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[Collected Annotations]
Yu Chang stated: A weak pulse at the cun position indicates the pulse pattern of wind-stroke, characterized by a mild and moderate quality at the cun position; a full and solid pulse at the cun position indicates the pulse pattern of cold damage, characterized by a tight and solid quality at the cun position. "Yang exhaustion" is a synonymous term for the loss of body fluids. Zhang Zhongjing often referred to cases of fluid loss as "absence of Yang." Careful reading of the text "Yang exhausted internally, fluids lost, stool becomes..." reveals this principle clearly. When inducing sweat to treat Taiyang (Bladder Meridian) cold damage, one must protect Yang Qi, because the Bladder governs Qi transformation. When inducing sweat to treat Yangming (Stomach Meridian) cold damage, one must protect Yin fluids, because the Stomach stores fluids. Therefore, Yangming diseases often present with heat venting outward, meaning that fluids in the Stomach are completely vaporized and vented outward due to heat, resulting in continuous sweating. Thus, in Yangming disease, whether wind-stroke or cold damage, if the pulse is mild or solid, slight sweating will allow pathogenic factors to resolve spontaneously; excessive sweating will easily lead to the depletion of Yin fluids.

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Yangming disease typically presents with profuse sweating; conversely, if there is no sweating, and the body feels as if insects are crawling under the skin, this is due to long-standing deficiency.
[Annotation]
Yangming disease should theoretically present with profuse sweating; conversely, if there is no sweating, and the body feels as if insects are crawling under the skin, it is because the person's Stomach Qi has been deficient for a long time, causing pathogenic factors to stagnate at the exterior of Taiyang, preventing the Yangming muscle and interstices from dispersing and producing sweat. It is appropriate to use a small dose of Gegen Tang (Pueraria Decoction) to induce slight sweating, harmonize the muscle layer, and achieve recovery naturally.
[Collected Annotations]
Han Hu stated: Regarding this clause, Zhang Zhongjing did not provide a treatment method. Chang Qizhi said: Guizhi Jia Huangqi Tang (Cinnamon Twig Decoction with Astragalus) can be used. Guo Yong said: Guizhi Mahuang Ban Tang (Half-and-Half Decoction of Cinnamon Twig and Ephedra) is suitable. However, these two decoctions are medicines for the Taiyang meridian. Since this is a case of Yangming disease without sweating, Gegen Tang should still be used as the primary treatment.
Wei Litong stated: Yangming disease should theoretically present with profuse sweating; now there is no sweating, only the symptom of feeling like insects crawling under the skin. This indicates that pathogenic heat desires to exit the exterior through sweating, but righteous Qi is too weak to drive it out.

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In Yangming disease, if initially there is an appetite, urination is conversely obstructed, stools are normal, the person experiences joint pain, slight fever resembling heat, sudden onset of mania, followed by continuous sweating leading to resolution, this is because water-dampness cannot overcome grain Qi. The grain Qi combines with sweat and exits together; if the pulse is tight, the disease will heal.
[Annotation]
In Yangming disease, initial appetite indicates transmission from wind-stroke heat pathogens. When Yangming is affected, frequent urination and loose stools are expected; now urination is conversely obstructed and stools are normal, indicating that fluids are not injured and Stomach Qi is harmonious, failing to form interior excess syndrome. Since interior excess does not form, the pathogen in the meridians is light and can resolve spontaneously. If the person has joint pain and slight fever resembling heat, this means the Taiyang exterior syndrome remains unresolved. "Yan" means suddenly. Sudden mania followed by continuous sweating and resolution occurs because the pathogen transmitted from Taiyang is light, the pathogen received by Yangming is shallow, fluids are not injured, and Stomach Qi is harmonious, so the pathogen should return to the exterior to resolve. However, resolution occurring only after mania happens because water-Qi in the Stomach is insufficient to counteract the Grain Qi desired initially. Grain Qi generates heat through Yang transformation; water cannot overcome heat, brewing sweat to exit together, thus causing mania and resolution. Whenever resolution via sweating is anticipated, the pulse must first become floating. Now stating that a tight pulse indicates healing refers to the pathogen returning to the exterior, which is the pulse pattern seen when resolution is imminent.

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In cold damage, if there is fever, no sweating, vomiting, inability to eat, but conversely continuous sweating, this indicates transmission to Yangming.
[Annotation]
In cold damage, fever, no sweating, vomiting, and inability to eat indicate that Taiyang pathogenic factors are attempting to transmit. If there is no sweating, it means the exterior of Taiyang-Yangming is still present, and sweating therapy is applicable. Now, conversely, there is continuous sweating, indicating that pathogenic factors have transmitted to the Yangming Fu organs; purgation is applicable, not sweating therapy.
[Collected Annotations]
Cheng Wuji stated: Fever, no sweating, vomiting, and inability to eat in cold damage indicate Taiyang disease. If conversely there is continuous sweating, it means Taiyang pathogenic factors have transmitted to Yangming. Hence, the classic states: Yangming disease typically presents with profuse sweating.
Fang Youzhi stated: Vomiting and inability to eat indicate heat entering the Stomach. Conversely, sweating indicates that heat adheres to the muscles, causing the skin pores to open.
Cheng Yingmao stated: Although the primary symptoms of Taiyang are present, conversely having continuous sweating means that although the exterior syndrome has not ceased, it has already transmitted to Yangming. "Jiji" means continuous and unbroken, as commonly said: sweat on one part of the body is not finished before another part sweats.

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In cold damage, if the pulse is floating, there is fever and no sweating, and the exterior syndrome is not resolved, Baihu Tang (White Tiger Decoction) should not be given. If there is thirst desire to drink water and no exterior syndrome, Baizhu Jia Renshen Tang (White Tiger Decoction with Ginseng) is the primary treatment.
[Annotation]
When cold damage pathogens transmit to Yangming, presenting with floating pulse, fever, and no sweating, if the exterior syndrome is not resolved, even if there is dryness and thirst, it is a Da Qinglong Tang (Major Green Dragon Decoction) syndrome, and Baihu Tang should not be given. Even if there are Yangming heat symptoms such as thirst desire to drink water requiring Baihu Tang, one must verify the absence of Taiyang exterior syndrome before administering it. Ginseng is added because the pulse is floating rather than slippery, indicating not an excess condition, and to rapidly generate fluids amidst significant heat clearance.
[Collected Annotations]
Zheng Zhongguang stated: This clarifies the method of using Baihu Tang. Baihu Tang can clear heat but does not release the exterior. If there is any external contraction with exterior symptoms such as no sweating, aversion to cold, body pain, and headache, it must strictly not be used.