竹叶（二把辛平） 石膏（一斤甘寒） 半夏（半升洗辛温） 人参（三两甘温）
甘草（二两甘平炙） 粳米（半升甘微寒） 麦门冬（一升甘平去心）
上七味。以水一斗。煮取六升。去滓。内粳米。煮米熟。汤成。去米。温服一升。
日三服。
辛甘发散而除热。竹叶石膏甘草之甘辛。以发散余热。甘缓脾而益气。麦门冬人参
粳米之甘。以补不足。辛者散也。气逆者欲其散。半夏之辛。以散逆气。
病患脉已解。而日暮微烦。以病新瘥。人强与谷。脾胃气尚弱。不能消谷。故令微
烦。损谷则愈。
阳明王于申酉戌。宿食在胃。故日暮微烦。当小下之。以损宿谷。
夫以为疾病至急。仓卒寻按要者难得。故重集诸可与不可方治。比之三阴三阳篇中。
此易见也。又时有不止是三阴三阳。出在诸可与不可中也。
诸不可汗。不可下。病证药方。前三阴三阳篇中。经注已具者。更不复出。其余无
者。于此以后。经注备见。
脉濡而弱。弱反在关。濡反在巅。微反在上。涩反在下。微则阳气不足。涩则无血。阳
气反微。中风汗出而反躁烦。涩则无血。厥而且寒。阳微发汗。躁不得眠。
寸关为阳脉当浮盛。弱反在关。则里气不及。濡反在巅。则表气不逮。卫行脉外。
浮为在上。以候卫。微反在上。是阳气不足。荣行脉中。沉为在下。以候荣涩。反在下。是
无血也。阳微不能固外。腠理开疏。风因客之。故令汗出而躁烦无血则阴虚。不与阳相
顺接。故厥而且寒。阳微无津液。则不能作汗。若发汗则必亡阳而躁。经曰。汗多亡阳。
遂虚。恶风。烦躁。不得眠也。
动气在右。不可发汗。发汗则衄而渴。心苦烦。饮即吐水。
动气者。筑筑然气动也。在右者。在脐之右也。难经曰。肺内证。脐右有动气。按之
牢若痛。肺气不治正气内虚。气动于脐之右也。发汗则动肺气。肺主气。开窍于鼻。气
虚则不能卫血。血溢妄行。随气出于鼻为衄。亡津液胃燥。则烦渴而心苦烦。肺恶寒。
饮冷则伤肺。故饮即吐水。
活人云。先服五苓散三服。次服竹叶汤。
动气在左。不可发汗。发汗则头眩汗不止。筋惕肉 。
难经曰。肝内证。脐左有动气。按之牢若痛。肝气不治。正气内虚。气动于脐之左
也。肝为阴之主。发汗。汗不止。则亡阳外虚。故头眩筋惕肉 。针经曰。上虚则眩。
活人云。先服防风、白术、牡蛎。汗止。次服建中汤。
动气在上。不可发汗。发汗。则气上冲。正在心端。
难经曰。心内证脐上有动气。按之牢若痛。心气不治。正气内虚。气动于脐之上也。
心为阳。发汗亡阳。则愈损心气。肾乘心虚欲上凌心。故气上冲。正在心端。
活人云。宜服李根汤。
动气在下。不可发汗。发汗。则无汗。心中大烦。骨节苦疼。目晕恶寒。食则反吐
谷不得前。
难经曰。肾内证。脐下有动气。按之牢。若痛。肾气不治。正气内虚。动气发于脐
之下也。肾者主水。发汗。则无汗者。水不足也。心中大烦者。肾虚不能制心火也。骨
节苦疼者。肾主骨也。目晕者。肾病则目KT KT 。如无所见。恶寒者。肾主寒也。食则
反吐。谷不得前者。肾水干也。王冰曰。病呕而吐。食久反出。是无水也。
活人云先服大橘皮汤。吐止。后服小建中汤。
咽中闭塞不可发汗。发汗。则吐血。气欲绝。手足厥冷。欲得蜷卧。不能自温。
咽门者。胃之系。胃经不和。则咽内不利。发汗攻阳。血随发散而上。必吐血也。胃
经不和。而反攻表。则阳虚于外。故气欲绝。手足冷。欲蜷而不能自温。
诸脉得数动微弱者。不可发汗。发汗。则大便难。腹中干。胃燥而烦。其形相像。
根本异源。
动数之脉。为热在表。微弱之脉。为热在里。发汗亡津液。则热气愈甚。胃中干燥。
故大便难。腹中干。胃燥而烦根本虽有表里之异。逆治之后。热传之则一。是以病形相
像也。
脉微而弱。弱反在关。濡反在巅。弦反在上。微反在下。弦为阳运。微为阴寒。上
实下虚。意欲得温。微弦为虚。不可发汗。发汗。则寒栗。不能自还。
弦在上。则风伤气。风胜者。阳为之运动。微在下。则寒伤血。血伤者。里为之阴寒。
外气怫郁为上实。里有阴寒为下虚。表热里寒。意欲得温。若反发汗。亡阳阴独。故寒栗不能
自还。
咳者则剧数吐涎沫咽中必干。小便不利。心中饥烦。 时而发。其形似疟。有寒无
热。虚而寒栗。咳而发汗。蜷而苦满。腹中复坚。
肺寒气逆咳者则剧。吐涎沫。亡津液。咽中必干。小便不利。膈中阳气虚。心中饥
而烦。一日一夜。气大会于肺。邪正相击。 时而发。形如寒疟。但寒无热。虚而寒栗。
发汗攻阳。则阳气愈虚。阴寒愈甚。故蜷而苦满。腹中复坚。
厥脉紧。不可发汗。发汗。则声乱咽嘶。舌萎声不得前。
厥而脉紧。则少阴伤寒也。法当温里。而反发汗。则损少阴之气。少阴之脉。入肺
中。循喉咙。挟舌本。肾为之本。肺为之标。本虚则标弱。故声乱咽嘶舌萎。声不得前。
诸逆发汗。病微者难瘥。剧者言乱目眩者死。命将难全。
不可发汗。而强发之。轻者因发汗而重。而难瘥。重者脱其阴阳之气。言乱目眩而死。
难经曰。脱阳者见鬼。是此言乱也。脱阴者目盲。是此目眩也。眩非玄而见玄。是近于
盲也。
咳而小便利。若失小便者。不可发汗。汗出则四肢厥逆冷。
肺经虚冷。上虚不能治下者。咳而小便利。或失小便。上虚发汗。则阳气外亡。四
肢者。诸阳之本。阳虚则不与阴相接。故四肢厥逆冷。
伤寒头痛。翕翕发热。形象中风。常微汗出。自呕者。下之益烦。心中懊 如饥。发汗
则致 。身强难以屈伸。熏之则发黄。不得小便。灸则发咳唾。
伤寒当无汗恶寒。今头痛发热。微汗出。自呕。则伤寒之邪。传而为热欲行于里。
若反下之。邪热乘虚。流于胸中。为虚烦心懊 如饥。若发汗。则虚表。热归经络。热
甚生风。故身强直而成 。若熏之。则火热相合。消烁津液。故小便不利而发黄。肺恶
火。灸则火热伤肺。必发咳嗽而唾脓。
永类钤方云。伤寒发汗有四难。凡发热头疼。有汗而非无汗。恶风而非恶寒。例发
其汗。汗不止为漏风。间有发而为痉者。此分外症发汗之一难也。至于发热头痛。尺脉
迟者。为荣虚血少。不可发汗。发热头痛。脉弦细。属少阳不可汗。汗则谵语。此分脉发
汗之二难也。动气在左不可汗。汗则头眩汗不止。则筋惕肉 。动气在右不可汗。汗则衄
而渴。心烦。饮则吐水。动气在上不可汗。汗则气冲心。动气在下不可汗。汗则无汗。
心烦骨节疼。此分内证发汗之三难也。春宜汗。不可大发。以阳气尚微。冬不大汗以阳
气伏藏。汗之必吐利。口烂生疮。此知时发汗之四难也。
竹叶（二把，性味辛平） 石膏（一斤，性味甘寒） 半夏（半升，洗净，性味辛温） 人参（三两，性味甘温）
甘草（二两，炙，性味甘平） 粳米（半升，性味甘微寒） 麦门冬（一升，去心，性味甘平）
以上七味药。用水一斗。煮取六升药液。滤去药渣。加入粳米。煮至米熟。汤剂即成。再滤去米粒。每次温服一升。
每日服用三次。
辛味和甘味的药物配合能发散邪气并清除热邪。竹叶、石膏、甘草的甘辛之性，用来发散残留的热邪。甘味能缓和脾气并补益正气。麦门冬、人参、粳米的甘味，用来补充不足的正气。辛味具有散的作用。对于气机上逆的情况，需要使其消散。半夏的辛味，用来散除上逆之气。
病人脉象已经平和，但到了傍晚时分有轻微烦闷。这是因为病刚痊愈，人体勉强进食谷物，脾胃之气尚且虚弱，不能消化食物，所以导致轻微烦闷。减少饮食量就会痊愈。
阳明经在申时、酉时、戌时当令。如果有宿食停留在胃中，所以傍晚时分会有轻微烦闷。应当用小剂量泻下法。以消除宿食。
认为疾病发生得急迫，仓促之间寻找适用的方剂很难得到。所以重新收集各种可以治疗和不可治疗的方治方法。比起三阴三阳篇中的内容。这里更容易看到。又有时情况不止限于三阴三阳，出现在各种可治与不可治的内容中。
所有不可发汗、不可泻下的病症和药方，在三阴三阳篇中，经文和注释已经具备的，不再重复列出。其余没有列出的，在此之后，经文和注释都详细可见。
脉象濡软而弱，弱脉反而出现在关部，濡脉反而出现在寸部（巅指寸口），微脉反而出现在上部（寸部），涩脉反而出现在下部（尺部）。微脉表示阳气不足，涩脉表示无血。阳气反而微弱，中风出汗反而躁动烦闷。涩脉表示无血，四肢厥冷而且寒冷。阳气微弱而发汗，会导致躁动无法入睡。
寸部和关部为阳脉应当浮盛。弱脉反而在关部，则里气不足。濡脉反而在寸部，则表气不达。卫气行于脉外。
浮脉主在上，用以候察卫气。微脉反而在上部，是阳气不足。营气行于脉中。沉脉主在下，用以候察营气。涩脉反而在下部，是无血的表现。阳气微弱不能固护体表，腠理开疏，风邪因而客居体内。所以导致出汗并且躁动烦闷。无血则阴虚。不能与阳气相顺接。所以四肢厥冷而且寒冷。阳气微弱缺乏津液，则不能化生汗液。如果发汗则必然亡失阳气而躁动。经书说：汗出过多会亡失阳气。于是身体虚弱，怕风，烦躁，无法入睡。
脐右部位有动气，不可发汗。发汗则会导致鼻出血并且口渴，心中苦于烦闷，喝水即呕吐清水。
动气，是指腹部跳动不安的感觉。在右侧，是指肚脐的右边。《难经》说：肺的内证，脐右有动气，按压坚硬且疼痛。肺气不调，正气内虚，气动于脐的右边。发汗则会扰动肺气。肺主气，开窍于鼻。气虚则不能固摄血液，血液溢出妄行，随气从鼻而出为鼻衄。亡失津液导致胃燥，则烦渴且心中苦烦。肺恶寒。喝冷水则伤肺。所以喝水即呕吐清水。
《活人书》说：先服用五苓散三次，接着服用竹叶汤。
脐左部位有动气，不可发汗。发汗则会导致头晕、汗出不止、筋肉跳动。
《难经》说：肝的内证，脐左有动气，按压坚硬且疼痛。肝气不调，正气内虚，气动于脐的左边。肝为阴之主。发汗，汗出不止，则亡失阳气导致外虚。所以头晕、筋肉跳动。《针经》说：上虚则眩晕。
《活人书》说：先服用防风、白术、牡蛎。汗止后，接着服用建中汤。
脐上部位有动气，不可发汗。发汗，则会导致气向上冲，直冲在心窝处。
《难经》说：心的内证，脐上有动气，按压坚硬且疼痛。心气不调，正气内虚，气动于脐的上方。心属阳。发汗亡失阳气，则进一步损伤心气。肾水乘心气虚弱欲上凌犯心脏。所以气向上冲，直冲在心窝处。
《活人书》说：适宜服用李根汤。
脐下部位有动气，不可发汗。发汗，则会导致无汗、心中大烦、骨节痛苦疼痛、眼花、怕冷、进食反而呕吐、食物无法下行。
《难经》说：肾的内证，脐下有动气，按压坚硬，好像疼痛。肾气不调，正气内虚，动气发于脐的下方。肾主水。发汗，则无汗是因为水液不足。心中大烦是因为肾虚不能制约心火。骨节痛苦疼痛是因为肾主骨。眼花是因为肾病则眼睛视物模糊不清，像看不见东西一样。怕冷是因为肾主寒。进食反而呕吐，食物无法下行是因为肾水枯竭。王冰说：病呕而吐，食物久后反出，这是无水（肾水干涸）的表现。
《活人书》说：先服用大橘皮汤。呕吐停止后，后服用小建中汤。
咽喉闭塞不可发汗。发汗，则会导致吐血、气息将绝、手脚冰冷、想要蜷缩卧倒、不能自我温暖。
咽门是胃的系带。胃经不和，则咽内不利。发汗攻伐阳气，血液随发散之力而上逆，必定吐血。胃经不和，反而攻伐体表，则阳气虚于外。所以气息将绝，手脚冷，想蜷缩而不能自我温暖。
各种脉象出现数、动、微弱者，不可发汗。发汗，则会导致大便困难、腹中干燥、胃燥而烦。其症状形态相似。根本原因却不同源。
数动的脉象，表示热在体表。微弱的脉象，表示热在体内。发汗亡失津液，则热气更加严重。胃中干燥。所以大便困难，腹中干燥，胃燥而烦。根本虽然有表里之异，误治之后，热邪传变则是一样的。所以病形相似。
脉微而弱，弱脉反而在关部，濡脉反而在寸部，弦脉反而在上部，微脉反而在下部。弦脉代表阳气运行，微脉代表阴寒。上实下虚，想要得到温热。微弦脉属于虚证，不可发汗。发汗，则会导致寒战，无法恢复常态。
弦脉在上，则风伤气。风胜者，阳气为之运动。微脉在下，则寒伤血。血伤者，里气为之阴寒。外气郁结为上实，里有阴寒为下虚。表热里寒，想要得到温热。如果反而发汗，亡失阳气而阴独存。所以寒战无法恢复。
咳嗽严重的，频繁吐出涎沫，咽喉必定干燥，小便不利，心中饥饿烦闷，时而发作，形态类似疟疾，只有寒战没有发热，虚弱而寒战。咳嗽而发汗，会导致蜷缩且苦于胀满，腹中再次坚实。
肺寒气逆，咳嗽则严重。吐涎沫，亡失津液，咽喉必定干燥。小便不利，膈中阳气虚，心中饥饿而烦。一天一夜，气大会于肺。邪正相击，时而发作，形态如寒疟，只有寒战没有发热，虚弱而寒战。发汗攻伐阳气，则阳气更虚，阴寒更甚。所以蜷缩且苦于胀满，腹中再次坚实。
厥逆脉紧，不可发汗。发汗，则会导致声音混乱、咽喉嘶哑、舌体萎软、声音无法发出。
厥逆而脉紧，则是少阴伤寒。治法应当温里，而反而发汗，则损伤少阴之气。少阴经脉，入肺中，循喉咙，挟舌本。肾为本，肺为标。本虚则标弱。所以声音混乱、咽喉嘶哑、舌萎、声音无法发出。
各种逆证发汗，病情轻的难以痊愈，病情重的言语错乱、目眩的会死亡，生命将难以保全。
不可发汗而强行发汗，轻的因为发汗而加重，难以痊愈。重的脱失阴阳之气，言语错乱、目眩而死。《难经》说：脱阳者见鬼，这就是言语错乱。脱阴者目盲，这就是目眩。眩不是看见玄妙，而是接近于盲。
咳嗽而小便通利，或者大小便失禁的，不可发汗。汗出则四肢厥冷逆乱。
肺经虚冷，上虚不能治理下部的，咳嗽而小便通利，或者大小便失禁。上虚发汗，则阳气外亡。四肢是诸阳之本。阳虚则不与阴相接。所以四肢厥冷逆乱。
伤寒头痛，翕翕发热，形象像中风，经常微微出汗，自行呕吐的，如果用下法会增加烦闷，心中懊恼如饥。如果发汗则会导致痉病，身体强直难以屈伸。如果用熏法则会发黄，小便不通。如果用灸法则会引发咳嗽吐脓。
伤寒应当无汗恶寒。现在头痛发热，微汗出，自行呕吐，则伤寒之邪，传变为热欲行于里。如果反而用下法，邪热乘虚流于胸中，形成虚烦心懊恼如饥。如果发汗，则使虚表更虚，热归经络。热甚生风，所以身体强直而成痉病。如果用熏法，则火热相合，消烁津液。所以小便不利而发黄。肺恶火。灸则火热伤肺，必定引发咳嗽而唾脓。
《永类钤方》说：伤寒发汗有四难。凡是发热头疼，有汗而非无汗，恶风而非恶寒，一概发其汗，汗不止成为漏风。间或有发而为痉病的。这是分外症发汗的第一难。至于发热头痛，尺脉迟的，为荣虚血少，不可发汗。发热头痛，脉弦细，属少阳不可汗。汗则谵语。这是分脉发汗的第二难。动气在左不可汗。汗则头眩汗不止，则筋惕肉 。动气在右不可汗。汗则衄而渴，心烦，饮则吐水。动气在上不可汗。汗则气冲心。动气在下不可汗。汗则无汗，心烦骨节疼。这是分内证发汗的第三难。春季宜汗，不可大发，因为阳气尚微弱。冬季不大汗，因为阳气伏藏。汗之必致吐利，口烂生疮。这是知时发汗的第四难。
Bamboo Leaf (Ye Zhu, two handfuls, acrid and neutral) Gypsum (Shi Gao, one jin, sweet and cold) Pinellia Tuber (Ban Xia, half sheng, washed, acrid and warm) Ginseng Root (Ren Shen, three liang, sweet and warm) Licorice Root (Gan Cao, two liang, roasted, sweet and neutral) Rice Grain (Jing Mi, half sheng, sweet and slightly cold) Ophiopogon Tuber (Mai Men Dong, one sheng, heart removed, sweet and neutral)
The above seven ingredients. Use ten dou of water. Boil to obtain six sheng of liquid. Remove the dregs. Add Jing Mi (Rice Grain). Cook until the rice is ripe. The decoction is ready. Remove the rice grains. Take one sheng warm.
Take three times a day.
Acrid and sweet substances disperse and eliminate heat. The sweet and acrid properties of Ye Zhu (Bamboo Leaf), Shi Gao (Gypsum), and Gan Cao (Licorice) are used to disperse residual heat. Sweetness soothes the Spleen Qi and tonifies deficiency. The sweetness of Mai Men Dong (Ophiopogon Tuber), Ren Shen (Ginseng Root), and Jing Mi (Rice Grain) is used to replenish insufficiency. Acridity has a dispersing function. For rebellious Qi, dispersion is desired. The acridity of Ban Xia (Pinellia Tuber) is used to scatter rebellious Qi.
When the patient's pulse has resolved but there is slight vexation at dusk, it is because the disease has just healed, the person forces food intake, the Spleen and Stomach Qi are still weak, unable to digest food, thus causing slight vexation. Reducing food intake leads to recovery.
Yang Ming channel dominates during Shen, You, and Xu hours. If retained food remains in the Stomach, slight vexation occurs at dusk. A mild purgative method should be used to reduce the retained food.
Given that diseases arise urgently, it is difficult to find applicable prescriptions hastily. Therefore, various treatable and untreatable methods are re-collected. Compared to the Three Yin and Three Yang chapters, these are easier to see. Sometimes situations extend beyond the Three Yin and Three Yang, appearing in sections on treatable and untreatable conditions.
All conditions and prescriptions where sweating or purging are contraindicated, which are already detailed in the text and annotations of the Three Yin and Three Yang chapters, are not repeated here. Others not listed previously are fully detailed in the text and annotations from this point onwards.
A pulse that is soggy and weak, with weakness reversed at the Guan position, sogginess reversed at the Cun position (Cun refers to the distal part of the radial artery), faintness reversed at the upper position (Cun), and choppy reversed at the lower position (Chi). Faintness indicates insufficient Yang Qi; choppy indicates lack of Blood. If Yang Qi is faint, wind-stroke causes sweating with restlessness and vexation. Choppy indicates lack of Blood, leading to cold limbs and coldness. Sweating when Yang Qi is faint leads to restlessness and insomnia.
The Cun and Guan positions represent Yang pulses, which should be floating and vigorous. Weakness at the Guan position indicates interior Qi insufficiency. Sogginess at the Cun position indicates exterior Qi failure. Wei Qi circulates outside the vessels.
Floating pulse indicates presence above, reflecting Wei Qi. Faintness at the upper position indicates Yang Qi insufficiency. Ying Qi circulates inside the vessels. Deep pulse indicates presence below, reflecting Ying Qi. Choppy pulse at the lower position indicates lack of Blood. Insufficient Yang Qi fails to secure the exterior, opening the pores, allowing Wind pathogen to invade, causing sweating, restlessness, and vexation. Lack of Blood leads to Yin deficiency, failing to connect smoothly with Yang, resulting in cold limbs and coldness. Yang insufficiency lacks fluids for sweat production. Sweating would cause loss of Yang Qi and restlessness. The Classic states: "Excessive sweating causes loss of Yang Qi." This leads to emptiness, aversion to wind, restlessness, and inability to sleep.
Motional Qi (Dong Qi) on the right side is a contraindication for sweating. Sweating causes epistaxis, thirst, mental vexation, and vomiting water upon drinking.
Motional Qi refers to palpable pulsation in the abdomen. On the right means to the right of the umbilicus. The Nan Jing states: "Lung internal syndrome presents with motional Qi at the right of the umbilicus, hard and painful upon pressure." Lung Qi dysfunction and interior deficiency cause Qi movement at the right of the umbilicus. Sweating disturbs Lung Qi. Lung governs Qi and opens into the nose. Qi deficiency fails to control Blood, causing blood to溢 extravasate and flow out through the nose as epistaxis. Loss of fluids causes Stomach dryness, leading to vexation, thirst, and mental distress. Lung dislikes cold. Cold drinks injure the Lung, causing immediate vomiting of water.
The Huo Ren Shu states: First administer Wu Ling San (Five-Ingredient Powder with Poria) three doses, then follow with Zhu Ye Tang (Bamboo Leaf Decoction).
Motional Qi on the left side is a contraindication for sweating. Sweating causes dizziness, continuous sweating, and muscle twitching.
The Nan Jing states: "Liver internal syndrome presents with motional Qi at the left of the umbilicus, hard and painful upon pressure." Liver Qi dysfunction and interior deficiency cause Qi movement at the left of the umbilicus. The Liver is the master of Yin. Sweating causes continuous loss of Yang Qi and exterior deficiency, leading to dizziness and muscle twitching. The Zhen Jing states: "Deficiency above causes dizziness."
The Huo Ren Shu states: First administer Fang Feng (Saposhnikovia Root), Bai Zhu (Atractylodes Macrocephala Rhizome), and Mu Li (Oyster Shell). Once sweating stops, follow with Jian Zhong Tang (Middle-Building Decoction).
Motional Qi above is a contraindication for sweating. Sweating causes Qi rushing upward, directly striking the heart region.
The Nan Jing states: "Heart internal syndrome presents with motional Qi above the umbilicus, hard and painful upon pressure." Heart Qi dysfunction and interior deficiency cause Qi movement above the umbilicus. The Heart is Yang. Sweating causes loss of Yang Qi, further damaging Heart Qi. Kidney Water exploits Heart deficiency to ascend and oppress the Heart, causing Qi rushing upward to the heart region.
The Huo Ren Shu states: Li Gen Tang (Li Root Decoction) is appropriate.
Motional Qi below is a contraindication for sweating. Sweating causes anhidrosis, severe mental vexation, bone and joint pain, blurred vision, aversion to cold, vomiting after eating, and food stagnation.
The Nan Jing states: "Kidney internal syndrome presents with motional Qi below the umbilicus, hard and painful upon pressure." Kidney Qi dysfunction and interior deficiency cause Qi movement below the umbilicus. The Kidney governs Water. Sweating results in anhidrosis due to fluid insufficiency. Severe mental vexation arises because Kidney deficiency fails to control Heart Fire. Bone and joint pain occur because the Kidney governs bones. Blurred vision occurs because Kidney disease causes visual impairment ("KTKT" implies unclear vision). Aversion to cold occurs because the Kidney governs cold. Vomiting after eating and food stagnation occur because Kidney Water is exhausted. Wang Bing states: "Vomiting and regurgitation of old food indicate lack of Water."
The Huo Ren Shu states: First administer Da Ju Pi Tang (Large Tangerine Peel Decoction). Once vomiting stops, follow with Xiao Jian Zhong Tang (Small Middle-Building Decoction).
Throat obstruction is a contraindication for sweating. Sweating causes hematemesis, impending death of Qi, cold hands and feet, desire to curl up, and inability to self-warm.
The throat is the connection of the Stomach. Stomach Channel disharmony causes throat discomfort. Sweating attacks Yang, causing Blood to rise with dispersal, inevitably leading to hematemesis. Stomach Channel disharmony attacking the exterior causes Yang deficiency externally, leading to impending Qi loss, cold hands and feet, and curling inability to self-warm.
Pulses showing rapid, moving, or faint characteristics are contraindications for sweating. Sweating causes difficult defecation, abdominal dryness, Stomach dryness, and vexation. The symptoms appear similar, but the root origins differ.
Rapid and moving pulses indicate Heat in the exterior. Faint pulses indicate Heat in the interior. Sweating causes loss of fluids, intensifying Heat. Stomach dryness leads to difficult defecation, abdominal dryness, and Stomach dryness with vexation. Although roots differ by exterior/interior, mis-treatment leads to similar Heat transmission, hence similar symptoms.
Faint and weak pulses, with weakness at Guan, sogginess at Cun, wiriness at upper, and faintness at lower. Wiry represents Yang movement; faint represents Yin Cold. Upper excess and lower deficiency indicate a desire for warmth. Faint and wiry pulses indicate deficiency; sweating is contraindicated. Sweating causes chills and inability to recover.
Wiry pulse above indicates Wind injuring Qi. Excess Wind causes Yang movement. Faint pulse below indicates Cold injuring Blood. Injured Blood causes interior Yin Cold. Exterior Qi stagnation creates upper excess; interior Yin Cold creates lower deficiency. Exterior Heat and interior Cold indicate a desire for warmth. Reversed sweating causes Yang loss and Yin dominance, leading to chills and inability to recover.
Severe coughing with frequent salivation, dry throat, difficult urination, hungry vexation, paroxysmal episodes resembling malaria (cold without heat), and deficiency chills. Coughing with sweating causes curling, fullness, and abdominal hardness.
Lung Cold with rebellious Qi causes severe coughing. Salivation causes fluid loss and dry throat. Difficult urination and hungry vexation indicate Diaphragm Yang deficiency. Qi gathers in the Lung daily; pathogen and righteous Qi clash, causing paroxysmal episodes resembling cold malaria. Sweating attacks Yang, increasing Yang deficiency and Yin Cold, leading to curling, fullness, and abdominal hardness.
Jue syndrome with tight pulse is a contraindication for sweating. Sweating causes hoarseness, tongue flaccidity, and inability to speak.
Jue with tight pulse indicates Shaoyin Cold Damage. Treatment should warm the interior; reversed sweating damages Shaoyin Qi. The Shaoyin channel enters the Lung, follows the throat, and binds the tongue base. Kidney is root, Lung is branch. Root deficiency leads to branch weakness, causing hoarseness, tongue flaccidity, and speech difficulty.
Reversal syndromes treated with sweating: mild cases are hard to cure; severe cases with confused speech and dizziness die, life cannot be saved.
Forced sweating in contraindicated cases worsens mild cases and cures them poorly. Severe cases lose Yin and Yang Qi, dying with confused speech and dizziness. The Nan Jing states: "Loss of Yang causes hallucinations (confused speech); loss of Yin causes blindness (dizziness)." Dizziness approaches blindness.
Cough with free urination or urinary incontinence is a contraindication for sweating. Sweating causes cold reversal of the four limbs.
Lung Channel deficiency-cold with upper deficiency failing to control lower causes cough with free urination or incontinence. Sweating in upper deficiency causes external loss of Yang Qi. The four limbs are the root of all Yang. Yang deficiency fails to connect with Yin, causing cold reversal of the four limbs.
Cold Damage headache,翕翕 (warm) fever, resembling wind-stroke, with slight spontaneous sweating and vomiting. Purging increases vexation and mental depression like hunger. Sweating causes stiffness and difficulty bending. Moxibustion causes jaundice and urinary retention. Cauterization causes cough and pus expectoration.
Cold Damage should present with anhidrosis and aversion to cold. Now headache, fever, slight sweating, and vomiting indicate Cold Damage pathogen transforming into Heat entering the interior. Reversed purging allows Heat to enter the chest, causing empty vexation and depression. Sweating makes the deficient exterior vulnerable; Heat enters meridians, generating Wind, causing stiffness and spasms. Moxibustion combines fire, consuming fluids, causing jaundice and urinary retention. Lung dislikes fire; cauterization injures Lung, causing cough and pus expectoration.
Yong Lei Qian Fang states: Four difficulties in sweating for Cold Damage. Fever and headache with sweating (not anhidrosis), aversion to wind (not cold), if sweated generally, causes leakage wind (continuous sweating). Occasionally causes spasms. This is the first difficulty of exterior syndrome sweating. Fever and headache with slow Chi pulse indicate Ying deficiency and Blood scarcity; sweating is contraindicated. Fever and headache with wiry-thin pulse indicate Shaoyang; sweating is contraindicated (causes delirium). This is the second difficulty of pulse-based sweating. Motional Qi on left: sweating causes dizziness, continuous sweating, muscle twitching. Motional Qi on right: sweating causes epistaxis, thirst, vexation, vomiting water. Motional Qi above: sweating causes Qi rushing to heart. Motional Qi below: sweating causes anhidrosis, vexation, bone/joint pain. This is the third difficulty of internal syndrome sweating. Spring favors sweating but not excessive, as Yang Qi is slight. Winter avoids heavy sweating as Yang Qi is hidden; sweating causes vomiting, diarrhea, mouth ulcers. This is the fourth difficulty of seasonal sweating.