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In cold damage (Shanghan), if the pulse is floating, this indicates heat at the exterior and cold at the interior; it should be treated with Baihu Tang (White Tiger Decoction).

In Shaoyin disease (Disease of the Lesser Yin), if there is diarrhea with undigested food in the stool, this indicates cold at the interior and heat at the exterior. The hands and feet are cold and inverted (Jue), the pulse is faint and nearly imperceptible, yet the body does not feel aversion to cold, and the person's face appears red. Alternatively, there may be abdominal pain, dry retching, sore throat, or cessation of diarrhea while the pulse remains unobtainable. In such cases, Tongmai Sini Tang (Pulse-Restoring Four Reversal Decoction) should be used. (Cheng Wuji notes: Vomiting and diarrhea deplete fluids, so urination should decrease. However, here urination is frequent accompanied by profuse sweating, indicating that fluids are uncontrolled and Yang Qi is severely deficient. A faint pulse signifies impending Yang collapse. If there were no exterior heat and only interior cold with undigested diarrhea, it would be a pure Yin syndrome. Since there is exterior heat, it indicates that Yang has not completely perished, and Tongmai Sini Tang can still be used to rescue it.)

If there is diarrhea with undigested food, cold at the interior and heat at the exterior, sweating, and cold extremities, Tongmai Sini Tang (Pulse-Restoring Four Reversal Decoction) should be used. (Cheng Wuji notes: Diarrhea with undigested food indicates interior cold; persistent body heat indicates exterior heat. Sweating implies Yang Qi circulating to the exterior, which normally should not lead to cold extremities. The combination of sweating and cold extremities indicates severe Yang deficiency, requiring Tongmai Sini Tang to consolidate Yang Qi.)

If the pulse is floating and slow, indicating heat at the exterior and cold at the interior, accompanied by diarrhea with undigested food, Tongmai Sini Tang (Pulse-Restoring Four Reversal Decoction) should be used. (Cheng Wuji notes: A floating pulse indicates exterior heat; a slow pulse indicates interior cold. Diarrhea with undigested food signifies severe interior cold, requiring Sini Tang (Four Reversal Decoction) to warm the interior and dispel cold.)

In cases of heat at the exterior and cold at the interior, although the pulse may be deep and slow, with slight cold extremities and diarrhea with undigested food, this is due to cold at the interior. Therefore, Yin syndromes can also present with fever, which represents heat at the exterior. (Treat with Sini Tang (Four Reversal Decoction) or Tongmai Sini Tang (Pulse-Restoring Four Reversal Decoction).)

In cases of cold at the exterior and heat at the interior, the pulse must be slippery, accompanied by cold extremities and a dry tongue. Thus, in Shaoyin disease, aversion to cold and curling up indicate cold at the exterior; frequent spontaneous vexation and a desire not to wear heavy clothing indicate heat at the interior. (Treat with Da Chaihu Tang (Major Bupleurum Decoction).)

In Taiyang disease (Disease of the Greater Yang), if there is fever and aversion to cold, with more heat than cold, and the pulse is faint, this indicates "absence of Yang" (deficiency of Yang Qi). Sweating methods should not be used; instead, Guizhi Er Yuebi Yi Tang (Cinnamon Twig Twice, Poria and Gypsum Decoction in One Part) should be preferred. (Liu states: If the pulse is slow, Xiaojianzhong Tang (Minor Construct the Middle Decoction) with Huangqi (Astragalus) or warming methods may be used.)

In Taiyang disease, after eight or nine days, if the condition resembles malaria with fever and aversion to cold, where heat predominates over cold, the patient does not vomit, bowel movements and urination are relatively normal, and episodes occur two or three times a day, a slightly rapid pulse indicates that recovery is imminent. If the pulse is faint and there is aversion to cold, this indicates deficiency of both Yin and Yang; sweating, purging, or emetic methods should not be used again. If the face appears reddish, the disease has not resolved because slight sweating has not occurred to release the pathogen, leading to itching of the skin. In this case, Guizhi Mahuang Ge Ban Tang (Half Cinnamon Twig and Half Ephedra Decoction) should be used.

Zhao Yiyu carefully examined Zhang Zhongjing's discussions, noting that "more heat than cold" appears in only two conditions. As mentioned above, Zhang Zhongjing's intent was likely to treat the sixteen characters "getting sick for seven or eight days, resembling malaria, fever and aversion to cold, more heat than cold" as the overall condition from onset to the present, while the following text describes preventive measures for subsequent changes. This should be divided into three sections. If the patient does not vomit, bowel movements and urination are normal, episodes occur two or three times a day, and the pulse is slightly rapid, this is a sign of impending recovery. This section indicates that the interior is harmonious and free of disease; a faint pulse suggests weak pathogens, and a rapid pulse suggests balanced Yin and Yang, with all signs pointing towards peace. Recovery may occur without sweating. If the pulse is faint and there is aversion to cold, this indicates deficiency of both Yin and Yang; sweating, purging, or emetics are contraindicated, and warming treatment is appropriate. If the face appears reddish, the disease has not resolved because slight sweating cannot be achieved, causing itching; Guizhi Mahuang Ge Ban Tang (Half Cinnamon Twig and Half Ephedra Decoction) is required, and recovery depends on inducing sweating. *The Book of Vitality* (*Huo Ren Shu*) misunderstands the text structure. It incorrectly applies Guizhi Mahuang Ge Ban Tang (Half Cinnamon Twig and Half Ephedra Decoction) to sweat the patient, misinterpreting the nine characters "the patient does not vomit, bowel movements and urination are normal" which originally indicated recovery. It omits the contraindications for sweating, purging, and emesis, and wrongly uses diaphoretic drugs for symptoms that do not require them. Regarding the second condition, Zhang Zhongjing stated: "Taiyang disease, fever and aversion to cold, more heat than cold, faint pulse, loss of Yang, sweating is contraindicated, use Guizhi Er Yuebi Yi Tang." *The Book of Vitality* added the words "very much" to "faint pulse," questioning whether Zhang's pulse description was insufficient. Regarding the third condition, regarding a slow Chi pulse, Zhang Zhongjing's original text did not mention "more heat than cold," but rather: "Floating and tight pulse, methodologically associated with body pain, should be treated with sweating. Suppose the Chi position pulse is slow, sweating is contraindicated because Ying Qi is insufficient and blood is scant." *The Book of Vitality* merely cited the slow Chi pulse and scant blood, arbitrarily adding "less cold, more heat" and incorporating it into this question, which is erroneous. The case of a slow Chi pulse should have been classified under contraindications for sweating.

Liu pointed out that Zhang Zhongjing's work contains only the clause for "more heat than cold" and lacks evidence for "more cold than heat." Furthermore, it states: If there is no vexation and cold extremities, but the pulse is floating and relaxed, this is Wind Injury (Shang Feng), which can be treated with Da Qinglong Tang (Major Green Dragon Decoction) or, alternatively, Guizhi Mahuang Ge Ban Tang (Half Cinnamon Twig and Half Ephedra Decoction).