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No sweating occurs; even with thick coverings and proximity to fire, there is no sweat. When the pathogenic factor initially emerges, it must be located in the half-exterior, half-interior region. Regarding the transmission of the disease, some pathogens emerge to the exterior, some enter the interior, and some transmit simultaneously between the exterior and interior. Whenever both exterior and interior syndromes are present, one must first attack the interior pathogens; only after the interior pathogens are eliminated can sweating occur. If the interior qi is congested and obstructed, and yang qi cannot circulate freely, resulting in cold limbs (Jue), how can the body generate steam-like qi and fluid dynamics to reach the surface and produce sweat? In such a prolonged state, it is like a water channel blocked at its outlet, unable to drip a single drop. For syndromes involving simultaneous transmission to the exterior and interior, it is essential to use Chengqi Tang (Cathartic Powder). Once the interior qi is unblocked, spontaneous sweating and resolution often occur without the need for diaphoretic herbs. Otherwise, even if large doses of Mahuang Tang (Ephedra Decoction) are administered continuously, not only will there be no sweat, but irritability will worsen.

Zhanhan (Shivering Sweat) occurs when the pathogen moves from the exterior to the interior. Sudden shivering followed by sweating indicates that the meridian qi is舒展 (unfolding) and venting. At this point, the pulse should become calm, the body cool, and irritability and thirst should instantly resolve. If purgation was indicated but neglected, leading to depletion of qi and consumption of blood, the patient may attempt to produce Zhanhan but only shiver without sweating; this is critical because the Middle Qi is deficient and collapsing, capable only of sinking rather than ascending. On the following day, another episode of shivering is expected. If the limbs warm up and sweat appears, the patient lives; if the limbs remain cold and no sweat appears, the patient dies, due to the exhaustion of righteous qi which cannot overcome the pathogen. If shivering occurs, limbs warm up, but no sweat appears, it indicates that True Yang still exists, but the exterior qi is dry and depleted; gradual recovery is possible. If shivering stops abruptly and spasms (Jing) suddenly appear, death is certain. During Zhanhan, the patient must not be disturbed; only warm covering is allowed. Disturbance will interrupt the shivering process, and another episode is expected on the next day. (For cases where shivering occurs but no sweat follows, large doses of Danggui (Angelicae Sinensis Radix), Dihuang (Rehmanniae Radix), and Renshen (Ginseng Radix) should be used to support the interior.)

Zihan (Spontaneous Sweating) refers to natural sweating not induced by diaphoretic herbs, indicating that the pathogen is departing. If accompanied by high fever, severe thirst, and a long, surging, and rapid pulse, Baihu Tang (White Tiger Decoction) is appropriate; resolution occurs after Zhanhan. If spontaneous sweating persists for several days after purgation, with sweating proportional to the heat intensity (more heat, more sweat; less heat, less sweat), this indicates lingering pathogens in the exterior and constitutes an excess syndrome; sweating stops only when all pathogens are expelled. If sweating does not cease, Chaihu Tang (Bupleurum Decoction) can be used as an adjunct; once the exterior is resolved, sweating will stop naturally. If syndromes of the Three Yang meridians are present, follow the previously mentioned methods of modifying herbs specific to each meridian. Mistaking this for deficiency-type spontaneous sweating and using consolidating and antiperspirant formulas would be an error. If there are interior syndromes during midsummer heat, Baihu Tang is suitable. If the face lacks spirit, lips are pale upon scraping, there are no exterior or interior heat signs, the patient prefers hot drinks, fears cold, and has a faint pulse, sudden spontaneous sweating indicates collapse of deficiency. Death may occur if onset is at night and resolves by day, or vice versa; urgent vigorous tonification is required, and if tonification fails, death ensues. Several days after recovery from a major illness, sweating triggered by diet or emotional disturbance indicates deficiency and fragility of both exterior and interior; Ren Shen Yang Rong Tang (Ginseng Nourishing the Spirit Decoction) is indicated: Renshen (Ginseng Radix), Maidong (Ophiopogonis Tuber), Wuweizi (Schisandrae Fructus), Dihuang (Rehmanniae Radix), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Zhimu (Anemarrhenae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), and Huangqi (Astragali Radix) doubled in dosage.

Daohan (Night Sweating) occurring after purgation of interior syndromes indicates slight residual pathogens within. When a person closes their eyes to sleep, Wei Qi (Defensive Qi) enters the Yin aspect. If latent heat exists internally, the interaction of two Yangs causes the pores (Couli) to open, resulting in night sweating. Once the latent heat is completely cleared, night sweating ceases spontaneously. If it persists, Chaihu Tang (Bupleurum Decoction) can be used as an adjunct: Chaihu (Bupleuri Radix, 3 qian), Huangqin (Scutellariae Radix, 1 qian), Chenpi (Citri Reticulatae Pericarpium, 1 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian), Shengjiang (Zingiberis Rhizoma Recens, 1 qian), Dazao (Jujubae Fructus, 2 pieces), decocted and taken orally. After recovery, when the pulse is calm and the body cool, if night sweating and spontaneous sweating recur after several days, it belongs to exterior deficiency; Huangqi Tang (Astragalus Decoction) is indicated: Huangqi (Astragali Radix, 3 qian), Wuwei (Schisandrae Fructus, 3 qian), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 qian each), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 qian). If sweating continues, add Mahuanggen (Ephedrae Radix et Rhizoma Caudex, 1.5 qian). If heat signs are present, it is an excess syndrome, and this formula is contraindicated.

Kuanghan (Manic Sweating) occurs when the pathogen is about to depart and resolve through sweating. Because the patient’s constitution is robust and Yang qi is abundant, the opening cannot happen instantly. (These three sentences should be revised to: Yang qi floats abundantly on the exterior, causing restlessness and agitation.) The patient suddenly becomes restless, sitting and lying down uncomfortably, exhibiting manic agitation. After a short while, profuse sweating occurs, agitation ceases, the pulse becomes calm, the body cools, and the patient recovers abruptly.

Fabang (Manifestation of Macules/Petechiae) occurs when pathogens linger in the Blood aspect, and interior congestion blocks the outward penetration of latent pathogens, preventing them from manifesting as macules. If purgation is applied, the internal congestion clears, allowing Wei Qi (Defensive Qi) to circulate freely, enabling pathogens to penetrate the exterior as macules, thereby resolving externally. If macules gradually appear after purgation, do not administer heavy purgatives again. If there are indications for purgation, administer Chengqi Tang (Cathartic Powder) in small amounts slowly. If heavy purgation is repeated, Middle Qi will fail to rise, and macule toxins may sink inward, creating danger; Tuoli Jubang Tang (Support Interior and Raise Macules Decoction) is indicated: Baishao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix, 1 qian each), Shengma (Cimicifugae Rhizoma, 0.5 qian), Baizhi (Angelicae Dahuricae Radix), Chaihu (Bupleuri Radix, 0.7 fen each), Shanjia (Manis Squama, roasted yellow, 2 qian), decocted with water and ginger. If macules appear gradually after purgation but heavy purgation is repeated, causing toxins to recede, and symptoms such as grasping at bedclothes (Xunyimo Chuang) and picking at empty air (Cuokong Li Xian) appear with a gradually faint pulse, the condition is critical; add Renshen (Ginseng Radix, 1 qian) to the base formula. If tonification fails, death ensues. If macules appear before any purgation, and purgation is indicated, administer Chengqi Tang (Cathartic Powder) in small amounts, proceeding slowly.

Rejie Pangliu (Heat Binding with Peripheral Flow) involves chronic dysentery with clear watery stools, where fluids are depleted, preventing sweating. In epidemic diseases, neglecting purgation or having diarrhea mixed with heat leads to a deep pulse. Prolonged failure to purge results in exhaustion of body fluids. Even if purgation is later applied and interior syndromes resolve, if the pulse remains floating but sweating cannot be induced, this is "fluid depletion without sweat." However, since interior pathogens have been removed, if dietary intake improves slightly, after ten or so days, Middle Qi will recover and descend. Zhanhan (Shivering Sweat) should then occur, leading to resolution. (Yin can be nourished; once Yin fluids are充盈 (replenished) internally and overflow externally, sweating will occur naturally.)