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The sequence of disease transmission proceeds from Shaoyin (Lesser Yang) to Jueyin (Terminal Yin). Jueyin refers to the Liver; the Liver is the zang organ associated with Jueyin. The portion of the liver diaphragm that hangs downward and connects with the fatty membrane surrounding the Kidney constitutes the Jueyin meridian. Because this meridian connects with the fatty membrane of the Shaoyin meridian, pathogenic factors can transmit from Shaoyin to Jueyin. "Jue" implies reversal or extremity. Pathogenic qi transmitted from Shaoyang (Lesser Yang) and Taiyin (Greater Yin) enters Shaoyin, then reverses and transmits upward to the Liver. Furthermore, the transformation of qi within the meridians reaches its conclusion here, where Yin is exhausted and Yang begins to generate; thus it is named Jueyin.

The original text of *Shanghan Lun* states: In Jueyin disease, symptoms include excessive thirst (Xiaoke), a sensation of Qi rushing upward to strike the heart, pain and heat in the chest/heart region, hunger without desire to eat, vomiting of roundworms if food is ingested, and unceasing diarrhea if purgatives are misused.

The *Neijing* states: "At the upper aspect of the Jueyin, Wind Qi governs, and internally it corresponds to Shaoyang." Here, Shaoyang refers to the Ministerial Fire residing within the Liver. Because Ministerial Fire resides in the Liver, when provoked by external pathogens, it flares up violently, causing excessive thirst. The Ministerial Fire, carrying Liver Qi, rushes upward, creating the sensation of Qi striking the heart and causing pain and heat in the chest. Generally, individuals with Liver Heat also possess Stomach Heat. Stomach Heat aids digestion, while Liver Heat induces nausea; thus, the patient feels hungry but lacks the desire to eat. Regarding intestinal roundworms, the intestines are influenced by Wood Qi and Shaoyang transformations, which naturally foster worm generation. After illness, laziness to eat leaves the intestines empty, depriving worms of nourishment. When the patient eats slightly, the worms detect the food odor and ascend, resulting in vomiting of roundworms. As for unceasing diarrhea following misuse of purgatives: when the Liver is invaded by external pathogens, it is unable to perform its function of free flow and discharge (Liver governs Shuxie). If purgative drugs act as guides at this moment, they cause the Kidney to over-activate Qi movement (as the Liver directs Kidney Qi), leading to uncontrollable hyper-secretion and diarrhea.

The original text of *Shanghan Lun* states: In cold damage, if the pulse is faint and there is coldness of the extremities, and by the seventh or eighth day, the skin becomes cold and the patient is restless with no moment of peace, this is Zang Jue (Organ Cold Reversal), not Tui Jue (Roundworm Reversal). Patients with Tui Jue typically vomit roundworms. If the patient is quiet but experiences intermittent irritability, it indicates internal cold causing worms to ascend into the diaphragm, causing irritability, which ceases after a short while. Eating causes vomiting and renewed irritability because worms emerge upon smelling food; such patients will spontaneously vomit roundworms. For Tui Jue, Wumei Wan is indicated; it is also indicated for chronic diarrhea.

[Wumei Wan Formula] Wumei (Mume Fruit) 300 pieces, Xixin (Asarum Root) 6 liang, Ganjiang (Dried Ginger) 10 liang, Huanglian (Coptis Rhizome) 1 jin, Danggui (Angelica Sinensis Root) 4 liang, Fuzi (Prepared Aconite Root) 6 liang (peeled and processed), Shujiao (Sichuan Pepper) 4 liang (stir-fried until oil exudes), Renshen (Ginseng Root) 6 liang, Huangbai (Phellodendron Bark) 6 liang, Guizhi (Cinnamon Twig) 6 liang (peeled).
Process the ten ingredients separately by pounding and sieving, then mix them. Soak Wumei in vinegar overnight, remove pits, and steam over five sheng of rice. Once the rice is cooked, pound the Wumei into a paste, mix thoroughly with the powdered herbs, place in a mortar, add honey, and pound two thousand times to form pills the size of paulownia seeds. Take ten pills before meals with warm water, three times daily, gradually increasing to twenty pills. Avoid raw, cold, slippery, and spoiled foods.

The Jueyin chapter presents profound pathology, making it difficult to elucidate. Commentators, citing the phrase "Yin and Yang Qi fail to connect smoothly," use the text to explain itself regarding cold extremities, failing to deeply investigate why this disconnection occurs specifically in the Jueyin meridian. The Liver governs free flow and discharge and belongs to Wind-Wood. Corresponding to Spring, it represents the beginning of growth. Its lower diaphragmatic extension connects with Qihai (Sea of Qi), allowing it to disseminate congenital Yuan Qi throughout the body, ensuring smooth Qi transformation everywhere. When external pathogens invade the Liver, its ability to discharge is suddenly lost. Consequently, Qi transformation within the organs cannot reach the exterior. Although substantial heat accumulates internally, the extremities become cold; this is the "failure of Yin and Yang Qi to connect smoothly." Vomiting often occurs because the discharge force has nowhere to go outward, so it accumulates to an extreme and rushes upward against the stomach opening. Additionally, constant irritation by Liver Qi damages Spleen-Stomach Earth (Wood overacting on Earth), weakening Middle Qi, which may lead to Chuzhong (Elimination of the Middle). Chuzhong indicates that Spleen-Stomach Qi is exhausted, signaling imminent danger. Diarrhea is not always due to organ cold; if latent heat窜入 (intrudes into) the Liver meridian, suppressing Liver Qi excessively, it can stimulate the discharge force to rush upward or downward, causing diarrhea. However, the stool will feel hot, not cold.

Consider this clinical case for illustration: Mr. Liu XX from Liaoning, residing in Tianjin, nearly forty years old, contracted vomiting and diarrhea in early autumn. Within six days, he could retain nothing; he suffered diarrhea more than twenty times in a single day and night, facing critical danger. His pulse was faint and fine, yet deep pressure revealed a string-taut and long quality. Extremities were very cold, skin near-cold, but the chest felt intensely hot, and the stool felt hot. I diagnosed Jueyin Warm Disease (equivalent to Jueyin Cold Damage in *Shanghan Lun*, though Wenbing was distinguished early on, later subsumed under Shanghan). His vomiting was severe; any medicine taken was immediately expelled, leaving me helpless. I asked, "Since your chest burns, do you crave ice?" He replied, "Yes, but my family forbids it." I said, "This condition is critical. Another day and night of this vomiting and diarrhea cannot be saved even by immortal elixirs. Only by consuming ice cream mixed with finely ground Shigypsum Fibrosum (Raw Gypsum) can we stop the vomiting; once vomiting stops, treating diarrhea will be easier." I advised purchasing ice cream mixed with approximately one liang of Raw Gypsum powder. After ingestion, symptoms improved; he could tolerate some thin porridge, and diarrhea decreased. On the second day, extremities were no longer cold, body temperature slightly warm, pulse larger than before, chest still hot, occasional vomiting persisted. I prescribed another one liang of Raw Gypsum powder mixed into watermelon. Vomiting ceased completely. On the third day, heat remained; although chest heat subsided somewhat, he craved cool foods, lacked appetite, and diarrhea had improved significantly. I prescribed Baihu Jia Renshen Tang (White Tiger Plus Ginseng Decoction): Shigypsum Fibrosum 2 liang, Yetairen (Wild Ginseng) 3 qian, replaced Zhimu (Anemarrhena Rhizome) with Sheng Hangshao (Raw Paeonia Radix Alba) 6 qian, replaced Jingmi (Rice) with Sheng Shanyao (Dioscorea Rhizome) 6 qian, increased Gancao (Licorice Root) to 4 qian, and added Huashi (Talcum) 6 qian. These substitutions aimed to clear heat and stop diarrhea. Decocted into two bowls, taken warm in two doses, the patient recovered fully. This method applies to Jueyin Warm Disease; similarly, for Winter Jueyin Cold Damage with substantial heat, this approach is valid. Jueyin belongs to Wood, inherently warm; with resident Shaoyang Ministerial Fire, it becomes hot. If latent heat intrudes and agitates the Ministerial Fire, extreme heat results. Using Gypsum, ice cream, and watermelon together seems aggressive, but I have witnessed many deaths from intractable vomiting, especially with concurrent diarrhea. Driven by compassion, I devised this miraculous rescue formula amidst hopeless circumstances, disregarding concerns about its aggression. If ice cream or watermelon is unavailable, fresh pear slices dipped in Raw Gypsum powder may be used to facilitate swallowing and stop vomiting.