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Chills and tremors are not necessarily signs of a cold syndrome. When Yang qi is hyperactive and subtle nutrients accumulate with deep-seated heat, similar symptoms may occur. Do not let a slight error lead to a massive deviation; one must carefully investigate the underlying mechanism. Among cases of aversion to cold, some present with Yin-cold manifestations due to Yang hyperactivity; this is false cold with true heat. If it is a true cold syndrome, the pulse will be slow (Chi), minute (Wei), or weak (Ruo), accompanied by Qi deficiency approaching collapse, cold feet, cold extremities (Jue Ni), spontaneous sweating, and diarrhea. In such cases, urgent warming and tonification are required, indicating a true cold syndrome. If aversion to cold results from extreme heat, the pulse will certainly be forceful, and Chengqi Tang (Cinnamon Twig and Rhubarb Decoction) should be used for purgation.

Aversion to heat does not necessarily indicate a heat syndrome; it may arise from damage to Yuan Qi (Primordial Qi). Do not treat it as an excess condition; instead, use formulas that tonify deficiency. In cases of aversion to heat, some result from damaged Yuan Qi and rampant pathogenic fire, illustrating the principle that "fire and Yuan Qi cannot coexist." By warming and tonifying the True Yuan, the fire will naturally subside. This is due to Yang deficiency causing fire movement, rather than a true heat disease. True heat diseases typically present with a surging (Hong) and forceful pulse, high fever, delirium, dry and constipated stool, thirst, and absence of sweating. (The Qian edition adds thirteen characters here: "If probing with well water does not cause resistance, heavy purgation is undoubtedly indicated." Zhang Dongfu stated: Dry stool, thirst, and lack of sweat can also occur in Yang deficiency with fire movement; one must refer to the preceding two sentences to grasp the true evidence.) If aversion to heat stems from damaged Yuan Qi, despite external signs like dry stool and thirst, if the pulse is large but forceless, treatment should involve herbs such as Renshen (Ginseng Radix et Rhizoma), Maidong (Ophiopogonis Tuber), Wuweizi (Schisandrae Fructus), Shanyao (Dioscoreae Rhizoma), Gouqi Zi (Lycii Fructus), Rougui (Cinnamomi Cortex), Xixin (Asari Radix et Rhizoma), Shengdi Huang (Rehmanniae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Baishao (Paeoniae Radix Alba), and Dangguishen (Angelicae Sinensis Radix).

Yin abundance and Yang decline, with thin Qi, favor warmth and dislike cold, which is consistent with human nature. If physicians can discern the essence within, they can revive the dying and achieve effective results. The Classics state: Qi and Blood prefer warmth and dislike cold. Warm flavors possess the nature of growth and are mostly tonifying; cold flavors possess the nature of destruction and are mostly draining. Furthermore, all things are born from Earth; Earth governs sowing and reaping, producing sweetness, which tonifies the Spleen and Stomach, serving as the source of postnatal Qi and Blood. In treating diseases, using sweet-warm herbs to tonify Earth yields many successes. However, when applying tonification methods, one should start lightly and increase gradually; insufficient effect can be augmented, but excessive application may worsen the condition. (Observing closely, the vital energy of recent times has gradually declined. The human body is a microcosm, corresponding naturally to Heaven and Earth. Most diseases are suitable for warming and tonification rather than cooling and dispersing, based on the principle of Yin abundance and Yang decline, verified through long-term quiet observation. Treating illnesses according to this principle yields significant results; this is indeed a profound insight gained from personal experience. The Qian edition includes these additional lines, whereas the Caolu edition omits them, likely recording Master Shen Zhai's past words by his disciples, now appended here.)