治伤寒脉微而厥。至七八日肤冷。其人躁无暂安时者。此为脏厥。非蛔厥也。蛔厥
其人当吐蛔。今病者静而复时烦。此为脏寒。蛔上入膈故烦。须臾复止。得食而呕又烦者。
蛔闻食臭出。其人当吐蛔。蛔厥者。乌梅丸主之。又主久利方。
乌梅（三百枚） 细辛（六两） 干姜（十两） 黄连（一斤） 蜀椒（四两 炒去汗。）
上十味。异捣筛。合治之。以苦酒浸乌梅一宿。去核。蒸之五升米下。饭熟捣成泥。和
药令相得。内臼中。与蜜杵二千下。丸如梧桐子大。先食。服十丸。日三服。稍加至二十丸。
禁
歌曰 六两柏参桂附辛。黄连十六厥阴遵。归椒四两梅三百。十两干姜记要真。
论云。厥阴之为病。消渴。气上撞心。心中疼热。饥而不欲食。食则吐蛔。下之。利不
止。此厥阴病之提纲也。经云。厥阴之上。风气主之。中见少阳。是厥阴以风为本。以阴寒
为标。而火热在中也。至厥阴而阴已极。故不从标本而从于中治。沈尧封云。此厥阴证之提
纲也。消渴等证外。更有厥热往来。或呕。或利等证。犹之阳明病胃家实之外。更有身热汗
出不恶寒反恶热等证。故阳明病。必须内外证合见。乃是真阳明。厥阴病亦必内外证合见。
乃是真厥阴。其余或厥或利或呕。而内无气上撞心心中疼热等证。皆似厥阴而非厥阴也。男
元犀按。论云。伤寒脉微而厥。至七八日肤冷。其人躁无暂安时者。是以少阴证之脏厥。唤
起厥阴之蛔厥也。然少阴证水火不交。则为烦躁。若真阳欲脱危证。则但躁不烦。与厥阴之
但烦不躁者不同。故曰肤冷而躁。名曰脏厥。非蛔厥也。蛔厥为厥阴病的证。厥阴阴极阳生。
中为少阳相火。名曰蛔厥。此蛔字所包者广。厥阴主风木。若名为风厥。则遗去木字。若名
为木厥。又遗去风字。且用字亦不雅驯。若名为风木厥。更见执着。第以蛔厥二字该之。盖
以蛔者风木之虫也。而吐蛔为厥阴之真面目。拈此一字。而病源病证俱在其中。其人当吐蛔
者。以风木之病当有是证。亦不必泥于蛔之有无。如本节静而复烦。与上节气上撞心心中疼
热皆是也。曰蛔闻食臭出。其人当自吐蛔。又用一当字者。言吐蛔者其常。即不吐蛔而呕而
又烦。风木之动。亦可以吐蛔例之也。曰静而复烦。曰须臾复止。曰又烦者。风有作止也。
然通篇之眼目。在此为脏寒四字。言见证虽曰风木为病。相火上攻。而其脏则为寒。何也。
厥阴为三阴之尽也。周易震卦。一阳居二阴之下。为厥阴本象。病则阳逆于上。阴陷于下。
饥不欲食。下之利不止。是下寒之确证也。消渴。气上撞心。心中疼热。吐蛔。是上热之确
证也。方用乌梅。渍以苦酒。顺曲直作酸之本性。逆者顺之。还其所固有。去其所本无。治
之所以臻于上理也。桂、椒、辛、附。辛温之品。导逆上之火。以还震卦下一画之奇。黄连、
黄柏。苦寒之品。泻心胸之热。以还震卦上四画之偶。又佐以人参之甘寒。当归之苦温。干
姜之辛温。三物合用。能令中焦受气而取汁。而乌梅蒸于米下。服丸送以米饮。无非补养中
焦之法。所谓厥阴不治。取之阳明者此也。此为厥阴证之总方。注家第谓蛔得酸则静。得辛
则伏。得苦则下。犹浅之乎测乌梅丸也。
治疗伤寒病，脉象微弱且四肢厥冷。到了七八天，全身皮肤发凉，病人烦躁不安，没有片刻安宁的时候，这叫做脏厥，不是蛔厥。
如果是蛔厥，病人通常会吐出蛔虫。现在病人安静下来却又时不时感到心烦，这是因为内脏有寒，蛔虫向上进入膈部所以引起心烦。过了一会儿又停止，进食后呕吐并再次心烦，是因为蛔虫闻到食物的气味而出来，病人应当吐出蛔虫。患蛔厥病的，用乌梅丸主治。乌梅丸也用于治疗久泻久痢。
乌梅（三百枚） 细辛（六两） 干姜（十两） 黄连（一斤） 蜀椒（四两，炒至出汗）。
以上十味药，分别捣碎过筛，混合在一起。用醋浸泡乌梅一夜，去掉核，放在五升米下蒸，饭熟后将乌梅捣成泥状，与药物混合均匀，放入臼中，加蜂蜜杵打两千下，制成梧桐子大小的丸剂。饭前服用，每次十丸，每日三次，逐渐增加到二十丸。
禁忌事项：
歌诀说：六两柏枝、人参、桂枝、附子、细辛，黄连十六两遵循厥阴经的治法。当归、蜀椒各四两，乌梅三百枚，干姜十两要牢记真传。
论述说：厥阴病的提纲证是：口渴，气向上冲撞心脏，心中疼痛且有灼热感，饥饿但不想吃东西，吃东西就会吐出蛔虫。如果误用攻下法，会导致腹泻不止。这是厥阴病的提纲。经典说：厥阴之上，由风气主司，中间见少阳之气，所以厥阴以风为本，以阴寒为标，而火热在内部。到了厥阴阶段，阴气已经极盛，所以不遵循本标而从中间治理。沈尧封说：这是厥阴证的提纲。除了消渴等症状外，还有厥热往来，或者呕吐，或者腹泻等症状。就像阳明病胃家实之外，还有身热汗出、不恶寒反而恶热等症状一样。所以阳明病，必须内外症状同时出现，才是真正的阳明病；厥阴病也必须内外症状同时出现，才是真正的厥阴病。其余如果有厥冷或腹泻或呕吐，但内部没有气上撞心、心中疼热等症状的，都像是厥阴病而不是真正的厥阴病。
男元犀按语：论述中说：伤寒病脉象微弱且四肢厥冷，到了七八天全身皮肤发凉，病人烦躁不安没有片刻安宁，这是以少阴证的脏厥，来唤起对厥阴蛔厥的认识。然而少阴证水火不交，就会产生烦躁；如果是真阳欲脱的危重证候，则只有躁动而没有烦闷，这与厥阴病只有烦闷而没有躁动的情况不同。所以说皮肤发凉且躁动，名叫脏厥，不是蛔厥。蛔厥是厥阴病的证候，厥阴阴极阳生，中间是少阳相火，名叫蛔厥。“蛔”这个字包含的意义很广。厥阴主风木，如果命名为风厥，就遗漏了“木”字；如果命名为木厥，又遗漏了“风”字；而且用字也不雅驯。如果命名为风木厥，更显执着。只用“蛔厥”二字概括它，大概因为蛔虫是风木之虫，而吐蛔是厥阴病的真实面目，拈出这一个字，病源和病证都包含在其中。病人应当吐出蛔虫，是因为风木之病应当有这种证候，也不必拘泥于是否有蛔虫。如本节中“安静而又心烦”，与上一节“气上撞心、心中疼热”都是如此。说“蛔闻食臭出，病人应当自行吐出蛔虫”，又用一个“当”字，是说吐蛔是其常态，即使不吐蛔而呕吐并且心烦，风木之气动，也可以按照吐蛔的情况类推。说“安静而又心烦”，说“一会儿又停止”，说“又心烦”，说明风邪有发作和停止的时候。然而全篇的关键眼目，在于“此为脏寒”四个字。说明虽然见证说是风木致病，相火上攻，但其内脏却是寒的。为什么呢？厥阴是三阴的尽头。《周易》震卦，一阳爻居于两个阴爻之下，这是厥阴的本象。生病时阳气逆乱于上，阴气陷落于下。饥饿不想吃东西，误下后腹泻不止，这是下寒的确切证据。口渴，气上撞心，心中疼热，吐蛔，这是上热的确切证据。方中使用乌梅，用苦酒浸泡，顺应曲直作酸的本性，使逆乱者顺从，恢复其固有的属性，去除其本无的属性，这就是治疗达到最高境界的原因。桂枝、蜀椒、细辛、附子，是辛温的药物，引导逆上的火气，以恢复震卦最下面那一画奇数的阳气；黄连、黄柏，是苦寒的药物，泻除心胸的热气，以恢复震卦上面四画偶数的阴气。又佐以人参的甘寒，当归的苦温，干姜的辛温，这三味药合用，能使中焦受纳水谷之气而化生津液。而乌梅在米下蒸制，服药时用米汤送服，无非是补养中焦的方法。所谓“厥阴不治，取之阳明”就是这个意思。这是厥阴证的总方。注家只说蛔虫得到酸味就安静，得到辛味就伏藏，得到苦味就下行，这还是浅薄地推测乌梅丸的作用啊。
Treats Taiyang disease (Taiyang syndrome) with a faint pulse and cold extremities. After seven or eight days, the skin becomes cold throughout the body, and the patient is restless without any moment of peace; this is called Zang Jue (Visceral Cold-Jue), not Hui Jue (Roundworm Cold-Jue).
In cases of Hui Jue (Roundworm Cold-Jue), the patient typically vomits roundworms. Now, if the patient is quiet but occasionally experiences vexation, it is due to cold in the viscera, causing the roundworms to move upward into the diaphragm, thus causing vexation. After a short while, it stops again. If vomiting occurs after eating, accompanied by renewed vexation, it is because the roundworms are disturbed by the odor of food and come out; the patient should expectorate roundworms. For Hui Jue (Roundworm Cold-Jue), Wu Mei Wan (Mume Pill) is the primary formula. It is also indicated for chronic diarrhea and dysentery.
Wu Mei (Fructus Mume, 300 pieces); Xi Xin (Herba Asari, 6 liang); Gan Jiang (Rhizoma Zingiberis Recens, 10 liang); Huang Lian (Rhizoma Coptidis, 1 jin); Shu Jiao (Pericarpium Zanthoxyli, 4 liang, stir-fried until sweat appears).
The above ten ingredients are separately pounded and sifted, then mixed. Soak Wu Mei (Fructus Mume) in vinegar (Ku Jiu) overnight, remove the pits, and steam them over five sheng of rice. When the rice is cooked, pound the Wu Mei into a paste, mix thoroughly with the other medicines, place in a mortar, add honey, and pound two thousand times to form pills the size of paulownia seeds. Take ten pills before meals, three times a day, gradually increasing to twenty pills.
Contraindications:
The song states: Six liang each of Bai Zhu (Atractylodis Macrocephalae Rhizoma - *Note: Text says Bo/Shen/Gui/Fu/Xin, likely referring to Baizhu/Renshen/Guizhi/Fuzi/Xixin based on context of standard Wu Mei Wan variants or specific commentary interpretation, but strictly translating text: "Six liang of Cypress/Bai, Ginseng/Shen, Cinnamon/Gui, Aconite/Fu, Asarum/Xin"*), sixteen liang of Huang Lian (Rhizoma Coptidis) follow the treatment of Jueyin (Jueyin syndrome). Four liang each of Dang Gui (Radix Angelicae Sinensis) and Shu Jiao (Pericarpium Zanthoxyli), three hundred Wu Mei (Fructus Mume), and ten liang of Gan Jiang (Rhizoma Zingiberis Recens) must be remembered as the true transmission.
The discussion states: The outline syndrome of Jueyin (Jueyin syndrome) includes: excessive thirst (Xiao Ke), sensation of Qi rushing up to strike the heart, pain and heat in the epigastrium/heart region, hunger without desire to eat, and vomiting roundworms upon eating. If purgatives are misused, it leads to unceasing diarrhea. This is the outline of Jueyin (Jueyin syndrome) disease. The Classics state: Above Jueyin (Jueyin syndrome), Wind Qi governs; it reveals Shaoyang (Shaoyang syndrome) internally. Thus, Jueyin (Jueyin syndrome) has Wind as its root, Yin-Cold as its branch, and Fire-Heat within. At the stage of Jueyin (Jueyin syndrome), Yin is at its extreme, so treatment does not follow the root or branch but addresses the middle. Shen Yaofeng stated: This is the outline of Jueyin (Jueyin syndrome) patterns. Besides symptoms like excessive thirst, there are also alternating cold and heat, vomiting, or diarrhea. Just as Yangming (Yangming syndrome) Stomach Excess (Wei Jia Shi) presents with additional symptoms like fever, sweating, aversion to cold turning to aversion to heat, so too must Yangming (Yangming syndrome) present with both internal and external signs to be considered true Yangming (Yangming syndrome). Similarly, Jueyin (Jueyin syndrome) must present with both internal and external signs to be considered true Jueyin (Jueyin syndrome). Other presentations involving cold extremities, diarrhea, or vomiting, but lacking internal signs like Qi rushing up to strike the heart and pain/heat in the heart region, resemble Jueyin (Jueyin syndrome) but are not true Jueyin (Jueyin syndrome).
Commentary by Nan Yuanxi: The discussion mentions that Taiyang disease (Taiyang syndrome) with faint pulse and cold extremities, progressing to cold skin after seven or eight days and restlessness without peace, uses the Zang Jue (Visceral Cold-Jue) of Shaoyin (Shaoyin syndrome) to introduce the concept of Hui Jue (Roundworm Cold-Jue) of Jueyin (Jueyin syndrome). However, in Shaoyin (Shaoyin syndrome), when Water and Fire do not interact, Fanzao (Restlessness and Vexation) arises. In critical conditions where True Yang is about to collapse, there is only Zao (Restlessness/Agitation) without Fan (Vexation), which differs from Jueyin (Jueyin syndrome) where there is Fan (Vexation) without Zao (Restlessness). Therefore, cold skin with agitation is named Zang Jue (Visceral Cold-Jue), not Hui Jue (Roundworm Cold-Jue). Hui Jue (Roundworm Cold-Jue) is a pattern of Jueyin (Jueyin syndrome); Jueyin (Jueyin syndrome) reaches extreme Yin generating Yang, with Shaoyang Ministerial Fire in the middle, hence named Hui Jue (Roundworm Cold-Jue). The character "Hui" (Roundworm) encompasses broad meanings. Jueyin (Jueyin syndrome) governs Wind-Wood. If named Feng Jue (Wind Jue), the Wood aspect is omitted; if named Mu Jue (Wood Jue), the Wind aspect is omitted; and such terms are inelegant. If named Feng Mu Jue (Wind-Wood Jue), it appears overly rigid. Using only "Hui Jue" (Roundworm Cold-Jue) suffices because roundworms are insects of Wind-Wood, and vomiting roundworms is the true manifestation of Jueyin (Jueyin syndrome). Highlighting this one character captures both the etiology and the syndrome. The statement that the patient should vomit roundworms implies that Wind-Wood diseases should exhibit this sign; one need not rigidly insist on the physical presence of roundworms. For instance, "quiet yet vexed" in this section and "Qi rushing up to strike the heart and pain/heat in the heart region" in the previous section are analogous. Saying "roundworms emerge smelling food, and the patient should vomit them," using the word "should" (Dang), indicates that vomiting roundworms is the norm. Even if roundworms are not vomited but vomiting and vexation occur, the movement of Wind-Wood can be inferred analogously. "Quiet yet vexed," "stops after a moment," "vexed again" indicate that Wind has periods of activity and cessation. However, the key point of the entire passage lies in the four characters "this is Zang Han" (Visceral Cold). Although the presentation suggests Wind-Wood pathology with Ministerial Fire attacking upward, the viscera themselves are cold. Why? Jueyin (Jueyin syndrome) is the end of the Three Yin channels. In the I Ching, the Zhen trigram has one Yang line below two Yin lines, representing the original image of Jueyin (Jueyin syndrome). In disease, Yang rebels upward, and Yin sinks downward. Hunger without desire to eat, and unceasing diarrhea after purgation, are definitive evidence of lower cold. Excessive thirst, Qi rushing up to strike the heart, pain/heat in the heart region, and vomiting roundworms are definitive evidence of upper heat. The formula uses Wu Mei (Fructus Mume), soaked in bitter wine (Ku Jiu), to follow its natural sour property (curving and straightening to become sour), reversing rebellion to restore what is inherent and removing what is not. This is how treatment achieves perfection. Gui Zhi (Ramulus Cinnamomi Cassiae), Shu Jiao (Pericarpium Zanthoxyli), Xi Xin (Herba Asari), and Fu Zi (Radix Aconiti Lateralis Preparata) are acrid-warm herbs that guide rebellious fire downward, restoring the single Yang line at the bottom of the Zhen trigram. Huang Lian (Rhizoma Coptidis) and Huang Bo (Cortex Phellodendri) are bitter-cold herbs that drain heat from the heart and chest, restoring the four Yin lines at the top of the Zhen trigram. They are assisted by Ren Shen (Radix Ginseng) which is sweet-cool, Dang Gui (Radix Angelicae Sinensis) which is bitter-warm, and Gan Jiang (Rhizoma Zingiberis Recens) which is acrid-warm. These three together enable the Middle Jiao (Middle Burner) to receive Qi and extract essence. Wu Mei (Fructus Mume) steamed under rice, and taken with rice water, are methods to nourish the Middle Jiao (Middle Burner). This is what is meant by "When Jueyin (Jueyin syndrome) cannot be treated directly, treat the Yangming (Yangming syndrome)." This is the master formula for Jueyin (Jueyin syndrome) patterns. Commentators merely say that roundworms become quiet with sourness, subdue with acridity, and descend with bitterness; this is a superficial understanding of Wu Mei Wan (Mume Pill).