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The *Classic* states: Aversion to cold and shivering all belong to heat. It also states: Shivering as if losing the control of the spirit all belongs to fire. "Aversion to cold" refers to feeling chilly even in hot months when exposed to wind and frost, wearing heavy cotton clothes, yet still feeling piercingly cold. Shivering and trembling are manifestations of bodily movement. "As if losing the control of the spirit" describes severe aversion to cold. Liu Wansu in *Yuan Bing Shi* (Original Treatise on Disease Mechanisms) states: When a disease is extremely hot but the patient feels cold internally, this is a heat disease, not actually a cold condition. One might ask: Often, patients taking warm-hot medicines show slight improvement; why is this? I say: In patients with heat diseases, their Qi flares upward, stagnating into phlegm-fluids, obstructing the clear pathways, preventing Yin Qi from ascending, thereby exacerbating the heat disease. Accumulated phlegm may temporarily recede upon contact with heat medicine, but the heat trend aids the pathogen, making the disease deeper. One might ask: Given such complexity in cold and heat signs, who dares to use cold-cool medicines? Would that not be killing them? I say: In ancient times, for cases of shivering, there were cures using Da Cheng Qi Tang (Major Order the Qi Decoction) to purge dry feces; aversion to cold and shivering are clearly heat syndromes, differing only in deficiency or excess. The *Classic* states: Yin deficiency leads to fever. Yang resides outside, guarding Yin; Yin resides inside, anchoring Yang. If spirit wanders outward and desires are unregulated, Yin Qi dissipates, leaving Yang without attachment, thus floating and scattering between the muscle and surface, causing aversion to heat. This is not truly heat; it should be treated as Yin deficiency using nourishing methods.

One might ask: Aversion to cold is not cold, so cold medicines are suitable; aversion to heat is not heat, so tonifying medicines are suitable. This is startling. Can you clarify the method? I say: Jinshi Zhou Bendao, over thirty years old, suffered from aversion to cold. After taking Fuzi (Prepared Aconite Root) for several days, his condition worsened, and he sought my treatment. His pulse was wiry yet seemingly moderate. I administered Jiang Cha (Jiang Tea) mixed with Ginger Juice (Shengjiang Zhi) and a little Sesame Oil (Xiangyou), causing him to vomit about one liter of phlegm. His need for heavy cotton clothing decreased by more than half, and he was very pleased. I said: Not yet cured. There is much dry-heat, and blood injury is deep. He must eat bland food to nourish Stomach Qi and practice introspection to nourish Spirit, so that Kidney Water can generate and Heart Fire can descend. He was eager for official advancement, pursuing external matters exclusively, ignoring taboos. I said: If given more blood-nourishing herbs, the cold-heat imbalance might stabilize slightly. Without inner and outer tranquility, Kidney Water will not generate, and the toxicity of Fuzi will inevitably manifest. After recovery, he served as an official in Wucheng. While patrolling at night, he caught cold; only Fuzi could treat it, but he feared Ginger. Thus, he sliced Pork Kidney (Zhuyaozi), boiled it with Fuzi, took three doses, and stabilized. I said: Return home immediately. I knew his Fuzi toxicity would likely flare. He thought me pedantic. Half a year later, he died from a carbuncle on the back.

Another case is Sicheng Shu, whose feet below the ankles always felt hot since birth; he could not wear socks in winter, often saying, "My constitution is strong; I fear no cold." I said: This is deficiency of the Three Yin Meridians of the Foot. He should abstain from sexual activity early on to tonify and nourish Yin Blood, perhaps avoiding disaster. He laughed and did not answer. At fifty, he died after six months suffering from Wei Syndrome (Flaccidity Syndrome).

Observing these two treatments, the principles become clear. One might ask: Are the aversion to cold and heat seen in Shanghan (Cold Damage) diseases also due to deficiency? I say: For Shanghan diseases, where pathogens enter from outside to inside, the sages have discussed this in detail.