气自下逆上，手足冷为厥，厥者尽也，危候也。经曰∶下虚
则厥，故阳衰于下，则为寒厥，阴衰于下，则为热厥，阴阳之气不相顺接，则病厥逆，手之三阴三阳，相接
于手十指。足之三阴三阳，相接于足十趾。阳气内陷，阳不与阴相顺接，故手足厥冷也。寒厥者，身寒面清，
四肢逆冷，指甲冷，蜷卧不渴，便利，脉微迟，即阴厥也。热厥者，身热面赤，四肢厥逆，指甲暖，烦渴昏冒，
便短涩，脉滑数，即阳厥也。按《内经》论十二经阴阳之厥详矣，而仲景以厥隶厥阴。《活人》亦谓诸手足逆
冷，皆属厥阴，以肝脏风火，为厥逆之主。故厥症种种，类由肝风痰火，冲激闭塞，以至昏痉为多。今标举其
目，有寒热、气血、食痰、尸蛔、煎薄、痿痹、风痫、喑郁、骨痛、肾色、暴疟诸厥，施治最所宜审。寒厥初病
即肢冷，腹痛脉微，附子理中汤。或表热里寒，下利清谷，厥逆干呕咽痛，脉沉细而微，四逆汤。独指尖冷，
名清厥。理中汤。热厥初病身热，烦臊脉滑，数日后忽肢冷，乍温，乃热深发厥。火郁汤。便秘，大柴胡汤。
烦渴躁妄，失下而手足冷，乃阳极似阴，热极似寒，不可疑作阴症，轻用热药。热微厥亦微，四逆散。热深厥
亦深，承气汤。如阴衰于下，足下热而厥者，六味汤。凡伤寒之厥，辨邪气，寒厥宜温，热厥可散可攻。若由
阴阳之衰，则元气为重，寒厥宜补阳，热厥宜补阴。气厥症有二，气虚气实，皆能致厥。气虚而厥者，必形色
消索，身微冷、脉微弱，为气脱。参、 、归、术、地黄、枸杞之属。甚者，回阳饮、独参汤。气实而厥者，
形色郁勃，脉沉弦而滑，胸膈喘满，为气逆。先理其气，四七汤、排气饮，再随症调之。血厥症有二，血脱
血逆，皆能致厥。吐衄暴崩，及产后血大脱，则气随之，故猝仆。宜先掐人中，或烧醋炭以收其气，急煎人
参汤灌之。但气不尽脱，必渐苏。血逆者，暴怒伤阴，血逆于上，先理其气，则血自行。通瘀煎、化肝煎，
俟血行气舒，随症调之。食厥由醉饱过度，偶感风寒恼怒，食气填中，脾阳不运，忽仆不省，误作中风中气治，
则死。煎姜盐汤探吐，食出则愈。如感风寒，藿香正气散。伤气滞，八味顺气散。纵饮痰升，猝仆者，名酒厥。
二陈汤加青皮、葛根、砂仁。痰厥由痰热阻蔽心包，肢冷猝仆，先探吐其痰，瓜蒂散，痰开再治本病。火痰
宜清降，寒痰宜温散，湿
痰宜燥利。因脾虚者健脾，因肾虚者补肾。尸厥即中恶之候，因犯不正之气，忽手足厥冷，牙紧口噤，昏不
知人。或由登冢吊死，飞尸鬼击，语妄面青，苏合香汤灌之，候苏，服调气平胃散。仲景云∶尸厥脉动无气，
气闭不通者，还魂丹。蛔厥多因胃寒，蛔虫攻胃，心腹痛不可忍，或吐涎沫，或吐蛔虫，发有休止，不宜用
寒药。理中汤加炒川椒、槟榔，水煎，下乌梅丸，或安蛔散、芜荑散。蛔虫得苦则安，得酸则止，得辛则伏。
吐蛔亦有阳症，口疮咽疼吐蛔，竟以冷剂取效者，不可专以胃冷概也。煎厥者，诸动属阳，烦劳则阳气暴张，
劳火亢炎而精绝，迁延至夏，内外皆热，孤阳厥逆，如煎如熬。宜清心益肾，或咸寒降逆。人参固本丸加淡菜、
阿胶、方诸水。薄厥者，肝本藏血，怒则火起于肝，迫血上行而厥。蒲黄酒降之。痿厥亦热厥症，厥从肝起，
致四末不用，因水亏则阳风烁筋，络热沸腾，须血肉咸润之品，熬膏服以填其隙。鳖甲、龟板、阿胶、淡菜、
生地、猪羊脊髓。痹厥香港脚顽麻，初发必身痛，肢节肿。当归拈痛散。其自踝以下痛极者，五兽三匮丸、滋
肾丸。风厥手足搐搦，身体强直，名痉厥。小续命汤。痫厥肝风发痉，肢掣液涸。固本丸加阿胶、鸡子黄、
龙骨。喑厥乃类中风症，暴喑不语，经所谓内夺而厥，则为喑痱。地黄饮子加减。郁厥亦血厥症，平居无疾，
忽默默无知，目闭口噤，恶闻人声，移时方寤，由热升风动，郁冒而厥，妇人多有之。羚羊角散。虚则填补奇
经，杞子、当归、鹿角霜、茯苓、肉苁蓉。骨厥骨枯爪痛，六味丸。痛厥由胃阳久衰，肝木来乘，浊气攻胃。
吴萸、半夏、茯苓、姜汁、广皮之属。肾厥火由背脊上升，肢逆吐沫。椒附汤。其有肾厥气逆至巅、头脑大痛。
玉真丸。色厥乃纵欲竭情，精脱于下，气脱于上。独参汤。暴厥脉至如喘，气闭肢冷，若鼻及心腹微温，目中
神采不变，口无涎，卵不缩，皆可救。备急丸。疟厥由疟邪陷阴，发厥不省，当和正以托邪。人参、半夏、
知母、草果、乌梅、生姜之属。凡诸厥，脉大浮洪有力易醒，脉细沉伏数急不连贯，凶。厥仆大指掐拳内，凶；
掐拳外，轻。面青，环口青，唇白，鼻青孔黑，人中吊，危也。
Qi reverses upward from the lower body, causing coldness in the hands and feet, which is termed "Jue" (Reversal Cold). "Jue" implies exhaustion or extremity, representing a critical condition. The Classics state: "Deficiency at the lower part leads to Jue." Therefore, when Yang Qi declines at the lower jiao, it results in Cold Jue; when Yin Qi declines at the lower jiao, it results in Heat Jue. When the Qi of Yin and Yang fails to connect smoothly, disease manifests as Reversal Cold. The three Yin and three Yang meridians of the hand connect at the tips of the ten fingers. The three Yin and three Yang meridians of the foot connect at the tips of the ten toes. When Yang Qi sinks inward and Yang fails to connect smoothly with Yin, coldness in the hands and feet occurs.
The symptoms of Cold Jue include: cold body, pale/bluish complexion, cold limbs extending up to the elbows/knees, cold fingernails, curling up while lying down, no thirst, normal bowel movements, and a faint, slow pulse. This is also known as Yin Jue (Cold Jue). The symptoms of Heat Jue include: hot body, red face, cold limbs (reversal cold), but warm fingernails, irritability, thirst, mental confusion, scanty and difficult urination, and a slippery, rapid pulse. This is also known as Yang Jue (Heat Jue).
Examining the *Nei Jing* (Inner Canon), the discussion on the Jue of the twelve meridians' Yin and Yang is detailed. However, Zhang Zhongjing classified Jue under the Jueyin Meridian. The *Huoren Shu* (Book of Vitality) also states that all cases of cold hands and feet belong to the Jueyin Meridian, because wind and fire of the Liver are the main causes of reversal cold. Thus, various manifestations of Jue syndrome mostly arise from Liver Wind and Phlegm-Fire rushing and blocking, leading frequently to coma and convulsions. Now, listing its categories, there are Cold Jue, Heat Jue, Qi Jue, Blood Jue, Food Jue, Phlegm Jue, Corpse Jue, Roundworm Jue, Decoction Jue, Thin Jue, Atrophy Jue, Bi Jue, Wind Jue, Epileptic Jue, Aphonic Jue, Depressed Jue, Bone Jue, Painful Jue, Kidney Jue, Sexual Depletion Jue, Sudden Jue, and Malaria Jue. Treatment must be carefully examined for each.
Cold Jue begins with cold limbs, abdominal pain, and a faint pulse; treat with Fuzi Lizhong Tang (Aconite and Poria Decoction). If there is exterior heat and interior cold, with diarrhea of undigested food, reversal cold, dry heaving, sore throat, and a deep, fine, faint pulse, treat with Sini Tang (Frigid Extremities Decoction). If only the fingertips are cold, it is named Qing Jue (Clear Jue); treat with Lizhong Tang (Center-Regulating Decoction).
Heat Jue begins with a hot body, irritability, foul odor, and a slippery, rapid pulse. After several days, sudden coldness in the limbs with intermittent warmth occurs; this is "deep heat causing Jue" (Shen Re Fa Jue). Treat with Huoyu Tang (Fire-Stagnation Decoction). If constipated, treat with Daxiehu Tang (Major Bupleurum Decoction). If there is irritability, thirst, restlessness, and delirium, and the hands/feet become cold due to failure to purge earlier, this is "extreme Yang resembling Yin" or "extreme heat resembling cold." Do not mistake it for a Yin syndrome and lightly use hot medicines. Mild heat causes mild Jue; treat with Sini San (Frigid Extremities Powder). Deep heat causes deep Jue; treat with Chengqi Tang (Order the Qi Decoction). If Yin declines at the lower part, causing heat in the soles and Jue, treat with Liuwei Wan (Six-Ingredient Rehmannia Pill).
For all Jue caused by Shanghan (Cold Damage), distinguish the pathogenic factor: Cold Jue should be warmed; Heat Jue can be dispersed or purged. If caused by deficiency of Yin and Yang, prioritize restoring Yuan Qi (Primal Qi): Cold Jue requires tonifying Yang; Heat Jue requires tonifying Yin.
Qi Jue has two types: Qi Deficiency and Qi Excess can both cause Jue. In Qi Deficiency Jue, the patient necessarily shows emaciation and sallow complexion, slight body coldness, and a weak pulse, indicating Qi Collapse. Use herbs such as Renshen (Ginseng), Huangqi (Astragalus), Danggui (Angelica), Baizhu (Atractylodes), Dihuang (Rehmannia), and Gouqi (Goji berry). For severe cases, use Huiyang Yin (Return Yang Decoction) or Dushen Tang (Single Ginseng Decoction). In Qi Excess Jue, the patient appears depressed/stagnant, with a deep, wiry, and slippery pulse, chest/diaphragmatic fullness and wheezing, indicating Qi Rebellion. First regulate Qi using Siqi Tang (Seven-Ingredient Decoction) or Paixi Yin (Expel Qi Decoction), then adjust according to symptoms.
Blood Jue also has two types: Blood Loss and Blood Rebellion can both cause Jue. Sudden vomiting of blood, epistaxis, metrorrhagia, or massive postpartum hemorrhage cause Qi to follow the loss, leading to sudden collapse. Pinch Renzhong (GV26) first, or burn vinegar-soaked charcoal to consolidate Qi, and urgently decoct Renshen Tang (Ginseng Decoction) to administer. As long as Qi is not completely depleted, consciousness will gradually return. In Blood Rebellion, violent anger injures Yin, causing Blood to rebel upward. First regulate Qi, then Blood will flow naturally. Use Tongyu Jian (Unblocking Stasis Decoction) or Huagan Jian (Transforming Liver Decoction). Wait until Blood flows and Qi relaxes, then adjust according to symptoms.
Food Jue results from excessive drinking and overeating, occasionally combined with exposure to Wind-Cold or anger. Food Qi fills the middle Jiao, Spleen Yang fails to transport, leading to sudden collapse and unconsciousness. Mistaking this for Stroke or Qi Stagnation treatment will result in death. Decoct ginger-salt water to induce vomiting; recovery follows once food is expelled. If complicated by Wind-Cold, use Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi). If due to Qi injury and stagnation, use Bawei Shunqi San (Eight-Ingredient Qi-Regulating Powder). Sudden collapse due to alcohol-induced Phlegm rising is named Wine Jue. Treat with Erchen Tang (Two-Aged Decoction) plus Qingpi (Tangerine Peel), Gegen (Kudzu Root), and Sharen (Amomum Fruit).
Phlegm Jue is caused by Phlegm-Heat obstructing the Pericardium, leading to cold limbs and sudden collapse. First induce vomiting to expel Phlegm using Gouti San (Melon Seed Powder). Once Phlegm is cleared, treat the root disease. Fire-Phlegm should be cleared and descended; Cold-Phlegm should be warmed and dispersed; Damp-Phlegm should be dried and drained. If due to Spleen Deficiency, strengthen the Spleen; if due to Kidney Deficiency, tonify the Kidney.
Corpse Jue is the presentation of Zhong'e (Sudden Evil Invasion). Due to encountering evil Qi, sudden coldness in limbs, clenched teeth, locked jaw, and coma occur. It may result from visiting graves or being struck by "flying corpses/ghosts," with delirious speech and bluish complexion. Administer Suhexiang Wan (Styrax Pills) via gavage. Upon awakening, take Tiaoqi Pingwei San (Regulate Qi and Calm Stomach Powder). Zhang Zhongjing stated: For Corpse Jue where the pulse moves but there is no Qi, and Qi closure prevents flow, use Huanhun Dan (Soul-Returning Pill).
Roundworm Jue often stems from Stomach Cold, where roundworms attack the Stomach, causing unbearable heart/abdominal pain, sometimes spitting saliva or worms, with paroxysmal attacks. Cold medicines are contraindicated. Use Lizhong Tang plus fried Chuanjiao (Sichuan Pepper) and Binglang (Areca Seed), decocted in water, followed by Wu Mei Wan (Mume Pill), Anhui San (Calming Worms Powder), or Wuyi San (Changium Powder). Roundworms are pacified by bitter flavors, stopped by sour flavors, and subdued by pungent flavors. Vomiting worms can also occur in Yang syndromes; if mouth ulcers and sore throat lead to worm vomiting, and cold remedies are effective, one cannot generalize all cases as Stomach Cold.
Decoction Jue: All movement belongs to Yang. Irritation and fatigue cause Yang Qi to surge violently. Labor-fire flares excessively, exhausting Essence. Delaying into summer, internal and external heat prevail, leading to solitary Yang rebellion, feeling like boiling or simmering. Clear Heart and tonify Kidney, or use salty-cold descending methods. Use Renshen Guben Wan (Ginseng Root-Solidifying Pill) plus Dansai (Sea Vegetable), Ejiao (Donkey-Hide Gelatin), and Fangzhu Shui (Alum Water).
Thin Jue: The Liver stores Blood. Anger causes Fire to rise in the Liver, forcing Blood upward and causing Jue. Use Pu Huang Jiu (Polygonum Wine) to descend.
Atrophy Jue is also a type of Heat Jue. Jue originates from the Liver, rendering the four extremities useless. Due to Water (Kidney Yin) deficiency, Yang-Wind scorches tendons, and collateral heat boils. Use fleshy, salty-moistening substances, decocted into paste to fill deficiencies. Herbs include Biejia (Turtle Shell), Guiban (Tortoise Shell), Ejiao, Dansai, Shengdi (Raw Rehmannia), and Pig/Sheep Spinal Cord.
Bi Jue (Hong Kong Foot/Palsy Numbness): Initial onset involves body pain and swollen joints. Use Danggui Niangong San (Angelica Analgesic Powder). If pain is extreme below the ankles, use Wushou San Kui Wan (Five Beasts Three Trunks Pill) or Zishen Wan (Tonify Kidney Pill).
Wind Jue: Hand/foot spasms and body rigidity, named Jing Jue (Spasm Jue). Use Xiao Xuming Tang (Minor Rescue Life Decoction).
Epileptic Jue: Liver Wind triggers spasms, limb jerking, and fluid depletion. Use Guben Wan plus Ejiao, Ji Zi Huang (Chicken Egg Yolk), and Longgu (Dragon Bone).
Aphonic Jue resembles Stroke. Sudden aphonia and inability to speak. As the Classics say: "Internal depletion with Jue leads to aphonia and flaccidity." Modify Dihuang Yinzi (Rehmannia Decoction).
Depressed Jue is also a Blood Jue. Usually healthy, suddenly silent and unaware, eyes closed, jaw locked, aversion to sound, waking after some time. Caused by Heat rising and Wind moving, depression leading to Jue, common in women. Use Lingyang Jiao San (Antelope Horn Powder). For deficiency, tonify the Extraordinary Vessels using Gouqi, Danggui, Lujiaoshuang (Deer Antler Frost), Fuling (Poria), and Rongshu (Cistanche).
Bone Jue: Bone withering and claw pain. Use Liuwei Wan (Six-Ingredient Rehmannia Pill).
Painful Jue: Due to prolonged Stomach Yang decline, Liver Wood overacts, turbid Qi attacks the Stomach. Herbs include Wuyu (Evodia), Banxia (Pinellia), Fuling, Jiangzhi (Ginger Juice), and Guangpi (Tangerine Peel).
Kidney Jue: Fire rises along the spine, limbs reverse cold, spitting foam. Use Jiaofu Tang (Pepper and Aconite Decoction). If Kidney Jue Qi rebels to the vertex causing severe headache, use Yuzhen Wan (True Jade Pill).
Sexual Depletion Jue: Due to excessive sexual activity exhausting emotions, Essence depleted below, Qi depleted above. Use Dushen Tang (Single Ginseng Decoction).
Sudden Jue: Pulse rapid like panting, Qi closure, cold limbs. If nose and heart/abdomen are slightly warm, eye spirit unchanged, no oral saliva, testicles not retracted, rescue is possible. Use Beijii Wan (Emergency Pill).
Malaria Jue: Malaria pathogen sinks into Yin, causing Jue and unconsciousness. Harmonize Zheng Qi (Upright Qi) to expel pathogen. Herbs include Renshen, Banxia, Zhimu (Anemarrhena), Cao Guo (Black Cardamom), Wumei (Mume Fruit), and Shengjiang (Fresh Ginger).
For all Jue, a large, floating, full, and forceful pulse indicates easy recovery; a fine, deep, hidden, rapid, and irregular pulse indicates a ominous prognosis. If upon falling, the thumb presses inward into the palm, it is ominous; if outward, it is mild. Bluish face, blue around the mouth, white lips, black nostrils, and twitching of the philtrum indicate critical danger.