仲景曰。脉尺寸俱微缓者。厥阴受病也。当六七日发。以其脉循
阴器。络于肝。故烦满而囊缩。庞氏曰。脉微缓者。囊不缩。若外证发
热恶寒似疟。为欲愈。宜桂枝麻黄各半汤。若尺寸俱沉短者。囊必
缩。宜承气汤下之。雍曰。厥阴见沉短。短。命脉。下证未具。更宜详
下证中。下证全则可下。
又曰。三阴皆受病。已入于府。可下而已。雍曰。三阴可下。三阳
可汗。此言其大略也。阳之中自有可汗不可汗证。阴之中自有可下
不可下证。故阴阳之中。又当各详其可汗可下而施行之。
又曰。厥阴之为病。消渴。气上撞心。心中疼热。饥而不欲食。食
则吐蛔。下之。利不止。庞氏云。可乌梅丸。常氏以有余证。故曰可乌
梅丸、四逆汤。雍曰。无厥证者。不用四逆。消渴下利。饥不欲食。宜
理中汤。下利甚者。去白术。加附子。气上如奔豚者。茯苓桂枝甘草
大枣汤。吐蛔。服乌梅丸。兼理中丸。
又曰。厥阴中风。脉微浮为欲愈。不浮为未愈。
又曰。厥阴病欲解时。从丑至卯上。
又曰。厥阴病。渴欲饮水者。少少与之愈。
又曰。诸四逆厥者。不可下之。虚家亦然。常氏曰。可当归四逆
汤。
又曰。伤寒先厥。后发热而利者。必自止。见厥复利。常氏云。可
白头翁汤。雍曰。白头翁治热利。此当更审证冷热用之。
又曰。伤寒。始发热六日。厥反九日而利。凡厥利者。当不能食。
今反能食者。恐为除中。（一云消中）食以索饼。不发热者。知胃气尚
在。必愈。恐暴热来出而复去也。后三日脉之。其热续在者。期之旦
日夜半愈。所以然者。本发热六日。厥反九日。复发热三日。并前六
日。亦为九日。与厥相应。故期之旦日夜半愈。后三日脉之而脉数。
其热不罢者。此为热气有余。必发痈脓也。常氏曰。可服千金漏芦汤。
又曰。伤寒脉迟。六七日。而反与黄芩汤彻其热。脉迟为寒。今
与黄芩汤。复除其热。腹中应冷。当不能食。今反能食。此名除中。必
死。
又曰。伤寒先厥后发热。下利必自止。而反汗出。咽中痛者。其
喉为痹。发热无汗。而利必自止。若不止。必便脓血。便脓血者。其喉
不痹。常氏云。喉痹。可桔梗汤。便脓血。可桃花汤。
又曰。伤寒一二日。至四五日而厥者。必发热。前热者后必厥。
厥深者热亦深。厥微者热亦微。厥应下之。而反发汗者。必口伤烂
赤。雍曰。仲景言厥应下之者。谓有当下之厥而误汗也。非谓皆可下
也。故仲景又曰。诸四逆厥者。不可下。然厥病至于发痈疽。便脓血。
应下者。不必拘此。
又曰。伤寒病厥五日。热亦五日。设六日当复厥。不厥者自愈。
厥终不过五日。以热五日。故知自愈。庞氏续云。若六日厥者。必发
热愈甚。仍下利也。雍曰。此恐论中语。而诸书皆不见。若六日厥。则
知阳气有余。故知热愈甚也。
又曰。凡厥者。阴阳气不相顺接。便为厥。厥者。手足逆冷者是
也。庞氏曰。凡厥。通用四逆汤。谓其脉浮迟。或微。或细。或沉。皆属
里有寒也。雍曰。世之论厥者。皆不达其源。厥者。逆也。凡逆皆为
厥。伤寒所论。盖手足厥逆之一证也。凡阴阳正气偏胜而厥者。一寒
不复可热。一热不复可寒。伤寒之厥。非本阴阳偏胜。暂为毒瓦斯所苦
而然。毒瓦斯并于阴。则阴盛而阳衰。阴经不能容其毒。必溢于阳。故
为寒厥。毒瓦斯并于阳。则阳盛而阴衰。阳经不能容其毒。必溢于阴。
故为热厥。其手足逆冷。或有温时。手足虽逆冷。而手足掌心必暖。
庞氏谓非正厥。皆寒气之轻者也。故可消息汗下。或者以此便为热
厥。非也。热厥之热。与寒厥之寒一也。伤寒厥阴。止论寒厥。唯有轻
重之异。无热厥也。其谓寒热相胜复五日六日之言。谓发热五日复
寒。厥深重者。后发热亦深重。其寒厥轻微者。其后发热亦轻微。此
仲景论文本意。误读者谓手足寒厥深者。其内蓄热亦深。寒厥微者。
其内蓄热亦微。大非也。然则热厥之证何如。曰。手足如炭火炮烙。
或如入汤中是也。曰。伤寒有此证乎。曰。虽未之见。以理推之。阳毒
恐有此证。人见之。未悟其为热厥也。曰。寒热二厥之论。始于何时。
曰。始于素问。岐伯曰。阳气衰于下。则为寒厥。阴气衰于下。则为热
厥。故阳气胜。则足下热。阴气胜。则从五指至膝上寒也。曰。经又言
足如履冰。时如入汤中一证。岂寒热并厥乎。曰。此为风痹淫烁。阴
阳二经俱不足。邪气乘虚而入。舍于二经之间。往来寒热。正气不能
与之争。邪气日进。正气日衰。所以不出三年死。非厥也。
又问曰。厥病发痈脓。便脓血。何也。雍曰。毒瓦斯随三阴经走下。
不复可止。非发脓痈便脓血。则无自而出。故其毒下于表者。则发痈
脓。下于里者。则便脓血。以是知厥亦有可下逐之理。免发痈脓便脓
血也。便脓血则喉不痹者。以毒下也。应下之而反汗。则口伤烂赤
者。以毒下而复上也。曰。厥阴论寒厥。而此皆热厥。何也。素问曰。
人之伤于寒者。则为病热。寒极则生热。是为热厥也。
庞氏曰。手足厥冷。皆属厥阴。不可下。亦不可汗。有须下证者。
谓手足虽厥冷。或有温时。手足虽逆冷。而手足掌心必暖。非正厥
也。故可消息汗下。
庞氏又曰。寒热而厥。面色不泽。冒昧者。当用绵衣包手足令
暖温。必大汗而解。
庞氏曰。有不因大汗下。而两手忽无脉。谓之双伏。或一手无
脉。谓之单伏。或利止。如此必有正汗。急用四逆辈温之。得有汗便
安。脉终不出者死。
仲景曰。伤寒脉微而厥。至七八日。肤冷。其人躁无暂安时者。
此为脏厥。非蛔厥也。庞氏曰。四逆辈冷服之。常氏云。可当归四逆汤。
又曰。蛔厥者。其人当吐蛔。今病者静而复时烦。此为脏寒。蛔
上入膈。故烦。须臾复止。得食而呕又烦者。蛔闻食臭出。其人当自
吐蛔。蛔厥者。乌梅丸主之。又主久利。
又曰。伤寒热少厥微。指头寒。默默不欲食。烦躁数日。小便利色
白者。此热除也。（庞氏曰宜干姜甘草汤）欲得食。其病为愈。若厥而
呕。胸胁烦满者。其后必便血。雍曰。热不除而便血。可犀角地黄汤。
又曰。病者手足厥冷。言我不结胸。小腹满。按之痛者。此冷结
在膀胱关元也。庞云。宜灸关元。
又曰。伤寒发热四日。厥反三日。复热四日。厥少热多。其病当
愈。四日至七日。热不除者。必便脓血。常氏云。可桃花汤。
又曰。伤寒厥四日。热反三日。复厥五日。其病为进。寒多热少。
阳气退。故为进也。常氏云。可四逆汤。待其热退寒存。厥不复热。始
可用之。雍曰。寒多热少。便宜四逆汤少与之。
又曰。伤寒六七日。脉微。手足厥冷。烦躁。灸厥阴。厥不还者
死。常氏云。可灸太冲穴。
又曰。伤寒发热下利。厥逆。躁不得卧者死。
又曰。伤寒发热下利至甚。厥不止者死。
又曰。伤寒六七日。不利。便发热而利。其人汗出不止者死。有
阴无阳故也。雍曰。汗出不止者死。先服防风牡蛎汤以止汗。次服甘
草干姜汤以复其阳。得厥愈足温。更作芍药甘草汤以和之。
又曰。伤寒五六日。不结胸。腹濡。脉虚。复厥者。不可下。此亡
血。下之死。常氏云。可当归四逆汤、四逆加人参汤。
又曰。发热而厥。七日下利者。为难治。常氏云。四逆散。
又曰。伤寒脉促。手足厥逆。可灸之。常氏云。灸太冲穴。
又曰。伤寒脉滑而厥者。里有热也。白虎汤主之。
又曰。手足厥寒。脉细欲绝者。当归四逆汤主之。若其人内有久
寒者。宜当归四逆加吴茱萸生姜汤。
又曰。大汗出。热不去。内拘急。四肢疼。又下利厥逆而恶寒者。四逆汤主之。
又曰。大汗。若大下利而厥冷者。四逆汤主之。
又曰。病患手足厥冷。脉乍紧者。邪结在胸中。心下满而烦。饥
不能食者。病在胸中。当须吐之。宜瓜蒂散。
又曰。伤寒厥而心下悸者。宜先治水。当服茯苓甘草汤。却治其
厥。不尔。水渍入胃。必作利也。雍曰。治厥。四逆汤。
又曰。伤寒六七日。大下后。寸脉沉而迟。手足厥逆。下部脉不
至。咽喉不利。唾脓血。泄利不止者。为难治。麻黄升麻汤主之。雍
曰。服汤已。脉终不至。泄利不止。宜服通脉四逆汤。
又曰。伤寒四五日。腹中痛。若转气下趋少腹者。此欲自利也。
常氏云。可四逆汤散。
又曰。伤寒本自寒下。医复吐下之。寒格。更逆吐下。若食入口
即吐。干姜黄芩黄连人参汤主之。雍曰。窃疑此汤性寒。又干姜黄连
相反。若更呕吐者。当服当归四逆加茱萸生姜汤。及吴茱萸汤。
又曰。下利有微热而渴。脉弱者。令自愈。
又曰。下利脉数。有微热汗出。令自愈。设复紧。为未解。雍曰。
紧为有寒。须温之。宜四逆汤。
又曰。下利手足厥冷。无脉者。灸之不温。若脉不还。反微喘者
死。少阴负趺阳者。为顺也。常氏云。当灸气海关元二穴。庞氏云。凡
厥通用四逆汤。谓其脉浮迟。或微。或细。或沉。皆里有寒也。
又曰。下利。寸脉反浮数。尺中自涩者。必圊脓血。常氏云。可桃
花汤。
又曰。下利清谷。不可攻表。汗出必胀满。雍曰。宜通脉四逆汤。
又曰。下利。脉沉弦者。下重也。脉大者。为未止。脉微弱数者。
为欲自止。虽发热。不死。
又曰。下利脉沉而迟。其人面少赤。身有微热。下利清谷者。必
郁冒。汗出而解。病患必微厥。所以然者。其面戴阳。下虚故也。雍
曰。不解。宜通脉四逆汤少与之。其人下利清谷。里寒外热。正通脉
四逆证也。
又曰。下利。脉数而渴者。令自愈。设不瘥。必圊脓血。以有热故
也。常氏云。可黄芩汤。
又曰。下利后脉绝。手足厥冷。 时脉还。手足温者生。脉不还
者死。雍曰。宜通脉四逆汤。
又曰。伤寒下利。日十余行。脉反实者死。
又曰。下利清谷。里寒外热。汗出而厥者。通脉四逆汤主之。
又曰。热利下重者。白头翁汤主之。
又曰。下利欲饮水者。以有热故也。白头翁汤主之。
又曰。下利腹胀满。身体疼痛者。先温其里。乃攻其表。温里宜
四逆汤。攻表宜桂枝汤。
又曰。下利谵语者。有燥屎也。宜小承气汤。
又曰。下利后更烦。按之心下濡者。为虚烦也。宜栀子豉汤。
又曰。呕家有痈脓者。不可治呕。脓尽自愈。
又曰。呕而脉弱。小便复利。身有微热。见厥者难治。四逆汤主之。
又曰。干呕。吐涎沫。头痛者。吴茱萸汤主之。
又曰。呕而发热者。小柴胡汤主之。
又曰。伤寒大吐大下之。极虚。复极汗出者。以其人外气怫郁。
复与之水。以发其汗。因得哕。所以然者。胃中寒冷故也。常氏云。可
吴茱萸汤。
又曰。伤寒哕而腹满。视其前后。知何部不利。利之则愈。常氏
云。前部不利。猪苓汤。后部不利。调胃承气汤。雍曰。哕者胃中有
寒。不宜更服调胃承气汤。先宜服半夏生姜汤。腹满如故。后部不利
者。小承气汤微和之。
庞氏曰。三阳皆有合病。凡十四证。唯三阴无合病。
Zhang Zhongjing said: When both the Cun (inch) and Chi (cubit) pulses are faint and slow, it indicates that the Jueyin meridian is affected. Symptoms typically manifest on the sixth or seventh day of illness. Since the Jueyin meridian circulates through the genitalia and connects with the Liver, symptoms such as irritability, chest and hypochondriac fullness, and retraction of the scrotum occur. Pang Anshi stated: If the pulse is faint and slow, the scrotum will not retract. If external signs such as fever and aversion to cold resembling malaria appear, it indicates that the disease is about to resolve; Guizhi Mahuang Ge Ban Tang (Cinnamon Twig and Ephedra Half-Half Decoction) is appropriate. If both the Cun and Chi pulses are deep and short, the scrotum will definitely retract; Chengqi Tang (Gut-Draining Decoction) should be used to purge. Guo Yong stated: In Jueyin disease, a deep and short pulse indicates a decline in vital Qi, and the signs of excess below are not yet fully established. One must carefully examine the signs of excess below. Only when the signs for purging below are completely present should the purging method be employed.
It is also said: When all three Yin meridians are affected and the pathogen has entered the Fu organs, purging can cure the disease. Guo Yong stated: Purging is applicable to Three Yin diseases, and sweating is applicable to Three Yang diseases; this is a general principle. Within Three Yang diseases, there are conditions suitable and unsuitable for sweating; within Three Yin diseases, there are conditions suitable and unsuitable for purging. Therefore, in the differentiation of Yin and Yang, one must carefully determine which cases require sweating and which require purging before applying treatment.
It is also said: The typical manifestations of Jueyin disease include excessive thirst (Xiao Ke), sensation of Qi rushing up to strike the heart, pain and burning heat in the heart, hunger without desire to eat, and vomiting of roundworms after eating. If purged inappropriately, diarrhea will persist uncontrollably. Pang Anshi said: Wumei Wan (Mume Pill) can be used. Chang Qizi considered this an excess condition, stating that Wumei Wan and Sini Tang (Recovery from Cold Extremities Decoction) could be used. Guo Yong stated: If there are no signs of cold extremities, Sini Tang should not be used. For symptoms of excessive thirst, diarrhea, hunger without desire to eat, Lizhong Tang (Regulate the Middle Decoction) is appropriate. If diarrhea is severe, remove Baizhu (Atractylodis Macrocephalae Rhizoma) and add Fuzi (Aconiti Lateralis Radix Praeparata). If the sensation of Qi rushing upward resembles Ben Tun (Roving Piglet), Fuling Guizhi Gancao Dazao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction) should be used. For vomiting roundworms, take Wumei Wan combined with Lizhong Wan.
It is also said: In Jueyin wind-strike, a slightly floating pulse indicates impending recovery; a non-floating pulse indicates incomplete recovery.
It is also said: The time when Jueyin disease tends to resolve is from Chou hour to Mao hour (1:00 AM – 7:00 AM).
It is also said: In Jueyin disease, if the patient desires water and drinks it in small amounts, they will recover.
It is also said: In all cases of Sini cold extremities, purging is contraindicated. This also applies to patients with deficiency constitutions. Chang Qizi said: Danggui Sini Tang (Angelica Sinensis Recovery from Cold Extremities Decoction) can be used.
It is also said: In Shanghan (Cold Damage), if cold extremities appear first, followed by fever and diarrhea, the diarrhea will stop spontaneously. If cold extremities recur, diarrhea will resume. Chang Qizi said: Baitouweng Tang (Pulsatilla Decoction) can be used. Guo Yong stated: Baitouweng Tang treats heat-type diarrhea; here, one must carefully assess the cold-heat nature of the syndrome before use.
It is also said: In Shanghan, initial fever lasts six days, while cold extremities last nine days accompanied by diarrhea. Generally, those with cold extremities and diarrhea cannot eat. If the patient can now eat, it may indicate Chu Zhong (Elimination of the Middle), a false sign of recovering stomach Qi before its exhaustion. (Another term is Xiao Zhong). Feeding the patient Suobing (noodles/wheat cakes); if no fever ensues, it indicates that Stomach Qi remains, and recovery is likely. However, one must fear a sudden burst of heat that quickly disappears. After three days, if the pulse is taken and the heat persists, recovery is expected at midnight of the following day. This is because the initial six days of fever plus the subsequent three days of fever total nine days, matching the nine days of cold extremities, thus indicating balance. If the pulse is taken after three days and shows rapidity with persistent heat, this indicates excess heat, which will likely lead to carbuncles and pus. Chang Qizi said: Qianjin Loulu Tang (Thousand-Gold Rhinanthus Decoction) can be taken.
It is also said: In Shanghan with a slow pulse lasting six or seven days, if Huangqin Tang (Scutellaria Decoction) is incorrectly administered to clear heat, the abdomen should become cold and the patient unable to eat due to the cold nature of the pulse. If the patient can now eat, this is called Chu Zhong, and death is certain.
It is also said: In Shanghan, if cold extremities appear first followed by fever, diarrhea will stop. However, if sweating occurs instead, causing throat pain, Bi obstruction of the throat will result. If there is fever without sweating, diarrhea will stop; if it does not stop, pus and blood in stool will occur. Those with pus and blood in stool will not have throat Bi. Chang Qizi said: For throat Bi, Jiegeng Tang (Platycodon Decoction) can be used. For pus and blood in stool, Taohua Tang (Peach Kernel Decoction) can be used.
It is also said: In Shanghan, if cold extremities appear on the fourth or fifth day, fever will follow. Previous fever leads to subsequent cold extremities. Severe cold extremities indicate deep internal heat; mild cold extremities indicate mild internal heat. Cold extremities should be treated with purging; if sweating is mistakenly used, oral ulcers and redness will occur. Guo Yong stated: Zhang Zhongjing’s statement that cold extremities should be purged refers to cases where purging was indicated but sweating was mistakenly used. It does not mean all cold extremities can be purged. Hence, Zhang Zhongjing also said: All cases of Sini cold extremities are not suitable for purging. However, if cold extremities progress to carbuncles or pus/blood in stool requiring purging, this rule need not be rigidly adhered to.
It is also said: In Shanghan, if cold extremities last five days and fever lasts five days, and if on the sixth day cold extremities do not return, the disease will heal spontaneously. Cold extremities do not exceed five days; balanced by five days of fever, healing is known. Pang Anshi added: If cold extremities appear on the sixth day, fever will be more severe, accompanied by persistent diarrhea. Guo Yong stated: This might be an original textual remark not found in other books. If cold extremities appear on the sixth day, it indicates excess Yang, hence more severe fever.
It is also said: All cold extremities result from the failure of Yin and Yang Qi to connect smoothly. "Jue" refers to cold extremities. Pang Anshi said: For all cold extremities, Sini Tang is generally used, assuming the pulse is floating-slow, faint, fine, or deep, indicating interior cold. Guo Yong stated: Scholars discussing cold extremities often miss the root. "Jue" means reversal. Any reversal is called Jue. Zhang Zhongjing’s discussion covers only hand-foot cold extremities. When Yin-Yang righteous Qi is imbalanced leading to cold extremities, once cold, it cannot be heated; once hot, it cannot be cooled. Shanghan cold extremities are not due to inherent Yin-Yang imbalance but temporary toxicity. Toxicity merging into Yin causes Yin excess and Yang decline; Yin meridians cannot contain the toxin, spilling into Yang, causing Cold Jue. Toxicity merging into Yang causes Yang excess and Yin decline; Yang meridians cannot contain the toxin, spilling into Yin, causing Heat Jue. Hand-foot cold extremities may have warm periods; palms and soles remain warm. Pang Anshi considered this not true Jue but mild cold qi, allowing for斟酌 sweating or purging. Some mistake this for Heat Jue, which is incorrect. Heat Jue heat and Cold Jue cold are similar in nature. The Jueyin chapter discusses only Cold Jue, varying only in severity, not Heat Jue. The discussion of alternating cold/heat over five/six days refers to: after five days of fever turning cold, severe cold extremities lead to severe subsequent fever; mild cold extremities lead to mild subsequent fever. This is Zhang Zhongjing’s intent. Misreadings suggest deep cold extremities imply deep internal heat, which is wrong. What is Heat Jue? Hands and feet feel like charcoal fire or immersion in boiling water. Does Shanghan have this? Unseen, but logically, Yang Du (Yang Toxin) might cause it. People may not recognize it as Heat Jue. When did the theory of Cold/Heat Jue begin? With Suwen. Qibo said: Yang Qi deficiency below causes Cold Jue; Yin Qi deficiency below causes Heat Jue. Thus, Yang excess causes hot soles; Yin excess causes coldness from toes to knees. Regarding "feet like ice, sometimes like entering soup," is this mixed Jue? No, this is Feng Bi (Wind Bi) damaging Yin-Yang meridians, allowing evil to enter between them, causing alternating chills and fever. Righteous Qi cannot fight, evil advances, righteousness declines, leading to death within three years. This is not Jue.
Question: Why does Jue disease lead to carbuncles/pus or pus/blood in stool? Answer: Toxins travel down the Three Yin meridians and cannot stop. They exit via carbuncles/pus or pus/blood. Toxins exiting outward cause carbuncles; toxins exiting inward cause pus/blood in stool. Thus, purging can expel toxins from Jue, preventing these outcomes. Pus/blood in stool without throat Bi indicates downward expulsion of toxins. Purging indicated but sweating used causes oral damage because toxins move down then up. Question: Why does Jueyin discuss Cold Jue but here Heat Jue? Answer: Suwen says cold injury causes heat. Extreme cold generates heat, called Heat Jue.
Pang Anshi said: Hand-foot cold extremities belong to Jueyin, not suitable for purging or sweating. If purging is necessary, it refers to cases where extremities are cold but occasionally warm, and palms/soles are warm. This is not true Jue, allowing for斟酌 sweating or purging.
Pang Anshi also said: For cold/heat with cold extremities, dull complexion, and dizziness, wrap hands/feet in cotton to warm them; profuse sweating will resolve the condition.
Pang Anshi said: Without massive sweating or purging, if both wrists lack a pulse, it is called Shuang Fu (Double Hidden); if one wrist lacks a pulse, it is Dan Fu (Single Hidden); or if diarrhea stops. In such cases, normal sweating must occur urgently; use Sini Tang category to warm. Sweating brings safety. If pulse never returns, death ensues.
Zhang Zhongjing said: In Shanghan, faint pulse with cold extremities, progressing to day seven or eight with cold skin and constant restlessness is Zang Jue (Organ Cold Extremities), not Hui Jue (Roundworm Cold Extremities). Pang Anshi said: Take Sini Tang category cold. Chang Qizi said: Danggui Sini Tang can be used.
It is also said: In Hui Jue, the patient vomits roundworms. The patient is quiet but intermittently irritable due to cold organs causing roundworms to ascend to the Diaphragm. Irritability stops briefly. Eating causes vomiting and irritability as roundworms smell food and emerge. The patient will vomit roundworms. Hui Jue is treated with Wumei Wan, which also treats chronic diarrhea.
It is also said: In Shanghan with slight heat and mild cold extremities (cold fingertips), silence, anorexia, and irritability for several days, if urination is clear and abundant, heat is removed. (Pang Anshi: Ganjiang Gancao Tang [Dried Ginger and Licorice Decoction] is appropriate). Desire to eat indicates recovery. If cold extremities with vomiting and chest/hypochondriac fullness occur, blood in stool will follow later. Guo Yong stated: If heat persists and blood in stool occurs, Xijiao Dihuang Tang [Rhino Horn and Rehmannia Decoction] can be used.
It is also said: If the patient has cold extremities, denies Jie Xiong (Chest Binding), but has lower abdominal fullness and tenderness upon pressure, this is Cold Binding at Bladder Guan Yuan point. Pang Anshi said: Moxibustion on Guan Yuan is appropriate.
It is also said: In Shanghan, fever for four days, cold extremities for three days, then fever for four days again. Less cold, more heat implies recovery. If heat persists from day four to seven, pus/blood in stool will occur. Chang Qizi said: Taohua Tang can be used.
It is also said: In Shanghan, cold extremities for four days, fever for three days, then cold extremities for five days. Disease progresses due to more cold, less heat, and declining Yang. Chang Qizi said: Sini Tang can be used. Wait until heat recedes and cold remains, and cold extremities do not turn hot, then use it. Guo Yong stated: With more cold and less heat, give Sini Tang in small doses.
It is also said: In Shanghan on day six or seven, with faint pulse, cold extremities, and irritability, moxa Jueyin points. If cold extremities do not return, death ensues. Chang Qizi said: Moxa Taichong point.
It is also said: In Shanghan with fever, diarrhea, cold extremities, and restlessness preventing lying down, death ensues.
It is also said: In Shanghan with severe fever, severe diarrhea, and unrelenting cold extremities, death ensues.
It is also said: In Shanghan on day six or seven, if previously no diarrhea, sudden fever with diarrhea and unremitting sweating indicates death due to Yin without Yang. Guo Yong stated: Unremitting sweating leads to death. First take Fangfeng Muli Tang [Saposhnikovia and Oyster Shell Decoction] to stop sweat, then Gancao Ganjiang Tang [Licorice and Dried Ginger Decoction] to restore Yang. Once extremities warm, make Shaoyao Gancao Tang [Peony and Licorice Decoction] to harmonize.
It is also said: In Shanghan on day five or six, no Jie Xiong, soft abdomen, deficient pulse, and recurrent cold extremities indicate Blood Loss; purging is contraindicated as it leads to death. Chang Qizi said: Danggui Sini Tang or Sini Jia Renshen Tang [Sini Decoction with Ginseng] can be used.
It is also said: Fever with cold extremities, followed by diarrhea on day seven, is difficult to treat. Chang Qizi said: Sini San [Recovery from Cold Extremities Powder].
It is also said: In Shanghan with rapid pulse and cold extremities, moxibustion is appropriate. Chang Qizi said: Moxa Taichong point.
It is also said: In Shanghan with slippery pulse and cold extremities, there is interior heat. Baihu Tang [White Tiger Decoction] treats it.
It is also said: Cold extremities with fine, nearly imperceptible pulse are treated with Danggui Sini Tang. If interior chronic cold exists, Danggui Sini Jia Wuzhuyu Shengjiang Tang [Angelica Sinensis Recovery from Cold Extremities Decoction with Evodia and Fresh Ginger] is appropriate.
It is also said: Massive sweating with persistent heat, internal cramping, limb pain, diarrhea, cold extremities, and aversion to cold are treated with Sini Tang.
It is also said: Massive sweating or severe diarrhea with cold extremities are treated with Sini Tang.
It is also said: If a patient has cold extremities and a suddenly tight pulse, evil is bound in the Chest. Fullness and irritability below the heart, hunger without ability to eat, indicate pathology in the Chest. Emesis is required using Gouti San [Melon Seed Powder].
It is also said: In Shanghan with cold extremities and palpitations below the heart, treat water retention first with Fuling Gancao Tang [Poria and Licorice Decoction], then treat cold extremities. Otherwise, water infiltrates the Stomach causing diarrhea. Guo Yong stated: For treating cold extremities, use Sini Tang.
It is also said: In Shanghan on day six or seven after severe purging, if Cun pulse is deep and slow, cold extremities occur, lower pulses are absent, throat is obstructed, expectoration of pus/blood occurs, and diarrhea is unceasing, it is difficult to treat. Mahuang Shengma Tang [Ephedra and Cyathula Decoction] treats it. Guo Yong stated: If after taking the decoction the pulse remains absent and diarrhea unceasing, Tongmai Sini Tang [Pulse-Recovering Sini Decoction] is appropriate.
It is also said: In Shanghan on day four or five, abdominal pain with gas moving toward the lower abdomen indicates impending spontaneous diarrhea. Chang Qizi said: Sini Tang San [Powder] can be used.
It is also said: In Shanghan with pre-existing cold diarrhea, if the doctor mistakenly uses emesis or purging, cold rejection occurs, worsening vomiting/diarrhea. If food is vomited immediately upon entry, Ganjiang Huangqin Huanglian Renshen Tang [Dried Ginger, Scutellaria, Coptis, and Ginseng Decoction] treats it. Guo Yong stated: Suspect this decoction is cold-natured and Ganjiang/Huanglian are contrary. If vomiting recurs, take Danggui Sini Jia Zhuyu Shengjiang Tang or Wuzhuyu Tang [Evodia Decoction].
It is also said: Diarrhea with slight fever and thirst, weak pulse, indicates self-healing.
It is also said: Diarrhea with rapid pulse, slight fever, and sweating indicates self-healing. If pulse becomes tight again, the disease is unresolved. Guo Yong stated: Tight pulse indicates cold, requiring warming with Sini Tang.
It is also said: Diarrhea with cold extremities and absent pulse, unresponsive to moxibustion warmth, with returning pulse but slight panting, indicates death. If Shaoyin pulse is weaker than Duyang pulse, it is favorable. Chang Qizi said: Moxa Qihai and Guan Yuan points. Pang Anshi said: All cold extremities use Sini Tang, assuming floating-slow, faint, fine, or deep pulses indicating interior cold.
It is also said: Diarrhea with Cun pulse floating-rapid and Chi pulse choppy indicates pus/blood in stool. Chang Qizi said: Taohua Tang can be used.
It is also said: Diarrhea with undigested food contraindicates exterior attack. Sweating will cause abdominal fullness. Guo Yong stated: Tongmai Sini Tang is appropriate.
It is also said: Diarrhea with deep-chord pulse indicates tenesmus. Large pulse indicates disease continues. Weak-rapid pulse indicates impending cessation. Even with fever, death is avoided.
It is also said: Diarrhea with deep-slow pulse, slight facial redness, slight body heat, and undigested food indicates Yu Mao (depression/dizziness), resolving with sweating. Patients have slight cold extremities due to Dai Yang (floating Yang) and lower deficiency. Guo Yong stated: If unresolved, give Tongmai Sini Tang in small doses. Undigested food, interior cold/exterior heat is exactly Tongmai Sini Tang indication.
It is also said: Diarrhea with rapid pulse and thirst indicates self-healing. If not healed, pus/blood in stool occurs due to heat. Chang Qizi said: Huangqin Tang can be used.
It is also said: After diarrhea, if pulse vanishes and extremities are cold, but pulse returns and extremities warm, survival is possible. If pulse does not return, death ensues. Guo Yong stated: Tongmai Sini Tang is appropriate.
It is also said: In Shanghan diarrhea occurring ten-plus times daily, if pulse becomes unexpectedly strong/excess, death ensues.
It is also said: Diarrhea with undigested food, interior cold/exterior heat, sweating, and cold extremities are treated with Tongmai Sini Tang.
It is also said: Heat diarrhea with tenesmus is treated with Baitouweng Tang.
It is also said: Diarrhea with desire to drink water indicates heat; Baitouweng Tang treats it.
It is also said: Diarrhea with abdominal fullness and body pain requires warming the interior first, then attacking the exterior. Warm interior with Sini Tang; attack exterior with Guizhi Tang [Cinnamon Twig Decoction].
It is also said: Diarrhea with delirium indicates dry feces; Xiao Chengqi Tang [Minor Gut-Draining Decoction] is appropriate.
It is also said: Increased irritability after diarrhea with soft epigastrium indicates empty irritability; Zhizi Chi Tang [Gardenia and Fermented Soybean Decoction] is appropriate.
It is also said: Vomiting with carbuncle pus should not be treated for vomiting; healing occurs when pus is exhausted.
It is also said: Vomiting with weak pulse, clear urination, slight body heat, and cold extremities is difficult to treat; Sini Tang treats it.
It is also said: Dry heaving, salivation, and headache are treated with Wuzhuyu Tang.
It is also said: Vomiting with fever is treated with Xiaochaihu Tang [Minor Bupleurum Decoction].
It is also said: After massive emesis/purging in Shanghan causing extreme deficiency and massive sweating, if water is given to induce sweating due to exterior Qi stagnation, hiccups result due to cold Stomach. Chang Qizi said: Wuzhuyu Tang can be used.
It is also said: In Shanghan with hiccups and abdominal fullness, check anterior/posterior obstructions; relieving the obstruction cures it. Chang Qizi said: Anterior (urine) obstruction uses Zhuling Tang [Polyporus Decoction]; posterior (stool) obstruction uses Tiaowei Chengqi Tang [Regulate-Stomach Gut-Draining Decoction]. Guo Yong stated: Hiccups indicate Stomach cold; Tiaowei Chengqi Tang is unsuitable. First use Banxia Shengjiang Tang [Pinellia and Fresh Ginger Decoction]. If fullness persists and posterior obstruction exists, use Xiao Chengqi Tang mildly.
Pang Anshi said: Three Yang meridians have He Bing (Combined Diseases), totaling fourteen syndromes. Three Yin meridians have no He Bing.