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Among all diseases, only Shanghan (Cold Damage) is of the most critical importance; however, its treatment also has a concise and essential method. As long as one treats it early according to the correct principles when the pathogen is initially at the muscle and surface level, there will be no case that does not heal.

This is like defending against thieves before they enter the room; it is naturally easy to drive them away, provided that the differentiation is accurate. It is said: "When Yin is excessive and Yang is deficient, sweating leads to recovery, while purging leads to death; when Yang is excessive and Yin is deficient, purging leads to recovery, while sweating leads to death." A difference of a hair's breadth can lead to an error of a thousand miles. If a patient dies not from the disease but from medical mismanagement, it is better to abstain from medication altogether. Hence, it is said that "abstaining from medication in Shanghan constitutes the skill of a middle-tier physician" (implying that avoiding unnecessary or harmful intervention is wise). This is often because one might be staying in an inn or on a boat, or in a remote village, without access to a knowledgeable physician; under such circumstances, one must never take medicine rashly.

Whenever Shanghan begins, presenting with headache, body pain, aversion to cold, limb stiffness, and absence of sweating, this indicates Cold damaging Ying (Nutritive Qi). At this stage, one must strictly avoid seafood, alcohol, grains, fruits, and any other solid, hard-to-digest foods. One should also avoid labor, anger, sexual desire, and exposure to wind and cold, and rest peacefully in bed.

Urgently gather a handful of green onion heads with roots, 5 qian of fresh ginger, 2-3 qian of Chenpi (Aged Tangerine Peel), a pinch of fine tea leaves, one white plum, and 3 qian of Zisu (Perilla Leaf). Add two large zhong (ancient liquid measure) of water, boil in a clay pot. Cover the patient with quilts, positioning their head near the steam so that the hot vapor first fumigates the head and face. Once sweating occurs, drink one large zhong of the decoction while hot. Re-boil the dregs and continue drinking. Cover the body with thick quilts, wrap the head, and warm the feet. Recovery is indicated when sweat reaches the feet. If the legs and feet do not sweat, yet fever and headache persist, it means the Cold pathogen has not been fully expelled; induce mild sweating again.

If at the onset, there is headache, fever, and profuse sweating, this belongs to Wind damaging Wei (Defensive Qi). Sweating therapy is not required, as it may cause Wang Yang (Collapse of Yang). If the patient already has slight sweating, follow the previous method but induce only slight additional sweating. In the previous formula, remove Zisu and green onion heads, add three black dates, decoct and administer. Recovery is indicated when sweating stops.

If upon onset, there is distension and fullness in the chest and diaphragm due to dietary injury from grains and meats, give hot light salt water to drink (2-3 bowls) on the same day, until the ingested food is vomited out. If vomiting does not occur, burn the ingested substance to ash, mix with ginger soup, and administer. If several days have passed, use the Jiang Cong Yi (Ginger and Green Onion Moxibustion/Fumigation) method (see Shanghan section). The utmost taboo is consuming seafood and alcohol. Do not drink a single drop of rice gruel; starvation is impossible. Strictly abstain from grain foods, which facilitates ease of management. In cases of Jiaochang Sha (Intestinal Colic/Spasm), even a sip of rice gruel can be fatal.

If there is dry mouth and extreme thirst, consume only tea, plain boiled water, Dengxin Cao Tang (Juncus Decoction), or ginger soup. Or, if by the seventh or eighth day the heat is extreme, add Xini (likely a local fruit or cooling agent), watermelon, fresh water caltrop, tender lotus root, and raw radish. Crush these to extract the clear juice and drink it, discarding the residue.

If management is improper, leading to Heat pathogen transmitting inward after several days, symptoms may include high fever, extreme thirst, delirious speech, irritability, manic talk, macules, constipation; or dysentery with foul watery stool, flailing hands and feet, removing clothes and covers, cracked lips, and tongue coating changing from white to yellow/black. Or, if the weather is hot and internal/external heat is extreme, place the patient on a cool mat, surround them with basins of water, and let the patient immerse their hands in the water; alternatively, wet a piece of blue cloth and apply it to the chest. Avoid wind strictly. This should only be done if the patient finds it comfortable and desirable. If extremely thirsty and desiring water, ask how much they wish to drink, but provide only half that amount. Do not allow excessive drinking to prevent Shui Jie Xiong (Water Accumulation in the Chest).

In another scenario, after six or seven days of high heat, the patient suddenly becomes cold, feels cold even under thick covers, and experiences uncontrollable shivering. This is called Fa Zhan (Shivering), indicating that Zheng Qi (Upright Qi) is recovering and the pathogen is attempting to exit. Urgently brew a large pot of ginger soup, place it near the patient's chest, and allow them to inhale the aroma and sip as desired to support Zheng Qi. Soon, Zheng Qi will overcome the pathogen, and recovery will occur through sweating.

After the seventh or eighth day, if the fever subsides, or there is occasional tidal fever, bowel and bladder movements are smooth, and the chest/diaphragm feels clear, drink clear rice gruel, gradually increasing to thicker gruel, then thin congee, emphasizing small quantities. If seafood or alcohol is consumed, relapse will be immediate; exercise caution regarding sexual activity.

It is particularly lamentable that in villages, people specifically slaughter animals to pray to gods, meaning "the meat is shared by the crowd, but the blame falls on the patient." Alas! For Yin Syndrome Shanghan, characterized by abdominal pain and cold limbs, refer to the Zhong Han (Middle Jiao Cold) section: consume more strong ginger soup, use fried salt for external warming, and treat with moxibustion.