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For conditions such as jaundice and yellowing of the skin, they are mostly caused by damp-heat. If urination is difficult, with urine being yellow or red, or if there is fullness and distension in the lower abdomen without pain, or if the stool is dry and there is extreme thirst, and the pulse is deep, solid, and forceful, these are all signs of damp-heat. For mild cases, Yinchen Wuling San (Yinchen Five-Ling Powder) is used; for severe cases, Yinchen Tang (Inula Decoction) is used. By promoting diuresis to separate dampness from heat, clearing blood and draining fire, the yellow color will naturally recede. However, jaundice also includes yin-patterns and various other treatment methods, which are detailed in the chapter on Jaundice and should be consulted.

Zhang Zhongjing stated: In Taiyang disease, if the pulse is floating, active, and rapid, accompanied by headache, fever, slight night sweating, and aversion to cold, the exterior syndrome has not yet resolved. If a physician erroneously applies purgation, it leads to Jie Xiong (Chest Binding); if it does not lead to Chest Binding, but only head sweating occurs, along with difficulty in urination, the body will inevitably become yellow. He also stated: In Yangming disease, if there is no sweating, difficulty in urination, and mental restlessness (Ao Nao), the body will inevitably become yellow. In Yangming disease, if there is fever and sweating, this indicates that heat is venting outward, and jaundice will not occur. If there is only head sweating, no body sweating, sweating stopping at the neck, difficulty in urination, and a desire to drink fluids, this indicates stagnant heat inside the body, leading to inevitable jaundice, treated primarily with Yinchen Hao Tang (Artemisia Capillaris Decoction). He further stated: In Shang Han (Cold Damage), if the pulse is floating and slow, and the hands and feet are warm, the disease is related to Taiyin, and the body should become yellow. If urination is normal, jaundice will not occur; after seven or eight days, if the stool becomes hard, it becomes Yangming disease. He also stated: After treating Shang Han with sweating, if the body and eyes turn yellow, it is because cold-dampness is trapped inside and cannot resolve. Purging should not be used; instead, treatment should seek to address the cold-dampness. For Shang Han presenting with body yellowing and fever, Zhizi Bopi Tang (Gardenia and Phellodendron Bark Decoction) is used.

Sun Simiao stated: For jaundice with a floating pulse, sweating should be induced to resolve the exterior, using Guizhi Jia Huangqi Tang (Cinnamon Twig Decoction plus Astragalus).

Shang Han (Cold Damage) causing mania is originally a disease of Yangming excess-heat. However, there is also a condition resembling mania (Ru Kuang), which looks like mania but is not true mania. The difference between deficiency and excess here is opposite, requiring careful differentiation, and must not be ignored. True mania caused by excess-heat belongs to Yangming, as Yangming is a meridian abundant in Qi and Blood. When pathogenic Yang heat transmits to the Stomach Fu organ, heat binds and does not resolve, leading to mania. The *Neijing · Yangming Meridian Resolution Chapter* states: The Stomach belongs to Earth, so hearing Wood sounds causes fright because Earth fears Wood. Fearing fire is due to excessive heat. Hating people is because when Yangming Qi rebels, there is panting and depression, leading to aversion to others. When the disease is severe, patients may discard clothes and run, climb high and sing, go several days without eating, or jump over walls and roofs. This is because the four limbs are the root of all Yang meridians; when Yang is excessive, the limbs become solid and strong, enabling climbing. Discarding clothes and running is due to heat prevailing in the body. Speaking nonsense, cursing, ignoring kinship, and singing are due to Yang excess becoming pathogenic. It also states: When Yin cannot overcome Yang, the pulses flow rapidly and violently, resulting in mania. It also states: When pathogenic factors enter the Yang aspect, mania occurs. These all indicate that Yangming heat pathogens ascend to overwhelm the Heart and Lungs, causing such mental confusion, which is Yang Mania. However, when Shang Han progresses to mania, it means the pathogenic heat is extremely intense. Unless fierce expulsion of fire pathogens is employed, it cannot cease. Therefore, if one observes hard and bound stools, or abdominal fullness and hardness, indicating signs suitable for purging, Da Cheng Qi Tang (Major Order the Qi Decoction), Xiao Cheng Qi Tang (Minor Order the Qi Decoction), Liang Ge San (Cool the Diaphragm Powder), or Liu Yi Shun Qi Tang (Six-One Smooth Qi Decoction) can be used to purge. If there are no signs of fullness, hardness, or excess, but the cause is solely Stomach Fire, then Bai Hu Tang (White Tiger Decoction) or Chou Xin Yin (Fire-Draining Drink) can be used to drain the fire pathogens, and the disease will heal itself.

First, the condition resembling mania is not originally caused by excess-heat mania, and its severity varies. As Zhang Zhongjing stated: If Taiyang disease does not resolve, and heat binds in the Bladder, the person resembles mania. If the exterior symptoms have not resolved, purging should not yet be applied; the exterior should be resolved first. Once the exterior is resolved, if only urgency and binding in the lower abdomen remain, purging can be applied, using Tao Ren Cheng Qi Tang (Peach Kernel Order the Qi Decoction). He also stated: In Taiyang disease, after six or seven days, if the exterior syndrome persists, the pulse is faint and deep, and contrary to expectation, there is no Chest Binding, but the person resembles mania, it is because heat is in the Lower Jiao, and the lower abdomen should be hard and full. If urination is normal, purging the blood will cure it, using Di Dang Tang (Di Dang Decoction). According to these two passages, because Taiyang heat pathogens do not resolve and follow the meridians into the Fu organs, but have not reached true mania, it is called "resembling mania." This is because heat combats blood, accumulating in the Lower Jiao, hence purging is appropriate.

Second, recently I have observed cases of Shang Han with a different type of resembling mania, which ancient texts did not mention. This may arise from illness due to frustration, affecting the Heart; or from grief and sorrow, affecting the Lungs; or from loss of essence, affecting the Kidneys; or from fatigue and overthinking, affecting the Liver and Spleen. In these cases, the root disease has already injured the interior, and cold pathogens are externally contracted, so the illness arises following the pathogens. The symptoms resemble mania, known as Deficiency Mania. Symptoms of deficiency mania definitely lack external signs of red face and eyes or violent temperament, and internally lack chest/abdominal binding or slippery/solid pulses. Although there may be occasional restlessness, it stops when restrained; speech may be absurd, but the voice and breath are weak; the patient may see empty spaces or be constantly frightened. Examination shows no scorched thirst above, and no hard stools below. These are all signs of damaged Jing-Qi and unsettled Shen-Hun. This is contrary to Yang Excess Mania, like ice and charcoal. Contemporary physicians often fail to distinguish this; seeing confusion, they assume Yang Mania and blindly apply purging, which inevitably leads to death. Treatment for such cases requires distinguishing Yin and Yang. For deficiency with accompanying pathogens, if the pathogen is in the Yang aspect, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is suitable; if in the Yin aspect, Bu Yin Yi Qi Jian (Nourish Yin and Augment Qi Decoction) is suitable. For deficiency without pathogens, if in the Yang aspect, Si Jun Zi Tang (Four Gentlemen Decoction), Ba Zhen Tang (Eight Treasures Decoction), Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction), or Da Bu Yuan Jian (Great Tonify Origin Decoction) are suitable; if in the Yin aspect, Si Wu Tang (Four Substances Decoction), Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill), Zuo Gui Yin (Left Restoring Drink), or Yi Yin Jian (One Yin Decoction) are suitable. For Yin deficiency with fire, Jia Jian Yi Yin Jian (Modified One Yin Decoction) or Er Yin Jian (Two Yins Decoction) are suitable. For Yang deficiency with cold, Li Zhong Tang (Regulate the Middle Decoction), Hui Yang Yin (Restore Yang Drink), Ba Wei Tang (Eight Flavor Decoction), or You Gui Yin (Right Restoring Drink) are suitable. The general principles of treatment are as described above; variations in complex syndromes may exceed verbal description, but understanding the intent behind the words reveals what is unsaid.

Third, if there is slight body heat, or a red face with floating Yang (Dai Yang), or irritability and restlessness, desiring to sit or lie in mud or water, but the pulse is faint and weak, this is a Yin syndrome resembling Yang, named Yin Zao (Yrestlessness). Because Yang is deficient in the lower part, Qi fails to return to its origin and floats upward, causing restlessness resembling mania. Immediate warming and tonification of the lower part is required; once the Mingmen (Gate of Life) is warmed, Fire returns to its source, and the disease heals. If physicians do not recognize this and mistakenly use cold-cooling herbs, death is certain.

Fourth, mania accompanied by dysentery and delirious speech is incurable. Manic speech with reversed gaze and fixed staring indicates Kidney Exhaustion, leading to death. Sweating followed by recurrent fever, manic speech, and refusal to eat indicates death.