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This is due to a deficiency of Yin Qi (Yin Energy) and an excess of Yang Qi (Yang Energy), resulting in feverish body heat and vexation. If the toxic influence resides in the Heart and causes vexation, it leads to chest oppression and nausea. If dry feces in the Stomach cause vexation, it results in delirious speech and pain around the umbilicus.

When the disease is severe, patients may discard their clothes and run, climb high places and sing, or go without food for several days, jumping over walls and climbing onto roofs; these actions are beyond their usual capabilities. The ability to perform such acts during illness occurs because of the struggle between Yin and Yang, with pathogenic factors merging outwardly into the Yang aspects. The four limbs are the root of all Yang meridians. When pathogens are excessive, the four limbs become solid and strong, enabling one to climb and sing; when heat is excessive throughout the body, one discards clothes to run; when Yang is excessive, one speaks wildly, curses, disregards kinship ties, experiences full-body high fever, and suffers from manic speech along with hallucinations of hearing and sight.

When pathogenic heat lodges in the chest and epigastrium, and there is heat in the Upper Jiao (Upper Burner), the person will necessarily desire to drink water. If water stagnates below the heart (epigastric region), it ascends to invade the Lungs, causing coughing.

If there is heat in the Stomach, when food enters the Stomach, it combines with the heat; if Qi rebels upward, vomiting occurs. Alternatively, after vomiting or purging, if too much water is drunk, leading to coldness and deficiency of Stomach Qi, vomiting also occurs.

Latent heat remaining in the Stomach causes chest fullness; chest fullness leads to rebellious Qi, and rebellious Qi causes hiccuping (Yue). After severe purgation, if Stomach Qi becomes deficient and cold, hiccuping may also result.

When hot toxins enter the Kidneys, which dislike dryness, excessive heat causes Kidney dryness; Kidney dryness leads to thirst and a desire to drink.

In warm diseases, if heat manifests for four days and the pathology is located in the chest and diaphragm, emesis should be induced to achieve cure. In cases where, within one or two days of contracting the disease, the patient experiences vexation and fullness in the chest and heart, it indicates that the toxin has entered internally combined with phlegm and excess; emesis should also be induced here.

After sweating fails to resolve the condition, warm toxic qi stasis accumulates in the Stomach, causing difficulty in urination; consequently, jaundice develops, with the body taking on the color of an orange peel.

When hot toxins reside in the chest and epigastrium, the San Jiao (Triple Burner) becomes obstructed, and pathogens lodge in the collaterals of the Foot-Shaoyin (Kidney) meridian. With the lower pulse channels blocked, hot Qi attacks upward toward the throat and pharynx, causing pain or ulceration.

The Liver opens into the eyes. When Liver Qi is deficient, hot toxins rush upward through the deficiency into the eyes, causing redness and pain; in severe cases, sores and pterygia (cloudy membranes over the cornea) develop.

This is caused by heat accumulation in the Five Zang Organs. The Heart governs Blood, and the Lungs govern Qi, opening into the nose. Pathogenic heat injuring the Heart (Note: Text implies Lung/Heart interaction regarding nasal bleeding) leads to epistaxis. Epistaxis refers to blood flowing from the nose.

When the Yang meridians are invaded by pathogens, heat initially remains at the exterior. If sweating is not applied as indicated, hot toxins penetrate deeply, knotting within the Five Zang Organs. With internal stasis of blood accumulating, hematemesis (vomiting blood) occurs.