典藏书目

(Qi rushing up to the heart, hunger without desire to eat, vomiting of roundworms, Jue (cold extremities), fullness in the lower abdomen, retraction of the scrotum)

The typical manifestation of Jueyin disease is vexation, fullness, and retraction of the scrotum. The pulse at both the Cun (inch) and Chi (cubit) positions is slightly slow and moderate (Wei Huan). If the pulse is slightly floating, it indicates that the disease is about to resolve; if not floating, the disease has not yet healed, and Xiao Jian Zhong Tang (Minor Construct the Middle Decoction) is appropriate. If the pulse is floating and slow, retraction of the scrotum will certainly not occur, and the external symptoms must include fever and aversion to cold, resembling malaria; this is a sign that the disease is about to heal, and Guizhi Mahuang Ge Ban Tang (Guizhi and Mahuang Half-Dose Decoction) is appropriate. If the pulses at both Cun and Chi are deep and short, retraction of the scrotum will certainly occur because toxic factors have entered the Zang organs, and Chengqi Tang (Purgative Decoction) should be used for purgation. Generally, in Shanghan (Cold Damage) diseases, the transmission of pathogens among Zang and Fu organs follows the order where Yang meridians are affected first, thus sequentially transmitting to Yin meridians. Because Yang governs generation, Taiyang Water transmits to Foot-Yangming Earth, and then to Foot-Shaoyang Wood, which constitutes a minor pathogenic factor. Because Yin governs destruction, Wood transmits to Foot-Taiyin Earth, Earth transmits to Foot-Shaoyin Water, and Water transmits to Foot-Jueyin Wood. By the sixth or seventh day, the transmission reaches Jueyin Liver Wood, where Qi inevitably transfers to overcome Spleen Earth. If the Spleen suffers again from a "thief" pathogen, all five Zang and six Fu organs will be exhausted and endangered. When Ying (Nutritive) and Wei (Defensive) Qi do not circulate, it leads to deafness, retraction of the scrotum, loss of consciousness, and death. At this point, rapidly using Chengqi Tang for purgation can save one in ten lives. Ancient texts state: "Spleen heat disease endangers the five Zang organs"; also, "When Earth fails and Wood attacks, death ensues." If on the sixth or seventh day the transmission reaches Jueyin and the pulse becomes slightly slow or slightly floating, these are pulses of the Spleen and Stomach, indicating that Spleen Qi is intact and no longer subject to pathological overcoming. With pathogens having nowhere to reside, extreme conditions reverse into auspicious ones, Ying and Wei Qi are about to recover, Water rises and Fire descends, resulting in chills and high fever followed by profuse sweating and resolution of the disease. Treatment methods for the Jueyin meridian include Sweating (Han), Purgation (Xia), Vomiting (Tu), Warming (Wen), Harmonizing (Hejie), and Moxibustion (Jiu).

Sweating methods: Mahuang Shengma Tang, Guizhi Tang, Guizhi Fuling Baizhu Tang.
Purgation methods: Xiao Chengqi Tang, Sanhuang Xiexin Tang.
Vomiting methods: Gouti San, Zhizi Chi Tang.
Warming methods: Wu Mei Wan, Zhenwu Tang, Danggui Sini Tang, Danggui Sini Jia Wuzhuyu Shengjiang Tang, Wuzhuyu Tang, Fuzi Ganjiang Tang, Lizhong Tang, Tongmai Sini Tang.
Harmonizing methods: Ganjie Tang, Baihu Tang, Ganjiang Huanglian Huangqin Renshen Tang, Baitouweng Tang, Xiaochaihu Tang.
Moxibustion points/methods: Jueyin point, moxibustion for rapid pulse, moxibustion for diarrhea with cold extremities.

The *Neijing* states: "When the pulses at Cun and Chi are slightly slow and moderate, it is Jueyin disease affecting the body." The Jueyin meridian traverses the genitalia and connects to the Liver; therefore, vexation and retraction of the scrotum occur. (Note: The Jueyin chapter lacks the symptom of "scrotal retraction." Yang Renji stated: In women, breast retraction occurs. Pang Shi stated: If the pulse is slightly slow, the scrotum will certainly not retract. If external symptoms include fever and aversion to cold resembling malaria, it is a sign of impending resolution, suitable for Guizhi Mahuang Ge Ban Tang. If Cun and Chi pulses are both deep and short, the scrotum will certainly retract, suitable for purgation with Chengqi Tang.)

Symptoms of Jueyin disease include Xiao Ke (wasting-thirst/polydipsia), Qi rushing up to strike the Heart, pain and burning sensation in the Heart region, hunger without desire to eat, and vomiting of roundworms after eating. If Purgation (Xia) is applied, it will lead to persistent diarrhea. (Cheng Wuji commented: When pathogens transmit to Jueyin, the heat is already profound. Transmission from Taiyang to Taiyin causes abdominal fullness and dry throat but does not yet form thirst. Transmission to Shaoyin causes dry mouth and tongue with thirst but does not yet form wasting-thirst. Reaching Jueyin forms wasting-thirst because intense heat consumes fluids; drinking much water results in little urine, termed Xiao Ke. Wood generates Fire; Fire originates from Wood. Liver Qi connects to the Heart. Pathogenic heat in Jueyin rushes upward to the Heart, causing pain and burning in the chest. During the sixth or seventh day of Shanghan, when Jueyin is affected, marking the completion of meridian transmission, pathogens enter the Fu organs. Deficiency of Stomach Qi with exogenous heat causes hunger without desire to eat. Roundworms in the stomach move when empty and emerge upon smelling food odor; upon receiving food, they cause vomiting. This indicates heat in the Jueyin meridian. Immediate purgation damages Stomach Qi, allowing Jueyin Wood pathogens to invade, inevitably leading to persistent diarrhea. Wu Mei Wan and Guizhi Baizhu Fuling Tang are applicable.)

Formula: Guizhi Qu Gui Jia Fuling Baizhu Tang (Guizhi Decoction minus Cinnamon Twig plus Poria and Atractylodes Macrocephala Decoction):
Shaoyao (Peony Root), Fuling (Poria), Baizhu (Atractylodes Macrocephala Rhizome) (each 2 qian); Gancao (Licorice Root) (1 qian). Add 1.5 cups of water, 3 slices of Shengjiang (Fresh Ginger), and 2 dates. Decoct until 0.8 cups remain, strain, and administer.

In Jueyin disease, if there is thirst and desire for water, giving small amounts of water will lead to recovery. In Jueyin Wind-Stroke, a slightly floating pulse indicates impending resolution; a non-floating pulse indicates the disease has not yet resolved. The time when Jueyin disease tends to resolve is from Chou hour to Mao hour (Jueyin corresponds to Wood, which is prosperous during Chou, Yin, and Mao hours; approaching prosperity is the time of resolution).

Dai Yuanli pointed out: Diarrhea with undigested food (Qinggu) belongs to Yin within Yin, suitable for Tongmai Sini Tang or Danggui Sini Tang added with Shengjiang and Wuzhuyu. Tongue retraction and scrotal retraction are not only seen in Yin within Yin but also when Yangming heat sinks into Jueyin. Generally, Yangming governs the Zongjin (major sinews). When Zongjin are attacked by heat-toxic wind pathogens, they fail to receive nourishment and become tense, pulling the tongue and testicles, resulting in tongue retraction and scrotal retraction. One should purge Yangming Yang to rescue Yin, suitable for Da Chengqi Tang. When Yang transmits to Taiyin causing diarrhea, Xiao Jianzhong Tang and Xiaochaihu Tang minus Huangqin plus Shaoyao are used. These agents treat Taiyin diarrhea, borborygmus, and abdominal pain. Post-diarrheal abdominal pain indicates deficiency, which causes borborygmus. This is because Yang Qi transmitting to Yin gradually diminishes, so cold agents should not be overused; instead, Shaoyao is used to unblock stagnation.