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Therefore, it is said that the distinction between Shanghan (Cold Damage) and Rebing (Heat Disease) lies in the difference of diagnosis, not symptoms; in the difference of treatment principles, not herbs. When Qi is abundant but the body feels cold, this results from contracting Shanghan; when Qi is deficient but the body feels hot, this results from contracting Shangs (Summerheat). This constitutes the distinction in diagnosis. However, during the transmission of Shanghan, the body may also become hot; when Shangs leads to mania, Qi may also become abundant. Is this not an indication that there is no distinction in symptoms? Superficial practitioners misunderstand this, precisely due to this reason!

The treatment for Shanghan typically employs sweating methods first, followed by purgative methods; whereas the treatment for Wenre (Warm-Heat) diseases may employ purgative methods first, followed by sweating methods: this constitutes the distinction in treatment principles. However, sweating often utilizes Ephedrae Herba (Mahuang, 麻黄) and Puerariae Radix (Gegen, 葛根); purgation often utilizes Mirabilite (Xiashaofen, 硝) and Rhubarb (Dahuang, 大黄). The sweating and purgative treatments for Shanghan use these, and the sweating and purgative treatments for Wenre also use these. Is this not an indication that there is no distinction in herbs? From this we can infer: although Shanghan originates from Cold pathogen, once it transforms into Heat, apart from Coptidis Rhizoma (Huanglian, 黄连) and Gypsum Fibrosum (Shigao, 石膏), what other herbs can be used to cool it? Although Wenre disease is already a Heat condition, if treated excessively leading to Yang deficiency, apart from Zingiberis Radix Preparata (Ganjiang, 干姜) and Aconiti Lateralis Radix Preparata (Fuzi, 附子), what other herbs can be used to warm it? Human ailments, though myriad in nature, are limited by the fixed number of herbs in Materia Medica. If herbs can be used universally, why should formulas not be used universally?

Recent commentators on the *Treatise on Cold Damage* (*Shanghan Lun*) cling to formulas such as Baihu Tang (White Tiger Decoction) and Huangqin Tang (Scutellaria Decoction) found within the text, using them to prove that this book encompasses treatment methods for Warm-Heat diseases. Would they claim that Shanghan disease should never use Cold herbs throughout its course, and that Warm-Heat disease should never use Warm herbs throughout its course? Alas! Can physicians be so rigid and inflexible?

The Qi of Cold, although distinctly opposed to Heat, affects humans according to their constitution's excess or deficiency. If a person is Excess (Shi), Cold cannot penetrate deeply; it merely attaches to the skin and closes the Couli (pores), inevitably resulting in Heat manifestation. If a person is Deficient (Xu), Cold encounters no obstruction, passes through the muscle layer, and reaches the Zang-Fu organs, inevitably resulting in Cold manifestation. If one expounds upon the principles of the *Suwen: Fenglun* (Wind Chapter of the Basic Questions), one will understand the reason why Zhang Zhongjing’s formula discussions present mixed Cold and Heat symptoms.

The statement in *Suwen: Relun* (Heat Chapter of the Basic Questions) that "when humans are injured by Cold, they develop Heat diseases," etc., specifically addresses the standard method of Cold pathogen residing in the meridians, answering the question posed at the beginning of the chapter regarding the six-to-seven-day progression. It does not include direct invasion (Zhizhong) into the interior, which differs in meaning from Zhang Zhongjing’s exhaustive elaboration on the concept of "Cold." Liu Hejian, adhering rigidly to this view, asserted that Shanghan involves only Heat and no Cold, attributing conditions treated with Tongmai Sini Tang (Pulse-Recovering Decoction) and Lizhong Tang (Regulate the Middle Decoction) solely to errors caused by mistaken purgation with Cold herbs. This not only severely slandered Zhang Zhongjing but also misinterpreted the *Neijing*.

Cold attacks more fiercely than other pathogens; hence, the general principle states: "Injury by the Qi of the four seasons can all cause disease." Shanghan is termed "poison" because it forms the most lethal and destructive Qi. Liu Hejian, however, argued that Warm, Heat, Cool, and Cold are all derived from Shanghan, differentiated only by degree, thereby treating Shanghan as a collective term for diseases caused by the four seasonal pathogens. Is this really the case?

Cold hides within the body. Passing through Spring to Summer, Yang Qi is greatly depleted and cannot remain stored. Therefore, the general principle states only that Cold poison hides in the muscles and bones, transforming into Wenbing (Warm Diseases) in Spring and Shubing (Summerheat Diseases) in Summer. Liu Hejian added: transforming into Shibing (Dampness Diseases) in Autumn, and Zhengshanghan (True Shanghan) in Winter. Such arbitrary alteration makes it clear that he is unworthy of discussing the principles of Shanghan.