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Translation of Zhang Zhongjing's "Treatise on Cold Damage" states: "Shanghan" (Cold Damage) refers to the disease name for illness occurring immediately after contracting cold pathogens during winter. The Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction) were established for the Shanghan of that time; what relevance do they have with the Wenshu (Warmth and Summerheat diseases) of later times? Although the principle of contracting disease is the same, and all can be collectively termed Shanghan, since the time of onset differs, the treatment methods cannot be confused. Let me briefly elaborate.

Spring warmth, summer heat, autumn coolness, and winter cold are the correct Qi (vital energy) of the four seasons, serving the functions of growth, flourishing, harvesting, and storage. Wind also manifests as warm, cool, cold, or hot according to the seasonal Qi. If the climate is extremely severe and cold, the wind is biting; if the heavenly order is mild and warm, the wind is gentle. In winter, Kan Water (associated with the Kidney/Northern Water element) governs; the heavenly mandate is in a state of closure and storage, water freezes, and the ground hardens. Wind combines with cold to form a lethal pathogenic Qi. When humans encounter this, the Couli (pores and interstices) become obstructed and stagnant, resulting in aversion to wind and aversion to cold symptoms, which are absent in other months.

Zhang Zhongjing inherently understood that Shanghan was caused by the lethal Qi of winter, distinct from other ailments that could be delayed. Therefore, his discourse in this book is particularly detailed regarding this condition, while being concise about miscellaneous diseases. If one can seek the reality through the name, more than half of the understanding will be achieved. Unfortunately, due to the long transmission of this book, many scrolls have been lost. Wang Shuhe, Imperial Physician of the Jin Dynasty, collected the remaining scattered texts, edited them, and circulated them, achieving great merit. However, he unfortunately mixed his own theories with the classics, leading to forced interpretations. Chen Wuji (Chen Yan) subsequently annotated the text following the original wording without pointing out omissions or correcting errors. This led to the widespread misinterpretation that formulas for winter Shanghan were applicable to Wenshu, causing harm that persists to this day. Formulas specifically for Wenshu must exist but are now lost and unverified.

My dynasty's scholar Song Lian once lamented that the "Treatise on Cold Damage" is not a complete work; he truly grasped the essence. Generally, patients suffering from Shanghan first contract the pathogen at the Exterior (Biao). What is the Exterior? It refers to the Foot-Taiyang Bladder Channel (Cold Water Channel). This channel runs along the back of the body, from the head through the spine, manifesting as headache, stiffness of the neck and back, and aversion to cold—symptoms not found in other channels. Moreover, this channel serves as the framework of the entire body and the master of Yang Qi, akin to a major intersection. A slight error in treatment can lead to countless complications. Therefore, it is appropriate to use these two decoctions to disperse cold pathogens from the exterior. The Classic states: "Pungent and sweet substances disperse and belong to Yang." Using these decoctions to treat spring warmth or summer heat would be a grave error.

Commentary: Mahuang Tang and Guizhi Tang were originally the primary remedies for winter Shanghan; they should not be confusedly applied to Wenshu. Jie'an vigorously refuted longstanding misconceptions. By analyzing the missing chapters and errors in Zhang Zhongjing's book and attributing them to Wang Shuhe's editing and Chen Wuji's annotations, he revealed insights previously unexplored. However, Zhang Zhongjing's medical writings specifically elucidate Shanghan; thus, they detail cold diseases and briefly mention warmth and summerheat, as they were not originally intended for Wenshu.