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Vomiting roundworms indicates heat in the Stomach, definitely not cold in the Zang organs. Wu Mei Wan (Mume Pill) and Lizhong Tang (Regulate the Middle Decoction) must absolutely not be used; only Tiaowei Chengqi Tang (Harmonize the Stomach and Order the Qi Decoction) should be employed, after which the roundworms will naturally cease their upward movement.

Blood Accumulation. If an epidemic disease persists for a long time without timely purgation, blood is constrained by heat, becomes corrupted and turns purple-black, overflowing into the intestines and stomach. Symptoms include rinsing the mouth with water but not swallowing it, free urination, and black stools. This is the characteristic presentation. Tao Ren Chengqi Tang (Peach Kernel to Order the Qi Decoction) is indicated: Dahuang (Rhubarb Root), Mangxiao (Mirabilite), Taoren (Peach Seed), Danggui (Angelicae Sinensis Radix), Shaoyao (Peony Root), Danpi (Moutan Cortex). After taking this medicine, when the heat is eliminated, the patient recovers. If residual heat remains, Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) is appropriate: Dihuang (Rehmanniae Radix Preparata, 5 qian, pounded and mixed with water to extract juice, dregs boiled separately), Baishao (White Peony Root, 1.5 qian), Danpi (Moutan Cortex, 1 qian), Xijiao (Rhino Cornu, 1 qian), taken together with the Dihuang juice.

Jaundice. The epidemic pathogen transmits inward, transferring heat to the Lower Jiao. Urination is difficult, so the pathogen has no outlet, causing stagnation of the meridians and resulting in jaundice. The body and eyes appear golden yellow. Yinchin Tang (Artemisiae Scopariae Decoction) is indicated: Yinchin (Artemisiae Scopariae Herba, 1 qian), Shanzhi (Gardeniae Fructus, 2 qian), Dahuang (Rhubarb Root, 5 qian), decocted with fresh ginger.

Clutching at clothes and picking at empty air, grasping at imaginary threads, muscle twitching, limb tremors, and blurred vision are all due to delayed purgation or the use of mild medicines that prolonged the condition. This signifies the impending collapse of the Primordial Spirit. Tonification will exacerbate the toxicity, while purgation will deplete the already deficient Qi; this is a critical condition. As a last resort, Huanglong Tang (Yellow Dragon Decoction) may be tentatively used: Dahuang (Rhubarb Root), Nongpo (Magnolia Bark), Zhishi (Immature Bitter Orange), Mangxiao (Mirabilite), Renshen (Ginseng Root), Dihuang (Rehmanniae Radix Preparata), Danggui (Angelicae Sinensis Radix). Alternatively, Renshen Yangrong Tang (Ginseng to Nourish the Vigor Decoction) can be used, but it should be discontinued as soon as the deficiency signs subside slightly; do not use it for long.

Inability to tolerate medication, sweating on the forehead, cold limbs with tremors, irritability, and restlessness indicate that the Middle Qi is deficient and cannot bear the medicinal force. This is termed "Medication Irritation." Immediately administer Ginger Decoction to resolve it instantly, or add more fresh ginger to the herbal decoction to prevent these symptoms. It is also advisable to divide the dose into two or three administrations to prevent vomiting.

If, after administering Chengqi Tang, there is no bowel movement, or if movement occurs only the next day, or if the original medicine is vomited up within half a day, this is because the deficient Middle Qi cannot transport the medicine. This is a sign of great peril. Add fresh ginger and Renshen (Ginseng Root) to support the Stomach Qi. However, cases where the disease is severe but the dosage is too light, resulting in lack of effect, are not included in this category.

Craving cold drinks indicates severe heat and thirst. Regardless of the season, provide them in moderation. If allowed to drink excessively, water will accumulate under the Heart.

Empty irritability, restlessness, restless hands and feet, invisible six pulses, and absent Chi pulse indicate that the Primordial Qi cannot govern the body. The treatment method should be major tonification.

Spiritual Deficiency with Delirious Speech. Delirium before purgation must be accompanied by internal heat, irritability, and thirst; this is an Excess pattern suitable for purgation. Delirium persisting for several days after purgation indicates that the Primordial Spirit has not yet recovered; Qingzao Yangrong Tang (Clear Dryness and Nourish Vigor Decoction) should be urgently administered.

Collateral Heat with Diarrhea. Loose stools with red-yellow or scorched-yellow color indicate that the Stomach does not retain pathogens. If diarrhea stops and heat subsides within one or two days, the disease is cured. If diarrhea persists, Xiaochengqi Tang (Minor Order the Qi Decoction) should be used mildly to stop the diarrhea. If diarrhea stops for one or two days and then sudden irritability, thirst, and renewed diarrhea occur, this indicates the re-emergence of latent pathogens; treat according to the previous methods.

Constipation is due to internal heat; purgation is indicated, after which all diseases will vanish.

Hiccups can be Cold or Heat patterns; refer to the primary syndrome. For Heat, use Baihu Tang (White Tiger Decoction) or Chengqi Tang; for Cold, use Sini Tang (Frigid Extremities Decoction).

Heat Binding with Peripheral Flow. First constipation, followed by pure watery discharge without feces, indicates fecal impaction inside. Chengqi Tang should be used to purge the impacted feces, after which the diarrhea will stop. If, after medication, the impaction is not expelled and foul-smelling water continues to flow, the pathogen remains, and the disease will not diminish; purge again.

Large Intestine Glue Closure. Excretion is extremely foul and sticky like glue but not dry/hard; this indicates extreme heat. Without purgation, death will ensue.

Red urine indicates Stomach heat; Tiaowei Chengqi Tang (Harmonize the Stomach and Order the Qi Decoction) is indicated.

Urgent and frequent urination with turbid white fluid resembling horse urine indicates Bladder heat; Zhuling Tang (Polyporus Decoction) is indicated: Zhuling (Polyporus, 2 qian), Zexie (Alisma Rhizome, 1 qian), Huashi (Talcum, 0.5 qian), Gancao (Licorice Root, 0.8 qian), Mutong (Akebia Caulis, 1 qian), Cheqian (Plantago Seed, 2 qian).

Hardness and pain upon pressing the lower abdomen, with normal urination, indicates Blood Accumulation. Tao Ren Tang (Peach Kernel Decoction) is indicated: Taoren (Peach Seed, 3 qian), Danpi (Moutan Cortex, 1 qian), Danggui (Angelicae Sinensis Radix, 1 qian), Chishao (Red Peony Root, 1 qian), Ejiao (Donkey-Hide Gelatin, 2 qian), Huashi (Talcum, 0.5 qian).

Pulse Jue. The spirit and complexion are not ruined, speech and movement are normal, with no other strange symptoms, yet suddenly the six pulses become thread-like or imperceptible, or one hand's pulse vanishes first. This is due to Qi closure from delayed purgation. Chengqi Tang should be used gently to purge, after which the pulses will recover. Shengmai San (Generate the Pulse Powder) is contraindicated.