阴阳二厥。节庵辨之详矣。但寒厥易辨。而热厥易忽。以其脉俱微细。四肢
俱冷。则有以认热为寒者矣。但寒厥腹疼而泻。热厥腹或疼而不泻。寒厥
则喜热饮。热厥则喜冷冻饮料。寒厥喜暖与日火光。热厥畏热而不喜明。寒厥
投热药或捍格而移时即安。热厥服香燥而呕逆弥甚。余一日初秋冒暑。
饮食未化。即便吐逆。少顷气上壅。四肢渐冷。语言难布。及按脉则细微。自
思吐之太甚。故气逆不下。当晚以铁锈水磨下。觉少平。次日又出外不避
暑。逾日复作。一友教以沉香磨服。气不下。若见日光与火。便觉厌极。且终
夜危坐。不能安寝。余乃思曰。此火逆冲上四肢故冷。是热厥也。命取黑山
栀三钱冷水调下。当饮便安。复治一女子。下痢艰迫。四肢冷。脉微细。一医
欲用理中加茱萸治。余曰。此火邪内伏。非寒也。竟以山栀芍药黄连木香
等而愈。况伤寒热厥从传经来。寒厥从直中来。又甚不侔者乎。
按二厥之外。有气厥者。五志过极。气郁不伸。脉必沉伏。妇人多见之。苏
合香丸。乌药顺气选用。有痰厥者。体肥痰盛。气壅脉滑。宜导痰汤二陈
汤。虚者倍加人参。有食厥者。发之必暴。饮食不化。填塞中焦。上部有脉。
下部无脉。盐汤探吐。最妙法也。有大吐血后或产后。去血过多。阳无所
附。自汗手足冷。宜益气。独参汤理中汤之类。有真气虚寒者。参附汤八
味汤。益火之原。以消阴翳。
阴阳二厥。节庵辨之详矣。但寒厥易辨。而热厥易忽。以其脉俱微细。四肢 俱冷。则有以认热为寒者矣。但寒厥腹疼而泻。热厥腹或疼而不泻。寒厥 则喜热饮。热厥则喜冷冻饮料。寒厥喜暖与日火光。热厥畏热而不喜明。寒厥 投热药或捍格而移时即安。热厥服香燥而呕逆弥甚。余一日初秋冒暑。 饮食未化。即便吐逆。少顷气上壅。四肢渐冷。语言难布。及按脉则细微。自 思吐之太甚。故气逆不下。当晚以铁锈水磨下。觉少平。次日又出外不避 暑。逾日复作。一友教以沉香磨服。气不下。若见日光与火。便觉厌极。且终 夜危坐。不能安寝。余乃思曰。此火逆冲上四肢故冷。是热厥也。命取黑山 栀三钱冷水调下。当饮便安。复治一女子。下痢艰迫。四肢冷。脉微细。一医 欲用理中加茱萸治。余曰。此火邪内伏。非寒也。竟以山栀芍药黄连木香 等而愈。况伤寒热厥从传经来。寒厥从直中来。又甚不侔者乎。
按二厥之外。有气厥者。五志过极。气郁不伸。脉必沉伏。妇人多见之。苏 合香丸。乌药顺气选用。有痰厥者。体肥痰盛。气壅脉滑。宜导痰汤二陈 汤。虚者倍加人参。有食厥者。发之必暴。饮食不化。填塞中焦。上部有脉。 下部无脉。盐汤探吐。最妙法也。有大吐血后或产后。去血过多。阳无所 附。自汗手足冷。宜益气。独参汤理中汤之类。有真气虚寒者。参附汤八 味汤。益火之原。以消阴翳。
阴阳两种厥证，节庵已经辨析得很详细了。但是寒厥容易辨别，而热厥容易被忽视。因为它们的脉象都微细，四肢都冰冷，所以有人会把热厥误认为寒厥。寒厥表现为腹痛且腹泻，热厥腹部有时疼痛但不腹泻。寒厥喜欢喝热饮，热厥喜欢喝冷饮。寒厥患者喜欢温暖环境和阳光火光，热厥患者怕热且不喜光亮。寒厥服用热性药物时，即使起初有抵触反应，过一会儿也能安定；热厥服用芳香燥烈药物后，呕吐逆气会更加严重。我曾在初秋时节中暑，食物尚未消化，随即发生呕吐逆气。过了一会儿，气机上壅滞，四肢逐渐变冷，说话困难。等到诊脉，脉象细微。我自己思考是因为呕吐太过剧烈，导致气机逆乱不能下行。当天晚上我用铁锈水磨药送服，感觉稍微平稳。第二天我又外出没有躲避暑热，过了一天病情复发。一位朋友教我磨沉香粉服用，但气机仍不能下行。如果见到日光和火光，就觉得极度厌恶，并且整夜端坐，无法安睡。我于是想到：这是火热之气逆冲向上，导致四肢寒冷，这是热厥啊。于是让人取黑山栀子三钱，用冷水调服，刚喝下去就感到安宁。后来又治疗一个女子，患痢疾艰难窘迫，四肢冰冷，脉象微细。一位医生打算用理中汤加吴茱萸治疗。我说：这是火邪内伏，不是寒证。最终用山栀子、芍药、黄连、木香等药治愈。况且伤寒的热厥是从传经而来，寒厥是从直中而来，两者更是大不相同。
按照这两种厥证之外，还有气厥。五志（喜、怒、忧、思、恐）过度，气机郁结不能舒展，脉象必然沉伏。妇女多见此症。可选用苏合香丸、乌药顺气散。有痰厥者，身体肥胖痰多，气机壅滞脉象滑利，适宜用导痰汤或二陈汤。体虚者加倍加入人参。有食厥者，发病必定突然，饮食不化，堵塞中焦。寸口（上部）有脉，尺部（下部）无脉。用盐汤催吐，是最妙的治疗方法。有大吐血之后或产后，失血过多，阳气无所依附，出现自汗、手脚冰冷，适宜补益元气，可用独参汤、理中汤之类的方剂。有真气虚寒的，用参附汤或八味汤。补益火的根本，以消除阴寒之邪。
Yin and Yang Jue (Cold and Heat Extremities) have been thoroughly differentiated by Jie'an. However, Cold Jue is easy to identify, whereas Heat Jue is easily overlooked. This is because both present with fine and minute pulses and cold extremities, leading some to misidentify Heat Jue as Cold Jue. In Cold Jue, there is abdominal pain accompanied by diarrhea; in Heat Jue, the abdomen may be painful but without diarrhea. Patients with Cold Jue prefer hot drinks, while those with Heat Jue prefer cold beverages. Those with Cold Jue favor warmth and sunlight or firelight, whereas those with Heat Jue fear heat and dislike brightness. When administering hot-natured medicines to patients with Cold Jue, even if there is initial resistance, they usually settle after a while. Conversely, when patients with Heat Jue take aromatic and drying medicines, their vomiting and rebellious Qi worsen significantly.
One day in early autumn, I was exposed to summer heat. My food had not yet digested when I suddenly experienced vomiting and rebellious Qi. Shortly afterward, my Qi became congested upward, my extremities gradually turned cold, and I found it difficult to speak clearly. Upon palpating my pulse, it was fine and minute. I reasoned that excessive vomiting had caused Qi rebellion and failure to descend. That night, I took medicine ground with rust water and felt slightly relieved. The next day, I went out without avoiding the heat, and the condition recurred the following day. A friend advised me to take ground Chenxiang (Aquilaria Lignum), but my Qi did not descend. Seeing sunlight or fire made me feel extreme aversion, and I sat upright all night, unable to sleep. I then thought: "This is Fire Qi rebelling upward, causing coldness in the four limbs; this is Heat Jue." I ordered three qian of Heishanzhi (Gardeniae Fructus, Gardenia jasminoides) mixed with cold water to be taken orally. Immediately after drinking it, I felt at peace.
I later treated a young woman suffering from dysentery with difficulty and urgency, cold extremities, and a fine, minute pulse. One physician intended to treat her with Lizhong Tang (Replenish the Middle Decoction) added with Zhuyu (Evodiae Fructus, Evodia rutaecarpa). I said, "This is latent Fire pathogen, not Cold." She was ultimately cured using Shanzhi (Gardeniae Fructus), Shaoyao (Paeoniae Radix Alba, White Peony Root), Huanglian (Coptidis Rhizoma, Coptis chinensis), and Muxiang (Aucklandiae Radix, Aucklandia lappa). Furthermore, in Shanghan (Cold Damage diseases), Heat Jue arises from transmission through meridians, while Cold Jue arises from direct invasion; these are vastly different.
Aside from these two types of Jue, there is Qi Jue (Qi Collapse). When the Five Emotions (Joy, Anger, Worry, Thought, Fear) reach extremes, Qi becomes stagnant and fails to extend, resulting in a deep and hidden pulse. This is commonly seen in women. Sube Xiang Wan (Styrax Pills) or Wuyao Shunqi San (Tso-yu Powder for Directing Qi) can be selected. There is also Tan Jue (Phlegm Collapse), characterized by obesity, abundant phlegm, congested Qi, and a slippery pulse. Daotan Tang (Expel Phlegm Decoction) or Erchen Tang (Two-Cured Decoction) is appropriate. For deficiency cases, add Ren Shen (Ginseng Radix et Rhizoma, Panax ginseng) in double dosage. There is Shi Jue (Food Collapse), which strikes suddenly due to undigested food blocking the Middle Jiao. There is a pulse in the upper part (cun position) but none in the lower part (chi position). Using salt water to induce vomiting is the most excellent method. After massive hematemesis or postpartum hemorrhage, excessive blood loss leaves Yang Qi without attachment, manifesting as spontaneous sweating and cold hands and feet. It is suitable to tonify Qi using Dushen Tang (Single Ginseng Decoction) or Lizhong Tang. For cases of True Qi deficiency and Cold, Shenfutang (Ginseng and Aconite Decoction) or Bawei Tang (Eight-Ingredient Decoction) should be used to benefit the source of Fire and eliminate Yin shadows.