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The fact that the Treatise on Cold Damage (Shanghan Lun) discusses "syndromes" (Zheng, clinical manifestations/syndromes) rather than "diseases" (Bing, diseases) contains profound significance. The term "syndrome" implies clear evidence, observed manifestations, and targeted symptoms. Just as a woman uses evidence to prove adultery, stolen goods to prove theft, and a weapon to prove murder, leaving no room for denial or escape from the truth. Moreover, the Heart, Liver, Spleen, Lung, and Kidney are hidden within the body and not visible. In contrast, the mouth, nose, tongue, ears, and eyes are exposed and visible to all. How can one know if the Zang organs are diseased? Generally, internal pathology must manifest externally. If the Liver is diseased, vision is impaired; if the Heart is diseased, speech is affected; if the Spleen is diseased, taste is lost; if the Lung is diseased, smell is diminished; if the Kidney is diseased, hearing is dulled. Thus, syndromes are indeed intimate and significant indicators.

Furthermore, when Wind-Cold pathogens invade the human body, they affect specific meridians and regions. Once injured, the syndromes of the affected meridian appear. By correlating these with pulse diagnosis, errors can be avoided. Hence, I say that in Cold Damage medicine, we discuss syndromes. For instance, Taiyang Cold Damage represents the exterior of the exterior. Its meridian runs along the posterior aspect of the body, from the head down to the feet. Therefore, symptoms such as headache, stiff neck, and stiffness in the lower back and spine appear in the nape and back. Aversion to cold is also an exterior symptom. Cold damage causes aversion to cold, while wind strike causes aversion to wind. The Taiyang meridian is associated with Cold Water; thus, any presence of aversion to cold indicates an exterior syndrome, which is most accurate. If the pathogen transmits to the Yangming meridian, aversion to cold ceases, and exterior-releasing methods should not be used. If there is even slight headache and aversion to cold, the pathogen remains in Taiyang, meaning the exterior syndrome has not resolved, and interior purgation is contraindicated. Therefore, it is warned: "If the exterior is not released, do not purge the interior." Failure to understand this leads to rapid death. It is also stated: "In cases of vomiting, do not use purgatives." The Classic says: "With frequent vomiting, even if Yangming syndromes are present, do not attack/purge; doing so constitutes reverse treatment." If there is hardness below the heart, do not purge. Careful attention is required.

The Yangming meridian is the interior of the exterior. It runs along the anterior aspect of the body, connecting the nose and eyes. Thus, eye pain, dry nose, and insomnia occur. The Shaoyang meridian runs along the lateral aspect of the body, representing the half-exterior, half-interior stage. It starts at the outer canthus, follows the hypochondrium, connects to the ear, and intersects at the Danzhong (Conception Vessel 17) and between the breasts. Thus, chest and hypochondriac pain and deafness occur. These three meridians' diseases are easily diagnosed in this manner, supplemented by pulse examination.

Taiyang disease has two types: Cold Damage and Wind Strike. Pulse floating and tight, with aversion to cold and absence of sweating, indicates Cold Damage. Floating pulse indicates the exterior; tight pulse indicates Cold. Since the exterior is invaded by Cold but has not entered the interior, Xin-Gan-Warm formulas like Mahuang Tang (Ephedra, Cinnamon Twig, and Apricot Seed Decoction) should be used to induce sweating. (In winter, use the standard formula; in summer, use Qianghuo Tang.) These present with aversion to cold and headache, indicating Taiyang exterior syndrome not yet transmitted inward, requiring dispersal through sweating. If in Yangming, the pulse is slightly surging and long, felt beneath the skin and within the muscles, indicating neither pure exterior nor pure interior, but involvement of the meridian. If thirst is present, Gegen Tang (Kudzu Root Decoction) is used to resolve the muscle layer. In Shaoyang, the pulse is wiry and rapid, neither floating nor sunken, situated in the half-exterior, half-interior region. Xiaochaihu Tang (Minor Bupleurum Decoction) is used to harmonize. (There are modification methods.) These two meridians are treated via the middle method, neither following the root nor the branch. The "middle" refers to the area below the muscles and between the sinews and bones. If the pulse is deep, rapid, and forceful upon pressure, it indicates Heat entering the root of Yangming. Dachaihu Tang (Major Bupleurum and Rhubarb Decoction) or the Three Chengqi Decoctions (Three Bowel-Regulating Decoctions) should be used to purge, depending on the severity of dryness and accumulation. The previously mentioned aversion to cold and headache are general treatments. If the pulse is not floating but deep, solid, and forceful, it indicates that the exterior syndrome has resolved and the interior syndrome is established. Purging the excess heat in the Stomach will lead to recovery. For the elderly, weak, postpartum women, or those who must be purged despite having exterior symptoms, Dachaihu Tang is used. If the pulse is deep, slow, weak, and forceless, it indicates a Yin syndrome. Warmth is indicated, not purgation. Caution is essential.