急慢惊风，古所为阴阳痫。急惊属阳，阳盛而阴亏；慢惊属阴，阴盛而阳亏，故阳
病烦躁，阴病沉缓也。然惊邪入心，则面红颊赤，惕惕夜啼；入肝则面目俱青，眼睛窜
视；入肾则面黑恶叫，啮啮切牙；入肺则面色淡白，喘息气乏；入脾则呕吐不食，虚汗
多睡，而色淡黄。《经》曰∶诸躁狂越皆属心火；诸风悼眩，皆属肝木。风非火不动，
火非风不发，风火相搏，而成惊风。故手少阴足厥阴主之，然火盛则金伤，水失其母，
而火无所畏，且木无所制，则脾上又受伤矣。
急惊者，阳症也。小儿阳常有余，阴常不足，故易于生热，热盛则生风、生痰、生
惊。且食饮难节，喜怒不常，《经》曰∶暴喜伤阳，暴怒伤阴。书曰∶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，则痰涎壅塞，郁滞熏蒸，内有食
热，外感风邪，心家热盛则生惊，肝家风盛则发搐，肝风心火，二脏交争，因乃痰生于
脾，风生于肝，惊出于心，热出于肺。惊风痰热四症若具，八候生焉。（搐搦掣颤反引窜视是
也。）一曰搐。搐者，肘臂伸缩。书云∶肝风则发搐。二曰搦。搦者，十指开合，或握
拳，男握拇指，出外为顺，入里为逆，女则反之，出入相半者，难痊。三曰掣。掣者，
肩头相扑，或连身跳起。四曰颤。颤者，或头或身，或手足口目，偏动不止。五曰反。
反者，身仰向后，势如反张。六曰引。引者，臂如挛弓，男左手直，右手曲为顺，否
则为逆。女则反之。七曰窜。窜者，直目似怒，男眼上窜为顺，下窜为逆，女则反之。
八曰视。视者，男引睛视左为顺，视右为逆。但顺则无声，逆则有声，何也？左者，
肝部也。引睛窜视者，又肝候也。以肝候而现于肝症，故无声而为顺。右者，肺部也。
不视左而反视右，是肝木乘金，金欲克木，故相争有声而为逆，更必三焦烦闷，狂叫频
频，其声浮者，易治，沉而不响者，难痊，更必睡卧不宁，牙关紧闭，便坚壮热，喉有
锯声。如若牙关不紧，喉无痰鸣，此发痘疮之候而非惊也。然阳症急迫，治之不可稍
缓，须急截风化痰，疏通顺气，凉脏镇惊，随候加减而已，截风不可过用防风辛味之
剂，以其辛能助火，能使热识，而致杀人。又不可过用脑麝等剂，以致阳亏阴盛，而变
慢惊，故治搐先于截风。搐者，肝家有风，其筋不舒转而致，风去而搐自止也。治风先
于利惊，惊在则热炽，热炽则生风，惊散而风自己也。治惊先于豁痰，痰塞气壅，则百
脉凝滞，惊何由而散也？治痰先于解热，盖痰非火不升，热退而痰自息也。最所要者，
宜于祥症处方，外感者，疏其表，内伤者，调其中，则有据之疾病既除，而无形之惊气
自散。若于镇惊起见，一概牛黄、脑麝、朱砂，则反引外邪迸入，为害益甚矣。其脉弦
数浮洪，其纹色红而见于风气二关者为轻，现于命关者为重。如鼻中出血者，此热已
泄，易治。若口中出血，啼哭无泪，寻衣摸缝，口鼻干黑，自头至足，偏动不止，其纹
三关通度，色青紫黑，或纹射甲者，并皆不治。又有一症，身发壮热，噤口切牙，宛似
惊风，但发无度数，又似疟疾，此名锁肠疳，必死之候也。
急惊风和慢惊风，在古代被称为阴阳痫。急惊风属于阳证，表现为阳气亢盛而阴液亏损；慢惊风属于阴证，表现为阴气亢盛而阳气亏损，因此阳证患者出现烦躁不安，阴证患者则表现为神情沉滞、动作迟缓。然而，若惊邪侵入心脏，则见面部发红、两颊赤红，夜间惊恐啼哭；侵入肝脏，则见面部和眼睛均呈青色，眼球上翻或斜视；侵入肾脏，则见面色发黑、恶声大叫、牙齿切磨作响；侵入肺脏，则见面色淡白、呼吸急促、气息虚弱；侵入脾脏，则见呕吐、不能进食、虚汗多、嗜睡，面色淡黄。《黄帝内经》说：各种躁动狂乱的行为都属于心火；各种风病引起的眩晕，都属于肝木。风没有火就不会动，火没有风就不会发作，风与火相互搏结，从而形成惊风。因此，手少阴心经和足厥阴肝经主要主管此病。然而，如果火邪过盛，就会损伤肺金，导致肾水失去母源（金生水），火邪无所畏惧，且肝木失去制约，那么脾土又会受到损伤。
急惊风是阳证。小儿的生理特点是阳气常有余，阴气常不足，所以容易产生内热，热盛则生风、生痰、生惊。加上饮食难以节制，喜怒情绪无常，《黄帝内经》说：突然大喜损伤阳气，突然大怒损伤阴气。医书说：伤阴会导致腹泻，伤阳会导致惊风。小儿因突然大喜而损伤乳食。乳汁味甘性缓，留恋于胸膈，再加上外感寒邪，就会导致痰涎壅塞，郁滞熏蒸，内有食积化热，外感风邪，心家热盛则产生惊悸，肝家风盛则引发抽搐，肝风与心火二脏交争，于是痰生于脾，风生于肝，惊出于心，热出于肺。惊、风、痰、热四症具备，就会产生八种候象（即搐、搦、掣、颤、反、引、窜、视）。第一种叫“搐”。搐，是指肘臂伸缩。医书说：肝风则引发搐。第二种叫“搦”。搦，是指十指开合，或者握拳，男孩握拳时拇指在外为顺，在内为逆，女孩则相反，出入相半者，难治愈。第三种叫“掣”。掣，是指双肩耸动，或者连身体一起跳起。第四种叫“颤”。颤，是指头或身体，或手足口眼，偏侧跳动不止。第五种叫“反”。反，是指身体向后仰，势如角弓反张。第六种叫“引”。引，是指手臂像拉弓一样挛急，男孩左手伸直、右手弯曲为顺，否则为逆，女孩则相反。第七种叫“窜”。窜，是指两眼直视似怒，男孩眼球上窜为顺，下窜为逆，女孩则相反。第八种叫“视”。视，是指男孩眼球向左看为顺，向右看为逆。凡是顺证则无声响，逆证则有声响，为什么呢？左边属肝部。眼球牵引上窜直视，又是肝的征候。以肝的征候出现在肝的病证中，所以无声响而为顺证。右边属肺部。不看左边反而看右边，这是肝木乘克肺金，肺金想要克制肝木，所以相互争斗而有声响，为逆证。更伴有三焦烦闷、狂叫频频，声音浮越者，容易治疗；声音沉浊不响者，难治愈。更伴有睡卧不宁、牙关紧闭、大便干结、壮热、喉间有锯木声。如果牙关不紧，喉间无痰鸣声，这是出痘疮的征候而不是惊风。然而阳证病情急迫，治疗不可稍作迟缓，必须紧急截断风邪、化解痰浊，疏通顺气，清凉脏腑、镇惊安神，根据具体候象加减用药即可。截风不可过度使用防风等辛味药剂，因为辛味能助长火势，使热邪炽盛，从而导致死亡。也不可过度使用牛脑、麝香等药剂，以致阳气亏损、阴气亢盛，从而转变为慢惊风。所以治疗抽搐首先要截风。抽搐是因为肝家有风，筋脉不舒展所致，风邪去除则抽搐自然停止。治疗风邪首先要利惊，惊在则热势炽盛，热盛则生风，惊散则风自息。治疗惊首先要豁痰，痰浊阻塞气机壅滞，则百脉凝滞，惊从何而散呢？治疗痰首先要解热，因为痰非火不升，热退则痰自息。最重要的是，应当详细审察症状后处方，外感者，疏解其表邪，内伤者，调理其中焦，这样有形的疾病既除，无形的惊气自然消散。如果在镇惊方面，一概使用牛黄、脑麝、朱砂，则会反而引外邪深入，危害更加严重。其脉象弦数浮洪，指纹颜色红而见于风关、气关者为轻证，现于命关者为重证。如鼻中出血者，这是热邪已泄，容易治疗。若口中出血，啼哭无泪，寻衣摸缝，口鼻干黑，从头至足偏侧跳动不止，指纹三关通度，颜色青紫黑，或纹射指甲者，都属不治之症。又有一种病症，身体发出壮热，口噤切牙，宛似惊风，但发作没有定数，又似疟疾，这名叫锁肠疳，必死的征候。
Acute and chronic convulsion (Ji Man Jing Feng), known in ancient times as Yin-Yang Epilepsy (Yin Yang Xian). Acute convulsion belongs to Yang syndrome, characterized by excess of Yang and deficiency of Yin; chronic convulsion belongs to Yin syndrome, characterized by excess of Yin and deficiency of Yang. Therefore, Yang syndromes manifest with irritability and restlessness, while Yin syndromes present with lethargy and sluggishness. However, if pathogenic shock enters the Heart, the face becomes red with flushed cheeks, accompanied by nocturnal crying due to fright; if it enters the Liver, both the face and eyes turn green, with eyes rolling upward or deviating; if it enters the Kidney, the face turns black with aversion to sound and loud screaming, teeth grinding; if it enters the Lung, the complexion is pale white, with panting and shortness of breath; if it enters the Spleen, there is vomiting, anorexia, profuse spontaneous sweating, excessive sleepiness, and a pale yellow complexion. The *Classic* states: "All restlessness, mania, and deviation belong to Heart Fire"; "All wind diseases causing dizziness and vertigo belong to Liver Wood." Wind does not move without Fire, and Fire does not erupt without Wind; when Wind and Fire clash, convulsion results. Thus, the Hand-Shaoyin Heart Meridian and Foot-Jueyin Liver Meridian are primarily involved. However, if Fire is excessive, it injures Metal (Lung), causing Water (Kidney) to lose its mother source, making Fire fearless and Wood (Liver) uncontrolled, thereby injuring Earth (Spleen).
Acute convulsion is a Yang syndrome. Children typically have abundant Yang and insufficient Yin, making them prone to generating heat. Excessive heat generates Wind, Phlegm, and Fright. Additionally, diet may be irregular, and emotions volatile. The *Classic* states: "Sudden joy injures Yang, sudden anger injures Yin." Medical texts state: "Injury to Yin leads to diarrhea, injury to Yang leads to convulsion." Sudden joy in children can damage milk digestion. Milk is sweet and cloying, lingering in the chest and diaphragm; combined with external cold pathogens, it causes phlegm-saliva obstruction, stagnation, and steaming. Internally, food stagnation transforms into heat; externally, wind pathogens invade. Excessive heat in the Heart generates Fright, while excessive wind in the Liver triggers spasms. The struggle between Liver Wind and Heart Fire leads to Phlegm arising from the Spleen, Wind from the Liver, Fright from the Heart, and Heat from the Lung. When these four conditions—Fright, Wind, Phlegm, and Heat—are present, eight specific signs (Hou) emerge: spasm (Chu), grasping (Nuo), pulling (Che), trembling (Chan), arching (Fan), drawing (Yin), staring (Cuan), and gazing (Shi).
1. **Spasm (Chu)**: Extension and flexion of elbows and arms. Texts say: Liver Wind causes spasm.
2. **Grasping (Nuo)**: Opening and closing of ten fingers, or clenching fists. In boys, thumb outward is favorable (Shun), inward is unfavorable (Ni); in girls, it is reversed. Equal distribution indicates difficult recovery.
3. **Pulling (Che)**: Shrugging shoulders or jumping up with the whole body.
4. **Trembling (Chan)**: Unilateral movement of the head, body, limbs, mouth, or eyes that does not cease.
5. **Arching (Fan)**: Body bending backward, resembling opisthotonos.
6. **Drawing (Yin)**: Arms bent like a bow. In boys, left arm straight and right arm bent is favorable; otherwise unfavorable. Reversed in girls.
7. **Staring (Cuan)**: Eyes fixed straight ahead as if angry. In boys, upward deviation is favorable, downward is unfavorable. Reversed in girls.
8. **Gazing (Shi)**: In boys, looking left is favorable, looking right is unfavorable. Favorable cases are silent; unfavorable cases produce sounds. Why? The left side corresponds to the Liver. Eye deviation and staring are Liver manifestations. Since the sign matches the organ, it is silent and favorable. The right side corresponds to the Lung. Looking right instead of left indicates Liver Wood overacting on Lung Metal. Metal attempts to control Wood, resulting in conflict and sound, hence unfavorable. Accompanied by Sanjiao oppression, frequent manic screaming, floating pulse sound indicates easy treatment; sinking, dull sound indicates difficult recovery. Also accompanied by restless sleep, locked jaw, hard stool, high fever, and saw-like throat sounds. If the jaw is not locked and no phlegm rale is heard, it is a sign of smallpox eruption, not convulsion.
Yang syndromes are urgent; treatment must not be delayed. One must urgently stop Wind, resolve Phlegm, regulate Qi, cool Zang organs, and settle Fright, adjusting based on specific signs. Do not overuse acrid agents like Fangfeng (Saposhnikovia Root), as acridity aids Fire and intensifies heat, potentially causing death. Do not overuse Nao (Brain) and She (Musk), as this depletes Yang and exacerbates Yin, transforming acute convulsion into chronic convulsion. Therefore, treating spasms begins with stopping Wind. Spasms result from Liver Wind causing tendon tension; removing Wind stops spasms. Treating Wind begins with resolving Fright; Fright causes intense Heat, which generates Wind; dispersing Fright extinguishes Wind. Resolving Fright begins with clearing Phlegm; Phlegm obstruction stagnates meridians, preventing Fright resolution. Clearing Phlegm begins with relieving Heat; Phlegm rises only with Fire; cooling Heat settles Phlegm. Crucially, prescribe based on detailed symptoms: for exterior pathogens, release the exterior; for internal injuries, regulate the middle Jiao. Once tangible diseases are removed, intangible Fright Qi dissipates. Using Niuhuang (Calculus Bovis), Nao, She, and Zhusha (Cinnabar) indiscriminately for settling Fright may draw external pathogens deeper, worsening the condition. A wiry, rapid, floating, and full pulse, with red fingerprint visible at the Wind and Qi gates, indicates mild disease; visibility at the Life Gate indicates severe disease. Nasal bleeding indicates heat release and easy treatment. Oral bleeding, crying without tears, picking at clothes/seams, dry/black nose and mouth, unilateral tremors from head to foot, three-gate fingerprint penetration, blue-purple-black color, or fingerprint extending to the nail indicate untreatable conditions. Another condition presents with high fever, locked jaw, and teeth grinding, resembling convulsion but occurring intermittently like malaria; this is called Suochang Gan (Locking Intestine Malnutrition), a fatal prognosis.