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In cold damage (Shanghan) disease, the development of cheek toxin (Yidu) manifests as swelling below the ears. This toxin arises from improper application of sweating (fahan) or purgative (gongxia) therapies. A favorable prognosis is indicated by high, red, hot, and painful swelling; conversely, clouding of spirit (shenhun) signifies a critical condition.

Before the toxin erupts, the pulse may be hidden, with profuse cold sweating and icy limbs. Symptoms include vexing thirst, constipation, and purple fingernails. This presentation closely resembles yang collapse (wangyang) patterns of the three yin diseases (sanyin bing), but is distinguished by a light body and clear, bright eyes.

[Annotation] Cheek toxin in cold damage disease is all caused by improper sweating or purgation, leading to toxic heat (dure) carrying ministerial fire (xianghuo) of the Shaoyang channel to attack upward. If the patient's yang qi is inherently robust, the swelling will be high, red, hot, and painful, easily suppurating, which is a favorable sign. Lianqiao Baidu San (Forsythia Toxin-Resolving Powder) is appropriate to dissipate it. If the patient's yang qi is inherently deficient, or if excessive cold medicinals have been taken, the toxic heat may be depressed and hidden internally. Internal attack leads to clouding of spirit; externally, the toxin causes diffuse swelling with unchanged skin color, absence of pain, and wooden hardness, indicating a critical condition. Before the latent toxin erupts, it often resembles yang collapse patterns of the three yin diseases: hidden pulse, profuse cold sweating, icy limbs. However, it differs by a light body, clear and bright eyes, vexing thirst, constipation, and red-purple fingernails. This marks the onset of toxin eruption and must not be overlooked in clinical treatment.

The ancient name is "fox-corroding disorder" (Huhuo), recently called "gan" (malnutrition/erosion). Fox (Hu) corrodes the anus and genitals; corroding (Huo) affects the lips and throat. It occurs from residual toxin after cold damage disease, after macules and papules (banzhen), or similarly after accumulations (piji) and dysentery (li). The complexion and canthi vary between red, white, and black. The eyes cannot close, and there is a tendency to excessive sleep, tidal fever (chaore), hoarse voice, and foul odor from putrefaction. If the stomach is strong and the patient can eat, tolerating potent medicinals to attack the disease, or if the disease progression is slow, treatment is often successful.

[Annotation] Fox-corroding disorder is the ancient name for conditions like ulcerative gingivitis (Yagan) and chancre (Xiagan), recently referred to simply as "gan". Chancre corresponds to fox, eroding the anus and genitals. Ulcerative gingivitis corresponds to corroding, eroding the throat, putrefying the gums, causing tooth loss, perforating the cheeks, and ulcerating the lips. The toxin results from residual pathogen after cold damage disease, combined with the harm of dampness and depression (shiyu), or occurs after macules and papules, or after accumulations and dysentery, with similar manifestations. The signs are a complexion and eye canthi that are sometimes red, sometimes white, sometimes black, constantly varying. There is a desire to sleep but an inability to close the eyes, tidal fever, hoarse voice, and a foul, offensive odor from putrefied areas. If the stomach is strong and the patient can eat, able to tolerate potent medicinals to attack the disease, or if the disease progression is slow, treatment is often successful.

Lily disease (Baihe Bing) is a condition where the hundred vessels unite into one illness. It resembles cold or heat, but medicinals are ineffective. Eating, drinking, living, and resting are all done in a dazed manner, as if a spirit or ghost has attached to the body. With a rapid pulse (shuomai), urination is accompanied by headache; recovery takes sixty days. If urination occurs without headache but with an aversion to wind and cold, recovery takes forty days. If urination brings a sense of relief but with dizziness only, recovery takes twenty days.

[Annotation] Lily disease refers to a condition where, after the period of cold damage disease has passed, the pathogen lingers unresolved, not distinguishing among channels, collaterals, or the hundred vessels, but uniting them all into one illness. It resembles cold or heat, yet all medicinals are ineffective. The patient wants to drink but cannot, wants to eat but cannot, wants to lie down but cannot, wants to walk but cannot. The spirit is dazed and confused, as if a spirit or ghost has attached to the body, leaving one at a loss. For example, with a rapid pulse and headache occurring during each urination, recovery takes sixty days. If urination occurs without headache, but only with an aversion to wind and cold, recovery takes forty days. If urination brings a sense of relief but with dizziness only, recovery takes twenty days. Hence it is said: sixty, forty, twenty days until the illness subsides.