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Patient Wang: Heterogeneous qi entered through the mouth and nose, injuring the Stomach and causing vomiting. When Earth (Spleen/Stomach) is deficient, Wood (Liver) overacts upon it. Liver Wind moves internally and horizontally; the three parasites are disturbed, causing pain. Treatment should follow the pattern of Huì Jué (Roundworm Cold Syndrome). (Huì Jué with vomiting)
Sichuan Pepper, Dried Ginger, Cinnamon Twig Wood, Sichuan Loranthus Fruit, Ginseng, Coptis Rhizome, Mume Fruit, Raw White Peony Root, Phellodendron Bark (20 units).

Another patient: It is stated that during the summer and autumn eleven years ago, well water and salted sour plums were frequently consumed, leading to syncope. Since then, it has recurred every three to five days. Although consciousness returns after the illness subsides, the body becomes progressively thinner and weaker.
Occasionally, speech cannot be connected. Investigating the underlying principle, the acidity of well water and salted plums severely drains the Yin of the Liver and Kidney. The term "Jue" refers to the counterflow of Yang Qi, resulting in confused spirit and mental clouding. The condition has become a chronic, entrenched disease. This is not treated by methods for clearing orifices from phlegm and fire as seen in Epileptic Jue syndromes. This is a disease of Zang Yin. The Zang organs govern storage and conservation; physicians erroneously focus on expelling pathogens and consuming Yin. Whenever Yin fluid is exhausted and near depletion, it is like oil running out in a lamp: the flame flickers and suddenly extinguishes. The sages have never established fixed formulas for this, so I dare not arbitrarily combine herbs to deceive patients. (Yin exhaustion nearing depletion) Often use one cup of human milk.

Certain patient: The pulse on the left beats rapidly like a Shu (Rapid) pulse; the right pulse is small, soggy, and weak. The illness began with anger, followed immediately by alternating chills and fever, sweating, and palpitations. Subsequently, the spirit and soul felt scattered and dissipated. The Liver stores the Hun (Ethereal Soul); due to anger, all Yang mechanisms move. The observed pathology stems from Yang movement transforming into internal Wind, leading to Jue syndrome. Therefore, most Jue syndromes belong to the Jueyin Liver channel. Examining the *Neijing*’s treatment of the Liver, it does not exceed using Pungent flavors to regulate function, Sour flavors to nourish substance, and Sweet flavors to relieve urgency. Now, with spiritual essence lost, sedation and consolidation are still feared to be insufficient, yet formularies contain many methods for draining, calming, or suppressing the Liver. As for tonification, it mostly treats via the mother-son generation cycle. This illness is primarily governed by the Lower Jiao of the Liver and Kidneys. The medicines taken do not follow ancient canonical formulas; what is the rationale?
Donkey-hide Gelatin (1.5 qian), Chicken Egg Yolk (one piece), Ginseng (1 qian), Rehmannia Root (3 qian), Gold Leaf (five pieces).

Certain patient: Cold sensation penetrates from the feet up to the Heart. Initially, the whole body was numb; now, cold air is felt in the mouth and nose. The illness began with fright, damaging the Liver and Kidney internally, leading to Jue. The Chong Mai (Penetrating Vessel) belongs to the Liver and Kidney. When these two Zang organs lose their storing function, the Chong Qi boils and rebels. The pulse ascends from the Yin extremities, hence the sensation of cold. (Liver-Kidney deficiency with rebellious Chong Qi)
Cistanche Stem, Prepared Rehmannia Root Charcoal, Schisandra Berry, Purple Quartz, Poria, Achyranthes Root.

Patient Wang: Stomach Yang is damaged; turbid Qi attacks upward, likely leading to painful Jue. Treatment should focus on the Yang of the Yangming channel. (Painful Jue)
Evodia Fruit, Ginger Juice, Pinellia Tuber, Poria, Coix Seed (Note: Text says Jing Mi/Rice, usually Glutinous Rice in Wu Zhu Yu Tang context, but text says 粳米 - Japonica Rice).

Second visit: Remove Evodia from the previous formula, add Tangerine Peel.

Certain patient: Severe heat accompanied by Jue indicates the pathogenic heat must be in the Yin division. Ancients called this "Deep heat leads to deep Jue." During the illness, seminal emission occurred, injuring Yin and allowing pathogen to sink. Releasing the exterior or purging the interior is strictly contraindicated. Harmonizing Zheng Qi to support the expulsion of pathogen is the correct method. (Malaria Jue)
Areca Seed, Anemarrhena Rhizome, Ginseng, Pinellia Tuber, Ginger Juice, Mume Fruit.

Jue is a disease where rebellion rises from below. Jing (Spasm/Convulsion) clarifies the state of strong Wind. Hence, the two terms are often used together, originally differing from those recorded in the Shaoyang/Taiyang chapters of Shanghan Lun. It is presumed this syndrome generally arises from daily deviation of Qi and Blood, and simultaneous disorder of Yin and Yang. Like fierce wind and thunder, it erupts when depression reaches its limit. If recovery occurs gradually after onset, danger can turn to safety. If the condition worsens reversely after onset, the root will be pulled out, leading to death. The mechanism of life and death lies in the fullness or emptiness of the Mingmen (Gate of Life).
Examining various names in formularies, the causes of disease are also numerous. Generally, those suitable for emesis, such as phlegm and food obstructing the chest, use formulas like Gualisan or methods like probing with roasted salt. Those suitable for clearing and subduing, such as rebellious Jue Yang and vigorous Fire rising uncontrollably, use Yuping Decoction or Xuanming Longhui Wan methods. Those suitable for opening and descending, such as Qi Jue and Bo Jue, where form and Qi suddenly cease, use Wumo Yinzi or Pu Huang Wine methods. For turbid filth obscuring the spirit causing confusion and unconsciousness, there are Niuhuang Zhibao Dan and Suhexiang Wan. For Feishi sudden Jue, wine should first be used to guide, and acupuncture and moxibustion can be applied at specific acupoints. If discussed from a deficiency perspective, such as internal loss leading to Jue resulting in aphasia and flaccidity (Yinfei), Dihuang Yinzi is used to connect and secure the Lower Jiao. Excessive fatigue causing Yang expansion leading to Jian Jue uses Renshen Guben Tang added with Gold Leaf and Zhusha Water, which is a method of strengthening Water to control Fire. Blood Jue with soaring Yang and boiling collaterals refers to methods following Yin or Yang. Color Jue with essence depletion below urgently requires large doses to salvage Yuan Qi. Kidney Jue follows Scholar Xu’s Jiaofu Tang to unblock Yang. Roundworm Jue follows Zhang Zhongjing’s Anwei (Calming Roundworm) method. Extreme Yang uses severe Yin-nourishing agents; extreme Yin uses Yang-supporting methods. Various patterns are fully prepared. In reviewing the cases, Mr. Ye focuses uniquely on the Liver for this syndrome. The Liver is the General Officer, prone to interfering with other Zang organs. Know that if Liver Qi rebels, all Qi rebels. Qi rebellion generates Phlegm; thus Fire boils, Wind whirls, Spirit is confused, Hun is scattered, reaching extremes. If it offends the Upper, it may damage Metal and melt fluids; Maidong Tang and Qiongyu Gao are used to tonify Metal and soften/restrain. If it offends the Middle, causing vomiting and distension, Liujunzi Decoction without Atractylodes, plus Quince, Ginger, and Peony, or Fuzi Jingmi Tang with Ginseng, is used to tonify Stomach and consolidate Liver. If it shocks Heart and Spleen, causing palpitations and wasting-thirst, Ganmai Dazao Tang combined with Dragon Bone and Oyster Shell is used for easing urgency and heavy sedation. If it carries the power of Shaoyang to attack the vertex and shake collaterals, Antelope Horn, Uncaria, Scrophularia, and Forsythia are used for extinguishing Wind and clearing collaterals. If the organ itself is diseased with disharmony of substance and function, Spikenard, Mume, Cinnamon, and Peony are used to benefit substance and promote function. If due to Mother Zang deficiency disturbing the Son Zang position, Santian Formula combined with Turtle Shell, Magnetite, and Fumai Decoction minus pungent flavors, re-added with Chicken Egg Yolk, is used to calm and secure the mother-son relationship. Regarding the treatment of Wei Jue (Flaccidity-Jue), it is particularly miraculous. Using flesh-blood and shell-class animals, changing decoctions to pastes, because their strength and flavor are heavy and substantial, filling gaps and stopping Jue is fastest. Is this not supplementing the deficiencies of predecessors and opening doors for future students? Those reviewing these cases, do not neglect them. (Commentary by Shao Xinpu)

Xu’s Commentary: The cases recorded are very mixed. There are epileptic syndromes, spastic syndromes, palpitation syndromes, fire-stagnation syndromes, fright syndromes, and phlegm-obscuration syndromes, all called Jue. This is the fault of the book compiler. As for the use of Ginseng, in Jue syndromes, it applies to less than one in ten, yet constitutes three or four tenths here. There will inevitably be those harmed by retaining pathogenic factors.