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1. Treatment of Cold Jue and Heat Jue: In cases of Cold Jue (cold extremities), the limbs are invariably cold, the pulse is deep, thready, and not rapid, or if rapid, it lacks force; the patient may fear cold and prefer warmth, pull clothes to cover themselves, suffer from diarrhea with undigested food, and generally appear alert. Although these all belong to cold syndromes, there are many cases that resemble heat but are not true heat. Therefore, whenever extremities are cold and the pulse and symptoms show no signs of excess heat, it is undoubtedly Cold Jue.

In cases of Heat Jue, there are initially multiple heat symptoms: the pulse is deep, slippery, and rapid; the patient fears heat and prefers cold, waves hands and kicks feet, suffers from restlessness and irritability, has constipation and dark urine, and generally appears dazed or confused. To treat these two types, one should primarily adopt the methods for treating cold and heat syndromes as outlined in the "Non-Stroke Section" (Fei Feng Men). Regarding Jue syndromes in Shanghan (Cold Damage) disease, whether Yin or Yang, they should also be differentiated using this method. However, Jue in Shanghan focuses on differentiating the pathogenic factor; thus, Cold Jue is suitable for warming, while Heat Jue can be treated with purgation. The Jue described in the *Neijing* emphasizes Yuan Qi (Original Qi); therefore, Heat Jue requires nourishing Yin, and Cold Jue requires tonifying Yang. The treatments for these two must be carefully distinguished.

2. There are two types of Qi Jue (Qi-induced fainting): both Qi deficiency and Qi excess can cause Jue. In sudden collapse due to Qi deficiency, the patient’s form and Qi appear depleted, complexion is pale or bluish-white, the body is slightly cold, and the pulse is weak; this is a Qi Collapse syndrome. It is appropriate to use herbs such as Renshen (Ginseng Radix et Rhizoma), [text missing, likely Huangqi or Baizhu], Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Dihuang (Rehmanniae Radix), Gouqi (Lycii Fructus), and formulas like Dabu Yuan Jian (Great Tonification of the Origin Decoction). For severe cases, Huiyang Yin (Decoction to Return Yang) or Dushen Tang (Single Ginseng Decoction) should be used. In Jue caused by Qi excess, the patient’s Qi appears angry and vigorous, the pulse is deep, wiry, and slippery, with chest and diaphragm fullness and wheezing; this is a Qi Rebellion syndrome. The classics state: "Great anger causes the form and Qi to sever, and blood stagnates above," which belongs to this category. Treatment should prioritize smoothing Qi using Paqi Yin (Decoction to Expel Qi), Simo Yin (Four-Monk Decoction), Bawei Shunqi San (Eight-Spice Qi-Smoothing Powder), or Suhexiang Wan (Styrax Pill). After Qi is smoothed, regulation should follow based on deficiency or excess. Furthermore, if anger causes Qi rebellion and subsequent damage to True Qi, the Qi is inherently deficient; similarly, if one is prone to depression and fear, leading to timid and sinking Qi, the deficiency is even more evident. Using Qi-moving and stagnation-resolving agents in such cases would be an error.

3. There are two types of Xue Jue (Blood-induced fainting): Blood depletion and Blood rebellion can both cause Jue. In Blood depletion, such as massive hemorrhage or severe vomiting, or excessive blood loss after childbirth, Qi follows and depletes, causing sudden collapse and apparent death. One should first pinch the Renzhong acupoint or burn vinegar-soaked charcoal to consolidate Qi, then urgently administer a decoction of 50–100g of Renshen (Ginseng Radix et Rhizoma). As long as Qi does not completely dissipate, consciousness will gradually return. Subsequently, regulate gently according to cold or heat patterns. This is known as "tonifying Qi in cases of Blood depletion." If one fails to recognize this and uses only blood-nourishing medicines, the faint trace of Qi will scatter, Yin will lose its master, and life will cease. Those who use cold-cooling herbs to stop bleeding will inevitably destroy Yang Qi, accelerating death. Blood rebellion refers to the classic description of "blood and Qi rushing upward together," or "great anger causing Qi to sever and blood to stagnate above." Since blood follows Qi rebellion, Qi must be regulated first; once Qi moves, blood will flow. Use Tongyu Jian (Decoction to Unblock Stasis) or Huagan Jian (Decoction to Transform Liver Fire) to resolve stasis. Once blood flows and Qi relaxes, regulate according to symptoms.

4. Tan Jue (Phlegm-induced fainting) occurs when phlegm-saliva suddenly obstructs the airway, causing Qi blockage, unconsciousness, and inability to take medicine or food. One must first treat the branch (symptom) by inducing vomiting or opening the orifices to address the emergency. Once phlegm and Qi are slightly cleared, treat the root cause. If phlegm is generated by fire, clear and descend it; if by wind-cold, disperse and warm it; if by dampness, dry and drain it; if by Spleen deficiency, tonify the Spleen; if by Kidney deficiency, tonify the Kidney. Thus, direct treatment of phlegm is unnecessary; treating the cause clears the phlegm naturally. However, some cases cannot tolerate aggressive phlegm-resolving methods, as attacking further weakens the patient and worsens phlegm. Various phlegm-treatment methods are detailed in the "Phlegm Section" of the "Non-Stroke Chapter."

5. Jiu Jue (Alcohol-induced fainting) belongs to the category of Heat Jue mentioned in the classics. The classics also refer to "Jiu Feng" (Wind from Alcohol) as similar. People who drink without restraint often suffer from this. When their Qi and Blood are strong, they can withstand alcohol and perceive no harm; but as vitality declines, the damaging effects of alcohol become terrifying. Alcohol diseases are numerous, but Jiu Jue resembles stroke. Mild cases retain awareness; severe cases involve sudden collapse, unconsciousness, irritability, muteness, profuse phlegm, wheezing, fever, cough, or hematemesis. If the stool is dry, the pulse is excess-type, and the patient prefers cold, it is a syndrome of Damp-Heat obstructing upwards. Use Chouxin Yin (Decoction to Draw Out the Firewood) to rapidly reduce fire. For severe fire, alternate Lijiang Yin (Pear Juice Decoction) and Ludou Yin (Mung Bean Decoction) to detoxify. This syndrome strictly prohibits pungent-drying substances. Ensure damp-heat recedes and Shen Qi (Spiritual Qi) recovers slightly before using Yin-tonifying agents for recovery. If the stool is loose, there are no fire signs, and the pulse is slow and weak, do not clear fire; instead, use Erchen Tang (Two-Aged Decoction), Liujunzi Tang (Six-Gentlemen Decoction), or Jinshui Liujun Jian (Metal-Water Six-Gentlemen Decoction). If alcohol damages Yin, leading to dual deficiency of Spleen and Kidney and resulting in Jue collapse, urgent rescue of the root source is essential. Patients must abstain from alcohol for life. Failure to heed this warning makes recurrence difficult to treat.

6. Se Jue (Sexual Activity-induced fainting) has two types: sudden collapse and blood movement. Sudden collapse in Se Jue occurs in individuals with inherent deficiency who exert themselves excessively during sexual activity or indulge in prolonged desire. Post-coitally, Qi departs with Essence, leading to irreversible collapse. Urgently pinch Renzhong, have the partner hold the patient, and use mouth-to-mouth resuscitation to transmit warm breath and reconnect Qi, preserving the Spirit. Immediately administer Dushen Tang (Single Ginseng Decoction) or moxibustion on Qihai (CV6) dozens of times to restore Yang Qi. Due to panic at the moment, proper care is often neglected, leading to death. This describes immediate onset; delayed onset is more common. Frequent essence loss leads to gradual Qi depletion. Symptoms often appear 2–3 days after intercourse. Because it is not immediate, it is often ignored. Many hide this fact, yet middle-aged individuals frequently fall ill due to it. Unskilled physicians often misdiagnose this as stroke, leading to death. Treatment should focus on tonifying Mingmen (Gate of Life), either by nourishing Water or Fire, following the third method in the "Non-Stroke Section." The second type, blood movement in Se Jue, involves Qi and Blood rushing upward, belonging to Xue Jue. Unlike blood rebellion from anger, this is caused by Desire Fire flaring up, forcing blood upward. It occurs when desire is intense but unfulfilled, or when alcohol is used to suppress suppressed fire. Symptoms include sudden hematemesis, uncontrollable epistaxis, Jue, sweating, wheezing, or cough, all due to Deficient Fire rushing upward. Treat by suppressing fire using Qinghua Yin (Clearing Transformation Decoction), Siyin Jian (Four-Yin Decoction), or Jiayi Yiyin Jian (Modified Single-Yin Decoction). In cases of Yin exhaustion below, Fire failing to return to its source, without heat signs, but with persistent critical blood Jue, Zhenyin Jian (Settling Yin Decoction) is indispensable. Stabilize the condition first, then treat according to symptoms.

7. Zang Jue (Viscera Jue) and Hui Jue (Roundworm Jue) are both Shanghan syndromes; see the "Shanghan Section."