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Taiyang disease (Taiyang Syndrome), if treated first with purgation without resolution, and then sweating is induced again, thereby causing both exterior and interior deficiency. Consequently, the patient experiences "mao" (a sensation of dizziness or clouding of consciousness as if covered by something). For those suffering from "mao", spontaneous sweating leads to natural recovery. The reason for this is that sweating harmonizes the exterior; if the interior remains unharmonized, only then should purgation be applied subsequently.

[Annotation] In Taiyang exterior syndrome, when sweating should have been induced but was not, and purgation was used first without success, followed by inducing sweating, this results in both exterior and interior deficiency. Due to this deficiency, the patient develops "mao" (dizziness/clouded consciousness); this is logically inevitable. "Mao jia" refers to anyone who suffers from dizziness or clouded consciousness due to illness. However, among those with "mao", some recover through spontaneous sweating. The reason is not merely exterior-interior deficiency, but rather that both pathogenic factors and healthy qi have declined, allowing the exterior and interior to naturally harmonize. Recovery through sweating indicates harmony at the exterior; recovery through diarrhea indicates harmony at the interior. When the interior is not yet harmonized, purgation may then be applied; Tiaowei Chengqi Tang (Stomach-Regulating Major Order the Grain Decoction) is suitable to harmonize it. By inference, if the exterior is not yet harmonized, sweating should be induced subsequently; Guizhi Tang (Cinnamon Twig Decoction) would be appropriate to harmonize it, which is implied.

[Collected Annotations] Cheng Zhi stated: "Mao" refers to unclear consciousness, as if obscured by an object. Spontaneous sweating harmonizes the exterior and resolves the pathogen. If the exterior is harmonized but the interior is not, purgation follows. This clarifies that one should not mistake "mao" for pathogen entering the interior and thus erroneously use purgation, nor should one mistake "mao" for unresolved exterior syndrome and thus erroneously induce sweating again.

Wang Hu stated: Regarding the character "li" (interior) in "obtaining interior unharmonized," many commentators refer to urination and defecation. I ponder that since the text says "then purge," it specifically refers to defecation; if it referred to promoting urination, it would not say "purge." The meaning is self-evident.

In any disease, whether resulting from sweating, vomiting, purgation, blood loss, or fluid depletion, if yin and yang naturally harmonize, the disease will surely resolve spontaneously.

[Annotation] "Any disease" refers to all conditions, including Wind-strike and Cold damage. Whether after sweating, vomiting, purgation, or following blood/fluid loss, if treatment is appropriate, recovery occurs naturally. Even if treatment is inappropriate and recovery does not immediately occur, it will not lead to complicated or adverse transformations. At this stage, both pathogen and healthy qi are diminished; further treatment may not be necessary. One should remain calm and wait. Upon diagnosis showing natural harmony of yin and yang, spontaneous recovery is certain.

[Collected Annotations] Fang Youzhi stated: Yin and yang refer to pulse characteristics, encompassing urination and defecation. When these two aspects are harmonious, blood and qi do not overpower each other, ensuring spontaneous recovery.

Cheng Zhi stated: A pulse that is even and balanced across the left and right three positions indicates no disease. Therefore, after sweating, vomiting, or purgation, if yin and yang harmonize, spontaneous recovery occurs without need for excessive treatment.

Question: Why do some patients experience chills followed by sweating, leading to resolution? Answer: A floating and tight pulse, which feels hollow upon deep pressure (Kou pulse), indicates underlying deficiency. Thus, chills and sweating occur for resolution. The patient's inherent deficiency causes the chills; the floating pulse indicates that sweating will lead to resolution. If the pulse is floating and rapid, and not hollow upon deep pressure, the patient is inherently not deficient. To resolve spontaneously, only sweating occurs, without chills. Question: Why do some patients resolve through sweating without chills? Answer: A large, floating, and rapid pulse indicates resolution through sweating without chills. Question: Why do some patients resolve neither through chills nor sweating? Answer: A faint pulse indicates previous sweating, vomiting, purgation, or blood loss, leading to internal fluid depletion. This represents natural harmony of yin and yang, ensuring spontaneous resolution without chills or sweating.

[Annotation] A floating and tight pulse indicates excess pathogen; a hollow feeling upon deep pressure indicates deficient healthy qi. Deficient healthy qi and excess pathogen clash, causing chills and sweating for resolution. A floating and rapid pulse indicates the pathogen is not yet excessive; non-hollow deep pressure indicates healthy qi is not deficient. With healthy qi intact and pathogen not excessive, there is no clash, so resolution occurs through sweating alone, without chills. Non-hollow pulse implies no chills; non-floating pulse implies no sweating; faint pulse implies previous sweating, vomiting, purgation, or blood loss. Internal fluid depletion leads to decline of both pathogen and healthy qi, natural harmony of yin and yang, and resolution without chills or sweating.

Question: In Cold damage after three days, why is the pulse floating, rapid, and faint, while the patient's body is cool and peaceful? Answer: This indicates impending resolution, occurring at midnight. Resolution associated with a floating pulse involves slight sweating; resolution associated with a rapid pulse implies ability to eat; resolution associated with a faint pulse involves profuse sweating.

[Annotation] A floating and rapid pulse, weak upon deep pressure, suggests chills and subsequent sweating for resolution due to inherent deficiency. A floating and rapid pulse, strong upon deep pressure, suggests sweating without chills due to lack of inherent deficiency. A faint pulse, following previous sweating, vomiting, purgation, or blood loss, indicates resolution without chills or sweating due to decline of both pathogen and healthy qi and natural harmony of yin and yang. In Cold damage after three days, without prior sweating, vomiting, purgation, or blood loss, a floating, rapid, and faint pulse, along with reduced heat and physical comfort, indicates impending resolution. Resolution at midnight occurs because Yang diseases harmonize during Yin hours (midnight). Although floating, rapid, and faint pulses are all signs of potential resolution, the manifestations differ. Floating pulse with slight sweating indicates pathogen returning to the exterior for resolution; rapid pulse with appetite indicates stomach harmony; faint pulse with profuse sweating indicates resolution without chills because the patient is not deficient, fluids are intact, and thus profuse sweating occurs.

[Collected Annotations] Fang Youzhi stated: Three days refers to the transmission through all three Yang meridians. Floating and rapid indicate no transmission to Yin meridians. Faint indicates declining pathogen. Midnight is the time when Yin ends and Yang begins. "Zhi ran" describes gentle sweating. Ability to eat indicates restoration of Stomach Qi.

If Taiyang disease remains unresolved, and the pulses at Cun, Guan, and Chi positions all become imperceptible (Ting), the patient will first experience tremors and shaking, followed by sweating and resolution. If only the Yang pulse (Cun position) becomes slightly perceptible, resolution occurs through sweating; if only the Yin pulse (Chi position) becomes slightly perceptible, resolution occurs through purgation. If purgation is desired, Tiaowei Chengqi Tang (Stomach-Regulating Major Order the Grain Decoction) is indicated.

[Annotation] Unresolved Taiyang disease typically shows specific pulses. The absence of these, with all pulses becoming imperceptible and sunken, might suggest a fatal condition. However, the absence of fatal signs indicates impending resolution. This resolution sign manifests initially as tremors and sweating, caused by the struggle between pathogen and healthy qi generating sweat. This resolving pulse state cannot last long; its reappearance has precursors. These precursors are found where pulses were previously sunken and imperceptible. If the Yang pulse (Cun) becomes slightly perceptible, the pathogen trends outward, resolving via sweating. If the Yin pulse (Chi) becomes slightly perceptible, the pathogen trends inward, resolving via spontaneous diarrhea. If spontaneous diarrhea does not occur, and purgation is needed to harmonize the interior, Tiaowei Chengqi Tang (Stomach-Regulating Major Order the Grain Decoction) is indicated. By inference, if spontaneous sweating does not occur, and sweating is needed to harmonize the exterior, Mahuang Guizhi Gehan Tang (Ephedra, Cinnamon Twig, and Half-Dose Decoction) would be indicated. The phrasing "if purgation is desired..." implies a mild approach, avoiding drastic purgation, which is implied.

[Collected Annotations] Cheng Yingmao stated: Resolution via tremors and sweating refers specifically to imperceptible pulses. The subsequent two resolutions do not involve chills/sweating but refer to the gradual reappearance of pulses.

In Cold damage, abdominal fullness and delirium, with a floating and tight pulse at Cun Kou, indicate Liver Wood overacting on Spleen Earth, termed "Zong" (Vertical/Unrestrained). Treatment involves acupuncture at Qimen (LR14).

[Annotation] Floating and tight pulse in Cold damage indicates Taiyang exterior cold. Abdominal fullness and delirium indicate Taiyin and Yangming interior heat. Inducing sweating from Taiyang is contraindicated by the interior syndromes; purging from Taiyin/Yangming is contraindicated by the exterior syndrome. Treatment is difficult, hence acupuncture is used instead of herbs. Although, in the Taiyin chapter, Taiyang exterior unresolved with Taiyin abdominal fullness/pain can be treated with Guizhi Jia Dahuang Tang (Cinnamon Twig plus Rhubarb Decoction), which is also a valid method. The statement here regarding Liver overacting on Spleen ("Zong") and acupuncture at Qimen seems disconnected from the preceding context, possibly indicating a textual error or omission.

In Cold damage, fever, aversion to cold, extreme thirst desiring water, and abdominal fullness, if accompanied by spontaneous sweating and free urination, indicate impending resolution. This is Liver Wood overacting on Lung Metal, termed "Heng" (Horizontal/Rebellious). Treatment involves acupuncture at Qimen (LR14).

[Annotation] Fever and aversion to cold in Cold damage indicate an exterior syndrome without sweating. Extreme thirst and abdominal fullness indicate fluid retention causing distension. Spontaneous sweating resolves the exterior; free urination removes the fluid retention and distension, hence "impending resolution." If there is no sweating and urine is obstructed, Xiao Qinglong Tang (Minor Blue Dragon Decoction) should be used first to resolve the exterior. After the exterior is resolved, if fullness persists, Shizao Tang (Ten Jujube Decoction) can be used to purge, leading to recovery. The statement regarding Liver overacting on Lung ("Heng") and acupuncture at Qimen also seems disconnected from the preceding context, possibly indicating a textual error or omission.

The time when Taiyang disease tends to resolve is from Si (9-11 AM) to Wei (1-3 PM).

[Annotation] Diseases tend to resolve when the Qi of the affected meridian is prosperous. Taiyang is the meridian of abundant Yang. Yang Qi is prosperous at midday; therefore, resolution occurs during the prosperous hours of Si, Wu, and Wei.