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There are cases of food stagnation where pain radiates to the chest and diaphragm, accompanied by a sensation of fullness and oppression with blocked qi mechanism, cold extremities, and an absent radial pulse at the Cun position (尺脉). This is known as "Zhong Shi" (Food Stroke). If sudden cold extremities occur, along with the inability to speak or move the limbs, it is named "Shi Jue" (Food Syncope). If treated as Wind-Stroke or Qi-Stagnation, death will follow immediately. One should first induce vomiting with salt water, then administer herbs that digest food and guide out stagnant qi. (Jie Jie)

The wife of Censor Yan Huaiquan previously suffered from chest and abdominal pain. The next day, she suddenly fainted with cold extremities. A physician was about to grind Niuhuang Wan (Calculus Bovis Pill) for her to take. Upon examination, I found all six pulses hidden (Fu Mai), except for the Qi Kou pulse (the pulse at the right cun-guan-chi positions, reflecting Lung/Stomach condition) which showed slight movement. This indicated food accumulation in the chest causing blockage of Yin and Yang, leading to failure of ascending and descending functions, hence the hidden pulses with only the Qi Kou visible. I prescribed Chenpi (Citri Reticulatae Pericarpium) and Sharen (Amomi Fructus Rotundus), each one liang, Ginger eight qian, and Salt three qian, decocted in water. After inducing vomiting by stimulating the throat, five to six bowls of retained food were expelled, and all six pulses became palpable. The Zuo Guan (left guan) pulse was wiry and large, and chest/abdominal pain was severe, indicating injury from extreme anger. I prescribed Muxiang (Aucklandiae Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Juhong (Citri Reticulatae Pericarpium Rubrum), Baizhu (Atractylodis Macrocephalae Rhizoma), and Xiangfu (Cyperi Rhizoma) decocted together. After two doses, the pain ceased. Subsequently, Sijunzi Tang (Four Gentlemen Decoction) with added Muxiang and Wuyao (Linderae Radix) was used for regulation over ten days until recovery. This was Food Syncope combined with Qi Syncope. (Bidu)

Jiu Jue (Wine Syncope) (Refer to the section on Shang Jiu/Wine Injury). The syndrome of Jiu Jue belongs to the category of Re Jue (Heat Syncope) described in the classics. The "Jiu Feng" (Wind of Wine) mentioned in the classics also falls into this category. People who drink excessively without restraint often suffer from this disease. When their qi and blood are vigorous, they can withstand the alcohol and do not perceive its harm. However, when their vitality declines, the damaging effect of wine becomes terrifying. Alcohol causes many diseases, but its origins vary. Jiu Jue resembles Wind-Stroke completely. In mild cases, the patient remains conscious; in severe cases, they suddenly faint and fall into deep coma, may be restless and irritable, mute, have profuse phlegm, experience panting and fever, cough, or hematemesis. If the stool is dry, the pulse is excess and rapid, and the patient prefers cold drinks, this is a syndrome of Damp-Heat obstructing upwards. It is appropriate to use Chouxin Yin (Fire-Draining Decoction - formula attached to the Bi/Gibi section) to rapidly descend the fire. For severe fire, Lijiang Yin (Pear Juice Drink) or Ludou Yin (Mung Bean Drink) can be alternated to resolve toxicity. This syndrome strictly prohibits acrid and drying substances. One must ensure damp-heat gradually recedes and spirit/qi slightly recovers before using Yin-nourishing formulas for aftercare. If there is loose stool, no signs of fire, and a slow/weak pulse, clearing fire is inappropriate; instead, Liujunzi Tang (Six Gentlemen Decoction) should be the primary treatment. If yin is damaged by alcohol, leading to deficiency of both Spleen and Kidney resulting in syncope/collapse, saving the root source quickly is essential, otherwise it is futile. Patients should abstain from alcohol for life. If they fail to戒 (restrain) themselves and relapse, it will be difficult to treat. (Jingyue)

Se Jue (Sexual Syncope) There are two types of Se Jue: one is sudden collapse (Baotuo), and the other is bleeding due to sexual activity (Dongxue). Sudden collapse in Se Jue occurs because the person is originally deficient, and either exerted themselves excessively during an unexpected encounter or indulged in lust after long-term mutual affection. Consequently, after intercourse, qi follows the essence outwards, leading to sudden collapse that cannot return. Immediate pressure on Renzhong (GV26) is required. The female partner should hold the patient firmly, mouth-to-mouth resuscitation should be performed to transmit warm air and reconnect the qi, preventing qi dispersion to preserve the shen (spirit). Immediately administer Duchang Tang (Single Ginseng Decoction) or moxa Qihai (CV6) dozens of times to restore yang qi, hoping to save the life. However, panic at the moment often leads to improper handling and failure to rescue. This refers to immediate onset; such cases are rare. Many more cases do not manifest immediately but appear later. Why? Because essence is lost frequently, and qi depletes gradually. Thus, symptoms often appear two or three days after intercourse. Because the illness is not immediate, people do not recognize it as a disease. Moreover, people hide this secret, unaware that many after middle age fall ill due to this, which is called Se Jue. Unfortunately, contemporary physicians fail to diagnose it correctly and often misdiagnose it as Wind-Stroke, leading to death. Treatment should focus solely on tonifying the Mingmen (Gate of Life). (Note: Shishi Milu states: Some people suddenly feel dizzy and fall during urination, which is also due to the collapse of yin and yang qi. This results from excessive lust, similar to Jingyue's description of delayed-onset Se Jue. A formula, Fengtu Dan, is proposed using Renshen (Ginseng Radix et Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata), Baizhu (Atractylodis Macrocephalae Rhizoma), Changpu (Acori Tatarinowii Rhizoma), Banxia (Pinelliae Rhizoma), and Sheng Zaoren (Ziziphi Spinosae Semen).) The other type, bleeding Se Jue, occurs because blood and qi rush upwards simultaneously, belonging to the category of Blood Syncope. It differs from blood reversal caused by extreme anger, and thus the treatment differs. This is due to desire-fire flaring up, causing blood to follow qi upwards. It happens when desire is intense but unfulfilled, or when liquor is used to suppress suppressed fire. Symptoms include sudden hematemesis, uncontrollable epistaxis, cold extremities, sweating, panting, or coughing, all caused by Yin-fire rushing upward. Treatment must first control the fire to suppress its momentum. If yin is exhausted below, fire does not return to its source, without other heat signs/pulses, and blood syncope is critical and persistent, only Zhenyin Jian (Yin-Suppressing Decoction - using Shudihuang (Rehmanniae Radix Praeparata), Niuxi (Achyranthis Bidentatae Radix), Zexie (Alismatis Rhizoma), Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata), Rougui (Cinnamomi Cortex), and Fuzi (Aconiti Lateralis Radix Praeparata)) can save the patient. Once stabilized, treat according to specific symptoms. (Jingyue)

If excessive sexual intercourse leads to massive loss of true qi and unconsciousness, do not separate the partners. Maintain genital contact until qi naturally recovers. Separating them immediately will lead to certain death. Be extremely cautious. (Yuanbing Ji) (Note: The original "Tuo Yang" section cites Wei Sheng Jia Bao regarding Cold Syndrome Tuo Yang treatment. The formula uses Congbai (Allii Tuberosi Bulbus), Fuzi (Aconiti Lateralis Radix Praeparata), Baizhu (Atractylodis Macrocephalae Rhizoma), Ganjiang (Zingiberis Rhizoma), Muxiang (Aucklandiae Radix), and Wuwei Zi (Schisandrae Chinensis Fructus). Jingyan Liangfang included it in Hua Tuo's Zhouhou Fang emergency list, removing "Cold Syndrome". Xiuzhen Fang cited it. Dexiao Fang included it in Deficiency sections as Da Gu Yang Tang, though not explicitly linked to this syndrome. The creation of this syndrome description and the name "Tuo Yang" is attributed to Tang Shi. His formula effectively treats this, so Jiujixuanfang included it in Tuo Yang. Wei Sheng Jia Bao's theory is in Shanghan, refer to it.)

Death resulting from sexual intercourse is called Tuo Yang (Yang Collapse) in men and Tuo Yin (Yin Collapse) in women. Even if a man dies, his penis remains erect. Even if a woman dies, her vulva remains open. Death during dreams with emission involves an erect penis and seminal discharge, and the corpse may show a smiling expression, which helps distinguish it. All these cases are incurable. (Fangkao)

In men who have been abstinent for a long time or those who indulge excessively, prolonged ejaculation during intercourse is called "Zou Yang" (Running Yang). The female partner must hold him tightly, ensuring the penis does not withdraw. Quickly blow warm air into his mouth and press the Weilü point (near the coccyx) with fingers to rescue. If the woman escapes in fright, nine out of ten die. Urgently connect breath with a virgin girl and administer a large dose of Duchang Tang (Single Ginseng Decoction); survival is possible. (Bidu) (Note: Shishi Milu states: If Duchang Tang is brewed urgently in large quantities, with one qian of Fuzi (Aconiti Lateralis Radix Praeparata) added and given hot, even those already dead may revive.)