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Exterior syndromes are characterized by fever, aversion to cold (Ehan), headache, body aches, and a floating pulse. Among these, aversion to cold indicates an exterior syndrome; it signifies deficiency at the exterior level and belongs to the Taiyang channel, for which diaphoresis (sweating method) is appropriate. However, if heat predominates over cold, or if the pulse is weak and thready, or if the Chi position pulse is slow, diaphoresis is contraindicated. If there is bleeding from the lower orifice, diaphoresis is contraindicated. In cases of Huai Bing (complicated disease due to mis-treatment), diaphoresis is contraindicated. When menstruation has just begun, diaphoresis is contraindicated. In Feng Wen (wind-warmth disease), diaphoresis is contraindicated. In Shi Wen (damp-warmth disease), diaphoresis is contraindicated. In Xu Fan (deficiency irritability), diaphoresis is contraindicated. In Dong Qi syndrome (palpitations/throbbing at the umbilicus), diaphoresis is contraindicated. Furthermore, in Three Yin diseases (Taiyin, Shaoyin, Jueyin diseases), diaphoresis is contraindicated; forcing sweat will disturb the blood in the meridians. If Taiyin syndrome presents with a floating pulse, mild diaphoresis is appropriate. If Shaoyin syndrome presents with fever and a deep pulse, Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction) should be used for diaphoresis.

Interior syndromes are characterized by absence of aversion to cold, but presence of aversion to heat, tidal fever (Cha Re), delirium (Zhanyu), abdominal fullness and distension, hard dry stools, and a deep, slippery pulse. Among these, aversion to heat indicates an interior syndrome; it signifies excess at the interior level and belongs to the Yangming channel, for which purgation (downward-draining method) is appropriate. However, if the pulse is floating, purgation is contraindicated. If the pulse is deficient and thready, purgation is contraindicated. If there is vomiting, purgation is contraindicated. If there is no passage of flatus (Zhuan Shi Qi), purgation is contraindicated. If the urine is clear and copious, purgation is contraindicated. Generally, Three Yin diseases are suitable for warming methods rather than purgation; however, if there are accumulation syndromes (Ji Zheng), purgation is indicated. For example, in Taiyin syndrome with abdominal fullness and intermittent pain, or in Shaoyin syndrome with dry mouth and throat, or with abdominal fullness and constipation, or with diarrhea of clear water and pain in the epigastrium, these constitute accumulation syndromes requiring purgation.

If a patient's pulse is floating and large, it indicates an exterior syndrome that requires diaphoresis. If the patient has fever, irritability, thirst, and urinary difficulty (Zhi [likely typo for Bu Li], interpreted as difficulty in urination), yet purgation is required, this represents simultaneous exterior and interior syndromes, treated primarily with Wuling San (Five-Ingredient Poria Powder).

In Shang Han (cold damage) disease, if there has been no bowel movement for six or seven days, accompanied by headache and fever, it indicates an interior syndrome requiring purgation. However, if the urine is clear, it indicates the pathogen is not in the interior but remains in the exterior, requiring diaphoresis. This represents simultaneous exterior and interior symptoms where purgation is premature; Guizhi Tang (Cinnamon Twig Decoction) is appropriate.

If a patient has fullness in the epigastrium, loss of appetite, and hard stools, it indicates an interior syndrome requiring purgation. However, if the patient has sweating only on the head, slight aversion to cold, and cold hands and feet, diaphoresis is required. This represents simultaneous exterior and interior symptoms, which Zhang Zhongjing refers to as Half-Exterior Half-Interior syndrome, treated primarily with Xiaochaihu Tang (Minor Bupleurum Decoction).