厥阴阴邪微细厥，肤冷脏厥躁难安，囊缩舌短苔滑黑，四逆当归四逆先，少满痛厥
姜萸入，蛔厥静而复时烦，得食而呕蛔闻臭，烦因蛔动乌梅丸。
【注】厥阴阴邪，谓邪从阴化之寒证也。微细，厥阴阴邪脉也。厥，谓四肢厥冷也。肤
冷，谓肌肤冷也。脏厥，谓寒阴脏厥也。躁难安，谓烦躁无有安时也。囊缩，谓外肾为
寒收引缩入腹也，妇人则乳缩阴收也。舌短，谓舌缩短也。苔滑黑，谓舌苔不干而色黑也。
四逆，谓四逆汤也，当归四逆，谓当归四逆汤也。先者，谓先服当归四逆汤也，少满痛，
谓少腹满按之痛也。厥，谓厥冷也。姜萸入，谓当归四逆汤加入吴莱萸、生姜也∶蛔厥，谓
厥而吐蛔也。静而复时烦，谓烦时止时烦也。得食而呕蛔闻臭，谓呕因蛔闻食臭而始呕也。
烦因蛔动，谓烦因蛔动而始烦也。乌梅丸蛔厥，谓宜用乌梅丸也。详厥阴篇。
阳邪热厥厥而热，消渴热气撞心疼。烦满囊缩舌焦卷，便硬尚任大承攻，四逆不分
四逆散，咳加姜味下利同，悸加桂枝腹痛附，下重薤白秘尿苓。
【注】阳邪，谓厥阴邪从阳化之热证也。厥，谓手足寒也。厥而复热，热而复厥，是
为热厥。厥微热微，厥深热深也。消渴，谓饮水多而小便少也。热气上撞心疼，是火挟
木邪而逆也。烦满，谓少腹烦满也；囊缩，谓外肾为热灼，筋缩入腹也。舌焦卷，谓舌苔
干焦而卷也。便硬，谓大便硬，尚可任攻，宜大承气汤。四逆，谓四肢厥冷也。不分，谓
寒热之厥，疑似不分也。宜四逆散，疏达厥阴。其厥不回，再审寒热可也。或咳加生姜、
五味子。下利亦加，故曰同也。心下悸加桂枝，腹痛加附子，泻利下重加薤白，秘尿不
利加茯苓。详少阴厥阴篇。
厥阴病中，若为阴邪所致，脉象微细，出现四肢厥冷，肌肤寒冷，内脏虚寒导致的躁动不安难以平复，伴有睾丸收缩、舌体短缩、舌苔滑润且色黑等症状，治疗应先使用四逆汤和当归四逆汤。若伴有少腹部胀满疼痛的厥证，则在方中加入吴茱萸和生姜。若是蛔虫引起的厥证（蛔厥），患者表现为时而安静时而烦躁，进食后因闻到食物气味而呕吐蛔虫，这种烦躁是因为蛔虫扰动所致，应使用乌梅丸治疗。
【注释】厥阴病的阴邪，是指病邪从阴化寒的寒证。“微细”是厥阴阴邪的脉象特征。“厥”，指四肢厥冷。“肤冷”，指肌肤寒冷。“脏厥”，指寒邪深入脏腑导致的厥逆。“躁难安”，指烦躁不安，没有片刻安宁。“囊缩”，指外生殖器因寒邪收引而收缩入腹，女性则表现为乳房收缩、外阴内收。“舌短”，指舌体缩短。“苔滑黑”，指舌苔不干润且颜色发黑。“四逆”，指四逆汤；“当归四逆”，指当归四逆汤。“先者”，指先服用当归四逆汤。“少满痛”，指少腹部胀满，按压时疼痛。“姜萸入”，指在当归四逆汤中加入吴茱萸和生姜。“蛔厥”，指四肢厥冷并吐出蛔虫。“静而复时烦”，指烦躁症状时止时作。“得食而呕蛔闻臭”，指因闻到食物气味引发呕吐及吐蛔。“烦因蛔动”，指烦躁因蛔虫扰动而产生。乌梅丸适用于蛔厥证。详见厥阴篇。
阳邪所致热厥，表现为四肢厥冷但体内有热，口渴多饮，自觉有热气上冲心胸疼痛。伴有烦躁、少腹胀满、睾丸收缩、舌苔焦干卷曲，大便坚硬者，尚可承受攻下法，宜用大承气汤。若四肢厥冷不分寒热疑似难辨，宜用四逆散以疏达厥阴之气。若服药后厥逆不回，再仔细辨别寒热属性。若兼见咳嗽，加生姜、五味子；下利亦加此二味，故称“同”。若心下悸动，加桂枝；腹痛，加附子；泻痢伴肛门重坠感，加薤白；小便不利，加茯苓。详见少阴、厥阴篇。
【注释】阳邪，指厥阴病邪从阳化热的热证。“厥”，指手足寒冷。厥冷与发热交替出现，称为热厥。厥冷轻微则热轻微，厥冷深重则热深重。“消渴”，指饮水多而小便少。“热气上撞心疼”，是火邪挟带木邪（肝邪）上逆所致。“烦满”，指少腹部烦躁胀满；“囊缩”，指外生殖器因热邪灼烧，筋脉收缩入腹。“舌焦卷”，指舌苔干燥焦枯且卷曲。“便硬”，指大便坚硬，尚可耐受攻下，适宜用大承气汤。“四逆”，指四肢厥冷。“不分”，指寒厥与热厥疑似难分。适宜用四逆散，以疏通达理厥阴经气。若厥逆不缓解，再审察寒热性质即可。若有咳嗽，加生姜、五味子。下利也加入这两味药，所以说“同”。心下悸动加桂枝，腹痛加附子，泻利伴肛门重坠加薤白，小便不利加茯苓。详见少阴、厥阴篇。
In Jueyin disease, if caused by Yin pathogenic factors, the pulse is faint and fine (Wei Xi Mai), accompanied by cold extremities (Jue), cold skin and muscles, restlessness and inability to find comfort due to internal organ coldness (Zang Jue), contraction of the scrotum, short tongue, and a slippery, black-coated tongue. Treatment should initially employ Sini Tang (Four Reversal Decoction) and Danggui Sini Tang (Angelica Sinensis Decoction for Reversal Cold). If accompanied by fullness and pain in the lower abdomen with cold extremities, add Evodia Fruit (Wuzhuyu) and Fresh Ginger (Shengjiang) to the formula. In cases of ascariasis-induced reversal cold (Hui Jue), patients exhibit alternating periods of calmness and irritability; vomiting of roundworms occurs upon eating due to the smell of food. This irritability arises from the movement of roundworms, and Wumei Wan (Mume Pill) should be administered.
[Note] "Yin pathogenic factors" in Jueyin refers to cold syndromes where the pathogen transforms into cold following the Yin nature. "Faint and fine" describes the pulse characteristic of Jueyin Yin pathogens. "Jue" denotes cold extremities. "Skin cold" indicates coldness of the skin and muscles. "Zang Jue" refers to reversal cold caused by cold invading the internal organs. "Restlessness and inability to find comfort" signifies persistent irritability without relief. "Scrotal contraction" implies the external genitalia retracting into the abdomen due to cold constriction; in women, this manifests as retraction of the breasts and vulva. "Short tongue" means the tongue body is shortened. "Slippery black coating" refers to a non-dry, black-colored tongue coating. "Sini" refers to Sini Tang; "Danggui Sini" refers to Danggui Sini Tang. "Initially" means administering Danggui Sini Tang first. "Lower abdominal fullness and pain" indicates distension and tenderness upon pressure in the lower abdomen. "Adding Jiang and Yu" means adding Evodia Fruit (Wuzhuyu) and Fresh Ginger (Shengjiang) to Danggui Sini Tang. "Hui Jue" denotes reversal cold accompanied by vomiting of roundworms. "Calm then intermittently irritable" means irritability comes and goes. "Vomiting worms after eating due to smell" means vomiting and expulsion of worms triggered by the odor of food. "Irritability due to worm movement" means irritability originates from the agitation of roundworms. Wumei Wan is indicated for Hui Jue. See the Jueyin Chapter for details.
Yang pathogenic heat reversal cold presents with cold extremities but internal heat, excessive thirst (Xiao Ke), a sensation of hot qi rushing up causing chest/heart pain, irritability, lower abdominal fullness, scrotal contraction, and a dry, scorched, curled tongue. If stool is hard and the patient can still tolerate purgation, Dachengqi Tang (Major Order the Qi Decoction) is appropriate. If cold extremities are indistinguishable between cold and heat syndromes, Sini San (Four Reversal Powder) should be used to soothe and unblock the Jueyin channel. If reversal does not resolve, re-evaluate the cold-heat nature. For accompanying cough, add Fresh Ginger (Shengjiang) and Schisandra Berry (Wuweizi); these are also added for diarrhea, hence termed "same." For epigastric palpitations, add Cinnamon Twig (Guizhi); for abdominal pain, add Prepared Aconite Root (Fuzi); for dysentery with tenesmus, add Scallion Bulb (Xiebai); for difficult urination, add Poria (Fuling). See the Shaoyin and Jueyin Chapters for details.
[Note] "Yang pathogen" refers to heat syndromes in Jueyin where the pathogen transforms into heat following the Yang nature. "Jue" denotes cold hands and feet. Alternating cold and heat is called heat reversal cold. Mild cold corresponds to mild heat; deep cold corresponds to deep heat. "Xiao Ke" (wasting-thirst) refers to drinking much water but producing little urine. "Hot qi rushing up causing heart/chest pain" results from fire pathogen carrying Wood (Liver) pathogen counterflow upward. "Irritability and fullness" refer to irritability and distension in the lower abdomen; "scrotal contraction" implies the external genitalia retracting into the abdomen due to heat scorching the sinews. "Scorched and curled tongue" indicates a dry, scorched, and curled tongue coating. "Hard stool" means hardened feces that can still withstand purgation, making Dachengqi Tang suitable. "Sini" refers to cold extremities. "Indistinguishable" means cold and heat reversals are similar and hard to differentiate. Sini San is suitable to vent and unblock Jueyin. If reversal persists, reassess the cold-heat status. Cough warrants adding Fresh Ginger (Shengjiang) and Schisandra Berry (Wuweizi). Diarrhea also uses these two, thus "same." Epigastric palpitations add Cinnamon Twig (Guizhi); abdominal pain adds Prepared Aconite Root (Fuzi); dysentery with tenesmus adds Scallion Bulb (Xiebai); difficult urination adds Poria (Fuling). See the Shaoyin and Jueyin Chapters for details.