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The treatment of initial contraction in Shanghan (Cold Damage) is inherently different from that of transmitted diseases. Generally, all patients suffering from Shanghan or plague exhibit fever. However, at the time of initial contraction, the pathogenic factor remains in the exterior, has not yet transmitted to the interior, and has not reached a state of stagnant heat. Although there is heat on the body surface, it is merely cold pathogenic factors affecting the skin and interstices, with no internal fire; thus, how can it be immediately diagnosed as a Yang syndrome? At this stage, one should simply use warm dispersing herbs, or combine them with supporting dispersing methods. If the prescription matches the syndrome, recovery will occur promptly. Regrettably, contemporary physicians, upon seeing fever, invariably attribute it to fire and immediately prescribe cold-natured herbs such as Huangqin (Scutellariae Radix), Lianzi (Coptidis Rhizoma), Zhimu (Anemarrhenae Rhizoma), and Baipiao (Phellodendri Cortex). They fail to realize that without excess heat in the interior, these herbs are ill-suited. Applying cold herbs to cold pathogens results in coldness in both the exterior and interior, causing the pathogen to linger unresolved and transmit inward day by day. The reckless use of cold-cooling agents leads to the daily decline of Yuan Yang (Primal Yang). Many have died due to such harm. If this principle is not understood, one fails to distinguish between the exterior and interior, neglects the sequence of treatment, remains ignorant throughout life, frequently causes medical errors, and yet dares to speak arrogantly about medicine. How can their conscience be at peace?

Regarding diet in Shanghan, some items are suitable, some are contraindicated, and others need not be restricted. If a patient with Shanghan retains their appetite, it indicates the pathogen remains in the exterior and has not penetrated deeply. As the pathogen moves slightly deeper into the Shaoyang (Half-Exterior, Half-Interior) region, appetite gradually decreases. Once it enters the chest, diaphragm, and stomach area, appetite ceases completely. When the pathogen resides in the Stomach, the desire for food diminishes. Therefore, lack of appetite during Shanghan, whether lasting ten or twenty days, is not a cause for concern, provided the Stomach Qi remains robust and does not collapse. However, when appetite is absent, forcing food intake should be avoided, as it may exacerbate the pathogen. Similarly, after recent recovery, when Stomach Qi is just beginning to revive, one must not indulge in eating, as doing so may lead to "Food Relapse" (recurrence of disease due to improper diet); these are major taboos. Conversely, there are cases where dietary restriction is inappropriate. For instance, individuals suffering from fatigue-induced internal injury who contract cold pathogens will also develop fever. This is primarily due to damage to Middle Jiao Qi from overexertion, rather than true external cold invading the interior. Thus, although there is external fever, the interior feels empty and hungry, often creating a strong desire to eat. Unfortunately, mediocre and ignorant physicians, seeing only fever, claim that "starvation cannot kill Shanghan," and indiscriminately prohibit food regardless of deficiency or excess. It is common to see patients desiring food but being denied it, while simultaneously receiving attacking and cold-cooling prescriptions. Alas! The hungry intestines are further depleted, the deficient become more deficient, subjected to attacks from both inside and outside, with nowhere to turn for relief. By the time Stomach Qi collapses, they lose even the desire to eat. Even if one wishes to save them, it is too late. I often treat such conditions, using food as medicine, saving many lives, while witnessing numerous deaths caused by forced fasting. Hence, I elaborate on this matter. If a patient constantly feels hunger and seeks food, it indicates the pathogen is not in the Zang-Fu organs but rather due to emptiness in the Stomach; such cases absolutely must not restrict food, though indulgence should be avoided. This observation helps discern deficiency and excess, which is significant and should not be neglected.

Chao Yuanfang stated: After the recent recovery from plague, the Spleen and Stomach remain weak, and Gu Qi (Grain Qi/Nutritive Energy) has not yet recovered. If one engages in laborious exertion or consumes pork, mutton, chicken, dog, raw fish, roasted foods, fatty/greasy items, raw fruits, wheat products, or hard/astringent foods difficult to digest, these will stagnate and accumulate in the intestines and stomach. This leads to chest oppression, abdominal distension, constipation, or severe vomiting and diarrhea. Fever may recur, and the condition may become incurable.