冬令暴冷折阳,外感发热,头疼身痛,呕恶必从太阳。若渴能饮水者,则里热见症,又非伤寒可比。幼科太
阴中寒居多,厥阴间亦有之,若冬令应寒而反温,气候应藏反泄,即病冬温,古法亦以辛温为主。
〔真按〕冬温非寒症可解,若涉表邪一二,里热必兼七八,或外受之邪,与里邪相搏,则郁于经络,治法
当以里证为主,稍兼清散,方用大沙参三钱,桑叶二钱,肥玉竹三钱,生苡仁三钱,甜杏仁三钱,苦杏仁二钱,
炒麦冬钱半,生甘草之分,引用丝瓜络三寸、广橘络钱半为剂。
惊风二字,立名不慎,小儿之罹其厄者,指不胜屈,揆厥原因,实不能归咎于钱仲阳,虽喻嘉言欲纠正之,
莫能翻其成案,吁!可慨也。考惊风古有八候之名。
一曰搐,谓肘臂伸缩也。
二曰搦,谓十指开合也。
三曰掣,谓肩头相扑也。
四曰颤,谓手足动摇也。
五曰反,谓身仰向后也。
六曰引,谓手足开弓也。
七曰窜,谓目直而似怒也。
八曰视,谓睛露而不活也。
此八候者,无论急惊、慢惊、慢脾风,皆见之候,故谓之惊风八候。厥后因证立名,又有三十个某惊之名,
间多乖谬,姑举之以明画蛇添足之说。
一曰急惊,口眼歪斜,四肢搐掣,痰壅心迷,人事不省,谓肝经积热风火之证也。
二曰慢惊,面青唇白,四肢厥冷,人事昏迷,手足搐掣,眼翻痰壅,谓由大病之后,吐泻之余,脾土虚败,
肝木无风而自动也。
三曰盘肠惊,气吼肚膨,饮食不进,人瘦体弱,肚起青筋,眼黄手软,大小便不通,肚腹疼痛,谓六腑有寒也。
四曰马蹄惊,四肢乱舞,头向上,谓因受风热被吓之症也。
五曰鲫鱼惊,口吐白沫,四肢摆动,嘴歪常搭,眼翻白,谓胃经有风,脾经有寒也。
六曰摆手惊,两眼向上,四肢反后,或两手垂下,眼黄口口,人事昏沉,谓因水唬,掐之觉痛者治之,
不痛不治。
七曰宿沙惊,曰轻夜重,到晚昏迷,口眼歪斜,四肢掣跳,黑鼻气凝,谓脾肾有寒之证也。
八曰内吊惊,两眼迷闭,哭声不止,面青眼黄,手眼望内掣者,谓肺经受寒症也。
九曰天吊惊,眼向上,哭声号,四肢掣,口眼歪斜,鼻流清水或衄血,谓肺经受风,或食后感寒而成也。
十曰弯弓惊,头仰后,四肢向后,眼翻或闭,腹胀,哭声不止,谓肺受风积痰所致也。
十一曰蛇丝惊,口中拉舌,肢冷而掣,哭声不出,谓心经有热,睡中食乳口角入风也。
十二曰鹰爪惊,两手抓人,捻拳切牙,手望下,口望上,身寒战,谓被吓伤乳,心有风热也。
十三曰乌沙惊,四肢掣跳,口唇青黑,肚胀青筋,谓脏腑受寒之证也。
十四曰乌鸦惊,手足掣跳,口眼俱闭,大叫一声,形状呆滞,谓心有热有痰也。
十五曰锁心惊,口吐沫,鼻流血,四肢软,好吃冷物,眼白不哭,谓心肝经有热,火盛痰壅之证也。
十六曰撒手惊,翻眼切牙,手足一掣一不动,谓心经被风吓,先寒后热,有痰之证也。
其余胎惊、月家惊、潮家惊、脐风惊、呕逆惊、泄泻惊、膨胀惊、夜啼惊、看地惊、飞大惊、擗地惊、马路
惊、瞌睡惊、饕餮惊。
凡如此类,种种牵强不通名目,一若有病皆惊,无病非惊,惊之命名虽多,究不越急慢惊之范围,附会穿
插,类似雷同,以眩耀庸耳俗目,误药误儿,职此之故,吁!更可哂也。
惊字命名,均不可靠,再祥叙诸家惊风之说,加以签注,其说益明。
或曰∶急惊身热目赤,口鼻气粗,痰涎潮涌,忽然而发,发过容色如旧,有因惊骇者,亦有不因惊骇者,大
都是火燥木急,故身先有热,未有身凉而发者,证皆属阳,宜用凉剂,除热化痰,则惊自息,昔人谓痰生热,热
生风,风生惊,其实皆本气自病,世不解风自内生,徒执天麻、胆星、栝蒌、贝母、僵蚕、全蝎,杂乱风痰之
药,治之不应,更以夺命丹、或蜡丸、牛黄丸、紫雪丹等药治之,及至元气损伤,虚痰上逼,胸膈膨胀,则谓证
变结胸,有是理哉。
〔真按〕目赤、身热、气粗、痰壅诸见端,皆由外感内伤,安有突如其来。又云火燥木急,亦有因寒伤筋而
急者,未必尽由火燥。又云身先有热而发,此热究竟在表在里,并未指明。又云宜用凉剂,仍虑引邪入里。又云
本气自病,毫无根据。又云风自内生,安知其非由外生。此说之不足凭者一也。
或曰∶惊者吓也,由儿先有内伤,复来外感,肺窍痰迷,心无所主,一着惊而即发也。
〔真按〕先内伤而复外感,以致肺窍痰迷,心无所主者,非由于惊,而实由于病也,迨一着惊而即发,如专
治惊而不治痰,置内伤外感于不问,不揣其本,而求其末,安望其药能中病。此说之不足凭者二也。
或曰∶惊生于心,痰生于脾,风生于肝,热出于肺,此一定之理也,热盛则生风,风盛生痰,痰盛生惊,此
贼邪必至之势也,疗惊必先豁痰,豁痰必先祛风,祛风必先解热,而解热又将以何为先乎,肺主皮毛,皮毛为热
邪出入之门户,彼风、寒、
暑、湿、燥、火六淫之气,皮毛受之,即入于肺,肺本出热地也,燥火暑邪一入,则热与热根据,而热盛,风寒湿
邪一入,肺窍为之闭塞,则热无所泄,而热亦盛,故解热必先祛邪。
〔真按〕惊生于心等语,是惊风痰热,皆由本脏自生,又云热生风,风生痰,痰生惊,何以又认为贼邪,治
惊先治痰,治痰先治热,治热先治风,又明指外邪非心肝脾肺自主,即云内生,又云外至,前后语相矛盾,难以
自圆,且肺为清肃之地,非出热之地,六淫初入,无过皮毛,使知先从外解,何至使入肺窍,而致胃塞耶,其归
宿一语,又云解热必先祛邪,更与各本脏自生之说,互相抵忤,此说之不足凭者三也。
或曰∶急惊者,肝经血虚,火动生风,盖风生则阴血愈散,阴火愈炽,火动则肺金愈虚,肝邪愈炽,宜滋肝
血,养脾气,若屡服祛风化痰之剂而不效,泻火而亦不效,便宜认作脾虚血损,急补脾土。
〔真按〕所云阴虚则阴火愈炽,是不知肺为何物而言,如果火盛生风,则祛风化痰泻火之剂,不为误用,
至屡服不效,急补脾土,可见证候不确,药不对病,误治致变,虽煞费揣摩,亦终归于无济。此说之不足凭者四也。
或曰∶急惊属木火土实,木实则搐而有力,两目上视,土实则身热面赤,而不吐泻,偃卧合睛,治宜凉泻,
亦有因惊而发者,壮热、牙关紧急,此内有实热,外有风邪,当截风定搐。
〔真按〕所云木火土实,不知所解,盖木邪凌土,木旺土衰,何以土亦云实,又云因惊而发,可知其神必
虚,神虚则火虚,又非火实,以截风定搐为利器,类皆以风药尝试之。此说之不足者凭五也。
或曰∶急惊者,壮热痰壅、窜视反张,搐搦掣动,牙关紧急,口中气热,颊赤唇红,脉浮洪数,此肝邪风热,
阳盛阴虚证也。
〔真按〕上述症候,明明表邪失治,未能外解,以致热邪入里,表里俱急之状,安得谓之急惊。此说之不
足凭者六也。
或曰∶小儿惊风,肝病也,亦脾热心肺病也,盖小儿之真阴未足,柔不济刚,故肝邪扫动,木能生火,火能
生风,风热相搏则血虚,血虚则筋急,筋急则眩掉反张强直之类,皆肝木之本证也,至其相移,木邪侮土则脾病,
木盛金衰则肺病,木火相炎则心病,木火伤阴则肾病,此五脏惊风之大概也,治之之法,一曰风,二曰火,三曰
痰,四曰阳虚,五曰阴虚。
〔真按〕人身荣卫脉度,每日寅时,起于手太阴肺,然后五十度周于身,至丑时终于足厥阴肝,寅时复交
于肺,今专指肝邪,殊不适当,即眩掉反张强直,本内经太阳经所主之病,亦非专属于肝,若因肝而波及此脏,
速宜滋水养血,犹虑其迟,安能一味施以攻伐,最后所云阳虚阴虚,与惊风毫不相涉。此说之不足凭者七也。
或曰∶急慢惊风,古人所谓阴阳痫也,急惊属阳,慢惊属阴,惊邪入心,则面红颊赤,惕惕夜啼,入肝则面
目皆青,眼睛窜视,入肾则面黑恶叫,啮齿咬人,入肺则面色淡白,喘息气急,入脾则呕吐不食,面色淡黄,然
风非火不动,火非风不发,风火相搏而成惊风,故心肝二脏主之,然火虚则金伤,水失其母,而火无所畏,且木
无所制,而脾土又受伤矣。
〔真按〕痫为痼疾,非惊风之暴病,惊惟心脏受之,何至入肝入脾入肺入肾,既云惊入五脏,则肝风无与
焉。又云风火相搏而成惊风,心肝为主,欲证其木火生风之语,殊近牵扯。若云水盛则火伤,土失其母,而水无
所畏,且金无所制,而肝木又受伤,亦无不可。此说之不足凭者八也。
或∶急惊者阳证也,小儿阳常有余,阴常不足,易于生热,热甚则生风生痰生惊,且饮食难节,喜怒不常,
暴怒伤阴,暴喜伤阳,伤阴则泻,伤阳则惊,小儿暴喜伤乳,夫乳甘缓恋膈,又
兼外感寒邪,则痰凝壅塞,郁滞熏蒸,内有食热,外有风寒,心家热甚则生惊,肝家风甚则发搐,肝风心火交争,
故痰生于脾,风生于肝,惊出于心,热出于肺,惊风痰热四证,而八候生焉。
〔真按〕儿体易虚易实,阳未必尽有余,阴未必常不足,经曰婴儿内脆,血少气弱,未尝云血少气多,盖
谓真气未生,惟此呼吸一腺而已,阳既有余,何又有暴喜伤阳之虑,乳非属阳,何以有暴喜伤乳之词,从阳盛阴
虚、以及饮食喜怒、内伤外感,仍旧说到惊风痰热,杂乱无章。此说之不足凭者九也。
或曰∶急慢惊风,或闻大声,或大惊而发搐,发过如故,此无阴也,当下之,此证因热生于心,身热面赤嗜
饮,口中气热,大小便黄赤,剧则热也,盖热盛则生风,属肝阳或阴证也,阴证指阴虚而言,故下之以除其痰,
小儿痰热客于心间,因闻非常之声而发搐,若热盛,不闻声及惊,亦自惊而自发搐矣。
〔真按〕内经之大惊猝恐,气血分离,此正神志受伤,阴阳破败,急救尚恐不及,何以谓无阴而当下,且
既云因惊,何以又云心热,既云发过如故,何以又云身热面赤二种,宜除其痰,况小儿禀受薄者,先天不足于妊
前,癸水未成于现下,元精未满,元气无根,何得因惊而牵扯及热生风乎。此说之不足凭者十也。
或曰∶小儿平常无事,忽然壮热,手足抽搐,眼目戴上,涎潮壅塞,牙关紧急,身热目赤,此急惊属阳,病在腑。
〔真按〕小儿忽发壮热,及种种恶候,非风寒入里为壮热,即饮食停滞为壮热,此实因病而发。固非平常
无事之谓,但应察其受病之原,外因则达之发之,内因则导之化之,又云急惊属腑,则与心脏肝脏渺不相关,断
无是理。此说之不足凭者十一也。
或曰∶急惊者阳证也,俱腑受病耳,小儿客痰热于心膈,是少阳相火旺,经云∶热生风,因时火盛而作,盖
东方之震木,得火气而发搐。
〔真按〕心火显非少阳相火,其云震木得火而搐,亦属杜撰。此说之不足凭者十二也。
或曰∶身热脉浮,精神恍惚,或吐泻不思乳食,发搐,即半阴半阳合病,身热脉沉,精神倦怠,或吐或泻,
又能乳食,发搐,亦半阴半阳合病。
〔真按〕脉浮属太阳,明明外感风寒,吐泻兼作,属阳明太阴,明明内伤饮食,身热脉沉,属太阳受寒,但
吐不泻,属阳明伤食,明明夹食伤寒,不得谓为半阴半阳,更不得谓之惊风。此说之不足凭者十三也。
或曰∶亦有急惊惊泻而不愈,或与吐下药太过,变为慢惊者,又有慢惊补温而不愈,变为急惊者。
〔真按〕诸书以急惊为阳,为实热,既是急惊,则用凉泻无疑,何以不愈,盖因误以伤寒表证为急惊,所以
不愈也,既系脾虚阴寒为慢惊,则用温补适宜,何以不特不愈,反加变证,盖因误以伤寒自汗为慢惊,不知此
证本有风邪,在表,正宜外解,而误用温补,所以更剧。此说之不足凭者十四也。
或曰∶病有阴阳,急惊风属实热,病在心肝二脏,谓之阳痫,慢惊风属虚寒,病在脾肺二脏,谓之阴痫,此
以寒热分阴阳也,五脏属阴,六腑属阳,急惊发于六腑为易治,慢惊发于五脏为难治,此以脏腑分阴阳也。
〔真按〕上节云急惊病在心肝,慢惊病在脾肺,此以急慢二惊属五脏,与六腑无涉也明矣。下节又云急惊发
于六腑,慢惊发于五脏,是又以脏腑皆有惊风也,属脏属腑,且分不清,治证安有不误。此说之不足凭者十五也。
诸家之说,曰风,曰痰,曰惊,曰吓,曰火,曰热,曰血虚,曰木急,曰相火,曰阴火,曰外感,曰内伤,
曰喜怒,曰乳哺,曰阳盛,曰阴虚,曰属腑,曰属脏,种种不经之言,究与惊风二字,毫无着落,夫所谓惊风者,
必须认定此两字,针锋相
对,加以急字或慢字,更须字字贴切,方可命名,独慨夫世之有是症,而不必以此命名者,使忽改此名而不仍其
旧,恐一误再误,其误伊芳于胡底,今姑从世俗最普通习惯之名称,并古之举症施治,详列辨明于后。
冬令时节突然寒冷,损伤阳气,若外感发热,出现头痛、身体疼痛,呕吐恶心等症状,病位多从太阳经开始。如果口渴且能饮水,则说明体内有热证表现,这就不是伤寒所能比拟的了。儿科疾病中,太阴脾经受寒的情况居多,厥阴肝经受邪的情况也有发生。如果在冬季本该寒冷的时候反而温暖,气候本该闭藏的时候反而泄散,就会引发“冬温”病。古代的治疗方法多以辛温解表为主。
〔陈守真按〕:冬温并不是单纯的寒症可以用温法解除的。如果涉及表邪一二分,里热必然兼有七八分。或者是外受的邪气与体内的邪气相互搏结,郁积在经络之中。治疗应当以调理里证为主,稍微兼顾清热发散。方剂使用大沙参三钱,桑叶二钱,肥玉竹三钱,生薏苡仁三钱,甜杏仁三钱,苦杏仁二钱,炒麦冬一钱半,生甘草三分,引用丝瓜络三寸、广橘络一钱半作为药引煎服。
“惊风”这两个字,命名不够审慎。遭受这种病症折磨的小儿,数不胜数。推究其根本原因,实在不能归咎于宋代医家钱仲阳(钱乙)。虽然明代医家喻嘉言想要纠正这一名称,但无法推翻既成的定论,唉!真是令人感慨。考证发现,古时候惊风有“八候”的名称。
第一叫“搐”,指的是肘部和手臂的伸缩抽动。
第二叫“搦”,指的是十个手指的开合痉挛。
第三叫“掣”,指的是肩膀头部相互扑动牵扯。
第四叫“颤”,指的是手脚摇动颤抖。
第五叫“反”,指的是身体向后仰倒角弓反张。
第六叫“引”,指的是手脚像拉弓一样伸展拘急。
第七叫“窜”,指的是眼睛直视且似乎发怒的样子。
第八叫“视”,指的是眼球外露且转动不灵活。
这八种症状,无论是急惊风、慢惊风还是慢脾风,都会见到这些征象,所以称之为惊风八候。后来因为根据症状立名,又有了三十多种带“惊”字的病名,其中很多谬误。姑且列举一些来说明这是画蛇添足的说法。
第一种叫急惊风,表现为口眼歪斜,四肢抽搐痉挛,痰液壅塞心窍导致神志昏迷,人事不省,这被认为是肝经积热、风火相煽的证候。
第二种叫慢惊风,表现为面色青白,嘴唇苍白,四肢厥冷,人事昏迷,手脚抽搐痉挛,眼睛上翻,痰液壅塞,这被认为是在大病之后,吐泻之余,脾土虚弱败坏,肝木没有风邪却自动妄动的结果。
第三种叫盘肠惊,表现为气喘肚胀,饮食不进,人瘦体弱,腹部鼓起青筋,眼黄手软,大小便不通,肚腹疼痛,这被认为是六腑有寒的表现。
第四种叫马蹄惊,表现为四肢乱舞,头向上仰,这被认为是因受风热惊吓导致的病症。
第五种叫鲫鱼惊,表现为口吐白沫,四肢摆动,嘴歪常搭,眼睛上翻白眼,这被认为是胃经有风,脾经有寒的表现。
第六种叫摆手惊,表现为两眼向上,四肢向后反张,或者两手垂下,眼黄口角流涎,人事昏沉,这认为是因为被水吓到所致,掐之觉痛的要治疗,不痛的不治。
第七种叫宿沙惊,表现为白天轻晚上重,到了晚上昏迷,口眼歪斜,四肢抽搐跳动,鼻孔黑气凝结,这被认为是脾肾有寒的证候。
第八种叫内吊惊,表现为两眼迷闭,哭声不止,面青眼黄,手眼向内牵引抽搐,这被认为是肺经受寒的证候。
第九种叫天吊惊,表现为眼睛向上,哭声号叫,四肢抽搐,口眼歪斜,鼻流清水或鼻出血,这被认为是肺经受风,或者进食后感寒而成的。
第十种叫弯弓惊,表现为头向后仰,四肢向后伸展,眼睛上翻或闭合,腹胀,哭声不止,这被认为是肺受风邪积聚痰浊所致。
第十一种叫蛇丝惊,表现为口中伸舌,肢体冰冷而抽搐,哭不出声,这被认为是心经有热,睡觉时吃奶嘴角进风所致。
第十二种叫鹰爪惊,表现为两手抓人,捻拳磨牙,手向下,口向上,身体寒战,这被认为是被惊吓伤及乳食,心有风热的表现。
第十三种叫乌沙惊,表现为四肢抽搐跳动,口唇青黑,肚胀青筋,这被认为是脏腑受寒的证候。
第十四种叫乌鸦惊,表现为手足抽搐跳动,口眼俱闭,大叫一声,形状呆滞,这被认为是心有热且有痰的表现。
第十五种叫锁心惊,表现为口吐泡沫,鼻流血,四肢软弱,喜欢吃冷物,眼白不哭,这被认为是心肝经有热,火盛痰壅的证候。
第十六种叫撒手惊,表现为翻眼磨牙,手足一抽一动,这被认为是心经被风惊吓,先寒后热,有痰的证候。
其余还有胎惊、月家惊、潮家惊、脐风惊、呕逆惊、泄泻惊、膨胀惊、夜啼惊、看地惊、飞大惊、擗地惊、马路惊、瞌睡惊、饕餮惊等。
凡是如此类种种牵强不通的名目,仿佛是有病就是惊,无病就不是惊。惊风的命名虽然多,终究不离急惊和慢惊的范围,这些都是附会穿插,类似雷同,用来炫耀庸俗之辈的耳朵和眼睛,导致误药误儿,就是这个缘故,唉!更令人可笑。
用“惊”字命名,都不可靠。再详细叙述各家关于惊风的说法,加以签注,道理就更加明白了。
有人说:急惊风身体发热,眼睛红赤,口鼻气息粗重,痰涎如潮涌般发作,突然发病,发作过后脸色如旧。有的因为惊吓引起,也有的不因惊吓引起。大都是火燥木急,所以身体先有热,没有身体凉快才发病的。证候都属于阳证,适宜用凉剂,清除热邪化痰,惊风自然平息。古人说痰生热,热生风,风生惊,其实这都是本气自病。世人不懂风是从内生发的,只执着于使用天麻、胆星、栝蒌、贝母、僵蚕、全蝎等杂乱的风痰药物来治疗,治疗无效,再用夺命丹、蜡丸、牛黄丸、紫雪丹等药物治疗。等到元气损伤,虚痰上逼,胸膈膨胀,就说证候变成了结胸,哪有这个道理呢?
〔陈守真按〕:眼睛红赤、身体发热、气息粗重、痰液壅塞等各种表现,都是由外感内伤引起的,怎么会有突如其来的情况?又说火燥木急,也有因为寒邪损伤筋脉而导致拘急的,未必全部是由火燥引起。又说身体先有热才发病,这热究竟在表还是在里,并没有指明。又说适宜用凉剂,仍然担心引邪入里。又说本气自病,毫无根据。又说风从内生,怎么知道它不是由外而生?这个说法不足以凭信,这是一点。
有人说:惊就是惊吓。因为小儿先有内伤,又外来感受邪气,肺窍被痰迷住,心神无所主宰,一旦受到惊吓就立即发病。
〔陈守真按〕:先有内伤又复外感,导致肺窍痰迷,心神无所主宰的,不是因为惊吓,而是确实因为生病。等到一受到惊吓就立即发病,如果专门治疗惊风而不治疗痰浊,置内伤外感于不问,不探究根本,而追求末节,怎么能希望药物能击中病灶呢?这个说法不足以凭信,这是第二点。
有人说:惊生于心,痰生于脾,风生于肝,热出于肺,这是固定的道理。热盛则生风,风盛生痰,痰盛生惊,这是贼邪必至的趋势。治疗惊风必须先豁痰,豁痰必须先祛风,祛风必须先解热,而解热又要以什么为先呢?肺主皮毛,皮毛是热邪出入的门户。风寒暑湿燥火六淫之气,皮毛受之,即进入肺脏。肺本是出热之地,燥火暑邪一进入,则热与热结合,热势盛大;风寒湿邪一进入,肺窍为之闭塞,则热无处宣泄,热势也盛大。所以解热必须先祛邪。
〔陈守真按〕:“惊生于心”等话语,是说惊风痰热都由本脏自生。又说热生风,风生痰,痰生惊,为什么又认为是贼邪?治惊先治痰,治痰先治热,治热先治风,又明确指外邪非心肝脾肺自主。如果说内生,又说外至,前后言语矛盾,难以自圆其说。而且肺为清肃之地,不是出热之地。六淫初入,不过皮毛,如果知道先从外部解除,何至于让邪气进入肺窍,导致胃气壅塞?最后归结为一句话,又说解热必须先祛邪,更与各本脏自生的说法互相抵触。这个说法不足以凭信,这是第三点。
有人说:急惊风是肝经血虚,火动生风。盖因风生则阴血愈散,阴火愈炽;火动则肺金愈虚,肝邪愈炽。适宜滋补肝血,养护脾气。如果屡次服用祛风化痰的药剂而不效,泻火也不效,就应当认作脾虚血损,紧急补益脾土。
〔陈守真按〕:所说的阴虚则阴火愈炽,是不了解肺为何物的言论。如果确实是火盛生风,那么祛风化痰泻火的药剂就不算误用。至于屡次服用不效,紧急补益脾土,可见证候判断不准确,药物不对症,误治导致病变。虽然煞费苦心揣摩,最终也无济于事。这个说法不足以凭信,这是第四点。
有人说:急惊风属于木火土实。木实则抽搐有力,两目上视;土实则身体发热面赤,而不吐泻,仰卧合眼。治疗适宜凉泻。也有因惊吓而发病的,壮热、牙关紧急,这是内有实热,外有风邪,应当截风定搐。
〔陈守真按〕:所说的木火土实,不知所云。大概木邪凌犯脾土,木旺土衰,为什么说土也是实?又说因惊吓而发病,可知其神必虚,神虚则火虚,又不是火实。用截风定搐作为利器,大都是用风药尝试治疗。这个说法不足以凭信,这是第五点。
有人说:急惊风,壮热痰壅,目睛窜视,角弓反张,抽搐痉挛,牙关紧急,口中气息热,脸颊红嘴唇红,脉象浮洪数,这是肝经风热,阳盛阴虚的证候。
〔陈守真按〕:上述症候,明明是表邪失治,未能外解,导致热邪入里,表里俱急的状态,怎么能说是急惊风?这个说法不足以凭信,这是第六点。
有人说:小儿惊风,是肝病,也是脾、心、肺的病。因为小儿的真阴不足,柔不能济刚,所以肝邪扫动,木能生火,火能生风,风热相搏则血虚,血虚则筋急,筋急则出现眩晕掉动、角弓反张、强直之类,都是肝木的本证。至于其传变,木邪侮土则脾病,木盛金衰则肺病,木火相炎则心病,木火伤阴则肾病。这是五脏惊风的大概情况。治疗的方法,一是风,二是火,三是痰,四是阳虚,五是阴虚。
〔陈守真按〕:人身营卫脉度,每天寅时,起于手太阴肺经,然后五十度周行全身,到丑时终于足厥阴肝经,寅时又交于肺经。现在专门指肝邪,殊不恰当。即使眩晕掉动、角弓反张、强直,原本是本经《内经》中太阳经所主的病,也并非专属于肝。如果是因为肝而波及此脏,速宜滋水养血,还担心太迟,怎么能一味施以攻伐?最后所说的阳虚阴虚,与惊风毫不相涉。这个说法不足以凭信,这是第七点。
有人说:急慢惊风,古人所谓的阴阳痫。急惊属阳,慢惊属阴。惊邪入心,则面红颊赤,惕惕夜啼;入肝则面目皆青,眼睛窜视;入肾则面黑恶叫,啮齿咬人;入肺则面色淡白,喘息气急;入脾则呕吐不食,面色淡黄。然而风非火不动,火非风不发,风火相搏而成惊风,所以心肝二脏主之。然而火虚则金伤,水失其母,而火无所畏,且木无所制,而脾土又受伤了。
〔陈守真按〕:痫是痼疾,不是惊风的暴病。惊只有心脏受之,何至于入肝、入脾、入肺、入肾?既然说惊入五脏,那么肝风就没有关系了。又说风火相搏而成惊风,心肝为主,想要证明木火生风的话语,殊近牵扯。如果说水盛则火伤,土失其母,而水无所畏,且金无所制,而肝木又受伤,也可以这么说。这个说法不足以凭信,这是第八点。
有人说:急惊风是阳证。小儿阳常有余,阴常不足,易于生热。热甚则生风、生痰、生惊。且饮食难节,喜怒不常,暴怒伤阴,暴喜伤阳。伤阴则泻,伤阳则惊。小儿暴喜伤乳,夫乳甘缓恋膈,又兼外感寒邪,则痰凝壅塞,郁滞熏蒸。内有食热,外有风寒,心家热甚则生惊,肝家风甚则发搐。肝风心火交争,故痰生于脾,风生于肝,惊出于心,热出于肺。惊风痰热四证,而八候生焉。
〔陈守真按〕:小儿体质易虚易实,阳未必尽有余,阴未必常不足。经曰婴儿内脆,血少气弱,未尝说血少气多。既然阳有余,怎么又有暴喜伤阳的忧虑?乳非属阳,怎么有暴喜伤乳的词句?从阳盛阴虚,以及饮食喜怒、内伤外感,仍旧说到惊风痰热,杂乱无章。这个说法不足以凭信,这是第九点。
有人说:急慢惊风,或闻大声,或大惊而发搐,发作过后如故,这是无阴,当下之。此证因热生于心,身热面赤嗜饮,口中气热,大小便黄赤,剧则热也。盖热盛则生风,属肝阳或阴证也。阴证指阴虚而言,故下之以除其痰。小儿痰热客于心间,因闻非常之声而发搐,若热盛,不闻声及惊,亦自惊而自发搐矣。
〔陈守真按〕:《内经》的大惊猝恐,气血分离,这正是神志受伤,阴阳破败,急救尚恐不及,怎么能说无阴而当下?况且既然说因惊,为什么又说心热?既然说发过如故,为什么又说身热面赤两种情况?适宜除其痰,何况小儿禀受薄者,先天不足于妊前,癸水未成于现下,元精未满,元气无根,怎么能因惊而牵扯及热生风呢?这个说法不足以凭信,这是第十点。
有人说:小儿平常无事,忽然壮热,手足抽搐,眼目戴上,涎潮壅塞,牙关紧急,身热目赤,此急惊属阳,病在腑。
〔陈守真按〕:小儿忽发壮热,及种种恶候,非风寒入里为壮热,即饮食停滞为壮热,这实在是因病而发。固非平常无事之谓。但应察其受病之原,外因则达之发之,内因则导之化之。又说急惊属腑,则与心脏肝脏渺不相关,断无是理。这个说法不足以凭信,这是第十一点。
有人说:急惊风是阳证,都是腑受病耳。小儿客痰热于心膈,是少阳相火旺。经云:热生风,因时火盛而作,盖东方之震木,得火气而发搐。
〔陈守真按〕:心火显非少阳相火,其云震木得火而搐,亦属杜撰。这个说法不足以凭信,这是第十二点。
有人说:身热脉浮,精神恍惚,或吐泻不思乳食,发搐,即半阴半阳合病。身热脉沉,精神倦怠,或吐或泻,又能乳食,发搐,亦半阴半阳合病。
〔陈守真按〕:脉浮属太阳,明明是外感风寒;吐泻兼作,属阳明太阴,明明是内伤饮食;身热脉沉,属太阳受寒,但吐不泻,属阳明伤食,明明是夹食伤寒,不得谓为半阴半阳,更不得谓之惊风。这个说法不足以凭信,这是第十三點。
有人说:亦有急惊惊泻而不愈,或与吐下药太过,变为慢惊者;又有慢惊补温而不愈,变为急惊者。
〔陈守真按〕:诸书以急惊为阳,为实热。既是急惊,则用凉泻无疑,为什么不愈?盖因误以伤寒表证为急惊,所以不愈。既系脾虚阴寒为慢惊,则用温补适宜,为什么不特不愈,反加变证?盖因误以伤寒自汗为慢惊,不知此证本有风邪,在表,正宜外解,而误用温补,所以更剧。这个说法不足以凭信,这是第十四点。
有人说:病有阴阳,急惊风属实热,病在心肝二脏,谓之阳痫;慢惊风属虚寒,病在脾肺二脏,谓之阴痫。此以寒热分阴阳也。五脏属阴,六腑属阳,急惊发于六腑为易治,慢惊发于五脏为难治。此以脏腑分阴阳也。
〔陈守真按〕:上节云急惊病在心肝,慢惊病在脾肺,此以急慢二惊属五脏,与六腑无涉也明矣。下节又云急惊发于六腑,慢惊发于五脏,是又以脏腑皆有惊风也。属脏属腑,且分不清,治证安有不误?这个说法不足以凭信,这是第十五点。
诸家的说法,曰风,曰痰,曰惊,曰吓,曰火,曰热,曰血虚,曰木急,曰相火,曰阴火,曰外感,曰内伤,曰喜怒,曰乳哺,曰阳盛,曰阴虚,曰属腑,曰属脏,种种不经之言,究与惊风二字,毫无着落。夫所谓惊风者,必须认定此两字,针锋相对,加以急字或慢字,更须字字贴切,方可命名。独慨夫世之有是症,而不必以此命名者,使忽改此名而不仍其旧,恐一误再误,其误伊芳于胡底?今姑从世俗最普通习惯之名称,并古之举症施治,详列辨明于后。
In the winter season, sudden cold damages Yang Qi. If external contraction causes fever, accompanied by headache and body pain, vomiting and nausea, the disease location mostly starts from the Taiyang (Greater Yang) channel. If there is thirst and the ability to drink water, it indicates internal heat symptoms, which cannot be compared to Shanghan (Cold Damage). In pediatrics, Cold in the Taiyin (Lesser Yin) Spleen is common, and pathogen involvement in the Jueyin (Terminal Yin) Liver also occurs. If winter should be cold but turns warm, and the climate should store but instead leaks, "Winter Warmth" (Dong Wen) disease arises. Ancient treatment methods mainly relied on Acrid-Warm (Xin Wen) approaches.
[Chen Shouzhen's Note]: Winter Warmth is not a simple cold syndrome that can be resolved with warmth. If there is one or two parts of exterior pathogen, there must be seven or eight parts of interior heat. Or, the externally acquired pathogen combats with the interior pathogen, stagnating in the meridians. Treatment should focus on regulating interior syndromes, slightly combining clearing heat and dispersing. The formula uses Da Sha Shen (Glehniae Radix) 3 qian, Sang Ye (Mori Folium) 2 qian, Fei Yu Zhu (Polygonati Odorati Rhizoma) 3 qian, Sheng Yi Yi Ren (Coicis Semen) 3 qian, Tian Xing Ren (Armeniacae Semen Dulce) 3 qian, Ku Xing Ren (Armeniacae Semen Amarum) 2 qian, Chao Mai Dong (Ophiopogonis Radix) 1.5 qian, Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma) 0.1 qian, with Si Gua Luo (Luffae Fructus Retinervus) 3 cun and Guang Ju Luo (Citri Reticulatae Pericarpium Viride Retinervum) 1.5 qian as guides for decoction.
The term "Jing Feng" (Convulsion/Wind), named carelessly, has afflicted countless children. Investigating the root cause, one cannot blame Qian Zhongyang (Qian Yi). Although Yu Jiayan attempted to correct this naming, he could not overturn the established cases. Alas! It is lamentable. Research shows that anciently, Jing Feng had the name of "Eight Signs" (Ba Hou).
First is "Chu" (Twitching), referring to the extension and flexion of elbows and arms.
Second is "Nuo" (Grasping/Spasm), referring to the opening and closing of ten fingers.
Third is "Che" (Pulling/Tugging), referring to the mutual扑 (pouncing/pulling) of shoulders and head.
Fourth is "Chan" (Trembling), referring to the shaking and trembling of hands and feet.
Fifth is "Fan" (Reversal), referring to the body arching backward (opisthotonos).
Sixth is "Yin" (Drawing), referring to hands and feet extending like a bow.
Seventh is "Cuan" (Staring/Glaring), referring to eyes staring straight as if angry.
Eighth is "Shi" (Looking), referring to eyeballs exposed and unresponsive.
These eight signs appear regardless of whether it is Ji Jing Feng (Acute Convulsion), Man Jing Feng (Chronic Convulsion), or Man Pi Feng (Chronic Spleen Wind). Thus, they are called the Eight Signs of Jing Feng. Later, names based on symptoms led to thirty-plus "Jing" names, many of which were erroneous. I list some here to illustrate this superfluous addition.
One is Ji Jing Feng (Acute Convulsion): mouth and eyes deviated, limbs twitching and spasming, phlegm obstructing the heart causing confusion and unconsciousness. This is considered a syndrome of Liver channel accumulated heat and wind-fire.
Two is Man Jing Feng (Chronic Convulsion): face green, lips white, limbs cold, unconsciousness, limb spasms, eyes rolling, phlegm obstruction. This is attributed to post-major illness, after vomiting and diarrhea, where Spleen Earth is deficient and failing, and Liver Wood moves spontaneously without wind.
Three is Pan Chang Jing (Intestine-Coiling Convulsion): wheezing, distended abdomen, inability to eat, emaciation, visible blue veins on abdomen, yellow eyes, soft hands, urinary and fecal retention, abdominal pain. This is considered Cold in the Six Fu organs.
Four is Ma Ti Jing (Horse-Hoof Convulsion): limbs dancing wildly, head tilted up. This is considered a syndrome caused by wind-heat and fright.
Five is Ji Yu Jing (Crucian Carp Convulsion): foaming at the mouth, limb movement, mouth deviation, eye rolling. This is considered Wind in the Stomach channel and Cold in the Spleen channel.
Six is Bai Shou Jing (Waving Hand Convulsion): eyes looking up, limbs extending backward, or hands hanging down, yellow eyes, drooling, drowsiness. This is attributed to being frightened by water; treat if painful upon pinching, do not treat if painless.
Seven is Su Sha Jing (Overnight Sand Convulsion): mild during day, severe at night, coma at dusk, mouth and eyes deviated, limb spasms, black qi condensing in nostrils. This is considered Cold in Spleen and Kidney.
Eight is Nei Diao Jing (Internal Hanging Convulsion): eyes closed/dazed, incessant crying, green face, yellow eyes, hands and eyes pulling inward. This is considered Cold in the Lung channel.
Nine is Tian Diao Convulsion: eyes upward, wailing cry, limb spasms, mouth and eyes deviated, clear nasal discharge or epistaxis. This is considered Wind in the Lung channel, or Cold contracted after eating.
Ten is Wan Gong Convulsion (Bow-Bending): head arched back, limbs extended backward, eyes rolling or closed, abdominal distension, incessant crying. This is considered Wind in the Lung accumulating phlegm.
Eleven is She Si Convulsion (Silk Worm): tongue protruding, cold limbs with spasms, inability to cry. This is considered Heat in the Heart channel, wind entering the corners of the mouth while nursing.
Twelve is Ying Zhua Convulsion (Eagle Claw): grabbing people, grinding teeth, hands downward, mouth upward, body shivering. This is considered fright injuring milk, with Wind-Heat in the Heart.
Thirteen is Wu Sha Convulsion (Black Sand): limb spasms, cyanotic black lips, abdominal distension with blue veins. This is considered Cold in Zang and Fu organs.
Fourteen is Wu Ya Convulsion (Crow): limb spasms, eyes and mouth closed, loud scream, dull appearance. This is considered Heat and Phlegm in the Heart.
Fifteen is Suo Xin Convulsion (Locked Heart): foaming at mouth, bloody nose, soft limbs, craving cold substances, white eyes without crying. This is considered Heat in Heart and Liver channels, excessive Fire and Phlegm obstruction.
Sixteen is Sa Shou Convulsion (Open Hand): eye rolling, tooth grinding, limbs alternating between spasm and stillness. This is considered Wind-Fright in the Heart channel, initially cold then hot, with Phlegm.
Others include Tai Jing (Fetal Convulsion), Yue Jia Jing, Chao Jia Jing, Qi Feng Jing (Umbilical Wind), Ou Ni Jing, Xie Xie Jing, Peng Zhang Jing, Ye Ti Jing, Kan Di Convulsion, Fei Da Jing, Pi Di Convulsion, Ma Lu Convulsion, Ke Shui Convulsion, and Tao Tie Convulsion.
All such forced and illogical names imply that all illness is Convulsion and no illness is not Convulsion. Despite many names, they ultimately fall within the scope of Acute and Chronic Convulsions. These are fabricated insertions, similar and redundant, used to dazzle the vulgar, leading to mismedication and harm to children. Alas! How laughable.
Naming with "Jing" is unreliable. I will detail various theories on Convulsion and annotate them to clarify.
Some say: Acute Convulsion presents with fever, red eyes, coarse breath, surging saliva/phlegm, sudden onset, and recovery of normal complexion afterward. It may be caused by fright or not. Mostly, it is Dry Fire and Urgent Wood, so fever precedes onset; there is no case of onset with cool body. Syndromes belong to Yang, suitable for Cooling agents to clear heat and resolve phlegm, so convulsion subsides. Ancients said Phlegm generates Heat, Heat generates Wind, Wind generates Convulsion. Actually, this is self-disease of original Qi. People do not understand Wind generating internally, sticking only to chaotic use of Tian Ma (Gastrodiae Rhizoma), Dan Xing (Arisaematis Cum Bile), Gua Lou (Trichosanthis Radix), Bei Mu (Fritillariae Bulbus), Jiang Can (Bombyx Batryticatus), Quan Xie (Scorpio), etc. When ineffective, using Duo Ming Dan, La Wan, Niu Huang Wan, Zi Xue Dan, etc., leads to damage of Yuan Qi, forcing deficiency-phlegm upward, chest/diaphragm distension, mistakenly diagnosed as Jie Xiong (Chest Binding). Is this logical?
[Chen Shouzhen's Note]: Red eyes, fever, coarse breath, phlegm obstruction—all stem from external contraction and internal injury, how can they be sudden? Saying Dry Fire and Urgent Wood, there are cases of urgency due to Cold damaging sinews, not just Dry Fire. Saying fever precedes onset, where is this heat—exterior or interior—is not specified. Saying Cooling agents are suitable, yet fearing pathogen entry into interior. Saying self-disease of original Qi, baseless. Saying Wind generates internally, how do we know it doesn't generate externally? This theory is unreliable (Point 1).
Some say: Jing means fright. Due to prior internal injury plus external contraction, Lung orifices confused by phlegm, Heart lacks mastery, immediate onset upon fright.
[Chen Shouzhen's Note]: Prior internal injury plus external contraction causing Lung phlegm confusion and Heart lack of mastery is due to illness, not fright. Waiting for fright to trigger onset, treating only Jing without resolving phlegm, ignoring internal/external causes, seeking the branch without the root, how can medicine hit the target? Unreliable (Point 2).
Some say: Jing generates in Heart, Phlegm in Spleen, Wind in Liver, Heat in Lung. Fixed principle. Heat excess generates Wind, Wind excess generates Phlegm, Phlegm excess generates Jing. Treating Jing requires resolving Phlegm, resolving Phlegm requires dispelling Wind, dispelling Wind requires clearing Heat. Lung governs skin/hair, the portal for Heat. Six Evils enter via skin/Lung. Lung is an exit for Heat;燥FireSummer enters, Heat combines with Heat. Cold/Damp enter, Lung orifices close, Heat trapped. So clearing Heat requires expelling Evil first.
[Chen Shouzhen's Note]: "Jing generates in Heart" implies Jing/Phlegm/Heat arise from Zang organs. Yet later calls them "Zei Xie" (Robber Evils). Treating Jing->Phlegm->Heat->Wind contradicts "self-generated." Says internal and external simultaneously, contradictory. Lung is pure/clear, not an exit for Heat. Six Evils start at skin; why let them enter Lung/Stomach? Contradictory. Unreliable (Point 3).
Some say: Acute Convulsion is Liver Blood deficiency, Fire moving generating Wind. Wind scatters Yin Blood, Yin Fire flares. Fire damages Lung Metal, Liver Evil flares. Nourish Liver Blood, tonify Spleen Qi. If Wind-resolving/Phlegm-resolving/Fire-purging fail, recognize Spleen deficiency/Blood loss, urgently tonify Spleen Earth.
[Chen Shouzhen's Note]: "Yin deficiency leads to Yin Fire flare" shows ignorance of Lung. If Fire excess generates Wind, purging isn't wrong. Failure suggests incorrect diagnosis/mismatched medicine. Unreliable (Point 4).
Some say: Acute Convulsion is Wood/Fire/Earth Excess. Wood excess: strong spasms, eyes up. Earth excess: fever, red face, no vomit/diarrhea, lying down with eyes closed. Treat with Cooling/Purging. Some due to fright: high fever, locked jaw, internal Heat + external Wind. Intercept Wind, stop spasms.
[Chen Shouzhen's Note]: "Wood/Fire/Earth Excess" is confusing. Wood overacting on Earth means Wood Excess/Earth Deficiency, not Earth Excess. Fright implies Spirit deficiency, thus Fire deficiency, not Fire Excess. Using Wind drugs empirically. Unreliable (Point 5).
Some say: Acute Convulsion: high fever, phlegm obstruction, staring, opisthotonos, spasms, locked jaw, hot breath, red cheeks/lips, floating/rapid pulse. Liver Wind-Heat, Yang Excess/Yin Deficiency.
[Chen Shouzhen's Note]: These are clearly untreated exterior pathogens entering interior, causing exterior-interior urgency. Not Acute Convulsion. Unreliable (Point 6).
Some say: Pediatric Convulsion is Liver disease, also Spleen/Heart/Lung. Children have insufficient True Yin, unable to soften Yang. Liver Evil stirs, Wood generates Fire, Fire generates Wind. Wind-Heat combats, Blood deficiency, Sinew urgency. Opisthotonos/stiffness are Liver Wood signs. Transmission: Wood insults Spleen, Wood exhausts Lung, Wood-Fire inflames Heart, Wood-Fire injures Kidney Yin. Five-Zang Convulsion overview. Treatments: Wind, Fire, Phlegm, Yang Deficiency, Yin Deficiency.
[Chen Shouzhen's Note]: Meridian circulation starts Lung (Yin hour) ends Liver (Chou hour), returns to Lung. Focusing only on Liver is inappropriate. Opisthotonos/stiffness belong to Taiyang channel per Neijing, not exclusively Liver. If Liver affects others, nourish Water/Blood; attacking is wrong. Yang/Yin Deficiency irrelevant to Convulsion. Unreliable (Point 7).
Some say: Acute/Chronic Convulsion are Yin/Yang Epilepsy. Acute is Yang, Chronic is Yin. Evil enters Heart (red face, night crying), Liver (green face, staring), Kidney (black face, biting), Lung (pale face, panting), Spleen (vomiting, yellow face). Wind needs Fire, Fire needs Wind. Heart/Liver govern. Fire deficiency damages Metal, Water loses mother, Fire unrestrained, Wood unchecked, Spleen injured.
[Chen Shouzhen's Note]: Epilepsy is chronic, Convulsion is acute. Fright affects Heart, not necessarily other Zang. "Wind-Fire combat" logic is forced. If Water excess damages Fire, etc., makes sense. Unreliable (Point 8).
Some say: Acute Convulsion is Yang. Children have Excess Yang/Deficient Yin, prone to Heat. Heat generates Wind/Phlegm/Jing. Diet/emotions irregular. Anger injures Yin (diarrhea), Joy injures Yang (Jing). Milk is sweet/cloying, combined with external Cold, creates Phlegm stagnation. Internal Food-Heat, External Wind-Cold. Heart Heat generates Jing, Liver Wind generates Spasms. Jing/Phlegm/Wind/Heat four syndromes, Eight Signs arise.
[Chen Shouzhen's Note]: Children are easily deficient/excess. Yang not always excess, Yin not always deficient. Neijing says infants have weak Qi/Blood. "Joy injures Yang/Milk" is illogical. Logic is chaotic. Unreliable (Point 9).
Some say: Acute/Chronic Convulsion triggered by loud noise/fright, resolves normally. No Yin, need Purging. Heat in Heart: fever, red face, thirst, hot breath, yellow/red urine. Heat generates Wind, belongs to Liver Yang or Yin Syndrome (Yin Deficiency). Purge to remove Phlegm. Phlegm-Heat in Heart triggers spasms on noise; if Heat severe, spasms occur spontaneously.
[Chen Shouzhen's Note]: Neijing says Great Fright separates Qi/Blood, damages Spirit/Yin-Yang. Emergency needed, not Purging. "No Yin" vs "Heart Heat" contradictory. "Resolves normally" vs "Fever/Red Face" contradictory. Children have congenital deficiency; how does Fright relate to Heat/Wind? Unreliable (Point 10).
Some say: Child suddenly high fever, spasms, eyes up, phlegm, locked jaw, fever/red eyes. Acute Convulsion is Yang, disease in Fu organs.
[Chen Shouzhen's Note]: Sudden fever/spasms are due to Wind-Cold entering interior or Food stagnation. Illness-induced, not "normal." Exterior: release; Interior: guide/digest. Claiming Acute Convulsion is Fu organ disease ignores Heart/Liver. Illogical. Unreliable (Point 11).
Some say: Acute Convulsion is Yang, Fu organ disease. Phlegm-Heat in Chest/Diaphragm is Shaoyang Minister Fire prosperity. Heat generates Wind. East Wood (Zhen) gets Fire energy to spasm.
[Chen Shouzhen's Note]: Heart Fire is not Shaoyang Minister Fire. "Zhen Wood" fabrication. Unreliable (Point 12).
Some say: Fever/Floating pulse,恍惚 (trance), vomit/diarrhea/no appetite, spasms = Half-Yin/Half-Yang combined disease. Fever/Sinking pulse, fatigue, vomit/diarrhea/eating, spasms = Half-Yin/Half-Yang combined disease.
[Chen Shouzhen's Note]: Floating pulse = Taiyang (Exterior Wind-Cold). Vomit/Diarrhea = Yangming/Taiyin (Interior Food Injury). Sinking pulse/vomit only = Yangming Food Injury. Clearly Combined Cold-Damage with Food, not Half-Yin/Yang or Convulsion. Unreliable (Point 13).
Some say: Acute Convulsion with diarrhea may not heal, or excessive Purgatives turn it into Chronic Convulsion. Chronic Convulsion with Warming/Tonifying may not heal, turning into Acute Convulsion.
[Chen Shouzhen's Note]: Books say Acute is Yang/Excess Heat, so Cooling/Purging is standard. Non-healing implies misdiagnosing Exterior Cold-Damage as Acute Convulsion. Chronic is Spleen Deficiency/Cold, so Warming/Tonifying is standard. Non-healing/worsening implies misdiagnosing Exterior Wind-Sweat as Chronic Convulsion, missing the need to release exterior. Unreliable (Point 14).
Some say: Disease has Yin/Yang. Acute Convulsion is Excess Heat, Heart/Liver, called Yang Epilepsy. Chronic Convulsion is Deficiency Cold, Spleen/Lung, called Yin Epilepsy. Differentiate Yin/Yang by Cold/Heat. Zang are Yin, Fu are Yang. Acute in Fu is easy, Chronic in Zang is hard. Differentiate Yin/Yang by Zang/Fu.
[Chen Shouzhen's Note]: Previous section said Acute=Heart/Liver (Zang), Chronic=Spleen/Lung (Zang). Next section says Acute=Fu, Chronic=Zang. Confusion between Zang/Fu leads to treatment error. Unreliable (Point 15).
Various theories mention Wind, Phlegm, Jing, Fright, Fire, Heat, Blood Deficiency, Wood Urgency, Minister Fire, Yin Fire, External Contraction, Internal Injury, Emotions, Nursing, Yang Excess, Yin Deficiency, Fu/Zang affiliation. All nonsensical and unrelated to the term "Jing Feng." To name properly, one must stick to these two characters, add Acute/Chronic, ensure precision. Lamentably, those with this symptom don't need this name. Changing it abruptly risks further error. I will follow common custom and ancient practice to list and clarify below.