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Six or seven days into the illness, if the pulses at the three positions (Cun, Guan, Chi) of both hands and feet are all palpable, and the patient experiences extreme restlessness (Fan), lockjaw (Jin Kou) preventing speech, and is agitated and disturbed, this indicates that the pathogen and healthy Qi are contending vigorously, and a resolution through sweating is imminent. Therefore, it is said: "Resolution is certain."

[Annotation] When the disease reaches six or seven days, if the pulses of the Yin and Yang channels of the hands and feet all become superficial (Fu), sudden extreme restlessness, lockjaw preventing speech, and agitation indicate that both the pathogen and healthy Qi are substantial, contending for victory to produce sweat. Thus, it is said: "Resolution is certain."

[Collected Commentaries] Cheng Wuji stated: The fact that the pulses at the three positions of the hands and feet are all present indicates strong healthy Qi. Although the pathogen is severe, resolution is certain.

If the pulse is harmonious, the patient is extremely restless, the eyelids are heavy and drooping, and the inner canthus appears yellow, this indicates impending resolution.

[Note] The character "Lian" should be "Jian". "Jian" refers to the eyelid margin. Writing it as "Lian" is incorrect.

[Annotation] If the pulse is harmonious but the patient is extremely restless, resolution cannot yet be predicted. If the patient has heavy, drooping eyelids, indicating a desire to close the eyes, this is a sign of Yin coming to nourish Yang. Yellowing of the inner canthus is a sign of the recovery of Stomach Qi. Therefore, it is said: "This indicates impending resolution."

Question: Regarding a diseased pulse, how can one determine if the disease will resolve? Answer: At the three positions—Cun Kou (Radial Artery at wrist), Guan (Middle position), and Chi (Distal position)—if the pulse characteristics of size, depth (Fu/Chen), rate (Chi/Shu), etc., are equal and balanced, even if symptoms of cold and heat have not resolved, this indicates that the Yin and Yang in the pulse have achieved harmony. Even if the condition is severe, it will likely resolve.

[Annotation] Disease arises from excessive pulse qualities; health arises from harmonious pulses. Now, if the pulses at the Cun, Guan, and Chi positions all show balanced characteristics of depth, rate, and size, this is an image of Yin-Yang harmony. Even with unresolved cold/heat symptoms, the disease will resolve despite severity.

[Collected Commentaries] *Nei Jing* states: When the Cun Kou and Ren Ying pulses correspond like a taut rope and are equal in size, the person is called "Ping Ren" (a healthy person).

Cheng Zhi stated: "Equal in size, depth, rate" means there is no discrepancy among the Three Parts and Nine Positions. Specifically, large but not excessively large, small but not excessively small, superficial but not excessively superficial, deep but not excessively deep, slow but not excessively slow, rapid but not excessively rapid. This represents a balanced and moderate image.

Illnesses presenting with fever and aversion to cold originate in the Yang (channels); illnesses presenting with aversion to cold but no fever originate in the Yin (channels). Those originating in Yang resolve in seven days; those originating in Yin resolve in six days, because the number associated with Yang is seven and with Yin is six.

[Annotation] Here, "illness" refers to Wind Strike (Zhong Feng) and Cold Damage (Shang Han). Those who have fever and aversion to cold from the onset are suffering from Wind Strike, originating in the Defensive Yang (Wei Yang). Those who have aversion to cold without fever from the onset are suffering from Cold Damage, originating in the Nutritive Yin (Ying Yin). Originating in Yang resolves in seven days; originating in Yin resolves in six days, because Yang corresponds to the number seven and Yin to the number six.

[Collected Commentaries] Fang Youzhi stated: This deduces the origin of Wind Strike and Cold Damage to summarize their conclusion. All Taiyang diseases involve aversion to cold. "Fa" means arising; "Yu" means healing.

Cheng Zhi stated: This distinguishes the reasons for fever and non-fever in Taiyang disease. Wind is Yang; Wei (Defensive) is also Yang. Cold is Yin; Ying (Nutritive) is also Yin. Both Wind Strike and Cold Damage are Exterior syndromes. However, when Wind enters Wei, the pathogen manifests in Yang causing heat; when Cold enters Ying, the pathogen manifests in Yin without immediate heat. Yang moves quickly, so recovery often takes one day longer than expected after passing through the stages; Yin moves slowly, so recovery often occurs one day earlier within the stages. Observing this clarifies the distinction between Wind and Cold.

Wei Litong stated: Wind injures Wei, Cold injures Ying. Since they are in the Taiyang stage, fever is inevitable, differing only in speed. Aversion to cold is the same. The meaning of "originating in Yang/Yin" merely refers to Wind being Yang and Wei being Yang, Cold being Yin and Ying being Yin; it does not extend to the Three Yin stages.

Question: For any illness, how can one know when it was contracted and when it will heal? Answer: If contracted at midnight (Zi hour), it will heal at noon (Wu hour). If contracted at noon, it will heal at midnight. Why? Noon contraction healing at midnight is because Yang obtains Yin to resolve. Midnight contraction healing at noon the next day is because Yin obtains Yang to resolve.

[Annotation] The origin of all illnesses lies in Yin and Yang pathology: either Yang overcoming Yin or Yin overcoming Yang. The resolution of all illnesses lies in Yin-Yang harmony: either Yang resolving via Yin or Yin resolving via Yang. "Yang resolving via Yin" refers to noon contraction healing at midnight. "Yin resolving via Yang" refers to midnight contraction healing at noon the next day.

[Collected Commentaries] Fang Youzhi stated: Noon and midnight are general approximations; other times can be inferred similarly.

In Taiyang disease, if headache persists for more than seven days and resolves spontaneously, it is because the pathogen has completed its course through the channels. If transmission to the next channel is anticipated, needling the Foot-Yangming channel prevents transmission and leads to healing.

[Annotation] In Taiyang disease, spontaneous resolution after more than seven days of headache occurs because the pathogen has exhausted its course through the channels. This means that after Taiyang receives the pathogen, it transmits through the channels for six days. By the seventh day, the pathogen has traversed the Three Yang and Three Yin channels, the disease qi declines, and the major pathogen departs. Without transmitting to the next stage, it resolves spontaneously. "Transmitting again" refers to transmission to the Yangming channel. If the pathogen has exhausted the current cycle but heat remains abundant, it may transfer to Yangming. Needling the Foot-Yangming channel drains the heat, preventing further transmission, leading to healing.

[Collected Commentaries] Fang Youzhi stated: "More than seven days" includes the six days.

Wei Litong stated: Fang Youzhi says needling arrests the pathogen; Yu Chang says needling exhausts the pathogen. Both terms imply draining. All needling aims to drain excessive Qi. Hence, previously mentioning needling Fengchi and Fengfu also aimed to drain violent wind pathogens. Since needling is a good strategy for treating heat, it discourages reckless use of Sweating, Purging, and Warming methods. Mentioning Foot-Yangming implies using stomach meridian points; this is only appropriate if there is a clear tendency for the pathogen to transmit to Yangming.

Min Zhiqing stated: Taiyang receiving the pathogen and transmitting sequentially until Jueyin is "exhausting the channel course." For diseases in any channel resolving after seven days, it is due to exhausting the channel course. There is a theory of re-transmission from Taiyang. If it truly transmitted through all six channels, Jueyin re-transmitting to Taiyang, then Taiyang re-transmitting to Yangming, why not needle Taiyang before Jueyin transmits to it, but wait until Yangming to needle Yangming? From this, we know Three Yin never re-transmits to Taiyang; it only transfers to Yangming.

For patients prone to wind disorders, if the exterior syndrome resolves but the patient still feels unwell ("Bu Liao Liao"), they will heal in twelve days.

[Annotation] "Feng Jia" refers to Taiyang Wind Strike. "Biao Jie" means the exterior syndrome has resolved after using Guizhi Tang. "Bu Liao Liao" means unclear or uncomfortable. Using Guizhi Tang resolves the exterior, but lingering discomfort indicates residual pathogen in the channels. At twelve days, when the channel course is complete, the residual pathogen clears, and natural healing occurs.

[Collected Commentaries] Wei Litong stated: This clause explains that after Taiyang Wind Strike resolves, if wind pathogen lingers causing discomfort, one should allow it to heal spontaneously.

Taiyang disease presenting with headache, fever, sweating, and aversion to wind is treated with Guizhi Tang. (Repeated text, likely an interpolation.) Guizhi Tang is primarily for releasing the muscle layer. If the patient has a floating-tight pulse, fever, and no sweating, it must not be given. Always keep this in mind to avoid errors.

[Annotation] Guizhi Tang is for releasing the muscle layer, treating Wind Strike with Exterior Deficiency. If the patient has a floating-tight pulse, fever, and no sweating, it is Cold Damage with Exterior Excess, and Guizhi Tang must not be given. Always remember this is a Mahuang Tang syndrome to avoid mistakenly giving Guizhi Tang.

[Collected Commentaries] Cheng Yingmao stated: The decision to give or not give lies in subtle distinctions. Errors often arise from haste. One must constantly compare the differences between Ying and Wei, ensuring Yin and Yang are consistent and Deficiency/Excess are clear. Not mistaking Guizhi Tang for Cold Damage with floating-tight pulse and no sweating prevents mistaking Mahuang Tang for Wind Strike with floating-slow pulse and spontaneous sweating.

If a chronic drinker ("Jiu Ke") is ill, Guizhi Tang must not be given. Doing so causes vomiting because drinkers dislike sweet flavors.

[Annotation] "Jiu Ke" refers to habitual drinkers. "Jiu Ke Bing" refers to illness caused by excessive drinking. Symptoms include headache, fever, sweating, and vomiting, caused by damp-heat steaming, not wind pathogen. Mistakenly giving Guizhi Tang causes vomiting because drinkers dislike sweet flavors.

[Collected Commentaries] Cheng Wuji stated: Drinkers have internal heat, preferring pungent flavors and disliking sweet ones. Guizhi Tang is sweet; drinkers taking it experience internal restlessness and vomiting.

Anyone who vomits after taking Guizhi Tang will subsequently vomit pus and blood.

[Annotation] For drinkers who vomit after Guizhi Tang, it is because pungent and sweet herbs promote heat and upward surging. If the patient has inherent excess internal heat and does not vomit immediately after taking Guizhi Tang, the heat increases, leading to subsequent vomiting of pus and blood. However, some do not vomit pus and blood, indicating mild injury and less intense heat.

[Collected Commentaries] Liu Hongbi stated: Guizhi has a thin flavor; prohibiting it for drinkers is an example to illustrate others. Unskilled doctors, misunderstanding this, remove Guizhi for patients with high heat but use other pungent-sweet-hot herbs without caution. Did Zhongjing foresee such stupidity? Just as postpartum women should avoid cold, citing Bai Shao's sour-cool nature as a warning, now people only remove Bai Shao but recklessly use bitter-cold herbs like San Huang. The Sage's words contain infinite wisdom. If thin-flavored herbs are prohibited, thick-flavored ones are certainly worse; if slightly cool herbs are forbidden, strongly cold ones are doubly warned against. Laypeople fail to generalize, acting rashly. Ancient medical texts require careful study to yield benefits!

In Taiyang disease, if sweating leads to continuous leakage ("Lou Bu Zhi"), accompanied by aversion to wind, difficulty urinating, slight stiffness of the four limbs making flexion and extension difficult, treat with Guizhi Jia Fuzi Tang.

[Annotation] In Taiyang Wind Strike, the proper treatment is releasing the muscle layer. If excessive sweating occurs like flowing water, leading to continuous leakage, the pores open widely, and Exterior Yang fails to secure, causing aversion to wind. Fluids are depleted internally, bladder fluids are scarce, causing difficulty urinating. Fluids are depleted externally, compounded by wind invasion, causing slight limb stiffness and difficulty moving. Treat with Guizhi Jia Fuzi Tang. Following Guizhi Tang administration methods solidifies Yang, retains fluids, harmonizes Ying and Wei, and releases wind pathogen.

[Collected Commentaries] Fang Youzhi stated: This is a complication of mistaken sweating in Taiyang Wind Strike. Difficulty urinating results from continuous sweating leading to loss of Yang and body fluids. Loss of Yang means Qi deficiency; loss of fluids means drying of water pathways. Urination is governed by the Bladder. The Bladder belongs to the Taiyang channel and governs Yang Qi. Qi deficiency leads to failure of transformation.

Cheng Zhi stated: This involves simultaneous loss of Yang Qi and Yin fluids, plus external wind invasion, distinct from Zhenwu Tang syndrome. Zhenwu Tang saves Interior Cold Yang collapse, urgently restoring Yang; Guizhi Jia Fuzi Tang saves Exterior Cold wind leakage, urgently warming the channels.

Guizhi Jia Fuzi Tang Formula
Add one Fuzi (Prepared Aconite Root) to the Guizhi Tang formula. Follow the rest of the Guizhi Tang preparation method.

[Collected Commentaries] Ke Qin stated: Adding Fuzi to Guizhi Tang greatly tonifies Exterior Yang. Securing Exterior Yang stops leaking sweat and aversion to wind. Stopping sweat restores fluids, leading to normal urination and flexible limbs. Continuous leaking sweat is similar to profuse sweating, but the pathological transformation differs. After profuse sweating from Guizhi/Mahuang Tang, if extreme restlessness and thirst occur, Yang has sunk inward, requiring urgent Yin rescue with Baitu Jia Renshen Tang. After sweating from Guizhi/Mahuang Tang, if leaking sweat occurs without restlessness/thirst, Yang has collapsed outward, requiring urgent Yang rescue with Guizhi Jia Fuzi Tang. Generally, improper use of Guizhi leads to Yang sinking inward; improper use of Mahuang leads to Yang collapsing outward. Since Guizhi Tang contains Shaoyao but lacks Mahuang, even with profuse sweating, the pores can self-close, rarely causing outward Yang collapse.

After taking Guizhi Tang, if profuse sweating occurs followed by extreme restlessness, unquenchable thirst, and a flooding-large pulse, treat with Baitu Jia Renshen Tang.

[Annotation] Extreme restlessness and thirst are Yangming syndromes. Flooding-large pulse is a Yangming pulse. If Wind Strike pathogen, after taking Guizhi Tang and profuse sweating, remains unresolved with extreme restlessness, thirst, and flooding-large pulse, the pathogen has entered Yangming. Body fluids are damaged by profuse sweating, causing dryness in the Stomach. Treat with Baitu Jia Renshen Tang to clear heat and generate fluids, resolving restlessness and thirst.

[Collected Commentaries] Zhang Lu stated: Baitu Tang clears internal steaming heat, not exterior channel heat. Some claim Gypsum's pungent-cool nature clears Yangming wind-heat, asking how it reaches the exterior without Mahuang or Ge Gen. This view is plausible but incorrect. Pathogens in the Yangming channel, even with high heat but no restlessness/thirst, are treated with Gegen Tang or Guizhi Jia Gegen Tang, not relying on Gypsum.

Baitu Jia Renshen Tang Formula (See Yangming Chapter)

In Taiyang disease, if three days pass and sweating fails to resolve the condition, presenting with steaming fever ("Zheng Zheng Fa Re"), it belongs to the Stomach. Treat with Tiaowei Chengqi Tang.

[Annotation] In Taiyang disease, if three days pass and sweating fails to resolve the condition, if there is intermittent fever with sweating that does not resolve, the Taiyang Exterior syndrome is not yet finished, and Guizhi Tang should harmonize it. Now, with steaming fever and sweating that does not resolve, it belongs to Yangming Interior disharmony, hence Tiaowei Chengqi Tang is used.

[Collected Commentaries] Cheng Yingmao stated: Taiyang disease at three days is early stage. Why does sweating failure lead to Stomach involvement? Because the Stomach is inherently dry. Even if other exterior symptoms cease, sweating and heat persist. Observing the heat rising like steam from a cooking basket indicates continuous sweating, which is a sign of hardened stool, thus "belongs to Stomach." Although heat gathers in the Stomach, without tidal fever or delirium, Tiaowei Chengqi Tang is used. Within purgation methods, this treats from the middle because the duration is short.

Wang Hu stated: Taiyang disease should not be judged solely by days. If Stomach signs appear, purgation is indicated. After three days and prior sweating, heat rises from within. It is not unresolved exterior pathogen, but Taiyang pathogen transferring to the Stomach, making disease heat unrecoverable.

Tiaowei Chengqi Tang Formula (See Yangming Chapter)

In Taiyang disease, after sweating, if profuse sweating occurs causing dryness in the Stomach, restlessness, insomnia, and desire for water, give small amounts of water frequently. If Stomach Qi harmonizes, the patient heals. If the pulse is floating, urination is difficult, there is slight fever, and polydipsia ("Xiao Ke"), treat with Wuling San.

[Annotation] In Taiyang disease, after sweating or profuse sweating, internal exhaustion of body fluids causes Stomach dryness, restlessness, insomnia, and thirst. Give small amounts of water frequently to moisten Stomach dryness and harmonize Stomach Qi for healing. If Stomach Qi remains unharmonized despite drinking, and the patient presents with floating pulse, difficulty urinating, slight fever, and polydipsia, the Taiyang exterior pathogen has not resolved, and fluid retention has formed in the Bladder interior. The Classic states: "The Bladder is the mansion of body fluids; Qi transformation allows excretion." Heat scorches existing fluids, drinking fails to transform, new fluids are cut off, fluid depletion prompts self-rescue via drinking, so water is consumed immediately, and thirst persists. Wuling San is used to release exterior heat externally and transport water internally, promoting Qi transformation, generating fluids, stopping heat/thirst, and facilitating urination.

[Collected Commentaries] Zhang Jianshan stated: Baitu treats interior heat/restlessness after exterior resolution. Here, floating pulse, slight fever, and thirst indicate incomplete exterior resolution, hence Wuling San. Guizhi's pungency disperses to harmonize the muscle layer and relieve slight fever. Atractylodes, Alisma, and Poria's bland leaching transforms water, generates fluids, and stops dry thirst.

Yu Chang stated: Floating pulse suggests Guizhi, why change to Wuling San? Heat combined with water reduces significantly, leaving slight heat and difficulty urinating. Polydipsia indicates fluid retention syndrome. Thus, dual resolution is chosen over single resolution. Drinking much with little urination is called "Xiao Ke". With interior heat and abundant fluid retention, Guizhi alone cannot release the muscle layer; diuresis is added. Only Wuling San achieves full effect.

Cheng Yingmao stated: Compare "slight fever" here with "fever" in the next clause. Fever in the exterior indicates shallow involvement, where heat accumulates and repels water. Slight fever here indicates deep exterior heat affecting the interior, where heat binds and consumes fluids. Thus, treatment with water vs. Wuling San differs, as does the indication for Wuling San in previous vs. later contexts.

Wind Strike with fever, unresolved for six or seven days with restlessness, presenting with both exterior and interior signs. Thirst for water, but vomiting upon ingestion, is named "Water Reversal" (Shui Ni). Treat with Wuling San.

[Annotation] Wind Strike fever, unresolved for six/seven days with restlessness, indicates exterior syndrome. Thirst for water with vomiting upon ingestion indicates interior syndrome. If thirst resolves immediately upon drinking (as in Stomach dryness), small frequent sips harmonize the Stomach. Now, thirst persists, water is not absorbed, reverses upward, and vomits, named "Water Reversal". The cause is pathogenic heat entering the interior, combing with retained fluid, disrupting Sanjiao steaming/transformation, failing to regulate water passages to the Bladder. Heat and fluid clash above, water has no exit below, causing vomiting upon ingestion. Urination is definitely difficult. Use Wuling San's pungent-sweet-bland-leaching properties to release exterior and drain interior. Drink warm water frequently to induce sweating and promote urination, resolving both exterior and interior.

[Collected Commentaries] Fang Youzhi stated: Wind Strike fever involves spontaneous sweating. Unresolved for six/seven days with restlessness indicates excessive sweating depletes fluids, causing internal dryness. "Exterior" refers to unresoved symptoms; "Interior" refers to restlessness/thirst involving the Fu organs. Thirst indicates severe dryness seeking relief. Vomiting upon ingestion indicates latent fluid retention obstructing entry. Fluid is water; adding water to water causes overflow and rejection, hence "Water Reversal". Wuling San resolves both exterior and interior; sweating leads to healing.

Yu Chang stated: Wind strike naturally involves sweating. Prolonged lack of muscle-releasing treatment causes excessive sweating, damaging fluids without resolving the exterior, increasing restlessness/thirst. Pathogen enters Fu organs, causing vomiting upon drinking, named "Water Reversal". Heat pathogen carries accumulated fluid upward, rejecting external water. Taking Wuling San with hot soup induces sweating, resolving both exterior and interior simultaneously.

Wuling San Formula
Zhu Ling (Poria with Hosta Stem, remove black skin, 18 zhu)
Fu Ling (Poria, 18 zhu)
Ze Xie (Alisma Rhizome, 1 liang, 6 zhu)
Bai Zhu (Atractylodes Macrocephala Rhizome, 18 zhu)
Gui (Cinnamon Twig, half liang)
Grind these five herbs into powder, pound in a mortar, mix with rice water, take one cun-bi dose. Take three times daily. Drink plenty of warm water until sweating occurs for healing.

[Formula Analysis] This formula addresses Taiyang pathogenic heat entering the Fu organs and failure of water Qi transformation, acting on both the exterior and interior of the Bladder. It treats Water Reversal (vomiting upon drinking) and Xiao Ke (drinking leads to consumption). The Bladder is the mansion of body fluids; Qi transformation allows excretion. Pathogenic heat enters, combining with water to form pathology. If water exceeds heat, water stagnates and fails to transform, accumulating above, causing vomiting upon drinking due to failed Bladder Qi transformation and absent urination. If heat exceeds water, water is scorched by heat, depleted above, causing consumption upon drinking due to Bladder fluid exhaustion and absent urination. Two...