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There is a type of Yin Toxicity (Yin Du) formed due to extreme hyperactivity of Yin-Heat. The *Jingui Yaolue* states: In the disease of Yin Toxicity, the face and eyes appear blue/green, body pain feels as if beaten with a club, and there is sore throat. It can be treated within five days; after seven days, it becomes difficult to treat. The main treatment is Shengma Biejia Tang (Coptis and Softshell Turtle Shell Decoction) with Xionghuang (Realgar) and Shujiao (Sichuan Pepper) removed. The *Huo Ren Shu* uses this formula adding Guizhi (Cinnamon Twig), naming it Yin Du Gancao Tang (Yin Toxicity Licorice Decoction).

Furthermore, there is another type of Yin Toxicity formed due to extreme abundance of Yin-Cold. These are two distinct conditions and must not be confused. Only when Yin-Cold reaches its extreme does it paradoxically present with intense heat, restlessness, thirst, cold limbs (Jue Ni), a deep and fine yet rapid pulse, or a short pulse at the Chi position and a large pulse at the Cun position, cold forehead and back of hands, and unceasing sweating. This may occur after sexual intercourse followed by exposure to cold, or due to internal injury from raw/cold food combined with sexual excess. Internally, Yin-Cold lies latent; externally, Cold invades. Accumulated Cold hides in the lower part, while slight Yang Qi dissipates in the upper part, resulting in a syndrome of Yin Excess repelling Yang (Yin Sheng Ge Yang) and Yang Qi escaping upwards. After five or six days, red spots appear on the chest; their color is pale and spots are small; this is called Yin Spots (Yin Ban). Even in midsummer, Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) should be used. In severe cases presenting with heavy body, eye pain, cold sweat on the forehead, vomiting and hiccupping, cyanotic nails, abdominal colic, red face with cold feet and limb reversal, restlessness and thirst without desire to drink, dark green-black spots on the body, grayish hue around eyes and nose, black and curled tongue, retraction of penis and scrotum, deep fine and slow pulse, or hidden pulse not palpable, or rapid pulse reaching 7-8 beats per breath and uncountable, urgently apply a warm compress of scallion cake on the navel. Subsequently administer Fuzi San (Aconite Powder), or Renshen Sanbai Tang (Ginseng Three Whites Decoction), combined with Sini Tang (Frigid Extremities Decoction). After warming and taking the decoction, if the hands and feet remain cold and unharmonized, the condition is incurable.

Liu Shouzhen said: What the secular world calls Yin Toxicity is actually Yang-Heat hyperactive to the extreme, with accumulated heat deep inside, making the body surface appear to have Yin-Cold symptoms. This specifically refers to the syndrome of extreme Yin-Heat hyperactivity treated by Zhang Zhongjing’s Shengma Biejia Tang with Xionghuang and Shujiao removed. If it is the Yin-Toxicity of extreme Yin-Cold as described in later generations, without using herbs that restore Yang and retreat Yin, internally warming the righteous Qi and forcing pathogens outward, how could one revive the dying?

Wang Andao said: Yin-Yang Two Toxicities are radically different from Yin-Yang Two Syndromes. Although Zhang Zhongjing’s texts mention the name "Yin Toxicity," the symptoms described are merely blue-green face and eyes, body pain like being beaten, and sore throat. There is no mention of extreme Yin-Cold abundance. The formulas he treated with consisted only of Shengma (Cimicifugae Rhizoma), Gancao (Glycyrrhizae Radix), Danggui (Angelicae Sinensis Radix), and Biejia (Trionycis Carapax); no strongly warming or hot herbs were used. Thus, we know that Zhang Zhongjing’s "Yin Toxicity" is not a disease of Yin-Cold, but rather caused by absorbing the malignant toxic Qi of Heaven and Earth into the Yin Meridians, hence named Yin Toxicity. It is not comparable to pure Yin freezing cold which can be treated with hot herbs.

Zhao Yi-de said: According to ancient medical books, Yang Toxicity occurs when Yang Qi is exclusively abundant and Yin Qi suddenly declines, resulting in Yang both inside and outside, thus forming Yang Toxicity. Yin Toxicity occurs when Yin Qi is exclusively abundant and Yang Qi greatly declines, resulting in Yin both inside and outside, thus forming Yin Toxicity. These two conditions either exist upon the initial onset of Shanghan (Cold Damage) or develop after medication. Yang Toxicity is treated with cold-cooling agents, and Yin Toxicity with warm-heating agents; the medicinal properties differ as much as ice and charcoal. Why did Zhang Zhongjing use one formula to treat them? Moreover, treating Yin Toxicity by removing Xionghuang and Shujiao removes the warming herbs. Does this not imply that both are Heat Toxins injuring the Yin and Yang meridians? When affecting the Yang meridians, it presents as a red face like brocade patterns and spitting pus and blood; when affecting the Yin meridians, it presents as a blue-green face and body pain as if beaten. These are the fundamental images of Yin-Yang, Water-Fire, Motion, and Stillness. The statement "untreatable after seven days" implies that the fluids, Qi, and Blood of Yin-Yang have been depleted. By the seventh day of Shanghan, the meridian Qi is exhausted, and with the addition of toxicity, by the seventh day, not only is Yin destroyed, but the Fire pathogen also naturally diminishes.