尺寸俱微者，厥阴受病也。当六七日发，以其脉循阴而络于肝，故烦满而囊缩。（微缓者，囊
必不缩。若外证发热，恶寒似疟，为欲愈候，宜桂枝麻黄各半汤也。若尺寸俱沉短者，囊必缩，宜
承气汤下之，方在可下证中。）
厥阴之为病，消渴，气上冲心，心中痛热，饥而不欲食，食则吐蛔，下之利
不止，乌梅丸主之。
伤寒，脉微而厥，至七八日肤冷，其人躁无暂安者，此脏厥，非蛔厥也。蛔厥者，其人当吐蛔，
令病者静而复烦也，此脏寒。蛔上入其膈，故烦，须臾复止。得食而呕又烦者，蛔闻食臭即出，其
人常自吐蛔。蛔厥者，乌梅丸主之。又治久痢。（脏厥宜四逆辈，极冷服之。）
乌梅（一百五十个） 干姜（五两） 黄连（八两） 当归（二两） 川椒 桂枝 附子 人
参黄柏 细辛（各三两）
异捣筛，合治之。以苦酒浸乌梅一宿，去核，蒸之二斗米下，饭熟捣成泥，和药令相得，内臼
中，与蜜再杵二千下，丸如梧桐子大，先食饮服十丸，日三服。稍加至二十丸，禁生冷、滑臭食物
等。
厥阴中风，脉微浮者为欲愈，不浮者为未愈。
脉迟，反以黄芩汤得彻其热，腹中应冷，当不得食，今反能食，此为除中，必死。
先厥后发热，下利必自止，而反汗出咽痛者，其喉为痹；发热无汗，其利自止，
若不止，必便脓血者，其喉不痹。
庞曰∶热少厥微，指头寒，嘿嘿不欲食，烦躁数日，小便自如，此热除也。宜干姜甘草汤。
（方在太阳证中。）
庞曰∶手足逆冷，皆属厥阴，不可下，亦不可汗。有须下证者，谓手足虽逆冷，或有温时，手
足虽逆冷而手足掌心必暖，非正厥也，故可消息汗下也。
伤寒一二日，至四五日，厥者必发热，前发厥者，后必发热，厥甚热亦甚，厥微热亦微。厥不
过五日，六日不厥者必愈。若六日厥者，必发热愈甚，仍下利也。
庞曰∶寒热而厥，面色不泽，冒昧者，当用绵衣包手足，令温暖，必大汗而解也。有不因大汗
下，而两手忽无脉，谓之双伏；或一手无脉，谓之单伏。或利止，如此必有正汗，急用四逆辈温之，
时有汗便安。脉终不出者，死。
下利，先厥后发热，利必自止。不尔，咽中痛，或喉痹；若便脓血者，其喉不痹。
厥而下利者，当不能食；反能食者，为除中，必死。能食反发热，脉数者，必发痈脓；厥而呕，
胸胁烦满，后必便脓血。
病者手足冷，小腹按之痛，此结冷在膀胱关元也。（当关元灸之。）发热下利，厥逆，躁不得
卧者，死。
病患手足厥冷，脉乍紧者，邪结在胃中，心下满而烦，不能饮食者，病在胸中，当吐之，宜瓜
蒂散。凡病可吐者皆宜此方。
瓜蒂 赤小豆（等分）
细末，别以香豉一合，热汤三盏，煮作稀糜，去滓。取汁和散一钱，温温顿服。不吐者，少少
加药再服，得吐快乃止。诸亡血虚家，不可与服。（有用丁香者吐之，多霍燥人。）
伤寒厥而心下悸，宜先治水，当服茯苓甘草汤，次治其厥，不尔，水渍入胃，必作利也。茯
苓甘草汤
茯苓 桂（各一两） 生姜（一两半） 甘草（半两）
细锉，水二升，煎一升，温饮一盏，悸止为度。
伤寒六七日，大下后，寸脉沉而迟，手足厥逆，下部脉不至，咽喉不利，唾脓
血，泄利不止者，为难治，宜麻黄升麻汤。（有不因下而自利加衄血者，亦宜此方。）
麻黄（一两） 升麻 当归（各半两） 知母 黄芩 葳蕤（各三钱） 芍药 天门冬 桂枝
茯苓 甘草 石膏 白术 干姜（各一钱半）
细锉，水二升半，先煮麻黄一二沸，去沫，内诸药，煮一升二合，去滓，温服一盏，如人行七
八里久，进一服，以汗出即住服。
本自寒，医复吐下之，寒格愈逆，食入口即吐，宜干姜黄芩汤。
干姜 黄芩 黄连 人参（各一两半）
细锉，水三升，煮取一升半，去滓。温服一盏。
下利，微热而渴，脉弱者自愈。脉数汗出亦然，紧为未解，发热而厥，七日下利，为难治。
凡厥，通用四逆汤，方在四逆证中。谓其脉浮迟，或微，或细，或沉，皆属里有寒也。
厥而脉滑者，为里有热，白虎汤主之。
知母 石膏（八两） 甘草（半两） 粳米（三合）
以水五升，煮米熟汤成，去滓。温服一盏，日三服，有渴加人参半两。
庞曰∶三阳皆有合病。凡合病者，有十四证，唯三阴无合病。
脉象在寸部和尺部都呈现微象的，是厥阴经受邪所致。这种病通常在发病后的第六或第七天发作，因为厥阴经脉循行经过阴器并联络肝脏，所以会出现心烦、胸胁胀满以及阴囊收缩的症状。（如果脉象微而缓，则阴囊一定不会收缩。如果伴有外部发热、恶寒且症状类似疟疾的表现，这是病情将要痊愈的征兆，适宜使用桂枝麻黄各半汤。如果寸部和尺部的脉象都沉而短，则阴囊一定会收缩，适宜用承气汤攻下，该方剂详见“可下证”章节。）
厥阴病的典型症状包括：口渴多饮，气向上冲撞心脏，心中感觉疼痛且有灼热感，虽然感到饥饿却不想进食，如果进食则会吐出蛔虫，如果误用攻下法会导致腹泻不止。这种情况应当以乌梅丸为主治方剂。
患伤寒病，脉象微弱且四肢厥冷，到了第七或第八天全身皮肤发冷，病人烦躁不安片刻不得安宁，这是脏厥（内脏阳气衰竭），而不是蛔厥（蛔虫引起的厥逆）。蛔厥的病人通常会吐出蛔虫，表现为病人时而安静时而烦躁，这是因为内脏虚寒。蛔虫上行进入膈部，所以引起烦躁，过了一会儿又停止。如果进食后出现呕吐并再次烦躁，是因为蛔虫闻到食物的气味就出来活动，这类病人经常自行吐出蛔虫。蛔厥应当用乌梅丸主治。此外，乌梅丸也用于治疗久痢。（脏厥适宜使用四逆汤类方剂，并且要极冷服用。）
乌梅（一百五十个） 干姜（五两） 黄连（八两） 当归（二两） 川椒 桂枝 附子 人参 黄柏 细辛（各三两）
将药材分别捣碎过筛，然后混合在一起。用醋浸泡乌梅一夜，去掉核，放在两斗米上蒸熟，待饭熟后将乌梅捣成泥状，与药粉混合均匀，放入臼中，再加入蜂蜜捣击两千下，制成梧桐子大小的药丸。饭前用温水送服十丸，每日三次。逐渐增加至二十丸。服药期间禁止食用生冷、滑腻及有异味的食物。
厥阴经感受风邪，脉象微浮的是病情将要痊愈，不浮的是尚未痊愈。
脉象迟缓，反而用黄芩汤来清除其热邪，腹部应该变冷，此时应当不能进食，现在反而能够进食，这是“除中”（胃气将绝的假象），必定死亡。
先出现四肢厥冷随后发热，腹泻自然会停止；但如果反而出现出汗和咽喉疼痛，说明喉部发生痹阻；如果发热但没有出汗，腹泻自然停止，如果腹泻不停止，必然会出现大便带脓血，此时喉部不会发生痹阻。
庞安石说：热势轻微，四肢厥冷程度也很轻，仅指尖发凉，神情沉默不想吃东西，烦躁持续数日，小便通畅自如，这说明热邪已除。适宜使用干姜甘草汤。（该方剂详见“太阳证”章节。）
庞安石说：手足逆冷，都属于厥阴病范畴，不可使用攻下法，也不可使用发汗法。如果有必须使用攻下法的情况，是指虽然手足逆冷，但偶尔会有温暖的时候，或者虽然手足逆冷但手心脚心必然是温暖的，这不是真正的厥逆，因此可以斟酌情况使用发汗或攻下法。
患伤寒病，从第一二天到第四五天，出现厥冷的必定会发热，先前出现厥冷的，随后必定发热，厥冷严重则发热也严重，厥冷轻微则发热也轻微。厥冷不超过五天，第六天不再厥冷的必定痊愈。如果第六天仍然厥冷，必定发热更加严重，同时伴有腹泻。
庞安石说：既有寒热往来又有四肢厥冷，面色无光泽，头昏目眩的，应当用绵衣包裹手脚，使其温暖，必定通过大汗而解表痊愈。有的不是通过大汗导致下肢脉搏消失，称为“双伏”；或者一只手没有脉搏，称为“单伏”。或者腹泻停止，像这样的情况必然会有正常的汗出，急需使用四逆汤类方剂温补，有时即使有汗也会安定。如果脉搏始终无法恢复，则死亡。
腹泻，先出现四肢厥冷随后发热，腹泻必定自行停止。否则，咽喉疼痛，或者喉部痹阻；如果大便带脓血，则喉部不会痹阻。
出现厥冷并伴有腹泻的，应当不能进食；如果反而能进食，这是“除中”，必定死亡。如果能进食且反而发热，脉象数的，必然会引发痈脓；出现厥冷并呕吐，胸胁烦闷胀满的，随后必然大便带脓血。
病人手足冰冷，小腹部按压时疼痛，这是寒邪凝结在膀胱关元穴部位。（应当在关元穴进行艾灸。）如果发热、腹泻、四肢厥逆、烦躁无法躺卧的，属于死证。
病患手足厥冷，脉象突然变得紧实的，说明邪气结聚在胃中，心下部胀满且烦躁，不能饮食的，病位在胸中，应当使用催吐法，适宜使用瓜蒂散。凡是适合催吐的病证都适宜使用此方。
研成细末，另外取香豉一合，热水三盏，煮成稀粥状，滤去渣滓。取药汁调和药散一钱，温热顿服。如果不吐，少量增加药量再服，直到吐出感到畅快为止。所有失血者和体质虚弱的人，不可服用。（有人使用丁香催吐，大多导致霍乱燥热之人病情加重。）
患伤寒病出现厥冷且心下悸动，应当先治疗水饮，适宜服用茯苓甘草汤，然后再治疗厥冷，否则，水气浸渍入胃，必然导致腹泻。茯苓甘草汤
切碎，用水二升，煎煮至一升，温热饮用一盏，以心悸停止为度。
患伤寒病六七天，经过猛烈攻下后，寸脉沉而迟，手足厥逆，下部脉搏摸不到，咽喉不利，唾吐脓血，腹泻不止的，属于难治之症，适宜使用麻黄升麻汤。（有的不是因攻下而自利并加上鼻出血的，也适宜使用此方。）
麻黄（一两） 升麻 当归（各半两） 知母 黄芩 葳蕤（各三钱） 芍药 天门冬 桂枝 茯苓 甘草 石膏 白术 干姜（各一钱半）
切碎，用水二升半，先煮麻黄一二沸，去掉浮沫，加入其他药物，煎煮至一升二合，滤去渣滓，温热服用一盏。大约行走七八里的时间后，再服用一次，以出汗为度即停止服药。
原本就是寒证，医生又错误地使用吐法和下法，导致寒邪格拒更加逆乱，食物入口即吐，适宜使用干姜黄芩汤。
切碎，用水三升，煎煮取一升半，滤去渣滓。温热服用一盏。
腹泻，伴有轻微发热和口渴，脉象弱的会自愈。脉数且出汗的也是如此，脉紧表示病邪未解，发热且厥冷，持续七日腹泻的，属于难治。
凡是厥逆，通用四逆汤，该方剂详见“四逆证”章节。这是因为脉象浮迟，或微弱，或细，或沉，都属于里有寒邪。
用水五升，煮米熟汤成，滤去渣滓。温热服用一盏，每日三次，如果有口渴症状，加人参半两。
When the pulse at both the Cun (inch) and Chi (cubit) positions is faint (Wei, weak/faint), it indicates that the Jueyin (Jueyin Meridian Disease) has been affected. This condition typically manifests on the sixth or seventh day of onset because the Jueyin meridian courses through the genitalia and connects with the Liver; therefore, symptoms include irritability, chest and hypochondriac fullness, and retraction of the scrotum. (If the pulse is faint and slow, the scrotum will certainly not retract. If external signs such as fever and aversion to cold resembling malaria are present, this is a sign of impending recovery, and Guizhi Mahuang Ge Ban Tang [Cinnamon Twig and Ephedra Half-Dose Decoction] should be used. If the pulses at both Cun and Chi are deep and short, the scrotum will certainly retract, and Chengqi Tang [Stomach-Clearing Decoction] should be used to purge the interior; see the "Purgative Patterns" chapter for the formula.)
The hallmark manifestations of Jueyin disease are: excessive thirst (Xiao Ke), Qi rushing up to the heart, pain and burning sensation in the heart region, hunger without desire to eat, vomiting of roundworms upon eating, and intractable diarrhea if purged inappropriately. Wumei Wan [Mume Pill] is the primary treatment.
In Shaoyang disease, if the pulse is faint and there is cold extremities (Jue), progressing to the seventh or eighth day with whole-body skin coldness and restlessness without respite, this is Zang Jue (Visceral Cold Reversal), not Hui Jue (Roundworm Reversal). Patients with Hui Jue typically vomit roundworms and exhibit alternating periods of quietness and irritability due to visceral cold. When roundworms ascend into the diaphragm, irritability occurs but subsides shortly after. Vomiting accompanied by renewed irritability after eating occurs because the worms emerge upon smelling food odor; these patients often spontaneously vomit roundworms. Hui Jue is treated with Wumei Wan. It is also used for chronic dysentery. (Zang Jue should be treated with Sini Tang [Frigid Extremities Decoction] category formulas, administered cold.)
Wumei (150 fruits), Ganjiang (Dried Ginger, 5 liang), Huanglian (Coptis Rhizome, 8 liang), Danggui (Angelica Sinensis Root, 2 liang), Chuanjiao (Sichuan Pepper), Guizhi (Cinnamon Twig), Fuzi (Prepared Aconite Root Lateralis), Renshen (Ginseng Root), Huangbai (Phellodendron Bark), Xixin (Asarum Root) (each 3 liang).
Grind each herb separately and sieve, then mix. Soak Wumei in vinegar overnight, remove pits, steam over two dou of rice until cooked, then pound into a paste. Mix with the herbal powders, place in a mortar, add honey, and pound two thousand times until uniform. Form pills the size of paulownia seeds. Take ten pills before meals with warm water, three times daily. Gradually increase to twenty pills. Avoid cold, slippery, and strong-smelling foods.
In Jueyin wind-stroke, a slightly floating pulse indicates impending recovery; a non-floating pulse indicates no recovery.
A slow pulse treated incorrectly with Huangqin Tang [Scutellaria Decoction] to clear heat should result in abdominal coldness and an inability to eat. If the patient suddenly regains the ability to eat, this is Chu Zhong (Elimination of the Middle/False Appetite), indicating certain death.
If cold extremities precede fever, diarrhea will cease spontaneously. However, if sweating and sore throat occur instead, Bi syndrome of the throat develops. If fever occurs without sweating and diarrhea ceases spontaneously, but persists, pus and blood will appear in the stool, and the throat will not be bi-blocked.
Pang Anshi states: Mild heat and slight cold extremities, with cold fingertips, silence, anorexia, and irritability lasting several days, with normal urination, indicates the elimination of heat. Ganjiang Gancao Tang [Dried Ginger and Licorice Decoction] is appropriate. (See "Taiyang Patterns" for the formula.)
Pang Anshi states: Cold reversal of the hands and feet belongs to Jueyin; purgatives and diaphoretics are contraindicated. However, if purgation is necessary, it refers to cases where hands and feet are cold but occasionally warm, or where palms and soles remain warm despite cold extremities; this is not true Jue, so diaphoresis or purgation may be considered cautiously.
In Shaoyang disease from day one or two to four or five, cold extremities must be followed by fever. Previous cold reversal is followed by subsequent fever; severe cold reversal corresponds to severe fever, and mild cold reversal to mild fever. If cold reversal does not exceed five days, and ceases on the sixth day, recovery is certain. If cold reversal persists on the sixth day, fever will intensify, accompanied by persistent diarrhea.
Pang Anshi states: In cases of alternating chills and fever with cold extremities, lusterless complexion, and dizziness, wrap the hands and feet in cotton cloth to keep them warm; profuse sweating will lead to resolution. Some cases do not resolve via profuse sweating but present with absent radial pulses in both hands, termed Shuang Fu (Double Hidden Pulse); or absent pulse in one hand, termed Dan Fu (Single Hidden Pulse). If diarrhea stops, normal sweating must follow; urgently administer Sini Tang [Frigid Extremities Decoction] category formulas to warm. If sweating occurs, the patient stabilizes. If the pulse never returns, death ensues.
In diarrhea, if cold extremities precede fever, diarrhea ceases spontaneously. Otherwise, sore throat or throat Bi occurs; if pus and blood appear in stool, the throat is not Bi-blocked.
In cold reversal with diarrhea, anorexia is expected. If the patient can eat, this is Chu Zhong, indicating certain death. If able to eat and febrile with a rapid pulse, carbuncles and abscesses will develop. In cold reversal with vomiting and chest/hypochondriac irritability, pus and blood will subsequently appear in the stool.
Patients with cold hands and feet and tenderness upon palpation of the lower abdomen indicate cold stagnation in the Bladder Guan Yuan area. (Moxibustion should be applied to Guan Yuan.) Fever, diarrhea, cold reversal, and restlessness preventing lying down indicate a fatal prognosis.
Patients with cold hands and feet and a suddenly tight pulse indicate pathogenic accumulation in the Stomach. Fullness and irritability in the epigastrium with inability to eat indicate the pathology is in the Chest; emesis is indicated. Gouti San [Seeds of Melon Trichosanthes Powder] is appropriate. This formula is suitable for all conditions requiring emesis.
Gouti (Thistle Fruit), Chixiaodou (Red Adzuki Bean) (equal parts).
Grind into fine powder. Separately, decoct Xiangchi (Prepared Soybean) one he with three cups of hot water until a thin porridge forms, strain. Mix one qian of the powder with the decoction and take warm in one dose. If vomiting does not occur, gradually increase the dose and retake until comfortable vomiting ensues. Contraindicated in patients with blood loss or deficiency. (Some use Dingxiang [Clove] for emesis, which often aggravates Huoxuan [Cholera-like] dryness.)
In Shaoyang disease with cold reversal and epigastric palpitations, treat the water retention first with Fuling Gancao Tang [Poria and Licorice Decoction], then treat the cold reversal. Otherwise, water infiltrating the Stomach will cause diarrhea.
Fuling (Poria), Guizhi (Cinnamon Twig) (each 1 liang), Shengjiang (Fresh Ginger, 1.5 liang), Gancao (Licorice Root, 0.5 liang).
Coarsely chop, decoct in two sheng of water to one sheng. Drink one wan warm until palpitations cease.
After severe purgation in Shaoyang disease on the sixth or seventh day, if the Cun pulse is deep and slow, hands and feet are cold, lower pulses are imperceptible, throat is obstructed, spitting of pus and blood occurs, and diarrhea is intractable, this is difficult to treat. Mahuang Shengma Tang [Ephedra and Corydalis Decoction] is appropriate. (Also applicable to spontaneous diarrhea with epistaxis not caused by purgation.)
Mahuang (Ephedra Herb, 1 liang), Shengma (Corydalis Rhizome), Danggui (Angelica Sinensis Root) (each 0.5 liang), Zhimu (Anemarrhena Rhizome), Huangqin (Scutellaria Root), Weirui (Polygonatum Rhizome) (each 3 qian), Shaoyao (Peony Root), Tianmendong (Asparagus Tuber), Guizhi (Cinnamon Twig), Fuling (Poria), Gancao (Licorice Root), Shigao (Gypsum Fibrosum), Baizhu (Atractylodes Macrocephala Rhizome), Ganjiang (Dried Ginger) (each 1.5 qian).
Coarsely chop, decoct in two and a half sheng of water. Boil Mahuang briefly, skim foam, add other herbs, boil to one and two-tenths sheng, strain. Drink one wan warm. After walking for the time it takes to cover seven or eight li, take another dose. Stop administration once sweating occurs.
For pre-existing cold patterns mistakenly treated with emesis and purgation, leading to increased cold rejection and immediate vomiting upon ingestion, Ganjiang Huangqin Tang [Dried Ginger and Scutellaria Decoction] is appropriate.
Ganjiang (Dried Ginger), Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), Renshen (Ginseng Root) (each 1.5 liang).
Coarsely chop, decoct in three sheng of water to one and a half sheng, strain. Drink one wan warm.
In diarrhea with mild fever and thirst, a weak pulse indicates self-healing. A rapid pulse with sweating indicates the same. A tight pulse indicates unresolved pathogen. Fever with cold reversal and diarrhea persisting for seven days is difficult to treat.
For general cold reversal, Sini Tang [Frigid Extremities Decoction] is universally used. See "Sini Patterns" for the formula. This applies when the pulse is floating and slow, or faint, or fine, or deep, indicating interior cold.
Cold reversal with a slippery pulse indicates interior heat; Baihu Tang [White Tiger Decoction] is the primary treatment.
Zhimu (Anemarrhena Rhizome), Shigao (Gypsum Fibrosum) (each 8 liang), Gancao (Licorice Root, 0.5 liang), Jingmi (Rice, 3 he).
Decoct in five sheng of water until rice is cooked and liquid remains, strain. Drink one wan warm, three times daily. Add Renshen (Ginseng Root) 0.5 liang if thirst is present.
Pang Anshi states: The Three Yang meridians all have He Bing (Combined Disease). There are fourteen types of He Bing, but the Three Yin meridians do not have He Bing.