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33. Yin-Excess Repelling Yang manifests as a pale red complexion, fever without thirst, cold limbs with irritability, diarrhea with clear urine and cyanotic nails, and a floating, faint pulse. Tongmai Sini Decoction (Pulse-Recovering Cold-Treating Decoction) is used to restore Yang.
[Note] The Classic says: "When Yin Qi is excessively abundant, Yang Qi cannot circulate mutually." Mutual non-circulation means they do not enter each other. Since they do not enter each other, Yang is repelled to the exterior, hence it is called "Yin-Excess Repelling Yang." "Pale red" refers to a superficial reddish hue on the face. Externally, symptoms include facial flushing, fever, and irritability, resembling Yang-Heat; internally, however, there is no thirst, diarrhea of undigested food, clear urine, cyanotic nails, cold limbs, and a floating, faint pulse nearly imperceptible—a full picture of Yin-Cold deficiency. It is appropriate to administer Tongmai Sini Decoction cold, following the Yin nature to restore Yang. If diarrhea stops but the pulse does not return, double the dosage of Renshen (Ginseng Radix et Rhizoma). If diarrhea occurs with no pulse, Baitong Zhu Danzhi Renao Tang (Baitong Decoction with Pig Gallbladder Bile and Human Urine) is indicated. For severe cold limbs and irritability bordering on death, Wuzhuyu Tang (Evodia Decoction) is indicated.

34. Yang-Toxin results from extreme heat where sweating or purgation was missed, presenting with a curled, scorched-black tongue, soot-like deposits in the nose, coma, trismus, mania seeing ghosts, sore throat, hemoptysis, and red cloud-like rashes. If treated within six or seven days, it is still manageable. If both exterior and interior are excess, Heinu Wan (Black Slave Pill) is used. For intense heat requiring detoxification and interior excess requiring purgation, [purgative formulas] are used. For exterior excess, Sanhuang Shigao Jian (Three-Yellow Gypsum Decoction) is used.
[Note] Yang-Toxin refers to a syndrome of extreme Yang-Heat. "Missed sweating/purgation" means failing to sweat when sweating was indicated, or failing to purge when purgation was indicated, thus missing the proper timing. The blazing heat-toxin persists, causing the tongue to curl and turn scorched-black, and soot-like matter to form in the nose. Heat-toxin attacking inward affects the Heart, causing coma, trismus with shivering, mania seeing spirits, sore throat, and hemoptysis. Heat-toxin pressing outward on the skin causes red rashes like brocade clouds. Within six or seven days indicates a short duration where toxin has not deeply penetrated, so it is still treatable. "Exterior and Interior Excess" refers to having these symptoms with anhidrosis and constipation; Heinu Wan is indicated for simultaneous resolution of both. For those without exterior-interior excess patterns but with intense heat, Huanglian Jiedu Tang (Coptis Detoxification Decoction) is indicated; if accompanied by dryness and thirst, Baihu Tang (White Tiger Decoction) is combined to clear heat. For interior excess with constipation, Jiedu Chengqi Tang (Detoxification and Bowel-Unblocking Decoction) is indicated for purgation. For exterior excess with anhidrosis, Sanhuang Shigao Tang (Three-Yellow Gypsum Decoction) is indicated to induce sweating.