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Any person with strong Stomach Qi (Wei Qi) can tolerate hunger and fullness; however, after a prolonged illness, when Stomach Qi becomes weak, it is most difficult to regulate. The Stomach organ is like a stove, Stomach Qi is like fire, and food is like firewood. The essence of grain and water that is ascended and dispersed into the blood vessels is like flames, while the dregs that turn downward into feces are like ashes. Therefore, a large stove with much firewood produces strong fire; even if the wood breaks, the residual flame remains, and although new wood is added, the fire burns again. If it is a small pot, only a few stalks of wood are suitable; slightly more will block and extinguish the fire, and slightly less will cause the fire to die out. Is it not difficult to make dead ashes burn again?

As for after a major illness, when pathogenic factors have just been expelled and the appetite has just opened, the vital Qi is minute. Therefore, feeding too early or too late is inappropriate. One should first provide rice soup, then paste-like drinks, then thin porridge, and finally soft rice. It is especially important to proceed step by step without disrupting the timing. One should maintain the fire like a stove, ensuring it never goes out day or night, to be prepared for emergencies. When the patient desires food, give it to them; if delayed slightly, the stomach will feel hungry as if cut; if delayed further, Stomach Qi will be injured, and the patient will lose the desire to eat. Once the desire to eat is lost, if one feeds according to previous methods, although food is ingested, it will not digest. Failure to digest causes further injury. If "food relapse" (recurrence due to improper diet) does not occur, one should follow the initial nourishing method; if more food, especially sticky or hard items, is given, Stomum Qi will be severely obstructed, inevitably leading to unbearable distension. If Qi fails but food remains, it leads to repeated fluctuations, exhaustion of form and spirit, and death.

The transmission of plague has nine types, yet it does not go beyond the exterior and interior. The so-called nine transmissions refer to patients manifesting each type individually, not that one disease has nine transmissions. Generally, when warm plague arrives, pathogens enter via the mouth and nose and lodge in the Membrane Source (Mo Yuan), lying dormant without manifestation, unnoticed by people. After manifestation, fever gradually increases, and the pulse is surging and rapid; this is common among all. It is appropriate to use Da Yuan Yin (Reach the Original Drink) to disperse it. Subsequently, once pathogens leave the Membrane Source, observing their transmission reveals differences among individuals due to varying conditions of the exterior and interior. Some are only in the exterior and not the interior; some only in the interior and not the exterior; some in the exterior and again in the exterior; some in the interior and again in the interior; some transmit simultaneously in both exterior and interior; some transmit simultaneously in both and then again; some have exterior syndrome predominating over interior; some have interior syndrome predominating over exterior; some manifest exterior first then interior; some manifest interior first then exterior. All these nine transmissions share the same principle of eliminating disease. If physicians do not know the methods of the nine transmissions and do not know where the pathogens lie, they are like blind men unable to manage a cane or deaf men unable to hear musical tones, having no sound to seek and no path to follow. They inevitably fail to apply sweating therapy when indicated, or purgation when indicated, or use them incorrectly, or treat symptoms without addressing pathogens, ultimately all resulting in error.

Regarding "only in the exterior and not the interior," symptoms include headache, body pain, fever, and chills, without internal chest fullness or abdominal distension, normal eating habits, no irritability, and no thirst. This indicates pathogens transmitting outward from the muscle layer. Resolution occurs either through the appearance of macules (ban zhen, peach-blossom macules, purple-cloud macules) or through sweating (spontaneous sweating, night sweats, manic sweating, battle sweating). These are natural manifestations of the disease qi and need not be overly debated; recovery is achieved when macules appear or sweat is released. Outward transmission is considered favorable and may resolve spontaneously without medication. Occasionally, if sweating is incomplete and fever persists, Bai Hu Tang (White Tiger Decoction) is appropriate; if macules are incomplete and fever persists, Ju Ban Tang (Raise Macules Decoction) is appropriate; if both macules and sweat occur concurrently for recovery, but macules are incomplete and sweating is insufficient with persistent fever, Bai Hu Tang combined with Ju Ban Tang is appropriate.

Occasionally, there is "in the exterior and again in the exterior." The emitted pathogens are not exhausted, and hidden pathogens remain in the Membrane Source. Two to three days or four to five days later, fever recurs with a surging and rapid pulse. Upon resolution, those with macules still have macules, and those with sweat still sweat, leading to recovery. Those not recovered are treated as before, though this is rare. Three times in the exterior is even rarer.

If "only in the interior and not the exterior," there are no external headaches or body pains, nor the three macules or four types of sweat. There is only epigastric stuffiness, a desire to vomit without success, and discomfort even after slight vomiting. This indicates pathogens transmitting to the upper interior. Gua Di San (Melon Sepal Powder) is appropriate to induce vomiting; as pathogens decrease with vomiting, the disease ends when pathogens are exhausted. For pathogens transmitting to the middle and lower interior, there is heart and abdominal distension, no vomiting, dry constipation, heat-binding with diarrhea, heat-collateral diarrhea, or intestinal glue-blockage. Cheng Qi class formulas (e.g., Da Cheng Qi Tang) are appropriate to guide out pathogens; as pathogens decrease, symptoms lessen, and the disease ends when pathogens are exhausted. If all three jiao are affected, vomiting is contraindicated as it is adverse treatment. Only Cheng Qi formulas should be used to guide pathogens downward; thus, upper pathogens flow down, vomiting stops immediately, and distension gradually resolves.

There is "in the interior and again in the interior." Two to three or four to five days after recovery, symptoms recur. Upper cases are still vomited, lower cases are still purged. Re-involvement of the interior is common; triple involvement is rare. Although divided into upper, middle, and lower, all are interior syndromes.

If "simultaneous exterior-interior transmission," initially pathogens hide in the Membrane Source, which is half-exterior half-interior. This transmission occurs because pathogens divide equally: half entering the interior presents interior symptoms, half exiting the exterior presents exterior symptoms. This is common in plague. However, with both exterior and interior affected and internal-external obstruction, sweating is impossible until Middle Qi reaches the exterior. Previously stagnated pathogens in the muscles erupt onto the skin surface, manifesting as macules or vomiting, following their nature to ascend and vent. When all symptoms cease but fever persists without exterior-interior signs, it indicates unexhausted pathogens in the Membrane Source. San Xiao Yin (Three Eliminations Drink) is appropriate for regulation.

If "simultaneous exterior-interior transmission and again simultaneous transmission," treating simultaneous exterior-interior illness with San Xiao Yin, followed by purgation and sweating as before, leads to recovery. This is common. Triple eruption is rare.

If "exterior predominates over interior," when Membrane Source latent pathogens erupt, more transmit to the exterior and fewer to the interior. How to treat? If exterior symptoms predominate and interior symptoms are few, treat the exterior primarily and address the interior secondarily; if interior symptoms predominate and exterior symptoms are few, treat the interior primarily, and the exterior will resolve spontaneously.

If "exterior first then interior," initially there are only exterior symptoms without interior symptoms. Da Yuan Yin is appropriate. If channel syndromes exist, add the Three Yang modifications. If channel symptoms are not obvious and only fever exists, do not add modifications. Subsequently, with a surging, rapid pulse, spontaneous sweating, and thirst, pathogens have left the Membrane Source but cannot exit the exterior. Bai Hu Tang is appropriate for acrid-cool dispersion; pathogens resolve via sweating, and the patient recovers with a calm pulse and cool body. Two to three or four to five days after recovery, if fever recurs, Da Yuan Yin is appropriate. Later, if chest/abdominal fullness, loss of appetite, irritability, thirst, and prickly tongue coating appear, add Rhubarb (Da Huang) for mild purgation. If lingering, upper cases use Gua Di San to vomit, lower cases use Cheng Qi Tang to guide out.

If "interior first then exterior," initially fever gradually becomes an interior syndrome. After purgation removes interior symptoms, fever returns within two to three days, accompanied by headache, body pain, and floating pulse. Bai Hu Tang is appropriate. If fever decreases slightly after purgation, and after three to four days, mental spirit is dull with a floating pulse, Bai Hu Tang is appropriate to induce sweating. If no sweat occurs after taking the decoction, it is due to exhaustion of fluids and essence; add Ginseng (Ren Shen), cover, and lie down to induce sweating. This resembles simultaneous exterior-interior transmission and is excluded here.

After severe purgation and profuse sweating, if all exterior-interior symptoms disappear, followed by whole-body pain, feeling beaten, inability to turn over, and bone cold/pain throughout, this is not an exterior syndrome. No treatment is needed; Yang Qi returns naturally within two to three days, and pain resolves.

When plague pathogens re-involve the exterior, re-involve the interior, or re-transmit simultaneously in exterior-interior, physicians who do not understand blame patients for poor regulation causing recurrence; patients who do not understand blame physicians for erroneous medication causing relapse. Both blame each other and err. They do not realize this is the inevitable course of the disease's momentum. Nature dictates that one cannot become two, nor two become one. It is neither physician nor patient fault. As long as the patient relies on solid spiritual essence, despite repeated recurrences, timely treatment leads to immediate recovery.

Occasionally, delay in treatment or incorrect methods lead to prolonged illness and exhaustion of spirit. Subsequent physicians may prescribe correctly, removing current pathogens and achieving effect. However, latent pathogens in the Membrane Source remain. Within one to two days, previous symptoms recur, accompanied by grasping at bedclothes, mental confusion, and fixed gaze. Patients blame subsequent physicians for killing them rather than blaming prior physicians for delays. This is lamentable!

At this stage, attacking depletes fragile Yuan Qi, seeking rapid death; tonifying intensifies pathogenic fire, drying essence; maintaining status quo allows Zheng Qi to fail against pathogens, leaving no hope for life.