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Alternating chills and fever (alternation of aversion to cold and fever) occurring four or five times, or even ten times a day, all indicate the struggle between healthy qi (Zheng Qi) and pathogenic factors.

When the pathology is at the exterior level, characterized by chills and fever with more heat than cold, and without interior syndromes, Guizhi Mahuang Ge Ban Tang (Cinnamon Twig and Ephedra Half-Half Decoction) is indicated.

When the pathology is at the half-exterior half-interior level, Xiao Chaihu Tang (Minor Bupleurum Decoction) is indicated for alternating chills and fever; if accompanied by interior syndromes, Da Chaihu Tang (Major Bupleurum Decoction) is indicated.

This represents Yang collapse (extreme depletion of Yang Qi), with a faint pulse, more heat than cold; sweating methods are contraindicated, and Guizhi Er Yuebi Yi Tang (Cinnamon Twig Twice, Minor Bi Decoction Once) is indicated.

This represents Blood deficiency, with a slow and choppy pulse at the Chi position (cun-kou pulse diagnosis), more heat than cold; Jianzhong Tang (Middle-Building Decoction) added with [missing character, likely Astragali Radix or Angelicae Sinensis Radix] is indicated.

For alternating chills and fever persisting after prior sweating or purging treatments, Guizhi Ganjiang Tang (Cinnamon Twig and Dried Ginger Decoction) is indicated.

Feeling cold without exposure to wind, yet unwilling to remove clothes despite high body temperature, and feeling cold even in thick clothing or near fire, indicates "Exterior Heat and Interior Cold" (body hot but desiring to keep clothes on). Conversely, feeling cold and desiring to remove clothes indicates "Exterior Cold and Interior Heat".

There is a distinction between Deficiency and Excess patterns: Sweating with aversion to cold indicates Exterior Deficiency, treatable by resolving the muscle layer (Jie Ji); no sweating with aversion to cold indicates Exterior Excess, treatable by inducing sweating.

There is a distinction between Yin and Yang patterns: Aversion to cold with curling up and a deep, fine, and tight pulse indicates onset from the Yin meridians, treatable by warming methods; alternating chills and fever indicates onset from the Yang meridians, treatable by inducing sweating.

In cases of Qi deficiency following vomiting, purging, or excessive sweating, where aversion to cold worsens and the pulse is faint, Shaoyao Fuzi Gancao Tang (Peony, Aconite, and Licorice Decoction) is indicated.

There is a distinction between Yin Excess and Yang Excess.

When Yin-Cold Qi is excessive and Yang Qi is insufficient, the mouth feels neutral (neither bitter nor dry); Fuzi Tang (Aconite Decoction) is prescribed.

When Yang Qi sinks inward and Yin Qi is insufficient, causing dryness in the mouth, Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) is used to restore fluids.

Sensitivity to wind causes aversion; staying in a sealed room brings comfort and lack of fear. Exposure to fans or drafts causes a shivering sensation of aversion. It is said that patients feel aversion to wind even when there is no actual wind, manifesting as gooseflesh on the skin. Generally, diseases of the Three Yang meridians present with aversion to wind, whereas diseases of the Three Yin meridians do not.

There is a distinction between Shanghan (Cold Damage) and Zhongfeng (Wind Strike): No sweating indicates Shanghan; sweating indicates Zhongfeng.

There is a distinction between Yang collapse and Wind-Dampness: Excessive sweating leading to Yang collapse and continuous leakage of sweat indicates failure of the defensive Wei Qi to secure the exterior; Fuzi Guizhi Tang (Aconite and Cinnamon Twig Decoction) is used to warm the channels and consolidate the Wei Qi. When Wind and Dampness contend, causing severe joint pain, with dampness predominance, spontaneous sweating, loose pores, and aversion to wind, Gancao Fuzi Tang (Licorice and Aconite Decoction) is indicated.