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The term "Shanghan" (Cold Damage) refers to the lethal pathogenic qi formed by severe cold in winter. When individuals are exposed to this pathogen and fall ill immediately, it is named Shanghan. If it does not manifest immediately, the cold toxin hides in the skin and muscles; by spring, it transforms into Wenbing (Warm Disease), and by summer, it transforms into Shubing (Summerheat Disease). Shubing involves heat that is more severe than that of Wenbing. Once transformed into Wenbing, it can no longer be described as cold; its manifestations include aversion to cold being absent and thirst, which is consistent with Zhang Zhongjing's classic text. Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction) were established for immediate-onset Shanghan and have no relevance to warm-heat diseases. Although the source of infection is the same, the time of onset differs. Zhang Zhongjing treated Shanghan with specific formulas, but these have been lost and cannot be verified, leading to divergent opinions among various schools of thought that remain unresolved to this day.

Liu Wansu (Liu Shouzhen) argued that if Mahuang or Guizhi must be used, cooling herbs should be added to prevent jaundice. Zhang Congzheng’s Liushentong Jie San (Six-Spirit Resolving Powder) adds Mahuang and Cangzhu (Atractylodes Rhizome) to cold herbs like Shigao (Gypsum). Both approaches are incorrect. Mahuang and Guizhi are acrid and hot, suitable for dispersing cold pathogens in winter, but inappropriate for use in spring and summer. Tao Hua (Tao Shi) proposed using Jiuwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction), claiming one formula could replace three. This is also incorrect. Jiuwei Qianghuo Tang was formulated by Wang Haogu (Yi Lao) to treat irregular qi of the four seasons, such as cold when warmth is expected in spring, coolness when heat is expected in summer, heat when coolness is expected in autumn, and warmth when cold is expected in winter. Additionally, sudden cold injuries during spring, summer, and autumn may present with aversion to cold and fever, but they are not as severe as the killing qi of winter. Therefore, Mahuang and Guizhi are unnecessary for dispersing cold; acrid-cooling herbs are preferred to unblock the interior and exterior and resolve the pathogen. Moreover, this formula requires modification according to the Six Channels (Liu Jing) and cannot be used indiscriminately. Xiaoyao San (Free and Easy Wanderer Powder) is superior and truly capable of replacing multiple formulas.

So, how should Wenbing be treated? I propose a method. The classic states: "Absence of aversion to cold and presence of thirst." Absence of aversion to cold indicates no exterior cold pathogen; thirst indicates dryness and depletion of Kidney Water (Jin Ye, body fluids). Generally, this occurs because the individual has inherent internal fire. Winter cold exposure causes only slight injury. Because internal fire exists, the cold cannot penetrate deeply, so it does not manifest immediately. Instead, cold qi lies dormant in the skin and muscles. From winter to the third or fourth lunar month, the duration is long. Fire is constrained by cold, lingering in the middle jiao, boiling and depleting Kidney Water. Jia Wood (Liver/Gallbladder Yang Wood) relies on Gui Water (Kidney Yin/Water) for nourishment. With Kidney Water depleted, the vigorous Liver Wood at this time lacks the root for growth and moistening, resulting in fever and thirst. This is not due to external contraction. Hai Zang (Zhang Yuansu) claimed that "new pathogens awaken old pathogens," which is incorrect. If a new pathogen were contracted, there would be aversion to cold. I use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) to nourish water and Chaihu (Bupleurum Root), an acrid-cooling herb, to soothe Liver Wood stagnation, yielding immediate results. This formula has saved many lives.

Extending this reasoning, all cases of Shanghan in winter are essentially Stagnant Fire (Yu Huo) patterns. If the person lacks internal fire, it is a direct transmission (Zhizhong) to the Yin channels. Because internal fire exists, the pathogen moves from hair follicles to muscles, then to the Fu and Zang organs. Modern practitioners claim cold pathogens transmit inward and transform into heat. If it is a cold pathogen, why does it become heat upon entering the interior? It is actually the body's own fire, constrained by cold and unable to vent, retreating step by step inward. Over time, it becomes purely heat without cold. Thus, Sanhuang Jiedu San (Three-Yellow Detoxifying Powder) clears the fire; Shengma Gegen Tang (Cimicifuga and Kudzu Root Decoction) employs the principle of "releasing stagnant fire"; the Three Chengqi Decoctions apply "purging earth stagnation"; and Xiao Chaihu Tang (Minor Bupleurum Decoction) applies "soothing wood stagnation." The logic is simple. The confusion arises from excessive theories regarding meridian transmission and the Six Channels, which are fragmented and misleading. Any miscellaneous disease presenting with fever may involve headache, neck stiffness, eye pain, nasal dryness, hypochondriac pain, and bitter taste. Why restrict treatment to Shanghan formulas? In winter, for true Shanghan, I treat only Mahuang and Guizhi patterns as cold stagnation; all others without aversion to cold are treated as stagnant fire. This is my original theory. Listeners are often shocked. However, reading Yu Tianmin’s *Yixue Zhengzhuan* (Correct Transmission of Medical Learning), chapter on Shanghan, I found a teaching stating that transmitted Shanghan is a stagnation disease. I was pleased, seeing agreement with my views. Consulting the *Neijing* (Classic of Internal Medicine), the Yellow Emperor asks: "Why does cold injury transform into heat?" Qibo answers: "External cold condensation and internal stagnation occur when pores are tight and sweat ducts closed, preventing qi circulation. Dampness accumulates internally, battling with external cold, generating heat from cold excess. Hence, cold injury transforms into heat, cured by sweating." This confirms the mechanism of external condensation and internal stagnation. My view of Shanghan as stagnant fire is well-founded. Thus, I wrote the "Treatise on Stagnation."

Regarding Yang Du (Yang Toxin) and Yin Du (Yin Toxin):
The *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) states: Yang Du presents with a red face, mottled rash like brocade, sore throat, and expectoration of pus and blood. It is treatable within five days but incurable after seven days.
Yin Du presents with blue-green complexion, body pain as if beaten by a club, and sore throat. Mortality parallels Yang Du. Shengma Biejia Tang (Cimicifuga and Turtle Shell Decoction) treats both.
The *Qianjin Fang* (Prescriptions Worth a Thousand Gold) states: Yang Du Tang treats Shanghan transforming into Yang Du after one or two days, or following emetic/purgative treatments. Symptoms include heavy body, back and spine pain, restlessness, delirium, running about, hallucinations, hematemesis, or diarrhea. The pulse is floating.