Tremors and shivering result from the contention between Yin and Yang, causing the body to shake. When pathogenic factors contend with healthy Qi on the exterior, it is called "tremor" (Zhan); when they contend within, it is called "shivering" (Li). If healthy Qi prevails over pathogens, resolution occurs through sweating; if pathogens prevail, a cold syndrome ensues. For manifestations at the exterior, Qianghuo Chonghe Tang (Qianghuo Chonghe Decoction) is used. For manifestations at the interior, Renshen Lizhong Tang (Ginseng Spleen-Regulating Decoction) is used. These are applied to true cold syndromes directly affecting the Yin meridians. For tremors resulting from transmitted heat, Dachaihu Tang (Major Bupleurum Decoction) is the appropriate treatment.

I specialize in Shanghan (Cold Damage), deeply understanding its profound principles. When the pulse is regular, the medical Dao aligns; by applying spiritual insight to medication, results are achieved effortlessly. The original meaning of the *Shanghan Lun* and subsequent discussions are fully elucidated here. The "Sha Che Chui Fa" (Method of Killing the Cart Mallet) is rare in the world and serves as an eternal treasure for health preservation. I hereby present thirty-seven secret effective prescriptions, corresponding thirty-seven "Chui" methods, twenty decoction instructions, twenty disease-seizing methods, and detoxification protocols, collectively named "Sha Che Chui." This is indeed my innermost, untransmitted wisdom. My descendants must not reveal even a single word lightly, nor share it with commoners or allow quacks to see it. It should be guarded carefully and cautiously, without violating my earnest instructions.

First: In Shanghan, if a patient exhibits manic running and cannot be restrained, first kindle a basin of fire near the patient. Pour one bowl of vinegar onto the fire so that the smoke enters the nose, calming the patient. Only then can one accurately distinguish between Yang mania (Yang Kuang) and Yin restlessness (Yin Zao), ensuring correct medication. If initially there was headache, fever, and aversion to cold which have just subsided, followed by climbing high and singing, discarding clothes and running, scaling walls and roofs, cursing and shouting, extreme thirst desiring death, and a forceful pulse, this is due to pathogenic heat transmitting inward, with excessive Yang causing mania. This is Yang mania, and cold-purgative herbs should be used. Any case presenting with tongue retraction and testicular retraction is incurable. If onset lacks headache, features slight fever, flushed face resembling floating Yang, irritability, and a deep, faint, and forceless pulse, with a desire to sit in mud or water, this is restlessness caused by extreme cold, i.e., Yin syndrome mimicking Yang. This is Yin restlessness, and warm herbs should be used. Any case presenting with cold extremities, diarrhea, and delirium is incurable. Physicians who do not examine the pulse may mistake restlessness caused by deficient Yang floating upward for excess heat, administering cooling medicines instead. This exacerbates thirst and dryness, leading to Qi depletion and severe harm. One must carefully discern whether the pulse is forceful or forceless; this is a sound method.

Second: In Shanghan, if abdominal pain is severe, give the patient one cup of cool water. If the pain alleviates slightly, it is a heat pain, treated with cooling medicines. If cooling fails, or if hard pain surrounds the umbilicus, stool is dry and hard, accompanied by irritability and thirst, it is pain caused by dry feces. Urgently use cold purgatives. Food stagnation pain is treated similarly. If lower abdominal hardness and pain occur with free urination, black stool, and jaundice of the body and eyes, it is blood stasis pain. Use cold agents combined with blood-invigorating herbs until black material is evacuated, then recovery occurs. These three cases follow the principle that pain diminishes with unblocking. If drinking water increases pain, it is a cold pain, treated with warming harmonizing medicines. If harmonization fails, or if cold extremities, abdominal pain, vomiting, and diarrhea appear, urgently use hot rescue medicines. Carefully discern the forcefulness of the pulse; this is a sound method.

Third: In direct invasion of Yin meridians with true cold syndrome, where the condition is severe and pulseless, or pulseless due to vomiting/diarrhea depleting Yuan Qi, administer half a cup each of good wine and ginger juice. If the pulse returns, the case is treatable. Medication should be guided by the pulse, regardless of floating/sinking or large/small qualities; any palpable pulse indicates life. If the pulse does not return after this method, death is certain. Additionally, ask about painful areas. If pain exists, severe pain implies a hidden pulse; adapt treatment accordingly. If no pain exists and the pulse returns, it is an auspicious sign. Specifically inquire if the patient normally lacks a radial pulse at the standard position; if so, use the dorsal hand (reverse gate pulse, Fan Guan Mai) to locate it; the pulse will appear. Diagnosis follows standard methods. If a pulse is normally present but absent during illness, check the dorsal hand. Appearance of the pulse indicates chaotic Yin-Yang, requiring harmonization. If both dorsal and palmar checks yield no pulse, death is certain. This is a sound method.

Fourth: In Shanghan, if moss coats the tongue, regardless of slippery/white/yellow/black color, wash the tongue clean with a green cloth soaked in well water. Then, frequently scrape the tongue with ginger slices dipped in water; the coating will naturally recede. Black coated tongue with prickles indicates inevitable death due to deep heat toxicity overcoming Heart Fire with Kidney Water; nine out of ten die. For jaundice, rub the whole body frequently with ginger; the yellow will fade. For stubborn evil qi in the chest, heart, or hypochondrium causing fullness, stiffness, and pain: take one jin of ginger, crush and remove juice, stir-fry until slightly dry yet moist, wrap in silk, and apply to the affected area with gentle ironing. Upon slight relief, mix residue with previous juice, dry, and iron again. After prolonged application, sudden relief occurs. These are sound methods.

Fifth: For persistent epistaxis in Shanghan, stir-fry Gardenia (Zhizi, Fructus Gardeniae) until black, powder it finely, and insufflate into the nostrils. Apply wet paper externally to stop bleeding. If bleeding is merely dripping and not flowing, the pathogen remains in the meridians; use secret formulas listed later, not this method.

Sixth: In Shanghan, after heat transmits inward and cathartics are taken, wrap one sheng of salt-fried bran in silk and gently iron the abdomen. Heat facilitates drug action, easing bowel movement.

Seventh: For uncontrollable hematemesis in Shanghan, grind Chinese Inkstone Ink (Jingmo) with leek juice and sip slowly. Blood turning black indicates cessation. If leek juice is unavailable, egg white suffices. Red corresponds to Fire, black to Water.

Eighth: In direct invasion of Yin meridians with true cold or Yin toxin syndrome, body feels beaten, severe colic, heavy retching, unconsciousness, limbs hard/cold as stone, cyanotic nails/lips, inability to swallow medicine, deep/fine or absent pulse: Bind a handful of scallions, trim roots/leaves, take ~3 cun of white part, mash into a cake. Place half fen of Musk (Shexiang, Moschus) in the umbilicus, then place the scallion cake on top. Iron with heat, replacing 2-3 cakes. Once slightly conscious, pour ginger juice and administer Huiyang Jiuji Tang (Return Yang Rescue Emergency Decoction). If unconscious, moxa Guanyuan (CV4) and Qihai (CV6) points 20-30 moxa cones to conduct heat internally, expel evil externally, and restore Yang. If hands/feet remain cold, no sweat, and unconsciousness persists after this method, death is certain. This is a sound method.

Ninth: In Shanghan febrile disease, with extreme internal heat unresolved: Decoct Coptis (Huanglian, Rhizoma Coptidis) in one cup of water, chill thoroughly in well water. Soak a green cloth and apply to the chest, changing slowly. Remove once heat subsides slightly; do not soak long. Suitable for summer, not winter.

Tenth: In Shanghan, if vomiting prevents retention of medicine: Firmly press Neiguan (PC6) with a bamboo tube. Then drink half a cup of fresh ginger juice, warmed. Vomiting stops. Generally, take cold medicines hot, hot medicines cold, and neutral medicines lukewarm. To induce sweating, even acrid-sweet formulas should be taken hot. To stop sweating, even acrid-sweet-warm formulas should be taken lukewarm. This is a sound method.

Eleventh: In wind-stroke with phlegm-jue coma, sudden collapse, unconsciousness, impending death: First, burn soap pod (Zaojiao, Fructus Gleditsiae Sinensis) powder wrapped in paper to inhale smoke. Sneezing indicates treatability. Then induce vomiting: Mix 5 fen soap pod powder, 3 fen Pinellia (Banxia, Rhizoma Pinelliae Ternatae), and 3 fen Alum (Baifan, Alumen) into fine powder. Take with ginger juice to provoke vomiting. Subsequently treat with modified Daotan Tang (Phlegm-Draining Decoction). No sneeze means untreatable. This is a sound method.

Twelfth: For Gan Huoluan (Dry Cholera) unable to vomit: Drink one bowl of boiling water mixed with 3 fen soap pod powder and a pinch of salt to provoke vomiting. Do not give rice soup; doing so causes death as grain Qi aids pathogenic Qi.

Thirteen: In Cold Strike with sudden collapse and coma: Instill half a cup each of hot wine and ginger juice. Upon slight recovery, administer Jiawei Lizhong Yin (Modified Spleen-Regulating Infusion). Non-drinkers use only ginger juice. Treat according to this method. This syndrome is common in winter, rare in other months.