急惊者，因闻大声及大惊而发搐，发过则如故，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，剧则搐也。盖热甚则风生，风属肝，此阳盛阴虚也，故利惊丸主之，以除其热痰，
不可与巴豆及温药大下之，恐搐虚热不消也。小儿热痰客于心胃，因闻声非常，则动惊搐矣；若热极，虽不因闻声及惊，
亦自发搐，急惊之候，牙关紧急，壮热涎潮，窜视反张，搐搦（搦者十指开合）颤动，唇口眉眼眨引频并，口中热气，
颊赤唇红，大小便黄赤，其脉浮数洪紧。盖由内有实热，外挟风邪，心经受热而积惊，肝经生风而发搐。治法大要，用
药有序，通关以后，且与截风定搐，痰热尚作乃下之，痰热一泄，又须急与和胃定心之剂，如搐定而痰热少者，则但用
轻药消痰除热可也。盖急惊须当下，切不可过用寒凉及银粉巴消辈，荡涤太骤，此等重剂，医家不得已而用之，仅去疾
即止，或不当用而用，或当用而过焉，往往由此而成慢惊矣。此证亦用搐鼻通关打喷涕，牙关开后，用疏风化痰退热药
导赤散、柴胡天麻等剂，便可无事，琥珀散通治诸经惊狂之要药，至宝丹亦可服。
利惊丸 治小儿急惊，风痰盛，发热潮搐。
青黛 轻粉（各一钱） 牵牛末（半两） 天竺黄（二钱）
上为末，白面糊丸，如小豆大，二十丸，薄荷汤下。一法炼蜜丸，如芡实大，一粒化下。
导赤散 见第八问。
至宝丹 见第二十问。
琥珀散 治小儿急慢惊风，涎潮昏冒，目瞪搐搦，惊吊肚疼，及和顺痘疮，小可惊哭，眠卧不安，入口立效，
惊痫时攻发作，常服永除病根。
辰砂（一钱半） 琥珀 牛黄 天麻 僵蚕（炒，去丝咀） 全蝎（去毒） 白附子 乳香 蝉蜕（各一钱） 麝
香（半钱） 代赭石（ ，醋淬七次，一钱） 片脑（一字） 牛胆南星（一字）
上为末，三岁一钱，薄荷汤下，慢惊加附子一分。
急惊风，是因为听到巨大的声响或受到极大的惊吓而引发抽搐，发作过后则恢复如常，这属于无阴（体内阴液枯竭）的证候，应当使用利惊丸为主进行治疗。小儿患急惊风，根本原因是心经生热，表现为身体发热、面色发红、想喝水、口中呼出热气、大小便颜色黄赤，病情严重时出现抽搐。大概是因为热邪极盛则生风，风归属于肝，这是阳盛阴虚的表现，所以用利惊丸主治，以清除体内的热痰，不可使用巴豆及温热药物进行猛烈攻下，恐怕会导致抽搐虽止但虚热不消。小儿的热痰客居于心胃之间，因为听到不寻常的声音，就会触动惊风导致抽搐；如果热邪极盛，即使没有听到声音或受到惊吓，也会自发抽搐。急惊风的征候包括：牙关紧闭、高热、涎沫上涌、两眼上视或斜视、角弓反张、四肢抽搐（搦是指十指开合）、颤动、嘴唇口角眉眼频繁眨动牵引、口中呼出热气、脸颊红、嘴唇红、大小便黄赤，脉象浮数洪紧。大概是由于体内有实热，外受风邪侵袭，心经受热而积聚惊邪，肝经生风而引发抽搐。治疗的大要在于用药要有次序，在通关（开通闭塞）之后，先给予截断风邪、制止抽搐的药物，如果痰热仍然严重才使用泻下法，一旦痰热泄去，又必须立即给予调和胃气、安定心神的药剂。如果抽搐停止且痰热较少，那么只需使用轻剂量的药物消除痰热即可。大概急惊风必须采用泻下法，切不可过度使用寒凉药物以及银粉、巴豆霜之类的猛药，以免荡涤太过迅猛。这些重剂是医生不得已时才使用的，病去即止，如果不该用却用了，或者该用却用量过大，往往因此转变为慢惊风。此证也可以使用搐鼻法使患者打喷嚏以通关窍，牙关打开后，使用疏风化痰退热的药物，如导赤散、柴胡天麻汤等方剂，就可以痊愈。琥珀散是通治各经惊狂的重要药物，至宝丹也可以服用。
利惊丸：治疗小儿急惊风，风痰盛，发热并伴有潮式抽搐。
配方：青黛、轻粉（各一钱），牵牛子末（半两），天竺黄（二钱）。
制法与用法：以上药物研为细末，用白面糊制作成丸，大小如小豆，每次二十丸，用薄荷汤送服。另一种方法是炼蜜为丸，大小如芡实，每次一粒化开服用。
导赤散：见第八问。
至宝丹：见第二十问。
琥珀散：治疗小儿急惊风和慢惊风，涎沫上涌、昏蒙冒昧，眼睛直视、抽搐痉挛，惊吊腹痛，以及痘疮顺行过程中出现的轻微惊哭、睡眠不安，入口后立即见效；对于惊痫时常发作的情况，常服可永远去除病根。
配方：辰砂（一钱半），琥珀、牛黄、天麻、僵蚕（炒，去丝切碎）、全蝎（去毒）、白附子、乳香、蝉蜕（各一钱），麝香（半钱），代赭石（醋淬七次，一钱），片脑（一字），牛胆南星（一字）。
制法与用法：以上药物研为细末，三岁儿童服用一钱，用薄荷汤送服，若是慢惊风加附子一分。
Acute convulsion (Ji Jing) arises from hearing loud noises or experiencing sudden fright, leading to spasms; after the episode, the child returns to normal. This condition indicates a deficiency of Yin (Yin fluids), and should be primarily treated with Lijing Wan (Detoxifying Convulsion Pill). In children, acute convulsion originates from heat generating in the Heart channel, presenting with fever, flushed face, thirst, hot breath, and yellow-red urine and stool. Severe cases involve spasms. Generally, excessive heat generates wind, and wind is associated with the Liver; this represents an excess of Yang and deficiency of Yin. Therefore, Lijing Wan is used to clear heat-phlegm. One must not use Croton seed (Badou) or warming purgatives for severe purging, as this may stop spasms but fail to resolve the deficient heat. Heat-phlegm lodging in the Heart and Stomach can trigger convulsions upon hearing unusual sounds. If heat is extreme, spontaneous spasms may occur even without auditory triggers or fright. Signs of acute convulsion include locked jaw, high fever, salivary overflow, upward gaze or strabismus, opisthotonos, limb spasms (Nu refers to opening and closing of fingers), tremors, frequent blinking and twitching of lips, mouth, eyebrows, and eyes, hot breath, red cheeks and lips, yellow-red urine and stool, and a floating, rapid, full, or tight pulse. This is caused by internal excess heat combined with external wind pathogen; heat affecting the Heart channel accumulates fright, while wind generated in the Liver channel induces spasms. The general principle of treatment requires orderly medication: after unblocking obstructions (Tongguan), first administer herbs to arrest wind and stop spasms. Only if phlegm-heat persists should purgatives be used. Once phlegm-heat is evacuated, immediately administer formulas to harmonize the Stomach and calm the Heart. If spasms cease and phlegm-heat is mild, only light-dose herbs for resolving phlegm and clearing heat are needed. Acute convulsion requires purgation, but one must strictly avoid overusing cold-natured drugs or heavy agents like Calomel (Yinfen) and Croton resin (Baxiao) to prevent overly rapid cleansing. These heavy agents are used only when necessary and discontinued once the disease is alleviated. Improper use or overdose often leads to chronic convulsion (Man Jing). For this condition, nasal insufflation to induce sneezing can open the orifices. After the jaw relaxes, use wind-dispersing, phlegm-resolving, and heat-clearing formulas such as Daochi San (Drain the Heart Powder) or Chaihu Tianma Tang (Bupleurum and Gastrodia Decoction) for recovery. Hupo San (Amber Powder) is a key formula for treating various types of fright and mania across meridians; Zhibao Dan (Precious Treasure Pill) is also applicable.
Lijing Wan: Treats pediatric acute convulsion with abundant wind-phlegm, fever, and tidal spasms.
Ingredients: Indigo Naturalis (Qingdai), Calomel (Qingfen) (each 1 qian), Semen Kochiae Pulverized (Qianniu Mo) (0.5 liang), Tianshu Huang (2 qian).
Preparation and Administration: Grind all ingredients into powder, bind with wheat flour paste to form pills the size of small beans. Take 20 pills per dose with mint decoction. Alternatively, bind with refined honey to form pills the size of Chinese tallow seeds; dissolve one pill per dose.
Daochi San: See Question 8.
Zhibao Dan: See Question 20.
Hupo San: Treats pediatric acute and chronic convulsions, salivary overflow, dizziness, fixed gaze, spasms, fright-induced abdominal pain, mild fright during the favorable course of variola (smallpox), crying, and restlessness. It acts immediately upon ingestion. For recurrent epilepsy, long-term use permanently eliminates the root cause.
Ingredients: Cinnabar (Chensha) (1.5 qian), Amber (Hupo), Calculus Bovis (Niuhuang), Rhizoma Gastrodiae (Tianma), Bombyx Batryticatus (Jiangcan) (stir-fried, silk removed, broken), Scorpio (Quanxie) (de-toxicated), Rhizoma Typhonii (Baifuzi), Resina Draconis (Ruxiang), Periostracum Cicadae (Chantui) (each 1 qian), Moschus (Shexiang) (0.5 qian), Haematitum (Daizheshi) (calcined in vinegar seven times, 1 qian), Borneolum Syntheticum (Pian Nao) (1 zi), Arisaema cum Bile (Niudan Nanxing) (1 zi).
Preparation and Administration: Grind all ingredients into powder. For a three-year-old child, take 1 qian per dose with mint decoction. For chronic convulsion, add Radix Aconiti Lateralis Preparata (Fuzi) 1 fen.