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Yin and Yang Jue (Cold and Heat Extremities) have been thoroughly differentiated by Jie'an. However, Cold Jue is easy to identify, whereas Heat Jue is easily overlooked. This is because both present with fine and minute pulses and cold extremities, leading some to misidentify Heat Jue as Cold Jue. In Cold Jue, there is abdominal pain accompanied by diarrhea; in Heat Jue, the abdomen may be painful but without diarrhea. Patients with Cold Jue prefer hot drinks, while those with Heat Jue prefer cold beverages. Those with Cold Jue favor warmth and sunlight or firelight, whereas those with Heat Jue fear heat and dislike brightness. When administering hot-natured medicines to patients with Cold Jue, even if there is initial resistance, they usually settle after a while. Conversely, when patients with Heat Jue take aromatic and drying medicines, their vomiting and rebellious Qi worsen significantly.

One day in early autumn, I was exposed to summer heat. My food had not yet digested when I suddenly experienced vomiting and rebellious Qi. Shortly afterward, my Qi became congested upward, my extremities gradually turned cold, and I found it difficult to speak clearly. Upon palpating my pulse, it was fine and minute. I reasoned that excessive vomiting had caused Qi rebellion and failure to descend. That night, I took medicine ground with rust water and felt slightly relieved. The next day, I went out without avoiding the heat, and the condition recurred the following day. A friend advised me to take ground Chenxiang (Aquilaria Lignum), but my Qi did not descend. Seeing sunlight or fire made me feel extreme aversion, and I sat upright all night, unable to sleep. I then thought: "This is Fire Qi rebelling upward, causing coldness in the four limbs; this is Heat Jue." I ordered three qian of Heishanzhi (Gardeniae Fructus, Gardenia jasminoides) mixed with cold water to be taken orally. Immediately after drinking it, I felt at peace.

I later treated a young woman suffering from dysentery with difficulty and urgency, cold extremities, and a fine, minute pulse. One physician intended to treat her with Lizhong Tang (Replenish the Middle Decoction) added with Zhuyu (Evodiae Fructus, Evodia rutaecarpa). I said, "This is latent Fire pathogen, not Cold." She was ultimately cured using Shanzhi (Gardeniae Fructus), Shaoyao (Paeoniae Radix Alba, White Peony Root), Huanglian (Coptidis Rhizoma, Coptis chinensis), and Muxiang (Aucklandiae Radix, Aucklandia lappa). Furthermore, in Shanghan (Cold Damage diseases), Heat Jue arises from transmission through meridians, while Cold Jue arises from direct invasion; these are vastly different.

Aside from these two types of Jue, there is Qi Jue (Qi Collapse). When the Five Emotions (Joy, Anger, Worry, Thought, Fear) reach extremes, Qi becomes stagnant and fails to extend, resulting in a deep and hidden pulse. This is commonly seen in women. Sube Xiang Wan (Styrax Pills) or Wuyao Shunqi San (Tso-yu Powder for Directing Qi) can be selected. There is also Tan Jue (Phlegm Collapse), characterized by obesity, abundant phlegm, congested Qi, and a slippery pulse. Daotan Tang (Expel Phlegm Decoction) or Erchen Tang (Two-Cured Decoction) is appropriate. For deficiency cases, add Ren Shen (Ginseng Radix et Rhizoma, Panax ginseng) in double dosage. There is Shi Jue (Food Collapse), which strikes suddenly due to undigested food blocking the Middle Jiao. There is a pulse in the upper part (cun position) but none in the lower part (chi position). Using salt water to induce vomiting is the most excellent method. After massive hematemesis or postpartum hemorrhage, excessive blood loss leaves Yang Qi without attachment, manifesting as spontaneous sweating and cold hands and feet. It is suitable to tonify Qi using Dushen Tang (Single Ginseng Decoction) or Lizhong Tang. For cases of True Qi deficiency and Cold, Shenfutang (Ginseng and Aconite Decoction) or Bawei Tang (Eight-Ingredient Decoction) should be used to benefit the source of Fire and eliminate Yin shadows.