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Shanghan (Cold Damage), is the general term for all exogenous diseases. It includes minor syndromes, major syndromes, newly acquired syndromes, latent qi syndromes, combined syndromes, complicated syndromes, deteriorated syndromes, and recurrent syndromes. Its transmission is unpredictable, and life or death can be decided in an instant; it differs from miscellaneous diseases. However, *Nan Jing* (Classic of Difficult Issues, attributed to Bian Que) only mentions that "Shanghan comprises five types": one is Zhongfeng (Wind Strike), two is Shanghan (Cold Damage), three is Shiwen (Damp-Warmth), four is Rebing (Heat Disease), and five is Wenbing (Warm Disease). It only records the similarities and differences in pulse presentations, without detailing the symptomatology and treatment protocols. The explanation is vague, leaving students with no basis for study. Moreover, Zhongfeng is inherently Zhongfeng, Shanghan is inherently Shanghan, Shiwen is inherently Shiwen, and Wenre (Warm-Heat) is inherently Wenre; this distinction is already evident. Nevertheless, these conditions were all categorized under the Shanghan section because Zhang Zhongjing of the Eastern Han Dynasty authored *Shanghan Zabing Lun* (Treatise on Cold Damage and Miscellaneous Diseases), which was not circulated during his lifetime. Later, Wang Shuhe of the Jin Dynasty used fragmented manuscripts to supplement prescriptions and compose treatises, confusingly naming the work *Shanghan Lun* (Treatise on Cold Damage), rather than *Sishi Gan Zheng Lun* (Treatise on Seasonal Exogenous Syndromes). From then on, all exogenous diseases were collectively referred to as Shanghan, following ancient custom and popular usage. I also follow this custom, titling my work *Putong Shanghan Lun* (Popularized Treatise on Cold Damage).

People claim that among all diseases, none is more difficult to treat than Shanghan. I argue that treating Shanghan itself is not difficult; treating the combined syndromes of Shanghan is slightly more difficult; treating the complicated syndromes is relatively more difficult; treating the recurrent syndromes is even more difficult; and treating the deteriorated syndromes is the most difficult. This is because cold and heat may mix, dampness and dryness may intermingle, deficiency and excess may be confused, and yin and yang may be suspected and indistinguishable. Without rich clinical experience, agile hands and mind, and the ability to adapt flexibly to changing circumstances, one is certainly inadequate for such a heavy responsibility. I engage daily with Shanghan syndromes. As the proverb says, "Familiarity with Wang Shuhe's text is inferior to extensive clinical practice." This does not mean that those with extensive clinical practice need not read books; rather, it implies that only through extensive clinical practice can one truly understand the books. Yu Jiayan of the early Qing Dynasty once said, "Reading without insight leads to patients losing their lives." How profound these words are! I have specialized in Shanghan for over forty years. Here, I shall briefly state the essentials derived from my personal insights.

The Taiyang Meridian (Taiyang Channel) governs the skin and hair; the Yangming Meridian (Yangming Channel) governs the muscles; the Shaoyang Meridian (Shaoyang Channel) governs the interstices (Couli); the Taiyin Meridian (Taiyin Channel) governs the extremities; the Shaoyin Meridian (Shaoyin Channel) governs the blood vessels; and the Jueyin Meridian (Jueyin Channel) governs the tendons and membranes.
[Rongzhai's Note]: The term "Six Meridian Morphological Layers" originates from Zhou Xuehai's "Five, Nine, and Eleven Points Discussed with Friends on Reading Shanghan Lun." "Six Meridians" is a deeply entrenched orthodox terminology within the theory of *Shanghan Lun*. In this section, the Six Meridians are hypothetically assumed to represent six layers of the organism. Although sufficient justification cannot be fully provided, using them as provisional "codes" in specific pathological divisions is appropriate. Mr. Yun Tieqiao once stated: "The Six Meridians define the boundaries based on the disease manifestations presented by the human body." The Japanese scholar Tsuruoka Gen'i also wrote in *Yidan*: "The Six Meridians of Shanghan do not imply that the disease resides in the Six Meridians; they are merely used as markers for recording; when treatment is applied, one follows the syndrome without being rigidly bound by them." Fujimoto Ren stated more explicitly: "For what purpose were the names of Three Yin and Three Yang established? All diseases have six levels of difference, with distinct locations, pulses, and symptoms. Summarizing various theories, all regard the Six Meridians as hypothetical designations for disease location, rejecting the literal meaning of meridians." Generally speaking, the Six Meridians of Shanghan simply divide the pathological changes into six stages. However, there are many dynamic processes between the hyperactivity and decline of human physiological functions, making definitive division impossible. Therefore, Section 3 details the complex and intertwined syndrome clusters of the Six Meridian diseases.

Internally, the Taiyang Meridian governs the chest center; the Shaoyang Meridian governs the diaphragm center; the Yangming Meridian governs the epigastric region; the Taiyin Meridian governs the great abdomen; the Shaoyin Meridian governs the lower abdomen; and the Jueyin Meridian governs the hypogastric region.
[Xiu's Note]: This refers to the partial governance of the Sanjiao (Triple Burner) by the Six Meridians. *Nei Jing* (Inner Canon) states: The Upper Jiao is governed by the Heart and Lungs; the Middle Jiao by the Spleen and Stomach; the Lower Jiao by the Liver and Kidneys. This is a brief mention of the regional distribution of the Sanjiao and Zang-Fu organs. Viewing them together, the Six Meridians serve as the pathway for the transmission of exogenous syndromes, while the Sanjiao serves as their destination. Having studied Zhang Zhongjing's *Shanghan Lun*, I note frequent mentions of the chest center, heart center, below the heart, hypochondrium, stomach center, abdominal center, and hypogastric region. Although the Sanjiao is not explicitly named, it is described more clearly than in works specifically discussing the Sanjiao.
[Lian's Commentary]: Zhang Changsha's (Zhang Zhongjing's) method of treating Shanghan, although divided into Six Meridians, essentially encompasses the Sanjiao. Discussing the Six Meridians clarifies the gateways for pathogenic invasion, the pathways of meridian circulation, and the origins and transmission of disease. Encompassing the Sanjiao addresses the formation and transformation of disease due to the binding of tangible pathogens such as phlegm-fluids, water retention, blood stasis, and residues. I privately believe that when disease is in the body shell, one should distinguish the Six Meridian morphological layers; when disease enters the internal organs, one should differentiate the Sanjiao regions. One must carefully examine what pathogenic factors are involved and analyze the distinctions clearly to avoid confusion and negligence. The analytical method begins by distinguishing the Sanjiao regions. Above the diaphragm, clear Qi governs, corresponding to the Lungs and Heart. Below the diaphragm, turbid Qi governs, corresponding to the Spleen, Stomach, Large Intestine, Small Intestine, Kidneys, and Bladder. Between clear and turbid lies the diaphragm, which corresponds to the Liver and Gallbladder. From below the diaphragm upwards to the chest and laterally to the hypochondrium is the area where clear Qi and Body Fluids circulate. Diseases here are primarily due to phlegm-fluids and water retention being attacked by pathogens and binding with Qi. From the epigastrium and abdomen down to the hypogastric region, residues and turbid substances accumulate, allowing pathogens to attach and form Lower Jiao syndromes. This constitutes the main principles of the Upper, Middle, and Lower Sanjiao.