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[Suwen] When Yin prevails, Yang becomes diseased; when Yang prevails, Yin becomes diseased. Yang prevalence manifests as heat, and Yin prevalence manifests as cold. Extreme cold transforms into heat, and extreme heat transforms into cold. (From *Treatise on the Correspondences of Yin and Yang*, same below) Yang prevalence causes body heat, closure of interstices (skin pores and texture), rapid and coarse breathing, bodily undulation, anhidrosis with fever, dry teeth, and vexation/oppression. If abdominal fullness occurs, it is a death sign; the patient can endure winter but not summer. Yin prevalence causes body cold, sweating, constant chilliness, frequent shivering/chills, and cold extremities. If cold extremities are accompanied by abdominal fullness, it is a death sign; the patient can endure summer but not winter.

[Li Dongyuan] In all cases, if the pulse is choppy, it indicates excess Yang Qi. If the pulse is slippery, it indicates excess Yin Qi. Excess Yang Qi manifests as body heat without sweat. Excess Yin Qi manifests as profuse sweating and body cold. Excess of both Yin and Yang manifests as anhidrosis and body cold. Deficiency of both Yin and Yang manifests as sweating and body heat. I add this sentence: Among severe diseases, none is more critical than this, resembling muscles being carved by knives; it is extremely dangerous and cannot last long. According to the classics: Pathogens arising from the Yang aspect result from wind, rain, cold, and heat. It also states: Yang deficiency generates external cold. Yang receives Qi from the Upper Jiao to warm the skin and muscle spaces. Now, if cold pathogen remains outside, the Upper Jiao becomes obstructed. Obstruction of the Upper Jiao causes cold pathogen to remain solely on the exterior, resulting in chills. It also states: Yang excess generates external heat. If the Upper Jiao is not unobstructed, the skin becomes dense, interstices close, and xuanfu (sweat pores) are blocked, preventing Wei Qi (Defensive Qi) from venting, thus generating external heat. The classics state: Pathogens arising from the Yin aspect result from diet, lifestyle, and emotional fluctuations. It also states: Yin deficiency generates internal heat. Due to overwork and fatigue, form and Qi decline, Grain Qi fails to flourish, the Upper Jiao fails to circulate, and the lower Stomach opening is blocked. Stomach Qi stagnates and generates heat, which steams upward into the chest, causing internal heat. It also states: Yin excess generates internal cold. Rebellious Qi ascends, and cold pathogen accumulates in the chest without dispersing. Without dispersal, warming Qi departs, leaving only cold. Cold causes blood coagulation, leading to blocked vessels. The pulse becomes large and choppy, indicating middle cold. (See Acupuncture section for details.)

[Lingshu] Observing complexion: yellow-red indicates abundant heat Qi; blue-white indicates deficient heat Qi; black indicates abundant blood and deficient Qi. (From *Chapter on Five Tones and Five Flavors*) The classics state: Generally, inspecting collaterals, blue color indicates cold and pain, red indicates heat. Cold in the Stomach makes the collateral at the thenar eminence appear blue; heat in the Stomach makes it appear red. Sudden blackness indicates long-standing Bi syndrome. Mixed red, black, and blue indicate mixed cold and heat. Short pulse indicates deficient Qi. Blue floating collaterals indicate pain; black indicates Bi; yellow-red indicates heat; white indicates cold. Seeing all five colors reveals cold and heat patterns. (See General Treatise on Yin and Yang for details.)

[Nan Jing] The classics state: Rapid pulse indicates heat, slow pulse indicates cold; all Yang pulses relate to heat, all Yin pulses relate to cold. (Full text in General Treatise on Diagnosis) The classics state: A full Renying pulse indicates heat, a deficient one indicates cold. A full Qikou pulse indicates abdominal fullness, cold in the middle, and indigestion; a deficient one indicates heat in the middle, vomiting of mucoid matter, deficient Qi, and altered urine color. (Full text in Acupuncture: Excess and Deficiency) Cold conditions are treated with heat; heat conditions are treated with cold. Mild cases are treated inversely (Zheng Zhi); severe cases are treated according to symptoms (Fan Zhi). Inverse treatment is standard treatment; following treatment is counter-treatment. Dosage depends on the situation. The Emperor asked: What is counter-treatment? Qibo replied: Heat used with cold agents, cold used with heat agents, obstruction treated with obstruction methods, diarrhea treated with purgatives. One must subdue the main pathogen and address its cause initially. Though starting similarly, the outcome differs. This can break accumulations, dissipate hardness, harmonize Qi, and ensure cure. (Full text in General Treatise on Therapeutics) Mild cases are regulated; next, balanced; excess is drained via sweating or purging. Cold, heat, warmth, and coolness are used according to their nature to reduce pathology, following what is beneficial. (Full text in General Treatise on Therapeutics: Excess and Deficiency)

Wang Bing’s commentary: For mild cold, use warm harmonizing agents. For severe cold, use hot resolving agents. For extreme cold, use purgative draining. If draining fails, use inverse suppression. If suppression fails, seek the affiliated organ to reduce pathology. For mild heat, use cool harmonizing agents. For severe heat, use cold resolving agents. For extreme heat, use diaphoretic dispersing. If dispersing fails, use inverse control. If control fails, seek the affiliated organ to reduce pathology.

[Nan Jing] Yang excess and Yin deficiency: Purging leads to recovery, sweating leads to death. (This is a heat disease. Yang excess generates external heat; Yin deficiency generates internal heat. Use cold purgatives. Zhang Zhongjing said: Once Guizhi Tang enters the throat, Yang excess leads to death.) Yin excess and Yang deficiency: Sweating leads to recovery, purging leads to death. (This is a cold disease. Yin excess generates internal cold; Yang deficiency generates external cold. Use hot diaphoretics—not just to induce sweat, but to assist Yang. Zhang Zhongjing said: Once Chengqi Tang enters the stomach, Yin excess leads to demise. Li Dongyuan said: Use sweet herbs to assist ascending and growing Qi.)

[Suwen] The Emperor asked: Discussions say treat cold with heat and heat with cold. Physicians should not abandon rules. But some heat patients do not improve with cold drugs; some cold patients do not improve with heat drugs. Both exist, and new diseases arise. How to handle this? Qibo replied: For diseases that become hotter after cold treatment, treat the Yin; for those that become colder after heat treatment, treat the Yang. This is called "seeking the affiliation" (root cause). (Wang Bing notes: Nourish the source of Fire to eliminate Yin shadows; strengthen the master of Water to control Yang brilliance.) The Emperor asked: Good. Why does taking cold drugs cause heat, and heat drugs cause cold? Qibo replied: Because you treated the Wang Qi (excessive manifest Qi), hence the reversal. The Emperor asked: What if not treating Wang Qi still causes this? Qibo replied: Excellent question! It is because you did not treat the五味 (Five Flavors) affiliations. Five flavors enter the Stomach and go to their preferred organs: Sour to Liver, Bitter to Heart, Sweet to Spleen, Pungent to Lung, Salty to Kidney. Long-term use increases the Qi of these organs, which is the normal transformation of things. However, prolonged increase of Qi leads to premature death. (From *Treatise on the Great Essentials of True Demand*, same below) Wang Bing notes: Entering Liver is Warm, Heart is Hot, Lung is Clear, Kidney is Cold, Spleen is Supreme Yin combining four temperatures. All increase flavor to benefit Qi. Thus, long-term Coptis or Picrorhiza may cause heat. This is why long-term use increases Qi, the norm of transformation. Prolonged Qi increase leads to organ excess. Organ excess leads to organ exhaustion. Organ exhaustion leads to sudden death. Hence, prolonged Qi increase is the cause of premature death.

[Zhu Danxi] Question: Why does cold disease not resolve with heat drugs, and heat disease not resolve with cold drugs? Answer: Qixuanzi (Wang Bing) said: Heat cannot be cured by cold due to lack of Water (Yin deficiency). Cold cannot be cured by heat due to lack of Fire (Yang deficiency). Failure to warm cold blames Water deficiency. Failure to clear heat blames Fire deficiency. The classics say: Nourish the source of transformation. If the source is exhausted, how can drug assistance nourish true Water and Fire?

The Emperor asked: What about pulses conforming to symptoms but symptoms being opposite? Qibo replied: Pulse conforms, but pressure reveals no pulsation; this applies to all Yang pulses. (Wang Bing notes: Heat disease with rapid pulse, but non-pulsating upon pressure, indicates Cold excess repelling Yang, not true heat. Symptoms belong to Yang, pulse conforms, but pathology is cold. "All Yang" refers to tight/rapid San Yang pulses lacking pulsation, differing in Sun Taiyang root and branch.) The Emperor asked: What about Yin pulse reversals? Qibo replied: Pulse conforms, but pressure reveals strong, vigorous pulsation. (Wang Bing notes: Cold symptoms, but strong pulsation upon pressure, indicates Heat excess rejecting Yin, not true cold. Symptoms belong to Yin, pulse conforms, but pathology is heat.) Therefore, diseases arise from Root (Ben), Branch (Biao), or Middle Qi. Treatment can target Root, Branch, Middle Qi, Root-Branch combination, Inverse method, or Following method. Inverse treatment appears contrary but is actually correct compliance. Blind compliance is actually inverse treatment. Thus: Knowing Root and Branch ensures safety; knowing Inverse and Following ensures correct action without doubt. Ignorance here prevents diagnosis and disrupts meridians. The Great Summary says: Crude physicians laugh, thinking they know; speaking of heat while cold disease starts anew, confusing similar Qi with different forms, disrupting meridians. The Root-Branch doctrine is concise yet broad, small yet great, summarizing hundred diseases' harms. Discussing Root and Branch is easy but vital. Examining Root and Branch harmonizes Qi; knowing Sheng-Fu cycles serves as a model for people, completing Heavenly Dao. (Among Six Qi diseases, Root-Branch opposition is most prominent in Sun Taiyang and Shao Yin. Taiyang Branch is Yang, Root is Cold; Shao Yin Branch is Yin, Root is Heat. Wang Bing explains: Rapid pulse conforming to heat is Taiyang Branch; non-pulsating pressure indicates Cold excess repelling Yang, opposing Root/Branch. Slow pulse conforming to cold is Shao Yin Branch; strong pulsating pressure indicates Heat excess rejecting Yin, opposing Root/Branch. Not knowing opposition, treating Branch oppositely with standard method worsens Root pathology. Knowing opposition, treating Branch oppositely with counter-method heals Root pathology. Thus: Inverse is correct compliance. Knowing Root/Branch ensures safety; knowing Inverse/Following ensures correct action.)

Above describes pulse conforming to symptoms but pathology reversing: Symptoms like Yang, pulse like Yang, but pathology is Cold. Symptoms like Yin, pulse like Yin, but pathology is Heat. Thus, treat opposite to pulse/symptoms. E.g., body heat, slight fever, irritability, red face, but deep/faint pulse indicates Yin disease mimicking Yang. Body heat is due to interior cold. Irritability is due to Yin excess. Face redness (floating Yang) is due to lower deficiency. If doctors ignore pulse, mistaking for excess heat, and give cooling drugs, Qi dissipates, causing major illness. *Waitai Miyao* says: Yin excess causing agitation is called Yin Agitation; patient wants to sit in a well; treat with hot drugs. Thus, Zhang Zhongjing treats Shao Yin disease with red face using Si Ni Tang plus Scallion White. (Li Dongyuan says: Cold drugs entering abdomen make fire rise with water; extreme Yin dryness causes desire to sit in well. Yin is already lost, yet doctors mistake for heat and give heavy cold drugs; death is inevitable.)

Inverse Qi resembles Yang. (Full text in Five Zang Organs.)

[Li Dongyuan] Vomiting, retching, or coughing may trigger restlessness, steaming heat, feeling like sitting in a steamer, wanting to remove clothes, stay in cold places, or drink cold water, yet stool remains normal. Chills return, causing shortness of breath and chest oppression nearing death. Severe cases involve open mouth, fixed eyes, loud voice, excessive tears, snot, saliva, and phlegm. Restlessness lasts briefly. Six pulses are fine, wiry, choppy, and deficient upon pressure. This is Major Cold Disease. Use pungent-sweet-cold and sweet-warm formulas to greatly drain South (Heart Fire), restoring North (Kidney Water).

*[Huoyan Shu]* Cold hands/feet, constipation, red urine, or black stool, with deep-slippery pulse indicates Yang disease mimicking Yin. Mild cases: Bai Hu Tang. Severe cases: Cheng Qi Tang. Typhoid missed by purging causes Qi/Blood blockage and cold limbs; this is deep latent heat causing deep厥 (Jue). Quickly purge with Da Cheng Qi Tang plus Calomel; sweating brings immediate cure. Heat Jue differs from Yin Jue. Heat Jue: mild cold limbs followed by fever. Yin Jue: no fever, cold limbs, aversion to cold, deep-thin pulse, loose stools/urine.

These two sections discuss symptoms mimicking Yang but pathology belonging to Yin, and symptoms mimicking Yin but pathology belonging to Yang; thus, treat opposite to symptoms. People can distinguish symptoms-like-Yang/pathology-Yin. But when pulse/symptoms are Yin yet pathology is Yang, few recognize it, leading to many deaths. Scholar Xu said: During Xining era, Shou Di’s nephew had typhoid with irritability, thirst, and sweating. Treated with cooling drugs, he developed Yin Du (Yin Toxin) and died days later. Shou Di mourned, writing *Three Chapters on Yin Du Forms/Symptoms*, deeply warning society.

[Li Dongyuan] Foot-Taiyang Bladder Meridian uses "Heat due to Cold application." Bladder Root is Cold, Meridian is Old Yang. Taiyang is Branch, having Yang name but not substance, implying transition to Yin. Pulse is tight-rapid, non-pulsating/vacuous upon pressure, showing external false Yang and internal true Cold. Thus, Zhang Zhongjing uses Jiang Fu Tang (Ginger-Aconite Decoction), boiled long, served cold. This is cold treatment. Ginger/Aconite are Yang in nature; long boiling extracts double Yang heat to drain pure Yin cold, treating the Root. Serving cold uses fake cold to treat Taiyang Branch's fake Yang, a true-false relative method. When treating with drugs, know vacuous pulse indicates internal hidden Yin Cold manifesting as heat symptoms: extreme thirst, red eyes/mouth, red face/body heat, fiery limbs. This is floating Yang perishing externally, rejected by internal cold. Hand-Shaomin Heart Meridian uses "Cold due to Heat application." Shaomin Meridian is True Yin; Heart disease root is True Fire. Thus: Shaomin Branch is Yin, Root is Heat. Internally, Heart Yang is Root; externally, True Yin is Branch. Pulse is deep-thin; if pressure reveals large-tight-strong, Heart Fire is internal (tight-large), while True Yin Branch shows deep-thin (Cold Water nature). Thus, Zhang Zhongjing uses Da Cheng Qi Tang, with wine-processed Rhubarb boiled hot to remove Branch Cold, using bitter-cold Da Huang and Mang Xiao to drain Root Heat. This medication method serves as a eternal model.

[Suwen] Treat heat with cold, administer warm. (Similar to "Cold due to Heat application," e.g., hot administration of cold Da Huang/Mang Xiao.)

Zhu Danxi treated a woman of Western Regions features with aversion to cold using Ba Wu Tang minus Chuanxiong plus fried Phellodendron, worsening condition. He realized deep heat and lack of counter-agent, so he reheated the decoction and administered it, curing her. This is treating heat with cold, borrowing fire's power to administer warmly.

[Li Dongyuan] Treating heat with cold, administering warm, has three principles: 1. For major heat, use Huang Qi, Ren Shen, Gan Cao (sweet-warm). Though interior/exterior heat exists, internal dryness manifests externally as skin heat. These harmonize, inducing sweat and resolution. This is the principle of "Warmth removing major heat." 2. Extreme heat generates Wind, moving left into Earth. Tonify Mother to empty Child, allowing Heavenly Dao to move right forward. Diseases heal under Heavenly Command. 3. Major heat above implies hidden major cold inside. Warmth retreats cold, assisting Earth Qi (Stomach's generating Qi), strengthening True Qi.

[Suwen] Treat cold with heat, administer cool. (Similar to "Heat due to Cold application," e.g., cold administration of hot Gan Jiang/Fu Zi.)

Zhang Zhongjing treated Shao Yin dysentery with faint pulse using Bai Hu Tang. If dysentery persisted, with cold limbs, absent pulse, dry retching, and irritability, use Bai Tong Tang plus Pig Gallbladder Bile. This is treating cold with heat, borrowing bile's coolness to administer.

[Li Dongyuan] Treating cold with heat, administering cool, has three principles: 1. Northerners injured by major cold have swollen calves (Cold excess causes floatiness). Fire baths cause hair loss/bone exposure; first wash with fresh water for recovery. Frozen face/ears near fire cause peeling/sores; first bathe in cool room, then warm hand compresses restore integrity. This is "Cool administration" removing major cold. 2. Major cold causes Mother excess, moving left into Lung against Heaven. Cool drugs allow Heavenly Dao to move right forward, healing diseases. 3. Major cold outside hides major heat underground (Root of San Jiao/Bao Luo True Qi). Heat hiding injures Yuan Qi (Stomach). Cool drugs harmonize, protecting Yuan Qi.

[Zhu Danxi] Aversion to Cold is not Cold; Aversion to Heat is not Heat. Classics: Aversion to cold/shivering belongs to Heat. Shivering losing spiritual control belongs to Fire. Aversion to cold: even in summer, facing wind/rain, wearing thick layers, shivering violently, losing spiritual control, is extreme cold aversion. *Yuan Bing Shi* says: Heat disease feeling cold is heat disease, not cold. Some ask: Why do heat drugs cure some? Heat patients have rising Qi, stagnating as phlegm-fluid, blocking clear pathways, preventing Yin ascent, worsening heat. Phlegm gets heat, temporarily recedes, but heat aids pathogen, deepening disease. Some ask: Who dares give cold drugs for such cold? Isn't it killing? I say: Ancients cured shivering with Da Cheng Qi Tang purging dry feces. Aversion to cold/shivering is clearly heat, differing in excess/deficiency. Classics: Yin deficiency generates heat. Yang is outside, guarding Yin; Yin is inside, guarding Yang. Wandering spirit, unrestrained desires, consume Yin Qi. Yang loses attachment, floats to muscle surface, causing aversion to heat (not true heat). Treat as Yin deficiency with tonification. Some ask: Is typhoid aversion to cold/heat the same? I say: Typhoid enters from outside; ancients discussed this in detail; I need not add.