瘟疫呃逆不止者，大是凶候。余在长安治贺水部莲友，患瘟发黄，而兼呃逆，用承气辈加茵陈
与服，大便行而黄渐退，惟呃逆不止，更兼喘而痰壅，众皆谓不治，适得鲜花粉数枚，大如臂，
捣烂少加水，滤汁数碗，外用前胡、枳壳、橘红、香圆、柿蒂，煎出，兑花粉汁频服，一昼夜服尽，
呃逆稍止，瞬息复作，又令其仍将前药再作一剂，入碗内，用箸一双，十字加于碗上，令病者自持
碗，于箸之四空处，每空吸药一口，圆转挨次吸之，持碗不得换手，一顺吸去。（此泛常饮水治呃
良方，以以之服药，冀其获效。）服后觉渐轻，然时作止，又迟二三日始愈。若诿之不治，不几误人
性命乎！再者，瘟疫打呃皆热症，丁香四逆辈，断不可用。
头为诸阳之会，阳脉有乘，则头为之动摇。经曰∶诸风掉眩，皆属肝木。多因
风火上乘所致，风木动摇之象也。古人治此，有灸百会、风府等穴者，吾终不以为然，头之所以
摇，以热极生风故耳。清其邪热，其摇自定，何必用火攻耶。又有心绝而摇头者，心绝则神去而
阴竭，阳独无根，不能自主所以摇头。
（音炽纵。螈与 字异。 音记，狂也。疯狗曰 狗。）
筋急而缩为螈。筋缓而伸为 。或缩或伸而不止者，为螈 ，与小儿之发搐相似，亦有嘴眼
歪邪，角弓反张，有类于发痉与中风者，皆螈 之类。此症多属于风，风主动摇也。而致此之由
不一。有瘟病热极而生风者；有其人本虚，因汗下后血虚而然者；有因汗后，冒风而然者；有汗
下后，因惊恼而然者；有风温被火而然者。（此症绝少。）大抵此症，热极生风只一条，而虚者有数
端。虚者投以寒剂，立见危殆。若未经汗下，只因风火相扇者，当平肝木，降心火，佐以和血之
药。盖心属火主脉，肝属木主筋，火为热，木生风故耳。药则用羌活、防风、全蝎、僵蚕、柴胡、
天麻、生地、麦冬、白芍、丹皮、当归、川芎之类。如热甚，黄连、栀子、胆草、黄芩，俱可酌
用。有痰者，加蒌仁、胆星、竹沥。若汗下后，稍涉虚弱，或冒风，或因惊因气恼而螈 者，断
不可用寒剂，养血祛风汤主之。至于汗下后多日，传变而为螈 ，以
及出汗露风，汗出不透与被火劫等螈 ，俱载伤寒门中，兹不赘。
养血祛风汤（自定新方。）
熟地 当归（酒洗） 白芍（酒炒） 川芎（酒洗） 半夏（制） 僵蚕（泡去涎，焙）
天麻（酒蒸）
生姜、大枣为引。若虚甚者，加人参；有风者，酌加羌活、白芷、柴胡、防风。
瘟疫病中出现呃逆不止的情况，是非常凶险的征兆。我在长安治疗贺水部的莲友时，他患有瘟病发黄，同时兼有呃逆症状，我使用承气汤类方剂加入茵陈让他服用，大便通畅后黄疸逐渐消退，但呃逆仍然不止，并且更加严重地伴有气喘和痰液壅塞，大家都认为无法治愈。恰好得到几枚鲜花粉，大小如手臂，将其捣烂并加少量水，过滤出数碗汁液；外用前胡、枳壳、橘红、香圆、柿蒂煎煮取汁，将花粉汁兑入其中频繁服用，一昼夜服完。呃逆稍微停止，但片刻后又发作，于是又命令他将前面的药再煎一剂，放入碗中，用一双筷子十字交叉架在碗上，让病人自己手持碗，通过筷子四方的空隙，每个空隙吸一口药，依次环绕吸尽，持碗时不得换手，顺着一个方向吸完。（这是平常饮水治疗呃逆的良好方法，借此服药，希望获得疗效。）服药后感觉病情逐渐减轻，但有时发作有时停止，又过了两三天才痊愈。如果推脱说无法治愈，岂不是误人性命吗！再者，瘟疫引起的打呃都属于热证，丁香、四逆汤类方剂，绝对不可使用。
头部是诸阳经汇聚的地方，阳脉受到邪气侵袭，头部就会随之动摇。《内经》说：“各种风病引起的震颤眩晕，都归属于肝木。”多因风火之邪上乘所致，这是风木动摇的现象。古人治疗这种情况，有用灸百会穴、风府穴等穴位的，我始终不以为然。头部之所以摇动，是因为热极生风的原因。清除体内的邪热，头摇自然停止，何必用火攻呢？又有因为心气绝灭而摇头的，心气绝则神志离去而阴液枯竭，阳气独存而无根，不能自主所以摇头。
（“螈”音同“炽”，纵也。“螈”与“掣”字不同。“掣”音同“记”，意为狂乱。疯狗称为“掣狗”。）
筋脉拘急收缩称为“螈”。筋脉松弛伸展称为“掣”。或收缩或伸展不止的，称为“螈掣”，与小儿发搐相似，也有嘴眼歪斜、角弓反张的，类似于发痉和中风，都属于螈掣这一类。此症多属于风，因为风性主动摇。而导致此症的原因不一。有的因瘟病热极而生风；有的人原本体虚，因发汗或攻下后血虚而导致的；有的因发汗后，冒受风邪而导致的；有的在发汗或攻下后，因惊恐恼怒而导致的；有的因风温病被火劫而导致的。（此症极少见。）大抵来说，此症中热极生风只有一条，而虚证有好几种情况。虚证患者投以寒凉药剂，立刻可见危殆。如果未经过发汗或攻下，只因风火相煽的，应当平抑肝木，清降心火，佐以调和血脉的药物。因为心属火主血脉，肝属木主筋脉，火即为热，木能生风。药物则使用羌活、防风、全蝎、僵蚕、柴胡、天麻、生地、麦冬、白芍、丹皮、当归、川芎之类。如果热势很盛，黄连、栀子、龙胆草、黄芩，都可以酌情使用。有痰的，加入瓜蒌仁、胆南星、竹沥。如果是发汗或攻下后，稍涉虚弱，或者冒受风邪，或者因惊恐、气恼而引发螈掣的，绝对不可使用寒凉药剂，以养血祛风汤为主治方。至于发汗或攻下后多日，传变而为螈掣，以及出汗露风、汗出不透或被火劫等引发的螈掣，都记载在伤寒门中，这里不再赘述。
养血祛风汤（自定新方。）
熟地黄、当归（酒洗）、白芍（酒炒）、川芎（酒洗）、半夏（制）、僵蚕（泡去涎，焙干）、天麻（酒蒸）。
生姜、大枣作为药引。如果虚损严重的，加入人参；如果有风邪的，酌情加入羌活、白芷、柴胡、防风。
In cases of plague where hiccups (Hiccups, 呃逆) persist without cessation, it is a highly ominous sign. While in Chang'an, I treated He Shuibu Lianyou, who suffered from plague-induced jaundice (Plague Jaundice, 瘟发黄) accompanied by hiccups. I administered a variation of Chengqi Tang (Cedar Bark Decoction, 承气汤) with Yinchen (Artemisiae Scopariae Herba, 茵陈). After bowel movements occurred and the jaundice gradually subsided, the hiccups persisted, worsening with panting and phlegm obstruction. Everyone deemed it incurable. Fortunately, I obtained several fresh roots of Arnebiae Radix et Rhizoma (Huafen, 花粉), as large as an arm. They were pounded into a paste with a little water, and several bowls of juice were filtered out. Externally, Qianhu (Peucedani Radix, 前胡), Zhike (Aurantii Fructus, 枳壳), Juhong (Citri Ruber Pericarpium, 橘红), Xiangyuan (Citri Sarcodactylis Fructus, 香圆), and Shidi (Diospyri Fructus Calyx, 柿蒂) were decocted. The Huafen juice was mixed in, and the patient took frequent sips, finishing within one day and night. The hiccups stopped slightly but recurred instantly. I then ordered him to prepare another dose of the same medicine, place it in a bowl, and cross a pair of chopsticks over the bowl. The patient held the bowl himself and sucked the medicine through the four gaps created by the chopsticks, moving in circles sequentially, without changing hands, sucking in one direction until finished. (This is a common method for drinking water to treat hiccups; using it for medicine, we hoped for efficacy.) After taking it, he felt gradual relief, though the hiccups came and went intermittently, finally healing after two or three more days. If we had dismissed it as incurable, would we not have endangered lives? Furthermore, hiccups caused by plague are always heat syndromes; Dingxiang (Caryophylli Flos, 丁香) and Sixini Tang (Four Reversal Decoction, 四逆汤) categories must absolutely not be used.
The head is the convergence point of all Yang meridians. When Yang meridians are invaded by pathogenic factors, the head trembles. The Classics state: "All wind disorders involving tremors and dizziness belong to Liver Wood." This is mostly caused by Wind-Fire pathogens ascending, manifesting as the shaking of Wood. Ancients treated this by moxa-burning acupoints such as Baihui (GV20, 百会) and Fengfu (GV16, 风府), but I never agreed. The reason for head trembling is that extreme heat generates wind. Clearing the pathogenic heat will naturally stop the trembling; why resort to fire therapy? There is also head trembling due to Heart Qi exhaustion. When Heart Qi exhausts, Spirit departs and Yin fluids deplete, leaving Yang rootless and unable to control itself, causing head trembling.
("Chong" sounds like "Chi", meaning vertical/straight. "Chong" differs from "Che". "Che" sounds like "Ji", meaning madness. A mad dog is called a "Che Dog".)
Tendon contraction and shortening is called Chong (Chong, 螈). Tendon relaxation and extension is called Che (Che, 掣). Continuous alternating contraction and extension is called Chong-Che (Chong-Che, 螈掣), similar to pediatric convulsions. It may also present with facial deviation and opisthotonos, resembling tetanus or stroke, all falling under the category of Chong-Che. This syndrome mostly belongs to Wind, as Wind is characterized by movement. The causes vary. Some result from extreme heat in plague generating wind; some occur in individuals with underlying deficiency after sweating or purging, leading to blood deficiency; some result from exposure to wind after sweating; some from fright or anger after sweating/purging; some from Fire-heat treatment of Wind-Warmth disease. (This is rare.) Generally, only one type involves extreme heat generating wind, while there are several types of deficiency. Administering cold/cold-natured medicines to deficient patients leads to immediate danger. If no sweating or purging has occurred, and it is merely Wind-Fire agitating each other, one should soothe Liver Wood, descend Heart Fire, and assist with blood-harmonizing herbs. Since Heart belongs to Fire and governs vessels, and Liver belongs to Wood and governs tendons, Fire is Heat, and Wood generates Wind. Herbs include Qianghuo (Notopterygii Rhizoma et Radix, 羌活), Fangfeng (Saposhnikoviae Radix, 防风), Quanxie (Scorpio, 全蝎), Jiangcan (Bombyx Batryticatus, 僵蚕), Chaihu (Bupleuri Radix, 柴胡), Tianma (Gastrodiae Rhizoma, 天麻), Shengdi (Rehmanniae Radix, 生地), Maidong (Ophiopogonis Radix, 麦冬), Baishao (Paeoniae Radix Alba, 白芍), Danpi (Moutan Cortex, 丹皮), Danggui (Angelicae Sinensis Radix, 当归), and Chuanxiong (Ligustici Chuanxiong Rhizoma, 川芎). If heat is severe, Huanglian (Coptidis Rhizoma, 黄连), Zhizi (Gardeniae Fructus, 栀子), Danshen (not listed, likely Danshen/Caulis Scutellariae Barbatae or Longdancao/Gentianae Radix - text says Dancao which usually refers to Gentianae Radix, Longdancao), Huangqin (Scutellariae Radix, 黄芩) can be used discretionarily. With phlegm, add Louren (Trichosanthis Semen, 瓜蒌仁), Danning (Arisaematis Cum Bile, 胆星), and Zhuli (Bambusae Caulis in Taenia, 竹沥). If after sweating/purging, there is slight weakness, or exposure to wind, or fright/anger causing Chong-Che, cold medicines must absolutely not be used; Yangxue Qufeng Tang (Blood-Nourishing and Wind-Expelling Decoction, 养血祛风汤) is the primary formula. Cases of Chong-Che developing days after sweating/purging, or caused by exposure to wind/sweat, incomplete sweating, or fire coercion, are recorded in the Shanghan section and are not repeated here.
Yangxue Qufeng Tang (Self-prescribed new formula.)
Shudi (Prepared Rehmanniae Radix, 熟地), Danggui (Angelicae Sinensis Radix washed with wine, 当归), Baishao (Paeoniae Radix Alba stir-fried with wine, 白芍), Chuanxiong (Ligustici Chuanxiong Rhizoma washed with wine, 川芎), Banxia (Prepared Pinelliae Rhizoma, 半夏), Jiangcan (Bombyx Batryticatus soaked to remove saliva, dried, 僵蚕), Tianma (Gastrodiae Rhizoma steamed with wine, 天麻).
Shengjiang (Zingiberis Rhizoma Recens, 生姜) and Dazao (Jujubae Fructus, 大枣) as guides. For severe deficiency, add Renshen (Ginseng Radix, 人参); for wind, discretionarily add Qianghuo, Baizhi (Angelicae Dahuricae Radix, 白芷), Chaihu, and Fangfeng.