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Diseases caused by exposure to cold pathogenic factors are termed Shanghan (Cold Damage). Postpartum women suffer from deficiency of both blood and qi. If they rise and engage in labor before the postpartum period has elapsed, they may be injured by cold, resulting in aversion to cold (se se e han) and slight fever (xi xi wei re), which cease after several days. In severe cases, pain occurs in the head and bone joints, taking seven or eight days to recover.

Labor during childbirth damages blood and qi, causing disharmony between Yin and Yang, leading to mutual overcoming. When Yang prevails, heat occurs; when Yin prevails, cold occurs. The interaction of Yin and Yang thus generates alternating chills and fever. Retained blood within the body after childbirth also causes chills and fever, characterized by occasional stabbing pain in the abdomen.

Malaria (Nue) arises from summerheat injury in summer, where the pathogen resides in the skin. In autumn, due to labor-induced fluctuation of blood and qi, the cou li (pores and interstices) become deficient, allowing wind pathogens to invade. This stirs up latent summerheat, causing a clash between righteous qi and pathogenic factors, and an exchange struggle between Yin and Yang. Excess Yang leads to heat, while excess Yin leads to cold. As Yin and Yang alternate between deficiency and excess, chills and fever manifest; when Yin and Yang separate, both symptoms cease. If the pathogen moves and qi arrives, reigniting the struggle, malaria exhibits periodic attacks.

When attacks occur progressively later, it is because the pathogen lodges at Fengfu (GV16). The pathogen descends along the Du Meridian (spine). Wei Qi (Defensive Qi) gathers at Fengfu once daily and nightly. On the following day, it descends one vertebral level, causing the attack time to delay daily. When attacks occur earlier, it is because Wei Qi descends one level daily from Fengfu. After twenty-one days, it reaches the coccyx; on the twenty-second day, it enters the spine internally, ascending into the Fu Chong Mai (Deep Penetrating Vessel). Its qi ascends for nine days, emerging inside the Quepen (ST12) region. Since the qi has ascended, the disease manifests earlier.

When attacks occur every other day, it is because the pathogenic factor presses inward toward the Zang organs and extends horizontally to the Mu Yuan (Sea of Origin/Membrane Source). The path is distant, the qi is deep, and its movement is slow, preventing daily occurrence, hence the interval.

Postpartum damage to blood and qi, combined with prior summerheat injury, creates a state of deficiency. Upon encountering wind pathogens, righteous qi and pathogens clash, Yin and Yang struggle, resulting in the formation of malaria.

"Ji" (Accumulation) belongs to Yin energy and originates from the Zang organs; "Ju" (Gathering) belongs to Yang energy and forms from the Fu organs. Both result from irregular diet and imbalance of cold and heat, leading to the accumulation of Qi in the Zang and gathering of Qi in the Fu. Ji presents with fixed pain location; Ju presents with migratory pain. This is because Ji is Yin energy, which is sinking and hidden, so pain remains localized. Ju is Yang energy, which is floating and moving, so pain lacks a fixed site. Postpartum damage to blood and qi weakens the Fu and Zang organs. Invasion by wind-cold causes the pathogen to knot with the organs and congeal with blood and qi, forming Ji-Ju disorders.