此证即系于寒气外侵，其剧者卒然昏倒，要皆少阴直中之例，至其传化，则实不能外于伤寒之理，故此所
揭，特止于初犯一类云。
源候 人有在于途路，逢凄风苦雨，繁霜大雪，衣服沾
濡，冷气入脏，致令阴气闭于内，阳气绝于外，荣卫结涩，不复流通，故致噤绝而死。若早得救疗，血温气通
则生。又云冻死一日犹可治，过此则不可。（《病源论》）
夫寒者，乃天地杀厉之气，在天为寒，在地为水，在人藏为肾，故寒喜中肾。肾中之，多使挛急疼痛，昏
不知人，挟风则眩晕，兼湿则肿疼，治之唯宜温剂，不可吐下，皆逆也。然寒性虽喜归肾，五脏皆能中之，若
中于经络之表则易散，入里则不消，与伤寒脉证无异，但轻重不同。（《三因》）
《素问》云∶冬三月，是谓闭藏，水冰地拆，无扰乎阳，早卧晚起，必待日光。此去寒就温之意也。不善
调摄，触冒之者，卒然眩晕，口噤失音，四肢强直（按∶《要诀》曰∶身体强直，四肢战掉），或洒洒恶寒，
或翕翕发热，面赤多汗。（《要诀》曰∶身无汗。《沈氏尊生书》曰∶其为症定当无汗，有汗反不治）大抵中
寒，脉必迟紧，挟风则脉浮，眩晕不仁，兼湿则脉濡，肿满疼痛。（《济生》）
夫中寒者，寒为天地杀厉之气，人中之者，其病速而危，仓卒受邪，生命暴绝。盖由胃气大虚，而又触冒
大寒，胃虚则肺不能生旺，而皮毛之气先绝，气弱则表失卫护，而寒邪易于外入，使周身阳气遏绝而不行，
四肢厥逆禁固而僵直。故口噤目瞪而色青白，或自汗表绝，或下痢内脱，内外俱虚而寒邪独盛，治失稍缓，脉
散而死。（《奇效良方》）
先头痛身热，恶寒体痛，此是伤寒也，当以伤寒法内求之。若卒然运倒，懵然无所知觉，而牙紧口噤，与
中风相类，但脉弦紧或沉细者，乃中寒也。（同上）
中寒者，谓冬月卒中寒气，昏冒口噤，肢挛恶寒，战栗腹痛，脉浮紧或豁大，此腠理内疏，故一身受病也。
不必分经络，宜温补自解。（《证治大还》）
脉滑实，手足温者顺；虚结，手足寒者逆。（《云林神彀》）
治例 如昏不知人事，脐腹冷痛，或霍乱，宜姜附汤。如兼冷气刺痛呕逆，宜附子理中汤。如虚冷无
阳，胃弱干呕，手足厥逆，宜附沉汤（按∶附沉汤，系于四逆汤加沉香、白术）。如弱人寻常感冷，腹胀停饮
恶心，宜五积散。如上症有汗，宜本方去麻黄。冷甚，加附子。（《如宜方》）
中寒，宜先用酒调苏合香丸，轻则进五积散，加香附一钱，麝香少许，重则用姜附汤。（《要诀》）
中寒者，寒邪直中三阴也。盖中寒比伤寒尤甚，若不急治，死在旦夕也。如寒中太阴者，则中脘疼痛也，
宜理中汤或藿香正气加味理中汤主之。寒甚脉沉细足冷者，必加附子，名曰附子理中汤。若寒中少阴，则脐腹
疼痛，宜五积散加吴茱萸主之。寒甚脉沉足冷者，宜四逆汤加吴茱萸主之。若寒中厥阴，则小腹至阴疼痛，宜
当归四逆汤加吴茱萸，甚者必用附子倍之。如冷极唇青厥逆无脉囊缩者，仍用葱熨法，或吴茱萸炒熨法，并艾
灸脐中并气海、关元二三十壮最佳。取脉渐渐而来，手足温暖，乃可生也。如一时无药，急用凉水搭手足四腕，
视其青紫筋处，以三棱针刺其血出亦愈，或于十指尖出血亦佳，或一味吴茱萸煎汤与之，亦可救之也。（《伤
寒蕴要》）
若平素怯弱之人，外中寒邪而得者，盖虚人腠理疏豁，气血内损，故寒邪直中于中，不作热，手足厥冷，
用麻黄附子细辛汤、五积散。房劳而中寒厥逆者，四逆汤、三建汤主之，外用温脐法。（《明医指掌》）（三
建汤今不录，温脐法见于后。）
中寒卒倒，昏迷不省者，先用热酒、姜汁各半盏灌服，稍醒后，进理中汤。（《寿世保元》）
中寒虽燥热烦渴，可煎理中汤，水中顿冷服之，此寒因寒用之法也。若以寒凉治之，立死。（《古今医鉴》）
治须温血 温肾御寒，如干姜、附子、川乌、天雄辈，佐之以养正灵砂，此固药笼中物。然寒伤荣气，
徒知温肾而不知温血，恐未必有十全之功，是则官桂、当归，又温血之上药也，不然古人何以致意于寒泣血云。
（《直指》）
急救诸方（详出《救急选方》，兹存其一二，宜参彼书。）《肘后》疗冬天堕水，四肢冻直，口噤裁有
微气出方。以大器，中多熬灰使暖，囊盛以薄其心上，冷即易，心暖气通，目则得转，口乃开，可温尿粥清，
稍稍含之即活。若不先温其心，便持火炙其身，冷气与火相搏则死。（《外台》）
凡冬月冻倒人，急与冷水一两口，扶在温暖处，不得与热汤，如便与热物及向火必死。雪泥中行便近火，
即脚指堕落。（《奇效》）
温散诸方（病后调养方） 附子理中汤，治五脏中寒，口噤，四肢强直，失音不语。昔有武士守边，
大雪出帐外观瞻，忽然晕倒，时林继作随行医官，灌以此药两剂遂醒。
大附子（炮去皮脐） 人参 干姜（炮） 甘草（炙） 白术（各分）
上为锉散，每服四大钱，水一盏半，煎七分去滓，不以时服，口噤则斡开灌之。（《三因》）
干姜附子汤，治中寒卒然晕倒，或吐逆涎沫，状如暗风，手脚挛搐，口噤，四肢厥冷，或复燥热。
干姜（炮） 附子（炮去皮脐）
上锉散，每服四钱，水盏半，煎七分去滓，食前服。（同上）
附子麻黄汤，治寒湿所中，昏晕缓弱，或腰背强急，口 ，语声混浊，心腹 胀，气上喘，不能动转。
附子（炮去皮脐） 麻黄（去节汤） 白术 干姜 甘草（炙） 人参（等分）
上为锉散，每服四钱，水盏半，煎七分，去滓空心服。（同上）
增味真武汤，治寒中少阴，小腹疼痛，自利清水，阴躁不宁。
白芍药（酒炒三钱） 白术（二钱） 茯苓（二钱） 甘草（炙一钱） 人参（二钱） 附子（二钱）
上锉一剂，水煎温服。（《医约》）
当归四逆汤，治寒中厥阴，小腹连阴疼痛，阴囊渐缩，手足厥冷，脉弦细欲绝，身如反弓。
附子（三钱） 甘草（三钱） 干姜（三钱） 当归（二钱） 吴茱萸（二钱）
上锉一剂，水煎温服，取少汗乃愈。（同上）
大病之后，诸虚寒证悉除，而真元因之重伤，不加意调养，时进汤液，非惟难以保完精气，抑恐病加于小
愈也，宜用人参固本汤。（人病退方药平）
人参 黄 当归 干姜 白术 茯苓 川芎 肉桂 （《医经会解》）
熨法 灸法 中寒熨法，宜以吴茱萸二升，酒略煮湿，以绢袋盛，蒸令极热，熨心腹及脚手心，候气
通畅匀暖，即停止，累用有效。（《医书大全》）（按∶此本《圣惠》治阴毒伤寒、四肢逆冷方。又《伤寒广
要·少阴病》中所收熨法宜酌用。）
温脐法，用麝香、半夏、皂荚各一字为末，填脐中，将生姜切薄片贴之，放大艾火于姜片上，熏灸三七壮，
灸关元、气海二十壮，热气通于内，寒气逼于外，阴自退而阳自
复矣。（《明医指掌》）
灸法，脐下一寸五分气海、二寸石关、三寸关元皆可。（《丹溪心法·附录》）
灸中寒阴症法，气海穴在脐下一寸五分，丹田在脐下二寸，关元在脐下三寸，用艾火灸二七壮。但手足温、
脐暖、脉至、知人事，无汗要有汗即生，不暖不省者死。（《云林神彀》）
这段病症是由于寒气从外部侵袭所致，病情严重的会突然昏倒，这都属于少阴经直接受寒的范畴。至于病情的传变转化，其实离不开伤寒的理论原理，因此这里所阐述的，仅局限于初感寒邪这一类情况。
《诸病源候论》记载：有人在旅途中，遭遇凄厉的风雨、浓霜大雪，衣服被淋湿浸透，冷气进入脏腑，导致阴气在内闭塞，阳气在外断绝，营气和卫气凝结涩滞，不再流通，因此导致牙关紧闭、气息断绝而死。如果及早得到救治，血液温暖、气机通畅就能存活。又说，冻死一天之内还可以治疗，超过这个时间就不行了。
寒气是天地间具有杀伤力的厉气，在天为寒，在地为水，在人体对应肾脏，所以寒气容易伤害肾脏。寒气中伤肾脏，多引起肢体挛急疼痛、昏迷不省人事；兼夹风邪则出现眩晕，兼夹湿邪则出现肿胀疼痛。治疗应当只用温性药物，不可使用催吐或泻下的方法，否则都是逆治。虽然寒气本性喜欢归入肾脏，但五脏都能受到寒气侵害。如果寒气侵犯经络体表，容易消散；如果深入体内，则难以消除。其脉象症状与伤寒无异，只是轻重程度不同。（出自《三因极一病证方论》）
《素问》说：冬季三个月，称为闭藏，此时水结冰、地开裂，不要扰动阳气，应早睡晚起，一定要等到太阳出来再起床。这是远离寒冷、趋向温暖的意思。如果不善于调养摄生，触犯冒犯寒气，就会突然眩晕、口噤失音、四肢强直（按：《要诀》说：身体强直，四肢颤抖），或者感觉阵阵恶寒，或者感觉微微发热、面色发红、多汗。（《要诀》说：身上无汗。《沈氏尊生书》说：这种病症必定无汗，有汗反而难治。）大抵中寒之症，脉象必定迟而紧；兼夹风邪则脉浮，伴有眩晕和麻木；兼夹湿邪则脉濡软，伴有肿胀、满闷和疼痛。（出自《济生方》）
所谓中寒，是因为寒气是天地间具有杀伤力的厉气，人一旦受到，发病迅速且危险，仓促间受邪，生命可能突然断绝。这是因为胃气极度虚弱，又触犯了大寒，胃虚则肺金不能生化旺盛，皮毛之气首先断绝；气弱则体表失去卫护，寒气易于从外侵入，使周身阳气被遏制断绝而不能运行，四肢厥冷僵硬、拘禁不动。所以出现牙关紧闭、两眼直视、面色青白，或者自汗导致表气绝脱，或者下痢导致内气脱失。内外都虚而寒气独盛，治疗稍微迟缓，脉象散乱就会死亡。（出自《奇效良方》）
先是头痛、身热、恶寒、身体疼痛，这是伤寒，应当按照伤寒的方法去寻求治法。如果是突然晕倒，茫然无知觉，牙关紧闭、口噤，这与中风相似，但脉象弦紧或沉细的，才是中寒。（同上）
中寒，是指冬天突然遭受寒气侵袭，导致昏迷、口噤、肢体挛缩、恶寒、战栗、腹痛，脉象浮紧或豁大，这是因为腠理内部疏松，所以全身都受到病邪影响。不必区分具体是哪条经络，适宜用温补的方法自然解除。（出自《证治大还》）
脉象滑实、手足温暖的为顺证；脉象虚结、手足寒冷的为逆证。（出自《云林神彀》）
治疗原则：如昏迷不知人事、脐腹冷痛，或者霍乱，适宜用姜附汤。如果兼有冷气刺痛、呕吐逆气，适宜用附子理中汤。如果虚冷无阳、胃弱干呕、手足厥冷，适宜用附沉汤（按：附沉汤，是在四逆汤基础上加沉香、白术而成）。如果是体弱之人平时感受寒冷，腹胀、停饮、恶心，适宜用五积散。如果上述症状有汗，适宜用本方去掉麻黄。寒气特别重，加附子。（出自《如宜方》）
中寒，适宜先用酒调服苏合香丸，轻症进服五积散，加香附一钱、麝香少许，重症用姜附汤。（出自《要诀》）
中寒，是指寒邪直接中伤三阴经。中寒比伤寒更严重，如果不紧急治疗，可能在早晚之间就会死亡。如果寒气中伤太阴经，则中脘穴处疼痛，适宜用理中汤或藿香正气加味理中汤主治。寒气很重、脉沉细、足冷的，必须加附子，名叫附子理中汤。如果寒气中伤少阴经，则脐腹部疼痛，适宜用五积散加吴茱萸主治。寒气很重、脉沉、足冷的，适宜用四逆汤加吴茱萸主治。如果寒气中伤厥阴经，则小腹部至阴器处疼痛，适宜用当归四逆汤加吴茱萸，严重的必须加倍使用附子。如果冷至极点、嘴唇发青、四肢厥冷、无脉、睾丸收缩，仍可用葱熨法，或者炒吴茱萸熨法，并艾灸脐中以及气海、关元穴二三十壮效果最佳。等到脉象渐渐恢复，手足温暖，才可以存活。如果一时没有药物，急忙用凉水搭在手足四个手腕处，观察青紫色的筋络，用三棱针刺破放血也能痊愈，或者刺十指尖出血也很好，或者单用一味吴茱萸煎汤给患者服用，也可以救活。（出自《伤寒蕴要》）
如果平素怯弱的人，因外感寒邪而致病，因为虚人的腠理疏松，气血内损，所以寒邪直接中伤体内，不表现为热证，而是手足厥冷，用麻黄附子细辛汤、五积散。因房事劳累而中寒导致四肢厥冷的，用四逆汤、三建汤主治，外用温脐法。（《明医指掌》）（三建汤此处不收录，温脐法见后文。）
中寒突然晕倒、昏迷不醒的，先用热酒、姜汁各半盏灌服，稍清醒后，进服理中汤。（出自《寿世保元》）
中寒虽然出现燥热烦渴的症状，可以煎煮理中汤，在水中顿冷后服用，这是“寒因寒用”的方法。如果用寒凉药治疗，立即致死。（出自《古今医鉴》）
治疗需要温养血脉。温肾御寒的药物，如干姜、附子、川乌、天雄之类，佐以养正灵砂，这确实是药箱中的必备之物。然而寒气损伤荣气，只知道温肾而不知道温血，恐怕未必能有十全的效果，所以官桂、当归，又是温血的上等药物，不然古人怎么会在意“寒泣血”的说法呢？（出自《直指方》）
急救各方（详见《救急选方》，此处只保留一二种，参看那本书即可。）《肘后备急方》治疗冬天落水，四肢冻僵挺直，口噤只有微弱气息出的方子。用大容器，里面多烧灰使其温暖，用袋子装好敷在心口上，冷了即更换，心口暖气通达，眼睛就能转动，嘴巴才能张开，可以喂温热的米粥清液，慢慢含服就能活过来。如果不先温暖心口，就拿着火烤身体，冷气与热气相搏就会死亡。（出自《外台秘要》）
凡是冬天冻倒的人，急忙给一两口冷水，扶到温暖的地方，不得给热汤，如果立刻给热物及靠近火源必死。在雪泥中行路便近火，脚趾就会脱落。（出自《奇效良方》）
温散各方（病后调养方） 附子理中汤，治疗五脏中寒，口噤，四肢强直，失音不语。过去有位武士守边，大雪天出帐外观望，忽然晕倒，当时林继作为随行医官，灌服此药两剂便醒了。
大附子（炮制去皮脐） 人参 干姜（炮制） 甘草（炙） 白术（各等分）
以上锉成散剂，每次服用四大钱，水一盏半，煎至七分，去渣，不分时候服用，口噤则撬开嘴灌服。（出自《三因方》）
干姜附子汤，治疗中寒突然晕倒，或者呕吐逆出涎沫，状如暗风，手脚挛缩抽搐，口噤，四肢厥冷，或者又出现燥热。
干姜（炮制） 附子（炮制去皮脐）
以上锉成散剂，每次服用四钱，水一盏半，煎至七分，去渣，饭前服用。（同上）
附子麻黄汤，治疗寒湿所中，昏晕缓弱，或者腰背强急，口噤，语声混浊，心腹胀满，气上喘，不能动转。
附子（炮制去皮脐） 麻黄（去节，用汤煮） 白术 干姜 甘草（炙） 人参（等分）
以上锉成散剂，每次服用四钱，水一盏半，煎至七分，去渣，空腹服用。（同上）
增味真武汤，治疗寒中少阴，小腹疼痛，自利清水，阴躁不安。
白芍药（酒炒三钱） 白术（二钱） 茯苓（二钱） 甘草（炙一钱） 人参（二钱） 附子（二钱）
以上锉成一剂，水煎温服。（出自《医约》）
当归四逆汤，治疗寒中厥阴，小腹连阴器疼痛，阴囊逐渐收缩，手足厥冷，脉弦细欲绝，身体像反弓一样。
附子（三钱） 甘草（三钱） 干姜（三钱） 当归（二钱） 吴茱萸（二钱）
以上锉成一剂，水煎温服，取微汗才痊愈。（同上）
大病之后，各种虚寒证候都已去除，但真元因此受到重伤，如果不注意调养，不时进服汤药，不仅难以保全精气，恐怕病情会在刚愈时加重，适宜用人参固本汤。（原方药味平和）
人参 黄芪 当归 干姜 白术 茯苓 川芎 肉桂 （出自《医经会解》）
熨法 灸法 中寒熨法，适宜用吴茱萸二升，用酒略微煮湿，用绢袋装好，蒸得极热，熨烫心腹及手脚心，等到气机通畅均匀温暖，就停止，多次使用有效。（出自《医书大全》）（按：这原本是《圣惠方》治疗阴毒伤寒、四肢逆冷的方子。另外《伤寒广要·少阴病》中所收录的熨法也适宜酌情使用。）
温脐法，用麝香、半夏、皂荚各一字量研末，填入脐中，将生姜切成薄片贴在上面，放艾火在姜片上熏灸三七壮，灸关元、气海穴二十壮，热气通于内，寒气逼于外，阴气自然消退而阳气自然恢复。（出自《明医指掌》）
灸法，脐下一寸五分的气海穴、二寸的石关穴、三寸的关元穴都可以。（出自《丹溪心法·附录》）
灸中寒阴症法，气海穴在脐下一寸五分，丹田在脐下二寸，关元在脐下三寸，用艾火灸十四壮。只要手足温暖、脐部暖、脉象恢复、知晓人事，无汗要有汗才能生，不暖不醒的就会死。（出自《云林神彀》）
This syndrome is caused by the external invasion of cold pathogenic factors. In severe cases, sudden fainting occurs; these all belong to the category of Shaoyin (Lesser Yin) directly struck by cold. Regarding the transmission and transformation of the disease, it cannot deviate from the principles of Shanghan (Cold Damage); therefore, what is presented here specifically covers only the initial stage of cold invasion.
*Zhubing Yuanhou Lun* (Treatise on the Pathogenesis and Symptoms of All Diseases) records: When a person is traveling and encounters biting winds, bitter rains, heavy frost, or snow, causing their clothes to become wet and soaked, cold qi enters the zang organs. This leads to the closure of yin qi internally and the severance of yang qi externally. Ying (Nutritive) and Wei (Defensive) qi become knotted and stagnant, ceasing to circulate freely, resulting in trismus (lockjaw), cessation of breath, and death. If treated early, when blood becomes warm and qi flows smoothly, life can be preserved. It is also stated that someone who has frozen to death can still be treated within one day; beyond this time, treatment is ineffective.
Cold is a lethal energy of heaven and earth. In heaven, it manifests as cold; on earth, as water; in the human body, it corresponds to the Kidney. Therefore, cold tends to injure the Kidney. When cold injures the Kidney, it often causes spasms, pain, coma, and unconsciousness. If accompanied by wind, dizziness occurs; if accompanied by dampness, swelling and pain result. Treatment should exclusively use warming agents; emetics and purgatives are contraindicated, as they constitute contrary treatments. Although cold naturally tends to affect the Kidney, all five zang organs can be injured by it. If cold invades the exterior of the meridians, it is easily dispersed; if it enters the interior, it is difficult to eliminate. Its pulse and symptoms are no different from Shanghan, differing only in severity. (*San Yin Fang*)
*Suwen* (Basic Questions) states: The three months of winter are called "closing and storing." Water freezes, and the ground cracks. One should not disturb yang qi, sleep early, rise late, and wait for sunlight. This expresses the intention of avoiding cold and seeking warmth. If one fails to regulate lifestyle properly and is exposed to cold, sudden dizziness, trismus with loss of voice, and rigid limbs may occur. (Note: *Yaojue* states: rigid body, trembling limbs.) There may be aversion to cold with shivering, or slight fever, flushed face, and profuse sweating. (*Yaojue* states: no sweat on the body. *Shen Shi Zun Sheng Shu* states: this syndrome definitely presents without sweat; if there is sweat, it is untreatable.) Generally, in Zhonghan (Strike Cold), the pulse must be slow and tight. If accompanied by wind, the pulse is floating, with dizziness and numbness. If accompanied by dampness, the pulse is soggy, with swelling, fullness, and pain. (*Jisheng Fang*)
Zhonghan refers to cold as a lethal energy of heaven and earth. When humans are affected, the disease progresses rapidly and dangerously. Sudden exposure to pathogens can cause abrupt cessation of life. This is due to extreme deficiency of Stomach qi combined with exposure to severe cold. Deficiency of Stomach qi prevents Lung metal from flourishing, causing the qi of skin and hair to fail first. Weak qi means the exterior lacks protection, allowing cold pathogens to enter easily. This suppresses and severs the body's yang qi, preventing its circulation, leading to cold extremities, rigidity, and immobility. Thus, there is trismus, staring eyes, and blue-white complexion, or spontaneous sweating leading to exterior collapse, or diarrhea leading to interior collapse. With both interior and exterior deficiency and overwhelming cold, any delay in treatment results in a scattered pulse and death. (*Qixiao Liangfang*)
Initial headache, body heat, aversion to cold, and body pain indicate Shanghan; seek treatment according to Shanghan methods. If there is sudden fainting, confusion, lack of consciousness, trismus, and lockjaw, resembling Zhongfeng (Wind Stroke), but the pulse is wiry-tight or deep-thin, it is Zhonghan. (Ibid.)
Zhonghan refers to suddenly contracting cold pathogenic factors in winter, leading to coma, trismus, limb spasms, aversion to cold, shivering, abdominal pain, and a floating-tight or expansive pulse. This is because the interstices (cou li) are internally loose, so the whole body is affected. Differentiation by meridian is unnecessary; warming and tonifying will resolve it naturally. (*Zhengzhi Dahuan*)
A slippery and solid pulse with warm hands and feet indicates a favorable prognosis; a deficient and knotted pulse with cold hands and feet indicates an unfavorable prognosis. (*Yunlin Shen Gou*)
Treatment Principles: For coma, loss of consciousness, cold pain in the umbilical/abdominal region, or Huoluan (Cholera-like disorder), Jiangfu Tang (Ginger and Aconite Decoction) is suitable. If accompanied by stabbing cold pain and vomiting, Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) is suitable. For deficiency-cold with absence of yang, weak stomach with dry retching, and cold extremities, Fuchen Tang (Aconite and Agarwood Decoction) is suitable. (Note: Fuchen Tang is Si Ni Tang added with Chenxiang and Baizhu.) For frail individuals commonly affected by cold, presenting with abdominal distension, fluid retention, and nausea, Wuji San (Five Accumulations Powder) is suitable. If the above symptoms present with sweating, remove Mahuang from the formula. If cold is severe, add Fuzi. (*Ruyi Fang*)
For Zhonghan, initially administer Suhexiang Wan (Styrax Pill) mixed with wine. For mild cases, administer Wuji San added with Xiangfu and a small amount of Shexiang (Musk). For severe cases, use Jiangfu Tang. (*Yaojue*)
Zhonghan involves cold pathogens directly striking the Three Yin meridians. Zhonghan is more severe than Shanghan; if not treated urgently, death may occur within a day or night. If cold strikes Taiyin, there is pain at the Zhongwan point; Lizhong Tang or Huoxiang Zhengqi Jia Wei Lizhong Tang is indicated. If cold is severe with a deep-thin pulse and cold feet, add Fuzi, named Fuzi Lizhong Tang. If cold strikes Shaoyin, there is pain in the umbilical/abdominal region; Wuji San added with Wuzhuyu is indicated. If cold is severe with a deep pulse and cold feet, Si Ni Tang added with Wuzhuyu is indicated. If cold strikes Jueyin, there is pain from the lower abdomen to the genitalia; Danggui Sini Tang added with Wuzhuyu is indicated. In severe cases, double the dose of Fuzi. If cold is extreme with blue lips, cold extremities, absent pulse, and retracted testicles, apply Congyi method (Scallion moxibustion/ironing) or stir-fried Wuzhuyu ironing method, and moxa the umbilicus, Qihai, and Guanyuan points for 20-30 moxa cones. Recovery is possible when the pulse gradually returns and hands/feet become warm. If medicine is unavailable temporarily, quickly apply cold water to the four wrists, observe the cyanotic veins, puncture them with a three-edged needle to release blood, which can also cure the condition. Alternatively, pricking the tips of the ten fingers to bleed is effective. Or, decoct a single herb of Wuzhuyu and give it to drink to save the patient. (*Shanghan Yunyao*)
For those who are constitutionally weak and contract cold from the exterior, because their interstices are loose and internal qi/blood are damaged, cold pathogens strike directly inward without generating heat, causing cold extremities. Use Mahuang Fuxi Xixin Tang (Ephedra, Aconite, and Asarum Decoction) or Wuji San. For Zhonghan and cold extremities caused by sexual exhaustion, Si Ni Tang and Sanjian Tang are indicated, along with external application of the Warm Umbilicus method. (*Ming Yi Zhi Zhang*) (Sanjian Tang is not recorded here; Warm Umbilicus method is described later.)
For sudden fainting and coma due to Zhonghan, first灌服 (force-feed) half a cup each of hot wine and ginger juice. After slight recovery, administer Lizhong Tang. (*Shoushi Baoyuan*)
Even if Zhonghan presents with dryness, heat, irritability, and thirst, decoct Lizhong Tang and administer it cold after cooling it in water. This is the method of "treating cold with cold" (using cold administration for cold pathology). Using cold-natured herbs would lead to immediate death. (*Gujin Yi Jian*)
Treatment requires warming the blood. To warm the kidney and resist cold, herbs such as Ganjiang (Dried Ginger), Fuzi (Prepared Aconite Root), Chuanwu (Sichuan Aconite), and Tianxiong (Male Aconite) are used, assisted by Yangzheng Lingsha. These are indeed essential medicines. However, since cold damages Ying qi, knowing only to warm the kidney but not the blood may not yield perfect results. Therefore, Guigui (Cinnamon Bark) and Danggui (Angelica Sinensis) are superior blood-warming herbs. Otherwise, why did ancient physicians emphasize "cold constricts blood"? (*Zhizhi Fang*)
Emergency Formulas (Detailed in *Jiuji Xuanfang*, retaining only a few here): *Zhouhou Beiji Fang* treats falling into water in winter, with limbs frozen rigid, trismus, and only faint breath. Use a large vessel, fill with hot ashes, place in a bag, and apply to the heart area. Replace when cool. Once heart warmth restores, eyes move, mouth opens. Administer warm rice water slowly. Do not apply fire to the body before warming the heart, as cold and fire will clash, causing death. (*Waitai Miyao*)
For anyone frozen in winter, immediately give one or two mouthfuls of cold water, move to a warm place. Do not give hot soup. Giving hot substances or approaching fire immediately will cause death. Walking in snow/mud and approaching fire causes toes to fall off. (*Qixiao Liangfang*)
Warming and Dispersing Formulas (Post-illness Convalescence): Fuzi Lizhong Tang treats cold striking the five zang organs, trismus, rigid limbs, aphasia. A warrior guarding the border once fainted in heavy snow while looking out from his tent. Lin Ji, the accompanying physician, administered two doses of this medicine, and he woke up.
Da Fuzi (Pao, peeled, navel removed) Renshen Ganjiang (Pao) Gancao (Zhi) Baizhu (Equal parts)
Grind into powder. Take 4 qian per dose with 1.5 cups of water, decoct to 0.7 cups, strain. Take at any time. If trismus occurs, pry open mouth and灌服. (*San Yin Fang*)
Ganjiang Fuzi Tang treats sudden fainting due to Zhonghan, vomiting saliva/froth, resembling dark wind, limb spasms, trismus, cold extremities, or subsequent dryness/heat.
Ganjiang (Pao) Fuzi (Pao, peeled, navel removed)
Grind into powder. Take 4 qian per dose with 1.5 cups of water, decoct to 0.7 cups, strain. Take before meals. (Ibid.)
Fuzi Mahuang Tang treats cold-damp strike, fainting, weakness, rigid back/waist, trismus, turbid voice, abdominal distension, asthma, immobility.
Fuzi (Pao, peeled, navel removed) Mahuang (remove joints, boil in water) Baizhu Ganjiang Gancao (Zhi) Renshen (Equal parts)
Grind into powder. Take 4 qian per dose with 1.5 cups of water, decoct to 0.7 cups, strain. Take on an empty stomach. (Ibid.)
Zengwei Zhenwu Tang treats cold striking Shaoyin, lower abdominal pain, clear watery diarrhea, yin restlessness.
Baishao (wine-fried 3 qian) Baizhu (2 qian) Fuling (2 qian) Gancao (Zhi 1 qian) Renshen (2 qian) Fuzi (2 qian)
Grind one dose, decoct in water, take warm. (*Yiyue*)
Danggui Sini Tang treats cold striking Jueyin, lower abdominal pain radiating to genitals, gradual retraction of scrotum, cold extremities, wiry-thin pulse nearly absent, body arched like a bow.
Fuzi (3 qian) Gancao (3 qian) Ganjiang (3 qian) Danggui (2 qian) Wuzhuyu (2 qian)
Grind one dose, decoct in water, take warm. Cure is achieved with slight sweating. (Ibid.)
After severe illness, if all deficiency-cold syndromes are resolved but true yuan is severely damaged, neglecting convalescence and merely administering decoctions occasionally will not preserve essence/qi and may worsen the condition upon slight recovery. Ren Shen Gu Ben Tang is suitable. (Original prescription is mild.)
Renshen Huangqi Danggui Ganjiang Baizhu Fuling Chuanwu Rougui (*Yijing Huijie*)
Ironing Method Moxibustion Method: Zhonghan Ironing Method: Use 2 sheng of Wuzhuyu, slightly boiled in wine until moist, placed in a silk bag, steamed until very hot. Iron the chest/abdomen and palms/soles. Stop when qi flows smoothly and warmth is uniform. Repeated use is effective. (*Yishu Daquan*) (Note: This originates from *Shenghui Fang* treating Yin-toxin Shanghan with cold extremities. Also, ironing methods in *Shanghan Guangyao · Shaoyin Bing* are suitable for reference.)
Warm Umbilicus Method: Use Shexiang, Banxia, and Zaojia (each 1 zi weight) ground to powder, fill the umbilicus. Place thin slices of fresh ginger on top. Apply moxa on the ginger slice for 21-30 cones. Moxa Qihai and Guanyuan for 20 cones. Heat penetrates inward, forcing cold outward; yin retreats, yang recovers. (*Ming Yi Zhi Zhang*)
Moxibustion Points: Qihai (1.5 cun below umbilicus), Shiguan (2 cun below umbilicus), Guanyuan (3 cun below umbilicus) are all suitable. (*Danxi Xinfa · Appendix*)
Moxibustion for Zhonghan Yin Syndromes: Qihai is 1.5 cun below umbilicus, Dantian is 2 cun below, Guanyuan is 3 cun below. Moxa 14 cones. Survival is indicated if hands/feet become warm, umbilicus warms, pulse returns, consciousness is restored, and sweating occurs (from no sweat). Death is indicated if there is no warmth or consciousness. (*Yunlin Shen Gou*)