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The principles of life and death, growth and decline in the world are entirely determined by Yin and Yang Qi (Vital Energy), and the power of human effort to reverse these trends also lies entirely in understanding "Yin" and "Yang". This is particularly true for Shanghan (Cold Damage) diseases, which are closely linked to this principle and must not be neglected. However, the concepts of Yin syndrome and Yang syndrome in Shanghan have two meanings. These two aspects refer to: meridians having Yin and Yang distinctions, and syndromes having Yin and Yang distinctions.

If meridians have Yin and Yang distinctions, then the Three Yang meridians (Taiyang, Yangming, Shaoyang) constitute Yang syndromes, and the Three Yin meridians (Taiyin, Shaoyin, Jueyin) constitute Yin syndromes. If syndromes have Yin and Yang distinctions, then Excess-Heat constitutes a Yang syndrome, while Deficiency-Cold constitutes a Yin syndrome. Regarding the Yin-Yang of meridians, there are both Cold and Heat patterns; thus, Yang meridians can present with Yin syndromes, and Yin meridians can present with Yang syndromes. Regarding the Yin-Yang of syndromes, there are both false and true manifestations; thus, fever can belong to a Yin syndrome, and cold extremities (Jue Ni) can belong to a Yang syndrome. This distinction between meridian pathology and syndrome manifestation is the most crucial guideline in Shanghan studies and must not be confused.

However, many physicians today fail to understand this, often misidentifying Yin and Yang, and recklessly employing purgative or attacking methods, killing patients in an instant without ever realizing their error, which is deeply lamentable. The origin of this error lies in Li Zijian's "Ten Admonitions on Shanghan". Among the "Ten Admonitions", only the Eighth states: "If the pathogen has entered the interior, do not induce sweating"; the Ninth states: "Do not drink excessive water"; and the Tenth states: "After illness, one must avoid improper diet and sexual activity". These three points are reasonable, yet they are common knowledge requiring no special admonition.

The remaining seven admonitions, however, strictly prohibit warm and tonifying therapies.

For instance, the First Admonition claims: "Shanghan presenting with headache and body heat indicates a Yang syndrome; hot-natured medicines must not be taken." If this view were adopted, all exterior conditions of the Yang meridians would be treated as interior Heat syndromes using cold-natured medicines, inevitably leading to death. Consider Zhang Zhongjing's treatment of Taiyang Shanghan: for patients with headache, fever, and no sweat, he used Mahuang Tang (Ephedra Decoction); for those with headache, fever, sweating, and aversion to wind, he used Guizhi Tang (Cinnamon Twig Decoction); for Taiyang disease presenting with fever, headache, a surprisingly deep pulse, and body pain, he prioritized rescuing the interior using Sini Tang (Four Reversal Decoction); for Yangming disease with a floating pulse, no sweat, and wheezing, he recommended inducing sweat to cure it, suitable for Mahuang Tang. Do these not demonstrate the use of warm/hot medicines to treat pain and fever in Yang meridians?

Furthermore, when Cold pathogens invade the body, they first enter the exterior of the Three Yang meridians, causing symptoms like headache and fever. At this stage, using warm-dispersing methods makes the condition superficial and easy to treat. As Qibo stated: "To release the exterior, one should not avoid hot medicines." This is indeed a sacred transmission of wisdom, known well by Zhang Zhongjing, who employed warm dispersal so effectively. Does this not prove that diseases of Yang meridians are not necessarily Yang syndromes? To forbid the use of warm medicines due to unclear meridian-syndrome relationships is the most absurd theory; this is the first error.

The Second Admonition states: "Shanghan requires direct attack on toxic pathogens; tonification must not be used." Following this logic, all Shanghan cases would be considered Excess syndromes, leaving no room for Deficiency syndromes. Yet Qibo said: "Where pathogenic factors gather, Qi is necessarily deficient." He also said: "When Cold invades, True Qi departs; its departure leads to deficiency, and deficiency allows Cold to contend within the skin." Furthermore, Zhang Zhongjing discusses numerous Deficiency syndromes and pulses in Shanghan, along with over a hundred clauses advising against sweating, vomiting, or purging methods. Additionally, the formulas used by Li Dongyuan, Zhu Danxi, and Tao Jian'an—such as Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction), Huiyang Fanben Tang, and Wenjing Yiyuan Tang—clearly indicate the appropriateness of warm and tonifying treatments. Moreover, people suffering from fatigue, emotional stress, excessive sexual activity, or congenital weakness account for seven or eight out of ten. If such individuals contract pathogens due to deficiency, and one only knows how to directly attack toxins while ignoring Yuan Yang (Original Yang), the host will be damaged before the enemy is expelled, and the vessel broken before the mouse is thrown. How can one recklessly attack without caution? Many have died from this harm; this reckless talk is the second error.

The Third Admonition states: "In Shanghan, if there is no appetite, warm spleen medicines must not be taken." According to this, any Shanghan patient lacking appetite must have an Excess-Heat syndrome. Why did Zhang Zhongjing state: "In Yangming disease, inability to eat means that attacking the heat will cause hiccups; this is because the stomach is deficient and cold"? He also said: "If a patient has a rapid pulse, indicating Heat, one expects efficient digestion and thirst, but if vomiting occurs instead, it is because sweating depleted Yang Qi, causing emptiness in the Diaphragm Qi, resulting in a rapid pulse. This rapid pulse represents 'guest heat' and cannot digest food, again due to a deficient and cold stomach." He further stated: "Those who feel like vomiting after eating belong to Yangming disease, treated primarily with Wuzhuyu Tang (Evodia Fruit Decoction)." Are these not examples of Cold syndromes requiring warm treatment? While Heat syndromes in Shanghan certainly cause loss of appetite, Cold syndromes causing loss of appetite are even more common. If middle-jiao Cold is not warmed by tonifying the spleen, Yuan Yang will surely collapse, leading to death. This is the third error of reckless talk.

The Fourth Admonition states: "Abdominal pain in Shanghan can also be a Heat syndrome; warm medicines must not be lightly administered." By claiming there are also Heat syndromes, it implies Cold syndromes are predominant. Since Cold pain is more common, why not advise against lightly administering cold medicines, but specifically prohibit warm ones? Did one not see Zhang Zhongjing treating abdominal pain with Zhenwu Tang (True Warrior Decoction), Tongmai Sini Tang (Pulse-Rescuing Four Reversal Decoction), or Sini San (Four Reversal Powder) added with Fuzi (Aconite Root)? He also noted: "Cold extremities, fullness in the lower abdomen, and tenderness upon pressure indicate Cold binding at the Bladder and Guanyuan acupoint." If one forbids warmth for such conditions, how can Cold in the Yin divisions fail to cause death? This is the fourth error of reckless talk.

Regarding the Fifth Admonition (self-directed diarrhea in Shanghan should not generally be treated with tonics, warming agents, or antidiarrheals), the Sixth (prohibition of moxibustion), and the Seventh (cold extremities should not generally be classified as Yin syndromes), these all fall under prohibitions of heat therapies. I disdain to debate them extensively. Instead, I will extract the established laws of sages and wise maxims, restate them here to aid future generations, as this is an urgent task today. Upon detailed examination of Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Damage), among the 397 methods listed, over 100 involve deficiency-cold pulses and syndromes; among the 113 prescriptions, 20 contain Renshen (Ginseng), and over 50 contain Guizhi (Cinnamon Twig) or Fuzi (Aconite Root). Li Dongyuan stated: "Excess Fire is suited to draining, Deficient Fire is suited to tonifying." Xue Lizhai stated: "Generally, fever arising from weak Yuan Qi is actually internal True Cold with external False Heat." Are such statements my fabrication? Or did Li Zijian and others see nothing? If they saw nothing, how could they speak rashly? If they saw something, how dare they speak rashly? In the "Ten Admonitions," prohibitions on warm and tonifying therapies comprise eight or nine parts, with absolutely no warning against cold and cooling therapies. What is the intent behind this?

Consequently, inexperienced practitioners regard these admonitions as sacred scriptures, mistaking all Yin syndromes for Yang, and all Deficiency syndromes for Excess. They know only the benefits of cooling and purging, completely forgetting the great harm of deficiency-cold. How many people possess sufficient Yuan Qi to withstand this silent thief that consumes them? Alas! Alas! Who is this insignificant talent daring to propose the "Ten Admonitions"? Unable to search classics for instruction or clearly distinguish Yin and Yang, nor able to discern deficiency and excess or trace origins to ends, they neither seek the prosperity of Yang Virtue nor recognize the arrival of frost. Many students have been deceived by this, creating lifelong karmic debts, while innocent people suffer hidden slaughter. Can one not pity the aggrieved souls? When I speak of this, how can compassion not turn to anger, using writing as admonition? Is my harsh criticism of predecessors born of malice? No, it stems from witnessing too much hardship, unable to suppress sorrow, and speaking out of necessity.

Recently, triggered by past experiences, a relative of mine, who had overworked himself in middle age, suffered from fatigue-induced fever. I urgently rescued his root constitution, and he was nearly recovered. Suddenly, disciples of Li Zijian insisted on opposing me, adhering rigidly to the "Ten Admonitions." Ignorant observers, seeing his fever, sided with them. Within just a few doses, a living person was put to death. Combining this with past observations, I feel doubly heartbroken and hateful. Li Zijian, Li Zijian, I know your accumulated grievances have long existed. Thus, I write this treatise to resolve your future karmic debts. If you have consciousness, would you not feel gratitude?