【纲】仲景曰。太阳病。脉阴阳俱浮。自汗。身重。多眠。鼻鼾。语言难出。不可下。不可火。
若被火者。微则发黄。剧则惊痫螈 。
【目】吴绶曰。夫螈 者。一伸一缩。手足相引。搐搦不已。大抵与婴儿发搐相似。古人以此
症多属于风。风主动摇也。骆龙吉言心主脉。肝主筋。心属火。肝属木。火主热。木主风。风火相
扇。则为螈 也。若不因汗下所生者。当平肝木。降心火。佐以和血脉之剂。如羌、防、柴、芍、
芎、归、芩、连、生地、天麻之类。若兼有痰。必加竹沥、星、夏。如风邪内煽。加全蝎、僵蚕。
若伤寒曾经汗下后。多所传变而得。为病势已过。多难治也。盖因虚极生风所致。须用小续命汤或
大建中汤加减一二味主之。凡伤寒汗出露风。则汗不通流。遂变筋脉挛急。手足搐搦。宜牛蒡根。
如本条。由风温被火。宜葳蕤汤。若螈 戴眼反折。绝汗乃出。大如贯珠。着身不流者。此太阳终
也。不可治。又有四肢 习。动而不止。似螈 而无力抽搐者。此为肝绝。盖汗下后变生此症者多
死。
凡用小续命汤。有汗去麻黄。无汗去黄芩。要在通变而已。
【纲】仲景曰。风湿为病。脉阴阳俱浮。自汗出。身重。多眠睡。鼻息必鼾。语言难出。若被
下者。小便不利。直视失溲。若被火者。微发黄色。剧则如惊痫。时螈 。
【目】成无己曰。螈者筋脉急也。 者筋脉缓也。急则引而缩。缓则纵而伸。或缩或伸。动而
不止者。名曰螈 。俗谓之搐搦是也。内经以螈为契合之契。 为放纵之纵。以急为螈。以缓为 。
理至明矣。螈 者。风疾也。而癫痫则螈 焉。伤寒螈 者。邪实气极也。热盛则风抟并经络。
风主动。故四肢螈 而不宁也。风湿被火而螈 。言热气之剧盛
也。伤寒至于发螈 。病势已过矣。内经曰。太阳终者。戴眼反折螈 。绝汗乃出。大如贯珠。着
身不流。是见其螈 为已过之疾也。螈 之症虽剧。若能以祛风涤热之剂折其大势。则亦有生者。若妄灼灸。或与发表
之药。必死。经曰。一逆尚引日。再逆促命期。
鳌按。此乃风热甚之病。宜祛风散热为主。然或有一二可生耳。非谓其必生也。
【纲】张仲景说：太阳病（太阳经受邪所致的病证），脉象寸关尺三部均浮，自汗出，身体沉重，嗜睡，鼻息有声（打鼾），言语困难。不可使用攻下法，不可使用火疗。
如果误用火疗，轻则导致发黄，重则出现惊悸、癫痫及抽搐（肢体筋脉拘急松弛交替发作）。
【目】吴绶说：所谓抽搐（螈疭），表现为手足一伸一缩，相互牵引，搐搦不止。大体上与婴儿发生惊风抽搐相似。古人认为此症多归属于风邪，因为风性主动摇。骆龙吉说：心主血脉，肝主筋脉。心属火，肝属木。火主热，木主风。风与火相互煽动，就会形成抽搐。如果不是因发汗或攻下引起的，应当平抑肝木，清降心火，辅以调和血脉的药物，如羌活、防风、柴胡、白芍、川芎、当归、黄芩、黄连、生地黄、天麻之类。如果兼有痰湿，必须加入竹沥、天南星、半夏。如果是风邪内盛煽动，加入全蝎、僵蚕。如果是伤寒经过发汗或攻下后，病情多已传变而产生，属于病势已过阶段，大多难以治疗。这是因为极度虚弱而生内风所致。须用小续命汤或大建中汤加减一二味来主治。凡是伤寒出汗后受风，导致汗液不通畅流动，进而变为筋脉挛急，手足搐搦，适宜用牛蒡根。如本条所述，由风温误用火疗引起，适宜用葳蕤汤。如果出现抽搐、眼球上翻、角弓反张，绝汗流出，汗珠大如串珠，粘在身上不流动的情况，这是太阳经气终绝的表现，不可治愈。又有四肢颤动（瞤动），动个不停，类似抽搐但无力抽搐的，这是肝气绝的表现。大概是因为发汗或攻下后变生此症的，大多死亡。
凡是用小续命汤，有汗者去掉麻黄，无汗者去掉黄芩，关键在于灵活变通而已。
【纲】张仲景说：风湿致病，脉象寸关尺三部均浮，自汗出，身体沉重，嗜睡，鼻息必然打鼾，言语困难。如果被误用攻下法，会导致小便不利，直视，大小便失禁。如果被误用火疗，轻则微现黄色，重则像惊痫一样，时时发生抽搐。
【目】成无己说：抽搐（螈）是筋脉拘急，瘛（疭）是筋脉弛缓。拘急则牵引而收缩，弛缓则舒展而伸长。或收缩或伸长，动个不停，名叫抽搐（瘛疭）。俗称搐搦。《内经》将“螈”解释为契合之契（引申为紧缩），将“瘛”解释为放纵之纵（引申为舒张）。以急为螈，以缓为瘛，道理非常明白。抽搐（瘛疭）是风疾，而癫痫也伴有抽搐。伤寒引起的抽搐，是邪气实而正气极虚。热盛则风邪搏结于经络，风性主动，所以四肢抽搐而不安宁。风湿被火疗灼烧而引发抽搐，说明热气极其旺盛。伤寒发展到发生抽搐，病势已经过了极期。《内经》说：太阳经气终绝时，会出现眼球上翻、角弓反张、抽搐，绝汗流出，汗珠大如串珠，粘在身上不流动。这说明出现抽搐是病势已过的疾病表现。抽搐的症状虽然剧烈，如果能用祛风涤热的药物遏制其大势，也有存活的可能。如果妄用艾灸，或与发表的药物，必定死亡。经文说：一次误治尚且拖延时日，再次误治就会加速死亡。
[General Principle] Zhang Zhongjing stated: In Taiyang disease (a syndrome caused by pathogenic invasion of the Taiyang channel), the pulse is floating at all three positions (cun, guan, chi). There is spontaneous sweating, heaviness of the body, somnolence, snoring, and difficulty in speaking. Purging methods should not be used, nor should fire therapy be applied.
If fire therapy is mistakenly applied, mild cases may result in jaundice, while severe cases may lead to fright, epilepsy, and chi-zong (alternating contraction and relaxation of tendons and sinews).
[Annotation] Wu Shou said: Chi-zong refers to a condition where the limbs extend and contract alternately, pulling against each other, with continuous spasms. It is generally similar to convulsions seen in infants. Ancient physicians attributed this syndrome mostly to Wind, as Wind is characterized by movement and tremor. Luo Longji stated: The Heart governs the blood vessels, and the Liver governs the sinews. The Heart belongs to Fire, and the Liver belongs to Wood. Fire corresponds to Heat, and Wood corresponds to Wind. When Wind and Fan stir each other, chi-zong occurs. If this condition does not arise from sweating or purging therapies, one should soothe the Liver Wood, descend Heart Fire, and assist with agents that harmonize the blood vessels, such as Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Chai Hu (Bupleuri Radix), Bai Shao (Paeoniae Radix Alba), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), Huang Qin (Scutellariae Radix), Lian Zi (Coptidis Rhizoma), Sheng Di Huang (Rehmanniae Radix), and Tian Ma (Gastrodiae Rhizoma). If phlegm is also present, Zhu Li (Bambusae Succus) and Nan Xing (Arisaematis Tuber), Ban Xia (Pinelliae Rhizoma) must be added. If internal Wind pathogen is stirring vigorously, Quan Xie (Scorpio) and Jiang Can (Bombyx Batryticatus) should be added. If this arises after sweating or purging in a Shanghan (Cold Damage) case, it indicates that the disease has progressed through many transformations; the pathological process is largely exhausted, and it is difficult to treat. This is caused by extreme deficiency generating internal Wind. One should use Xiao Xu Ming Tang (Minor Continuation of Life Decoction) or Da Jian Zhong Tang (Major Construct the Middle Decoction) with minor modifications. Whenever sweating occurs in Shanghan followed by exposure to wind, sweat flow becomes obstructed, leading to tendon and vessel spasm and limb convulsions; Niu Bang Gen (Arctii Radix) is suitable. As in this specific clause, if caused by Wind-Wen (Wind-Heat) mistaken for fire therapy, Zhe Yu Tang (Zhe Yu Tang, Reed Rhizome Decoction) is suitable. If chi-zong is accompanied by Dai Yan (upward deviation of the eyes), Fan Zhe (opisthotonos), and Jue Han (collapse sweat) flowing out like beads strung together that do not flow away upon touching the body, this signifies the termination of the Taiyang channel; it is incurable. There is also a condition where the four limbs tremble continuously, resembling chi-zong but without forceful spasms; this indicates the exhaustion of the Liver Qi. Generally, when this syndrome arises after sweating or purging, death is likely.
When using Xiao Xu Ming Tang, remove Ma Huang (Ephedrae Herba) if there is sweating, and remove Huang Qin if there is no sweating; the key lies in flexible adaptation.
[General Principle] Zhang Zhongjing stated: In diseases caused by Wind-Dampness, the pulse is floating at all three positions. There is spontaneous sweating, heaviness of the body, somnolence, snoring, and difficulty in speaking. If mistakenly treated with purging, it leads to dysuria, fixed gaze, and incontinence of urine and feces. If mistakenly treated with fire therapy, mild cases result in slight yellowing of the skin, while severe cases resemble fright and epilepsy, with intermittent chi-zong.
[Annotation] Cheng Wuji said: "Chi" refers to the tension of tendons and sinews, while "Zong" refers to their relaxation. Tension causes contraction, and relaxation causes extension. Alternating contraction and extension with continuous movement is called chi-zong, commonly known as spasms. The Nei Jing interprets "chi" as fitting together tightly (contraction) and "zong" as letting go loosely (relaxation). Considering tension as chi and relaxation as zong makes the principle very clear. Chi-zong is a Wind disease, and epilepsy also involves chi-zong. Chi-zong in Shanghan indicates excess pathogen and extreme depletion of healthy qi. When heat is excessive, Wind pathogen binds to the meridians. Since Wind is active, the four limbs undergo chi-zong and restlessness. Wind-Dampness triggered by fire therapy leading to chi-zong indicates extreme abundance of Heat. When Shanghan progresses to cause chi-zong, the disease momentum has passed its peak. The Nei Jing states: When the Taiyang channel terminates, symptoms include Dai Yan, Fan Zhe, and chi-zong, along with Jue Han flowing out like beads that do not flow away. This shows that the appearance of chi-zong indicates a disease in its terminal stage. Although the symptoms of chi-zong are severe, if one can suppress the major trend using agents that dispel Wind and purge Heat, survival is possible. However, if cauterization is wrongly applied, or diaphoretic drugs are given, death is inevitable. The Classic says: One error may prolong life for a time, but two errors will hasten death.
Shen Jin'ao commented: This is a disease of severe Wind-Heat, primarily requiring treatment to dispel Wind and dissipate Heat. However, perhaps only one or two cases might survive; it does not mean they will definitely survive.