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Gan Zheng (Infection Syndrome), also known as Shang Han Zheng (Cold Damage Syndrome). The ancients referred to those who directly contracted cold pathogenic factors after the Frost's Descent solar term and before the Spring Equinox as having Shang Han. (This observation further reveals the fallacy of the theory that spring transforms into warm diseases and summer transforms into heat diseases.) Now, speaking generally of the conditions prevalent throughout the four seasons, we call them Gan Zheng. Generally, when a pathogen invades, it must first affect the skin and hair (mao pi), then enter the meridians (jing luo), and from there enter the zang-fu organs. (Transmission from collaterals to meridians, and from meridians to fu organs, requires distinct consideration.) However, according to the *Nei Jing* which refers to "zang" (solid organs), and various medical texts which refer to "fu" (hollow organs), they all primarily discuss the Stomach. (The main theme of this book focuses solely on this.) The Six Meridians are meridians located within the muscles. (Dong Zhuang stated: Muscles themselves do not undergo transmission; within the muscles are all meridians. Meridians are termed "Zhong" (middle/interior relative to exterior but interior to muscle surface), while inside are the zang-fu organs, and outside are the skin and hair. The qi and blood of the zang-fu organs are conveyed only through meridians; the stagnation and heat of external pathogens also transmit only through meridians. Therefore, Yangming and Shaoyang disorders are treated from the "Zhong". "Zhong" refers to meridian disease, not stomach or gallbladder disease. Meridian disease is treated with harmonizing methods, and harmonizing must necessarily involve sweating to disperse. However, this is no longer a method of opening the skin pores. When pathogens initially lodge in the exterior, the yin fluids in the meridians are not yet damaged; simply opening the pores allows sweat to flow naturally. But when heat transmits to the middle meridians, the blood is scorched and dried. Although the pores are opened, sweat is blocked by heat and cannot reach the exterior. Unskilled physicians, unaware of this, still use wind-heat promoting drugs to induce sweating at the exterior, which further assists heat and consumes yin. With the original fluids already dried up, many ultimately die because they cannot sweat. Zhang Zhongjing's harmonizing method merely clears and resolves heat pathogens, thereby preserving body fluids. Once the yin juices are replenished, they surge to the muscle surface, and external pathogens naturally dissipate. This is nourishing sweat to open the xuankou (pores), which is vastly different from opening the xuankou to force sweat out.) The Bladder, Stomach, Gallbladder, Spleen, Kidney, and Liver are fu and zang organs located inside the body shell. When the xuankou (pores) are closed, internal heat becomes stagnant in the meridians and gradually moves inward. The Jing-Ru-Shu-Jing-Yuan-He (Well, Spring, Stream, River, Source, Sea) acupoints of each meridian have their respective junctions. Thus, transmission proceeds from Taiyang to Yangming, from Yangming to Shaoyang, and then to Taiyin, Shaoyin, and Jueyin. This is the sequence of meridian transmission. (Dong Zhuang stated: The Taiyang meridian is in the outermost layer, so when pathogens enter the skin and hair, they injure it first. Skin and hair do not transmit; transmission occurs from the Taiyang collaterals to the meridians, and then internally to other meridians. When pathogens lodge in the skin and hair, the xuankou closes. The qi of human zang-fu organs is constantly communicating with external qi, maintaining harmony. If the xuankou closes, internal qi cannot vent, generating heat; this is not because wind-cold transforms into heat. At this time, one should only release the exterior via sweating; once the xuankou opens, pathogens scatter with sweat. Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction) are formulas for inducing sweating at the exterior, not for harmonizing. If the exterior is not resolved, heat accumulates and intensifies daily. From the primary meridian, it reverses inward to the junctions of the Jing-Ru-Shu-Jing-Yuan-He points of various meridians, where heat intersects with other meridians, manifesting as diseases of those meridians. In the commentary, the nine characters "pathogens lodging in skin and hair immediately close the xuankou" should be moved below the word "harmony," making the reading flow continuously and appearing particularly lucid.) Nevertheless, during meridian transmission, within the Jing-Ru-Shu-Jing-Yuan-He points, pathogenic qi becomes stagnant and vigorous. Since it cannot penetrate outward through the xuankou, it must move inward toward void spaces. Among the twelve zang-fu organs, only the Stomach is the sea of water and grain, with an opening above (the mouth/esophagus) and an opening below (the anus), being the most deficient and receptive. Therefore, pathogens from the six meridians can all enter the Stomach. Once pathogens enter, the Stomach becomes full/excess. When the Stomach is excess, body fluids dry up. When body fluids dry up, death ensues. (These few sentences exhaustively explain the root cause of death in infection syndromes. Those who recklessly use astringent, wind-dispersing, and fluid-drying agents, destroying life, do so only because they do not understand this principle. Upon reading this, one should naturally regret past errors and urgently seek alternative strategies. The Stomach is the sea of five grains, the great source of the six fu organs, governs the muscles, and the Yangming meridian circulates qi among the three yang meridians, governing body fluids. This statement is profound.) As the classics state, "Yangming [Earth] receives no further transmission." Therefore, when Shang Han texts refer to zang-fu organs, they specifically refer to the Stomach, not including the Bladder, Gallbladder, Spleen, Kidney, or Liver. One might ask: What about deaths caused by the exhaustion of qi in the Bladder, Gallbladder, Spleen, Kidney, and Liver in Shang Han? I reply: These cases result from heat pathogens forcing entry from the primary meridian. For example, when Shaoyin meridian pathogenic qi is excessive, it directly forces into the Kidney, causing kidney water depletion. This is called "direct invasion" or "forcing entry," not "meridian transmission." However, such cases are extremely rare. In summary, there is no rule in Shang Han of transmission from Bladder to Stomach, Stomach to Gallbladder, Gallbladder to Spleen, Spleen to Kidney, or Kidney to Liver. Students should investigate this deeply here. Furthermore, Shang Han symptoms differ in Yin/Yang and Exterior/Interior; individuals contracting the disease vary in Deficiency/Excess and Acute/Chronic duration; and clinical manifestations differ between Primary Symptoms, Modified Symptoms, and Combined Symptoms. Now, the Primary Symptoms of Shang Han are listed first, followed by Modified Symptoms, and then Combined Symptoms. Within each symptom category, treatment is divided into Attacking (purging) and Tonifying (supplementing) approaches, to facilitate the study of practitioners in this field.