羌活 前胡 制半夏 陈皮 柴胡 赤芍 茯苓 川芎 枳壳 制川朴 桔梗 苍术
升麻 葛根 藿香 独活 甘草
方内柴、前、升、葛,为必用之药。湿盛者,朴、夏、陈、术,亦不可少。骨节酸楚者
,风
淫于内也,羌、独为主;倘已化燥,舌上少津,则朴、夏、陈、术等燥品,宜从删减。不可
执一不化也。(鞠坪又识。)
急惊实热,慢惊虚寒;急惊骤发,慢惊渐成。急惊生于壮实之体,慢惊因于不足之躯。
急惊
之热,如火烧,必面赤口渴,喜冷冻饮料,声壮气粗,大便或闭结,或洞泄,小便短赤而热,甚
至四肢厥冷,面色转青,热极似寒之象也。治宜泻火为急。(莫妙于夏禹铸之《幼科铁镜》
。)慢惊之寒,是真阳告竭,譬如隆冬冰合,未易解疑,非用附、桂、姜、椒,断难挽救,
况
虚阳上浮,亦必发热,其热夜盛朝淡,温和而不烙手,面色桃红,或白或青,口鼻中无莽莽
之热气,舌必滋润,苔必淡白,或微红,口不作渴,即饮亦不多,喜热不喜冷,是谓虚热,
甚至有唇裂出血,寒极似火者,治宜引火归原,大剂扶正,庶乎有济。(莫妙于庄在田之《
福幼编》。)若误认实热为虚热,而投以温补;误认虚热为实热,而投以寒凉,皆必死之道
也。
炳按∶此虽陈言,申说有理。
羌活、前胡、制半夏、陈皮、柴胡、赤芍、茯苓、川芎、枳壳、制厚朴、桔梗、苍术、升麻、葛根、藿香、独活、甘草。
方中柴胡、前胡、升麻、葛根,是必须使用的药物。湿气盛者,厚朴、半夏、陈皮、苍术,也不可缺少。骨节酸痛的人,是风邪侵入体内所致,以羌活、独活为主药;倘若已经化燥,舌上津液减少,那么厚朴、半夏、陈皮、苍术等燥性药物,应当酌情删减。不可固执一端不知变通。(鞠坪又记。)
急惊风属于实热证,慢惊风属于虚寒证;急惊风突然发作,慢惊风逐渐形成。急惊风产生于体质壮实之人,慢惊风因于体质虚弱不足之躯。
急惊风的发热,像火烧一样,必定面色红赤、口渴,喜欢喝冷冻饮料,声音洪亮、气息粗重,大便或者闭结不通,或者呈水样腹泻,小便短少、颜色深黄且灼热,甚至四肢厥冷,面色转青,这是热极似寒的现象。治疗应当以泻火为紧急要务。(没有比夏禹铸的《幼科铁镜》更妙的了。)慢惊风的寒冷,是真阳衰竭的表现,譬如隆冬时节冰层冻结,不容易化解疑惑,非要用附子、肉桂、干姜、花椒,很难挽救,况且虚阳上浮,也必然发热,这种发热夜间加重、早晨减轻,温度温和而不烫手,面色桃红,或者白或者青,口鼻中没有猛烈热气,舌头必定滋润,舌苔必定淡白,或者微红,口不觉得渴,即使喝水也不多,喜欢热的不喜欢冷的,这叫做虚热,甚至有嘴唇开裂出血,这是寒极似火的现象,治疗应当引火归原,大剂量扶正固本,才可能有疗效。(没有比庄在田的《福幼编》更妙的了。)如果错误地把实热认作虚热,而投用温补药物;错误地把虚热认作实热,而投用寒凉药物,都是必死的路径。
炳按:这虽然是陈旧的言论,但申述解说很有道理。
Notopterygii Rhizoma et Radix (Qianghuo), Peucedani Radix (Qianhu), Pinelliae Rhizoma Praeparatum (Zhi Banxia), Citri Reticulatae Pericarpium (Chenpi), Bupleuri Radix (Chaihu), Paeziae Radix Rubra (Chishao), Poria (Fuling), Chuanxiong Rhizoma (Chuanxiong), Aurantii Fructus Immaturus (Zhike), Magnoliae Officinalis Cortex Praeparatus (Zhi Houpo), Platycodonis Radix (Jiegeng), Atractylodis Rhizoma (Cangzhu), Cimicifugae Rhizoma (Shengma), Puerariae Lobatae Radix (Gegen), Agastaches Herba (Huoxiang), Angelicae Dahuricae Radix (Duhuo), Glycyrrhizae Radix et Rhizoma (Gancao).
In this formula, Bupleuri Radix (Chaihu), Peucedani Radix (Qianhu), Cimicifugae Rhizoma (Shengma), and Puerariae Lobatae Radix (Gegen) are essential herbs. For those with excessive dampness, Magnoliae Officinalis Cortex Praeparatus (Zhi Houpo), Pinelliae Rhizoma Praeparatum (Zhi Banxia), Citri Reticulatae Pericarpium (Chenpi), and Atractylodis Rhizoma (Cangzhu) are also indispensable. For individuals with soreness and aching in the bone joints, it is due to wind pathogen invading internally; Notopterygii Rhizoma et Radix (Qianghuo) and Angelicae Dahuricae Radix (Duhuo) serve as the principal herbs. If the condition has transformed into dryness, indicated by a lack of saliva on the tongue, then the drying herbs such as Magnoliae Officinalis Cortex Praeparatus (Zhi Houpo), Pinelliae Rhizoma Praeparatum (Zhi Banxia), Citri Reticulatae Pericarpium (Chenpi), and Atractylodis Rhizoma (Cangzhu) should be appropriately reduced or omitted. One must not adhere rigidly to one approach without flexibility. (Recorded again by Juping.)
Acute convulsion (Ji Jing Feng) belongs to excess-heat syndrome, while chronic convulsion (Man Jing Feng) belongs to deficiency-cold syndrome; acute convulsion occurs suddenly, whereas chronic convulsion develops gradually. Acute convulsion arises in individuals with robust constitutions, while chronic convulsion results from deficient constitutions.
The fever in acute convulsion is like fire burning; symptoms necessarily include red face and thirst, preference for cold drinks, loud voice and coarse breathing, constipation or watery diarrhea, scanty dark yellow and hot urine, and even cold limbs with bluish complexion, which is a phenomenon of extreme heat resembling cold. Treatment should urgently focus on purging fire. (Nothing is more excellent than Xia Yuzhu's *Youke Tiejing* [Iron Mirror of Pediatrics].) The cold in chronic convulsion indicates exhaustion of true yang, akin to ice freezing in deep winter, which is difficult to resolve. It is hardly possible to save the patient without using Aconiti Lateralis Radix Praeparata (Fuzi), Cinnamomi Cortex (Rougui), Zingiberis Rhizoma (Ganjiang), and Zanthoxyli Pericarpium (Jiaojiao). Moreover, floating deficient yang also causes fever; this fever is worse at night and lighter in the morning, feels warm but not scalding to the touch, presents with a peach-red, white, or bluish complexion, lacks fierce hot breath from mouth and nose, features a moist tongue with pale white or slightly red coating, involves no thirst or only slight drinking preference, and favors hot over cold drinks. This is called deficient heat. In severe cases, cracked lips and bleeding may occur, representing extreme cold resembling fire. Treatment should guide fire back to its source and strongly support healthy qi with large doses, which may yield benefits. (Nothing is more excellent than Zhuang Zaitian's *Fuyou Bian* [Compilation for Benefiting Infants].) If excess heat is mistakenly identified as deficient heat and treated with warming and tonifying herbs; or if deficient heat is mistakenly identified as excess heat and treated with cooling herbs, both lead to certain death.
Bing notes: Although these are old words, the explanation makes good sense.