| The research paper contains the following four sections:The historical and present study of JueYin diseaseThe research of the Origin of JueYin disease theoryThe study of JueYin disease pulses together with syndromesConclusionThe below is the brief overview.1 The historical and present study of JueYin diseaseThe first section introduces the past and present study of JueYin disease by summarizing documents. There is a particular topic of "study JueYin disease in MingGuo (1911- 1940's) period", focus on Lu Yuan Lei. It's because that Lu is considered the first person to completely disagree JueYin disease. Lu is a scholar and a practitioner. His opinion has been well valued by people after him. The peak arguments of JueYin disease occurred after 50's of the last century, are well related to his idea.Lu has three obvious viewpoints. The first one is that there is no clue to study JueYin disease. He said "JueYin chapter in ShangHan Lun, is a suspicious case over centuries. In the chapter it states that there are only four items for JueYin disease, and besides the first item Synopsis has syndromes, the rest three are not detailed and hard to understand, no trace to study it". The second is that the JueYin chapter is a mixture. He said "since the entire body deficient cold is ShaoYin, abdominal deficient cold is TaiYin, then there is no other deficient cold syndrome can be JueYin. So the purpose is to make up to six Jing (meridians), just like cutting heel to fit the shoe". Third is that there is no corresponding disorders of JueYin disease. He doesn't agree "Mr. TieJiao considers that abdominal disorders with wind" is JueYin disease, neither he agrees with Zhang TaiYan that relapsing fever is the JueYin disease. Lu again remarks, "There is no JueYin, in addition to ShaoYin and TaiYin".The second topic in the first section is "The center of JueYin disease controversy and study". This part combs the main issue of the disagreement. Since the modern disagreement are based on the point of view of the doctors in history, cannot completely separate present to past, so sum them up to discuss. The major differences include synopsis, syndromes, formulas, cold and heat property, where is JueYin disease coming from, whether JueYin disease the laststage of Heat disease, etc. Based on those, some scholars from the point of published book editions, bring up again the idea that there are only four items in JueYin chapter, initiate to divide JueYin chapter to two parts, one is JueYin disease, and the other is diarrhea and vomiting. This paper attempts to discuss and prove that idea of four items is helpful, and it doesn't work to separate four items.The reason of disagreement about JueYin disease is that major trace to connect the entire chapter has not been found yet. It seems that the first four items didn't go with the rest. This is the root cause of the JueYin disease disagreement. It's also the confusion of scholars whom ever since Lu to promote that there are only four items in JueYin disease. This discovery determined my research direction.2 The research of the Origin of JueYin disease theoryThe particular discussion of this topic is not found before. With the question of where the JunYin disease theory comes from, I have read Huang Di Nei Jing thoroughly. I have found that the theory is from Su Wen - Re Lun (discussion of Heat), moreover, it's from Su Wen -Zhi ZhenYao Da Lun.JueYin disease shows the academic ideas of Su Wen - Zhi ZhenYao Da Lun.In the Su Wen - Zhi ZhenYao Da Lun, while it discusses that JueYin governs the Sky, JueYin locating at the spring, JueYin's invading and over-invading;it brings up all symptoms of JueYin disease. Those are: capturing upper abdominal Qi and surging, causing the upper abdominal pain, food and drink cannot digest, vomiting if eating;going down block the spleen Yang to cause abdominal bloating, cold and diarrhea, difficulty urine. The severe ones die with upper abdominal Qi exhausted. The mechanism is that the Wood invading the Soil. In addition to have the similar symptoms, the JueYin invading also includes JueYin heat transformation syndrome, "Qi builds up in side chest, transform to heat", also JueYin heat diarrhea that "abdominal pain, and diarrhea with mucus and blood. Over-invading of JueYin adds "QinJue", hands and feets cold. All the above descriptions have established the fundamental of JueYin theory.In the JueYin chapter of the Shang Han Lun, Jue heat invading and over-invading is consistence with invading Qi and over-invading Qi concept in the Su Wen - Zhi ZhenYao Da Lun.In the Su Wen - Zhi ZhenYao Da Lun, it also describes the appearances of invading and over-invading. Invading means that too much evil Qi invades other organs. Over-invading means that invaded organs retaliate. In the Shang Han Lun, many indicators of Jue Heat invading and over-invading are the same as the above.In the Ling Shu - Shang Ge (diaphragm) No. 68, it discusses the reasons of upper heat and lower cold, and roundworms going up. Lower cold is because of "inappropriate emotion", "eating without control", "cold and warm at the wrong time". The mechanism for Lower cold is that "cold fluid flowing in the Intestine". In addition, worms building up in the abdomen can cause welling abscess, further to pus.The above paragraph in the classic works can be viewed as the origin source of JueYin disease roundworm Jue syndrome. Also it helps to understand why the following is in the JueYin disease chapter, "vomiting with welling abscess and pus, do not treat vomiting, it will stop when pus is gone".The above discussion suggests that the concept of JueYin disease theory is from Huang Di Nei Jing. Upper heat and lower cold syndrome in its Synopsis, Jue syndrome, Jue Heat invading and over-invading, Jue diarrhea and heat diarrhea, vomiting, roundworm Jue, spitting pus and blood, and JueYin is the end of three Yins, the root of JueYin is cold, and it transforming to heat, all can find footprints in the Su Wen - Zhi Zhen Yao Da Lun and Shang Ge chapter.From the related discussions in Huang Di Nei Jing, we can follow the main ideas of Zhang ZhongJing when writing JueYin disease chapter, and this can help to understand JueYin disease in depth. This is also requirement (expectation) from Zhang to whom studying Shang Han Lun. He said in the introduction, "If can find my collections, already learned most of it." "Find my collections" not means the material of Shang Han Za Bin Lun, but more important is the idea of ZhongJing.3 The study of JueYin disease pulses together with syndromesThis section provides a full analysis and methodically discussion of the JueYin disease chapter. It also raises my ideas towards controversy of the JueYin disease chapter. This is the longest section of the paper, includes many of my ideas.The mechanism of the JueYin disease: At the upper part, Liver captures Stomach Qi surging. At the lower part, Liver blocks the Spleen Yang diarrhea. When all shut, then becomes open, open then shut, Jue Heat invading and getting hit back. Completely blockage leads to exhaustion, Yang Qi is all gone.JueYin catches pathogenic factors, Liver Qi moves abnormally, captures upper abdomen (Stomach) pushing up, and leads to Upper Heat symptoms in JueYin Synopsis. If it doesn't surge, stays and gathers in the upper abdomen to transform to YangMing, or becomes symptoms need purge. If not surging but forced to go down, it's heat diarrhea. If blocked in the upper abdomen, causes Stomach Yang failure (gone). It's "Chu Zhong" (eliminate the Middle burner). Overall, Liver Qi invading upper abdomen is Heat, upper abdomen belongs to Yang and has dry property. Pathogenic factors goes to dry property, all transform to Heat. But if it gets shut inside to failure, heats will sudden transform to cold, "each approaches to its limitation".The Spleen governs up-rise and clear, and controls moving and transforming. If spleen doesn't go upwards and clear, then it will cause diarrhea. If Spleen doesn't move then there is no more resource to transform. Actions of Spleen depend on spreading of Spleen Yang, which depends on open function of Liver. Actually, Liver owns the power to control Spleen. When JueYin catches pathogenic factor, Liver blocks Spleen Yang, diarrhea is common to seen with hands and feet cold. It's JueYin diarrhea. JueYin diarrhea is different from TaiYin diarrhea and ShaoYin diarrhea. Although all three Yin diarrhea are deficient cold, TaiYin deficient cold is from the middle burner Yang deficiency, and ShaoYin deficient cold is from the lower burner Yang deficiency. But JueYin deficient cold is from Liver blocking Spleen Yang. When Liver blocking Spleen Yang, Yang cannot arrive to Spleen. Without Yang the Spleen is cold, cold causes diarrhea. Completely block causes exhaustion, then to die. So JueYin diarrhea is dangerous.JueYin also has heat diarrhea. It's caused by Liver abnormal Qi does not gather in the upper abdomen, whereas it is forced to go down to intestine. So it does not have vomiting roundworm, Qi moving up hits the Heart, and chest pain and heat syndromes, etc. The majority is heat diarrhea. When JueYin abnormal Qi gathers at the Stomach, or is forced to intestine, depend on where is the deficiency. Deficient locale is easy to be attacked by pathogenic factors. If upper abdomen is deficient, then backwards Qi gathers in the upper abdomen. If Intestine is often deficient, heat will be forced down to the Intestine.The above are caused by the Liver Qi moves towards wrong directions. It doesn't matter that it captures the upper abdomen surging, or blocks Spleen diarrhea, it shows that Yin Qi and Yang Qi don't connect to each other.JueYin disease pulse indicatorsIn the JueYin disease chapter, there are 20 items describe about pulses, taking more than 2/3 of total 56 items. It shows that Zhang ZhongJing paid lots of attention to pulse indicators of the JueYin disease. Carefully study pulses helps to understand JueYin disease mechanism better.The JueYin disease pulses can divide to three groups. The first, pulses that Yang Qi moves smoothly after blocking, contains "slightly float", "weak pulse", "rapid pulse", and "slightly weak rapid pulse". The common one is "rapid pulse". The item 332, 361, and 367 talk about after Jue (extremities cold) and diarrhea, rapid pulse means healed, or Yang hits back too much. ZhongJing emphases it over and over, definitely there are remarkable meanings behind it. Rapid pulse with feeling warm, rapid pulse with slight warm sweating, rapid pulse with thirst, all talk about JueYin's Yang gets hit back. Also it differs JueYin diarrhea from TaiYin and ShaoYin diarrhea. TaiYin and ShaoYin diarrhea are cold, JueYin diarrhea is blocking. Treat cold with warm, treat blocking with warm open. When blocking cold pathogens sudden occur, Yang Qi cannot move, hands and feet become cold, Yin cold diarrhea, but it's not real cold. Once pathogenic factor is dispelled, Yang Qi circulates, can reach inside and outside, then feels warm with rapid pulse, sweating and thirst, JueYin diarrhea will disappear in a short time. This is character of JueYin diarrhea. Without knowing that "Liver blocking Spleen Yang", cannot understand JueYin heat invading and over-invading and JueYin diarrhea. Although the three items don't have the title of JueYin disease, they indeed discuss the JueYin disease.The second group is pulses of Liver Qi block. Liver blocking Spleen Yang, intestine cold diarrhea, are main signs of the JueYin diarrhea. The pulses are consistent with its mechanism. Main pulses are: deep wiry, tight, weak pulse, pulse not coming, no pulse, pulse gone, rapid pulse, and false excess pulse. The pulses indicate the mechanism of JueYin blocking, blocking Stomach Yang, or blocking Spleen Yang. Reducing of block leads to feeling warm, blocking more leads to the Jue (extremities cold) and diarrhea, Completely block leads to death.The third group of pulses is: slow pulse, slippery pulse, thin pulse almost can't feel, sudden tight pulse. They fit in JueYin miscellaneous diseases and like-wise syndromes, to differ from the JueYin disease.Study of the JueYin diseases main symptoms and causesDiscussions are in eleven sub-topics. First, explain why the item 326 is Synopsis of JueYin disease. Then discuss about the number one symptom of JueYin disease "XiaoKe" (wasted thirst) is caused by "water not return to good side", not caused by "lots of Heat consumers up water", which is considered correct over years. Because the XiaoKe symptom is related to how to understand the causes of JueYin disease, so need to clarify. Ever since Cheng WuYi explained it as "lots of Heat consumers up water", many scholars followed;this is a mistake of a wise scholar. "Lots of Heat consumer up water" can explain that thirst leads to drink, no longer thirsty after drink in YangMing disease. But it cannot explain XiaoKe in JueYin disease. XiaoKe person feels thirsty and like to drink water, but after drink, still feels thirsty. The reason is that JueYin Qi mechanism malfunctions, drinking water cannot transform to the body fluid, water is still water, and thirsty person still feels thirsty. Water stays in the upper abdomen, or goes out with urine, or bowl movement. Fu Lin Gan Cao Tang syndrome can prove it. It can also refer to Xu ShuWei's clinical cases study.Roundworm Jue is a sign of JueYin disease surging at the upper part and blocking at the lower part. It's not roundworm disorder. In the Jin Gui Yao Yue, roundworm disorder has its own synopsis, the treatment principle is to capture and kill roundworm by Gan Cao Fen Mi Tang. Whereas roundworm Jue is a sign of the JueYin disease, Liver Qi malfunction breaks up the living environment of roundworm, spitting roundworm is only one of its symptoms."Chu Zhong" (eliminate the Middle) syndrome of JueYin disease is "liver blocking Stomach Yang", to eliminate the middle soil. It's not the Yin cold. "Chu Zhong" occurs after the Heat Jue (internal heat and extremity cold). If "Chu Zhong" doesn't happen, the Heat Jue can be gone or Yang over-invading too much causes "welling abscess with pus". Clearly the Yin Cold does not cause it. If so, it cannot be Yang over-invading too much. "Chu Zhong" is a server result of "Liver blocking Stomach Yang". JueYin catches pathogenic factors, Liver Qi malfunctions, Stomach Qi is blocked, initially there is more and more inner heat, and if blocked for a long period then it loses ability to produce Yang Qi. Pathogenic factors and Heat sudden explodes to outside become "Chu Zhong".Zhang (Dirty) Jue, mostly consider as the development of ShaoYin cold Jue. In fact, it's a dangerous syndrome of the JueYin disease. Its locale is at JueYin Liver, not at the ShaoYin Kidney. It can be seen from treatment of moxa JueYin. The JueYin cold is because of Qi mechanism is blocked, Completely block can cause exhaustion and failure, should open Yang, moxa JueYin is to warm it to open. After moxa if Yang Qi circulates then can survive, else "Jue cannot return will die".Indications of the JueYin disease severe syndrome can be unclear spirit and tetanic reversal, scrolled and draw in tongue, but more are the Jue (hands and feet cold) and diarrhea. Most of JueYin death syndromes are combined Jue (hands and feet cold) and diarrhea. The root cause is Liver blocking Spleen Yang, Yang Qi is gone because of obstruction.Deep Jue and Deep Heat mean that YangMing catches pathogenic factors. In the section that discussion of mechanism, I have discussed about mechanism that JueYin transforms to YangMing. JueYin catches pathogen factors, Liver Qi malfunctions, often capturing Stomach Qi transforms to fire then surge. Therefore XiaoKe, Qi going upward hits heart, chest pain and heat, spitting roundworm syndromes take place. If Stomach is excess, it will not surge, just stay in the upper abdomen, gets more and more there, so should clear and purge. Together with the item 335, the item 374 should have the JueYin disease first, then diarrhea and delirious speech, and dry stools, so diagnosis it as JunYin returning to YangMing. If there isn't JueYin disease at first, then it's YangMing disease. The item 335 "Deep Jue and Deep Heat", "Jue need purge." It has symptoms need to purge, also cold hands and feet. Cold hands and feet are not caused by that Liver blocks Stomach Yang. It's caused by Yang Ming Heat stagnation;it's called JueYin returning to YangMing.In conclusion, the JueYin disease is a stage of many disorders, not the entire process of one disorder. So JueYin disease can be seen in many disorders, but there isn't any singe disorder to corresponding to JueYin disease.The paper also discusses the treatment principle and formulas of the JueYin disease, transforming and returning of the JueYin disease, and early preventing of JueYin disease progress to death syndrome. Also, the paper provides analysis and diagnosis of JueYin miscellaneous diseases, like-wise syndromes and severe cases.Limited to the size of abstract, there are some contents in the paper are not mentioned here.
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