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A two- or threefold concurrence of interior, exterior, cold, heat, vacuity and repletion, excluding cold with heat or vacuity with repletion, which, involving contradictions in the nature of the disease, are known as complexes rather than combinations. Most disease patterns are combinations. For example, initial-stage externally contracted febrile diseases manifest as exterior patterns, which must be further differentiated as exterior cold or exterior heat. Enduring diseases presenting as vacuity patterns must be further differentiated into vacuity cold and vacuity heat. Clearly the principles follow a strict order of importance. Exterior cold and exterior heat patterns are primarily exterior patterns, and secondarily cold or heat patterns. Vacuity cold and vacuity heat patterns are primarily vacuity patterns and secondarily cold or heat patterns. In exterior-interior combinations, principle precedence varies from case to case. Compare complex.

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