论曰伤寒病手足逆冷，其名曰厥，此因阳气衰阴气盛，阴胜则阳脉逆而不通于四肢，所
以逆冷。其证令人恶寒，不饮水，下利清谷，或清便自调，或小便数，外证默静，是其候也。
宜温之灸之，若灸之而手足不温者，为难治，然厥亦有热者，先发热而后厥。热深厥亦深，
热微厥亦微，脉虽沉伏，按之当滑，若或畏热，或饮水，或扬手掷足，烦躁不得眠，大便秘，
小便赤，外证昏愦者，虽厥不可温也，宜下之。
治伤寒手足厥逆，微喘脉不出。通脉四逆汤方
附子（炮裂去皮脐半两） 干姜（炮裂一两半） 人参（一两） 甘草（一两炙）
上四味，各锉如麻豆，每服五钱匕，水一盏半，煎至八分，去滓温服。
治伤寒手足厥寒，脉细欲绝。当归四逆汤方
当归（切焙） 桂（去粗皮） 芍药 细辛（去苗叶各一两） 木通 甘草（炙各七钱）
上六味，锉如麻豆，每服五钱匕，水一盏半，枣二枚劈破，煎至八分，去滓温服。
治伤寒下利清谷，里寒外热，汗出而厥，腹痛兼呕。芍药汤方
芍药（一两） 附子（炮裂去皮脐三分） 人参 甘草（炙各半两）
上四味，锉如麻豆，每服五钱匕，水一盏半，入生姜半分拍碎，同煎至八分。去滓温服，
日晚再服。
治伤寒手足厥冷，脉细欲绝者。吴茱萸汤方
吴茱萸（汤淘三遍焙干炒） 当归（切焙） 芍药（各一两） 甘草（炙三分） 干姜
（炮裂半两） 桂（去粗皮一两） 辛（去苗叶三分）
上七味，粗捣筛，每服五钱匕，水一盏，酒半盏，枣三枚劈破，同煎至八分，去滓温服。
治伤寒手足厥冷，汗出脉微。白术汤方
白术（一两） 人参（三分） 桂（去粗皮） 干姜（炮裂） 附子（炮裂去皮脐各半
两） 甘草（三分炙）
上六味，锉如麻豆，每服五钱匕，水一盏半，煎至一盏，去滓温服。
治伤寒四肢厥冷，又下利恶寒。附子汤方
附子（炮裂去皮脐半两） 甘草（炙） 干姜（炮裂） 芍药（各一两）
上四味，锉如麻豆，每服五钱匕，水一盏半，煎至一盏，去滓温服。
治伤寒里寒外热，手足多厥。人参汤方
人参 白术（各一两） 细辛（去苗叶） 干姜（炮裂各三分） 甘草（半两炙）
上五味，粗捣筛，每服五钱匕，水一盏半，煎至一盏，去滓食前温服。
治伤寒四逆。阳起石丸方
阳起石 太阴玄精石 硝石 附子（炮裂去皮脐等分）
上四味，捣研为细末，汤浸蒸饼和丸，如梧桐子大，每服五丸至十丸，新汲水下，汗出
解。
治伤寒手足厥冷，脉沉细。正阳丸方
硫黄（一两） 硝石（一两） 太阴玄精石（半两）
上三味，细研，入瓷瓶子内，瓦子塞口，黄泥固济阴干，以炭火一斤，养令火尽，放冷
出药，研如粉，酒煮面糊和丸，如梧桐子大，每服十五丸至二十丸。热酒下，不计时候。
治气虚阳脱，体冷无脉，气息欲绝，不省人事，及伤寒阴厥，百药不效者，葱熨法
葱（一斤水洗净）
上以麻缕缠如盏许大，切去根及叶，惟存白长二寸许，如大饼 ，先以火 一面令通热，
乃以热处放在病患脐中连脐下，其上以熨斗满贮火熨之，令葱饼中热气入肌肉中，须预作三
四饼子，一饼坏不可熨，又易一饼，良久病患当渐醒，手足温有汗，更服四逆汤辈温其内，
即瘥。
论述说：伤寒病出现手足逆冷，这种病症称为“厥”，这是因为阳气衰弱、阴气偏盛，阴气胜则导致阳脉逆行且不能通达于四肢，所以出现逆冷。其症状表现为怕冷，不想喝水，大便泻下未消化的食物，或者大小便正常，或者小便频数，外在表现神情安静，这是该证的征候。适宜采用温法和灸法治疗；如果施灸后手足仍不温暖，属于难治之症。然而厥证也有热证类型，先发热而后出现厥冷。热邪越深重，厥冷也越严重；热邪轻微，厥冷也轻微。脉象虽然沉伏，但按之应当滑利；如果有畏热、想喝水、扬手掷足、烦躁不得睡眠、大便秘结、小便色赤、外在表现神志昏乱等症状，虽然是厥证也不可用温法，适宜用下法。
治疗伤寒导致的手足厥逆，伴有轻微气喘、脉搏微弱或摸不到。通脉四逆汤方：
附子（炮制裂开，去皮和脐，半两） 干姜（炮制裂开，一两半） 人参（一两） 甘草（炙，一两）
以上四味药，各切碎如麻豆大小，每次服用五钱匕，用水一盏半，煎煮至八分，去渣，温服。
治疗伤寒导致的手足厥寒，脉细欲绝。当归四逆汤方：
当归（切片焙干） 桂枝（去除粗皮） 芍药 细辛（去苗叶，各一两） 木通 甘草（炙，各七钱）
以上六味药，切碎如麻豆大小，每次服用五钱匕，用水一盏半，大枣二枚劈破，煎煮至八分，去渣，温服。
治疗伤寒导致的大便泻下未消化食物，内寒外热，出汗且厥冷，腹痛兼有呕吐。芍药汤方：
芍药（一两） 附子（炮制裂开，去皮和脐，三分） 人参 甘草（炙，各半两）
以上四味药，切碎如麻豆大小，每次服用五钱匕，用水一盏半，加入生姜半分拍碎，同煎煮至八分。去渣，温服，晚上再服一次。
治疗伤寒导致的手足厥冷，脉细欲绝者。吴茱萸汤方：
吴茱萸（用汤水洗三遍，焙干炒） 当归（切片焙干） 芍药（各一两） 甘草（炙，三分） 干姜（炮制裂开，半两） 桂枝（去除粗皮，一两） 细辛（去苗叶，三分）
以上七味药，粗捣筛过，每次服用五钱匕，用水一盏，酒半盏，大枣三枚劈破，同煎煮至八分，去渣，温服。
治疗伤寒导致的手足厥冷，出汗、脉微。白术汤方：
白术（一两） 人参（三分） 桂枝（去除粗皮） 干姜（炮制裂开） 附子（炮制裂开，去皮和脐，各半两） 甘草（炙，三分）
以上六味药，切碎如麻豆大小，每次服用五钱匕，用水一盏半，煎煮至一盏，去渣，温服。
治疗伤寒导致四肢厥冷，又伴有下利、恶寒。附子汤方：
附子（炮制裂开，去皮和脐，半两） 甘草（炙） 干姜（炮制裂开） 芍药（各一两）
以上四味药，切碎如麻豆大小，每次服用五钱匕，用水一盏半，煎煮至一盏，去渣，温服。
治疗伤寒导致内寒外热，手足多厥冷。人参汤方：
人参 白术（各一两） 细辛（去苗叶） 干姜（炮制裂开，各三分） 甘草（半两炙）
以上五味药，粗捣筛过，每次服用五钱匕，用水一盏半，煎煮至一盏，去渣，饭前温服。
治疗伤寒四逆证。阳起石丸方：
阳起石 太阴玄精石 硝石 附子（炮制裂开，去皮和脐，等分）
以上四味药，捣研成细末，用热水浸泡蒸饼调和做成丸药，如梧桐子大小，每次服用五丸至十丸，用新汲水下送，出汗即解。
治疗伤寒导致的手足厥冷，脉沉细。正阳丸方：
硫黄（一两） 硝石（一两） 太阴玄精石（半两）
以上三味药，细研，放入瓷瓶内，用瓦片塞住口，用黄泥密封加固并阴干，用一斤炭火煅烧直至火尽，放冷后取出药物，研成粉末，用酒煮面糊调和做成丸药，如梧桐子大小，每次服用十五丸至二十丸。用热酒送下，不限时候。
治疗气虚阳脱，身体冰冷无脉，气息将绝，不省人事，以及伤寒阴厥，百药无效者，使用葱熨法：
葱（一斤，水洗净）
以上用麻线缠绕成约杯口大小的形状，切去根和叶，只保留白色部分长约二寸左右，做成大饼状。先用火在一面加热使其通热，然后将热的一面放在患者肚脐中连同脐下，上面用熨斗装满火熨烫，使葱饼中的热气进入肌肉中。必须预先制作三四张葱饼，一张坏了不可再用，就换一张。良久之后患者应当逐渐苏醒，手足温暖并有汗出，再服用四逆汤之类的药物温补内部，即可痊愈。
Discourse states: In the disease of Shanghan (Cold Damage), when the hands and feet are cold in a reverse manner, this condition is named "Jue" (Reversal Cold). This occurs because Yang Qi is deficient and Yin Qi is excessive. When Yin prevails, the Yang meridians become reversed and fail to circulate to the four limbs, resulting in reverse coldness. The manifestations include aversion to cold, lack of desire for water, diarrhea with undigested food, or normal bowel movements, or frequent urination. Externally, the patient appears quiet and still; these are the signs of this syndrome. It is appropriate to treat with warming methods and moxibustion. If the hands and feet remain cold after moxibustion, it is considered difficult to treat. However, Jue can also present as a heat syndrome, characterized by fever preceding the cold extremities. The deeper the heat, the deeper the cold reversal; the slighter the heat, the slighter the cold reversal. Although the pulse may be deep and hidden, palpation should reveal a slippery quality. If there is fear of heat, desire for water, tossing arms and legs, restlessness, insomnia, constipation, dark urine, and external signs of confusion, even though it presents as Jue, warming methods are contraindicated, and purgative methods are appropriate.
For treating Shanghan causing reverse coldness of hands and feet, accompanied by slight wheezing and absent or faint pulse. Tongmai Sini Decoction Formula:
Fuzi (Aconiti Lateralis Radix Praeparata, prepared until cracked, skin and umbilicus removed, half liang) Ganjiang (Zingiberis Rhizoma, prepared until cracked, one and a half liang) Renshen (Ginseng Radix, one liang) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, one liang)
The above four ingredients are each chopped like hemp seeds. Each dose consists of five qian bi, boiled in one and a half zhan of water until reduced to eight parts. Strain and take warm.
For treating Shanghan causing cold extremities of hands and feet, with fine pulse nearly imperceptible. Danggui Sini Decoction Formula:
Danggui (Angelicae Sinensis Radix, sliced and baked) Guizhi (Cinnamomi Ramulus, coarse bark removed) Shaoyao (Paeoniae Radix) Xixin (Asari Radix et Rhizoma, seedlings and leaves removed, one liang each) Mutong (Akebiae Caulis) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, seven qian each)
The above six ingredients are chopped like hemp seeds. Each dose consists of five qian bi, boiled in one and a half zhan of water with two jujubes split open, until reduced to eight parts. Strain and take warm.
For treating Shanghan causing diarrhea with undigested food, interior cold with exterior heat, sweating with cold extremities, abdominal pain combined with vomiting. Shaoyao Decoction Formula:
Shaoyao (Paeoniae Radix, one liang) Fuzi (Aconiti Lateralis Radix Praeparata, prepared until cracked, skin and umbilicus removed, three fen) Renshen (Ginseng Radix) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, half liang each)
The above four ingredients are chopped like hemp seeds. Each dose consists of five qian bi, boiled in one and a half zhan of water with half a fen of fresh ginger smashed, together until reduced to eight parts. Strain and take warm. Take again in the evening.
For treating Shanghan causing cold extremities of hands and feet, with fine pulse nearly imperceptible. Wuzhuyu Decoction Formula:
Wuzhuyu (Evodiae Fructus, rinsed three times with decoction, baked dry and stir-fried) Danggui (Angelicae Sinensis Radix, sliced and baked) Shaoyao (Paeoniae Radix, one liang each) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, three fen) Ganjiang (Zingiberis Rhizoma, prepared until cracked, half liang) Guizhi (Cinnamomi Ramulus, coarse bark removed, one liang) Xixin (Asari Radix et Rhizoma, seedlings and leaves removed, three fen)
The above seven ingredients are coarsely crushed and sifted. Each dose consists of five qian bi, boiled in one zhan of water and half a zhan of wine with three jujubes split open, together until reduced to eight parts. Strain and take warm.
For treating Shanghan causing cold extremities of hands and feet, sweating, and faint pulse. Baizhu Decoction Formula:
Baizhu (Atractylodis Macrocephalae Rhizoma, one liang) Renshen (Ginseng Radix, three fen) Guizhi (Cinnamomi Ramulus, coarse bark removed) Ganjiang (Zingiberis Rhizoma, prepared until cracked) Fuzi (Aconiti Lateralis Radix Praeparata, prepared until cracked, skin and umbilicus removed, half liang each) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, three fen)
The above six ingredients are chopped like hemp seeds. Each dose consists of five qian bi, boiled in one and a half zhan of water until reduced to one zhan. Strain and take warm.
For treating Shanghan causing coldness of four limbs, accompanied by diarrhea and aversion to cold. Fuzi Decoction Formula:
Fuzi (Aconiti Lateralis Radix Praeparata, prepared until cracked, skin and umbilicus removed, half liang) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) Ganjiang (Zingiberis Rhizoma, prepared until cracked) Shaoyao (Paeoniae Radix, one liang each)
The above four ingredients are chopped like hemp seeds. Each dose consists of five qian bi, boiled in one and a half zhan of water until reduced to one zhan. Strain and take warm.
For treating Shanghan causing interior cold with exterior heat, and frequent cold extremities. Renshen Decoction Formula:
Renshen (Ginseng Radix) Baizhu (Atractylodis Macrocephalae Rhizoma, one liang each) Xixin (Asari Radix et Rhizoma, seedlings and leaves removed) Ganjiang (Zingiberis Rhizoma, prepared until cracked, three fen each) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, half liang)
The above five ingredients are coarsely crushed and sifted. Each dose consists of five qian bi, boiled in one and a half zhan of water until reduced to one zhan. Strain and take warm before meals.
For treating Shanghan Sini Syndrome. Yangqishi Pill Formula:
Yangqishi (Stellatitum) Taiyin Xuanjingshi (Selenitum) Xiaoshi (Natrii Sulfas) Fuzi (Aconiti Lateralis Radix Praeparata, prepared until cracked, skin and umbilicus removed, equal parts)
The above four ingredients are pounded and ground into fine powder. Mix with steamed dough soaked in hot water to form pills the size of paulownia seeds. Each dose is five to ten pills, taken with newly drawn cold water. Perspiration indicates resolution.
For treating Shanghan causing cold extremities of hands and feet, with deep and fine pulse. Zhengyang Pill Formula:
Liuhuang (Sulfur, one liang) Xiaoshi (Natrii Sulfas, one liang) Taiyin Xuanjingshi (Selenitum, half liang)
The above three ingredients are finely ground, placed in a porcelain bottle, sealed with a tile lid, and secured with yellow mud. Dry in shade. Roast with one jin of charcoal until the fire extinguishes naturally. Allow to cool, remove the medicine, and grind into powder. Mix with flour paste boiled in wine to form pills the size of paulownia seeds. Each dose is fifteen to twenty pills, taken with hot wine at any time.
For treating deficiency of Qi and collapse of Yang, characterized by cold body, absence of pulse, impending cessation of breath, unconsciousness, as well as Yin Jue from Shanghan unresponsive to various medicines, use the Scallion Moxibustion Method:
Congbai (Allii Fistulosi Bulbus, one jin, washed clean)
Tie the scallions with hemp thread into bundles about the size of a cup. Cut off roots and leaves, retaining only the white part, approximately two cun long, forming a cake-like shape. Heat one side over fire until thoroughly hot. Place the heated side on the patient's navel and below. Cover the top with a moxibustion iron filled with burning charcoal. Ensure the heat from the scallion cake penetrates into the muscles. Prepare three or four such cakes in advance; replace a cake if it becomes ineffective. After some time, the patient should gradually regain consciousness, with warm hands and feet and perspiration. Subsequently, administer Sini Decoction or similar formulas to warm the interior, leading to recovery.