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From the time after Frost's Descent (Shuangjiang) to before Spring Equinox (Chunfen), when the weather is severely cold, if one fails to regulate life carefully and contracts the pathogenic factor, resulting in headache and high fever, it is named Cold Damage (Shanghan).

In the other two seasons, although it is cold, it is not severe; how can there be a true Cold Damage disease? However, why are there many cases of Cold Damage but few cases of Middle Cold during the severe winter, while in the other three seasons with slight cold, there are no cases of Cold Damage but many cases of Middle Cold? This is because Winter governs closure and storage; the Yang Qi of Heaven and the Yang Qi of humans are hidden within. Therefore, although it is severely cold outside, the pathogen cannot enter directly, which is why it is called "injury" (Shang). Treatment should focus on dispersing from the exterior. Once the exterior syndrome resolves and the interior harmonizes, one should not be constrained by the transmission patterns of the Three Yin meridians. If it occurs in Spring or Summer, the Yang Qi of Heaven and humans ascends and floats outward. Coupled with careless regulation, even slight cold outside can directly penetrate the Yin meridians, which is why it is called "middle" (Zhong). Treatment should urgently employ warming and tonifying methods. Even if there is fever, this is due to deficient Yang floating on the surface; the pulse must be deep, fine, and lacking spirit. One should tonify the Middle Qi to consolidate the deficient Yang. If there is headache, this is due to deficient fire rising from weak Stomach Earth; the pulse must be large and floating but powerless. It is appropriate to warm the Lower Yuan to conceal the Dragon Fire. This is the method of guiding fire back to its source, used to treat symptoms of false heat. Furthermore, there are cases of false distension. Whenever the Middle Qi of a person is sufficient and the Spleen and Stomach transport functions are unceasing, where would there be worry about distension? If the Stomach is deficient and cannot receive food, there will be the hazard of false fullness; if the Spleen is deficient and cannot transform grain, there will be the risk of regurgitation and distension. Moreover, if the Lower Yuan is extremely deficient, with rootless and escaping Qi ascending to the chest fire: since the Kidney governs receiving Qi and the Lung governs expelling Qi, Kidney deficiency fails to close and store, so Qi goes out without being received. Although the Lung manages expulsion, the Qi rushes too urgently, going out without returning, causing the Lung to become distended. Thus, between the chest and diaphragm, there is unbearable distension and oppression, and in severe cases, it attacks and pierces the Heart, causing severe pain almost leading to death. In such cases, only tonification as a method of elimination is suitable, following the principle of "treating obstruction with obstruction" (Sai Yin Sai Yong). For Heart and Spleen insufficiency, greatly tonify the Heart and Spleen so that the Middle Qi circulates smoothly and brings relief. For Kidney Meridian deficiency-cold, warm and tonify the Lower Yuan so that the True Qi is sealed and stored, leading to recovery. This is the method of receiving Qi and storing at the source, used to treat symptoms of false distension. If one does not understand this and continues to use digestive, purgative, or Qi-regulating drugs, it will only make the deficient Qi more unsupported, attacking upward causing panting and death. However, the reason why Qi-regulating drugs fail for Qi disorders is that the storage function of Qi lacks consolidation. The Lung governs Qi, and the Kidney stores Qi. Therefore, ancients used Kidney-tonifying herbs added with Rou Gui (Cinnamon Twig) and Wu Wei Zi (Schisandra Fruit) to collect turbid Qi and guide it downward. In summary, excessive exterior heat is due to Interior Yang escaping outward; upper heat is all due to lower fire ascending. Although there may be external pathogenic contact, it is merely the beginning of the initial onset. Moreover, studying the *Classic* states: "Where the pathogen resides, the Qi must be deficient." This shows that external pathogenic invasion is also caused by deficiency. During Spring and Summer, when Yang Qi floats outward, it is especially easy for Righteous Qi to leak outward. If one does not know this and lightly administers cold-cooling agents, then how will the floating and scattered Yang return? The remaining dying Yang inside will be further extinguished, leading to sudden death in severe cases or middle-fullness in mild cases. Alas, modern physicians do not recognize the condition. Whenever there is fever in the fifth or sixth month, they generally call it Plague Disease or Cold Damage. If slightly red spots appear, they call it seasonal epidemic or plague rash, and administer cold-cooling medicines, misleading many people. As for dry mouth, vexation, thirst, and preference for cold drinks, which seem to be excess heat, investigating the source reveals that either the Stomach fluids are dried up or the Kidney water is parched, thus drawing water to save oneself. Ice water entering the stomach causes body fluids to congeal further; cold entering the Dantian makes deficient fire rise higher. Although it is Dragon-Thunder fire, it can still scorch grass and trees. Hence, red eyes, scorched teeth, and dry tongue appear, and the six pulses are surging and rapid, seemingly indicating excess. Administering cold-cooling medicines will inevitably lead to vexation, mania, and death due to exhaustion of body fluids. If one seeks the source and treats according to the nature, using formulas that tonify fire within water or take hot medicines coolly, after two or three doses, the false Yang symptoms will naturally subside, and the true Cold symptoms will fully emerge. More people are misled by cold-cooling medicines because they do not understand this. Only in cases of true Cold Damage with excess heat and constipation should one follow the method of cold-cooling and purging. Treating the branch first and the root later is acceptable. However, one must distinguish the syndrome accurately, carefully examining whether to use cold or purge. One must hit the disease precisely; otherwise, it kills like a sword. Be cautious!