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Yinyang Yi (Exchange of Yin and Yang) refers to the condition where a healthy person contracts the disease after sexual intercourse with a patient recovering from Shanghan (Cold Damage). The manifestations include constipation, mental confusion, fright and restlessness, heavy body with shortness of breath, urgency and tension in the lower abdomen extending to spasms in the genitalia, heat rushing up to the chest, heaviness of the head making one unwilling to lift it, visual disturbances such as seeing spots, and stiffness and cramping of the knees and calves. This occurs because the Kidney meridian is depleted and damaged, and the True Yang is deficient; thus, there are cold signs without heat signs, a deficient pulse, and cold feet. It is appropriate to administer Renshen Sini Tang (Ginseng and Aconite Decoction), taken with Shaosan (Burnt Powder, made from burning the patient's clothing), and if the glans penis swells slightly, the disease will resolve. If a female patient engages in sexual activity before her illness has fully resolved, presenting with urgent pain in the lower abdomen, pain in both the waist and knees, numbness in the four limbs, and no fever, Danggui Baizhu San (Angelica Sinensis and Atractylodes Macrocephala Powder) should be used. Yinyang Yi is extremely difficult to regulate; treatment must distinguish between cold and heat patterns. If the tongue protrudes several inches and cannot be retracted, the prognosis is fatal.

Edema occurring after the recovery from Shanghan: if caused by water qi retention, diuresis is indicated. If due to deficiency of Stomach Qi and poor appetite, Wuling San (Five-Ingredient Poria Pill) added with Cangzhu (Atractylodis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Muxiang (Aucklandiae Radix), and Sharen (Amomi Fructus) is suitable. If Stomach Qi is not deficient, consuming porridge boiled with a single herb, Shanglu (Phytolaccae Radix), is also effective. Foot edema following severe Shanghan is not alarming. As long as diet is regulated, and alcohol and sexual indulgence are abstained from, once Stomach Qi strengthens, the edema will subside spontaneously.

When Shanghan is not fully resolved through sweating or purging, residual pathogenic factors may knot in the area one cun two fen three li behind the ear, or cause hardness and swelling below both ears. This is named Weidu (Residual Toxin). It should be dispersed quickly; delay will lead to suppuration. Lianqiao Baidu San (Forsythia Decoction for Resolving Toxins) is indicated. If there is swelling and pain in the neck, add Weilingxian (Syringae Ramulus et Folium); if stool is hard, add Dahuang (Rhei Radix et Rhizoma) and Chuanshanjia (Manis Squama). If swelling persists with pus formation, whether broken or unbroken, Neituo Xiaodu San (Internal Support and Detoxification Powder) added with Jiaoci (Gleditsiae Spina), Shengma (Cimicifugae Rhizoma), Jinyinhua (Lonicerae Japonicae Flos), and Gancao (Glycyrrhizae Radix et Rhizoma) should be used. However, although ancient texts describe it this way, in reality, it is mostly due to prolonged high fever injuring Yin fluids. The Shaoyang and Shaoyin meridians suffer extreme Yin deficiency, leading to deficient fire rushing upward, causing swelling and pain in the cheeks and behind the ears. The Classic states: "When Ying Qi does not follow its course and reverses into the flesh, carbuncles and swellings arise." Moreover, the area round one cun behind the ear belongs to the Kidney; what toxin could there be? Treatment should focus on nourishing Yin, resolving phlegm, dispersing stagnation, and harmonizing the Liver, so that the swelling heals itself. Herbs such as Shudi (Rehmanniae Radix Preparata), Maidong (Ophiopogonis Radix), Tubei Mu (Fritillariae Thunbergii Bulbus), Sheng Baishao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), and Lianqiao (Forsythiae Fructus) can be used, with small amounts of Qingpi (Citri Reticulatae Pericarpium Viride) and Chaihu (Bupleuri Radix) as adjuvants. If the Chi pulse (cun position at the wrist corresponding to the Kidney) is very weak, the method of treating the upper by addressing the lower should be employed, using herbs that guide fire back to its source, allowing the swelling to disperse without direct treatment. If mistakenly treated as a toxic accumulation and attacked with harsh purgatives, the swelling will not only persist but worsen, potentially leading to other critical conditions. This is my humble opinion.