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Passage of black, tarry stools indicates the presence of blood stasis; *Didang Tang* (Rescue the Extremities Decoction) is indicated. If the pulse remains rapid and symptoms do not resolve, accompanied by incessant diarrhea, it is certain that heat will combine with blood to produce pus and blood in the stool.

Although it is stated that there are no typical exterior or interior syndromes, the presence of fever and a floating, rapid pulse indicates that the exterior syndrome still exists. The reason why purgation can be used is that after seven or eight days, the duration has been long, and combined with fever and a rapid pulse, the heat in the stomach is blazing and body fluids are exhausted. Under these circumstances, purgation becomes necessary, such as using *Da Chaihu Tang* (Major Bupleurum Decoction). If the rapid pulse does not resolve after purgation, it can be inferred that the stomach heat is indeed severe; the manifestation should be excessive hunger due to efficient digestion. However, if food intake is high, bowel movements should increase, yet if there is no bowel movement for six or seven days, it is clearly not qi stagnation but blood stasis. Therefore, *Didang Tang* is also appropriate here. If the pulse remains rapid but is accompanied by incessant diarrhea, the commentator's assertion that *Didang Tang* should be used to purge, resulting in an unresolved rapid pulse, is a gross error. This passage addresses the five sentences regarding "if purgation has already been administered and the rapid pulse does not resolve": if purgation has been given, the rapid pulse does not resolve, and there is no bowel movement for six or seven days, then *Didang Tang* should be used to purge the blood stasis; however, if purgation has been given, the rapid pulse does not resolve, and there is incessant diarrhea, then the harsh purgative action of *Didang Tang* is contraindicated. Instead, one should carefully assess the condition and clear the heat pathogen in the blood level; if the heat pathogen in the blood level is not eliminated, it will inevitably lead to pus and blood in the stool due to heat combining with blood. (Yu Jiayan)

After five or six days of *Shanghan* (Cold Damage), if there is sweating only on the head, slight aversion to cold, cold hands and feet, fullness in the epigastrium, lack of desire to eat, hard stools, and a fine pulse, this is called "Yang Wei Jie" (Minor Yang Binding/Constriction). There must be both an exterior and an interior component. A deep pulse also indicates an interior location. Sweating indicates minor yang binding; if it were pure yin binding, there would be no exterior symptoms remaining, and all signs would be internal. This represents a condition half in the interior and half in the exterior. Even if the pulse is deep and tight, it cannot be diagnosed as a *Shaoyin* disease. The reason is that yin conditions typically do not present with sweating; since there is sweating on the head, it is known not to be *Shaoyin*. *Xiao Chaihu Tang* (Minor Bupleurum Decoction) may be administered. If the patient remains uncomfortable, resolution will occur upon passing stool.

"Yang Wei Jie" refers to mild binding of yang pathogens that have not yet fully dispersed. The commentator's interpretation that this is due to the decline of yang qi leading to pathogen binding is a major deviation! If that were the case, head sweating would be a sign of yang collapse, not a half-exterior/half-interior syndrome. Furthermore, yin binding would imply a decline of yin qi. Examining the text's phrase "if pure yin binding," the meaning is clear: if the yang pathogen were not mildly bound but purely yin pathogen binding internally, there would be no exterior symptoms. "Resolution upon passing stool" implies the intent of using *Da Chaihu Tang* as a harmonizing method. (*Shanglun Pian*)

For recurrence of illness due to overexertion after a major illness has healed, *Zhishi Zhizi Chi Tang* (Immature Bitter Orange, Gardenia, and Fermented Soybean Decoction) is the primary treatment.

"Lao Fu" (recurrence due to labor) refers to residual heat arising after physical exertion in daily activities. The commentator's interpretation that this refers to recurrence after sexual intercourse is a gross error! Recurrence after sexual intercourse ("Nv Lao Fu") is a major taboo after contracting *Shanghan*, often leading to death rather than survival. How could one use a formula with emetic and purgative properties in such a case? (Yu Jiayan)

If the patient's pulse has returned to normal, but they experience slight irritability in the evening, it is because the illness has just healed, and people force-feed them. The spleen and stomach qi are still weak and unable to digest food, causing slight irritability. Reducing food intake will lead to recovery.

"Pulse resolved" means yin and yang are harmonious, indicating no exterior or interior pathogens. Slight irritability in the evening occurs because wei qi (defensive qi) travels through the yang channels during the day, so irritability should not normally occur; it is caused by weak spleen and stomach qi failing to digest food. Reducing food intake allows spleen and stomach qi to gradually recover, leading to self-healing. Commentators erroneously associate the evening with the flourishing time of the *Yangming* channel, suggesting that reducing food should involve mild purgation. They fail to realize this discusses post-healing conditions, not the transmission of the Six Channels into *Yangming*. "Evening" refers to the concept in the *Neijing* that when the sun sets, yang qi begins to decline, hence the inability to digest food. "Reducing food" means decreasing grain consumption to nourish and rest the spleen and stomach. One should not cite previous cases of retained food to lightly administer *Dahuang* (Rhubarb Root), which would severely damage the spleen and stomach. (Yu Jiayan)