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When the eyelids and the areas above and below them are swollen, it indicates a disease of water qi (Water Qi, pathogenic fluid retention). Swelling that starts from the face is called Fengshui (Wind Water, edema caused by wind attacking the exterior), which belongs to Yang Water. Swelling that starts from the lower legs and shins is called Shishui (Stone Water, severe edema with abdominal distension), which belongs to Yin Water.

If swelling extends to the wrists in the hands and to the ankles in the feet, and to the neck in the face, this is not due to water qi; rather, it is a critical condition indicating death caused by deficiency and stagnation of Yang Qi failing to return.

The *Classic* states: The Five Zang Organs are the strength of the body. The head is the mansion of Jingming (Clear Brightness, referring to mental clarity and spirit). If the head droops and the eyes are sunken, the Spirit (Shen) is about to be exhausted. The back is the mansion of the organs within the chest. If the back is curved and the shoulders sag, the mansion's function is about to deteriorate. The waist is the mansion of the Kidneys. If turning and shaking the waist is difficult, the Kidneys are about to become exhausted. The knees are the mansion of the Sinews (Jin). If flexion and extension are impossible, and walking involves stooping, the Sinews are about to become exhausted. The bones are the mansion of the Marrow. If one cannot stand for long, and trembles while walking, the Bones are about to become exhausted. All these conditions, where form and spirit are about to be depleted, and the appearance shows the decadence of sinews and bones, all indicate a fatal prognosis.

1. False Heat is when Water extreme resembles Fire. In cases of Shanghan (Cold Damage) or miscellaneous diseases, some arise because the patient has a constitution of inherent deficiency-cold and accidentally contracts pathogenic factors; some arise from excessive fatigue; some from excessive alcohol and sexual indulgence; some from excessive emotional stress; and some are originally not Heat patterns but result from the mistaken administration of cold-cooling herbs. True Heat patterns naturally involve fever, and False Heat patterns also involve fever. Their symptoms include red face, restlessness, and irritability; constipation; dark and scanty urine; shortness of breath; sore and swollen throat; or fever with a tight and rapid pulse. Physicians seeing these may mistakenly diagnose Heat and recklessly administer cold-cooling herbs, leading to death upon ingestion. They fail to realize that although there is heat on the surface, there is internal Cold repelling Yang, or deficient Yang failing to consolidate, which often presents such symptoms. However, the internal signs reveal that although the mouth is dry and thirsty, there is no desire for cold drinks; even if desired, intake is small. There may be loose stools, or hard stools followed by loose ones, or clear and frequent urination, or dryness and yellow-red discoloration of the genitals, or shortness of breath and reluctance to speak, or dull complexion and spiritual fatigue. Restlessness resembling madness may occur, but stops when restrained, differing from those who climb high and curse, which is false mania. Rashes may appear like mosquito bites, light red and fine, differing from the purple-red rashes of extreme heat, which are false rashes. The pulse in False Heat must be deep, fine, slow, and weak; or although floating, large, tight, and rapid, it lacks force and spirit. This means heat is in the skin and Cold is in the Zang-Fu organs. It is said that "aversion to heat is not true heat," but actually a Yin pattern. When encountering such internal decadence and distress, if one only knows how to attack pathogens, death is inevitable. One should urgently use formulas similar to Sini Tang (Recover the Extremity Decoction), doubling the dosage of Fuzi (Aconite Lateral Root), to tonify True Yang and guide fire back to its source. Once Yuan Qi (Original Qi) gradually recovers, the heat will retreat and store itself, and the illness will heal spontaneously. This illustrates the principle that "fire moves towards dryness." Therefore, whenever body heat and rapid pulse are present, but pressing reveals no pounding force against the fingers, this is Yin excess repelling Yang, meaning it is not Heat.

2. False Cold is when Fire extreme resembles Water. In cases of severe Shanghan heat, failure to induce sweating or purge leads to Yang pathogens becoming extremely hyperactive and stagnant internally. Thus, pathogens transmit from Yang meridians to Yin divisions, resulting in body heat with cold extremities, lethargy, or occasional aversion to cold, mimicking a Yin pattern. True Cold inherently involves aversion to cold, and False Cold also involves aversion to cold. This is because the deeper the heat, the deeper the cold limbs; extreme heat manifests with cold transformation. Generally, this pattern features strong voice and coarse breathing, robust physical strength, or scorched lips and black tongue, thirst with desire for cold drinks, dark and scanty urine, and constipation. Or, due to drinking too much medicinal water, it causes diarrhea of pure clear water, yet dry feces remain inside, accompanied by extremely foul-smelling flatulence. Examining the six pulses reveals they are all deep, slippery, and forceful, indicating a Yang pattern. For internal excess, choose among San Chengqi Tangs (Three Attendant Qi Decoctions) as appropriate. For tidal fever, use Da Chaihu Tang (Major Bupleurum Decoction) to harmonize and purge. For internal non-excess, clear with Baizhu Tang (White Tiger Decoction) or similar. In miscellaneous diseases, False Cold may also manifest as aversion to cold or shivering. This occurs because heat is extreme internally while Cold invades externally; the conflicting cold and heat energies do not merge, causing chills. This indicates Cold in the skin and Heat in the marrow. It is said that "aversion to cold is not true cold," clearly a Heat pattern. Examining internal signs reveals either preference for cold, constipation, hot and obstructive urination, bad breath with irritability. The pulse must be slippery, full, and forceful. Upon seeing this pattern, one should use Lian Ge Qing Re Tang (Cool the Diaphragm Clear Heat Decoction) or Huangqin Huanglian Tang (Scutellaria and Coptis Decoction) to nourish Yin and clear Fire. Once internal heat is removed, external cold naturally subsides. This illustrates the principle that "water flows to dampness." Therefore, whenever body cold and cold extremities are present, but the pulse is slippery and rapid, and pounding against the fingers upon pressure, this is Yang extreme resembling Yin, meaning it is not Cold.