参附汤（补三七） 术附汤（补四一） 《神效》黄 汤（补四八 麻木） 人参膏（补一六
三） 地黄饮子（补九九） 青州白丸子（和百十二 痰气） 三生饮（热九四 痰盛） 愈风丹（
和二七四 血气受邪） 易老天麻丸（和二七五 血虚受邪） 交加散（和二五二 血虚经闭）
三建汤（热四二 阴厥） 神应养真丹（和三一三 瘫痪） 通关散（因九八） 续断丸（和三
百六 脚病） 酒浸牛膝丸（和三百八 腰脚无力） 调元健步丸（和三一一 下步无力）
《脉解篇》曰∶内夺而厥，则为喑俳，此肾虚也。少阴不至者，厥也。
详本篇之言厥者，以其内夺，谓夺其五内之精气也。喑，声不能出也。俳，肢体偏废也
。今人见此，必皆谓之中风，而不知由于内夺，由于肾虚。盖声出于肺而本乎肾，形强在血
而本乎精，精气之本皆主于肾，故少阴不至则为厥。又《调经论》曰∶志不足则厥。《本神
篇》曰∶肾气虚则厥。观此诸论，则非风之义可知矣。故凡治此者，当以前非风证治第三条
等法主之。
《调经论》∶岐伯曰∶气之所并为血虚，血之所并为气虚。帝曰∶人之所有者，血与气
耳。今夫子乃言血并为虚，气并为虚，是无实乎？岐伯曰∶有者为实，无者为虚。今血与气
相失，故为虚焉。血与气并，则为实焉。血之与气并走于上，则为大厥。厥则暴死。气复反
则生，不反则死。
气并为血虚，血并为气虚，此阴阳之偏败也。今其气血并走于上，则阴虚于下，而神气
无根，是即阴阳相离之候，故致厥脱而暴死。复反者轻，不反者甚。此正时人所谓卒倒暴仆
之中风，亦即痰火上壅之中风，而不知实由于下虚也。然上实者，假实也，其有甚者，亦宜
稍为清理；下虚者，若无实邪可据，则速当峻补其下。
《阳明脉解篇》曰∶厥逆连脏则死，连经则生。
观本篇之连经连脏，本以厥逆为言，何其明显平正。盖连经者病在肌表，故轻而生；连
脏者病在根本，故重而死。既知此为厥逆，则凡卒倒暴仆等证，其非风也可知，而河间诸公
，皆以中腑中脏为言，则是风非风始混乱而莫辨矣。
《大奇论》曰∶脉至如喘，名曰暴厥。暴厥者，不知与人言。
《解精微论》曰∶厥则目无所见。夫人厥则阳气并于上，阴气并于下。阳并于上，则火
独光也；阴并于下，则足寒，足寒则胀也。
详此二论，云脉至如喘者，谓脉之急促如喘，此血气败乱之候。故致暴厥不言，即今人
所谓中风不语之属也。云阳并于上，阴并于下，此即上热下寒，水火不交之候，故为目无所
见，即中风昏眩之属也。不语者，责在肺肾。昏眩者，责在肝脾。暂见者，气复则苏。阴败
者，最危之候。俱当按法如前而救其本。
《癫狂篇》曰∶厥逆为病也，足暴清，胸若将裂，肠若将以刀切之，烦而不能食，脉大
小皆涩。暖取足少阴，清取足阳明。清则补之，温则泻之。
暴清，即暴冷也。若裂若切，谓其懊 痛楚，莫可名状，此即所谓躁扰烦乱之中风
也。有火者，多温热而脉洪大，宜清阴中之火；有痰者，多喘壅而脉滑实，宜开上焦之痰；
无火无痰，多寒凉而脉涩弱，宜补其元气。凡证有若此而兼之昏乱不醒者，此真连脏之甚者
也。多不可治。
《生气通天论》曰∶阳气者，烦劳则张，精绝，辟积于夏，使人煎厥。阳气者，大怒则
形气绝，而血菀于上，使人薄厥。
此云煎厥者，即热厥之类。其因烦劳而病积于夏，亦今云暑风之属也。若见抽搐痰涎卒
倒者，当即以前暑风之法治之。薄厥者，急迫相搏之谓，因于大怒，即气厥血厥之属，治法
如后。
《通评虚实论》曰∶凡治消瘅仆击，偏枯痿厥，气满发逆，肥贵人，则膏粱之疾也。膈
塞闭绝，上下不通，则暴忧之病也。暴厥而聋，偏塞闭不通，内气暴薄也。不从内、外中风
之病，故瘦留着也。
详此膏粱之疾，即酒色之伤，脾肾之病也。暴忧之病，即悲忧伤肺之属也。内气暴薄，
即郁怒伤肝之属也，凡此皆内伤之病。其有不从内，而外中于风者，则必留着经络，故为消
瘦痛痹之病。是可见内伤外感之辨，其不可混言有如此。
《逆顺肥瘦篇》曰∶夫冲脉者，五脏六腑之海也，五脏六腑皆禀焉。其上者，出于颃颡
，渗诸阳，灌诸精。其下者，注少阴之大络，出于气街，循阴股内廉，入 中，伏行
骨内，下至内踝之后属而别。其下者，并于少阴之经，渗三阴。其前者，伏行出跗属，
下循跗，入大指间，渗诸络而温肌肉。故别络结则跗上不动，不动则厥，厥则寒矣。
详此冲脉之义，则上自头，下自足，后自背，前自腹。凡五脏六腑，十二经脉，无所不
禀，故称为五脏六腑十二经脉之海。夫海为百川之宗，凡诸经发源之处，即皆有会合之义，
其于通身血气盛衰皆归乎此可知也。然冲脉起于胞中，即其经络之所，亦即其聚蓄之所，故
称为血海，亦称为命门。此即所谓根本之宅也。若素纵情欲，以致精气之源伤败于此，则厥
脱暴仆等病，亦因于此。不然，则何以忽然仆倒而神形俱败，表里俱残，全无知觉，一至于
此，是岂一经一脏之病之所致欤？于此察之，则实由冲脉崩败必无疑矣。故凡治此者，欲舍
根蒂而求其济，吾知其必无是理也。冲脉详义具《类经·经络类》第二十七篇注中。
《缪刺论》曰∶邪客于手足少阴太阴足阳明之络，此五络皆会于耳中，上络左角。五络
俱竭，令人身脉皆动，而形无知也。其状若尸，或曰尸厥。剃其左角之发方一寸，燔治，饮
以美酒一杯，不能饮者灌之，立已。（仍有刺法，详二十七卷耳证门）
详此尸厥一证，乃外邪卒中之恶候。凡四时不正之气，及山魔土煞五尸魇魅之属，皆是
也。犯之者，忽然手足厥冷，肌肤寒栗，面目青黑，精神不守，或口噤妄言，痰涎壅塞，或
头旋运倒，不省人事，即名飞尸卒厥，宜用针法，具见本经。若用艾灸，则无如秦承祖灸鬼
法及华陀灸阳脱法为妙。凡用药之法，当知邪之所凑，必因气虚，故在本经即以左角之血余
，用补五络之脱竭，其义可知。若此危急之际，非用参附回阳等药，何以挽回？若果邪气壅
盛，胸膈不清，则不得不先为开通，然后调理，宜不换金正气散，流气饮，葱姜汤，苏合丸
之类酌而主之。
《方盛衰论》∶雷公请问，气之多少，何者为逆？何者为从？帝曰∶阳从左，阴从右，老
从上，少从下。是以气多少，逆皆为厥。问曰∶有余者厥耶？答曰∶一上不下，寒厥到膝。
少者，秋冬死。老者，秋冬生。气上不下，头痛癫疾，求阳不得，求阴不审，五部隔无征。
若居旷野，若伏空室，绵绵乎属不满日。是以少气之厥，令人妄梦，其极至迷。
此言气逆者，即为厥也。凡阴阳之气，阳从左而升，阴从右而降，故阳病者左为甚，阴
病者右为甚，以升者不升，降者不降，而逆其升降之气也。又人之生气，必自下而升，故老
人之气已衰于下，而从上者为顺；少壮之气，先盛于下，而从下者为顺。若以老人而神衰于
上，其所终之气可知；少壮而形衰于下，其所始之气可知，皆逆候也。及其为病而一上不下
，此其根本已亏，故寒厥到膝。少年以阳气方盛，而阳衰若此，故秋冬当死。老人以阳气本
衰，而畏寒其常，故秋冬无虑。凡此厥逆之病，谓其阳若非阳，谓其阴若非阴，五脏隔绝，
无征可验。若不能终其日者，盖甚言其凋敝难为也。再若人之妄梦而有至迷乱昏绝者，此以
心肾不交而精神散越，故为厥逆。有至如此，亦总属少阴根本之病。
《厥论》∶岐伯曰∶阳气衰于下，则为寒厥；阴气衰于下，则为热厥。帝曰∶热厥之为
热也，必起于足下者，何也？岐伯曰∶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。帝曰∶寒厥之为寒也，必从五指而上于膝者，何也？曰∶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
。寒厥何失而然也？此人者质壮，以秋冬夺于所用，阳气衰不能渗营其经络，阳气日损，阴
气独在，故手足为之寒也。热厥何如而然也？酒入于胃，则络脉满而经脉虚，阴气虚则阳气
入，阳气入则胃不和，胃不和则精气竭，精气竭则不营其四支也。此人必数醉若饱以入房，
气聚于脾中不得散，酒气与谷气相搏，热盛于中。故热遍于身，内热而溺赤也。夫酒气盛而
悍，肾气日衰，阳气独胜。故手足为之热也。帝曰∶厥或令人腹满，或令人暴不知人
，或至半日远至一日乃知人者，何也？岐伯曰∶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，逆则阳气乱，阳气乱则不知人也。
《厥论》帝曰∶愿闻六经脉之厥状病能也。岐伯曰∶巨阳之厥，则肿首头重，足不能
行，发为 仆，呕血善衄。阳明之厥，则癫疾欲走呼，腹满不得卧，面赤而热，妄见而
妄言，喘咳身热，善惊衄、呕血。少阳之厥，则暴聋颊肿而热，胁痛， 不可以运，机
关不利，腰不可以行，项不可以顾，发肠痈不可治，惊者死。太阴之厥，则腹满 胀，
后不利，不饮食，食则呕，不得卧， 急挛，心痛引腹。少阴之厥，则口干溺赤，腹满
心痛，呕变，下泄清。厥阴之厥，则少腹肿痛，腹胀，泾溲不利，好卧屈膝，阴缩肿，
内热，挛腰痛，虚满（前闭，谵言）。三阴俱逆，不得前后，使人手足寒，三日死。手太阴
厥逆，虚满而咳，善呕沫。手心主、少阴厥逆，心痛引喉，身热。死不可治。手太阳厥逆，
耳聋泣出，项不可以顾，腰不可以俯仰。手阳明、少阳厥逆，发喉痹，嗌肿，痉。
详本论之寒厥热厥，虽皆以手足为言，而实以阴阳之败乱为言也。故寒厥言夺于所用，
热厥言因于数醉，正以阴阳之气无不起于手足。故凡厥之将作，则寒热麻痹必先由手足而起
，及其甚也，则变出百端，或五脏六腑各有其证如此。然则手足之厥，特其形见之征兆耳。
而见微知着，自当因标而虑本也。
参附汤（补益类第三十七方） 术附汤（补益类第四十一方） 《神效》黄芪汤（补益类第四十八方，主治麻木） 人参膏（补益类第一十六至三十三方） 地黄饮子（补益类第九十九方） 青州白丸子（调和类第一百一十二方，主治痰气） 三生饮（热证类第九十四方，主治痰盛） 愈风丹（调和类第二百七十四方，主治血气受邪） 易老天麻丸（调和类第二百七十五方，主治血虚受邪） 交加散（调和类第二百五十二方，主治血虚经闭） 三建汤（热证类第四十二方，主治阴厥） 神应养真丹（调和类第三百一十三方，主治瘫痪） 通关散（因证类第九十八方） 续断丸（调和类第三百六方，主治脚病） 酒浸牛膝丸（调和类第三百八方，主治腰脚无力） 调元健步丸（调和类第一千一百一方，主治下肢无力）
《脉解篇》说：体内精气被夺而致厥逆，就会失音和瘫痪，这是肾虚的表现。少阴经气不至，就是厥逆。
详细考察本篇关于“厥”的论述，是因为内部精气被夺，即五脏的精气受损。失音，是指声音发不出。瘫痪，是指肢体偏废不用。现在的人见到这种情况，一定都说是中风，却不知道这是由于内部精气被夺，由于肾虚所致。大概声音出于肺但根本在肾，形体强健在于血但根本在精，精气的根本都由肾主宰，所以少阴经气不至就会发生厥逆。又《调经论》说：意志不足就会发生厥逆。《本神篇》说：肾气虚就会发生厥逆。观察这些论述，那么非风（非外感风邪）的道理就可以知道了。所以凡是治疗这种情况，应当以前面“非风证治”第三条等法则为主。
《调经论》记载：岐伯说：气与血相并，则血虚；血与气相并，则气虚。黄帝问：人拥有的东西，不过是血和气罢了。现在先生您说血并则为虚，气并也为虚，难道就没有实证了吗？岐伯说：有邪气存在为实，无邪气存在为虚。现在血与气分离失调，所以表现为虚。血与气相并聚集，就表现为实。血与气一起向上冲逆，就会发生大厥。厥逆发作就像暴死一样。如果气能回复下行则生，不能回复则死。
气并与血相并导致血虚，血并与气相并导致气虚，这是阴阳偏衰败坏的表现。现在气血一起向上冲逆，则下部阴虚，神气没有根基，这就是阴阳离决的征候，所以导致厥脱而暴死。气能回复的就轻，不能回复的就重。这正是当时人所说的突然昏倒仆地的中风，也就是痰火上壅的中风，却不知道实际上是由于下焦虚弱所致。然而上部的实是假实，病情严重的，也应当稍微进行清理；下部的虚，如果没有实邪可据，则应当迅速峻补下焦。
《阳明脉解篇》说：厥逆连及脏腑则死，连及经络则生。
观察本篇所说的连经连脏，本来是以厥逆而言的，多么明显平正。大概连及经络的病在肌表，所以轻而生；连及脏腑的病在根本，所以重而死。既然知道这是厥逆，那么凡是突然昏倒仆地等症状，其非外感风邪就可以知道了，而河间诸公，都以中腑、中脏来论述，于是风与非风开始混乱而无法辨别了。
《大奇论》说：脉搏急促如喘，名叫暴厥。暴厥的人，不知道与人说话。
《解精微论》说：厥逆时眼睛看不见东西。人发生厥逆时，阳气并聚于上部，阴气并聚于下部。阳并于上，则火独显光芒；阴并于下，则足冷，足冷就会胀满。
详细考察这两篇论述，说脉搏急促如喘，是指脉搏急迫急促像喘息一样，这是血气败乱的征候。所以导致暴厥不语，即今人所谓中风不语之类。说阳并于上，阴并于下，这就是上热下寒、水火不交的征候，所以眼睛看不见东西，即中风昏眩之类。不语者，责任在肺肾。昏眩者，责任在肝脾。暂时看见的，气回复就能苏醒。阴气败坏的，是最危险的征候。都应当按照前面的方法救治其根本。
《癫狂篇》说：厥逆作为疾病，足部突然冰冷，胸部像要裂开，肠道像被刀切一样疼痛，烦躁而不能进食，脉搏无论大小都涩滞。温暖取足少阴经穴，清凉取足阳明经穴。清凉的证候用补法，温热的证候用泻法。
暴冷，就是突然寒冷。像撕裂像切割，形容其懊恼痛楚，无法名状，这就是所谓躁扰烦乱的中风。有火的，多表现为温热且脉搏洪大，宜清阴中之火；有痰的，多表现为喘促壅塞且脉搏滑实，宜开通上焦之痰；无火无痰的，多表现为寒凉且脉搏涩弱，宜补其元气。凡是有这种症状并且兼有昏乱不醒的，这是真正连及脏腑的严重情况。大多不可治愈。
《生气通天论》说：人的阳气，烦劳过度就会亢张，精气枯竭，积累到夏天，使人发生煎厥。人的阳气，大怒就会导致形气隔绝，血液郁积于上部，使人发生薄厥。
这里说的煎厥，就是热厥之类。其原因是烦劳而病积累于夏季，也就是今人所说暑风之类。如果见到抽搐、痰涎、突然昏倒的，应当立即用前面治疗暑风的方法治疗。薄厥，是急迫相互搏结的意思，因为大怒引起，也就是气厥、血厥之类，治疗方法如下。
《通评虚实论》说：凡是治疗消瘅、仆击、偏枯、痿厥、气满发逆，肥贵之人，则是膏粱之疾。膈塞闭绝，上下不通，则是暴忧之病。突然厥逆而耳聋，偏侧闭塞不通，是内气突然迫激所致。不从内外中风而来的病，所以消瘦留着不去。
详细考察这膏粱之疾，就是酒色所伤，属于脾肾的疾病。暴忧之病，就是悲忧伤肺之类。内气暴薄，就是郁怒伤肝之类，凡此都是内伤之病。那些不从内部受伤，而是外感风邪的，则必然留着经络，所以成为消瘦痛痹之病。由此可见内伤与外感的区别，不可以混为一谈到了如此地步。
《逆顺肥瘦篇》说：冲脉，是五脏六腑的海，五脏六腑都禀受于此。其上行的部分，出于颃颡，渗入诸阳经，灌注诸精。其下行的部分，注入少阴的大络，出于气街，沿大腿内侧，进入腘中，伏行于骨内，下行至内踝之后分支。其下行的另一支，并行于少阴经，渗入三阴经。其前行的部分，伏行出于跗属，下行沿足背，进入大趾间，渗入诸络脉以温养肌肉。所以别络结滞则足背上不动，不动则发生厥逆，厥逆则寒冷。
详细考察冲脉的意义，则上自头，下自足，后自背，前自腹。凡五脏六腑、十二经脉，无所不禀受，所以称为五脏六腑十二经脉之海。海是百川的宗汇，凡各经发源之处，都有会合的意义，其对全身血气盛衰皆归于此处可以知道了。然而冲脉起于胞中，既是其经络所在，也是其聚蓄所在，所以称为血海，也称为命门。这就是所谓的根本之宅。如果素来纵情欲事，以致精气之源在此损伤败坏，那么厥脱、暴仆等疾病，也就因此产生。不然，为什么忽然仆倒而神形俱败，表里俱残，完全无知觉，达到这种地步呢？这难道是一经一脏的疾病所能导致的吗？由此察之，确实是由冲脉崩败无疑了。所以凡是治疗这种情况，想要舍弃根蒂而求其救济，我知道必定没有这个道理。冲脉的详细意义参见《类经·经络类》第二十七篇注中。
《缪刺论》说：邪气客居于手足少阴、太阴、足阳明之络，这五络都会合于耳中，上行联络左角。五络都衰竭，使人全身脉搏跳动，而形体无知觉。其状态像尸体，有的叫尸厥。剃去其左角头发方一寸，烧制成炭，用一杯美酒送服，不能喝的灌下去，立刻就好。（仍有刺法，详见二十七卷耳证门）
详细考察这尸厥一证，乃是外邪猝然中中的恶候。凡四时不正之气，以及山魔土煞、五尸魇魅之类，都是。犯病的人，忽然手足厥冷，肌肤寒栗，面目青黑，精神不守，或者口噤妄言，痰涎壅塞，或者头晕跌倒，不省人事，就名叫飞尸卒厥，适宜用针法，详见本经。如果用艾灸，则不如秦承祖灸鬼法及华陀灸阳脱法为妙。凡用药的方法，当知道邪气凑集，必因气虚，所以在本经中以左角的血余（头发），用来补五络的脱竭，其中的道理可以知道了。如果在这样危急之际，不用参附回阳等药，怎么能挽回？如果果真是邪气壅盛，胸膈不清，则不得不先为开通，然后调理，适宜选用不换金正气散、流气饮、葱姜汤、苏合丸之类酌情主治。
《方盛衰论》：雷公请问，气的多少，什么是逆？什么是从？黄帝说：阳从左升，阴从右降，老人从上，少年从下。所以气的多少，逆都为厥。问：有余的是厥吗？答：气上一而不下的，寒厥到达膝盖。少年，秋冬死。老人，秋冬生。气上而不下，头痛癫疾，求阳不得，求阴不审，五部隔绝无征验。如果居住在旷野，如果伏在空室，绵绵不绝不满一天。所以少气之厥，使人做妄梦，其极至迷乱。
这里说的气逆，就是厥。凡阴阳之气，阳从左而升，阴从右而降，所以阳病者左边为重，阴病者右边为重，因为升者不升，降者不降，而逆其升降之气。又人的生气，必自下而升，所以老人的气已在下面衰弱，而从上面来的为顺；少壮之气，先在下面旺盛，而从下面来的为顺。如果老人神气在上面衰弱，其所终结的气可以知道；少壮形体在下面衰弱，其所起始的气可以知道，都是逆候。等到他们生病而气上一而不下的，这是其根本已亏，所以寒厥到达膝盖。少年阳气正盛，而阳气衰弱到如此地步，所以秋冬当死。老人阳气本衰，而畏寒是其常态，所以秋冬无忧。凡此厥逆之病，说其阳若非阳，说其阴若非阴，五脏隔绝，无征验可查。如果不能终其日的，大概是极言其凋敝难以为继。再如果人的妄梦而有至迷乱昏绝的，这是因为心肾不交而精神散越，所以为厥逆。有达到这样的，也总属于少阴根本之病。
《厥论》：岐伯说：阳气衰于下，则为寒厥；阴气衰于下，则为热厥。黄帝问：热厥的热，一定从脚下开始，为什么呢？岐伯说：阳气起于足五指之表，阴脉者集于足下，而聚于足心，所以阳气胜则足下热。黄帝问：寒厥的寒，一定从五指而上至膝盖，为什么呢？回答说：阴气起于五指之里，集于膝下而聚于膝上。所以阴气胜则从五指至膝上寒，其寒，不从外部，皆从内部产生。寒厥为何失去平衡而这样呢？这个人身体壮实，在秋冬季节过度使用精气，阳气衰不能渗营其经络，阳气日损，阴气独在，所以手足为之寒冷。热厥为何这样呢？酒入于胃，则络脉满而经脉虚，阴气虚则阳气入，阳气入则胃不和，胃不和则精气竭，精气竭则不营养其四肢。这个人必定经常醉酒或饱食后行房，气聚于脾中不得散，酒气与谷气相搏，热盛于中。所以热遍于身，内热而尿赤。酒气盛而猛烈，肾气日衰，阳气独胜。所以手足为之发热。黄帝问：厥有时让人腹部胀满，有时让人突然不知人，有时半天远至一天才知人，为什么呢？岐伯说：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，逆则阳气乱，阳气乱则不知人。
《厥论》黄帝说：希望听闻六经脉的厥状病能。岐伯说：巨阳之厥，则肿首头重，足不能行，发为仆倒，呕血善衄。阳明之厥，则癫疾欲走呼，腹满不得卧，面赤而热，妄见而妄言，喘咳身热，善惊衄、呕血。少阳之厥，则暴聋颊肿而热，胁痛，关节不可以运，机关不利，腰不可以行，项不可以顾，发肠痈不可治，惊者死。太阴之厥，则腹满胀，后不利，不饮食，食则呕，不得卧，筋脉急挛，心痛引腹。少阴之厥，则口干溺赤，腹满心痛，呕变，下泄清。厥阴之厥，则少腹肿痛，腹胀，泾溲不利，好卧屈膝，阴缩肿，内热，挛腰痛，虚满（前闭，谵言）。三阴俱逆，不得前后，使人手足寒，三日死。手太阴厥逆，虚满而咳，善呕沫。手心主、少阴厥逆，心痛引喉，身热。死不可治。手太阳厥逆，耳聋泣出，项不可以顾，腰不可以俯仰。手阳明、少阳厥逆，发喉痹，嗌肿，痉。
详细考察本论的寒厥热厥，虽然都以手足而言，但实际上是以阴阳的败乱而言。所以寒厥说夺于所用，热厥说因于数醉，正是以阴阳之气无不始于手足。所以凡是厥将发作，则寒热麻痹必先由手足而起，等到严重时，则变出百端，或五脏六腑各有其证如此。那么手足之厥，特是其显现的征兆而已。而见微知着，自然应当因标而虑本。
Shenfu Tang (Tonifying Category, Formula 37) Shuzhu Fu Tang (Tonifying Category, Formula 41) *Shenxiao* Huangqi Decoction (Tonifying Category, Formula 48, indicated for numbness) Renshen Gao (Tonifying Category, Formulas 16-33) Dihuang Yinzi (Tonifying Category, Formula 99) Qingzhou Baiwanzi (Harmonizing Category, Formula 112, indicated for phlegm and qi stagnation) Sansheng Yin (Heat Category, Formula 94, indicated for severe phlegm) Yufeng Dan (Harmonizing Category, Formula 274, indicated for blood and qi affected by pathogenic factors) Yilao Tianma Wan (Harmonizing Category, Formula 275, indicated for blood deficiency with pathogenic invasion) Jiaojiao San (Harmonizing Category, Formula 252, indicated for amenorrhea due to blood deficiency) Sanjian Tang (Heat Category, Formula 42, indicated for Yin Jue) Shenyang Zhen Dan (Harmonizing Category, Formula 313, indicated for paralysis) Tongguan San (Indication Category, Formula 98) Xuduan Wan (Harmonizing Category, Formula 306, indicated for foot diseases) Jiujin Niuxi Wan (Harmonizing Category, Formula 308, indicated for weakness of waist and legs) Tianyuan Jianbu Wan (Harmonizing Category, Formula 1101, indicated for weakness in walking)
The *Maijie Pian* (Chapter on Pulse Explanation) states: When internal essence is depleted leading to Jue (syncope/cold extremities), it results in aphonia (loss of voice) and paraplegia; this is Kidney Deficiency. When the Shaoyin channel Qi fails to arrive, it is Jue.
Examining the discussion of "Jue" in this chapter, it refers to the depletion of internal essence, meaning the essence and Qi of the five zang organs are damaged. Aphonia means the inability to produce sound. Paraplegia means the loss of function in one side of the body. People nowadays seeing this condition always attribute it to Zhongfeng (Wind Stroke), unaware that it stems from internal depletion and Kidney Deficiency. Sound originates from the Lung but its root lies in the Kidney; physical strength resides in Blood but its root lies in Essence. The root of both essence and Qi is governed by the Kidney; thus, when Shaoyin Qi does not arrive, Jue occurs. Furthermore, the *Tiaojing Lun* states: Insufficiency of Zhi (Willpower) leads to Jue. The *Benshen Pian* states: Kidney Qi deficiency leads to Jue. Observing these discussions, the principle of Feifeng (Non-Wind conditions) becomes clear. Therefore, in treating such cases, one should primarily follow the methods outlined in Article 3 of the "Treatment of Non-Wind Conditions" mentioned earlier.
The *Tiaojing Lun* records: Qibo said: When Qi and Blood congregate, Blood becomes deficient; when Blood and Qi congregate, Qi becomes deficient. The Yellow Emperor asked: What humans possess is merely Blood and Qi. Now you say that congregation of Blood leads to deficiency, and congregation of Qi also leads to deficiency; is there no Excess? Qibo replied: Presence of pathogen is Excess; absence is Deficiency. When Blood and Qi lose their harmony, it manifests as Deficiency. When Blood and Qi congregate, it manifests as Excess. If Blood and Qi rush upward together, Da Jue (Great Jue) occurs. Jue resembles sudden death. If Qi returns downward, life is preserved; if it does not return, death ensues.
Qi congregating with Blood causing Blood deficiency, and Blood congregating with Qi causing Qi deficiency, represents the partial failure of Yin and Yang. Now, when Qi and Blood rush upward together, Yin is deficient below, and Shen Qi lacks a root. This is the sign of Yin-Yang separation, leading to Jue collapse and sudden death. Cases where Qi returns are mild; those where it does not return are severe. This is precisely what people today call Zhongfeng characterized by sudden falling and fainting, or Zhongfeng caused by Phlegm-Fire surging upward, yet they fail to realize it actually stems from lower Jiao deficiency. However, the Excess above is false Excess; in severe cases, it may require slight clearing. For the Deficiency below, if there is no pathogenic Excess to address, one must swiftly tonify the lower Jiao with strong herbs.
The *Yangming Maijie Pian* states: If Jue connects to the Zang organs, death results; if it connects to the channels, survival is possible.
Observing the connection between channels and Zang organs discussed in this chapter, it speaks clearly and correctly of Jue. Disease connecting to channels is in the muscle and surface, hence mild and survivable; disease connecting to Zang organs is in the root, hence severe and fatal. Knowing this is Jue, any symptoms like sudden fainting and falling indicate non-wind etiology. However, Hejian scholars spoke of Zhongfu (Wind affecting Fu organs) and Zhongzang (Wind affecting Zang organs), thereby confusing Wind with non-Wind to the point of indistinguishability.
The *Daqi Lun* states: A pulse rapid like panting is named Bao Jue (Sudden Jue). Those with Bao Jue cannot speak with others.
The *Xiejingwei Lun* states: In Jue, the eyes see nothing. When a person suffers Jue, Yang Qi congregates above and Yin Qi congregates below. Yang congregating above means Fire shines alone; Yin congregating below causes cold feet, and cold feet lead to distension.
Examining these two chapters, "pulse rapid like panting" refers to a pulse urgent and rapid like breathing difficulty, a sign of chaotic Blood and Qi deterioration, leading to Bao Jue and muteness, similar to modern "stroke with muteness." "Yang congregating above, Yin below" indicates Upper Heat and Lower Cold, a state of Water and Fire failing to interact, leading to blindness, similar to stroke with dizziness. Muteness is attributed to Lung and Kidney. Dizziness is attributed to Liver and Spleen. Temporary vision recovery implies Qi returning and revival. Yin collapse is the most critical sign. All should be treated according to previous methods to rescue the root.
The *Diankuang Pian* states: In the disease of Jue, the feet become suddenly cold, the chest feels as if tearing apart, the intestines feel as if cut by a knife, there is irritability preventing eating, and the pulse is choppy regardless of size. Warmth should be applied to Foot Shaoyin points; cooling to Foot Yangming points. Cooling patterns use tonification; warm patterns use sedation.
Sudden cold refers to abrupt chilling. Feeling like tearing or cutting describes indescribable distress and pain, which is the irritability and confusion seen in certain strokes. With Fire, symptoms are often warm with a洪大 (Surging-Large) pulse; clear Fire within Yin. With Phlegm, symptoms include wheezing and congestion with a滑实 (Slippery-Excess) pulse; open Upper Jiao Phlegm. Without Fire or Phlegm, symptoms are cold with a weak and choppy pulse; tonify Yuan Qi. If these symptoms accompany unconsciousness, it is severe involvement of Zang organs, mostly incurable.
The *Shengqi Tongtian Lun* states: Human Yang Qi, when overworked, expands; essence is exhausted. Accumulating into summer causes Jian Jue (Frying Jue). Human Yang Qi, upon great anger, causes form and Qi to sever, and Blood stagnates above, causing Bo Jue (Thin/Impetuous Jue).
Jian Jue mentioned here is akin to Re Jue (Heat Jue). Caused by overwork accumulating in summer, it corresponds to modern Shu Feng (Summerheat Wind). If convulsions, phlegm, and sudden collapse occur, treat immediately using methods for Summerheat Wind. Bo Jue refers to impetuous struggle, caused by great anger, corresponding to Qi Jue or Blood Jue; treatment follows below.
The *Tongping Xushi Lun* states: In treating Xiaodan (Wasting-Thirst), Puji (Falling Strike), Piangu (Hemiplegia), Weijue (Atrophy-Jue), and Qi Man Fani (Fullness and Reverse Flow), fat and noble individuals suffer from Gaoliang diseases (rich diet disorders). Ge Sai Bi Jue (Diaphragm obstruction and closure) with upper-lower blockage is caused by Bao You (Sudden Grief). Sudden Jue with deafness and unilateral blockage is due to internal Qi suddenly pressing inward. Diseases not originating from internal or external Wind remain lingering, causing emaciation.
Examining Gaoliang diseases, these are injuries from alcohol and sex, belonging to Spleen and Kidney disorders. Bao You diseases belong to grief injuring the Lung. Internal Qi pressing inward belongs to depression and anger injuring the Liver. All are internal injury diseases. Those not injured internally but externally struck by Wind linger in the channels, causing emaciation and painful bi syndrome. Thus, the distinction between internal injury and external contraction cannot be confused.
The *Nishun Feishou Pian* states: The Chong Mai (Penetrating Vessel) is the Sea of the Five Zang and Six Fu organs; all receive from it. Its ascending branch emerges at Kangsang, permeates the Yang channels, and nourishes essences. Its descending branch injects into the large collateral of Shaoyin, emerges at Qichuang, follows the medial thigh, enters the popliteal fossa, runs deep within the bone, and descends behind the medial malleolus to branch. Another descending branch runs parallel to Shaoyin, permeating the Three Yin. The anterior branch runs deep emerging at the dorsum, descends along the foot, enters the space between the big toe, permeates collaterals to warm muscles. If collaterals knot, the dorsum becomes immobile; immobility leads to Jue, and Jue leads to cold.
Examining the Chong Mai, it spans head to foot, back to front. All Zang-Fu and twelve channels receive from it, hence called the Sea of Zang-Fu and Twelve Channels. The sea is the source of rivers; all channel origins have convergence meanings, indicating it governs whole-body Blood and Qi prosperity and decline. The Chong Mai originates in the Baozhong (Uterus/Energy Center), being both its meridian path and storage site, hence called Blood Sea and Mingmen (Gate of Life). This is the residence of the root. If one indulges in desires, damaging the source of essence here, then Jue collapse and sudden falling arise from this. Otherwise, how could one suddenly fall with spirit and form ruined, interior and exterior destroyed, completely insensible? Could this be caused by a single channel or Zang organ? Clearly, it is undoubtedly Chong Mai collapse. Thus, treating this by abandoning the root to seek relief is impossible. Detailed meaning of Chong Mai is in *Leijing*, Meridian Class, Chapter 27 note.
The *Mici Lun* states: Pathogens invade the collaterals of Hand/Foot Shaoyin, Taiyin, and Foot Yangming. These five collaterals converge in the ear and ascend to connect the left corner of the head. If all five collaterals exhaust, the body's pulses move, but the form is insensible. The state resembles a corpse, called Shi Jue (Corpse Jue). Shave one square cun of hair from the left corner, burn to ash, drink with a cup of fine wine; if unable to drink, force-feed, and recovery is immediate. (Acupuncture methods detailed in Vol 27 Ear Section).
Examining Shi Jue, it is a severe outcome of sudden external pathogen invasion. It includes irregular Qi of four seasons, mountain demons, earth煞, Wu Shi, and Yan Mei. Victims suddenly experience cold extremities, shivering skin, blue-black face, unsettled spirit, locked jaw with delirium, congested phlegm, dizziness, fainting, and unconsciousness. Named Fei Shi Cu Jue, acupuncture is suitable (see original text). For moxibustion, Qin Chengzu’s Ghost-Moxibustion or Hua Tuo’s Yang Collapse Moxibustion are excellent. Regarding medication, since pathogens gather where Qi is deficient, the original text uses hair (Blood Remainder) to tonify the exhaustion of the five collaterals. In such crises, without Shenfu Hu yang (Return Yang) herbs, how can life be saved? If pathogenic Excess is severe and chest/diaphragm unclear, one must first open/blockages, then regulate. Suitable formulas include Buhuanjin Zhengqi San, Liqi Yin, Scallion-Ginger Soup, or Suhexiang Wan, chosen appropriately.
The *Fang Shengshuai Lun*: Leigong asks: Regarding the quantity of Qi, what is Ni (Reverse) and what is Cong (Following)? The Yellow Emperor says: Yang follows Left, Yin follows Right; Elderly follow Up, Youthful follow Down. Thus, regardless of Qi quantity, reversal leads to Jue. Asked: Is excess Jue? Answer: Qi going up but not down leads to Han Jue reaching the knees. Youth die in Autumn/Winter; Elderly survive Autumn/Winter. Qi going up but not down causes headache and epilepsy; seeking Yang yields nothing, seeking Yin is unclear; Five Regions are isolated without signs. Living in wilderness or empty rooms,绵延 (continuous) for less than a day. Thus, Jue from Qi deficiency causes wild dreams, extreme confusion.
Here, Qi reversal is Jue. Yang rises from Left, Yin descends from Right; thus Yang disease is worse on Left, Yin disease on Right, because rising fails to rise and descending fails to descend, reversing their movement. Human Sheng Qi must rise from below; thus, for the elderly whose Qi declines below, rising from above is smooth; for youth whose Qi is abundant below, rising from below is smooth. If Elderly have spirit declining above, their end is known; if Youth have form declining below, their beginning is known; both are reverse signs. When illness causes Qi up but not down, the root is deficient, hence Han Jue reaches knees. Youth have vigorous Yang; if Yang declines thus, they die in Autumn/Winter. Elderly have naturally weak Yang and fear cold normally, so Autumn/Winter is safe. All such Jue diseases appear neither purely Yang nor purely Yin; Five Zang are isolated without signs. Inability to last a day emphasizes severe decline. Wild dreams leading to coma result from Heart-Kidney non-interaction and spirit scattering, causing Jue. Such cases belong to Shaoyin root disease.
The *Jue Lun*: Qibo said: Yang Qi deficiency below is Han Jue; Yin Qi deficiency below is Re Jue. The Yellow Emperor asked: Why does Re Jue heat start from the soles? Qibo said: Yang Qi starts at the dorsal aspect of the five toes; Yin meridians gather at the sole and center. Thus, Yang excess causes hot soles. The Yellow Emperor asked: Why does Han Jue cold start from toes and rise to knees? Answer: Yin Qi starts at the palmar aspect of the five toes, gathers below the knee, and accumulates above the knee. Thus, Yin excess causes cold from toes to knees. This cold comes from inside, not outside. Why did this person lose balance? This person was robust but depleted essence in Autumn/Winter. Yang Qi declined, unable to nourish channels; Yang daily decreased, Yin remained alone, causing cold hands and feet. How does Re Jue occur? Wine enters the Stomach, filling collaterals but emptying meridians. Yin deficiency allows Yang entry; Yang entry causes Stomach disharmony; Stomach disharmony exhausts essence; essence exhaustion fails to nourish limbs. Such persons often drink heavily or engage in sex after full meals. Qi gathers in Spleen, unable to disperse; Wine Qi and Grain Qi struggle, generating intense heat in the middle. Heat pervades the body, causing internal heat and red urine. Wine Qi is potent; Kidney Qi declines daily; Yang stands alone. Thus, hot hands and feet. The Yellow Emperor asked: Why does Jue cause abdominal fullness, sudden unconsciousness, or delayed consciousness (half a day to a day)? Qibo said: Yin excess above causes lower deficiency; lower deficiency causes abdominal fullness. Yang excess above causes lower Qi to press upward and pathogenic Qi to reverse; reversal causes Yang chaos; Yang chaos causes unconsciousness.
The *Jue Lun* Yellow Emperor asked: I wish to hear the manifestations of Jue in the six meridians. Qibo said: Jue of Juyang (Taiyang) causes swollen head, heavy head, inability to walk, falling, vomiting blood, and frequent epistaxis. Jue of Yangming causes mania, running and shouting, abdominal fullness, inability to lie down, red hot face, hallucinations, delirium, wheezing cough, fever, fright, epistaxis, vomiting blood. Jue of Shaoyang causes sudden deafness, swollen hot cheeks, hypochondriac pain, immovable joints, stiff neck, inability to look back, inability to walk, intestinal abscess (incurable), and death if frightened. Jue of Taiyin causes abdominal fullness, difficult defecation, anorexia, vomiting after eating, inability to lie down, tendon spasm, heart pain radiating to abdomen. Jue of Shaoyin causes dry mouth, red urine, abdominal fullness, heart pain, vomiting changes, clear diarrhea. Jue of Jueyin causes lower abdominal swelling/pain, abdominal distension, difficult urination, desire to lie with bent knees, penile retraction/swelling, internal heat, spasmodic back pain, empty fullness (urinary retention, delirium). Jue of all Three Yin causes inability to pass stool/urine, cold hands/feet, death in three days. Jue of Hand Taiyin causes empty fullness, cough, frequent vomiting of foam. Jue of Hand Jueyin (Pericardium) and Shaoyin causes heart pain radiating to throat, fever; death, incurable. Jue of Hand Taiyang causes deafness, weeping, stiff neck, inability to look back, inability to bend/extend waist. Jue of Hand Yangming and Shaoyang causes Houbi (throat obstruction), throat swelling, spasms.
Examining Han Jue and Re Jue in this chapter, although discussed via hands and feet, it truly refers to Yin-Yang chaos. Han Jue mentions depletion from overuse; Re Jue mentions frequent drunkenness, emphasizing that Yin-Yang Qi originates in the extremities. Thus, impending Jue shows cold/hot/numbness starting in extremities; when severe, complications arise, with each Zang-Fu having specific signs. Extremity Jue is merely the visible sign. Seeing the subtle reveals the significant; one must consider the root based on the branch.