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Direct invasion of the Yin meridians presents without fever. Abdominal pain, aversion to cold, and cold limbs are observed. Cyanosis of the lips and black complexion indicate true Yin-cold syndrome. Sini Decoction (Nìxī Tāng) and Lizhong Decoction (Lǐzhōng Tāng) are truly excellent prescriptions. (This refers to direct invasion of cold into the Taiyin meridian; the pulse is deep, fine, and forceless, warranting warming treatment.)

Sini Decoction contains one tael of dried ginger. Raw Aconite Root (Fuzi, 附子) is halved, with skin and tips removed. One tael of Licorice Root (Gancao, 甘草) is decocted in water. It cures cold limbs accompanied by diarrhea. In Lizhong Decoction, Licorice Root, dried ginger, Atractodes Rhizome (Baizhu, 白术), and Ginseng Root (Renshen, 人参) are appropriately used. If Aconite Root is added to it, it is renamed Fuzi Lizhong Decoction (Fùzǐ Lǐzhōng Tāng).

Yang pathogenic factors transmitting into the Shaoyin meridian present with dry mouth, dry throat, and delirious speech. Constipation and periodic hard pain around the umbilicus occur. Dry fecal matter in the fu organs should be purged.
Note: Within five or six days of Shanghan (Cold Damage), the disease affects the Foot-Shaoyin Kidney Meridian. Its vessel originates at Yongquan (KI1), ascends through the spine, follows the throat, connects with the tongue root, enters the heart, runs along the anterior aspect of the body, and terminates at Shufu (BL27). Symptoms include dry mouth and throat, constipation, delirium, or abdominal pain around the umbilicus, caused by dry fecal matter in the fu organs. This is unrelated to direct invasion. Purging is indicated, such as with Da Chengqi Decoction (Dà Chéngqì Tāng) or Tiaowei Chengqi Decoction (Tiáowèi Chéngqì Tāng).
Mahuang Fuzi Xixin Decoction (Máhuáng Fùzǐ Xìxīn Tāng) releases the exterior and warms the meridians.

Aversion to cold without fever, cold limbs like ice. Vomiting and diarrhea occurring together with abdominal pain. The six pulses are deep and slow, indicating severe Yin-toxin accumulation. The body feels as if beaten with a club, with cyanotic nails and lips.
This is direct invasion of cold into the Shaoyin meridian. The pulse is deep, fine, and forceless, warranting warming treatment, such as with Sini Decoction or Lizhong Decoction.

Tongue curling, retraction of the testes, and severe thirst. Cold limbs that occasionally warm up. Irritability, fullness, and hard stool mostly indicate heat syndrome. Liuyi Shunqi Decoction (Liùyī Shùnqì Tāng) can be taken rapidly.
Note: Within six or seven days of Shanghan, the disease affects the Foot-Jueyin Liver Meridian. Its vessel originates at Dadun (LR1) on the big toe, follows the genitalia, reaches the lower abdomen, and connects with the Liver. It runs along the lateral anterior aspect of the body and terminates at Qimen (LR14). Symptoms include irritability, fullness, and testicular retraction; tendon stiffness and cyanotic lips. In men, this manifests as testicular retraction; in women, urgency and pain in the vaginal opening, radiating to the lower abdomen. "Tingkong" refers to the deep interior of the yin organs. Treatment should distinguish between transmitted-heat and direct-invasion patterns. If the pulse is deep, solid, and forceful, purging is indicated, such as with Liuyi Shunqi Decoction; if the pulse is deep, slow, and forceless, warming is indicated, such as with Huiyang Jiuji Decoction (Huíyáng Jiùjí Tāng).
Liuyi Shunqi Decoction features Peony Root (Shaoyao, 芍药) as a key component, containing Bupleurum Root (Chaihu, 柴胡), Immature Bitter Orange (Zhishi, 枳实), Rhubarb Root (Dahuang, 大黄), and Mirabilite (Xiaoshuang, 芒硝). Combined with Scutellaria Root (Huangqin, 黄芩), Magnolia Bark (Houpo, 厚朴), and Licorice Root, it can replace Sanhuang Xiexin Decoction with even higher efficacy.