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Fire pathogen refers to the condition caused by the inappropriate use of fire therapy when it should not have been used. In cases of cold damage where sweating does not occur, and after repeated administration of diaphoretic medicines, sweat still fails to emerge, this indicates the exhaustion of body fluids internally, rendering the condition critical. If it is a common case of impaired sweating where the medication has not yet taken effect, and one hastily applies heat beneath the bedstead to forcibly extract sweat, the scorching heat will combine with the pathogenic heat, transforming into symptoms such as fright and mania. In excess conditions, there is incessant irritability; in deficiency conditions, the true yang qi escapes and perishes. One must assess the excess or deficiency and apply dispersing treatments accordingly. After sweating and purging in Taiyang disease, if epigastric fullness occurs with both exterior and interior deficiency, and moxibustion or burning needles are additionally applied, chest irritability, bluish complexion, and dry skin indicate a difficult-to-treat condition. A yellowish complexion and warm hands and feet indicate a treatable condition. In Taiyang wind-strike, if forced by fire therapy, the fire heat and wind pathogen (both yang) bind together, scorching and causing fever externally, leading inevitably to jaundice. If heat binds internally, urination becomes difficult. When fire heat is extreme, restlessness of the hands and feet, grasping at clothes, and touching the bedclothes occur, indicating a difficult-to-treat state. If urination is free, the fire pathogen is not severe, and treatment is still possible.

[Cool Blood] In Taiyang disease, if fumigation with fire fails to induce sweating and the dryness persists, lower bleeding (hematochezia) will inevitably occur. This is definitely due to the fire pathogen; treat with Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction).

[Induce Sweating] When the pulse is floating, sweating is appropriate for resolution. If moxibustion is used, the pathogen has no outlet, and the disease manifests as heaviness and numbness from the waist down, termed "fire reversal." Treat with Mahuang Xingzi Yiyi Gancao Tang (Ephedra, Apricot Kernel, Coix Seed, and Licorice Decoction).

In cold damage, if vomiting fails to resolve the condition, and constipation persists for five to ten days or more, with tidal fever in the late afternoon, aversion to cold absent, and solitary speech resembling hallucinations of ghosts: in severe cases, the patient loses recognition of others, exhibits grasping at clothes and touching bedclothes, fearfulness and unrest, slight panting, and fixed gaze. In milder cases, fever and delirium occur; treat with Dachengqi Tang (Major Order the Qi Decoction). If one dose results in bowel movement, stop administering it. Re-evaluate the pulse: a wiry pulse indicates survival, while a choppy pulse indicates death. Zhang Zhongjing stated: "Grasping at clothes and touching bedclothes is untreatable."

[Purgative Method] Dachengqi Tang (Major Order the Qi Decoction) and Xiaochengqi Tang (Minor Order the Qi Decoction) may be selected for use.

Fixed gaze refers to the inability of the eyeballs to move. The essence of water stores zhi (will), and the essence of fire stores shen (spirit), governed by the Heart. In cold damage, fixed gaze occurs because pathogenic qi is abundant and obstructs the true qi, preventing the spirit from guarding the heart and the essence from nourishing the eyes. This usually indicates an incurable condition. Patients prone to epistaxis should not undergo sweating therapy; if sweated, the pulses on the forehead become tight, and fixed gaze with immobility ensues. Delirious speech with fixed gaze indicates kidney exhaustion; head shaking with fixed gaze indicates heart exhaustion; both signify the collapse of organ qi. Fixed gaze accompanied by panting, fullness, and loss of consciousness, or lower body manifestations of grasping at clothes and touching bedclothes, or simply fixed gaze alone, all indicate death.

[Purgative Method] If the eyes appear dim and the pupils are unresponsive, without exterior or obvious interior signs, with difficulty in defecation and slight body heat, this is not fixed gaze but internal excess. Urgent purgation is required. Use Daichaihu Tang (Bupleurum and Rhubarb Decoction) or Dachengqi Tang (Major Order the Qi Decoction), selecting as appropriate.