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In the context of Cold Damage (Shanghan) presenting with anhidrosis (lack of sweating), how should this be understood? The Couli (interstitial spaces of the skin and muscles) are the sites where body fluids (Jinye) exude and escape. "Cou" refers to the gaps between skin textures, while "Li" refers to the grain of the muscle tissue. If body fluids are disturbed by Wind, Summerheat, or Dampness pathogens and exude outward into the skin and Couli, it manifests as spontaneous sweating. However, if Cold pathogens invade the meridians, causing the Couli to become dense and tight, and body fluids infiltrate inward rather than reaching the exterior, it manifests as anhidrosis. Nevertheless, there are several causes for anhidrosis: such as Cold pathogens remaining at the Exterior, pathogenic factors moving into the Interior, internal accumulation of Fluid retention (Shuiyin), or prolonged deficiency of Yang Qi, all of which can lead to anhidrosis. If sweating should have been induced but was not, and symptoms persist after administering decoctions, leading to a state where no sweat occurs even after three doses, the prognosis is fatal.

Headache is caused by Cold pathogens invading the Foot-Taiyang Meridian and attacking upward toward the head. Generally, the meridians of the Three Yang channels all ascend to the head, but headache is predominantly associated with the Taiyang channel. The meridians of the Taiyin and Shaoyin channels return at the neck and do not ascend to the head; therefore, they do not present with headache symptoms. The Jueyin channel meridian circulates through the throat, enters the pharynx (Hangsang), connects to the inner canthus of the eye, and ascends to the forehead. Although headache may occur in Jueyin disorders, it does not typically present with sweating of the body. Thus, the combination of fever, aversion to cold, and headache indicates a Taiyang disorder. Regarding headache accompanied by constipation, tidal fever, and delirium, Chengqi Tang (Gut-Draining Decoction) is indicated. For headache accompanied by a bitter taste in the mouth and a wiry pulse, Xiaochaihu Tang (Minor Bupleurum Decoction) is indicated. For headache accompanied by vomiting of clear saliva or froth, Wuzhuyu Tang (Evodia Decoction) is indicated. If one suffers from simultaneous invasion of Exterior and Interior by Cold (Lianggan) resulting in headache, or if the pain extends into the brain with hands and feet turning cyanotic up to the joints, this is termed direct headache (Zhitou Tong) and is incurable.

Body pain is generally caused by Wind-Cold invading the skin and muscles, closing the pores, and causing gradual stagnation and disharmony in the blood vessels; this is a disease of the Taiyang channel. However, treatment methods differ between inducing sweating and warming the meridians. For Taiyang body pain accompanied by aversion to cold, fever, headache, and anhidrosis, Mahuang Tang (Ephedra Decoction) is used. For body pain due to Wind-Dampness, characterized by a sensation of heaviness throughout the body and inability to turn over, Guizhi Tang (Cinnamon Twig Decoction) combined with Fuzi (Prepared Aconite Root) is used. For Yin-pattern body pain described as feeling like being beaten with a club, accompanied by a deep pulse and spontaneous diarrhea, Sini Tang (Frigid Extremities Decoction) is used. In cases where the pulse is slow at the Cun position with body pain, or where body pain persists with a deep and slow pulse after sweating therapy, these indicate insufficiency of Blood; Huangqi Jianzhong Tang (Astragalus Decoction for Building the Middle) is applied to both scenarios. For individuals suffering from fatigue and exhaustion who experience body pain, characterized by a deficient pulse and fatigue, Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) is used. For patients with sores or ulcers experiencing body pain, sweating therapy must strictly be avoided; inducing sweat in such cases will transform the condition into Spasm (Jing).