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In general, cold diseases caused by external factors may result from wind-cold damaging the body surface or from raw and cold foods damaging the internal organs; those caused by internal factors may result from excessive labor and sexual indulgence depleting Yang Qi, or from weak congenital constitution. When cold enters from the exterior, it inevitably progresses from superficial to deep levels, often leading to vomiting, nausea, abdominal distension, fullness, pain, or diarrhea. When cold originates internally, it spreads from the zang-fu organs to the exterior, resulting in shivering, aversion to cold, cold limbs (Jue Ni), or spasms and contractures. In summary, heat syndromes are mostly excess patterns, while cold syndromes are mostly deficiency patterns. Therefore, when treating cold syndromes, one must simultaneously assess for deficiency and carefully identify the affected Zang-Fu organs; this is an unchangeable principle.

1. When Yin-toxic cold pathogens directly strike the Three Yin meridians, this corresponds to the "Yin syndrome of direct strike into Yin meridians" described in Shanghan Lun (Treatise on Cold Damage) literature. Sudden exposure to cold can lead to bodily tremors and shivering, limb spasms, heart and abdominal pain, locked jaw with loss of voice, coma, cold limbs, vomiting and diarrhea with a curled posture, a faint and thin pulse, or a deep and tight pulse lacking spirit. These are all manifestations of this condition. One must absolutely avoid recklessly using wind-dispelling herbs, which would further scatter the healthy Qi. Instead, rapid warming of the Middle Jiao should be employed so that the cold pathogen dissipates spontaneously. For mild cases, Lizhong Tang (Regulate the Middle Decoction) or Wenwei Yin (Warm the Stomach Beverage) are indicated; for severe cases, Sini Tang (Frigid Extremities Decoction), Dawenzhong Yin (Greatly Warm the Middle Beverage), or Fuzi Liyin Jian (Aconite Nourish Yin Decoction) are used as main prescriptions. In critical situations where the lips are cyanotic, the scrotum is retracted, and there is no palpable pulse, Huatuo Jiuyang Tuo Fang (Hua Tuo’s Rescue Yang Collapse Formula) should be used urgently. Alternatively, moxibustion on Qihai (CV6) and Guanyuan (CV4) for 20-30 moxa cones may be applied; survival is possible if the hands and feet gradually warm up and the pulse becomes faintly perceptible. Another folk remedy involves crushing pepper, soaking it in boiling wine, and drinking it, combined with external application of hot compresses made of green onion and salt. Another remedy uses two he of black beans stir-fried until hot, cooked in wine, boiled briefly, then the beans removed, and two bowls of the wine consumed for recovery.

1. When cold invades the Taiyin channel, pain occurs at Zhongwan (CV12); Lizhong Tang or Wenwei Yin is appropriate. When cold invades the Shaoyin channel, pain occurs around the umbilicus and abdomen; Guiqi Yin or Wuji San (Five Accumulations Powder) added with Evodiae Fructus (Wuzhuyu) is appropriate. When cold invades the Jueyin channel, pain occurs in the lower abdomen; Sini Tang, Guiqi Yin, or Nuangan Jian (Warm Liver Decoction) is appropriate. If cold invades the Three Yin channels and cold stagnation fails to dissipate, leading to severe distension and pain, Paxi Yin (Discharge Gas Beverage) or Han Shi Wenzhong Tang (Master Han’s Warm Middle Decoction) should be temporarily used to first disperse the stagnation, followed by regulation and tonification. Alternatively, Wuwei Chenfu Tang or Nuogan Jian may be selected.

1. Internal injury from raw and cold foods leads to coldness in the Zang-Fu organs, manifesting as pain, vomiting, diarrhea, etc. Treatment methods refer to respective chapters. Furthermore, individuals with a constitutive Yang pattern who rely on their robustness and habitually consume raw/cold tea and food may transform their condition from Yang to Yin; the treatment is the same as described above.

1. Those with inherently weak constitutions often suffer from Yang deficiency and Yin excess, which is due to insufficient congenital Yang Qi. Excessive depletion through sexual indulgence may lead to decline of the Fire of the Gate of Life (Mingmen), representing a loss of acquired Yang Qi. Manifestations include feeling cold before actual temperature drops, cold and frigid extremities, bodily cold shivering, poor spleen and stomach function, empty/unfirm abdomen, frequent urination, impotence, frequent fearfulness, and lack of spirit in the eyes and ears. All these indicate cold generated by Yang deficiency, treated by warming and tonifying Yuan Qi (Original Qi). For mild cases, Wujunzi Jian, Liyin Jian, Liuqi Jian, Wenwei Yin, or Shoupi Jian are chosen. For severe cases, Dabu Yuan Jian, Yougui Yin, Yougui Wan, Siwei Huiyang Yin, Liuwei Huiyang Yin, or Haizang Bawei Dihuang Wan are used. Spleen and Kidney deficiency-cold often presents with abdominal pain and undigested stool diarrhea (Sun Xie). For Kidney diarrhea, Jiuqi Dan or Yiqi Dan are indicated, and treatment principles should be sought in the Diarrhea chapter.