寒战者，阳中之气虚也，阳气虚则阴乘之，阳不胜阴，故寒栗而战也。切牙者阴中之气
虚也，阴气虚者肾元惫，骨气消索，故切齿而鸣也。总之，虚在气分，则无非阴盛阳虚之
病耳，非大加温补不可也。
《心鉴》云∶七日前见寒战者，表虚也；切牙者，内虚也。七日后见寒战者，气虚极也；
切牙者，血虚极也。气虚者，保元汤倍加肉桂以温阳分。血虚者，保元汤加芎、归以益
阴分。余常用六气煎，或六物煎加桂附治之，无不应手而止。其有独寒战、独切牙者，亦一
体治之，或合二仙散用之亦妙。
一、有寒邪在表，身体大热，脉紧数无汗，邪正相争而为战栗者，此即似疟之类，但散
其邪而战自止，宜柴葛桂枝汤之类主之。
一、痘疮灰白溃烂，泄泻而寒战切牙者，此纯阴无阳之证，宜九味异功煎，或陈氏十二
味异功散亦可。
一、痘色干紫黑陷，大小便不通，烦躁大渴而寒战切牙者，此纯阳无阴，火极似水之证
也，宜双解散。
一、养浆结靥之时，有红紫 肿，大小便秘，烦渴喜水者，乃表里俱热之证，以疮痛而振摇
忍痛而切牙也。此非寒战切牙之属。如热甚而便秘者，宜四顺清凉饮加连翘、木通、金银花之
类主之。
一、筋惕肉 似战者，以经络血气为疮所耗，不能荣养肌肉，主持筋脉，故惕惕然肌肉
自跳， 然肌肉自动，本非寒战之证也，宜十全大补汤之类主之。
陈氏曰∶切牙者，齿槁也，乃血气不荣，不可妄作热治。
一、寒战切牙而气喘谵妄，闷乱足冷者，非倒陷即倒靥也，不治。
寒战，是由于阳气中的气虚所致。阳气虚弱则阴气乘虚而入，阳不胜阴，所以出现寒冷颤抖的症状。切牙（咬牙），是由于阴气中的气虚所致。阴气虚弱则是肾元疲惫，骨气消损，所以出现咬牙作响的症状。总之，病机在于气分的虚损，无非是阴盛阳虚的病证罢了，必须大力进行温补治疗才有效。
《心鉴》说：发病七日前出现寒战的，是表虚；出现切牙的，是内虚。发病七日后出现寒战的，是气虚到了极点；出现切牙的，是血虚到了极点。气虚的，用保元汤倍加肉桂以温补阳气分。血虚的，用保元汤加川芎、当归以滋补阴血分。我平时常用六气煎，或者六物煎加肉桂、附子来治疗这些病症，没有不立刻见效停止的。那些单独出现寒战或单独出现切牙的，也按照同一类方法治疗，或者配合使用二仙散，效果也很奇妙。
其一，有寒邪停留在体表，身体高热，脉象紧数且无汗，邪气与正气相争而导致战栗的，这属于类似疟疾的证候，只要发散其邪气，战栗自然停止，适宜用柴葛桂枝汤之类的方剂主治。
其二，痘疮颜色灰白溃烂，伴有泄泻以及寒战切牙的，这是纯阴无阳的证候，适宜用九味异功煎，或者陈氏十二味异功散也可以。
其三，痘色干枯紫黑下陷，大小便不通畅，烦躁大渴并伴有寒战切牙的，这是纯阳无阴，火极似水的证候，适宜用双解散。
其四，在养浆结痂的时候，如果患处红紫肿胀，大小便秘结，烦渴喜饮水的，这是表里俱热的证候，是因为疮痛导致身体振摇，忍受疼痛而咬牙。这不属于寒战切牙的范畴。如果热势严重且便秘的，适宜用四顺清凉饮加连翘、木通、金银花之类的药物主治。
其五，筋惕肉瞤（肌肉跳动）看起来像战栗的，是因为经络气血被疮毒耗伤，不能荣养肌肉，主持筋脉，所以肌肉不由自主地跳动，筋肉自动抽动，这本来就不是寒战的证候，适宜用十全大补汤之类的方剂主治。
Chills and shivering (Han Zhan) result from the deficiency of Qi within Yang. When Yang Qi is deficient, Yin encroaches upon it; as Yang cannot overcome Yin, coldness and trembling occur. Teeth grinding or clenching (Qie Ya) results from the deficiency of Qi within Yin. Deficiency of Yin Qi indicates exhaustion of the Kidney Yuan (Original Qi), leading to the depletion of Bone Qi, thus causing teeth to grind and make noise. In summary, when the deficiency lies in the Qi aspect, it is invariably a disease pattern of Excess Yin and Deficient Yang, which requires vigorous warming and tonification.
*Xin Jian* states: Chills appearing seven days prior indicate Exterior Deficiency; teeth grinding indicates Interior Deficiency. Chills appearing seven days later indicate extreme Qi deficiency; teeth grinding indicates extreme Blood deficiency. For Qi deficiency, Baoyuan Tang (Preserve the Origin Decoction) with doubled Rougui (Cinnamon Bark) should be used to warm the Yang aspect. For Blood deficiency, Baoyuan Tang with Xiong (Ligusticum Rhizome) and Gui (Angelica Sinensis Root) should be used to nourish the Yin aspect. I commonly use Liuqi Jian (Six Qi Decoction) or Liuwu Jian (Six Ingredients Decoction) added with Guizhi (Cinnamon Twig) and Fuzi (Prepared Aconite Root) to treat this, with immediate cessation of symptoms in all cases. Those presenting with isolated chills or isolated teeth grinding are treated similarly; combining with Erxian San (Two Immortals Powder) is also effective.
First, if pathogenic Cold remains in the Exterior, accompanied by high body heat, a tight and rapid pulse without sweating, and chills due to the struggle between Pathogen and Righteous Qi, this resembles malaria-like patterns. Dispersing the pathogen will naturally stop the chills; Chaige Guizhi Tang (Bupleurum and Kudzu and Cinnamon Twig Decoction) is appropriate.
Second, if pustules are grayish-white and ulcerated, accompanied by diarrhea, chills, and teeth grinding, this is a pattern of Pure Yin without Yang. Jiwei Yigong Jian (Nine-Ingredient Extraordinary Efficacy Decoction) or Chen's Shi'er Wei Yigong San (Twelve-Ingredient Extraordinary Efficacy Powder) may be used.
Third, if pustules are dry, purple-black, and sunken, accompanied by obstruction of urination and defecation, irritability, intense thirst, chills, and teeth grinding, this is a pattern of Pure Yang without Yin, where extreme Fire mimics Water. Shuangjie San (Double Release Powder) is indicated.
Fourth, during the stage of pus formation and scabbing, if there is red-purple swelling, constipation of urine and stool, irritability, and thirst preferring water, this is a pattern of Heat in both the Interior and Exterior. The body trembles due to pain, and teeth are ground while enduring pain; this does not belong to the category of chills and teeth grinding. If Heat is severe with constipation, Sishun Qingliang Yin (Four Smooth Cooling Beverage) added with Qiaofen (Forsythia Fruit), Mutong (Akebia Stem), and Jinyinhua (Honeysuckle Flower) is appropriate.
Fifth, muscle twitching (Jin Ti Rou Yu) resembling chills occurs because meridional Qi and Blood are depleted by sores, failing to nourish muscles and govern sinews. Consequently, muscles twitch involuntarily. This is fundamentally not a pattern of chills; Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) is appropriate.
Chen states: Teeth grinding indicates withered teeth, caused by Qi and Blood failing to nourish; it must not be mistakenly treated as Heat.
Sixth, if chills and teeth grinding are accompanied by panting, delirium, mental confusion, and cold feet, this indicates either internal collapse of the eruption or inversion of the scabs, and is untreatable.