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(The discussion has been seen in the general examples of the first chapter.)

Winter cold invasion is called Shanghan (Cold Damage); spring warmth disease is called Wenbing (Warm Disease); summer heat disease is called Shubing (Summer Heat Disease); autumn malaria is called Nue (Malaria); when people of all ages in a year have similar illnesses, it is called Yi (Epidemic). Excessive sleep, excessive sweating, and floating pulse indicate Fengwen (Wind-Warmth). Whole-body pain indicates Shi (Dampness). Body rigidity with opisthotonos indicates Jing (Spasm).

Wu stated: The disease of Shanghan occurs when one contracts cold after the Frost's Descent solar term, when the weather is severely cold; this is true Shanghan. If one contracts pathogenic factors during warm weather, it is called Dongwen (Winter Warmth). When spring arrives and the weather is warm, if someone develops high fever, it is called Wenbing. If the weather remains cold with ice and snow unmelting, and one contracts cold, it is also called Shanghan. If between the third month and the seventh or eighth month, sudden severe cold occurs due to celestial changes and one contracts it, this is named Shixing Hanyi (Seasonal Cold Epidemic). If after the Summer Solstice, high fever and a flooding pulse occur, it is called Rebing (Heat Disease). If the climate of the four seasons is abnormal, causing illness upon contraction, where symptoms are similar among young and old and spread contagiously, it is called Shixing Zhiqi (Seasonal Pathogenic Qi). This "Shiqi" is also known as Shi Yi (Seasonal Epidemic), caused by contracting epidemic pestilential qi from heaven and earth, which is not cold. Furthermore, there are conditions such as Wen Nue (Warm Malaria), Fengwen, Wendu (Warm Toxin), Wenyi (Warm Epidemic), Zhongfeng (Stroke/Attack by Wind), Shangfeng (Injury by Wind), Zhongshi (Attack by Dampness), Fengshi (Wind-Dampness), Zhongshu (Attack by Summer Heat), and Zhong Wenwen (Attack by Warm-Dampness). All these present with fever and resemble Shanghan; thus, physicians generally refer to them as Shanghan because their fever and progression are similar. However, the medication differs, specifically in the methods of releasing the exterior and resolving the muscle layer.

Generally, winter Shanghan is an immediate onset following cold exposure. If not immediately ill, it transforms into Wenbing in spring and Rebing in summer. Wenbing and Rebing result from latent cold transforming; once transformed, it can no longer be described as cold. Shixing Hanyi involves sudden cold of the season, differing in severity from the severe cold of winter. Shiqi refers to epidemic qi circulating through nature, distinct from cold. Wenbing arises from vapor rising from mountains and marshes; Shubing arises from the fire of scorching suns; Feng is the thief-evil of heaven harming humans. There are attacks, heavy injuries, and light injuries. Wen Nue and Fengwen are complications of Shanghan that have deteriorated and transformed due to subsequent contraction of different pathogens; each has its own cause. How can they all be labeled as Shanghan and treated uniformly? If one does not recognize their names and treats blindly, treating Summer Heat attack as Heat Disease, or Warm-Dampness as Wind-Warmth, confusing deficiency and excess, creating chaos between right and wrong, leading to premature death, how can one not be cautious?

For Shanghan across the four seasons, supplementation combined with dispersal is generally appropriate. Therefore, Zhu Danxi often used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) for Shanghan. For those with Qi deficiency, Sijunzi Tang (Four Gentlemen Decoction) plus dispersing agents was used; for Blood deficiency, Siwu Tang (Four Substance Decoction) plus dispersing agents was used. Li Dongyuan treated Wind-Dampness using Buzhong Yiqi Tang added with Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), and Shengma (Cimicifugae Rhizoma). Haicang treated Wind-Dampness without sweat using Shenzhu Tang (Divine Skill Decoction) and with sweat using Baizhu Tang (Atractylodis Macrocephalae Decoction). For Gangjing (Rigid Spasm), Shenzhu Tang added with Qianghuo and Mahuang (Ephedrae Herba) was used; for Roujing (Soft Spasm), Baizhu Tang added with Guixin (Cinnamomi Cortex) and Baizhu (Atractylodis Macrocephalae Rhizoma) was used. For Wind-Dampness, Baizhu Tang was used with modifications according to symptoms. For Summer Heat attack presenting with string-taut, fine, hollow, or slow pulses, Huangqi Tang (Astragali Decoction) was used. All these align with Zhang Zhongjing's description of Shanghan contracted by hardworking individuals exposed to pathogenic factors.

Zhang Zhongjing discussed Shanghan but did not address Zhonghan (Severe Cold Attack). Ancient sages treated Zhonghan characterized by fainting due to exposure to extreme cold using Fuzi Lizhong Tang (Aconite Decoction to Regulate the Middle). Their prescription of medicine was correct, but they did not discuss the differences between "Shang" (Injury) and "Zhong" (Attack). Shanghan may manifest immediately or be delayed. Because internal stagnant heat exists, external wind-cold constricts the skin and pores, causing heat to erupt from stagnation. The pathogen enters via the meridians, deepening gradually. Initially, mild diaphoresis with Mahuang and Guizhi (Cinnamomi Ramulus) suffices because the body is not significantly deficient. In contrast, Zhonghan results from sudden exposure; the disease manifests immediately and violently. Because the pores are open and the whole body is affected, meridian differentiation is difficult, and there is typically no fever to release; warming and tonification are required for resolution. This occurs due to severe deficiency of vital energy; without urgent treatment, death ensues. Shangfeng (Wind Injury), Shangshu (Summer Heat Injury), and Shangshi (Dampness Injury) enter gradually like Shanghan. Zhongfeng (Wind Attack), Zhongshu (Summer Heat Attack), and Zhongshi (Dampness Attack) occur suddenly like Zhonghan. Beyond Shanghan, the treatment of miscellaneous diseases can be inferred by analogy from these principles.