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Yang syndrome resembling Yin (Yang hyperactivity within, forcing Yin to the exterior): Yang pathogen transmitting into the Yin meridians (possessing the nomenclature of Yin meridians, but belonging to excess-heat in the Stomach fu). Yang jue (cold limbs) should be treated with purgation (when heat pathogen transmits inward and purgation is missed, the deeper the heat, the deeper the jue/cold limbs). Exterior cold with interior heat (body and limbs are cold, yet there is a reluctance to wear clothes; cold is in the skin, heat is in the bone marrow). Yang abundance rejecting Yin (though the body feels cold, the pulse is surging and rapid). Fire extreme resembling Water (hyperactivity causes harm, control follows to maintain balance). The above six syndromes have different names but share the same pathology. At the onset, high fever and pain in the head and neck indicate a Yang syndrome. After six or seven days, heat lies hidden within, and Yang pathogen sinks into the Shaoyin meridian. Although the exterior presents with generalized coldness and a reluctance to wear clothes, cold limbs do not extend beyond the elbows and knees, or may alternate between cold and warm. This results from the failure or delay in using Rhizoma Pinelliae Preparata (Dahuang, 大黄) for purgation, causing deep-seated latent heat. Yin loses its holding function and retreats to the muscle layer, while hyperactive Yang invades the interior, creating a pattern of interior heat and exterior cold. Despite these symptoms, it can be confirmed by thirst, dry tongue, delirium, restlessness, insomnia, constipation or passage of black watery stool, red urine, red nail beds, and a deep, firm, and forceful pulse in all six positions. If righteous Qi is still substantial, Liu Yi Shun Qi Tang (Six-Earth Smooth-Qi Decoction) should be used to purge; if weak, Rushen Baihu Tang (Miraculous White Tiger Decoction) should be used to clear heat; if critical, Guide Earth Nourish-Younger Decoction (Guidi Yangrong Tang) is indicated. Misidentifying this as Yin-cold and using hot/warm herbs will lead to immediate death.

Yin syndrome resembling Yang (Yin lurking within, forcing Yang to the exterior): Yin abundance repelling Yang (excessive Yin hides within, lone Yang flies upward). Yin jue (cold limbs) should be treated with warming (interior and exterior are both Yin without Yang, cold limbs exceed the elbows and knees). Exterior heat with interior cold (Yin syndromes can also present with fever; heat is in the skin, cold is in the bone marrow). Yin extreme causing restlessness (Yin restlessness should be treated with warm herbs). Water extreme resembling Fire (extremes reverse). Yin syndrome (pulse is wiry, alternating chills and fever; misdiagnosed as malaria leads to many deaths, must be known). The above six syndromes have different names but share the same pathology. At the onset, no fever, no headache, no thirst, or alternating chills and fever, constantly cold hands and feet, diarrhea, or constipation due to Yin-cold coagulation, and clear, long urination indicate a Yin syndrome. On the third or fourth day, Yin reaches its extreme causing irritability, facial redness without body heat, desire to sit in mud or a well, slight thirst wanting to drink but unable to swallow, or feeling hot on the body yet desiring to wear clothes (hot when clothed, cold when undressed). This results from the failure or delay in using Radix Aconiti Lateralis Preparata (Fuzi, 附子) to warm the meridians, causing deep-seated latent cold. Yang loses its holding function and floats to the muscle layer, excessive Yin usurps the interior, creating a pattern of interior cold and exterior heat. Despite these symptoms, it can be confirmed by aversion to cold, curling up to sleep, difficulty turning the body, drowsiness, cyanotic/black nail beds, and a deep, faint, and weak pulse in all six positions. Li Zhong Tang (Regulate the Middle Decoction), Si Ni Tang (Frigid Extremities Decoction), or Huiyang Fanben Tang (Restore Yang and Return to Root Decoction) should be used to warm and disperse cold pathogens, allowing Yang Qi to recover and mild sweating to occur for recovery. Misidentifying this as Yang-heat and using cool/cold herbs will lead to immediate death.

Taiyang pulse resembling Shaoyin: Upon initial illness, headache and body heat indicate a Taiyang syndrome, where the pulse should be floating. Now it is instead sunken, resembling a Shaoyin pulse. This is often due to interior deficiency and chronic cold, with decline of righteous Qi, necessarily accompanied by body pain. Therefore, rescue the interior is required to strengthen righteous Qi internally and force pathogens outward, using Raw Radix Aconiti Lateralis Si Ni Tang (Raw Fuzi Frigid Extremities Decoction). Although described as warming the interior, it can also resolve via sweating.

Shaoyin syndrome resembling Taiyang: Upon initial illness, the pulse is deep and fine, without headache, indicating a Shaoyin syndrome which should lack fever. Now there is fever, resembling a Taiyang syndrome. This is because cold pathogen remains in the exterior, not yet transmitted inward, with interstices congested and closed generating heat. Ma Huang Fu Zi Gan Cao Tang (Ephedra, Aconite, and Licorice Decoction) is appropriate. Cooked Radix Aconiti Lateralis warms interior cold, Ephedrae Herba (Mahuang, 麻黄) disperses exterior heat.