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Sangdan Decoction (Mulberry and Cinnabar Decoction) and Sizhi Zijin Ding (Four-Juice Purple Gold Pill, composed of watermelon juice, reed rhizome juice, raw radish juice each 5 ladles, sugarcane juice 1 cup, with 0.5 fen of Zijin Ding ground into juice for mixing. This is an empirical formula by Xu Huixi) are examples. Although these formulas are miraculously effective, one must guard against the rise of cold pathogen after the heat pathogen recedes. I often see that after taking the medicine, although the patient's consciousness becomes clear, they experience deficiency-related irritability and spontaneous diarrhea, while their hands and feet remain cold, and they suffer from dry mouth and thirst craving drink. At this point, the treatment should shift to Jiji Tang (Jilin Ginseng 0.5 fen, Oryzae Semen Preparatum [Yuan Maidong] 1.5 qian, Raw Licorice Root 0.5 fen, Xian Lu Xia 1 qian, Dan Fu Pian 0.5 fen, Fresh Bamboo Leaf 20 slices, Sheng Jing Mi wrapped in Lotus Leaf 3 qian. This is a simple formula by Song Yushuo), which acts as if by magic. It must be understood that this is "extreme yang resembling yin," indicating that the patient's root qi is necessarily deficient. In severe cases, Danggui Sini Tang (Zhang Zhongjing's formula) may be used with Xipi Zhibao Dan (He Lianchen's empirical formula) mixed in. Or Wuzhi Jiangfu Tang (Chuan Guizhi 0.5 fen, Xi Heliu tender branches 3 qian, Zisu pangzhi 1.5 qian, Nen Sangzhi 2 chi, Taoshu nenzhi 1 chi, Zhen Xinjiang 1.5 qian, Xuanfuhua 3 qian, Qingcong Guan 5 cun. Shen Yunchen's empirical formula) may be used with Jufang Laifudan mixed in. All these methods can unblock yin, restore yang, clear the spirit, and reverse cold extremities. However, once the limbs become warm and yang returns, the treatment strategy must change immediately; overmedication must be avoided to prevent depletion of essence and fluids. This approach is designed for patients with deficient root qi at the lower jiao. If the root qi is not deficient, but the four extremities are cold due to fire stagnation in the collaterals, the appropriate treatment is Zhang Zhongjing's Sini San (Chuan Chaihu 0.8 fen, Xiao Zhishi 1.5 qian, Chi Shao 1.5 qian, Sheng Gancao 0.5 fen), added with Gouteng 3 qian, Tianxianteng 3 qian, Luoshiteng 3 qian, Nen Sangzhi 2 chi, and Jiegeng 1 qian, to disperse latent wind in the liver collaterals, allowing it to transform and resolve via the qi level. Furthermore, if symptoms include cold extremities, cyanotic nails, black lips, and constipation, one should refer to the method of "purging in jue syndrome." The appropriate treatment is Zhang Zhongjing's Dahuang Huanglian Xixin Tang combined with Jiangfu Tang to unblock and purge latent pathogens in the liver collaterals, allowing them to exit via the intestinal collaterals. This is also an orthodox treatment method. In cases where liver collateral blood stasis extends to the pericardium collaterals, causing simultaneous disease of the hand and foot jueyin meridians, characterized by coma, cold extremities, and blood jue resembling death, Tongqiao Huoxue Tang (Chi Shao 1 qian, Chuan Xiong 1 qian, Taoren 3 qian, Zanghonghua 0.5 fen, Qingcong Guan 5 cun, Xian Jiangzhi 2 drops, Hongzao 2 pieces, Shexiang 0.05 li. Wang Qingren's *Yilin Gaicuo* formula) should be used with Zhuhuang San taken once (Zhufen 0.02 fen, Xihuang 0.02 fen, Chen Sha 0.02 fen, Chuan Bei Mo 0.06 fen. Zhou Danshan's *Wen Zheng Zhi Gui* formula). After administration, patients often expectorate purple blood and viscous saliva, followed by clarity of spirit and warming of extremities. For clearing and venting brain collaterals, Guashuang Zixue Dan and Jisheng Lingxi Tang (Lingjiaojiao 1 qian, Xijiaojiao 0.8 fen, Sheng Shigao 4 qian, Sheng Gancao 0.6 fen, Xuanfuhua 3 qian, Ziwan 1.5 qian, Qianhu 1.5 qian, Xixin 0.03 fen. Yan Yonghe's *Jisheng Fang* formula) are most effective; secondarily, Xiling Zhenjing Tang also has special merits. These are all essential methods for clearing collaterals and venting qi. Details are provided in the section on "Kaitou Fa" involving blood accumulation.

Ten, the method of combining bitter-cold with sweet-cold, referred to by Chen Xiuyuan as "bitter-sweet transforming into yin" and by Wu Jutong as "sweet-bitter jointly transforming yin qi." This is because latent fire scorches fluids and consumes body liquids, or because the patient constitutionally lacks fluids. Although treatment requires bitter-cold herbs to clear fire, sweet-cold herbs must be included to generate fluids. This is the orthodox method for simultaneous burning of qi and blood levels. Mild cases use Baibu Jia Shengdi Huang Tang (Wang Mengying's formula), Qingzao Yangrong Tang (Wu Youke's formula), or Jiabai Baibu Tang (He Lianchen's empirical formula). Severe cases use Qianjin Shengdi Huang Jian, Zhunsan Sanhuang Shigao Tang, or Baihu He Huanglian Jiedu Tang (*Zhunsan Lei Fang*). If fever persists after sweating or rash eruption, stomach fluids are depleted; treatment should focus on sweet-cold herbs, slightly incorporating bitter-draining herbs to consolidate yin. Examples include Baihu Jia Renshen Tang (Zhang Zhongjing's formula), Renshen Hua Tang (*Zhunsan Lei Fang*), and Jiawei Lugeng Yinzi (He Lianchen's empirical formula). The newly formulated Wuzhi Yin (Fresh Shengdihuang juice 5 ladles, Fresh Jinchai Shi juice 5 ladles, Fresh Lugeng juice 2 ladles, Ya Li juice 2 ladles, Sugarcane juice 2 ladles, warmed by double boiling. He Lianchen's empirical formula) is particularly effective. This represents the method of sweet-cold combined with bitter-cold. In summary, bitter-cold combined with sweet-cold focuses on clearing and descending excess fire, while sweet-cold incorporated with bitter-cold focuses on clearing and nourishing deficiency heat. One must carefully distinguish between prior/subsequent and excess/deficiency when prescribing.

Eleven, the method of combining bitter-cold with sour-cold: bitter clears the stomach, sour drains the liver. Examples include Huangqin Tang (Zhang Zhongjing's formula) using Huangqin and Shaoyao together; Xijiao Huanglian Tang (*Waitai Mi Yao* formula) using Huanglian and Wumei together; Qingzhong Anqi Tang (Wang Hu's commentary on *Shanghan Lun*) using Huanglian, Huangbai, and Wumei together; Qingdu Huoxue Tang (Nie Jiuwu's formula) using Huangqin, Huanglian, Mutong, Chi Shao, and Shanzha together; and Lianmei Anwei Tang (Chuan Lianlian 0.06 fen, Chuan Lianzi 1 qian, Sheng Baishao 1.5 qian, Wumei Rou 0.03 fen, Guixu 0.08 fen, Lai Juhong 0.05 fen, Chao Chuanjiao 0.01 fen. Ye Tianshi's empirical formula) using Huanglian, Chuanlian, Wumei, and Baishao together. All these exemplify the *Neijing* principle of "sour-bitter draining heat." If stomach yin is already deficient, Wu's Lianmei Tang (Xiao Chuanlian 1 qian, Wumei Rou 1 qian, Lianxin Maidong 3 qian, Xi Shengdi 3 qian, Ejiao 2 qian. Wu Jutong's empirical formula) should be used, applying the sour-bitter combined with sweet-cold method. If stomach yang is already deficient, Wang's Anwei Tang (Mi Chao Ludangshen 1.5 qian, Dan Ganjiang 0.08 fen, Xiao Chuanlian 0.05 fen, Wumei Rou 0.05 fen, Chao Zhishi 0.08 fen, Chao Chuanjiao 0.02 fen. Tang Zongsan's new empirical formula) should be used, applying the sour-bitter combined with pungent-sweet method. Others include Zhang's Zhuzang Wan (*Jingyue Quanshu* formula) and Jiawei Zanglian Wan (He Lianchen's empirical formula); the former boils Huaimi with vinegar, the latter boils Hualian with vinegar, representing the method of bitter consolidating intestines and sour draining liver. Zanglian Liuwei Wan represents sour-bitter draining heat and sour-sweet transforming yin. Renshen Wumei Tang (Xiyangshen 1.5 qian, Wumei Rou 0.03 fen, Mugua 0.08 fen, Zhi Gancao 0.05 fen, Huaishanyao 3 qian, Daixin Shilianzi 1 qian. Wu Jutong's *Wenbing Tiaobian* formula) represents sour-sweet transforming yin and slight bitter draining heat. In short, although all employ sour-bitter draining heat, the principles differ, and each excels in different functions; select according to symptoms.

Twelve, the method of combining bitter-cold with salty-cold, utilizing the descending action of salty and bitter flavors. There are four aspects:
First, clearing and draining internal kidney urine toxins: Chen's Dueming Yin and Xiling Erxian Tang (both from *Yisha Cao*) have the greatest efficacy; Xiaobian Yinzi (Tongzi Xiaobian, fresh Shengdihuang juice, fresh Oujiu juice each 1 cup, Sheng Chuanbai infused juice 2 ladles. Pang Anchang's *Shanghan Zongbing Lun* formula), Hongbai San (Chensha 1 qian, Renzhongbai, Yuanmingfen each 0.05 fen, soaked in boiling water, strained and taken. Gong Juzhong's *Shoushi Xiandan* formula), Daochi San mixed with Sizhi Yin (Ximutong 1.5 qian, Sheng Ganshao 0.08 fen, Dan Zhuye 2 qian, decocted in 1 bowl of boiling water, then mixed with: fresh Shengdihuang juice, fresh Oujiu juice, fresh Maogen juice, Tongzi Xiaobian each 1 cup. He Lianchen's empirical formula), and Tongbian Sicao Tang all frequently yield excellent results.
Second, calming rebellious chong qi and nourishing fluids to save from burning: Ziyejiaofen Tang (*Yimen Falü* formula), Pingyang Qingli Tang (Liang's *Shejian Bianzheng* formula), and Jiabai Xiling Erxian Tang (He Lianchen's empirical formula) are most effective; Huanglian Ejiao Tang (Zhang Zhongjing's formula) mixed with 1 cup of Tongzi Xiaobian, and Sanjia Baiwei Tang (Sheng Biejia, Sheng Da Zuomuli, Sheng Guixinxin each 6 qian, Dong Baiwei 5 qian, Xiyangshen 1.5 qian, Guixu 1 qian, Sheng Ganshao 0.08 fen, decocted with silver and gold vessels as water. He Lianchen's empirical formula) are also extremely effective.
Third, clearing and unblocking external kidney seminal impurities: Qianjin Zhichi Jia Shigao Shushi Tang and Tao's Xiaoyao Tang (Tao Jian'an's *Shanghan Quansheng Ji* formula) are recommended first; secondly, Daochi San combined with Jiawei Huzhang San, or Zhuling Tang combined with Shushi San (all He Lianchen's empirical formulas) can be used. If seminal impurities accumulate in the uterus, often binding with turbid blood, symptoms include lower abdominal distension and pain radiating to waist and abdomen, unbearable stabbing pain, obstruction of urination and defecation, inability to sit or lie down, crying and groaning. Urgent treatment is required; delay leads to upward progression of pathology, resulting in ten deaths without cure. Urgently administer Shushe Tongjing Wan (Xiongshufen, Wangbuliuxing each 1 liang, Chao Heiqian Niu, Wulingzhi, Chao Chuannanjia, Taoren each 5 qian, Dunniumi powder 3 qian, Shexiang 0.03 fen, finely ground, pills made with fresh Leizhi juice, size of hemp seeds, dose 1 qian. He Lianchen's empirical formula) 1 qian or 1.5 qian, delivered with Qian Niu Lianshi Tang (Chao Heiqian Niu 3 qian, Yanshui Chao Chuan Lianzi 1.5 qian, Chao Chuannanjia 1 qian, Xiaohui Xiang 0.03 fen. Li Shizhen's empirical formula). Often, one dose reduces symptoms, three doses resolve them.
Fourth, nourishing ren mai yin essence: Danxi's Dabu Yin Wan is best; Zishen Yiyin Jian (Zhi Guiban, Da Shudi each 4 qian, Chuanbai 0.08 fen, Zhimu 2 qian, Sheng Ganshao 0.08 fen, Chuna Ren 0.06 fen. *Jinjian Fuke Xinfa* formula) is also effective. Others include Zishen Liuwei Tang (Zhimu 1.5 qian, Chuanbai 0.06 fen, Shudi 3 qian, Shanyurou 0.08 fen, Danpi, Zexie, Chifuling each 1.5 qian, Huaishanyao 4 qian, Zhi Guiban 3 qian, Mengzigu 0.02 fen, Tongzi Xiaobian 1 cup mixed), and Jiuyin Ziren Tang (Daheidou 3 qian, Shudi 2 qian, Maidong, Dong Sangye, Danpi, Shanyao, Nanshashen each 1.5 qian, Zhu Suizhui 1 strip, Qingyan 0.02 fen. All He Lianchen's empirical formulas) also show frequent efficacy.

The above twelve sections describe the items of the Cooling Method. Regarding heat: superficial heat in Ying and Wei uses Shigao and Huangqin as main herbs, with Chaihu and Gegen as auxiliaries; deep heat in Chest and Diaphragm uses Fenhua, Zhimu, Louren, Zhizi, and Douchi as main herbs; heat in Stomach and Intestines requires purgative methods rather than cooling, or purgatives combined with cooling; heat entering Pericardium uses Huanglian, Xijiao, and Lingyangjiao as main herbs; if heat enters the Heart directly, it is difficult to save; Niuhuang can save one in ten, requiring a dose of about 1 qian; less is ineffective, unlike pediatric convulsion formulas where small doses suffice, as stated by Dai Beishan. This only covers the general principles. The following details symptoms requiring cooling methods:

Heat in Ying and Wei: Fever with spontaneous sweating, aversion to cold replaced by aversion to heat, heaviness of body, redness and swelling of head, face, and neck, generalized redness and swelling, yellow whites of eyes, distending pain of eyeballs, dry nostrils, dry lips, irritability; mild cases present with rashes, severe cases with erysipelas-like spots; tongue coating white with crimson base, or white coating on sides with red center; or fever decreases while aversion to heat increases, cough with phlegm, wheezing, thirst or vomiting, purple-crimson tongue edges with pink-white coating in center.

Heat in Chest and Diaphragm, Qi level depression: Dry throat and sore throat, fullness and pain in chest and hypochondrium, even redness and swelling in anterior chest with intense heat on pressure, yellow urine; thick white and rough tongue coating, or yellow-greasy and dry, or vermilion points, or cracks, or yellow-white mixed, or grey-white.

Heat sinking into Pericardium and Heart, Blood level scorching: Delirium and mania, or lethargy and drowsiness, or irritability and insomnia, cold extremities, cyanotic-purple nails, loose black foul-smelling stool, red scanty or painful urination, crimson tongue without coating, or tongue with slight sticky coating (see Kaitou Fa symptoms).

Pathogenic heat attacking Brain, or Urine toxin ascending to Brain: Syncope and muteness, spasms of hands, resembling epilepsy, occasional tremors, independent shaking of head, even enuresis and fixed gaze, muscle twitching, grasping at empty air, picking at bedclothes, putrid tongue coating with occasional black spots, or black halos and petals.

Heat in Stomach and Intestines: Bloody stool, pus and blood in stool, delirious speech, abdominal fullness and pain, cracked lips, dry teeth, yellow-dry tongue coating (see Gongli Fa symptoms).

Heat sinking into Liver and Kidney: Milder during day, heavier at night, cool in morning, hot in evening, lackluster complexion, dry mouth and excessive thirst, qi rushing to heart, painful heat in heart, hunger without desire to eat, vomiting roundworms upon eating, cold extremities, irritability and insomnia, scanty painful urination, even urinary retention, cold waist and feet, constipation or loose stools, even watery diarrhea, crimson tongue without coating, dry-sticky and rough, or purple with black spots.

Heat sinking into Chong and Ren: Cool in morning, hot in evening, pulsation of Chong and Ren pulses, urgency in lower abdomen, spasm in genitals, even curled tongue and contracted testicles, scanty painful urination, males with spermatorrhea and backache, females with profuse leukorrhea; tongue color scorched purple with prickles like bayberry, or purple without coating with spots, or red without coating and gelatinously dry, or red with white fungal spots.