战。身抖耸动也。振、亦耸动。比战稍轻也。栗心内发抖也。振轻而战重。战外而栗内也。
邵评∶战者。身体抖摇不定。如交战之象。有形外见也。振则一身振摇。比战似轻。
亦有形可见也。栗则无形外见。但心内凛凛。似痉抖。比战振轻。为邪重耳。
战为正气胜。故正与邪争。争则股栗而战矣。振为正气衰。衰则不能争。故止于振
耸耳。栗亦正衰邪胜。不能外战而内栗也。总之。战为正气胜。而栗为邪气胜。振为
正气衰。而战为邪气衰也。三者皆邪正相交。故争也。
邵评∶正气未虚。而能胜邪。邪正交争则为战。战则邪从汗而解矣。振为正气虚
弱。不能与邪相争。故不作战而但振摇耳。栗为正气虚弱。邪气正盛。正虚不能
胜邪。故不能外战而内栗也。总之。正胜邪衰。则战而邪达。振则正气虚。而邪气
亦不盛。故不作战。而但振摇。邪不能外解耳。栗为正衰邪旺。正不胜邪。邪气内
扰。正不与邪争。但心内凛凛而发抖也。
此症若生于三法之前。乃邪衰正复之兆。欲作战栗。汗出而解也。当静候其战汗。
不可遽投汤药。若生于三法之后。则为气血两虚。不能荣养筋骨。故为之振摇。不
能主持也。当大补气血。人参养荣汤主之。身摇不得眠。十味温胆汤倍人参。
邵评∶三法者。汗吐下也。三法之前。正气未伤。与邪争胜。邪不胜正。则周身发战。
战则汗出。邪气从汗而外解也。发战之时。宜安舒静卧。不可扰乱投药。以阻其
邪出之机。若汗吐下之后。正气已虚。不能送邪外出。营血衰耗。不能滋养筋脉。
故但振振动摇。无以自主。而不能作战也。宜补气养营治之。
Chhan (Shivering). Refers to the shaking and耸ing (upward movement/trembling) of the body. Zhen (Tremor) also refers to trembling, but is slightly milder than Chhan. Li (Inner Shuddering) refers to shuddering within the heart/mind. Zhen is mild while Chhan is severe; Chhan manifests externally, while Li manifests internally.
Commentary by Shao: "Chhan" refers to the body shaking uncertainly, resembling the scene of a battle; it has form and is visible externally. "Zhen" involves the whole body trembling, which seems milder than Chhan, yet still has visible form. "Li" has no external manifestation, only an inner feeling of dread and coldness, resembling spasmodic trembling, and is milder than both Chhan and Zhen, indicating that the pathogenic factor is heavy.
Chhan occurs because the healthy Qi (Vital Energy) overcomes the pathogen; thus, Healthy Qi contends with the Pathogen. Contention leads to thigh shuddering and chills. Zhen occurs because the Healthy Qi is deficient and weak, unable to contend with the Pathogen, resulting only in trembling and耸ing. Li also results from deficient Healthy Qi and dominant Pathogen; the Healthy Qi cannot manifest as external Chhan, leading only to internal Li. In summary, Chhan indicates Healthy Qi victory, Li indicates Pathogen victory, and Zhen indicates Healthy Qi deficiency, while Chhan also implies the Pathogen's decline. All three scenarios involve the contention between Pathogen and Healthy Qi, hence termed "contention."
Commentary by Shao: When Healthy Qi is not yet deficient and can overcome the Pathogen, their interaction results in Chhan. After Chhan, the Pathogen is resolved through sweating. Zhen occurs due to deficient Healthy Qi, which cannot contend with the Pathogen, so there is no Chhan, only trembling. Li occurs when Healthy Qi is weak and the Pathogen is vigorous; the deficient Healthy Qi cannot overcome the Pathogen, so there is no external Chhan, only internal Li. In summary, when Healthy Qi prevails and the Pathogen declines, Chhan occurs, allowing the Pathogen to be expelled outward. If it is merely Zhen, it indicates Healthy Qi deficiency, while the Pathogen is also not vigorous; thus, there is no Chhan, only trembling, and the Pathogen cannot be resolved externally. Li indicates Healthy Qi deficiency and Pathogen excess; the Healthy Qi cannot overcome the Pathogen, causing the Pathogen to disturb internally. The Healthy Qi does not contend with the Pathogen, resulting only in inner dread and shuddering.
If this symptom appears before the application of the Three Methods (diaphoresis, emesis, purgation), it is a sign of declining Pathogen and recovering Healthy Qi, indicating an impending resolution through sweating after chills. One should quietly await the occurrence of "chhan-sweat" (sweating following chills) and must not hastily administer herbal decoctions. If it appears after the Three Methods, it indicates dual deficiency of Qi and Blood, which fails to nourish the sinews and bones, causing tremors and loss of voluntary control. One should strongly tonify Qi and Blood, using Renshen Yangrong Tang (Ginseng Nourishing the Spirit Decoction). If the body shakes and sleep is impossible, use Shiwei Wendan Tang (Ten-Ingredient Calming the Gallbladder Decoction) with doubled dosage of Renshen (Ginseng).
Commentary by Shao: The "Three Methods" refer to diaphoresis, emesis, and purgation. Before these methods, Healthy Qi is undamaged and contends with the Pathogen. Since the Pathogen cannot overcome Healthy Qi, the whole body experiences chills. After chills, sweating occurs, and the Pathogen is resolved externally via sweat. During the onset of chills, one should lie comfortably and quietly, avoiding disturbance or medication administration, to prevent obstructing the mechanism of Pathogen expulsion. After diaphoresis, emesis, or purgation, Healthy Qi is already deficient and cannot expel the Pathogen outward. Ying Blood (Nutritive Blood) is depleted and fails to nourish the sinews and vessels, resulting only in trembling and shaking without autonomous control, and without the ability to generate Chhan. Treatment should focus on tonifying Qi and nourishing Ying Blood.