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[Verse] Chills (aversion to cold) arise from the deficiency of Yang Qi in the six channels. If accompanied by tremors and aversion to cold with excess Fire, it indicates a different pattern. In external contraction, the pulse is floating with pain in the head and nape. If caused by Lung Qi deficiency leading to shivering chills, there is no doubt.

[Discussion] Regarding chills: Some cases stem from Yang Qi deficiency causing loose interstices (pores), inability to resist Wind-Cold, and必然 profuse spontaneous sweating. Some cases result from extreme Fire excess, which paradoxically takes on Water characteristics to restrain itself, thus causing tremors and chills. Some cases are due to external contraction of Wind-Cold pathogens, presenting as exterior syndrome with a floating pulse, headache, and fever. Some cases occur when the Lung is constrained by Fire, becoming deficient and losing its governing function, resulting in shivering chills. Others are due to Wei Qi (Defensive Qi) deficiency failing to secure the interstices, or excessive sweating. Zhang Zhongjing stated: "Fever with chills indicates onset in Yang; absence of fever with chills indicates onset in Yin." This clearly distinguishes the principles of Yin/Yang and Deficiency/Excess.

For Exterior Deficiency Syndrome: Exterior deficiency inevitably leads to profuse spontaneous sweating. For those with chills, use Guizhi Tang (Cinnamon Twig Decoction). If sweating is excessive, and the exterior is too weak to protect the body, with a weak pulse and aversion to wind and cold, use Huangqi Jianzhong Tang (Astragalus Build the Middle Decoction).

Guizhi Tang (Cinnamon Twig Decoction): Composition: Guizhi (Cinnamon Twig, superior grade), Shaoyao (Peony Root, medium grade), Gancao (Licorice Root, inferior grade). Preparation: Add three slices of Shengjiang (Fresh Ginger) and two Jujubes (Chinese Dates), decoct with two cups of water until one cup remains. Take warm.

Xiao Jianzhong Tang (Minor Build the Middle Decoction): Is Guizhi Tang plus Yitang (Maltose), one he.

Huangqi Jianzhong Tang (Astragalus Build the Middle Decoction): Is Xiao Jianzhong Tang plus Huangqi (Astragalus Root) and Guizhi in equal parts.

For Yang Deficiency Syndrome: When Yang Qi is deficient and cannot resist Wind-Cold, with a weak body, deficient pulse, and chills, use Sijunzi Tang (Four Gentlemen Decoction) with increased doses of Huangqi (Astragalus Root) and Guizhi (Cinnamon Twig). For severe deficiency, add two or three slices of Shu Fuzi (Prepared Aconite Root), or use Huangqi Jianzhong Tang with Fuzi (Aconite Root).

Sijunzi Tang (Four Gentlemen Decoction) (See Spleen/Stomach section for formula).

For Fire Excess Syndrome: When Fire is extremely excessive, chills may appear paradoxically; this is not true cold, but an extreme condition taking on Water characteristics. To restrain it, use Siwu Tang (Four Substances Decoction) added with Huangqi (Astragalus Root), Huangbai (Phellodendron Bark), and Huanglian (Coptis Rhizome). Once Fire descends, the sensation of cold will naturally resolve.

Siwu Tang (Four Substances Decoction) (See Blood Disorders section for formula).

For Defensive Qi Disharmony Syndrome: Qi acts as Wei Qi (Defensive Qi), primarily protecting the skin and hair, warming the muscles, and solidifying the interstices. When Wei Qi is disharmonious, the interstices are not firm, leading to chills. Use Tiaozhong Yiqi Tang (Regulate the Middle and Boost Qi Decoction) with increased doses of Huangqi (Astragalus Root) and Guizhi (Cinnamon Twig).

Tiaozhong Yiqi Tang (Regulate the Middle and Boost Qi Decoction) (See Qi Disorders section for formula).

For External Contraction Syndrome: External contraction of Wind-Cold with no sweating, fever, and chills requires Mahuang Tang (Ephedra Decoction). With sweating and aversion to wind, use Guizhi Tang (Cinnamon Twig Decoction). For habitual exposure to Cold pathogens causing chills and fever, use Xiangsu San (Fragrant Perilla Powder).

Mahuang Tang (Ephedra Decoction) (See Fever section for formula).

Xiangsu San (Fragrant Perilla Powder): Composition: Xiangfu (Cyperus Rhizome, superior grade), Zisu Ye (Perilla Leaf, superior grade), Chenpi (Aged Tangerine Peel, medium grade), Gancao (Licorice Root, inferior grade). Preparation: Coarsely crush the herbs. For one dose, add three slices of Shengjiang (Fresh Ginger) and two Jujubes, decoct with two cups of water until eight-tenths remain. Take hot. If Chuanxiong (Ligusticum Rhizome) and Baizhi (Angelica Dahurica Root) are added, it is named Xiongzhi Xiangsu San (Ligusticum and Angelica Fragrant Perilla Powder).

For Lung Disease Syndrome: When the Lung is harmed by Fire pathogens, loses its function, fails to secure the interstices, and presents with shivering chills, use Ganjie Tang (Licorice and Platycodon Decoction) added with Jiuhuangqin (Scutellaria Root processed with wine), Shanzhi (Gardenia Fruit), Maimendong (Ophiopogon Tuber), Wuweizi (Schisandra Berry), and Suanzaoren (Ziziphus Seed).

Ganjie Tang (Licorice and Platycodon Decoction): Composition: Gancao (Licorice Root), Jiegeng (Platycodon Root) in equal parts. Preparation: Decoct with water and take.