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In cold damage (Shanghan) disease, if the six pulses are floating and tight, the patient groans incessantly, but the toes are warm, this indicates that Yang Qi is still present; at this time, it is contraindicated to take cooling medicines, lest the condition transform into a Yin syndrome, endangering life. By the sixth day, if irritability arises, this is the exchange of Yin and Yang Qi, indicating that sweating is about to occur; administer Danggui Fuling San (Angelica and Poria Powder), and upon sweating, the illness will resolve.

If the six pulses are tight and large, or wiry and fine, without groaning, accompanied by excessive sleepiness, deafness, cold toes, pain in the limbs and joints, yellowing of the skin, emergence of dark red-black spots on the body, and frequent belching, these are all signs of Yin syndrome. In such cases, moxibustion should be applied to Guanyuan (CV-4) for three hundred moxa cones, and Jin Ye Dan (Golden Elixir Pill) and Jiang Fu Tang (Ginger and Aconite Decoction) should be taken. After ten days or half a month, upon sweating, the illness will resolve. If moxibustion is not performed early, and cooling medicines are given instead, death will result. (Distinguishing between Yin and Yang is not limited to this; however, mastering these two principles will reduce errors in treating cold damage syndromes. Although moxibustion cannot be universally applied, for poor families unable to afford expensive herbs like Ren Shen (Ginseng) when facing critical illnesses, advising them that moxibustion can save lives, if they comply, may well be an aspect of benevolent medicine. I often see, during epidemics, households in rural areas where everyone dies, feeling deep pity; if one exerts utmost effort combining pills and drugs to aid them, not only will oneself receive blessings, but descendants will surely prosper.)

If there is vomiting and epigastric fullness, apply moxibustion to Zhongwan (CV-12) for fifty cones. If there is slight trembling, this indicates impending sweating; administer Jiang Fu Tang (Ginger and Aconite Decoction) to resolve the condition. If a young and robust person suffers from cold damage, and by the fifth or sixth day exhibits mania, climbing walls and roofs, this is due to accumulated heat in the Stomach; administer Datong San (Great Unblocking Powder). For milder cases, Zhimu San (Anemarrhena Powder) will also suffice.

Cold damage involves only four meridians, excluding Shaoyang (Lesser Yang) and Jueyin (Terminal Yin). When cold invades the human body, Taiyang (Greater Yang) governs the skin and hair, so cold pathogens first lodge in this meridian; Yangming (Bright Yang) governs the Stomach, so physical exposure to cold or drinking cold beverages injures it; Taiyin (Greater Yin) governs the Spleen, so irregular diet or excessive consumption of cold foods injures it; Shaoyin (Lesser Yin) governs the Kidney, as cold water qi tends to return to its home meridian. Thus, cold damage involves only four meridians. Shaoyang and Jueyin govern the Liver and Gallbladder; they are injured only by emotions such as worry, thought, anger, etc., so cold-induced diseases are rare. Symptoms such as deafness and retraction of the testicles belong to Shaoyin; alternating chills and fever with bitter taste in the mouth belong to Yang syndromes. None of these four conditions should be treated with cooling medicines. (The statement that there are no Shaoyang and Jueyin meridians is not a comprehensive theory. Contemporary physicians, seeing symptoms like alternating chills and fever, bitter taste, deafness, hypochondriac pain, dry heaving, and vomiting, fail to distinguish Yin from Yang or assess deficiency and excess, immediately diagnosing Shaoyang disease and using Xiaochaihu Tang (Minor Bupleurum Decoction) throughout for reconciliation, believing it safe. They do not realize that this represents floating deficient Yang with worsening internal Yin, leading to restlessness, chest and diaphragm fullness, thirst, delirium, and wiry-tight pulses. They then claim deep internal heat, prescribing Xiexin Tang (Drain the Epigastrium Decoction) or Baihu Tang (White Tiger Decoction) for mild cases, and Xianxiong Tang (Pierce the Chest Decoction) or Chengqi Tang (Assist the Qi Decoctions) for severe cases, until ice-cold depletion occurs. As for Jueyin, its exterior marker is Yin, its root is Wind, and it transforms via Fire; its manifestations are complex and confusing, leading to many misdiagnoses and deaths.)