疝为任病与肝经,茴(小茴香)木(木通,木香)金铃是典型,合入五苓汤散妙,锻石(捣如米大
入棉布中,以线缝好,包肾囊,隔夜再易之)外法亦神灵(素臬台云∶此方屡试屡验。
厥证者,四肢逆冷是也。伤寒寒厥,初病即厥,表宜当归四逆汤,里宜通脉四逆汤。伤
寒热厥,多见于传经之后,轻者宜四逆散,脉长者宜白虎汤,脉沉实大便闭者宜承气汤,详
于伤寒门不赘。若《内经》之论厥多端,阳气衰于下,则手足寒。亦名寒厥,宜桂附八味丸
,阴气衰于下,则手足热,亦名热厥,宜六味地黄丸。血之与气并走于上,则为大厥,厥则
暴死,气复还则生,不还则死。此不能以药治,当徐俟之,或半夏末搐鼻取嚏,厥回后议药
。尸厥身脉皆动而形无知,宜还魂汤,方用麻黄三钱,杏仁(去皮尖)二十五粒,炙草一钱,
水煎服。如药灌不入,分病患发,左右捉搦,按肩引之令服,取效。煎厥者,阴亏阳扰,心
如火燎,不必手足逆冷,病在于中,宜白虎加人参汤。搏厥者,气血俱乱,相搏成厥,似大
厥而稍轻,病在气血,宜生蒲黄一两,黑豆二两(炒),以清酒淋下取饮。血厥者,似大厥而
亦稍轻,妇人多有之,宜白薇汤,方用白薇、人参、当归各二钱,炙草一钱,水煎服。气厥
者,因怒气而得,宜七气汤。痰厥者,痰涎如涌,宜二陈汤加苍术、白术、制南星、竹沥、
姜汁。食厥者,因过饱而得,宜平胃散加莱菔子三钱,煎服探吐。酒厥者,醉后发厥,宜五
苓散去桂加黄连、黄芩、干葛,皆是昏不知人而名之,其实为风 之类。近医于猝倒之厥,
多混认为伤寒热厥,误人不少。《内经》寒热二厥,虽手足合言,究竟寒热先从足起,知其
阴阳先衰于下,不待手寒手热,皆当以厥论也,说本张心在《附经》。此证虽寒热俱有,而
仲景每指肢冷而言,仲时称名,从仲景而不照《内经》,故列于寒证。
(经义)《脉解篇》曰∶“内夺而厥,则为喑痱,此肾虚也,少阴不至者厥也。”《调经论
》岐伯曰∶“气之所并为血虚,血之所并为气虚。帝曰∶人之所以有者,血与气耳,今夫子乃言血
并为虚,气并为虚,是无实乎。岐伯曰∶有为实,无者为虚,今血与气相失,故为虚焉。
血与气并,则为实焉。血之于气,并走于上,则为大厥,厥则暴死,气复反则生,不反则死
。”《阳明脉解篇》曰∶“厥逆连脏则死,连经则生。”按∶《内经》论厥,不能尽述,而
此数节,可以挈其大纲。盖内者,肾也,夺者,精夺也,厥者,气逆也。喑者,口哑也,痱
者,足废也。今厥虚而厥,口不能言,以肾脉挟舌本也,足不能行,以肾脉循阴股也。次章
谓∶血气并走于上,则下之空虚,可知神气俱失其根,所以暴脱欲死。三章言连经者,病在
肌表,故轻而生,连脏者,病在根本,故重而死。人之根本维何,肾中之水火也。三章互相
发明。火虚者用刘河间地黄饮子,水虚者用骆龙吉接命丹。附录接命丹方,用人乳二酒盏,
好梨捣汁一酒盏,倾银罐内,重汤炖滚,黄沫起,开青路为度,每日空心一服,盖取以人补
人之义也。
The translation is based on the Baihua text generated in Task 1.
Hernia (Shan) involves the Ren Mai (Conception Vessel) and the Liver Meridian. Xiao Hui Xiang (Fennel), Mu Tong (Akebia Stem, or Mu Xiang Aucklandiae Root), and Jin Ling Zi San (Melia Toosendan Fruit Powder) are typical remedies. Combined with Wu Ling Tang (Five-Ingredient Powder with Poria), the dispersion of dampness is miraculous. An external method using Duan Shi (calcined stone, crushed to rice-grain size, wrapped in cotton cloth, sewn, and applied to the scrotum, replaced overnight) is also highly effective. (Su Nie Tai stated: This prescription has been tested repeatedly with consistent success.)
Jue Syndrome (Reversal Cold/Heat) refers to cold extremities. In Cold Jue due to Cold Damage (Shang Han), reversal occurs from the onset; for exterior patterns, Dang Gui Si Ni Tang (Cinnamon Twig Decoction with Angelica) is appropriate, while for interior patterns, Tong Mai Si Ni Tang (Pulse-Reviving Four Reversal Decoction) is appropriate. In Hot Jue due to Cold Damage, it often appears after disease transmission; for mild cases, Si Ni San (Four Reversal Powder) is appropriate; if the pulse is long, Bai Hu Tang (White Tiger Decoction) is appropriate; if the pulse is deep and solid with constipation, Cheng Qi Tang (Order the Qi Decoction) is appropriate. Details are provided in the Shang Han chapter, so they are not repeated here. Regarding the various types of Jue discussed in *Nei Jing* (Inner Canon): If Yang Qi declines at the lower part, hands and feet become cold, known as Cold Jue, treated with Gui Fu Ba Wei Wan (Eight-Ingredient Pill with Cinnamon and Aconite); if Yin Qi declines at the lower part, hands and feet become hot, known as Hot Jue, treated with Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia). If Blood and Qi rush together upward, it is called Great Jue (Da Jue); sudden death ensues, but life is preserved if Qi returns, and death occurs if it does not. This condition cannot be treated directly with medicine; one must wait patiently, or induce sneezing by insufflating Ban Xia powder (Pinellia Rhizome) into the nose, and discuss medication only after the reversal subsides. In Corpse Jue (Shi Jue), the body’s pulses beat but the form is unconscious; Huan Hun Tang (Return the Soul Decoction) is appropriate, composed of Ma Huang (Ephedra Herb) 3 qian, Xing Ren (Apricot Seed, peeled and tip removed) 25 grains, Zhi Gan Cao (Prepared Licorice Root) 1 qian, decocted in water and taken orally. If the medicine cannot be swallowed, part the patient's hair, grasp and shake them from left and right, press the shoulders and pull to facilitate administration, which can yield results. Jian Jue (Boiling Jue) results from Yin deficiency and Yang disturbance, feeling like fire burning in the heart, without necessarily having cold extremities; the pathology lies in the middle jiao, treated with Bai Hu Jia Ren Shen Tang (White Tiger Decoction plus Ginseng). Bo Jue (Striking Jue) involves chaotic Qi and Blood struggling against each other, resembling Great Jue but slightly milder, with pathology in Qi and Blood, treated with Sheng Pu Huang (Raw Lygodium Spore) 1 liang and Hei Dou (Black Soybean) 2 liang (stir-fried), poured with clear wine and drunk. Xue Jue (Blood Jue) resembles Great Jue but is slightly milder, common in women, treated with Bai Wei Tang (Cynanchum Roseum Decoction), composed of Bai Wei (Cynanchum Roseum Root), Ren Shen (Ginseng Root), and Dang Gui (Angelica Sinensis Root) each 2 qian, and Zhi Gan Cao 1 qian, decocted in water. Qi Jue (Qi Jue) arises from anger, treated with Qi Qi Tang (Seven-Qi Decoction). Tan Jue (Phlegm Jue) features surging phlegm-saliva, treated with Er Chen Tang (Two-Aged Decoction) added with Cang Zhu (Atractylodes Rhizome), Bai Zhu (Atractylodes Macrocephala Rhizome), Zhi Nan Xing (Prepared Arisaema Rhizome), Zhu Li (Bamboo Sap), and Jiang Zhi (Ginger Juice). Shi Jue (Food Jue) results from overeating, treated with Ping Wei San (Peaceful Stomach Powder) added with Lai Fu Zi (Radish Seed) 3 qian, decocted and used to induce vomiting. Jiu Jue (Wine Jue) occurs after drunkenness, treated with Wu Ling Tang minus Gui Zhi (Cinnamon Twig), added with Huang Lian (Coptis Rhizome), Huang Qin (Scutellaria Root), and Gan Ge (Pueraria Root). All these are named for loss of consciousness, but essentially belong to Wind syndromes. Modern physicians often confuse sudden collapse Jue with Hot Jue of Cold Damage, causing much harm. Although *Nei Jing* discusses Cold and Hot Jue together regarding hands and feet, the cold or heat typically starts in the feet, indicating that Yin and Yang decline first at the lower part; regardless of hand temperature, it should be diagnosed as Jue. This view originates from Zhang Xin in *Fu Jing*. Although this syndrome includes both cold and heat, Zhang Zhongjing usually referred to cold limbs. Zhang Shi named it following Zhang Zhongjing rather than strictly adhering to *Nei Jing*, thus listing it under Cold Syndromes.
(Interpretation of Classics) *Mai Jie Pian* (Chapter on Pulse Explanation) states: "Internal depletion leading to Jue results in aphasia and flaccidity, which is Kidney deficiency; when Shaoyin pulse qi fails to arrive, it is Jue." In *Tiao Jing Lun* (Chapter on Regulating the Channels), Qibo said: "Where Qi gathers excessively, Blood becomes deficient; where Blood gathers excessively, Qi becomes deficient." The Yellow Emperor asked: "Humans exist because of Blood and Qi. Now you say gathering makes them deficient; is there no excess?" Qibo replied: "Excess exists where there is gathering; deficiency exists where there is none. When Blood and Qi lose their harmony, it is deficiency. When Blood and Qi gather together, it is excess. If Blood and Qi rush together upward, it is Great Jue; sudden death ensues, but life is preserved if Qi returns, and death occurs if it does not." *Yangming Mai Jie Pian* states: "If Jue connects to the Zang organs, death results; if it connects to the meridians, survival is possible." Note: *Nei Jing* cannot exhaustively describe all Jue, but these sections outline the main principles. Generally, "Internal" refers to the Kidney, "Depletion" refers to essence loss, and "Jue" refers to rebellious Qi. "Yin" refers to muteness, and "Fei" refers to leg paralysis. In current Jue deficiency, inability to speak occurs because the Kidney meridian attaches to the root of the tongue; inability to walk occurs because the Kidney meridian runs along the inner thigh. The second chapter states: When Blood and Qi rush upward, the lower part becomes empty, showing that Spirit and Qi lose their root, leading to sudden collapse. The third chapter explains that connecting to meridians means pathology is in the muscle and surface, hence mild and survivable; connecting to Zang organs means pathology is in the root, hence severe and fatal. What is the human root? It is the Water and Fire within the Kidney. These three chapters elucidate each other. For Fire deficiency, use Liu Hejian's Di Huang Yin Zi (Rehmannia Infusion); for Water deficiency, use Luo Longji's Jie Ming Dan (Life-Sustaining Pill). Appendix: Jie Ming Dan formula uses two cups of human milk and one cup of juice from good pears mashed, poured into a silver pot, simmered in boiling water until yellow foam rises and the liquid clears ("opens the green path"), taken once daily on an empty stomach, embodying the principle of using humans to nourish humans.