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When a person encounters severe cold, they suddenly feel a yin-cold sensation that penetrates directly into the fu organs (hollow organs such as the stomach, intestines, etc.), causing the hands, feet, and body to become cold. The complexion turns cyanotic, clear water is vomited, borborygmus (intestinal rumbling) is heard in the abdomen, there is qi rebellion and fullness in the chest and hypochondrium, the body is cold and trembling, and a sensation of cold air wrapping around the abdomen rushes upward, leading to sudden unconsciousness. This is known as "cold striking directly" (Zhong Han) into the seven fu organs. The disease of Zhong Han is vastly different from the symptoms of Shang Han (Cold Damage). The cold in Shang Han enters from the exterior into the interior; whereas the cold in Zhong Han enters from the fu organs into the zang organs (solid organs such as the heart, liver, etc.). Although both entering the fu and entering the zang belong to direct strike syndromes, the treatment methods ultimately differ. Generally, cold invading the fu is lighter than that invading the zang; thus, how can the treatment for fu cold be heavier than that for zang cold? Since there are seven fu organs (a traditional reference often encompassing all hollow organs or including the pericardium), the medicines for treating mid-fu cold should seemingly be distinguished. Typically, when yin-cold invades the human body, it takes advantage of the cold in the San Jiao (Triple Burner) to enter first. By warming the cold of the San Jiao, the cold of the seven fu organs can be entirely dispersed. However, the reason for the cold in the San Jiao lies in the deficiency of Stomach Qi. If one merely warms the cold of the San Jiao without urgently tonifying the Stomach Qi, the deficient Qi cannot sustain itself, and how can Yang Qi be restored in an instant? The prescription used is Jiu Fu Hui Yang Tang (Rescue Fu Organs and Restore Yang Decoction): Ren Shen (Ginseng Radix et Rhizoma, 5 qian), Fu Zi (Aconiti Lateralis Radix Praeparata, 1 qian), Rou Gui (Cinnamomi Cortex, 2 qian), Ba Ji Tian (Morindae Officinalis Radix, 1 liang), decocted in water and taken orally.

This formula uses Ren Shen to support Stomach Qi and Rou Gui to restore Yang. One might think there is no need to rely on Ba Ji Tian as the sovereign drug. However, Ba Ji Tian tonifies the Fire of the Heart and Kidney. When the Fire of the Heart and Kidney is vigorous, the Fire of the San Jiao becomes even more vigorous. Moreover, Ba Ji Tian generates Stomach Qi and restores Yang. Therefore, using it as the sovereign drug allows it to command Ren Shen, Fu Zi, and Rou Gui as generals working in unison, sweeping away and dispelling the pathogen, incorporating suppression within pacification. Thus, after one dose, efficacy is achieved: Yang returns, and Yin-cold dissipates immediately.

For this syndrome, Shu Gui Gan Jiang Tang (Atractylodes, Cinnamon, and Dried Ginger Decoction) is also very effective: Bai Zhu (Atractodis Rhizoma, 1 liang), Rou Gui (Cinnamomi Cortex, 3 qian), Gan Jiang (Zingiberis Rhizoma, 3 qian), decocted in water and taken orally.

When a person is exposed to severe cold and suddenly feels yin-cold, with cyanotic lips, a cold body, spasmodic contraction of tendons and vessels in the hands and feet, vomiting and diarrhea, heart pain, abdominal pain, retraction of the scrotum, cyanotic fingernails, and inability to bend or extend the waist, this is a disease of Yin-cold striking directly into the Zang organs. Striking the Zang organs is more severe than striking the Fu organs. When cold Qi enters the five Zang organs, it seems appropriate to treat each organ separately; however, separate treatment is unnecessary. One need only directly warm the Fire of the Ming Men (Gate of Life), and the cold of all Zang organs can be entirely dispersed. The Ming Men is the master of the twelve meridians. If the master does not perish, the Heart Monarch will not scatter like one leaving the hall; if the master does not perish, the Liver Wood will not undergo changes like a wandering soul; if the master does not perish, the Lung Metal will not ascend like scattered魄 (Hun/Po); if the master does not perish, the Spleen Earth will not collapse. Once the Ming Men is cold, and Yang Qi is forced out of the Kidneys by Yin pathogens, the spirits of the five Zang organs cannot remain peaceful individually, and they flee together following the Yang. Therefore, when the five Zang organs are invaded by cold pathogens, there is no need to treat them individually; one need only warm the Ming Men, and the cold of the five Zang organs can be resolved. Although the Ming Men is the master of the five Zang organs, if the Qi of the five Zang organs is deficient, the "great army" sent to sweep away the demons will lack provisions. Thus, while the Ming Men should be warmed, the Qi of the five Zang organs must also be tonified. The prescription used is Dang Yin Jiu Ming Tang (Sweep Yin and Save Life Decoction): Ren Shen (Ginseng Radix et Rhizoma, 1 liang), Bai Zhu (Atractodis Rhizoma, 3 liang), Shu Di Huang (Rehmanniae Radix Praeparata, 3 qian), Rou Gui (Cinnamomi Cortex, 1 qian), Fu Zi (Aconiti Lateralis Radix Praeparata, 3 qian), Shan Zhu Yu (Corni Fructus, 2 qian), Fu Shen (Poria with Hostwood, 3 qian), decocted in water and taken orally. After one dose, Yang returns; after two doses, complete recovery occurs.

Why is the effect so rapid? Because cold entering the five Zang organs results from the outward escape of Ming Men Yang. Once Yang is restored, the cold has nowhere to remain in the Zang organs. Using Ren Shen and Bai Zhu as sovereign drugs seems to save only the Heart and Spleen meridians. Although Fu Zi and Rou Gui are used with Shu Di Huang and Shan Zhu Yu, saving the Kidney, the Liver and Lung seem neglected. How can it penetrate barriers and restore Yang instantly? It is unknown that when the five Zang organs are invaded by cold, after invading the Kidney, it typically invades the Spleen, then the Heart; invasion of the Liver and Lung is less common. Thus, specifically caring for the Heart, Kidney, and Spleen meridians naturally includes the Liver and Lung. Furthermore, Ren Shen combined with Fu Zi reaches every meridian; how could the Lung and Liver be excluded? Additionally, herbs that tonify the Liver and Lung are mostly astringent. To expel pathogens, one must not use astringents that retain pathogens. Using astringents to tonify the Liver and Lung would hinder Ren Shen and Fu Zi, preventing the rapid sweeping of Yin-cold. This non-mixed medication holds profound meaning. Moreover, Water and Fire in the Kidney are originally inseparable. Using hot herbs like Gui and Fu to restore Yang may cause dryness in the Kidney. Rather than tonifying Kidney Water after restoring Yang, it is better to prevent this during the application of fire. Hence, I use small amounts of Shu Di Huang and Shan Zhu Yu with Gui and Fu to restrain the rampant Fire. Fire returning to its source with Water, and Water inviting Fire into its residence, achieves the state of Ji Ji (Water-Fire Intersection) without excessive flare-up.

For this syndrome, Shen Zhu Gui Jia Shu Di Tang (Ginseng, Atractylodes, Cinnamon, plus Prepared Rehmannia Decoction) is also excellent: Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractodis Rhizoma) (each 1 liang), Fu Zi (Aconiti Lateralis Radix Praeparata), Rou Gui (Cinnamomi Cortex) (each 2 qian), Shu Di Huang (Rehmanniae Radix Praeparata, 5 qian), decocted in water and taken orally.

In winter, direct strike of Yin-cold causes alternating vomiting and diarrhea with body heat. People assume this is a Shang Han transmitting through meridians. However, although it is Shang Han, there is a distinction: this is a direct strike of Sha Yin (Lesser Yin) pathogen, not a transmitted Sha Yin pathogen. Direct strike of Yin meridians originally presents without body heat. Why is there heat here? This is due to the struggle between Zheng Qi (Upright Qi) and Yin pathogens; the pathogen is strong, and Zheng Qi refuses to remain weak, resulting in heat from the struggle. In transmitted Sha Yin syndrome, vomiting and diarrhea occur only after several days, not on the first day with immediate heat and GI symptoms. Thus, this is definitely a direct strike, not transmission. Direct strike means the pathogen enters the interior immediately; transmission means the pathogen is initially in the exterior before entering the interior. These are vastly different and must be observed carefully. The treatment method uses Shen Fu Fu Ling Tang (Ginseng, Aconite, and Poria Decoction): Ren Shen (Ginseng Radix et Rhizoma, 1 liang), Fu Zi (Aconiti Lateralis Radix Praeparata, 1 qian), Fu Ling (Poria, 5 qian), decocted in water and taken orally. After one dose, vomiting and diarrhea stop, and body heat subsides.

Why is the efficacy so fast? This syndrome arises because weak Zheng Qi cannot overcome strong Yin pathogens, causing fever. By assisting Zheng Qi, Yang becomes strong and Yin naturally declines. With the brave assistance of Fu Zi breaking through the enemy, Yang becomes even stronger, turning defeat into victory. Adding Fu Ling's mild diuresis disperses dampness, calming the Stomach Earth. With Yang Qi ascending and descending freely, how can Yin pathogens break through?

For this syndrome, Shen Ling Fu Zhu Jia Sheng Jiang Tang (Ginseng, Poria, Aconite, Atractylodes plus Fresh Ginger Decoction) is also usable: Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractodis Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens) (each 1 liang), Fu Zi (Aconiti Lateralis Radix Praeparata, 2 qian), Fu Ling (Poria, 3 qian), decocted in water and taken orally.

When a person suffers a direct strike of Yin-cold, with the Kidney Meridian uniquely affected, causing body tremors and hand shaking, people think cold has entered the bones. Who knows it is due to cold Ming Men Fire failing to repel external Yin-cold externally? The Ming Men is the ruler of the twelve officials. Life exists with this Fire; death comes without it. Vigorous Fire circulates throughout the body, keeping hands and feet warm; deficient Fire fails to reach up and down, causing whole-body coldness, let alone warming the extremities. Thus, vigorous Ming Men Fire repels external cold. Only when Fire is extremely deficient does Yin-cold force inward, entering the Kidney Palace. The Ming Men fears the cold so much it seems unable to coexist. Body tremors indicate loss of autonomy; hand shaking indicates inability to guard the exterior. The treatment urgently needs to warm and tonify the Ming Men, ensuring its Fire overcomes external cold. Then the Master of the Ming Men is not weak, Yang Qi becomes robust, circulating up and down, Yin dissipates, and cold scatters, preventing invasion of the Heart Palace. Use the First Formula for Direct Strike of Yin Zang: Fu Zi (Aconiti Lateralis Radix Praeparata, 1 qian), Rou Gui (Cinnamomi Cortex, 2 qian), Ding Xiang (Caryophylli Flos, 1 qian), Bai Zhu (Atractodis Rhizoma, 2 qian), decocted in water and taken orally. After one dose, cold is expelled, and tremors/shaking cease.

This formula consists entirely of Yang herbs, suitable for treating Yin syndromes. For critical conditions, why are dosages low yet efficacy divine? Because Fire desires to escape outward; once assisted, it returns to its palace. Fire flees due to weakness but returns upon encountering strength. Once Fire returns, remaining Fire assists it, making the Ming Men vigorously prosperous. Not only is cold expelled, but cold pathogens also flee at the sight of Fire.

For this syndrome, Yuan Ming Ju Han Tang (Support Life and Repel Cold Decoction) is truly miraculous: Bai Zhu (Atractodis Rhizoma, 3 liang), Rou Gui (Cinnamomi Cortex, 3 qian), Po Gu Zhi (Psoraleae Fructus, 3 qian), Du Zhong (Eucommiae Cortex, 3 qian), decocted in water and taken orally.

When a person's Sha Yin Kidney Meridian is struck by pathogens, causing lower abdominal pain and cold feet (Jue Ni), people think cold directly invades the Kidney. Who knows it enters the Kidney and simultaneously affects the Small Intestine Fu? Since the pathogen enters the Zang (Kidney), which is heavier than the Fu, why distinguish Small Intestine involvement? However, unclear differentiation leads to poor efficacy. Although the Kidney opens into the two orifices and governs urination and defecation, Kidney cold implies Small Intestine cold. Treating the Kidney heals the Small Intestine, but one must understand they share the cold pathogen. Cold lodging in the Small Intestine causes abdominal pain and blocked pulses; blocked pulses lead to cold feet. Do not assume cold enters only the Kidney and not the Small Intestine. Yet, treatment need not target the Small Intestine directly but must treat the Kidney. Treating the Kidney means warming the Kidney, which warms the Small Intestine. Use Zhi Ni Tang (Stop Reversal Decoction): Fu Zi (Aconiti Lateralis Radix Praeparata, 1 qian), Bai Zhu (Atractodis Rhizoma, 3 qian), Che Qian Zi (Plantaginis Semen, 3 fen), Wu Zhu Yu (Evodiae Fructus, 5 fen), decocted in water and taken orally. After one dose, pain ceases and reversal resolves.

This formula uses Fu Zi to expel cold and Wu Zhu Yu to promote Qi flow. Bai Zhu and Che Qian Zi benefit the waist/navel and eliminate dampness. Though difficult to treat the Small Intestine directly, it actually warms the Kidney Palace. Heat in the Ming Men of the Kidney Palace allows Small Intestine Qi transformation to function naturally, resolving blockage. Thus, pain stops and reversal resolves without direct intervention.

For this syndrome, Shu Gui Dou Ling Tang (Atractylodes, Cinnamon, Nutmeg, and Poria Decoction) is also effective: Rou Gui (Cinnamomi Cortex, 1 qian), Bai Zhu (Atractodis Rhizoma, 1 liang), Fu Ling (Poria, 3 qian), Rou Dou Kou (Myristicae Semen, 1 piece), decocted in water and taken orally.

When a person suddenly strikes Yin-cold and cannot move, people think cold strikes the Spleen. Who knows it still strikes the Kidney? Inability to move hands and feet due to cold strike is already critical; total immobility is worse. Cold hands/feet with immobility is a limb issue; rigid body immobility is a central (Middle Jiao/Spleen-Stomach) disaster. Humans need Fire for life, and this Fire is Kidney Fire, not Heart Fire. Vigorous Kidney Fire allows infinite Spleen Earth operation; deficient Kidney Fire hinders continuous Spleen transport. Thus, Kidney cold causes Spleen cold, and Spleen cold causes bodily immobility. Treatment must not solely target the Spleen but must treat the Kidney; specifically, it must warm the Fire within the Kidney. Use the Second Formula for Direct Strike of Yin Zang: Fu Zi (Aconiti Lateralis Radix Praeparata, 1 qian), Rou Gui (Cinnamomi Cortex, 1 qian), Shu Di Huang (Rehmanniae Radix Praeparata, 2 qian), Gan Jiang (Zingiberis Rhizoma, 1 qian), decocted in water and taken orally. After one dose, movement returns and cold dissipates.

This formula uses Gui, Fu, and Gan Jiang to strike the core and rapidly sweep cold. Ming Men Fire in the Kidney erupts suddenly, and cold departs. However, excessive pure Yang herbs may be too drying. Adding Shu Di Huang balances this; Yang supported by Yin does not deplete Water. This mutual assistance ensures success.

For this syndrome, Fu Gui Jiang Zhu Jia Shu Di Tang (Aconite, Cinnamon, Ginger, Atractylodes plus Prepared Rehmannia Decoction) is usable: Shu Di Huang (Rehmanniae Radix Praeparata, 5 qian), Bai Zhu (Atractodis Rhizoma, 1 liang), Gan Jiang (Zingiberis Rhizoma, 3 qian), Rou Gui (Cinnamomi Cortex, 2 qian), Fu Zi (Aconiti Lateralis Radix Praeparata, 3 fen), decocted in water and taken orally.

When a person suddenly encounters Yin-cold Qi, experiencing extreme bilateral hypochondriac pain as if rupturing, people think cold invades the Liver. Who knows it still invades the Kidney? The hypochondrium is the Liver's domain; Kidney cold should affect the Kidney, not the Liver. Due to Kidney cold and fear of external cold, Kidney Qi escapes to the Liver (its "child"). Deeply injured, it dares not return. Can Liver Wood watch its parent suffer? It fights fiercely despite injury. Hypochondriac rupture imagery reflects Liver Wood stagnation. Warming externally with fire provides temporary relief. Use Kuan Gan Tang (Relax Liver Decoction): Ren Shen (Ginseng Radix et Rhizoma, 1 liang), Shu Di Huang (Rehmanniae Radix Praeparata, 2 liang), Fu Zi (Aconiti Lateralis Radix Praeparata, 1 qian), Chai Hu (Bupleuri Radix, 5 fen), Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen), Rou Gui (Cinnamomi Cortex, 3 qian), decocted in water and taken orally. After one dose, pain stabilizes.

People may doubt using Ren Shen and Fu Zi to restore Yang, but using Shu Di Huang to nourish Yin raises suspicion. Alas! Kidney Qi has fled to the Liver Palace, and cold pathogens press upon the Liver. If Liver Qi becomes timid, it either ascends to the Heart or descends to the Kidney. Ascending to the Heart invites pathogens to attack the Heart Monarch, causing disaster. Descending to the Kidney invites pathogens to invade the Ministerial position, risking mutual destruction. Thus, Ren Shen tonifies the Heart so it fears no pathogen attack; Shu Di Huang tonifies the Kidney so it fears no invasion. With Liver Qi considering its mother-child relationship, there is no worry, allowing joint resistance against cold. Added herbs assist Fire and soothe Wood, resolving Liver stagnation, leading to victory in battle. If these herbs yield no effect, it indicates Heart and Kidney are exhausted, and Liver Qi alone cannot survive.

For this syndrome, Qu Han Shu Xie Tang (Expel Cold and Relax Hypochondrium Decoction) is also miraculous: Ren Shen (Ginseng Radix et Rhizoma, 5 qian), Rou Gui (Cinnamomi Cortex, 3 qian), Bai Shao (Paeoniae Radix Alba, 2 qian), Dang Gui (Angelicae Sinensis Radix, 3 qian), Chai Hu (Bupleuri Radix, 5 fen), Bai Zhu (Atractodis Rhizoma, 1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 5 fen), decocted in water and taken orally.