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Regarding the discourse on Shanghan (Cold Damage) disease, it began with the Yellow Emperor who opened the precedent, and Zhang Zhongjing's prescriptions established its categories. Superficial learning of later generations failed to grasp its depth. Those who formulated theories only stated: "If the pathogen is in the exterior, sweating may be induced; if in the interior, purgation may be applied," or alternatively, "sweating is contraindicated," or "purgation is contraindicated." There was never mention of warming the middle (warming the Middle Jiao/Spleen-Stomach). Zhang Zhongjing's *Shanghan Lun* states: "When both Cun (inch) and Chi (cubit) pulses are deep and fine, the Taiyin meridian is affected; when both Cun and Chi pulses are deep, the Shaoyin meridian is affected; when both Cun and Chi pulses are slightly slow and moderate, the Jueyin meridian is affected." Furthermore, regarding Taiyin syndrome: "In Taiyin disease, if the pulse is floating, sweating may be induced, and Guizhi Tang (Cinnamon Twig Decoction) is appropriate." It also states: "If the hands and feet are warm, with spontaneous diarrhea and no thirst, Sini Tang (Frigid Extremities Decoction) is appropriate." Regarding abdominal fullness with intermittent pain, Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction with Added Peony Root) is indicated. Regarding Shaoyin syndrome: "At the onset of Shaoyin disease, with fever and a deep pulse, Mahuang Xixin Fuzi Tang (Ephedra, Asarum, and Aconite Decoction) is used." Also, for Shaoyin disease persisting for two to three days, Mahuang Fuzi Gancao Tang (Ephedra, Aconite, and Licorice Decoction) is used. Additionally, for Shaoyin disease presenting with body pain, cold hands and feet, joint pain, and a deep pulse, Fuzi Tang (Aconite Decoction) is used. For Jueyin disease presenting with vomiting and diarrhea, cold extremities, and severe restlessness desiring death, Wuzhuyu Tang (Evodia Fruit Decoction) is used. Furthermore, for Shaoyin disease with a deep pulse, urgent warming is required, and Sini Tang (Frigid Extremities Decoction) is appropriate. These excerpts from Zhang Zhongjing's treatise represent excellent methods for treating the Three Yin diseases (Taiyin, Shaoyin, and Jueyin). However, contemporary clinical application remains incomplete. I have observed patients from the early Zhihe era up to the present thirty-plus years. Regardless of whether the annual climate is excessive or deficient, before the Summer Solstice, seven or eight out of ten patients suffering from Shanghan exhibit deep, fine, and rapid pulses in both hands. They predominantly suffer from chest and diaphragm fullness and oppression, or vomiting and regurgitation, or qi stagnation, or borborygmus, or abdominal pain. Although the pulse principles align with Zhang Zhongjing’s description of Three Yin diseases, the symptoms differ. Therefore, I dare not recklessly administer Zhang Zhongjing’s formulas for Three Yin diseases. When encountering a deep pulse accompanied by chest and diaphragm fullness, practitioners often immediately apply purgatives, which frequently leads to fatal outcomes. I once carefully administered Lizhong Wan (Regulate the Middle Pill) based on Zhang Zhongjing’s formula. For mild cases, patients felt immediate relief in the chest; for severe cases, the fullness and oppression persisted after half a day. In some cases where patients presented with deep, fine, and slow pulses, administering Sini Tang (Frigid Extremities Decoction) for warming proved too hot due to its potent medicinal force, subsequently causing irritability and restlessness. By comparing these manifestations and symptoms, I have formulated new prescriptions for treatment, obtaining many effective remedies that must be transmitted.

The preceding passage does not imply that Sini Tang (Frigid Extremities Decoction) is improperly warm; rather, Zhang Zhongjing lived at the end of the Han Dynasty, while Han Zhihe lived during the height of the Song Dynasty; the eras differed. If a patient presents with deep, fine, and rapid pulses in both hands—whether forceful or weak—or a short Guan (bar) pulse with weak strength, accompanied by chest and diaphragm blockage and oppression, and shortness of breath unable to connect, one should flexibly administer warming-the-middle herbs according to the pulse and symptoms. This method is highly adaptable.

If a patient’s hands and feet pulses are deep and slow, or moderate or tight, this indicates Cold in the Stomach. If the Cun (inch) pulse is short and weaker than the Guan (bar) and Chi (cubit) pulses, this signifies Excess of Yin and Deficiency of Yang. If accompanied by chest and diaphragm blockage and oppression, abdominal distension, bodily stiffness and urgency, and cold extremities, urgent warming is indicated.

From after Lichun (Start of Spring) until before Qingming (Clear and Bright), Wenzhong Tang (Warm the Middle Decoction) is appropriate. From after Qingming until before Mangzhong (Grain in Ear), Chupi Tang (Tangerine Peel Decoction) is appropriate. From after Mangzhong until before Liqiu (Start of Autumn), Qiwu Lizhong Wan (Seven-Ingredient Regulate the Middle Pill) is appropriate. These adjustments follow the seasonal changes.