时疫呃逆与伤寒不同∶伤寒呃逆，虚、实、寒、热俱有；时疫呃逆，惟热结下焦而已。凡见呃逆，即当下之，
下之不止，按其脐腹有硬痛拒按处，仍当下之，有下至十数次方止者。总之逐尽结热，肠胃通达，其呃自止。慎不
可用丁香柿蒂汤，治呃而遗结热，致成危证也。
伤寒吐蛔，多寒热错杂；时疫吐蛔，则有热无寒。治此证之当汗、当清、当下，一以传变之大势为主，惟加乌
梅、黄连以安之，慎勿用乌梅丸中诸辛热药，致成危笃也。
时疫贵解其邪热，而邪热必有着落。方着落在肌表时，非汗则邪无出路，故汗法为治时疫之一大法也。但风
寒汗不厌早，时疫汗不厌迟。风寒发汗，必兼辛温、辛热以宣阳；时疫发汗，必兼辛凉、辛寒以救阴。风寒发汗，
治表不犯里；时疫发汗，治表必通里。其不同有如此，故方疫邪传变出表时，轻者亦可得表药而汗散，若重者，虽
大剂麻黄、羌、葛，亦无汗也，以伏邪发而未尽之故。亦有不用表药而自汗淋漓，邪终不解者。盖此汗缘里热郁蒸
而出，乃邪汗，非正汗也，必待伏邪尽发，表里全彻，然后或战汗，或狂汗而解，所谓汗不厌迟者，此也。辛凉发
汗，则人参败毒散、荆防败毒散之类是；辛寒发汗，则大青龙，九味羌活、大羌活之类是；发表兼通里，则吴氏三
消饮、六神通解散、防风通圣散之类是。
更有不求汗而自汗解者。如里热闭甚，用大承气以通其里，一不已而再，再不已而三，直待里邪逐尽，表里自
和，多有战汗而解，此不求汗而自汗解者一。又如里热燥甚，病者思得凉水，久而不得，忽得痛饮，饮盏落枕而汗
大出，汗出即解，此不求汗而自汗解者二。又如平素气虚，屡用汗药不得汗，后加人参于诸解表药中，复杯立
汗，凡不求汗而自汗解者三。又如阴虚及夺血，枯竭之
极，用表药全然无汗，用大滋阴、润燥、生津药数剂而汗出如水，此不求汗而自汗解者四。
总之疫邪汗法，不专在乎升表，而在乎通其郁闭，和其阴阳。郁闭在表，辛凉、辛寒以通之；郁闭在里，苦寒
攻利以通之。阳亢者，饮水以济其阴；阴竭者，滋润以回其燥。气滞者开导，血凝者消瘀。必察其表里无一毫阻
滞，乃汗法之万全，此时疫汗法，理不同于风寒。
谨撮诸汗证，详列于下∶发热，恶寒，无汗，头项痛，背痛，腰痛，肩臂痛，膝胫痛，周身肢节痛。
时疫（流行性温热病）引起的呃逆与伤寒不同：伤寒引起的呃逆，虚证、实证、寒证、热证都可能出现；而时疫引起的呃逆，只有热邪结聚在下焦这一种情况。凡是见到呃逆症状，就应当使用泻下法治疗，如果泻下后呃逆不止，按压其脐腹部发现有硬块且疼痛拒按，仍然应当继续使用泻下法，有的患者需要泻下十几次才能停止。总之，只有将结聚的热邪彻底清除，使肠胃气机通畅，呃逆自然就会停止。千万不要使用丁香柿蒂汤来治疗呃逆，以免遗留结聚的热邪，导致病情危重。
伤寒引起的吐蛔虫，多是寒热错杂的证候；时疫引起的吐蛔虫，则只有热邪而没有寒邪。治疗这种证候，无论是应当用汗法、清法还是下法，都要以疾病传变的大趋势为主，只需加入乌梅、黄连来安蛔止呕，千万不要使用乌梅丸中的各种辛热药物，以免导致病情危笃。
治疗时疫贵在解除邪热，而邪热必须有出路。当邪热停留在肌表时，如果不通过发汗，邪气就没有出路，所以汗法是治疗时疫的重要方法之一。但是，风寒感冒的发汗不宜过早，时疫的发汗不宜过迟。风寒发汗，必须兼用辛温、辛热的药物来宣通阳气；时疫发汗，必须兼用辛凉、辛寒的药物来保护阴液。风寒发汗，只治表证而不侵犯里证；时疫发汗，治表证时必须兼顾通利里证。它们的不同之处就像这样，所以当疫邪传变出表时，轻症也可以借助解表药而发汗解散，如果是重症，即使使用大剂量的麻黄、羌活、葛根等药，也无法出汗，这是因为伏留的邪气发作但未完全透达的缘故。也有不使用解表药而自然大汗淋漓，但邪气始终不能解除的情况。这种汗是因为里热郁蒸而出，属于“邪汗”，不是正常的“正汗”，必须等到伏邪全部发散，表里之气完全透彻，然后才会出现战汗或狂汗而病愈，这就是所说的“时疫发汗不宜过早”的原因。辛凉发汗，如人参败毒散、荆防败毒散之类的方剂；辛寒发汗，如大青龙汤、九味羌活汤、大羌活汤之类的方剂；发表兼通里，如吴氏三消饮、六神通解散、防风通圣散之类的方剂。
更有不刻意追求发汗而自然汗出病解的情况。比如里热闭阻严重，使用大承气汤来通利里实，一次不行就用两次，两次不行就用三次，一直等到里邪被彻底驱逐，表里调和，大多会出现战汗而病愈，这是第一种不追求发汗而自然汗解的情况。又如里热燥热严重，病人想喝凉水，长时间得不到，忽然得到并痛快饮用，杯子放下枕头便大汗出，汗出即病愈，这是第二种。又如平时气虚的人，多次使用发汗药却不出汗，后来在解表药中加入人参，喝完药立刻出汗，这是第三种。又如阴虚及失血过多，枯竭到了极点，使用解表药完全无汗，使用大剂量滋阴、润燥、生津的药物几剂后，汗出如水，这是第四种。
总之，疫病的汗法，并不专门在于升提透表，而在于疏通郁闭，调和阴阳。郁闭在表，用辛凉、辛寒的药物来疏通；郁闭在里，用苦寒攻下的药物来疏通。阳气亢盛者，饮水以济助阴液；阴液枯竭者，滋润以恢复干燥。气滞者开导，血凝者化瘀。必须观察确认表里没有一丝一毫的阻滞，这才是汗法的万全之策，此时疫的汗法原理与风寒不同。
谨将各种汗证概要，详细列举如下：发热，恶寒，无汗，头项痛，背痛，腰痛，肩臂痛，膝胫痛，周身肢节痛。
The hiccups caused by epidemic febrile diseases (Shi Yi, epidemic warm diseases) differ from those in Cold Damage (Shang Han): Hiccups in Cold Damage may arise from deficiency, excess, cold, or heat patterns; whereas hiccups in epidemic febrile diseases are solely due to the accumulation of heat in the lower jiao. Whenever hiccups are observed, purgation should be employed immediately. If hiccups persist after purgation and hard, painful areas that resist pressure are found upon palpation of the umbilical and abdominal regions, purgation should still be continued; some patients may require purgation ten or more times before it ceases. In summary, once the accumulated heat is thoroughly cleared and the qi mechanism of the intestines and stomach becomes unobstructed, the hiccups will naturally stop. One must strictly avoid using Dingxiang Shidi Tang (Clove and Persimmon Calyx Decoction) to treat hiccups, lest the residual heat be retained, leading to a critical condition.
Vomiting roundworms (Tu Hui) in Cold Damage often presents as a complex pattern of cold and heat; however, vomiting roundworms in epidemic febrile diseases involves heat only, without cold. The treatment for this condition—whether employing diaphoresis (Han Fa), clearing (Qing), or purgation (Xia)—should primarily follow the general trend of disease transmission. Only Wumei (Mume Fructus) and Huanglian (Coptidis Rhizoma) should be added to calm the parasites. One must strictly avoid using the various acrid-warm herbs found in Wumei Wan (Mume Pill) to prevent the condition from becoming critical.
Treating epidemic febrile diseases prioritizes resolving pathogenic heat, which must have an exit route. When pathogenic heat resides on the exterior (muscle-surface), if diaphoresis is not used, there is no way for the pathogen to exit; thus, diaphoresis is one of the major methods for treating epidemic febrile diseases. However, while diaphoresis for Wind-Cold should not be delayed, diaphoresis for epidemic febrile diseases should not be performed too early. Diaphoresis for Wind-Cold must be combined with acrid-warm or acrid-hot herbs to disseminate Yang qi; diaphoresis for epidemic febrile diseases must be combined with acrid-cool or acrid-cold herbs to preserve Yin fluids. Diaphoresis for Wind-Cold treats the exterior without invading the interior; diaphoresis for epidemic febrile diseases treats the exterior while necessarily unblocking the interior. Their differences are such that when epidemic pathogens transmit to the exterior, mild cases can be resolved via diaphoresis using exterior-releasing herbs. In severe cases, even large doses of Mahuang (Ephedrae Herba), Qianghuo (Notopterygii Rhizoma et Radix), and Gegen (Puerariae Lobatae Radix) may fail to induce sweating, because the latent pathogen has emerged but not fully expressed. There are also cases where profuse spontaneous sweating occurs without using exterior-releasing herbs, yet the pathogen remains unresolved. This type of sweat arises from the steaming of internal heat郁闭 (stagnation); it is "pathogenic sweat," not "normal sweat." Recovery only occurs after the latent pathogen is fully expressed and both interior and exterior are thoroughly cleared, leading to either Zhan Han (shivering sweat) or Kuang Han (delirious sweat). This explains why "diaphoresis for epidemic febrile diseases should not be performed too early." Acrid-cool diaphoresis includes formulas such as Renshen Baidu San (Ginseng Detoxification Powder) and Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxification Powder); acrid-cold diaphoresis includes Da Qinglong Tang (Major Green Dragon Decoction), Jiuwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction), and Da Qianghuo Tang (Major Notopterygium Decoction); exterior-releasing combined with interior-unblocking includes Wu's Sanxiao Yin (Wu's Triple Elimination Drink), Liushentongjie San (Six-Awakening Unblocking Powder), and Fangfeng Tongsheng San (Saposhnikovia Unblocking and Generating Powder).
There are further cases where recovery occurs through spontaneous sweating without actively seeking diaphoresis. First, when internal heat closure is severe, using Dachengqi Tang (Major Order the Qi Decoction) to unblock the interior—if once is ineffective, twice; if twice is ineffective, three times—until the interior pathogen is completely expelled and the interior and exterior harmonize, Zhan Han (shivering sweat) often occurs, marking resolution. This is the first case of spontaneous resolution without seeking sweat. Second, when internal heat dryness is extreme, the patient desires cold water; after a long wait, sudden abundant drinking leads to profuse sweating upon putting down the cup, resulting in immediate resolution. This is the second case. Third, in patients with chronic Qi deficiency who fail to sweat despite repeated use of diaphoretic herbs, adding Renshen (Ginseng Radix) to exterior-releasing formulas induces immediate sweating upon completion of the dose. This is the third case. Fourth, in cases of Yin deficiency and blood loss reaching extreme depletion, exterior-releasing herbs produce no sweat; however, several doses of strong Yin-nourishing, moisture-moistening, and fluid-generating herbs induce profuse sweating like water. This is the fourth case.
In summary, the diaphoretic method for epidemic pathogens does not rely solely on ascending and releasing the exterior, but rather on unblocking stagnation and harmonizing Yin and Yang. Stagnation at the exterior is unblocked with acrid-cool or acrid-cold herbs; stagnation at the interior is unblocked with bitter-cold purgative herbs. For hyperactive Yang, drinking water nourishes Yin; for exhausted Yin, moistening remedies restore dryness. For Qi stagnation, guiding and opening methods are used; for Blood coagulation, stasis-resolving methods are applied. One must observe that there is absolutely no obstruction in the exterior or interior; only then is the diaphoretic method comprehensive. Thus, the principle of diaphoresis in epidemic febrile diseases differs from that in Wind-Cold.
Herein, various sweat-related syndromes are summarized and listed in detail: Fever, aversion to cold, absence of sweating, pain in the head and nape, back pain, lumbar pain, shoulder and arm pain, knee and shin pain, and pain throughout the body and joints.