此腹中之气。时时上冲也。气撞心疼。吐蛔者。厥阴病也。不吐蛔者。病在阳分。表邪
也。桂枝汤。气上冲咽而喘者。胸中有痰也。瓜蒂散。（参金鉴）
邵评∶分肝火表邪痰逆三因。最精。
按厥阴气撞热疼。知饥不纳。食则吐蛔等症。总属肝胃之病。因胃中虚寒。肝风袭
胃。相火挟浊阴上冲。故致斯症。治法当以苦辛酸寒热并用。如川连、吴萸、黄芩、干
姜、茯苓、半夏、川椒、乌梅之类。（参叶案）
胃中虚冷。理中安蛔散。肝邪犯胃。乌梅丸。
邵评∶此中虚寒伏之正法。又肝胃不和之正法。
厥者。手足逆冷。有阴阳之分。自热至温。自温至厥者。邪从三阳经来。传经之热
邪也。四逆散。甚者四肢虽厥。大便秘。小便赤。脉沉滑。此阳症似阴。所谓厥深热亦
深也。宜白虎承气等汤为治。
邵评∶此为阳邪热厥治法。
阴厥乃三阴自受寒邪。或腹痛吐利。或下利清谷。宜四逆汤、理中汤、当归四逆汤主治。（参准绳）
邵评∶此阴胜寒厥治法。
按少阴有寒厥而无热厥。厥阴有寒热二厥。寒厥者。止寒而不热也。热厥者。由热
而至厥。由厥而至热。相因不已也。当分阴阳浅深治。（参金鉴）
邵评∶此辨寒厥热厥见象之不同。
热者。下利谵语。有燥矢也。宜小承气汤。热利下重。欲饮水者。白头翁汤。
邵评∶此热利分阳明厥阴。最为精确。
寒者。下利清谷。手足厥冷者。四逆汤。下利汗出而厥者。亦四逆汤。
邵评∶寒利以扶阳为主。
这是腹中的气，时时向上冲逆。如果感到气撞击心部疼痛，并且呕吐蛔虫的，属于厥阴病。如果不呕吐蛔虫的，说明病在阳分，是表邪所致。可用桂枝汤治疗。如果气上冲至咽喉并伴有喘息的，说明胸中有痰饮。可用瓜蒂散治疗。（参考《医宗金鉴》）
按语：厥阴病的气撞心痛、知饥但不能进食、进食后呕吐蛔虫等症状，总归属于肝胃的疾病。这是因为胃中虚寒，肝风侵袭胃部，相火挟带浊阴之气上冲，从而导致这些症状。治疗方法应当采用苦、辛、酸、寒、热药并用。例如黄连、吴茱萸、黄芩、干姜、茯苓、半夏、川椒、乌梅等药物。（参考《临证指南医案》）
胃中虚冷导致的，用理中安蛔散。肝邪侵犯胃部导致的，用乌梅丸。
邵氏评注：这是治疗中焦虚寒伏邪的正法，也是治疗肝胃不和的正法。
“厥”是指手足逆冷，有阴厥和阳厥的区别。从发热转为温暖，再转为厥冷的，是邪气从三阳经传来，属于传经的热邪。可用四逆散治疗。病情严重的，虽然四肢厥冷，但大便秘结，小便色赤，脉象沉滑，这是阳证似阴证，也就是所谓的“厥深热亦深”。适宜用白虎承气汤等方剂治疗。
邵氏评注：这是治疗阳邪热厥的方法。
阴厥是三阴经直接感受寒邪所致，或者出现腹痛吐利，或者下利清谷（排出未消化的食物）。适宜用四逆汤、理中汤、当归四逆汤主治。（参考《医学准绳六要》）
邵氏评注：这是治疗阴盛寒厥的方法。
按语：少阴病只有寒厥而没有热厥。厥阴病则有寒厥和热厥两种。寒厥表现为只有寒冷而没有发热。热厥是由热转变成厥冷，再由厥冷转变成发热，两者相互交替不止。应当根据阴阳的浅深来分别治疗。（参考《医宗金鉴》）
发热的，伴有下利和谵语，说明有燥屎内结。适宜用小承气汤。热性下利伴有肛门重坠感，想要喝水的，用白头翁汤。
邵氏评注：这里对热利分为阳明病和厥阴病进行辨析，最为精确。
属寒的，下利清谷，手足厥冷的，用四逆汤。下利且出汗同时伴有厥冷的，也用四逆汤。
邵氏评注：寒性下利以扶助阳气为主。
This refers to the Qi in the abdomen rushing upward from time to time. If there is a sensation of Qi striking the heart causing pain, accompanied by vomiting of roundworms (Ascaris), it is Jueyin disease (Disease of the Jueyin channel). If there is no vomiting of roundworms, the disease is in the Yang aspect, caused by exterior pathogenic factors. Guizhi Tang (Cinnamon Twig Decoction) may be used. If Qi rushes up to the throat and is accompanied by wheezing, it indicates Phlegm-fluid retention in the chest. Gouti San (Melon Seed Powder) may be used. (Refer to *Yizong Jinjian*)
Commentary by Shao: Distinguishing between Liver Fire, Exterior Pathogens, and rebellious Phlegm as three causes is most precise.
Note: Symptoms of Jueyin disease such as Qi-striking heart pain, feeling hungry but unable to eat, and vomiting roundworms after eating, generally belong to diseases of the Liver and Stomach. This is due to deficiency-cold in the Stomach, where Liver Wind invades the Stomach, and Ministerial Fire carries turbid Yin upward, resulting in these symptoms. The treatment method should employ bitter, pungent, sour, cold, and hot herbs together. Examples include Chuanlian (Coptidis Rhizoma), Wuzhuyu (Evodiae Fructus), Huangqin (Scutellariae Radix), Ganjiang (Zingiberis Rhizoma), Fuling (Poria), Banxia (Pinelliae Rhizoma), Chuanjiao (Sichuan Pepper), and Wumei (Mume Fructus). (Refer to *Linzheng Zhinan Yian*)
For deficiency-cold in the Stomach, Lizhong Anhui San (Gastrodia and Pinellia Decoction for Calming Roundworms) is used. For Liver Pathogen invading the Stomach, Wu Mei Wan (Mume Pill) is used.
Commentary by Shao: This is the standard method for treating latent deficiency-cold in the middle jiao, and also the standard method for treating disharmony between the Liver and Stomach.
"Jue" refers to cold extremities (cold reversal of hands and feet), which can be classified into Yin Jue and Yang Jue. When fever turns to warmth, and then to cold reversal, it indicates that the pathogen has come from the Three Yang channels, representing heat pathogens transmitted through the channels. Sini San (Frigid Extremities Powder) may be used. In severe cases, although the limbs are cold, there is constipation, dark urine, and a deep, slippery pulse. This is a Yang syndrome resembling Yin syndrome, known as "the deeper the Jue, the deeper the heat." Baihu Chengqi Tang (White Tiger and Major Order the Emperor Decoction) or similar formulas should be used.
Commentary by Shao: This is the treatment method for heat-induced Jue caused by Yang pathogens.
Yin Jue occurs when the Three Yin channels directly contract cold pathogens, manifesting as abdominal pain with vomiting and diarrhea, or diarrhea with undigested food. Sini Tang (Frigid Extremities Decoction), Lizhong Tang (Regulate the Middle Decoction), and Danggui Sini Tang (Angelica Sinensis Decoction for Frigid Extremities) are suitable for treatment. (Refer to *Yixue Zhunsheng Liuyao*)
Commentary by Shao: This is the treatment method for cold Jue caused by Yin excess.
Note: Shaoyin disease presents only with cold Jue, not heat Jue. Jueyin disease presents with both cold and heat Jue. Cold Jue manifests as coldness without heat. Heat Jue progresses from heat to cold reversal, and then back to heat, alternating continuously. Treatment must distinguish based on the depth of Yin and Yang. (Refer to *Yizong Jinjian*)
Commentary by Shao: This distinguishes the different manifestations of cold Jue and heat Jue.
In cases of heat, diarrhea accompanied by delirium indicates dry fecal impaction. Xiao Chengqi Tang (Minor Order the Emperor Decoction) is appropriate. For heat-type diarrhea with a sensation of heaviness in the anus and thirst, Baitouweng Tang (Pulsatilla Decoction) is used.
Commentary by Shao: Differentiating heat diarrhea into Yangming and Jueyin categories here is most precise.
In cases of cold, diarrhea with undigested food and cold extremities requires Sini Tang (Frigid Extremities Decoction). Diarrhea accompanied by sweating and cold extremities also requires Sini Tang (Frigid Extremities Decoction).
Commentary by Shao: Treatment for cold diarrhea focuses on supporting Yang Qi.