问曰∶病有太阳阳明，有正阳阳明，有少阳阳明，何谓也？答曰∶太阳阳明者，脾约是也。正阳阳明者，
胃家实是也。少阳阳明者，发汗、利小便，胃中燥、烦、实、大便难是也。阳明之为病，胃家实也。问曰∶缘
何得阳明病？答曰∶太阳病，发汗若下若利小便者，此亡津液，胃中干燥，因转属阳明，不更衣，内实，大便
难者，此名阳明病也。伤寒脉浮而缓，手足自温者，是为系在太阴。太阴者，身当发黄，若小便利，
不能发黄，至七八日，大便硬者，为阳明病也。阳脉实，因发其汗，汗出多者，亦为太过，太过为阳绝于里，
亡津液，大便因硬也。阳明病，若能食为中风，不能食为中寒。阳明病，但头眩不恶寒，故能食而咳，其人必
咽痛，若不咳者，咽不痛也。阳明病，不能食，攻其热必哕，所以然者，胃中虚冷故也，以其人本虚，故攻其
热必哕也。阳明病，脉迟，食难用饱，饱则微烦头眩，必小便难，此欲作谷疸，下之腹满如故。所以然者，脉
迟故也。阳明病，欲解时，从申至戌上。伤寒呕多，虽有阳明症，不可攻也。阳明病，面合赤色，不可攻之，
攻之必发热，色黄，小便不利也。阳明病，心下硬满者，不可攻之。攻之，利遂不止者死，利止者愈。
伤寒不大便六七日，头痛有热者，与承气汤。其小便清者，知不在里，仍在表也，须当发汗，若头痛者必
衄，宜桂枝汤。阳明病，脉浮无汗而喘者，发汗则愈，宜麻黄汤。阳明病，胁下硬满，大便不利而呕，舌上白
胎者，可与小柴胡汤。若上焦得通，津液得下，胃气因和，身 然汗出而解。
阳明中风，脉弦浮大，而短气，腹满，胁下及心痛，久按之气不通，鼻干，不得汗，嗜卧，一身及面目悉
黄，小便难，有潮热，时时哕，耳前后肿，刺之小瘥，外不解。病过十日，脉续浮者，与小柴胡汤；脉但浮无
余症者，与麻黄汤；若不小便，腹满加哕者，不治。
阳明中风，口苦咽干，腹满微喘，发热恶寒，脉浮而紧。若下之，则腹满小便难也。（许学士云∶宜小柴
胡汤。）阳明腹满，脉浮紧，口苦咽干而喘，若发热汗出，不恶寒反恶热，身重者，忌发汗，忌加烧针，忌
下也。（论见自汗。）阳明病，脉浮而紧者，必潮热发作有时；但浮者，必盗汗出。
上胃家实不大便，虽三尺之童，亦知可下也。殊不知仲景之法，虽有胃实症，若表未解，及有半表者，
亦先用桂枝、柴胡以解外，然后视虚实消息之也。
阳明病，自汗出，若发汗，小便自利者，此为津液内竭，虽硬不可攻之，当须自欲大便时，宜用蜜煎导而
通之。若土瓜根及入猪胆汁皆可导之。
蜜煎导法
用蜜七合，入铜器中，微火熬，稍凝似饴状，搅之勿令焦，候可丸，以手捏作挺子，令头锐，大如指，长
二寸许。乘热急作之，纳谷道中，用手急捺住，欲大便时乃去之。又，猪胆汁方
用大猪胆一个，泻汁和醋少许，和匀灌入谷道中，如饭时顷，大便自去。
太阳病，寸缓、关浮、尺弱，其人发热汗出，复恶寒，不呕，但心下痞者，此以医下之也。如其不下者，
病患不恶寒而渴者，此转属阳明也。小便数者，大便必硬，不更衣十日，无所苦也。渴欲饮水，少少与之，但
以法救之。渴者，宜五苓散。阳明病，本自汗出，医更重发汗，病已瘥，尚微烦不了了者，此大便必硬故也。
以亡津液，胃中干燥，故令大便硬。当问其小便日几行，若本小便日三四行，今日再行，故知大便不
久出。今为小便数少，以津液当还入胃中，故知不久必大便也。
阳明病，潮热，不大便六七日，恐有燥粪，欲知之法，少与小承气汤，转矢气者，有燥屎，可攻；若不转矢气者，
无燥粪，不可攻。（方论见潮热。）阳明病，汗出，大便硬而谵语者，宜小承气汤。（方见谵语。）不大便腹满者，宜下之，
若但绕脐痛者，则为燥屎，宜承气汤。若心下至小腹满痛者，则为结胸，宜陷胸汤。（方见腹痛。）阳明病不吐不下，
心烦者，宜调胃承气汤。阳明病，发热汗出，此为热越，不能发黄也。但头汗出，身无汗，汗剂颈
而还，小便不利，渴饮水浆者，此为瘀热在里，身必发黄，茵陈汤主之。小便不利，大便乍难乍易，有微热，
喘冒不卧者，宜大承气汤。（论见不得卧。）阳明症，其人喜忘者，必有蓄血。所以然者，本有久瘀血，
故令喜忘，屎虽硬，大便反易，其色必黑，宜抵当汤下之。（方见蓄血。）无尽里症，下后脉数不解，
消谷易饱，六七日不大便者，有瘀血，宜抵当汤。伤寒六七日，目中不了了，睛不和，无表里证，大便难，
身微热者，此为实也，急下之，宜大承气汤。趺阳脉浮而涩，浮则胃气强，涩则小便数，浮涩相搏，
大便难，其脾为约，麻仁丸主之。
麻仁丸（丹溪云∶气实而表药也。）
麻仁（一升） 芍药 浓朴（去皮，姜制） 枳实（各四两） 杏仁 大黄（煨。各八两）
上为末，蜜和丸，如桐子大，米饮下二三十丸，未知，益之，每日三服。
阳明口燥，但欲漱水不欲咽者，此必衄。（《活人》云∶轻则犀角汤，重则抵当汤。）
〔许学士〕有一士人家病二人，皆旬日矣，一则身热无汗，大便不通，小便如涩，神昏而睡，诊其脉长大
而实，予用承气下之而愈。一则阳明自汗，大便不通，小便利，津液少，口干燥，其脉亦大而虚，作蜜煎三易
之，下燥粪得溏利而解。其家曰∶皆阳明不通，何以治之异？予曰∶二症虽相似，然自汗小便利者，
不可荡涤五脏，为无津液也。然则伤寒大症相似，两症稍有不同，宜仔细斟酌。正如格局看命，虽年月
日时皆同，而贵
贱穷通不相侔者，于一时之中有浅深，故知不可不谨。
阳明病发多反无汗，其身如虫行皮中状者，此久虚故也。阳明病，反无汗而小便利，三日呕而咳，手足厥
者，必头痛，若不咳呕，手足不厥者，头不痛。（注云∶小便利者，寒邪内攻；肢厥头痛，寒邪外攻也。）
阳明胃实，脉浮无汗而喘，宜麻黄汤。（论见胃实有表条。）阳明病，无汗，小便利，心中懊 者，身必
发黄，宜茵陈蒿汤。
脉浮而数，能食，不大便者，此为实，名曰阳结也，期十七日当剧。脉沉而迟，不能食，身体重，
大便硬，名曰阴结也，期十四日当剧。
少阴病，但欲寐，腹胀不大便者，承气汤主之。（论见但欲寐。）
问：疾病有太阳阳明、正阳阳明、少阳阳明之分，这是什么意思？答：太阳阳明，是指脾约（脾阴不足导致的大便干结）。正阳阳明，是指胃家实（胃肠燥热积滞）。少阳阳明，是指经过发汗或利小便治疗后，胃中干燥、心烦、实热、大便困难的情况。阳明病的总纲，就是胃家实。
问：为什么会得阳明病？答：患太阳病时，如果误用发汗、攻下或利小便的方法，会导致津液耗伤，胃中干燥，从而转化为阳明病。如果不解大便，体内实热积聚，大便困难，这就叫作阳明病。伤寒脉象浮而缓，手足自然温暖，这是病邪关联在太阴经。太阴病通常会出现身黄，但如果小便通利，就不会发黄；到了七八天，如果大便变硬，就转为阳明病了。阳脉实大，如果强行发汗，汗出过多，属于太过，这会导致阳气在体内枯竭，津液亡失，大便因此变硬。
阳明病中，如果能进食，属于中风；如果不能进食，属于中寒。阳明病患者，如果只是头晕而不恶寒，所以能进食且咳嗽，其人必定咽喉痛；如果不咳嗽，咽喉就不痛。阳明病患者不能进食，如果用寒凉药攻其热，一定会发生呃逆（打嗝），之所以这样，是因为胃中虚冷，因为患者本身正气虚弱，所以攻热必致呃逆。
阳明病，脉象迟缓，吃东西难以吃饱，饱食后会有轻微烦闷、头晕，必定小便困难，这是将要发生谷疸（因饮食不当引起的黄疸），如果用攻下法，腹部胀满依旧。之所以这样，是因为脉迟的缘故。阳明病欲缓解的时间，是从申时到戌时（下午3点到晚上7点）。
伤寒呕吐频繁，即使有阳明症状，也不可攻下。阳明病，面色通红，不可攻下，攻下后必定发热、面色发黄、小便不利。阳明病，心下部硬满的，不可攻下。如果攻下，腹泻不止的会死亡，腹泻停止的痊愈。
伤寒不大便六七天，头痛且有发热的，给予承气汤。如果小便清长，知道病不在里，仍在表，应当发汗，如果头痛剧烈必定流鼻血，适宜用桂枝汤。阳明病，脉浮、无汗且喘息的，发汗则愈，适宜用麻黄汤。阳明病，胁下硬满，大便不通且呕吐，舌上有白苔的，可以给予小柴胡汤。如果上焦气机通畅，津液下行，胃气调和，身体微微出汗而病解。
阳明中风，脉弦、浮、大，短气，腹部胀满，胁下及心痛，久按之气不通畅，鼻干，无汗，嗜睡，全身及面目都发黄，小便难，有潮热，时时呃逆，耳前后肿胀，针刺后稍有好转，但表证未解。病过十天，脉仍浮的，给予小柴胡汤；脉仅浮而无其他症状的，给予麻黄汤；如果小便不通，腹满加重并出现呃逆的，属不治之症。
阳明中风，口苦咽干，腹部胀满微喘，发热恶寒，脉浮紧。如果误用下法，会导致腹满、小便困难。（许学士说：适宜用小柴胡汤。）阳明腹满，脉浮紧，口苦咽干且喘，如果发热汗出，不恶寒反而恶热，身体沉重，忌发汗，忌加烧针，忌攻下。（相关论述见自汗篇。）阳明病，脉浮紧的，必定有定时发作的潮热；脉仅浮的，必定有盗汗。
以上提到胃家实不大便，即使是三岁孩童也知道可以用下法。殊不知张仲景的法度，虽然有胃实证，如果表证未解，或者兼有半表半里证，也先用桂枝汤、小柴胡汤来解外，然后再根据虚实情况斟酌处理。
阳明病，自汗出，如果再发汗，小便自利，这是津液内竭，虽然大便硬，不可攻下，应当等到患者想排便时，适宜用蜜煎导法通便。也可以用土瓜根或猪胆汁导便。
蜜煎导法：用蜂蜜七合，放入铜器中，用微火熬煮，稍微凝固像饴糖状，搅拌不要让它焦糊，候温可丸，用手捏成条状，头要尖，直径如手指，长约二寸。趁热急做，纳入肛门中，用手按住，想排便时再取出。另外，猪胆汁方：用一个大猪胆，取汁加少许醋，混合均匀灌入肛门中，约一顿饭工夫，大便自然排出。
太阳病，寸脉缓、关脉浮、尺脉弱，其人发热汗出，又恶寒，不呕，只是心下痞塞，这是医生误用下法造成的。如果没下，病人不恶寒而口渴的，这是转属阳明。小便频数的，大便必定硬，十天不解大便，也没有痛苦。想喝水，少量给之，只需用正确方法救治。口渴者，适宜五苓散。阳明病，本来自汗出，医生更重发汗，病虽好转，但仍轻微烦闷不适，这是因为大便硬的缘故。因为津液亡失，胃中干燥，所以令大便硬。应当问其一天小便几次，如果原本一天小便三四次，今天只有两次，就知道大便不久会排出。现在因为小便次数减少，津液应当回归胃中，所以知道不久必然大便排出。
阳明病，潮热，不大便六七天，恐怕有燥屎，想知道的方法，少量给予小承气汤，如果放屁（转矢气），说明有燥屎，可以攻下；如果不放屁，说明无燥屎，不可攻下。（方论见潮热篇。）阳明病，汗出，大便硬且谵语的，适宜小承气汤。（方见谵语篇。）不大便且腹满的，适宜攻下，如果仅是绕脐痛，则是燥屎，适宜承气汤。如果从心下到小腹满痛，则是结胸，适宜陷胸汤。（方见腹痛篇。）阳明病，没有吐下，心烦的，适宜调胃承气汤。阳明病，发热汗出，这是热邪外越，不会发黄。如果只有头部出汗，身上无汗，汗止于颈部，小便不利，渴饮水浆，这是瘀热在里，身体必定发黄，茵陈汤主治。小便不利，大便乍难乍易，有微热，喘促头晕不能卧的，适宜大承气汤。（论述见不得卧篇。）阳明证，其人喜忘（健忘）的，必有蓄血。之所以这样，是因为本有久瘀血，所以令喜忘，屎虽硬，大便反而容易，颜色必定黑，适宜抵当汤攻下。（方见蓄血篇。）如果没有里证，下后脉数不解，消谷善饥，六七天不大便的，有瘀血，适宜抵当汤。伤寒六七天，眼睛看不清，眼球转动不灵活，无表里证，大便难，身体微热的，这是实证，急下之，适宜大承气汤。趺阳脉浮而涩，浮则胃气强，涩则小便频数，浮涩相搏，大便难，脾被约束，麻仁丸主治。
麻仁丸（朱丹溪说：是行气实而解表的药。）
麻仁（一升） 芍药 浓朴（去皮，姜制） 枳实（各四两） 杏仁 大黄（煨。各八两）
以上研为末，蜂蜜和丸，如梧桐子大，米饮送服二三十丸，无效则增加剂量，每日三服。
阳明口燥，只想漱水不想吞咽的，这必定会流鼻血。（《活人书》说：轻则犀角汤，重则抵当汤。）
许学士曾诊治一户人家的两个病人，都病了十几天了。一个身体发热无汗，大便不通，小便涩滞，神志昏沉嗜睡，诊其脉长大而实，我用承气汤攻下而痊愈。另一个阳明病自汗，大便不通，小便通利，津液少，口干燥，其脉亦大而虚，我用蜜煎导法三次，排出燥粪后得到溏利而解。这家人说：都是阳明不通，为什么治疗不同？我说：这两个症状虽然相似，但自汗小便利的，不可荡涤五脏，因为没有津液。然而伤寒大病症状相似，两症稍有不同，应该仔细斟酌。正如看八字算命，虽然年月日时相同，但贵贱穷通不相等，在于一时之中有深浅，所以知道不可不谨慎。
阳明病发多反无汗，身体像虫行皮中状的，这是久虚的缘故。阳明病，反无汗而小便利，三天后呕吐且咳，手足厥冷的，必定头痛，如果不咳不呕，手足不厥冷，头就不痛。（注云：小便利，是寒邪内攻；肢厥头痛，是寒邪外攻。）
阳明胃实，脉浮无汗而喘，适宜麻黄汤。（论述见胃实有表条。）阳明病，无汗，小便利，心中懊恼的，身体必定发黄，适宜茵陈蒿汤。
脉浮而数，能食，不大便的，此为实证，名叫阳结，预计十七天病情加重。脉沉而迟，不能食，身体沉重，大便硬的，名叫阴结，预计十四天病情加重。
Question: There are Taiyang Yangming, Zhengyang Yangming, and Shaoyang Yangming diseases. What does this mean? Answer: Taiyang Yangming refers to Pi Yue (Spleen Constraint). Zhengyang Yangming refers to Wei Jia Shi (Stomach House Excess). Shaoyang Yangming refers to the condition where, after sweating or promoting urination, the stomach becomes dry, causing irritability, excess heat, and difficulty in defecation. The general principle of Yangming disease is Wei Jia Shi (Stomach House Excess).
Question: How does one contract Yangming disease? Answer: When suffering from Taiyang disease, if improper methods such as inducing sweat, purging, or promoting urination are used, body fluids are depleted, the stomach becomes dry, and the condition transforms into Yangming disease. If one fails to defecate, internal excess heat accumulates, and defecation is difficult, this is called Yangming disease. In cold damage with a floating and slow pulse, and naturally warm hands and feet, the pathogen is associated with the Taiyin meridian. Taiyin disease typically presents with jaundice; however, if urination is unobstructed, jaundice will not occur. After seven or eight days, if the stool becomes hard, it has transformed into Yangming disease. A solid yang pulse indicates that excessive sweating leads to the exhaustion of yang within and the loss of body fluids, causing the stool to become hard.
In Yangming disease, the ability to eat indicates Wind Strike, while the inability to eat indicates Cold Strike. In Yangming disease, if there is only dizziness without aversion to cold, the patient can eat and may cough; such a person will definitely have a sore throat. If there is no cough, there is no sore throat. In Yangming disease, if the patient cannot eat and heat-clearing drugs are used, hiccups will inevitably occur. This is because the stomach is deficient and cold; since the patient's original qi is deficient, clearing heat will cause hiccups.
In Yangming disease, a slow pulse, difficulty in eating to fullness, slight irritability and dizziness after eating, and necessarily difficult urination indicate impending Gu Dan (Grain Jaundice). Purging will not relieve abdominal fullness due to the slow pulse. Yangming disease tends to resolve between Shen and Xu hours (3 PM to 7 PM). In cold damage, if vomiting is frequent, even if Yangming symptoms exist, purging is contraindicated. In Yangming disease, if the face is red, purging is contraindicated; purging will cause fever, yellow complexion, and difficult urination. In Yangming disease, if there is hardness and fullness below the heart, purging is contraindicated. If purged and diarrhea continues uncontrollably, death ensues; if diarrhea stops, recovery occurs.
If cold damage presents with constipation for six or seven days, headache, and fever, Chengqi Tang should be administered. If urine is clear, the pathogen is still in the exterior, and sweating is indicated. If headache is severe, epistaxis may occur, and Guizhi Tang is suitable. In Yangming disease, with a floating pulse, anhidrosis, and wheezing, sweating will lead to recovery; Mahuang Tang is suitable. In Yangming disease, with hardness and fullness in the hypochondrium, difficult defecation, vomiting, and a white tongue coating, Xiaochaihu Tang may be given. If the Upper Jiao becomes unobstructed, body fluids descend, stomach qi harmonizes, and mild sweating occurs, the disease resolves.
Yangming Wind Strike presents with wiry, floating, and large pulses, shortness of breath, abdominal fullness, pain in the hypochondrium and chest, obstruction of qi upon pressure, dry nose, anhidrosis, lethargy, generalized and facial jaundice, difficult urination, tidal fever, intermittent hiccups, and swelling around the ears. Acupuncture provides slight relief, but the exterior syndrome remains unresolved. If the disease persists beyond ten days and the pulse remains floating, Xiaochaihu Tang is given; if the pulse is merely floating without other symptoms, Mahuang Tang is given. If urination is obstructed, abdominal fullness worsens, and hiccups appear, the condition is untreatable.
Yangming Wind Strike presents with bitter taste, dry throat, abdominal fullness, slight wheezing, fever, aversion to cold, and a floating, tight pulse. Purging will cause abdominal fullness and difficult urination. (Xu Xueshi states: Xiaochaihu Tang is suitable.) In Yangming abdominal fullness with a floating, tight pulse, bitter taste, dry throat, and wheezing, if there is fever, sweating, aversion to cold turning into aversion to heat, and heavy body, sweating, moxibustion with burning needles, and purging are all contraindicated. (See section on spontaneous sweating.) In Yangming disease, a floating and tight pulse indicates regular tidal fever; a merely floating pulse indicates night sweats.
Regarding Wei Jia Shi and constipation, even a child knows purging is indicated. However, Zhang Zhongjing's method dictates that even with Stomach Excess, if the exterior is unresolved or there is a half-exterior/half-interior syndrome, Guizhi Tang or Chaihu Tang should first be used to resolve the exterior, followed by assessment of deficiency and excess.
In Yangming disease, with spontaneous sweating, further sweating and diuresis deplete internal fluids. Even if the stool is hard, purging is contraindicated. One should wait for the urge to defecate and use Honey Suppository (Mi Jian Dao) to guide the stool. Tugua Gen (Root of Trichosanthes Kirilowii) or Pig Bile can also be used.
Honey Suppository Method: Use seven he of honey, boil gently in a copper vessel until it thickens like maltose, stirring to prevent burning. When cool enough to mold, shape into a cone, sharp at the head, finger-thick, about two cun long. Insert into the anus while warm, hold in place, and remove when the urge to defecate arises. Pig Bile Formula: Mix juice from one large pig gallbladder with a little vinegar, and enema into the anus. After a meal's time, the stool will pass naturally.
In Taiyang disease, with a slow inch pulse, floating guan pulse, and weak chi pulse, fever, sweating, aversion to cold, no vomiting, but epigastric stuffiness, this is due to physician-induced purging. If not purged, and the patient is not averse to cold but thirsty, it has transformed into Yangming. Frequent urination leads to hard stool; ten days without defecation causes no distress. For thirst, give small amounts of water and treat appropriately. Thirst is treated with Wuling San. In Yangming disease, originally with spontaneous sweating, if the physician induces heavy sweating again, and although the illness improves, slight irritability remains, this is due to hard stool caused by fluid depletion and stomach dryness. Ask about daily urination frequency; if it decreases, fluids return to the stomach, and defecation will occur soon.
In Yangming disease with tidal fever and constipation for six or seven days, suspecting dry feces, administer a small amount of Xiao Chengqi Tang. If flatus occurs, dry feces are present, and purging is allowed. If no flatus, no dry feces, and purging is forbidden. (See section on tidal fever.) In Yangming disease with sweating, hard stool, and delirium, Xiao Chengqi Tang is suitable. (See section on delirium.) Constipation with abdominal fullness requires purging; if pain surrounds the navel, it is dry feces, and Chengqi Tang is suitable. If fullness and pain extend from the epigastrium to the lower abdomen, it is Jie Xiong (Chest Binding), and Xianxiong Tang is suitable. (See section on abdominal pain.) In Yangming disease without vomiting or purging, if there is mental restlessness, Tiaowei Chengqi Tang is suitable. In Yangming disease, fever and sweating indicate heat dispersing outward, preventing jaundice. If only the head sweats, the body is dry, sweat stops at the neck, urination is difficult, and thirst for liquids exists, this is stagnant heat in the interior, leading to jaundice; Yinchen Tang is the main treatment. With difficult urination, alternating hard and soft stool, slight fever, wheezing, vertigo, and inability to lie down, Da Chengqi Tang is suitable. (See section on inability to lie down.) In Yangming syndrome, if the patient suffers from forgetfulness, there must be blood stasis. Due to old blood stasis, forgetfulness occurs; although stool is hard, defecation is easy, and the color is black; Didang Tang is suitable for purging. (See section on blood stasis.) If there are no interior symptoms, but after purging the rapid pulse persists, digestion is rapid, yet constipation lasts six or seven days, blood stasis is present, and Didang Tang is suitable. In cold damage after six or seven days, if vision is blurred, eyes are unresponsive, with no exterior/interior signs, difficult defecation, and slight fever, this is an excess syndrome requiring urgent purging with Da Chengqi Tang. At the foot pulse, floating and choppy indicates strong stomach qi and frequent urination; their interaction causes difficult defecation and Spleen Constraint, treated with Maren Wan.
Maren Wan (Zhu Danxi says: It moves qi excess and releases the exterior.)
Hemp Seed (one sheng), Peony, Prepared Magnolia Bark (peeled, ginger-processed), Immature Bitter Orange (each four liang), Apricot Kernel, Rhubarb (roasted, each eight liang).
Grind into powder, mix with honey to make pills the size of tung seeds. Take 20-30 pills with rice broth. Increase dose if ineffective. Three times daily.
In Yangming, mouth dryness with desire to rinse mouth but not swallow indicates impending epistaxis. (The Huoren Shu says: Mild cases use Xijiao Tang, severe cases use Didang Tang.)
Xu Xueshi treated two patients in one household who had been ill for ten days. One had fever, anhidrosis, constipation, scanty urination, and lethargy; the pulse was large, long, and solid. He used Chengqi Tang to purge, resulting in recovery. The other had Yangming spontaneous sweating, constipation, free urination, fluid deficiency, dry mouth, and a large, empty pulse. He used Honey Suppositories three times, expelling dry feces and resolving the condition with loose stools. The family asked why treatments differed despite similar Yangming obstruction. Xu replied: Although symptoms are similar, spontaneous sweating and free urination indicate no fluid reserve, so harsh purging of the five zang organs is contraindicated. One must carefully distinguish subtle differences. Just as in fortune-telling, identical birth data can yield different fates based on subtle depths, caution is essential.
In Yangming disease, profuse sweating with anhidrosis and a sensation of insects crawling under the skin indicates chronic deficiency. In Yangming disease, anhidrosis with free urination, followed by vomiting, cough, and cold limbs after three days, leads to headache. If there is no vomiting/cough and limbs are warm, there is no headache. (Note: Free urination indicates internal cold attack; cold limbs and headache indicate external cold attack.)
Yangming Stomach Excess with floating pulse, anhidrosis, and wheezing is treated with Mahuang Tang. (See section on Stomach Excess with Exterior Syndrome.) Yangming disease with anhidrosis, free urination, and mental agitation leads to jaundice; Yinchen Hao Tang is suitable.
A floating and rapid pulse with ability to eat and constipation indicates Excess, named Yang Jie (Yang Knot), worsening on the seventeenth day. A sinking and slow pulse with inability to eat, heavy body, and hard stool indicates Yin Jie (Yin Knot), worsening on the fourteenth day.
Shaoyin disease with lethargy, abdominal fullness, and constipation is treated with Chengqi Tang. (See section on lethargy.)