轩岐之所谓厥者，热厥则其内热而外证亦热，寒厥则其内寒而外证亦寒；仲景之所谓厥者，其外证则必
寒，而其内则有寒者、有热者，此其异也。至后世则概卒然昏运诸病名之为厥，抑又异矣。轩岐之厥，鲜能演
其义者；仲景之厥，前人所说既拈出《伤寒》中，今此所举者，多为后世之厥，而寒热二证固亦所及焉。
名义 厥，逆气从下厥起上行，入心胁也。（《释名》）
夫厥者逆也，谓阴阳二气卒有衰绝，逆于常度。（《病源论》）（按∶此说欠当。）
今人又以忽然昏运，不省人事为厥。（《准绳》）
总说 厥逆之证，危证也。盖厥者尽也，逆者乱也，即气血败乱之谓也（按∶此说非是）。故《内
经》特重而详言之，如云卒厥暴厥者，皆厥逆之总名也。如云寒厥热厥者，分厥逆之阴阳也。如云连经连脏
者，论厥逆之死生也。再若诸经脏腑之辨，亦既详矣。又近世犹有气厥、血厥、酒厥、脏厥、蛔厥等证，亦
无非本之经义。观《内经》诸论已极明显，奈何后人犹不能察，凡遇此证，则悉认之为中风，竟不知厥逆
为何病而通作风治，害孰甚焉。（《景岳》）
阳厥阴厥 骤风暴热，云物飞 ，晨晦暮晴，夜炎昼冷，
应寒不寒，当雨不雨，水竭土坏。时岁大旱，草木枯悴，江
河乏涸，此天地之阳厥也。暴壅塞，忽喘促，四肢不收，二腑不利，耳聋目盲，咽干口焦，舌生疮，鼻流
清涕，颊赤心烦，头昏脑重，只睛似火，一身如烧，素不能者乍能，素不欲者乍欲，登高歌笑，弃衣奔走，
狂言妄语，不辨亲疏，发躁无度，饮水不休，胸膈膨胀，腹与胁满闷，背疽肉烂，烦溃消中，食不入胃，水
不穿肠，骤肿暴满，叫呼昏冒，不省人事，疼痛不知去处，此人之阳厥也。阳厥之脉，举按有力者生，绝
者死。飞霜走雹，朝昏暮霭，云雨飘 ，风露寒冷，当热不热，未寒而寒，时气霖霪，泉生田野，山摧地裂，
土坏河溢，月晦日昏，此天地之阴厥也。暴哑卒寒，一身拘急，四肢拳挛，唇青面黑，目直口噤，心腹满痛，
头颔摇鼓，腰脚沉重，语言謇涩，上吐下泻，左右不仁，大小便活，吞吐酸渌，悲忧惨 ，喜怒无常者，此
人之阴厥也。阴厥之脉，举指弱，按指大者生。举按俱绝者死，一身悉冷，额汗自出者亦死。阴厥之病，过三
日勿治。（《中藏》）（按∶此所云别是一义，故自为条。）
寒热虚实 经论如此（按∶此上载《厥论》文），虽粗分六经，殊不出寒热二证所因，欲求备治，
当历明之。寒厥则因多欲而夺其精，故致阳衰阴盛。热厥则因醉饱入房，精虚则热入，故致阴虚阳盛。考
其厥因，多以不胜乘其所胜，气不得行，遂致于逆。如肾移寒于脾，则水乘于土，水既不行，乃成寒厥。如心
移热于肾，则火乘于水，火既不行，乃成热厥。六经皆然，可次第论也。所谓得其要者，一言而终矣。（按∶
此下论尸厥。录在后。）寒则热，热则寒，闭则通，如经所谓盛则泻，虚则补，不盛不虚，以经取之，其旨一
也。经中以数醉为热厥之因，学人不可拘此，盖伤寒温病皆
有热厥，仲景所谓热深厥深，圣意以酒能发百脉热，故举此
以为例耳，不可不知。（《三因》）
厥者逆也。谓阴气乘于阳，阴气居于下，阳气处于上，阳虚则阴实，实则阴盛，阴盛则上乘于阳，卫气为
之厥逆，失于常度，故寒从背起，手足冷逆，阴盛故也。（《病源论》）
厥证寒热，亦有阴阳虚实不同，如形气稍实者，宜从子和之法吐下之。虚甚者，惟宜随其所因而调理
之可也。（《微义》）
《伤寒》之厥，辨在邪气，故寒厥宜温，热厥可攻也。《内经》之厥，重在元气，故热厥当补阴，寒厥
当补阳也。二者之治，不可不察。（《景岳》）
厥有多端，须分阴阳虚实。如未厥前吐泻不渴，身凉蜷卧，及已发而脉迟，口出涎沫者，阴厥也。如未厥
前便秘溺涩，口渴身热烦躁，及已发而脉数大，口中反干燥者，阳厥也。若厥而口噤牙闭者，实厥也。厥而口
张自汗者，虚厥也。（《汇补》）
阳厥即热厥，其证四肢厥逆，身热面赤，唇燥大渴，口干舌苔，目闭或不闭，小便赤涩短少，大便燥结，
忌升发、补敛、燥热辛温，宜下、清热、甘寒、苦寒、咸寒。阴厥即寒厥，其证四肢厥逆，身冷面青蜷卧，手
指爪青黯，腹痛大便溏，或完谷不化，小便自利，不渴，不省人事，忌下、破气、苦寒、咸寒、酸寒，宜
补气、温中、甘温、辛热。（《本草经疏》）
病由气闭肝逆 或曰∶前之论厥有六（按∶所谓六者，系寒、热、痰、气、蛔、血），致厥之因可
能悉否？答曰∶厥症不止于六者，其常也。致厥之因，因于气闭，而一时诸
经之脉，内外陡闭不通。何也？营者营于中，卫者卫于外，
今营气反拒绝于外，卫气反隔闭于中，所以内格外拒，上下不通，故肢体僵卧，手足厥逆，六脉沉伏，厥之大
义如此。诸厥之为病，虽四肢厥逆，少刻阴退阳回，气脉一通即愈。不若诸虚之症，手足冷厥，脉微欲绝，汗
出如雨，痰声如锯，此皆临危之绝症。（《百问》）
先生于是症，独重在肝。盖肝者将军之官，善干他脏者也。要知肝气一逆，则诸气皆逆，气逆则痰生，遂
火沸风旋，神迷魂荡，无所不至矣。（《临证指南》邵新甫）
脉候 涩则无血，厥寒为甚，尺微无阴，下痢逆冷。热厥脉伏，时或而数，便秘必难，治不可错。（
《崔氏脉诀》）
厥逆之脉多于沉伏者。但沉迟散为之寒，沉伏而数为之热，浮而无力者是气虚，洪滑有力属顽痰，沉滑
身冷者难治。（《玉案》）
辨异 （轻重）卒中之脉，由气虚欲脱，有浮洪、搏急、缓滑、弦紧之脉候。诸厥之脉，由气闭不
通，则沉伏涩脱或沉弦微滑之分别也。卒中之症，面赤肢温，息粗鼻鼾，体和顺而不象病形。诸厥之症，面青
口噤，四肢厥冷，肢体僵强，奄奄一息，如死状也。（《百问》）
古人又有尸厥、痰厥、风厥、寒厥、痉、 、痫、角弓反张皆似厥，极惊人，极难辨，识得真，勿惊忙，
候脉息面色，看清动作厥状而治之。大指掐拳内凶，掐拳外轻。脉大浮洪有力易醒，脉细沉伏数急不连贯凶，
面青、环口青、唇白、鼻青孔黑、人中吊危。此论极为秘要。（《尊生书》）
诸厥总略（附治方） 有涎如拽锯声在咽喉中为痰厥，手足搐搦者为风厥，因醉而得之为酒厥，
暴怒而得之为气厥。凡尸厥、痿厥、风厥、气厥、酒厥，可一涌而醒，次服降心
火，益肾水，通血和气之药，使粥食调养，无不瘥者。若其
余诸厥，仿此行之。慎勿当疑似之间，便作风气，相去邈矣。（《事亲》）
若伤寒手足厥逆，昏不知人，邪正已极，温下之间，稍或迟缓，祸不旋踵。或汗不解，暴衄不知人而厥，
或杂病得吐衄血而厥，不知人者，一二日或三日必间，间则为愈矣。盖阴气尚实，必身不热，热则不厥，厥则
为血温身热主死矣。暴气厥而形实者，七情所致，痰饮内郁而厥，或半日或一二时必间。形虚而气逆甚者，
多致不救。此又可见气血为厥，阴阳暴逆之甚也，故不可断作风治。（《微义》）
厥有七症，寒、热、痰、气、食、尸、蛔，七者是也。（《司命》）
苏合香丸，治卒暴厥不知人，未辨风痰气厥，宜与此膏，化浓汤灌之，醒后却议脉证用药。（《微义》）
（按∶此门别无通治之方，仍附于此。）
气厥（宜与《诸气》门气中参看）（气虚厥）脉至如喘，名曰气厥，气厥者不知与人言（《素问》、
《甲乙》作暴厥）。（《脉经》）
仁宗最宠贵妃，一日食次，忽仆倒，遍身卒冷。急奏帝。上乃急召孙、杜。既至奏曰∶不妨，此乃气
厥尔，少顷，吐即复苏也。御坐良久，果吐而苏。上问因何而得。二人并奏曰∶此贵妃方食，因忧怨气上，
遂与食相并，故如此者。吐即气透，故复苏也。上问妃，有何事如此。妃对曰∶陛下无嗣，臣外家不能为陛下
生皇嗣，所以自怨，气忽上逆，而至惊动圣驾。上叹曰∶朕亦自责，乃劳汝致病耶。因嘉奖孙、杜之能，良久
曰∶医道如此，岂非良医也耶。（《纲目》引孙）（按∶楼氏谓上暴厥不知人不治自愈，举经文“气复反
则生”以征之。）
气厥之证有二，以气虚气实皆能厥也。气虚卒倒者，必其形气索然，色清白，身微冷，脉微弱，此气脱证
也，宜参、 、归、术、地黄、枸杞、大补元煎之属，甚者以回阳饮、独参汤之类主之。（按∶《医方考》
曰∶行立之间，暴眩仆绝，喉无痰声，身无邪热者，阴虚阳暴绝也，独参汤主之。即此证也。）气实而厥者，
其形气愤然勃然，脉沉弦而滑，胸膈喘满，此气逆证也，经曰大怒则形气绝而血菀于上，即此类也，
治宜以四磨饮或八味顺气散、苏合香丸之类，先顺其气，然后随其虚实而调理之。又若因怒伤气，逆气旋去
而真气受损者，气本不实也，再若素多忧郁恐畏而气怯气陷者，其虚尤可知也，若以此类而用行气开滞等
剂则误矣。（《景岳》）
尸厥（附治方） （按∶尸厥一证，《肘后》间之中恶客忤，而《巢源》收在中恶诸候中，并似以尸
为尸注之尸；然考经文曰其状若尸，考之《扁鹊传》实系阳实犯阴之证，而未见鬼邪恶气为其所因，
故今列于气厥之后。《扁仓传汇考》更有详说，宜并考。）
（原书此处有缺）
煎令百沸，并灌两服，亦根据前法用灸也。（《家宝》）
二十四味流气饮和苏合香丸。
尸厥者，破阴绝阳，形静如死。医者不知针石，宜此二方主之，使其气血流动，阳无绝络，阴无破纽，
则亦五会之针、五分之熨、八减之剂尔。（《方考》）
血厥（附治方） 人平居无疾苦，忽如死人，身不动摇，默默不知人，目闭不能开，口噤不能言，或
微知人，恶闻人声，但如眩冒，移时方寤。此由已汗过多，血少气并于血，阳独上而不下，气壅塞而不行，
故身如死。气过血还，阴阳复通，故移时方寤。名曰郁冒，亦名血厥，妇人多有之，宜
白薇汤、仓公散。（《本事》）
白薇汤。
白薇 当归（洗去芦薄切焙干秤各一两） 人参（去芦半两） 甘草（一分炙）
上粗末，每服五钱，水二盏，煎至一盏，去滓温服。
仓公散
瓜蒂 藜芦 雄黄（水飞） 矾石（ ）
上各等分，细末，少许吹入鼻中。（并同上）
有血厥者，因而吐衄过多，上竭下厥，先致足冷，有如水洗，冷过腰膝，入腹即死，此血竭而作厥也。
皆由阳气妄行于上，阴血无所根据附，气血相离，不居本位，宁有不死之理乎。（《绳墨》）
血厥之证有二，以血脱、血逆皆能厥也。血脱者，如大崩大吐，或产血尽脱，则气亦随之而脱，故致卒仆暴
死。宜先掐人中，或烧醋炭以收其气，急用人参一二两煎汤灌之，但使气不尽脱，必渐苏矣。然后因其寒热，
徐为调理，此所谓血脱益气也。若不知此而但用血分等药，则几微之气忽而散失，阴无所主，无生机矣。
其或有用寒凉以止血者，必致败绝阳气，适足以速其死耳。血逆者，即经所云血之与气并走于上之谓，又曰
大怒则形气绝而血菀于上之类也。夫血因气逆，必须先理其气，气行则血无不行也。俟血行气舒，然
后随证调理。（《景岳》）
痰厥（宜与《痰涎》门相参） 厥有涎潮，如拽锯声在咽中，为痰厥。先用瓜蒂散或人参芦煎汤
探吐，随用导痰汤加竹沥、姜汁。（《统旨》）
痰厥，昏迷不醒，稀涎散、导痰汤。（《指掌》）
痰厥者，卒中昏倒，不知人事。急灌苏合香丸、滚痰丸，
或用吐法，随服二陈加胆星、僵蚕、白附子、竹沥开痰顺气药。（《司命》）
痰厥，痰涎壅盛，必吐之。稀涎散。或碧霞散，拣上好石绿研细，水飞再研，取二三钱，同冰片三四豆
许研匀，以鲜薄花汁合温酒调下，不大呕吐，但口角涎流出自醒。若见虚症，遗尿自汗，不可吐，速随虚治。
（《六要》）
不因恚怒，忽然气闷痰升，肢冷吐涎，喉中有声，为之痰厥，脉必沉滑，宜导痰顺气。又气实多怒之人，
忽大叫发厥者，乃痰闭于上，火起于下，先行探吐，后用导痰。（《汇补》）
痰厥者。乃寒痰迷闷。四肢逆冷。宜姜附汤。以生附代热附。（《丹溪心法·附录》）
痰厥之证，凡一时痰涎雍塞，气闭昏愦，药食俱不能通，必先宜或吐或开以治其标，此不得不先救其急
也。但觉痰气稍开，盒饭治其病本。如因火生痰者，宜清之降之。因风寒生痰者，宜散之温之。因湿生痰者，
宜燥之利之。因脾虚生痰者，自宜补脾。因肾虚生痰者，自宜补肾。此痰之不必治也，但治其所以痰而痰自
清矣。然犹有不可治痰者，恐愈攻愈虚而痰必愈甚也。（《景岳》）
食厥（宜与伤食门相参） 食厥必因饮食而起，痰裹食物，妨碍升降，关格不通。急用吐法，食
出乃苏，随进顺气消导药，研保和丸（用山楂、神曲、半、茯、陈、卜、连翘、麦芽）和末饮之，大率与干霍
乱相似。（《司命》）
Background Information:
Book: Zabing Guangyao (Comprehensive Requirements for Miscellaneous Diseases)
Author: Tanba Genken (Japanese)
Dynasty: Qing Dynasty
Chapter: Jue (Cold Extremities/Fainting) (1/2)
Category: Comprehensive
Translation:
The "Jue" (rebellious Qi/cold extremities) mentioned by Huangdi and Qibo (Xuanqi) refers to conditions where, in Heat Jue, internal heat is accompanied by external heat symptoms; in Cold Jue, internal cold is accompanied by external cold symptoms. The "Jue" mentioned by Zhang Zhongjing refers to conditions where the external symptoms are necessarily cold, but internally there may be either Cold or Heat patterns; this is the difference between them. Later generations generally named various diseases characterized by sudden fainting and loss of consciousness as "Jue," which is yet another variation. Few can elaborate on the meaning of Xuanqi's Jue; the predecessors have already extracted Zhang Zhongjing's discussion of Jue into the *Shanghan Lun* (Treatise on Cold Damage). Therefore, what is cited here mostly refers to later generations' concept of Jue, although it does cover both Cold and Heat patterns.
Etymology: "Jue" refers to rebellious Qi rising from the lower body upwards, entering the heart and hypochondrium. (*Shiming*)
"Jue" means rebellion/reversal, referring to the sudden decline and severance of Yin and Yang Qi, deviating from normal limits. (*Zhubing Yuanhou Lun*) [Note: This explanation is considered inadequate.]
Modern people also call sudden fainting and loss of consciousness "Jue." (*Yixue Zhunsheng*)
General Discussion:
Jue-ni (Rebellious Cold Extremities) is a critical condition. Generally, "Jue" implies exhaustion, and "Ni" implies chaos, referring to the deterioration and disorder of Qi and Blood. [Note: This view is incorrect.] Therefore, the *Neijing* (Inner Canon) emphasizes and details it extensively. For example, "Cu Jue" (Sudden Jue) and "Bao Jue" (Violent Jue) are general terms for Jue-ni. "Han Jue" (Cold Jue) and "Re Jue" (Heat Jue) distinguish the Yin and Yang of Jue-ni. "Lian Jing" (Connecting Meridians) and "Lian Zang" (Connecting Organs) discuss the prognosis of life and death in Jue-ni. Furthermore, the differentiation of various meridians and organs is already detailed. Additionally, recent times have seen patterns such as Qi Jue, Blood Jue, Wine Jue, Zang Jue, and Ascaris Jue, all of which are based on the principles of the Classics. Observing the discussions in the *Neijing*, they are extremely clear. Why can later scholars still not discern them? Whenever encountering this pattern, they mistakenly identify it as Stroke (Zhong Feng), failing to recognize what Jue-ni actually is, and treating it uniformly as Stroke. What harm could be greater than this? (*Jingyue Quanshu*)
Yang Jue and Yin Jue:
Violent storms and intense heat, flying clouds and objects, morning darkness and evening clarity, night heat and day cold, cold when it should not be cold, rain when it should not rain, water exhausted and soil crumbling. Prolonged drought, withered grass and trees, dried-up rivers, this is the Heaven and Earth's Yang Jue. Sudden obstruction, panting and shortness of breath, limbs unable to hold themselves, dysfunction of the Fu organs, deafness and blindness, dry throat and scorched mouth, sores on the tongue, runny nose, red cheeks and vexation, dizziness and heavy head, eyes burning like fire, body feeling like burning, doing things previously impossible, wanting things previously unwanted, climbing high singing and laughing, discarding clothes and running wildly, delirious speech, inability to distinguish relatives from strangers, extreme restlessness, unceasing thirst, chest and diaphragm distension, abdominal and hypochondriac fullness, back carbuncles and rotting flesh, vexation, ulceration, Xiao Zhong (Wasting and Thirsting), food not entering the stomach, water not passing through the intestines, sudden swelling and fullness, shouting and fainting, loss of consciousness, pain without location, this is Human Yang Jue. In Yang Jue, if the pulse is forceful upon light and heavy pressure, survival is possible; if the pulse is absent, death ensues. Flying frost and hail, morning and evening mist, drifting clouds and rain, cold wind and dew, hot when it should not be hot, cold before the time comes, prolonged seasonal rains, springs emerging in fields, mountain collapses and earth cracks, soil crumbling and rivers overflowing, moon darkening and sun dimming, this is Heaven and Earth's Yin Jue. Sudden aphonia and chilling cold, whole-body stiffness, curled and contracted limbs, blue lips and black face, staring eyes and locked jaw, abdominal fullness and pain, shaking head and chin, heavy waist and legs, slurred speech, vomiting and diarrhea, numbness on left and right sides, free urination and defecation, vomiting acid fluids, sorrow and misery, unpredictable anger and joy, this is Human Yin Jue. In Yin Jue, if the pulse is weak on light pressure and large on heavy pressure, survival is possible. If absent on both pressures, death ensues. Whole-body coldness with spontaneous sweating on the forehead also indicates death. Yin Jue lasting more than three days should not be treated. (*Zhongzang Jing*) [Note: This refers to a different meaning, hence listed separately.]
Cold, Heat, Deficiency, and Excess:
The classics state thus [Note: Above cites text from *Suwen: Jue Lun*]. Although roughly divided into the Six Stages, it fundamentally stems from Cold or Heat etiologies. To seek comprehensive treatment, one must clarify them sequentially. Cold Jue often results from excessive sexual activity depleting Essence, leading to Yang deficiency and Yin excess. Heat Jue often results from intercourse after drunkenness and overeating; Essence deficiency allows Heat to enter, leading to Yin deficiency and Yang excess. Examining the causes of Jue, they often arise from one element overcoming its conquered element, causing Qi stagnation and rebellion. For instance, Kidney transferring Cold to Spleen means Water overcoming Earth; if Water fails to flow, Cold Jue forms. Heart transferring Heat to Kidney means Fire overcoming Water; if Fire fails to flow, Heat Jue forms. This applies to all Six Stages and can be discussed sequentially. Grasping the essence, one word suffices. [Note: Below discusses Shi Jue, recorded later.] Cold requires Heat therapy, Heat requires Cold therapy, obstruction requires unblocking. As the classics say: "Excess, drain it; Deficiency, tonify it; Neither excess nor deficiency, treat via the meridian." The principle is the same. The classics cite frequent drunkenness as a cause of Heat Jue; students should not be rigidly bound by this, as both Shanghan (Cold Damage) and Wenbing (Warm Diseases) present Heat Jue. Zhang Zhongjing's statement "the deeper the heat, the deeper the Jue" uses alcohol as an example because it can induce heat in all vessels. This must be understood. (*Sanyin Fang*)
"Jue" is rebellion. It refers to Yin Qi attacking Yang Qi. Yin resides below, Yang resides above. When Yang is deficient, Yin becomes excessive. Excessive Yin attacks Yang, causing Wei Qi (Defensive Qi) to rebel and deviate from normal limits. Thus, cold arises from the back, and hands and feet become cold and reversed due to Yin excess. (*Zhubing Yuanhou Lun*)
Jue patterns vary in Cold, Heat, Yin, Yang, Deficiency, and Excess. For those with slightly robust constitution and Qi, Hezi's methods of emesis and purgation are suitable. For severe deficiency, regulation according to the etiology is appropriate. (*Weiyi*)
In *Shanghan Lun*, Jue is differentiated by pathogenic factors; thus, Cold Jue warrants warming, and Heat Jue warrants purging. In the *Neijing*, Jue focuses on Yuan Qi (Primal Qi); thus, Heat Jue requires nourishing Yin, and Cold Jue requires tonifying Yang. These two treatments must be carefully distinguished. (*Jingyue Quanshu*)
Jue has many types; one must distinguish Yin/Yang and Deficiency/Excess. Before Jue onset, if there is vomiting/diarrhea without thirst, cool body, and curling up, and upon onset, slow pulse and salivation, it is Yin Jue. Before onset, if there is constipation, difficult urination, thirst, fever, irritability, and upon onset, rapid/large pulse and dry mouth, it is Yang Jue. If Jue presents with locked jaw, it is Excess Jue. If Jue presents with open mouth and spontaneous sweating, it is Deficiency Jue. (*Huibu*)
Yang Jue is Heat Jue. Symptoms include cold extremities, fever, red face, dry lips/thirst, dry tongue coating, closed or open eyes, scanty dark urine, dry stool. Avoid ascending, astringent, drying, warm, and acrid-warm herbs. Use purgatives, clearing-heat, sweet-cold, bitter-cold, and salty-cold herbs. Yin Jue is Cold Jue. Symptoms include cold extremities, cold body, blue face, curling up, cyanotic fingers/nails, abdominal pain, loose stools or undigested food, free urination, no thirst, unconsciousness. Avoid purgatives, Qi-breaking, bitter-cold, salty-cold, and sour-cold herbs. Use Qi-tonifying, middle-warming, sweet-warm, and acrid-hot herbs. (*Bencao Jingshu*)
Pathogenesis involves Qi closure and Liver rebellion: One might ask: The previous discussion mentions six types of Jue (Cold, Heat, Phlegm, Qi, Ascaris, Blood). Do these cover all causes? Answer: Jue is not limited to these six; that is the norm. The cause of Jue lies in Qi closure, causing sudden blockage of all meridians internally and externally. Ying Qi (Nutritive Qi) circulates inside, Wei Qi circulates outside. Now Ying Qi is rejected externally, and Wei Qi is blocked internally. Thus, inner gridlock and outer rejection occur, upper and lower communication ceases, leading to stiff lying, cold extremities, and deep-hidden pulses. This is the general meaning of Jue. Various Jue diseases, though presenting with cold extremities, recover quickly once Yin retreats, Yang returns, and Qi flows. Unlike deficiency diseases where cold extremities, thready pulse, profuse sweat, and saw-like phlegm sounds indicate terminal crisis. (*Baiwen*)
Mr. Shao Xinpu emphasizes the Liver in this disease. The Liver is the General, prone to interfering with other organs. Once Liver Qi rebels, all Qi rebels. Qi rebellion generates Phlegm, leading to boiling Fire and whirling Wind, confusing the Spirit and dissipating the Soul. (*Linzheng Zhinan*)
Pulse Diagnosis:
Choppy pulse indicates blood deficiency, severe cold Jue. Thin Chi pulse indicates Yin deficiency, with dysentery and cold extremities. Heat Jue pulse is hidden, sometimes rapid; constipation makes treatment difficult. (*Cui Shi Maijue*)
Jue-ni pulses are mostly deep and hidden. Deep-slow-scattered indicates Cold; deep-hidden-rapid indicates Heat; floating-weak indicates Qi deficiency; surging-sliding-forceful indicates stubborn Phlegm; deep-sliding with cold body is hard to treat. (*Yu An*)
Differentiation (Severity):
Stroke pulses result from Qi deficiency approaching collapse: floating-surge, pounding-rapid, slow-smooth, string-tight. Jue pulses result from Qi blockage: deep-hidden-choppy-abandoned or deep-string-thin-smooth. Stroke symptoms: red face, warm limbs, coarse breathing, snoring, relaxed body. Jue symptoms: blue face, locked jaw, cold extremities, stiff limbs, faint breath, resembling death. (*Baiwen*)
Ancients also described Shi Jue (Corpse Jue), Tan Jue (Phlegm Jue), Feng Jue (Wind Jue), Han Jue (Cold Jue), Spasm, Epilepsy, and Opisthotonos, all resembling Jue, shocking and hard to differentiate. Identify accurately, do not panic. Observe pulse, complexion, movements. Pressing the inner fist is ominous; pressing the outer fist is mild. Large-floating-forceful pulse wakes easily; thin-deep-hidden-rapid-disconnected pulse is ominous. Blue face, perioral blue, white lips, black nostrils, inverted Philtrum are critical. This theory is highly secret. (*Zunsheng Shu*)
Summary of All Jue (With Formulas):
Phlegm sound like sawing in throat is Tan Jue; limb convulsions are Feng Jue; caused by drunkenness is Jiu Jue; caused by rage is Qi Jue. Shi Jue, Wei Jue, Feng Jue, Qi Jue, Jiu Jue can be awakened by emesis, followed by herbs lowering Heart Fire, benefiting Kidney Water, and harmonizing Blood/Qi, plus dietary care. Others follow this. Do not mistake for Wind-Qi. (*Shiqin*)
If Shanghan causes cold extremities and unconsciousness, with extreme pathogen vs. righteous Qi conflict, hesitation between warming and purging brings disaster. Or sweating fails, sudden epistaxis leads to Jue. Or miscellaneous diseases with hematemesis/epistaxis lead to Jue. Unconsciousness resolves in 1-3 days. If Yin Qi is substantial, body is not hot; if hot, no Jue. Jue with warm body indicates death. Sudden Qi Jue with robust form is due to Seven Emotions, internal Phlegm-Fluid retention. Resolves in hours. Robust form with severe Qi rebellion is often fatal. This shows Qi/Blood Jue and violent Yin/Yang rebellion; do not treat as Wind. (*Weiyi*)
Seven Types of Jue: Cold, Heat, Phlegm, Qi, Food, Corpse, Ascaris. (*Siming*)
Suhe Xiang Wan treats sudden Jue with unconsciousness, before distinguishing Wind/Phlegm/Qi. Administer paste in thick decoction. After waking, treat based on pulse/symptoms. (*Weiyi*) [Note: No universal formula for this section, attached here.]
Qi Jue (See *Zhu Qi* section): (Qi Deficiency Jue) Pulse急促如喘 (rapid like panting) is named Qi Jue; patient cannot speak. (*Maijing*, citing *Suwen*/*Jiayi*)
Emperor Renzong's favorite Concubine fainted while eating, body suddenly cold. Emperor summoned Sun and Du. They said: "No danger, this is Qi Jue. Vomiting will restore consciousness." Later she vomited and recovered. Emperor asked cause. They replied: "She was eating,憂怨 qi rose with food. Vomiting released the Qi." Concubine explained: "No heir, my family blamed myself, Qi rebelled." Emperor praised their skill. (*Gangmu*, citing Sun) [Note: Lou notes spontaneous recovery confirms "Qi returning brings life."]
Two types of Qi Jue: Deficiency and Excess.
Qi Deficiency sudden collapse: exhausted form, pale/clear face, slight cold, weak pulse. Qi Collapse syndrome. Use Renshen, Danggui, Baizhu, Dihuang, Gouqi, Dabu Yuanjian. Severe cases: Huiyang Yin, Dushen Tang. [Note: *Yifang Kao*: Sudden fainting without phlegm sound or heat is Yin deficiency with Yang collapse; Dushen Tang.]
Qi Excess Jue: angry form, deep-string-slippery pulse, chest oppression. Qi Rebellion syndrome. "Great anger causes Qi/Blood to rise." Use Simo Yin, Bawei Shunqi San, Suhe Xiang Wan. First smooth Qi, then regulate. Anger damaging Qi or chronic depression causing Qi sinking requires tonification, not Qi-moving herbs. (*Jingyue Quanshu*)
Shi Jue (Corpse Jue) (With Formula): [Note: *Zhouhou* links to Evil Invasion; *Chaoyuan* to Middle Evil. Text says "like corpse." *Bianque Zhuan* attributes to Yang invading Yin, not ghosts. Listed after Qi Jue.]
[Text missing]
Boil and administer twice, also apply moxibustion. (*Jiabao*)
Ershisiwei Liuqi Yin and Suhe Xiang Wan.
Shi Jue breaks Yin and severs Yang, body still as dead. Doctors unaware of acupuncture should use these two formulas to move Qi/Blood, preventing Yang severance and Yin rupture. Equivalent to Wuhui acupuncture and warming therapies. (*Fangkao*)
Blood Jue (With Formula):
Healthy person suddenly dies-like, motionless, silent, eyes closed, jaw locked, or slightly aware but hates noise, dizzy/faint, recovers after time. Caused by excessive sweating, blood deficiency, Qi merging with Blood, Yang rising alone, Qi blockage. Body feels dead. Qi passes, Blood returns, Yin/Yang reconnect, recovery occurs. Named Yumao or Blood Jue, common in women. Use Baiwei Tang, Cangong San. (*Benshi Fang*)
Baiwei Tang:
Baiwei, Danggui (washed, sliced, dried, 1 liang each), Renshen (0.5 liang), Gancao (1 fen, roasted).
Coarse powder. 5 qian per dose, 2 zhan water, boil to 1 zhan, strain, warm drink.
Cangong San:
Gua Di, Li Lu, Xiong Huang (water-ground), Fan Shi (calcined).
Equal parts, fine powder. Blow small amount into nose. (*Same source*)
Blood Jue from excessive bleeding: Upper exhaustion, lower Jue, feet cold like washing, cold past waist/knees, fatal if entering abdomen. Blood exhaustion causes Jue. Yang wanders up, Yin Blood has no root, Qi/Blood separate. Death inevitable. (*Shengmo*)
Two types of Blood Jue: Blood Loss and Blood Rebellion.
Blood Loss: Massive hemorrhage/vomiting/postpartum blood loss. Qi follows Blood loss, sudden collapse/death. Pinch Renzhong, burn vinegar charcoal to gather Qi. Urgently give 1-2 liang Renshen decoction. If Qi not fully lost, recovery likely. Then regulate by Cold/Heat. This is "Tonify Qi for Blood Loss." Do not just use Blood herbs, or remaining Qi scatters. Cold hemostatics destroy Yang, accelerating death.
Blood Rebellion: Qi and Blood rushing up together. "Great anger causes Qi/Blood to rise." Must regulate Qi first. Once Qi moves, Blood moves. Then treat symptoms. (*Jingyue Quanshu*)
Tan Jue (Phlegm Jue) (See *Tan Xian* section):
Phlegm tide with sawing sound in throat is Tan Jue. First Guati San or Renshen Lu decoction for emesis, then Daotan Tang with Zhuli and Jiangzhi. (*Tongzhi*)
Tan Jue, coma: Xixian San, Daotan Tang. (*Zhang*)
Tan Jue, sudden collapse: Urgent Suhe Xiang Wan, Untan Wan, or emesis, then Erchen Tang with Danxing, Jiangcan, Fuzi, Zhuli. (*Siming*)
Tan Jue, abundant phlegm: Must emesis. Xixian San. Or Bixia San (Shilu + Bingpian) with flower juice/warm wine. Saliva flows from corner of mouth, patient wakes. If deficiency signs (incontinence, sweat), do not emesis, treat deficiency. (*Liuyao*)
Sudden Qi oppression/phlegm rise without anger, cold limbs, salivation, throat sound, deep-slippery pulse: Guide Phlegm and smooth Qi. Angry person shouting and fainting: Phlegm blocking above, Fire rising below. Emesis first, then Daotan. (*Huibu*)
Tan Jue from Cold Phlegm confusion, cold limbs: Jiangfu Tang (use raw Fuzi). (*Danxi Xinfa*)
Tan Jue, acute phlegm blockage, unconscious, unable to take meds/food: Treat branch first (emesis/opening). Once phlegm clears, treat root. Fire-phlegm: Clear/Descend. Wind-Cold-phlegm: Disperse/Warm. Damp-phlegm: Dry/Drain. Spleen-deficiency-phlegm: Tonify Spleen. Kidney-deficiency-phlegm: Tonify Kidney. Treating the cause clears phlegm. Do not attack phlegm excessively in weakness. (*Jingyue Quanshu*)
Shi Jue (Food Jue) (See *Shangshi* section):
Caused by diet, Phlegm trapping food, obstructing ascent/descent. Urgent emesis. Recovery after food expulsion. Follow with Qi-smoothing and digestion-promoting herbs. Baohe Wan (Shanzha, Shenqu, Banxia, Fuling, Chenpi, Boluozhi, Lianqiao, Maiya) powder. Similar to Gan Huoluan. (*Siming*)