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[Collected Commentaries] Fang Youzhi stated: All conditions in the Taiyang (Greater Yang) stage are exterior syndromes. If purgation is mistakenly applied, various transformation syndromes will emerge and cannot be restricted to a single treatment approach.
Cheng Zhi stated: When purgation is used inappropriately, the number of resulting transformations is countless; this is what is meant. The current symptoms of sore throat, hypochondriac stiffness, and desire to vomit are transformations caused by cold pathogen entering the interior. Headache, fever, diarrhea, and bloody stool are transformations caused by wind pathogen entering the interior. The reason for this is that floating (Fu), slippery (Hua), and rapid (Shuo) pulses belong to Yang, while deep (Chen), wiry (Xian), tight (Jin), and fine (Xi) pulses belong to Yin.
Cheng Yingmao stated: Based on the pulse and symptoms, the use of the word "must" (Bi) indicates the inevitability of the condition's progression. Tracing back to the source, it all stems from the Taiyang disease being treated with purgation. Therefore, although there is a distinction between established and unestablished Huai Bing (complicated diseases), one should employ flexible treatment methods and not treat merely based on the pulse or symptoms alone.

In Taiyang disease, after two or three days, if the patient cannot lie down but desires to sit up, there must be stagnation in the epigastrium (Xin Xia). If the pulse is weak and faint (Wei Ruo), this indicates the patient originally had cold-fluid retention. If purgation is mistakenly applied, and the diarrhea stops, Jie Xiong (Chest Binding) will inevitably develop; if the diarrhea does not stop, and upon the fourth day the diarrhea recurs, this is called Xie Re Li (Collaborating Heat Diarrhea).
[Note] In the phrase "on the fourth day, purge again," the character "Zhi" (之) should be "Li" (利/Diarrhea). Since the text previously stated that the diarrhea had not stopped, how could there be a rationale for purging again? Careful study will reveal this is likely a transcription error.

[Annotation] Taiyang disease refers to headache, stiff neck, and aversion to cold. The appearance of inability to lie down and desire to sit up within two or three days indicates transmission to the Yangming (Bright Yang) stage. "Xin Xia" refers to the stomach region. "Must stagnate" means there must be obstruction in the stomach region. If the pulse is solid and large, it indicates heat causing stagnation in the stomach, which requires purgation. Now, since the pulse is weak and faint, it indicates cold causing stagnation in the stomach; according to principles, purgation is contraindicated. Applying purgation when it is contraindicated is termed "reverse purgation." At two or three days, the proper course is to resolve the exterior of Taiyang and Yangming. Mistakenly applying purgation allows exterior heat to enter the interior due to deficiency, inevitably causing spontaneous diarrhea. If the diarrhea stops spontaneously, it implies the pathogen has entered the stomach and combined with dryness to transform into heat, leading to Jie Xiong. Now, since the diarrhea has not stopped, and recurs on the fourth day, it indicates stomach deficiency combining with dampness to transform, thus inevitably leading to Xie Re Li.

[Collected Commentaries] Cheng Zhi stated: This illustrates that mistaken purgation of an exterior syndrome can lead to transformations such as Jie Xiong and Heat Diarrhea; caution is essential. Since the pulse is weak and faint, it is cold stagnation in the epigastrium, and the method should be warming and dispersing. The physician, seeing epigastric stagnation, used purgation to induce diarrhea, which is contrary to the correct treatment.
Wang Hu stated: In Taiyang disease, after two or three days, inability to lie down and desire to sit up, with epigastric heat stagnation, seems amenable to purgation. However, the pulse is weak and faint, indicating the patient originally harbored cold; how can purgation be used?

In Taiyang disease, if the exterior syndrome remains unresolved and purgation is applied repeatedly, it leads to Xie Re Li (Collaborating Heat Diarrhea); if diarrhea persists incessantly, accompanied by epigastric fullness and hardness, with both exterior and interior unresolved, Gui Zhi Ren Shen Tang (Cinnamon Twig and Ginseng Decoction) is indicated.
[Annotation] This elaborates on the previous case of weak pulse and Xie Re Li to clarify the treatment. "Exterior syndrome unresolved" means Taiyang disease is not resolved. "Repeated purgation" implies more than one instance. Due to repeated purgation, the interior becomes deficient, collaborating with exterior heat to cause diarrhea; incessant diarrhea indicates interior deficiency failing to secure. Epigastric fullness and hardness indicate interior deficiency with pathogenic binding. Since the exterior syndrome is unresolved, the exterior is not released; therefore, Gui Zhi (Cinnamon Twig) is used to release the exterior. The diarrhea and epigastric hardness indicate the interior, due to deficiency from purgation, transforms toward cold; the pulse would be weak and faint as described earlier. Thus, Ren Shen (Ginseng), Bai Zhu (Atractylodes Macrocephala Rhizome), Gan Jiang (Dried Ginger), and Gan Cao (Licorice Root) are used to warm the interior. This is a method of warming and tonifying while simultaneously resolving the exterior and interior. If the pulse were forceful, the method of Gan Cao Xie Xin Tang (Licorice Decoction to Drain the Epigastrium) would be appropriate.

[Collected Commentaries] Yu Chang stated: Mistaken purgation causes interior deficiency, allowing exterior heat to invade, resulting in incessant diarrhea due to interior failure to maintain. Fullness and hardness result from righteous Qi deficiency and pathogenic excess, creating obstruction in the middle Jiao (Middle Burner), leading to blockage. Because the exterior is unresolved, Gui Zhi is used to release it. Because the interior is recently deficient, Li Zhong Tang (Regulate the Middle Decoction) is used to harmonize. This formula is essentially Li Zhong Tang plus Gui Zhi with a changed name, serving as a method for treating deficiency-type epigastric fullness and diarrhea.
Li Zhongzi stated: The classic states that if a Gui Zhi Tang syndrome is mistakenly purged, leading to incessant diarrhea, Ge Gen Huang Qin Huang Lian Tang (Kudzu Root, Scutellaria, and Coptis Decoction) is given. Here, Gui Zhi Ren Shen Tang is given instead. Why the difference in warming versus cooling herbs? The former case only says "purged," whereas this case says "repeatedly purged"; the former says "diarrhea," whereas this says "incessant diarrhea." Comparing the two contexts reveals the distinction between deficiency and excess.
Cheng Zhi stated: For exterior syndrome mistakenly purged, if diarrhea is incessant with wheezing and sweating, Ge Gen, Huang Qin, and Huang Lian are used. If epigastric fullness and hardness occur, Gui Zhi, Ren Shen, and Bai Zhu are used. One rescues excess heat from exterior pathogen entering the interior; the other rescues deficiency-cold from exterior pathogen entering the interior. Both are methods of simultaneous exterior-interior resolution.
Cheng Yingmao stated: Xie Re Li has traditionally been interpreted as Yang pathogen sinking into the Lower Jiao. If true, how could Li Zhong Tang be used? This arises from not understanding that diarrhea has both cold and heat patterns.

Gui Zhi Ren Shen Tang Formula
Gui Zhi (Cinnamon Twig) - 4 liang
Zhi Gan Cao (Honey-fried Licorice Root) - 4 liang
Bai Zhu (Atractylodes Macrocephala Rhizome) - 3 liang
Ren Shen (Ginseng Root) - 3 liang
Gan Jiang (Dried Ginger) - 3 liang
These five ingredients are decocted in 9 sheng of water. First, boil the first four ingredients to obtain 5 sheng. Add Gui Zhi and boil further to obtain 3 sheng. Strain. Take 1 sheng warm. Administer twice daily and once at night.

In Taiyang disease presenting with Gui Zhi Tang syndrome, if the physician mistakenly applies purgation, leading to incessant diarrhea: if the pulse is Cun Cu (Rapid/Agitated), the exterior is unresolved. If there is wheezing and sweating, Ge Gen Huang Qin Huang Lian Tang (Kudzu Root, Scutellaria, and Coptis Decoction) is indicated.
[Annotation] This continues the discussion on Xie Re Li, specifically addressing the Cun Cu pulse to differentiate treatment. In Taiyang disease with Gui Zhi Tang syndrome, Gui Zhi Tang should be used to release the muscle layer. Mistaken purgation leads to incessant diarrhea because the exterior heat sinks into the interior due to the error. If the exterior is unresolved and the pulse is slow and weak, even with diarrhea and wheezing (interior signs), the method should follow Gui Zhi Ren Shen Tang for diarrhea, or Gui Zhi Jia Hou Po Xing Zi Tang (Cinnamon Twig Decoction Augmented with Magnolia Bark and Apricot Kernel) for wheezing. Now, with incessant diarrhea, a forceful Cun Cu pulse, sweating, and wheezing, although the exterior is unresolved, the absence of aversion to cold indicates heat has sunk into Yangming. Even if Gui Zhi Tang signs exist, Ge Gen Huang Qin Huang Lian Tang is the primary indication. The formula uses Ge Gen (Kudzu Root) in quadruple dose as the sovereign herb, with Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome), and Gan Cao as ministers. Its intent is to specifically resolve the Yangming muscle layer and clear interior stomach heat. This is a method of clearing and resolving while simultaneously addressing exterior and interior. If the pulse were deep-slow or weak/faint, indicating interior cold and deficiency, Li Zhong Tang plus Gui Zhi would be used. From this, we understand that in the previous case of Xie Re Li with incessant diarrhea, epigastric fullness/hardness, and unresolved exterior-interior, if the pulse were not weak/faint, it would necessarily be deep-slow.
[Note] The two cases of Xie Re Li are distinguished by the yin/yang nature of the pulse to determine deficiency/excess, making the treatment correct. However, one must distinguish whether the diarrhea involves sticky/foul stool or duck-like loose stool, whether urine is white or red, and whether the pulse is forceful or weak.

[Collected Commentaries] Cheng Wuji stated: "Sweating and wheezing" refers to spontaneous sweating followed by wheezing, caused by strong pathogenic qi on the exterior. "Wheezing with sweating" refers to sweating resulting from wheezing, caused by interior heat qi rebelling upward. Therefore, Ge Gen Huang Qin Huang Lian Tang is given to scatter exterior pathogen and remove interior heat.
Fang Youzhi stated: The diarrhea is the same as the previous case. The previous case used Li Zhong Tang because fullness/hardness and weak pulse indicated cold. This case uses Huang Qin and Huang Lian because wheezing, sweating, and Cun Cu pulse indicated heat.
Yu Chang stated: Taiyang disease originally has no indication for purgation; Gui Zhi Tang should be used to release the exterior. Mistaken purgation causes heat pathogen in Taiyang to enter the interior of Yangming before reaching its exterior. Hence, the pulse is rapid/agitated, sweat escapes outward, heat rushes upward causing wheezing, and downward causing diarrhea. Thus, Gui Zhi is abandoned for Ge Gen to focus on Yangming exterior, and Huang Qin/Huang Lian are added to clear interior heat. Wheezing and diarrhea cease without direct treatment. This is another variable method for simultaneous resolution of Taiyang and Yangming exterior-interior.
Wang Hu stated: Mistaken purgation empties the intestines and stomach, allowing heat pathogen to invade, causing incessant diarrhea. This is not true gastrointestinal deficiency, but rather stomach heat flowing downward into the intestines to cause diarrhea. Cun Cu pulse means the pulse is rapid with occasional pauses; this is a pulse of exclusive Yang excess. A Cun Cu pulse in a Yang context indicates the exterior is unresolved; here, the "exterior" refers to Yangming channel disease, not the Taiyang Gui Zhi exterior syndrome. Wheezing and sweating are caused by interior heat qi rebelling in the Yangming stomach organ, not by Taiyang wind pathogen congestion nor the sweating of Gui Zhi Tang syndrome. Therefore, one must resolve Yangming exterior pathogen and clear Yangming stomach interior heat.

Ge Gen Huang Qin Huang Lian Tang Formula
Ge Gen (Kudzu Root) - 8 liang
Huang Qin (Scutellaria Root) - 3 liang
Huang Lian (Coptis Rhizome) - 3 liang
Zhi Gan Cao (Honey-fried Licorice Root) - 2 liang
These four ingredients are decocted in 8 sheng of water. First, boil Ge Gen until reduced by 2 sheng. Add the remaining herbs and boil to obtain 2 sheng. Strain. Divide into two warm doses.

[Collected Explanations] Ke Qin stated: Exterior heat unresolved means exterior is not released; incessant diarrhea means interior is not harmonized. Mistaken purgation causing diarrhea shares the same etiology. One case has weak pulse and epigastric fullness/hardness, indicating insufficient pulse but excessive symptoms; the other has Cun Cu pulse with wheezing and spontaneous sweating, indicating excessive pulse but insufficient symptoms. Exterior-interior and deficiency-excess must be differentiated by the pulse. Especially since a weak pulse appears after repeated purgation, epigastric fullness/hardness is clearly deficiency. Therefore, Li Zhong Tang's acrid-sweet-warm tonification is used to stop diarrhea and resolve fullness/hardness, plus Gui Zhi to release the exterior. Boiling the first four ingredients first, then adding Gui Zhi, provides rich harmonizing power and sharp muscle-releasing energy, embodying a flexible method within dual resolution. Gui Zhi syndrome normally has a slow pulse; after mistaken purgation, the pulse becomes Cun Cu, indicating internal Yang excess and pathogen steaming outward, causing sweating. Violent heat internally and fire rebelling upward causes wheezing. Violent rushing downward causes diarrhea. Thus, Ge Gen, light and ascending, is used as sovereign to release muscle and stop diarrhea; Huang Qin and Huang Lian, bitter-cold and purifying, are used as ministers to stop sweating and calm wheezing; Gan Cao is added to harmonize the middle. Boiling Ge Gen first, then adding other herbs, ensures pure muscle-releasing power and sharp interior-clearing energy, differing from methods that tonify the middle to expel pathogen.

After Taiyang disease is treated with purgation, if the pulse is Cun Cu and there is chest fullness, Gui Zhi Qu Shao Yao Tang (Cinnamon Twig Decoction without Paeonia) is indicated. If there is slight aversion to cold, remove Shao Yao and add Fu Zi to the formula, using Gui Zhi Qu Shao Yao Jia Fu Zi Tang (Cinnamon Twig Decoction without Paeonia plus Aconite).
[Note] "If there is slight aversion to cold" should ideally include "sweating." Without "sweating," it indicates unresolved exterior, and adding Fu Zi is unnecessary.
[Annotation] In Taiyang disease, if the exterior is unresolved and purgation is applied, excess in the chest leads to pathogen sinking, causing chest fullness and Qi rushing to the throat preventing breathing; this is Gua Di San (Melon Spore Powder) syndrome. Deficiency in the chest leads to pathogen sinking, causing Qi rushing upward; this is Gui Zhi Tang syndrome. Now, after purgation, pathogen sinks into the chest, causing fullness and Cun Cu pulse. It seems like chest excess but lacks throat-rushing/breathing-prevention symptoms; it seems like chest deficiency yet presents chest fullness. Therefore, Gua Di San is not used for excess, nor Gui Zhi Tang for deficiency. Instead, the sweet-acrid nature of Gui Zhi is used to harmonize the Taiyang exterior, and Shao Yao (Paeonia Root) is removed to avoid its sour-astringent property aggravating chest fullness. If there is sweating with slight aversion to cold, removing Shao Yao and adding Fu Zi prevents the transformation of Yang collapse.
[Note] The previous case had Cun Cu pulse, wheezing, sweating, no aversion to cold, and incessant diarrhea, classified as excess-heat. This case has Cun Cu pulse, chest fullness, sweating, slight aversion to cold, no wheezing, no diarrhea, yet is classified as deficiency-cold. Why? The previous case involved sweat from interior heat steaming outward, hence no aversion to cold, representing Yang excess; wheezing and diarrhea were heat. This case involves sweat from exterior Yang insecurity, hence slight aversion to cold, representing Yang deficiency; even without wheezing/diarrhea, it is cold. One must know that Zhang Zhongjing’s laws often distinguish at minute levels to prevent oversight. Here, "slight aversion to cold" reveals the principle. Differentiation of cold/heat is not based on "sweating" alone, but on "sweating with/without aversion to cold"; not on "Cun Cu pulse" alone, but on "forceful/weak Cun Cu pulse." Furthermore, differentiation of deficiency/excess in chest fullness depends on whether it is constant/full-unrelenting versus intermittent.

[Collected Commentaries] Yu Chang stated: Observing "slight aversion to cold" in this case alongside the previous one reveals that within the mechanisms of Cun Cu pulse, chest fullness, wheezing, and sweating, there lies a latent tendency for deficient Yang to collapse. Thus, Zhang Zhongjing specifically uses "slight aversion to cold" to highlight this. It shows that Yang deficiency causes aversion to cold; conversely, aversion to cold without sweating is not Yang deficiency.
Cheng Yingmao stated: There are Cun Cu pulses caused by Yang excess and those caused by Yang deficiency. They must be differentiated by forcefulness/weakness and correlated with external symptoms.
Shen Mingzong stated: Mistaken purgation disturbs Yin-Yang Qi, causing Cun Cu pulse. Pathogen enters the chest-diaphragm, nearly forming Jie Xiong, but only fullness exists without pain. Thus, Gui Zhi Tang is used to lift pathogen from the chest-diaphragm for exterior resolution. Shao Yao is removed because its sour-astringency might draw pathogen inward. If Cun Cu pulse, chest fullness, and slight aversion to cold coexist, it indicates deficiency with Yang about to collapse, distinct from Yang excess. Hence, Fu Zi is added to secure True Yang. Note that aversion to cold after mistaken purgation for wind-stroke differs significantly from aversion to cold before purgation. Similarly, aversion to cold after sweating differs from that before sweating.

Gui Zhi Qu Shao Yao Tang Formula
Take Gui Zhi Tang and remove Shao Yao. Follow the previous method for preparation and administration.

Gui Zhi Qu Shao Yao Jia Fu Zi Tang Formula
Take Gui Zhi Tang, remove Shao Yao, add one Fu Zi (Aconite Lateralis Radix Praeparata), prepared, peeled, broken into eight pieces. Follow the previous method.

After Taiyang disease is treated with purgation, if there is slight wheezing, it is because the exterior is unresolved; Gui Zhi Jia Hou Po Xing Zi Tang (Cinnamon Twig Decoction Augmented with Magnolia Bark and Apricot Kernel) is indicated. For patients with chronic asthma who develop symptoms, Gui Zhi Tang augmented with Hou Po and Xing Zi is preferable.
[Annotation] Taiyang disease requires sweating; mistaken purgation leading to diarrhea, Cun Cu pulse, wheezing, sweating, and no aversion to cold indicates pathogen sinking into the interior, heat in Yangming, which is Ge Gen Huang Qin Huang Lian Tang syndrome. Now, Taiyang disease requiring sweating is mistakenly purged, resulting in no diarrhea but slight wheezing. This indicates pathogen sinking into the chest, not reaching the stomach, with the exterior still unresolved. Therefore, Gui Zhi Tang is used to release the muscle-exterior, augmented with Hou Po (Magnolia Bark) and Xing Zi (Apricot Kernel) to descend rebellious Qi and calm wheezing. "Chuan Jia" (Asthma Family) refers to individuals with a history of asthma. For those with wind-stroke triggering asthma, Gui Zhi Tang is suitable, especially when augmented with Hou Po and Xing Zi.

[Collected Commentaries] Fang Youzhi stated: Wheezing is Qi rebelling upward, causing difficult respiration and abnormal breath sounds. "Slight" means breath sounds are slow, unlike the urgency of severe wheezing. Since the exterior remains, failing to resolve the exterior means wheezing cannot settle. Thus, Gui Zhi releases the exterior, Hou Po moves Qi, and Xing Zi descends Qi; these are key herbs for calming wheezing.
Yu Chang stated: This outlines the major treatment principle for wind-pathogen mistaken purgation causing wheezing. For cold-pathogen mistaken purgation causing wheezing, Ma Huang, Xing Zi, Shi Gao, and Gan Cao (Ma Xing Shi Gan Tang) should be used; this can be inferred. Also, slight wheezing with unresolved exterior indicates exterior pathogen rebelling upward due to mistaken purgation, distinct from deficiency syndromes.
Cheng Yingmao stated: Wheezing has both exterior and interior aspects; differentiation is crucial. Post-purgation sweating and wheezing with severe wheezing belongs to interior heat congestion and fire rebellion. Post-purgation slight wheezing with minimal sweating belongs to exterior pathogen constriction and Qi rebellion; Gui Zhi Tang is still used to release the exterior, augmented with Hou Po and Xing Zi to descend rebellious Qi.
Wei Litong stated: Patients with pre-existing asthma will inevitably wheeze upon contracting external pathogens, hence the term "Chuan Jia."

Gui Zhi Jia Hou Po Xing Zi Tang Formula
To Gui Zhi Tang, add Hou Po (2 liang) and Xing Zi (50 seeds). Follow the Gui Zhi Tang method.

[Note] Dai Yuanli stated: Taiyang disease may present with wheezing/cough. For non-sweating wheezing, Ma Xing Shi Gan Tang is appropriate; for sweating wheezing, Gui Zhi Jia Hou Po Xing Zi Tang is appropriate; for non-sweating cough, Xiao Qing Long Tang is appropriate. Shaoyang disease has cough but no wheezing; for cough, Xiao Chai Hu Tang plus Wu Wei Zi and Gan Jiang is appropriate. Yangming disease has wheezing but no cough; for interior excess wheezing, Da Cheng Qi Tang is appropriate; for diarrhea, Ge Gen Huang Qin Huang Lian Tang is appropriate. Among the Three Yin stages, only Shaoyin presents with wheezing/cough. For wheezing, Si Ni Tang plus Wu Wei Zi and Gan Jiang is appropriate; for cough due to Yin pathogen diarrhea, Zhen Wu Tang plus Wu Wei Zi and Gan Jiang is appropriate; for Yang pathogen diarrhea, Zhu Ling Tang is appropriate. However, wheezing is always a critical sign.

After Taiyang disease is treated with purgation, if Qi rushes upward, Gui Zhi Tang may be administered following the previous method. If Qi does not rush upward, it should not be given.
[Annotation] In Taiyang disease, if the exterior is unresolved and purgation is applied, interior excess leads to pathogen sinking forming Jie Xiong (Da Xian Xiong Tang syndrome); interior deficiency leads to pathogen sinking causing diarrhea (Gui Zhi Ren Shen Tang syndrome). Chest excess leads to pathogen sinking causing epigastric fullness/hardness and Qi rushing to the throat preventing breathing (Gua Di San syndrome). Now, with chest deficiency, pathogen sinks into the chest, causing only Qi rushing upward. The exterior is not yet resolved, but there are no signs of congestion/prevented breathing or hardness. Therefore, emetic and purgative methods are contraindicated; the exterior must still be resolved. Gui Zhi Tang may be given to induce sweating according to protocol. This allows the sunken chest pathogen to be unbound externally, enabling chest Qi to circulate freely, preventing internal congestion and upward rushing. If Qi does not rush upward, do not administer it.

[Collected Commentaries] Fang Youzhi stated: Qi rushing upward occurs because Yang governs Qi rising; wind is a Yang pathogen. After purgation, it enters the interior and rushes upward due to deficiency. If it does not rush upward, it is known not to be a Yang pathogen, so it should not be given.

When symptoms resemble Gui Zhi Tang syndrome, but there is no headache or stiff neck, the Cun pulse is slightly floating, there is epigastric/chest fullness and hardness, and Qi rushes to the throat preventing breathing, this is Cold-Fluid (Han) in the chest. Emesis should be induced using Gua Di San (Melon Spore Powder).
[Annotation] "Symptoms resembling Gui Zhi Tang syndrome" refers to headache, stiff neck, fever, sweating, aversion to wind, and floating-slow pulse. Now, absence of headache and stiff neck means Gui Zhi syndrome signs are incomplete. Slightly floating Cun pulse indicates the pathogen has left the exterior but remains close. Epigastric/chest fullness/hardness and Qi rushing to the throat preventing breathing indicate the pathogen has entered the interior but not deeply, residing in the chest, likely due to pre-existing cold-fluid in the chest. Cold-fluid in the chest, not in the muscle layers, makes muscle-releasing methods ineffective. Fullness/hardness in the chest, not the epigastrium, makes interior-purging methods inapplicable. Only the method of "vomiting what is high" can expel the chest cold-fluid suddenly. Therefore, emesis with Gua Di San is indicated.

[Collected Commentaries] Cheng Yingmao stated: Fullness/hardness caused by emesis/purgation is deficiency; fullness/hardness not caused by them is excess. Excess pathogenic phlegm-fluid filling the heart-chest blocks the Middle and Lower Jiao, necessitating an exit via the Upper Jiao. This is the principle of "Those above should be expelled upwards."
Wang Hu stated: In Shang Han (Cold Damage) disease, the emetic method must be studied. Zhang Zhongjing placed this case in the Upper Taiyang section because emesis should not be delayed; it is equal in importance to Taiyang sweating methods. It should be applied within two to three days after assessing the syndrome.
Shen Mingzong stated: Pre-existing internal phlegm-fluid accumulation, triggered by slight wind-cold, can manifest externally like Gui Zhi Tang syndrome. However, the absence of headache/stiff neck indicates it is not wind-pathogen attacking the exterior.
Zhang Xiqiu stated: Qi rushing to the throat preventing breathing indicates pathogen carrying cold-fluid surging upward via Taiyang Qi.

Gua Di San Formula
Gua Di (Melon Spore) - roasted yellow, 1 fen
Chi Xiao Dou (Red Adzuki Bean) - 1 fen
These two ingredients are separately pounded and sifted into powder, then mixed. Take one qian-bi (measure) of the powder. Use Xiang Chi (Prepared Soybean) 1 he, boiled in 7 he of hot water to make a thin gruel. Strain, mix the juice with the powder, and take warm in one dose. If vomiting does not occur, increase the dose slightly. Stop when vigorous vomiting occurs. Do not administer to patients with blood loss or constitutional deficiency.

[Formula Explanation] The chest is the residence of Clear Yang. Various pathogens entering the chest obstruct Yang Qi, preventing dissemination, leading to chest fullness, hardness, upward rushing of heat, dry mouth/thirst, irritability, and desire to vomit. A rapid/agitated pulse indicates heat constraint. Chest fullness/hardness, Qi rushing to the throat preventing breathing...