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There are no Yin syndromes in Shanghan (Cold Damage). When humans are injured by cold pathogens, they develop febrile diseases; febrile diseases are sweating diseases. The sweat fluids of creation are all generated by Yang Qi. In winter, when Kidney Water is dominant, those suffering from Shanghan have wind pathogens injuring Ying and Wei (Nutritive and Defensive levels), causing hair follicles to stand erect, skin pores to close, and resulting in fever. Initially, the Taiyang Bladder channel is affected, presenting with headache, aversion to cold, fever, stiffness of the waist and spine. Palpation at the superficial skin level reveals a floating, tight, and forceful pulse without sweating, which characterizes the exterior syndrome of Shanghan. Cold injures Ying Blood; in winter, Mahuang Tang (Ephedra Decoction) is used to open the Cou Li (skin and muscle interstices) and expel pathogens through sweating. A floating, slow, and weak pulse with sweating and aversion to wind indicates Wind Injury. Wind injures Wei Qi; in winter, Guizhi Tang (Cinnamon Twig Decoction) is used to fill the Cou Li, stop sweating, and scatter pathogens. During other seasons, although there may be no obvious aversion to cold, the condition is heavier. For cold injuries in these three seasons without sweating, Qianghuo Chonghe Tang (Notopterygium Harmonizing Decoction) with Dihuang (Rehmannia) removed, plus Zisu (Perilla Leaf) and Huoxiang (Patchouli), is used to disperse; if sweating is present, Jiajian Qianghuo Tang (Modified Notopterygium Decoction) is used. If Jiegeng Tang (Platycodon Decoction) is used to stop sweating and retreat pathogens, cooling herbs must be added to avoid complications like rashes and jaundice; this is called not violating Tian He (Heavenly Harmony/Natural Balance). Using winter-specific Shanghan formulas indiscriminately for non-seasonal acute cold-heat conditions will definitely cause harm.

If, from day one to thirteen, there is even a slight headache and aversion to cold persisting daily, regardless of the number of days, the exterior syndrome remains unresolved, and mild sweating should still be induced; interior purgation must not be used. If purged, it leads to syndromes such as Jie Xiong (Chest Binding).
On days one or two, if aversion to cold disappears completely, followed by chest fullness, pain, constipation, thirst, absence of aversion to cold but presence of aversion to heat, this indicates Heat entering the interior. Da Chaihu Tang (Major Bupleurum Decoction) or Chengqi Tang (Purgative Decoctions) should be used for purgation; one must not rigidly adhere to theories regarding the number of days or the progression from Taiyang to Jueyin.
On days two or three, the pathogen transmits to the Yangming Stomach channel, presenting with body heat, eye pain, nasal dryness, and insomnia. Palpation between the skin and muscle reveals a slightly surging and long pulse, belonging to the half-exterior, half-interior stage. With thirst but no sweating, Gegen Tang (Kudzu Decoction) is indicated; with thirst and sweating, Renshen Baihu Tang (Ginseng White Tiger Decoction) is indicated; with slight aversion to cold, Guizhi Tang (Cinnamon Twig Decoction) is indicated. If there is no headache or aversion to cold but rather aversion to heat, constipation, dry thirst, delirious speech, removing clothes/bedding, and waving hands/kicking feet, this is Heat pathogen transmitting to the root of Yangming. A deep, rapid, and forceful pulse indicates that Chengqi Tang (Purgative Decoction) is appropriate to purge excess heat and dry feces from the Stomach for recovery.
On days three or four, the pathogen transmits to the Shaoyang Gallbladder channel, presenting with hypochondriac pain, deafness, alternating chills and fever, vomiting, and bitter taste. Palpation at the semi-Yin semi-Yang area and a wiry, rapid pulse indicate the half-exterior, half-interior stage. Since the Gallbladder channel has no direct exit/entry pathway, Xiao Chaihu Tang (Minor Bupleurum Decoction) is used. This channel has three prohibitions: sweating, purgation, and vomiting. Generally, the Yangming and Shaoyang channels do not follow the root/subtle principle but are treated via the "Middle." The Middle refers to the half-exterior, half-interior, where two Yangs intersect, named Shaoyang.
On days four or five, the pathogen transmits to the Taiyin Spleen channel, presenting with abdominal fullness, dry throat, dry mouth, and thirst. Palpation between sinews and bones reveals a deep and forceful pulse; Guizhi Dahuang Tang (Cinnamon Twig and Rhubarb Decoction) is used. If there is no thirst, spontaneous diarrhea, no body heat, and a deep, slow, weak pulse, Sini Tang (Frigid Extremities Decoction) is used for warming.
On days five or six, the pathogen transmits to the Shaoyin Kidney channel, presenting with dry tongue and mouth. Heavy palpation between sinews and bones reveals a deep and forceful pulse; Da Chaihu Tang (Major Bupleurum Decoction) or Chengqi Tang (Purgative Decoction) should be used for purgation. If thirst occurs, spontaneous passage of clear water in small amounts, and abdominal distension, purgation is also indicated. These are all Yin syndromes caused by Yang pathogens transmitting into Yin channels. However, if upon initial onset, the pathogen does not enter Taiyang but directly enters Taiyin, without headache or body heat, immediately presenting with cold limbs, aversion to cold, or abdominal pain with spontaneous diarrhea, clear urine, deep weak pulse, or absent pulse, this is a Zhizhong Yin Jing (Direct Invasion of Yin Channel) Yin syndrome, not transmitted from the Three Yang channels. Fuzi Lizhong Tang (Aconite and Poria Decoction) should be urgently used for warming. Deep pulses can be categorized into Yin/Yang, Cold/Heat, Deficiency/Excess, distinguished by forcefulness. Forceful indicates Heat; weak indicates Cold. There are also combined Shaoyin and Taiyang syndromes with deep, weak pulses. One should expect no heat, but if heat is present, and there is no headache, it is a Yin syndrome turning Yang, treated with Mahuang Xixin Tang (Ephedra and Asarum Decoction). If the body is hot and the pulse should be floating and large but is instead deep and thin, and if headache is present, it is a Yang syndrome turning Yin, treated primarily with Sini Tang (Frigid Extremities Decoction).
On days six or seven, the pathogen transmits to the Jueyin Liver channel, presenting with irritability, thirst, scrotal retraction, curled tongue, deafness, no body heat, and constipation. Palpation between sinews and bones reveals a solid, wiry, and forceful pulse; Chengqi Tang (Purgative Decoction) is used for purgation. This is pathogen transmission from Three Yang to Three Yin, with external cold limbs and internal heat. If the pulse is faint and weak, with abdominal pain, spontaneous diarrhea, no thirst, cold limbs, and aversion to cold, it is a True Yin Cold syndrome, treated with Fuzi Lizhong Tang (Aconite and Poria Decoction) for warming. Saliva drooling and foam from the mouth also indicate Cold, treated with Zhuyu Lizhong Tang (Cornus and Poria Decoction).