（《素问·厥论》）
黄帝问曰∶厥之寒热者何也？（厥者，逆也。气逆则乱，故忽为眩仆脱绝，是名为厥。愚按∶厥证之起于足者，厥
发之始也。甚至猝倒暴厥，忽不知人，轻则渐苏，重则即死，最为急候。后世不能详察，但以手足寒热为厥，又有以脚
气为厥者，谬之甚也。虽仲景有寒厥热厥之分，亦以手足为言，盖彼以辨伤寒之寒热耳，实非若《内经》之所谓厥也。
观《大奇论》曰∶暴厥者不知与人言。《调经论》曰∶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。
《缪刺论》曰∶手足少阴太阴足阳明五络俱竭，令人身脉皆重而形无知也，其状若尸，或曰尸厥。若此者，岂止于手足
寒热及香港脚之谓耶？今人多不知厥证，而皆指为中风也。夫中风者，病多经络之受伤；厥逆者，直因精气之内夺。表里
虚实，病情当辨，名义不正，无怪其以风治厥也，医中之害，莫此为甚。今将风厥二类并列于此，以便观者之究正。诸
篇厥义，详会通类疾病二十三。）岐伯对曰∶阳气衰于下则为寒厥，阴气衰于下则为热厥。（凡物之生气，必自下而升，
故阴阳之气衰于下，则寒厥热厥由之而生也。）帝曰∶热厥之为热也，必起于足下者何也？（足下，足心也。热为阳邪而
反起于阴分，故问之。）岐伯曰∶阳气起于足五趾之表，阴脉者集于足下而聚于足心，故阳气胜则足下热也。（足趾之端
曰表，三阳之所起也。足下、足心，三阴之所聚也。若阳气胜则阴气虚，阳乘阴位，故热厥必从足下始。凡人病阴虚者，
所以足心多热也。）帝曰∶寒厥之为寒也，必从五趾而上于膝者何也？（五趾为阳气之所起，寒为阴邪，反从阳分而上，
故问之。）岐伯曰∶阴气起于五趾之里，集于膝下而聚于膝上，故阴气胜则从五趾至膝上寒，其寒也不从外，皆从内也。
（里言内也，亦足下也。若阴气胜则阳气虚，阳不胜阴，故寒厥必起于五趾而上寒至膝。然其寒也，非从外入，皆由内
而生也。故凡病阳虚者，必手足多寒，皆从趾端始。）
帝曰∶寒厥何失而然也？（厥之将发，手足先寒者，是为寒厥。）岐伯曰∶前阴者宗筋之所聚，太阴、阳明之所合也。
（前阴者，阴器也。宗筋者，众筋之所聚也。如足之三阴、阳明、少阳及冲、任、督、跷，筋脉皆聚于此，故曰宗筋。
此独言太阴、阳明之合者，重水谷之藏也。盖胃为水谷气血之海，主润宗筋；又阴阳总宗筋之会，会于气街，而阳明为
之长，故特言之，以发明下文之义。）春夏则阳气多而阴气少，秋冬则阴气盛而阳气衰。（天人之道皆然也。）此人者质壮，
以秋冬夺于所用，下气上争不能复，精气溢下，邪气因从之而上也，（质壮者有所恃，当秋冬阴胜之时，必多情欲之用，
以夺肾中之精气，精虚于下则取足于上，故下气上争也。去者太过，生者不及，故不能复也。精溢则气去，气去则阳虚，
阳虚则阴胜为邪，故寒气因而上逆矣。）气因于中，（气即上文之精气邪气也。精气之原，本于水谷，水谷之化，出于脾
胃，故凡病为寒厥，为下气上争，为精气溢下，皆气因于中也。然水谷在胃，命门在肾。以精气言，则肾精之化因于胃；
以火土言，则土中阳气根于命门。阴阳颠倒，互有所关，故上文云厥起于下，此云气因于中，正以明上下相因之义。）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。（阳气者，即阳明胃气也。四肢皆禀气于胃，故阳虚于中，
则不能渗营经络而手足寒也。）
帝曰∶热厥何如而然也？（厥之将发，手足皆热者，是为热厥。）岐伯曰∶酒入于胃，则络脉满而经脉虚。（酒为热
谷之液，其气悍而疾，故先充络脉。络满而经虚者，酒能伤阴，阳盛则阴衰也。酒之详义，见经络类六及藏象类二十一。）
脾主为胃行其津液者也，阴气虚则阳气入，阳气入则胃不和，胃不和则精气竭，精气竭则不营其四肢也。（脾主为胃行其
津液，故酒入于胃，必归于脾。湿热在脾，则脾阴虚，阳独亢，而胃不和矣。脾胃俱病则精气竭，故不能营其经络四肢
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。（数醉若饱入房者，既伤其脾，复伤其肾，皆阴虚也，故手足为热。按∶
本篇寒热二厥∶一由恃壮以秋冬夺于所用，故阳气衰而为寒厥；一由数醉若饱入房，故精气竭而为热厥。二者皆因于酒
色，致伤真元，乃为是病，故本篇首言其所由然，则厥之重轻，于兹可见矣。）
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？（暴不知人，猝然昏愦也。）岐伯曰∶
阴气盛于上则下虚，下虚则腹胀满；（阴气盛于上，则不守于下，故下虚。阴虚于下，则脾肾之气不化，故腹为胀满。）
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。（重，并也。邪气，气失常也。阳气盛于上，则下气
并而上行，并则逆，逆则乱，阳气乱则神明失守，故暴不知人也。）
（《素问·厥论》）
黄帝问道：厥证出现寒象或热象的原因是什么？（所谓“厥”，就是逆乱的意思。气机逆乱则秩序大乱，因此突然发生眩晕、仆倒甚至神志丧失，这就叫做厥。我按语：厥证发作始于足部，这是厥病发生的起始表现。严重的会出现猝然昏倒、暴发性厥逆，忽然失去知觉，轻者逐渐苏醒，重者立即死亡，属于最危急的病症。后世医生不能详细考察，仅仅把手脚寒冷或发热当作厥证，又有把脚气病当作厥证的，这种错误非常严重。虽然张仲景有寒厥和热厥的区分，也是针对手脚而言的，大概他是用来辨别伤寒病的寒热罢了，实际上并不是像《内经》中所说的厥证。看《素问·大奇论》说：突然发生的厥证，患者不知道与人说话。《素问·调经论》说：血与气一起向上冲逆，就会发生大厥，厥逆会导致突然假死，如果气机能回复则生，不回复则死。《素问·缪刺论》说：手足少阴、太阴以及足阳明这五条络脉都衰竭了，使人全身经脉沉重而形体无知觉，其状态像尸体一样，有的称为尸厥。像这样的情况，哪里仅仅是手脚寒热及脚气病所能概括的呢？现在的人大多不知道什么是厥证，而都把它指认为中风。中风这个病，多是因为经络受到损伤；厥逆这个病，直接是因为精气在内被耗夺。表里虚实，病情应当辨别，名义如果不正确，难怪会用治风的方法来治疗厥证，医学中的危害，没有比这更严重的了。现在将风证和厥证两类并列在这里，以便读者研究纠正。各篇关于厥义的论述，详见会通类疾病二十三。）
岐伯回答说：阳气在下部衰微就会发生寒厥，阴气在下部衰微就会发生热厥。（凡是万物的生机，必定是从下往上升发的，所以阴阳之气在下部衰微，寒厥和热厥就由此产生了。）
黄帝说：热厥的热象，为什么一定从足底开始呢？（足底，就是足心。热是阳邪，反而起于阴分，所以询问它。）
岐伯说：阳气起于足五趾的外侧，阴脉汇聚于足下并聚集在足心，所以阳气胜则足下发热。（足趾的末端叫作“表”，是三阳经所起的地方。足下、足心，是三阴经所汇聚的地方。如果阳气胜则阴气虚，阳乘袭阴的位置，所以热厥必定从足下开始。凡人患有阴虚病的，所以足心大多发热。）
黄帝说：寒厥的寒象，为什么一定从五个脚趾向上发展到膝盖呢？（五个脚趾是阳气起始的地方，寒是阴邪，反而从阳分向上发展，所以询问它。）
岐伯说：阴气起于五个脚趾的内侧，汇聚于膝下并聚集在膝上，所以阴气胜则从五个脚趾到膝盖以上感到寒冷，这种寒冷不是从外部侵入的，都是从内部产生的。（“里”指内侧，也就是足下。如果阴气胜则阳气虚，阳不胜阴，所以寒厥必定起于五个脚趾并向上寒冷至膝盖。然而这种寒冷，并非从外而入，都是由内而生。所以凡是患阳虚病的，必定手脚多寒冷，都是从脚趾端开始的。）
黄帝说：寒厥是由于什么失误才这样的呢？（厥证将要发作时，手脚先感到寒冷的，这就是寒厥。）
岐伯说：前阴是宗筋汇聚的地方，也是太阴经和阳明经相合的地方。（前阴，就是生殖器。宗筋，是众多筋脉汇聚的地方。如足的三阴经、阳明经、少阳经以及冲脉、任脉、督脉、跷脉，筋脉都汇聚于此，所以叫作宗筋。这里唯独提到太阴、阳明两经的相合，是重视水谷之脏的作用。因为胃是水谷气血的海源，主要滋润宗筋；而且阴阳总汇于宗筋，交会于气街穴，而阳明经在其中居于主导地位，所以特别提及，以阐明下文的意义。）春夏时节阳气多而阴气少，秋冬时节阴气盛而阳气衰。（天地自然之道都是这样的。）这种人身体壮实，却在秋冬季节因过度使用精力（指房事），导致下部的精气向上争竞而不能恢复，精气从下部溢出，邪气便随之而上逆，（身体壮实的人有所依仗，应当在秋冬阴气胜的时候，必然多有房欲之举，从而耗夺肾中的精气。精虚于下则取资于上，所以下气向上争竞。离去（消耗）的太过，生成的不及，所以不能恢复。精溢则气去，气去则阳虚，阳虚则阴胜成为邪气，所以寒气因而向上逆行了。）气被困阻在中焦，（气即上文所说的精气和邪气。精气的本源，在于水谷，水谷的化生，出于脾胃，所以凡是病为寒厥、下气上争、精气溢下的，都是因为气困阻于中焦。然而水谷在胃，命门在肾。从精气来说，肾精的化生依赖于胃；从火土来说，土中的阳气根源于命门。阴阳颠倒，互相关联，所以上文说厥起于下，这里说气因于中，正是为了说明上下相互关联的意义。）阳气衰微不能渗透滋养其经络，阳气日益损耗，阴气独存，所以手脚为之寒冷。（阳气，就是阳明胃气。四肢都禀受气于胃，所以中焦阳虚，就不能渗透滋养经络，从而导致手脚寒冷。）
黄帝说：热厥又是由于什么情况才这样的呢？（厥证将要发作时，手脚都发热的，这就是热厥。）
岐伯说：酒进入胃中，则络脉充满而经脉空虚。（酒是热性谷物酿成的液体，其气悍烈而疾速，所以先充盈络脉。络脉满而经脉虚，是因为酒能伤阴，阳盛则阴衰。酒的详细意义，见经络类六及藏象类二十一。）脾的主要功能是替胃运行津液，阴气虚则阳气内入，阳气内入则胃功能不和，胃不和则精气枯竭，精气枯竭则不能营养四肢。（脾主要替胃运行津液，所以酒进入胃中，必然归于脾。湿热在脾，则脾阴虚，阳独亢，而胃功能不和。脾胃都生病则精气枯竭，所以不能营养经络和四肢。）这种人一定是经常醉酒或者饱食后行房事，气聚结在脾中不得疏散，酒气与谷气相互搏结，热盛于中焦，所以热遍于全身，表现为内热且小便赤黄。酒气盛大而悍烈，肾气日益衰微，阳气独盛，所以手脚为之发热。（经常醉酒或饱食后行房事，既损伤脾，又损伤肾，都是阴虚，所以手脚发热。按：本篇中寒热两种厥证：一种是由于倚仗强壮而在秋冬季节过度使用精力，导致阳气衰微而发生寒厥；一种是由于经常醉酒或饱食后行房事，导致精气枯竭而发生热厥。这两种情况都因于酒色，致使真元受损，才产生这些病，所以本篇首先讲述它们产生的原因，那么厥证的轻重，从这里就可以看出来了。）
黄帝说：厥证有的使人腹部胀满，有的使人突然昏迷不知人事，有的半天，远的要一天以后才恢复知觉，这是什么原因呢？（突然不知人事，就是猝然昏愦。）
岐伯说：阴气在上部旺盛则下部虚弱，下部虚弱则腹部胀满；（阴气在上部旺盛，就不守持于下部，所以下部虚弱。下部阴虚，则脾肾之气不能运化，所以腹部胀满。）阳气在上部旺盛则下部的气并重地向上逆行，气逆则阳气紊乱，阳气紊乱则人不知人事。（“重”意为并合。邪气，指气失常。阳气在上部旺盛，则下部的气并合而上行，并合则逆，逆则乱，阳气紊乱则神明失守，所以突然不知人事。）
(Suwen, Chapter 45: Lun Jue)
The Yellow Emperor asked: What is the reason for cold and heat manifestations in Jue syndrome? (Jue refers to rebellion or reversal. When Qi rebels, order is disrupted, leading to sudden dizziness, collapse, or loss of consciousness; this is termed Jue. My commentary: The onset of Jue syndrome begins in the feet, marking the initial stage of the disease. In severe cases, it presents as sudden collapse or violent Jue with immediate loss of consciousness; mild cases gradually recover, while severe cases may result in immediate death, representing a critical emergency. Later physicians failed to examine this in detail, merely equating cold or hot hands and feet with Jue, and some even identified foot qi disease as Jue, which is a significant error. Although Zhang Zhongjing distinguished between Cold Jue and Hot Jue, his discussion focused on the extremities, likely to differentiate cold and heat patterns in Shanghan (Cold Damage) disease, rather than addressing the concept of Jue as described in the Neijing. As stated in the Daqi Lun: "In sudden Jue, the patient does not speak with others." In the Tiaojing Lun: "When blood and Qi rush upward together, it results in Great Jue; Jue leads to sudden death-like state; if Qi returns, life is preserved; if not, death ensues." In the Miaci Lun: "When the five collaterals of the Hand and Foot Shaoyin, Taiyin, and Foot Yangming are exhausted, the body's pulses become heavy and the form loses sensation; the condition resembles a corpse, sometimes called Corpse Jue." Such conditions clearly go beyond mere cold/hot extremities or foot qi. Nowadays, most people do not understand Jue syndrome and misidentify it as Fengzhong (Wind Stroke). Fengzhong typically involves injury to meridians and collaterals, whereas Jue-ni (Reversal of Qi) is directly caused by the internal depletion of Essence and Qi. The exterior-interior and deficiency-excess aspects of the pathology must be distinguished. If the nomenclature is incorrect, it is no wonder that wind-treating methods are applied to Jue; among medical harms, none is greater than this. Here, Wind and Jue categories are listed side by side for readers to study and correct. Detailed discussions on Jue from various chapters can be found in Huitong Class, Disease 23.)
Qibo replied: When Yang Qi declines at the lower part, Cold Jue occurs; when Yin Qi declines at the lower part, Hot Jue occurs. (The vital energy of all things necessarily rises from below; thus, when Yin and Yang Qi decline at the lower part, Cold Jue and Hot Jue arise from this.)
The Emperor asked: Why does the heat of Hot Jue always begin at the sole of the foot? (The sole refers to the center of the foot. Heat is a Yang pathogen, yet it arises in the Yin region; hence the inquiry.)
Qibo said: Yang Qi originates from the lateral aspect of the five toes of the foot, while Yin meridians gather at the sole and converge at the foot center. Therefore, when Yang Qi prevails, the sole becomes hot. (The distal end of the toes is termed "biao" (exterior), where the Three Yang meridians originate. The sole and foot center are where the Three Yin meridians converge. If Yang Qi prevails, Yin Qi becomes deficient; Yang invades the Yin territory, so Hot Jue necessarily starts from the sole. In general, patients with Yin deficiency often experience heat in the soles of their feet.)
The Emperor asked: Why does the cold of Cold Jue necessarily start from the five toes and ascend to the knees? (The five toes are where Yang Qi originates; cold is a Yin pathogen, yet it ascends from the Yang region; hence the inquiry.)
Qibo said: Yin Qi originates from the medial aspect of the five toes, gathers below the knee, and converges above the knee. Therefore, when Yin Qi prevails, coldness extends from the five toes up to the knees. This coldness does not come from the exterior but arises from within. ("Li" refers to the interior/medial side, i.e., the sole. If Yin Qi prevails, Yang Qi becomes deficient; Yang cannot overcome Yin, so Cold Jue starts at the five toes and ascends with cold to the knees. However, this coldness is not acquired from outside but generated internally. Thus, in cases of Yang deficiency, coldness in the hands and feet invariably starts from the toe tips.)
The Emperor asked: What mistake leads to Cold Jue? (When Jue is about to manifest, if the hands and feet feel cold first, it is Cold Jue.)
Qibo said: The anterior yin (genitals) is the gathering point of Zongjin (tendons), and it is where the Taiyin and Yangming meridians combine. (The anterior yin refers to the genital organ. Zongjin refers to the convergence of numerous tendons. The three Yin meridities of the foot, along with Yangming, Shaoyang, Chong, Ren, Du, and Qiao meridians, all converge here, hence called Zongjin. Mentioning only the combination of Taiyin and Yangming emphasizes the importance of the water-grain storage organs. The Stomach is the sea of water-grain and Qi-blood, primarily moistening the Zongjin. Furthermore, Yin and Yang converge at the Zongjin, meeting at the Qichuan acupoint, with Yangming acting as the leader; thus, it is specifically mentioned to elucidate the following text.) In spring and summer, Yang Qi is abundant and Yin Qi is scarce; in autumn and winter, Yin Qi is prosperous and Yang Qi declines. (This follows the natural laws of Heaven and Earth.) Such individuals possess strong constitutions but squander their vitality during autumn and winter through excessive sexual activity. The Qi in the lower jiao struggles upward but cannot replenish itself; essence overflows downward, and evil Qi follows it upward. (Those with robust constitutions rely on their strength, but during times of Yin dominance in autumn/winter, they indulge in desires, depleting Kidney essence. Deficiency of essence below causes Qi to seek compensation from above, leading to lower Qi struggling upward. Excessive consumption outpaces generation, preventing recovery. Overflow of essence leads to loss of Qi; loss of Qi leads to Yang deficiency; Yang deficiency allows Yin excess to become pathogenic, causing cold Qi to rebel upward.) The Qi becomes trapped in the middle jiao. (Qi here refers to the essence Qi and evil Qi mentioned earlier. The source of essence Qi lies in water-grain; the transformation of water-grain depends on the Spleen and Stomach. Therefore, conditions such as Cold Jue, lower Qi rebelling upward, and essence overflowing downward are all due to Qi being trapped in the middle. While water-grain resides in the Stomach and Mingmen is in the Kidney, regarding essence, Kidney essence transformation relies on the Stomach; regarding Fire and Earth, Yang Qi in Earth roots in Mingmen. Yin and Yang are inverted and interrelated. Thus, stating that Jue originates below and Qi is trapped in the middle clarifies the mutual dependence between upper and lower.) Yang Qi declines and fails to permeate and nourish the meridians. Yang Qi is daily diminished, leaving Yin Qi alone, resulting in cold hands and feet. (Yang Qi here refers to Yangming Stomach Qi. The four limbs receive Qi from the Stomach; thus, central Yang deficiency prevents permeation and nourishment of the meridians, causing cold extremities.)
The Emperor asked: How does Hot Jue occur? (When Jue is about to manifest, if both hands and feet are hot, it is Hot Jue.)
Qibo said: When wine enters the Stomach, the collateral vessels become full while the main meridians remain empty. (Wine is a liquid made from hot grains; its Qi is fierce and rapid, thus filling the collateral vessels first. Full collaterals and empty meridians indicate that wine damages Yin; Yang excess leads to Yin deficiency. For detailed meanings of wine, see Meridian Class 6 and Zang-Xiang Class 21.) The Spleen's function is to transport fluids for the Stomach. When Yin Qi is deficient, Yang Qi enters inward; when Yang Qi enters inward, the Stomach becomes disharmonious; when the Stomach is disharmonious, essence and Qi are exhausted; when essence and Qi are exhausted, the four limbs are not nourished. (The Spleen transports fluids for the Stomach; thus, wine entering the Stomach ultimately reaches the Spleen. Damp-heat in the Spleen leads to Spleen Yin deficiency and solitary Yang hyperactivity, causing Stomach disharmony. When both Spleen and Stomach are diseased, essence and Qi are exhausted, failing to nourish the meridians and limbs.) Such individuals likely engage in frequent drunkenness or sexual intercourse after full meals. Qi accumulates in the Spleen without dispersing; wine Qi and grain Qi contend, generating intense heat in the middle jiao. Consequently, heat pervades the body, presenting as internal heat and dark urine. Wine Qi is vigorous and fierce, causing Kidney Qi to decline daily while Yang Qi stands alone in excess, resulting in hot hands and feet. (Frequent drunkenness or sex after eating damages both the Spleen and Kidney, leading to Yin deficiency, hence hot extremities. Commentary: The two types of Jue in this chapter—one caused by relying on strength to squander vitality in autumn/winter, leading to Yang decline and Cold Jue; the other caused by frequent drunkenness or sex after eating, leading to essence exhaustion and Hot Jue—both result from alcohol and sexual indulgence damaging true Yuan Qi. Thus, the chapter first explains their origins, allowing one to discern the severity of Jue.)
The Emperor asked: Why does Jue sometimes cause abdominal fullness, sometimes sudden unconsciousness, and why does consciousness return after half a day or even a day? (Sudden unconsciousness refers to abrupt coma.)
Qibo said: When Yin Qi is excessive in the upper part, the lower part becomes deficient; lower deficiency leads to abdominal distension. (Excessive Yin Qi in the upper part fails to secure the lower part, causing lower deficiency. Yin deficiency below impairs the transformation of Spleen and Kidney Qi, resulting in abdominal fullness.) When Yang Qi is excessive in the upper part, lower Qi merges and rebels upward; rebellion causes Yang Qi to become chaotic; chaos in Yang Qi leads to loss of consciousness. ("Chong" means merging. Evil Qi refers to abnormal Qi flow. Excessive Yang Qi in the upper part causes lower Qi to merge and ascend; merging leads to rebellion, rebellion leads to chaos, chaos in Yang Qi causes the Spirit to lose its residence, resulting in sudden unconsciousness.)