency, resulting in Jing disease, this is caused by internal deficiency. It should not be classified as Rou Jing (Soft Spasm) or Gang Jing (Hard Spasm). The appropriate treatment is Guizhi Jia Fuzi Tang (Guizhi Decoction with Added Prepared Aconite Root), which primarily aims to consolidate the Exterior and dispel Wind. By analogy, any condition arising from excessive sweating during illness, or excessive blood loss after childbirth, that develops into this syndrome, belongs to this category.
[Collected Notes]
Cheng Yingmao stated: Inferring from this single aspect, one can understand that there are many cases where the disease results from the loss of Body Fluids and Blood, leading to Cold due to deficiency, and Dryness due to deficiency. Generally, Yang Qi softens and nourishes the sinews. Excessive sweating causes the loss of Yang Qi, thereby damaging the blood within the meridians.

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Patients suffering from Dampness diseases present with pain throughout the entire body, fever, and a skin color resembling smoked yellow.
[Annotation]
"Shi Jia" (Dampness Patient) refers to a person suffering from a Dampness disease. Such diseases may arise from external contraction of Dampness, causing pain throughout the body, or from internally generated Dampness, causing fever and jaundice. If both internal and external Dampness are present, the patient experiences pain throughout the body, fever, and a "smoked yellow" complexion. "Smoked yellow" refers to jaundice caused by excessive Dampness, belonging to stagnant Dampness in the Spleen; thus, the color is dark and dull like smoke. This differs from the jaundice caused by intense Heat in Shanghan (Cold Damage), which belongs to stagnant Heat in the Yangming channel, resulting in a bright orange-yellow color.
[Collected Notes]
Zhang Lu stated: Jaundice in Dampness syndromes must be differentiated by Yin/Yang and Interior/Exterior. For Yang Dampness, use Yinchen Hao Tang (Artemisia Capillaris Decoction) for Interior involvement, and Mahuang Lian Qiao Chi Xiao Dou Tang (Ephedra, Forsythia, and Adzuki Bean Decoction) for Exterior involvement. For Yin Dampness, use Baizhu Fuzi Tang (Atractylodes Macrocephala and Prepared Aconite Root Decoction) for Interior involvement, and Mahuang Baizhu Tang (Ephedra and Atractylodes Macrocephala Decoction) for Exterior involvement; this addresses jaundice due to Yin Dampness at the Exterior. The *Jingui Yaolue* states: "For a Dampness patient with painful restlessness, Mahuang Jia Zhu Tang (Ephedra and Atractylodes Macrocephala Decoction) may be used." Since Cold combines with Dampness, heavy sweating is inappropriate, hence Atractylodes Macrocephala is added. When Ephedra is combined with Atractylodes Macrocephala, sweating does not occur abruptly; when Atractylodes Macrocephala is combined with Ephedra, stagnant Dampness is disseminated and unblocked.

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In Dampness disease, the patient suffers from body pain, fever, yellowish complexion, and wheezing, along with headache, nasal congestion, and irritability. The pulse is large. The patient can eat normally, and the abdomen is harmonious without pathology. The disease lies in Cold-Dampness affecting the head, causing nasal congestion. Administering medication into the nose will result in recovery.
[Annotation]
This elaborates on the previous clause, detailing the symptoms and pulse to distinguish the treatment. In Dampness disease, body pain, fever, yellowish complexion, and wheezing indicate Dampness originating internally and contracting externally. Externally, Qianghuo Shengshi Tang (Notopterygium Decoction for Overcoming Dampness) is suitable; internally, Ychen Wuling San (Artemisia Capillaris and Five-Ingredient Poria Powder) is suitable. For severe wheezing, Daxiexiong Wan (Major Thorax-Sinking Pill) is used. If accompanied by headache, nasal congestion, and irritability, with a large pulse, the presentation resembles Shanghan. However, since the interior is harmonious and the patient can eat, it is not Shanghan, and diaphoresis (sweating) is contraindicated. The pathogen is Cold-Dampness located in the head, causing headache and nasal congestion. The only appropriate treatment is to administer medication intranasally, guiding the yellow fluid out via nasal discharge, leading to natural recovery. The administered medication would be similar to Gouti San (Melon Trichosanthes Powder).
[Collected Notes]
Zheng Zhongguang stated: Body pain, fever, yellowish complexion, wheezing, headache, and nasal congestion indicate that Cold-Dampness pathogens reside in the Upper Jiao (Upper Burner). The Classics state: "Due to Dampness, the head feels wrapped." Using Gouti San insufflated into the nose follows the principle of "treating those in the upper by inducing vomiting/emesis."

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In Taiyang disease, if there is joint pain accompanied by vexation, and the pulse is deep and fine, this is named Shi Bi (Dampness Bi Syndrome). The manifestation of Shi Bi includes difficulty in urination and loose stools. The treatment should focus on promoting urination.
[Annotation]
The pulse in Dampness disease is typically floating and fine, indicating Dampness at the Exterior, which should be treated with diaphoresis. Now, in Taiyang disease, with joint pain, vexation, difficulty in urination, loose stools, and a deep-fine pulse (rather than floating-fine), this indicates excessive internal Dampness leading to obstruction characteristic of Shi Bi. Therefore, the treatment should solely focus on promoting urination to allow Dampness to exit via the urine. This is the correct treatment for Dampness overflowing internally.
[Collected Notes]
Cheng Wuji stated: Excessive Dampness leads to loose stools. Difficulty in urination and loose stools indicate the flow of Dampness inward. One should promote urination to ventilate and drain abdominal Dampness. As the ancients said: "Treating Dampness without promoting urination is not the proper treatment."
Fang Youzhi stated: This discusses Dampness entering the Interior. Joint pain occurs because Cold-Dampness qi wanders and infiltrates inward, resulting in a deep and fine pulse. "Bi" refers to pain. Difficulty in urination and loose stools occur because Dampness is Water; if Water does not seep outward properly, it flows horizontally, deviating from its normal path. Promoting urination guides it back to its normal path.
Zhang Zicong stated: Joints refer to the major joints of the waist, back, elbows, and knees, governed by the large sinews, distinct from bone joints. When Dampness flows into the joints, the large sinews become disharmonious, causing pain and obstruction. Dampness injures the Taiyang channel, causing stagnation in the sinews and vessels, hence named Shi Bi. Promoting urination allows the water passages to function, ensuring the regulation of water metabolism proceeds without error; once Dampness is expelled, the sinews and vessels return to harmony.

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A Dampness patient sweats only on the head, has a stiff back, and desires to be covered with blankets or sit near fire. If purgatives are used prematurely, hiccups, chest fullness, difficulty in urination, and a tongue coating resembling a membrane will appear. This is due to Heat in the Lower Dantian (Lower Abdomen) and Cold in the Chest, thirst desire for water but inability to drink, dry mouth, and irritability.
[Annotation]
Sweating only on the head in Dampness patients is sweat caused by Dampness steaming upward, not Heat in the Yangming channel failing to vent. Back stiffness in Dampness patients is heaviness and stiffness due to Dampness obstructing flow, not the spasmodic rigidity of Jing disease. Desiring blankets and fire is not aversion to cold from the exterior, but internal Cold generated by excessive Dampness. If one mistakenly treats the head sweat (caused by Dampness overflow) as Yangming stagnant Heat and uses purgatives, Cold-Dampness qi enters the chest due to deficiency, causing chest fullness, and enters the Stomach, causing hiccups. Since Cold-Dampness fails to transform, urination is difficult; Cold in the chest causes a slippery white tongue coating resembling a membrane; Heat in the Lower Dantian causes dry mouth and thirst for water, but the inability to drink is due to Cold-Dampness in the chest.
[Collected Notes]
Cheng Wuji stated: In Shanghan, there is no sweating. Although Dampness patients have sweat, it does not cover the whole body, hence only the head sweats.
Cheng Yingmao stated: Although the patient desires water, appearing hot, the inability to drink distinguishes it. This is merely dry mouth and irritability, confirming that the interior is not truly dry and irritated, showing identical symptoms but different pathogenesis.

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If a Dampness patient is incorrectly treated with purgatives, and subsequently presents with sweating on the forehead, slight wheezing, and free urination, death ensues. If diarrhea persists uncontrollably, death also ensues.
[Annotation]
This continues from the previous clause, describing the adverse reactions of incorrectly using purgatives on Dampness patients. Incorrect purgation in Dampness patients leads to chest fullness, hiccups, difficulty in urination, a tongue coating like a membrane, and thirst with inability to drink; this is already an adverse reaction but remains treatable. After incorrect purgation, if forehead sweating and slight wheezing persist, this indicates the collapse of Yang Qi upward. If urination becomes free and diarrhea persists, this indicates the collapse of Yin Qi downward. The separation of Yin and Yang leads to death.
[Collected Notes]
Fang Youzhi stated: Treating Dampness requires promoting urination, yet here free urination is a sign of death. Why? Because mistreatment causes the dispersion and loss of Yin and Yang.
Cheng Zhi stated: Dampness affects humans, and Yin is affected first. Thus, Dampness syndromes in this classic are often treated by assisting Yang and warming/dispersing. If purgatives are wrongly used, Yang deficiency and Yin excess become incurable. Forehead sweating and slight wheezing indicate vacuous Yang attempting to collapse upward; incontinence of urine and stool indicates abundant Yin attempting to collapse downward. The separation of Yin and Yang leads to death.

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The patient suffers from pain throughout the entire body and fever. The condition worsens in the late afternoon (Ri Bu, approx. 3-5 PM). This is named Feng Shi (Wind-Dampness). This disease is caused by sweating while exposed to wind, or long-term exposure to cold.
[Annotation]
"The patient" refers to one suffering from body-wide pain. Both Dampness patients and Wind-Dampness patients suffer from body-wide pain. However, the pain in Dampness is heavy and fixed, preventing turning over; the pain in Wind-Dampness is light and pulling, preventing flexion and extension. This distinguishes the nature of the pain. Regarding fever: in Dampness, fever intensity does not vary significantly between morning and evening; in Wind-Dampness, fever inevitably worsens in the late afternoon. This results from sweating while exposed to wind, or long-term injury by Dampness followed by exposure to Wind-Cold.
[Collected Notes]
Zhang Zicong stated: Sweating while exposed to wind leads to Wind-Dampness; long-term exposure to cold leads to Cold-Dampness.
Zhang Xiju stated: Fever worsening in the late afternoon occurs because Yang Qi declines and Yin Qi rises at this time. Since Dampness is a Yin pathogen, the disease intensifies during its dominant time (Yin time).

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Question: When Wind and Dampness contend, causing pain throughout the body, the method dictates resolving it through sweating. If it rains continuously and the physician says sweating is indicated, why does the disease not resolve after sweating? Answer: If sweating induces profuse perspiration, only the Wind pathogen is expelled, while Dampness remains; therefore, the disease does not resolve. To treat Wind-Dampness, induce sweating such that the patient appears slightly moist with sweat; then both Wind and Dampness are expelled.
[Annotation]
This details that in Wind-Dampness contention with body-wide pain, not only is purgation contraindicated, but diaphoresis must also be applied appropriately. Wind is a Yang pathogen, Dampness is a Yin pathogen. Their contention affects both Yin and Yang, causing body-wide pain. Resolution via sweating is indicated. However, during continuous rain, Dampness is abundant. Even if sweating is induced, if perspiration is profuse and the disease does not resolve, it is because Wind is gone but Dampness remains. During times of high Dampness, inducing profuse sweating is improper technique, hence failure to resolve. To treat Wind-Dampness, one should wait for clear weather to induce sweating, ensuring only a slight, continuous moisture of sweat. Then both Wind and Dampness are expelled, and the disease resolves.
[Collected Notes]
Fang Youzhi stated: Continuous rain means Dampness is not removed, so sweating is even more necessary. However, since Wind-Dampness originates from sweating while exposed to wind, profuse sweating will likely exacerbate the Dampness. Only slight, continuous moisture without visible dripping will dissipate Dampness and scatter Wind. This is the subtle key to diaphoresis; later practitioners who advocate for profuse sweating are far from the correct path.
Zhang Lu stated: In Wind-Dampness contention, resolution via sweating is indicated. Combining Guizhi Jia Zhu Tang (Guizhi Decoction with Added Atractylodes Macrocephala) allows for slight evaporation, harmonizing the Interior and Exterior, expelling both Wind and Dampness. This is analogous to using Mahuang Tang (Ephedra Decoction) with added Atractylodes Macrocephala for Dampness patients with painful restlessness.
Cheng Yingmao stated: Dampness patients must not be incorrectly purged, nor incorrectly sweated. In Wind-Dampness contention with body-wide pain, although it involves mild Exterior pathogens, the pulse is not floating, making profuse sweating difficult. Treating Wind while addressing Dampness, ensuring only slight, continuous moisture of sweat, is the correct method.

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After eight or nine days of Shanghan, Wind and Dampness contend. The body is painful and vexed, unable to turn over independently. There is no vomiting or thirst. The pulse is floating, deficient, and choppy. Guizhi Fuzi Tang (Guizhi Decoction with Added Prepared Aconite Root) is the primary formula. If the patient has hard stools and spontaneous free urination, remove Cinnamon Twig and add Atractylodes Macrocephala (Guizhi Fuzi Tang minus Cinnamon Twig plus Atractylodes Macrocephala) as the primary formula.
[Annotation]
This continues from the previous clause, detailing the pulse and symptoms to clarify treatment. After eight or nine days of Shanghan, absence of vomiting and thirst indicates no Interior Shanghan pathology. A floating-deficient-choppy pulse indicates no Exterior Shanghan pathology. A floating-deficient pulse indicates Exterior pathology due to deficient Wind; a choppy pulse indicates Meridian pathology due to Cold-Dampness. Body pain and vexation belong to Wind; inability to turn over belongs to Dampness. This is a Wind-Dampness contention syndrome, not Shanghan. Guizhi Fuzi Tang is used to warm and disperse Wind-Dampness, allowing resolution from the Exterior. If the pulse were floating and solid, Mahuang Jia Zhu Tang (Ephedra and Atractylodes Macrocephala Decoction) would be used to vigorously disperse Wind-Dampness. If the patient has these symptoms but hard stools and free urination, purgation is not considered because the hard stool is not due to Heat entering the Interior, but rather dryness from Wind and expulsion of Dampness. Therefore, Guizhi Fuzi Tang is used with Cinnamon Twig removed. Since stools are hard and urination is free, we avoid sweating to prevent further depletion of Body Fluids. Atractylodes Macrocephala is added because body heaviness indicates Dampness in the muscle layer; it assists Prepared Aconite Root in driving Dampness from the muscles.
[Collected Notes]
Cheng Wuji stated: Vexation indicates Wind. Body pain and inability to turn over indicate Dampness. The Classics state: "Wind manifests as floating and deficient pulses." The *Maijing* states: "A choppy pulse indicates Cold-Dampness disease."