周 稚年痫厥。病发迅速。醒来二便自通此系阳气拂逆。阻其灵窍。姑与清络宣通方法。（热邪阻窍）
犀角 远志 胆星 黑山栀 元参 菖蒲 连翘 竹叶心
唐（十四） 面青脉濡。神呆。舌缩不伸。语寂寂然。痫症。四肢皆震。口吐涎沫。此阴风已入脾络矣。
（阴风入脾络）
人参 生术 蜈蚣 全蝎 姜汁炒南星 姜汁炒白附
某 伏邪经旬。发热不解。唇焦舌渴。暮夜神识不清。虑其邪陷心胞。有痉厥之变。（邪逼心胞）
犀角 卷心竹叶 鲜石菖蒲 连翘 元参心 浙生地
又 化热液枯。
生地 竹叶心 丹皮 元参 麦冬 生白芍
吴 冬月伏邪。入春病自里发。里邪原无发散之理。更误于禁绝水谷。徒以芩连枳朴。希图清
火消食。以退其热。殊不知胃汁再劫。肝风掀动。变幻痉厥危 。诊视舌绛。鼻窍黑煤。肌肤甲
错干燥。渴欲饮水。心中疼热。何一非肝肾阴液之尽。引水自救。风阳内烁。躁乱如狂。皆缘医
者未曾晓得温邪从阴。里热为病。清热必以存阴为务耳。今延及一月。五液告涸。病情未为
稳当。所恃童真。食谷多岁。钱氏谓幼科易虚易实。望其尚有生机而已。（热邪伤阴肝风动）
阿胶 生地 天冬 川石斛 鸡子黄 元参心
又 咸润颇安。其热邪深入至阴之地。古云热深厥深。内涸若此。阴液何以上承。虑其疳蚀阻
咽。故以解毒佐之。
元参心 真阿胶 真金汁 细生地 天冬 银花露
又 胃未得谷。风阳再炽。入暮烦躁。防其复厥。
生地 白芍 麦冬 金汁 阿胶 牡蛎 金银花露
又 神识略苏。常欲烦躁。皆是阴液受伤。肝风不息。议毓阴和阳。
生地 牡蛎 阿胶 麦冬 木瓜 生白芍
又 膻中热炽。神躁舌干。痰多咳呛。皆火刑肺金。宜用紫雪丹一钱。
小儿痫痉厥。本属险症。十中每死二三。奈今之患者。十中常死六七。其故何也。盖缘医者。
不察病情。概以芩连钩藤菖蒲橘红等。夹金石之药投之。以冀清火降痰而已。此医之不
善治也。而最可恶者。尤在病家之父母。失于调治。有名为爱之。实以杀之之故。何也。小儿
诸症。如发热无汗。烦躁神昏谵语之顷。或战汗大汗将止之时。或呕吐泄泻之后。或痉厥
渐苏。或便久闭。而适然大便。或灌药之后。斯时正元气与病邪交战之际。若能养得元气
一分。即退一分病邪。此际小儿。必有昏昏欲睡。懒于言语。气怯神弱。身不转动之状。此正
当养其元神。冀其邪退正复。乃病家父母。偏于此际。张惶惊恐。因其不语而呼之唤之。因
其鼾睡而频叫醒之。因其不动而摇之拍之。或因微有昏谵。而必详诘之。或急欲以汤饮
进之。或屡问其痛痒之处。哓哓不已。使其无片刻安宁。如此必轻变为重。重变为死矣。更
有豪富之家。延医数人。问候者多人。房中聚集者多人。或互谈病情病状。夜则多燃灯烛
以照之。或对之哭泣不已。或信巫不信医。祈祷叠兴。举家纷扰。此非爱之。实以杀之也。试
以大人之病情体贴之。抑好安然寂静乎。抑好喧哗动扰乎。此理概可知也。予曾见一孩。
患暑湿初疟。半月有余。病势甚重。医者投以苍术白虎汤。夜半发汗。至寅时身体渐凉。冷
汗不止。默默倦睡。口不肯言。气息甚微。医云六脉安静。并不烦躁。此病退之象也。因戒其
父母。切勿扰动。直至申时。汗止声出。而病已霍然矣。可见无论大人与小儿诸病。总宜安
然寂静为主。其调养之法。有非笔墨所能罄者。惟在病家能细心体会。医者能谆谆告戒。
勿以余言为迂。则幸甚。更有幼孩。发热昏迷。手足厥冷。窍络阻塞。哭不出声。药难下咽。斯
时惟有请善于推拿者。可使立时苏醒。然后再议用药。至于治法。痫痉厥本属三症。与大
方相类。兹不重赘。（华岫云）
徐评 小儿无痫症。不必另立一门。即痉厥亦仅病中之一症耳。
周姓患儿，年幼时患痫厥。发病迅速，醒来后大小便自然通畅。这是阳气拂逆，阻蔽了灵明的清窍。暂且给予清泄络热、宣通窍道的治法。（热邪阻窍）
犀角 远志 胆星 黑山栀 元参 菖蒲 连翘 竹叶心
唐姓患儿（十四岁），面色青，脉象濡软，神情呆滞，舌体短缩不能伸展，沉默不语。此为痫症，四肢震颤，口吐涎沫。这是阴风已侵入脾之络脉所致。
（阴风入脾络）
人参 生白术 蜈蚣 全蝎 姜汁炒制南星 姜汁炒制白附子
某患者，伏留之邪气经过十余日，发热不退，嘴唇焦裂，舌干口渴，夜间神志不清。担心邪气陷入心包，有发生痉厥的变证。（邪气逼迫心包）
犀角 卷心竹叶 鲜石菖蒲 连翘 元参心 浙产生地
又诊：热邪化火耗伤津液，导致阴液枯竭。
生地 竹叶心 丹皮 元参 麦冬 生白芍
吴姓患儿，冬季感受伏邪，入春后病从体内发出。体内的邪气本无发散之理，医生更错误地禁止饮食水谷，仅仅使用黄芩、黄连、枳实、厚朴等药，企图清热消食以退热。殊不知这样再次劫夺胃中津液，引动肝风，变幻出危险的痉厥症状。诊察见舌质深红，鼻孔周围如煤炭般黑燥，肌肤干燥粗糙如鳞甲，口渴想喝水，心中疼痛且有灼热感。哪一样不是肝肾阴液耗尽，饮水自救的表现？风阳在内灼烁，躁动混乱如狂，都是因为医者不懂得温邪从阴分而起，里热为病的道理。清热必须以保存阴液为要务。如今拖延了一个月，五液告竭，病情并不稳妥。所依靠的是患儿天真未泯，进食多年，正如钱乙所说儿科疾病易虚易实，只希望他还有生机罢了。（热邪伤阴，肝风内动）
阿胶 生地 天冬 川石斛 鸡子黄 元参心
又诊：服用咸味滋润药物后颇觉安宁。但热邪深入至阴之地，古语说“热深厥亦深”，内部阴液枯竭如此，阴液如何能上承？担心出现疳蚀阻塞咽喉的情况，所以配合解毒之法。
元参心 真阿胶 真金汁 细生地 天冬 银花露
又诊：胃气未能恢复受纳水谷的功能，风阳再次炽盛，入夜烦躁，防止其再次发生厥逆。
生地 白芍 麦冬 金汁 阿胶 牡蛎 金银花露
又诊：神志稍微清醒，但仍常欲烦躁，这都是阴液受伤，肝风不息的缘故。建议采用滋养阴液、调和阴阳的方法。
生地 牡蛎 阿胶 麦冬 木瓜 生白芍
又诊：膻中部位热势炽盛，神志躁动，舌干，痰多咳嗽呛逆，都是火邪刑克肺金所致。宜用紫雪丹一钱。
小儿的痫、痉、厥，本来属于险恶病症，十人中往往死亡二三人。无奈现在的患者，十人中常死亡六七人。这是什么原因呢？大概是因为医者不考察病情，一概使用黄芩、黄连、钩藤、菖蒲、橘红等夹杂金石类药物投下，只希望清热降痰而已。这是医者不善治疗的表现。而最可恶的，还在于患儿的父母，失于调护，名义上是爱护，实际上是杀害。为什么呢？小儿的各种病症，如发热无汗，烦躁神昏谵语的时候，或战栗出汗大汗将要停止的时候，或呕吐泄泻之后，或痉厥逐渐苏醒，或大便久闭突然通畅，或灌药之后，这时正是正气与病邪交战的关键时刻。如果能养护一分正气，就能退却一分病邪。此时小儿，必定会有昏昏欲睡，懒于言语，气怯神弱，身体不动的状态。这正当养护其元神，期望邪退正复。然而患儿的父母，偏偏在此时惊慌恐惧，因为孩子不说话就呼唤他，因为孩子打鼾睡觉就频繁叫醒他，因为孩子不动就摇晃拍打他，或者因为轻微的神志恍惚谵语，就必定详细询问他，或者急于喂汤药，或者屡次问痛痒之处，喋喋不休，使他不得片刻安宁。这样做必然使轻症变为重症，重症变为死亡。更有豪富之家，请多位医生，问候的人众多，房中聚集多人，互相谈论病情病状，夜里多燃灯烛照明，对着孩子哭泣不止，或者信巫不信医，祈祷不断，全家纷扰。这不是爱他，实际上是杀他啊。试着用大人的病情来体贴体会一下，是喜欢安然寂静呢，还是喜欢喧哗动扰呢？这个道理大概可以知道了。我曾见过一个孩子，患暑湿初起疟疾，半月有余，病势很重。医生投以苍术白虎汤，半夜发汗，到寅时身体渐渐凉下来，冷汗不止，默默倦睡，口不肯言，气息很微弱。医生说六脉安静，并不烦躁，这是病退的迹象。于是告诫其父母，切勿打扰惊动，直到申时，汗止声音发出，病已经霍然痊愈了。可见无论大人和小孩的各种疾病，总以安然寂静为主。其调养的方法，有笔墨无法穷尽的，只在病人家属能细心体会，医者能谆谆告诫，不要认为我的话迂腐，那就万幸了。还有幼孩，发热昏迷，手足厥冷，窍络阻塞，哭不出声，药难下咽，这时只有请善于推拿的人，可以使立即苏醒，然后再议用药。至于治法，痫、痉、厥本来属于三种病症，与大方的治法相似，这里不再重复赘述。（华岫云评注）
Zhou, a young child suffering from epilepsy and convulsions. The onset was rapid, and upon waking, urination and defecation occurred naturally. This is due to the rebellion of Yang Qi obstructing the orifices of spiritual clarity. Temporarily employ methods to clear the collaterals and promote unblocking. (Heat pathogen obstructing the orifices)
Rhinoceros Horn (Xijiao), Polygala Root (Yuanzhi), Phallenia Scabra Rhizome Processed with Pig Bile (Danning), Black Gardenia Fruit (Heishanzhi), Scrophularia Root (Yuanshen), Acorus Tatarinowii Rhizome (Changpu), Forsythia Fruit (Lianqiao), Heart of Bamboo Leaf (Zhuyexin).
Tang (14 years old), complexion cyanotic, pulse soggy, spirit dull, tongue retracted and unable to extend, silent speech. Epilepsy, tremors in all four limbs, foaming at the mouth. This indicates Yin Wind has entered the Spleen collaterals.
(Yin Wind entering Spleen collaterals)
Ginseng Root (Renshen), Raw Atractylodes Macrocephala Rhizome (Shengzhu), Centipede (Wugong), Whole Scorpion (Quanxie), Pinellia Ternata Tuber Processed with Ginger Juice (Jiangzhichao Nanting), Typhonium Rhizome Processed with Ginger Juice (Jiangzhichao Baifu).
Certain patient, latent pathogen persisting for over ten days, fever unresolved, lips cracked, tongue dry and thirsty, mental confusion at night. Fear that the pathogen has sunk into the Pericardium, risking transformation into stiff neck and convulsions. (Pathogen forcing its way into the Pericardium)
Rhinoceros Horn (Xijiao), Rolled Bamboo Leaf (Juanxin Zhuyeqin), Fresh Acorus Tatarinowii Rhizome (Xian Shichangpu), Forsythia Fruit (Lianqiao), Center of Scrophularia Root (Yuanshenxin), Zhejiang Rehmannia Root (Zhe Shengdi).
Re-examination: Heat transforms into fire, consuming fluids; Yin fluids are exhausted.
Rehmannia Root (Shengdi), Heart of Bamboo Leaf (Zhuyexin), Moutan Bark (Danpi), Scrophularia Root (Yuanshen), Ophiopogon Tuber (Maidong), Raw White Peony Root (Sheng Baishao).
Wu, a child who contracted latent pathogen in winter, disease emerging from the interior in spring. Interior pathogens have no principle of dispersal. Furthermore, the physician erroneously prohibited food and water, using only Scutellaria Root (Huangqin), Coptis Rhizome (Huanglian), Immature Bitter Orange (Zhishi), and Magnolia Bark (Houpo), hoping to clear heat and digest food to reduce fever. Little did they know this further robbed the Stomach juices, stirring up Liver Wind, leading to dangerous transformations of stiff neck and convulsions. Examination revealed crimson tongue, nostrils black like coal, skin dry and rough like fish scales, thirst desiring water, pain and burning sensation in the heart region. Are these not signs of exhaustion of Liver and Kidney Yin fluids, drinking water to save oneself? Internal scorching by Wind-Yang, restlessness and madness, all stem from the physician's ignorance that warm pathogens arise from the Yin level and interior heat causes illness. Clearing heat must prioritize preserving Yin. Now extended to one month, the Five Fluids are depleted, condition precarious. Relying on the child's innate vitality and long nursing, as Qian Yi stated, pediatric diseases are prone to both deficiency and excess; we can only hope for remaining vitality. (Heat pathogen injuring Yin, stirring Liver Wind)
Donkey-Hide Gelatin (Ejiao), Rehmannia Root (Shengdi), Asparagus Tuber (Tiantong), Dendrobium Stem (Chuan Shihu), Chicken Egg Yolk (Jizihuang), Center of Scrophularia Root (Yuanshenxin).
Re-examination: Salty moistening agents provided relief. However, heat pathogen has penetrated to the deepest Yin levels. As the ancients said, "The deeper the heat, the deeper the cold extremities." With such internal depletion, how can Yin fluids ascend? Fear of gan erosion blocking the throat, so antidotal measures were added.
Center of Scrophularia Root (Yuanshenxin), Genuine Donkey-Hide Gelatin (Zhen Ejiao), Genuine Gold Juice (Zhen Jinzhi), Fine Rehmannia Root (Xi Shengdi), Asparagus Tuber (Tiantong), Honeysuckle Infusion (Yinhualu).
Re-examination: Stomach failed to receive grain, Wind-Yang flared again, irritability at dusk, preventing recurrence of syncope.
Rehmannia Root (Shengdi), White Peony Root (Baishao), Ophiopogon Tuber (Maidong), Gold Juice (Jinzhi), Donkey-Hide Gelatin (Ejiao), Oyster Shell (Muli), Honeysuckle Infusion (Yinhualu).
Re-examination: Spirit slightly recovered, yet often irritable. All due to injured Yin fluids and unceasing Liver Wind. Propose nourishing Yin and harmonizing Yang.
Rehmannia Root (Shengdi), Oyster Shell (Muli), Donkey-Hide Gelatin (Ejiao), Ophiopogon Tuber (Maidong), Quince (Muwa), Raw White Peony Root (Sheng Baishao).
Re-examination: Intense heat in the Chest Center (Shanzhong), restless spirit, dry tongue, profuse phlegm, coughing and wheezing. All indicate Fire punishing Lung Metal. Should use Zi Xue Dan (Purple Snow Pill) one qian.
Pediatric epilepsy, stiff neck, and convulsions are inherently perilous conditions, with two or three deaths out of ten. Regrettably, current patients show six or seven deaths out of ten. Why? Because physicians fail to examine the condition accurately, indiscriminately prescribing Scutellaria (Huangqin), Coptis (Huanglian), Uncaria Ramulus cum Uncis (Gouteng), Acorus (Changpu), Tangerine Peel (Juhong), etc., mixed with mineral drugs, merely hoping to clear heat and descend phlegm. This is poor medical practice. Most detestable, however, lies with the parents' failure in care, ostensibly out of love but actually causing death. Why? In various pediatric conditions, such as fever without sweat, irritability, coma, and delirium; or during the cessation of chills-sweating; or after vomiting and diarrhea; or as convulsions subside; or after prolonged constipation followed by sudden bowel movement; or after administering medicine—these are moments when healthy Qi battles the pathogen. If one nurtures even a fraction of healthy Qi, one repels a fraction of the pathogen. At this time, the child will appear drowsy, reluctant to speak, weak in Qi and spirit, and immobile. This is precisely when one should nurture the Primordial Spirit, hoping for pathogen retreat and Zheng recovery. Yet parents panic, calling out because the child is silent, waking them frequently due to snoring sleep, shaking and patting due to immobility, interrogating due to slight delirium, rushing to administer decoctions, repeatedly asking about pain or itchiness, incessantly disturbing them, allowing no peace. Thus, mild cases become severe, severe cases become fatal. Moreover, wealthy families summon multiple physicians, numerous visitors gather, discussing illnesses loudly, lighting many lamps at night, crying before the child, trusting shamans over doctors, engaging in endless prayers, causing family chaos. This is not love, but killing. Consider adult conditions: do they prefer tranquility or noise? This logic is evident. I once saw a child with early-stage summerheat-damp malaria lasting over half a month, severe condition. Physician prescribed Cang Zhu Bai Hu Tang (Atractylodes Macrocephala and White Tiger Decoction). Sweat occurred at midnight. By Yin hour, body cooled, cold sweat continued, silent drowsiness, refusal to speak, faint breath. Physician noted calm six pulses, no irritability, indicating disease retreat. Warned parents not to disturb until Shen hour. Sweat stopped, voice returned, disease resolved completely. Thus, regardless of age, tranquility is paramount for all diseases. Care methods exceed words; it depends on parents' careful observation and physicians' earnest warnings. Do not deem my words pedantic; this would be fortunate. For infants with fever, coma, cold extremities, blocked orifices and collaterals, inability to cry, difficulty swallowing medicine, only skilled massage (Tui Na) can restore consciousness immediately, after which medication can be considered. Regarding treatment, epilepsy, stiff neck, and convulsions share similarities with general formulas, so repetition is omitted. (Commentary by Hua Xiuyun)
Xu's Commentary: Children do not have independent epilepsy; there is no need to establish a separate category. Even stiff neck and convulsions are merely symptoms within a disease.