凡小儿因闻非常之声,见异类之物,或为争斗推跌,或大小
禽兽之类致惊,其神气结于心而痰生焉。痰壅气逆,遂成搐溺。
口眼歪斜,口吐涎沫,一时即醒,如常无事。或一日一发,或间
日再发,或三五日一发,或半年一发,一年一发。若不急治,变
成瘤疾,而为终身之痼病也。治法当先利痰顺气,后用清心安神。
风者,或因外感风寒,或内伤饮食,以致热生痰,痰壅发
搐,口眼歪斜,手足牵动,气喘涎潮。口吐涎沫,发过略醒。潮
热不退。须臾复发。治法当先泻(15)火开痰,后用安神清热。
惊风有二,有急有慢。急惊风为实为热,当凉惊泻(16)火;
慢惊风为虚为寒,当用温补。不可一概(17)混治,以致杀人。
急惊风。小儿元气素实,或因恐怖,或因风,或因饮食而
发,要审明白,详察症侯。而施治法。
如曾因恐怖而成惊者,其症发过即如常,若无他症,先以利
痰丸顺气开痰,后用安神丸调之。
如曾因风寒而成者,其症发过略醒,须臾复发。轻者,只用
导赤散吞下泻青丸,以清心肝之火,后以抱龙丸治痰,保命丹除
风,缓缓调之。
如曾因伤饮食而成者,其症发过略醒,醒多啼哭,须臾复
发,不思乳食。先用陈皮麦芽汤吞下五色丸,推去食积,则痰自
降。后用辰砂五苓散治之。
凡治急惊风,除饮食一症外,不可遽用下药,必先间其大小
便如何。若小便清,大便通利,其邪在表,只用导赤散加防风,
或泻青丸去大黄加全蝎作汤服之。去表中之寒邪,其风自退。后
以辰砂五苓散谓之,不可犯麝香,恐引邪入里。若小便赤涩,大便
闭结,此邪在里,可用五色丸下之。后用抱龙丸、保命丹调之。
凡急惊发时,牙关紧闭不醒着,急用艾炷灸两手大指头少商
穴(在甲旁),合而灸之,即醒,而后施治法。
凡急惊风,痰气喘急者,用定喘汤加竹沥治之。痰涎壅塞(18)
不开者,可用吐法。
凡病退后潮热不退者,此脾虚热也,四君子汤加炒干姜治
之。若小便赤,大便硬,两腮红,足胫热者,此余邪未尽,不可作
虚看。用凉惊丸。薄荷灯心煎汤吞下调之而愈。
凡病退后,睡眠不醒者,此心脾二经之邪热未尽去也,安神
九治之。
凡小儿但有潮热,观其两颊若赤,目上视者,必作惊风也。
当先以导赤散,加灯心,薄荷以去其热。次用抱龙丸以安其神,
则风自不作矣。
凡是小儿因为听到不寻常的声音,看到奇异的事物,或者被争斗推搡跌倒,或被飞禽走兽等惊吓,导致神气郁结于心而生痰。痰浊壅盛、气机逆乱,于是形成抽搐和惊厥。出现口眼歪斜,口吐涎沫,片刻后即苏醒,像没事一样。或者一天发作一次,或者隔天再发,或者三五天发作一次,甚至半年或一年发作一次。如果不及时治疗,会演变成慢性顽疾,成为终身的痼疾。治疗方法应当先化痰顺气,后用清心安神之法。
风证,有的因外感风寒,有的因内伤饮食,导致热生痰,痰壅引发抽搐,口眼歪斜,手足牵动,气喘且痰涎如潮。口吐涎沫,发作后稍微清醒,随即又复发。潮热不退。须臾间再次发作。治疗方法应当先泻火开痰,后用安神清热之法。
惊风分为两种,有急惊风和慢惊风之分。急惊风属于实证、热证,应当用凉惊泻火法;慢惊风属于虚证、寒证,应当用温补法。不可一概而论混合治疗,以免导致死亡。
急惊风:小儿元气本来充实,或因恐怖,或因风邪,或因饮食不当而发病,必须仔细审察,详细观察症状,然后施治。
如果曾因恐怖而成惊者,其症状发作过后即如常人,若无其他症状,先用利痰丸顺气开痰,后用安神丸调理。
如果曾因风寒而成者,其症状发作后稍微清醒,须臾间又复发。轻症者,只用导赤散吞服泻青丸,以清心肝之火,后用抱龙丸治痰,保命丹祛风,缓缓调理。
如果曾因伤食而成者,其症状发作后稍微清醒,醒后多啼哭,须臾间又复发,不思乳食。先用陈皮麦芽汤吞服五色丸,推去食积,则痰自降。后用辰砂五苓散治疗。
凡治疗急惊风,除饮食停滞这一种情况外,不可急于使用下药,必须先询问大小便情况。若小便清,大便通利,说明邪气在表,只用导赤散加防风,或泻青丸去大黄加全蝎煎汤服用。去除表中之寒邪,风邪自然消退。后用辰砂五苓散调理,不可犯麝香,恐引邪入里。若小便赤涩,大便闭结,说明邪气在里,可用五色丸攻下。后用抱龙丸、保命丹调理。
凡急惊风发作时,牙关紧闭不醒的,急用艾炷灸两手大拇指少商穴(在指甲旁侧),双侧同灸,即醒,然后再施治法。
凡急惊风,痰多气喘急促者,用定喘汤加竹沥治疗。痰涎壅塞不通者,可用吐法。
凡病退后潮热不退者,这是脾虚热,用四君子汤加炒干姜治疗。若小便赤,大便硬,两腮红,足胫热者,这是余邪未尽,不可当作虚证看。用凉惊丸,薄荷灯心煎汤吞服调理而愈。
凡病退后,睡眠不醒者,这是心脾二经的邪热未尽去也,用安神丸治疗。
凡小儿只要有潮热,观察其两颊若发红,眼睛上视者,必定是惊风。应当先用导赤散,加灯心草、薄荷以去其热。次用抱龙丸以安其神,则风邪自然不作矣。
In general, when children are startled by unusual sounds, strange sights, being pushed or fallen during conflicts, or frightened by birds and beasts, their spirit and qi become knotted in the Heart, generating phlegm. When phlegm becomes obstructive and qi rebels, convulsions and tremors ensue. Symptoms include deviation of the mouth and eyes, foaming at the mouth, followed by awakening after a short while as if nothing had happened. Attacks may occur once a day, every other day, every three to five days, or even once every half year or once a year. If not treated urgently, it will transform into a chronic disease, becoming a lifelong stubborn ailment. The treatment method should first resolve phlegm and regulate qi, then use methods to clear the Heart and calm the spirit.
Wind syndromes may arise from external contraction of Wind-Cold or internal injury from diet, leading to heat generating phlegm. Obstructed phlegm triggers convulsions, with deviation of the mouth and eyes, pulling movements of hands and feet, panting, and tidal flow of saliva. Foaming at the mouth occurs; the child wakes slightly after an attack but relapses shortly thereafter. Tidal fever does not subside. Treatment should first purge fire and open phlegm, then calm the spirit and clear heat.
Jing Feng (Startling Wind) has two types: Ji Jing Feng (Acute Startling Wind) and Man Jing Feng (Chronic Startling Wind). Ji Jing Feng is excess and heat, requiring cooling the startle and purging fire; Man Jing Feng is deficiency and cold, requiring warming and tonification. They must not be treated indiscriminately, lest this lead to death.
Ji Jing Feng (Acute Startling Wind): Children generally have robust Yuan Qi (Primal Qi). It may be triggered by terror, Wind pathogen, or dietary irregularities. One must carefully examine and detail the symptoms before applying treatment.
If caused by terror, the child returns to normal after an attack. If there are no other symptoms, first use Li Tan Wan (Phlegm-Resolving Pill) to regulate qi and open phlegm, then follow with An Shen Wan (Spirit-Calming Pill) for regulation.
If caused by Wind-Cold, the child wakes slightly after an attack but relapses shortly. For mild cases, simply swallow Xie Qing Wan (Drain Green Pill) with Dao Chi San (Guide Out the Red Powder) to clear Heart and Liver fire. Subsequently, use Bao Long Wan (Dragon-Preserving Pill) to treat phlegm and Bao Ming Dan (Life-Preserving Elixir) to dispel wind, regulating slowly.
If caused by dietary injury, the child wakes slightly after an attack, cries frequently upon waking, relapses shortly, and loses appetite for milk and food. First, swallow Wu Se Wan (Five-Color Pill) with Chen Pi Mai Ya Tang (Tangerine Peel and Malt Decoction) to push out food stagnation, so that phlegm naturally descends. Then treat with Chen Sha Wu Ling San (Cinnabar Five-Aliquots Powder).
When treating Ji Jing Feng (Acute Startling Wind), except for cases involving food stagnation, do not hastily use purgatives. First inquire about urination and defecation. If urine is clear and stool is unobstructed, the pathogen is in the exterior. Use only Dao Chi San (Guide Out the Red Powder) plus Fang Feng (Saposhnikovia Root), or Xie Qing Wan (Drain Green Pill) minus Da Huang (Rhubarb) plus Quan Xie (Scorpion) decocted as a soup. This removes Cold pathogen from the exterior, and the wind recedes naturally. Afterwards, regulate with Chen Sha Wu Ling San (Cinnabar Five-Aliquots Powder). Do not use She Xiang (Musk), as it may guide the pathogen inward. If urine is red and scanty, and stool is constipated, the pathogen is in the interior. Use Wu Se Wan (Five-Color Pill) to purge. Afterwards, regulate with Bao Long Wan (Dragon-Preserving Pill) and Bao Ming Dan (Life-Preserving Elixir).
When Ji Jing Feng (Acute Startling Wind) attacks, and the jaw is tightly closed with unconsciousness, urgently moxa-burn the Shao Shang acupoint (located beside the nail on the thumb) on both hands simultaneously. The child will awaken, after which treatment can be applied.
For Ji Jing Feng (Acute Startling Wind) with excessive phlegm and rapid breathing, use Ding Chuan Tang (Asthma-Stopping Decoction) plus Zhu Li (Bamboo Sap) for treatment. If phlegm and saliva are obstructive and blocked, emetic therapy may be used.
After the illness subsides, if tidal fever persists, this is Spleen deficiency heat. Treat with Si Jun Zi Tang (Four Gentlemen Decoction) plus Chao Gan Jiang (Stir-fried Dried Ginger). If urine is red, stool is hard, cheeks are red, and calves are hot, this indicates residual pathogens remain; do not view it as deficiency. Use Liang Jing Wan (Cool Startle Pill), taken with decoction of Bo He (Mint) and Deng Xin Cao (Juncus Effusus Pith) for regulation until recovery.
After the illness subsides, if the child sleeps without waking, this indicates residual heat pathogens in the Heart and Spleen meridians have not been fully cleared. Treat with An Shen Wan (Spirit-Calming Pill).
Whenever a child presents with tidal fever, if one observes redness in the cheeks and upward deviation of the eyes, it must be considered Jing Feng (Startling Wind). First, use Dao Chi San (Guide Out the Red Powder) plus Deng Xin Cao (Juncus Effusus Pith) and Bo He (Mint) to remove heat. Next, use Bao Long Wan (Dragon-Preserving Pill) to calm the spirit, so that wind will naturally cease.