厥者，从下逆上之病也。（《伤寒论》厥以手足厥冷而言。阳厥用四逆散，阴厥用四逆汤。
此主《内经》暴厥者不知与人言，及血之与气并走于上，则为大厥之旨与《伤寒》不同。
）痉者，强直反张之象也。痫者，猝然昏仆，筋脉螈 ，口角流涎，或作牛马猪羊鸡之声
，后人分为五痫是也。（病有间断故名为痫。）癫者，或歌或哭，如醉如痴，其候多静而常昏。狂
者，语言狂妄，少卧不饥，其候多躁而常醒。瘫痪者，病在筋骨，左瘫右痪，将成废人。六
症医书分治，其实一厥阴尽之。治得其要，只取数方，捷如影响。盖厥阴属风木，与少阳相
火同居，厥阴之气一逆，则诸气皆逆。气逆则火发，火发则风生。风生则必挟木势而害土，土
病则聚液而成痰，其归并于心也。心气大虚，而不能御之，或从阳化而为狂，或从阴化而为
癫。心气尚未全虚，受其所凌则昏倒，正气一复而遂瘥。其症有作有止，则为痫。其逆行于
内也。或乘肾气之虚，则为喑痱而为肾厥。或因烦劳以扰其阳，阳亢阴亏而为煎厥；或怒火载血上行，气血
乱于胸中，相薄而厥逆，则为薄厥。或因怫郁不解，阳气不能四达，手足与身俱冷，
（中风身温，中气身冷。）则为气厥。或阳腾络沸，则为血厥。或因秽浊蒙神，乱其阴阳之气，
则为尸厥。或于饱食之后，适有感触，胃气不行，阳并于上，则为食厥。时见吐蛔，则为蛔
厥。湿痰上逆，则为痰厥。以及阳衰而阴凑之，令人五指至膝上皆寒，则为阴厥。阴衰而阳
凑之，令人足下热，热甚则循三阴上逆，则为热厥。其发见于外也，风火迅发，病起于骤然
，手足抽掣，角弓反张。或从实化，为无汗之刚痉。或从虚化，为有汗之柔痉。《内经》
云∶诸暴强直，支痛软戾，里急筋缩，皆属于风。医者可于此而验风邪之体假焉。土为木克
，则聚液而成痰，痰挟风而流注，则左瘫而又右痪。《左传》云∶风淫末疾。医者可于此
而知风邪之流极焉。凡此六者，症各不同，其源则一。余只以乌梅丸益厥阴之体，以宣厥阴
之用。又以风引汤治厥阴风火，痰涎幻变错杂之病。举凡治刚痉，用葛根汤，柔痉用桂枝加
栝蒌根汤。痉之表症急者，用小续命汤以攻表，痉之里症急者，用承气汤以攻里之类而不效
。治寒厥用六物附子汤，热厥用六味汤，薄厥用蒲黄汤，煎厥用玉女煎、龙荟丸，气厥用八
味顺气汤，血厥用白薇汤，尸厥用苏合香丸，食厥用加味平胃散，蛔厥用扫虫煎，肾厥用地
黄饮子，痰厥用瓜蒂散之类而不效。治狂用白虎汤、生铁落饮、凉膈散、滚痰丸。治癫用定
志丸、天王补心丹、导痰汤及独参汤加竹沥、姜汁之类而不效。治痫用龙荟丸、丹矾丸、
五痫丸及紫河车丸之类而不效。治瘫痪用二妙散及舒筋保肝散之类而不效者。种种方药，无
不对症，对症而犹不效，其故何也？盖缘未尝求于厥阴一经，而信服乌梅丸、风引汤二方
神妙也。二方本于仲景，而喻嘉言独得其旨，但引而不发，浅学人扪索不来，至叶天士则引
伸触类，妙义无穷。若风火犯于上者，（此风火二字即上厥阴风木与少阳相火之义，勿误解为
外来风火。）不免凌金烁液，用麦门冬汤及琼玉膏，为补金柔制法。若风火犯于中而为呕为胀
者，用六君子汤去术加木瓜、姜、芍之类，及附子粳米汤加人参，为补脾凝肝法。若风火震
动心脾，而为悸为消者，用甘麦大枣汤合龙、牡之属，为缓其急、镇其逆法。若少阳相火，挟
厥阴风木之威，而乘巅摇络者，用羚羊、钩藤、元参、连翘之剂，为熄风清络法。若肝胆厥
阴化风旋逆者，用龙胆、芦荟、木通、青黛之类，为苦降直折法。若本脏自痛，而体用失和
者，以椒、梅、桂、芍之类，为寒暄各得法。若因母脏之虚，而扰及子脏之位者，用三才配
合龟甲、磁朱，及复脉汤去姜、桂，入鸡子黄之属，为安摄其子母法。至于痿厥之治，（厥
阴病风旋阳冒神迷则为厥；阳明病络空四末不用则为痿。）尤觉神奇，取血肉介类，
改汤为膏，谓其力浓重实，填隙止厥最速。凡此之类，虽不明用乌梅丸、风引汤成方，而细
味其旨，无一不从此二方神悟出来。甲寅岁，余在吴航书院掌教，尝与学徒讲论，以“读于无
字处，文到有神时”，二句为举业妙谛，而学医者，亦必到此境地，方许出而论证也。
厥证，是从下部向上逆冲的病症。（《伤寒论》中的“厥”主要指手足冰冷。阳厥使用四逆散，阴厥使用四逆汤。此处主要阐述《内经》中关于突然昏厥、不能言语，以及气血并走于上导致的大厥的含义，这与《伤寒论》的观点不同。）
痉证，表现为身体强直、角弓反张的症状。痫证，是指突然昏倒仆地，筋脉抽搐，口角流涎，有时发出牛、马、猪、羊、鸡等动物的叫声，后人将其分为五痫。（因为病情有间歇性，所以称为痫。）癫证，有时唱歌有时哭泣，像喝醉了一样或像痴呆一样，其症状多安静且常处于昏沉状态。狂证，语言狂妄，睡眠少且不觉得饥饿，其症状多烦躁且常处于清醒状态。瘫痪证，病位在筋骨，左侧瘫痪右侧无力，即将成为废人。医书将这六种病症分开治疗，其实都由厥阴经统摄。治疗抓住关键，只需选取几个方剂，见效快如影随形。因为厥阴属风木，与少阳相火同居，厥阴之气一旦逆乱，则诸气皆逆。气逆则火发，火发则风生。风生则必然挟带木势而伤害脾土，脾土生病则聚积津液而成痰，痰归并于心。心气大虚，不能抵御，或者从阳化而为狂，或者从阴化而为癫。心气尚未完全虚弱，受到邪气凌犯则昏倒，正气恢复后随即痊愈。其症状有发作也有停止，则为痫证。邪气逆行于内，如果乘肾气之虚，则为喑痱（失音足废）和肾厥。或者因烦劳扰动阳气，阳亢阴亏而为煎厥；或者怒火载血上行，气血在胸中混乱，相互搏击而厥逆，则为薄厥。或者因郁结不解，阳气不能通达四肢，手足与身体都冷，（中风身温，中气身冷。）则为气厥。或者阳气腾涌脉络沸腾，则为血厥。或者因秽浊之气蒙蔽心神，扰乱阴阳之气，则为尸厥。或者在饱食之后，恰好受到感触，胃气不行，阳气并聚于上，则为食厥。时常吐出蛔虫，则为蛔厥。湿痰上逆，则为痰厥。以及阳气衰微而阴寒凑集，使人五指至膝盖以上都寒冷，则为阴厥。阴气衰微而阳气凑集，使人脚底发热，热甚则沿三阴经向上逆冲，则为热厥。其表现于外部的，风火迅速发作，病起骤然，手足抽搐，角弓反张。或者从实证转化，为无汗的刚痉。或者从虚证转化，为有汗的柔痉。《内经》说：各种突然发生的强直，肢体疼痛、拘挛、里急筋缩，都属于风邪。医生可以从这里验证风邪的本质。脾土被肝木克制，则聚积津液而成痰，痰挟带风邪流注经络，则左侧瘫痪右侧无力。《左传》说：风邪淫溢会导致四肢末端的疾病。医生可以从这里知道风邪流传的极致。凡此六种，症状各不相同，但根源相同。我只用乌梅丸来补益厥阴的本体，以宣通厥阴的作用。又用风引汤治疗厥阴风火、痰涎幻变错杂的病症。凡是治疗刚痉，用葛根汤，治疗柔痉用桂枝加栝蒌根汤。对于表症急重的痉证，用小续命汤攻表；对于里症急重的痉证，用承气汤攻里，如果这些方法无效。治疗寒厥用六物附子汤，治疗热厥用六味地黄汤，治疗薄厥用蒲黄汤，治疗煎厥用玉女煎、当归龙荟丸，治疗气厥用八味顺气汤，治疗血厥用白薇汤，治疗尸厥用苏合香丸，治疗食厥用加味平胃散，治疗蛔厥用扫虫煎，治疗肾厥用地黄饮子，治疗痰厥用瓜蒂散，如果这些方法无效。治疗狂证用白虎汤、生铁落饮、凉膈散、滚痰丸。治疗癫证用定志丸、天王补心丹、导痰汤及独参汤加竹沥、姜汁，如果这些方法无效。治疗痫证用龙胆泻肝丸、丹矾丸、五痫丸及紫河车丸，如果这些方法无效。治疗瘫痪用二妙散及舒筋保肝散，如果这些方法无效。种种方药，没有不对症的，对症却仍然无效，原因是什么呢？大概是因为未曾寻求厥阴一经的治疗根本，而没有信服乌梅丸、风引汤这两个方子的神妙之处。这两个方子源于张仲景，而喻嘉言独自得其精髓，只是引用而不深入阐发，浅学之人摸索不到，到了叶天士则引申触类，妙义无穷。如果风火侵犯上部，（这里的“风火”二字即上文厥阴风木与少阳相火的含义，不要误解为外来的风火。）不免克伐肺金灼伤津液，用麦门冬汤及琼玉膏，这是补金柔制的治法。如果风火侵犯中部而导致呕吐胀满，用六君子汤去白术加木瓜、生姜、芍药之类，以及附子粳米汤加人参，这是补脾敛肝的治法。如果风火震动心脾，导致心悸消渴，用甘麦大枣汤合龙骨、牡蛎之类，这是缓急镇逆的治法。如果少阳相火，挟持厥阴风木的威力，而冲击头部经络，用羚羊角、钩藤、玄参、连翘的药剂，这是熄风清络的治法。如果肝胆厥阴化风旋逆，用龙胆草、芦荟、木通、青黛之类，这是苦降直折的治法。如果是本脏自痛，而体用失和，用花椒、乌梅、桂枝、芍药之类，这是寒温各得其所的治法。如果是由于母脏虚弱，而波及子脏的位置，用三才配合龟甲、磁石朱砂，以及复脉汤去掉生姜、桂枝，加入鸡蛋黄之类，这是安摄子母的治法。至于痿厥的治疗，（厥阴病风旋阳冒神迷则为厥；阳明病经络空虚四肢不用则为痿。）尤其觉得神奇，取血肉介类药材，将汤剂改为膏剂，认为其力浓重实在，填补空隙止住厥逆最快。凡此之类，虽然不明确使用乌梅丸、风引汤成方，但细细体味其旨意，无一不是从这两个方子的神悟中出来的。甲寅年，我在吴航书院掌教，曾与学徒讲论，以“读于无字处，文到有神时”这两句作为科举考试的妙谛，而学医者，也必须达到这种境界，才被允许出来进行临床论证。
Jue syndrome (Jue, a condition characterized by cold extremities or reversal of qi) is a disease where pathology reverses from the lower part upwards. (In *Shanghan Lun* [Treatise on Cold Damage Diseases], "Jue" refers primarily to cold hands and feet. Yang Jue is treated with Sini San [Four Reversal Powder], and Yin Jue is treated with Sini Tang [Four Reversal Decoction]. This text mainly elucidates the principles from *Neijing* [The Inner Canon] regarding sudden syncope where the patient cannot speak, and "Da Jue" [Great Jue] caused by blood and qi rushing upward together, which differs from the perspective in *Shanghan Lun*.)
Jing syndrome (Jing, stiffness and spasms) manifests as body rigidity and opisthotonos (arching of the back). Xian syndrome (Xian, epilepsy/seizures) refers to sudden collapse and loss of consciousness, twitching of sinews and vessels, drooling from the corners of the mouth, and sometimes emitting sounds like those of cattle, horses, pigs, sheep, or chickens; later generations divided this into five types of Xian. (Because the illness has intervals, it is named Xian.) Dian syndrome (Dian, manic-depressive psychosis/schizophrenia-like state) involves singing or crying, appearing intoxicated or foolish, with symptoms that are mostly quiet and often accompanied by drowsiness. Kuang syndrome (Kuang, mania/psychosis) involves arrogant speech, little sleep, lack of appetite, with symptoms that are mostly restless and often accompanied by wakefulness. Tanhuan syndrome (Tanhuan, paralysis) involves pathology in the sinews and bones, with left-side paralysis and right-side weakness, leading to becoming an invalid. Medical texts treat these six syndromes separately, but in reality, they are all governed by the Jueyin channel. If treatment grasps the key, only a few formulas are needed, and efficacy is swift as shadow and echo. This is because Jueyin belongs to Wind-Wood and shares residence with Shaoyang Ministerial Fire. When Jueyin qi rebels, all qi rebels. Qi rebellion causes fire to erupt; fire eruption causes wind to generate. Generated wind inevitably carries the force of Wood to damage Earth (Spleen/Stomach). When Earth is diseased, fluids accumulate to form Phlegm, which converges on the Heart. If Heart qi is severely deficient and cannot resist, it may transform via Yang into Kuang, or via Yin into Dian. If Heart qi is not yet completely deficient but is overwhelmed by pathogenic factors, syncope occurs; upon recovery of righteous qi, the condition resolves. If symptoms appear and cease intermittently, it is Xian syndrome. If pathogenic qi rebels internally and exploits deficiency in Kidney qi, it results in Anfei [aphasia and foot atrophy] and Ren Jue [Kidney Jue]. Or, due to mental fatigue disturbing Yang, causing Yang hyperactivity and Yin deficiency, it becomes Jian Jue [Frying Jue]. Or, anger drives blood upward, causing chaos of qi and blood in the chest, clashing and reversing, resulting in Bo Jue [Thinning Jue]. Or, due to unresolved depression, Yang qi cannot reach the four extremities, causing coldness in hands, feet, and body (Zhongfeng [Wind Strike] presents with warm body, Zhongqi [Qi Strike] presents with cold body), resulting in Qi Jue [Qi Jue]. Or, if Yang surges and collaterals boil, it becomes Xue Jue [Blood Jue]. Or, if turbid filth confounds the Spirit, disrupting yin and yang qi, it becomes Shi Jue [Corpse Jue]. Or, after a full meal, if suddenly disturbed, Stomach qi fails to descend, and Yang gathers above, it becomes Shi Jue [Food Jue]. If roundworms are frequently vomited, it becomes Hui Jue [Roundworm Jue]. If damp-phlegm rebels upward, it becomes Tan Jue [Phlegm Jue]. And if Yang declines while Yin encroaches, causing coldness from the five fingers up to the knees, it becomes Yin Jue. If Yin declines while Yang encroaches, causing heat in the soles of the feet, which then rebels upward along the Three Yin channels when severe, it becomes Re Jue [Heat Jue]. Manifesting externally, wind and fire erupt swiftly, starting suddenly with convulsions of hands and feet and opisthotonos. It may transform from excess into Gang Jing [Rigid Jing] without sweat, or from deficiency into Rou Jing [Soft Jing] with sweat. *Neijing* states: "All sudden rigidity, limb pain, cramping, internal tension, and sinew contraction belong to Wind." Physicians can verify the nature of Wind pathogen here. When Earth is overcome by Wood, fluids accumulate to form Phlegm; Phlegm carrying Wind flows through collaterals, causing left-side paralysis and right-side weakness. *Zuo Zhuan* states: "Excessive Wind leads to diseases of the extremities." Physicians can understand the ultimate spread of Wind pathogen here. Although these six syndromes have different manifestations, their source is one. I use Wumei Wan [Mume Pill] solely to nourish the substance of Jueyin and promote its function. I also use Fengyin Tang [Wind-Driving Decoction] to treat disorders of Jueyin wind-fire and complex, illusory phlegm-saliva. For treating Gang Jing, Ge Gen Tang [Kudzu Decoction] is used; for Rou Jing, Guizhi Jia Gualougen Tang [Cinnamon Twig Decoction plus Trichosanthes Root Decoction] is used. For acute exterior syndromes of Jing, Xiao Xuming Tang [Minor Rescue Life Decoction] is used to attack the exterior; for acute interior syndromes of Jing, Chengqi Tang [Purgative Decoctions] are used to attack the interior. If these fail... To treat Han Jue [Cold Jue], Liwu Fuzi Tang [Six-Ingredient Aconite Decoction] is used; for Re Jue [Heat Jue], Liuwei Dihuang Tang [Six-Ingredient Rehmannia Decoction] is used; for Bo Jue [Thinning Jue], Puhuang Tang [Powdered Pollen Decoction] is used; for Jian Jue [Frying Jue], Yunu Jian [Jade Maiden Decoction] and Danggui Longhui Wan [Angelica and Gardenia Pill] are used; for Qi Jue [Qi Jue], Bawei Shunqi Tang [Eight-Ingredient Regulating Qi Decoction] is used; for Xue Jue [Blood Jue], Baiwei Tang [Baiwei Decoction] is used; for Shi Jue [Corpse Jue], Suhe Xiang Wan [Styrax Pill] is used; for Shi Jue [Food Jue], Jiawei Pingwei San [Modified Level Stomach Powder] is used; for Hui Jue [Roundworm Jue], Saochong Jian [Worm-Sweeping Brew] is used; for Ren Jue [Kidney Jue], Dihuang Yinzi [Rehmannia Infusion] is used; for Tan Jue [Phlegm Jue], Gudi San [Melon Seed Powder] is used. If these fail... To treat Kuang [Mania], Baihu Tang [White Tiger Decoction], Shengtie Luo Yin [Raw Iron Drop Drink], Liangge San [Cooling Diaphragm Powder], and Tuntan Wan [Rolling Phlegm Pill] are used. To treat Dian [Depression/Psychosis], Dingzhi Wan [Calming Spirit Pill], Tianwang Buxin Dan [Emperor of Heaven's Heart-Nourishing Pill], Daotan Tang [Leading Phlegm Decoction], and Dushen Tang [Single Ginseng Decoction] added with Zhuli [Bamboo Sap] and Jiangzhi [Ginger Juice] are used. If these fail... To treat Xian [Epilepsy], Longhui Wan [Dragon Gallbladder Pill], Danfan Wan [Alum Pill], Wu Xian Wan [Five Epilepsy Pills], and Zihewanche [Placenta Pill] are used. If these fail... To treat Tanhuan [Paralysis], Ermiao San [Two Marvels Powder] and Shujin Bao Gan San [Sinew-Calving Liver-Protecting Powder] are used. If these fail... All these prescriptions match the symptoms, yet if they still fail despite matching symptoms, why? The reason is likely that the root in the Jueyin channel was not sought, and faith in the miraculous efficacy of Wumei Wan and Fengyin Tang was lacking. These two formulas originate from Zhang Zhongjing, and Yu Jiayan alone grasped their essence, though he cited them without deep elaboration, leaving shallow learners unable to grasp them. Ye Tianshi later extended and applied them, revealing infinite profound meanings. If wind-fire attacks the upper jiao (the terms "wind-fire" here refer to the aforementioned Jueyin Wind-Wood and Shaoyang Ministerial Fire, do not misunderstand them as exogenous wind-fire), it inevitably damages Metal and scorches fluids; Maimen Dong Tang [Lily Bulb Decoction] and Qiongyu Gao [Jade Jade Ointment] are used, representing the method of tonifying Metal and softening restriction. If wind-fire attacks the middle jiao causing vomiting and distension, Liujunzi Tang [Six Gentlemen Decoction] minus Baizhu plus Mugua [Chaenomeles], Shengjiang [Fresh Ginger], and Shaoyao [Peony], or Fuzi Jingmi Tang [Aconite and Rice Decoction] plus Renshen [Ginseng] are used, representing the method of tonifying Spleen and consolidating Liver. If wind-fire shakes Heart and Spleen causing palpitations and wasting-thirst, Ganmai Dazao Tang [Licorice, Wheat, and Jujube Decoction] combined with Longgu [Dragon Bone] and Muli [Oyster Shell] is used, representing the method of relaxing urgency and suppressing rebellion. If Shaoyang Ministerial Fire, leveraging the might of Jueyin Wind-Wood, attacks the vertex and disturbs collaterals, Lingyang [Antelope Horn], Gouteng [Uncaria], Xuanshen [Scrophularia], and Lianqiao [Forsythia] preparations are used, representing the method of extinguishing wind and clearing collaterals. If Liver-Gallbladder and Jueyin transform into wind and rebel, Longdan [Gentian], Lvhui [Aloe], Mutong [Akebia], and Qingdai [Indigo Naturalis] are used, representing the method of bitter descent and direct suppression. If the affected organ itself hurts and substance-function are disharmonious, Jiaopei [Sichuan Pepper], Wumei [Mume Fruit], Guizhi [Cinnamon Twig], and Shaoyao [Peony] are used, representing the method of balancing cold and warmth appropriately. If deficiency in the Mother Organ disturbs the position of the Child Organ, Santian [Three Immortals] combined with Guijia [Turtle Shell], Cizhu [Magnetite], and Fumai Tang [Restore Pulse Decoction] minus Shengjiang and Guizhi plus Jizihuang [Chicken Egg Yolk] are used, representing the method of anchoring the mother-child relationship. Regarding the treatment of Wei Jue [Atrophy-Jue] (Jueyin disease with wind spinning, Yang covering, and spirit confusion constitutes Jue; Yangming disease with empty collaterals and non-use of four extremities constitutes Wei), it is particularly miraculous to take flesh-and-blood and shellfish materials, changing decoctions into pastes, believing their potency is dense and substantial, filling gaps and stopping Jue most rapidly. All such cases, although not explicitly using the ready-made formulas Wumei Wan and Fengyin Tang, upon careful tasting of their essence, none do not emerge from the divine insight of these two formulas. In the year Jiayin, while teaching at Wuhang Academy, I once lectured students, using the phrase "Read between the lines, write with divine inspiration" as the profound truth for imperial examinations. Similarly, medical students must reach this realm before being permitted to engage in clinical practice.