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Headache, bone pain, fever with aversion to cold belong to Taiyang disease (disease of the Taiyang channel), suitable for dispersing exterior pathogens; palpation revealing chest and abdominal fullness accompanied by food stagnation requires digestion-promoting methods. Dry mouth, dry nose, eye pain, and insomnia belong to Yangming disease (disease of the Yangming channel), suitable for resolving the muscle layer; if the chest is comfortable but constipation exists, purgative methods are indicated. Alternating chills and fever, bitter taste in the mouth, hypochondriac pain, and deafness belong to Shaoyang disease (disease of the Shaoyang channel), suitable for harmonizing.

If the syndrome of one stage has not resolved and symptoms of another stage appear, it is called "He Bing" (Combined Disease); if symptoms of two stages appear simultaneously, it is called "Er Yang He Bing" (Combined Disease of Two Yang Stages). Cold hands and feet with a deep pulse indicate Yin syndrome, where tongue color should be carefully examined. The key to treating Shanghan (Cold Damage) lies in distinguishing eight principles: Exterior, Interior, Yin, Yang, Cold, Heat, Deficiency, and Excess, which determine life or death. A red and moist tongue indicates Exterior, Yin, Cold, or Deficiency syndromes; a dry tongue with coating indicates Interior, Yang, Heat, or Excess syndromes. A bluish-purple tongue indicates Yin-Cold; a muddy tongue color indicates extreme deficiency. A dry tongue with white coating indicates pathogenic factors just entering the Interior; yellow coating indicates severe heat; black coating like thorns or curled indicates extreme heat. Red face with intense illness or yellow complexion indicates critical condition. Tongue without coating forming a dry, red, shiny skin resembling roasted pig kidney indicates Yin hiding within Yang. Black and slippery tongue coating indicates Zang-Jie syndrome (accumulation in Zang organs). Yellow and dry tongue coating with cold feet and deep pulse does not indicate pure Yang syndrome; Magnoliae Officinalis Cortex (Huangbo, 黄柏) and Rheum Palmatum (Dahuang, 大黄) must be strictly avoided.

In Shanghan, floating, large, moving, slippery, and rapid pulses belong to Yang; deep, choppy, weak, wiry, and minute pulses belong to Yin. Survival is predicted when Yin syndrome presents with Yang pulse; death is predicted when Yang syndrome presents with Yin pulse. Pulses of external contraction and internal injury require careful differentiation. Tightness and excess at the Renying point (ST9, Renying) indicate wind-cold invasion; tightness and excess at the Qikou point (LU9, Taibai) indicate dietary injury. Initial floating and tight pulse with strength indicates Shanghan; initial floating and slow pulse without strength indicates Shangfeng (Wind Injury). Some pulses do not float: absence of pulse in one hand is called Dan Fu (Single Hidden Pulse); absence in both hands is called Shuang Fu (Double Hidden Pulse). If mild headache and fever occur with complete exterior symptoms, diaphoretic formulas should be primary; this is a case where syndrome determines treatment rather than pulse. When heat pathogen transmits inward, the pulse becomes deep; deep and slippery with strength indicates Interior Excess; deep and slippery without strength indicates Interior Deficiency. Occasionally, a deep, minute, and weak pulse appears, yet thirst, constipation, high fever, and warm extremities present fully as Excess-Heat syndrome; in such cases, Chaihu Daizhu Tang (Bupleurum and Rhubarb Decoction) should be used mildly to purge. Deep, slow, minute, and weak pulses in Yin syndrome indicate Deficiency, Cold, and Zang organ disease, suitable for sweet-warm tonification or pungent-hot warming dispersion. Floating, surging, excess, and rapid pulses with strength in Yang syndrome indicate Excess, Heat, and Stomach fu organ disease, suitable for sweet-cool clearing or bitter-cold purging. Floating, hollow, fine, and rapid pulses without strength in Deficiency syndrome indicate Exterior Deficiency, suitable for Ginseng Radix (Renshen, 人参), [missing character], Cinnamomi Ramulus (Guizhi, 桂枝), and Paeoniae Radix Alba (Baishao, 白芍) to consolidate the exterior. Deep, choppy, weak, and minute pulses without strength indicate Interior Cold, suitable for Ginseng Radix (Renshen, 人参), Atractylodis Macrocephalae Rhizoma (Baizhu, 白术), Zingiberis Rhizoma Recens (Shengjiang, 生姜), Cinnamomi Ramulus (Guizhi, 桂枝), and Aconiti Lateralis Radix Praeparata (Fuzi, 附子) to warm the interior. Surging, large, slippery, and rapid pulses with strength in Excess syndrome, presenting with macules, mania, and delirium, indicate disease in the channels, suitable for Sanhuang Shigao Tang (Three-Yellow and Gypsum Decoction) or Baihu Tang (White Tiger Decoction) for clearing and draining. Constipation with abnormal tongue coating indicates disease in the fu organs, suitable for Chaihu Daizhu Tang (Bupleurum and Rhubarb Decoction) or Chengqi Tang (Chengqi Decoction) for purging.