论曰卒死者,缘人有三虚,一谓乘年之衰,二谓逢月之空,三谓失时之和,贼风鬼邪之
气,乘虚而入,故令阴气偏竭于内,阳气阻隔于外,二气壅闭,不得升降,厥气上行而暴绝
也,气还时复生,不还则死,内经曰,出入废则神机化灭,升降息则气立孤危,盖谓是也。
上以葱中央心,刺耳中令入七八寸、无苦,使目中血出立活,亦可男左女右,刺鼻内,
一云、耳中血出佳。
又方
令二人以衣拥口,以笔管强力吹两耳,困即易人吹之。
又方
以绵渍好酒,手 令入鼻中,并持两手,勿令惊动。
扁鹊治卒死方
湿牛马粪绞取汁,灌口中,令入喉,若口噤者,斡开灌之,不可斡者,扣折一齿下之,
若无新马粪,以水或人尿和,干者绞取汁用之。
又方
半夏末如大豆许,吹鼻中。
又方
捣薤若韭,取汁以灌口鼻中。
又方
猪膏如鸡子大,苦酒一升,煮沸灌喉中。
治卒死而壮热者方
白矾半斤,煮令消,渍脚令没踝。
治卒死而目闭者方
骑牛临其面,捣薤汁灌耳中,又末皂荚吹鼻中。
治卒死四肢不收,失便者方。
马粪一升,以水三斗,煮取二斗、洗足,又取牛粪一升,温酒和绞去滓,灌口中。
论曰内经谓邪客于手足少阴太阴足阳明之络,五络俱竭,令人身脉皆动而形无知,其状
若尸,故曰尸厥,盖五络皆会于耳中,苟为邪所客,则其气逆厥,上下暴隔,五络闭结而不
通,故俱竭而令人状若尸焉,治法当先刺其足大趾内侧爪甲上,去端如韭叶,后刺足心,后
刺足中指爪甲上,各一 ,后刺手大指内侧去端如韭叶,后刺手心主少阴锐骨之端,各一
立已,不已以竹管吹两耳,使气脉疏通,内助五络,然后以药石治之。
治五络闭竭,病发尸厥不知人,通微丸方
营实根(五两蔷薇根是也) 白薇(三两) 虎骨 獭肝(微炙) 五灵脂(各二两) 丹
砂(
上九味,捣罗为末,炼蜜和丸,如弹子大,温木香酒化下一丸,日三,以知为度,不计
时。
治尸厥之病,卒死而脉犹动,听其耳中,循循有如啸声,而股间暖是也,耳中虽无啸声
而脉动,亦当以尸厥救之方
上以竹管吹其左耳,极三度,复吹其右耳三度、即起。
又方
捣菖蒲末,如枣核大,着舌下,又内下部中。
治尸厥、脉动而无气,气闭不通,故冥然如死方。
上以菖蒲末,吹入两鼻孔中,又以桂末着舌下。
治尸厥方
左角发方寸烧灰,以醇酒一杯饮之,不能饮者,灌之立已。
又方
以绳围两臂腕,男左女右,伸绳从大椎度,下行当脊上,灸绳头五十壮、即活。
治尸厥方
熨两胁下,又取灶中墨如弹丸,以浆水和饮之,须臾可三四度,又取梁上尘,如小豆许,
竹管吹入鼻孔中。
Commentary states: The condition of sudden death (Zusi) arises from three types of deficiency in the person: first, encountering the decline of the year; second, meeting the emptiness of the moon; third, losing the harmony of the seasons. At such times, pathogenic winds and evil qi penetrate due to the deficiency, causing Yin qi to be excessively depleted internally and Yang qi to be blocked externally. The two Qi become congested and closed, unable to ascend and descend. The rebellious Qi ascends violently leading to abrupt cessation. If Qi returns, life is restored; if it does not return, death ensues. The *Neijing* states: "When entry and exit cease, the Shen mechanism perishes; when ascending and descending stop, the Qi establishment stands alone in danger." This refers precisely to this situation.
Method 1: Use the central heart of a green onion stalk, puncture into the ear to a depth of seven or eight cun, without causing pain, until blood flows from the eyes, which will lead to immediate revival. Alternatively, according to gender (left for males, right for females), puncture into the nasal cavity. Another school of thought suggests that bleeding from the ears is preferable.
Another prescription: Have two people cover the patient's mouth and nose with clothing, and forcefully blow air into both ears using a pen tube. When the blower becomes fatigued, replace them with another person.
Another prescription: Soak cotton wool in good wine, hold it with fingers, and insert it into the nasal cavity. Hold both hands of the patient to prevent惊动 (startling movements).
Bian Que's prescription for treating sudden death: Squeeze juice from wet cow or horse manure, and pour it into the patient's mouth, allowing it to flow down the throat. If the jaw is clenched, pry it open to administer the juice. If prying is impossible, break a tooth to create an opening for administration. If fresh horse manure is unavailable, mix dry manure with water or human urine, squeeze out the juice, and use it.
Another prescription: Grind Banxia (Pinelliae Rhizoma) into powder, take an amount the size of a soybean, and blow it into the nasal cavity.
Another prescription: Crush Xie (Allii Macrostemonis Bulbus) or Jiucai (Chives), extract the juice, and pour it into the mouth and nose.
Another prescription: Take Zhu Gao (Porcine Fat) the size of a chicken egg, boil it with one Sheng of Ku Jiu (Vinegar), and pour it into the throat.
Prescription for sudden death accompanied by high fever: Take half a Jin of Bai Fan (Alumen), boil until dissolved, and soak the feet until they are submerged up to the ankles.
Prescription for sudden death with closed eyes: Ride a cow facing the patient's face, crush Xie juice, and pour it into the ears. Also, blow powder made from Zao Jia (Gleditsiae Fructus) into the nasal cavity.
Prescription for sudden death with flaccid limbs and loss of bowel/bladder control: Take one Sheng of horse manure, add three Dou of water, boil down to two Dou, and use this decoction to wash the feet. Then, take one Sheng of cow manure, mix with warm wine, squeeze out the residue, and pour into the mouth.
Commentary states: The *Neijing* mentions that when pathogens lodge in the collaterals of the Hand-Shaoyin, Foot-Shaoyin, Hand-Taiyin, Foot-Taiyin, and Foot-Yangming meridians, and all five collaterals are exhausted, the body's pulses may move while the form remains unconscious. The appearance resembles that of a corpse, hence it is called Shi Jue (Corpse-like Syncope/Coma due to Qi rebellion). Since the five collaterals converge in the ear, if invaded by pathogens, Qi rebels and becomes cold, causing abrupt blockage between upper and lower parts. The five collaterals close and knot, becoming unpatent, leading to exhaustion and a corpse-like state. The treatment method should first involve needling the medial side of the big toe on the nail bed, at a distance from the corner like the width of a leek leaf. Then needle the center of the foot (Yongquan point). Then needle the medial side of the middle toe on the nail bed. Each location receives one insertion. Next, needle the medial side of the thumb on the nail bed, at a distance from the corner like the width of a leek leaf. Finally, needle the end of the Shaoyin Rigu (styloid process of ulna) where the Pericardium meridian meets Shaoyin. One insertion at each site leads to immediate recovery. If there is no improvement, blow air into both ears using a bamboo tube to unblock Qi and vessels, assisting the five collaterals internally, and then treat with herbs and acupuncture.
Tongwei Wan Prescription for treating five collaterals' closure and exhaustion, manifesting as Shi Jue with unconsciousness:
Yingshi Gen (Wu Lei Wei Gen / Rosa rugosa root, 5 liang), Baiwei (Cynanchi Atrati Radix, 3 liang), Hu Gu (Ossis Tigris), Ta Gan (Leporis Hepatis, slightly roasted), Wu Ling Zhi (Trogopterori Faeces, 2 liang each), Dan Sha (Cinnabar).
The above nine ingredients are crushed, sifted into powder, mixed with refined honey, and formed into pills the size of a bullet. Dissolve one pill in warm Muguxiang (Aquilariae Lignum Resinatum) wine for oral administration. Take three times daily, adjusting dosage until efficacy is achieved, without strict time limits.
For treating Shi Jue disease where the patient appears suddenly dead but the pulse still moves, hearing a faint whistling sound in the ears, and warmth in the thighs indicates Shi Jue. Even if there is no whistling sound in the ears but the pulse moves, one should also treat it as Shi Jue. Method: Blow air into the left ear using a bamboo tube, three times vigorously, then blow into the right ear three times; the patient will awaken.
Another prescription: Crush Chang Pu (Acori Tatarinowii Rhizoma) into powder, take an amount the size of a jujube pit, place it under the tongue, and also insert it into the lower orifice (vagina or anus).
Prescription for Shi Jue with pulse movement but no breath, where Qi is closed and unpatent, leading to coma resembling death: Blow Chang Pu powder into both nostrils, and place Gui (Cinnamomi Cortex) powder under the tongue.
Prescription for treating Shi Jue: Take hair from the left corner of the head, one cun square, burn it to ash, and drink it with one cup of Chun Jiu (pure wine). If the patient cannot drink, force-feed it; recovery will be immediate.
Another prescription: Wrap a rope around both wrists (left wrist for males, right wrist for females). Stretch the rope from Dazhui (GV14) downwards along the spine. Moxibustion is applied to the ends of the rope for fifty moxa cones; the patient will revive.
Prescription for treating Shi Jue: Apply hot compresses (ironing/warming) to the hypochondriac regions. Also, take soot from the stove (Zao Zhong Mo) the size of a bullet, mix with Jiang Shui (fermented grain liquid), and drink. This can be repeated three to four times within a short period. Additionally, take dust from the roof beams, the size of a small bean, and blow it into the nasal cavity using a bamboo tube.