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This condition presents with cold fingers and toes despite warmth in the body and head, caused by internal constraint of yang qi that cannot circulate to the extremities. The red tongue with a yellow coating indicates internal heat, while the wiry pulse and irritability show qi stagnation. Traditionally, this represents a yang-type inversion rather than yang collapse. Over time, the formula for this pattern was also applied to Liver–Spleen disharmony, marked by hypochondriac pain, distention, digestive irregularities, and a wiry pulse.