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Lu Shang contracted Cold Damage (Shanghan). He experienced spontaneous diarrhea (Zili) and abdominal fullness. There was no mental restlessness (Fan). There was no thirst. Vomiting occurred. Headache was present. Xu Shuwei palpated the Duyang pulse (pulse at the dorsum of the foot, reflecting Spleen and Stomach status), which was large and tight. He said this is a Taiyin syndrome (Syndrome of Spleen Yang deficiency with cold-dampness internal accumulation). If Shaoyin syndrome involved diarrhea, there would inevitably be thirst. Since there is no thirst now, it is known to be a Taiyin syndrome. Zhang Zhongjing stated that spontaneous diarrhea without thirst belongs to Taiyin. After several days of regulation and treatment, he recovered.

The commentary states: Someone asked why diagnose the Duyang pulse in Cold Damage? I said Zhang Zhongjing mentioned that when the Duyang pulse is large and tight, diarrhea should immediately occur. The *Mai Jing* (Classic of Pulses) states that for diarrhea, a large pulse indicates the disease has not yet stopped. A fine and minute pulse indicates recovery on that day. Zhang Zhongjing discussed the Duyang pulse in ninety-one places, all established due to the Spleen and Stomach. For instance, if the Duyang pulse is slippery and tight, it is said that slippery indicates Stomach excess, and tight indicates Spleen weakness. If the Duyang pulse is floating and choppy, it is said that floating indicates vomiting and counterflow qi, with undigested food and water. Choppy indicates inability to ingest food. If the Duyang pulse is tight and floating, floating indicates abdominal fullness, and tight indicates colic pain. If the Duyang pulse is imperceptible, it indicates Spleen deficiency. Coldness in the upper and lower body, and hard skin, all indicate these are indications set for Spleen and Stomach diseases. Generally, in exterior syndromes, such as abdominal fullness, spontaneous diarrhea, nausea, vomiting, and counterflow qi, if it is determined that the disease lies in the Spleen and Stomach, and this is corroborated by the Duyang pulse, there will be no error. The pulse appears on the Yang aspect of the dorsum of the foot, hence called Duyang. Zhang Zhongjing ridiculed people who only palpate the wrist pulse and neglect the foot pulse.

Li Sishun contracted Cold Damage. He had aversion to cold and fever. His breath from the mouth was hot like fire. This persisted for seven or eight days. Moreover, his eyes were closed and unwilling to open. Xu Shuwei palpated his pulse; the Yin and Yang pulses (referring to Cunkou/Guan/Kou positions or superficial/deep aspects) were both tight. This must have been caused by sweating followed by purging. This is a Huai Zheng (complicated/deteriorated syndrome due to mis-treatment). The patient's family said, "A physician induced sweating three days ago, but the illness did not resolve. Another physician then used purgation, resulting in closed eyes." Subsequently, Xiao Chaihu Tang (Minor Bupleurum Decoction) was administered. After five doses, he recovered.

The commentary states: Someone asked how one knows that sweating and purging led to closed eyes? I said Zhang Zhongjing stated that in Cold Damage with fever, breath from the mouth is hot and steaming, headache, and yellow eyes; if purged, the eyes will close. It also says that in Cold Damage, if the Yin and Yang pulses are both tight, with aversion to cold and fever, red eyes, and the pulse often shows dull spirit in the eyes, if the physician induces sweating, the throat will be injured. If purgation is applied again, both eyes will close. This is a Huai Zheng (deteriorated syndrome). Xiao Chaihu Tang must be used. Regulation leads to recovery.