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The Heart governs the Shen (Spirit); when the Heart is tranquil, the Shen is clear and bright. If the Heart is scorched by fierce fire, the Shen becomes unclear, which gives rise to delirious speech (confused talking due to mental disorder).

The body's Yin Qi relies on the Stomach for nourishment. When Stomach Fire rushes upward, the Fire of the Liver and Gallbladder follows to assist it. Consequently, the Qi of Lung Metal cannot descend but instead rushes up along the clear pathways to the throat, resulting in hiccups accompanied by sound.

When pathogenic factors invade the Stomach, vomiting occurs; the toxin may be expelled through vomiting. However, if only dry heaving occurs, the condition is severe. This is fundamentally due to latent toxins within, making the clearing of Stomach Heat urgent.

When plague toxins shift to the Large Intestine, there is tenesmus (urgent need to defecate with a feeling of incomplete evacuation), mixed red and white discharge, or passage of foul-smelling filth or purple blood. The patient must experience aversion to cold and fever, with short, scanty urine. This indicates heat stagnation in the Large Intestine; one should only employ methods to clear heat and promote urination, after which the dysentery will cease. Misusing purgatives or astringents will lead to untreatable conditions.

When toxic fire pours into the Large Intestine, some pass foul filth, some pass clear water, some suffer from profuse direct diarrhea, and some pass undigested food. This is because pathogenic heat fails to digest food properly, not due to Spleen deficiency; it is slightly milder than cases resembling dysentery. Examining the symptoms: the body must be highly febrile, the breath vigorous, urine short, lips charred and purple, extreme thirst with preference for cold drinks, occasional coldness of the four limbs, and unceasing abdominal pain. This is heat pouring into the Large Intestine; by following the pathological trend to clear heat and promote drainage, the diarrhea will stop.

The Large Intestine is the official organ of transmission. It is easy to make it flow freely but difficult to make it obstructed. In miscellaneous diseases presenting this way, treatments include tonification or purging. However, in epidemic diseases, constipation arises because toxic fire has boiled away fluids, causing the Large Intestine to become dry and unable to lubricate downward. Misusing purgatives here accelerates death.

When pathogens invade the five Zang organs, the meridians of the three Yin channels become disharmonious, blood stagnates, and infiltrates the Large Intestine, causing blood to exit via stool.

Astringent, red urine also belongs to extreme heat in the Bladder. Moreover, if it is short and contracted, with a color like oil! This is because heat-toxin pours downward and knots in the Bladder.

Hematuria (blood in urine) implies the lower abdomen must be distended and painful. As for bleeding without pain, this is the Heart transferring heat to the Small Intestine, so blood flows from the urethra.

Frenzied, violent, and aggressive behavior, cursing without regard for kinship or distance, even climbing high places to sing, discarding clothes to run, leaping over walls and roofs—actions beyond ordinary capability—speaking of things never done or seen in one's life, as if possessed by evil spirits. This is Yangming pathogenic heat disturbing the Shen (Spirit); the patient is unaware of their own actions. Many resort to burning incense, exorcising ghosts, or taking talismans to drive out evil, which is laughable.