治小儿急惊风。其风猝然而得，四肢搐溺，身挺颈痉，神昏面热，或目睛上窜，或痰涎上壅，或牙关紧闭，
或热汗淋漓。
钩藤钩（三钱） 羚羊角（一钱，另炖兑服） 龙胆草（二钱） 青黛（二钱） 清半夏（二钱） 生赭石（二钱，
轧细） 茯神（二钱） 僵蚕（二钱） 薄荷叶（一钱） 朱砂（二分，研细送服）
磨浓生铁锈水煎药。
小儿得此证者，不必皆由惊恐。有因外感之热，传入阳明而得者，方中宜加生石膏；有因热疟而得者，方
中宜加生石膏、柴胡。
急惊之外，又有所谓慢惊者，其证皆因寒，与急惊之因热者，有冰炭之殊。方书恒以一方治急、慢惊风二
证，殊属差谬。慢惊之证，惟庄在田《福幼编》辨之最精，用方亦最妙。其辨慢惊风，共十四条∶一、慢惊吐
泻，脾胃虚寒也。一、慢惊身冷，阳气抑遏不出也。一、慢惊鼻风煽动，真阴失守，虚火烧肺也。一、慢惊面
色青黄及白，气血两虚也。一、慢惊口鼻中气冷，中寒也。一、慢惊大小便清白，肾与大肠全无火也。一、慢
惊昏睡露睛，神气不足也。一、慢惊手足抽掣，血不行于四肢也。一、慢惊角弓反张，血虚筋急也。一、慢惊
乍寒乍热，阴血虚少，阴阳错乱也。一、慢惊汗出如洗，阴虚而表不固也。一、慢惊手足螈 ，血不足养筋也。
一、慢惊囟门下陷，虚至极也。一、慢惊身虽发热、口唇焦裂出血却不喜饮冷茶水，进以寒凉愈增危笃，以及
所吐之乳、所泻之物皆不甚消化，脾胃无火可知。唇之焦黑，乃真阴之不足也明矣。
脾风之证，亦小儿发痉之证，即方书所谓慢惊风也。因慢惊
二字欠解，近世方书有改称慢脾风者，有但称脾风者。二名较之，似但称脾风较妥，因其证之起点由于脾胃虚
寒也。盖小儿虽为少阳之体，而少阳实为稚阳，有若草木之萌芽，娇嫩畏寒。是以小儿或饮食起居多失于凉，
或因有病过服凉药，或久疟、久痢，即不服凉药亦可因虚生凉，浸成脾风之证。其始也，因脾胃阳虚，寒饮凝
滞于贲门之间，阻塞饮食不能下行，即下行亦不能消化，是以上吐而下泻。久之，则真阴虚损，可作灼热，其
寒饮充盛，迫其身中之阳气外浮，亦可作灼热，浸至肝虚风动，累及脑气筋，遂至发痉，手足抽掣。此证庄在
田《福幼编》论之最详，其所拟之逐寒荡惊汤及加味理中地黄汤二方亦最善。先用逐寒荡惊汤，大辛大热之剂，
冲开胸中寒痰，可以受药不吐，然后接用加味理中地黄汤，诸证自愈。愚用其方救人多矣，而因证制宜又恒有
所变通，方能随手奏效。
【附方】
（1）逐寒荡惊汤
胡椒、炮姜、肉桂各一钱，丁香十粒，共捣成细渣。以灶心土三两煮汤，澄清，煎药大半茶杯（药皆捣碎，
不可久煎，肉桂又忌久煎，三四沸即可），频频灌之。接服加味理中地黄汤，定获奇效。
按∶此汤当以胡椒为君。若遇寒痰结胸之甚者，当用二钱，而稍陈者，又不堪用。族侄××六岁时，曾患
此证。饮食下咽，胸膈格拒，须臾吐出。如此数日，昏睡露睛，身渐发热。投以逐寒荡惊汤原方，尽剂未吐。
欲接服加味理中地黄汤，其吐又作。恍悟，此药取之乡间小药坊，其胡椒必陈。且只用一钱，其力亦小。遂于
食料铺中，买胡椒二钱，炮姜、肉桂、丁香，仍按原方，煎服一剂。而寒痰开豁，可以受食。继服加味理中地
黄汤，一剂而愈。
方中所用灶心土，须为更改。凡草木之质，多含碱味。草木烧化，其碱味皆归灶心土中。若取其土煎汤，
碱味浓浓，甚是难服，且与脾胃不宜。以灶圹内周遭火燎红色之土代之，则无碱味，其功效远胜于灶心土。
（2）加味理中地黄汤
熟地五钱，焦白术三钱，当归、党参、炙 、故纸（炒捣）、枣仁（炒捣）、枸杞各二钱，炮姜、萸肉
（去净核）、炙草、肉桂各一钱，生姜三片，红枣三枚（捭开），胡桃二个（用仁）打碎为引。仍用灶心土
（代以灶圹土）二两，煮水煎药。取浓汁一茶杯，加附子五分，煎水搀入。量小儿大小，分数次灌之。
如咳嗽不止者，加米壳、金樱子各一钱。如大热不退者，加生白芍一钱。泄泻不止，去当归加丁香七粒。
隔二三日，止用附子二三分。盖因附子大热，中病即宜去之。如用附子太多，则大小便闭塞不出。如不用附子，
则脏腑沉寒，固结不开。若小儿虚寒至极，附子又不妨用一二钱。若小儿但泻不止，或微见惊搐，尚可受药吃
乳便利者，并不必服逐寒荡惊汤，只服此汤一剂，而风定神清矣。若小儿尚未成慢惊，不过昏睡发热，或有时
热止，或昼间安静，夜间发热，均宜服之。若新病壮实之小儿，眼红口渴者，乃实火之证，方可暂行清解。但
果系实火，必大便闭结，气壮声洪，且喜多饮凉水。若吐泻交作，则非实火可知。倘大虚之后，服一剂无效，
必须大剂多服为妙。方书所谓天吊风、慢脾风皆系此证。
按∶此原方加减治泻不止者，但加丁香，不去当归。而当归最能滑肠，泻不止者，实不宜用。若减去当
归，恐滋阴之药少，可多加熟地一二钱（又服药泻仍不止者，可用高丽参二钱捣为末，分数次用药汤送服，其
泻必止。）。
慢惊风，不但形状可辨，即其脉亦可辨。族侄××七八岁时，疟疾愈后，忽然吐泻交作。时霍乱盛行，其
家人皆以为霍乱
证。诊其脉弦细而迟，六脉皆不闭塞。愚曰∶此非霍乱。吐泻带有粘涎否？其家人谓偶有带时。愚曰∶此寒痰
结胸，格拒饮食，乃慢惊风将成之兆也。投以逐寒荡惊汤、加味理中地黄汤各一剂而愈。
又∶此二汤治慢惊风，虽甚效验。然治此证者，又当防之于预，乃为完全之策。一孺子，年五六岁，秋夏
之交，恣食瓜果当饭。至秋末，其行动甚迟，正行之时，或委坐于地。愚偶见之，遂恳切告其家人曰∶此乃慢
惊风之先兆也。小儿慢惊风证，最为危险，而此时调治甚易，服药两三剂，即无患矣。其家人不以为然。至冬
初，慢惊之形状发现，呕吐不能受食，又不即治。迁延半月，病势垂危，始欲调治。而服药竟无效矣。
又∶有状类急惊，而病因实近于慢惊者。一童子，年十一二，咽喉溃烂。医者用吹喉药吹之，数日就愈。
忽然身挺，四肢搐搦，不省人事，移时始醒，一日数次。诊其脉甚迟濡。询其心中，虽不觉凉，实畏食凉物。
其呼吸，似觉短气。时当仲夏，以童子而畏食凉，且征以脉象病情，其为寒痰凝结，瘀塞经络无疑。投以《伤
寒论》白通汤，一剂全愈。
又∶治一五岁幼童，先治以逐寒荡惊汤，可进饮食矣，而滑泻殊甚。继投以加味理中地黄汤，一日连进两
剂，泄泻不止，连所服之药亦皆泻出。遂改用红高丽参大者一支，轧为细末，又用生怀山药细末六钱煮作粥，
送服参末一钱强。如此日服三次，其泻遂止。翌日仍用此方，恐作胀满，又于所服粥中调入西药百布圣六分，
如此服至三日，病全愈。
又治一未周岁小孩，食乳即吐，屡次服药亦吐出，囟门下陷，睡时露晴，将成脾风。俾其于每吃乳时，用
生硫黄细末一捻，置儿口中，乳汁送下，其吐渐稀，旬日全愈。
治疗小儿急惊风。这种风邪是突然感受到的，症状表现为四肢抽搐痉挛，身体挺直、颈部僵硬，神志昏迷、面部发热，或者眼球上翻，或者痰涎上涌堵塞气道，或者牙关紧闭，或者热汗淋漓。
钩藤钩（三钱） 羚羊角（一钱，单独炖煮后兑入药液服用） 龙胆草（二钱） 青黛（二钱） 清半夏（二钱） 生赭石（二钱，碾碎） 茯神（二钱） 僵蚕（二钱） 薄荷叶（一钱） 朱砂（二分，研细后送服）
用磨浓的生铁锈水煎煮药物。
患此证的小儿，不一定都是由惊恐引起的。有的因为外感热邪，传入阳明经而致病，方中适宜加入生石膏；有的因为热疟疾而致病，方中适宜加入生石膏和柴胡。
除了急惊风之外，还有所谓的慢惊风，其病症都是由于寒邪引起，与急惊风因热邪引起相比，有着冰炭般的巨大差异。医书常常用同一个方子治疗急惊风和慢惊风两种病症，这显然是错误的。对于慢惊风的辨析，庄在田的《福幼编》辨别得最精辟，所用方剂也最为巧妙。他辨析慢惊风共有十四条：第一，慢惊风出现呕吐腹泻，是脾胃虚寒所致。第二，慢惊风身体发冷，是阳气被抑制无法外达所致。第三，慢惊风鼻翼煽动，是真阴失守，虚火灼烧肺部所致。第四，慢惊风面色青黄或苍白，是气血两虚所致。第五，慢惊风口鼻中呼出的气寒冷，是中焦受寒所致。第六，慢惊风大小便颜色清白，是肾脏和大肠完全没有火气所致。第七，慢惊风昏睡且眼睛半睁露出眼白，是神气不足所致。第八，慢惊风手足抽动掣动，是血液不能运行到四肢所致。第九，慢惊风角弓反张，是血虚导致筋脉拘急所致。第十，慢惊风忽冷忽热，是阴血亏少，阴阳错乱所致。第十一，慢惊风出汗如洗，是阴虚且表卫不固所致。第十二，慢惊风手足蠕动抽搐，是血不足无法滋养筋脉所致。第十三，慢惊风囟门凹陷，是虚损到了极点所致。第十四，慢惊风身体虽然发热、口唇焦裂出血却不喜饮冷茶水，如果给予寒凉药物会使病情更加危重，以及所吐出的乳汁、所排泄的物质都不甚消化，可知脾胃没有火气。嘴唇焦黑，显然是真阴不足的明证。
脾风证，也是小儿发生痉挛的病症，即医书中所谓的慢惊风。因为“慢惊”二字难以理解，近世的医书有改称为“慢脾风”的，有只称“脾风”的。比较这两个名称，似乎只称“脾风”更为妥当，因为其病症的起因是由于脾胃虚寒。大概小儿虽然属于少阳之体，但少阳实际上是稚嫩的阳气，就像草木的萌芽一样，娇嫩怕冷。因此，小儿如果饮食起居稍有不慎受凉，或者因病过服凉药，或者久患疟疾、久患痢疾，即使不服凉药也会因虚而生寒，逐渐形成脾风证。起初，因为脾胃阳气虚弱，寒饮凝结停滞在贲门之间，阻塞饮食不能下行，即使下行也不能消化，所以上吐下泻。久而久之，真阴亏损，可产生灼热感；寒饮充盛，逼迫身体中的阳气外浮，也可产生灼热感，进而导致肝虚风动，累及脑气筋，最终导致痉挛，手足抽搐。这个病症庄在田在《福幼编》中论述得最详细，他所拟定的逐寒荡惊汤和加味理中地黄汤两个方剂也最好。先用逐寒荡惊汤，这是大辛大热的药剂，冲开胸中的寒痰，使患者能够接受药物而不呕吐，然后接着使用加味理中地黄汤，各种病症自然痊愈。我使用他的方子救人多矣，并且根据病情制宜又常有变通，才能随手奏效。
【附方】
（1）逐寒荡惊汤
胡椒、炮姜、肉桂各一钱，丁香十粒，共同捣成细渣。用灶心土三两煮汤，澄清后，煎药至大半茶杯（药物都要捣碎，不可久煎，肉桂又忌讳久煎，煮沸三四次即可），频繁灌服。接着服用加味理中地黄汤，定能获得奇效。
按语：此汤应当以胡椒为君药。如果遇到寒痰结胸严重的情况，应当用二钱，但如果胡椒年代较久（陈货），则不堪使用。族侄××六岁时，曾患此证。饮食咽下后，胸膈格拒，一会儿就吐出来。如此持续数日，昏睡且眼睛半睁露出眼白，身体渐渐发热。投予逐寒荡惊汤原方，全部服完未再呕吐。想要接着服用加味理中地黄汤时，呕吐又发作了。恍然大悟，此药取自乡间小药坊，其中的胡椒必定是陈货。而且只用了一钱，药力也小。于是从食料铺中，买了二钱胡椒，炮姜、肉桂、丁香，仍按原方，煎服一剂。结果寒痰开豁，可以进食。继服加味理中地黄汤，一剂而愈。
方中所用的灶心土，需要更改。凡是草木的材质，多含有碱味。草木烧化后，其碱味都归于灶心土中。如果取这种土煎汤，碱味浓厚，很难服用，且对脾胃不利。用灶坑内四周被火烧红的土代替，就没有碱味，其功效远胜于灶心土。
（2）加味理中地黄汤
熟地黄五钱，焦白术三钱，当归、党参、炙黄芪、故纸（炒后捣碎）、枣仁（炒后捣碎）、枸杞各二钱，炮姜、山茱萸（去净核）、炙甘草、肉桂各一钱，生姜三片，红枣三枚（掰开），胡桃二个（只用果仁）打碎作为药引。仍然用灶心土（用灶坑土代替）二两，煮水煎药。取浓汁一茶杯，加入附子五分，煎水掺入其中。根据小儿年龄大小，分几次灌服。
如果咳嗽不止，加米壳、金樱子各一钱。如果大热不退，加生白芍一钱。泄泻不止，去掉当归，加丁香七粒。隔两三天，只用附子二三分。因为附子大热，病愈后就应当去除。如果使用附子太多，会导致大小便闭塞不通。如果不使用附子，则脏腑沉寒，固结不开。如果小儿虚寒至极，附子不妨用一二钱。如果小儿只是泄泻不止，或者轻微出现惊搐，还可以服药吃奶、大小便正常者，并不一定非要服用逐寒荡惊汤，只服用此汤一剂，风停神清了。如果小儿尚未形成慢惊风，不过是昏睡发热，或者有时热退，或者白天安静，夜间发热，都适宜服用。如果是新病体质壮实的小儿，眼睛红、口渴的，是实火证，才可以暂时使用清热解表法。但如果是真正的实火，必然大便闭结，气壮声洪，且喜欢多喝凉水。如果吐泻交作，那就不是实火可知。如果在极度虚弱之后，服用一剂无效，必须大剂量多服才妙。医书中所谓的天吊风、慢脾风都属于此证。
按语：此原方加减治疗泄泻不止者，只加丁香，不去当归。而当归最能滑肠，泄泻不止者，实在不宜使用。如果减去当归，恐怕滋阴的药物少了，可以多加熟地黄一二钱（如果服药后泄泻仍不止，可用高丽参二钱捣为末，分几次用药汤送服，泄泻必止）。
慢惊风，不但形状可以辨认，其脉象也可以辨认。族侄××七八岁时，疟疾痊愈后，忽然吐泻交作。当时霍乱盛行，其家人都认为是霍乱证。诊察其脉象弦细而迟，六脉皆不闭塞。我说：这不是霍乱。吐泻带有粘涎吗？其家人说偶尔带有。我说：这是寒痰结胸，格拒饮食，是慢惊风将成的征兆。投予逐寒荡惊汤、加味理中地黄汤各一剂而愈。
又：这两首汤药治疗慢惊风，虽然非常有效。然而治疗此证，又应当预防在先，这才是完善的策略。有一个幼儿，年五六岁，在秋夏之交，恣意吃瓜果当饭。到了秋末，行动非常迟缓，正行走时，有时委顿坐在地。我偶然见到，便恳切地告诉其家人说：这是慢惊风的先兆。小儿慢惊风证，最为危险，而此时调治很容易，服药两三剂，就没有祸患了。其家人不以为然。到了初冬，慢惊的形状显现，呕吐不能进食，又不立即治疗。拖延半个月，病势垂危，才开始调治。而服药竟然无效了。
又：有症状类似急惊风，而病因实际上接近慢惊风的。一个童子，年十一二岁，咽喉溃烂。医生用吹喉药吹治，几天就好了。忽然身体挺直，四肢抽搐，不省人事，过了一会儿才醒，一天数次。诊察其脉象甚迟濡。询问心中感觉，虽然不觉凉，但实际上害怕吃凉物。其呼吸，似乎觉得短气。当时正值仲夏，以童子之身却害怕吃凉物，且征验脉象病情，其为寒痰凝结，瘀塞经络无疑。投予《伤寒论》中的白通汤，一剂全愈。
又：治疗一个五岁幼童，先以逐寒荡惊汤治疗，可以进食了，但滑泻非常严重。继投以加味理中地黄汤，一天连进两剂，泄泻不止，连所服的药也都泻出来了。于是改用大红高丽参一支，碾为细末，又用生怀山药细末六钱煮成粥，送服参末一钱强。如此每天服三次，泄泻便停止了。第二天仍用此方，担心造成胀满，又在所服的粥中调入西药百布圣六分，如此服用至三日，病全愈。
又治疗一个未满周岁的婴儿，吃乳即吐，屡次服药也吐出，囟门凹陷，睡觉时露睛，将要形成脾风。让他在每次吃乳时，用生硫黄细末一捻，放在婴儿口中，用乳汁送下，其呕吐逐渐减少，十天全愈。
Zhenfeng Tang (Wind-Extinguishing Decoction)
Treats infantile acute convulsion (Ji Jing Feng). This pathogenic wind is acquired suddenly, with symptoms manifesting as spasms and twitching of the four limbs, rigidity of the body and neck, coma, and facial heat. Alternatively, there may be upward deviation of the eyeballs, accumulation of phlegm and saliva obstructing the airway, lockjaw, or profuse sweating due to heat.
Gouteng Hook (Uncariae Ramulus cum Uncis) - 3 qian
Lingyangjiao (Saiga Antelope Horn) - 1 qian, stewed separately and mixed into the decoction
Longdancao (Gentianae Radix) - 2 qian
Qingdai (Indigo Naturalis) - 2 qian
Qing Banxia (Pinelliae Rhizoma Preparatum) - 2 qian
Sheng Zheshi (Hematitum) - 2 qian, finely crushed
Fushen (Poria with Hostwood) - 2 qian
Jiangcan (Bombyx Batryticatus) - 2 qian
Boheye (Menthae Haplocalycis Herba) - 1 qian
Zhusha (Cinnabaris) - 2 fen, finely ground and taken with water
Decoct the herbs in concentrated rust water from raw iron.
Infants suffering from this syndrome do not necessarily contract it due to fright. Some cases arise from external heat pathogens transmitting to the Yangming channel; in such instances, Sheng Shigao (Gypsum Fibrosum) should be added to the formula. Others arise from heat malaria; in these cases, Sheng Shigao (Gypsum Fibrosum) and Chaihu (Bupleuri Radix) should be added.
Besides acute convulsion, there is what is called chronic convulsion (Man Jing Feng). The pathology of chronic convulsion is rooted in cold, which stands in stark contrast to the heat-based pathology of acute convulsion, much like ice and charcoal. Medical texts often use a single formula to treat both acute and chronic convulsions, which is fundamentally erroneous. Zhuang Zaitian’s *Fu You Bian* (Compilation for Nourishing Infants) offers the most precise differentiation of chronic convulsion and employs the most exquisite formulas. His differentiation of chronic convulsion comprises fourteen points:
1. Chronic convulsion accompanied by vomiting and diarrhea indicates deficiency-cold of the Spleen and Stomach.
2. Coldness of the body in chronic convulsion results from the suppression of Yang Qi, preventing its outward distribution.
3. Flaring of the nostrils in chronic convulsion signifies the loss of control over True Yin, with deficient fire scorching the Lungs.
4. Greenish-yellow or pale complexion in chronic convulsion indicates deficiency of both Qi and Blood.
5. Cold breath from the mouth and nose in chronic convulsion denotes middle-jiao cold.
6. Clear and colorless urine and stool in chronic convulsion indicate a complete lack of Fire in the Kidneys and Large Intestine.
7. Coma with eyes half-open in chronic convulsion reflects insufficiency of Shen Qi (Spiritual Qi).
8. Twitching and jerking of the limbs in chronic convulsion occurs because Blood fails to circulate to the extremities.
9. Opisthotonos in chronic convulsion is caused by Blood deficiency leading to tendon tension.
10. Alternating chills and fever in chronic convulsion results from insufficient Yin-Blood and disorder of Yin and Yang.
11. Sweating profusely in chronic convulsion indicates Yin deficiency and insecure exterior defense.
12. Tremors and writhing of the limbs in chronic convulsion occur because Blood deficiency fails to nourish the tendons.
13. Sunken fontanelle in chronic convulsion signifies extreme deficiency.
14. Although the body may be feverish with cracked, bleeding lips that do not desire cold drinks, administering cold-natured medicines worsens the critical condition. Furthermore, undigested milk in vomitus and undigested matter in stool reveal the absence of Fire in the Spleen and Stomach. Blackened, cracked lips clearly demonstrate insufficiency of True Yin.
Spleen Wind (Pi Feng) is also a syndrome of spasms in infants, known in medical texts as chronic convulsion. Because the term "chronic convulsion" is somewhat obscure, modern texts have renamed it "Chronic Spleen Wind" or simply "Spleen Wind." Comparing the two terms, "Spleen Wind" seems more appropriate, as the origin of the syndrome lies in deficiency-cold of the Spleen and Stomach. Although infants are considered to possess a Shaoyang constitution, Shaoyang is actually tender Yang, akin to the sprout of grass and trees—delicate and fearing cold. Therefore, if an infant’s diet or daily activities involve exposure to cold, or if they take excessive cold-natured medicines during illness, or suffer from prolonged malaria or dysentery (even without taking cold medicines), deficiency-generated cold can gradually develop into Spleen Wind. Initially, due to deficiency of Spleen-Stomach Yang, cold fluids condense and stagnate at the cardia, blocking food from descending; even if it descends, it cannot be digested, resulting in vomiting and diarrhea. Over time, True Yin becomes damaged, potentially generating burning sensations; alternatively, abundant cold fluids force the body's Yang Qi to float outward, also creating a burning sensation. This progresses to Liver deficiency with internal wind stirring, affecting the brain nerves, ultimately leading to spasms and limb twitching. Zhuang Zaitian discusses this syndrome in detail in *Fu You Bian*, proposing two excellent formulas: Zhuhan Dangjing Tang (Cold-Expelling Convulsion-Shaking Decoction) and Jiawei Lizhong Dihuang Tang (Modified Regulate the Middle and Rehmannia Decoction). First, administer Zhuhan Dangjing Tang, a strongly acrid-hot preparation, to resolve cold-phlegm in the chest, allowing the patient to tolerate medication without vomiting. Then, follow up with Jiawei Lizhong Dihuang Tang, and all symptoms will naturally resolve. I have used his formulas to save many lives, but by adapting them to specific conditions, I achieve immediate efficacy.
[Attached Formulas]
(1) Zhuhan Dangjing Tang (Cold-Expelling Convulsion-Shaking Decoction)
Hu jiao (Piperis Longi Fructus), Pao Jiang (Zingiberis Rhizoma Preparatum), Rougui (Cinnamomi Cortex) each 1 qian; Dingxiang (Caryophylli Flos) 10 grains. Pound together into fine dregs. Boil Zaoxintu (Caulis Arundinis Taedia) 3 liang in water, clarify the liquid, and decoct the herbs until only half a teacup remains. (The herbs must be crushed; do not decoct for too long, especially Rougui, which should only boil three or four times). Administer frequently by force-feeding. Follow with Jiawei Lizhong Dihuang Tang for miraculous effects.
Note: Hu jiao (Piperis Longi Fructus) should be the sovereign herb in this decoction. In severe cases of cold-phlegm binding the chest, use 2 qian. However, aged Hu jiao is unsuitable. My clan nephew XX, at age six, suffered from this syndrome. Food swallowed was rejected in the chest and diaphragm, vomiting immediately. This persisted for several days, accompanied by coma, eyes half-open, and gradual fever. I administered the original Zhuhan Dangjing Tang; after finishing the dose, there was no vomiting. When attempting to follow up with Jiawei Lizhong Dihuang Tang, vomiting recurred. I realized then that the medicine was purchased from a rural pharmacy, where the Hu jiao was likely aged. Moreover, using only 1 qian provided insufficient potency. I subsequently bought 2 qian of fresh Hu jiao from a spice shop, kept the other ingredients according to the original formula, and administered one dose. The cold-phlegm dispersed, and eating became possible. Following with Jiawei Lizhong Dihuang Tang cured him in one dose.
The Zaoxintu (Caulis Arundinis Taedia) used in the formula requires substitution. Plant materials generally contain alkaline flavors. Upon combustion, these alkaline residues accumulate in the hearth soil. Using this soil to decoct soup yields a strong alkaline taste, which is difficult to ingest and detrimental to the Spleen and Stomach. Instead, use the red-soot-stained soil from the surrounding walls of the stove pit, which lacks alkalinity and far surpasses standard hearth soil in efficacy.
(2) Jiawei Lizhong Dihuang Tang (Modified Regulate the Middle and Rehmannia Decoction)
Shudi (Rehmanniae Radix Preparata) 5 qian; Jiao Baizhu (Atractylodis Macrocephalae Rhizoma Carbonisatum) 3 qian; Danggui (Angelicae Sinensis Radix), Dangshen (Codonopsis Radix), Zhi Huangqi (Astragali Radix Preparated), Guzhi (Psoraleae Fructus, stir-fried and crushed), Zaoren (Ziziphi Spinosae Semen, stir-fried and crushed), Gouqi (Lycii Fructus) each 2 qian; Pao Jiang (Zingiberis Rhizoma Preparatum), Yurou (Corni Fructus, pits removed completely), Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparatum), Rougui (Cinnamomi Cortex) each 1 qian; Shengjiang (Zingiberis Rhizoma Recens) 3 slices; Hongzao (Jujubae Fructus) 3 pieces (split); Hutao 2 pieces (kernel only, crushed) as guide drugs. Use Zaoxintu (substituted with stove-pit soil) 2 liang to boil water for decocting the herbs. Extract one teacup of concentrated juice, add Fuzi (Aconiti Lateralis Radix Preparata) 5 fen, decoct in water, and mix in. Administer based on the child's age, divided into several doses.
If cough persists, add Bieke (Papaveris Pericarpium) and Jinyingzi (Rosae Laevigatae Fructus) each 1 qian. If high fever persists, add Sheng Baishao (Paeoniae Radix Alba) 1 qian. If diarrhea persists, remove Danggui and add Dingxiang (Caryophylli Flos) 7 grains. After two or three days, use only 2-3 fen of Fuzi. Since Fuzi is strongly hot, it should be discontinued once the disease is addressed. Excessive use of Fuzi causes constipation and urinary retention. Absence of Fuzi leaves deep cold in the viscera, causing stubborn stagnation. If the infant suffers from extreme deficiency-cold, using 1-2 qian of Fuzi is acceptable. If the infant merely has persistent diarrhea, slight convulsions, and can still take medicine and breastfeed with normal bowel/bladder function, Zhuhan Dangjing Tang is not strictly necessary; one dose of this formula alone will stop the wind and clear the spirit. If the infant has not yet developed full chronic convulsion but exhibits lethargy and fever, or intermittent fever, quietness by day and fever by night, this formula is suitable. For newly ill, robust infants with red eyes and thirst indicating excess fire, temporary clearing and resolving methods may be used. However, true excess fire presents with constipation, robust qi and voice, and a preference for cold water. Vomiting and diarrhea together rule out excess fire. If ineffective after one dose in a state of extreme deficiency, larger doses and repeated administration are advisable. Tian Diao Feng (Heaven-Hanging Wind) and Man Pi Feng (Chronic Spleen Wind) mentioned in texts refer to this syndrome.
Note: Regarding the modification for persistent diarrhea in the original formula, only Dingxiang is added without removing Danggui. However, Danggui promotes intestinal lubrication and is unsuitable for persistent diarrhea. If Danggui is removed, the yin-nourishing capacity decreases; thus, increase Shudi (Rehmanniae Radix Preparata) by 1-2 qian. (If diarrhea persists despite medication, use Gaolishen (Codonopsis Radix Koreanensis) 2 qian, powdered, and administer in divided doses with the decoction; diarrhea will cease.)
Chronic convulsion can be diagnosed not only by physical signs but also by pulse. My clan nephew XX, at age seven or eight, suddenly experienced alternating vomiting and diarrhea after recovering from malaria. Cholera was prevalent at the time, and his family suspected cholera. His pulse was wiry, thin, and slow, with no obstruction in any of the six positions. I stated: This is not cholera. Is there sticky phlegm in the vomit and stool? His family replied it occurred occasionally. I said: This is cold-phlegm binding the chest, rejecting food intake, signaling impending chronic convulsion. One dose each of Zhuhan Dangjing Tang and Jiawei Lizhong Dihuang Tang cured him.
Furthermore, while these two decoctions are highly effective for chronic convulsion, prevention is the complete strategy. An infant of five or six years old consumed fruits and melons excessively as meals during the transition from summer to autumn. By late autumn, his movements were sluggish, often sitting on the ground while walking. I observed this and earnestly warned his family: This is a precursor to chronic convulsion. Infantile chronic convulsion is extremely dangerous, but treatment at this stage is easy; two or three doses of medicine would prevent disaster. The family dismissed my advice. By early winter, the manifestations of chronic convulsion appeared: vomiting prevented food intake, and treatment was delayed. After half a month of procrastination, the condition became critical, and treatment began, but medications failed.
Another case resembled acute convulsion but had an etiology closer to chronic convulsion. An eleven or twelve-year-old boy suffered throat ulceration. A physician applied throat powder, curing it in days. Suddenly, he exhibited body rigidity, limb convulsions, and unconsciousness, waking intermittently several times a day. His pulse was very slow and soggy. He reported no internal cold sensation but feared cold foods. His respiration seemed short. Despite it being midsummer, his fear of cold combined with the pulse and symptoms confirmed cold-phlegm coagulation and meridian blockage. I administered Bainong Tang (White Connecting Decoction) from *Shanghan Lun*, which cured him in one dose.
I treated another five-year-old child who, after taking Zhuhan Dangjing Tang, could eat but suffered severe slippery diarrhea. Subsequent administration of Jiawei Lizhong Dihuang Tang (two doses in one day) failed to stop the diarrhea; even the ingested medicine was expelled. I switched to a large piece of Red Gaolishen (Codonopsis Radix Koreanensis), powdered, and boiled 6 qian of raw Huai Shan Yao (Dioscoreae Hypoglaucae Rhizoma) into porridge, mixing in slightly more than 1 qian of the ginseng powder. Administered three times daily, the diarrhea stopped. The next day, I continued this formula but added 6 fen of the Western enzyme "Bromelain" (Bubusheng) to the porridge to prevent bloating. After three days of this regimen, the illness resolved completely.
I also treated an infant under one year old who vomited immediately upon breastfeeding, expelling all administered medicines. The fontanelle was sunken, and eyes opened during sleep, indicating impending Spleen Wind. I instructed placing a pinch of finely powdered Sheng Liuhuang (Sulfur) in the infant's mouth during each feeding, washed down with breast milk. Vomiting gradually decreased, and full recovery occurred within ten days.