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1. A patient, due to long-term frustration and depression, combined with habitual mental overexertion, suffered from the consumption and dispersion of Heart Blood. In the early winter, upon rising in the morning, his left foot's five toes suddenly became numb and cold, rapidly extending up to the knee, followed immediately by loss of consciousness. He recovered after a long period, alternating between wakefulness and confusion, experiencing this episode more than ten times within a day and night. Everyone considered it Phlegm Jue (Phlegm Reversal). Zhang Zhongchun (Zhang Jingyue) stated: "This is purely deficient fire." After taking one dose of pill medicine, he felt slightly better by spring. However, after April, when the supply of pills ran out, and given that sexual activity was slightly excessive, the previous symptoms recurred in June, requiring a long time to regain consciousness. Six days later, due to rain and slight exposure to cold qi, he suffered two more episodes. Currently, both legs are weak, and he fears cold intensely, although he does not feel cold above the abdomen. Zhongchun said: "When one's will and intent are unfulfilled, the Heart is injured; when sexual labor is unrestrained, the Kidney is injured. When both Heart and Kidney are diseased, Yin and Yang are on the verge of separation. Once separated, severe illness must arise because the two zang organs fail to interact. The treatment method should employ Maidong (Ophiopogon Root), Fushen (Poria with Hostwood), and Zaoren (Ziziphus Seed) to clear heat and tonify the Heart; Su Zi (Perilla Fruit), Beimu (Fritillaria Bulb), Niuhuang (Calculus Bovis), and Zhuli (Bamboo Juice) to direct qi downward and resolve phlegm, treating the upper aspect. Niu Xi (Achyranthes Root), Shihu (Dendrobium Stem), and Yuanzhi (Polygala Root) should be used to benefit essence, tonify the Kidney, and strengthen the will, treating the lower aspect. Furthermore, one must clear the heart and reduce desires, so that the root of the disease will surely be eradicated." To the previous formula, add Renshen (Ginseng Root) and Xiatiangao (Cassia Twig Paste) each at 5 qian. The pill medicine should consist of Er Dong (Tian Dong and Mai Dong), Fushen, Yuanzhi, Zaoren, Shengdi (Rehmannia Root), Niu Xi, Duzhong (Eucommia Bark), Wuweizi (Schisandra Berry), and Huangbai (Phellodendron Bark), taken with Shihu Decoction added with Zhuli.

Jue refers to reversal or counterflow. When qi reverses, chaos ensues; thus, sudden dizziness, falling, collapse, and unconsciousness are named Jue. The Classics state: "In sudden Jue, one cannot speak with others." This means sudden reversal leading to unawareness of people. It also states: "When blood and qi rush upward together, it forms Great Jue. Jue leads to sudden death; if qi returns, life is preserved; if it does not return, death occurs." When blood and qi rush upward, there is excess above and deficiency below. Deficiency below leads to the depletion of Yin. If the root is severed, sudden death occurs. If qi returns after reaching its extreme, Yin will gradually recover, allowing for resuscitation; hence, this condition is extremely critical. Later physicians equated Jue solely with cold hands and feet, a view originating from Zhang Zhongjing. The *Shanghan Lun* (Treatise on Cold Damage) states: "In all cases of Jue, the failure of Yin and Yang qi to connect smoothly results in Jue. Jue is characterized by cold extremities." However, can we say that Jue is limited to this? Although the *Neijing* (Inner Canon) chapter on Jue also mentions the hands and feet, stating: "If Yang qi is deficient below, it becomes Cold Jue," the cause of Cold Jue is described as follows: The person relies on their robust constitution and, during the yin-abundant seasons of autumn and winter, indulges in desire, depleting the essence and qi of the Kidney. Yang qi becomes deficient and fails to permeate and nourish the meridians. As Yang qi diminishes daily, only Yin remains, causing coldness in the hands and feet. It further states: "If Yin qi is deficient below, it becomes Heat Jue." The cause of Heat Jue is described as: The person engages in sexual activity after drinking and eating heavily, injuring the Yin of both Spleen and Kidney. Heat flourishes internally, spreading throughout the body, causing internal heat and dark urine. As Kidney qi declines daily, Yang qi dominates, causing heat in the hands and feet. Zhang Jingyue noted that the *Neijing* distinguishes impending Jue by cold hands and feet as Cold Jue, and hot hands and feet as Heat Jue, providing very clear annotations. Both Cold and Heat Jue result from damage to the True Yuan by alcohol and sexual indulgence. Therefore, Cold Jue requires tonifying the source of Fire (warming Yang), while Heat Jue requires strengthening the master of Water (nourishing Yin), which differs from the treatment of Jue in Cold Damage. Other types include Qi Jue caused by anger injuring the Liver; Blood Jue caused by evil blood rushing to the Heart; Phlegm Jue caused by rebellious heat-phlegm; Food Jue caused by dietary injury; and Corpse Jue caused by sudden invasion of evil pathogens. These are all sudden dizziness, falling, and coma-type Jue conditions. Practitioners must carefully differentiate symptoms to apply treatment, avoiding errors in using cold/heat or attacking/tonifying methods. There are many names for Jue, too numerous to list. Those who wish to deepen their understanding should study the chapters on Jue and Reversal in the *Neijing*.

Dushen Tang (Single Ginseng Decoction): Treats sudden dizziness, falling, and coma, with no phlegm sounds in the throat, no pathogenic heat in the body, indicating symptoms of Yin deficiency with sudden collapse of Yang.
Renshen (1 liang to 3 liang). Add Shudi (indicates Yin deficiency, where solitary Yang has no attachment and is about to collapse). Add Zhuli (indicates deficiency with phlegm). Add Tongbian (child's urine, indicates deficiency with fire). Add Fuzi (indicates deficiency without fire).
This is a divine prescription for treating critical conditions of various deficiencies and weak qi. Zhang Jingyue stated that Jue reversal is directly due to the internal depletion of essence and qi. Zhu Danxi stated that Jue mostly belongs to Qi and Blood deficiency; Qi deficiency presents with a fine pulse, and Blood deficiency presents with a large pulse like an onion stalk; both are suitable for tonic prescriptions. Yu Tianmin stated: "The patient must originally have a weak constitution, such as the elderly or those recovering from major illness; if a robust person suffers this, one should urgently treat the branch/symptoms." One must clearly distinguish between deficiency/excess and cold/heat.

Wumo Yin (Five Frustrations Drink) (see Stomach Pain section): Treats sudden anger injuring the Liver, locked jaw, cold extremities, blue complexion, and cold body (Qi is the Yang of the human body; once constrained, Yang qi cannot distribute to the four extremities, hence cold limbs and body), deep and hidden six pulses (The Classics state: "Sudden aphonia with absent pulses may heal without treatment. This refers to sudden rebellion of Qi; when Qi restores, recovery occurs"). Named Qi Jue.
This is a formula for treating Qi Jue. The Classics state: "Great anger causes form to become excessive and Qi to cease, with blood stagnating above, causing Bo Jue (Close Jue)." Great anger causes both Qi and Blood to rebel, even to the point of cessation of form and Qi. Blood rebels and flows recklessly, stagnating in the Upper Jiao. Mutual pressure is called "Bo" (Close), and Qi rebellion is called "Jue". With both Qi and Blood chaotic, it is termed Bo Jue. It is appropriate to add Xiang (Costus Root), Sanqi (Notoginseng Root), Yujin (Curcuma Tuber), and Lingyangjiao (Antelope Horn) to this base formula.

Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) (see Shanghan section): Treats evil blood rushing to the Heart, causing fainting and cold extremities, named Blood Jue.
The original formula is suitable for adding Xiang (Costus Root, most effective for directing Qi downward, miraculous for moving stasis), Sanqi, Tongbian (moves stasis gently, stops bleeding without coagulation), and Lingyangjiao (dispels evil blood, directs rebellious Qi downward). For severe cases, add Huaruishi (Flower Ochre Stone, transforms blood stasis into yellow water, taken as powder mixed with liquid, doses of 1, 3, or 5 qian).
This formula is suitable for Blood Jue. Medical texts state: "Someone usually free from illness suddenly appears dead, motionless, eyes closed, mouth tight, or slightly aware, dizzy for a while before waking. This is due to excessive sweating, leading to decline of Ying Blood, with Yang Qi rising alone, blocking Qi flow. Thus the body appears dead. When Qi passes and Blood returns, Yin and Yang reconnect, so waking occurs after a while. This is also named Blood Jue, or Yu Mao (Depressed Dizziness)." Women suffer from this condition particularly often. Baiwei Tang (Baiwei 1 liang as Sovereign, Danggui, Renshen, Gancao) is suitable for treatment.

Shunqi Kaitan Yin (Direct Qi and Open Phlegm Drink) (see Stroke section): Treats heat-phlegm congestion causing昏冒 (dizziness/fainting) and cold extremities, named Phlegm Jue.
This formula is suitable for heat-phlegm Jue reversal. If it is damp-phlegm congestion in obese individuals causing Jue reversal, Erchen Tang combined with Xingxiang San, added with Zhiqiao (Bitter Orange), Zhuli, and Jiangzhi (Ginger Juice) is suitable.

Baohe Tang (Preserve Harmony Decoction) (see Diarrhea section): Treats situations after heavy eating/drinking, or exposure to wind-cold, or emotional distress, where food fills the Taiyin Spleen, Stomach Qi fails to move, leading to sudden Jue reversal and coma, named Food Jue. (Wancun stated: "Stomach Qi fails to move, Yang merges into the Upper Jiao. Symptoms include heat in the upper body, abdominal fullness, or irritability and headache. From the navel down to the feet, it is cold as ice-iron; huddling by a stove brings no warmth. Mistaking this for Yin-Cold and using warming/tonifying methods will cause death.")
This formula is suitable for combining with Wumo Yin for modification. If food stagnation is in the Upper Wan (epigastrium), urgently induce vomiting with salt water.
This formula is suitable for Food Jue, modified according to symptoms.

Quxie San (Evil-Expelling Powder) (Self-made): Treats sudden invasion of evil pathogens, blue-black face, locked jaw, closed eyes, unconsciousness, cold extremities, gooseflesh skin, or delirious speech. Or staring straight, clenched fists, or severe pain in all joints.
Xijiao (Rhino Horn), Lingyangjiao (Antelope Horn), Longchi (Dragon Bone), Hutougu (Tiger Head Bone) (all powdered). Muxiang (Costus Root), Chenxiang (Agarwood), Tanxiang (Sandalwood), Xiang (Costus Root/Dragon's Blood - context implies aromatic woods) (each purified 1 qian). Shexiang (Musk) (Pathogens attaching to humans close the orifices. Musk's pungent and aromatic penetrating nature guides the aromatic righteous Qi and anti-pathogen herbs from inside to outside, opening hair follicles and joints, allowing pathogens to exit. 2 fen). Xionghuang (Realgar) (2 qian). Niuhuang (Calculus Bovis) (also a powerful anti-pathogen agent. 2 fen). Zhusha (Cinnabar) (with Fushen, Zaoren, Yuanzhi to calm the Spirit. 2 qian). Yangrou (Mutton) (2-3 liang, omit if Stomach is weak). Fushen, Zaoren, Yuanzhi (each 5 qian). Decoct soup to mix with the medicine powder (3 qian), taken twice daily.
This is a modification of Jiayan's (Li Zhongzi's style) method for expelling malevolent spirits, used to treat Zhong'e (sudden invasion of evil), with great efficacy.