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Shanghan (Cold Damage) is caused by cold qi invading the skin, clashing with blood and qi, causing the couli (skin pores and interstices) to become closed and dense. As a result, qi cannot be diffused, leading to the accumulation of toxic vapors, which causes headache, body pain, and high fever. The occurrence of biyu (epistaxis/nosebleed) in this context is due to heat clashing with qi and then invading the blood. The Lung governs the skin and hair of the body, and its orifice opens at the nose. Cold qi first invades the skin, clashes with qi to generate heat, and then the heat attacks the blood. When blood is heated, it flows recklessly and exits from the nose; this condition is named biyu (epistaxis).

In general, when observing febrile diseases that should manifest as epistaxis, the patient presents with high fever, frequent sweating but with incomplete sweat discharge, or before sweating therapy has been applied, symptoms such as dry nose, panting, and nasal resonance occur, followed immediately by epistaxis. In cases of significant bleeding, if a child loses between one sheng and several he (ancient volume units), the heat will subside due to this loss; however, if the loss reaches one to two sheng, the prognosis is fatal.

Shanghan (Cold Damage) involves cold qi invading the skin, clashing with blood and qi, making the couli (skin pores and interstices) closed and dense, preventing qi diffusion, and accumulating toxic vapors, resulting in headache, body pain, and high fever. If diarrhea occurs after the heat subsides, it is because the heat has moved from the exterior to the interior. Although the exterior heat has resolved, interior heat remains stagnant in the intestines and stomach, combining with food and fluids. Due to the deficiency of the intestines and stomach, this leads to diarrhea and dysentery. The stool appears yellow. If high fever persists without stopping, it may transform into bloody stools (blood dysentery). If exposed to severe cold subsequently, the cold and heat pathogens combine, transforming into dysentery with both red and white discharge (red and white dysentery).

Shiqi Bing (Seasonal Qi Disease) refers to abnormal, non-seasonal climatic conditions occurring suddenly during the four seasons, such as cold weather in spring when warmth is expected, coolness in summer when heat is expected, heat in autumn when coolness is expected, and warmth in winter when cold is expected. This pathogenic qi damages the human body, causing symptoms like headache and high fever. Generally, it resembles Shanghan (Cold Damage); regardless of age, the clinical manifestations are roughly identical. Because this pathogenic qi circulates widely during this specific time, it is called Shiqi (Seasonal Qi). It is also commonly referred to as Tianxing (Epidemic/Contagious Disease).

When abnormal, non-seasonal qi in the four seasons damages the human body, it is called Tianxing (Epidemic/Contiguous Disease). It generally resembles Shanghan (Cold Damage), presenting with headache and high fever. If the heat enters the Spleen and Stomach and stagnates, it leads to jaundice (yellowing). The Spleen and Stomach are paired and correspond to the element Earth, whose color is yellow, and they reflect on the muscles. When heat qi accumulates, its yellow color evaporates and manifests externally, thus causing jaundice.