阳明病汗出多而渴者不可与猪苓汤以汗多胃中燥猪苓汤复利其小便故也
六十五章渴而小便不利者乃与猪苓汤若汗出多而渴者则应白虎不可与猪苓汤以汗多则胃中已燥猪苓汤复利其小便以
亡津也此申明上章及六十五章猪苓汤之义
阳明病口燥但欲漱水不欲咽此必衄
口干而漱水不咽以热在经而不在腑经热不泄此必衄也
脉浮发热口干鼻燥能食者则衄
脉浮发热表寒外束口干鼻燥经热内蒸能食则热不在腑经热不能旁泄则上衄也
阳明病脉浮而紧者必潮热发作有时但浮必盗汗出
脉浮而紧太阳之脉阳明得之必潮热按时而发以表寒郁其腑热也若但浮而不紧则外无表寒而内无里热寐时卫气不入阴
分皮毛失敛经热蒸泄必盗汗出凡盗汗之家皆阴盛脏寒阳不内交者也
阳明病初欲食小便反不利大便自调其人骨节疼翕翕如有热状奄然发狂 然汗出而解者此水不胜谷气与汗共并脉紧则
愈
初欲食是有谷气小便不利大便自调骨节疼（湿流关节故疼）是土湿而水停也谷气胜则汗出水气胜则汗不出乃翕翕如
有热状忽然发狂 然汗出而解者此谷气欲发水气郁热而不能发是以躁乱发狂究之水气不胜谷气故 然汗出汗出而水气亦
随汗泄与汗共并于外表寒与里水皆去脉紧自愈也
阳明病面合赤色不可攻之必发热色黄小便不利也
表寒外束郁其经热则面见赤色此可汗而不可攻以面之赤色是经热而非腑热腑热则毛蒸汗泄阳气发越面无赤色攻之则
阳败湿作而表寒未解湿郁经络必发热色黄小便不利也
阳明病，汗出多且口渴的，不可给予猪苓汤。因为汗出过多导致胃中干燥，若再用猪苓汤通利小便，就会更加耗伤津液。
第六十五章中提到，口渴且小便不利的，才给予猪苓汤；如果汗出多且口渴的，则应当用白虎汤，不可用猪苓汤。因为汗出多则胃中已经干燥，猪苓汤会进一步通利小便，从而亡失津液。这是为了阐明上一章及第六十五章使用猪苓汤的道理。
阳明病，口干燥，只想含水漱口而不想咽下的，这必定会发生鼻衄（流鼻血）。
口干而只漱口不吞咽，是因为热邪在经络而不在腑脏。经络之热不得宣泄，所以必定发生鼻衄。
脉象浮、发热、口干、鼻燥，能进食的，将会发生鼻衄。
脉浮发热，是表寒外束；口干鼻燥，是经热内蒸。能进食说明热邪不在腑脏。经络之热不能向旁侧宣泄，只能向上通过鼻衄来发泄。
阳明病，脉象浮而紧的，必定有潮热，发作有定时；如果脉象仅浮而不紧，必定会有盗汗。
脉浮而紧，是太阳病的脉象，阳明病见到这种脉象，必定出现按时发作的潮热，这是因为表寒郁闭了腑中的热邪。如果脉象仅浮而不紧，则外部没有表寒，内部也没有里热。睡眠时卫气不能入于阴分，皮毛失去收敛，经络之热蒸腾外泄，必定导致盗汗。凡是患有盗汗的人，都是阴盛脏寒，阳气不能内交所致。
阳明病，起初想要进食，小便反而不利，大便正常，其人骨节疼痛，身体微微发热像是有热状，忽然发狂，随后濈然汗出而病愈的，这是水湿之气不胜谷气，随着汗液一同排出。脉象变紧则是痊愈的征兆。
起初想要进食，说明体内有谷气。小便不利但大便正常，骨节疼痛（因湿气流注关节故疼痛），这是脾土湿气重而水液停聚。谷气旺盛则能出汗，水气旺盛则汗不出。此时身体微微发热，忽然发狂，随后濈然汗出而病解，这是因为谷气欲发散，而水气郁结的热邪不能发散，所以导致躁乱发狂。究其根本，是水湿之气不胜谷气，所以濈然汗出。汗出之后，水湿之气也随着汗液排泄，与水湿并见于体表，使得表寒与里水一并去除，脉象转紧即为自愈。
阳明病，面色通红发赤的，不可使用攻下法。否则必定会出现发热、面色发黄、小便不利。
表寒外束，郁闭了经络之热，所以面色呈现红色。这种情况可以用发汗法，而不可用攻下法。因为面部的红色是经络之热，而非腑脏之热。如果是腑热，则会毛孔蒸腾、汗液排泄，阳气发越，面部不会有红色。如果误用攻下法，会导致阳气败坏、湿气内生，且表寒未解，湿气郁滞于经络，必定出现发热、面色发黄、小便不利。
In Yangming disease, if there is profuse sweating accompanied by thirst, Zhu Ling Tang (Polyporus Decoction) must not be administered. This is because excessive sweating causes dryness in the Stomach; administering Zhu Ling Tang to promote urination would further deplete body fluids.
Chapter 65 states that if there is thirst with difficulty in urination, Zhu Ling Tang should be given. However, if there is profuse sweating and thirst, Bai Hu Tang (White Tiger Decoction) should be used instead of Zhu Ling Tang. Since profuse sweating has already caused dryness in the Stomach, Zhu Ling Tang would further promote urination, leading to the loss of Jin-Ye (body fluids). This clarifies the rationale for using Zhu Ling Tang mentioned in the previous chapter and Chapter 65.
In Yangming disease, if the mouth feels dry and the patient desires to rinse water in the mouth but does not wish to swallow it, epistaxis (nosebleed) will certainly occur.
Dryness in the mouth with a desire to rinse but not swallow indicates that the Heat pathogen is in the Channels and Collaterals rather than in the Fu organs. Since the Channel Heat cannot dissipate, epistaxis is inevitable.
If the pulse is floating, accompanied by fever, dry mouth, dry nose, and the ability to eat, epistaxis will occur.
A floating pulse and fever indicate external constraint by Cold pathogen on the exterior. Dry mouth and nose indicate internal steaming of Heat within the Channels. The ability to eat suggests that the Heat is not in the Fu organs. Since the Channel Heat cannot vent laterally, it must vent upwards through epistaxis.
In Yangming disease, if the pulse is floating and tight, tidal fever (chaore) occurring at specific times will definitely occur. If the pulse is only floating without being tight, night sweats will definitely occur.
A floating and tight pulse is characteristic of Taiyang disease. When Yangming disease presents this pulse, tidal fever occurring at fixed times is certain, caused by external Cold constraining the internal Fu Heat. If the pulse is only floating and not tight, there is no external Cold and no internal Repletion Heat. During sleep, Wei Qi (Defensive Qi) fails to enter the Yin aspect, causing the skin pores to lose their closure. The Channel Heat steams and vents outwards, resulting in night sweats. Individuals suffering from night sweats generally have excess Yin and cold Zang organs, preventing Yang from interacting internally.
In early Yangming disease, if the patient initially desires food, yet urination is obstructed while bowel movements remain normal, and they experience pain in the bone joints, a slight feeling of heat as if feverish, followed suddenly by mania, and then resolving with copious sweating, this indicates that the Water-Dampness pathogen is overcome by Gu Qi (Grain Qi), which exits together with sweat. A return to a tight pulse signifies recovery.
Initial desire to eat indicates the presence of Gu Qi. Obstructed urination with normal stools and joint pain (due to Dampness flowing into the joints) indicate Spleen Earth Dampness and Water retention. When Gu Qi is strong, sweating occurs; when Water-Dampness is strong, sweating does not occur. At this stage, the body feels slightly hot, and sudden mania occurs before resolving with copious sweating. This happens because Gu Qi attempts to disperse, but the Heat constrained by Water-Dampness cannot disperse, leading to restlessness and mania. Ultimately, since Water-Dampness is inferior to Gu Qi, copious sweating ensues. Upon sweating, the Water-Dampness is excreted along with the sweat, combining to exit via the exterior. Both the external Cold and internal Water are eliminated, and a tight pulse indicates self-healing.
In Yangming disease, if the face appears red or flushed, purgative methods must not be used. Otherwise, fever, yellow complexion, and difficulty in urination will certainly occur.
External Cold constrains the Channel Heat, causing the face to appear red. This condition can be treated with diaphoresis (sweating method) but not with purgation. The redness on the face indicates Channel Heat, not Fu organ Heat. If it were Fu organ Heat, the pores would steam, sweat would be excreted, and Yang Qi would vent outward, resulting in no facial redness. Purgation would damage Yang, generate Dampness, fail to resolve the external Cold, and cause Dampness to stagnate in the channels and collaterals, inevitably leading to fever, yellow complexion, and urinary difficulty.