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Sun Zhao and Du Ren jointly treated the favorite consort of Emperor Renzong of Song. One day, while eating, the consort suddenly collapsed, and her entire body became cold instantly. The matter was urgently reported to the Emperor. The Emperor then hastily summoned Sun Zhao and Du Ren. Upon arrival, they reported: "There is no danger; this is Qi Jue (Qi Syncope), a condition caused by the stagnation of vital energy. She will recover shortly after vomiting." After some time, the consort indeed vomited and regained consciousness. The Emperor asked how they knew this. Both replied: "This consort recently suffered from sorrow and resentment, causing Qi to rebel upwards. This rebellious Qi combined with food, leading to this condition. Once vomited, the Qi flows freely, hence she recovers." The Emperor asked what caused such distress for the consort. She answered: "Your Majesty has no heir, and my family cannot produce a royal successor for Your Majesty. Therefore, I resent myself. My Qi suddenly rebelled, disturbing Your Majesty's presence." The Emperor said: "I also blame myself; did I not cause you illness through worry?" He praised the medical skills of Sun and Du, and after a long pause, added: "Are you not excellent physicians of our time?" (From *Medical Outline*.)

Yu Ao's maid, acquired by Cui Shiyu, suddenly died. Liang Ge said: "This is not death, but Shi Jue (Corpse-like Syncope)." He punctured points around the heart and below the navel, dressed her in single-layer clothing, laid her on a bed, bound her limbs, placed mild heat under the bed, and upon slight recovery, fed her scallion porridge, reviving the maid. (Xu Yingqiu noted: In cases of Shi Jue, if there is no response to calling and the pulse is hidden, it is fatal; if the pulse becomes surprisingly large, it is also fatal.)

Dou Cai treated a patient who fell ill due to extreme anger and sadness. The patient was calm during the day but restless at night, refused food, had no pulse on the left wrist, and a deep, fine pulse on the right. Other physicians deemed it a terminal case. Dou Cai said: "This is Shen Jue (Kidney Syncope), caused by cold pathogenic factors lodging in the Liver and Kidney meridians." He moxaized the Zhongwan (CV12) point 50 cones and the Guanyuan (CV4) point 500 cones, administering Jin Ye Dan and Si Shen Dan daily. By the seventh day, the left pulse returned. Shortly after, several liters of greenish-white purulent stool were passed, and the patient fully recovered. This was due to extreme deficiency of True Qi, which medication alone could not treat; only moxibustion could cure it. (Original note: This condition cannot be cured without moxibustion, nor can it be effective without elixirs. Most people cannot perform these treatments; doctors using only ordinary medicines cannot save them.)

A woman suffered postpartum syncope, dry eyes, facial numbness, locked jaw, and spasms of both hands. Dou Cai said: "This is due to the closure of Stomach Qi." (Also caused by rebellious Liver Qi and knotted Stomach Qi forming Jue). The Stomach meridian circles the lips and emerges from between the teeth, explaining these symptoms. He ordered moxibustion on Zhongwan (CV12) for 50 cones, resulting in immediate recovery. (Original note: For postpartum Blood Jue, Cang Gong Bai Wei Tang may be used.)

Another woman fainted repeatedly for two days. Physicians treating her as a Wind disease failed. Dou Cai moxaized Zhongwan (CV12) for 50 cones, curing her. (This is Shi Jue.)

Zhang Zihe treated a patient with Tan Jue (Phlegm Syncope) who was unconscious with a locked jaw. Medications could not be administered, and death seemed imminent. Zhang asked the caregiver: "Was there saliva in the mouth?" The answer was yes. He first prepared a decoction of Fang Feng and Li Lu, mixed with Geng Ti powder, and attempted to administer it orally. When oral administration failed, he took a long clam shell, ground off the sharp edges, wrapped the tip in paper, and inserted it into the right nostril. Swallowing sounds were heard. He repeated this in the left nostril, stating: "It can be treated." After a long wait with no phlegm expulsion, he administered one qian of Pi Shi (Arsenic) into the nose. The patient suddenly lay supine, appeared to feel pain, and soon retched, expelling several liters of sticky, foul-smelling saliva. Pi Shi should generally not be used, but due to the severity of the illness, it was necessary to move the pathogen. However, without Geng Ti, it should not be used directly; discretion is required. Generally, stroke with phlegm obstruction is often misdiagnosed merely as Wind, leading to excessive use of Wind-dispelling herbs. Ling Bao Wan and Zhi Bao Wan have misled many. Thus, Liu Hejian, when treating Wind, disregarded Wind itself and focused on the Two Fires.

The wife of Chang Zhongming experienced hot and painful hands every winter. Zhang Zihe said: "The four limbs are the root of all Yang meridians. In summer, Yang disperses and there is no pain; in autumn and winter, Yang converges, causing pain." He administered San Hua Shen Wan to induce strong purgation, removing the heat and pain. (This is Re Jue/Heat Syncope.)

Old Man Zhang, over sixty, suffered from headache due to Re Jue. He had been using emetic drugs for a month. Combined with fire therapy, he previously had diarrhea. Being elderly and weak, he collapsed upon seeing the sun outdoors and lost consciousness. Family members panicked and wanted to rub or beat him. Zhang Zihe said: "Absolutely do not disturb him." He provided watermelon, cool water, and honey snow. The patient recovered shortly. Because the illness was severe and the patient old, emesis and purgation could disrupt the pulse. Internal inflammatory fire combined with external solar exposure caused the collapse. Further disturbance would be fatal. Only by calming the spirit, providing cool water, and maintaining stillness (which belongs to Water) could safety be ensured. Clinicians must master this principle.

The son of Chang Mingzhong suffered from Wind-Phlegm disease from age four, worsening by fifteen. He had headaches twice a month, punching hundreds of times until he vomited one or two cups of yellow-green saliva. Attacks became more frequent, with visual black spots, unconsciousness (Jue), and recovery taking three to four days. Physicians used Nan Xing and Ban Xia to resolve phlegm without effect. Meeting Zhang Zihe south of HT Water, he was treated with Shuang Jie San to induce sweating, followed by bitter emetics to expel phlegm, resolving most symptoms. Subsequently, Fen Xiao Ji regulated his health, achieving full recovery from spring to autumn.

Zhuang Yisheng treated the wife of Zhang Fengfu, a scholar from Jintan. While eating, she encountered sudden rage, collapsed, and lost breath. A physician blew Rhizoma Smilacis Glabrae ash into her nose to induce sneezing, but she did not sneeze. Decoctions were refused. By midnight, the physician declared her untreatable and left. Zhuang Yisheng was urgently consulted. Six pulses were present, but the Qi Kou pulse was deep and hidden; careful palpation revealed significant slipperiness. He stated: "Liver Wood Qi rebels into the Stomach. Phlegm exists in the Stomach, causing phlegm and food to block the Stomach opening, preventing Qi flow and causing sudden cessation. Since time has passed, decoctions cannot enter. Emesis is urgently needed to save her, following the principle 'When Wood is constrained, unblock it.'" He positioned her prone with her head hanging down, used a goose feather dipped in tung oil to open her teeth and probe the throat, inducing vomiting. After one mouthful of phlegm and food, Qi flowed slightly. After two or three more probes, she smelled oil and pushed away with her hand but could not speak. Zhuang said: "No harm." Knowing her frail constitution, he avoided excessive vomiting, instead brewing a decoction of Zhi Ju to push out stagnation. She recovered after finishing the dose. Later, Liver-calming and Stomach-harmonizing herbs restored her health. This was caused by sudden rage, where Qi rebels upward, trapping phlegm, presenting as Shi Jue. Errors in treating Jue are common; I record this to warn future practitioners. (From *Guang Biji*.)

Ji Qiu stated: The wife of Zhu Fangzhong from the Imperial Academy had a very weak constitution, worked hard, was prone to anger, suffered internal heat and palpitations, and had deficient Gallbladder Qi and timidity for three to four years. In the summer of Ren Shen year, she suddenly developed Jue Mao (syncope with dizziness), rising phlegm-Qi, eyes rolling up, limb convulsions, and unconsciousness. Initially once a day, it progressed to continuous attacks, hundreds per day. Niu Huang Zhu Li was tried without effect. I exhausted my strategies and considered strong tonification with Ren Shen and Fu Zi, but due to her thirst and constipation, I hesitated. A friend arrived, strongly advocating decisive action, insisting on Fu Zi. We forcibly administered two qian of Fu Zi and six qian of Ren Shen in one dose. After noon dosing, she developed high fever, restlessness, and extreme thirst, dying within two days. This was not solely due to Fu Zi, but because the syndrome absolutely contraindicated its use. Do not rely on luck or experiment casually. (Same source.)

In the Yi You year, Zhang Yitian treated a patient who suddenly had diarrhea several times, collapsed, lost consciousness, had dull eyes, muscle twitching, and locked jaw, resembling stroke. The pulse was deep, wiry, and slow; limbs were not cold, body stiff, no sweat, nose blue, cheeks red. This was a recurrence of Liver constraint. He administered hot Tong Bian (Child's Urine) and Ci Cong (Scallion), restoring slight consciousness. Then used Qiang Huo, Fang Feng, Chai Hu, Gou Teng, Xiang Fu, and Zhi Zi. Subsequently, Tian Ma Bai Zhu Tang plus Dang Gui, Bai Shao, Dan Pi, and Zhi Zi cured him. Asked about the recurrence of Liver constraint, he explained: When Luck (Yun Qi) is discordant, deficient individuals contract it. That year, Yangming Dry Metal governed the sky, Metal Luck at You branch was insufficient, causing late flourishing of grass and trees. Last winter was sunny without snow, failing to store Yin in winter. Early spring, before storage was complete, plants flourished early. Dry Metal governs肃杀 (killing/cold); although Wood expands, Metal overcomes it. Thus, plum blossomed prematurely amidst hail and wind. Extreme Wood constraint leads to "Re" (counterattack). As the Classics say: bending trees and flying sand, trembling limbs and vertigo, sudden upward rebellion of Wind-Heat is called Qing Jue. The current deep, wiry, slow pulse indicates Heat of Wind Wood. Considering the heavenly timing, Tong Bian and Ci Cong were used to rapidly descend turbid Yin and transform clear Yang, clearing the spirit. Qiang Huo and Fang Feng soothed Wind Wood; Xiang Fu and Zhi Zi resolved constraint and cleared stagnant Fire. Tian Ma Bai Zhu Tang with tonics cultivated Earth, cleared Fire, and smoothed Liver Wood to achieve Spring energy. Though one cannot control creation, one should not violate heavenly timing.

Li Dongyuan treated a Secretary whose feet, knees, buttocks, and lower back were cold. The pulse was deep, rapid, and forceful. He prescribed Huang Bo Zi Shui Wan, curing him after two doses.

Wang Shishan treated a patient with sudden Jue and apparent death, unconscious. Previously suffering from slight chills and recurrent fever, with sallow complexion and deep, wiry, fine pulses, he identified chronic Middle Qi constraint. He administered Ren Shen Qi Qi Tang. Before the medicine warmed, the patient ceased breathing. Wang instructed someone to hold the patient tightly, breathe into their mouth, and slowly pour hot Ginger Decoction, prohibiting noise or movement, lest Qi fail to return. The patient revived and recovered after half a month of warm nourishment. Not only this case, but for Stroke, Qi Strike, Cold Strike, and Sudden Jue, one must not disturb the Qi to sever it. The *Neijing* clearly states: if Qi returns, life is preserved. Those who fail to understand this and disturb the patient, preventing Qi restoration, often die prematurely. (Not disturbing is a key method.)

Physicians and families encountering sudden acute illnesses must know this. Acute illnesses often involve Fire; disturbance scatters Zheng Qi leading to death. My eighteen-year-old daughter suddenly suffered Jue. Her family, unaware, gathered noisily, moved her elsewhere, causing her to relapse after brief recovery, beyond rescue. Recording the cases of Zhang and Wang breaks my heart.

Sheng Yongjing treated a woman with sudden Jue, drowsy as if drunk, with limb tendon pulling. His pulse diagnosis showed all six pulses vanished. A man in mourning clothes stood nearby; he was the patient's husband. His wife had died half a month prior from postpartum complications. Sheng realized: "This illness must be caused by depression/grief." He administered Mu Xiang Liu Qi Yin, curing her after one dose. (*Wujiang County Gazetteer*.)

Lu Yi, from Huating, was skilled in medicine. Duan Shi, a tenant neighbor, died suddenly one night. Lu Yi removed the bottom of a horse stable rack, placed it over a large cauldron, put the deceased on it, and steamed them with Scallion and herbal medicines. By morning, the skin rotted, but Qi returned. (*Jiangsu Province Gazetteer*.)

Sun Wen Yuan treated the eldest sister of Ding Yaochuan, who often suffered fainting spells (All wind tremors and vertigo belong to Liver). She vomited a bowl of phlegm before recovering (Phlegm moves due to Fire), occurring 3-5 times a month. Later, she developed thirst, early morning fullness (new terms), borborygmus, abdominal pain, diarrhea, scanty urine, and cough (all caused by Liver Fire). Pulses were soft and weak at Cun, slippery and large at Guan. This was caused by Phlegm accumulation in the Middle Jiao (manifestation rather than root). First, Er Chen Tang plus Cang Zhu, Shan Zha, and Mai Ya was used to strengthen Spleen (Minister), Bai Shao for pain (Chief), Hua Shi and Ze Xie to guide damp-heat via urine (Assistant), and Huang Qin as Deputy Assistant for ten doses, stopping pain in the two Yin areas. Then switched to Liu Wei Di Huang Wan, Zhi Mu, Huang Bo, and Niu Xi, achieving cure.

Note: This girl's illness inherited maternal Qi. I often see that children of parents with Liver disease also suffer from it. This Jue is also a Liver disease. Her mother's illness was severe in the two Yin. See Depression Syndrome section.

Madam Bai Yangyun fainted whenever angered, requiring closed doors and quiet sitting without others nearby (showing this illness should not be disturbed). Limbs were cold, sweating profusely, breath faint. She recovered after an hour. Originally, due to neck lumps, she frequently took female doctors' prescriptions and toxic substances like Ban Mao, damaging Spleen/Stomach and depleting Yuan Qi. At thirty-eight, she had never given birth. She kicked her legs when trying to sleep and startedle easily. Two days before menstruation, lower abdomen hurt, blood dark with clumps (all Liver diseases). Muscle and diet were normal (Spleen/Stomach healthy). Pulses: short and weak at Cun, large and forceless at Left Guan, slippery at Right Guan, slippery at Left Chi, deep and faint at Right Chi. According to pulses: Lung Qi deficient, Liver Wood excess, Stomach Earth excess, Phlegm in Stomach (Wood heat flows fat; impossible to have strong Liver Fire without Phlegm; do not blame Stomach). Used Liu Jun Zi Tang plus Dan Shen, Jiu Lian, and Qing Pi, externally managed with Zhen Zhu Mu Wan and Du Huo Tang, achieving peace. (Both formulas from *Medical Outline*.)

Gong Zicai treated Vice Minister Liu, who collapsed unconscious, with eye and mouth deviation, and limb tremors. One physician treated as Wind, another as Phlegm-Fire, both ineffective. Pulses were deep, rapid, and tight at Qi Kou. This was neither Wind nor Phlegm, but Qi combined with Food. The family realized: "We were eating when anger struck, causing this." Xing Qi Xiang Su San plus Mu Xiang, Qing Pi, and Shan Zha cured him. (*Ten Thousand Diseases Revived*.)

Yu Jiayan treated the mother of Official Wu Tian. Frequent rage stopped her menstruation. Since autumn, she felt Qi rebelling upward, fearing boats, fainting upon movement, lying in bed feeling like the world was turning upside down, unable to rise, unresponsive to hundred treatments. Small doses of Ren Shen (3-5 fen) brought brief relief. Finally, doses reached five qian per prescription, costing gold daily, exhausting family wealth, worsening condition with high fever, thirst, splitting headache, poor appetite, and diarrhea. Yu diagnosed: "Curable." Severe rage causes Blood to pool above and Qi to fail returning below, named Jue Dian Ji (Syncope of the Vertex). Jue means rebellion; Dian means high. Qi and Blood rebel to the high vertex, causing vertigo. Upper excess and lower deficiency relate to Foot Shaoyang. Shaoyang Gallbladder connects to the brain. Depressive anger fire attacks the brain; tonification fuels it, causing splitting pain, same as Jue Dian disease. Wind and Fire stir each other, causing shaking and steaming heat; Wood and Earth clash, causing difficult eating and diarrhea. Combining the *Neijing* concept of Tie Luo (Iron Filings) to suppress, he used Dai Zhe Shi, Long Dan Cao, Lu Hui, and Huang Lian to descend rebellious Qi; Shu Qi, Dan Pi, and Chi Shao to move pooled Blood; Mu Li, Long Gu, and Wu Wei Zi to gather floating Spirit. Crucially, two raw pig gallbladders were added to each dose. With Shaoyang heat blazing, bile must be dry; similar substance replenishes it, supporting critical situations. Upon ingestion, the patient felt spirit return, forgetting bitterness. After dozens of doses, fever subsided, body cooled, appetite improved, diarrhea stopped, able to walk steps. Still felt light as a leaf, unable to sustain. Fearing bitterness, Pig Gall and Lu Hui were reduced, adding Dang Gui and Ren Shen, guided by Ginger and Jujube. Regulated for several days, fully recovered.

Li Shicai treated Madam Yan. First chest/abdominal pain, next day sudden fainting, cold limbs. A physician prepared Niu Huang Wan. Pulse: all six hidden, Qi Kou slightly moving. Food filled chest, Yin/Yang blocked, ascending/descending obstructed, hence hidden pulse but visible Qi Kou. Treated with Chen Pi, Sha Ren (1 liang each), Ginger (8 qian), Salt (3 qian) decoction, induced vomiting with finger, expelling 5-6 bowls of old food, revealing all pulses. Left Guan wiry and large, severe pain, indicating damage from great anger. Treated with Mu Xiang, Qing Pi, Ju Hong, Bai Zhu, Xiang Fu decoction, pain stopped in two doses. Then Liu Jun Zi Tang plus Mu Xiang and Wu Yao, regulated for ten+ days, cured.

A fifty-year-old man, indulging in wine and sex, suddenly had headache and fever. Physician used Qiang Huo Tang to disperse, causing endless sweat, coma. Li moxaized Guanyuan (CV4) 10 cones, waking him. Si Jun Zi Tang plus Ginger and Gui, three doses daily, improved by third day. Relapsed Jue due to labor and anger; treated with 1 liang good Ren Shen, 3 qian Shu Fu Zi, 10 slices Wei Jiang decoction, slightly woke. Collapsed upon slightest movement, seven times in a day, consumed 3 liang Ren Shen. Next day, mutton soup and rice porridge given, collapsed 2-3 more times. By fifth day, Jue stabilized. Crying, asked: "Can I live again?" Answer: "Pulse has root, but Yuan Qi extremely deficient. Years of regulation needed to recover." Fortunately, he trusted firmly. In two months, consumed 4 jin Ren Shen. In three years, 600 decoctions, 70 jin pills, walked normally again. Many relatives discussed (biggest taboo for patients). If trust wavered, compliance would drop, survival unlikely.

Zhang Luyu treated the wife of Gu Yunxiang. Rage injured food, causing wheezing, distension, and fullness (Rage makes Qi rebel). Physician mistook Wind pathogen and gave exterior-releasing drugs, causing confusion, staring, mutism, unconsciousness (Stirring Liver Evil, heavy Phlegm causing Jue). Pulse: six regions choppy and hidden. Identified as Phlegm due to Qi closure. Should guide according to trend, induce vomiting to open orifices. But family feared violent vomiting, so Dao Tan Tang plus Shi Pu and Yuan Zhi was given. One sip allowed speech. Added Bing Lang and Tie Luo to previous formula, achieved evacuation and peace.

Huang Lvsu said: People with robust spirit occasionally suffering Tan Jue can take Niu Huang Wan for immediate cure. My brother-in-law Zhou Gongmei suddenly had dull spirit and staring, followed by surging phlegm, flailing limbs, resembling stroke. No medicine taken, self-healed next day. Such constitutions are rare (one in a hundred).

Madam Grand Historian Yang suddenly fainted. Physicians treated as Stroke, ineffective. Li diagnosed: Left Guan wiry and urgent, Right Guan slippery, large, and soft. Root cause: insufficient Yuan Qi, plus food retention after anger. First, Qi-regulating and food-resolving drugs expelled black stools. Urgently, Liu Jun Zi Tang plus Ginger Juice, four doses stopped fainting. Then Ren Shen 5 qian, Bai Zhu, Ban Xia 3 qian each, Fu Ling, Dang Gui 2 qian, adjusted and regulated, cured in two months.

Xue Lizhai treated a woman who convulsed due to anger, vomited phlegm-saliva, locked jaw, confused, Qi Kou pulse larger than Ren Ying. This was Qi stagnation and Food Jue. Treated with Ping Wei San plus Fu Ling, Ban Xia, Mu Xiang, revived. Then Liu Jun Zi Tang plus Mu Xiang gradually improved. Removed Mu Xiang, continued twenty+ doses, cured.

Lu Yangyu treated Xu Shennan, sudden acute illness resembling stroke, mute, unrecognized, limbs immobile. Su He and Niu Huang Wan ineffective. Xiao Xu Ming Tang increased wheezing, high fever, cold limbs. Due to deep, faint pulses, Fu Zi Li Zhong Tang was planned. Diagnosis: Cun pulses barely perceptible, Guan and Chi hard to find.