[General Principle] Zhang Zhongjing stated: In Shaoyin disease, if diarrhea occurs and then stops spontaneously, accompanied by aversion to cold and a curled-up posture in bed, but the hands and feet remain warm, this condition is treatable.

[Commentary] Ke Qin stated: In Shanghan (Cold Damage) diseases, Yang Qi is paramount. Not only do Yin syndromes with Yang pulses indicate survival, but Yin diseases manifesting Yang symptoms are also treatable. The back belongs to Yang, and the abdomen belongs to Yin. Excess Yang leads to spasm (Jingbing), while excess Yin leads to a curled-up posture. If diarrhea occurs yet the hands and feet remain warm, it indicates the return of Yang Qi; therefore, it is treatable.

[General Principle] Zhang Zhongjing stated: When the pulse is tight at all three positions (Cun, Guan, Chi), with hot breath from the mouth, dry lips and oral cavity, nasal discharge, a curled-up posture, cold feet, coating on the tongue, and thirst, do not treat rashly. After seven days, if the patient has slight fever and warm hands and feet, this indicates the impending resolution of the disease. However, if after eight or more days there is sudden high fever, this is difficult to treat. If accompanied by aversion to cold, vomiting will likely occur; if accompanied by abdominal pain, diarrhea will likely occur.

[Commentary] Xu Shuwei stated: Although the fever is slight, the natural warmth of the hands and feet indicates that the Yin syndrome is resolving due to the arrival of Yang Qi.

[General Principle] Zhang Zhongjing stated: In Shaoyin disease, if the pulse is tight, and after seven or eight days, spontaneous diarrhea occurs, the pulse suddenly becomes faint, the hands and feet become warm, and the tightness of the pulse disappears, this indicates impending resolution. Even if there is irritability and diarrhea, it will heal spontaneously.

[Commentary] Wei Litong stated: This further explains why pathogenic factors in the Shaoyin meridian may resolve spontaneously. Generally, pathogens in the Zang organs constitute Interior syndromes requiring warming, while pathogens in the Jing meridians constitute Exterior syndromes requiring dispersal. However, the depth of meridian pathogen invasion varies, and individual constitutional strength differs. If Zheng Qi (Upright Qi) is weak and Xie Qi (Pathogenic Qi) is strong, medical intervention is necessary. If Zheng Qi is robust and the pathogen is superficial, the disease may resolve spontaneously after one cycle of the six meridians. This applies to all six meridians. The pulse and symptoms in this passage do not represent deficiency-cold diarrhea of the Shaoyin Zang organs, but rather the dissipation of cold pathogen in the meridian. Thus, the tight pulse loses its tightness and suddenly changes to a faint pulse. "Faint" here means slow and level, the opposite of "tight," not referring to a deficient or minute pulse. Furthermore, Zang organ diarrhea invariably presents with cold hands and feet; if warmth returns only after diarrhea stops, the pathology is different. Here, the hands and feet are warm despite ongoing diarrhea, indicating the pathogen is in the meridian, not the Zang organ. This clearly indicates impending resolution. Although there is irritability, there is no restlessness, which is not the image of Yin excess with returning Yang. Even if diarrhea has not stopped, the meridian pathogen is gradually dissipating. There is a principle that meridian pathogens can resolve spontaneously after passing through the meridian cycle; hence, the tightness disappears and the faint pulse appears.

[General Principle] Zhang Zhongjing stated: In Shaoyin disease, after eight or nine days, if the entire body and hands and feet become hot, it is because the heat is in the Bladder, and hematochezia (blood in stool) or hematuria (blood in urine) will certainly occur.

[Commentary] Wei Litong stated: Heat in the entire body and hands and feet after eight or nine days might seem like heat in the Taiyang or Yangming meridians. However, given that Shaoyin symptoms are present, such heat does not indicate a Yang meridian disease but remains a Yin meridian disease. The Kidney and Bladder are interior-exterior pairs; heat in the Kidney naturally spreads to the Bladder. The Bladder is the Fu organ of Taiyang, so the heat from the Fu organ disperses throughout the body via the Taiyang meridian. This confirms the disease is in the Yin meridian, not the Yang meridian, and consumes Yin fluids urgently. One cannot assume that Yin diseases becoming Yang are easily cured. The certainty of bleeding is stated regarding heat syndromes in the Taiyang Bladder meridian itself. Now, regarding heat syndromes transferring from the Shaoyin Kidney meridian to the Bladder meridian, bleeding is also certain. The Bladder, being interior-exterior to the Kidney and belonging to the Lower Jiao Blood Sea, is closely connected and shares the mechanism for bleeding with the Taiyang meridian. This refers to the most immediate manifestation. Without urgently draining the heat of the Lower Jiao, the Yin of the Shaoyin cannot be preserved. If blood stasis has not formed, Zhu Ling Tang (Polyporus Decoction) should be used; if blood stasis has formed, Di Dang Tang (Resident Beetle Decoction) should be used. Without these, rescue is impossible. This aligns with the principle of Taiyang invading Water. If bleeding has already occurred and heat is discharged with the blood, careful consideration is required.

[General Principle] Zhang Zhongjing stated: After diarrhea, if the pulse vanishes and the hands and feet are cold, but the pulse returns and the hands and feet become warm within a short time, the patient will live; if the pulse does not return, the patient will die.

[Commentary] Shen Jin'ao noted: The return of the pulse and the warming of the hands and feet are results of medical intervention.