In the original formula, add Shengma (Rhizoma Cimicifugae). Additionally add Gegen (Puerariae Radix) and Gancao (Glycyrrhizae Radix et Rhizoma) to resolve macules. Add a small amount of Baizhu (Atractylodis Macrocephalae Rhizoma) and Fuling (Poria) to remove dampness and promote urination. Use Renshen (Ginseng Radix), Huoxiang (Agastaches Herba), and Muxiang (Aucklandiae Radix) to harmonize the spleen and stomach and promote appetite. Decoct one qian (approx. 3-5g depending on historical context, here likely referring to a portion size for decoction) with water and take orally. After repeated administration, the macules recede, diarrhea stops, the body becomes warm, and consciousness returns. Subsequently administer Yigong San (Five-Agent Powder) or Zhizhong Tang (Decoction to Regulate the Middle) or other acrid-warm preparations for one to two doses. Within five days, the condition stabilizes, and medication can be stopped. Someone asked: "Although the illness has slightly improved, is it acceptable to stop medication?" I replied: "Medications are used to attack pathogens. The *Neijing* states that treatment aims at restoring balance. Once the pathogen is eliminated, forcing further medication may induce transformation syndromes. It is better to rely on dietary nourishment and wait for the true qi to recover. This is the principle of 'treating without medicine' and 'curing without intervention.' Recovery will likely occur within ten days." (One must carefully examine if purgation is indicated; Qianfu believed that when purgation is suitable, it should be performed.)

Huoren Shu (Manual of Living People) perspective: If a patient presents with alternating chills and fever accompanied by cold extremities, lackluster complexion, mental confusion, and sudden absence of pulse in both hands, or only one hand, this indicates that normal sweating (Zheng Han) is about to occur as a sign of righteous qi recovery. Wrap the hands and feet in cotton cloth to keep them warm, and immediately administer Wuweizi Tang (Schisandra Decoction), or combine it with Mahuang Xixin Gancao Tang (Ephedra, Asarum, and Licorice Decoction). At this time, profuse sweating will occur, leading to resolution of the disease.

Wuweizi Tang (Schisandra Decoction): Treats asthma and panting, submerged pulse, and cold extremities caused by Cold Damage.
Ingredients: Renshen (Ginseng Radix), Maidong (Ophiopogonis Radix, heart removed), Xingren (Prunus Armeniaca Seed, skin and tip removed), Shengjiang (Zingiberis Rhizoma Recens), Chenpi (Citri Reticulatae Pericarpium) (each 2.5 qian), Dazao (Jujubae Fructus) (two fruits), Wuweizi (Schisandrae Chinensis Fructus) (0.5 liang). Chop the ingredients, decoct with water, and take orally.

Dai Yuanli's perspective: Both Yin and Yang diseases can cause Jue (syncope/cold extremities), hence there are Yang Jue and Yin Jue, both indicating deep-seated disease. Among these two, Yang Jue is prone to misdiagnosis. One must inquire about the initial presentation. If initially the head was not painful, limbs were cold, legs were curled up with aversion to cold, or the patient sweated and preferred covering themselves with clothes, or had no thirst, or suffered from clear watery diarrhea, or had normal urination, and the person remained alert and quiet, this is Cold Jue, belonging to Yin within Yin. Si Ni Tang (Frigid Extremities Decoction) or Fuzi Lizhong Tang (Aconite Decoction to Regulate the Middle) are appropriate. If initially there was headache and fever with exterior Yang signs, and Jue developed after five to six days, although the limbs are cold, the patient may fear heat, desire water, toss arms and legs, suffer from restlessness and insomnia, constipation, dark urine, and often present with mental confusion, this is Heat Jue, belonging to Yang within Yin. Bai Hu Tang (White Tiger Decoction) or Da Cheng Qi Tang (Great Order the Qi Decoction) are appropriate. In Heat Jue, although hands and feet are cold, the fingernails remain warm, unlike Cold Jue where hands, feet, and nails are all cold. This is a key method for distinguishing Yin and Yang. Recently, some patients with Yang disease have extreme heat above the waist and constant coldness in both legs. This is because the Three Yin meridians do not ascend to the head, so there is no headache; the Three Yang meridians do not descend to the feet, so the feet are cold. Nanyang stated that in Cold Damage, hands and feet must be slightly cold; if they are naturally warm, it belongs to Taiyin. This explanation is insufficient. How could Yangming disease present with slightly cold hands and feet? Shaoyin and Jueyin diseases present with severe coldness, which cannot be described as "slightly cold." One should only say that among the Three Yin meridians, Shaoyin and Jueyin present with cold extremities, while only Taiyin presents with naturally warm hands and feet.

Tao Hua's perspective: Treatment of Yin and Yang Jue, if mistaken, leads to immediate death or life. Yang Jue originates in the Qi aspect of the Three Yang meridians due to cold pathogen invasion, starting with headache, fever, and aversion to cold, then transmitting to the Blood aspect of the Three Yin meridians, manifesting as Si Ni (Frigid Extremities) and Jue, sometimes with transient warmth, dry hard stool, delirium, thirst, tossing of limbs, aversion to heat rather than cold, abdominal pain with tenesmus, sticky diarrhea, dark scanty urine, and a deep, forceful pulse. This is a transmitted heat syndrome called Yang Jue. Extreme Yang generates Jue, meaning Yang syndrome mimics Yin: externally there is coldness, internally there is heat. This is generally due to unrelieved constipation causing stagnation of Qi and Blood, resulting in fluctuating hand temperature. Just as fire smelting gold turns it to water when extremely hot, or freezing water turns to ice but still bears weight: slight Jue implies slight heat, treated with Si Ni San (Frigid Extremities Powder); deep Jue implies deep heat, treated with Da Cheng Qi Tang. If this is not understood and hot medicines are administered, it is like adding firewood to save a fire. Yin Jue occurs when the Three Yin Blood aspect directly suffers cold pathogen invasion. Initially, there is no fever or headache, only aversion to cold and cold extremities extending beyond elbows and knees, curling up with desire to cover, no thirst, possibly abdominal pain, vomiting, diarrhea, clear urine, shivering, pale face, salivation, and a deep, slow, weak pulse. This is a True Cold syndrome directly entering the Yin meridians, not transmitting from Yang, called Yin Jue. Mild cases use Lizhong Tang (Regulate the Middle Decoction), severe cases use Si Ni Tang. Also, if a disease transmits from Yang meridians and currently presents as Yin syndrome with Jue, it is also Yin Jue. Furthermore, hands and feet are the extremities of Stomach Earth. Generally, Spleen/Stomach heat causes hot hands and feet; Spleen/Stomach cold causes cold hands and feet. This is the norm. However, extreme excess may transform into mixed characteristics, which is a variation. Students should study this diligently.

Wu Kun's perspective: Generally, Jue in Cold Damage indicates extreme depletion of righteous Qi, requiring rapid treatment. Yang Jue is caused by unresolved intense heat. Liu Hejian stated that limb coldness with chest/heart heat and constipation should be treated with Liang Ge San (Cool the Diaphragm Powder) to nourish Yin and retreat Yang, avoiding rapid purgation. If stool is not constipated, Huanglian Jiedu Tang (Coptis Decoction to Resolve Toxicity) is primary. For Jue syndromes treatable by purgation, there is dry feces inside. Palpate the umbilical area; hardness, fullness, or pain indicates dry feces. Flatus with foul odor or periumbilical stabbing pain confirms dry feces. Mild cases use Tiao Wei Cheng Qi Tang (Regulate the Stomach and Order the Qi Decoction), severe cases use Da Cheng Qi Tang. Alternatively, mix Xuanming Fen (Natrii Sulfas) with cool water (1-2 qian) for oral intake, which is also good. Or mix chicken egg white with honey and water, add Mangxiao (Natrii Sulfas) powder (2-3 qian), which is most effective. Yang Jue can be distinguished by a slippery pulse, ensuring accuracy. Yin Jue is caused by Kidney Qi deficiency and cold, external cold exposure, or error in administering cold/purgative medicines, leading to accumulation of Yin at the lower jiao and decline of Yang at the upper jiao, causing Jue. The pulse is deep, fine, and minute, disappearing upon pressure. Si Ni Tang should be used urgently to warm. Severe cold follows the protocol for Yin Du (Yin Toxin). Corpse Jue (Shi Jue) is described in classics: Shaoyin pulse does not reach, Kidney Qi is weak, Jing/Essence and Blood are deficient, rushing Qi is urgent, Zong Qi gathers, Blood knots below the Heart, Yang Qi retreats downward, Heat returns to the Yin thighs, interacting with Yin, causing insensibility. This is Shi Jue. Urgently puncture Qimen (LR14) and Juque (CV14). Bian Que cured the Crown Prince of Guo of Shi Jue by puncturing Sanyang Wuhui (GV20). This is because Yang meridians sink, Yin meridians rise, Zong Qi gathers and obstructs, there are severed Yang collaterals above and broken Yin ties below, causing pulse chaos, resulting in stillness, coldness, coma resembling death. Seek treatment methods in the Yin Du category. For Cold Damage with chills/fever, Jue, lackluster face, confusion, absent pulses in one or both hands, this indicates impending beneficial sweating, like rain following extreme heat. Wrap hands/feet warmly, urgently use Wuweizi Tang, or combine with Guizhi Mahuang Banxia Tang (Half-Guizhi Half-Mahuang Decoction) to induce sweat for cure. If pulse is absent and no sweat occurs, prognosis is fatal.

Acupuncture:
Treat Cold Damage with cold extremities: Dadu (SP2) (needle 1 fen).
Cold Damage with absence of all six pulses: Fuliou (KI7) (tonify to restore six pulses), Hegu (LI4), Zhongji (CV3), Zhigou (SJ6) (needle 1.5 cun, this point harmonizes pulse absence), Fuliou (KI7) (needle along bone downwards), Juque (CV14) (needle 3.3 cun), Qichong (ST30) (moxibustion 7 cones).
Corpse Jue: Shaoyin pulse does not reach, Kidney Qi is weak, Essence/Blood deficient, rushing Qi urgent, ascending to chest/diaphragm, Ying Qi gathers, Blood knots below Heart, Yang retreats, Heat returns to Yin thighs, interacting with Yin causing insensibility. This is Shi Jue, puncture Qimen (LR14).