〔钱〕全蝎散 治小儿惊风中风,口眼 斜,言语不正,手足偏废不举。
全蝎(去毒,炒) 僵蚕(直者,炒) 川芎 黄芩(去心) 甘草 桂枝 赤芍药 麻黄(去节。各一两)
天麻(六钱) 大南星(汤泡七次,
去皮脐,切,焙干,五钱)
上为粗末,每服三钱,水一钟半,姜七片,煎七分,温服无时,量大小与之,一日三四服。忌羊肉。
按惊、搐一也,而有晨夕之分,表里之异。身热力大者为急惊,身冷力小者为慢惊,仆地作声,醒时吐沫
者为痫,头目仰视者为天吊,角弓反张者为 ,而治各不同也。
〔钱〕潮热变发搐,在早晨寅、卯时者,此肝用事之时也。身体壮热,目上视,手足动摇,口内生热涎,
项颈强急,此肝旺也,当补肾治肝。补肾,地黄丸;治肝,泻青丸。(洁古云∶木之位肝旺也。)
因潮热发搐,在巳、午、未时者,此心用事之时也。心惕,目上视,白睛赤色,牙关紧急,口内涎生,手
足动摇,此心旺也。当补肝治心。治心,导赤散、凉惊丸;补肝,地黄丸。(洁古云∶火之位心热也。)
广亲宅七太尉,方七岁,潮热数日欲愈。钱谓父二大王曰∶七使潮热将安,八使预防惊搐。王怒曰∶但使
七使愈,勿言八使病。钱曰∶八使过来日午间即无苦也。次日午前果作搐,急召钱治之,三日而愈。盖预见其
目直视而腮赤,必肝心俱热,更坐石杌子,乃欲就冷,此热甚也。又肌肤素肥盛而本实,其脉急促,故发搐。
克言午时者,自寅至午,皆心肝用事之时,治之乃泻心肝补肾自安矣。
因潮热发搐,在申、酉、戌时者,此肺用事之时也。不甚搐而喘,目微斜视,身热如火,睡露睛,手足冷,
大便淡黄水,是肝旺。当补脾,益黄散;治肝,泻青丸;治心,导赤散。(洁古云∶脾病肝强,法当补脾,
恐木贼害,宜先泻心肝以挫其强,而后补脾为当。)
徐氏子三岁病潮热,每日西则发搐,身微热而目微斜露睛,四肢冷而喘,大便微黄。请钱与李同治。钱问
李曰∶病何搐也?李曰∶有风。何身热微温?曰∶四肢所作。何目斜睛露?曰∶搐则目斜。何肢冷?曰∶冷厥,
心内热。曰∶何喘?曰∶搐之甚也。曰∶何以治之?曰∶凉惊丸,鼻中灌之,必搐止。钱又问曰∶既谓风病温
壮,搐引目斜露睛,内热支冷,及搐甚而喘,并以何药治之?李曰∶皆此药也。钱曰∶不然。搐者,心肝实也;
身微热者,日西肺用事之时也;肺主身温,今且热者,肺虚也;目微斜露睛者,肝肺相乘胜也;四肢冷
者,脾虚也,肺若虚甚,则脾母亦弱,木气乘脾,四肢即冷。治之当先补脾肺,用益黄散、阿胶散,得脾虚
退,然后治其心肝,以泻青丸、导赤散、凉惊丸治之,九日愈。
因潮热发搐,在亥、子、丑时者,此肾用事之时也。不甚搐而卧不稳,身体温壮,目睛紧斜视,喉中有痰,
大便银褐色,乳食不消,多睡不省,当补脾治心。补脾,益黄散;治心,导赤散、凉惊丸。(洁古云∶皆因大
病后脾胃虚损,多有此疾。)
伤风发搐,因伤风后得之,口中气出热,呵欠顿闷,手足动摇,当发散,大青膏主之。小儿生来怯弱者,
多此病也。(大青膏方见伤寒。)
〔洁〕伤风发搐,因伤风而得之。症同大人伤风寒痰之类,当辨有汗无汗。阴阳二症,用大青膏、小续
命之类开发则愈。(大青膏,阴症;小续命,阳症也。)
〔钱〕伤食发搐,因伤食后得之,身体温,多唾多睡,或吐,不思乳食而发搐,当先定搐,搐退,白饼子
下之,后服安神丸。
〔洁〕伤食发搐,谓不因他症忽然而搐。此因饮食过度,致伤脾胃,故儿多睡多吐,不思饮食;脾胃既虚,
引动肝风则发搐。当先定其搐,加羌活、防风,煎下泻青丸,后用白饼子下其食,渐渐用调中丸、异功散养其气。
〔钱〕百日内发搐,真者不过两三次,必死。假者频发不为重。真者内生惊痫,假者外伤风冷。盖血气未
实,不能胜任,乃发搐也。欲知假者,口中气出热,治之可发散,大青膏主之,及用涂囟浴体法。
李司户孙,百日病来搐三五次,请众医治。或作天吊,或作胎惊,或作惊痫,皆无应者。后钱氏用大青膏
如豆许一服发之,复与涂囟法及浴体法,三日而愈。何以然?婴儿初生,肌骨嫩怯,一被风伤,遂不能任,故
发搐也。然频发者轻,以客风在内,每遇不任即搐,轻则易歇,故发频也。搐稀者是五内发病,不可救也。频
搐者宜散风冷,故用大青膏,亦不可多服。盖儿至小,易虚易实,多即生热,止宜用下涂囟法。
麝香(一字) 蝎尾(去毒,为末,半钱) 薄荷(半字) 蜈蚣(炙) 牛黄 青黛(各一字)
上同研末,用熟枣肉剂为膏,新绵纸上涂匀,贴囟上,四旁可出一指许,火上炙,手频熨。百日里外儿,
可用此涂囟法。
〔垣〕外物惊宜镇平之,以黄连安神丸。若气动所惊,宜寒水石丸、黄连安神丸。(黄连安神丸见燥条,
寒水石丸见治法。)
按外物惊者,元气本不病,故治以黄连安神之苦寒。气动惊者,不因外物惊,元气自有病,故治以寒水
石,安神之甘寒也。
〔钱〕镇心丸 凉心经,治惊热痰盛。
甜硝(白者,一两) 人参(一两) 甘草(炙) 寒水石(烧。各两半) 山药(白者,二两) 白茯苓(二两)
朱砂(一两) 龙脑 麝香(各一钱,三味另研)
凡急慢惊,阴阳异证,切宜辨而治之,急惊合凉泻,慢惊合温补。
上急惊症,属木火土实也。木实则搐而力大,目上目札,所谓木太过曰发生,其动掉眩癫痫是也;火实
则身热面赤;土实则不吐泻,睡合睛。故其治法合凉泻,而用凉惊丸、利惊丸之类。慢惊症属木火土虚也。
木虚则搐而力小,似搐而不甚搐,经所谓木不及曰委和,其病摇动注恐是也,谓手足搐动,腹注泄,心恐
悸也;火虚则身冷,口气冷;土虚则吐泻,睡露睛。故其治法合温补而用羌活膏、益黄散。有热者,用东
垣黄 益黄散。其东垣非钱氏羌活膏治慢惊者,谓土虚泄泻,火木乘之,谓手掌与腹俱热之症。若火木土
俱虚,而摇动恐悸注泻手腹冷者,非羌活膏不能治之。
〔丹〕急惊主痰热,当凉泻之,只用降火下痰养血之药。慢惊主脾虚,所以多死。先实脾土,后散风邪,
只用朱砂安神丸,更于血药中求之。(如四物、四君子、东垣黄 益黄散详用。)
〔钱〕急惊因闻大声或大惊而发搐,过则如故,此无阴也,当下利惊丸主之。小儿急惊者,本因热生于
心,身热面赤,引饮,口中气热,大小便黄赤,剧则发搐。盖热甚则风生,风属肝,此阳盛阴虚也,故利惊丸
主之,以除其痰热。不可用巴豆及温药大下之,恐搐虚热不消也。小儿热痰客于心胃,因闻大声非常,则动而
惊搐矣。若热极,虽不闻声及惊,亦自发搐。
〔洁〕急惊者阳症也,俱腑受病。热痰客于心肺,是少阳相火旺。经云∶热则生风,因闻大声而作。盖谓
东方震卦,得火气而发搐。火本不动,焰得风而动,当用利惊丸、导赤散、泻青丸、地黄丸。搐止,宜服安神
丸。
〔阎〕急惊,内有热即生风,又或因惊而发,则目上连札,潮涎搐搦,身体与口中气皆热,及其发定或睡
起,即了了如故,此急惊症也。当其搐势渐减时,与镇心治热之药一二服,如麝香丸、镇心丸、抱龙丸、辰砂
丸、紫雪之类。候惊势已定,须臾以药下其痰热,如利惊丸、软金丹、桃枝丸之类,利下痰热,心神安宁即愈。
〔丹〕大黑龙丸治小儿急惊神效。(方见后急慢惊治条。)
小黑龙丸 治小儿急惊轻者。
青礞石( ,一两) 青黛(一钱) 芦荟(一钱半) 胆星(一两)
上为极细末,甘草汤为丸如鸡头大。每一丸,姜蜜薄荷汤下。
上二方,礞石、胆星泻湿痰之剂为君,痰多者宜之。
〔钱〕凉惊丸
草龙胆 防风 青黛(研。各三两) 龙脑(研一钱) 黄连末(五分) 牛黄 麝香(各一字)
上为细末,面糊为丸如粟米大。每服一二十丸,金银煎汤下之。
〔无〕治阳痫,即急惊风。
朱砂(研,一分) 腻粉 麝香(各五分) 芦荟 白附子 甘草(各二钱) 胡黄连(一钱) 蝎梢(七个)
僵蚕(蜜炙,十条) 金箔(七片) 赤脚蜈蚣(炙,一条)
上为末,二岁以上服半钱匕,金钱薄荷汤调下。三岁一钱匕,如口不开,灌入鼻中。
〔钱〕利惊丸
轻粉 天竺黄 青黛(各一钱) 黑牵牛(头末,半两)
上同研,蜜丸豌豆大。一岁一丸,温薄荷汤下,食后服。海藏云∶凉惊、温惊、利惊,自有分别,
南星、胭脂、轻粉、青黛,色味各有轻重。
〔罗〕镇肝丸 治小儿急惊风,目直上视,抽搐昏乱,不省人事,是肝经风热也。
天竺黄(研) 生地 当归 竹叶 草龙胆 川芎 大黄(煨) 羌活 防风(以上各二钱半)
上为细末,炼蜜丸如鸡头大。每服二丸,砂糖水化下,先服此,后服天麻散。
上五方,泻肝木之剂为君。前二方轻剂通用,后三方峻剂,必脉有力,血气实者宜之。又,阎氏所
谓候搐势定,下其痰热之类是已。
〔海〕五福丸 治急惊风。
生蚯蚓一条,研烂,入五福化毒丹一丸,再研如泥,煎薄荷汤少许,调化,旋灌,量儿大小加减服之,无
不效者。
〔钱〕五福化毒丹 治惊热,凉心膈。
生地 熟地(焙。各五两) 天门冬 麦门冬(去心,焙。各三两) 甜硝 玄参 甘草(各二两。炙)
青黛(一两半)
上上六味为细末,后研入硝、黛,炼蜜丸如鸡头大,每服半丸或一丸,食后熟水化下。
安神丸(方见治法。) 镇心丸(方见前表里条。)
上三方,甘寒泻火之剂为君,小儿血气虚而急惊者宜之。又,洁古、阎氏所谓候搐止势减,宜安神镇心
之类是已。
〔钱〕慢惊,因大病后,或吐泻,或只吐不泻,变成脾胃虚损,遍身冷,口鼻气出亦冷,手足时螈 ,昏
睡露睛,此无阳也,栝蒌汤主之。
〔洁〕慢惊者,阴证,俱脏受病。盖小儿吐泻病久,脾胃虚损,若不早治,则成慢惊,名曰螈 ,似搐而
不甚搐也。因脾胃虚损,故大便不聚,当去脾间风。先用宣风散导之,后用益黄散、使君子丸平之,则其利自
止。既已失治,则脾胃俱虚,致被肝木所乘,是为慢惊。当用温补羌活膏主之。
〔钱〕东都王氏子吐泻,诸医用药下之,至虚变慢惊,其候昏睡露睛,手足螈 而身冷。钱曰∶此慢惊也。
与栝蒌汤,其子胃气实即开目而身温。王疑其子不大小便,令诸医以药利之,医留八正散等,数服不利,而身
复冷。令钱氏利小便。钱曰∶不当利小便,利之必身冷,一二日果身冷矣。因抱出。钱曰∶不能食而胃中虚,
若利大小便,则脾胃俱虚,当身冷而闭目即死。今幸胎气实而难衰也。钱氏用益黄散、使君子丸四服,令微能
饮食。至日午,果能饮食。所以然者,谓利大小便,脾胃虚寒,当补脾不可别攻也。后又不语,诸医作失音治
之。钱曰∶既失音,何开目而能饮食?又牙不紧而口不噤也?诸医不能晓。以地黄补肾,钱曰∶此因用凉药利
小便,至脾肾俱虚,今脾已实,肾尚虚,故补肾必安。治之半月而能言,一月而痊。
栝蒌汤
栝蒌(二钱) 白甘遂末(一钱)
上同于慢火上炒焦黄,研匀,每服一字,麝香薄荷汤调服。
上栝蒌汤,钱氏治慢惊法脉有力者宜用。盖湿痰积于膈中,使风火不得开发而身冷,故用栝蒌汤劫去湿
痰,使风火得伸而身温搐止。若脉无力者,不宜用之,盒饭补脾,及温白丸、羌活膏之类。
〔阎〕青州白丸子 治小儿惊风,大人诸风。
半夏(生,七两) 南星(生,三两) 白附子(生,二两) 川乌(生,半两,去皮脐)
上为末,以生绢袋盛井花水摆出。如未出者,更以手揉出。如有滓,更研,再入绢袋摆尽为度。于瓷盆中
日晒夜露,至晓撇去旧水,别用井花水搅,又晒至来日早,再换新水,搅如此法,春五日,夏三日,秋七日,
冬十日,去水晒干,后如玉片研细,以糯米粉煎粥清丸绿豆大,每服三五丸,薄荷汤下。瘫风,酒下,并无时。
钱氏异功散 温中和气,治吐泻不思食。(方见吐泻门。)
〔海〕惊啼,手足螈 ,睡卧不稳。四君子加全蝎去尾尖毒炒、钩藤、白附子炒,等分同煎。(方见治虚
实法)脾胃虚弱,生风多困,四君子加炒半夏曲、没石子,等分为细末,入冬瓜子少许,同煎服。
〔钱〕温白丸 治小儿脾气虚困,泄泻瘦弱,冷疳洞利,及因吐泻或久病成慢惊螈 。
天麻(生,半两) 白僵蚕(炒) 白附子(生) 天南星(锉,汤洗焙干。各一两) 干蝎(去毒,一钱)
上为末,汤浸,寒食面为丸如绿豆大,仍于寒食面中养七日取出用,每服五、七丸至二三十丸,空心,
生姜米饮下。量病势,渐加丸数服之。(寒食面,谓寒食日煮吃面,取之以焙干贮用也。)
钩藤饮子 治吐利,脾胃气弱,虚风慢惊。
【钱乙】全蝎散:治疗小儿惊风、中风,症见口眼歪斜、言语不清、手足偏瘫不能抬起。
配方:全蝎(去毒,炒制)、僵蚕(选直者,炒制)、川芎、黄芩(去心)、甘草、桂枝、赤芍药、麻黄(去节)。以上各一两。天麻(六钱)。大南星(用汤浸泡七次,去皮脐,切片,焙干,五钱)。
制法与用法:将上述药材捣成粗末。每次服用三钱,加水一钟半,生姜七片,煎至七分量,不拘时候温服。根据患儿年龄大小调整剂量,每日服用三四次。忌食羊肉。
按语:惊和搐本质相同,但有晨夕发作时间的区别,以及表里证候的差异。身体发热有力者为急惊;身体发冷无力者为慢惊;倒地时发出声音,清醒后吐白沫者为痫证;头目向上仰视者为天吊;角弓反张(身体向后弯曲如弓)者为[缺字,通常指痓或类似强直症状],治疗方法各不相同。
【钱乙】因潮热引发抽搐,若在早晨寅时、卯时发作,这是肝气当令的时辰。症状表现为身体壮热,眼睛上视,手足动摇,口中产生热涎,项颈僵硬紧急,这是肝旺的表现,应当补肾兼治肝。补肾用六味地黄丸;治肝用泻青丸。(洁古云:木之位属肝,肝旺。)
若因潮热引发抽搐,在巳时、午时、未时发作,这是心气当令的时辰。症状表现为心中惊恐惕动,眼睛上视,白眼球发红,牙关紧急,口中生涎,手足动摇,这是心旺的表现。应当补肝兼治心。治心用导赤散、凉惊丸;补肝用地黄丸。(洁古云:火之位属心,心热。)
广亲宅七太尉,当时七岁,潮热数日后即将痊愈。钱乙对父亲二大王说:“七使君的潮热将要安宁,但八使君需预防惊搐。”二大王生气地说:“只要让七使君痊愈,不要谈论八使君生病的事。”钱乙说:“八使君明天午间就会没有痛苦了。”第二天午前果然发生抽搐,急忙召钱乙诊治,三天后痊愈。这是因为钱乙预先观察到他的眼睛直视且腮部发红,必定是肝心俱热,加上他坐在石凳子上,想要靠近冷气,说明热势很盛。又因为他肌肤本来肥盛而体质充实,脉象急促,所以发生抽搐。钱乙预言午时发病,是因为从寅时到午时,都是心肝当令的时辰,治疗应当清泻心肝、补肾,自然就能安宁。
若因潮热引发抽搐,在申时、酉时、戌时发作,这是肺气当令的时辰。症状表现为抽搐不严重但伴有气喘,眼睛微微斜视,身体热如火,睡觉时眼睛睁开露出黑睛,手足冰冷,大便呈淡黄色水样,这是肝旺的表现。应当补脾,用益黄散;治肝用泻青丸;治心用导赤散。(洁古云:脾病则肝强,依法应当补脾,恐怕肝木贼害脾土,宜先清泻心肝以挫其强势,然后补脾为妥当。)
徐氏之子三岁,患潮热,每天傍晚发作抽搐,身体微热,眼睛微斜且露睛,四肢冰冷且气喘,大便微黄。请钱乙与李医生共同诊治。钱乙问李医生说:“这是什么原因的抽搐?”李医生说:“有风邪。”“为什么身体只是微温?”李医生说:“因为四肢厥冷。”“为什么眼睛斜视露睛?”李医生说:“抽搐时眼睛会斜视。”“为什么四肢冷?”李医生说:“这是冷厥,内心有热。”“为什么会气喘?”李医生说:“因为抽搐剧烈。”“怎么治疗?”李医生说:“用凉惊丸,灌入鼻中,抽搐一定会停止。”钱乙又问:“既然说是风病温壮,抽搐牵引眼睛斜视露睛,内热导致四肢冷,以及抽搐剧烈而气喘,都用什么药治疗?”李医生说:“都是这个药。”钱乙说:“不对。抽搐,是心肝实证;身体微热,是日西时分肺气当令的时候;肺主身之温,现在却发热,说明肺虚;眼睛微斜露睛,是肝肺相乘胜所致;四肢冷,是脾虚;如果肺虚得很严重,那么脾母也会虚弱,木气乘袭脾土,四肢就会冷。治疗应当先补脾肺,用益黄散、阿胶散,待脾气恢复后,再治疗心肝,用泻青丸、导赤散、凉惊丸治疗,九天痊愈。”
若因潮热引发抽搐,在亥时、子时、丑时发作,这是肾气当令的时辰。症状表现为抽搐不严重但卧睡不稳,身体温壮,眼睛紧紧斜视,喉中有痰,大便呈银褐色,乳食不消化,多睡且神志不清,应当补脾治心。补脾用益黄散;治心用导赤散、凉惊丸。(洁古云:这都是因为大病后脾胃虚损,多有此疾。)
伤风引发的抽搐,是在伤风之后得的,口中呼出热气,呵欠顿闷,手足动摇,应当发散风邪,以大青膏为主方。小儿生来怯弱的,多患此病。(大青膏方剂见伤寒篇。)
【张元素】伤风引发的抽搐,是因伤风而得的。症状同大人伤风寒痰之类,应当辨别有汗无汗。阴症和阳症两种情况,用大青膏或小续命汤等开发透散即可痊愈。(大青膏用于阴症;小续命汤用于阳症。)
【钱乙】伤食引发的抽搐,是在伤食之后得的,身体温热,多唾多睡,或者呕吐,不思乳食而引发抽搐,应当先止住抽搐,抽搐退去后,用白饼子攻下积食,随后服用安神丸。
【张元素】伤食引发的抽搐,是指不因其他病症而突然发生的抽搐。这是因为饮食过度,损伤了脾胃,所以孩子多睡多吐,不思饮食;脾胃既已虚弱,引动肝风则发生抽搐。应当先止住抽搐,加入羌活、防风,煎煮后送服泻青丸,后用白饼子攻下积食,渐渐用调中丸、异功散调养正气。
【钱乙】百日内婴儿发生抽搐,真正的(重症)不过两三次,必死无疑。假性的(轻症)频繁发作但不算严重。真正的抽搐源于内生惊痫,假性的源于外伤风冷。因为此时血气未实,不能胜任外邪,所以发生抽搐。想知道是否为假性抽搐,看口中呼出热气,治疗可用发散法,以大青膏为主,并配合涂囟法和浴体法。
李司户之孙,百日大小时患病抽搐三五次,请众医治疗。有的诊断为天吊,有的诊断为胎惊,有的诊断为惊痫,都没有效果。后来钱氏用大青膏如豆大一粒服用使其发散,再配合涂囟法和浴体法,三天痊愈。为什么会这样?婴儿初生,肌骨嫩弱,一旦受风邪侵袭,便不能承受,所以发生抽搐。然而频繁发作的较轻,因为客风在内,每当不能承受时就抽搐,轻症容易缓解,所以发作频繁。抽搐稀少的则是五脏内部发病,不可救治。频繁抽搐适宜疏散风冷,所以用大青膏,但也不可多服。因为婴儿太小,易虚易实,多服则生热,只适宜使用涂囟法。
配方:麝香(一字)、蝎尾(去毒,研末,半钱)、薄荷(半字)、蜈蚣(炙)、牛黄、青黛(各一字)。
制法与用法:以上一同研成细末,用熟枣肉调和成膏,涂在新绵纸上,贴在囟门上,四周可留出一指宽的距离,在火上烘烤,手经常熨烫。百日左右的婴儿,可以使用此涂囟法。
【李东垣】外物惊吓适宜用镇平之法,用黄连安神丸。若是气动所致的惊吓,适宜用寒水石丸、黄连安神丸。(黄连安神丸见燥湿条,寒水石丸见治法条。)
按语:外物惊吓,元气原本没有病,所以用黄连安神的苦寒药物治疗。气动惊吓,不是因外物惊吓,元气自身已有病,所以用寒水石、安神的甘寒药物治疗。
【钱乙】镇心丸:凉心经,治疗惊热痰盛。
配方:甜硝(白色者,一两)、人参(一两)、甘草(炙)、寒水石(烧制,各两半)、山药(白色者,二两)、白茯苓(二两)、朱砂(一两)、龙脑、麝香(各一钱,这三味另研)。
凡急惊、慢惊,阴阳证候不同,务必辨别后治疗。急惊适宜凉泻,慢惊适宜温补。
上述急惊症,属于木火土实证。木实则抽搐有力,眼睛上视或眨动,所谓木太过曰发生,其表现是动摇眩晕癫痫;火实则身体热面红;土实则不吐不泻,睡觉时眼睛闭合。所以治疗方法适宜凉泻,用凉惊丸、利惊丸之类。慢惊症属于木火土虚证。木虚则抽搐无力,似搐而不甚搐,经书所谓木不及曰委和,其病是摇动注恐,即手足搐动、腹部泄泻、心中恐惧心悸;火虚则身体冷,口气冷;土虚则吐泻,睡觉露睛。所以治疗方法适宜温补,用羌活膏、益黄散。若有热者,用东垣的黄连益黄散。这里的东垣并非钱氏的羌活膏治慢惊,而是指土虚泄泻,火木乘袭,表现为手掌与腹部都热的症候。如果火木土俱虚,且出现摇动恐惧心悸、泄泻、手足腹部冷者,非羌活膏不能治疗。
【朱丹溪】急惊主因痰热,应当凉泻,只用降火、下痰、养血的药物。慢惊主因脾虚,所以多死亡。先实脾土,后散风邪,只用朱砂安神丸,更于补血药中寻求疗效。(如四物汤、四君子汤、东垣的黄连益黄散详细使用。)
【钱乙】急惊因听到大声或大惊而引发抽搐,过后则恢复正常,这是无阴的表现,当下利惊丸为主方。小儿急惊,本因热生于心,身体热面红,想喝水,口中气热,大小便黄赤,严重时发生抽搐。盖因热甚则风生,风属肝,这是阳盛阴虚,故用利惊丸为主方,以清除痰热。不可用巴豆及温药大力攻下,恐怕抽搐虽止但虚热不消。小儿热痰客居于心胃,因听到非常的大声,则触动而惊搐。若热极,即使没听到声音及受惊,也会自发抽搐。
【张元素】急惊是阳症,都是腑受病。热痰客居于心肺,是少阳相火旺。经云:热则生风,因闻大声而发作。这指的是东方震卦,得火气而发搐。火本不动,焰得风而动,应当用利惊丸、导赤散、泻青丸、地黄丸。抽搐停止后,宜服安神丸。
【阎孝忠】急惊,内有热即生风,又或因惊而发,则眼睛上视连眨,潮涌之涎,抽搐掣肘,身体与口中气皆热,等到发作定或睡起,即清醒如常,这是急惊症。当其抽搐势头渐减时,给予镇心治热的药物一二服,如麝香丸、镇心丸、抱龙丸、辰砂丸、紫雪之类。等候惊势已定,片刻后用药物攻下其痰热,如利惊丸、软金丹、桃枝丸之类,利下痰热,心神安宁即愈。
【朱丹溪】大黑龙丸治疗小儿急惊神效。(方剂见后急慢惊治条。)
小黑龙丸:治疗小儿急惊轻症。
配方:青礞石(煅,一两)、青黛(一钱)、芦荟(一钱半)、胆星(一两)。
制法与用法:以上为极细末,甘草汤为丸如鸡头大。每一丸,姜蜜薄荷汤送下。
以上两个方子,礞石、胆星作为泻湿痰的主药,痰多者适宜。
【钱乙】凉惊丸
配方:草龙胆、防风、青黛(研,各三两)、龙脑(研,一钱)、黄连末(五分)、牛黄、麝香(各一字)。
制法与用法:以上为细末,面糊为丸如粟米大。每次服用一二十丸,金银煎汤送下。
【无名字】治疗阳痫,即急惊风。
配方:朱砂(研,一分)、腻粉、麝香(各五分)、芦荟、白附子、甘草(各二钱)、胡黄连(一钱)、蝎梢(七个)、僵蚕(蜜炙,十条)、金箔(七片)、赤脚蜈蚣(炙,一条)。
制法与用法:以上为末,两岁以上服用半钱匕,金钱薄荷汤调下。三岁服用一钱匕,如果口不开,灌入鼻中。
【钱乙】利惊丸
配方:轻粉、天竺黄、青黛(各一钱)、黑牵牛(头末,半两)。
制法与用法:以上同研,蜜丸豌豆大。一岁一丸,温薄荷汤送下,饭后服用。海藏云:凉惊、温惊、利惊,自有分别,南星、胭脂、轻粉、青黛,色味各有轻重。
【罗谦甫】镇肝丸:治疗小儿急惊风,眼睛直上视,抽搐昏乱,不省人事,这是肝经风热所致。
配方:天竺黄(研)、生地、当归、竹叶、草龙胆、川芎、大黄(煨)、羌活、防风(以上各二钱半)。
制法与用法:以上为细末,炼蜜为丸如鸡头大。每次服用二丸,砂糖水化下,先服此药,后服天麻散。
以上五个方子,以泻肝木的药剂为主药。前两个方子是轻剂通用,后三个方子是峻剂,必须脉有力,血气实者适宜。另外,阎氏所说的等候抽搐势头定,下其痰热之类即是如此。
【王好古】五福丸:治疗急惊风。
配方:生蚯蚓一条,研烂,入五福化毒丹一丸,再研如泥,煎薄荷汤少许,调化,随即灌服,根据孩子大小加减服用,无不有效。
【钱乙】五福化毒丹:治疗惊热,凉心膈。
配方:生地、熟地(焙,各五两)、天门冬、麦门冬(去心,焙,各三两)、甜硝、玄参、甘草(各二两,炙)、青黛(一两半)。
制法与用法:以上六味为细末,后研入硝、黛,炼蜜为丸如鸡头大,每次服用半丸或一丸,饭后熟水化下。
安神丸(方剂见治法条)。镇心丸(方剂见表里条)。
以上三个方子,以甘寒泻火的药剂为主药,小儿血气虚而患急惊者适宜。另外,洁古、阎氏所说的等候抽搐停止势头减,宜安神镇心之类即是如此。
【钱乙】慢惊,因大病后,或吐泻,或只吐不泻,变成脾胃虚损,遍身冷,口鼻呼出气亦冷,手足时而螈(抽缩),昏睡露睛,这是无阳的表现,用栝蒌汤为主方。
【张元素】慢惊是阴症,都是脏受病。盖因小儿吐泻病久,脾胃虚损,若不早治,则成慢惊,名曰螈,似搐而不甚搐。因脾胃虚损,所以大便不聚,应当去除脾间风。先用宣风散导之,后用益黄散、使君子丸平之,则其利自止。既然已经失治,则脾胃俱虚,致使被肝木所乘,是为慢惊。应当用温补羌活膏为主方。
【钱乙】东都王氏之子吐泻,众医用药攻下,导致极度虚弱变为慢惊,其症状为昏睡露睛,手足螈而身冷。钱乙说:“这是慢惊。”给予栝蒌汤,其子胃气实后即睁眼而身温。王某怀疑其子不大便,令众医用药通便,医生留下八正散等,数次服用不利,而身体复冷。令钱乙通小便。钱乙说:“不当利小便,利之必身冷,一二日后果然身冷。”于是抱出来。钱乙说:“不能食而胃中虚,若利大小便,则脾胃俱虚,当身冷而闭目即死。如今幸而胎气实而难衰也。”钱氏用益黄散、使君子丸四服,令其微能饮食。至日午,果然能饮食。之所以这样,是因为利大小便,脾胃虚寒,应当补脾不可别攻也。后来又不说话,众医作失音治疗。钱乙说:“既失音,为何睁眼而能饮食?又牙不紧而口不噤呢?”众医不能理解。用地黄补肾,钱乙说:“这是因为用凉药利小便,至脾肾俱虚,如今脾已实,肾尚虚,故补肾必安。”治疗半月而能言,一月而痊愈。
栝蒌汤
配方:栝蒌(二钱)、白甘遂末(一钱)。
制法与用法:以上同在慢火上炒焦黄,研匀,每次服用一字,麝香薄荷汤调服。
以上栝蒌汤,是钱氏治疗慢惊法,脉有力者适宜用。盖因湿痰积于膈中,使风火不得开发而身冷,故用栝蒌汤劫去湿痰,使风火得伸而身温搐止。若脉无力者,不宜用之,应当补脾,及温白丸、羌活膏之类。
【阎孝忠】青州白丸子:治疗小儿惊风,大人诸风。
配方:半夏(生,七两)、南星(生,三两)、白附子(生,二两)、川乌(生,半两,去皮脐)。
制法与用法:以上为末,以生绢袋盛井花水摆出。如未出者,更以手揉出。如有滓,更研,再入绢袋摆尽为度。于瓷盆中日晒夜露,至晓撇去旧水,别用井花水搅,又晒至来日早,再换新水,搅如此法,春五日,夏三日,秋七日,冬十日,去水晒干,后如玉片研细,以糯米粉煎粥清丸绿豆大,每次服用三五丸,薄荷汤送下。瘫风,酒送下,并无固定时间。
【王好古】惊啼,手足螈,睡卧不稳。四君子汤加全蝎去尾尖毒炒、钩藤、白附子炒,等分同煎。(方剂见治虚实法)脾胃虚弱,生风多困,四君子汤加炒半夏曲、没石子,等分为细末,入冬瓜子少许,同煎服。
【钱乙】温白丸:治疗小儿脾气虚困,泄泻瘦弱,冷疳洞利,及因吐泻或久病成慢惊螈。
配方:天麻(生,半两)、白僵蚕(炒)、白附子(生)、天南星(锉,汤洗焙干,各一两)、干蝎(去毒,一钱)。
制法与用法:以上为末,汤浸,寒食面为丸如绿豆大,仍于寒食面中养七日取出用,每次服用五、七丸至二三十丸,空心,生姜米饮送下。根据病势,逐渐增加丸数服用。(寒食面,谓寒食日煮吃面,取之以焙干贮用也。)
[Qian Yi] Quanxie San (Scorpion Powder): Treats infantile convulsions and wind-stroke, presenting with deviation of the mouth and eyes, speech impairment, and hemiplegia with inability to lift limbs.
Ingredients: Scorpio (Quanzhong, detoxified, stir-fried), Bombyx Batryticatus (Jiangcan, straight ones, stir-fried), Ligusticum Chuanxiong Rhizome (Chuanxiong), Scutellaria Baicalensis Root (Huangqin, heart removed), Glycyrrhiza Uralensis Root (Gancao), Cinnamomum Cassia Twig (Guizhi), Paeonia Rubra Root (Chishaoyao), Ephedra Sinica Stem (Mahuang, joints removed). Each 1 liang. Gastrodia Elata Rhizome (Tianma) 6 qian. Arisaema Cum Bile (Danxing/Da Nanting) 5 qian (soaked in decoction seven times, skin and navel removed, sliced, dried by roasting).
Preparation and Administration: Grind the above herbs into a coarse powder. Take 3 qian per dose, add 1.5 zhong of water and 7 slices of ginger, decoct until 0.7 zhong remains. Take warm at any time. Adjust dosage according to age and size. Administer 3-4 times daily. Avoid mutton.
Commentary: Convulsion (Jing) and tremor (Chu) are essentially the same but differ by morning/evening occurrence and exterior/interior differentiation. Those with high fever and strong force are acute convulsions (Ji Jing); those with cold body and weak force are chronic convulsions (Man Jing). Falling down making sounds and foaming at the mouth upon waking is epilepsy (Xian); looking upward with head and eyes is Tiandiao; opisthotonos is Chi. Treatments vary accordingly.
[Qian Yi] When tidal fever triggers convulsions occurring during Yin and Mao hours (morning), this is when Liver Qi governs. Symptoms include intense body heat, upward gaze, trembling limbs, hot saliva in the mouth, and stiff neck. This indicates Liver excess. Treatment should tonify Kidney and regulate Liver. Tonify Kidney with Dihuang Wan; regulate Liver with Xieqing Wan. (Jiegu said: The Wood position corresponds to Liver excess.)
When tidal fever triggers convulsions occurring during Si, Wu, and Wei hours, this is when Heart Qi governs. Symptoms include palpitations/fear, upward gaze, red sclera, locked jaw, salivation, and limb tremors. This indicates Heart excess. Treatment should tonify Liver and regulate Heart. Regulate Heart with Daochi San and Liangjing Wan; tonify Liver with Dihuang Wan. (Jiegu said: The Fire position corresponds to Heart heat.)
The Seventh Taivwei of Guangqin Mansion was seven years old, suffering from tidal fever for several days nearing recovery. Qian Yi told his father, the Second Da Wang: "The Seventh Envoy's fever will settle, but the Eighth Envoy must be prevented from convulsions." The King angrily replied: "Just let the Seventh Envoy recover, do not speak of the Eighth Envoy being ill." Qian Yi said: "The Eighth Envoy will have convulsions tomorrow around noon." The next day before noon, convulsions indeed occurred. Qian Yi was summoned urgently and cured him in three days. This was predicted because he saw fixed staring and red cheeks, indicating both Liver and Heart heat. Sitting on a stone stool showed a desire for coolness, indicating severe heat. His flesh was plump and constitution solid, with rapid pulse, hence convulsions. Predicting noon is because from Yin to Wu hours, Heart and Liver govern. Treatment involves clearing Heart/Liver and tonifying Kidney for peace.
When tidal fever triggers convulsions occurring during Shen, You, and Xu hours, this is when Lung Qi governs. Symptoms include mild convulsions but wheezing, slight oblique gaze, burning body heat, sleeping with eyes open exposing pupils, cold limbs, and pale yellow watery stool. This indicates Liver excess. Treatment should tonify Spleen and regulate Liver. Tonify Spleen with Yihuang San; regulate Liver with Xieqing Wan; regulate Heart with Daochi San. (Jiegu said: In Spleen disease with strong Liver, one should tonify Spleen. Fearing Wood attacking Earth, it is appropriate to first clear Heart/Liver to curb their strength, then tonify Spleen.)
The son of the Xu family, aged three, suffered from tidal fever with convulsions every afternoon. Body slightly hot, eyes slightly oblique and exposed, cold limbs, wheezing, slightly yellow stool. Qian Yi and Dr. Li treated together. Qian Yi asked Dr. Li: "What causes the convulsions?" Dr. Li: "Wind." "Why slight warmth?" Dr. Li: "Due to cold limbs." "Why oblique/exposed eyes?" Dr. Li: "Convulsions cause oblique eyes." "Why cold limbs?" Dr. Li: "Cold reversal, internal heat." "Why wheezing?" Dr. Li: "Severe convulsions." "How to treat?" Dr. Li: "Liangjing Wan, instilled in nose, convulsions will stop." Qian Yi asked again: "Since it is wind-heat, convulsions causing eye issues, internal heat with cold limbs, and wheezing from severe convulsions, what medicine treats all?" Dr. Li: "This same medicine." Qian Yi said: "Incorrect. Convulsions indicate Heart/Liver excess; slight heat at sunset indicates Lung Qi governance; Lung governs body warmth, so heat indicates Lung deficiency; oblique/exposed eyes indicate Liver/Lung mutual overcoming; cold limbs indicate Spleen deficiency. If Lung is very deficient, Spleen mother is also weak, Wood attacks Spleen, causing cold limbs. Treatment should first tonify Spleen/Lung using Yihuang San and Ejiao San. After Spleen deficiency recedes, then treat Heart/Liver with Xieqing Wan, Daochi San, Liangjing Wan. Cured in nine days."
When tidal fever triggers convulsions occurring during Hai, Zi, and Chou hours, this is when Kidney Qi governs. Symptoms include mild convulsions but unstable sleep, warm body, tight oblique gaze, phlegm in throat, silver-brown stool, indigestion, excessive sleep with confusion. Treatment should tonify Spleen and regulate Heart. Tonify Spleen with Yihuang San; regulate Heart with Daochi San and Liangjing Wan. (Jiegu said: Often due to Spleen/Stomach deficiency after major illness.)
Convulsions caused by Wind-Cold invasion occur after catching a cold. Hot breath, yawning/stifling sensation, limb tremors. Should disperse wind using Daqing Gao as main formula. Infants born weak often suffer this. (Daqing Gao formula see Shanghan section.)
[Zhang Yuansu] Convulsions from Wind-Cold invasion present similarly to adults' wind-cold-phlegm. Differentiate sweating/no sweating. For Yin/Yang syndromes, use Daqing Gao or Xiao Xuming Tang to vent and cure. (Daqing Gao for Yin syndrome; Xiao Xuming Tang for Yang syndrome.)
[Qian Yi] Convulsions from Food Injury occur after overeating. Warm body, excessive saliva/sleep, vomiting, anorexia leading to convulsions. First stop convulsions, then use Baixiazi to purge accumulation, followed by Anshen Wan.
[Zhang Yuansu] Convulsions from Food Injury refer to sudden convulsions without other symptoms. Caused by excessive diet damaging Spleen/Stomach, leading to sleepiness, vomiting, anorexia. Spleen/Stomach deficiency stirs Liver Wind. First stop convulsions, add Qianghuo and Fangfeng, decoct and administer Xieqing Wan. Then use Baixiazi to purge food. Gradually use Tiaozhong Wan and Yigong San to nourish Qi.
[Qian Yi] Convulsions in infants under 100 days: True cases occur only 2-3 times and are fatal. False cases occur frequently but are less severe. True cases stem from internal Jing-Xian; false cases from external Wind-Cold. Due to unformed Qi/Blood, unable to withstand pathogens. To identify false cases: hot breath indicates dispersal method using Daqing Gao, plus Fontanelle Application and Bathing methods.
Grandson of Official Li Si, aged 100 days, convulsed 3-5 times. Various doctors diagnosed as Tiandiao, Taijing, or Jing-Xian with no effect. Qian used Daqing Gao (bean-sized) to disperse, combined with Fontanelle Application and Bathing methods. Cured in 3 days. Why? Newborns have tender bones/muscles; wind injury overwhelms them, causing convulsions. Frequent convulsions are mild (external wind inside, easily stops when overwhelmed). Rare convulsions indicate internal organ disease (incurable). Frequent convulsions suit wind-cold dispersion (Daqing Gao), but do not overdose. Infants are prone to deficiency/excess; overdosing generates heat. Only Fontanelle Application is suitable.
Formula: Musk (Shexiang, 1 zi), Scorpion Tail (Xiewei, detoxified, powdered, 0.5 qian), Mint (Bohe, 0.5 zi), Centipede (Wugong, roasted), Bezoar (Niuhuang), Indigo Naturalis (Qingdai). Each 1 zi.
Preparation: Grind together. Mix with cooked date paste into a paste. Apply on new cotton paper to fontanelle, extending 1 finger width around. Roast over fire, keep hand warm pressing. Suitable for ~100-day-old infants.
[Li Dongyuan] External fright requires calming with Huanglian Anshen Wan. Fright from Qi movement requires Hanshui Shi Wan and Huanglian Anshen Wan. (See Dryness section for Huanglian Anshen Wan; Treatment section for Hanshui Shi Wan.)
Commentary: External fright implies original Qi is healthy, treated with bitter-cold Huanglian Anshen Wan. Fright from Qi movement implies original Qi is diseased, treated with sweet-cold Hanshui Shi Wan and Anshen Wan.
[Qian Yi] Zhenxin Wan: Cools Heart Meridian, treats fright-heat and abundant phlegm.
Ingredients: Sal Nitri (Tianxiao, white, 1 liang), Ginseng Radix et Rhizoma (Renshen, 1 liang), Licorice Root (Gancao, roasted), Aragonite (Hanshui Shi, calcined, each 1.5 liang), Dioscorea Opposita Rhizome (Shanyao, white, 2 liang), Poria Cocos (Fuling, 2 liang), Cinnabar (Zhusha, 1 liang), Borneol (Longnao), Musk (Shexiang). Each 1 qian (last two separately ground).
Acute and chronic convulsions have different Yin/Yang syndromes; must differentiate. Acute suits cooling/purging; Chronic suits warming/tonifying.
Above acute symptoms belong to Wood/Fire/Earth Excess. Wood excess: strong convulsions, upward/blinking eyes (Wood excess leads to growth/movement/dizziness/epilepsy); Fire excess: body heat/red face; Earth excess: no vomiting/diarrhea, sleeping with closed eyes. Treatment: Cooling/Purging using Liangjing Wan, Lijing Wan.
Chronic symptoms belong to Wood/Fire/Earth Deficiency. Wood deficiency: weak convulsions (Wood deficiency leads to weakness/shaking/fear); Fire deficiency: cold body/cold breath; Earth deficiency: vomiting/diarrhea, sleeping with open eyes. Treatment: Warming/Tonifying using Qianghuo Gao, Yihuang San. With heat, use Li Dongyuan's Huangqi Yihuang San. Note: Li Dongyuan's Qianghuo Gao treats Spleen deficiency diarrhea with Fire/Wood attack (hot palms/abdomen). If Fire/Wood/Earth all deficient with shaking/fear/diarrhea/cold limbs, only Qianghuo Gao works.
[Zhu Danxi] Acute convulsions are Phlegm-Heat, treat with cooling/purging using drugs that descend fire, resolve phlegm, and nourish blood. Chronic convulsions are Spleen Deficiency, often fatal. First solidify Spleen Earth, then disperse Wind. Use Zhusha Anshen Wan, seeking remedies in Blood-nourishing formulas (e.g., Siwu Tang, Sijunzi Tang, Li Dongyuan's Huangqi Yihuang San).
[Qian Yi] Acute convulsions triggered by loud noises or great fright, resolving afterwards, indicate Yin deficiency. Treat with Lijing Wan. Infantile acute convulsions originate from Heat in Heart: body heat, red face, thirst, hot breath, yellow/red urine/stool. Severe heat generates Wind (Liver). This is Yang excess/Yin deficiency. Lijing Wan clears Phlegm-Heat. Do not use Croton Seed (Badou) or warm purgatives, lest deficiency-heat persist. Heat-Phlegm in Heart/Stomach stirred by loud noises causes fright-convulsions. Extreme heat causes spontaneous convulsions even without noise/fright.
[Zhang Yuansu] Acute convulsions are Yang syndromes, affecting Fu organs. Heat-Phlegm in Heart/Lung indicates Shaoyang Minister Fire excess. Classics say: Heat generates Wind, triggered by loud noise. Eastern Zhen Trigram receives Fire Qi to cause convulsions. Fire does not move; flame moves with wind. Use Lijing Wan, Daochi San, Xieqing Wan, Dihuang Wan. After convulsions stop, take Anshen Wan.
[Yan Xiaozhong] Acute convulsions: Internal heat generates Wind, or triggered by fright. Eyes roll up/blinking, tidal saliva, convulsions, hot body/breath. Upon cessation or waking, patient is lucid. When convulsions subside, give 1-2 doses of Heart-calming/heat-clearing drugs like Shexiang Wan, Zhenxin Wan, Baolong Wan, Chencha Wan, or Zixue. Once settled, immediately purge Phlegm-Heat with Lijing Wan, Ruanjindan, Taozhi Wan. Purging Phlegm-Heat calms Spirit and cures.
[Zhu Danxi] Da Heilong Wan is highly effective for infantile acute convulsions. (See later sections.)
Xiao Heilong Wan: Treats mild infantile acute convulsions.
Ingredients: Qingmengshi (calcined, 1 liang), Qingdai (1 qian), Lu Hui (1.5 qian), Danxing (1 liang).
Preparation: Fine powder, Gancao decoction pills sized like chicken heads. One pill per dose, taken with Ginger-Honey-Mint decoction.
These two formulas use Mengshi and Danxing as chief agents to drain damp-phlegm, suitable for abundant phlegm.
[Qian Yi] Liangjing Wan
Ingredients: Longdan Cao, Fangfeng, Qingdai (ground, each 3 liang), Longnao (ground, 1 qian), Huanglian End (0.5 fen), Niuhuang, Shexiang. Each 1 zi.
Preparation: Fine powder, wheat paste pills sized like millet seeds. Take 10-20 pills per dose, washed down with Silver/Gold decoction.
[Anonymous] Treats Yang Epilepsy (Acute Convulsive Wind).
Ingredients: Zhusha (ground, 1 fen), Nifen, Shexiang (each 5 fen), Lu Hui, Baifuzi, Gancao (each 2 qian), Huhuanglian (1 qian), Xeshao (7 pieces), Jiangcan (honey-roasted, 10 pieces), Jinbo (7 sheets), Chi Jiao Wugong (roasted, 1 piece).
Preparation: Powder. >2 years: 0.5 qianbi, mixed with Golden Coin Mint decoction. 3 years: 1 qianbi. If mouth closed, instill in nose.
[Qian Yi] Lijing Wan
Ingredients: Qingfen, Tianzhuhuang, Qingdai (each 1 qian), Hei Qianniu (first powder, 0.5 liang).
Preparation: Grind together, honey pills sized like pea seeds. 1 year old: 1 pill, taken with warm Mint decoction after meals. Haizang said: Liangjing, Wenjing, Lijing are distinct. Nanxing, Yanzhi, Qingfen, Qingdai differ in color/taste/weight.
[Luo Tianyi] Zhen Gan Wan: Treats infantile acute convulsions with upward fixed gaze, tremors, confusion, unconsciousness. Syndrome: Liver Meridian Wind-Heat.
Ingredients: Tianzhuhuang (ground), Shengdi, Danggui, Zhuye, Longdan Cao, Chuanxiong, Dahuang (roasted), Qianghuo, Fangfeng (each 2.5 qian).
Preparation: Fine powder, refined honey pills sized like chicken heads. Take 2 pills, dissolved in brown sugar water. Take this first, then Tianma San.
These five formulas use Liver-draining agents as chiefs. First two are light/general; latter three are strong, suitable only for strong pulse/solid Qi-Blood. Yan's method of purging Phlegm-Heat after convulsions cease applies here.
[Wang Haizheng] Wufu Wan: Treats acute convulsions.
Ingredients: Fresh Earthworm (1 piece), mashed, mixed with Wufu Huadu Dan (1 pill), ground to mud. Decoct little Mint tea, dissolve and administer immediately. Dosage adjusted by age. Highly effective.
[Qian Yi] Wufu Huadu Dan: Treats fright-heat, cools Heart/Chest.
Ingredients: Shengdi, Shudi (roasted, each 5 liang), Tianmendong, Maimendong (heart removed, roasted, each 3 liang), Tianxiao, Xuanshen, Gancao (roasted, each 2 liang), Qingdai (1.5 liang).
Preparation: Six herbs fine powder. Add Xio/Dai, refine honey pills sized like chicken heads. Take 0.5-1 pill after meal, dissolved in warm water.
Anshen Wan (see Treatment section). Zhenxin Wan (see Exterior/Interior section).
These three formulas use Sweet-Cold Fire-descending agents as chiefs, suitable for infants with Qi-Blood deficiency and acute convulsions. Zhang Jiegu and Yan's advice to calm Spirit after convulsions cease applies here.
[Qian Yi] Chronic convulsions (Man Jing) result from major illness, vomiting/diarrhea, or vomiting alone, transforming into Spleen/Stomach deficiency. Cold body, cold breath from mouth/nose, intermittent limb twitching (Yongchong), lethargy with exposed eyes. This is Yang deficiency. Treat with Gualou Tang.
[Zhang Yuansu] Chronic convulsions are Yin syndromes, affecting Zang organs. Prolonged vomiting/diarrhea damages Spleen/Stomach. If untreated, becomes Man Jing (Yongchong-like, mild tremors). Spleen deficiency causes loose stools; remove Spleen Wind. First use Xuanfeng San to guide, then Yihuang San and Shijunzi Wan to calm, stopping diarrhea. If neglected, Spleen/Stomach deficiency allows Liver Wood to invade. Treat with warming/tonifying Qianghuo Gao.
[Qian Yi] Son of Wang family in Dongdu had vomiting/diarrhea. Doctors used purgatives, causing extreme weakness and Man Jing. Symptoms: lethargy, exposed eyes, limb twitching, cold body. Qian Yi said: "Chronic convulsion." Gave Gualou Tang. Stomach Qi recovered, eyes opened, body warmed. Wang suspected constipation, ordered purgatives (Bazheng San). No effect, body became cold again. Asked Qian Yi to promote urination. Qian Yi said: "Do not promote urination; it causes cold." Indeed, body became cold in 1-2 days. Qian Yi said: "Cannot eat, Stomach empty. Promoting urination/stool worsens Spleen/Stomach, leading to cold body, closed eyes, and death. Fortunately, fetal Qi is strong. Used Yihuang San and Shijunzi Wan four doses, allowing slight eating. By noon, ate normally. Promoting urination/stool damages Spleen/Stomach cold-deficiency; must tonify Spleen, not attack elsewhere." Later lost voice. Doctors treated aphasia. Qian Yi said: "If aphasic, why open eyes and eat? Why no jaw clenching?" Doctors confused. Used Dihuang to tonify Kidney. Qian Yi said: "Cool diuretics damaged Spleen/Kidney. Spleen now solid, Kidney still deficient. Tonifying Kidney ensures safety." Spoke in half month, cured in one month.
Gualou Tang
Ingredients: Gualou (2 qian), Baigan Sui End (1 qian).
Preparation: Stir-fry slowly until scorched yellow, grind evenly. Take 1 zi, mixed with Musk-Mint decoction.
Gualou Tang is Qian's method for Man Jing with strong pulse. Damp-phlegm accumulates in chest, blocking Wind/Fire, causing cold. Gualou Tang removes damp-phlegm, allowing Wind/Fire to extend, warming body and stopping convulsions. If pulse is weak, do not use; instead tonify Spleen with Wenbai Wan, Qianghuo Gao.
[Yan Xiaozhong] Qingzhou Baiwanzi: Treats infantile convulsions and adult wind disorders.
Ingredients: Banxia (raw, 7 liang), Nanxing (raw, 3 liang), Baifuzi (raw, 2 liang), Chuanwu (raw, 0.5 liang, skin/navel removed).
Preparation: Powder. Place in raw silk bag, wash in well water. Knead if residue remains. Repeat grinding/washing until clean. Sun-dry/day-expose in porcelain basin. Discard old water at dawn, mix with fresh well water. Repeat: Spring 5 days, Summer 3 days, Autumn 7 days, Winter 10 days. Dry, grind fine like jade flakes. Make pills with glutinous rice porridge liquid, sized like mung beans. Take 3-5 pills with Mint decoction. For paralysis, take with wine. Any time.
Qian's Yigong San: Warms middle, harmonizes Qi, treats vomiting/diarrhea/anorexia. (See Vomiting/Diarrhea section.)
[Wang Haizheng] Fright crying, limb twitching, unstable sleep. Sijunzi Tang plus Quanchen (tail tip removed, detoxified, roasted), Gouteng, Baifuzi (roasted), equal parts, decoct together. (See Deficiency/Excess treatment.) Spleen/Stomach weak, generating wind/drowsiness: Sijunzi Tang plus fried Banxia Qu, Meizi, equal parts powder, add winter melon seeds, decoct.
[Qian Yi] Wenbai Wan: Treats infantile Spleen Qi deficiency/drowsiness, diarrhea/emaciation, cold Gan diarrhea, and chronic convulsions from prolonged vomiting/diarrhea/illness.
Ingredients: Tianma (raw, 0.5 liang), Baijiangcan (roasted), Baifuzi (raw), Tian Nanxing (cut, washed in water, dried, each 1 liang), Ganxie (detoxified, 1 qian).
Preparation: Powder. Soak in water, make pills with Hanshi Mian (Cold Food Flour) sized like mung beans. Cultivate in Cold Food Flour for 7 days before use. Take 5-7 to 20-30 pills on empty stomach with Ginger-Rice drink. Increase dosage gradually based on condition. (Hanshi Mian: Noodles boiled on Cold Food Festival, dried for storage.)
Gouteng Yinzi: Treats vomiting/diarrhea, weak Spleen/Stomach Qi, deficiency-Wind chronic convulsions.