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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.