证
痼冷者，谓痼久而冷也。痼者，固也；冷者，寒之甚也。人之脏腑禀受不同，亦或将理失宜，遂致偏废，
故方中有痼冷、积热之说。痼冷，中寒也。其病多由真阳虚弱，胃气不实，复啖生冷冰
雪、水酪诸寒之物，或坐卧阴寒久湿之地，以致脏腑久痼而冷。其为病也，或手足厥冷；或腹中久痛，溏泄
无度；或腰腿重痛，如坐水中；或阴痿不举，寒精自出；或久呕逆，饮食不进；或自汗战
栗；或大腑洞泄；或小便频数。此皆痼冷之为病也。
治
治之之法，宜温补下元，健脾养胃，祛寒邪，固真气，使阳气得复，阴阳平和，则无偏胜之患而病愈矣。
凡脱阳症，或因大吐大泻之后，四肢逆冷，元气不接，人事不
省；或伤寒新瘥，误与女人交接。其症小腹紧痛，外肾拳缩，面
黑气喘，冷汗自出，是名脱阳证，须臾不救。急用葱烫法，更灸气海（在脐下一寸五分）、关元（在脐下二寸）
各五十壮，内服姜附汤、五积散之类。然后可服黑锡丹，或灸男左女右中指一壮，再灸关元穴七壮。
凡阴证身静而重，语言无声，气喘难以喘息，目睛不了了，口鼻气冷，水浆不入，大小便不禁，面上
恶寒，有如刀刮，先用葱熨法，次服四逆汤。
方
回阳返本汤（云林制） 治急阴证，手足冷，指甲青，少腹疼痛，外肾挛缩。
人参（一钱） 白术（一钱） 干姜（一钱，炒） 丁香（八分） 甘草（一钱） 陈皮
（一钱） 半夏（制，一钱） 大附子（制，一钱） 茯苓（八分） 神曲（炒，六分） 白豆蔻
（八分） 沉香（五分）
上锉一剂，生姜三片，枣二枚，盐少许，水煎服。外于脐上用熟葱贴，冷则复易。外肾并阴囊以绢帛扎
住，用炒盐款款烙之。再用炒盐烫胸膈、胁肋、上下小腹。如急阴不省人事，用盐填满脐
中，艾火灸之，以醒为度。或大便闭结，以利气丸通之。
敛阳丹 治阴寒痼冷。
丁香（一两） 砂仁（一两） 白豆蔻（一两） 红豆（二两） 人参（五钱） 浓桂（一两）
大附子（二两） 干姜（一两，炒） 良姜（二两，炒） 均姜（二两，炒）
上为末，好酒煮米糊为丸，如梧桐子大。每服五七十丸，空心温酒送下。
黑豆酒 治症同前。
黑豆不拘多少，锅内炒熟，以好酒淬之，就以碗盖，勿令泄气，候温饮酒，大效。
回春散（杨小川传） 治阴冷如神。歌曰∶
一钱白矾八分丹，二分胡椒细细研，焰硝一分共四味，酾醋
调和手内摊。男左女右合阴处，浑身是汗湿衣衫，此方用者如神效，不义之人不可传。
助阳散（秘方） 治极冷急症。
芥菜子（七钱） 干姜（三钱）
上为末，水调作一饼贴脐上，以绢帛缚住，上置盐以烫斗烫之
数次，汗出为度。又将病患小便，攀阴茎，往上尽头处，用艾炷灸七壮，神效。
回阳丹（秘方）
干姜（一两） 牡蛎（一两）
上为细末，以火酒调稠，搽手上，男子用双手揉外肾即愈，女
子以男子手搽药，急按两乳，仍揉擦热，汗出则愈。
固阳膏（秘方） 治因女色，致成阴证。
生白矾（三钱） 黄丹（二钱） 干姜（五钱） 母丁香（十个） 胡椒（十五粒）
上为末，用醋和得所，以男左女右手握药搭脐上，被盖少顷，汗出即愈。
【病症】
痼冷，是指病程长久且寒邪深重的病证。“痼”意为固结难解；“冷”意为寒气极盛。人的脏腑先天禀赋各不相同，加上调养护理不当，就会导致身体偏废失衡，因此医方中有“痼冷”和“积热”的说法。痼冷，即中寒之证。这种病多因真阳虚弱、胃气不实，又食用生冷冰雪、水乳等寒凉之物，或长时间坐卧在阴寒潮湿的地方，导致脏腑长期受寒而发病。其临床表现有：手足厥冷；腹部久痛，腹泻无度；腰腿沉重疼痛，如同坐在水中；阳痿不举，精液清冷自出；长期呕吐逆气，饮食不进；自汗且战栗；大便洞泄不止；小便频数。这些都是痼冷病的症状。
【治法】
治疗的方法，应当温补下元（肾与命门），健脾养胃，祛除寒邪，固护真气，使阳气恢复，阴阳平和，这样就不会出现偏胜的祸患，疾病也就痊愈了。
凡是脱阳证，可能是因为剧烈呕吐腹泻之后，四肢逆冷，元气断绝，人事不省；或者是伤寒刚刚痊愈，误与女性行房事。其症状为小腹紧绷疼痛，外生殖器收缩，面色发黑，气喘吁吁，冷汗自出，这称为脱阳证，若不及时抢救，片刻之间就会死亡。急救时需用葱熨法，并艾灸气海穴（位于脐下一寸五分）、关元穴（位于脐下二寸）各五十壮，内服姜附汤、五积散之类的方剂。然后可以服用黑锡丹，或者灸男左女右的中指一壮，再灸关元穴七壮。
凡是阴证，表现为身体安静沉重，说话无声，气喘难以喘息，眼神模糊不清，口鼻气息寒冷，无法进食进水，大小便失禁，面部感觉恶寒，如刀刮般难受。先用葱熨法，接着服用四逆汤。
【方剂】
回阳返本汤（云林制） 治疗急性的阴证，手足冰冷，指甲发青，小腹痛，外生殖器挛缩。
人参（一钱） 白术（一钱） 干姜（一钱，炒） 丁香（八分） 甘草（一钱） 陈皮（一钱） 半夏（制，一钱） 大附子（制，一钱） 茯苓（八分） 神曲（炒，六分） 白豆蔻（八分） 沉香（五分）
以上药材锉碎为一剂，加生姜三片，大枣二枚，少许盐，用水煎服。另外用熟葱贴在肚脐上，冷了再换。用绢帛扎住外生殖器和阴囊，用炒热的盐慢慢烙烫。再用炒热的盐烫胸膈、胁肋、上下腹部。如果是急性阴证导致人事不省，用盐填满肚脐，用艾火灸，以苏醒为度。如果大便闭结，用利气丸通便。
敛阳丹 治疗阴寒痼冷。
丁香（一两） 砂仁（一两） 白豆蔻（一两） 红豆（二两） 人参（五钱） 浓桂（一两） 大附子（二两） 干姜（一两，炒） 良姜（二两，炒） 均姜（二两，炒）
以上研为细末，用好酒煮米糊做成丸药，如梧桐子大小。每次服用五七十丸，空腹时用温酒送服。
黑豆酒 治疗症状同上。
黑豆不限数量，在锅内炒熟，用好酒浇淬，立即用碗盖住，不要漏气，待温热时饮酒，效果显著。
回春散（杨小川传） 治疗阴冷症如神效。歌诀说：
一钱白矾八分丹，二分胡椒细细研，焰硝一分共四味，酾醋调和手内摊。男左女右合阴处，浑身是汗湿衣衫，此方用者如神效，不义之人不可传。
（注：将白矾、朱砂、胡椒、焰硝四种药分别按一钱、八分、二分、一分的比例细细研磨混合，用醋调和后涂在手上。男性涂左手，女性涂右手，然后合于阴部，全身出汗湿透衣衫为止。此方使用如神效，但非正道之人不可传授。）
助阳散（秘方） 治疗极冷的急症。
芥菜子（七钱） 干姜（三钱）
以上研为细末，用水调成饼状贴在肚脐上，用绢帛绑紧，上面放置盐，用烫斗烫数次，以出汗为度。再将病人的尿液，攀住阴茎，向上推至尽头处，用艾炷灸七壮，效果神奇。
回阳丹（秘方）
干姜（一两） 牡蛎（一两）
以上研为细末，用火酒调成稠状，涂在手上。男子用双手揉搓外生殖器即可痊愈；女子由男子用手涂药，迅速按压两乳房，仍揉擦至热，出汗则愈。
固阳膏（秘方） 治疗因纵欲导致的阴证。
生白矾（三钱） 黄丹（二钱） 干姜（五钱） 母丁香（十个） 胡椒（十五粒）
以上研为细末，用醋调和得当，让男性用左手、女性用右手握住药粉搭在肚脐上，盖上被子片刻，出汗即愈。
[Symptoms]
Guleng (Chronic Cold Syndrome) refers to a condition characterized by long-standing duration and severe cold pathogen. "Gu" implies solidification or intractability; "Leng" signifies extreme cold. Human viscera have different congenital endowments, and improper nursing care can lead to imbalance and dysfunction. Therefore, medical texts mention the concepts of "Guleng" (Chronic Cold) and "Jire" (Accumulated Heat). Guleng is synonymous with Zhonghan (Cold Strike). This disease often arises from deficiency of Zhenyang (True Yang) and weakness of Weiqi (Stomach Qi), compounded by the consumption of raw, cold, ice, snow, water, or dairy products, or prolonged sitting/lying in damp, cold environments, causing chronic cold accumulation in the viscera. Clinical manifestations include: cold extremities (Shouzu Jueleng); chronic abdominal pain with profuse diarrhea (Tangxie Wudu); heavy and painful waist and legs, as if sitting in water; impotence (Yinwei Buju) with spontaneous emission of cold semen; chronic vomiting and regurgitation with inability to eat; spontaneous sweating with shivering (Zihan Zhanli); projectile diarrhea (Dafu Dongxie); frequent urination (Xiaobian Pinsu). These are all symptoms of Guleng syndrome.
[Treatment Principles]
The treatment principle is to warm and tonify the Xiayuan (Lower Origin/Kidney and Mingmen), strengthen the Spleen and nourish the Stomach, dispel cold pathogens, and consolidate True Qi. This restores Yang Qi and harmonizes Yin and Yang, preventing excess or deficiency imbalances, thereby curing the disease.
Tuoyang Syndrome (Yang Collapse) may occur after severe vomiting and diarrhea, presenting with cold extremities, disconnected Yuan Qi (Primal Qi), and loss of consciousness. It may also result from sexual intercourse shortly after recovering from Shanghan (Cold Damage). Symptoms include tight and painful lower abdomen, retraction of the external genitalia (Waiquan Juansuo), black complexion, panting, and spontaneous cold sweat. This is named Tuoyang Syndrome; without immediate rescue, death may occur within moments. Emergency treatment involves Congyun Fa (Scallion Moxibustion/Warming), followed by moxibustion on Qihai (CV6, 1.5 cun below the umbilicus) and Guanyuan (CV4, 2 cun below the umbilicus), 50 moxa cones each. Internally administer Jiangfu Tang (Ginger and Aconite Decoction) or Wuji San (Five Accumulations Powder). Subsequently, Heixi Dan (Black Tin Pill) may be taken, or moxibustion applied to the middle finger (left for males, right for females) once, followed by seven cones on Guanyuan.
For Yin Syndromes, symptoms include stillness and heaviness of the body, silent speech, dyspnea with difficulty breathing, blurred vision (Mujing Buliao), cold breath from mouth and nose, inability to take fluids, incontinence of urine and feces, and facial aversion to cold feeling like knife scraping. First apply Congyun Fa, then administer Sini Tang (Frigid Extremities Decoction).
[Formulas]
Huiyang Fanben Tang (Return Yang and Restore the Root Decoction, formulated by Yunlin): Treats acute Yin syndromes with cold hands and feet, cyanotic fingernails, lower abdominal pain, and contraction of external genitalia.
Ren Shen (Panax Ginseng Radix et Rhizoma, 1 qian), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 qian), Ganjiang (Zingiberis Rhizoma, 1 qian, stir-fried), Dingxiang (Caryophylli Flos, 8 fen), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian), Chenpi (Citri Reticulatae Pericarpium, 1 qian), Banxia (Pinelliae Rhizoma Praeparatum, 1 qian), Dafuzi (Aconiti Lateralis Radix Praeparata, 1 qian), Fuling (Poria, 8 fen), Shenqu (Massa Medicata Fermentata, 6 fen, stir-fried), Baidoukou (Cardamomi Rotundus Fructus, 8 fen), Chenxiang (Aquilariae Lignum Resinatum, 5 fen).
Crush these herbs into one dose. Add three slices of Shengjiang (Zingiberis Rhizoma Recens), two dates (Ziziphi Jujubae Fructus), and a little salt. Decoct in water and drink. Externally, apply cooked scallions to the umbilicus, replacing when cool. Bind the external genitalia and scrotum with silk. Slowly roast with stir-fried salt. Then roast the chest/diaphragm, hypochondrium, and upper/lower abdomen with stir-fried salt. If unconscious due to acute Yin syndrome, fill the umbilicus with salt and moxibustion until consciousness returns. For constipation, use Liqi Wan (Qi-Regulating Pill) to unblock bowels.
Lianyang Dan (Collect Yang Pill): Treats Yin-cold Guleng.
Dingxiang (Caryophylli Flos, 1 liang), Sharen (Amomi Fructus Rotundus, 1 liang), Baidoukou (Cardamomi Rotundus Fructus, 1 liang), Hongdou (Phaseoli Semen, 2 liang), Ren Shen (Panax Ginseng Radix et Rhizoma, 5 qian), Nonggui (Cinnamomi Cortex, 1 liang), Dafuzi (Aconiti Lateralis Radix Praeparata, 2 liang), Ganjiang (Zingiberis Rhizoma, 1 liang, stir-fried), Liangjiang (Alpiniae Officinarum Rhizoma, 2 liang, stir-fried), Junjiang (Zingiberis Rhizoma, 2 liang, stir-fried).
Grind into powder. Use good wine and rice paste to form pills the size of Sophora seeds. Take 50-70 pills per dose with warm wine on an empty stomach.
Heidou Jiu (Black Bean Wine): Treats the same symptoms as above.
Take any amount ofheidou (Phaseoli Semen), stir-fry until cooked in a pot, quench with good wine. Cover immediately with a bowl to prevent vapor escape. Drink when warm. Highly effective.
Huichun San (Revive Spring Powder, transmitted by Yang Xiaochuan): Treats Yin-cold with miraculous effect. Verse:
"One qian BaiFan (Alumen), eight fen ZhuSha (Cinnabaris), two fen Hujiao (Piperis Longi Fructus) ground finely; one fen Yanxiao (Natrii Nitratis Crystal), mix four ingredients. Blend with vinegar, spread in hand. Apply to male left/female right yin area. Whole body sweats, soaking clothes. This formula works miraculously; do not transmit to unworthy persons."
Zhuyang San (Assist Yang Powder, Secret Recipe): Treats extreme cold emergency syndromes.
Jiecaizi (Sinapis Semen, 7 qian), Ganjiang (Zingiberis Rhizoma, 3 qian).
Grind into powder. Mix with water to form a cake. Apply to the umbilicus and bind with silk. Place salt on top and heat with a hot iron tool several times until sweating occurs. Additionally, guide the patient's urine to flow over the penis up to the tip, then apply seven moxa cones. Miraculous effect.
Huiyang Dan (Return Yang Pill, Secret Recipe)
Ganjiang (Zingiberis Rhizoma, 1 liang), Muli (Ostreae Concha, 1 liang).
Grind into fine powder. Mix with fire wine to a thick consistency. Rub onto hands. Men rub both hands on external genitalia until cured. Women: men apply medicine to their hands, press firmly on both breasts, rub until hot, cure upon sweating.
Guyang Gao (Solidify Yang Ointment, Secret Recipe): Treats Yin syndrome caused by excessive sexual activity.
ShengBaifan (Alumen Crude, 3 qian), Huangdan (Minii Oxidum Rubrum, 2 qian), Ganjiang (Zingiberis Rhizoma, 5 qian), Mudingxiang (Eugeniae Caryophyllati Flos, 10 pieces), Hujiao (Piperis Longi Fructus, 15 grains).
Grind into powder. Mix appropriately with vinegar. Men hold with left hand, women with right hand, place on umbilicus. Cover with blanket briefly. Cure upon sweating.