惊风八候搐搦掣,颤反引窜视之名,胕臂伸缩名为搐,十指开合搦状成,
势若相扑谓之掣,颤则头肢动摇铃,反张身仰头向后,引状两手若开弓,
窜则目直常似怒,视则睹物不转睛,内外左右分顺逆,须视急慢证皆同。
[注]
八候谓搐搦掣颤反引窜视是也,
搐谓胕臂伸缩,
搦谓十指开合,
掣谓肩头相扑,
颤谓手足动摇,
反者身仰向后,
引者手若开弓,
窜则目直而似怒,
视则睛露而不活,
其搐以男左手女右手,男大指在外,女大指在内为顺,反是为逆,
此候急惊慢惊同皆见之,虚实无所异焉,治者宜切记之。
%
惊风门
惊风搐搦神昏愦,痰壅气塞在心胸,急用通关吹入鼻,无嚏则死有嚏生。
[注]
惊风搐搦,必神气昏愦,皆由痰壅气塞,壅结胸中而致,
急用通关散吹入鼻内,无嚏者不治,有嚏者审其表裹虚实随证治之。
(通关散)
半夏生 皂角 细辛 薄荷各等分 共为细末,用笔管吹入鼻内少许。
%
惊风门
急惊触异心惊热,或由风矾火生风,暴发痰盛或热极,壮热烦急面唇红,
痰壅气促牙关噤,二便秘涩脉数洪,惊用镇惊风至宝,牛黄攻痰凉膈清,
平治羌活泻青等,化痰导赤共凉惊。
[注]
急惊风一证,有因目触异物耳闻异声,神散气乱而生者,
有因心肝火盛,外为风寒郁闭,不得宣通而生者,
有因痰热极盛而内动风者,
然证多暴发壮热,烦急面红唇赤,痰壅气促,牙关噤急,二便秘涩,
噤急者齿紧急不能开也,
二便秘涩者,大便秘结而小便涩难也,
脉洪数者主阳热也,
触异致惊者,清热镇惊汤安神镇惊丸主之,
火郁生风者,至宝丹主之,
痰盛生惊者,牛黄丸攻下之,
热极生风者,凉膈散清解之,病不甚者,则用平治之法,
风热者,羌活散主之,
肝热者,泻青丸主之,
痰兼热者,清热化痰汤主之,
心经热者,导赤散凉惊丸主之,惟在临证者审而用之。
(清热镇惊汤) 柴胡 薄荷 麦冬去心 栀子 川黄连 龙胆草 茯神
□藤□ 甘草生 木通 引加灯心竹叶调朱砂末服。
(方歌)
清热镇惊治外惊,柴胡薄荷麦门冬,栀子黄连龙胆草,茯神钓藤草木通。
(安神镇惊丸)
天竺黄 茯神各五钱 胆星 枣仁炒 麦冬去心 赤芍 当归各三钱
薄荷叶 黄连 辰砂 牛黄 栀子 木通 龙骨各三钱煆 青黛一钱
以上为细末,炼蜜丸如菉豆大,赤金箔为衣,量儿大小与之,淡姜汤化下。
(至宝丹) 麻黄 防风 荆芥 薄荷 当归 赤芍 大黄 芒硝 川芎
黄芩 桔梗 连翘去心 白术土炒 栀子 石膏煆 甘草生 滑石
全蝎去毒 细辛 天麻 白附子 羌活 僵蚕炒 川连 独活 黄蘖各等分
以上共为细末,炼蜜为丸,每丸重五分,量儿大小与之,姜汤化下。
(牛黄丸) 黑牵牛 白牵牛各七钱半 胆星 枳实麸炒 半夏各五钱姜制
牙皂二钱去皮弦 大黄一两半 以上研极细末,炼白蜜为丸,重五分,
量儿大小与之,姜汤化下。
(凉膈散)
黄芩 大黄 连翘去心 芒硝 甘草生 栀子 薄荷 引用竹叶生蜜煎服。
无汗者,加防风羌活。
(方歌)
凉膈散治膈热盛,栀翘芩薄芒硝黄,便秘硝黄加倍用,无汗更加羌活防。
(羌活散) 羌活 防风 川芎 薄荷 天麻 僵蚕炒 甘草生 川黄连
柴胡 前胡 枳壳麸炒 桔梗 引用生姜水煎服。
(方歌)
羌活散风兼清热,羌防川芎薄荷叶,天麻僵蚕草黄连,柴胡前胡枳壳桔。
(泻青丸) 龙胆草焙 栀子 大黄煨 羌活 防风各一钱 川芎钱半
以上研末,炼蜜为丸,
如梧桐子大,竹叶薄荷汤调下。
(清热化痰汤) 橘红 麦冬去心 半夏姜制 赤苓 黄芩 竹茹
甘草生 川连 枳壳麸炒 桔梗 胆星 引用生姜灯心水煎服。
(方歌)
清热化痰有橘红,麦冬半夏赤茯苓,黄芩竹茹生甘草,川连枳桔胆南星。
(泻心导赤清) 方见木舌
(凉惊丸)
龙胆草 防风 青黛各三钱 □藤□二钱 黄连五钱 牛黄一钱
以上研细末,面糊为丸,如粟米大,量儿大小与之,金器煎汤化下。
%
惊风门
惊风八候是指搐、搦、掣、颤、反、引、窜、视这八种症状的名称。肢体伸缩称为“搐”,十指开合称为“搦”,势态如同相扑搏斗称为“掣”,头部和四肢摇动如铃作响称为“颤”,身体后仰头向后倾称为“反”,双手张开如同拉弓称为“引”,两眼直视常似愤怒称为“窜”,注视物体而眼球不转动称为“视”。内外左右分为顺证和逆证,但无论是急惊风还是慢惊风,其表现都是一样的。
[注]
所谓八候,就是指搐、搦、掣、颤、反、引、窜、视。
“搐”是指足臂的伸缩;
“搦”是指十指的开合;
“掣”是指肩头动作如同相扑;
“颤”是指手足动摇;
“反”是指身体后仰向后;
“引”是指双手如同拉开弓弩;
“窜”是指眼睛直视且似有怒意;
“视”是指眼珠外露且不灵活。
对于搐症,以男患儿左手拇指在外、女患儿右手拇指在外为顺证,反之则为逆证。
这些症状在急惊风和慢惊风中都会出现,虚实没有区别,治疗者应当牢记。
%
惊风门
惊风发作时出现抽搐痉挛、神志昏迷,痰浊壅盛、气机闭塞于心胸部位。此时急需使用通关散吹入鼻腔,如果不打喷嚏则死亡,如果打喷嚏则有生机。
[注]
惊风引起的抽搐痉挛,必然伴随神气昏乱,这都是由于痰浊壅盛、气机闭塞,郁结在胸中导致的。
紧急时使用通关散吹入鼻内,不打喷嚏的无法救治,打喷嚏的要根据表里虚实的不同随证治疗。
(通关散)
半夏(生用)、皂角、细辛、薄荷各等分,共研为细末,用笔管吹入鼻内少许。
%
惊风门
急惊风是因为接触异物导致心惊发热,或者因为风、矾、火等因素生风。突然发作时痰盛或热极,表现为高热烦躁急促、面唇发红,痰浊壅盛、呼吸急促、牙关紧闭,大小便不通畅、脉象数而洪大。惊风发作用镇惊风至宝丹,牛黄丸攻逐痰浊并清解膈热,平治法可用羌活散、泻青丸等,化痰导赤汤与凉惊丸共同清热惊风。
[注]
急惊风这一病证,有的因眼睛看到异物、耳朵听到异声,导致神气散乱而生;
有的因心肝火盛,外受风寒郁闭,不得宣通而生;
有的因痰热极盛而在体内动风;
然而病症多表现为突然发作的高热,烦躁急促、面红唇赤,痰浊壅盛、呼吸急促、牙关紧闭,大小便不通畅。
牙关紧闭是指牙齿紧急不能张开;
大小便不通畅是指大便秘结而小便涩滞困难;
脉象洪数是主阳热之证。
因接触异物致惊的,用清热镇惊汤或安神镇惊丸主治;
火郁生风的,用至宝丹主治;
痰盛生惊的,用牛黄丸攻下;
热极生风的,用凉膈散清解;病情不严重的,则用平治之法。
风热的,用羌活散主治;
肝热的,用泻青丸主治;
痰兼热的,用清热化痰汤主治;
心经热的,用导赤散或凉惊丸主治。全凭临证医生审察后使用。
(清热镇惊汤)
柴胡、薄荷、麦冬(去心)、栀子、川黄连、龙胆草、茯神、钩藤、甘草(生用)、木通。煎服时加灯心草、竹叶为引,调服朱砂末。
(方歌)
清热镇惊治外惊,柴胡薄荷麦门冬,栀子黄连龙胆草,茯神钓藤草木通。
(安神镇惊丸)
天竺黄、茯神各五钱,胆南星、炒枣仁、麦冬(去心)、赤芍、当归各三钱,薄荷叶、黄连、辰砂、牛黄、栀子、木通、煅龙骨各三钱,青黛一钱。
以上药材研为细末,炼蜜制成如绿豆大小的丸药,用赤金箔包衣,根据患儿年龄大小给予服用,用淡姜汤化开送下。
(至宝丹)
麻黄、防风、荆芥、薄荷、当归、赤芍、大黄、芒硝、川芎、黄芩、连翘(去心)、土炒白术、栀子、煅石膏、生甘草、滑石、去毒全蝎、细辛、天麻、白附子、羌活、炒僵蚕、川黄连、独活、黄柏各等分。
以上共研为细末,炼蜜为丸,每丸重五分,根据患儿年龄大小给予服用,用姜汤化开送下。
(牛黄丸)
黑牵牛、白牵牛各七钱半,胆南星、麸炒枳实、姜制半夏各五钱,去皮弦的牙皂二钱,大黄一两半。以上研成极细末,炼白蜜为丸,重五分,根据患儿年龄大小给予服用,用姜汤化开送下。
(凉膈散)
黄芩、大黄、连翘(去心)、芒硝、生甘草、栀子、薄荷。引用竹叶、生蜜煎服。
无汗者,加防风、羌活。
(方歌)
凉膈散治膈热盛,栀翘芩薄芒硝黄,便秘硝黄加倍用,无汗更加羌活防。
(羌活散)
羌活、防风、川芎、薄荷、天麻、炒僵蚕、生甘草、川黄连、柴胡、前胡、麸炒枳壳、桔梗。引用生姜水煎服。
(方歌)
羌活散风兼清热,羌防川芎薄荷叶,天麻僵蚕草黄连,柴胡前胡枳壳桔。
(泻青丸)
焙干龙胆草、栀子、煨大黄、羌活、防风各一钱,川芎钱半。
以上研末,炼蜜为丸,如梧桐子大小,用竹叶薄荷汤调服。
(清热化痰汤)
橘红、麦冬(去心)、姜制半夏、赤茯苓、黄芩、竹茹、生甘草、川黄连、麸炒枳壳、桔梗。引用生姜、灯心草水煎服。
(方歌)
清热化痰有橘红,麦冬半夏赤茯苓,黄芩竹茹生甘草,川连枳桔胆南星。
(泻心导赤清) 方见木舌条目下
(凉惊丸)
龙胆草、防风、青黛各三钱,钩藤二钱,黄连五钱,牛黄一钱。
以上研细末,用面糊为丸,如粟米大小,根据患儿年龄大小给予服用,用金器煎汤化开送下。
%
惊风门
The eight manifestations of convulsion (Jing Feng) refer to the names of twitching (Chu), grasping (Nuo), pulling (Che), trembling (Chan), arching (Fan), drawing (Yin), darting (Cuan), and staring (Shi). Limb extension and flexion are called "twitching" (Chu); opening and closing of the ten fingers constitute the state of "grasping" (Nuo); a posture resembling wrestling is called "pulling" (Che); trembling of the head and limbs like a bell is called "trembling" (Chan); body arching backward with the head tilted back is called "arching" (Fan); both hands opening as if drawing a bow is called "drawing" (Yin); eyes staring straight ahead, often appearing angry, is called "darting" (Cuan); gazing at objects without moving the eyeballs is called "staring" (Shi). These are classified into favorable (Shun) and unfavorable (Ni) patterns based on internal/external and left/right orientations. However, whether it is acute convulsion or chronic convulsion, the symptoms are identical.
[Note]
The so-called eight manifestations refer to twitching, grasping, pulling, trembling, arching, drawing, darting, and staring.
"Twitching" refers to the extension and flexion of feet and arms;
"Grasping" refers to the opening and closing of the ten fingers;
"Pulling" refers to shoulder movements resembling wrestling;
"Trembling" refers to the shaking of hands and feet;
"Arching" refers to the body leaning backward;
"Drawing" refers to hands resembling a drawn bow;
"Darting" refers to eyes staring straight with an appearance of anger;
"Staring" refers to exposed eyeballs that are not agile.
For the manifestation of twitching, in male infants, the left thumb being outside is favorable, while in female infants, the right thumb being outside is favorable; the reverse indicates an unfavorable pattern.
These manifestations appear in both acute and chronic convulsions, with no difference between deficiency and excess patterns. Practitioners should keep this in mind.
%
Convulsion Section
Convulsions accompanied by coma and confusion arise from phlegm turbidity obstructing and qi stagnation blocking the chest and heart. Urgently use Tongguan San (Pass-the-Gate Powder) blown into the nasal cavity. If sneezing does not occur, death ensues; if sneezing occurs, there is hope for life.
[Note]
Convulsions caused by fright inevitably involve confused spirit and qi, resulting from phlegm turbidity obstructing and qi stagnation knotting in the chest.
Urgently blow Tongguan San into the nose. Cases without sneezing are untreatable; cases with sneezing should be treated according to exterior/interior, deficiency/excess patterns.
(Tongguan San)
Raw Pinellia Rhizome (Banxia), Gleditsia Sinensis Spine (Zaogao), Asarum Root (Xixin), and Mint Leaf (Bohe) in equal parts. Grind into fine powder and blow a small amount into the nose using a quill tube.
%
Convulsion Section
Acute convulsion due to startling involves heart fright and heat, possibly arising from wind, alum, or fire generating wind. It manifests suddenly with abundant phlegm or extreme heat, presenting as high fever, restlessness, rapid breathing, red face and lips, phlegm obstruction, shortness of breath, locked jaw, constipation and dysuria, and a rapid, surging pulse. For fright-induced convulsion, Zhenjing Feng Zhibao Dan (Calming Fright and Treasuring Treasure Pill) is used; Niuhuang Wan (Calculus Bovis Pill) attacks phlegm and clears diaphragmatic heat; Pingzhi Fa (Neutralizing Method) uses Qianghuo San (Notopterygium Powder) and Xieqing Wan (Draining Green Pill); Huatan Daochi Tang (Phlegm-Resolving and Heart-Draining Decoction) and Liangjing Wan (Cooling Convulsion Pill) jointly clear heat and calm convulsion.
[Note]
Acute convulsion may arise because visual contact with foreign objects or auditory exposure to strange sounds scatters the spirit and disrupts qi;
It may arise because excessive fire in the heart and liver is externally constrained by wind-cold, preventing free circulation;
Or it may arise because extreme phlegm-heat stirs wind internally.
However, the syndrome usually presents with sudden onset of high fever, restlessness, red face and lips, phlegm obstruction, shortness of breath, and locked jaw.
Locked jaw means teeth are tight and cannot open;
Constipation and dysuria mean fecal impaction and difficult urination;
A surging and rapid pulse indicates yang-heat.
For convulsion caused by startling at foreign objects, Qingre Zhenjing Tang (Heat-Clearing and Fright-Calming Decoction) or Anshen Zhenjing Wan (Spirit-Anchoring and Fright-Calming Pill) are indicated.
For wind generated by depressed fire, Zhibao Dan (Treasure Treasure Pill) is indicated.
For convulsion caused by abundant phlegm, Niuhuang Wan (Calculus Bovis Pill) is used to purge downward.
For wind generated by extreme heat, Liangge San (Cooling Diaphragm Powder) is used to clear and resolve.
If the disease is not severe, the neutralizing method is used.
For wind-heat, Qianghuo San (Notopterygium Powder) is indicated.
For liver-heat, Xieqing Wan (Draining Green Pill) is indicated.
For phlegm combined with heat, Qingre Huatan Tang (Heat-Clearing and Phlegm-Resolving Decoction) is indicated.
For heart meridian heat, Daochi San (Draining Red Powder) or Liangjing Wan (Cooling Convulsion Pill) are indicated. The practitioner must examine the case and apply accordingly.
(Qingre Zhenjing Tang)
Bupleurum Root (Chaihu), Mint Leaf (Bohe), Ophiopogon Tuber (Maidong, dehearted), Gardenia Fruit (Zhizi), Coptis Rhizome (Chuan Huanglian), Gentian Root (Longdancao), Poria Sclerotium (Fushen), Uncaria Ramulus Cum Uncis (Gouteng), Raw Licorice Root (Gancao), Akebia Stem (Mutong). Add Centella Herb (Dengxincao) and Bamboo Leaf (Zhuye) as guides, and take with Cinnabar Powder (Zhusha mo).
(Prescription Song)
Qingre Zhenjing treats external fright, Chaihu, Bohe, Maidong, Zhizi, Huanglian, Longdancao, Fushen, Gouteng, Gancao, Mutong.
(Anshen Zhenjing Wan)
Tianzhuhuang (Sinarundinaria Tuber), Fushen each 5 qian; Dansheng (Arisaema with Calculus Bovis), stir-fried Jujube Seed (Zaoren), Maidong (dehearted), Red Peony Root (Chishao), Angelica Root (Danggui) each 3 qian; Boheye (Mint Leaf), Huanglian (Coptis Rhizome), Chencha (Vermilion Cinnabar), Niuhuang (Calculus Bovis), Zhizi (Gardenia Fruit), Mutong (Akebia Stem), calcined Longgu (Fossilized Bone) each 3 qian; Qingdai (Indigo Naturalis) 1 qian.
Grind the above into fine powder, mix with refined honey to form pills the size of mung beans, coat with Gold Leaf (Chijinbo), administer according to the child's age, and dissolve in weak Ginger Decoction.
(Zhibao Dan)
Ephedra Stem (Mahuang), Saposhnikovia Root (Fangfeng), Schizonepeta Spike (Jingjie), Mint Leaf (Bohe), Angelica Root (Danggui), Red Peony Root (Chishao), Rhubarb Rhizome (Dahuang), Mirabilite (Mangxiao), Ligusticum Rhizome (Chuanxiong), Scutellaria Root (Huangqin), Forsythia Fruit (Lianqiao, dehearted), Earth-fried Atractylodes Rhizome (Baizhu), Gardenia Fruit (Zhizi), calcined Gypsum Fibrosum (Shigao), Raw Licorice Root (Gancao), Talcum (Huashi), De-toxicated Scorpio (Quanxie), Asarum Root (Xixin), Gastrodia Rhizome (Tianma), Typhonii Rhizoma (Baifuzi), Notopterygium Rhizome (Qianghuo), stir-fried Silkworm (Jiangcan), Coptis Rhizome (Chuanlian), Angelica Dahurica Root (Duhuo), Phellodendron Bark (Huangbo) in equal parts.
Grind all into fine powder, make pills with refined honey, each pill weighing 5 fen, administer according to the child's age, and dissolve in Ginger Decoction.
(Niuhuang Wan)
Black Morning Glory Seed (Hei Qianniu), White Morning Glory Seed (Bai Qianniu) each 7.5 qian; Dansheng (Arisaema with Calculus Bovis), Bran-fried Immature Bitter Orange (Zhishi), Ginger-processed Pinellia Rhizome (Banxia) each 5 qian; Skin-and-string-free Tooth Soap Pod (Ya Zao) 2 qian, Rhubarb Rhizome (Dahuang) 1.5 liang. Grind all into extremely fine powder, make pills with refined white honey, each weighing 5 fen, administer according to the child's age, and dissolve in Ginger Decoction.
(Liangge San)
Scutellaria Root (Huangqin), Rhubarb Rhizome (Dahuang), Forsythia Fruit (Lianqiao, dehearted), Mirabilite (Mangxiao), Raw Licorice Root (Gancao), Gardenia Fruit (Zhizi), Mint Leaf (Bohe). Use Bamboo Leaf (Zhuye) and Raw Honey (Shengmi) as guides for decoction.
For those without sweat, add Fangfeng (Saposhnikovia Root) and Qianghuo (Notopterygium Rhizome).
(Prescription Song)
Liangge San treats excessive diaphragmatic heat, Zhizi, Lianqiao, Huangqin, Bohe, Mangxiao, Dahuang. For constipation, double the dose of Mangxiao and Dahuang. For no sweat, add Qianghuo and Fangfeng.
(Qianghuo San)
Notopterygium Rhizome (Qianghuo), Saposhnikovia Root (Fangfeng), Ligusticum Rhizome (Chuanxiong), Mint Leaf (Bohe), Gastrodia Rhizome (Tianma), stir-fried Silkworm (Jiangcan), Raw Licorice Root (Gancao), Coptis Rhizome (Chuanlian), Bupleurum Root (Chaihu), Peucedanum Root (Qianhu), Bran-fried Aurantium (Zhike), Platycodon Root (Jiegeng). Use Fresh Ginger (Shengjiang) water as guide for decoction.
(Prescription Song)
Qianghuo San disperses wind and clears heat, Qianghuo, Fangfeng, Chuanxiong, Boheye, Tianma, Jiangcan, Gancao, Huanglian, Chaihu, Qianhu, Zhike, Jiegeng.
(Xieqing Wan)
Roasted Gentian Root (Longdancao), Gardenia Fruit (Zhizi), Stir-baked Rhubarb Rhizome (Dahuang), Notopterygium Rhizome (Qianghuo), Saposhnikovia Root (Fangfeng) each 1 qian, Ligusticum Rhizome (Chuanxiong) 1.5 qian.
Grind into powder, make pills with refined honey, the size of Sophora seeds, take with Bamboo Leaf and Mint Tea.
(Qingre Huatan Tang)
Exocarpium Citri Reticulatae (Juhong), Ophiopogon Tuber (Maidong, dehearted), Ginger-processed Pinellia Rhizome (Banxia), Red Poria (Chiling), Scutellaria Root (Huangqin), Bamboo Shavings (Zhuru), Raw Licorice Root (Gancao), Coptis Rhizome (Chuanlian), Bran-fried Aurantium (Zhike), Platycodon Root (Jiegeng). Use Fresh Ginger (Shengjiang) and Centella Herb (Dengxincao) water for decoction.
(Prescription Song)
Qingre Huatan contains Juhong, Maidong, Banxia, Chiling, Huangqin, Zhuru, Gancao, Chuanlian, Zhike, Jiegeng, Dansheng.
(Xie Xin Dao Chi Qing) See entry for Wooden Tongue.
(Liangjing Wan)
Gentian Root (Longdancao), Saposhnikovia Root (Fangfeng), Indigo Naturalis (Qingdai) each 3 qian, Uncaria Ramulus Cum Uncis (Gouteng) 2 qian, Coptis Rhizome (Huanglian) 5 qian, Calculus Bovis (Niuhuang) 1 qian.
Grind into fine powder, make pills with wheat paste, the size of millet grains, administer according to the child's age, and dissolve in Golden Vessel Decoction.
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Convulsion Section