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In general, if a Yin disease presents with Yang pulses, the prognosis is good; if a Yang disease presents with Yin pulses, the prognosis is poor.

Ke Yunbo's Commentary: The use of the word "fan" (generally/all) at the beginning is a method to initiate discourse, not to connect with the preceding text. The Yin and Yang pulses here have the same wording as above but different meanings. By "Yang pulse," it refers to Stomach Qi (Wei Qi), which is what was previously called the "Twenty-Five Yangs." When the Yang Qi of the Five Zang Organs harmonizes and manifests, life is sustained. By "Yin pulse," it refers to the True Visceral Pulse (Zhen Zang Mai). If the Yang Qi of the Stomach House does not reach the Hand Taiyin Lung Meridian, and the True Yin of the Five Zang Organs manifests, death ensues. One must understand that the sinking (Chen), choppy (Se), weak (Ruo), string-taut (Xian), and slow (Chi) pulses mentioned earlier are pathological pulses, not necessarily fatal pulses; they appear most frequently in Yang diseases. If the True Visceral Pulses appear, such as the Liver pulse being tense inside and out, the Heart pulse being firm and forceful, the Lung pulse being large and floating, the Kidney pulse feeling like bouncing stones, and the Spleen pulse being sharp like a bird's beak, showing signs of excess, how can these be called Yang pulses? If one mistakes the Stomach pulse for a slow pulse and the True Yin for a rapid pulse, would this not lead to error?

Yi Bu Commentary: On the first day of Cold Damage (Shang Han), the Taiyang Meridian is affected. If the pulse remains calm, the disease has not transmitted; if the patient desires to vomit or is restless/agitated, and the pulse is rapid and urgent, transmission has occurred.

Yi Bu Commentary: The Classics state that on the first day, Taiyang is affected; on the second day, Yangming is affected; on the third day, Shaoyang is affected; and on the fourth, fifth, and sixth days, the Three Yin meridians are affected. This corresponds in structure to the *Hong Fan* chapter: "First longevity, second wealth, third peace and health, fourth love of virtue, fifth dying a natural death." This actually highlights the evidence of the Six Meridians to serve as the basis for treatment. How could it possibly teach people to be bound by the number of days! Later scholars interpreted "day" as an abstract concept rather than a literal count, which is like groping in the dark; no one from ancient times spoke of this. Some say the character "day" need not be taken literally. But "day" is a concrete term; how can it be used as an abstract one?

Ke Yunbo's Commentary: The so-called "transmission" refers to the transmission mentioned in the *Neijing*: "When humans are injured by cold, it transmits into heat." This means the Qi of Taiyang generates heat and transmits to the exterior, which is what is meant by "those originating in Yang recover in seven days." It does not refer to the meridian-to-meridian transmission between Taiyang, Yangming, and Shaoyang.

Ke Yunbo's Commentary: Two or three days after Cold Damage, if symptoms of Yangming and Shaoyang do not appear, it indicates that transmission has not occurred.

Ke Yunbo's Commentary: Saying Taiyang is affected on day one, Yangming on day two, and Shaoyang on day three refers to the period when symptoms manifest, not the days of meridian transmission. Qibo said: "If evil strikes the face, it descends to Yangming; if it strikes the nape, it descends to Taiyang; if it strikes the cheek, it descends to Shaoyang; if it strikes the chest, back, or flanks, it also affects their respective meridians." Since the Taiyang Meridian is located highest, it manifests on the first day; Yangming is next, manifesting on the second day; Shaoyang is lower still, manifesting on the third day. This is because Qi has high and low positions, and diseases have distant and near origins; the manifestation depends on where the pathogen arrives. Each of the Three Yang meridians can independently contract cold pathogens; they do not necessarily start from Taiyang. The assertion by various schools that the Three Yang meridians must transmit from Taiyang fails to examine this principle.

Ke Yunbo's Commentary: After three days of Cold Damage, the pathogenic factors in the Three Yang meridians should be exhausted, and the Three Yin meridians should be affected. However, if the patient can eat and does not vomit, this indicates that the Three Yin meridians are not affected.

Ke Yunbo's Commentary: After contracting cold for three days, if there are no exterior symptoms of the Three Yang meridians, it is because the person's Yang Qi is harmonious and does not contend with the cold; thus, the pathogen cannot enter, and the Three Yang meridians remain unaffected. If Yin deficiency prevents support, then the Three Yin meridians will naturally accept the pathogenic factor. Qibo said: "Evil striking Yin meridians starts from the arms." Therefore, the Three Yin meridians accept pathogens independently, without needing transmission from Yang meridians. The statements that Taiyin manifests on day four, Shaoyin on day five, and Jueyin on day six also refer to the timing of symptom manifestation based on the anatomical position of the Yin meridians, not the days of sequential transmission through the Six Meridians.

Ke Yunbo's Commentary: Six or seven days into Cold Damage, if there is no significant fever but the patient is irritable/restless, this is because Yang pathogenic factors have entered and moved into Yin (interior).

Ke Yunbo's Commentary: Here, "Yin" refers to the interior, not specifically the Three Yin meridians. It may involve entering the root of Taiyang with heat binding in the Bladder, entering the root of Yangming with dryness in the Stomach, entering the root of Shaoyang with hardness and fullness under the ribs, entering Taiyin with sudden irritability and diarrhea, entering Shaoyin with dry mouth and tongue, or entering Jueyin with pain and heat in the heart. All these constitute "entering Yin."

Ke Yunbo's Commentary: In Taiyang disease, headache persists; if it resolves spontaneously after seven days or more, it is because the pathogen has completed its course within its own meridian. If it is about to enter the next stage ("re-entering the meridian"), needling the Foot-Yangming meridian can prevent transmission and lead to recovery.

Ke Yunbo's Commentary: Old theories claimed Cold Damage transmits one meridian per day, reaching Jueyin on day six, re-transmitting to Taiyang on day seven, and Yangming on day eight, calling this "re-entering the meridian." Since this theory spread, Zhang Zhongjing's medical teachings became inaccessible. Zhang Zhongjing never proposed daily meridian transmission, nor did he mention headaches persisting after transmission to the Three Yin. The presence of headache indicates the pathogen has not left Taiyang. The term "xing" (travel/complete) differs from "chuan" (transmit). "Its meridian" refers to the primary meridian, not another. "Those originating in Yang recover in seven days" means seven days is the period for the completion of the Taiyang meridian's cycle, not the timeline for Six Meridian transmission. Qibo stated: "On the seventh day, Taiyang disease declines, and headache lessens," providing clear evidence. Thus, it says "about to re-enter the meridian" rather than "transmitting to Foot-Yangming," meaning Taiyang has passed its course without resolving, and Yangming becomes involved as a concurrent disease. Needling the Yuan-Source point of Foot-Yangming intercepts the transmission route, preventing the pathogen from re-entering Yangming, thereby dispersing residual Taiyang pathogen; it does not mean merging into Yangming to avoid Shaoyang.

Shanglun Pian Commentary: After sweating, if water and medicine cannot be swallowed, it is considered adverse ("ni"); if sweating is induced again, it will certainly result in incessant vomiting and diarrhea.

Shanglun Pian Commentary: This clause has always been misunderstood by various schools, incorrectly linked to the Four Contraindications of Guizhi Tang, claiming that using Guizhi caused the adverse reaction, and using it again would worsen it, which is extremely crude. The term "adverse" here refers to Water Adversity (Shui Ni), not a dire/fatal condition. Moreover, the original text does not say "give Guizhi again," but "induce sweating again," indicating that since both water and medicine are rejected, middle-jiao fullness is extreme. Any exterior-releasing drug could cause incessant vomiting and diarrhea, not just Guizhi. Therefore, for Taiyang Water Adversity, Zhang Zhongjing uses no exterior-releasing drugs, only Wuling San to guide out water, followed by hot porridge to induce sweat, which aligns with this clause. If only Guizhi were prohibited, drugs like Ephedrae Herba (Mahuang), Puerariae Radix (Gegen), and Bupleuri Radix (Chaihu) would remain permissible, and their misuse leading to vomiting and diarrhea would go unnoticed as violations.

Yu Jiayan's Commentary: In Taiyang disease, after inducing sweating, if the disease does not resolve despite sweating, and the patient still has fever, palpitations in the epigastrium, dizziness, body tremors, and feels as though trembling and wanting to fall to the ground, Zhenwu Tang should be administered.

Yu Jiayan's Commentary: The phrase "trembling and wanting to fall to the ground" vividly describes the state of Yang exhaustion. Various schools failed to analyze this carefully, wrongly citing the commentary on the *Classic of Poetry* regarding "striking the chest" to explain it. Zhang Zhongjing discusses palpitations in the epigastrium desiring pressure, and crossing hands over the heart, which do not align with "striking the chest." How can one arbitrarily interpret it? "Pi" means to push away or avoid. Excessive sweating disperses Defensive Qi (Wei Qi); the patient seems to lack external protection, trembling and looking around helplessly, having nowhere to stay, wishing to avoid the ground and hide inward. In Yin patterns resembling Yang, patients wish to sit in wells to avoid heat and seek cold. In cases of Yang loss due to excessive sweating, patients wish to enter the earth to avoid emptiness and seek solidity. Observe infants who sweat excessively, becoming spiritually weak and timid, often burying their faces into their mother's embrace; is this not a verification of "trembling and wanting to fall to the ground"?

Yu Jiayan's Commentary: In Taiyang Wind Strike, if fire therapy is used to forcibly induce sweating, the wind pathogen combined with fire causes blood and Qi to overflow, losing their normal regulation. The interaction of two Yangs scorching the body leads to jaundice. Excess Yang leads to nasal bleeding; Yin deficiency leads to difficult urination. If both Yin and Yang are depleted, the body becomes dry and withered. There is only sweating on the head up to the neck, abdominal fullness and wheezing, dry mouth and sore throat, or constipation. Over time, delirium occurs; severely, there may be hiccups, restlessness of hands and feet, and picking at clothes or beds. If urination is free, the patient can be treated.

Yu Jiayan's Commentary: Note: This pattern involves Yang pathogen combining with fire, disturbing the Yin aspect and depleting Yin, which is vastly different from Yang exhaustion. Observing phrases like "excess Yang desires nasal bleeding" and "body dry and withered," it is clearly caused by failure to sweat properly. Failure to sweat means Yang enters internally; why would it escape externally? Commentators stuck on the phrase "both Yin and Yang are depleted" argue that free urination indicates Yin is not severely deficient, so Yang can be restored, interpreting "can be treated" as restoring Yang. This greatly misses the Classic's intent. One should urgently drive out the Yang pathogen to preserve a thread of Yin Qi; fearing this might fail, how can one restore Yang to further劫 (rob) Yin? Head sweating is due to Yang pathogen obstructing upward, unable to descend to Yin, hence no sweat below the neck. If nasal bleeding occurs, the pathogen resolves through bleeding, and there would be no head sweat; if sweating occurs, the pathogen resolves through sweat, and there would be no bleeding. The later clause on deep-seated fire pathogen causing bloody stool states that those with dry bodies and no sweat will definitely have bloody stool. If there is sweat, there will be no bloody stool. Reading ancient texts requires grasping the meaning; how can there be sweating accompanied by nasal or rectal bleeding? And how can widespread absence of sweat with only head sweat indicate Yang exhaustion?

Yu Jiayan's Commentary: In Taiyang disease, if purgation is mistakenly used, and the pulse is hurried (Cu) without forming Chest Binding (Jie Xiong), this indicates the disease is about to resolve. If the pulse is floating, Chest Binding will definitely form; if tight, throat pain will occur; if wiry, bilateral hypochondriac stiffness will occur; if fine and rapid, headache will persist; if deep and tight, desire to vomit will occur; if deep and slippery, heat-coupled diarrhea will occur; if floating and slippery, bloody stool will occur.

Yu Jiayan's Commentary: A hurried pulse indicates excess Yang pathogen ascending; if it does not bind in the chest, the Yang pathogen has not sunk and can emerge vigorously from the exterior, hence indicating resolution. "Floating pulse leads to Chest Binding" elaborates on the hurried pulse: if the pulse is hurried and floating, pathogenic factors fill the Yang position, leading to Chest Binding. The character "floating" applies to the following four clauses: floating and hurried leads to Chest Binding; floating and tight leads to throat pain; floating and wiry leads to hypochondriac stiffness; floating and fine-rapid leads to persistent headache. These are all pulses of the primary Taiyang disease, so the pathology remains in the Taiyang domain. If the pulse is deep and tight, the Yang pathogen has entered the Yin aspect but is not yet deep, still attempting to rush upward causing vomiting. The absence of Chest Binding or throat pain is evident. Because the *Treatise* omitted one "hurried" and three "floating" characters, later readers were confused, claiming tightness belongs to the Lower Jiao and Shaoyin, which is highly misleading. The subsequent sentence explicitly states "deep and tight leads to vomiting," confirming the previous "tight" referred to "floating and tight." Deep and tight signifies Yang pathogen entering Yin and rushing upward to cause vomiting; how could floating and tight throat pain be Shaoyin cold pathogen rushing upward? These are clearly Taiyang errors after purgation; why insert Shaoyin to confuse later generations? As for the slippery pulse, situated between floating and deep, it follows similar logic: deep and slippery means Yang pathogen enters Yin causing diarrhea; floating and slippery means Yang pathogen is in the Ying level, disturbing blood, causing bloody stool. The pulses in Taiyang errors primarily relate to Yang and Exterior; even with deep/tight or deep/slippery variations, they cannot be named as Interior Yin. Zhang Zhongjing's precise differentiation should not be mixed with redundant complexities.

Zhou Yuzai's Commentary: Disease originating in Yang, if mistakenly purged, heat enters and forms Chest Binding; disease originating in Yin, if mistakenly purged, forms Epigastric Fullness/Stagnation (Pi). The reason Chest Binding forms is that purgation was done too early.

Zhou Yuzai's Commentary: The origin of Yang and Yin has been unknown for two millennia. If, as the original note suggests, "no heat and aversion to cold" defines Yin, then it is Cold Injury; purging would lead to immediate death. If *Shanglun* defines "cold injuring Ying and Blood" as Yin, then in Zhang Zhongjing's Pi and Binding chapters, Wind Strike and Cold Injury are interchanged without distinction. The truth is, "originating in Yin" refers to a Yin pattern, but the pathogen comes from Yang meridians, not direct invasion of Yin meridians. Pathogens entering via Yang meridians are originally Heat patterns; upon entering Yin meridians, internal heat deepens. This omission of "heat enters" creates a millennium-long mystery. Heat patterns transmitting from Yin to Fu organs allow for purgation; if purged while in the Meridians, it is still erroneous, similar to Three Yang in the Meridians. Thus, Yang pathogen binding in Yang positions binds in the Chest; Yin pathogen binding in Yin positions binds in the Epigastrium or sides. Mistaken purgation of Yin meridians causes more than just Pi; because the binding is only in Yin positions, unlike the vigorous Yang pathogen binding in Yang positions.

Ke Yunbo's Commentary: Yang refers to the exterior, i.e., the形体 (physical body). Yin refers to the interior, i.e., the Chest and Epigastrium.

Ke Yunbo's Commentary: This refers to the exterior of the human body as Yang and interior as Yin, not to Yin meridians or Yin patterns. "Originating in Yin/Yang" both refer to fever; Chest Binding and Pi are both Heat patterns. Pi is described without "heat entering" because the heat originates internally. Mistaken purgation prevents heat dispersion, leading to Pi and hardness; one cannot interpret "originating in Yin" as "no heat." If Pi were non-heat, Xiexin Tang would not contain Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), and Rhei Radix et Rhizoma (Dahuang). Cases like Zhizi Chihui Tang's mental agitation, Genti Powder's warm desire to vomit in the heart, epigastric fullness with irritability, and Huanglian Tang's heat in the chest are all diseases originating in Yin.

Wei Litong's Commentary: After Cold Damage sweating, or if resolved by vomiting/purgation, if there is epigastric hardness/stagnation and unrelenting belching, Xuanshi Daizheshi Tang should be administered.

Wei Litong's Commentary: Later scholars misunderstand this, claiming belching is due to latent fluid retention reversing upward, a view promoted by formula commentaries and echoed by others without basis. Latent fluid retention causing vomiting involves有形 (substantial) pathogen; current belching without vomiting involves无形 (insubstantial) deficient Qi rushing upward. How can they be conflated?

Yu Jiayan's Commentary: Six or seven days into Cold Damage, with fever, slight aversion to cold, limb joint discomfort, slight vomiting, subcostal stagnation (Zhi Jie), and unresolved exterior symptoms, Chaihu Guizhi Tang should be administered.

Yu Jiayan's Commentary: "Subcostal stagnation" means pathogen binds at the side of the epigastrium, not centrally. It is milder than the central binding of Xiaojie Xiong Tang. By day six or seven, transmission should be complete. However, fever, slight aversion to cold, limb pain, slight vomiting indicate the pathogen remains at the boundary of the Three Yang, not yet in the interior. Despite subcostal stagnation, since exterior symptoms persist, Daxie Xiong Tang cannot be used, as it treats Interior, not Exterior; nor can Xiaojie Xiong Tang be used, as it treats Fluid Retention, not Exterior. The subcostal pathogen is predominantly exterior with minimal interior penetration; thus, combining Chaihu and Guizhi to harmonize both methods treats the exterior. Once exterior pathogen is removed, subcostal stagnation resolves. Later scholars claim "Zhi Jie" is Zhi Yin (branch fluid) binding in the epigastrium with muttering dreamspeak; I do not know what "Zhi Yin" is!

Fang Zhongxing's Commentary: Taiyang disease, stiff and rigid neck and back (Jing Jing).

Fang Zhongxing's Commentary: "Jing Jing" refers to birds with short wings, stretching their necks when moving. "Jing Jing ran" describes the patient's neck and back illness, unable to bend or extend freely.

Zhengzhi Zhunsheng Commentary: The *Classic of Poetry* says: "Red shoes, jing jing." Commentary: "Jing jing" means steady and heavy posture, implying self-restraint, keeping eyes down and avoiding wandering glances. Note: This helps visualize neck/back stiffness. If interpreted as bird feathers, "Jing" should sound different, and the meaning of stiffness would be less accurate.

Yu Jiayan's Commentary: Taiyang disease, after three days, if sweating, vomiting, purgation, or warm needle therapy fails to resolve it, this is called a "Ruined Disease" (Huai Bing); Guizhi Tang is no longer applicable. Observe the pulse and symptoms, determine what error was made, and treat according to the pattern.

Yu Jiayan's Commentary: It is traditionally said that Cold Damage lingering past its course for 20-30 days is a "Ruined Disease," confusing it with unresolved post-course disease, a major ancient and modern error. Zhang Zhongjing only mentions three days, even five or six are not specified; and this clause only mentions Taiyang, excluding Shaoyang. Thus, Guizhi's exterior-focused method is inapplicable. Looking at Ruined Diseases transitioning from Taiyang to Shaoyang, the phrase "Chaihu syndrome has ceased" implies "Guizhi syndrome has ceased," hence it cannot be reused. If Guizhi syndrome persists, it cannot be called a Ruined Disease, echoing the Shaoyang chapter: "If Chaihu syndrome persists, although purged, it is not adverse; giving Chaihu Tang again will cause shivering, then fever and sweating for resolution." How can Guizhi or Chaihu syndromes persist yet be labeled Ruined? One must carefully inspect the pulse and symptoms, identify prior errors and current reversals, then treat accordingly.

Yu Jiayan's Commentary: Primary Taiyang disease unresolved, transferring to Shaoyang: hardness/fullness under ribs, dry retching, inability to eat, alternating chills and fever. If not yet vomited/purged/sweated/warm-needled, and pulse is deep and tight, give Xiaochaihu Tang. If already vomited, purged, sweated, or warm-needled, resulting in delirium and cessation of Chaihu syndrome, this is a Ruined Disease. Determine the reversal and treat accordingly.

Yu Jiayan's Commentary: Note: The previous clause is a Ruined Disease of the Taiyang Meridian; this clause is a Ruined Disease of the Shaoyang Meridian. Their meanings complement each other clearly. Wang Shuhe's compilation caused confusion. Viewing them together, the first clause states Guizhi Tang is inapplicable, implying errors limited to Taiyang (mistaken vomiting, purgation, sweating, burning needle). This clause states Chaihu Tang is inapplicable, implying errors limited to Shaoyang (same mistaken treatments). Later scholars praising the "determine reversal, treat accordingly" approach miss the obvious point; it is merely babbling!

Yu Jiayan's Commentary: If the Yang pulse is faint and sweating is scant, it is self-harmonizing; excessive sweating is excessive. If the Yang pulse is solid, and sweating is induced excessively, this is also excessive; excess leads to Yang extinction in the interior, loss of Body Fluids (Jin Ye), and hard stool.

Yu Jiayan's Commentary: "Yang extinction" is synonymous with "loss of Body Fluids." Zhang Zhongjing often names loss of fluids as "No Yang." The text "Yang extinction in the interior, loss of fluids, hard stool" is clear. Commentators mistake this for Yang escaping externally due to sweating, which is a major error!

Cheng Fusheng's Commentary: "No Yang" differs from "Yang Loss." Yang Loss results from excessive dispersion, where Yang Qi escapes with sweat. No Yang refers to deficiency of True Yang, lacking sufficient fluids to disperse.

Yu Jiayan's Commentary: In Yangming disease, if the pulse is floating and tight, tidal fever occurring at specific times is expected; if only floating, night sweats are expected.

Yu Jiayan's Commentary: The floating and tight pulse in Yangming is the same as the pulse for Cold injuring Ying in Taiyang; floating alone is the pulse for Wind injuring Wei in Taiyang. Upon transmission to Yangming, Zhang Zhongjing avoids using Ying/Wei differentiation, altering the terminology instead. Regarding unresolved Taiyang symptoms, despite detailed clauses, clarity is sought by highlighting tidal fever and night sweats as inevitable in Yangming, leaving no doubt. Previous annotations took fragments out of context, missing the main idea. They failed to realize that tight pulse/tidal fever and floating pulse/night sweats are not direct correspondences but references to distinguish Yangming (days 8-9) from Taiyang (days 1-2). Claiming floating indicates Yang excess, leading to Yin deficiency and night sweats, is superfluous and dream-like!

Yu Jiayan's Commentary: In Yangming disease, if mid-Cold (Zhong Han) occurs, inability to eat, difficult urination, and continuous sweating on hands and feet suggest impending Gu Jia (Solid Mass),必然 (inevitably) presenting with hard stool initially followed by loose stool. This is because the Stomach is cold, failing to separate Water and Grain.

Yu Jiayan's Commentary: Annotations defining "Gu" as solid and "Jia" as accumulation are grossly wrong. Hard stool initially followed by loose stool forms "Jia Diarrhea"; Jia Diarrhea is loose diarrhea. If prolonged and unceasing, it is called Gu Jia.

Ke Yunbo's Commentary: Gu Jia refers to hard stool initially followed by loose stool. Although the anus may feel constricted, the intestines are not completely dry. Loose stool represents the separation of Water and Grain; interpreting it as Symptom-Mass (Zheng Jia) is erroneous.

The patient has neither exterior nor interior symptoms, with fever for seven or eight days. Even if the pulse is floating and rapid, purgation may be indicated. Suppose purgation has been performed, but the rapid pulse persists. Combined heat causes efficient digestion and frequent hunger. By the sixth or seventh day, there is no bowel movement...