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The *Shaoyin Chapter* states: In Shaoyin disease, if the pulse is deep (Chen), urgent warming is required; Si Ni Tang (Four Reversal Decoction) is appropriate. The *Taiyang Chapter* states: When a patient presents with fever, headache, and a pulse that is surprisingly deep, accompanied by body pain, one should urgently rescue the interior Yang; Si Ni Tang (Four Reversal Decoction) is appropriate. The reason for urgent warming or urgent rescue in Shaoyin and Taiyang diseases lies in the qi transformation of water, fire, cold, and heat. When the disease is in Shaoyin and there is severe contraction of Ministerial Fire (Jun Huo), urgent purgation is indicated; when there is severe contraction of Yin-Cold, urgent warming is indicated. When Cold damages the Taiyang channel, if the pivot mechanism is obstructed and the Shen Qi floats outward, resulting in a surprisingly deep pulse, this indicates that Yang Qi has sunk inward; therefore, the interior must be urgently rescued. In these two cases, only a deep pulse is observed; if one waits until the limbs become cold and the pulse disappears, it will be beyond salvation. Thus, "urgent" means like a person falling into water or fire; delay leads to burning or drowning.

One fragrant herb mixed with one stinking herb leaves a bad smell for ten years; therefore, expelling pathogenic factors is best done swiftly. It is said: Excessive sweating causes loss of Yang Qi. If exterior pathogens are abundant, resolving them through sweating preserves Yang Qi. It is also said: Excessive purgation causes loss of Yin fluids; if interior pathogens are excess, resolving them through purgation preserves Yin fluids. Here, "excessive" refers to going too far. Going too far is inadvisable, let alone reckless administration! The *Ling Shu Jing* (Spiritual Pivot) states: The Upper Jiao opens and develops, disseminating the flavors of grains and foods, steaming the skin, filling the body, and moistening the hair, like mist and dew irrigating; this is called Qi. Generally, when Qi transforms, sweat flows profusely. It also states: Those who have lost blood do not sweat; this indicates insufficiency of Blood and Qi, so pathogens cannot be resolved through sweating. The *Shang Han Lun* (Treatise on Cold Damage) states: A faint pulse indicates insufficient Yang Qi; a choppy pulse indicates lack of Blood. If purgation is mistakenly used, epigastric fullness and hardness result, indicating that due to insufficiency of Blood and Qi, resolution via purgation is difficult. One must understand that while pathogenic evils should be attacked, Righteous Qi must also be nourished. When Pathogen and Righteous Qi contend, alternating chills and fever occur; if the Pathogen retreats, recovery ensues; if Righteous Qi collapses, danger arises. Sweating and purging methods are like reinforcements. A skilled commander can defeat many with few and the weak with the strong. If one does not examine deficiency and excess, nor understand the situation, but attacks recklessly, one will instead be harmed by the enemy!

The *Bian Mai Pian* (Chapter on Pulse Differentiation) states: Why does a patient experience shivering chills followed by fever? The answer is: When Yin pulses are deficient, Yang Qi moves to join them; when Yang pulses are deficient, Yin Qi invades them. Question: What is meant by Yang deficiency? Answer: For example, if the Cun Kou (radial artery at the wrist) pulse is faint, it is named Yang deficiency. When Yin Qi ascends into the Yang region, shivering chills occur. Question: What is meant by Yin deficiency? Answer: If the Chi pulse (distal radial pulse) is weak, it is named Yin deficiency. When Yang Qi sinks downward into the Yin region, fever occurs. If the Yang pulse is floating and the Yin pulse is weak, this indicates Blood deficiency; Blood deficiency leads to tendon tension. A deep pulse indicates slight Ying Qi (Nutritive Qi). A floating pulse with sweat droplets flowing like pearls indicates decline of Wei Qi (Defensive Qi). If Ying Qi is slight and moxibustion with heated needles (Shao Zhen) is applied, blood flow stagnates, leading to increased fever and restlessness. Zang pulses belong to Yin, Fu pulses belong to Yang; Blood belongs to Yin, Qi belongs to Yang; Ying belongs to Yin, Wei belongs to Yang; Interior belongs to Yin, Exterior belongs to Yang. The Yin and Yang mentioned here do not refer to these distinctions, but rather to the Qi of Yin and Yang! The Qi of Yin and Yang is the primordial Water and Fire. On earth, it manifests as Water; in heaven, as Cold; on earth, as Fire; in heaven, as Heat. Formless Qi is called Yin and Yang;有形 manifestations are called Water and Fire. When Yin and Yang Qi interact, the person is healthy. If this Qi invades the vessels, it results in alternating chills and fever. Thus, initially mentioning Yin and Yang pulses, then Cun Kou and Chi pulses, then Yin and Yang Qi, and Yin/Yang regions, refers to the mutual invasion of Yin and Yang Qi entering the vessels and manifesting at the Cun and Chi positions. Essentially, Cun and Chi are used to distinguish Yin and Yang, not implying that Zang pulses are Yin and Fu pulses are Yang; nor does it mean that vessels connecting internally to Zang-Fu are Yin and those connecting externally to the body are Yang. "Middle of the vessel" refers to within the vessel itself; "Yin middle" and "Yang middle" refer to the upper half of the body as Yang and the lower half as Yin, hence "ascending" and "sinking." This Yin-Yang Qi invading the vessels causes chills and heat, not due to Blood deficiency in the vessels; thus, floating Yang pulse and weak Yin pulse indicate Blood deficiency. Blood deficiency causing tendon tension means Blood circulates within vessels and seeps outside; it is governed by the Liver, and Blood itself has Yin and Yang aspects. (Inside the vessel is Yin, outside is Yang.) Slight Ying Qi results in a deep pulse; declining Wei Qi results in a floating pulse. The term "mutual invasion of Yin and Yang," seen as faint Cun Kou pulse and weak Chi pulse, does not equate Ying and Wei with Yin and Yang, but refers to the floating and deep nature of the pulse. Regarding heated needles causing stagnant blood flow, it means Blood follows the circulation of Ying Qi, not moving back and forth with Yin-Yang Qi. Increased fever and restlessness mean Ying Qi originates from the Yang Ming stage and is governed by the Heart and Kidney. The fire energy of heated needles damaging Yang Ming causes fever; damaging Heart and Kidney causes restlessness. This text states that Ying Blood is generated from postnatal essence of water and grains, while Yin and Yang are rooted in pre-natal Water and Fire Qi. It is the Yin-Yang Qi invading the vessels that causes chills and heat, not Ying Blood itself causing chills and heat. Master Nan Yu asked: How should this be treated? The answer is: Use Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet) as the primary formula, combined with Si Wu Tang (Four Substance Decoction) to nourish Blood.