小儿发搐。为急慢惊者。古书无有。惟曰阴痫阳痫。所谓急慢惊者。乃后世名之也。以阳动而速。故阳搐
曰急惊。阴静而缓。故阴搐曰慢惊。此阴阳惊痫发搐之别也。阳搐者。身大热。面赤引饮。口中气热。大小便赤
黄。眼上视连札。手足搐急。牙关紧噤。项背强直。涎潮响。此因心热极则生风。风属肝。心肝子母。风火搏
炽。动而发搐也。及其发定。则了然如故。此阳盛阴虚。治当利惊以除风热。不可与巴豆 药大下之。恐蓄虚热不消。
小儿痰壅积热于心。因闻大声。或误惊触。则动而发搐。若热极者。虽不因闻
声惊触。亦自发搐。小儿本实者。多此候也。
天吊（阳搐） 小儿心膈壅滞。涎盛热积。不得宣通。或因母饮酒食肉无度。致烦毒之气。流入于乳。
因以乳儿。令儿宿滞不消。热毒乘心。发为惊搐。眼目翻腾。壮热不休。甚者爪甲皆青。状若神祟。俗谓之天
吊。此非天能吊人。以其眼吊上视。故取意名之。况小儿发搐。未有不眼上者。实亦阳搐之候也。治宜去涎热。
昔钱乙治广亲宅七太尉弟八使者发阳搐。自寅至午。于未发前。钱乙见其目直视而腮赤。此心肝俱热。更坐石杌
子就冷。此热甚也。又肌体素肥而本实。其脉急促。发搐自寅至午。皆
心肝用事之时。治乃泻其心肝。而补其肾。病遂得愈。此亦泻强补弱也，阴搐者。身温面 白。手足似搐不搐。
但时时螈 。昏昏似睡。而无精神。眼露睛微微上视。或胃痛而啼作鸦声。或不能啼
哭。唇口白色。脉沉弱。此因大病之后。或吐泻过甚。致脾胃虚损而生风。荏苒乃成。此阴盛阳虚。治当补其
脾胃。泻去肝风。小儿虚弱。虽不因吐泻取转。直发阴搐者亦有之。本怯者多此候也。
慢脾风（阴搐） 小儿因伤风冷。或病吐泻。医以温药补之不已。复用凉药治之又不已。本谓伤于风
冷。医乱治之。致脾虚而内不能散。外不能解。至十余日。其证昏睡露睛。大便不聚而泻。此脾虚风入。风在
脾胃之间。故大便不聚而泻。时螈 。身体四肢口鼻中气皆冷。小儿亦有因惊所传。或诸病久变。见此证者。皆
因脾胃虚怯。而生风所为也。故俗谓慢脾风矣。实乃阴搐之危候。治当去脾间风。风退痢止。以补脾胃。昔钱乙
治王氏子病吐泻。他医以药下之。至虚变阴搐。其候睡露睛。手足螈 而身冷。乙见曰。此慢惊也。与药以实脾
胃。即开目身温。王疑其子不大小便。又令他医以药利之。而复身冷。尚欲令乙利小便。乙曰。不当利。利之必
身冷。王曰。已身冷矣。乙曰。不能食而胃中虚。若利大小便。使脾肾俱虚。当闭目身冷即死。今此儿幸胎气实
而难衰。乙复补脾胃。则微能饮食。所以然者。谓利大小便。脾胃虚寒。当补脾而不可别攻也。后不语。他医作
失音治。乙曰。既失音。何开目而能饮食。又牙不噤而口不紧。他医不能晓。乙曰。此因用清药利小便。致脾肾
俱虚。今脾已实。肾尚虚故也，遂以药补肾。及根据法为治。半月能言。一月而痊。
小儿出现抽搐症状，分为急惊风和慢惊风两种。古代医书中没有“急惊”和“慢惊”的称呼，只有阴痫和阳痫的说法。所谓的急惊和慢惊，是后世才有的名称。因为阳气主动且迅速，所以阳性的抽搐称为急惊；阴气主静且缓慢，所以阴性的抽搐称为慢惊。这是阴阳惊痫在发作抽搐时的区别。
阳搐（阳惊）的症状是：身体高热，面色红赤，想喝水，口中呼出的气息热，大小便颜色深黄，眼睛向上翻并频繁眨动，手足抽搐拘急，牙关紧闭，颈项和背部僵硬挺直，喉间痰声漉漉作响。这是因为心火极盛而生风，风归属于肝，心与肝是母子关系，风火相互搏结炽盛，导致肢体动摇而发为抽搐。等到抽搐停止后，患儿恢复如常。这属于阳盛阴虚，治疗应当使用利惊药物以祛除风热，不可使用巴豆等峻下药物进行猛烈攻下，恐怕会导致虚热蓄积无法消除。
小儿因痰浊壅塞、积热蕴结于心，如果听到巨大的声响，或者被惊吓触动，就会引发抽搐。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。先天禀赋充实的小儿，多患此类病症。
天吊（属于阳搐的一种表现）：小儿心膈部位气机壅滞，涎液增多且积热，导致气机不得宣通。有时是因为母亲饮酒过量、食用肉类无节制，导致烦毒之气流入乳汁，婴儿吃奶后宿食停滞不能消化，热毒乘袭心脏，引发惊搐。表现为眼球翻腾，持续高热不退，严重的指甲青紫，状似鬼神作祟，民间称之为“天吊”。这并不是天能吊起人，而是因为眼睛向上吊视，所以取此意命名。况且小儿发生抽搐时，没有不向上看眼的，这实际上也是阳搐的症状。治疗适宜去除涎热。
过去钱乙治疗广亲宅七太尉的弟弟八使者的阳搐病，从寅时到午时发作。在未发作前，钱乙观察到患儿眼睛直视、两腮发红，判断这是心肝俱热，且让患儿坐在石凳上靠近冷气，说明热势很盛。又因为患儿体质素来肥胖且根基充实，脉象急促，发病时间都在寅时至午时，这正是心肝经气旺盛的时辰。于是采用泻心肝之火、补肾水的方法，病情得以痊愈。这也是“泻强补弱”的治疗方法。
阴搐（阴惊）的症状是：身体温度正常或偏低，面色苍白，手足看似抽搐又不像抽搐，只是时不时地轻微抽动，神情昏昏欲睡，没有精神，眼睛露白且微微向上看，或者胃部疼痛啼哭发出类似鸦叫的声音，或者不能啼哭，嘴唇和口色淡白，脉象沉弱。这是因为大病之后，或者呕吐腹泻过于严重，导致脾胃虚弱受损而生风，病程迁延而成。这属于阴盛阳虚，治疗应当补益脾胃，泻除肝风。小儿体质虚弱，即使不是因为呕吐腹泻引起的，直接发生阴搐的情况也有，先天怯弱的小儿多患此类病症。
慢脾风（属于阴搐的危重阶段）：小儿因感受风寒，或者患有呕吐腹泻疾病，医生用温补药物治疗不止，又改用凉药治疗也不止。原本认为是伤于风寒，但医生胡乱治疗，导致脾气虚弱，内部不能运化，外部不能解表。到了十多天，出现昏睡、眼睛露白、大便不成形而泄泻的症状。这是脾虚导致风邪内入，风邪停留在脾胃之间，所以大便不成形而泄泻，时常出现轻微抽动，身体四肢及口鼻中呼出的气息都冷。小儿也有因受惊吓传变，或者其他疾病久治不愈演变而来出现这种证候的，都是因为脾胃虚弱怯懦而生风所致，所以民间称之为“慢脾风”。这实际上是阴搐的危重证候。治疗应当祛除脾间的风邪，风邪退去则痢止，随后补益脾胃。
过去钱乙治疗王氏之子患呕吐腹泻病，其他医生用下药攻伐，导致正气极度虚弱转变为阴搐。症状表现为睡觉时眼睛露白，手足轻微抽动且身体发冷。钱乙观察后说：“这是慢惊风。”给予实脾健胃的药物，患儿随即睁开眼睛，身体变暖。王姓家长怀疑孩子不大便和小便，又请其他医生用药通便利尿，结果孩子身体再次变冷。家长还想让钱乙给孩子利尿，钱乙说：“不应该利尿，利尿必然导致身体发冷。”家长说：“现在已经身体发冷了。”钱乙说：“孩子不能进食，说明胃中虚寒，如果再利尿大小便，会使脾肾都虚弱，如果出现闭目、身体冰冷的情况就会死亡。现在这个孩子幸好胎气充实，难以衰败。”钱乙再次补益脾胃，孩子才能稍微进食。之所以这样，是因为利尿导致脾胃虚寒，应当补脾而不可再攻伐。后来孩子不说话，其他医生当作失音症治疗。钱乙说：“既然失音，为什么能睁开眼睛并能进食？而且牙关不紧、嘴巴不僵硬？”其他医生不明白。钱乙说：“这是因为之前用了清热利尿的药，导致脾肾都虚弱。现在脾已充实，但肾还虚弱。”于是用药物补肾，并按照法则进行治疗，半个月能说话，一个月痊愈。
Pediatric convulsions are categorized into acute (Ji) and chronic (Man) types of convulsive disorders. Ancient texts do not use the terms "acute" and "chronic convulsion"; instead, they refer to Yin Epilepsy and Yang Epilepsy. The terms "acute" and "chronic convulsion" were coined in later periods. Since Yang is active and rapid, Yang-type convulsions are termed Acute Convulsion; since Yin is quiet and slow, Yin-type convulsions are termed Chronic Convulsion. This distinguishes the convulsions arising from Yang and Yin epileptic conditions.
Yang Convulsion symptoms include: high fever of the body, redness of the face, desire for drinking, hot breath from the mouth, dark yellow urine and stool, eyes rolling upward with frequent blinking, spasms and stiffness of hands and feet, locked jaw, rigidity of the neck and back, and noisy accumulation of saliva/phlegm. This occurs because extreme Heart Heat generates Wind. Wind is associated with the Liver. As the Heart and Liver share a mother-son relationship, Wind and Fire combine and blaze intensely, causing movement and convulsions. Once the convulsion subsides, the child returns to normal. This pattern represents Excess Yang and Deficient Yin. Treatment should focus on relieving convulsions to dispel Wind-Heat. One must not use drastic purgatives like *Radix et Rhizoma Rhei* (Dahuang, 大黄) or *Fructus Crotonis Tiglii* (Baidu, 巴豆) for severe purging, as this may cause deficiency heat to accumulate and persist.
When phlegm turbidity obstructs and accumulated heat stagnates in the Heart of a child, hearing a loud noise or being startled can trigger convulsions. If the heat is extreme, convulsions may occur spontaneously even without auditory stimuli or startling. Children with strong constitutional foundation often present with this condition.
Tiandiao (a manifestation of Yang Convulsion): Stagnation in the Heart and Diaphragm, excessive phlegm, and accumulated heat prevent the free flow of Qi. This may result from the mother consuming excessive alcohol and meat, leading to toxic heat entering the breast milk. After nursing, the infant suffers from retained food stagnation that fails to digest. Heat toxins attack the Heart, triggering convulsions. Symptoms include rolling eyes, persistent high fever, and in severe cases, cyanosis of the fingernails, resembling supernatural possession. Hence it is called "Tiandiao." It does not mean heaven lifts a person, but refers to the eyes looking upward. Since all pediatric convulsions involve upward gaze, this is essentially a symptom of Yang Convulsion. Treatment should aim to eliminate phlegm and heat.
Previously, Qian Yi treated the eighth messenger, brother of the Seventh Taiwei of Guangqin Residence, for Yang Convulsion. The episodes lasted from Yin hour to Wu hour. Before an episode, Qian Yi observed fixed staring and red cheeks, diagnosing combined Heat in the Heart and Liver. He had the child sit on a cold stone stool, indicating intense heat. Given the child's robust constitution and rapid pulse, and noting that the episodes occurred during the hours governed by the Heart and Liver meridians, Qian Yi employed a method to drain the Heart and Liver while tonifying the Kidney. The disease was cured. This exemplifies "draining the excess and tonifying the deficient."
Yin Convulsion symptoms include: normal or low body temperature, pale complexion, hands and feet appearing to spasm but not fully contracting, occasional mild twitching, lethargy resembling sleep but lacking spirit, eyes showing sclera with slight upward gaze, stomach pain with crying sounding like a crow, inability to cry, white lips and mouth, and a deep, weak pulse. This results from damage to the Spleen and Stomach due to severe illness, excessive vomiting, or diarrhea, leading to internal Wind generation. The condition develops gradually. This pattern represents Excess Yin and Deficient Yang. Treatment should tonify the Spleen and Stomach and drain Liver Wind. Weak children may develop Yin Convulsion directly without prior vomiting or diarrhea. Children with innate timidity often present with this condition.
Slow Spleen Wind (a critical stage of Yin Convulsion): A child contracts wind-cold or suffers from vomiting and diarrhea. Physicians repeatedly use warming tonics, then switch to cooling medicines without resolution. Originally caused by wind-cold, improper treatment leads to Spleen Qi deficiency, unable to transform internally or resolve externally. After more than ten days, symptoms include lethargy, exposed eyes upon waking, loose unformed stools, and diarrhea. This indicates Wind invading due to Spleen deficiency. Wind residing between the Spleen and Stomach causes loose stools and occasional mild twitching. The body, limbs, and breath from the mouth and nose feel cold. Some cases arise from transmission after fright or progression of other diseases. All stem from Spleen-Stomach deficiency generating Wind, hence the folk name "Slow Spleen Wind." It is actually a critical sign of Yin Convulsion. Treatment should remove Wind from the Spleen; once Wind recedes, diarrhea stops, followed by tonifying the Spleen and Stomach.
Previously, Qian Yi treated a son of the Wang family who suffered from vomiting and diarrhea. Other physicians used purgatives, causing extreme deficiency and transformation into Yin Convulsion. Symptoms included sleeping with eyes open, mild limb twitching, and cold body. Qian Yi diagnosed "Slow Convulsion" and prescribed medicine to strengthen the Spleen and Stomach. The child opened his eyes and warmed up. Mr. Wang suspected urinary/fecal retention and asked another physician to administer laxatives/diuretics, causing the body to become cold again. Mr. Wang requested diuresis from Qian Yi. Qian Yi refused, stating that diuresis would cause coldness. When Mr. Wang noted the child was already cold, Qian Yi explained that the child could not eat due to Stomach deficiency. Further diuresis would exhaust both Spleen and Kidney, leading to death if eyes closed and body became cold. Fortunately, the child had strong prenatal Qi. Qian Yi continued to tonify the Spleen and Stomach, allowing slight intake of food. The rationale is that diuresis damages Spleen-Stomach warmth; thus, one must tonify the Spleen and avoid further attacking. Later, the child lost speech. Other physicians treated it as aphonia. Qian Yi questioned why the child could open eyes and eat if truly aphonic, noting no jaw locking. He explained that previous clearing and diuretic drugs exhausted Spleen and Kidney. With the Spleen now solid but Kidney still deficient, he prescribed Kidney-tonifying medicine. Following this protocol, the child spoke within half a month and recovered in one month.