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For Taiyang disease (Taiyang syndrome) exterior patterns, sweating methods should be used, and purgation methods must not be used; for interior patterns, purgation methods should be used, and sweating methods must not be used. When the pathogen is half in the exterior and half in the interior, harmonizing methods should be used, and sweating or emetic/purgative methods must not be used. If the pathogen is in the upper jiao (Upper Burner), it should be cleared through vomiting or similar methods; if in the lower jiao (Lower Burner), it should be drained through purgation.

In cold damage with no sweating, where there is an exterior pattern but the interior qi is peaceful, Mahuang Tang (Ephedra Decoction) should be used to induce sweating, or Tianshui San (Cool Water Powder) and similar formulas are also excellent. If the exterior pattern remains unresolved, with the pathogen half entering the interior and half remaining in the exterior, Xiaochaihu Tang (Minor Bupleurum Decoction) should be used to harmonize, or Tianshui San and Liangge San (Cooling Chest Powder) are very effective. If both exterior and interior heat conditions are severe, Dachaihu Tang (Major Bupleurum Decoction) should be used for mild purgation. For more severe cases, Da Chengqi Tang (Major Order the Qi Decoction) should be used for purgation. If there is more exterior heat and less interior heat, a ratio of one part Tianshui San to half part Liangge San should be used for harmonization. If there is more interior heat and less exterior heat, and purgation is not yet indicated, a ratio of one part Liangge San to half part Tianshui San should be used for regulation. If the heat is even more severe, Xiao Chengqi Tang (Minor Order the Qi Decoction) should be used for purgation. If the exterior pattern has resolved and only interior patterns remain, Da Chengqi Tang should be used for purgation. For all these various patterns suitable for purgation, Sanyi Chengqi Tang (Three-One Order the Qi Decoction) is generally appropriate.

If the disease persists after sweating, or after purgation, with no significant change in symptoms before or after, Liangge San should generally be used to regulate and clear the heat. This principle applies similarly to Lianggan Shanghan (Simultaneous Invasion of Exterior and Interior).

For wind-strike with spontaneous sweating, where there is an exterior pattern but the interior qi is peaceful, Guizhi Tang (Cinnamon Twig Decoction) should be used to release the muscle layer. If the pathogen is half in the exterior and half in the interior, Baihu Tang (White Tiger Decoction) should be used for harmonization. If the pathogen is in the interior, Da Chengqi Tang should be used for purgation.

Another method states: Regardless of whether the external pathogen is wind-cold, summer-heat, or dampness, and regardless of the presence or absence of sweating, if injured by internal or external pathogens, whenever there are patterns suitable for purgation, or when neither exterior nor interior patterns are evident but the condition worsens daily, accompanied by unclear vision or abnormal eye movement, abdominal fullness and solid pain, irritability and thirst, delirium, mania, panting, and chest fullness, or extreme accumulation of heat leading to near-death, Da Chengqi Tang should be used for purgation, or Sanyi Chengqi Tang is even better.

In cold damage, after excessive sweating, if sweating occurs but the disease does not resolve, and instead there is no sweating with a deficient and floating pulse, Cangzhu Baihu Tang (Atractylodes White Tiger Decoction) should be used again to resolve the exterior and clear heat. In cases of summer-heat stroke with profuse spontaneous sweating, weak pulse, headache, dry mouth, fatigue, irritability, occasional aversion to cold, or fear of sunlight, regardless of exterior or interior involvement, Baihu Tang is generally appropriate. If interior heat is severe, with abdominal fullness and a deep pulse, indicating suitability for purgation, Da Chengqi Tang or Sanyi Chengqi Tang is appropriate.

In cold damage, if exterior heat is extremely severe, causing unbearable body pain and headache, or dizziness and vomiting, with slight interior heat, sweating, vomiting, and purgation are contraindicated. Xiaochaihu Tang, Tianshui San, and Liangge San may be considered for harmonization. However, this may not suffice to reduce severe heat. After major or repeated purgations, if heat remains severe and unresponsive, and the vital qi is damaged and weak with a pulse that cannot fill out, attempting further purgation risks immediate death from collapse, while failing to purge leads to death from extreme heat. At this stage, cold-natured herbs can no longer reduce the severe heat.

If there is internal retention of heat and dampness with continuous diarrhea and persistent heat, or if after major purgation, heat subsides but diarrhea continues without heat reduction, accompanied by a weak pulse and deficient qi, making further purgation impossible, or if various damp-heat pathogens cause red and scanty urination, loose stools, frequent urgent painful defecation indicative of impending dysentery, Huanglian Jiedu Tang (Coptis Decoction for Detoxification) is required.

If interior heat is extremely severe and yin qi fails to subside, or if heat persists after purgation, or if accumulated heat is severe causing deep yang reversal (Yang Jue), leading to sunken yang qi unable to circulate in the body, approaching yin exhaustion with cyanosis and coldness of the whole body, unbearable pain, stiffness of the neck and back, red and painful eyes, dizziness and confusion, dry or painful throat, dryness, thirst, deficiency sweating, vomiting and diarrhea, abdominal fullness and solid pain, irritability and stifling sensation, rapid breathing with hoarse voice, and a rapid pulse that becomes deep, thin, and nearly imperceptible due to blocked meridians from extreme heat accumulation—often misdiagnosed by laypeople as extreme cold-yin toxicity, or occurring initially with sudden violent yang heat, or in severe Lianggan cases—Jiedu Tang combined with Da Chengqi Tang should be used for purgation. If heat persists, purgation should be repeated. Although ancients stated that failure to reduce heat after three purgations leads to death, there are cases where four or five purgations, resulting in ten to twenty bowel movements, successfully reduced heat and saved lives, avoiding inevitable death from non-purgation.

After purgation, if heat slightly subsides but recovery is incomplete, Huanglian Jiedu Tang should be used for regulation. If slight heat remains, Liangge San should be used. If heat was neglected until extreme, leading to cold body and faint pulse with coma and near-death, emergency purgation would cause sudden destruction of residual yin and subsequent exhaustion of yang, leading to immediate death; likewise, non-purgation leads to death. In such cases, Liangge San or Huanglian Jiedu Tang should be used to nourish yin and subdue yang. As accumulated heat dissipates, the chest, heart, and abdomen will warm, and the pulse will gradually recover. Only when the yang pulse regains strength should Sanyi Chengqi Tang be used for mild purgation, or Jiedu Tang combined with Da Chengqi Tang for better results. If slight heat persists after purgation, Liangge San should be used for regulation. After recovery, only heat-clearing medicines should be used, avoiding foods that generate heat, as yang heat is prone to recurrence.