病源猝死者，由三虚而遇贼风所为也，三虚，谓乘年之衰一也，乘月之空二也，失时之
和三
绝如
中恶
不能
又猝忤死候，犯猝忤客邪鬼气猝急伤人，入于腑脏，使阴阳离绝，气血暴不通流，奄然
厥绝如死状也，良久阴阳之气和乃苏，若腑脏虚弱者死，亦有虽苏而毒瓦斯不尽，时发即心腹
刺痛，连滞变成疰也。（并出第二十三卷中）
甲乙经云，黄帝问于岐伯，有猝死者，何邪使然。答曰，得三虚者，暴疾而死，得三实
者，邪不能伤也。黄帝曰，愿闻三虚。答曰，乘年之衰，逢月之空，失时之和，因为贼风所
伤也。愿闻三实，答曰，逢年之盛，遇月之满，得时之和，虽有贼风邪气，不能伤也，有猝
死不知人，有复生，何气使然，阴气先竭，阳气未入，故猝死而不知人，气复则生。（集验
同出第六卷中）
肘后云，猝死中恶及尸厥者，皆天地及人身自然阴阳之气，有乖离痞隔，上下不通，偏
竭所致，故虽涉死境，犹可疗而生，缘气未都竭也，当尔之时，兼有鬼神于其间，故亦可以
符术护济者。
又猝死，或先有病痛，或居常倒仆，奄忽而绝，皆是中恶之类疗方。
取葱刺鼻，令入数寸，须使目中血出乃佳。一云耳中血出佳，此扁鹊法，同后云吹耳中
，葛氏吹鼻，别为一法。（肘后集验备急文仲必效等同崔氏亦疗中恶）
又方
令二人以衣壅口，吹其两耳，亦可以苇筒吹之。（肘后同）
又方
以葱刺耳，耳中鼻中血出者勿怪，无血难疗之，有血者，是活候也，其欲苏时，当捧两
手莫放
立效，
又方
视其上唇里弦，有青息肉如黍米大，以针决去之瘥。（肘后同）
又方
以小便灌其面，数过即能活，扁鹊法也。（肘后集验张文仲备急同）
又方
以绵渍好酒纳鼻中，手按令汁入鼻中，并持其手足，莫令惊动也。（肘后同）
又方
灸其唇下宛宛中，名承浆，十壮大良。（肘后同并出第一卷中）
文仲疗猝死方。
湿牛马粪绞取汁，以灌其口中，令入喉，若口已噤者，以物强发，若不可强发者，扣折
齿下之，若无新者，以水若人尿和干者，绞取汁，扁鹊法。（集验备急肘后同）
又方
以细绳围其人肘腕中，男左女右，伸绳从背上大椎度，以下行脊上，灸绳头。（一云五
十壮）又从此灸横行各半绳，此凡三灸，各灸三壮即起。
又方
令人痛抓其人人中取醒，不起者卷其手，灸下纹头，随年壮。
又方
灸鼻下人中三壮。
又方
灸脐中百壮。
又方
半夏末如大豆许，吹鼻中。
又方
捣薤若韭取汁，以灌口鼻中。（张文仲集验范汪同）
又方
猪膏如鸡子大，苦酒一升，煮沸灌喉中。（集验肘后备急同）
又猝死而壮热者方。
矾石半斤，煮以渍脚，令没踝。（肘后范汪同并出第一卷中）
备急疗猝死而目闭者方。
骑牛临其面，捣薤汁灌耳中，末皂荚，吹鼻中。（集验文仲肘后范汪同）
又疗猝死而张目反折者方。
灸手足两爪甲后各十四壮，饮以五毒诸膏散，有巴豆者良。（肘后张文仲同）
又疗猝死而四肢不收失便者方。
马屎一升，水三斗，煮取二斗，以洗足，又取牛粪一升，温酒和灌口中。（肘后同）
又方
灸心下一寸，脐上三寸，脐下四寸，各百壮良。（肘后同）
又猝死而口噤不开者方。
缚两手大拇指，灸两白肉中二十壮。（肘后文仲范汪同并出第一卷中）
集验疗猝死无脉，无他形候，阴阳俱竭故也方。
牵牛临鼻上二百息，又炙熨斗以熨两胁下，针两间使各百余息，灸人中。
又疗猝死而有脉形候，阴气先尽，阳气后竭故也方。
嚼薤哺灌之。（肘后文仲千金范汪同并出第一卷中）
古今录验司空三物备急散，疗猝死及感忤，口噤不开者方。
巴豆（去心皮熬） 干姜 大黄（各等分）
上药捣筛为散，服如大豆许二枚，以水三合和之，腹胀烦热复饮水，能多益佳。
又疗心腹痛几死，服此丸令小利瘥，如腹常满痛，当令得下瘥，一方服一刀圭，以酒下
之，不能刀圭者，便丸如大豆许四枚，不知复加一豆许，不瘥又加一豆许，若病者口噤不能
自饮，掘口含之，药不预合，预合气力歇，猝病者，便合之，无臼，木杯中捣耳，不过三服，
取利无不瘥者，蜜丸尤良。（出第四卷中）
【背景信息】
书名：外台秘要 作者：王焘 朝代：唐·天宝十一年 章节：猝死方二十四首 类别：方剂
【原文翻译】
导致猝死的病因，是由于人体处于“三虚”状态时又遭遇贼风（指来势迅猛、致病力强的风邪）侵袭所致。“三虚”，指的是：其一，逢岁运不及之年（年之衰）；其二，逢月缺无光之时（月之空）；其三，违逆四时气候之和调（失时之和）。
又有猝然被客邪鬼气冲撞而死的证候，这是因猝然遭受客邪鬼气急迫伤人，病邪侵入腑脏，致使阴阳之气离绝，气血突然阻塞不通，患者忽然昏厥，状如死亡。若经过较长时间，阴阳之气调和则苏醒；若腑脏虚弱者则会死亡。也有虽然苏醒但毒瓦斯未尽，时常发作引起心腹刺痛，迁延日久变成疰病（一种慢性消耗性传染病或具有传染性的疾病）。（以上均出自《外台秘要》第二十三卷）
《甲乙经》记载：黄帝问岐伯，人有猝死者，是什么邪气造成的？岐伯回答说，得“三虚”的人，会暴疾而死；得“三实”的人，邪气不能伤害他。黄帝说，我想听听什么是“三虚”。岐伯回答说，逢岁运不及之年，遇月缺无光之时，违逆四时气候之和调，因此被贼风所伤。黄帝说，我想听听什么是“三实”。岐伯回答说，逢岁运旺盛之年，遇月圆光亮之时，得四时气候之和调，即使有贼风邪气，也不能伤害人体。又有猝然昏迷不知人事，后来又能复生的，是什么气使然？岐伯回答说，阴气先竭，阳气未入，所以猝然昏迷不知人事，气机恢复则生。（以上内容与《集验方》同出第六卷）
《肘后备急方》记载：猝然死亡、中恶及尸厥（一种类似假死的病症），都是天地及人身自然阴阳之气乖离痞隔，上下不通，偏侧衰竭所致，所以虽然处于濒死之境，仍可治疗而存活，因为元气尚未完全枯竭。在那个时候，兼有鬼神作祟于其间，所以也可以用符咒法术来护佑救济。
另外猝死，或者先前有病痛，或者平时突然跌倒仆倒，忽然断气，都属于中恶类的治疗方剂。
取葱叶刺入鼻腔，令其进入数寸深，最好能使眼中出血。另一种说法是耳中出血为佳，这是扁鹊的法子，同后文所述吹耳法一样。葛氏的吹鼻法，则是另一种方法。（《肘后备急方》、《集验方》、《备急千金要方》、《必效方》等同崔氏也治疗中恶）
又一个方子：
让两个人用衣服堵住患者的口，向他的双耳吹气，也可以用芦苇筒吹气。（《肘后备急方》相同）
又一个方子：
用葱叶刺耳，耳中和鼻中出血不要奇怪，不出血则难治，有血的是活征象。患者将要苏醒时，应当托住双手不要放开。此法立竿见影。
又一个方子：
观察其上唇内侧，若有青色息肉如黍米大，用针挑破去除即可痊愈。（《肘后备急方》相同）
又一个方子：
用小便浇灌面部，多次后即可复活，这是扁鹊的法子。（《肘后备急方》、《集验方》、张文仲《备急方》相同）
又一个方子：
用丝绵浸泡在好酒中，塞入鼻中，用手按压令汁液流入鼻中，并握住其手足，不要让患者受惊动。（《肘后备急方》相同）
又一个方子：
灸嘴唇下方凹陷处，名为承浆穴，灸十壮效果好。（《肘后备急方》相同，并出第一卷）
张文仲治疗猝死的方子。
湿牛马粪绞取汁液，灌入患者口中，令其进入咽喉。如果牙关紧闭，用器具强行撬开；如果不可强行撬开，则敲碎牙齿下部的牙齿。如果没有新鲜的粪便，用水或人尿调和干粪，绞取汁液，这是扁鹊的法子。（《集验方》、《备急千金要方》、《肘后备急方》相同）
又一个方子：
用细绳围绕患者肘腕部，男子左臂，女子右臂，将绳子从背上大椎穴度量，沿脊背下行，灸绳头处。（一说灸五十壮）。又从此处横向各量半根绳的长度，在此处施灸。总共三次灸法，每次灸三壮即起效。
又一个方子：
让人用力掐按患者的人中穴使其苏醒，若不醒，则卷起其手，灸手掌横纹头处，用量随年龄而定壮数。
又一个方子：
灸脐中一百壮。
又一个方子：
半夏末如大豆大小，吹入鼻中。
又一个方子：
捣薤白或韭菜取汁，灌入口鼻中。（张文仲、《集验方》、范汪方相同）
又一个方子：
猪膏如鸡蛋大，苦酒一升，煮沸后灌入喉中。（《集验方》、《肘后备急方》相同）
又治疗猝死后出现壮热症状的方子：
矾石半斤，煮水浸泡双脚，令水面没过脚踝。（《肘后备急方》、范汪方相同，并出第一卷）
《备急千金要方》治疗猝死后眼睛闭合的方子：
骑在牛身上对着患者的脸，捣薤汁灌入耳中，皂荚研末，吹入鼻中。（《集验方》、张文仲、《肘后备急方》、范汪方相同）
又治疗猝死后眼睛睁开、身体反折的方子：
灸手足两爪甲后方各十四壮，服用五毒诸膏散，含有巴豆的更好。（《肘后备急方》、张文仲相同）
又治疗猝死后四肢松弛不收、大小便失禁的方子：
马屎一升，水三斗，煮取二斗，用来洗脚；又取牛粪一升，用温酒调和灌入口中。（《肘后备急方》相同）
又一个方子：
灸心下一寸、脐上三寸、脐下四寸，各灸一百壮效果好。（《肘后备急方》相同）
又治疗猝死后牙关紧闭不开的方子：
缚住两手大拇指，灸两手背白色肉际中各二十壮。（《肘后备急方》、张文仲、范汪方相同，并出第一卷）
《集验方》治疗猝死后无脉、无其他形候，因阴阳俱竭所致者的方子：
骑牛对着患者鼻孔吹气二百次，又用烧热的熨斗熨烫两胁下，针刺两间使穴各百余次，灸人中穴。
又治疗猝死后有脉象形候，因阴气先尽，阳气后竭所致者的方子：
嚼烂薤白喂服灌入。（《肘后备急方》、张文仲、《千金方》、范汪方相同，并出第一卷）
《古今录验》所载司空三物备急散，治疗猝死及感忤，牙关紧闭不开的方子：
巴豆（去心皮炒制）、干姜、大黄（各等分）。
以上药物捣筛为散，每次服用如大豆大小的两枚，用水三合调和送服。若腹胀烦热，再饮水，能多喝些更好。
又治疗心腹痛几乎致死，服用此丸令轻微腹泻即愈。如果腹部常满痛，应当令其大便通畅即愈。一方用法是服用一刀圭，用酒送下。不能精确到刀圭者，就制成如大豆大小的丸药四枚，不知效果再加一粒豆大小，不愈再加一粒豆大小。若病患者牙关紧闭不能自饮，挖开嘴含入其中。药不预先合好，预合则气力消散。猝病者，临时合药，没有臼，就在木杯中捣碎。不超过三服，取利后无不痊愈者，蜜丸尤其好。（出第四卷）
Background Information:
Book: *Waitai Miyao* (Essential Prescriptions Worth a Thousand Gold for Emergencies)
Author: Wang Tao
Dynasty: Tang Dynasty, Tianbao 11th Year
Chapter: Twenty-Four Formulas for Sudden Death
Category: Formulas
[Translation]
The etiology of sudden death is caused by encountering "robber wind" (a pathogenic wind with rapid onset and strong致病 force) when the body is in a state of "Three Deficiencies." The "Three Deficiencies" refer to: first, encountering a year of declining annual运气 (annual cosmic influence); second, encountering a time of empty moon (new moon or waning moon); third, deviating from the harmony of the four seasons.
There is also a syndrome of sudden death due to being struck by guest evil ghostly qi. This occurs when one is suddenly assaulted by guest evil and ghostly qi, which enters the fu-zang (viscera), causing the separation of yin and yang, and a sudden blockage of qi and blood flow. The patient suddenly faints, appearing as if dead. After a long time, if yin and yang qi harmonize, the patient revives; if the fu-zang are weak, death ensues. Some may revive but the toxic vapors remain incomplete, leading to occasional attacks of stabbing pain in the heart and abdomen, which lingers and transforms into zhu disease (a chronic infectious or consumptive disease). (All from Volume 23)
The *Jia Yi Jing* states: Huangdi asked Qibo, "What pathogen causes sudden death?" Qibo replied, "Those who obtain the Three Deficiencies die of acute illness; those who obtain the Three Excesses cannot be harmed by pathogens." Huangdi said, "I wish to hear about the Three Deficiencies." Qibo replied, "Encountering a year of decline, meeting an empty moon, and losing the harmony of the times leads to injury by robber wind." Huangdi said, "I wish to hear about the Three Excesses." Qibo replied, "Meeting a prosperous year, encountering a full moon, and obtaining the harmony of the times means that even with robber wind and evil qi, one cannot be harmed." There are cases of sudden coma without consciousness, followed by revival. What qi causes this? Qibo answered, "When yin qi exhausts first and yang qi has not yet entered, there is sudden coma and loss of consciousness. When qi recovers, life returns." (Same as *Ji Yan Fang*, Volume 6)
The *Zhou Hou Bei Ji Fang* states: Sudden death, zhong-e (sudden poisoning/evil invasion), and shi jue (corpse-like syncope) are all caused by the deviation and obstruction of natural yin and yang qi of heaven, earth, and the human body, resulting in blockage between upper and lower parts and partial exhaustion. Thus, although they enter the realm of death, they can still be treated and survive because the primordial qi has not completely exhausted. At that moment, ghosts and spirits may intervene, so talismans and spells can also be used for protection and rescue.
Additionally, sudden death may present with prior pain or illness, or sudden collapse while resting, ending abruptly. These all belong to the category of zhong-e treatment formulas.
Take green onion stalks and pierce the nose, inserting them several inches deep. It is best if blood comes out of the eyes. Another method says it is best if blood comes out of the ears; this is Bian Que's method, similar to the ear-blowing method mentioned later. Ge Shi's nasal-blowing method is a separate technique. (*Zhou Hou Bei Ji Fang*, *Ji Yan Fang*, *Bei Ji Qian Jin Yao Fang*, *Bi Xiao Fang* all treat zhong-e like Cui Shi does.)
Another formula:
Have two people cover the patient's mouth with clothes and blow air into both ears. Alternatively, use a reed tube to blow air. (*Zhou Hou Bei Ji Fang* same.)
Another formula:
Pierce the ear with a green onion stalk. Do not be surprised if blood comes from the ear and nose. If no blood comes, it is difficult to treat; if blood comes, it is a sign of life. When the patient is about to revive, hold both hands firmly without letting go. This method works immediately.
Another formula:
Inspect the inner surface of the upper lip. If there is a green polypus the size of a millet grain, puncture and remove it with a needle to cure. (*Zhou Hou Bei Ji Fang* same.)
Another formula:
Pour urine onto the face multiple times to revive. This is Bian Que's method. (*Zhou Hou Bei Ji Fang*, *Ji Yan Fang*, Zhang Wenzhong's *Bei Ji Fang* same.)
Another formula:
Soak silk cotton in good wine and insert it into the nose. Press with hand to let juice enter the nose. Hold the limbs to prevent startling movement. (*Zhou Hou Bei Ji Fang* same.)
Another formula:
Moxibustion on the depression below the lower lip, named Chengjiang (CV24). Ten moxa cones is effective. (*Zhou Hou Bei Ji Fang* same, also Vol 1.)
Zhang Wenzhong's formulas for sudden death.
Squeeze juice from wet cow or horse manure and pour into the mouth, allowing it to enter the throat. If the jaw is clenched, forcibly open it with an instrument. If it cannot be forcibly opened, break the lower teeth. If fresh manure is unavailable, mix dry manure with water or urine, squeeze to get juice. This is Bian Que's method. (*Ji Yan Fang*, *Bei Ji Qian Jin Yao Fang*, *Zhou Hou Bei Ji Fang* same.)
Another formula:
Wrap a thin string around the patient's elbow and wrist. For men, left arm; for women, right arm. Extend the string from the Dazhui (GV14) point on the back, down along the spine. Moxa at the end of the string. (Some say fifty cones). From this point, measure half the string length horizontally on each side and moxa there. Total three moxa sites, three cones each, then stop.
Another formula:
Have someone pinch the Renzhong (GV26) point forcefully to wake the patient. If not waking, roll up the hand and moxa at the head of the palm crease, number of cones according to age.
Another formula:
Moxa Renzhong (GV26) under the nose, three cones.
Another formula:
Moxa Zhongwan (CV12) in the center of the umbilicus, one hundred cones.
Another formula:
Banxia powder (Pinelliae Rhizoma), size of a soybean, blow into the nose.
Another formula:
Crush Xie (Allii Macrostemonis Bulbus) or Jiucai (Chinese Chive) to extract juice, pour into mouth and nose. (Zhang Wenzhong, *Ji Yan Fang*, Fan Wang same.)
Another formula:
Zhu Gao (Porcine Fat), size of a chicken egg, plus Ku Jiu (Vinegar), one sheng. Boil and pour into the throat. (*Ji Yan Fang*, *Zhou Hou Bei Ji Fang* same.)
Formula for sudden death accompanied by high fever:
Fan Shi (Alumen), half jin. Boil water and soak feet, covering the ankles. (*Zhou Hou Bei Ji Fang*, Fan Wang same, Vol 1.)
*Bei Ji Qian Jin Yao Fang* formula for sudden death with closed eyes:
Ride a cow facing the patient's face. Crush Xie juice and pour into ears. Powder Zao Jia (Gleditsiae Sinensis Fructus), blow into nose. (*Ji Yan Fang*, Zhang Wenzhong, *Zhou Hou Bei Ji Fang*, Fan Wang same.)
Formula for sudden death with open eyes and opisthotonos:
Moxa fourteen cones at the posterior aspect of the fingernails and toenails on both hands and feet. Drink Wu Du Zhu Gao San (Five-Toxic Ointment Powder); those containing Ba Dou (Crotonis Semen) are better. (*Zhou Hou Bei Ji Fang*, Zhang Wenzhong same.)
Formula for sudden death with flaccid limbs and incontinence:
Ma Shi (Equini/Cabri Littera), one sheng; water, three dou. Boil to two dou, wash feet. Also, Niu Fen (Bovini Corium or Manure - context implies manure here based on previous text, but strictly 'Niu Fen' usually means manure in this context of squeezing juice earlier, though sometimes horn. Given 'mix with wine', manure is more likely for enema/pouring, but historically 'Niu Fen' can be processed horn. However, *Zhou Hou* often uses manure juice. Let's stick to literal 'Cow Manure' or 'Bovine Excrement' for consistency with 'wet cow/horse manure' earlier, though some interpretations vary. WHO term: Bovini Corium is Horn. But here it says 'Niu Fen'. In TCM classics, Fen often means manure. I will translate as Cow Manure/Bovine Excrement). One sheng, mix with warm wine, pour into mouth. (*Zhou Hou Bei Ji Fang* same.)
Another formula:
Moxa one cun below the heart, three cun above the umbilicus, four cun below the umbilicus, one hundred cones each. (*Zhou Hou Bei Ji Fang* same.)
Formula for sudden death with clenched jaw:
Bind the two thumb fingers. Moxa the white flesh area on the back of the hands, twenty cones each. (*Zhou Hou Bei Ji Fang*, Zhang Wenzhong, Fan Wang same, Vol 1.)
*Ji Yan Fang* formula for sudden death with no pulse and no other symptoms, due to exhaustion of both yin and yang:
Ride a cow blowing air into the nostrils for two hundred breaths. Heat an ironing tool and apply heat to both hypochondriac regions. Needle Jian Shi (PC5) bilaterally for over one hundred manipulations. Moxa Renzhong (GV26).
Formula for sudden death with pulse present, due to yin exhausting first and yang exhausting later:
Chew Xie (Allii Macrostemonis Bulbus) and feed/pour into the patient. (*Zhou Hou Bei Ji Fang*, Zhang Wenzhong, *Qian Jin Fang*, Fan Wang same, Vol 1.)
*Gu Jin Lu Yan* recorded Sikong San Wu Bei Ji San, for sudden death and shock, with clenched jaw:
Ba Dou (Crotonis Semen, remove heart and skin, roast), Gan Jiang (Zingiberis Rhizoma), Da Huang (Rhei Radix et Rhizoma) (equal parts).
Grind these medicines into powder. Take two pills the size of soybeans, mixed with three he of water. If abdominal distension and irritability occur, drink more water; drinking more is better.
Another formula for severe heart and abdominal pain nearly causing death:
Take this pill to induce mild diarrhea for recovery. If the abdomen is constantly full and painful, ensure bowel movement for recovery. One method: take one Dao Gui (ancient weight unit), taken with wine. If unable to measure one Dao Gui, make four pills the size of soybeans. If ineffective, add one bean-sized pill. If ineffective again, add another bean-sized pill. If the patient has a clenched jaw and cannot swallow, pry the mouth open and place the medicine inside. Do not prepare the medicine in advance, as the potency will dissipate. For sudden illness, prepare it then. If no mortar is available, crush in a wooden cup. Within three doses, inducing bowel movement ensures recovery. Honey pills are especially good. (From Volume 4)