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When the epidemic pathogen transmits inward, the stomach heat is boiling like rolling water, causing the roundworms to move restlessly. Since the lower orifices are not unblocked, they must reverse and go upward; the roundworms are vomited out due to this, which is a common occurrence.
Simply treating the stomach will cause the roundworm jue (spasmodic abdominal pain with cold extremities) to heal spontaneously. I often see physicians blindly citing classical theories, believing it is visceral cold, where roundworms ascend into the diaphragm, stating that the patient should vomit roundworms, and also quoting the phrase: "Cold in the stomach inevitably leads to vomiting of roundworms." Consequently, they use Wumei Wan (Mume Pill) or Lizhong Anhe Tang (Regulate the Middle Decoction to Pacify Roundworms), which contain Xixin (Asarum Root), Fuzi (Prepared Aconite Root), Ganjiang (Dried Ginger), Guizhi (Cinnamon Twig), and Chuanjiao (Sichuan Pepper), all acrid-hot substances. Administering these is like adding oil to fire. They fail to realize that in epidemic conditions, both exterior and interior, upper and lower aspects are hot, and there has never been a cold syndrome from beginning to end. Failing to consider the immediate reality, they merely memorize textual words, using them as basis for annotation and application, administering them calmly without doubt, thus misleading many people.

Reversal of stomach qi results in hiccup (e'ni). In Wu region, it is called "cold hiccup"; because of the name "cold," it is identified as stomach cold. However, one does not know that both cold and heat syndromes can cause hiccups. Furthermore, by not referring to the primary syndrome but exclusively adhering to colloquialisms as indicating cold, they administer Dingxiang (Caryophylli Flos), Zhuyu (Evodia Fruit), Jiang (Ginger), and Guizhi (Cinnamon Twig), misleading many people. This is even more inappropriate than those who harm the meaning by sticking to literal words.
Treatment methods should be determined according to the primary syndrome. For example, if Baizhu Tang (White Tiger Decoction) syndrome is seen, administer Baizhu Tang; if Chengqi Tang (Purgative Decoction) syndrome is seen, administer Chengqi Tang. If phlegm obstruction exists in the diaphragm, expectorating phlegm is appropriate. If it is truly stomach cold, Dingxiang Shidi San (Clove and Persimmon Calyx Powder) is suitable, yet it is not as effective as Sini Tang (Frigid Extremities Decoction). In summary, simply treating the primary syndrome will stop the hiccups; other cases can be inferred analogously.

At the onset of seasonal epidemics, the pathogen lodges in the middle jiao, blocking the connection between exterior and interior. Stagnation of interior qi causes oppression, while stagnation of exterior qi causes headache and body pain. Seeing headache and body pain, physicians often mistakenly identify it as an exterior syndrome of Shanghan (Cold Damage), and thus use Mahuang (Ephedra Herb), Guizhi (Cinnamon Twig), Xiangsu San (Aromatic Su Decoction), Gegen (Kudzu Root), Baidu San (Rescue the Damaged Powder), or Jiuwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction). These are all dispersing agents that forcibly seek sweating, recklessly consuming body fluids. The channel qi becomes deficient first, the pathogen remains undamaged, and fever persists. Moreover, when the pathogen transmits inward, the exterior qi cannot communicate with the interior and must congest externally. This often results in tidal fever in the afternoon; when the heat is severe, the head swells and aches, and the pain ceases when the heat subsides. Is this truly an exterior excess syndrome? The above cases resemble exterior syndromes but are mistaken for such, leading to the reckless use of ascending and dispersing agents. This makes the channel qi more stagnant, fire qi rises, and the headache worsens. Purging is required; once the interior qi is unblocked and the channel qi descends, the headache stops immediately. If it were indeed a common cold causing headache, the pain would be constant at all times, which allows for differentiation. Additionally, other symptoms provide reference; one cannot rely on a single approach. After sweating or purging, if the pulse is calm and the body is cool, but limb joints suddenly become more painful, feeling as if beaten with sticks or suffering from bruising, with slight movement causing cries of pain, this indicates deficiency of channel qi and sluggish circulation of Ying and Wei (Nutritive and Defensive Qi). Within three to four days, as channel qi gradually returns, the pain subsides; even without medication, it will heal spontaneously. If one recklessly cites classics, attributing it to wind-dampness clashing, causing whole-body pain and inability to turn, and administers wind-dispelling and dampness-resolving agents, the body pain worsens. Such errors mislead many.

When Shanghan transmits to the stomach, tidal fever and delirious speech appear immediately, and purging is unquestionably indicated. However, in current seasonal epidemics, tidal fever appears at the onset, and severe heat can also cause delirium. Mistaking this for an interior syndrome and recklessly using Chengqi Tang constitutes punishing the innocent. One fails to realize that latent pathogens near the stomach, before entering the fu organs, can also cause tidal fever, with worsening heat in the afternoon and delirium, without needing gastric excess to occur. Suppose ordinary malaria; severe heat can also cause delirium. Danmalaria (Hot Malaria) presents without aversion to cold, only with tidal fever; is this gastric excess? The above cases resemble interior syndromes, but mistaking them for such and using Chengqi Tang causes prior deficiency of interior qi. When the pathogen then sinks into the stomach, chest and abdominal distension appear, and thirst and irritability increase severely. Seeing the critical condition, patients change doctors. Physicians, seeing the condition worsen after purgatives, blame Dahuang (Rhubarb Root) as arsenic poison, or administer Xiexin Tang (Drain the Epigastrium Decoction) or Chaihu Zhijie Tang (Bupleurum and Aurantium Decoction), leaving the pathogen in the stomach. Variations increase daily until spirit dissipates and qi exhausts, leading to death. Previously, purging was used when it shouldn't have been; now, purging is missed when it should have been used. This error stems from unclear differentiation of exterior and interior, and disorderly sequence of medication.