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Shaobyang (Half-Exterior, Half-Interior). A question was asked: "Yangming disease also presents with alternating chills and fever; what is the meaning of this?" The answer was: "If it is a Yangming channel disease, where the pathogen is in the muscles, the body will be feverish. How could there be alternating chills and fever? If the pathogen has already transmitted to the Yangming fu organs (the six hollow organs, specifically referring to the stomach, large intestine, small intestine, etc.), the stagnant heat steams and steeps, and dry feces are knotted inside. Therefore, alternating chills and fever occur. This is a Yangming fu organ disease, not a Yangming channel disease. It should be treated with Tiaowei Chengqi Decoction (Stomach-Regulating Purging Decoction) to purge [the accumulation]. (Tiaowei Chengqi Decoction consists of Mangxiao, Dahuang, and Gancao; its nature is sweet, warm, and mildly harmonizing, protecting the Stomach Qi without using Houpo or Zhishi which might damage the Upper Jiao; it is effective for Middle Jiao dryness and excess.) Thus it is said: Because of internal fullness in Yangming, alternating chills and fever occur."

Head Sweating. A question was asked: "Why is head sweating considered Shaobyang (Half-Exterior, Half-Interior)? Roughly speaking, all Yang channels ascend to the head, hence sweating occurs there; whereas all Yin channels connect to the back and return at the neck. How could there be head sweating? Therefore, upon seeing head sweating, it is attributed to Shaobyang (Half-Exterior, Half-Interior)." Another question: "Since all Yang channels ascend to the head, and now sweating occurs, shouldn't this be called an Exterior Syndrome? Why call it Shaobyang (Half-Exterior, Half-Interior)?" The answer was: "If it were an Exterior Syndrome, cold pathogens would still be closing the interstices (pores), so how could there be sweating? Now that there is sweating, it indicates that the cold pathogen is transforming into heat. If named an Interior Syndrome, there is head sweating; if named an Exterior Syndrome, there is no head sweating; thus it is called Shaobyang (Half-Exterior, Half-Interior)." It was further said: "Blood stasis, fluid retention causing jaundice, can also present with head sweating. Why? Head sweating due to blood stasis presents with free urination; head sweating due to fluid retention presents with chest fullness, coughing, and vomiting; head sweating due to jaundice presents with difficult urination. If it is head sweating from Shaobyang (Half-Exterior, Half-Interior), there must be alternating chills and fever. However, these three types of head sweating do not depart from Yang syndromes, confirming that head sweating belongs to Shaobyang (Half-Exterior, Half-Interior)."

Night Sweats. A question was asked: "Why are night sweats considered Shaobyang (Half-Exterior, Half-Interior)?" The answer was: "Heat pathogens scorch the interstices, causing sweating. Cold causes the interstices to close tightly, resulting in no sweating, which is an Interior Syndrome. Now, sweating occurs during sleep and stops upon waking. This means the pathogen is about to flourish in the Yin aspect but has not yet deeply penetrated the Yin. It also belongs to Shaobyang (Half-Exterior, Half-Interior)." Another question: "Are night sweats in miscellaneous diseases also treated as Shaobyang (Half-Exterior, Half-Interior)?" The answer was: "Night sweats in miscellaneous diseases indicate extreme Yin deficiency and depletion of the Blood aspect, known as consumptive weakness syndromes. Night sweats in Shanghan (Cold Damage) are caused by surplus pathogens, known as external contraction, and cannot be discussed in the same category as miscellaneous diseases."

Dizziness and Bitter Taste in the Mouth. A question was asked: "Why are dizziness and bitter taste in the mouth considered Shaobyang (Half-Exterior, Half-Interior)?" The answer was: "The eyes are the orifices of the Liver. Bile is stored in the Liver. When the disease is in the Shaoyang Gallbladder channel, dizziness and bitter taste in the mouth result from the leakage of bile juice. Heat forces the bile juice out, causing bitterness in the mouth. Both are diseases of the Shaoyang Gallbladder channel. For Shaobyang (Half-Exterior, Half-Interior), the appropriate method is harmonization. Other channels do not present these symptoms."

All the above involve pathogens in Shaobyang (Half-Exterior, Half-Interior) and should be treated with harmonization methods.

Deep and Forceful Pulse. A question was asked: "Why does a deep and forceful pulse indicate a transmitted Interior Syndrome?" The answer was: "Where the pulse exists, there is life; where it is absent, there is death. Excess or deficiency leads to disease. Internal fullness results in a forceful pulse; internal deficiency results in a deficient pulse. Now, a deep pulse is a pathological pulse indicating disease in the Interior. Forcefulness indicates excess, signifying heat. A deep and forceful pulse indicates Interior excess and heat."

Diarrhea of Clear Yellow Water. A question was asked: "Why is diarrhea of clear yellow water an Interior Syndrome?" The answer was: "Because the intestines and stomach have long been un-purged, dry feces have knotted into masses. Consequently, clear yellow water leaks from the anus. Just as when substances accumulate and harden, water cannot penetrate; if the substance is hard like a rock, pouring water on it will cause seepage. Now, the patient has diarrhea of clear yellow water, with fecal matter knotted inside like rocks. This water flows out from around the knotted feces. Urgent purging is undoubtedly required. Often, people mistake direct transmission cold syndrome diarrhea of undigested food for 'leaky bottom' Shanghan. If this condition is mistakenly identified as leaky bottom and Sini Decoction is administered, it is like adding firewood to a fire—dangerous! Therefore, diarrhea of clear yellow water is an Interior Syndrome and requires urgent purging."

Fullness in the Lower Abdomen. A question was asked: "Why is fullness in the lower abdomen an Interior Syndrome?" The answer was: "The chest and diaphragm belong to the realm of clear Yang. Although they may feel full, it is due to pathogenic qi, not tangible matter. The lower abdomen is the area for waste products. If there is fullness here, it is not just pathogenic qi but tangible matter. Thus, knowing there is matter, urgent purging is indicated." It was added: "Blood stasis syndromes and dysuria syndromes also present with lower abdominal fullness. How to distinguish them? If urination is free, and the lower abdomen is hard, full, and painful, this is a blood stasis syndrome. If urination is difficult and the lower abdomen is full, this is dysuria. If urine is scanty and dark, stool is constipated, leading to hardness in the lower abdomen, it is due to internal dry feces. Thus, both blood stasis and dysuria are Interior Syndromes."

Delirium and Mania. Delirium and mania are Interior Syndromes because heat is excessive in the Stomach. Extreme heat causes mania; mild heat causes delirium. All are transmitted Interior Syndromes. The *Nanjing* states: "Mania and delirium are caused by excess heat and flourishing Yang." The classics mention both deficiency and excess. Why? The answer is: Startled mania is deficiency. Or, if sweating should have been induced but wasn't, and moxibustion forced the condition, causing mania, it is called Fire Pathogen Startled Mania, treated with Chaihu Longgu Muli Tang (Bupleurum, Dragon Bone, and Oyster Shell Decoction). This differs from mania due to excess heat, which can be purged.

Eruption of Macules. A question was asked: "Is eruption of macules also an Interior Syndrome?" The answer was: "Macules arise from Warm Toxicity, Heat Toxicity, or Rotting of the Stomach. Warm Toxicity refers to cold contracted in winter, manifesting in spring when Yang and Yin qi contend. Heat Toxicity refers to summer heat latent in the Stomach, triggered by cold. Rotting of the Stomach occurs either from erroneous purging allowing heat to enter the empty Stomach, or from failure to purge, preventing heat from escaping, so toxic vapors penetrate deeply into the Stomach. Thus, macules represent toxicity. Toxicity is deviation from normalcy, reaching extremes of Yin or Yang. External factors of the Six Qi interact; heat toxicity steams the Stomach. The Stomach governs muscles. Extreme heat injures blood. Interior excess and Exterior deficiency cause macules to cover the entire body, resembling mosquito bites. Red macules indicate survival; purple-black macules indicate death, due to extreme heat causing rotting of the Stomach. Dry tongue coating and cracked lips indicate untreatability. Treatment should detoxify and cool; exterior-releasing drugs to induce sweating must not be used. Because Exterior is deficient and Interior is excess, sweating increases openness and worsens the macule erosion. Another question: "Can Yin Syndromes also present with macules?" The answer was: "This may occur after sweating, vomiting, or purging, depleting Middle Qi; or due to lifestyle draining True Yang; or from overuse of cooling drugs, forming a Yin Syndrome. Cold lurks below, forcing rootless, unanchored fire upward to steam the Lungs and Stomach, causing faint red spots hidden under the skin. This differs from Yang Syndrome macules which are purple-red. This indicates extreme Stomach Qi deficiency. Administering cooling drugs will lead to immediate danger. Wu Hegao said: Using Renshen (Ginseng), Rougui (Cinnamon Bark), and Fuzi (Aconite Root) to treat macules is a variation of method. Physicians who do not understand flexibility cannot discuss this." Another question: "Can Internal Injury also cause macules?" The answer was: "Internal injury is a disease of insufficient Yuan Qi. Due to dual deficiency of Qi and Blood, the body may ache, feel irritable, and have fever. However, the pulse is large and deficient, speech and movement are reluctant, and fatigue with spontaneous sweating distinguishes it. Mistaking this for an Exterior Excess syndrome leads to immediate peril. Rapidly administer Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). After sound sleep, the fever stops and health returns naturally. Danxi said: Internal injury macules indicate extreme Stomach Qi deficiency, with the fire of the whole body wandering externally. Tonification is needed to descend the fire. Dajianzhong Tang (Great Construct the Middle Decoction) is best. (Renshen, Danggui, Baishao, Zhi Gancao, Banxia, Rougui, Fuzi, plus Shengjiang and Dazao, decocted in water.) If there is latent Yin internally, and cooling drugs are mistakenly taken, forcing deficient Yang to float outward, Yin macules form. The pulse may be surging but weak upon pressure, or limbs may be cold past elbows and knees. First use Paosheng Jiang Lizhong Tang (Roasted Ginger, Cinnamon, and Central-Regulating Decoction) to restore Yang, then treat according to symptoms. If ineffective, add Fuzi."

Passing Gas. A question was asked: "Why is passing gas an Interior Syndrome?" The answer was: "It refers to gas escaping downward. Observing healthy people, before defecation, gas must escape first. Patients with internal dry feces, knotted and blocked, will inevitably lose gas downward. The Yangming chapter states: 'If there is no passing of gas, Chengqi Decoction should not be administered.' Thus, passing gas indicates an Interior Syndrome."

Cessation of Headache and Fever. Cessation of both headache and fever indicates the disease is in the Interior. Pathogens in the body start in Taiyang. Taiyang is the outermost layer of the Exterior. Headache and fever occur here. Shaoyang and Yangming are the middle of the Exterior, also presenting with headache and fever. If pathogens enter the Interior, all Exterior symptoms must disappear. How could headache and fever remain?

Spontaneous Sweating. Why is spontaneous sweating an Interior Syndrome? The classics state: Cold closes the interstices; heat opens them. When Taiyang first receives cold pathogens, before transformation into heat, the interstices are tight, and there is no sweating. Mahuang Tang (Ephedra Decoction) should be used. If initially no sweating suddenly turns to sweating, it indicates heat has entered the Fu organs, steaming fiercely. Thus, spontaneous sweating is an Interior Syndrome. If there were cold in the Exterior, how could there be sweating? A question arose: "Spontaneous sweating is an Interior Syndrome, yet Guizhi Tang (Cinnamon Twig Decoction) is sometimes used. Why?" The answer was: "When Guizhi Tang is used for spontaneous sweating, it is for a Taiyang Wind Strike syndrome. Spontaneous sweating in Interior Syndromes is due to Yang excess; who would dare use Guizhi Tang? Zhongjing said: 'Once Guizhi enters the throat, if Yang is in excess, death ensues.' How to distinguish? With chilliness, aversion to wind, headache, and fever all present, it is Taiyang Wind Strike spontaneous sweating. With irritability, aversion to heat, and no aversion to wind or cold, it is Interior Syndrome spontaneous sweating."

Frequent Urination. A question was asked: "Why is frequent urination an Interior Syndrome?" The answer was: "Food enters the Stomach and transmits to the Small Intestine. The classics say: The Small Intestine is the official of reception and transformation. The Stomach manages food and drink. If clear and turbid are not separated, they mix. From the Small Intestine, it goes to the Bladder and Large Intestine. Clear fluids seep into the Bladder via urination; residue passes from the lower Stomach to the Large Intestine. If the Bladder orifice is closed, water enters the Large Intestine, causing diarrhea. If stool is hard and blocked, fluids go forward, causing frequent urination. Now, frequent urination indicates constipation, so the syndrome belongs to the Interior. If urination is scanty, even with constipation, fluids do not immediately soak into the Large Intestine; the stool will first become hard and full, then loose. Zhongjing said: 'Do not purge if urination is scanty, as defecation will occur soon naturally.'"

Tidal Fever. A question was asked: "Why is tidal fever an Interior Syndrome?" The answer was: "Tidal fever, like the tide, arrives on time. For example, if it occurs at Wei and Shen hours today, it occurs at the same hours tomorrow. Wei and Shen hours belong to Yin. Seeing tidal fever now indicates the pathogen resides in the Yin aspect, with heat knotted in the Interior, steaming dry feces that require purging." Another question: "Tidal fever belongs to the Interior and requires purging. What if there is still an Exterior Syndrome?" The answer was: "If tidal fever exists alongside an unresolved Exterior Syndrome, one must first resolve the Exterior, then purge the Interior. This is correct."

Diarrhea of Intestinal Mucus. A question was asked: "Why is diarrhea of intestinal mucus an Interior Syndrome?" The answer was: "Diarrhea comes from the intestines and stomach. If there is a pathogen in the Exterior, the Interior is harmonious; how could there be diarrhea? Because the pathogen enters the Fu organs, heat scorches the intestines and stomach, causing this symptom." It was added: "Can Exterior Syndromes also present with diarrhea?" The answer was: "San Yang (Three Yang) combined diseases can present with diarrhea. Or Shaoyang-Yangming combined diseases. Yangming internally governs the Stomach Fu, hence diarrhea occurs. In San Yang combined diseases, if the pathogen does not enter the Fu organs, there is no diarrhea. How to distinguish? By the presence of fever and other Exterior symptoms. Diarrhea is indeed an Interior Syndrome, but one must distinguish between transmission and direct transmission. Transmission results in diarrhea of intestinal mucus; direct transmission results in diarrhea of undigested food. These two types of diarrhea differ by mucus versus undigested food."

Aversion to Heat. A question was asked: "Why is aversion to heat an Interior Syndrome?" The answer was: "Heat transmitting to the Zang and Fu organs causes steaming and oppression. Removing clothes and blankets, waving hands, and exposing the body indicates heat transmitting to the Interior. If there were cold inside, there would be aversion to cold. How could there be aversion to heat?"

Blurred Vision. Doubt arises: Why is blurred vision considered an Interior Syndrome? The answer is: The eyes gather the essence of the Five Zang organs. The Five Zang belong to Yin, and Yin resides in the Interior. Thus, it is said to be in the Interior. Moreover, the pupils belong to the Kidney. Extreme internal heat scorches, drying up Kidney Water, rendering it unable to illuminate objects. Like intense heat in summer causing visual obstruction, urgent purging is needed to save the nearly exhausted Kidney Water. If this syndrome is mistaken for deficiency and hot drugs are administered, the harm would be severe.

Abdominal Pain. A question was asked: "Why does abdominal pain belong to the Interior?" The answer was: "Kun represents the abdomen, which is pure Yin. Calling it Yin makes it clear that abdominal pain is definitely Interior. If the chest hurts but the abdomen does not, the pathogen has not deeply penetrated, and it is still a Shaobyang (Half-Exterior, Half-Interior) syndrome. Now, abdominal pain indicates the pathogen has transmitted to the Fu organs." It was asked: "Since abdominal pain belongs to the Interior, why use Dahuang and also Guizhi?" The answer was: "If Taiyang syndrome was erroneously purged causing abdominal pain, a slight Exterior may remain. Or, in a Taiyin Interior syndrome with a floating pulse, Guizhi and Dahuang are used to resolve both Exterior and Interior. However, although abdominal pain belongs to the Interior, one must distinguish between transmission and direct transmission. Caution is required."

Insomnia. A question was asked: "How does insomnia reveal an Interior Syndrome?" The answer was: "Heat pathogens entering the Fu organs cause irritability and restlessness. If cold is excessive (direct transmission), it belongs to Yin. Yin governs stillness; stillness leads to much sleep. How could there be insomnia?" Another question: "Inability to sleep certainly belongs to transmitted Interior Syndrome. Why does administering cold drugs sometimes worsen it?" The answer was: "This occurs after sweating, vomiting, or purging. It is named: Exhaustion of Body Fluids leading to insomnia. There must be internal emptiness and irritability. If the pulse is not floating and weak, Zhenwu Tang (True Warrior Decoction) and Suanzaoren Tang (Sour Jujube Seed Decoction) should be used. For Interior Syndrome insomnia, there is incessant irritability and thirst, and the pulse is certainly forceful, thus distinguishing it."

Sweating in Palms, Soles, and Axillae. Sweating in the palms, soles, and axillae indicates an Interior Syndrome. The back belongs to Yang; the abdomen belongs to Yin. The palms, soles, and axillae are Yin areas connected to the meridians of the Five Zang organs. Heat pathogens steam the Zang and Fu, causing sweating in the palms and axillae. If the palms and axillae are not moist, the pathogen is still in the Exterior, not having entered the Interior; this is called Exterior disease with Interior harmony. Now, sweating in the palms and axillae indicates the stool has hardened. Urgent purging is required; it is undoubtedly an Interior Syndrome.

Dry Throat and Dry Teeth. A question was asked: "Why do dry throat and dry teeth belong to the Interior?" The answer was: "The throat is the pathway of the Stomach; teeth are the surplus of bones. Now, a dry throat indicates excessive heat in the Fu organs; dry teeth indicate heat scorching the bones. Are bones and the Stomach not Interior?" Another question: "Severe internal heat should cause sore throat. Why do cold syndromes also cause sore throat?" The answer was: "Direct transmission cold causing sore throat must present with diarrhea of undigested food and cold limbs. This is extreme cold causing reverse sore throat. Such patients do not desire to swallow water. This differs from transmitted dry throat and dry teeth, where patients strongly desire to drink water."

All the above are transmitted Interior Syndromes requiring purging of the Interior.

Deep, Fine, and Weak Pulse. A question was asked: "Why does a deep, fine, and weak pulse indicate Direct Transmission Cold Syndrome?" The answer was: "Yuan Qi consolidates the body and flows freely through the limbs. Heat causes a rapid pulse; cold causes a slow pulse. This is a fixed principle. Deep indicates Yin; weakness indicates deficiency. This is cold invading the Yin channels, with declining Yang Qi, hence the pulse cannot be forceful. If there were internal heat, the pulse would be solid and slippery; how could it be weak? If the pulse is weak, it indicates cold, deficiency, or direct transmission. Even if there are Exterior symptoms or great heat externally, one dares not use purging or exterior-releasing drugs. If one ignores the pulse and indiscriminately administers Mahuang, causing double deficiency in the deficient, rescue will be too late."

Aversion to Cold in the Back. A question was asked: "How is aversion to cold in the back Direct Transmission?" The answer was: "Yin pathogens enter the Yang aspect; Yin is excess and Yang is deficient. Fuzi Lizhong Tang (Aconite and Central-Regulating Decoction) should be used." Someone said: "In Yangming Fu disease, why is there also aversion to cold in the back?" The answer was: "In Yangming Fu disease with aversion to cold in the back, there are no external cold signs. Instead, thirst and irritability must be present. The back belongs to Yang. When Yang heat sinks internally into the Fu organs, the back feels empty, causing slight aversion to cold. Hence, Baihu Tang (White Tiger Decoction) is used. If the mouth is harmonious (no thirst), it is truly Direct Transmission Cold Syndrome; who would dare use Baihu Tang! In summary, thirst indicates internal heat; lack of thirst indicates internal cold."

Vomiting of Clear Saliva and Foam. A question was asked: "Why is vomiting saliva and foam Direct Transmission?" The answer was: "Whether the Stomach Fu has cold or heat, saliva and foam must appear first. The *Neijing* states: 'All vomiting of sour water and turbid fluids belongs to heat; all vomiting of saliva and clear, cold fluids belongs to cold.' As cold weather makes water clear and hot weather makes it turbid: if there is heat and fire in the Stomach, consuming fluids leads to thirst, transforming into sour and turbid water. How could there be clear saliva and foam!"

Cold Extremities. A question was asked: "Why are cold extremities Direct Transmission Cold Syndrome?" The answer was: "The limbs belong to Yang; cold pathogens belong to Yin. Yang decline and Yin excess cause cold extremities extending past the elbows and knees. Since elbows and knees are the four gates of the body, cold surpassing them indicates direct transmission. If the pulse is deep, slow, and weak, urgent warming is required." Another question: "What about Yang Cold Extremities?" The answer was: "This is reversal due to extremity. Although the fingertips remain warm, unlike extreme cold extremities, external signs must include thirst, irritability, aversion to heat, scanty dark urine, and either constipation or diarrhea of intestinal mucus. The pulse must be deep, solid, and forceful. The presence of any one of these signs distinguishes it."

Excessive Sleep. A question was asked: "Why does excessive sleep belong to Direct Transmission?" The answer was: "Yin excess leads to stillness; stillness causes excessive sleep. Transmitted heat syndromes belong to Yang; Yang governs movement. How could there be excessive sleep?" It was also said: "Can Exterior Syndromes also present with excessive sleep?" The answer was: "Exterior syndromes involve deep pathogen invasion, necessarily presenting with headache and fever to be considered Exterior Syndrome excessive sleep. If it is a transmitted Interior Syndrome, there is irritability, aversion to heat, removal of clothes and blankets, and possibly delirium and mania. How could there be excessive sleep! In summary, excessive sleep is either Direct Transmission Cold Syndrome or an Exterior Syndrome."

Dry Retching. A question was asked: "Why is dry retching a Yin-Cold Syndrome?" The answer was: "Cold stagnates in the Middle Jiao, obstructing Yang Qi. The desire to vomit without success is called dry retching. If there is heat inside, vomitus may contain sour or bitter water, so this symptom would not occur." Some ask: "Do Taiyang, Shaoyang, and Water-Qi also cause dry retching?" The answer was: "Taiyang dry retching presents with headache and fever. Shaoyang dry retching presents with chest fullness and hypochondriac pain. Water-Qi dry retching presents with cough pulling pain in the hypochondrium. Only Direct Transmission dry retching has absolutely no Exterior signs, but must present with diarrhea of undigested food, pale and shivering face, and other cold signs. However, dry retching from Taiyang, Shaoyang, and Water-Qi ultimately does not depart from cold."

Diarrhea of Undigested Food. A question was asked: "Why is diarrhea of undigested food Direct Transmission Cold Syndrome?" The answer was: "When cold pathogens reside inside, food and drink are not digested. The classics state: 'Food transformed into foul-smelling decay and expelled indicates Fire; food expelled undigested indicates Cold.' Also: 'Cold weather makes water clear; hot weather makes it turbid.' The *Pathogenesis* states: 'All clear, cold, and transparent fluids belong to Cold.' Now, diarrhea of undigested food—if not cold, what else? If it were a transmitted heat syndrome, it would present with diarrhea of intestinal mucus, not undigested food."

Vomiting Roundworms. A question was asked: "Why is vomiting roundworms Direct Transmission?" The answer was: "Roundworms are calm with heat and restless/vomit with cold. There must be cold above the diaphragm. Administering cooling drugs will cause rebellion; urgent warming is required." Another question: "If there is a major Exterior Heat Syndrome with vomiting roundworms, are cooling drugs also contraindicated?" The answer was: "Wumei Lizhong Wan (Mume Pill for Regulating the Middle) is a worm-calming medicine. It uses Fuzi and Ganjiang. Even with heat signs, one must first calm the worms before treating other conditions. Other conditions are different. Deficient cold above the diaphragm, if violated, leads to danger."

Curled Posture. A question was asked: "Why is curled posture Direct Transmission?" The answer was: "Heat allows smooth flow; how could there be curled posture? Observe ordinary people sleeping alone in winter; extreme cold causes curling. When weather warms slightly, limbs extend, and sleeping becomes natural." Asked: "Do Yang Channel Exterior Syndromes also present with curled posture? Is it cold or heat?" The answer was: "Yang Channel curled posture is due to deep cold in the Exterior. Major exterior-releasing methods are needed. Distinction lies in the presence of headache, fever, and other Exterior signs. This is Yang Channel curled posture. Yin Channel curled posture has absolutely no Exterior signs."

Retraction of Testicles. A question was asked: "Why does retraction of testicles belong to Direct Transmission?" The answer was: "Heat promotes flow; cold causes retraction. Direct Transmission Cold Syndrome involves Yin excess and Yang deficiency, failing to warm the lower part, causing testicular retraction. Like ordinary people in winter, testes retract upward due to cold excess; in summer, they hang down due to Yang excess. However, *Zhangzhi* suggests using Chengqi Decoction for retraction. Why?" The answer was: "Jueyin is the Liver. The Liver governs sinews. If transmission proceeds sequentially to Jueyin, exhausting the Six Channels, and pathogens are strong, sinews tighten, the tongue curls like stroke, and the scrotum contracts because sinews gather at the genitalia. This is not like Direct Transmission described as hiding or shrinking. Those in *Zhangzhi* who advocate purging for retraction must have thirst and irritability...