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 医宗金鉴卷八

<<Yi Zong Jin Jian>> Chapter 8

辨厥阴病脉证并治全篇

Jueyin stage, its condition, pulse and treatment

厥阴者,阴尽阳生之藏,与少阳为表里者也。故其为病,阴阳错杂,寒热混淆,邪至其经,从化各异;若其人素偏於热,则邪从阳化,故消渴,气上撞心,心中疼热, 厥,口烂,咽痛,喉痹,痈脓,便血等阳证见矣;若其人素偏於寒,则邪从阴化,故手足厥冷,脉微欲绝,肤冷,藏厥,下利,除中等阴证见矣。所以少阳不解,传变厥阴而病危,厥阴病衰,转属少阳为欲愈,阴阳消长,大伏危机。兹以阴阳从化,厥热胜复之微旨,详发於篇中,俾临证者,诊治有要道焉。

Jueyin is the stage in which the Yin stage tends to turn to Yang stage of the body. It is associated with the Shaoyang stage: Shaoyang is the out layer, the Jueyin is the inside layer. Therefore, when a disease develops into the Jueyin stage, it shows a mixture syndrome/condition of Yin and Yang; Cold and Fire. Depending on the body’s original condition, the Xieqi may shows more as Fire, or as Cold. If the person originally belongs to a Fire body, the Xieqi coming into the Jueyin will cause terrible and extreme thirsty, a reverse pushing up feeling to the chest, pain and hot in the chest, reverse cold in hands and feet, mouth ulcer, sour throat, pain and tight in esophagus, stomach pus mass, bleeding in stool, and others. If the body is originally Cold, the Xieqi coming into the Jueyin is ready to cause reverse cold in hands and feet, cold in whole body, cold in inside  organs, diarrhea, functional loss of stomach, very weak pulse, etc. A Shaoyang stage tends to develop into the Jueyin stage, and the Jueyin stage also tends to the Shaoyang stage. From Shaoyang to the Jueyin suggests the worse of the disease, and from the Jueyin to the Shaoyang, improving. The Jueyin stage is also a very dangerous stage with many severe conditions to be solved as soon as possible to save life. Readers have to pay much attention to this. If you work in a emergency department of a hospital, you should have much more chance to meet the clinic manifestations listed here.

 

01 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。

If a person has following symptoms, his condition belongs to Jueyin stage: extreme thirsty[1], reverse pushing up feeling in the chest[2], hot and pain in the chest, very hungry but no willing to eat[3], vomiting worm if eat; if a bowel-cleansing therapy is used, he will have a continuous diarrhea hard to stop. [4]

02 厥阴病,渴欲饮水者,少少与之愈。

In Jueyin stage, if the person feels thirsty and want to drink, give water little bit to drink.[5]

03 伤寒,厥而心下悸,以饮水多[6], 宜先治水,当服茯苓甘草汤,却治其厥,不尔,水渍入胃,必作利也。

With Cold-invasion Shanghan disease, if the person has Jue condition and palpitation in the upper stomach, it is due to too much water drinking[7], the correct treatment is to solve the accumulated Water is to use Fuling Gancao Tang[8]. If the treatment focuses on the Jue condition, the water may come into stomach to cause diarrhea.

04 伤寒脉微而厥,至七、八日肤冷,其人躁无暂安时者,此为藏厥,非蛔厥也。蛔厥者,其人当吐蛔,今病者,静而复时烦者,非为藏寒。蛔上入其膈,故烦,须臾复止,得食而呕,又烦者, 闻食臭出,其人当自吐蛔。 厥者,乌梅丸主之,又主久利。

In Cold-invasion Shanghan disease, if the person has weak pulse and reverse cold in hands and feet, and up to the seventh and eighth day, he feels cold in whole body skin, feels annoyed without any minute’s quiet, it is Zangjue condition[9], not a Huijue condition[10]. If it is Huijue condition, the person should have vomiting worms, feel annoyed from time to time. The worm moves up above the diagram to make the person feels annoyed but feel quiet after a while. The worm moves again when it smells the food odor, to make the person annoyed again and vomiting the worm.  Huijue condition: use Wumei Wang; Zangjue: use Wuzhuyu Tang.

乌梅丸方

Wumei Wan

乌梅  三百枚, 细辛  六两, 乾姜  十两, 黄连  十六两, 当归  四两, 附子(去皮,炮)六两, 蜀椒(出汗)四两, 桂枝  六两, 人参  六两, 黄柏  六两

Wumei 300 badges, Xixin 90 gram, Ganjiang 150 gram, Huanglian 250 gram, Danggui 60 gram, Fuzi (remove skin, processed) 90 gram, Shujiao 60 gram, Guizhi 90 gram, Renshen 90 gram, Huangbo 90 gram.

右十味,异捣筛,合治之,以苦酒渍乌梅一宿,去核,蒸之五斗米下,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,先食饮服十丸,日三服,稍加至二十丸,禁生冷、滑物、臭食等。

Grind the herbs (except Wumei) into powder, then mix them well. Rinse the Wumei alone with vinegar overnight. Remove it’s kernel. Steam it with boiling water vapor, with 1300 gram rise, until the rise is eatable. Grind the Wumei and the rise in to mud. Add honey some amount and the herbal powder. Make it into pills about 2 to 3 cm in diameter. Eat ten pills each time, three times a day. Later gradually increase to twenty pills each time, three times a day. During taking this herbal pill, do not eat non-cooked food, cold food, sticky or oil-fried food, rotten or fertilized food.

05 伤寒六、七日,脉微,手足厥冷,烦躁,灸厥阴,厥不还者,死。

With Cold-invasion Shanghan disease for six to seven days, if the person has weak pulse, reverse cold in hands and feet, annoyed/impatience emotionally and physically, use moxibustion therapy on Jueyin meridian (Taichong point). If the reverse cold has no any improvement after the moxibustion, the one tends to die. [11]

06 手足厥寒,脉细欲绝者,当归四逆汤主之。若其人内有久寒者,宜当归四逆加吴茱萸生姜汤。

In Jueyin stage, if the person has reverse cold in hands and feet, the pulse is weak, thin and hard to feel[12], use Danggui Sini Tang. If the person has long history of Cold condition inside, add Wuzhuyu and fresh ginger in this herbal formula.

当归四逆汤方

Danggui Sini Tang

当归  三两, 桂枝  三两, 芍药  三两, 细辛  三两, 通草  二两, 甘草(炙)二两, 大枣(擘)二十五枚

Danggui 45 gram, Guizhi 45 gram, Shaoyao 45 gram, Xixin 45 gram, Tongcao 30 gram, Gancao (processed) 30 gram, Chinese date 25 badges.

右七味,以水八升,煮取三升,去滓,温服一升,日三服。

Add the herbs and 2000 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is 750 ml liquid left. Collect the herbal tea. Drink one third of the tea each time, three times a day.

当归四逆加吴茱萸生姜汤方

Danggui Sini jia Wuzhuyu Shengjinag Tang

於前方内,加吴茱萸半升,生姜三两。

Add Wuzhuyu 25 gram and Fresh ginger 45 gram into the previous Danggui Sini Tang.

右九味,以水六升,清酒六升和,煮取五升,去滓,温分五服,一方水酒各四升。

Add all herbs, 1500 ml of water, wine 1500 ml. Bring to boil and keep in mild boiling until there is about 1250 ml left. Collect the herbal tea, separate it into five parts. Drink one part each time, five times a day. In another formula, the water and the wine used are both 1000 ml.

07 病者手足厥冷,言:我不结胸,小腹满,按之痛者,此冷结在膀胱关元也。

If a person has verse Jue condition, but does not feel hard and pain in the upper stomach, but only fullness in the lower stomach, which is pain when press, it is Coldjie in urine bladder, or in the Guanyuan point. [13]

 

08 凡厥者,阴阳气不相顺接,便为厥;厥者,手足逆冷者是也。诸四逆厥者,不可下之,虚家亦然。

Reverse cold in hands and feet means the Yinqi and Yangqi cannot smoothly transfer on the hands and feet. It is also called Jue Condition. In the Jue condition, bowel-cleansing therapy should not be used. It should be used when the person is in a weak condition.

09 伤寒五、六日,不大便[14],腹濡,脉虚,复厥者,不可下,此亡血,下之死。

In Cold-invasion Shanghan disease for five to six days, no bowel movement[15], the person has soft stomach, weak pulse, has the Jue condition again, the bowel-cleansing therapy should not be used, since this is a blood depletion condition, the bowel-cleansing will cause death.  

10 伤寒病,厥五日,热亦五日,设六日,当复厥,不厥者,自愈,厥终不过五日,以热五日,故知自愈。

In Cold-invasion Shanghan disease, the person has Jue condition[16] for five days, then hot for five days[17]. On the sixth day, he usually has the Jue condition again. If not, his disease will recovery by itself.  [18] 

11 伤寒热少厥微,指头寒,默默不欲食,烦躁数日,小便利,色白者,此热除也。欲得食,其病为愈,若厥而呕,胸胁烦满者,其後必便血。

In Cold-invasion Shanghan disease, if the person has little hot mild Jue condition, feels only cold in the fingers or toes, is quiet and has low desire for eating, feels annoyed/impatience emotionally and physically for several days, has easy urine which is clear as water, it suggests that his Fire has been removed[19]. If he starts to have desire to eat, his disease is to recover; if he feel Jue condition and has nausea, feels fullness and annoyed in chest and side of upper stomach, he will have bleeding in stool. [20]

12 伤寒一、二日至四、五日,而厥者,必发热,前热者後必厥,厥深者热亦深,厥微者热亦微,厥应下之,而反发汗者,必口伤烂赤。

In Cold-invasion Shanghan disease, the person has hot on the first and second day, but has Jue condition on the fourth and fifth day. Though he has the Jue condition, he must have also hot feeling suggesting a Fire condition in the body, since if a person has fever, he will have Jue condition later. The more extent of the Jue condition, the high the fever. The less the Jue condition, the lower the fever. Such Jue condition is also called Fire Jue condition[21], meaning that the Jue condition is due to too much Fire in the body. It is different to the typical Jue condition that is due to the weak and Cold developing into the Jueyin stage.

For the Cold Jue, the warm therapy, or the Yang supplication therapy is needed; but for the Fire Jue condition, the bowel-cleansing therapy is needed to deplete the Fire through the stool. If a sweat therapy is used in the Fire Jue condition, the person will have ulcer in mouth.[22]

13 病人手足厥冷,脉乍紧者,邪结在胸中,心下满而烦,饥不能食者,病在胸中,当须吐之,宜瓜蒂散。

If a person has Jue condition, his pulse is tight from time to time, it suggests that the Xieqi is stick in the chest. In such condition, the person also feel fullness in the upper stomach, feels annoyed/impatience, feels hungry but cannot eat. Because the disease is in the chest, a vomiting therapy should be used, use Guadi San. [23]

14 伤寒脉滑而厥者,里有热,白虎汤主之

If the person has Cold-invasion Shanghan disease and has slippery pulse, it suggests he has Fire inside of the body, use Baihu Tang. [24]

15 伤寒脉促,手足厥逆,可灸之。

If a Cold-invasion Shanghan disease is with fast pulse and if the person has the Jue condition, use Moxibustion therapy. [25]

16 伤寒发热四日,厥反三日,复热四日,厥少热多者,其病当愈,四日至七日热不除者,必便脓血。伤寒厥四日,热反三日,复厥五日,其病为进,寒多热少,阳气退,故为进也。

If the Cold-invasion Shanghan disease has fever for four days, then the Jue condition for three days, then the fever again for four days, for such more fever than cold, the disease is to recover. If the fever lasts for four to seven days, there will be bleeding and pus in stool. If the Shanghan has four days of Jue condition, but only three days of fever, then five days of Jue condition, it suggests that the disease is developing worse since the Yangqi is depleting from the body.  

17 伤寒始发热六日,厥反九日而利,凡厥利者,当不能食,今反能食者,恐为除中,食以索饼,若发热者[26],知胃气尚在,必愈。恐暴热来,出而复去也,後三日脉之,其热续在者,期之旦日夜半愈。所以然者,本发热六日,厥反九日,复发热三日,并前六日,亦为九日,与厥相应,故期之旦日夜半愈。後三日脉之而脉数,其热不罢者,此为热气有馀,必发痈脓也。

In Cold-invasion Shanghan disease, the person has fever for six days, but has Jue condition for nine days and has diarrhea. The person has such Jue condition and diarrhea should have no appetite. If the person has such Jue condition and diarrhea but has appetite, be careful if he has Chuzhong[27] condition. How to know? Give him a cake. If he eats and has fever, it suggests his conditon is not Chuzhong condition, he still has Stomach function, his condition will be recovered. If the fever after eating comes suddenly and then disappears again soon, it is still a Chuzhong condition. Therefore, we must wait for three days to monitor the fever. If the fever lasts for three days, it is not the Chuzhong condition. It can then expect that his condition will get recover at noon next day or in middle night. This is because he previously has six days fever, then nine days Jue condition, now he has another three days fever, all together he has also nine days fever. The fever, the Yangqi, and the Jue condition, the Yinqi, are equal. If after the later three days of fever, his pulse is frequent, the fever continues, it means his Fire is overwhelming, he will has pus in the body.

18 伤寒脉迟, 六、七日,厥而下利[28],  而反与黄芩汤彻其热,脉迟为寒,今与黄芩汤复除其热,腹中应冷,当不能食,今反能食,此名除中,必死。

If Cold-invasion Shanghan has slow pulse for six and seven days, the person has Jue condition and diarrhea. He however is given Huangqin Tang to remove the Fire, he will have cold in stomach, loses appetite. If he remains appetite, his condition belongs to Chuzhong. He tends to die. Slow pulse suggests Cold. The use of Huangqin Tang will deplete the Yanggi from the stomach.

19 伤寒,先厥後发热而利者,必自止,见厥复利。

If Cold-invasion Shanghan has Jue condition, then fever and diarrhea, the diarrhea will stop by itself.[29]

20 伤寒先厥後发热,下利必自止,而反汗出,咽中痛者,其喉为痹,发热无汗,而利必自止,若不止,必便脓血,便脓血者,其喉不

If Shanghan has Jue condition, then fever and diarrhea, the diarrhea will stop by itself. If the person however has sweat later, feels pain in throat, he has already as throat Bi syndrome[30]. For people with fever but no sweat, even if he has diarrhea, the diarrhea will stop by itself. If it does not stop, he will have pus and bleeding in stool. In this case, he should have no throat Bi syndrome[31].

21下利脉数,有微热,汗出,令自愈,设复紧,为未解。

In Jueyin stage, if the person has diarrhea, frequent pulse, mild fever, and sweat, wait for the condition to recover by itself. If the pulse is tight again, it means the disease is not going to recover yet.  

22 下利有微热而渴,脉弱者,令自愈。

In Jueyin stage, if the person has diarrhea, mild fever, feels thirsty and has weak pulse,[32] wait for recover by itself.

23 下利脉数而渴者,令自愈,设不差,必圊脓血,以有热故也。

In Jueyin stage, if the person has diarrhea, the pulse if frequent and he feels thirsty, wait for the disease to recover by itself. If it does not recover, the person will have pus and bleeding, since there is Fire inside of the body.  

24 下利,寸脉反浮数,尺中自涩者,必圊脓血。

In Jueyin stage, if there is diarrhea, the pulse is floating the frequent in the Chun position, but harsh in the Chi position, the person will has pus and bleeding inside of the body.

25 下利脉沉弦者,下重也。脉大者,为未止,脉微弱数者,为欲自止,虽发热,不死。

In Jueyin stage, if the person has diarrhea, deep and string pulse, he will feel heavy and sticky feeling inside the anus. If he has big pulse, it indicates the disease is still under development. If the pulse is weak and frequent, it means the disease is to recover by itself. Even if he has fever, he will be alive.

26 下利欲饮水者,以有热故也,白头翁汤主之。热利下重者,白头翁汤主之。

If the person has diarrhea and has willing to drink water, it means he has Fire inside, use Baitouwen Tang. Usually if there is Fire, diarrhea with heavy and stick feeling in the anus, use the Baitouwen Tang.  

白头翁汤方

Baitouwen Tang

白头翁三两, 黄连(去须)三两, 黄柏(去皮)三两,  秦皮三两

Baitouwen 45 gram, Huanglian (remove small hair) 45 gram, Huangbo (remove skin) 45 gram, Qinpi 45 gram.

右四味,以水七升,煮取三升,去滓,温服一升,不愈,更服一升。

Add the herbs and 1750 ml water into a herbal pot. Bring to boil and keep in mild boiling until the liquid is about 750 ml. Drink one third of the herbal tea. If the diarrhea doesn’t stop, drink the second one third.  

27 伤寒下利,日十馀行,脉反实者死。

With Cold-invasion Shanghan and diarrhea, if it is more than ten times a day and the pulse is strong[33], the one will be hard to live.  

28 伤寒六、七日不利,便发热而利,其人汗出不止者死,有阴无阳故也

If the person with Cold-invasion Shanghan disease for six to seven days has no diarrhea, but has diarrhea whenever he has fever, he may live. If he has fever, diarrhea and continuous sweat, he may die. [34]

29 发热而厥,七日下利者,为难治。

If the person has fever and Jue condition, has diarrhea on the seventh day, his condition is hard to improve.

30 下利脉沉而迟,其人面少赤,身有微热,下利清谷者,必郁冒汗出而解,病人必微厥,所以然者,其面戴阳,下虚故也。(用通脉四逆汤)

In Jueyin stage, if the person has diarrhea with non-digested food in the stool, deep and slow pulse, has slight red color in the face, mild hot in the body, he will have sweat and feel cloudy mind, then to get recovered. He should also feel mild Jue condition, since he has a Daiyang condition[35]: his face is mild red in color. use Tongmai Sini Tang.

31 下利清谷, 里寒外热,汗出而厥者,通脉四逆汤主之。

In Jueyin stage, if the person has diarrhea with non-digested food in the stool, has Cold inside but Hot outside, has sweat and Jue condition, use Tongmai Sini Tang.

32 大汗出,热不去,内拘急,四肢疼,又下利厥逆而恶寒者,四逆汤主之。

In Jueyin stage, if the person has heavy sweat, continuous fever, spasm in the stomach, pain in the aims and legs, has diarrhea, Jue condition, and feels chilly, use Sini Tang.

33 大汗,若大下利而厥冷者,四逆汤主之。

In Jueyin stage, if the person has heavy sweat, heavy diarrhea and Jue condition, use Sini Tang. [36]

34 下利,手足厥冷,无脉者,灸之不温,若脉不还,反微喘者死。下利後脉绝,手足厥冷, 时脉还,手足温者生,脉不还者死。

In Jueyin stage, if the person has diarrhea, Jue condition, hard to feel the pulse, and if the moxibustion[37] fails to recover the pulse, and the person starts to have mild asthma, his condition is life-threatening. If person has diarrhea, then loses pulse, has Jue condition, but has pulse from time to time and warm hands and feet, he may live; if the pulse does not return, the Jue condition continues, he has death. 

35 伤寒发热,下利厥逆,躁不得卧者,死。伤寒发热,下利至甚,厥不止者,死。

In Cold-invasion Shanghan disease, if the person has fever, diarrhea and Jue condition, and if he feels annoyed/impatience so that he is hard to sit down or lie down[38], he is hard to be alive. If he has fever, heavy diarrhea, and the Jue condition continues[39], he will also have death. 

36 (厥阴) 呕而脉弱,小便复利,身有微热,见厥者,难治,四逆汤主之。

In Jueyin stage, if the person has nausea, weak pulse, easy urine again[40], mild hot, and Jue condition, it is hard to recover, use Sini Tang however. [41]  

37 (厥阴) 乾呕吐涎沫,头痛者,吴茱萸汤主之。

In Jueyin stage, if the person has dry nausea, vomits saliva, has headache, use Wuzhuyu Tang. [42]

38 呕家有痈脓者,不可治呕,脓尽自愈。

If a person is easy to have nausea, if he has pus and abscess, should not use any therapy aimed at the nausea. After clearing the pus and abscess, the nausea will stop. [43]

39 厥阴中风,脉微浮,为欲愈,不浮为未愈。

With Wind-invasion in the Jueyin stage, the person has slight and floating pulse, suggesting a recovery, if there is no slight floating pulse, the disease is still under development.  

40 厥阴病,欲解时,从丑至卯上。

For a disease in the Jueyin stage, it may be improved from any time between 1 am and 7 am, or it may be worse from any time of this time period.

With a proper treatment, or if the disease is in cure by itself, or if the disease belongs to a weak condition, the disease is improved from any time during this time period[44]. With an improper treatment, or if the disease is progressing, or if the nature of the disease belongs to a Shi condition, it will be worse from any time during this time period.



[44] Proper treatment plus the Yangqi movement in the Nature (moves deeper) helps the cure of the disease.



[1] This is a condition in which the person feels very thirsty, drinks lots, but has no responding amount of urine. The thirsty feeling is the most severe in the Jueyin stage, compared with any other stages. The drinking does not solve the thirsty at all. The person feels thirst, to drink, to feel thirsty again pretty soon, then drink again. This condition can be seen in some Type I diabetes patients.

[2] Jueyin meridian comes up into the chest. So the Xieqi could come up to cause hot and pain in the chest.

[3] Feels hungry, but can not eat, since the eating causes vomiting. In Shaoyang, the person has no desire to eat.

[4] Bowel-cleansing therapy cannot be used in either Shaoyang or Jueyin stages!

[5] Let the person drink water little by little. If let him drink lots once, it may cause accumulation of water in the stomach area to cause more disorders, such Yinxie syndrome and cause reverse cold in hands and feet.

[6] In original version, there is no these four words.

[7] Palpitation in the upper stomach suggests the accumulation of water there. Such person must have also difficult in urine.

[8] Reverse cold in hands and feet, and palpitation, all are due to drinking more water. The water stick to the stomach, prevents the Yangqi distribution to other parts of the body, so to cause the Jue condition. The cold in the hands and feet is the results of the water accumulation, not due to cold invasion out side of the body. Therefore, if the water accumulation is released, the cold in hands and feet is easy to remove. Reverse cold in hands and feet can be caused by either Phlegm, Shi xieqi, Cold, Fire, Qi, or Water. Here it is due to the water.

[9] Zangjue, Zang means body organs; jue: reverse cold.

[10] Huijue, Hui here means worms.

[11] Whenever the annoyed, reverse cold and weak pulse come together, the condition is life-threatening. Annoyed/impatience in this case suggests the jumping and releasing of body Yangqi. Once the Yangqi floats out of the body – the body is dead. 

[12] This condition belongs to mild condition of the Yueyin stage, since the person has no whole body skin cold, or continuous annoyed/impatience emotionally and physically yet. It is the our level of the Yueyin stage.

[13] If it is Bloodjie in the bladder, the person feels fullness and pain (when press) in the lower stomach and has easy urine; if the urine is difficult, it is Coldjie in the bladder; if the urine is harsh, hot, the hands and feet are hot, it is Firejie in th bladder; now, the person has Jue condition, the urine is clear as pure water, and the urine is frequent, all suggest Coldjie in the bladder. For Coldjie, use moxibustion on the Guanyuan point.

[14] In original version, it is “no Jiexiong syndrome”.

[15] It is “no Jiexiong condition” in original version. No bowel movement suggests the use of bowel-cleansing therapy, but it should not be used if the person has soft stomach, weak pulse and Jue condition. Such conditions can be seen commonly in person after heavy sweat, baby delivery, big bleeding, severe diseases.

[16] Reverse Jue condition.

[17] When the Yinqi comes to its peak, it starts to turn to Yangqi. Therefore the person in the Jueyin stage can have hot feeling. The hot also means that the condition comes into Shaoyang stage.  Shaoyang is Fire.

[18] Hot represents the extent of Yangqi, and Jue represents that of Yinqi. The Hot and the Jue condition are both five days, suggesting that the Yin and Yang condition is equal. On the six day, the Jue condition does not happen, so suggests that the disease will recover.

[19] In this condition, herb Gancao Ganjiang Tang can be used.

[20] When the Jue condition is accompanied with pain, fullness, annoyed, in the chest and the side of upper stomach, it suggests the Fire is deep in the body. The Fire will burn the blood vessel to cause bleeding. Xijiao Dihuang Tang can be used.

[21] In the Fire Jue condition, though the hands and feet are cold, but it can be warm from time to time, and the palm of the person is warm. For the Cold Jue condition, the cold is continuous and the palm is also cold. The Fire Jue is the standard shock during a severe infectious disease, such as in acute pneumonia. To distinguish the Fire Jue condition and the Cold Jue condition is the challenge to TCM doctors. The patient’s life is in their hands.

[22] This is because the Jueyin Liver meridian moves up into the mouth and tips.

[23] The Jue condition can be due to various reasons, not only due to the weak and cold condition in the Jueyin condition. The previous paragraph introduced the Fire Jue condition, this paragraph discusses the Cold Jiexiong in the chest. The tight pulse suggests the Cold Jiexiong condition.

[24] This is another kind of Jue condition – caused by pure Fire inside of the body, so Baihu Tang is used. If the Fire has developed deeper into Fullness Stomach condition (the person feels fullness and pain in whole stomach, hard in bowel movement), Chengqi Tang should be used. For such Baihu Tang condition, the person’s skin is cold when touch slightly, but warm when touch hard.

[25] Fast pulse with the Jue condition suggests that the Yangqi in the body is block to move to the body surface. It is not due to the short of Yangqi in the body. Therefore the moxibustion is used to conduct the Yangqi to the surface, not use the Sini Tang to supply the Yangqi to the body.

[26] In original version, it “if has no fever”.

[27] Chuzhong, a TCM term, means the stomach loses function completely.

[28] In original version, there is no “Jue condition and diarrhea”.

[29] Jue condition suggests Yinqi, and the fever, Yangqi. If there is coming of the Yangqi after the Jue condition, it means the Yangqi is more than the Yinqi. The more the Yangqi, the more chance to cure.

[30] Continued pain, tight, swelling, warm or cold feeling in the body.  Usually it refers to joint pain syndrome. Throat Bi syndrome here means the swelling is so much to cause close of the throat to swallow.

Sweat and sour throat suggests the Fire is overwhelming. The overwhelming Fire moves up to cause the throat pain. It moves down to the colon to cause ulcer in the colon, so to have pus and bleeding in stool. The Fire goes down to the colon, so there is no Fire in the throat to cause the throat Bi syndrome.

[31] Because the Jueyin meridian goes up alone the throat, it can cause the throat Bi syndrome.

[32] Here the weak pulse suggests the depletion of the Xieqi from the body, so that it is asked to wait for the disease to recovery by itself.

[33] Strong pulse in this case suggests the overwhelming of Xieqi in the body. This is a condition in which the pulse does not reflect the body its own condition, but the condition of the Xieqi.

[34] Such sweat suggests the floating of Yangqi in the out layer of the body and overwhelming of Yinqi inside. The Yangqi is depleting to die. In Yueyin stage, if the person has fever, he has high chance to live. However, if he has fever but has also following conditions, he may die: annoyed physically so that he cannot lie down; continued Jue condition; and continued sweat.

[35] Daiyang condition, a TCM concept, means the person has mild warm face, or mild red color on the face, but cold condition inside the body (the overwhelming Yinqi inside of the body: diarrhea with non-digested food in stool, deep and slow pulse). The overwhelming Yinqi pushes or refuses the Yagqi away from the body. This is dangerous condition. This is also a kind of True Cold, False Fire condition. The cloudy mind and sweat suggests the return of the Yangqi in the body, therefore suggests recover. The sweat is not the continuous sweat as indicated in previous paragraph.

[36] Continuous heavy sweat, use Guizhi jia Fuzi Tang; continuous heavy diarrhea, use Lizhong jia Fuzi Tang. Now, it is heavy sweat and heavy diarrhea, use Sini Tang.

[37] In Shaoyin stage, if the person has diarrhea, Jue condition and no pulse, use Baitong Tang. Here, in Jueyin stage, if the person has diarrhea, Jue condition and no pulse, use moxibustion.

[38] In this case, the annoyed/impatience so that he is hard to sit down or lie down suggests that his Yangqi is floating, and depleting out of the body.

[39] Continued Jue condition certainly indicates a death.

[40] In Jueyin stage, most condition is with diarrhea, the urine should be less. Now the urine becomes more, so the diarrhea should be less. 

[41] In Jueyin stage, more conditions are with diarrhea. Here the person has nausea, suggesting the development of Xieqi pushing up. 

[42] Taiyin can vomit food but no nausea; Shaoyin has willingness to vomit but no vomit, only has nausea after cough, the cough stimulates nausea; Jueyin has Jue condition, and nausea, then vomit. Taiyang, Shaoyang and Yangming have headache, but in most cases the headache is with fever; no headache in Taiyin and Shaoyin, only in the Jueyin stage, but no fever.

[43] If the nausea is with annoyed/impatience, it is due to Fire; if the nausea follows thirsty and water drinking, it is due to the water accumulation in the stomach; if there is pus and abscess inside, which can also stimulate nausea feeling. A therapy to stop a nausea tends to block the depletion of the pus and abscess too, so that it should not be used. The pus and abscess can be in the lung or in the stomach.

[44] Proper treatment plus the Yangqi movement in the Nature (moves deeper) helps the cure of the disease.