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Citing Yang syndromes, such as cold damage (Shanghan) and external contraction, presenting with slight coldness of the four limbs, pathogenic heat entering the interior, dry stools, and red, scanty, and difficult urination, this is defined as Heat.

Only in Yin syndromes caused by internal injury, when Yang floats to the exterior, deficient heat remains between the skin and hair, and the Lung Qi is affected by pathogens, transmitting downward to the Bladder, causing urine to resemble ash-water, accompanied by Spleen/Stomach deficiency and inability to eat. Wu (Earth) combines with Gui (Water), transformed by deficient pathogens; although the urine is red like ash-water, there is no astringency or pain in the urethra during urination, but rather a sensation of smooth flow.

When patients take warm-tonifying medicines, they sometimes pass gas, indicating the expulsion of Yin-cold qi. Han Shi treated lower-jiao Cold using a method of wrapping hot ashes for moxibustion-like warming; after one or two bowel movements, one or two urinations, and slight sweating, it is known that Yin-cold qi has been expelled downward, signifying inevitable recovery. From this, I know that after taking Zhongtang Decoction, Lizhong Decoction, and various Aconite preparations...

Delirious speech (Zhenyu): If it is a Yang syndrome, one should remove blankets, allowing the chest and hands to be slightly exposed to wind, and press them firmly. After a long time, if the muscles and bones are no longer hot, it is not a Yang syndrome, but a true Yin syndrome.
The above paragraph will later differentiate the manifestations of delirium.

Mental confusion, delirious speech, feeling as if something is lost, hallucinating sights and sounds, having expectations, and upon inquiry, sometimes forgetting, sometimes knowing; the Spirit scatters and disintegrates, on what can life rely?
The loss of Spirit is precisely what is meant here.

Question: In Yin syndromes from internal injury, some resolve with sweating, while others resolve without sweating. Why?
Answer: Those resolving with sweating may be young adults whose fluids are still intact, or those treated early with warmth, or where transmission followed the meridians smoothly without reversal, or those who maintained their constitution through daily care; thus, all resolve via sweating. Those resolving without sweating may be elderly individuals with depleted Qi and Blood, or those treated too late missing the optimal window, or where pathogens lingered without transmitting, or those with weak constitutions due to lack of nourishment; thus, all resolve without sweating. Cases resolving with sweating may leave residual pathogens; cases resolving without sweating, how could pathogens be completely eliminated? Therefore, the patient becomes dull-witted and weak, unable to return to normal health. One must wait for dietary intake to gradually increase, relying on the mild moistening effect of food, to stabilize the interior and exterior, each maintaining its proper position. Physicians must understand this!

*Yanyi* states: Taiyin Yuansheng Stone combined with other herbs, applied topically for treating severe dermatological diseases (like leprosy), follows specific methods. For Yin syndrome cold damage, if fingernails and complexion appear cyanotic/black, six pulses are deep, fine, and rapid, epigastric fullness and hardness occur, restlessness and thirst arise, spontaneous sweating persists, delirium occurs intermittently, four limbs are cold, throat feels obstructed, and abdominal pain exists, auxiliary herbs must also be used. *Tujing Bencao* already records these methods, noting that stones from Jiezhou are of superior quality.

Ancient formulas do not use this; however, the famous formula "Zhengyang Dan" in *Huoren Shanghan* treats cold damage after three days, characterized by headache, high fever, and limb immobility.
Ingredients: Taiyin Yuansheng Stone, Niter (Xiaoshi), Sulfur (Liu Huang) (each 2 liang), Sand (1 liang).
Grind all four substances into fine powder, place in a clay bottle, seal tightly, and calcine around the bottle with half a jin of fire embers at a distance of one inch for about half a day, until the medicine turns blue-purple. Stop heating, let cool, and remove. Mix evenly with snow water collected in the twelfth lunar month, moisten, and place in a porcelain bottle. Dry in the shade under the north side of the house, then bury underground for twenty-seven days. Remove, grind finely, and make pills using wheat paste, sized like corn kernels. First, take a hot bath, then swallow one pill with Artemisia decoction, cover with clothes to induce sweating, which indicates recovery.