急惊眼睛翻转,口中出血,而足摆跳,肚腹搐动,或神缓而摸
体寻衣,或证笃而神昏气促,喷药不下,通关不嚏,心中热痛,忽大叫者,不治。
慢惊四肢厥冷,吐泻咳嗽,面黯神惨,鸦声胃痛,两胁动气,
口生白疮,发直摇头,眼睛不转,涎鸣喘嗌,头软,大小便不禁,手足一边牵引者,皆不治。
慢脾身冷粘汗,直卧如尸,喘嗽头软,背直口噤,摇头,痰
如牵锯之声,面无润泽之色,缩唇气粗者,不治。
方
探生散 治小儿急、慢惊风,诸药无效,用此吹鼻,定其生死。
雄黄(一钱) 没药(一钱) 乳香(五分) 麝香(一字)
上为末,用少许吹鼻。如眼泪、鼻涕俱下者,可治。
败毒散 治急惊风初起,发热,手足搐搦,眼上视等证,并一
切感冒风寒,头痛发热,咳嗽鼻塞身重,及疮疹欲出发搐,并宜服之。
人参 羌活 独活 柴胡 前胡 茯苓 枳壳 桔梗 川芎
天麻 全蝎 僵蚕 白附子 地骨皮 甘草(各等分)
上锉,生姜三片,水煎服。
牛黄抱龙丸 治小儿急、慢惊风,痰嗽潮搐,及伤风瘟疫,身
热昏睡,气粗风热痰实,壅嗽喘急,一切发热,并宜服之,并痘疹
首尾可服。此药能镇惊安神,宁心定智,除诸热,住痰涎,止嗽定
喘。壮实小儿,宜时少与服之,则免痰热惊风之证,神效无比。
南星(为末,腊月纳牛胆中阴干,百日取,研,一两) 天竺黄(五钱) 雄黄(二钱
半) 辰砂(二钱半) 麝香(一钱) 珍珠(一钱) 琥珀(一两) 牛黄(五分) 金箔(十片,为衣)
上为细末,水煮甘草膏和为丸,如芡实大,金箔为衣。每三岁
儿服一丸,五岁儿服二丸,十岁儿服三、五丸,滚水待温磨化服,惊风薄荷汤磨化下。
珍珠丸(海一传)〔批〕(按此方治急惊风之剂) 治急惊风眼上视,筋脉
急,摆头搐搦,涎潮壮热,风痰气喘,及脐风撮口,痰嗽壅塞,停乳,肚腹胀硬等证。
南星(泡) 半夏(泡) 滑石(各一钱半) 巴豆(二十五个,去壳,去油) 轻粉(五
分) 朱砂(五分)
上为末,面糊为丸,如黍米大。每服量儿大小加减,惊风薄荷汤下,伤食茶下,一二岁三五丸,以利为度。
补脾汤 治小儿脾经不足,土败木来侮,目晴微动摇,微惊
搐,或潮热往来,脾胃有伤,饮食少进,或泄泻呕吐,面色黄,脉无力,宜调理脾胃。
陈皮(五分) 白术(一钱三分) 半夏(七分) 黄 (蜜炙,五分) 人参(五分)
白茯苓(七分) 当归(酒洗,五分) 川芎(五分) 白芍(酒炒,一钱) 黄连(炒,四分)
肉豆蔻(煨,五分) 干葛(五分) 神曲(炒,五分) 甘草(炙,四分)
上锉,姜、枣煎服。一方,去天麻、僵蚕,加南星泡、半夏曲、陈仓米二百粒,煎服累验。
黑附汤
附子(三钱,泡,去皮) 白附子(一钱) 甘草(五分) 木香(一钱半)
上锉,每三钱,生姜五片,煎服。若是手暖,而苏省即止。
异功散〔批〕(按此方治慢脾风之剂) 治小儿吐泻,不思饮食,此药温中壮胃,疗虚冷。
人参 茯苓 白术(炒,各一钱半) 橘红(七分) 木香 甘草(炙,各五分)
紫金锭子 治急、慢惊风,大有神效。
人参 白术 白茯苓 茯神 赤石脂(醋 ,七次) 辰朱(各二钱半)
麝香(五分) 牛黄(五分) 僵蚕(五分) 青礞石( ,一钱) 五灵芝(五分)
上为末,糯米糊为丸,如弹子大,金箔为衣。每一粒,薄荷汤磨化服。
保幼化风丹 治小儿四证八候,去风痰,散惊热。
南星 半夏 川乌 白附子(各一两,水洗净) 郁金(五钱)
上为末,装入腊月黄牛胆内阴干,百日取出,研,为末,每一两,入雄黄、朱砂、硼砂、
HT硝各一钱,片脑、麝香各少许,共为末,炼蜜为丸,豌豆大。灯草薄荷汤研化下。
〔批〕(按此方治一切急、慢惊风之剂) 夫小儿有热,热盛生痰,痰盛生惊,惊盛发搐。又盛则
牙关紧急,而八候生焉,搐、搦、掣、颤、反、引、窜、视是也。搐者,两手伸缩;搦者,十指开合;掣
者,势如相扑;颤者,头偏不正;反者,仰向后;引者,臂若开弓;窜者,目直似怒;视者,睛露不活,是
谓八候也。其四证者,即惊、风、痰、热是也,而化风丹,悉能主之。
治小儿惊风并退,只是声哑不能言,并诸病后不能言。
天南星去皮、脐,一个,泡,为末。每半字,或一字,三五岁半钱,用猪胆汁,食前调下,即言。
灸小儿惊风,男左乳黑肉上,女右乳黑肉上。周岁灸三壮,二三岁灸五七壮。
灸小儿慢惊、慢脾危证,药力不到者。但看两脚面中间陷处,有太冲脉,即灸之;又百会穴,具穴直
取前后发际,折中横取两耳尖,折中在头之中心。端正旋毛处是也,如有双旋,及旋毛不正
者,非。艾炷约小麦许,但灸三五壮而止,灸后仍以醒脾散等补之。
急惊风出现眼睛上翻或转动,口中出血,双脚跳动,腹部抽搐,或者神情呆滞、无意识地摸索身体和衣物,或者病情严重导致神志昏迷、气息短促,灌药无法咽下,通窍药物不能引起喷嚏,心中烦热疼痛,突然大声尖叫的,属于不治之症。
慢惊风出现四肢厥冷,呕吐腹泻咳嗽,面色晦暗、神情凄惨,声音嘶哑如乌鸦叫且胃痛,两胁部有气机动荡感,口腔生白疮,头发直立、摇头,眼球不转动,喉间痰鸣喘息,头部软弱无力,大小便失禁,手足向一侧牵引的,都属于不治之症。
慢脾风出现身体冰冷、粘汗,直挺挺躺着像尸体一样,气喘咳嗽、头部软弱,背部僵硬、牙关紧闭,摇头,痰声像拉锯一样响,面部没有润泽之色,嘴唇内缩、呼吸粗重的,属于不治之症。
方剂:
探生散:治疗小儿急惊风和慢惊风,其他药物无效时,用此药吹入鼻腔,以判断生死预后。
雄黄(一钱) 没药(一钱) 乳香(五分) 麝香(一字)
将上述药材研为细末,取少许吹入鼻中。如果眼泪、鼻涕同时流出的,说明还有生机,可以治疗。
败毒散:治疗急惊风初起,发热,手足抽搐,眼睛向上视等证候,以及一切感冒风寒引起的头痛发热、咳嗽鼻塞身重,还有痘疹欲发时出现的抽搐,都适宜服用。
人参 羌活 独活 柴胡 前胡 茯苓 枳壳 桔梗 川芎
天麻 全蝎 僵蚕 白附子 地骨皮 甘草(各等分)
将上述药材切碎,加生姜三片,水煎服。
牛黄抱龙丸:治疗小儿急惊风、慢惊风,痰嗽潮搐,以及伤风瘟疫引起的身体发热昏睡、气粗、风热痰实导致的咳嗽喘急,一切发热症状,都适宜服用,痘疹病程初期和末期也可服用。此药能镇惊安神,宁心定智,清除各种热邪,停止痰涎,止咳平喘。体质壮实的小儿,适宜少量适时服用,则可避免痰热惊风的证候,效果神奇无比。
南星(研为细末,腊月放入牛胆中阴干,一百天后取出,研磨,一两) 天竺黄(五钱) 雄黄(二钱半) 辰砂(二钱半) 麝香(一钱) 珍珠(一钱) 琥珀(一两) 牛黄(五分) 金箔(十片,作为包衣)
将上述药材研为细末,用水煮甘草膏调和制成丸剂,大小如芡实,外用金箔包裹。每三岁儿童服一丸,五岁儿童服二丸,十岁儿童服三至五丸,用温水磨化后服用,惊风发作时用薄荷汤磨化送服。
珍珠丸(出自《海一传》)【批注】(按:此方是治疗急惊风的药剂):治疗急惊风眼睛向上视,筋脉拘急,摇头抽搐,痰涌壮热,风痰气喘,以及脐风撮口,痰嗽壅塞,停乳,肚腹胀硬等证候。
南星(炮制) 半夏(炮制) 滑石(各一钱半) 巴豆(二十五个,去壳,去油) 轻粉(五分) 朱砂(五分)
将上述药材研为细末,用面糊制成丸剂,大小如黍米。每次服用量根据患儿年龄大小增减,惊风时用薄荷汤送服,伤食用茶送服,一至二岁儿童服三至五丸,以大便通畅为度。
补脾汤:治疗小儿脾经不足,土虚木乘(脾虚肝旺),眼球轻微动摇,轻微惊搐,或者往来潮热,脾胃受损,饮食减少,或者泄泻呕吐,面色萎黄,脉象无力,适宜调理脾胃。
陈皮(五分) 白术(一钱三分) 半夏(七分) 黄芪(蜜炙,五分) 人参(五分)
白茯苓(七分) 当归(酒洗,五分) 川芎(五分) 白芍(酒炒,一钱) 黄连(炒,四分)
肉豆蔻(煨,五分) 干葛(五分) 神曲(炒,五分) 甘草(炙,四分)
将上述药材切碎,加姜、枣煎服。另一版本,去掉天麻、僵蚕,加入炮南星、半夏曲、陈仓米二百粒,煎服,屡试有效。
黑附汤
附子(三钱,炮制,去皮) 白附子(一钱) 甘草(五分) 木香(一钱半)
将上述药材切碎,每次取三钱,加生姜五片,煎服。如果手脚变暖,患者苏醒即停药。
异功散【批注】(按:此方是治疗慢脾风的药剂):治疗小儿吐泻,不思饮食,此药温中壮胃,治疗虚寒证。
人参 茯苓 白术(炒,各一钱半) 橘红(七分) 木香 甘草(炙,各五分)
紫金锭子:治疗急惊风、慢惊风,大有神效。
人参 白术 白茯苓 茯神 赤石脂(醋淬七次) 辰砂(各二钱半)
麝香(五分) 牛黄(五分) 僵蚕(五分) 青礞石(煅,一钱) 五灵芝(五分)
将上述药材研为细末,用糯米糊制成丸剂,大小如弹子,外用金箔包裹。每一粒,用薄荷汤磨化后服用。
保幼化风丹:治疗小儿四证八候,祛风化痰,散惊清热。
南星 半夏 川乌 白附子(各一两,用水洗净) 郁金(五钱)
将上述药材研为细末,装入腊月黄牛胆中阴干,一百天后取出,研磨成细末,每一两药末中,加入雄黄、朱砂、硼砂、火硝各一钱,冰片、麝香各少许,共同研匀,炼蜜为丸,大小如豌豆。用灯草薄荷汤研化后送服。
【批注】(按:此方是治疗一切急惊风、慢惊风的药剂):小儿体内有热,热盛则生痰,痰盛则生惊,惊盛则发搐。如果病情加重,则牙关紧急,从而产生“八候”,即搐、搦、掣、颤、反、引、窜、视这八种症状。搐,是指两手伸缩;搦,是指十指开合;掣,是指势态如同相扑;颤,是指头偏斜不正;反,是指身体向后仰倒;引,是指手臂像拉开弓一样伸展;窜,是指目光直视似愤怒;视,是指眼珠外露且不灵活,这就称为“八候”。所谓的“四证”,就是惊、风、痰、热,而化风丹都能主治。
治疗小儿惊风退去后,只是声音嘶哑不能说话,以及患各种病后不能说话的情况。
天南星去皮、脐,一个,炮制,研为细末。每次取半字或一字,三至五岁儿童取半钱,用猪胆汁调服,饭前服用,即可恢复言语。
灸法治疗小儿惊风:男患儿灸左侧乳头下的黑肉处,女患儿灸右侧乳头下的黑肉处。一周岁灸三壮,二至三岁灸五至七壮。
灸法治疗小儿慢惊风、慢脾风的危重证候,药物难以奏效者。只要查看两脚背中间凹陷处,若有太冲脉搏动,就施灸;另外百会穴,具体定位是前后发际的中点,横向取两耳尖连线的中点,位于头顶中心的端正旋毛处。如果有双旋,或者旋毛位置不正的,则不是该穴位。艾炷大小约如小麦,只灸三至五壮即止,灸后仍需用醒脾散等药物进行补益。
Acute convulsion (Jing Feng) presenting with eyes rolling upward or rotating, bleeding from the mouth, jumping of the feet, and abdominal twitching; or with a sluggish spirit, unconsciously groping the body and clothing; or with severe symptoms leading to coma, shortness of breath, inability to swallow administered medicines, failure of nasal insufflation to induce sneezing, heat and pain in the heart region, and sudden loud screaming are considered incurable.
Chronic convulsion (Man Jing) presenting with cold extremities, vomiting, diarrhea, and coughing; dark complexion with a miserable spirit; hoarse voice like a crow accompanied by stomach pain; qi movement in both hypochondriac regions; white sores in the mouth; straight hair with head shaking; non-rotating eyeballs; phlegm rales and wheezing in the throat; soft head; incontinence of urine and feces; and traction of limbs to one side are all considered incurable.
Chronic spleen wind (Man Pi Feng) presenting with cold body and sticky sweat; lying straight like a corpse; wheezing, coughing, and soft head; stiff back and locked jaw; head shaking; phlegm sound resembling sawing; lack of luster on the face; retracted lips and coarse breathing are considered incurable.
Prescriptions:
Tansheng San (Exploring Life Powder): Treats pediatric acute and chronic convulsions when other medicines are ineffective. Insufflate this powder into the nose to determine prognosis.
Realgar (Xionghuang, 1 qian) / Myrrh (Moyao, 1 qian) / Frankincense (Ruxiang, 5 fen) / Musk (Shexiang, 1 zi)
Grind the above ingredients into fine powder. Insufflate a small amount into the nose. If tears and nasal discharge occur simultaneously, it indicates treatability.
Baidu San (Deficiency-Resolving Powder): Treats early-stage acute convulsion with fever, hand-foot spasms, and upward gaze; as well as any exterior contraction of wind-cold causing headache, fever, cough, nasal congestion, and heavy body; and spasms occurring during the eruption phase of chickenpox/smallpox. It is suitable for all these conditions.
Ginseng Radix et Rhizoma (Renshen) / Notopterygii Rhizoma et Radix (Qianghuo) / Angelicae Pubescentis Radix (Duhuo) / Bupleuri Radix (Chaihu) / Peucedani Radix (Qianhu) / Poria (Fuling) / Aurantii Fructus Immaturus (Zhike) / Platycodonis Radix (Jiegeng) / Chuanxiong Rhizoma (Chuanxiong)
Gastrodiae Rhizoma (Tianma) / Scorpio (Quanxie) / Bombyx Batryticatus (Jiangcan) / Aconiti Kusnezoffii Radix Preparata (Baifuzi) / Lycii Cortex (Digupi) / Glycyrrhizae Radix et Rhizoma (Gancao) (Equal parts)
Cut the herbs, add three slices of fresh ginger, decoct in water, and take orally.
Niuhuang Baolong Wan (Calculus Bovis Pacifying Dragon Pill): Treats pediatric acute and chronic convulsions, phlegmic cough with tidal spasms, wind-cold epidemic febrile diseases, fever with drowsiness, coarse breathing, wind-heat and phlegm-fullness causing cough and urgent wheezing, and all types of fever. It is also suitable for the beginning and end stages of smallpox/chickenpox. This medicine calms fright and soothes the spirit, stabilizes the heart and intellect, clears various heats, stops phlegm and saliva, arrests cough, and relieves wheezing. For robust children, administering small amounts occasionally can prevent phlegm-heat convulsion syndromes with miraculous efficacy.
Arisaema Cum Bile (Nanxing, prepared by drying in cattle gallbladder in the twelfth lunar month for 100 days, then ground, 1 liang) / Tianshu Huang (Tianzhuhuang, 5 qian) / Realgar (Xionghuang, 2.5 qian) / Cinnabar (Chensha, 2.5 qian) / Musk (Shexiang, 1 qian) / Pearl (Zhenzhu, 1 qian) / Amber (Hupo, 1 liang) / Calculus Bovis (Niuhuang, 5 fen) / Gold Leaf (Jinbo, 10 pieces, for coating)
Grind the above into fine powder. Mix with licorice paste boiled in water to form pills the size of Euryale seed (Qianshi), coated with gold leaf. Children aged three take one pill; aged five take two pills; aged ten take three to five pills. Grind in warm water or mint decoction for convulsions before administration.
Zhenzhu Wan (Pearl Pill) [Commentary]: (According to this prescription, it is an agent for treating acute convulsion.) Treats acute convulsion with upward gaze, tendon and vessel tension, head shaking and spasms, tidal phlegm and high fever, wind-phlegm asthma, umbilical wind with mouth closure, phlegmic cough obstruction, milk stasis, and abdominal distension and hardness.
Arisaema Cum Bile (Nanxing, processed) / Pinellia Rhizoma (Banxia, processed) / Talcum (Huashi, 1.5 qian each) / Crotonis Fructus (Badou, 25 seeds, shelled and oil removed) / Calomelas (Qingfen, 5 fen) / Cinnabar (Zhusha, 5 fen)
Grind into powder, bind with wheat flour paste to form pills the size of millet seeds. Dosage varies by child's size. Administer with mint decoction for convulsions, or tea for food stagnation. One to two years old: 3-5 pills; stop when bowels move freely.
Bupi Tang (Spleen-Supplementing Decoction): Treats pediatric deficiency of the Spleen Meridian, where Earth fails and Wood insults (Spleen deficiency with Liver overacting); slight eye movement, mild fright and spasms; tidal fever; Spleen-Stomach injury with poor appetite; diarrhea and vomiting; sallow complexion; and weak pulse. Suitable for regulating Spleen and Stomach.
Citri Reticulatae Pericarpium (Chenpi, 5 fen) / Atractylodis Macrocephalae Rhizoma (Baizhu, 1.3 qian) / Pinellia Rhizoma (Banxia, 7 fen) / Astragali Radix (Huangqi, honey-fried, 5 fen) / Ginseng Radix et Rhizoma (Renshen, 5 fen)
Poria (Baifuling, 7 fen) / Angelicae Sinensis Radix (Danggui, wine-washed, 5 fen) / Chuanxiong Rhizoma (Chuanxiong, 5 fen) / Paeoniae Radix Alba (Baishao, wine-fried, 1 qian) / Coptidis Rhizoma (Huanglian, fried, 4 fen)
Myristica Semen (Roudoukou, baked, 5 fen) / Puerariae Radix (Gange, 5 fen) / Mass Medicamentosa Fermentata (Shenqu, fried, 5 fen) / Glycyrrhizae Radix et Rhizoma (Gancao, roasted, 4 fen)
Cut the herbs, decoct with ginger and jujube, and take orally. Another variant removes Tianma and Jiangcan, adding processed Nanxing, Banxia Qu, and 200 grains of aged rice; decoct and take. Repeatedly effective.
Heifu Tang (Black Aconite Decoction)
Aconitum Lateralis Radix Preparata (Fuzi, 3 qian, processed, skin removed) / Aconiti Kusnezoffii Radix Preparata (Baifuzi, 1 qian) / Glycyrrhizae Radix et Rhizoma (Gancao, 5 fen) / Aucklandiae Radix (Muxiang, 1.5 qian)
Cut the herbs. Take 3 qian per dose, decoct with five slices of fresh ginger, and take orally. Stop if hands become warm and consciousness returns.
Yigong San (Extraordinary Skill Powder) [Commentary]: (According to this prescription, it is an agent for treating chronic spleen wind.) Treats pediatric vomiting and diarrhea, loss of appetite. This medicine warms the middle and strengthens the Stomach, treating deficiency-cold.
Ginseng Radix et Rhizoma (Renshen) / Poria (Fuling) / Atractylodis Macrocephalae Rhizoma (Baizhu, fried, 1.5 qian each) / Citri Reticulatae Pericarpium (Juhong, 7 fen) / Aucklandiae Radix (Muxiang) / Glycyrrhizae Radix et Rhizoma (Gancao, roasted, 5 fen each)
Zijin Dingzi (Purple Gold Tablet): Treats acute and chronic convulsions with great efficacy.
Ginseng Radix et Rhizoma (Renshen) / Atractylodis Macrocephalae Rhizoma (Baizhu) / Poria (Baifuling) / Poria cum Radix (Fushen) / Halloysit Rubrum (Chishizhi, vinegar-quenched seven times) / Cinnabar (Chenzhu, 2.5 qian each)
Musk (Shexiang, 5 fen) / Calculus Bovis (Niuhuang, 5 fen) / Bombyx Batryticatus (Jiangcan, 5 fen) / Calcareous Schist (Qingmengshi, calcined, 1 qian) / Ganoderma (Wulingzhi, 5 fen)
Grind into fine powder. Bind with glutinous rice paste to form pills the size of a bullet, coated with gold leaf. Take one pill, ground in mint decoction.
Baoyou Huafeng Dan (Child-Protecting Wind-Transforming Pill): Treats the four syndromes and eight signs of pediatric convulsion, dispelling wind-phlegm and dissipating fright-heat.
Arisaema Cum Bile (Nanxing) / Pinellia Rhizoma (Banxia) / Aconitum Carmichaelii Radix (Chuanwu) / Aconiti Kusnezoffii Radix Preparata (Baifuzi) (1 liang each, washed clean with water) / Curcumae Radix (Yujin, 5 qian)
Grind into powder. Place in a yellow ox gallbladder collected in the twelfth lunar month, dry in shade for 100 days, then grind into powder. To every 1 liang of powder, add Realgar (Xionghuang), Cinnabar (Zhusha), Borax (Pengsha), and Niter (Xiaoning/Huoxiao) each 1 qian, plus Camphora (Pianbrain/Bingpian) and Musk (Shexiang) in small amounts. Mix thoroughly. Form pills with refined honey, size of pea. Grind in lampwick mint decoction before administration.
[Commentary]: (According to this prescription, it is an agent for treating all acute and chronic convulsions.) When children have heat, excessive heat generates phlegm; excessive phlegm generates fright; excessive fright triggers spasms. If severe, the jaw becomes tight, giving rise to the "Eight Signs": Spasm (Chu), Grasping (Nuo), Jerking (Che), Trembling (Chan), Opisthotonos (Fan), Drawing (Yin), Gazing (Cuan), and Staring (Shi). Chu refers to extension and flexion of hands; Nuo refers to opening and closing of fingers; Che refers to movements like wrestling; Chan refers to tilting of the head; Fan refers to backward arching; Yin refers to arms extending like drawing a bow; Cuan refers to staring straight ahead as if angry; Shi refers to exposed, immobile eyeballs. These are the Eight Signs. The Four Syndromes are Fright, Wind, Phlegm, and Heat. Huafeng Dan addresses all of them.
For cases where pediatric convulsion has subsided but the child remains aphonic, or cannot speak after various illnesses:
Arisaema Cum Bile (Tiannanxing), peeled and navel removed, one piece, processed, ground into powder. Take half zi or one zi (for ages 3-5, take half qian). Mix with pig bile, administer before meals. Speech will return.
Moxibustion for pediatric convulsion: Moxa on the black flesh below the left nipple for males, right nipple for females. Three moxa cones for one-year-olds; five to seven cones for two-to-three-year-olds.
Moxibustion for critical cases of chronic convulsion and chronic spleen wind where medicinal power is insufficient. Locate the depression between the dorsum of the feet where the Taichong pulse is palpable, and moxa there. Also, Baihui (GV20) acupoint: located at the midpoint between the anterior and posterior hairlines, horizontally midway between the tips of the ears, at the center of the head where the hair whorl is upright. If there are double whorls or the whorl is not centered, do not use this point. Use moxa cones the size of wheat grains. Moxa three to five cones only. After moxibustion, supplement with Xingpi San (Awakening Spleen Powder) or similar tonics.