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1. Differentiation by Odor: The pathogenic factor of Wind-Cold enters from the exterior and converges inward; there is no steaming vapor emanating from the patient to be detected by others. If steaming vapor does occur, it must wait until several days later when the disease has transferred to the Yangming Fu-organ syndrome (Yangming bowel syndrome). In Warm-Heat diseases and Damp-Warmth diseases, the pathogenic Qi steams from the interior and reaches the exterior; thus, the disease presents with steaming vapor detectable by others. Mildly, it fills the bed curtains; severely, it steams through the entire room. This is because the Qi, Blood, Body Fluids, and Jin-Ye of the human body's Zang-Fu organs converge inward when exposed to Cold Qi, but flare upward when exposed to Fire Qi. Warm-Heat belongs to Fire Qi. When the human body is affected by it, the pathogen steams out from the Zang-Fu organs to the muscle surface. The Qi, Blood, and Body Fluids are corrupted by this steaming process, leading to leakage due to corruption. The degree of leakage varies in abundance or scarcity, and the extent of its reach varies in distance or proximity. Only those with a keen sense of smell can distinguish it. Once clearly differentiated, treatment will not be confused. Knowing that it is Warm-Heat rather than Cold Damage (Shanghan), one must not mistakenly use Acrid-Warm dispersing methods for exterior symptoms such as headache and fever. For interior symptoms requiring clearing and purging, one must not hesitate or look around uncertainly.

2. Differentiation by Complexion: Wind-Cold governs convergence; convergence leads to condensation, so the complexion is often tight, knotted, and lustrous. Warm-Heat governs steaming and scattering; scattering leads to relaxation, so the complexion is often loose, slack, and dull or grimy. When affected by steaming vapor, Body Fluids overflow upward to the face, causing grime and stagnation between the head and eyes, appearing either like grease or like smoke staining. These appearances, which look repulsive, are all complexions of Warm-Heat. Upon seeing this complexion, even if accompanied by headache and fever, one must not use Acrid-Hot dispersing methods. Upon seeing interior symptoms such as yellow tongue coating, restlessness, and thirst, one should proceed with purging immediately, without adhering to the saying that "purging is never too late."

3. Differentiation by Tongue: When Wind-Cold is at the exterior, the tongue usually has no coating. Even if there is a white coating, it is thin and slippery. It only turns from white to yellow, then dry and black, as it gradually transfers to the interior. In Warm-Heat diseases, upon the appearance of headache and fever, a white coating appears on the tongue immediately. This coating is thick and not slippery; its color may be pale yellow, or it may be rough like accumulated powder, or present multiple colors, or the white coating may be dry from the start. There are cases where the coating turns black but remains non-dry; this is due to the concurrent presence of Dampness and Phlegm. However, upon palpation, it feels rough and coarse, or is accompanied by cinnabar points or fissures. One must not mistakenly identify this as Interior Cold Yin-Knotting. Those treating Warm-Heat diseases should differentiate during the exterior stage first, avoiding Acrid-Warm dispersing methods. Upon seeing interior symptoms, they should immediately use Cooling and Purging methods. This approach is correct.

4. Differentiation by Spirit (Shen): When afflicted by Wind-Cold, the patient knows their suffering, and their Shen remains clear. For conditions like headache and chills/fever, the patient is fully aware. It is only when the pathogen transfers to the interior and enters the Stomach that confusion of Shen and delirious speech may occur. This is because Wind-Cold pathology does not cloud the Qi, leaving the Shen clear. In contrast, Warm-Heat disease from the onset causes abnormal spirit and an inability to pinpoint the source of suffering. Restlessness is predominant, and in severe cases, the patient may appear dazed or intoxicated, exhibiting agitation, palpitations, and fright. When asked about their suffering, they do not know. Even if occasionally the Shen is clear and the patient knows their suffering, they often suffer from restless dreams, closing their eyes as if seeing things. This is the root of delirium. This state may also result from failing to promptly use Cooling and Dispersing methods at the beginning, allowing time to pass and the condition to worsen.

5. Differentiation by Pulse: The pulse of Warm-Heat disease becomes similar to that of Wind-Cold after transmission, but differs significantly at the onset. Wind-Cold enters from the skin and hair pores; within one or two days, the pulse is mostly Floating, possibly combined with Tight, Slow, or Surging qualities, but always Floating. It is only after transferring to the interior that the Floating quality disappears, yet the pulse rate and rhythm remain distinct and not blurred. Warm-Heat emerges from the Middle Jiao; within one or two days, the pulse is mostly Deep. When the pathogen moves from the interior to the exterior, the pulse ceases to be Deep and becomes Rapid. It may be combined with Wiry or Large qualities, but generally remains non-Floating. Its rate and rhythm are blurred and indistinct. Whenever the pulse is Deep and Slow at the onset, do not mistake it for a Yin Syndrome. Deep indicates the pathogen is in the interior; Slow indicates the pathogen is in the Zang organs. Although the pulse image resembles Yin-Cold, the odor, complexion, tongue coating, and spirit, when differentiated according to the previous methods, will naturally differ. A Rapid but forceless pulse should not be viewed as Deficiency, because the Heat steams and scatters the Qi, causing the pulse to fail to beat forcefully against the fingers. One should resolve the Heat, not tonify Qi. Since the causes of disease vary, identical pulses yield different diagnoses.