真者。儿在母胎中时。血气未全。精神未备。则动静喘息。莫不随母。母调适乖宜。喜怒失常。或闻大声。
或有击触。母惊动于外。儿胎感于内。至生下百日以来。因有所犯。引动其疾。则身热吐 。心神不宁。睡卧昏
腾。躁啼无时。面青腰直。手足搐搦。口撮腮缩。目瞪气冷。或眼闭胶生。或泻青黄水。是胎痫也。是五内感
病。发为真搐。然亦发稀而难治。不过三两次必死矣。假者。儿生出母腹。百日以
来。肌肤嫩怯。血气软弱。被外风伤之。入客于内。每遇则儿不能任。故发搐搦。口中气热。呵欠嚏喷。此风
痫之候。重者亦不呵欠嚏喷。与胎痫相似。然发频者轻。轻则易歇故也。治当发散。昔钱乙治李司户孙。生百
日来发搐。日三五次。请众医治。或作热天吊。或作胎惊。或作惊痫。治皆无应。后请乙治。乙曰。婴儿初生。
肌骨嫩怯。被风伤之。儿不能任。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。乙用微剂以散风邪。兼涂囟浴法。治之乃愈。仍不可多服。盖儿至小。易
为虚实。多即生热。止一服而已。兼用涂。无不效。以上钱乙所用方。并本集载之。
凡小儿急惊。虽搐甚不用忙扰。亦不足畏。慢惊虽微搐切当救。乃危候也。方搐之时。但与扶持。慎勿擒
捉。盖风气方盛。恐流入筋脉。致手足曲戾不随。或成拘挛。
凡小儿急惊。阎孝忠云。当其搐势减。与镇心治热药一二服。如麝香丸抱龙丸辰砂丸紫雪之类。候惊势已
定。用药下其痰热。如麝香丸软金丹桃枝丸之类。如此则心神安宁即愈。
凡小儿慢惊。若因吐泻。已成虚损者。阎孝忠云。当与速生胃气。以理中丸。并研金
液丹末。煎生姜米粥调灌之。多服乃效。候胃气生。手足渐暖。四肢犹然螈 。即减金液丹一二分。增青州白
丸子一二分同研。如上服。渐渐以意减金液丹。加白丸子。兼用异功散羌活膏钩藤饮之类调理。频频与粥。虽至
危者。往往死中得生。
凡小儿急慢惊。阴阳异证。切宜辨而治之。急惊合用凉药。慢惊合用温药。世人多用一药。不能分别。误小
儿多矣。殊不知药性自有温凉。岂可泛用。初虞世谓治阴阳痫。寒温药性。当于方中用时增损。则无失矣。又阎
孝忠言。慢惊药中宜去龙脑。纵须合用。必以温药为佐。或少少用之。惟凉故也。
凡小儿于天阴雷发声之时。必掩塞其耳。或作杂声以乱之。恐猛闻大声而发搐。
凡小儿发搐。时醒而身软者为痫。若发搐不时醒。身硬者为 。（又名曰痉）乃中风之候。（论在中风门）
凡小儿惊痫泄泻等诸病。烦渴者皆津液内耗也。不问阴阳。煎钱氏白术散。使任意取足饮之。弥多弥好。
凡小儿惊痫药中。能不用水银轻粉者尤佳。如不得已而用之。仅去其疾即止。盖小儿肠胃易损。亦伤口齿。
今所集之方。多不用银、粉。如须用之者。当根据此酌量减损。
凡小儿欲生疮疹。有发搐者。当从疮疹为治。余诸病有与惊痫相兼。可以一方为治者。根据法用之。若不可
以一方为治者。则各用所主药。相兼治之。
凡小儿惊。蜣 为治第一。世医多不学。未见有用者。若用之。须择不伤水者。伤水即不堪用。去其头翅
足。炙令焦。乃入药。
凡小儿吐泻后。精神困顿。多睡。不吃乳食。四肢逆冷。欲变成痫者。以神曲为末。入脑麝各少许。温水调
服。若已成痫。哭如鸦声。面色青黄。手足螈 。咽中不利。更入朱砂同末服之。若变痫滑利者。以曲末。蜜
丸如鸡头大。温水化下。
又一方。曲末一两。琥珀甘草各二钱。朱砂雄黄各一分。同末。蜜丸如鸡头大。名太乙丹。治小儿百病。
真正的胎痫。婴儿在母体中时，气血尚未充盈，精神尚未完备，其动静呼吸无不随顺母亲。若母亲调适失宜，喜怒无常，或听到巨大声响，或有身体撞击触碰，导致母亲在外受惊动，胎儿在内感应。等到出生后百日以内，因受到某种诱发因素，引动潜伏的疾病，就会出现身体发热、呕吐、心神不宁、睡眠昏沉躁动、无定时躁哭、面色青紫、腰背挺直、手足抽搐掣动、口唇撮缩、腮部收缩、眼睛瞪大、气息冷凉，或者眼睑闭合有胶状分泌物生成，或者腹泻排出青黄色水样便。这就是胎痫。这是五脏内部感受病邪，发作表现为真搐。然而这种病症发作稀少却难以治疗，不过发作两三次必然死亡。
假性的风痫。婴儿出生离开母腹百日以来，肌肤娇嫩怯弱，气血软弱，被外感风邪所伤，风邪侵入体内客居。每次遇到诱因，婴儿不能承受，因此发生抽搐。口中气息热，打哈欠打喷嚏。这是风痫的征候。病情重的也不打哈欠打喷嚏，与胎痫相似。但是发作频繁的属于轻症，因为轻症容易停止的缘故。治疗应当发散风邪。从前钱乙治疗李司户的儿子，出生一百多天发生抽搐，每天三到五次，请众多医生医治，有的当作热天吊（急惊风），有的当作胎惊，有的当作惊痫，治疗都没有效果。后来请钱乙诊治。钱乙说：“婴儿初生，肌骨娇嫩怯弱，被风邪所伤，婴儿不能承受，所以发生抽搐。但是发作频繁的属于轻症，因为客风在体内，每次遇到诱因不能承受就抽搐，轻症容易停止，所以发作频繁。发作稀少的，是五脏内部发病，不可救治。”钱乙使用微量的药物来疏散风邪，兼用涂囟法和浴法治疗，病就好了。仍然不可以多服药，因为婴儿太小，容易虚实变化，多服就会生热，只服用一次即可。兼用外涂法，没有不有效的。以上钱乙所用的方剂，都收录在本集中。
凡是小儿急惊风，虽然抽搐严重，不要惊慌忙乱，也不必畏惧。慢惊风虽然抽搐轻微，却必须及时救治，这是危重的证候。在抽搐的时候，只是扶持保护，千万不要强行擒拿捉持。因为风气正盛，恐怕流入筋脉，导致手足弯曲僵硬不能随意活动，或者形成拘挛。
凡是小儿急惊风，阎孝忠说：当抽搐势头减弱时，给予镇心安神、清热的一两服药，如麝香丸、抱龙丸、辰砂丸、紫雪之类。等惊势已经平定，用药下其痰热，如麝香丸、软金丹、桃枝丸之类。这样心神安宁即痊愈。
凡是小儿慢惊风，如果因为吐泻，已经形成虚损的，阎孝忠说：应当迅速恢复胃气，用理中丸，并研磨金液丹粉末，煎生姜米粥调匀灌服。多服才见效。等胃气恢复，手足渐渐温暖，四肢仍有轻微抽搐（螈），就减少金液丹一两分，增加青州白丸子一两分一同研磨，像上面那样服用。渐渐根据情况减少金液丹，增加白丸子。兼用异功散、羌活膏、钩藤饮之类调理，频频给予米粥，即使是极其危重的，往往也能死里求生。
凡是小儿急惊风和慢惊风，阴阳是不同的证候，务必辨别后治疗。急惊风适合用凉药，慢惊风适合用温药。世人多用一种药，不能分别对待，误害小儿很多。殊不知药物性质自有温凉之分，岂可泛泛使用。初虞世说治疗阴阳痫，寒温药性，应当在方剂使用时增减损益，就不会出错了。又阎孝忠说慢惊风的药中应该去掉龙脑（冰片），即使必须合用，也一定要以温药为佐使，或者少量使用，只是因为龙脑性凉的原因。
凡是小儿在天阴雷声大作的时候，一定要掩塞耳朵，或者制造杂声来扰乱它，恐怕猛然听到大声而引发抽搐。
凡是小儿发搐，发作时清醒且身体柔软的称为痫；如果发搐时不时清醒，身体僵硬的称为痉（又名曰痉），这是中风的征候。（论述在中风门）
凡是小儿惊痫泄泻等各种疾病，出现烦躁口渴的，都是津液在内耗损。不问是阴证还是阳证，煎煮钱氏白术散，让患儿任意取足量饮用。越多越好。
凡是小儿惊痫药中，能不用水银、轻粉的尤其好。如果不得已而使用，仅去除疾病就立即停止。因为小儿肠胃容易受损，也会损伤牙齿和牙龈。现在收集的方剂，大多不用银粉。如果必须使用，应当根据此原则酌情减量。
凡是小儿欲生疮疹，伴有发搐的，应当从疮疹方面治疗。其余各种疾病如果有与惊痫相兼的，可以用一个方子治疗的，根据方法使用。如果不能用一个方子治疗的，则各用主治的药物，相兼治疗。
凡是小儿惊风，蜣螂（屎壳郎）作为治疗首选。世间的医生大多不学习，没见过使用的。如果使用，必须选择没有被水污染的。被水污染的就不可使用。去掉它的头、翅膀和脚，烤焦，然后入药。
凡是小儿吐泻之后，精神困顿，嗜睡，不吃乳食，四肢逆冷，想要变成痫证的，用神曲研成粉末，加入少许脑麝（冰片和麝香），温水调服。如果已经变成痫证，哭声像乌鸦叫，面色青黄，手足抽搐，咽喉不利，再加入朱砂同研成末服用。如果变痫且大便滑利的，用曲末，蜜丸如鸡头大小，温水化开服用。
True fetal epilepsy. When the infant is in the womb, the *Qi* and blood are not yet complete, and the spirit is not yet fully prepared; thus, all movements, breathing, and panting follow the mother. If the mother’s adjustments are inappropriate, or if she experiences abnormal anger or joy, or hears loud noises, or suffers physical impacts, causing external shock to the mother and internal sensation to the fetus, then within a hundred days after birth, upon encountering certain triggers, the latent disease is activated. This manifests as fever, vomiting, restlessness of the heart and mind, drowsy and restless sleep, constant crying without timing, cyanosis of the face, straightness of the waist, twitching and clonic spasms of the hands and feet, puckering of the mouth and shrinking of the cheeks, staring eyes with cold breath, or closed eyelids with sticky discharge, or diarrhea passing greenish-yellow watery stool. This is fetal epilepsy (*Tai Xian*). It arises from pathogenic invasion of the five zang organs, manifesting as true convulsions (*Zhen Chu*). However, this condition occurs infrequently but is difficult to treat; death usually ensues after only two or three episodes.
False wind epilepsy. Within a hundred days after leaving the womb, the infant’s skin and muscles are tender and fragile, and the *Qi* and blood are weak. Exogenous wind pathogens injure the body and lodge internally. Each time an trigger occurs, the infant cannot bear it, resulting in convulsions. The breath from the mouth is hot, accompanied by yawning and sneezing. These are signs of wind epilepsy (*Feng Xian*). In severe cases, there may be no yawning or sneezing, resembling fetal epilepsy. However, frequent attacks indicate a mild condition because mild cases resolve easily. Treatment should focus on dispersing wind pathogens. Previously, Qian Yi treated the grandson of Official Li, who developed convulsions at over one hundred days old, occurring three to five times daily. Many physicians were consulted; some diagnosed it as "heat-day hanging" (acute convulsive disorder), others as fetal shock, and still others as fright epilepsy, but none were effective. Qian Yi was then invited and stated: "The newborn has tender muscles and bones and is injured by wind pathogens, which the infant cannot tolerate, hence the convulsions. Frequent attacks indicate mildness due to exogenous wind lodging internally; each trigger causes intolerance and convulsion, which resolve easily, hence frequency. Infrequent attacks indicate internal organ pathology and are incurable." Qian Yi used a mild dose to disperse wind pathogens and combined it with fontanelle application and bathing methods, leading to recovery. Medication must not be overdosed, as infants are small and prone to rapid shifts between deficiency and excess; excessive use generates heat. One dose suffices. Combined with topical applications, efficacy is assured. The formulas used by Qian Yi mentioned above are recorded in this collection.
Regarding pediatric acute convulsive disorder (*Ji Jing*), even if convulsions are severe, one should not panic or disturb the child, nor need one fear it excessively. Regarding chronic convulsive disorder (*Man Jing*), although convulsions are mild, timely intervention is crucial as it is a critical sign. During convulsions, support and protect the child; do not forcibly restrain or grasp them. As wind pathogens are vigorous, they may invade the meridians and collaterals, causing flexion and stiffness of the limbs, potentially leading to contractures.
Regarding pediatric acute convulsive disorder, Yan Xiaozhong stated: When the intensity of convulsions subsides, administer one or two doses of herbs that calm the heart and clear heat, such as *Shexiang Wan* (Musk Pill), *Baolong Wan* (Embracing Dragon Pill), *Chensha Wan* (Cinnabar Pill), or *Zixue* (Purple Snow). Once the fright subsides, use medication to purge phlegm-heat, such as *Shexiang Wan*, *Ruanjindan* (Soft Gold Pill), or *Taozhi Wan*. This ensures the heart and mind become tranquil, leading to recovery.
Regarding pediatric chronic convulsive disorder, if caused by vomiting and diarrhea leading to deficiency and damage, Yan Xiaozhong stated: Rapidly restore stomach *Qi* using *Lizhong Wan* (Regulate the Middle Pill) mixed with powdered *Jinyedan* (Golden Liquid Pill), administered via ginger-infused rice gruel. Multiple doses are required for efficacy. Once stomach *Qi* recovers and extremities warm up, if mild tremors persist, reduce the dosage of *Jinyedan* slightly and increase *Qingzhou Baiwanzi* (Qingzhou White Pills) accordingly, mixing them as before. Gradually decrease *Jinyedan* and increase *Baiwanzi* based on clinical judgment. Supplement with *Yigong San* (Extraordinary Power Powder), *Qianghuo Gao* (Notopterygium Paste), or *Gouteng Yin* (Uncaria Decoction) for conditioning, and frequently provide rice gruel. Even in critical cases, survival is often achieved.
Acute and chronic convulsive disorders in children present distinct yin and yang patterns; differentiation is essential for treatment. Acute convulsions require cooling herbs, while chronic convulsions require warming herbs. Laypeople often use a single type of medicine indiscriminately, failing to differentiate, thereby harming many children. One must recognize that medicinal properties inherently possess warming or cooling natures and should not be applied generically. Chu Yushu stated that when treating yin and yang epilepsy, the addition or subtraction of cold and warm herbs within formulas prevents error. Furthermore, Yan Xiaozhong noted that *Longnao* (Borneol) should be removed from chronic convulsion formulas; if necessary, it must be used with warming herb assistants or in minimal amounts solely due to its cooling nature.
During cloudy weather with thunder, cover the infant's ears or create distracting noises to prevent sudden loud sounds from triggering convulsions.
When an infant experiences convulsions, if the child regains consciousness and the body remains soft during/after the episode, it is classified as epilepsy (*Xian*). If the child does not regain consciousness promptly and the body becomes stiff, it is classified as spasm (*Jing*, also known as *Jing*), which is a sign of wind-stroke (discussed in the Wind-Stroke chapter).
For various pediatric conditions including epilepsy, diarrhea, etc., if irritability and thirst are present, it indicates internal depletion of body fluids (*Jin Ye*). Regardless of yin or yang pattern, decoct *Qian Shi Baizhu San* (Master Qian’s Atractylodes Macrocephala Powder) and allow the child to drink freely. The more, the better.
In pediatric epilepsy medications, avoiding mercury (*Shuiyin*) and calomel (*Qingfen*) is preferable. If unavoidable, discontinue use immediately once the disease is resolved, as infants' gastrointestinal tracts are easily damaged, and these substances harm teeth and gums. The collected formulas herein largely exclude silver and mercury compounds. If usage is necessary, reduce dosages according to these guidelines.
If an infant developing exanthems (smallpox/measles) experiences convulsions, treat primarily based on the exanthem protocol. For other diseases co-occurring with epilepsy, if a single formula suffices, apply it according to method. If not, combine specific primary treatments for each condition.
For pediatric fright and convulsions, *Dung Beetle* (*Qiang Lang*) is the first-choice remedy. Most contemporary physicians lack knowledge of its use. If employed, select specimens not contaminated by water; water-contaminated specimens are unusable. Remove head, wings, and legs, roast until scorched, then incorporate into the prescription.
After vomiting and diarrhea, if the infant shows mental fatigue, excessive sleepiness, refusal of milk/food, and cold extremities, indicating potential progression to epilepsy, administer powdered *Shenqu* (Medicated Leaven) mixed with small amounts of *Naobing* (Borneol) and *Shexiang* (Musk), dissolved in warm water. If epilepsy has already manifested, characterized by crow-like cries, cyanotic-yellow complexion, limb tremors, and throat obstruction, add *Zhusha* (Cinnabar) powder. If epilepsy presents with loose stools, form *Shenqu* powder into honey pills the size of a corn kernel and dissolve in warm water for administration.
Another formula: 1 liang of *Shenqu* powder, 2 qian each of *Hupo* (Amber) and *Gancao* (Licorice), 1 fen each of *Zhusha* (Cinnabar) and *Xionghuang* (Realgar). Grind together, form honey pills the size of a corn kernel. Named *Taiyi Dan* (Great Unity Pill), it treats various pediatric ailments.