暑热时疫，恶毒之气攻于里，则为痰喘，为血瘀。昏迷沉重，不省人事，若元气壮实，内不
受邪，不入于里，即散其毒于肌肤血肉之表，为肿为胀。忌饮热汤热酒，刺腿湾痧筋并十指尖出
毒血，内服宝花散。（治痧仙剂。）
郁金（一钱） 细辛（三钱） 降香（三钱） 荆芥（四钱）
共为细末，清茶调三匙，冷服。
桃仁红花汤 （治血凝结。）
桃仁（去皮、尖） 红花 苏木（各一钱） 青皮（八分） 乌药（四分） 独活（六分）
白蒺藜（去刺、捣末，一钱二分）
水煎服。
紫朴汤 （治痧有食气壅盛者。）
浓朴（姜汁炒） 山楂 葡子（研） 三棱 莪术 枳实（麸炒） 连翘（去隔） 青皮 陈皮 细辛
等分，水煎，冷服。
其症先少腹痛，作羊毛疔挑之，无血，随作紫疙瘩，手足麻，麻至不知人而死。急令人以足
病者手之三关脉上，（男 左手，女 右手。）用力 勿放，直待四肢不麻，病患自觉心头发火，方
放之，自愈。若放之早，虽愈后亦缠滞。三关脉即两手寸口诊脉处。
此症仕宦幕友不可不知，倘遇患此死者，而顾执言为人所逼勒可乎？可补《洗冤录》一则。
闻之老医臧枚吉云∶余髫时闻先祖言，凡人无故自缢者，为扣颈瘟。伊芳时未解详问，及后遍
阅方书，并无此说。辛巳年一人来言∶其乡有一妇人，平日家道
充裕，子女成立，夫妇和偕，忽一日无故自缢几死，救之始免。询之毫无所为，惟日郁郁不乐，
藏绳袖中，无人处即自缢。罗守月余，饮食言动如常，述此求治。余因忆少时所闻，细绎其或者血
弱气尽，腠理开，邪气因入，与正气相搏，不结于胁下，而结于手足厥阴，及手太阴之三脏合病
者。《内经》曰∶膻中者，臣使之官，喜乐出焉。今病则忧戚，可知刺疟论曰∶厥阴之疟，意恐
惧，腹中悒悒。又，肝疟者，善太息，其状若死。又，肺疟者，善惊，如有所见。疟如此，疫可
类推。因处一方，用香附、郁金、雄黄为九气汤，开膻中之郁，再加二陈以开膈中之痰，更加羌
活、细辛温肝逐风，鬼箭羽、丹参、赤小豆，以通心包兼泄火邪，生姜煎服。服后竟头痛，发热，
身痛，瘟疫症悉具，自出其袖中之绳云∶谁纳我乎？告以自缢，茫不记忆。寝疾七日，又服发汗
药而解。始知此症亦系疫疠或百合病之类乎。
按∶既云疫疠之疾，何不投火、赴水、刎颈，而必欲自缢乎？意或太阴邪气传厥阴，而风木
太过者，故不思金、火、水，而独喜木也。缘肺金藏魄，肝木藏魂，脾土藏意智，而心君藏神，
为一身之主。包络实为臣使，代心君行令，而主喜乐，今手厥阴包络先病，臣使失其喜乐之职，
以扰心君之神明，君火不
生土，传足太阴脾而意智不清，土不生金，因传手太阴肺而悲忧，金不平木，因传足厥阴肝而郁
怒，肺金承所不胜，而木寡于畏，故风木太过。且肝之魂挟肺之魄，不安其舍，出而为祟，故喜
木而自缢也。非有祟凭之，乃魂、魄、意智作疠也。或苏合丸、牛黄清心丸，当亦可用，惜未诊
其脉色何如也。此症原名扣颈伤寒，然与寒疾太无涉，故改名瘟疫，而名实俱当也。
暑热时行疫病，恶毒之气攻入体内，就会形成痰喘、血瘀。出现昏迷沉重、不省人事的症状；如果患者元气壮实，内部不受邪气侵袭，病邪就不会深入体内，而是将毒素发散在肌肤血肉表层，表现为肿胀和胀满。此时忌讳饮用热汤和热酒，应刺破腿弯处的痧筋以及十个指尖放出毒血，内服宝花散。（这是治疗痧证的仙方。）
郁金（一钱） 细辛（三钱） 降香（三钱） 荆芥（四钱）
共研为细末，用清茶调服三匙，冷服。
桃仁红花汤 （治疗血凝结。）
桃仁（去皮、尖） 红花 苏木（各一钱） 青皮（八分） 乌药（四分） 独活（六分）
白蒺藜（去刺、捣成末，一钱二分）
水煎后服用。
紫朴汤 （治疗痧证伴有食积气滞壅盛者。）
浓朴（姜汁炒） 山楂 葡子（研磨） 三棱 莪术 枳实（麸炒） 连翘（去隔） 青皮 陈皮 细辛
以上药物等量，水煎，冷服。
这种病症先表现为少腹部疼痛，像羊毛疔一样进行挑治，如果没有出血，随即会出现紫色疙瘩，手足麻木，麻木严重到使人昏迷死亡。紧急情况下让人握住患病者的手三部脉位上端，（男性左手，女性右手），用力握持不要松开，直到四肢不再麻木，病人自觉心口发热，才松开手，病即可自愈。如果松手过早，即使痊愈后也会遗留缠绵难愈的后遗症。三部脉即两手寸口诊脉处。
这种病症是官员及幕僚不可不知的，如果遇到因此症死亡的人，却固执地说是被人逼迫致死，可以吗？这可以补充《洗冤录》中的一则案例。
听老医生臧枚吉说：我小时候听祖先说，凡人无故自缢的，称为扣颈瘟。当时我不理解，详细询问过，后来遍阅医书，都没有这种说法。辛巳年有一人来求医，说他家乡有一位妇人，平时家境充裕，子女已成年成家，夫妇和睦，忽然有一天无故自缢几乎死去，救醒后才免于一死。询问她没有任何作为，只是每天郁郁不乐，把绳子藏在袖中，在无人的地方就自缢。罗守月余，饮食言行如常，叙述此事求治。我因此回忆起年少时听到的话，细细推究，可能是血弱气尽，腠理开泄，邪气乘虚而入，与正气相搏结，不结于胁下，而结于手足厥阴经，以及手太阴肺经的三脏合病。《内经》说：膻中穴，是臣使之官，喜乐由此发出。现在生病则忧愁悲伤，可知《刺疟论》说：厥阴之疟，心中恐惧，腹中郁闷。另外，肝疟者，喜欢长叹息，症状像要死了一样。还有，肺疟者，容易受惊，好像看到了什么。疟疾如此，瘟疫也可以类推。于是开一方，用香附、郁金、雄黄制成九气丸，以开通膻中之郁结，再加二陈汤以开通膈中之痰浊，更加羌活、细辛温肝驱风，鬼箭羽、丹参、赤小豆，以通心包兼泄火邪，生姜煎服。服药后竟然头痛、发热、身痛，瘟疫症状全部具备，自己从袖中拿出绳子说：是谁把我放进去的？告诉她是自缢，茫然不记得。卧床七日，又服用发汗药而解。这才知道此症也是疫疠或百合病之类的吧。
按语：既然说是疫疠之疾，为什么不投火、赴水、割颈，而一定要自缢呢？推测可能是太阴邪气传入厥阴，导致风木太过，所以不想金、火、水，而唯独喜木。因为肺金藏魄，肝木藏魂，脾土藏意智，心君藏神，是一身之主。心包络实为臣使，代心君行使命令，主掌喜乐，现在手厥阴心包络先发病，臣使失去了喜乐的职责，从而扰乱心君的神明，君火不生脾土，传至足太阴脾经导致意智不清，脾土不生肺金，因传至手太阴肺经导致悲忧，肺金不能制约肝木，因肝木缺乏畏惧，所以风木太过。而且肝之魂挟带肺之魄，不安居其舍，出来作祟，所以喜木而自缢。并非有鬼怪凭依，乃是魂、魄、意智作乱所致。或许苏合丸、牛黄清心丸也可以使用，可惜没有诊察他的脉象和面色如何。此症原名扣颈伤寒，然而与寒疾毫无关系，所以改名为瘟疫，名实相符。
Summer-heat epidemic, where toxic qi attacks the interior, results in phlegm and wheezing (Tan Chuan) or blood stasis (Xue Yu). The patient experiences heavy coma and loss of consciousness. If the primordial qi is robust and the interior is not invaded by pathogenic factors, the toxins will be dispersed to the surface of the skin, muscles, and flesh, manifesting as swelling and distension. It is contraindicated to drink hot soup or hot wine. One should puncture the sha veins at the popliteal fossa (Tui Wan) and the tips of the ten fingers to release toxic blood, and internally administer Baohua San (Precious Flower Powder). (This is a celestial prescription for treating sha syndrome.)
Jinyu (Curcumae Radix, 1 qian), Xixin (Asari Radix et Rhizoma, 3 qian), Jiangxiang (Sappan Lignum, 3 qian), Jingjie (Schizonepetae Spica, 4 qian).
Grind all into fine powder, mix with clear tea water, take three spoonsful, and consume cold.
Taoren Honghua Tang (Peach Kernel and Safflower Decoction) (For treating blood coagulation.)
Taoren (Peach Kernel, peeled and tip removed), Honghua (Carthami Flos), Sumu (Sappan Lignum) (each 1 qian), Qingpi (Aurantii Fructus Immaturus Pericarpium, 8 fen), Wuyao (Linderae Radix, 4 fen), Duhuo (Angelicae Pubescentis Radix, 6 fen), Baijili (Tribuli Fructus, thorns removed and ground to powder, 1.2 qian).
Decoct in water and take orally.
Zipu Tang (Magnolia Bark Decoction) (For sha syndrome accompanied by excessive food stagnation and qi obstruction.)
Nongpu (Magnoliae Officinalis Cortex, stir-fried with ginger juice), Shanzha (Crataegi Fructus), Puzi (Breadfruit Seed? Note: likely a local variant or typo for another seed, kept as Puzi), Sanleng (Sparganii Rhizoma), Ezhu (Curcumae Rhizoma), Zhishi (Aurantii Fructus Immaturus, bran-fried), Lianqiao (Forsythiae Fructus, septum removed), Qingpi, Chenpi (Citri Reticulatae Pericarpium), Xixin.
Equal parts, decoct in water, and consume cold.
The symptoms begin with lower abdominal pain. Treated like Yangmao Ding (Wool Carbuncle) by pricking, if no blood is released, purple nodules appear subsequently. The hands and feet become numb; if the numbness progresses to unconsciousness, death ensues. Immediately, someone should press firmly on the "Three Passages" pulse points of the patient's hand (left hand for males, right hand for females) without releasing pressure, until the limbs cease to be numb and the patient feels heat rising from the heart region, then release. The disease will heal spontaneously. If released too early, even after recovery, the condition may linger. The Three Passages pulse refers to the Cun Kou pulse location on both wrists.
This syndrome is something that officials and their secretaries must know. If one encounters a person who died from this illness but stubbornly claims they were coerced into suicide, is that acceptable? This case could supplement an entry in *Xi Yuan Lu* (Collected Cases of Injustice Rectified).
I heard from the old physician Zang Meiji: When I was young, my ancestor told me that anyone who commits suicide by hanging without cause suffers from Kouben Wen (Neck-Buckling Plague). At that time, I did not understand and asked for details, but later, upon reviewing medical texts, I found no such description. In the Xin Si year, a person came to tell me: In his hometown, there was a woman who usually had ample wealth, her children were grown, and she lived harmoniously with her husband. Suddenly, one day, she attempted suicide by hanging almost to death and was saved. Upon inquiry, she had no apparent reason, only feeling depressed every day. She hid a rope in her sleeve and hanged herself whenever she was alone. After Luo Shou treated her for over a month, her diet, speech, and movements were normal, and she recounted this seeking treatment. I recalled what I had heard in my youth and deduced that perhaps due to weak blood and exhausted qi, the pores opened, allowing pathogenic qi to enter and contend with righteous qi. Instead of knotting in the hypochondrium, it knotted in the Jueyin meridians of the hands and feet, and involved a combined disease of the three zang organs of the Hand Taiyin (Lung). The *Neijing* states: Danzhong (Conception Vessel point/Renal Center concept), the official of the minister, gives rise to joy and pleasure. Now, because of the illness, there is sorrow and grief. It can be known from the *Ci Mie Lun* (Discussion on Acupuncture for Malaria): Jueyin malaria involves fear and apprehension, and a gloomy feeling in the abdomen. Furthermore, Liver malaria involves frequent sighing, and the appearance resembles death. Also, Lung malaria involves being easily startled, as if seeing things. Since malaria presents thus, plagues can be inferred analogously. Therefore, I prescribed a formula using Xiangfu (Cyperi Rhizoma), Jinyu (Curcumae Radix), and Xionghuang (Realgar) to make Jiuxi Wan (Nine Qi Pill), to open the depression in Danzhong, plus Erchen Tang (Two-Cured Decoction) to open phlegm in the diaphragm, plus Qianghuo (Notopterygii Rhizoma et Radix) and Xixin (Asari Radix et Rhizoma) to warm the liver and expel wind, Guijianyu (Ardisiae Caulis), Danshen (Salviae Miltiorrhizae Radix et Rhizoma), and Chixiaodou (Vigna Semen Rubrum) to unblock the Pericardium and drain fire pathogenic factors, decocted with fresh ginger. After taking it, the patient actually experienced headache, fever, and body pain, exhibiting all symptoms of a plague. She took out the rope from her sleeve herself and said: Who put this in me? I told her it was for hanging, but she had no memory of it. After lying ill for seven days, she took a sweating medicine and recovered. Only then did I realize that this syndrome also belongs to the category of epidemics or Baihe Bing (Lily Disease).
Commentary: Since it is stated to be an epidemic disease, why would one choose to throw oneself into fire, jump into water, or cut one's neck, rather than necessarily hanging oneself? My guess is that Taiyin pathogenic qi transmits to Jueyin, causing excessive Wind-Wood. Thus, one does not desire Metal, Fire, or Water, but exclusively desires Wood. Because Lung Metal stores Po (Corporeal Soul), Liver Wood stores Hun (Ethereal Soul), Spleen Earth stores Yi (Intellect), and Heart君主 (Monarch) stores Shen (Spirit), which is the master of the body. The Pericardium acts as the ministerial envoy, executing orders on behalf of the Heart Monarch, and governs joy and pleasure. Now, the Hand Jueyin Pericardium is diseased first; the ministerial envoy loses its function of joy, thereby disturbing the Spirit of the Heart Monarch. The Ministerial Fire fails to generate Earth, transmitting to Foot Taiyin Spleen, resulting in unclear intellect; Earth fails to generate Metal, transmitting to Hand Taiyin Lung, resulting in sorrow and grief; Metal fails to control Wood, transmitting to Foot Jueyin Liver, resulting in depression and anger. Lung Metal bears the weight of what it cannot overcome, while Wood lacks fear, so Wind-Wood becomes excessive. Moreover, the Hun of the Liver, carrying the Po of the Lung, does not rest in its dwelling and comes out to cause havoc, hence the desire for Wood and hanging. This is not possession by a spirit, but rather the Hun, Po, Yi, and Zhi acting as pathogens. Suhe Wan (Styrax Pill) or Niuhuang Qingxin Wan (Calculus Bovis Clearing the Heart Pill) might also be applicable, but unfortunately, I did not examine the pulse and complexion. This syndrome was originally named Kouben Shanghan (Neck-Buckling Cold Damage), but it has nothing to do with cold diseases, so it was renamed Wenbing (Plague Disease), which fits both name and reality.