疮疡发痉,因气血亏损,外邪所搏,或内虚郁火所致。其症牙关紧急,四肢劲强,腰背反张,肢体抽搐,有汗不恶
寒者,名曰柔痉,风伤卫故有汗也。无汗而恶寒者,名曰刚痉,寒伤荣故无汗也。皆因亡血过多,筋无所养,伤寒汗下
过多,及溃疡产后者多患之,此乃败症也。若大补气血,多有复生,如作风治,速其危矣。治在婴儿尤难调理,宜审其
禀赋,及乳母所致者而治之。
一小儿疮溃后患此,形气殊倦,用十全大补汤二剂稍缓,佐以补中益气汤数剂而痊。
一小儿患瘰 变痉,面青或赤,此脾经血虚而有热也,用八珍汤加柴胡、牡丹皮,热汗渐止;又用十全大补汤,寒
热渐止;又用托里散、附子饼而愈。后伤食,服克伐药仍发痉,手足如冰,余用人参理中丸、五味异功散而愈。
一小儿感冒发散变痉,汗出不止,手足并冷,用补中益气汤加肉桂,四剂而愈。
一小儿金刃伤脚面,出血过多,口噤目直,此出血过多,肝火内动而变症,用四物、参、术、钩藤钩,四剂其势稍
定;又用五味异功散加当归、柴胡变症悉愈;又用托里散、八珍汤,患处溃而痊。
一小儿伤手,出血烦躁,口噤昏愦,气息奄奄,先用东垣圣愈汤而安;又用托里散而溃,佐以八珍汤而敛。
一女子十五岁,伤手指出血,口噤如痉,脉浮数,肝脾为甚,先用加味归脾汤四剂稍缓,又数剂渐苏,却佐以加味
逍遥散,月余而苏,却用归脾汤为主,八珍汤为佐而愈。此等症候,用祛风化痰之药而死者,不可枚举。
十全大补汤(方见便痈)
补中益气汤(方见肌肉不生)
人参理中汤
五味异功散(方见用败毒之药)
附子饼(方见贴骨痈)
托里散(方见热毒疮疡)
归脾汤(方见胁痈)
八珍汤
加味逍遥散(二方见发热不止)
疮疡引发痉挛,是由于气血亏损,外邪侵袭搏结,或者体内虚弱导致郁火内生所致。其症状表现为牙关紧闭紧急,四肢僵硬强直,腰背向后反折如弓,肢体抽搐。如果有汗出且不恶寒的,称为柔痉,这是因为风邪损伤了卫气,所以有汗。如果没有汗出且恶寒的,称为刚痉,这是因为寒邪损伤了营血,所以无汗。这些情况都是因为失血过多,筋脉失去滋养,或者是伤寒病中发汗、攻下过度,以及溃疡疮口或产后妇女多患此病,这属于危重的败症。如果采用大补气血的方法治疗,大多可以起死回生;如果当作风证来治疗,就会加速死亡。对于婴儿的治疗尤其难以调理,应当仔细审查其先天禀赋,以及是否由乳母的影响所致,然后进行治疗。
有一个小儿在疮疡溃破后患上此病,形体和气力都非常疲倦,使用十全大补汤两剂后症状稍缓解,配合服用补中益气汤数剂而痊愈。
有一个小儿患有瘰疬并转变为痉挛,面色青紫或发红,这是脾经血虚而有热,使用八珍汤加入柴胡、牡丹皮,热汗逐渐停止;又使用十全大补汤,寒热症状逐渐停止;又使用托里散、附子饼贴敷而痊愈。后来因饮食积滞,服用克伐(攻伐)药物再次引发痉挛,手足冰冷,我用人参理中丸、五味异功散治疗而痊愈。
有一个小儿因感冒发散(误用发汗解表药)转变为痉挛,汗出不止,手足都冷,使用补中益气汤加入肉桂,四剂后痊愈。
有一个小儿被金刃利器伤及脚面,出血过多,出现牙关紧闭、两眼直视,这是出血过多,肝火内动而变生的病症,使用四物汤、人参、白术、钩藤钩,四剂后病情稍定;又使用五味异功散加入当归、柴胡,变症全部痊愈;又使用托里散、八珍汤,患处溃烂排脓后痊愈。
有一个小儿手部受伤,出血烦躁,牙关紧闭、神志昏乱,气息微弱,先用东垣的圣愈汤使病情安定;又使用托里散使疮口溃破排脓,配合八珍汤促进伤口收敛。
有一个十五岁的女子,手指受伤出血,牙关紧闭如同痉挛,脉象浮数,肝脾两脏受损严重,先用加味归脾汤四剂后稍缓解,又服数剂后逐渐苏醒,随后配合服用加味逍遥散,一个多月后苏醒,最后以归脾汤为主,八珍汤为辅而痊愈。这类症候,如果使用祛风化痰的药物治疗的死者,不可胜数。
十全大补汤(方剂见便痈章节)
补中益气汤(方剂见肌肉不生章节)
人参理中汤
五味异功散(方剂见用败毒之药章节)
附子饼(方剂见贴骨痈章节)
托里散(方剂见热毒疮疡章节)
归脾汤(方剂见胁痈章节)
八珍汤
加味逍遥散(二方见发热不止章节)
Spasms induced by sores and ulcers are caused by deficiency of Qi and Blood, invasion and binding of external pathogens, or endogenous stagnant fire due to internal deficiency. The symptoms include tightness and urgency of the jaw, stiffness and rigidity of the four limbs, opisthotonos (backward arching of the back), and limb convulsions. If sweating occurs without aversion to cold, it is named Rou Jing (Soft Spasm); this is because Wind pathogen damages Wei Qi (Defensive Qi), resulting in sweating. If there is no sweating with aversion to cold, it is named Gang Jing (Hard Spasm); this is because Cold pathogen damages Ying Blood (Nutritive Blood), resulting in absence of sweating. All these conditions arise from excessive blood loss, where tendons and vessels lose nourishment; they are commonly seen after excessive sweating or purgation in Shang Han (Cold Damage) diseases, and in patients with ulcerative wounds or postpartum women. This constitutes a critical condition known as Bai Zheng (Decadent Syndrome). If treated with substantial tonification of Qi and Blood, recovery is often possible; however, if treated merely as a Wind disorder, death will be hastened. Treatment in infants is particularly difficult to manage; one must carefully examine their innate constitution and whether the condition stems from the wet nurse's influence before treating.
A child developed this condition after a sore ulcerated, presenting with extreme fatigue in form and Qi. After two doses of Shiquan Dabu Tang (Complete Great Tonifying Decoction), symptoms slightly alleviated; subsequently, several doses of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) were administered, leading to recovery.
A child suffering from Luoli (Scrofula) developed spasms, with a cyanotic or flushed complexion. This indicated Blood deficiency with heat in the Spleen channel. Bazhen Tang (Eight Treasure Decoction) was used with added Chai Hu (Bupleuri Radix) and Mudan Pi (Moutan Cortex). The hot sweating gradually ceased. Subsequently, Shiquan Dabu Tang was used, and chills and fever gradually stopped. Finally, Tuoli San (Support the Interior Powder) and Fuzi Bing (Aconite Cake) were applied topically, leading to cure. Later, due to food stagnation, the administration of Ke Fa Yao (drugs that attack/deflate) triggered recurrent spasms with ice-cold hands and feet. Ren Shen Lizhong Wan (Ginseng Regulate the Middle Pill) and Wuwei Yigong San (Five-Ingredient Extraordinary Merit Powder) were used to achieve recovery.
A child developed spasms following inappropriate diaphoretic treatment for a common cold, presenting with incessant sweating and cold hands and feet. Buzhong Yiqi Tang with added Rou Gui (Cinnamon Bark) cured the condition in four doses.
A child suffered a laceration on the dorsum of the foot from a sharp instrument, resulting in excessive bleeding, trismus (lockjaw), and fixed gaze. This was attributed to excessive blood loss causing Liver Fire to move internally, generating pathological changes. Siwu Tang (Four Substance Decoction) combined with Ren Shen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Gouteng Gou (Uncariae Ramulus cum Uncis) stabilized the condition in four doses. Wuwei Yigong San with added Danggui (Angelicae Sinensis Radix) and Chai Hu resolved all pathological changes. Finally, Tuoli San and Bazhen Tang were used, leading to suppuration and healing of the affected area.
A child injured the hand, presenting with bleeding, irritability, trismus, confusion, and faint breath. Dongyuan's Shengyu Tang (Sage’s Life-Preserving Decoction) was first used to stabilize the patient. Tuoli San was then used to promote suppuration, assisted by Bazhen Tang to facilitate wound contraction and healing.
A fifteen-year-old girl injured her finger, causing bleeding, trismus resembling spasm, and a floating, rapid pulse, indicating severe involvement of the Liver and Spleen. Jiawei Guipi Tang (Modified Heart-Spleen Tonifying Decoction) was administered for four doses, providing slight relief; continued administration led to gradual revival. Subsequently, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) was added. After more than a month, she fully revived. Finally, Guipi Tang was used as the primary formula with Bazhen Tang as an adjunct, leading to recovery. For such syndromes, those who died using Wind-dispelling and Phlegm-resolving drugs cannot be enumerated.
Shiquan Dabu Tang (Formula see Pian Yong chapter)
Buzhong Yiqi Tang (Formula see Jirou Busheng chapter)
Renshen Lizhong Tang
Wuwei Yigong San (Formula see Yong Baidu Zhi Yao chapter)
Fuzi Bing (Formula see Tie Gu Yong chapter)
Tuoli San (Formula see Redu Chuangyang chapter)
Guipi Tang (Formula see Xie Yong chapter)
Bazhen Tang
Jiawei Xiaoyao San (Two formulas see Refeibuzhi chapter)