黄帝曰∶人之颤者，何气使然？岐伯曰∶胃气不实，则诸脉虚，诸脉虚则筋脉懈坠，筋
脉懈坠则行阴，用力不复，故为颤，因其所在，补分肉间。《医学纲目》云∶颤振与螈
相类，螈 则手足牵引而或伸或屈，颤振则但颤动而不伸屈也。胃虚有痰，用参、术以
补气，茯苓、半夏以行痰；如实热积滞，用张子和三法。
〔薛〕颤振者，掉眩也。《易》曰∶鼓万物者莫疾乎风。鼓之为言动也。大抵掉眩，
乃风木之摇运也。诸风掉眩，皆属于肝。治法∶若肝木实热，用泻青丸。（幼科肝。）肝木虚
热，用六味丸。（杂病虚劳。）肺金克肝木，用泻白散。（杂病发热。）肝木虚弱，用逍遥散（调经。）加
参、术、钓藤钩。脾血虚弱，用六君子汤（杂病虚劳。）加芎、归、钓藤钩。胃气虚弱，用补中
益气汤（难病伤劳倦。）加钓藤钩。若产后颤振，乃气血亏损，虚火益盛而生风也，切不可以风
为论，必当大补，斯无误矣。一妇人性善怒，发热，经水非过期则不及，肢体倦怠，饮
食少思而颤振，余谓脾气不足，肝经血少而火盛也。午前以调中益气汤加茯苓、贝母，送
六味丸，午后以逍遥散送六味丸，两月余而愈。一妇人身颤振，口妄言，诸药不效。余
以为郁怒所致，询其故，盖为素嫌其夫而含怒久矣，投以小柴胡汤（伤寒少阳。）稍可，又用
加味归脾汤（归牌汤加柴胡、山栀。）而愈。
交加散 治螈 或颤振，或产后不省人事，口吐痰涎。
当归 荆芥穗（各等分）
上为细末，每服三钱，水一盏，酒少许，煎至七分，灌下咽即有生理。
增损柴胡汤 治产后或经适断，致手足牵搐，切牙昏冒异证。
柴胡（八钱） 黄 （炒，五钱） 黄芩（炒） 石膏（各四钱） 半夏（三钱） 知母
甘草（炙，各二钱）
上为粗末，每服半两，姜五片，枣四枚，水煎温服。
本事青盐丸 治肝肾虚损，腰膝无力，颤振 曳。
香末（三两） 菟丝子（四两） 干山药（二两，末） 青盐（一两，研）
上先将菟丝子洗净，无灰酒浸晒七日，冬天近火煨，炙干，另为细末和匀，酒糊丸梧
子大。每服五七十丸，温酒或盐汤下。常服壮筋力，进饮食。一妇人素患足 曳，服此
药，履地如故。
本事星附散 治中风能言而手足 曳，脉虚浮而数。
天南星（制同半夏） 半夏（薄切片，姜汁浸透） 黑附子（炮） 白附子（炮）
川乌头（炮） 白僵蚕（炒） 没药 人参 白茯苓（各等分）
上为粗末，每服二钱，酒水各一盏，同煎至八分，去滓热进三二服，汗出即瘥。
在桐庐有患此证，用前药三服，得汗，手足即能举动。
三因独活散 治气虚感风，或惊恐相乘，肝胆受邪，使上气不守正位，致头招摇，手
足颤掉，渐成目昏。
独活 地骨皮 细辛 芎 菊花（甘味者） 防风（去叉） 甘草（炙，等分）
上为粗末，每服三钱，水盏半，煎至一盏，去滓，煎取清汁六分，入竹沥少许，再
煎一二沸，食后温服，日二服。
世传茯苓丸 治手臂抽牵，或战掉不能举物，服此药立愈。又治脾气虚弱，痰邪相
搏，停伏中脘，以致臂内筋脉挛急而痛。
茯苓 半夏（姜制，各二两） 枳壳（麸炒，半两） 风化朴硝（一两）
上为末，姜汁糊丸桐子大。每服二十丸，食后姜汤下。
黄帝问道：人出现身体颤动的症状，是什么气机导致的？岐伯回答：胃气不充实，就会导致全身经脉虚弱；经脉虚弱则筋脉松弛懈怠；筋脉松弛懈怠则导致行走无力、用力后无法恢复，因此产生颤动。治疗时，应根据病变部位，在分肉之间进行补法针刺。《医学纲目》说：颤振与抽搐（指手足牵引拘急）相似，抽搐表现为手足牵引，时而伸展时而屈曲；而颤振只是颤动，并不伴随伸展或屈曲的动作。如果是胃虚兼有痰湿，用人参、白术来补气，茯苓、半夏来化痰；如果是实热积滞，则使用张子和的汗、吐、下三法治疗。
薛己认为：颤振就是掉眩（摇动眩晕）。《易经》说：“鼓动万物没有比风更快的。”“鼓”的意思是动。大抵掉眩，是风木之气摇动运转所致。各种风病引起的掉眩，都归属于肝。治疗方法：如果是肝木实热，用泻青丸。（出自《幼科发挥》，主治肝病。）如果是肝木虚热，用六味丸。（出自《内科摘要》，主治杂病虚劳。）如果是肺金克制肝木，用泻白散。（出自《内科摘要》，主治发热。）如果是肝木虚弱，用逍遥散（主治调经。）加人参、白术、钩藤。如果是脾血虚弱，用六君子汤（出自《内科摘要》，主治杂病虚劳。）加川芎、当归、钩藤。如果是胃气虚弱，用补中益气汤（出自《难病伤劳倦》，主治难病及劳倦损伤。）加钩藤。如果是产后出现颤振，这是气血亏损，虚火旺盛而生风所致，切不可单纯按风证论治，必须大力补益，这样才不会出错。有一位妇人性格易怒，发热，月经要么过期不来，要么提前到来，肢体倦怠，饮食减少且食欲不振并伴有颤振，我认为这是脾气不足，肝经血少而火盛所致。午前服用调中益气汤加茯苓、贝母，送服六味丸；午后服用逍遥散送服六味丸，两个多月后痊愈。另一位妇人身体颤振，胡言乱语，服用多种药物无效。我认为是郁怒所致，询问原因，原来是因为她长期嫌弃丈夫而心怀愤怒，于是投以小柴胡汤（出自《伤寒论》，主治少阳病），症状稍缓解，后又用加味归脾汤（归脾汤加柴胡、山栀）而痊愈。
交加散：治疗抽搐或颤振，或产后昏迷不省人事，口吐痰涎。
药材：当归、荆芥穗（各等分）。
制法用法：研为细末，每次服用三钱，用水一盏，酒少许，煎至七分，灌服咽下即有生机。
增损柴胡汤：治疗产后或月经突然中断，导致手足牵拉抽搐，咬牙昏冒等异常症状。
药材：柴胡（八钱）、黄芪（炒，五钱）、黄芩（炒）、石膏（各四钱）、半夏（三钱）、知母、甘草（炙，各二钱）。
制法用法：研为粗末，每次服用半两，加生姜五片、大枣四枚，水煎温服。
本事青盐丸：治疗肝肾虚损，腰膝无力，颤振伴肢体牵引下垂。
药材：香末（三两）、菟丝子（四两）、干山药（二两，研末）、青盐（一两，研碎）。
制法用法：先将菟丝子洗净，用无灰酒浸泡晒七日，冬天靠近火源煨烤，炙干，另研为细末混合均匀，用酒糊制成梧桐子大小的丸药。每次服用五七十丸，用温酒或盐汤送下。常服可强壮筋骨，增进饮食。有一位妇人素来患有足部牵引下垂，服用此药后，走路如常。
本事星附散：治疗中风后能说话但手足牵引下垂，脉象虚浮而数。
药材：天南星（制法同半夏）、半夏（薄切片，姜汁浸透）、黑附子（炮制）、白附子（炮制）、川乌头（炮制）、白僵蚕（炒）、没药、人参、白茯苓（各等分）。
制法用法：研为粗末，每次服用二钱，用水和酒各一盏，同煎至八分，去渣，趁热服用二三服，出汗即愈。在桐庐有一人患此证，服用前三服药，出汗后，手足即能活动。
三因独活散：治疗气虚感受风邪，或惊恐相乘，肝胆受邪，导致上气不能守正位，致使头部摇晃，手足颤动，逐渐形成目昏。
药材：独活、地骨皮、细辛、川芎、菊花（甘味者）、防风（去叉）、甘草（炙，等分）。
制法用法：研为粗末，每次服用三钱，用水一盏半，煎至一盏，去渣，取清汁六分，加入少许竹沥，再煎一二沸，饭后温服，每日两次。
世传茯苓丸：治疗手臂抽拉牵引，或战栗抖动不能举物，服用此药立即痊愈。又治疗脾气虚弱，痰邪相互搏结，停滞伏于中脘，导致臂内筋脉挛急而痛。
药材：茯苓、半夏（姜制，各二两）、枳壳（麸炒，半两）、风化朴硝（一两）。
制法用法：研为细末，用姜汁糊制成梧桐子大小的丸药。每次服用二十丸，饭后用姜汤送下。
Huangdi asked: "What qi causes tremors in humans?" Qibo replied: "When Stomach Qi is not substantial, the various meridians become deficient. When the various meridians are deficient, the sinews and vessels become lax and sagging. When the sinews and vessels are lax and sagging, walking becomes difficult, and strength cannot be recovered after exertion; thus, tremors occur. Treatment should involve tonification between the muscle layers (Fenrou Jian) according to the location of the lesion." The *Medical Outline* states: "Tremor and convulsion are similar; convulsions involve traction of the hands and feet with extension or flexion, whereas tremors merely involve trembling without extension or flexion." If there is Stomach deficiency with phlegm, use Ginseng Radix et Rhizoma (Renshen, 人参) and Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) to tonify Qi, and Poria (Fuling, 茯苓) and Pinelliae Tuber (Banxia, 半夏) to resolve phlegm; if there is excess heat with accumulation, apply Zhang Hezi's three methods (sweating, vomiting, purgation).
Xue Ji stated: "Tremor is shaking and vertigo." The *I Ching* says: "Nothing moves the myriad things faster than Wind." "Gudong" (drumming/moving) implies motion. Generally, shaking and vertigo result from the oscillation of Wood-Wind Qi. All wind diseases causing shaking and vertigo belong to the Liver. Treatment methods: If Liver Wood has excess heat, use Xieqing Wan (Liver Clearing Pill) [from *Pediatrics*, treating Liver disease]. If Liver Wood has deficiency heat, use Liuwei Wan (Six-Ingredient Pill) [from *Internal Medicine*, treating deficiency consumptive disease]. If Lung Metal overacts on Liver Wood, use Xiebai San (Lung Clearing Powder) [from *Internal Medicine*, treating fever]. If Liver Wood is weak, use Xiaoyao San (Free and Easy Wanderer Powder) [for regulating menstruation], add Ginseng Radix et Rhizoma (Renshen, 人参), Atractylodis Macrocephalae Rhizoma (Baizhu, 白术), and Uncariae Ramulus cum Uncis (Gouteng, 钩藤). If Spleen Blood is deficient, use Liujunzi Tang (Six-Gentlemen Decoction) [from *Internal Medicine*, treating deficiency consumptive disease], add Ligusticum Chuanxiong Rhizoma (Chuanxiong, 川芎), Angelicae Sinensis Radix (Danggui, 当归), and Uncariae Ramulus cum Uncis (Gouteng, 钩藤). If Stomach Qi is weak, use Buzhong Yiqi Tang (Middle-Boosting and Qi-Invigorating Decoction) [for difficult diseases due to fatigue/overwork], add Uncariae Ramulus cum Uncis (Gouteng, 钩藤). If tremors occur postpartum, this is due to Qi and Blood depletion, with deficient fire flourishing generating Wind. One must not treat it solely as a Wind syndrome; one must strongly tonify, so as not to err.
One woman had a irritable disposition, fever, irregular menstruation (either delayed or early), limb fatigue, poor appetite, and tremors. I diagnosed Spleen Qi deficiency, Liver channel blood deficiency, and flourishing fire. In the morning, she took Tiaozhong Yiqi Tang (Regulating Middle and Boosting Qi Decoction) with added Poria (Fuling, 茯苓) and Fritillariae Thunbergii Bulbus (Beimu, 贝母), taken with Liuwei Wan (Six-Ingredient Pill); in the afternoon, she took Xiaoyao San (Free and Easy Wanderer Powder) taken with Liuwei Wan (Six-Ingredient Pill). She recovered after more than two months. Another woman had body tremors and delirious speech, unresponsive to various medicines. I attributed it to depression and anger. Upon inquiry, it was found she had harbored resentment toward her husband for a long time. She was given Xiao Chaihu Tang (Minor Bupleurum Decoction) [from *Shanghan Lun*, treating Shaoyang disease], which provided slight relief, followed by Jia Wei Guipi Tang (Modified Heart-Spleen Tonifying Decoction) [Guipi Tang plus Bupleuri Radix (Chaihu, 柴胡) and Gardeniae Fructus (Zhizi, 山栀)], leading to recovery.
Jiaojiao San (Cross-Adding Powder): Treats convulsions or tremors, or postpartum unconsciousness with salivation.
Ingredients: Angelicae Sinensis Radix (Danggui, 当归) and Schizonepetae Spica (Jingjie Sui, 荆芥穗) in equal parts.
Preparation: Grind into fine powder. Take 3 qian per dose, decoct with one cup of water and a little wine until reduced to 0.7 cups, and administer orally. Life can be restored.
Zengsun Chaihu Tang (Modified Bupleurum Decoction): Treats postpartum or sudden cessation of menstruation leading to hand and foot traction/twitching, teeth grinding, and fainting.
Ingredients: Bupleuri Radix (Chaihu, 柴胡) 8 qian, Astragali Membranacei Radix (Huangqi, 黄芪) stir-fried 5 qian, Scutellariae Radix (Huangqin, 黄芩) stir-fried, Gypsum Fibrosum (Shigao, 石膏) 4 qian, Pinelliae Tuber (Banxia, 半夏) 3 qian, Anemarrhenae Rhizoma (Zhimu, 知母), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) roasted 2 qian.
Preparation: Grind into coarse powder. Take 0.5 liang per dose, with 5 slices of ginger and 4 dates, decoct in water and take warm.
Benshi Qingyan Wan (Benshi Green Salt Pill): Treats Liver and Kidney deficiency with weakness in waist and knees, tremors, and dragging limbs.
Ingredients: Fragrant powder (Xiangmo, 香末) 3 liang, Cuscutae Semen (Tusizi, 菟丝子) 4 liang, Dioscoreae Rhizoma (Shanyao, 山药) dried 2 liang (powdered), Green Salt (Qingyan, 青盐) 1 liang (crushed).
Preparation: Wash Cuscutae Semen (Tusizi, 菟丝子), soak in clear wine for seven days, sun-dry, then roast near fire in winter until dry. Grind separately into fine powder and mix evenly. Form pills with wine paste, size of wu zi (large sesame seeds). Take 50-70 pills per dose with warm wine or salt water. Regular use strengthens sinews and bones and improves appetite. One woman who suffered from dragging limbs took this medicine and walked normally again.
Benshi Xingfu San (Benshi Star and Aconite Powder): Treats stroke where the patient can speak but has dragging limbs, with a deficient, floating, and rapid pulse.
Ingredients: Arisaematis Rhizoma (Nanxing, 南星) processed like Banxia, Pinelliae Tuber (Banxia, 半夏) sliced thin and soaked in ginger juice, Aconiti Lateralis Radix Preparata (Heifuzi, 黑附子) prepared, Aconiti Kusnezoffii Radix (Baifuzi, 白附子) prepared, Aconiti Radix (Chuanwu, 川乌头) prepared, Bombyx Batryticatus (Baijiangcan, 白僵蚕) stir-fried, Myrrha (Moyao, 没药), Ginseng Radix (Renshen, 人参), Polyporus (Baifuling, 白茯苓) in equal parts.
Preparation: Grind into coarse powder. Take 2 qian per dose, decoct with one cup of water and one cup of wine until reduced to 0.8 cups. Strain and take hot, 2-3 doses. Recovery occurs with sweating. In Tonglu, a patient treated with these three doses sweated and regained movement in hands and feet.
Sanyin Duhuo San (Three Causes Notopterygium Powder): Treats Qi deficiency with Wind invasion, or shock/fear exacerbating pathogenic factors in Liver and Gallbladder, causing Upper Qi to lose its proper position, resulting in head nodding/shaking, hand and foot trembling, gradually leading to blurred vision.
Ingredients: Notopterygii Rhizoma et Radix (Duhuo, 独活), Lycii Cortex (Digupi, 地骨皮), Asari Radix et Rhizoma (Xixin, 细辛), Ligusticum Chuanxiong Rhizoma (Chuanxiong, 川芎), Chrysanthemi Flos (Juhua, 菊花) sweet variety, Saposhnikoviae Radix (Fangfeng, 防风) de-bristled, Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) roasted in equal parts.
Preparation: Grind into coarse powder. Take 3 qian per dose, decoct with 1.5 cups of water until reduced to 1 cup. Strain, take 0.6 cup of clear liquid, add a little Bamboo Juice (Zhuli, 竹沥), boil briefly. Take warm after meals, twice daily.
Shichuan Fuling Wan (World-Transmitted Poria Pill): Treats arm traction/pulling or trembling inability to lift objects; immediate cure upon taking. Also treats Spleen Qi deficiency with Phlegm-Evil binding, stagnating in Zhongwan, causing cramping pain in arm sinews.
Ingredients: Polyporus (Fuling, 茯苓), Pinelliae Tuber (Banxia, 半夏) ginger-processed, each 2 liang; Aurantii Fructus (Zhike, 枳壳) bran-stir-fried 0.5 liang; Efflorescent Mirabilite (Fenghua Puxiao, 风化朴硝) 1 liang.
Preparation: Grind into powder, form pills with ginger juice paste, size of wu zi. Take 20 pills per dose after meals with ginger water.