Library

[Annotation] The patient having cold refers to cold in the stomach. Repeated sweating refers to sweating again after an initial sweat. With stomach cold compounded by sweating, yang qi becomes increasingly deficient, and cold in the stomach becomes severe; ascarids cannot remain tranquil, hence vomiting of ascarids is inevitable. It is appropriate to administer Lizhong Tang (Regulate the Middle Decoction) with Wumei Wan (Mume Pill).

[Collected Annotations] Cheng Yingmao stated: Sweat is generated from the essence of grain and water, brewed by the yang qi of the stomach. Having cold yet inducing sweat indicates that stomach yang qi no longer resides within; how can ascarids remain tranquil? After sweating, if water and medicine cannot enter the mouth, this is considered a reversal syndrome (ni zheng); if sweating is induced again, it will inevitably lead to continuous vomiting and diarrhea.

[Commentary] The character "diarrhea" (xia) in "inevitably continuous vomiting and diarrhea" should be considered a superfluous character (yan wen).

[Annotation] This follows the previous clause regarding misdiagnosis compounded by further error, inevitably transforming into a reversal syndrome. Stomach deficiency-cold originates from erroneous sweating; water and medicine cannot enter the mouth, and upon entry, are vomited immediately, constituting a reversal. If sweating is induced again, stomach rebellion worsens, and the capacity for reception is lost. Not only will water and medicine be vomited upon entry, but vomiting and rebellion will occur incessantly.

[Collected Annotations] Cheng Wuji stated: After sweating, if water and medicine cannot enter the mouth, it is termed vomiting and rebellion. Sweating causes loss of yang, leading to stomach deficiency-cold; if sweating is induced again, it further damages yang qi, causing extreme stomach qi deficiency, hence continuous vomiting.
Cheng Yingmao stated: The appearance of these symptoms after sweating indicates that prior to sweating, the person already had middle jiao deficiency and cold; thus, one error is unbearable, let alone a second.

If the pulse is floating and slow, indicating exterior heat and interior cold, accompanied by diarrhea with undigested food, Sini Tang (Frigid Extremities Decoction) is the primary formula.

[Annotation] In Yangming disease, a floating and slow pulse: floating indicates exterior heat, while slow indicates interior cold. Given the symptom of diarrhea with undigested food, interior cold is extremely severe. According to the principle, warming is indicated; Sini Tang (Frigid Extremities Decoction) is appropriate.

[Collected Annotations] Wang Hu stated: In Yangming channel disease, the pulse should be long and moderate. The current floating pulse indicates condensation of exterior heat. In fu-organ disease, the pulse should be rapid; the current excessively slow pulse indicates extreme interior cold, hence diarrhea with undigested food. The discharged grain remains unchanged in color and odorless, which is known as complete undigested stool. This indicates extreme interior cold, hence Sini Tang (Frigid Extremities Decoction) is administered.

Yangming disease tends to resolve between Shen (3 PM - 5 PM) and Xu (7 PM - 9 PM) hours.

[Annotation] For all Yangming diseases, whether in the channels or fu-organs, resolution occurs during their peak time. Shen, You, and Xu hours are when Yangming qi is prosperous. When channel qi is prosperous, pathogenic factors naturally recede, leading to resolution.

[Collected Annotations] Zhang Zhicong stated: The classics state: "When the sun sets, yang qi declines," which is governed by Yangming. From Shen to Xu hours is the time when Yangming governs qi. Pathogens in the exterior and interior seeking to exit must resolve following the peak time of qi prosperity.