Pang stated: The *Suwen* (Plain Questions) records "Lianggan" (simultaneous contraction of exterior and interior meridians due to cold pathogen), where the pulse corresponds with the clinical manifestations. On the first day, Taiyang (Greater Yang meridian disease) and Shaoyin (Lesser Yin meridian disease) are both affected, presenting with headache, dry mouth, and irritability/fullness; on the second day, Yangming (Yang Brightness meridian disease) and Taiyin (Greater Yin meridian disease) are both affected, presenting with abdominal fullness, fever, anorexia, and delirium; on the third day, Shaoyang (Lesser Yang meridian disease) and Jueyin (Terminal Yin meridian disease) are both affected, presenting with deafness, retraction of the testicles, and cold limbs, inability to take in fluids, unconsciousness, leading to death on the sixth day. When it states "death on the sixth day," it implies that the Zang-Fu organs and Ying-Wei (Nutritive and Defensive Qi) have a certain circulation; thus, on the fourth day, Shaoyin and Taiyang are simultaneously affected, on the fifth day, Taiyin and Yangming are simultaneously affected, and on the sixth day, Jueyin and Shaoyang are simultaneously affected. This is a repeated transmission resulting in death on the sixth day. Regarding cases of "death on the third day," the *Suwen* states that Yangming is the leader of the five Zang organs and twelve meridians; when the pathogenic factor is abundant, consciousness is lost. By the third day, the Qi is exhausted, hence death. When the pathogenic factor is abundant, it manifests as excess (Shi). With excess pathogens in both the exterior and interior, they guide blood and Qi into the Stomach, preventing them from circulating through the Ying-Wei system. Consequently, blood and Qi are consumed along with the pathogens, leading to death on the third day. The pulse diagnosis described in the *Suwen* has been lost; I will now elaborate. Generally, a deep (Chen) pulse belongs to Yin. On the first day, the pulse should be deep and large; deep indicates Shaoyin, and large indicates Taiyang. On the second day, the pulse should be deep and long. On the third day, the pulse should be deep and wiry (Xian), conforming to the pulse pattern of exterior-interior combination. Deep-long and deep-wiry pulses are implicit within the deep-large pulse. Typically, Yin meridians do not present combined diseases alone; only the Three Yang meridians can present combined diseases. Now, since there is a combination of Three Yin and Three Yang, the pulse appears similar to deep-tight and large, or deep-solid and long, resembling the Ge pulse (Leather pulse), which is a fatal pulse sign.

Pang stated: In Shanghan (Cold Damage) on the first day, Juyang (another name for Taiyang) receives the pathogen; the Bladder meridian has been discussed in detail previously. The *Bingyuan* (Source of Diseases) mentions the Small Intestine meridian. Although this may confuse the root and branch, there are indeed simultaneous diseases (Bingbing) between hand and foot Yin-Yang meridians. Thus, the *Suwen* states: After six days, the Three Yin and Three Yang, Five Zang, and Six Fu organs are all diseased, Ying-Wei circulation ceases, and the Five Zang become blocked, leading to death. This is a sequential transmission of exterior and interior, which does not necessarily require Lianggan; there are also cases where death occurs after six days of transmission throughout the Five Zang and Six Fu organs. The *Suwen* states: All floating pulses without agitation indicate the disease is in the Yang meridians, manifesting as heat; if there is agitation, the disease is in the Hand meridians. For example, if the pulse on the first day is not agitated, it is the Foot Taiyang Bladder meridian that is primarily diseased; if the pulse shows agitation, it additionally involves the Hand Taiyang Small Intestine meridian. It further states: All fine and deep pulses indicate the disease is in the Yin meridians, manifesting as bone pain; if the pulse is quiet (non-agitated), the disease is in the Foot meridians. For example, if the pulse on the fourth day is quiet, it indicates the Foot Taiyin Spleen meridian is beginning to transmit the disease; if the pulse becomes rapid (Shuo), it additionally involves the Hand Taiyin Lung meridian. Thus, by the sixth day, the disease can spread throughout the Zang-Fu organs. "Agitation" refers to a rapid pulse, while "quiet" refers to a non-rapid pulse. Herbal treatment remains the same, but if acupuncture is used, one must select points from both the Foot and Hand meridians.