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Furthermore, it is discussed that when the pathogenic factors of the Sanjiao (Triple Burner) cannot be resolved from the exterior, they inevitably lead to internal accumulation. Where does this internal accumulation occur? It occurs in the Yangming channel and the stomach and intestines. In such cases, purgation (a method using laxatives to evacuate pathogens) must also be employed; one should not refrain from purgation simply because the pathology involves the distinction between Qi and Blood. However, in Cold Damage (Shanghan), heat pathogens residing internally consume and dry up body fluids, so purgation should be applied vigorously. In contrast, damp-warmth diseases often involve internal struggle with dampness pathogens, so purgation should be applied gently. In Cold Damage, loose stools indicate that the pathogen has been exhausted, and purgation should not be repeated. In damp-warmth disease, loose stools indicate that the pathogen is not yet exhausted; one must wait until the stool becomes hard before cautiously refraining from further aggressive purgation, as dry stool signifies the absence of dampness. The upper part of the abdomen is called the "wan" (epigastrium), located in the middle jiao. If it is painful upon pressure, or spontaneously painful, or feels obstructed and distended, bitter-draining methods (using bitter-cold herbs to clear heat and drain excess) should be used because the location is close to the abdomen. However, this must be verified by inspecting the tongue. If the coating is yellow or turbid, Xiaoxianzhong Decoction (Small Trap Chest Decoction) or Xiexin Decoction (Drain the Epigastrium Decoction) may be administered according to the specific symptoms. If, however, the coating is white but not dry, or a mixture of yellow and white, or grayish-white without thirst, bitter-draining drugs must strictly not be administered indiscriminately. In such cases, there may be unresolved exterior pathogens with prior internal accumulation, or depressed pathogens failing to expand, or the patient may have a constitutionally cold middle jiao. Even if there is epigastric obstruction and pain, an opening and draining method (dispersing Qi stagnation) should be used to ventilate the Qi stagnation and restore its flow to the Lung. Herbs commonly used in modern secular practice, such as Xingren (Apricot Seed), Doukou (Black Cardamom), Jupi (Tangerine Peel), and Jiegeng (Platycodon Root), which are lightly bitter, slightly acrid, and possess mobile properties, are suitable. Regarding the previously mentioned yellow or turbid tongue coating, the yellow color must have a root (i.e., firmly attached to the tongue). If the tongue surface is smooth, it indicates formless damp-heat accompanied by deficiency signs, and the aforementioned bitter-draining method is strictly contraindicated. The area above the navel is called the "da fu" (large abdomen). If there is fullness, distension, or pain, it indicates that the pathogen has entered the interior. Exterior symptoms will certainly be absent, or only one or two out of ten may remain; the tongue must still be inspected. If the coating is deeply yellow, like the color of agarwood, grayish-yellow, old yellow, or has cracks in the center, purgation is indicated. For example, Xiao Chengqi Decoction (Minor Order the Qi Decoction) uses Binglang (Areca Seed), Qingpi (Green Tangerine Peel), Zhishi (Immature Bitter Orange), Yuanmingfen (Natrii Sulfas), and Sheng Shouwu (Raw Polygonum Multiflorum Rhizome). If these tongue signs do not appear, these methods should not be used. One must fear that the fullness might be due to dampness accumulating in the Taiyin spleen, pain due to mixed cold-dampness, or distension due to Qi congestion, in which case other methods should be employed. Furthermore, if the yellow coating is not thick but slippery, it indicates that heat has not yet damaged body fluids, and clearing heat and venting through the exterior can still be attempted. If the coating is thin but dry, it indicates that although the pathogen has departed, body fluids have been injured; bitter-cold medicines should be prohibited, and mild sweet-cold agents are appropriate.