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(Sensation of Qi rushing up to the heart, hunger without desire to eat, vomiting of Ascaris lumbricoides [roundworms], Jueyin cold limbs [Si Ni], fullness in the lower abdomen, retraction of the scrotum)

The typical manifestation of Jueyin disease (Disease of the Foot Jueyin Liver Channel) 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, it has not yet healed, and Xiao Jian Zhong Tang (Minor Construct the Middle Decoction) is appropriate. If the pulse is floating and slow, the patient will certainly not have scrotal retraction; 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 Ban Ge Tang (Guizhi and Mahuang Half-Volume Decoction) is appropriate. If the pulses at both Cun and Chi are deep and short, the patient will certainly exhibit scrotal retraction, indicating that toxic factors have entered the Zang organs. In this case, Chengqi Tang (Da Chengqi Tang or similar purgative formula) should be used to purge downwards. Generally speaking, in the transmission of Shanghan (Cold Damage) diseases among the Zang and Fu organs, the Yang channels are affected first, so the pathogen sequentially transmits to the Yin channels. Since Yang governs generation, Taiyang Water transmits to Foot Yangming Earth, and then to Foot Shaoyang Wood, which constitutes a minor pathogenic factor. Since 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 disease should transmit to Jueyin Liver Wood. At this time, the pathogenic Qi inevitably overacts upon Spleen Earth. If Spleen Earth suffers from a "thief" pathogen again, all five Zang and six Fu organs will become distressed and critical. When Ying (Nutritive) and Wei (Defensive) Qi fail to circulate, it leads to deafness, scrotal retraction, loss of consciousness, and death. At this point, one must rapidly use Chengqi Tang to purge downwards to preserve the one chance of life out of five deaths. The ancients said: "If the Spleen has heat disease, the five Zang organs are endangered," and also: "If Earth fails and Wood attacks, death ensues." If on the sixth or seventh day the disease transmits to Jueyin, and the pulse becomes slightly slow or slightly floating, these are pulses of the Spleen and Stomach. Thus, we know that Spleen Qi is fully restored and no longer subject to pathogenic suppression. The pathogen has no place to reside. After extreme decline comes prosperity (Pi Ji Tai Lai); Ying and Wei Qi will recover. Water ascends and Fire descends, resulting in alternating chills and fever, followed by profuse sweating and resolution of the disease.

Treatment methods for the Jueyin channel include Sweating (Han), Purging (Xia), Vomiting (Tu), Warming (Wen), Harmonizing (He), Resolving (Jie), and Moxibustion (Jiu).

Sweating methods: Mahuang Shengma Tang (Ephedra and Angelica Dahurica Decoction), Guizhi Tang (Cinnamon Twig Decoction), Guizhi Fuling Baizhu Tang (Guizhi, Poria, and Atractodes Macrocephala Decoction).
Purging methods: Xiao Chengqi Tang (Minor Da Chengqi Decoction), San Huang Xiexin Tang (Three Yellows Heart-Draining Decoction).
Vomiting methods: Guiti San (Melon Seed Powder), Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction).
Warming methods: Wu Mei Wan (Mume Pill), Zhenwu Tang (True Warrior Decoction), Danggui Sini Tang (Angelica Sinensis Reversing Cold Decoction), Danggui Sini Jia Wuzhuyu Shengjiang Tang (Angelica Sinensis Reversing Cold Decoction with Evodia and Fresh Ginger), Wuzhuyu Tang (Evodia Decoction), Fuzi Ganjiang Tang (Aconite and Dried Ginger Decoction), Lizhong Tang (Regulate the Middle Decoction), Tongmai Sini Tang (Unblocking the Pulse Reversing Cold Decoction).
Harmonizing methods: Ganjie Tang (Licorice and Platycodon Decoction), Baihu Tang (White Tiger Decoction), Ganjiang Huanglian Huangqin Renshen Tang (Dried Ginger, Coptis, Scutellaria, and Ginseng Decoction), Baitouweng Tang (Pulsatilla Decoction), Xiaochaihu Tang (Minor Bupleurum Decoction).
Moxibustion: Points on the Jueyin channel; moxibustion for rapid pulse; moxibustion for diarrhea with cold limbs.

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

Symptoms of Jueyin disease include Xiao Ke (wasting-thirst/polydipsia), sensation of Qi rushing up to strike the heart, pain and burning heat in the heart region, hunger without desire to eat, and vomiting roundworms after eating. If purging methods are used, it will lead to persistent diarrhea. (Cheng Wuji's commentary: 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. Arrival at Jueyin forms wasting-thirst because intense heat consumes fluids; drinking much water but producing little urine is called wasting-thirst. 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 heat in the chest. On the sixth or seventh day of Shanghan, when Jueyin is affected, marking the end of meridian transmission, the pathogen enters the Fu organs. Deficient Stomach Qi with invading heat causes hunger without desire to eat. Roundworms in the stomach move when empty and emerge upon smelling food; upon eating, they cause vomiting. This indicates heat in the Jueyin channel. If purged at this stage, Stomach Qi is damaged, Jueyin Wood pathogen overacts, and persistent diarrhea ensues. Use Wu Mei Wan or Guizhi Baizhu Fuling Tang.)

Formula: Guizhi Qu Gui Jia Fuling Baizhu Tang (Guizhi Decoction minus Cinnamon Twig plus Poria and Atractodes Macrocephala):
Shaoyao (Peony Root), Fuling (Poria), Baizhu (Atractodes 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 cup remains, strain, and take.

In Jueyin disease, if the patient desires water due to thirst, give small amounts frequently to cure. In Jueyin wind-stroke, a slightly floating pulse indicates impending resolution; a non-floating pulse indicates it 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 its peak prosperity is the time of resolution).

Dai Yuanli pointed out: Diarrhea with undigested food (Qing Gu) 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 syndromes but also when Yangming heat sinks into Jueyin. Yangming governs the tendons (Zong Jin); when attacked by heat-toxic wind, the tendons lose nourishment and contract, pulling the tongue and testicles, causing tongue retraction and scrotal retraction. One should purge Yangming Yang to save Yin, suitable for Da Chengqi Tang. When Yang transmits to Taiyin causing diarrhea, use Xiao Jian Zhong Tang or Xiaochaihu Tang minus Huangqin plus Shaoyao. These agents treat Taiyin diarrhea, borborygmus, and abdominal pain. Post-diarrheal abdominal pain indicates deficiency; deficiency leads to borborygmus. This occurs because Yang Qi transmitting to Yin gradually weakens. One dare not excessively use cold agents, but uses Shaoyao alone to unblock stagnation.