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All cases of astringency, withering, drying up, spasms, and skin cracking or peeling belong to Dryness (Zao). Yangming Dry Metal corresponds to the Qi of the Lung and Large Intestine. "Astringency" refers to obstruction and lack of flow. Just as objects are slippery when wet, now that the entire body feels obstructed and dry inside and out, this belongs to the transformation of Dry Metal; it arises from the depletion of body fluids leading to dryness and astringency, causing Qi to become congested and stagnant, unable to flow smoothly and freely, resulting in numbness. However, even if Dryness results from fluid loss due to Cold-induced vomiting and diarrhea, it stems from this same principle.

"Withering, drying up, and spasms": "Withering" means the body is not nourished; "drying up" means there is no fluid; "dry" means lacking moisture; "spasms" means lack of flexibility and softness.
"Cracking and peeling" refers to the splitting and peeling of the skin. Heaven is Yang and constitutes Dry Metal; Earth is Yin and constitutes Wet Earth. Heaven and Earth are opposite, and Dryness and Wetness have different functions. When Wet Earth is prosperous in late summer, all things are slippery, lush, and flourishing; when Dry Metal is prosperous in autumn and winter, all things are solemn and contracting. The principles of dryness, astringency, and skin cracking are all transformations of Dry Qi. Dry Metal governs convergence and storage; this must be known.

All diseases where discharges from above or below are clear, transparent, and cold, along with masses (Zheng), hernias (Shan), hard epigastric masses, abdominal fullness with urgent pain, dysentery with clear and white stools, feeling no hunger after eating, vomit and diarrhea with fishy or foul odors, difficulty in flexion and extension, cold limbs (Jue Ni), and rigidity/stiffness, all belong to Cold (Han). Foot-Taiyang Cold Water corresponds to the Qi of the Kidney and Bladder.

"Discharges from above and below, clear and cold": This refers to the failure to digest food and fluids, resulting in clear and cold vomiting and diarrhea, which indicates a Cold disease.
"Zheng" refers to hard masses in the abdomen that are palpable upon pressure. Water is naturally soft and compliant; for it to become hard like earth implies that excess leads to harm, requiring counteraction to maintain balance. For example, if Dampness becomes extreme, it may transform into Dryness, causing stiff sinews and tendons; this is a counter-transformation governed by Metal (Dryness). If Dryness becomes extreme, it may lead to irritability and thirst; this is a counter-transformation governed by Fire. If Heat becomes extreme, it may cause the discharge of the five fluids or manifest as shivering and aversion to cold; this is a counter-transformation governed by Water.

"Jia" refers to abdominal masses that are hard but gather and scatter intermittently without a fixed location. The Classics state: "Heat transferred from the Small Intestine to the Large Intestine, clashing together, causes blood extravasation forming hidden Jia." Thus, Jia diseases described in the classics can also involve Heat. Alternatively, if Yang Qi is constrained and stagnates with heat, forming hard, unresolving masses, this is not a Cold-type Zheng/Jia, and differentiation must be made based on pulse and symptoms.

"Shan" (Hernia) refers to swelling, urgency, and severe colicky pain in the lower abdomen radiating to the testicles. This is because Cold governs contraction and curling. When Cold reaches its extreme, Earth Qi counters it, resulting in swelling and pain. The Classics state: "The pulse in Shan is urgent." The commentary notes: "An urgent pulse is a sign of Cold." However, a Cold pulse should typically be short, small, and slow. Why is it described as "urgent"? Does this not imply that a Taut (Jin) pulse governs pain, and an Urgent pulse indicates severe pain? But how to distinguish Heat-Dampness type Shan? If the pulse is urgent and accompanied by Surging (Hong) and Rapid (Shu) qualities, it falls under the category of Heat-pain; this must be known.

"Hard masses, abdominal fullness, and urgent pain": Cold governs contraction, thus causing urgent pain. However, if Heat is constrained internally, causing abdominal fullness, hardness, clustering, and pain, one cannot simply categorize it as Cold.

"Dysentery with clear and white stools": This occurs because Cold water remains clear and pure.

"Feeling no hunger after eating": Stomach Heat causes rapid digestion and easy hunger; Cold disease makes it difficult to rot and transform food even after eating. There are also cases where pathogenic Heat fails to digest grains, leading to abdominal heat, fullness, and bloating, where one feels no hunger even after several days without food; this cannot be viewed as a Cold syndrome.

"Vomit and diarrhea with fishy/foul odors": This results from Cold in the intestines and stomach disrupting transmission and transformation. When Cold prevails, Heart Fire declines and Lung Metal prospers, leading to vomit and diarrhea with a fishy odor. Fishiness is the smell associated with Metal.

"Difficulty in flexion and extension, cold limbs, and rigidity": Cold causes cold limbs in the four extremities, making them rigid and fixed, disrupting normal movement and flexibility, leading to inconvenience.