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Lianggan (Two-Channel Simultaneous Infection) refers to the simultaneous transmission of pathogens to both the exterior and interior channels. On the first day, the Taiyang Channel (Greater Yang) and Shaoyin Channel (Lesser Yin) are affected simultaneously; on the second day, the Yangming Channel (Bright Yang) and Taiyin Channel (Greater Yin); on the third day, the Shaoyang Channel (Lesser Yang) and Jueyin Channel (Terminal Yin). If the pathogen is in the Taiyang Channel, fever and headache occur; if in the Shaoyin Channel, dryness of the throat and mouth occurs; if in the Yangming Channel, pain in the eyes and dryness of the nose occur; if in the Taiyin Channel, abdominal fullness and spontaneous diarrhea occur; if in the Shaoyang Channel, deafness and hypochondriac pain occur; if in the Jueyin Channel, irritability, chest fullness, and contraction of the genitalia occur. The simultaneous transmission of exterior and interior channels causes the most rapid deterioration. This discusses Lianggan resulting from sequential channel transmission. Furthermore, as mentioned by Zhang Zhongjing regarding Shaoyin syndrome presenting with fever, treated with Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction), this discusses Lianggan resulting from direct invasion by cold pathogens. For Lianggan via sequential transmission, treatment prioritizes releasing the exterior, assisted by clearing the interior. For Lianggan via direct invasion, treatment prioritizes warming the interior, with releasing the exterior as secondary. This is the general principle for treating Lianggan. One might ask: When Taiyang disease is just acquired, before it has transmitted to other channels, why are there immediately Shaoyin heat symptoms? The answer is: Such conditions frequently occur in warm-heat patterns. The patient inherently has accumulated heat within, which is stirred up by external wind-cold, resulting in simultaneous exterior and interior manifestations and dual transmission of Yin and Yang. The disease is extremely acute; if treated improperly, survival becomes distant.

Shanghan Jianzheng (Complications of Cold Damage) are not the primary diseases of the six-channel transmission nor the primary diseases of direct invasion into the three Yin channels, but rather symptoms constantly present in Shanghan, hence named "complications." Some appear in the Hand Channels (Lung, Pericardium, Sanjiao), some arise from mismanagement, some from improper care during illness, and some from contagion of pathogenic factors. Clinicians who apply methods according to principles and thoroughly understand these conditions will have exhausted the knowledge of Shanghan.

Ke Sou (Cough) is primarily due to Lung Cold. The Classics state: "Exposure to cold and consumption of cold drinks injure the Lung." The Lung governs the skin and hair. When cold pathogens invade the skin and hair, they extend to the Lung, causing cough. Zhisou San (Stop Cough Powder) added with Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), and Zisuzi (Perillae Fructus) is appropriate. One might ask: Shaoyang syndrome, direct invasion syndrome, and Shuiqi Syndrome (Water-Qi Syndrome) all cause cough. Why? The answer is: Shaoyang syndrome with cough is due to cold in the Lung; Zhang Zhongjing uses Xiaochaihu Tang (Minor Bupleurum Decoction), removing Renshen (Ginseng Radix et Rhizoma) and Dazao (Jujubae Fructus), adding Ganjiang (Zingiberis Rhizoma) to warm the Lung and disperse cold. Direct invasion syndrome with cough is also due to cold qi binding upward to the Lung; warming the middle jiao stops the cough naturally. Shuiqi Syndrome with cough is due to cold water flooding upward to the Lung. Treatment should distinguish between exterior and interior water-qis: If there is exterior water-qis with fever, use Xiao Qinglong Tang (Minor Green Dragon Decoction) to release the exterior and promote water metabolism; if there is interior water-qis with diarrhea, use the same formula minus Mahuang (Ephedrae Herba), adding Wanghua (Adenophorae Radix), to attack the pathogen; for mild cases, use Banxia Houpo Tang variant or specifically Xiaobanxia Jia Fuling Tang (Minor Pinellia plus Poria Decoction) to dredge the pathways, allowing water-drink to circulate freely, stopping the cough. These three syndromes all result from contracting cold-water qi, hence cough is attributed to Lung Cold. Another question: What is commonly called "Heat Wind-Cold" cough? Answer: Heat Wind-Cold, such as in Winter-Warmth seasons where weather is abnormally warm instead of cold, affects humans causing headache, sore throat, dry throat, and cough, differing slightly from standard wind-cold cough. Or, if a person has inherent stagnant heat bound by external wind-cold, with heat inside and cold outside, known colloquially as "Cold Wrapping Fire." Another question: What about coughs not associated with wind-cold but exclusively due to Fire? Answer: These are miscellaneous disease coughs, caused by summer heat-fire, spicy food-fire, Spleen-Lung Qi deficiency fire, or Dragon-Lei Fire rising. Each has accompanying symptoms, distinct from Shanghan symptoms like nasal congestion, heavy voice, headache, fever, and aversion to cold, and clearly different from Heat Wind-Cold cough. These should be sought in their respective categories and cannot be discussed alongside Shanghan.