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Sore throat (yan tong) varies according to Yin and Yang patterns, each requiring appropriate treatment. It is essential to correlate pulse findings with symptoms. If the pulse is floating and rapid, accompanied by expectoration of pus and blood, this is caused by Yang toxicity (Yang du). (*Shanghan Lun* records: pulse floating, rapid, and large, spitting pus and blood; *Qianjin Fang* and *Waitai Mi Yao* mention Wushan Gao for treatment.) If the pulse is deep and fine, with cold hands and feet, or accompanied by vomiting and diarrhea, it belongs to Shaoyin disease. (Zhang Zhongjing stated: Shaoyin disease typically presents with sore throat, yet may also involve vomiting cold substances.) If the pulses at all three positions in Shaoyin are tight, and sweating indicating Yang collapse occurs, urgent treatment is required. (Zhang Zhongjing stated: When the pulse is tight at both Yin and Yang positions but sweating occurs contrary to expectation, it indicates Yang collapse, and the disease pertains to Shaoyin.) There is also the condition caused by latent pathogenic factors (Fu Qi), which does not arise from exposure to extreme cold invading the muscles. The throat hurts first, followed by diarrhea; it can be treated as Kidney Shanghan (Kidney Cold Damage). (Zhang Zhongjing stated: For diseases of latent pathogens, one must infer the condition mentally. Within the current month, latent pathogens may be present. If there was a pre-existing latent pathogen, the pulse should be examined. If the pulse is weak, there should be throat pain, resembling Shanghan but not Hou Bi [sore throat obstruction]. The patient states that although the throat indeed hurts, they now desire to have diarrhea.)

Cough (ke sou) must be differentiated among the Taiyang, Yangming, and Shaoyin meridians. Taiyang water retention is identified by the Xiao Qing Long Tang pattern. (Zhang Zhongjing's two clauses on Xiao Qing Long Tang both state: When there is fluid retention in the epigastrium, causing dry heaving, fever, and cough, Xiao Qing Long Tang is the primary formula. Also: When there is fluid retention in the epigastrium, causing cough with slight wheezing, Xiao Qing Long Tang is used.) Xiao Chai Hu Tang treats cough with great value. (Zhang Zhongjing stated: After seven or eight days of Wind Stroke, if there is palpitations in the epigastrium, difficulty urinating, slight fever, or cough, Xiao Chai Hu Tang is the primary formula.) Yangming disease where the patient can eat but has a sore throat, and coughing accompanied by severe headache, is difficult to bear. (Zhang Zhongjing's *Jin Gui Yao Lue* states: In winter, Yangming disease presenting only with dizziness and no aversion to cold allows the patient to eat; if such a patient coughs, their throat will surely hurt. If they do not cough, the throat does not hurt. Also: In winter, Yangming disease presenting without sweat, with free urination, and after two or three days, vomiting and coughing with cold extremities, the head will surely hurt. If there is no vomiting or coughing, and extremities are not cold, the head does not hurt.) Shaoyin disease with irritability and thirst is treated with Zhu Ling Tang; diarrhea requires the efficacy of Si Ni Tang. (Zhang Zhongjing stated: In Shaoyin disease, with diarrhea for six or seven days, accompanied by cough, vomiting, thirst, irritability, and insomnia, Zhu Ling Tang is the primary formula. Also: In Shaoyin disease with cold extremities, if the patient has cough, difficulty urinating, abdominal pain, and diarrhea, Si Ni Tang is used.) Sudden cough arising from internal fluid retention is deeply addressed by Zhen Wu Tang. (Zhang Zhongjing stated: If Shaoyin disease persists for two or three days and progresses to four or five days, with abdominal pain, difficulty urinating, heavy and painful limbs, and diarrhea, this indicates fluid retention. If the patient has cough, or spontaneous urination, or diarrhea, or vomiting, Xuan Wu Tang [i.e., Zhen Wu Tang] is the primary formula.)