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。东垣云∶循衣撮
空，许学士说作肝热，风淫末疾，故手为之循衣撮空，此论虽然，莫若断之为肺热，似为愈矣。其人
必谵语妄言。经云∶肺入火为谵语，兼上焦有疾，肺必主之，手经者，上焦也，二者皆当，其理果如
何哉？天地互为体用，此肺之体肝之用。肝主诸血，血者阴物也，此静体何以自动？盖肺主诸气，为
气所鼓舞，故静得动。一者说肝之用，一者说肺之体，此天地互为体用，二者俱为当矣。是知肝脏血，
自寅至申行阳二十五度，诸阳用事，气为肝所使。肺主气，自申至寅行阴二
十五度，诸阴用事，血为肺所用。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，内躁热之极也。
气粗鼻干不润，上下通燥，此为难治，宜生地黄黄连汤主之。大承气汤气药也，自外而之内者用之。
生地黄黄连汤血药也，自内而之外者用之。气血合病，循衣撮空证同，自气而之血，血而复之气，大
承气汤下之。自血而之气，气而复之血，地黄黄连汤主之。二者俱不大便。
【诊】病患循衣缝谵语者，不可治。病患阴阳俱绝，掣衣撮空妄言者死。
循衣撮空摸床（手指无意识地抓摸衣物、空中或床沿），大多属于极度虚弱的证候，无论是杂病还是伤寒，使用大补的方剂进行治疗，往往有存活的可能。李东垣说：循衣撮空，许学士解释为肝热，风邪侵袭四肢末端所致的小病，所以手会出现抓摸衣物和空中的动作，这种说法虽然有理，但不如断定为肺热，似乎更为恰当。患者必定会出现胡言乱语的症状。医经说：肺气入于火则出现谵语，兼有上焦的疾病，肺必然主导，手经对应的是上焦，这两种解释都有道理，其原理究竟如何呢？天地互为体用，这是肺之体与肝之用的关系。肝主司全身血液，血属于阴质，这静止的物质为何会自行运动？因为肺主司全身之气，被气所鼓舞，所以静止的血得以运动。一种说法强调肝的作用，一种说法强调肺的本体，这符合天地互为体用的道理，两种说法都是恰当的。由此可知，肝脏主血，从寅时到申时运行于阳分二十五周次，诸阳经发挥作用，气受肝的驱使。肺主气，从申时到寅时运行于阴分二十五周次，诸阴经发挥作用，血受肺的支配。张元素（海藏）说：妇女患血风证，因大量失血、崩漏，或前后二阴出血，导致身体干枯燥热，热势不退，出现循衣撮空摸床，闭目不醒，扬手掷足，摇动不安，言语错乱，神志丧失，脉象弦浮而虚，这是内部躁热到了极点。呼吸粗重，鼻干不润，上下皆干燥，这属于难治之症，宜用生地黄黄连汤主治。大承气汤是行气的方剂，适用于病邪由外向内传变的情况。生地黄黄连汤是养血的方剂，适用于病邪由内向外透发的情况。气血同病，循衣撮空的证候相同，若病机由气及血，血复归于气，应用大承气汤攻下。若病机由血及气，气复归于血，应用生地黄黄连汤主治。这两种情况都伴有不大便。
【诊】患者边抓摸衣缝边胡言乱语的，不可治愈。患者阴阳之气俱绝，拉扯衣物、抓摸空中并胡言乱语的，预后不良，多致死。
Grasping at clothes, picking at empty air, and touching the bed (Xun Yi Cuo Kong Mo Chuang) are mostly signs of extreme deficiency. Regardless of whether it is a miscellaneous disease or Shanghan (Cold Damage), administering major tonifying formulas often leads to survival. Li Dongyuan stated: Grasping at clothes and picking at empty air; Scholar Xu interpreted this as Liver Heat, where Wind pathogen invades the extremities causing minor ailments, hence the hands grasp at clothes and pick at empty air. Although this argument has merit, it is more appropriate to diagnose it as Lung Heat. The patient must necessarily exhibit delirious speech (Chan Yu). The Classics state: When Lung Qi enters Fire, delirium occurs. Since the Upper Jiao diseases are primarily governed by the Lung, and the Hand meridians correspond to the Upper Jiao, both explanations are valid. What is the underlying principle? Heaven and Earth mutually constitute substance and function; here, the Lung represents the substance and the Liver represents the function. The Liver governs all blood; blood is a Yin substance. How can this static substance move spontaneously? Because the Lung governs all Qi, being urged by Qi, the static achieves movement. One view discusses the function of the Liver, the other the substance of the Lung; this aligns with the mutual substance-function relationship of Heaven and Earth, so both are correct. Thus, we know that the Liver governs Blood, which circulates in the Yang aspect for twenty-five cycles from Yin hour to Shen hour, when all Yang meridians are active, and Qi is driven by the Liver. The Lung governs Qi, which circulates in the Yin aspect for twenty-five cycles from Shen hour to Yin hour, when all Yin meridians are active, and Blood is utilized by the Lung. Zhang Congzheng (Hai Zang) stated: In women suffering from Xue Feng Syndrome (Blood Wind Disorder) due to massive blood loss, metrorrhagia, or bleeding from either the upper or lower orifices, leading to dryness and persistent heat, they may exhibit grasping at clothes, picking at empty air, touching the bed, closed eyes without waking, throwing hands and feet about, restless agitation, disordered speech, and loss of spirit. The pulse is wiry, floating, and deficient, indicating extreme internal restlessness and heat. With coarse breathing, dry and unmoistened nose, and generalized dryness above and below, this is difficult to treat. It should be managed with Sheng Di Huang Huang Lian Tang (Rehmannia and Coptis Decoction). Da Cheng Qi Tang (Major Order the Qi Decoction) is a Qi-moving formula used when pathology moves from exterior to interior. Sheng Di Huang Huang Lian Tang is a Blood-nourishing formula used when pathology moves from interior to exterior. When Qi and Blood are simultaneously affected, the presentation of grasping at clothes is similar. If the pathology moves from Qi to Blood, and Blood returns to Qi, Da Cheng Qi Tang should be used to purge. If the pathology moves from Blood to Qi, and Qi returns to Blood, Sheng Di Huang Huang Lian Tang should be administered. Both conditions involve constipation.
[Diagnosis] If the patient grasps at clothing seams while speaking deliriously, the condition is incurable. If the patient's Yin and Yang Qi are both exhausted, pulling at clothes, picking at empty air, and speaking deliriously, death ensues.