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Shenfu Tang (Tonifying Category, Formula 37) Shuzhu Fu Tang (Tonifying Category, Formula 41) *Shenxiao* Huangqi Decoction (Tonifying Category, Formula 48, indicated for numbness) Renshen Gao (Tonifying Category, Formulas 16-33) Dihuang Yinzi (Tonifying Category, Formula 99) Qingzhou Baiwanzi (Harmonizing Category, Formula 112, indicated for phlegm and qi stagnation) Sansheng Yin (Heat Category, Formula 94, indicated for severe phlegm) Yufeng Dan (Harmonizing Category, Formula 274, indicated for blood and qi affected by pathogenic factors) Yilao Tianma Wan (Harmonizing Category, Formula 275, indicated for blood deficiency with pathogenic invasion) Jiaojiao San (Harmonizing Category, Formula 252, indicated for amenorrhea due to blood deficiency) Sanjian Tang (Heat Category, Formula 42, indicated for Yin Jue) Shenyang Zhen Dan (Harmonizing Category, Formula 313, indicated for paralysis) Tongguan San (Indication Category, Formula 98) Xuduan Wan (Harmonizing Category, Formula 306, indicated for foot diseases) Jiujin Niuxi Wan (Harmonizing Category, Formula 308, indicated for weakness of waist and legs) Tianyuan Jianbu Wan (Harmonizing Category, Formula 1101, indicated for weakness in walking)

The *Maijie Pian* (Chapter on Pulse Explanation) states: When internal essence is depleted leading to Jue (syncope/cold extremities), it results in aphonia (loss of voice) and paraplegia; this is Kidney Deficiency. When the Shaoyin channel Qi fails to arrive, it is Jue.
Examining the discussion of "Jue" in this chapter, it refers to the depletion of internal essence, meaning the essence and Qi of the five zang organs are damaged. Aphonia means the inability to produce sound. Paraplegia means the loss of function in one side of the body. People nowadays seeing this condition always attribute it to Zhongfeng (Wind Stroke), unaware that it stems from internal depletion and Kidney Deficiency. Sound originates from the Lung but its root lies in the Kidney; physical strength resides in Blood but its root lies in Essence. The root of both essence and Qi is governed by the Kidney; thus, when Shaoyin Qi does not arrive, Jue occurs. Furthermore, the *Tiaojing Lun* states: Insufficiency of Zhi (Willpower) leads to Jue. The *Benshen Pian* states: Kidney Qi deficiency leads to Jue. Observing these discussions, the principle of Feifeng (Non-Wind conditions) becomes clear. Therefore, in treating such cases, one should primarily follow the methods outlined in Article 3 of the "Treatment of Non-Wind Conditions" mentioned earlier.

The *Tiaojing Lun* records: Qibo said: When Qi and Blood congregate, Blood becomes deficient; when Blood and Qi congregate, Qi becomes deficient. The Yellow Emperor asked: What humans possess is merely Blood and Qi. Now you say that congregation of Blood leads to deficiency, and congregation of Qi also leads to deficiency; is there no Excess? Qibo replied: Presence of pathogen is Excess; absence is Deficiency. When Blood and Qi lose their harmony, it manifests as Deficiency. When Blood and Qi congregate, it manifests as Excess. If Blood and Qi rush upward together, Da Jue (Great Jue) occurs. Jue resembles sudden death. If Qi returns downward, life is preserved; if it does not return, death ensues.

Qi congregating with Blood causing Blood deficiency, and Blood congregating with Qi causing Qi deficiency, represents the partial failure of Yin and Yang. Now, when Qi and Blood rush upward together, Yin is deficient below, and Shen Qi lacks a root. This is the sign of Yin-Yang separation, leading to Jue collapse and sudden death. Cases where Qi returns are mild; those where it does not return are severe. This is precisely what people today call Zhongfeng characterized by sudden falling and fainting, or Zhongfeng caused by Phlegm-Fire surging upward, yet they fail to realize it actually stems from lower Jiao deficiency. However, the Excess above is false Excess; in severe cases, it may require slight clearing. For the Deficiency below, if there is no pathogenic Excess to address, one must swiftly tonify the lower Jiao with strong herbs.

The *Yangming Maijie Pian* states: If Jue connects to the Zang organs, death results; if it connects to the channels, survival is possible.
Observing the connection between channels and Zang organs discussed in this chapter, it speaks clearly and correctly of Jue. Disease connecting to channels is in the muscle and surface, hence mild and survivable; disease connecting to Zang organs is in the root, hence severe and fatal. Knowing this is Jue, any symptoms like sudden fainting and falling indicate non-wind etiology. However, Hejian scholars spoke of Zhongfu (Wind affecting Fu organs) and Zhongzang (Wind affecting Zang organs), thereby confusing Wind with non-Wind to the point of indistinguishability.

The *Daqi Lun* states: A pulse rapid like panting is named Bao Jue (Sudden Jue). Those with Bao Jue cannot speak with others.

The *Xiejingwei Lun* states: In Jue, the eyes see nothing. When a person suffers Jue, Yang Qi congregates above and Yin Qi congregates below. Yang congregating above means Fire shines alone; Yin congregating below causes cold feet, and cold feet lead to distension.
Examining these two chapters, "pulse rapid like panting" refers to a pulse urgent and rapid like breathing difficulty, a sign of chaotic Blood and Qi deterioration, leading to Bao Jue and muteness, similar to modern "stroke with muteness." "Yang congregating above, Yin below" indicates Upper Heat and Lower Cold, a state of Water and Fire failing to interact, leading to blindness, similar to stroke with dizziness. Muteness is attributed to Lung and Kidney. Dizziness is attributed to Liver and Spleen. Temporary vision recovery implies Qi returning and revival. Yin collapse is the most critical sign. All should be treated according to previous methods to rescue the root.

The *Diankuang Pian* states: In the disease of Jue, the feet become suddenly cold, the chest feels as if tearing apart, the intestines feel as if cut by a knife, there is irritability preventing eating, and the pulse is choppy regardless of size. Warmth should be applied to Foot Shaoyin points; cooling to Foot Yangming points. Cooling patterns use tonification; warm patterns use sedation.

Sudden cold refers to abrupt chilling. Feeling like tearing or cutting describes indescribable distress and pain, which is the irritability and confusion seen in certain strokes. With Fire, symptoms are often warm with a洪大 (Surging-Large) pulse; clear Fire within Yin. With Phlegm, symptoms include wheezing and congestion with a滑实 (Slippery-Excess) pulse; open Upper Jiao Phlegm. Without Fire or Phlegm, symptoms are cold with a weak and choppy pulse; tonify Yuan Qi. If these symptoms accompany unconsciousness, it is severe involvement of Zang organs, mostly incurable.

The *Shengqi Tongtian Lun* states: Human Yang Qi, when overworked, expands; essence is exhausted. Accumulating into summer causes Jian Jue (Frying Jue). Human Yang Qi, upon great anger, causes form and Qi to sever, and Blood stagnates above, causing Bo Jue (Thin/Impetuous Jue).

Jian Jue mentioned here is akin to Re Jue (Heat Jue). Caused by overwork accumulating in summer, it corresponds to modern Shu Feng (Summerheat Wind). If convulsions, phlegm, and sudden collapse occur, treat immediately using methods for Summerheat Wind. Bo Jue refers to impetuous struggle, caused by great anger, corresponding to Qi Jue or Blood Jue; treatment follows below.

The *Tongping Xushi Lun* states: In treating Xiaodan (Wasting-Thirst), Puji (Falling Strike), Piangu (Hemiplegia), Weijue (Atrophy-Jue), and Qi Man Fani (Fullness and Reverse Flow), fat and noble individuals suffer from Gaoliang diseases (rich diet disorders). Ge Sai Bi Jue (Diaphragm obstruction and closure) with upper-lower blockage is caused by Bao You (Sudden Grief). Sudden Jue with deafness and unilateral blockage is due to internal Qi suddenly pressing inward. Diseases not originating from internal or external Wind remain lingering, causing emaciation.
Examining Gaoliang diseases, these are injuries from alcohol and sex, belonging to Spleen and Kidney disorders. Bao You diseases belong to grief injuring the Lung. Internal Qi pressing inward belongs to depression and anger injuring the Liver. All are internal injury diseases. Those not injured internally but externally struck by Wind linger in the channels, causing emaciation and painful bi syndrome. Thus, the distinction between internal injury and external contraction cannot be confused.

The *Nishun Feishou Pian* states: The Chong Mai (Penetrating Vessel) is the Sea of the Five Zang and Six Fu organs; all receive from it. Its ascending branch emerges at Kangsang, permeates the Yang channels, and nourishes essences. Its descending branch injects into the large collateral of Shaoyin, emerges at Qichuang, follows the medial thigh, enters the popliteal fossa, runs deep within the bone, and descends behind the medial malleolus to branch. Another descending branch runs parallel to Shaoyin, permeating the Three Yin. The anterior branch runs deep emerging at the dorsum, descends along the foot, enters the space between the big toe, permeates collaterals to warm muscles. If collaterals knot, the dorsum becomes immobile; immobility leads to Jue, and Jue leads to cold.
Examining the Chong Mai, it spans head to foot, back to front. All Zang-Fu and twelve channels receive from it, hence called the Sea of Zang-Fu and Twelve Channels. The sea is the source of rivers; all channel origins have convergence meanings, indicating it governs whole-body Blood and Qi prosperity and decline. The Chong Mai originates in the Baozhong (Uterus/Energy Center), being both its meridian path and storage site, hence called Blood Sea and Mingmen (Gate of Life). This is the residence of the root. If one indulges in desires, damaging the source of essence here, then Jue collapse and sudden falling arise from this. Otherwise, how could one suddenly fall with spirit and form ruined, interior and exterior destroyed, completely insensible? Could this be caused by a single channel or Zang organ? Clearly, it is undoubtedly Chong Mai collapse. Thus, treating this by abandoning the root to seek relief is impossible. Detailed meaning of Chong Mai is in *Leijing*, Meridian Class, Chapter 27 note.

The *Mici Lun* states: Pathogens invade the collaterals of Hand/Foot Shaoyin, Taiyin, and Foot Yangming. These five collaterals converge in the ear and ascend to connect the left corner of the head. If all five collaterals exhaust, the body's pulses move, but the form is insensible. The state resembles a corpse, called Shi Jue (Corpse Jue). Shave one square cun of hair from the left corner, burn to ash, drink with a cup of fine wine; if unable to drink, force-feed, and recovery is immediate. (Acupuncture methods detailed in Vol 27 Ear Section).
Examining Shi Jue, it is a severe outcome of sudden external pathogen invasion. It includes irregular Qi of four seasons, mountain demons, earth煞, Wu Shi, and Yan Mei. Victims suddenly experience cold extremities, shivering skin, blue-black face, unsettled spirit, locked jaw with delirium, congested phlegm, dizziness, fainting, and unconsciousness. Named Fei Shi Cu Jue, acupuncture is suitable (see original text). For moxibustion, Qin Chengzu’s Ghost-Moxibustion or Hua Tuo’s Yang Collapse Moxibustion are excellent. Regarding medication, since pathogens gather where Qi is deficient, the original text uses hair (Blood Remainder) to tonify the exhaustion of the five collaterals. In such crises, without Shenfu Hu yang (Return Yang) herbs, how can life be saved? If pathogenic Excess is severe and chest/diaphragm unclear, one must first open/blockages, then regulate. Suitable formulas include Buhuanjin Zhengqi San, Liqi Yin, Scallion-Ginger Soup, or Suhexiang Wan, chosen appropriately.

The *Fang Shengshuai Lun*: Leigong asks: Regarding the quantity of Qi, what is Ni (Reverse) and what is Cong (Following)? The Yellow Emperor says: Yang follows Left, Yin follows Right; Elderly follow Up, Youthful follow Down. Thus, regardless of Qi quantity, reversal leads to Jue. Asked: Is excess Jue? Answer: Qi going up but not down leads to Han Jue reaching the knees. Youth die in Autumn/Winter; Elderly survive Autumn/Winter. Qi going up but not down causes headache and epilepsy; seeking Yang yields nothing, seeking Yin is unclear; Five Regions are isolated without signs. Living in wilderness or empty rooms,绵延 (continuous) for less than a day. Thus, Jue from Qi deficiency causes wild dreams, extreme confusion.
Here, Qi reversal is Jue. Yang rises from Left, Yin descends from Right; thus Yang disease is worse on Left, Yin disease on Right, because rising fails to rise and descending fails to descend, reversing their movement. Human Sheng Qi must rise from below; thus, for the elderly whose Qi declines below, rising from above is smooth; for youth whose Qi is abundant below, rising from below is smooth. If Elderly have spirit declining above, their end is known; if Youth have form declining below, their beginning is known; both are reverse signs. When illness causes Qi up but not down, the root is deficient, hence Han Jue reaches knees. Youth have vigorous Yang; if Yang declines thus, they die in Autumn/Winter. Elderly have naturally weak Yang and fear cold normally, so Autumn/Winter is safe. All such Jue diseases appear neither purely Yang nor purely Yin; Five Zang are isolated without signs. Inability to last a day emphasizes severe decline. Wild dreams leading to coma result from Heart-Kidney non-interaction and spirit scattering, causing Jue. Such cases belong to Shaoyin root disease.

The *Jue Lun*: Qibo said: Yang Qi deficiency below is Han Jue; Yin Qi deficiency below is Re Jue. The Yellow Emperor asked: Why does Re Jue heat start from the soles? Qibo said: Yang Qi starts at the dorsal aspect of the five toes; Yin meridians gather at the sole and center. Thus, Yang excess causes hot soles. The Yellow Emperor asked: Why does Han Jue cold start from toes and rise to knees? Answer: Yin Qi starts at the palmar aspect of the five toes, gathers below the knee, and accumulates above the knee. Thus, Yin excess causes cold from toes to knees. This cold comes from inside, not outside. Why did this person lose balance? This person was robust but depleted essence in Autumn/Winter. Yang Qi declined, unable to nourish channels; Yang daily decreased, Yin remained alone, causing cold hands and feet. How does Re Jue occur? Wine enters the Stomach, filling collaterals but emptying meridians. Yin deficiency allows Yang entry; Yang entry causes Stomach disharmony; Stomach disharmony exhausts essence; essence exhaustion fails to nourish limbs. Such persons often drink heavily or engage in sex after full meals. Qi gathers in Spleen, unable to disperse; Wine Qi and Grain Qi struggle, generating intense heat in the middle. Heat pervades the body, causing internal heat and red urine. Wine Qi is potent; Kidney Qi declines daily; Yang stands alone. Thus, hot hands and feet. The Yellow Emperor asked: Why does Jue cause abdominal fullness, sudden unconsciousness, or delayed consciousness (half a day to a day)? Qibo said: Yin excess above causes lower deficiency; lower deficiency causes abdominal fullness. Yang excess above causes lower Qi to press upward and pathogenic Qi to reverse; reversal causes Yang chaos; Yang chaos causes unconsciousness.

The *Jue Lun* Yellow Emperor asked: I wish to hear the manifestations of Jue in the six meridians. Qibo said: Jue of Juyang (Taiyang) causes swollen head, heavy head, inability to walk, falling, vomiting blood, and frequent epistaxis. Jue of Yangming causes mania, running and shouting, abdominal fullness, inability to lie down, red hot face, hallucinations, delirium, wheezing cough, fever, fright, epistaxis, vomiting blood. Jue of Shaoyang causes sudden deafness, swollen hot cheeks, hypochondriac pain, immovable joints, stiff neck, inability to look back, inability to walk, intestinal abscess (incurable), and death if frightened. Jue of Taiyin causes abdominal fullness, difficult defecation, anorexia, vomiting after eating, inability to lie down, tendon spasm, heart pain radiating to abdomen. Jue of Shaoyin causes dry mouth, red urine, abdominal fullness, heart pain, vomiting changes, clear diarrhea. Jue of Jueyin causes lower abdominal swelling/pain, abdominal distension, difficult urination, desire to lie with bent knees, penile retraction/swelling, internal heat, spasmodic back pain, empty fullness (urinary retention, delirium). Jue of all Three Yin causes inability to pass stool/urine, cold hands/feet, death in three days. Jue of Hand Taiyin causes empty fullness, cough, frequent vomiting of foam. Jue of Hand Jueyin (Pericardium) and Shaoyin causes heart pain radiating to throat, fever; death, incurable. Jue of Hand Taiyang causes deafness, weeping, stiff neck, inability to look back, inability to bend/extend waist. Jue of Hand Yangming and Shaoyang causes Houbi (throat obstruction), throat swelling, spasms.
Examining Han Jue and Re Jue in this chapter, although discussed via hands and feet, it truly refers to Yin-Yang chaos. Han Jue mentions depletion from overuse; Re Jue mentions frequent drunkenness, emphasizing that Yin-Yang Qi originates in the extremities. Thus, impending Jue shows cold/hot/numbness starting in extremities; when severe, complications arise, with each Zang-Fu having specific signs. Extremity Jue is merely the visible sign. Seeing the subtle reveals the significant; one must consider the root based on the branch.