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Tonification is intended to tonify the middle jiao; how can it also release the exterior? This is because Yang deficiency is Qi deficiency. If Qi is deficient in the interior, how can it reach the exterior? Without tonifying its Qi, how can the muscle layer resolve the pathogen? Whenever the pulse is weak and forceless, or both Cun (inch) positions are short with frequent cold signs, this indicates the syndrome, which is Taiyang Cold Damage due to Yang deficiency (Yang Deficiency Cold Damage). Yin deficiency is Blood deficiency. If Blood is deficient in the interior, how can it transform into fluids? Without tonifying its Essence, how can sweat be generated? Whenever the pulse is floating, hollow, and not solid, or both Chi (cubit) positions lack root with frequent heat signs, this indicates the syndrome, which is Taiyang Cold Damage due to Yin deficiency (Yin Deficiency Cold Damage). However, although it is tonification, one must still consider the dosage. It is like a person who can drink one cup being given one sheng (a unit of volume); they will inevitably become intoxicated. Conversely, if someone who can drink one dou (a larger unit) is given only one ge (a small unit), it is like an ant trying to shake a large tree—futile.

The method of "Cold in the Middle" is used to clear fire; how can it also release the exterior? This is because Hyperactive Yang and Declining Yin refers to Water deficiency and Fire excess. When Water is dried up in the channels, how can sweat be produced? It is like a dry pot cracking from intense heat; where would moisture come from? Only by adding water can the stagnation evaporate vigorously, allowing Qi transformation to reach all directions. Sweat originates from fluids, following the same principle. As discussed earlier regarding tonifying Yang and Yin, one should assist Essence and Qi; here, regarding using Water to balance Fire, one should use Cold-Cooling herbs. Tonification addresses the insufficiency within the middle; balancing (Ji) controls the excess of Fire. All these methods can release the exterior, their efficacy seeming similar, yet whether to use Cold or Warm agents differs significantly in application, a distinction that must not be overlooked.

Cold Damage is a critical illness. Treating Cold Damage is difficult. The difficulty lies solely in unclear principles and failing to grasp the key. The key lies merely in distinguishing between Righteous Qi (Zheng Qi) and Pathogenic Qi (Xie Qi). If one knows the deficiency or excess of Righteous Qi and the depth or shallowness of Pathogenic Qi, the essence is mastered. External contraction of Cold pathogens always enters from the exterior into the interior. What enters from the exterior must exit via the exterior. Therefore, patients with Cold Damage must achieve sweating to resolve the disease. However, when Righteous Qi overcomes Pathogenic Qi, the invasion is shallow, indicating strong Yuan Qi (Primal Qi). When Pathogenic Qi overcomes Righteous Qi, the invasion is deep, indicating weak Yuan Qi. Since pathogens vary in depth, dispersal methods differ; since Righteous Qi varies in deficiency or excess, attack and tonification strategies differ. This explains why the Three Methods of Exterior Release (San Biao Fa) must be discussed. What are the Three Methods? Shallow pathogens are expelled from the fence and skin-hair layer; gradually deeper pathogens are expelled from the door/window layer (muscles and sinews/bones); deeply invading pathogens are expelled from the hall/chamber layer (zang-fu organs). Thus, for shallow and solid conditions, direct dispersal is suitable, meaning direct expulsion without difficulty. For deficient and deep conditions, supportive dispersal is suitable, meaning strengthening the host so that pathogens disperse naturally. Brief examples include: Mahuang Tang (Ephedra Decoction), Guizhi Tang (Cinnamon Twig Decoction), Rensu Yin (Ginseng and Perilla Drink), Qianghuo Tang (Notopterygium Decoction), and Magui Yin (Ephedra and Cinnamon Drink)—these purely expel external pathogens and are dispersants for the muscle-skin layer. Examples such as Xiaochaihu Tang (Minor Bupleurum Decoction), Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction), San Chaihu Yin (Three Bupleurum Drink), and Si Chaihu Yin (Four Bupleurum Drink)—these consider both pathogen and Righteous Qi and are dispersants for the meridians. Examples such as Liyin Jian (Regulate Yin Decoction), Dawenzhong Yin (Greatly Warm the Middle Decoction), Liuwei Huiyang Yin (Six-Ingredient Return Yang Drink), and Shiquan Dabu Tang (Ten Complete Great Tonification Decoction)—these establish the middle and expel pathogens, serving as dispersants for the zang-fu organs. Alas! Using dispersing herbs to disperse muscle-skin and meridian pathogens is widely known; few know how to disperse zang-fu pathogens. Using dispersal methods to disperse pathogens is common knowledge; but using "dispersal through non-dispersal" is profound and mysterious. Because ancients did not cover this, I specifically elucidate the refined essence of dispersing pathogens as follows.