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When discussing Shanghan (Cold Damage), people generally refer to it as Yin Syndrome, without realizing that there are three distinct categories. There is the Yin Syndrome of transmission through meridians, which is a Heat Syndrome within the Yin aspect; there is the Yin Syndrome of direct invasion, which is a Cold Syndrome within the Yin aspect; and there is the Yin Syndrome resulting from sexual indiscretion, which is a Deficiency Syndrome within the Yin aspect. If one contracts a Heat Syndrome due to sexual indiscretion, the internal burning heat will be extreme; if one contracts a Cold Syndrome due to sexual indiscretion, the internal Yin-Cold will be extreme. When the heat is extreme, Qingji (Clearing Agents) should be used lightly; when the cold is extreme, Wenji (Warming Agents) should be used heavily. This approach avoids弊端 (drawbacks). However, people indiscriminately label these conditions as Jia Yin (Clasped Yin, referring to external contraction complicated by Kidney deficiency or sexual injury), and physicians, acting arbitrarily without careful examination, instead apply harmonizing methods. Alas, how superficial this is!

The manifestations of Shiyi (Seasonal Epidemic Diseases) have two origins, three pathways of resolution, and five treatment methods, which comprehensively cover the subject. What are the two origins? Epidemics originate either from celestial factors (Tian Zai) or human factors (Ren Zai). For instance, if spring should be warm but turns cold, summer should be hot but turns cool, autumn should be cool but turns hot, or winter should be cold but turns warm, such abnormal Qi occurring out of season enters the human body via the meridians. Symptoms may include headache, fever, cough, neck swelling, Fayi (mumps-like swelling), or Datou Tianxing (Big Head Plague); this constitutes an epidemic from celestial factors. Conversely, if one person’s illness infects a room, a room’s illness infects a village, and a village’s illness infects a county, this results from the transmission of Pathogenic Qi and Filthy Qi. The pathogenic air enters through the mouth and nose, presenting with aversion to cold accompanied by high fever, chest and epigastric fullness and oppression, and vomiting of yellow saliva. This is an epidemic transmitted between humans through Qi resonance, unrelated to celestial factors. These constitute the two origins.

For epidemics originating from celestial factors, where pathogens enter via the meridians, one must differentiate between Cold and Heat and use Xinwen (Acrid-Warm) or Xinliang (Acrid-Cool) herbs to disperse the pathogen, such as Xiangsu San or Puji Xiaodu Yin, allowing pathogens entering via meridians to exit via meridians. For epidemics transmitted between humans, where pathogens enter via the mouth and nose, one should use aromatic herbs to resolve filth, such as Shenzhu San or Huoxiang Zhengqi San, allowing pathogens entering via the mouth and nose to exit via the mouth and nose. As for pathogens invading the Zang-Fu organs from the meridians and mouth/nose, progressing to tidal fever and delirious speech, abdominal fullness and pain, this indicates that toxic vapors have moved inward. Without unblocking the intestines and stomach, the toxin cannot be resolved; thus, the treatment method must employ Xiàfǎ (Purgative Method). If bowel movements occur spontaneously, then Qīngfǎ (Clearing Method) is used. If residual heat remains after purgation, Qīngfǎ is also employed, ensuring that Zang-Fu pathogens exit via the stool. These constitute the three pathways of resolution.

Dispersing, resolving filth, clearing heat, and purging constitute four methods. Why are there said to be five treatment methods? Generally, where pathogenic Qi gathers, Healthy Qi (Zheng Qi) must be deficient. When a constitutionally weak individual contracts pathogens, Bu Fa (Tonification Method) must be integrated into the treatment strategy to ensure complete efficacy. For example, tonifying Qi for Qi deficiency and nourishing Blood for Blood deficiency. In ancient formulas such as Renshen Su Yin, Renshen Baihu Tang, Renshen Baidu San, Huanglong Tang, and Sishun Qingliang Yin, the inclusion of Renshen (Ginseng Radix et Rhizoma) and Danggui (Angelicae Sinensis Radix) reveals their intent. By adding tonification to the previous four methods, one can maneuver flexibly, causing pathogenic Qi to retreat while stabilizing Yuan Qi. These constitute the five treatment methods. Once these five methods are mastered and thoroughly integrated, what difficulty could there possibly be in treating epidemics?