尺寸脉微缓者，厥阴受病也，当六七日发，其症少腹烦满而囊缩。（论见大法。《活人》云∶脉沉短囊缩者，承
气汤下之。）病者手足厥冷，言我不结胸，小腹满，按之痛者，此冷结在膀胱关元也。
少腹硬满，小便利者，为蓄血。若兼身黄发狂者，抵当汤主之。不身黄发狂者，抵当丸。但少腹急结者，
宜桃仁承气汤。（详见蓄血门。）伤寒表不解，干呕，发热而咳，或小便不利，少腹满者，小青龙去麻黄加
茯苓汤主之。（论见咳。）
不大便，日晡潮热，从心至少腹硬满而痛者，宜大陷胸汤。
〔《活》〕伤寒六七日，烦满囊缩，其脉尺寸俱微缓者，足厥阴肝经受病也。厥阴病，其脉微浮为欲愈，不
浮为未愈，宜小建中汤。脉浮缓者，必囊不缩，外症必发热恶寒似疟，为欲愈，宜桂枝麻黄各半汤。若尺寸俱
沉短者，必是囊缩，毒瓦斯入腹，宜承气汤下之。大抵伤寒病脏腑传变，阳经先受病，故次传入阴经，以阳主生，
故太阳水传足阳明土，土传足少阳木，为微邪也。阴主杀，故木传足太阴土，土传足少阴水，水传足厥阴木，
至六七日当传厥阴肝木，必移气克于脾土，脾再受邪，则五脏六腑，皆因而危殆，荣卫不通，耳聋囊缩，不知
人而死矣。速用承气汤下之，可保五生一死。古人云∶脾热病则五脏危。又，土为木贼则死。若第六七日传
厥阴，脉得微缓微浮，为脾胃脉也，故知脾气全不受克，邪无所容，否极泰来，荣卫将复，水升火降，则寒
热作而大汗解矣。
〔海〕厥阴症者，烦满囊缩，大小便不通，发热引饮，腹满，尺寸脉微缓。烦者火也，满者木也，虽不吐
蛔，囊缩但急者，亦木也。火与木相合，四肢厥逆而爪甲青，大小便不通，地道塞也。发热引饮，邪气在里，
宜温之下之。
以上诸症，大小便俱通，地道不塞，不发渴，不引饮，邪不在里，则宜温之灸之，则里外相接，以复阳
气。宜服正阳散
麝香（一钱。细研，性辛温，治腹急满痞风毒） 干姜（炮） 甘草（炙。各二钱半） 附子（一两。
炮，去皮脐，味辛咸温，治风利窍，疗腹满囊缩） 皂角（二两，酥炙，去皮弦，味咸温）
上为细末，每服二钱，白汤下，温服。
回阳丹
硫黄（半两，味酸温大热，治心腹肿聚邪气，冷癖左胁气咳上气，脚冷无力） 附子（炮，半两） 干
姜（炮，二钱半） 木香（半两，味辛温，疗肌中偏寒、主
气不足乏精） 全蝎（半两，味甘辛，治一切风） 荜澄茄（半两，味辛温，治皮风心腹气胀） 吴茱萸（半两
洗炒，味辛温大热，治中风逐邪，诸食不消，气逆，利五脏顺气。）
上为末，酒糊丸，如桐子大。生姜汤下三五十丸，并二三服，以热投之，衣被取汗。
脉象尺寸部均呈现微缓之象，这是厥阴经受邪所致，通常在发病后的第六七日出现，症状表现为少腹部烦闷胀满且阴囊收缩。（相关论述见“大法”篇。《活人书》记载：若脉象沉短且伴有阴囊收缩者，应用承气汤攻下。）患者手足冰冷，自述没有结胸证，但小腹胀满，按压时感到疼痛，这是寒气凝结在膀胱经的关元穴部位。
少腹部坚硬胀满，小便通畅的，属于蓄血证。如果同时伴有身体发黄、发狂的症状，主治方剂为抵当汤。若无身体发黄和发狂症状，则使用抵当丸。仅见少腹拘急结聚的，适宜使用桃仁承气汤。（详细内容详见“蓄血门”。）伤寒表证未解，伴有干呕、发热且咳嗽，或者出现小便不利、少腹胀满的情况，主治方剂为小青龙汤去麻黄加茯苓汤。（相关论述见“咳”篇。）
大便不通，下午申时左右出现潮热，从心窝直到小腹坚硬胀满且疼痛的，适宜使用大陷胸汤。
〔《活人书》〕伤寒病六七日，出现烦闷胀满、阴囊收缩，脉象尺寸两部都微缓的，是足厥阴肝经受病。厥阴病，若脉象微浮表示将要痊愈，若不浮则表示未愈，适宜用小建中汤。若脉象浮缓，必然不会出现阴囊收缩，外在症状必定是发热恶寒类似疟疾，这是将要痊愈的表现，适宜使用桂枝麻黄各半汤。若尺寸两部脉象都沉短，必然会出现阴囊收缩，毒邪之气入腹，适宜用承气汤攻下。
大抵伤寒病的脏腑传变规律，阳经先受病，所以依次传入阴经。因为阳主生发，所以太阳水经传给足阳明土经，土经传给足少阳木经，这属于轻微的邪气。阴主肃杀，所以木经传给足太阴土经，土经传给足少阴水经，水经传给足厥阴木经。到了第六七日应当传入厥阴肝木经，此时必然会有移气克制脾土的现象。脾再次受到邪气侵袭，那么五脏六腑都会因此陷入危险，营卫之气不通，导致耳聋、阴囊收缩、神志昏迷而死亡。此时应迅速使用承气汤攻下，可以保住五分生机，死里逃生。古人说：脾热病则五脏危殆。又说，土被木贼（克制）则死。如果第六七日传入厥阴，脉象得到微缓或微浮，这是脾胃的脉象，所以知道脾气完全不受克制，邪气无处容身，否极泰来，营卫之气即将恢复，水火既济（水升火降），那么寒热发作并大汗出而病解。
〔海藏〕厥阴症的表现是：烦闷胀满、阴囊收缩、大小便不通、发热且想喝水、腹部胀满、脉象尺寸部微缓。烦是因为火，满是因木，虽然不吐蛔虫，但只要阴囊收缩且拘急，也是木邪所致。火与木相结合，导致四肢厥逆且指甲青紫，大小便不通，这是地道闭塞。发热且想喝水，说明邪气在体内，适宜用温法配合攻下法治疗。
以上诸症，若大小便都通畅，地道不闭塞，不发渴，不想喝水，说明邪气不在体内，则适宜用温法和灸法，使里外气机相接，以恢复阳气。适宜服用正阳散：
麝香（一钱，细研，性味辛温，治疗腹部拘急胀满痞塞及风毒）、干姜（炮制）、甘草（炙，各二钱半）、附子（一两，炮制，去皮脐，性味辛咸温，治疗风利窍道，疗治腹满阴囊收缩）、皂角（二两，用酥炙，去皮弦，性味咸温）。
以上药物研为细末，每次服用二钱，用白开水送服，温服。
回阳丹：
硫黄（半两，性味酸温大热，治疗心腹肿聚邪气、冷癖、左胁气咳上气、脚冷无力）、附子（炮制，半两）、干姜（炮制，二钱半）、木香（半两，性味辛温，治疗肌中偏寒、主治气不足乏精）、全蝎（半两，性味甘辛，治疗一切风证）、荜澄茄（半两，性味辛温，治疗皮风、心腹气胀）、吴茱萸（半两，洗净炒制，性味辛温大热，治疗中风逐邪、各种食物不消化、气逆、利五脏顺气）。
以上药物研为末，用酒糊制作成丸，如梧桐子大小。每次服用三五十丸，用生姜汤送服，连续服用二三服，服药后注意保暖取汗。
If the pulse at both the cun (distal) and chi (proximal) positions is slightly slow and moderate, it indicates that the Jueyin meridian has been affected by disease. This typically manifests on the sixth or seventh day of illness, with symptoms including irritability and fullness in the lower abdomen, along with retraction of the scrotum. (For related discussions, see "General Principles." *Liu Ren Shu* states: If the pulse is deep and short accompanied by scrotal retraction, treat with Chengqi Tang to purge.) The patient experiences cold extremities, denies having chest binding (Jie Xiong), but presents with fullness in the lower abdomen that is painful upon palpation; this is due to cold congealing at the Guanyuan acupoint of the Bladder meridian.
If the lower abdomen is hard and full, yet urination is free, this is Blood Stasis (Xu Xue). If accompanied by jaundice and mania, Dandang Tang should be administered. If there is no jaundice or mania, Dandang Wan is indicated. If only there is a sensation of urgency and knotting in the lower abdomen, Tao Ren Chengqi Tang is appropriate. (See "Blood Stasis Section" for details.) In cases where Shaoyang exterior syndrome remains unresolved, accompanied by dry retching, fever, and cough, or if there is difficulty in urination and fullness in the lower abdomen, Xiao Qinglong Tang without Ephedrae Herba (Mahuang) plus Poria (Fuling) is the primary treatment. (See "Cough Section" for discussion.)
When constipation occurs, tidal fever arises around the Shen hour (3-5 PM), and the abdomen from the heart region down to the lower abdomen is hard, full, and painful, Da Xianxiong Tang is indicated.
[*Liu Ren Shu*] In typhoid febrile diseases lasting six to seven days, presenting with irritability, fullness, and scrotal retraction, with pulses at both cun and chi positions being slightly slow and moderate, the Foot Jueyin Liver Meridian is affected. In Jueyin disease, a slightly floating pulse indicates impending recovery; if not floating, recovery has not yet occurred, and Xiao Jianzhong Tang is suitable. If the pulse is floating and moderate, scrotal retraction will not occur; external symptoms will likely include fever and aversion to cold resembling malaria, indicating impending recovery, and Guizhi Mahuang Ge Ban Tang is suitable. If the pulses at both cun and chi are deep and short, scrotal retraction will definitely occur, and toxic pathogens have entered the abdomen; Chengqi Tang should be used to purge.
Generally, in the transmission of typhoid febrile diseases among zang-fu organs, Yang meridians are affected first, subsequently transmitting to Yin meridians. Since Yang governs generation, the Taiyang Water meridian transmits to the Foot Yangming Earth meridian, which then transmits to the Foot Shaoyang Wood meridian; this constitutes a mild pathogenic factor. Yin governs destruction; thus, Wood transmits to the Foot Taiyin Earth meridian, Earth to the Foot Shaoyin Water meridian, and Water to the Foot Jueyin Wood meridian. By the sixth or seventh day, transmission reaches the Jueyin Liver Wood meridian. At this stage, Qi inevitably overacts upon Spleen Earth. If the Spleen suffers further pathogenic invasion, all five zang and six fu organs will become critical. With Ying and Wei qi circulation blocked, leading to deafness, scrotal retraction, and loss of consciousness, death ensues. Rapid purgation with Chengqi Tang can save one life out of ten risks. Ancients stated: "Spleen heat disease endangers the five zang organs." Also, "Earth destroyed by Wood leads to death." However, if on the sixth or seventh day, when transmitting to Jueyin, the pulse becomes slightly slow or slightly floating—indicating Spleen-Stomach pulses—it shows that Spleen Qi is not being overacted upon. Pathogens have no place to reside. As adversity turns to prosperity, Ying and Wei qi will recover, Water ascends and Fire descends, resulting in alternating chills and fever followed by profuse sweating and resolution of the disease.
[Hai Zang] Symptoms of Jueyin syndrome include irritability, fullness, scrotal retraction, obstruction of both stool and urine, fever with thirst, abdominal distension, and slightly slow/moderate pulses at cun and chi. Irritability stems from Fire; fullness stems from Wood. Even without vomiting roundworms, if the scrotum is retracted and tense, it also indicates Wood pathology. When Fire and Wood combine, it causes cold reversal of the four limbs and cyanosis of the fingernails, along with obstruction of stool and urine, blocking the "earthly pathway" (bowels/genitals). Fever with thirst indicates pathogens residing internally; warm methods combined with purgation are appropriate.
In the above syndromes, if both stool and urine pass freely, the earthly pathway is unblocked, there is no thirst or desire for fluids, and pathogens are not internal, then warming and moxibustion are indicated to connect interior and exterior qi and restore Yang Qi. Zhengyang San is suitable:
Moschus (She Xiang, 1 qian, finely ground; pungent and warm; treats abdominal urgency, fullness, stagnation, wind-toxin); Gingerum Zingiberis Recens Preparatum (Pao Gan Jiang, prepared); Glycyrrhizae Radix et Rhizoma Praeparatum cum Melle (Zhi Gan Cao, honey-fried; each 2.5 qian); Aconiti Lateralis Radix Preparata (Pao Fu Zi, prepared, skin and rootlet removed; pungent, salty, and warm; treats wind facilitating orifices, abdominal fullness, and scrotal retraction); Gleditsiae Sinensis Fructus cum Spina (Zao Jiao, 2 liang, fried with butter, skin and string removed; salty and warm).
Grind all into fine powder. Take 2 qian per dose, washed down with white water, taken warm.
Huiyang Dan:
Realgar? No, Sulfur (Liu Huang, 0.5 liang; sour, warm, and extremely hot; treats heart/abdominal swelling, masses, evil qi, cold accumulation, left hypochondriac qi cough, upper-rebellious qi, cold feet with weakness); Aconiti Lateralis Radix Preparata (Pao Fu Zi, prepared, 0.5 liang); Gingerum Zingiberis Recens Preparatum (Pao Gan Jiang, prepared, 2.5 qian); Aucklandiae Radix (Mu Xiang, 0.5 liang; pungent and warm; treats localized cold in muscles, qi deficiency, lack of essence); Scorpio (Quan Xie, 0.5 liang; sweet and pungent; treats all wind disorders); Galangali Fructus (Bi Cheng Qie, 0.5 liang; pungent and warm; treats skin wind, heart/abdominal qi distension); Evodiae Fructus (Wu Zhu Yu, 0.5 liang, washed and stir-fried; pungent, warm, and extremely hot; treats wind-stroke expelling pathogens, indigestion, rebellious qi, benefiting the five zang organs and smoothing qi).
Grind all into powder. Make pills using wine paste, sized like wisteria seeds. Take 30-50 pills per dose with ginger decoction. Administer two or three doses. Keep warm after administration to induce sweating.