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Taiyang disease (Disease of the Taiyang/Bladder channel) should present with aversion to cold and fever. Now, there is spontaneous sweating, and conversely, no aversion to cold or fever. The pulse at the Guan position (middle position on the radial artery) is fine and rapid. This is an error caused by the physician's use of emesis (vomiting therapy). If emesis is used on the first or second day of illness, the patient will feel hungry in the abdomen but unable to eat. If emesis is used on the third or fourth day, the patient will dislike congee, desire cold food, and vomit what was eaten in the morning by evening. This is also a consequence of the physician's misuse of emesis, constituting a minor adverse reaction (minor inversion).

In Taiyang disease, if emesis is used, since Taiyang disease should involve aversion to cold, the fact that there is now no aversion to cold and no desire for clothing indicates internal heat and vexation caused by emesis.

In Shaoyin disease (Disease of the Shaoyin/Kidney-Heart channel), food and drink are vomited upon entry, the heart feels nauseous and desirous of vomiting but cannot do so. At the onset, the hands and feet are cold, and the pulse is wiry and slow. This indicates excess in the chest; purgation (downward draining) is contraindicated. If there is cold fluid above the diaphragm causing dry retching, emesis is also contraindicated; warming treatment should be applied.

For all cases of Sini Jue (Four Reversals/Cold Extremities), emesis is contraindicated, and this applies equally to patients with deficiency conditions.

The general principle states: Emesis is suitable in spring.

When administering decoctions for emesis, stop as soon as the disease is addressed; it is not necessary to finish the entire dose.

If the symptoms resemble Guizhi Tang (Cinnamon Twig Decoction) pattern, but the head does not hurt and the neck is not stiff, and the Cun position (distal position on the radial artery) pulse is slightly floating, with obstruction and hardness in the chest, Qi rushing up to the throat causing breathing difficulty, this indicates cold in the chest, and emesis should be used.

For various excesses in the upper chest, with depression and pain in the chest, inability to eat, desire for someone to press on the chest, yet expectorating turbid saliva, accompanied by diarrhea more than ten times a day, where the pulse is surprisingly slow and the Cun position is slightly slippery, emesis can be used; after emesis, the diarrhea will stop.

In Shaoyin disease, where food and drink are vomited upon entry, the heart feels nauseous and desirous of vomiting but cannot do so, emesis should be performed immediately. For retained food in the upper Wan (upper stomach), emesis should be used.

If the patient has cold extremities, the pulse suddenly becomes tight, and pathogenic factors are knotted in the chest, with fullness and vexation below the heart, hunger but inability to eat, the disease is in the chest, and emesis should be used.

A pulse that is soft and weak, with weakness appearing at the Guan position and softness at the Dian (Cun/top) position, faintness above, and choppy below, indicates insufficient Yang Qi (faint pulse) and lack of Blood (choppy pulse). If Yang Qi is faint, wind-stroke causes sweating and conversely restlessness and vexation; choppy pulse indicates lack of Blood, leading to Jue (reversal/cold extremities) and cold. Faint Yang cannot be treated with purgation; purgation will result in Pi Jian (obstruction and hardness below the heart).

Moving Qi (pulsation) on the right prohibits purgation. Purgation will deplete body fluids, causing dry throat and nose, dizziness, and palpitations.

Moving Qi on the left prohibits purgation. Purgation will cause abdominal cramping, inability to eat, exacerbation of moving Qi, and although the body may have heat, the patient desires to curl up while lying down.

Moving Qi above prohibits purgation. Purgation will cause hot vexation in the palms, floating coldness of the body, spontaneous hot sweating, and a desire to pour water over oneself.

Moving Qi below prohibits purgation. Purgation will cause abdominal fullness, dizziness upon sudden rising, passage of undigested food after eating, and Pi Jian below the heart. Obstruction in the throat prohibits purgation. Purgation will lead to lightness above and heaviness below, inability to take fluids, desire to curl up when lying down, acute body pain, and diarrhea more than ten times a day.

All external excesses prohibit purgation. Purgation will induce slight fever, loss of pulse with Jue, and heat grasped around the navel.

All deficiencies prohibit purgation. Purgation will cause thirst; those who seek water recover easily, while those who reject water worsen.

Pulse is soft and weak, weakness at Guan, softness at Dian, wiry above, faint below. Wiry indicates Yang movement; faint indicates Yin cold. Upper excess and lower deficiency indicate a desire for warmth. Faint and wiry indicate deficiency; deficiency prohibits purgation. Faint pulse leads to coughing and expectoration of saliva. Purgation stops the cough but not the diarrhea, causing a sensation like insect bites in the chest, regurgitation of porridge, difficult urination, spasm of both costal regions, difficult breathing,牽引 (pulling) of neck and back, numbness of arms, extreme cold with sweating, body cold as ice, dull eyes, incessant speech, and "Chuzhong" (elimination of the middle/Stomach Qi exhaustion) where grain enters but is rejected. Although the mouth wants to speak, the tongue cannot move forward.

Pulse is soft and weak, weakness at Guan, softness at Dian, floating above, rapid below. Floating indicates Yang deficiency; rapid indicates lack of Blood. Floating indicates deficiency; rapid generates heat. Floating indicates deficiency, spontaneous sweating, and aversion to cold. Rapid indicates pain, trembling, and chills. Weakness at Guan causes urgency below the chest, wheezing, sweating, and dyspnea. Pain occurs in the hypochondrium during respiration. Chills and tremors interlock, resembling malaria. If the physician erroneously uses purgation, the pulse becomes urgent and rapid, fever ensues, madness with hallucinations occurs, Pi forms below the heart, urination becomes dribbling, the lower abdomen becomes very hard, and hematuria appears.

Pulse is soft and tight. Soft indicates faint Yang; tight indicates Cold in Ying (Nutritive) level. Faint Yang with Wei (Defensive) wind-stroke causes fever and aversion to cold. Tight Ying with cold Stomach Qi causes slight vomiting and internal vexation. If the physician mistakes this for great heat and uses muscle-relaxing sweating, Yang collapses with deficiency-induced vexation, bitter Pi below the heart, exhaustion of interior and exterior, dizziness upon rising, lingering heat in the skin, discomfort preventing sleep, unawareness of cold Stomach Qi, and tight Cold at Guanyuan (CV4). Techniques fail. Pouring water on the body makes lingering heat cease but causes severe chills. Covering with heavy blankets causes sweating with head cloudiness, trembling, difficult urination, and Cold triggered by water causing continuous passage of undigested food, evisceration, restlessness, slight reversal of hands and feet, cold body with internal vexation. Can delayed rescue retrieve this?

Pulse is floating and large. Floating indicates Qi excess; large indicates Blood deficiency. Blood deficiency means no Yin; solitary Yang descends alone into the Yin region, causing difficult urination and emptiness in the Bao (uterus/bladder). Now, conversely, urination is free and sweating is profuse. Normally, Wei should be slight; now it is excessive, fluids scatter in four directions, Ying exhausts, Blood finishes, dry vexation and insomnia occur, blood thins, flesh wastes, forming sudden fluid collapse. If the physician attacks the Stomach with toxic drugs, this is double deficiency. The departure of lingering Yang is imminent; death will come with stool like mud.

Fuyang (foot yangming) pulse slow and moderate indicates normal Stomach Qi. Fuyang pulse floating and rapid: floating injures Stomach, rapid disturbs Spleen. This is not the original disease but caused by the physician's purgation. Ying and Wei sink inward; the rapid pulse first becomes faint, so the pulse is only floating; the person becomes firm, belches, and feels relieved. Why? Spleen pulse is originally moderate; now rapid pulse moves the Spleen, its rapidity first becomes faint, indicating Spleen Qi dysfunction. Hard stool and belching relief, now pulse floats, rapidity becomes faint, pathogen remains alone. Heart feels hungry, pathogenic heat fails to digest grain, tidal fever and thirst occur. Rapid pulse should become moderate and slow. If pulse degrees remain as before, the patient feels hungry. Irregular rapid pulse generates malignant sores. Rapid pulse, if long-lasting without stopping, stopping implies pathogen knotting; Zheng Qi (Upright Qi) cannot recover. Zheng Qi retreats and knots in Zang organs, so pathogen floats, associating with skin and hair. Rapid pulse prohibits purgation; purgation causes vexation and unceasing diarrhea.

Shaoyin disease, faint pulse, prohibits sweating, due to lack of Yang. If Yang is already deficient and Chi (proximal) position is weak and choppy, purgation is also prohibited. Floating-large pulse should induce sweating; erroneous purgation is a major inversion.

Floating-large pulse with reverse Pi hardness below the heart, heat belonging to Zang, attacking it results in only slight sweating. Heat belonging to Fu (Organs) with frequent urination makes stool hard; much sweat leads to recovery, little sweat makes urination difficult. Slow pulse is not yet ready for attack. Two Yangs combined disease: when Taiyang is newly acquired, sweating is induced. Sweat comes out first but is not thorough, thus transferring to Yangming, desiring spontaneous sweating, no aversion to cold. If Taiyang syndrome is not resolved, purgation is prohibited; purgation is inversion. Jie Xiong (Chest Binding) syndrome, floating-large pulse, prohibits purgation; purgation leads to death. Taiyang and Yangming combined disease, wheezing and chest fullness, prohibits purgation. Taiyang and Shaoyin combined disease, Pi hardness below heart, stiff neck and dizziness, do not purge. All Sini Jue prohibit purgation; deficiency families likewise. Disease desiring vomiting prohibits purgation. Taiyang disease, exterior syndrome unresolved, prohibits purgation; purgation is inversion. Disease originating from Yang, reversed by purgation, heat enters, forming Jie Xiong. Disease originating from Yin, reversed by purgation, forms Pi. Pi with floating-hard pulse, purged, tight pulse enters interior, forming Pi. Diseases with much Yang have heat; purgation makes it hard. Original deficiency, attacking heat causes hiccups. No Yang, Yin strong and hard, purgation causes undigested food and abdominal fullness. Taiyin disease: abdominal fullness and vomiting, inability to eat, purgation worsens it, abdominal pain, lower chest binding hardness. Jueyin disease: Xiao Ke (Wasting-Thirst), Qi rushing up, heart pain and heat, hunger but no desire to eat, severe cases desire vomiting, purgation causes unceasing diarrhea. Shaoyin disease: food/drink vomited upon entry, heart nauseous desiring to vomit but cannot. Onset: cold hands/feet, wiry-slow pulse, chest excess, prohibits purgation. Shanghan 5-6 days, no Jie Xiong, soft abdomen, empty pulse, again Jue, prohibits purgation; purgation causes blood loss and death. Shanghan, fever, only headache, slight sweating. Sweating causes unconsciousness. Moxibustion/fumigation causes wheezing, inability to urinate, heart/abdominal fullness. Purgation causes shortness of breath, abdominal fullness, difficult urination, headache, stiff back. Warm needle causes epistaxis. Shanghan, Yin-Yang pulses both tight, aversion to cold and fever, pulse desires Jue. Jue means pulse starts large, gradually small, then gradually large. Severe aversion to cold,翕翕 (light) sweating, sore throat. Much heat: red eyes, dull vision, further sweating injures throat. Further purgation: eyes closed. Much cold: undigested food. Much heat: pus/blood in stool. Fumigation causes jaundice. Ironing causes dry throat. Free urination can be saved. Difficult cases are critical. Shanghan fever, bubbling Qi from mouth, headache, yellow eyes, uncontrollable epistaxis. Water-loving causes vomiting; water-hating causes Jue. Purgation causes ulcers in throat. If hands/feet warm, heaviness below with pus/blood stool. Headache/yellow eyes, purgation causes eye closure. Water-loving, purgation causes Jue pulse, humming voice, throat blockage. Sweating causes shivering, Yin-Yang dual deficiency. Water-hating, purgation causes interior cold, anorexia, undigested stool. Sweating causes mouth injury, slippery tongue coating, vexation. Rapid-excess pulse, no bowel movement 6-7 days, later blood in stool. Further sweating makes urination free.

Illness 2-3 days, weak pulse, no Taiyang or Chaihu signs, but vexation and hard lower chest. By day 4, able to eat, give Chengqi Tang (Mireful Pill Decoction) slightly to harmonize mildly, allowing slight peace. By day 6, give one Sheng of Chengqi Tang. No bowel movement 6-7 days, little urine: even if no BM, only hard head and loose tail, not yet definitively hard, attacking causes loose stool. Wait for free urination and definitive hardness before attacking. Zang Jie (Organ Knotting) has no Yang signs, cold not hot (Shanghan Lun says no alternating cold/heat), patient is quiet, slippery tongue coating prohibits attack. Shanghan with much vomiting, even with Yangming signs, prohibits attack.

Yangming disease, tidal fever, slightly hard stool, can give Chengqi Tang; if not hard, do not give. If no BM 6-7 days, fearing dry stool, method to know: give small amount of Xiao Chengqi Tang (Minor Mireful Pill Decoction). If gas turns in abdomen, this is dry stool, can attack. If no gas, only hard head/loose tail, do not attack; attacking causes abdominal fullness and anorexia. Desiring water causes hiccups. Later fever means stool becomes hard again, harmonize with Xiao Chengqi Tang. If no gas, strictly do not attack.

Yangming disease, whole body red color, prohibits attack. Must have fever and yellow color, indicating difficult urination.

Yangming disease, hard/full below the heart, prohibits attack. Attacking leads to unceasing diarrhea: death. If stops: recovery.

Yangming disease, spontaneous sweating, if sweated, urine free: this is interior exhaustion. Even if hard, do not attack. Wait for desire to defecate; use Honey Suppository (Mi Jian Dao) to guide. Or Melon Root (Tugua Gen) or Pig Bile can guide. Diarrhea, floating-large pulse: this is deficiency, caused by forced purgation. If pulse is floating-leather, with intestinal rumbling, belongs to Danggui Sini Tang (Angelica Decoction for Reversals).