瘟疫而至循摸，势亦危矣，而治之得法，亦有生者。其一由阳明里热之极者。盖阳明胃也，
肝有邪热，而移于胃，故现此症。胃主四肢，而风木乃动摇之象，是
循摸乃肝与胃腑邪热所致也。脉滑者生，涩者死。如有下症，宜用承气等汤。其一由用火劫汗而然
者，小便利者生，不利者死。（利则肺气犹降，膀胱犹能化气，而肾水未枯也。）余曾见一人
患瘟疫，不时循摸，询之，谓曾用火罐将胃口乱拔，冀其作汗，变现此症。遂用寒凉和解之药而愈。
盖未现下症，第因火劫所致，清之即愈。亦有不因火劫，不因吐下后而有是症者，总宜清凉和解。
伤寒书中，亦有指循摸为虚极，而用微补峻补者，瘟疫未曾经过。
伤寒谵语、 语，解者纷纷。考其字义，谵语者，不论寤寐，乱言独语，如见鬼状。因胃热
上乘于心，心为热冒，则神识昏乱，错妄如此，俗谓之说糊话者是也，热之轻者也。甚则狂语不
休，骂詈喊叫，昏不识人，而热则深矣。 语者，乃合目自言，寤而自止，较之谵语则更轻矣。
此谵 二字之分也。谵语向入阳明门，以余之所阅历，三阳皆有，而阳明居多耳。亦有初得病而
即谵语者，更兼昏不识人及不
能食，其病必重。若无此症，或睡则 语，而寤则清醒，或寤时偶为 语，而有时止歇，其病则
轻矣。谵 之由，又自不同。有邪在表者，有邪入里者，有邪在半表半里者，有表虚里实者，有
汗后者，有下后者，有蓄血者，有燥屎者，有邪入心经者，有合病并病者，有过经者，有亡阳者，
当察其兼症与脉、与色、与声、与人之虚实，始得其病情也。此专讲邪热之症，亦间有汗下后用
补者，而阴寒不在此例也。脉和易愈，短则死。身微热，脉浮大洪者生；逆冷，脉沉微弱细急者
死。或气上逆而喘满，或气下夺而自利，皆为逆候。
瘟疫病发展到出现手不自主地摸弄衣被或空抓的动作时，病情已经非常危重了，但如果治疗方法得当，也有存活的可能。这种情况主要有两种原因：其一是由于阳明经里热极盛所致。因为阳明经对应胃腑，当肝脏有邪热并转移至胃部时，就会出现这种症状。胃主管四肢，而风木（肝）具有动摇的特性，所以这种摸弄动作是由肝和胃腑的邪热引起的。脉象滑利的预后良好，脉象涩滞的预后不良。如果伴有可以使用攻下法的症状，适宜使用承气汤等方剂。其二是由于误用火法强迫发汗所致。这种情况下，小便通利的预后良好，不通利的预后不良。（小便通利说明肺气还能下降，膀胱还能气化，肾水尚未枯竭。）我曾经见过一个人患瘟疫，不时出现摸弄动作，询问得知，他曾用火罐在胃口处乱拔，希望借此出汗，结果导致了这种症状。于是我用寒凉和解的药物治愈了他。这是因为没有表现出可以使用攻下法的症状，仅仅是因为火法劫迫所致，清热即可痊愈。也有既不是因火法劫迫，也不是因吐法或下法之后出现这种症状的，总宜用清凉和解的方法治疗。伤寒书中，也有将这种摸弄动作指认为虚损至极，而使用轻微补益或峻猛补益方法的，但这在瘟疫病中未曾见过。
关于伤寒病中的谵语和郑声，解释的人很多。考证其字义，谵语是指无论清醒还是睡眠，都胡言乱语、自言自语，好像看见鬼怪一样。这是因为胃热上冲于心，心被热邪蒙蔽，导致神识昏乱，错妄如此，俗称说糊话，这是热邪较轻的情况。严重时则狂言不休，骂人喊叫，昏迷不认识人，此时热邪已经很深了。郑声是指闭着眼睛自言自语，醒来就停止，比谵语更轻一些。这就是谵语和郑声的区别。谵语通常归入阳明病门，根据我的经验，三阳经都有可能出现，但以阳明经居多。也有刚得病就出现谵语的，再加上昏迷不认识人和不能进食，病情一定很重。如果没有这些症状，或者睡觉时说胡话，醒来则清醒，或者醒着的时候偶尔说胡话，有时又停止，病情就比较轻了。谵语和郑声的原因各不相同。有的邪气在表，有的邪气入里，有的邪气在半表半里，有的表虚里实，有的经过发汗后，有的经过攻下后，有的蓄血，有的燥屎内结，有的邪气侵入心经，有的合病并病，有的已过经传变，有的亡阳，应当观察兼夹症状以及脉象、面色、声音和病人的虚实情况，才能掌握病情。这里专门讲解邪热导致的症状，也间或有在汗法或下法之后使用补益药的，但阴寒证不在此例。脉象平和容易治愈，脉短则死。身体微热，脉象浮大洪大的预后良好；四肢逆冷，脉象沉微弱细急的预后不良。或者气机上逆而喘满，或者气机下夺而自利，都是逆证的征候。
When plague (Yiwen) progresses to the point of "seeking clothes and touching bed" (unconscious, repetitive grasping movements), the condition is critical; however, with appropriate treatment, survival is possible. There are two main causes: First, it results from extreme heat in the Yangming interior. The Yangming channel corresponds to the Stomach; when pathogenic heat from the Liver transfers to the Stomach, this symptom appears. The Stomach governs the four limbs, and Wind-Wood (Liver) exhibits a trembling nature; thus, these grasping movements are caused by pathogenic heat in the Liver and Stomach. A slippery pulse indicates survival, while a choppy pulse indicates death. If symptoms indicating the need for purgation are present, formulas such as Chengqi Tang (Gastrointestinal Releasing Decoction) should be used. Second, it results from improper use of fire therapy to force sweating. In this case, free urination indicates survival, while difficulty in urination indicates death. (Free urination implies that Lung Qi can still descend, Bladder Qi transformation remains functional, and Kidney Water has not been exhausted.) I once treated a patient with plague who exhibited intermittent grasping movements. Upon inquiry, he revealed that he had previously used cupping on his stomach area to induce sweating, which led to this symptom. I cured him using cooling and harmonizing herbs. Since there were no indications for purgation, and the cause was solely the coercive effect of fire therapy, clearing the heat resulted in recovery. There are also cases where this symptom occurs neither due to fire coercion nor after emesis or purgation; in all such instances, cooling and harmonizing methods are appropriate. Texts on Cold Damage sometimes attribute this grasping to extreme deficiency and recommend mild or severe tonification, but this approach has not been observed in plague.
Regarding "delirious speech" (Zhanyu) and "faltering speech" (Zhengsheng) in Cold Damage, interpretations vary. Etymologically, delirious speech refers to rambling and solitary talking regardless of whether the patient is awake or asleep, resembling seeing ghosts. This occurs because Stomach heat rises to overwhelm the Heart, causing mental confusion and erratic behavior, commonly known as speaking nonsense; this represents a milder form of heat. Severe cases involve incessant manic speech, cursing and shouting, unconsciousness, and failure to recognize people, indicating deep-seated heat. Faltering speech refers to murmuring with closed eyes, stopping upon waking; it is milder than delirious speech. This distinguishes the two terms. Delirious speech is traditionally categorized under Yangming disorders, but based on my experience, it can occur in all three Yang channels, though most frequently in Yangming. Some patients exhibit delirium immediately upon contracting the disease, accompanied by unconsciousness and inability to eat, indicating a severe condition. If these accompanying symptoms are absent, or if the patient murmurs only during sleep and is clear upon waking, or speaks erratically occasionally while awake with intervals of cessation, the condition is milder. The causes of delirium and faltering speech differ. Pathogens may be in the exterior, interior, half-exterior half-interior, or there may be exterior deficiency with interior excess. It may follow sweating therapy, purgative therapy, blood stasis, dry feces accumulation, pathogen invasion of the Heart channel, combined diseases, transmission beyond the usual sequence, or collapse of Yang. One must examine accompanying symptoms, pulse, complexion, voice, and the patient's deficiency or excess to ascertain the pathology. This section specifically addresses symptoms caused by pathogenic heat; occasionally, tonification is used after sweating or purgation, but Yin-cold patterns are excluded here. A harmonious pulse indicates ease of cure, while a short pulse indicates death. Slight body heat with a floating, large, and surging pulse indicates survival; cold extremities with a deep, weak, thin, and rapid pulse indicate death. Alternatively, rebellious Qi causing wheezing and fullness, or downward depletion causing spontaneous diarrhea, are both adverse signs.