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Wind, cold, summerheat, and dampness are four pathogenic factors causing disease. Adding dryness and fire makes six; thus, they cannot be indiscriminately treated as Cold Damage (Shanghan). Generally speaking, cold damages the meridians, governed by the Foot-Taiyang Meridian; wind damages the skin and hair, governed by the Hand-Taiyin Meridian. However, cold can also damage the Lungs, and wind can invade the Taiyang. The general principle is to treat cold with acrid-warm herbs and wind with acrid-cool herbs.

Although Ephedrae Herba (Mahuang) is hot in nature, its texture is light, allowing it to enter the Lung meridian; therefore, San'ao Decoction (Three Unrestrained Decoction) is used to drain pathogenic factors from the lungs. Cinnamon Twig (Guizhi) is acrid and sweet, hot in nature, yet capable of dispelling cold; thus, it is included in Mahuang Decoction to harmonize Ying (Nutritive) and Wei (Defensive) Qi. However, common practice often uses Guizhi for wind, which is less appropriate than using Schizonepetae Spica (Jingjie) and Saposhnikoviae Radix (Fangfeng). Since the Lung belongs to Metal and fears heat, I have often seen patients develop bleeding from the mouth and nose, as well as sore throat, after taking Guizhi.

Furthermore, cold damages the form (body structure), while summerheat damages Qi. When the form is damaged, there is an excess of pathogenic factors, requiring dispersal; when Qi is damaged, there is a deficiency of healthy Qi, requiring tonification. Therefore, although fever may be present in both, symptoms such as spontaneous sweating, panting, physical fatigue, mental restlessness, greasy complexion, dryness of the anterior teeth, and diarrhea differ significantly. If accompanied by cold invasion, these specific symptoms would not appear. One should use Shiwei Xiangru Powder (Ten-Ingredient Elsholtzia Powder), Qingshu Yiqi Decoction (Clear Summerheat and Tonify Qi Decoction), or Dashun Powder respectively, rather than confusing them with cold patterns.

Cold damaging the meridians presents with fever and pain; dampness damaging the sinews and bones presents with heaviness and pain. When dampness flows into the limbs and joints or waist and feet, the pulse must be fine or slow. Accompanied by cold, there is spasmodic contraction; accompanied by heat, there is swelling and redness. Severe cases involve vomiting, retching, vexation, and fullness. These should be treated internally and externally with Qianghuo Shengshi Decoction (Notopterygium Decoction to Overcome Dampness) or Cangzhu Pingwei Powder (Atractylodes Decoction to Calm the Stomach), which is distinctly different from cold. As for dryness and fire, their differences are even more extreme.

Note: Cold and wind are treated differently because cold patterns lack sweating, whereas wind patterns have sweating. Cold and summerheat are treated differently because cold requires inducing sweating, whereas summerheat requires stopping sweating. Cold and dampness are treated differently because cold resolves through sweating, whereas dampness should not be resolved through heavy sweating. Cold and dryness/fire are treated differently because dryness requires moistening (wind herbs exacerbate it), and fire requires descending (wind herbs intensify it).

Jingfang Decoction: Treats wind-cold injury with cough.
Saposhnikoviae Radix (Fangfeng), Schizonepetae Spica (Jingjie), Peucedani Radix (Qianhu), Platycodonis Radix (Jiegeng), Citri Reticulatae Pericarpium (Guangpi), Aurantii Fructus (Zhike) (each 1 qian), Licorice Root (Gancao) (0.3 qian). One slice of fresh ginger. Decoct in water and take.

San'ao Decoction: Treats lung wind, initial stage of phlegm-panting without sweating.
Ephedrae Herba (Mahuang) (not removing joints), Prunus Armeniacae Semen Amarum (Xingren) (not removing tips), Glycyrrhizae Radix et Rhizoma (Gancao) (not roasted, equal parts). Decoct with ginger water and take.

Shenxu Yin: Treats lung cold with cough.
Ginseng Radix (Renshen), Perillae Folium (Zisu), Peucedani Radix (Qianhu), Platycodonis Radix (Jiegeng), Citri Reticulatae Pericarpium (Chenpi), Aurantii Fructus (Zhike), Puerariae Radix (Gegen), Pinelliae Rhizoma Preparatum (Banxia), Poria (Fuling), Glycyrrhizae Radix et Rhizoma (Gancao) (equal parts), Aucklandiae Radix (Muxiang) (ground, add 0.1 qian). One jujube, one slice of ginger. Decoct in water and take.

Xiangru Yin: Treats all types of summerheat toxicity, cholera-like disorder with vomiting and diarrhea.
Elsholtziae Herba (Xiangru) (3 qian), Poria (Fuling), Phaseoli Semen Album (Bai Biandou) (stir-fried), Magnoliae Officinalis Cortex (Nongpu) (processed with ginger juice), Glycyrrhizae Radix et Rhizoma (Gancao) (each 1 qian). Decoct in water and take. Adding Scutellariae Radix (Huanglian) makes it Huanglian Xiangru Yin.

Shiwei Xiangru San: Treats latent summerheat, physical fatigue, mental confusion, heavy head, vomiting, and diarrhea.
Agastaches Herba (Huoxiang) (1 liang), Ginseng Radix (Renshen), Citri Reticulatae Pericarpium (Chenpi), Atractylodis Rhizoma (Baizhu) (soil-roasted), Poria (Fuling), Glycyrrhizae Radix et Rhizoma (Gancao) (roasted), Chaenomelis Fructus (Mu Gua), Magnoliae Officinalis Cortex (Nongpu) (processed with ginger juice), Phaseoli Semen Album (Biandou) (stir-fried), Astragali Radix (Huangqi) (each 0.5 liang, roasted). Take 1 liang per dose, decoct in water and take cold.

Dashun Powder: Treats excessive exposure to coolness and excessive consumption of cold drinks, leading to stomach-spleen cold injury, cholera-like disorder with vomiting and diarrhea, inability to retain food/water, and internal organ dysfunction. This is a formula that prioritizes symptoms over seasonal timing.
Glycyrrhizae Radix et Rhizoma (Gancao) (2 liang), Zingiberis Rhizoma (Ganjiang), Prunus Armeniacae Semen Amarum (Xingren) (skin and tip removed), Cinnamomi Cortex (Rougui) (skin removed, each 4 liang). First, roast Gancao until cooked. Then add Ganjiang and stir-fry until Ganjiang cracks. Add Xingren and stir-fry until no longer sizzling. Finally, add Rougui and grind into powder. Take 2 qian per dose, mixed well water (Jinghua Shui), or prepared with boiling water.

Qingshu Yiqi Decoction:
Atractylodis Rhizoma (Cangzhu) (1.5 qian, soaked in rice wash water and stir-fried), Astragali Radix (Huangqi) (honey-roasted), Cimicifugae Rhizoma (Shengma) (each 1 qian), Ginseng Radix (Renshen), Atractylodis Rhizoma (Baizhu) (soil-roasted), Angelicae Sinensis Radix (Danggui), Citri Reticulatae Pericarpium (Chenpi), Massa Medicata Fermentata (Shenqu) (stir-fried), Alismatis Rhizoma (Zexie) (each 0.5 fen), Puerariae Radix (Gange), Citri Reticulatae Pericarpium Viride (Qingpi), Glycyrrhizae Radix et Rhizoma (Gancao) (roasted), Phellodendri Cortex (Huangbai), Ophiopogonis Tuber (Maidong) (each 0.3 fen), Schisandrae Fructus (Wuweizi) (9 grains, crushed). Decoct in water and take.

Qianghuo Shengshi Decoction:
Notopterygii Rhizoma et Radix (Qianghuo), Angelicae Dahuricae Radix (Duohuo), Ligustici Rhizoma et Radix (Ben), Chuanxiong Rhizoma (Chuanxiong), Saposhnikoviae Radix (Fangfeng) (each 1 qian), Glycyrrhizae Radix et Rhizoma (Gancao), Viticis Fructus (Manjingzi) (each 0.3 fen). Decoct in water and take.

Pingwei Powder:
Atractylodis Rhizoma (Maocangzhu) (soaked in rice wash water and stir-fried), Magnoliae Officinalis Cortex (Nongpu) (stir-fried with ginger juice), Citri Reticulatae Pericarpium (Chenpi) (each 1 qian), Glycyrrhizae Radix et Rhizoma (Gancao) (0.3 fen, roasted). Decoct in water and take.