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Human life exists between heaven and earth. Fate encounters vary, and times have their ups and downs (Pi Tai). Auspiciousness or misfortune, safety or danger, joy or anger, love or hate, survival or death, worry or fear—these concerns occupy the mind with thousands of worries daily.

The occurrence of plague diseases (Wenyi Bing) is often related to miasma (Zhangqi). Competing use of herbal decoctions and foods, as well as massage methods, are all attempted; mild cases may respond similarly, while severe cases require formulas like Wuling San (Five-Ingredient Powder with Poria) to recover.

If it is a interior syndrome (Li Bing), purgation leads to recovery; sweating leads to death. If the interior is harmonious but exterior symptoms persist, sweating leads to recovery; purgation leads to death. Thus, one must not mistakenly induce sweating with Shen Dan (a term for potent emetic/purgative herbs), nor recklessly attack with Kansui (Radix Euphorbiae Lathyri). However, when Guizhi Tang (Cinnamon Twig Decoction) is taken, if the exterior qi harmonizes, recovery ensues; when Chengqi Tang (Stomach-Regulating Decoction) enters the stomach, if the interior qi levels out, convalescence follows. One must clearly observe the signs and symptoms of the disease and not indiscriminately administer herbal decoctions to deplete stomach qi. The Classics state: if the pulse is faint, vomiting is contraindicated; if the pulse is deficient and fine, purgation is contraindicated. This is a major prohibition for physicians.

Whenever pulses change from floating to sinking or vice versa, or due to wind-cold irregularities causing disharmony, one should judge according to the number of days.

Cold qi is the beginning of all diseases. It refers to the pathogenic qi of epidemics arising from improper conditions during the four seasons and eight solar terms. The Classics say: Spring qi is gentle and warm, Summer qi is hot and sultry, Autumn qi is cool and clear, Winter qi is cold.

Treating Cold Damage (Shanghan) requires distinguishing Yin and Yang. The human body has three Yin and three Yang meridians in the hands and feet, totaling twelve meridians. Those on the back of the hand are Yang, belonging to the Exterior and Fu organs; those on the palm are Yin, belonging to the Interior and Zang organs.

Liver Wood transmits to Spleen Earth, then to Shaoyang Gallbladder, which is a minor evil. Yin governs killing, so Shaoyang Wood transmits to Taiyin Earth, Earth transmits to Shaoyin Water, and Water transmits to Jueyin Wood. By the sixth or seventh day, transmission should occur.

The *Jia Yi Jing* states: Pathogens generated in the Yang aspect arise from wind, rain, cold, and heat; pathogens striking the Yin aspect arise from diet,起居 (daily routine), and emotional excesses. It also says: ...further aggravated slightly. For any illness from day one to thirteen, if Taiyang syndrome persists, treat only the Taiyang meridian. If Shaoyin syndrome appears immediately upon onset, directly attack Shaoyin. This is the most flexible method. Cold pathogens may remain in a single meridian from start to finish. It is also said: Pathogens of the six Qi invade meridians via deficiency. Entering from the back leads to the Taiyang meridian; entering from the face leads to the Yangming meridian, etc. It does not always begin in Taiyang, nor must it transmit sequentially through all meridians. Or the cold pathogen remains in one meridian throughout. Inferring from this principle, one should verify based on the pulse and external signs. For example, if a patient has a floating-tight pulse, stiffness and pain in the head and neck, fever, and aversion to cold, even if the disease has passed its designated period (Guojing), it is merely a Taiyang disease that will not transmit to other meridians. The rest follow this pattern.

Generally, Yang diseases should be treated with sour and bitter medicines. For mild cases, use bitter; for severe cases, combine them. Yin diseases should be treated with acrid and sweet medicines. For mild cases, use acrid and sweet; for severe cases, use them exclusively.

Taiyang Cold Damage on the first or second day presents with fever, aversion to cold, headache, stiffness of the waist and spine, and floating pulses at both cun and chi positions; the disease is in the Taiyang meridian. Yangming Cold Damage on the second or third day presents with deafness, dry throat, dry mouth and tongue; the disease is in the Yangming meridian.

The Classics state: In Cold Damage, form-cold injures the skin and hair; cold injures blood; cold injains Ying and Wei. Cold governs closure and condensation, making the couli (pores) tight. Yang qi becomes stifled and cannot flow freely.

Although cold diseases exist, they do not refer to diseases producing sweat. Furthermore, the qi that creates sweat is generated by Yang-heat, not by Yin-cold. Observing all things, fluid secretion occurs only when heat reaches its extreme; this is clear. The Classics say: Heat diseases are all a category of Cold Damage. It also says: When humans are injured by cold, they develop heat diseases. If there is Yin-cold inside the body, it is merely a miscellaneous disease and cannot become a disease producing sweat. Moreover, medical laws state: Body heat at the exterior indicates drinking water relates to the interior. This is the essence and details of Cold Damage diseases producing sweat. Cases where the body is cool, not thirsty, urine is not yellow, and the pulse is not rapid do not exist. Although Zhang Zhongjing used Sini Tang (Frigid Extremities Decoction), Ginger (Shengjiang), and Aconite (Fuzi), these were to treat the root interior cold. Mistakenly using cold medicines to purge too early causes the exterior heat to turn into cold before entering the interior, resulting in persistent diarrhea. In cases of exterior heat and interior cold with diarrhea, urgently use Sini Tang to attack the interior. Once diarrhea stops and the interior harmonizes, urgently use exterior-releasing methods. Therefore, after the Sini Tang syndromes, Zhang Zhongjing discusses Chengqi Tang for purging heat. From this, we see that Cold Damage diseases producing sweat are explicitly called heat diseases in the Classics, without mentioning cold coagulation. The Classics mention Three Yin syndromes because the pathogenic heat is in the interior; since Zang organs and the interior are Yin, they should not be hot. The distinction between Yin and Yang in Cold Damage is not just that exterior heat requires sweating (purging would cause death); nor that interior excess requires purging (sweating would cause death). Thus, Zhang Zhongjing said: When Guizhi Tang is swallowed, if Yang is excessive, death ensues; when Chengqi Tang enters the stomach, if Yin is solidified, death follows. The key to life and death lies in... observing the body leaves no time to count days. This is the interlacing of Yin-Yang and Deficiency-Excess, where signs are subtle, yet opposite treatments (sweating, vomiting, purging) bring swift disaster. For those with short lifespans, ignorance of treatment leads to mistaken deaths. However, if pathogenic heat is only at the exterior, sweat it; if in the interior, ... heat above, vomit it... What are the signs? Even if the pulse is rapid (eight beats or more)... verifying through creation and transformation, all speak of the Way of Five Phases, yet resembling water, with much saliva, lung heat, steaming hot qi... Heaven turns cool; humans cool down and recover; heat remains and disease persists. Thus, those with cold diseases have true cold diseases, not the qi of sweating diseases. Although cold belongs to Yin-Water, the way heaven and earth generate Yin-Yang and Qi-Fluid means cold transformation cannot regenerate Yin-Water. Thus, ancient sages said: Yang generates Yin within itself; Yin generates Yang within itself; Qi generates Fluid; Fluid generates Qi. It is also said: Accumulated Fluid generates Qi; accumulated Qi generates Fluid. The Classics also say: Harmonized Qi generates Essence and Fluid. Since Qi is Yang, all fluids in all things are generated by Yang-heat. When heavenly Yang-heat is extreme, all things are moist; in winter cold, all things are dry. Therefore, the qi causing sweat is fundamentally heat, not cold, which is clear. The Classics further say: All Cold Damage becoming Warm Diseases occur before the Summer Solstice as Warm Diseases; after the Summer Solstice as Summerheat Diseases. Summerheat and sweat both exit; this correctly states that pathogenic heat exits with sweat and recovers when exhausted. The Classics also say: After eating until full, sweat comes from the Stomach; startled and losing essence, sweat comes from the Heart; carrying heavy loads and walking far, sweat comes from the Kidney; running fast and fearing, sweat comes from the Liver; shaking the body and working hard, sweat comes from the Spleen. These are all caused by turmoil and labor generating Yang-heat to produce sweat. How can one wrongly claim the disease causing sweat is Yin-cold? Modern vulgar doctors do not understand the Way of Yin-Yang transformation and rashly take "Yang governs life, Yin governs death" to mean one should nourish Yang-heat. They do not realize this statement refers to post-birth manifestation: Yang is manifest, and Yang generates Yin, so life contains the path to death. After death, Yin is hidden, and Yin generates Yang, so death contains the path to life. This ancient discussion of the Dao refers to the Yin-Yang of existence/non-existence, movement/stillness, hidden/manifest—not the Yin-Yang of cold/heat. Vulgar people rashly quote immortal scriptures saying: Pure Yang ascends to become an immortal; pure Yin dies to become a ghost. Nourishing Yang-qi with Yin might not be so. Since Yang governs emptiness and non-being, spirit is Yang; Yin governs form, so form is Yin. Those who cultivate health well harmonize Yin-Yang, refine the Yang Spirit to ascend, abandon the Yin body, and thus the pure Yang Spirit becomes an immortal. Those who do not understand the Dao have unharmonized cold and heat, leading to Yin-Yang conflict, exhausting the Yang Spirit, leaving only the Yin shell, so the wandering spirit is dark—how else but a ghost? This is the cultivation school's talk of Form-Spirit Yin-Yang, not medical Yin-Yang. Vulgar people also wrongly claim the *I Ching* regards Yang as superior, beautiful, good, firm, clear, and correct, while Yin is the opposite. Wanting to nourish Yang-heat shows ignorance that the *I Ching* teaches the substance and function of Yin-Yang, not the cold/heat Yin-Yang of the body. Thus, Qian (Heaven) promotes life and Kun (Earth) harmonizes with it; Kun harmonizes, so Yin-Yang are peaceful and return to the good path. It is not that Qian-Yang is specifically heat. Moreover, Confucius said: Qian is Heaven, Circle, Ruler, Father, Jade, Metal, Cold, Ice. Then how can Qian's pure Yang be heat? This does not specifically take cold ice as Yang, but takes the strength, order, solemnity, and firmness of ice as the vigor of Qian. Kan (Water) and Li (Fire) are husband and wife; the *I Ching* takes the Yang-firm Kan-Water-Cold as husband and the Yin-soft Li-Fire-Heat as wife. This is not taking heat as Yang-firm and cold as... originally not taking the vigorous, clear, and orderly nature of Qian-Yang to resemble the Way of Qian. Vulgar people rashly claim humans are warm when alive and cold when dead; even if sick with body heat not yet fatal, the dying must turn from heat to cold before death. Yang is life, Yin is death; thus, they exclusively want to nourish Yang-heat. They do not realize that within the body, the Six Qi of Cold, Water, Dryness, Dampness, Wind, and Fire are mixed as one. Balanced, they are peaceful; one rising and one falling causes disease. The constant of peace is appropriate warmth and coolness, fitting the harmonious Yang Qi, as commonly said "human body is warm." In winter cold, couli are tight, so the body should be warm; in summer heat, couli open and sweat much, so the body should be slightly cool. Opposite conditions are disease; excess or deficiency are also disease. The interior Zang-Fu Yin division serves as the root, guarding the Yang-harmonious Qi. Only being warm constitutes peace. The Qi of each Zang-Fu varies slightly in deficiency/excess according to the Five Phases' times of rest, imprisonment, prosperity, phase, and death. Guarding internally achieves balance, enabling handling of internal and external cold. In summer, Heart Fire is Yang-prosperous and hot; combined with hot weather causing couli to open and Yang-heat to scatter outward, it achieves balance, enabling handling of internal and external heat. All things are like this. This is the principle of Yin-Yang obstruction and smoothness, the greatest reason of Heavenly Dao and Creation. Although Autumn and Winter are obstructed, this is because Lung-Kidney Yin is prosperous and finds its place, so health is strong and illnesses are few and mild. Spring and Summer are open and smooth, because Liver... Cold, Heat, Warmth, Coolness, Safety, Danger, Longevity, and Short Life are all the same. Thus, the Classics say: Those whose Yin Essence is offered/received live long; those whose Yang Essence is offered/receive die young. The Immortal Scripture *Xishan Ji* says: Healthy people should sigh in all four seasons, indicating Triple Burner Ministerial Fire is never insufficient; in the eight solar terms, one should not blow, indicating Kidney Yin rarely attains fullness. How can one not understand Yin-Yang deficiency and excess, yet only want to nourish Yang-heat? All diseases leading to death occur because Yang-Harmonious Qi no longer exists, leaving only Yin-damp form—is this not cold? Vulgar people do not know that extreme heat accumulates internally, preventing Yang-Qi from circulating to the limbs and body surface, causing cold extremities, eventually leading to cold body, fine pulse, and death. Accumulated heat is deep... reversed to say... Yang Qi... deeply... heat in... Jue syndrome... exterior tension... knot. Toward... rescue with... earlier warm it, do not use cold-cool, lest it become Yin-Du or Yin Syndrome leading to death. Vulgar doctors make many mistakes treating Cold Damage, none greater than this. Students of later generations should rely on the principles of natural creation in *Suwen* Yunqi, tracing root and branch to see clearly. Use established methods to save people; beware of being confused by popular opinions. Thus, the Classics say: Carefully master Yin-Yang, do not consult with the crowd. Also: Knowing reversal and compliance, act rightly without doubt. This is the Way.

Also, the Treatise on Cold Damage Contagion. The cause of Cold Damage contagion is inhaling foul toxins from heavy sweating, causing spirit madness and Qi chaos, with pathogenic heat violently increasing internally, erupting... infants, if... to infants, yellow disease, world uses moxa... why... self... and the methods for Cold Damage are no different.

Generally, treating disease requires first understanding that the Six Qi of Cold, Summerheat, Dryness, Dampness, Wind, and Fire are the most harmful. Thus, it is said: The method of treatment is using cold to treat heat, using heat to treat cold... should be like... treating heat... and taking... therefore use cold... eruption, by... treat severely... its end is... comply... and break... attack dampness... extinguish light... Reversal is direct treatment; compliance is counter-treatment. Follow less or more, observing what is correct. If reinforcing excess and draining deficiency, attacking cold with cold, attacking heat with heat, then regarding the Way of reversal and compliance... know... treat... injury... not... deficiency...

Humans inherit the Five Constants and grow due to Wind-Qi. Wind-Qi can generate all things but also harm all things, like water that can float a boat but also capsize it. If five... internal... therefore... four limbs... cause exhaustion... place... say... color... slight... cough... in... due...

There is arrival before time, arrival after time, arrival without departure, arrival exceeding limit. What does this mean? The Master said: After Winter Solstice, at midnight on the Jiazi day, Shaoyang rises. At the time of Shaoyang, Yang begins to generate, and heaven becomes warm. If heaven is warm before obtaining Jiazi, this is arrival before time. If obtaining Jiazi... and... warm... in... Yin... Fu... ask... mouth starts flowing... eighteen, distended heart and fullness... seven injuries from labor... food pathogen... up, wind... disease has urgency... after body... disease... and reversely sudden... this.

Song says: Cold Damage without sweat and aversion to cold attacks; tight, choppy, floating pulses look grim. Spontaneous sweat and aversion to wind with floating-slow pulse; shiny face without grimness is Wind Injury.

Another treatise says: Wind Injury pulse is floating and slow, spontaneous sweat, aversion to wind, headache, shiny face, fever, irritability, hands and feet not cold, heat severe; this cannot be called Cold Damage.

If neck... disperse... disperse, Ginseng... cold pulse floating... sweat, method... little... decoction... tight no... dizziness... cold... Wei both... simple...

Two Yang combined disease: Taiyang combined disease pulse is floating and long. If floating-string combined with Shaoyang, Gallbladder combining with Stomach time string is lower and short. Further deduce from external signs mutually.

Taiyang and Yangming: Originally Taiyang disease. If sweating or promoting urination, lacking fluids, Stomach interior becomes dry, transforming to Yangming. Thus stool is hard, urination is free, this is... give little... Huang Tang... Shaoyang... Da Chai... Tang... aversion to cold... passed period...

Taiyang-Yangming combined disease song says: Taiyang already sweated, disease moves to Yangming; no aversion to cold, interior not pacified. Fully entering Yangming troubles purgatives; sweating still remains in Tai... Yangming... Combined disease is Taiyang initial disease sweating not thorough, transforming to Yangming, continuing spontaneous sweat, no aversion to cold, thus combining into Yangming. If Taiyang signs still...

Spring Warmth Summer Heat song says: Spring warmth floating-tight, easy Jing An; fever, headache, cough, dryness. Summer month Cold Damage is heat disease; pulse surging and full, treatment difficult.

Warm... heat... summer... small... Like Guizhi, Mahuang, Qinglong Tang categories, must assist with Huangqin and Shengma. Heat disease after three days pulse still rapid, pathogen still in meridians, not entering Zang-Fu organs: Guizhi Shigao Tang. Third month to Summer Solstice called late eruption: Zhizi Shengma Tang.

Wind-Warmth-Dampness song says: Wind-dampness heat sweat pulse mostly floating; panting, thirst, convulsions, body unrestrained. Abdominal fullness, foot cold, head-eye pain; damp-warmth delirium heat sweat frequent flow.

Wind-dampness chi-cun both floating-tight, injured by wind thereby injuring heat; wind and heat contend thus erupting wind-dampness; only having wind, then four limbs slack and unrestrained.

Eyes... epilepsy... severe... treat theory... damp... heat... body... then... middle... use...

Wind-dampness song says: Wind-dampness floating, forehead sweat is sign; swelling, pain, fever, liking heavy clothes. Body yellow, heat pain, deep and slow; mid-dampness use dispersing, small fu rare.

Another treatise says: Wind-dampness pulse floating, first injured by dampness then by wind. External signs: limbs heavy pain unable to turn; slight sweat on forehead, fearful of cold and... unwilling... useless... pulse... exterior not hot, interior not thirsty, urination free: Zhufu Tang. If coma, abdominal fullness, body heavy spontaneous sweat, loss of voice, uncontrollable diarrhea: Baitong Tang. Add much Baizhu, use little Gancao. Body swelling pain, slight panting aversion to wind: Xingren Tang. Universally use Renshen Baidu San. Heat with irritability and thirst: add Gualou Gen. If set to purge, urination will surely be obstructed; can use Wuling San. Mid-dampness pulse deep and slow, wind-rain attacks deficiency, frost-mist takes advantage, humans mostly injured by dampness. Whole body painful and heavy, yellowing, joint vexing pain, fever, nasal congestion, occasional fullness, large stool free, urination difficult, external signs ear... Dampness patients must not sweat; sweating causes eruption... heat and... death. Must not purge; purging causes forehead sweat, chest fullness, slight panting and hiccups, urination obstructed, complete salvation difficult. Classics say: Method for treating dampness, not promoting urination is not its treatment. Mid-dampness urination obstructed, large stool free: Gancao Fuzi Tang, Wuling San, or Chushi Tang plus Fuling main treatment. Large and small stools both free then give Zhufu Tang. Body pain, nasal congestion, Huang... Jianzhong Tang, Xiao Jianzhong Tang. Cold-dampness attacking together, pain heavy: Yijian Shen Shi Tang. Severe cases: Canli Lizhong Tang plus Shu Fuzi. Wind-Cold-Dampness three Qi combine to form Bi syndrome, how to treat? Say: Cold much then pain, use Guanzi Gui, Ganjiang, Fuzi. Wind much then wandering, use Mahuang, Yiyi, Wutou. Middle Qi then hardness-fullness, Zisu, Chenpi, Zhike, indispensable. Middle dampness then heaviness, able to use Fuling, Cangzhu, Ganjiang main treatment, responding hand and healing.

Warm-Toxin Summerheat song says: Warm-toxin spring eruption spots pale; vomiting, cough, chest oppression penetrating heart injury. Back cold, face dirty, empty coming pulse; spontaneous sweat, scorched irritability is Summerheat injury.

Warm-toxin: Winter season feeling cold toxin, discordant Qi erupts in Spring. Exterior signs not retreated, toxin vapors not scattered, thus erupting spots, muscle twisting pain, heart... Xuan... treat... and... for... heat... scatter warm take, Xin Xiao Fang. Summerheat use Xiaochaihu Tang. Pulse deep-slow, couli open, shivering hair erect, mouth open front and plate teeth dry, use Baihu Jia Renshen Tang. Summerheat injury erupts great heat, headache spontaneous sweat, throat pain irritability, abdominal heat knot, all medicines ineffective, Xiaochaihu Tang best. Urine obstructed... feel cold to... disease... damp... calf reverse cold is also. Above three syndromes, summer month diseases often have them, must distinguish names, otherwise hundredths error thousand miles mistake. Generally summer month Summerheat injury, although heat toxin harms, all due to Spleen-Stomach deficiency cowardice and obtained thereof. Stomach empty then latent Summerheat, then irritability. Those drinking water too much, and using resolving Summerheat cold medicines too much, moving injuring middle, True Qi... like Yin盛 Ge Yang category, cannot... obstructed, absolutely cannot be heat... not internal, can use Xiao Banxia Fu... month disease mostly Summerheat injury, Summerheat family pulse empty... firewood saving fire, not yellowing then erupting spots... stop, stomach gate closed, food intake not enter... Summerheat pill, heart-abdomen stabbing pain, Xiangru... abdomen feels pain, urination obstructed, is... this vomiting syndrome, is Spleen-Stomach cold vomiting then mistaken...

Disease Warmth Malaria Epidemic song says:... severe wind epilepsy strong body limbs, soft-hard two syndromes must deduce. Post-cold pre-heat named Warm Malaria, epidemic pestilence evil blame... four seasons... ones first injured by wind, again feeling cold-warmth caused, fever abdominal pain, jaw locked head shaking, dementia not speaking, neck stiff back straight, waist body arching back.