《厥论篇》曰∶厥之寒热者,何也?阳气衰于下,则为寒厥。阴气衰于上,则为热厥。(阳,
谓足之三阳脉阴,谓足之三阴脉。下,谓足也。此言厥病之分寒热者,以足之阴阳六经,其气有偏盛
也。)热厥之为热也。必起于足下者,何也?(阳主外,而厥在内,故问之。)阳气起于足五指之
表,阴脉者,集于足下,而聚于足心,故阳气胜则足下热也。(足太阳脉,出于足小指之端外侧,
足少阳脉起出于足小指次指之端,足阳明脉出于足中指及大指之端,并循是阳而上,肝脾肾脉集
于足下,聚于足心,阴弱故足下热也。此言热厥之热在阴分者,以其阳盛阴也。)寒厥之为寒也。
必从五指,而上于膝者,何也?(阴主内而厥在外故问之。)阴气起于五指之里,集于膝下,而聚
于膝上,故阴气胜则从五指至膝上寒,其寒也。不从外皆从内也。(足太阴脉起于足下指之端内
侧,足厥阴脉起于足大指之端三毛中,足少阴脉起于足小指之下斜趋足心,并循足阴而上循股阴
入腹,故云集于膝下而聚于膝上也。此言寒厥之厥上于膝,以其阴胜阳也。)厥或令人腹满,或令
人暴不知人或至半日,远至一日,乃知人值者何也?阴气盛于上则下虚,下虚则腹胀满,阳气盛于
上则下气重上而邪气逆,则阳气乱则不知之也。(阴气盛于上,则腹胀满者,乃寒厥。阳气盛于
上则不知人者,乃厥热耳。)
《厥论篇》说:厥证有寒证和热证的区别,这是为什么呢?(答:)阳气在下部衰弱,就会发生寒厥。阴气在上部衰弱,就会发生热厥。(注:这里的“阳”,指的是足部的三条阳经;“阴”,指的是足部的三条阴经。“下”,指的是足部。这段话说明厥病分为寒证和热证,是因为足部阴阳六经的气机有偏盛偏衰的情况。)
热厥之所以表现为发热,且一定从脚底开始,这是为什么呢?(注:阳主表,而厥逆的病机在内,所以提出疑问。)阳气起始于足五指的表面,阴脉汇聚于脚底,并聚集在脚心,所以阳气胜则脚底发热。(注:足太阳经出于足小指外侧端,足少阳经起始于足次趾端,足阳明经出于足中趾及大趾端,都沿阳经向上行;肝、脾、肾的阴脉汇聚于足下,聚集于足心,因阴气虚弱故脚底发热。这说明热厥的热象在于阴分,是因为阳气盛而阴气虚。)
寒厥之所以表现为寒冷,且一定从五个脚趾开始,向上蔓延至膝盖,这是为什么呢?(注:阴主里,而厥逆的表现在外,所以提出疑问。)阴气起始于五个脚趾的内部,汇聚于膝下,并聚集于膝上,所以阴气胜则从脚趾到膝上都感到寒冷,这种寒冷不是从外部感受得来的,而是从内部产生的。(注:足太阴经起始于足大趾内侧端,足厥阴经起始于足大趾端丛毛中,足少阴经起始于足小趾之下斜向汇聚于足心,都沿足部阴经向上,沿大腿内侧进入腹部,所以云汇聚于膝下而聚集于膝上。这说明寒厥的厥冷上行至膝盖,是因为阴气胜而阳气虚。)
厥证有时让人腹部胀满,有时让人突然神志不清,或者半天、远则一天后才恢复意识,这是什么原因呢?(答:)阴气在上部过盛则下部空虚,下部空虚则腹部胀满;阳气在上部过盛则下部之气重而上逆,邪气随之上逆,导致阳气紊乱从而神志不清。(注:阴气盛于上导致腹胀满的,属于寒厥;阳气盛于上导致神志不清的,属于热厥。)
The *Jue Lun Pian* (Treatise on Jue) states: What is the reason for the cold and heat variations in Jue syndrome? (Answer:) When Yang Qi (Vital Energy of the Yang aspect) declines at the lower part, it results in Cold Jue. When Yin Qi (Vital Energy of the Yin aspect) declines at the upper part, it results in Heat Jue. (Note: "Yang" here refers to the three Yang meridians of the foot; "Yin" refers to the three Yin meridians of the foot. "Lower" refers to the feet. This passage explains that Jue diseases are classified into cold and heat types due to the excess or deficiency of Qi in the six meridians of the feet.)
Why does Heat Jue manifest as heat, necessarily starting from the soles of the feet? (Note: Yang governs the exterior, while Jue involves internal pathology, hence the inquiry.) Yang Qi originates at the dorsal surface of the five toes of the foot. The Yin meridians gather at the sole and converge at the center of the foot. Therefore, when Yang Qi prevails, the soles become hot. (Note: The Foot-Taiyang Bladder Meridian emerges from the lateral end of the little toe; the Foot-Shaoyang Gallbladder Meridian originates from the end of the fourth toe; the Foot-Yangming Stomach Meridian emerges from the ends of the middle and great toes, all ascending along the Yang meridians. The Yin meridians of the Liver, Spleen, and Kidney gather at the sole and converge at the center of the foot. Due to Yin deficiency, the soles become hot. This indicates that the heat of Heat Jue resides in the Yin aspect, caused by Yang excess and Yin deficiency.)
Why does Cold Jue manifest as cold, necessarily starting from the five toes and extending upward to the knees? (Note: Yin governs the interior, while Jue manifests externally, hence the inquiry.) Yin Qi originates within the five toes, gathers below the knees, and converges above the knees. Therefore, when Yin Qi prevails, coldness extends from the toes to above the knees. This coldness does not come from the exterior but arises from within. (Note: The Foot-Taiyin Spleen Meridian originates from the medial end of the great toe; the Foot-Jueyin Liver Meridian originates from the tuft of hair at the tip of the great toe; the Foot-Shaoyin Kidney Meridian originates below the little toe and slants toward the center of the foot, all ascending along the foot's Yin meridians, up the medial thigh, and into the abdomen. Thus, they gather below the knees and converge above them. This indicates that the coldness of Cold Jue extending to the knees is due to Yin excess and Yang deficiency.)
Why does Jue syndrome sometimes cause abdominal fullness, or sudden loss of consciousness, with recovery taking half a day or even up to a full day? (Answer:) When Yin Qi is excessive in the upper part, the lower part becomes deficient. Lower deficiency leads to abdominal distension and fullness. When Yang Qi is excessive in the upper part, Qi from the lower part rises heavily and reverses, causing pathogenic Qi to counterflow. This disrupts Yang Qi, leading to unconsciousness. (Note: Abdominal fullness caused by Yin excess in the upper part belongs to Cold Jue. Unconsciousness caused by Yang excess in the upper part belongs to Heat Jue.)