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In cases of Shanghan (Cold Damage) where emesis is indicated, there must be stagnation in the Upper Jiao (Upper Burner), whether due to food retention or phlegm-dampness, accumulating in the chest and diaphragm, preventing the pathogenic factor from dispersing; such cases require emesis. Alternatively, if cold pathogens and turbid qi sink inward into the diaphragm, causing obstruction (Pi syndrome) or pain, emesis is also indicated, as the act of vomiting inherently contains the principle of dispersing pathogens. However, if the Middle Qi is deficient and cold, with a weak and powerless pulse, or if there is shortness of breath, deficiency-related irritability, and restlessness, emesis must not be used. When using emetic drugs, stop once the desired effect is achieved; it is not necessary to consume the entire dose.

First: Ancient formulas for emesis mostly used Dusheng San (Solely Holy Powder) and Chatiao San (Tea-Regulating Powder), which can be applied to any stagnation of pathogens in the Upper Jiao. However, the new method of emesis is even more rapid. Furthermore, various herbs can be used for emesis; one simply selects herbs according to the pattern, decocts them into a soup, and after a short while, induces vomiting by stimulating the throat. This allows for adjusting the dosage based on the severity of the condition and addressing both the root and branch simultaneously, which is superior.

In cases of Shanghan or Wenyi (Plague-like diseases) where purgation is indicated, it must be that Yangming pathogenic excess has accumulated in the Fu organs, resulting in constipation and abdominal fullness; only then can purgation be employed. Or, if the patient's Yuan Qi (Original Qi) has always been strong and the Stomach Qi solid, purgation may also be used. If stool has not passed for several days but the abdomen is not distended, and there are no signs of fecal impaction or blockage, or if the patient has not eaten for consecutive days but the umbilical and abdominal regions are flat, soft, and unobstructed, this indicates that the Yangming Stomach Fu organ lacks excess pathogens. In such cases, one must absolutely not recklessly use purgatives or cathartics, so as not to drain the Middle Qi. Furthermore, all contraindications for purgation listed in the Shanghan section must be carefully examined to avoid misuse. Among the harms of various treatment errors, incorrect purgation is particularly severe and cannot be ignored. It is observed that some contemporary physicians use purgatives recklessly without causing death; this is likely because the patient's Yuan Qi was originally strong enough to withstand the attacking nature of the purgatives. If one generalizes this as evidence, it will inevitably lead to fatal consequences.

First: When Shanghan pathogens enter the Yangming stage, presenting with constipation, delirium, abdominal fullness, irritability, and heat, with both pulse and symptoms indicating excess, Dachengqi Tang (Major Order the Qi Decoction) or Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction) is appropriate. If the exterior syndrome of Shanghan has not yet resolved, and the interior syndrome is urgent, with both exterior and interior being excess, Dachaihu Tang (Major Bupleurum Decoction) is appropriate. If pathogenic fire from the Three Jiao and Six Channels is congested and knotted, causing constipation, while the exterior pathogen remains unresolved, Liangge San (Cool the Diaphragm Powder) from the Ju Fang (Formulas of the Bureau) is appropriate. If Shanghan heat pathogens have transmitted inward, requiring purgation, but both Qi and Blood are deficient, Huanglong Tang (Yellow Dragon Decoction) by Tao Hua (Tao Shi) is appropriate. If Shanghan heat pathogens have transmitted inward, and blood deficiency causes constipation, abdominal fullness, and pain, with pathogens unable to resolve, Yuzhu San (Jade Candle Powder) is appropriate. If seasonal epidemics are widespread, with internal accumulation of fire pathogens, excess heat in the Three Jiao, severe constipation, and pathogens unable to recede, Wuwen Dan (Five Plagues Pill) is appropriate. If seasonal epidemics cause fever, with fire floating upward and heat knotting in the chest and diaphragm, Daqing Wan (Great Clearing Pill) is appropriate. For all conditions suitable for unblocking or purging, one should prepare an appropriate guiding agent according to the pattern and administer 1 to 3 qian of Baishun Wan (Hundred Compliance Pill); this is the most rapid and excellent method.