循衣撮空摸床。多是大虚之候。不问杂病伤寒。以大补之剂投之。多有得生者。许学士谓肝
热风淫末疾。故手为之循衣撮空。其人必谵语妄言。经谓肺入火为谵妄是也。海藏云。妇人血风
证。因大脱血崩漏。或前后失血。因而枯燥。其热不除。循衣撮空摸床。闭目不醒。扬手掷足。
摇动不宁。错语失神。脉弦浮而虚。内躁之极也。生地黄黄连汤主之。热极神昏。十余日不大便。
腹胀喘满。气粗鼻干不润。上下通燥。脉沉实而滑。此地道阻塞不通之故。急宜凉膈、承气下之。
若热乘肺金。气虚不能主持。叉手冒心。循衣撮空。谵语昏沉。不省人事。节庵升阳散火汤。小
便利者可治。不利者不治。按凉膈、承气。气药也。自外而入内者用之。生地黄黄连汤。血药也。
自内而至外者用之。升阳散火汤。气虚火乘药也。内外合邪者用之。三方俱治不大便者。病患手
循衣缝。谵语者。不可治。病患阴阳俱绝。掣衣摸空妄言者死。撮空。服承气。下之后。脉弦者
生。涩者死。
经云。神有余则笑不休。精气并于心则喜。心主手厥阴之脉。是动则病目黄。喜笑不休。
河间云。喜笑者。皆心火之盛也。五行之中。惟火有笑。昔治人笑不休口流涎。用黄连解毒
汤加半夏、姜汁、竹沥。而笑止。
戴人治一妇。病喜笑不休。已半年矣。以盐块二两。烧令通赤。放冷研细。河水煎服。探吐
出热痰五升。次服降火之剂。不数日而笑定。内经曰。神有余则笑不休。此所谓神者。火是也。
火得风而成焰。笑之象也。
倪惟德治一妇。病气厥。笑哭不常。人以为鬼祟所凭。诊之。六脉俱沉。胃脘必有积。遂以
二陈汤导之。吐痰升许而愈。此积痰类祟也。
循衣撮空、摸床,多属于大虚的证候。无论是杂病还是伤寒,使用大补的方剂进行治疗,往往有痊愈的。许学士认为肝经风热淫邪导致四肢末端的疾病,所以手会出现循衣撮空的症状。这种人必定伴有谵语妄言,正如经典所说肺受热邪则出现谵妄。海藏说,妇人血风证,因大量失血崩漏,或前后失血,因而身体枯燥,热邪不退,出现循衣撮空、摸床,闭目不醒,扬手掷足,摇动不宁,错语失神,脉象弦浮而虚,这是内躁至极的表现。用生地黄黄连汤主治。若热极神昏,十余日不大便,腹胀喘满,气粗鼻干不润,上下通燥,脉沉实而滑,这是地道阻塞不通的缘故,急宜用凉膈散、承气汤攻下。如果热邪乘袭肺金,气虚不能主持,叉手冒心,循衣撮空,谵语昏沉,不省人事,用节庵升阳散火汤治疗。小便利的可以治愈,不利的不治。按:凉膈散、承气汤是气分药,用于外邪入内的情况;生地黄黄连汤是血分药,用于内邪出外的情况;升阳散火汤是气虚火乘的药,用于内外合邪的情况。三方都可用于治疗不大便的情况。病患手循衣缝,谵语的,不可治。病患阴阳俱绝,掣衣摸空妄言的,死。撮空,服用承气汤攻下后,脉弦的生存,脉涩的死亡。
经典说,神有余则笑不休。精气并于心则喜。心主手厥阴之脉,是动则病目黄,喜笑不休。河间说,喜笑都是心火盛的表现。五行之中,只有火有笑的特性。过去治疗人笑不休口流涎,用黄连解毒汤加半夏、姜汁、竹沥,而笑止。戴人治疗一妇人,病喜笑不休,已经半年了。用盐块二两,烧令通红,放冷研细,河水煎服,探吐出热痰五升。其次服用降火的药剂,不数日而笑定。内经说,神有余则笑不休,此所谓神者,火是也。火得风而成焰,是笑的象征。倪惟德治疗一妇人,病气厥,笑哭不常,人以为鬼祟所凭。诊之,六脉俱沉,胃脘必有积,遂以二陈汤导之,吐痰升许而愈。此积痰类祟也。
Grasping at clothes, picking at empty air, and touching the bed are mostly signs of severe deficiency. Regardless of whether it is a miscellaneous disease or cold damage, administering major tonifying formulas often leads to recovery. Xu Xueshi stated that wind-heat in the Liver channel causing disorders in the extremities results in hands grasping at clothes and picking at empty air. Such individuals must exhibit delirious speech and妄言 (delusions), as the classics state that when the Lung is affected by fire, delirium occurs. Haizang said that for women with Blood-Wind syndrome, due to massive blood loss from metrorrhagia or bleeding from both upper and lower orifices, the body becomes dry, heat persists, leading to grasping at clothes, picking at empty air, touching the bed, eyes closed and unconscious, waving hands and kicking feet, restlessness, disordered speech, and loss of spirit. The pulse is wiry, floating, and deficient, indicating extreme internal agitation. Shengdi Huang Lian Tang (Rehmanniae Radix et Coptidis Decoction) is the primary treatment. If heat reaches an extreme causing divine confusion, with no bowel movement for over ten days, abdominal distension, wheezing and fullness, coarse breathing, dry and unmoistened nose, and generalized dryness above and below, with a deep, solid, and slippery pulse, this is due to obstruction in the Lower Jiao (Earthly Pathway). It is urgent to use Liang Ge San (Cool the Chest Powder) or Cheng Qi Tang (Descending the Qi Decoction) to purge. If heat attacks Metal of the Lung, and Qi deficiency fails to govern, with hands crossed over the heart, grasping at clothes, picking at empty air, delirium, coma, and unconsciousness, Sheng Yang San Huo Tang (Ascending Yang and Dispersing Fire Decoction) by Jie'an should be used. If urination is free, it is treatable; if not, it is untreatable. Note: Liang Ge San and Cheng Qi Tang are Qi-moving medicines, used for pathogens entering from outside to inside. Shengdi Huang Lian Tang is a Blood medicine, used for pathogens moving from inside to outside. Sheng Yang San Huo Tang is for Qi deficiency with Fire attacking, used for combined internal and external pathogens. All three formulas can treat constipation. If the patient grasps the seams of clothes and speaks deliriously, it is untreatable. If Yin and Yang are both exhausted, pulling at clothes, picking at empty air, and speaking deliriously, death ensues. For picking at empty air, after taking Cheng Qi Tang and purging, a wiry pulse indicates survival, while a choppy pulse indicates death.
The classics state: When Shen (Spirit) is excessive, laughter is incessant. When Jing-Qi (Essence-Qi) merges into the Heart, joy arises. The Pericardium Meridian of Hand-Jueyin, when disturbed, causes yellow eyes and incessant laughter. Hejian stated that incessant laughter is all due to excess Heart-Fire. Among the Five Elements, only Fire has the characteristic of laughter. In the past, treating a person with incessant laughter and drooling, Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) was used with added Banxia (Pinelliae Rhizoma), Jiangzhi (Zingiberis Rhizoma Juice), and Zhuli (Bambusae Caulis in Taenia Succus), and the laughter ceased. Dairen treated a woman suffering from incessant laughter for half a year. Two liang of salt blocks were heated until red-hot, cooled, ground fine, decocted in river water, and administered to induce vomiting, expelling five sheng of hot phlegm. Subsequently, fire-descending agents were taken, and within a few days, the laughter subsided. The Neijing states: When Shen is excessive, laughter is incessant. This so-called Shen refers to Fire. Fire becomes flame when aided by wind, which is the image of laughter. Ni Weide treated a woman with Qi-jue (Qi collapse), exhibiting irregular laughter and crying. People thought she was possessed by ghosts. Upon diagnosis, all six pulses were deep, indicating accumulation in the epigastrium. Er Chen Tang (Two-Cured Decoction) was used to guide the expulsion, resulting in the vomiting of more than one sheng of phlegm, leading to recovery. This is accumulation of phlegm mimicking possession.