生命以阴阳为枢纽，阴在内，阳之守，阳在外，阴之使，阴阳互根，相抱不脱。《素问》所谓阴平阳秘，
精神乃治也。若夫元海根微，精关直泄，上引下竭，阴阳脱离，命立倾矣。《灵枢》云∶精脱者，耳聋；气
脱者，目不明；津脱者，腠理开，汗大泄；液脱者，骨属屈伸不利，色夭，脑髓消，胫酸，耳数鸣；血脱者，
色白，夭然不泽，其脉空虚。《难经》云∶脱阳者见鬼，脱阴者目盲。嘉言喻氏又分上脱、下脱、上下俱脱。
今详斯症，总由阴阳枢纽不固。如上脱者，喘促不续，汗多亡阳，神气乱，魂魄离，即脱阳也；下脱者，
血崩不止，大下亡阴，交合频，精大泄，即脱阴也；上下俱脱者，类中眩仆，鼻声鼾，绝汗出，遗尿失禁，
即阴阳俱脱也。更有内闭外脱者，痉厥神昏，产后血晕等症是也。治法∶在未脱之先，审其元阳欲绝者，于
回阳剂中兼引阴，参附汤用童便煎。真阴欲绝者，于摄阴剂中兼固阳，固阴煎。其心神浮越，起卧不安者，
招集溃散之阳。龙蛎救逆汤去桂、姜、蜀漆，加参、附、枣仁、茯神。脉微垂绝，气短汗出者，收拾虚耗之
阴。生脉散，或人参饮子。血脱者益气，吐衄不止，独参汤加参三七、童便。精脱者填营，纵欲走阳，救脱汤。
魂离者镇肝，身外有身，定魂丹。崩中者固下，血漏暴注，安崩汤。津脱者实卫，大汗亡阳，收汗丹。液脱者
滋阴，血枯成痿，加减四斤丸。喘促而吸入
短者资化源，气急不续，都气丸。类中而神昏者息风火，心火暴甚，河间地黄饮子去桂、附、巴戟。至于内
闭外脱，如痉厥神识不醒，暂用豁痰，鲜菖蒲根汁和送至宝丹。产后血晕不苏，急为开窍，外烧铁器淬醋熏鼻，
或烧苏合香嗅气，内灌清魂散。若血闷，用独圣散、参苏饮。凡诸暴脱，或孤阳无根，而阴失所系，或精血
骤去而神失所根据，洵有如喻氏所见，壮岁无病一笑而逝，少年交合一注而倾者，不早寻罅漏而缄固之，其能
拯危于一线也哉。
生命以阴阳为枢纽，阴在内，是阳的守持者；阳在外，是阴的役使者。阴阳互为根本，相互依抱而不分离。《素问》所说的“阴气平和，阳气固秘，精神才能正常”。如果元海（肾精之根）根基微弱，精关直接泄漏，上引下竭，导致阴阳脱离，生命立刻就会倾覆。《灵枢》说：精气脱失的人，耳聋；气脱失的人，眼睛看不清；津液脱失的人，腠理（皮肤毛孔及纹理）开泄，大汗淋漓；体液脱失的人，骨骼关节屈伸不利，面色枯槁，脑髓消减，小腿酸软，耳朵经常鸣响；血液脱失的人，面色苍白，干枯无光泽，脉象空虚。《难经》说：阳脱的人会看见鬼怪，阴脱的人会失明。明代医家喻嘉言又分为上脱、下脱、上下俱脱。现在详细分析这种病症，总归是由于阴阳枢纽不牢固。如上脱，表现为喘促气息接续不上，汗多导致亡阳，神气紊乱，魂魄离散，这就是脱阳；下脱，表现为血崩不止，严重腹泻导致亡阴，房事频繁，精液大量泄漏，这就是脱阴；上下俱脱，表现为中风眩晕仆倒，鼻出鼾声，绝汗流出，遗尿失禁，这就是阴阳俱脱。更有内闭外脱的情况，如痉厥神昏、产后血晕等病症。治疗方法：在尚未完全脱失之前，审查其元阳将要断绝的，在回阳剂中兼以引阴，用参附汤加童便煎服。真阴将要断绝的，在摄阴剂中兼以固阳，用固阴煎。心神浮越，坐卧不安的，招集溃散的阳气。用龙蛎救逆汤去掉桂枝、干姜、蜀漆，加入人参、附子、酸枣仁、茯神。脉象微细近乎断绝，气短出汗的，收拾虚耗的阴液。用生脉散，或人参饮子。血脱的补益益气，吐血衄血不止的，用独参汤加三七、童便。精脱的填补营血，纵欲导致阳气外泄的，用救脱汤。魂离的镇肝，感觉身体之外还有身体的，用定魂丹。血崩的固摄下部，暴注下迫的血漏，用安崩汤。津脱的充实卫气，大汗亡阳的，用收汗丹。液脱的滋阴，血枯导致痿证的，用加减四斤丸。喘促且吸气短浅的资助化源，气急气息不续的，用都气丸。中风而神昏的平息风火，心火暴盛的，用河间地黄饮子去掉桂枝、附子、巴戟天。至于内闭外脱，如痉厥神识不醒，暂时用豁痰法，用鲜石菖蒲根汁送服至宝丹。产后血晕不苏醒的，紧急开窍，外用烧红的铁器淬醋熏鼻，或燃烧苏合香让患者嗅闻气味，内灌清魂散。如果是血闷，用独圣散、参苏饮。凡是各种暴脱，或是孤阳没有根基，而阴失去所系，或是精血突然丧失而神失去依托，确实像喻氏所见，壮年人无病一笑而逝，少年性交一次即倾倒死亡的，如果不早点寻找漏洞并加以封闭巩固，难道还能挽救危处于一线之间吗？
Life relies on Yin and Yang as its pivot. Yin within is the guardian of Yang; Yang without is the servant of Yin. Yin and Yang are mutually rooted, embracing each other without separation. As stated in *Suwen* (Plain Questions): "When Yin is peaceful and Yang is secure, spirit and mind are regulated." If the root of the Yuan Sea (kidney essence) is weak, the gate of essence leaks directly, leading to exhaustion above and below, causing the detachment of Yin and Yang, upon which life immediately collapses. *Lingshu* (Spiritual Pivot) states: "Those who lose Jing (essence) suffer deafness; those who lose Qi suffer blurred vision; those who lose Jin (fluids) have open Couli (pores and skin texture) with profuse sweating; those who lose Ye (thick fluids) suffer difficulty in flexing and extending bones and joints, sallow complexion, depletion of brain marrow, soreness of the shins, and frequent tinnitus; those who lose Blood have a pale, dry, and lusterless complexion with empty pulses." *Nanjing* (Classic of Difficult Issues) states: "Those who lose Yang see ghosts; those who lose Yang go blind." Yu Jia Yan (Yu Chang), a Ming dynasty physician, further classified these into Upper Detachment, Lower Detachment, and Combined Upper and Lower Detachment. Analyzing this syndrome in detail, it generally stems from the instability of the Yin-Yang pivot. For Upper Detachment, symptoms include panting with inability to inhale fully, excessive sweating leading to Yang collapse, chaotic spirit, and scattered soul and魂魄 (hun and po), which constitutes Yang Detachment. For Lower Detachment, symptoms include unstoppable metrorrhagia, severe diarrhea leading to Yin collapse, frequent intercourse, and massive seminal emission, which constitutes Yin Detachment. For Combined Upper and Lower Detachment, symptoms include stroke-like dizziness and collapse, snoring breath, cold sweat (Jue Han), and urinary incontinence, which constitutes combined Yin and Yang Detachment. There is also Internal Closure with External Detachment, such as in tetany, convulsions, coma, and postpartum blood fainting. Treatment methods: Before complete detachment occurs, examine if Yuan Yang is about to fail; in Yang-restoring formulas, combine with Yin-guiding agents, using Shenfu Tang (Ginseng and Aconite Decoction) decocted with child's urine. If True Yin is about to fail, in Yin-nourishing formulas, combine with Yang-securing agents, using Guyin Jian (Solidify Yin Decoction). For floating spirit causing restlessness, gather scattered Yang. Use Longmu Jiuniu Tang (Dragon Shell and Oyster Shell Rescue Reversal Decoction), removing Guizhi (Cinnamon Twig), Ganjiang (Dried Ginger), and Shuqi (Farfara Flower), adding Renshen (Ginseng), Fuzi (Aconite Root), Suanzaoren (Ziziphus Seed), and Fushen (Poria with Hostwood). For faint pulse nearing cessation, shortness of breath, and sweating, gather depleted Yin. Use Shengmai San (Generate Pulse Powder) or Renshen Yinzi (Ginseng Infusion). For Blood loss, tonify Qi; for persistent hematemesis or epistaxis, use Dushen Tang (Single Ginseng Decoction) with Sanqi (Notoginseng Root) and child's urine. For Essence loss, fill Ying (Nutritive) level; for seminal emission due to licentiousness, use Jiutuo Tang (Rescue Detachment Decoction). For Soul scattering, calm the Liver; for somatic dissociation ("body outside body"), use Dinghun Dan (Stabilize Soul Pill). For Metrorrhagia, secure the lower jiao; for sudden heavy bleeding, use Anbeng Tang (Stabilize Bleeding Decoction). For Jin (fluid) loss, solidify Wei (Defensive) qi; for profuse sweating and Yang collapse, use Shouhan Dan (Stop Sweat Pill). For Ye (thick fluid) loss, nourish Yin; for blood dryness leading to flaccidity syndrome, use Jiajian Sijin Wan (Modified Four-Jin Pill). For panting with shallow inhalation, support the source of transformation; for急促 breathing and interrupted Qi, use Duqi Wan (All-Qi Pill). For stroke with coma, extinguish wind and fire; for violent Heart Fire, use Hejian Dihuang Yinzi (He Jian's Rehmannia Infusion), removing Guizhi (Cinnamon Twig), Fuzi (Aconite Root), and Bajitian (Morinda Root). Regarding Internal Closure with External Detachment, such as tetany and unconsciousness, temporarily use phlegm-resolving methods, administering Zhibao Dan (Treasure-Preserving Pill) mixed with fresh Changpu root juice. For postpartum blood fainting unresponsive to treatment, urgently open the orifices: externally, fumigate the nose with vinegar quenched on red-hot iron or inhale smoke from burning Suhexiang (Liquidambar); internally, pour Qinghun San (Clear Soul Powder). For blood stagnation obstruction, use Dusheng San (Single Holy Powder) or Renshen Suyin (Ginseng and Perilla Drink). In all cases of sudden detachment, whether due to rootless solitary Yang losing its Yin anchor, or sudden loss of essence and blood leaving the spirit without support, as observed by Yu Shi, where a healthy young man dies laughing or a youth collapses after a single sexual act, if one does not early find the cracks and seal them firmly, how can one save the critical situation from a thread?