黄连（去须） 黄柏 黄芩 大栀子（各半两）
上锉如麻豆大。每服五钱。水一盏。煎至四分。绞取汁。温服无时。日三四服。以效为度。
琥按上刘氏论热厥一条。可为畅发仲景之旨。无余蕴矣。但其用药有治气分。热而发厥者。有治血分热而发厥者。
学人所宜分别。有如解毒汤。承气汤。此治血。分热之药也。白虎汤。六一散。此治气分热之药也。又凉膈散。及解毒
汤。加甘遂末。此气血兼走之药也。倘一概混用。不无有误。余以邪传厥阴。病热已久。其人真阴之气有限。若大承气
三一承气汤中芒硝。宜审用之。
娄全善云。热厥者。国中病。必身热头痛。外别有阳证。二三日。至四五日。方发厥。兼热厥者。厥至半日。却身
热。盖热气深。方能发厥。须在二三日后也。若微厥。却发热者。热浅故也。其脉虽伏。按之而滑者。为里热。其人或
畏热。或饮水。或扬手掷足。烦躁不得眠。大便秘。小便赤。外证多昏愦者。知其热厥也。白虎承气汤。随证用之。
琥按上娄氏论。及所用之药。与朱奉议所言热厥之义相仿。至其辩二三日。四五日。又言国中病。必身热头痛。
方能发厥。此皆阐扬仲景极切要处。
或问厥阴病。消渴。气上撞心。心中疼热饥不欲食。食则吐蛔。此热郁于胃而吐长虫也。诸家皆以仲景治蛔厥证。
乌梅丸主之。是邪非邪。余答云。乌梅丸治胃中虚冷而蛔厥。乃厥阴直中之寒证也。今者邪传厥阴。胃中实热火气上逆。
故暴饥欲食。复不能食而吐蛔也。乌梅丸中。如桂附细辛辛热之剂太甚。何可用邪。陶尚文秘方。有理中安蛔散。方中
用参术为主。余复嫌其太补。缘立清中安蛔汤以主之。
Coptidis Rhizoma (remove the rootlets), Phellodendri Cortex, Scutellariae Radix, and Gardeniae Fructus (each half tael).
Crush the above herbs to the size of hemp seeds. For each dose, take five qian. Add one盏 (approx. 200ml) of water. Decoct until one-fourth of the liquid remains. Strain to obtain the juice. Take warm at any time. Administer three to four times daily. Continue until efficacy is achieved.
Hu notes: The aforementioned discussion by Liu on heat jue (heat-induced limb coldness) fully elucidates Zhang Zhongjing's intent without omission. However, the medications used distinguish between treating qi-level heat causing jue and blood-level heat causing jue.
Scholars should differentiate these. For instance, Jiedu Tang (Coptis Decoction) and Chengqi Tang (Order the Qi Decoction) are medications for treating blood-level heat. Baihu Tang (White Tiger Decoction) and Liuyi San (Six-to-One Powder) are medications for treating qi-level heat. Additionally, Liangge San (Cool the Diaphragm Powder) and Jiedu Tang with added Kansui Radix powder are medications that address both qi and blood levels. If used indiscriminately, errors may occur. I believe that when pathogenic factors transmit to the Jueyin level and the pathological heat has persisted for a long time, the patient's true yin qi is limited. Therefore, Mangxiao (Natrii Sulfas) in Dachengqi Tang (Major Order the Qi Decoction) and Sanchengqi Tang (Three-times Order the Qi Decoction) should be used with caution.
Lou Quanshan stated: Heat jue is a common disease in the region, characterized by fever and headache, accompanied by yang syndrome manifestations. After two to three days up to four or five days, jue occurs. In cases of combined heat jue, after half a day of jue, fever returns. This is because deep-seated heat is required to induce jue, which typically takes two to three days. If there is mild jue accompanied by fever, it indicates shallow heat. Although the pulse may appear hidden (fu), pressing reveals a slippery quality, indicating interior heat. The patient may fear heat, desire drinking water, throw hands and feet about, feel restless and unable to sleep, suffer from constipation, and have dark red urine. With exterior symptoms often including confusion, one can identify this as heat jue. Baihu Tang or Chengqi Tang should be selected according to the syndrome.
Hu notes: Lou's discussion and the medications used align with Zhu Fengyi's theory on heat jue. His differentiation of two to three versus four to five days, and his statement that common regional diseases must present with fever and headache before inducing jue, are all crucial points elaborating on Zhang Zhongjing's theories.
A question was raised: In Jueyin disease, symptoms include excessive thirst (xiaoke), qi rushing upward to the heart, pain and heat in the heart, hunger without desire to eat, and vomiting roundworms upon eating. This is due to heat stagnation in the stomach causing the expulsion of long worms. Various schools attribute Zhang Zhongjing's treatment of ascariasis jue (roundworm-induced jue) to Wumei Wan (Mume Pill). Is this "evil" or not? I answer: Wumei Wan treats wei-zhong xu-leng (stomach deficiency-cold) leading to roundworm jue, which belongs to the cold syndrome directly invading Jueyin. Currently, pathogenic factors transmit to Jueyin, causing excess fire-heat and rebellious qi in the stomach, leading to sudden hunger and desire to eat, yet inability to eat and subsequent vomiting of roundworms. Wumei Wan contains too many acrid-warm agents like Guizhi (Cinnamon Twig), Fuzi (Prepared Aconite Root), and Xixin (Asarum). How can they be used? Tao Shangwen's *Secret Formulas* contains Lizhong Anhui San (Regulate the Middle Stabilize Roundworms Powder), primarily using Renshen (Ginseng Root) and Baizhu (Atractylodes Macrocephala Rhizome). I found this too tonifying, so I established Qingzhong Anhui Tang (Clear the Middle Stabilize Roundworms Decoction) to treat it.