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It is stated: A pulse that is floating and tight, but feels hollow (Kou pulse) upon deep pressure, indicates underlying deficiency; therefore, chills and sweating should occur. Since the person's constitution is originally deficient, chills ensue; because the pulse is floating, relief should come through sweating. If the pulse is floating, large, and rapid, without a hollow feeling upon deep pressure, this indicates no underlying deficiency; thus, when the condition resolves, there will be sweating without chills.

First, "Zhan" (shivering/chills with movement) differs from "Li" (trembling/internal shivering). Zhan manifests externally, while Li arises internally. In cases of Shanghan (Cold Damage) where resolution and sweating are impending, if the healthy Qi is internally substantial and the pathogenic factor cannot contend with it, sweating occurs naturally without Zhan. The absence of Zhan indicates that the body is not deficient. However, if the person is originally deficient, the pathogen contends with the healthy Qi. Mild contention results in trembling (Zhen), while severe contention results in Zhan. When healthy Qi overcomes the pathogen, resolution occurs through Zhan and sweating. Therefore, contention between pathogen and healthy Qi on the exterior is termed Zhan, which signifies recovery; contention on the interior is termed Li, which signifies severity. The Classic states: "When Yin is attacked by pathogens, internal Li must occur." Zhan indicates the restoration of healthy Qi, whereas Li indicates the rampant strength of pathogenic factors. Thus, in Shanghan lasting six or seven days, cases presenting only Li without Zhan may progress to cold reversal syndromes, which are often incurable. This occurs due to central deficiency of healthy Qi and excess of Yin pathogens within, where healthy Qi fails to overcome the pathogen and is instead conquered by it. In such cases, unless large-tonifying and warming agents, along with methods such as moxibustion to restore Yang, are employed, how else can they be countered?

I once treated an elderly man over seventy years old who suddenly contracted Shanghan. From the onset, warming and tonifying treatments were used immediately. After调理 (regulation) for more than ten days, as healthy Qi was about to recover, he suddenly began to experience Zhan. From dawn until Chen hour (7–9 AM), he failed to sweat, suffering from severe cold and tremors. He urgently sought my help. I prescribed Liuwei Huiyang Decoction (Six-Ingredient Decoction to Restore Yang), adding one liang of Ren Shen (Ginseng Radix et Rhizoma), and three qian each of Jiang (Zingiberis Rhizoma Recens) and Fu Zi (Aconiti Lateralis Radix Praeparata), instructing him to decoct and take it. Shortly after swallowing, he sweated profusely as if bathing. By near noon, the sweating continued uncontrollably, his body became cold as if stripped naked, and his nasal breathing nearly ceased. He reported this again. I ordered the remaining medicine to be decocted and administered again. His attendant said, "Having taken this medicine before, he already suffered unbearable profuse sweating; now taking it again, can he bear another bout of sweating?" I smiled and replied, "There is a profound principle here unknown to you." Urgently ordering further administration, the sweating stopped, consciousness returned, and he recovered within ten days. Alas! Using this method to induce sweating, and using it again to stop sweating, no wonder people doubt it. Yet they do not realize that both the emergence and cessation of sweat are governed by Yuan Qi (Original Qi) as the pivot. Therefore, I recorded this case to illustrate that the control of opening and closing lies not merely in the ability to release or retain, but in the entity that governs them.