此证比之客忤为更甚。盖客忤无非外来人畜不正之气，中恶则中恶毒之气。如老柩荒厝，淫祠古树，冷庙
枯井，败屋阴沟，皆有恶毒之气存焉。小儿触之，从鼻而入，肺先受之，闭其清道，填塞胸中，忽然而倒，四
肢厥逆，两手握拳，上气喘急者是也。
复有中恶毒之物者，亦谓之中恶。如菌草河豚，瘟牛疫马，自死六畜，并水鸡虾蚌之类。自口而入，则胃
肠受之，故心腹刺痛，腹皮青黑，闷乱欲死。前后二证，俱宜霹雳散搐其鼻，令其喷嚏之后，毒瓦斯已出，然后
用药。前证中毒瓦斯死者，用返魂汤；此中毒
物死者，用雄黄解毒丸下去之。
霹雳散 治中恶卒死，并一切卒暴之证。
猪牙皂（三分） 北细辛（五分） 大川芎（五分香） 白芷（五分） 踯躅花（半分） 明雄黄（二分）
真麝香（半分）
上为极细末，每用少许，以灯芯三寸长，蘸药点鼻孔内，以得喷嚏为验。
返魂汤 治中恶卒死，宜此主之，即仲景之麻黄汤也。因其毒瓦斯闭塞肺窍，以此开通之。
净麻黄（去节，二钱） 光杏仁（去皮，七个） 炙甘草（一钱） 葱白（三寸）
水一盏，煎半盏，分数次服。
雄黄解毒丸 方见卷二类搐疮疡门。
一曰非搐，即幼科之慢惊风、慢脾风者是也。
按∶幼科有言曰∶急惊传慢惊，慢惊成慢脾。慢脾者纯阴之证也。然慢惊亦有虚热，尝多便秘痰壅气塞，
便误认为实热。妄用巴、黄，以下痰行便；或妄投脑、麝，以通窍凉脏。致使阴气愈张，阳气愈弱，幸不死而成
此证。又有一名虚风，因吐泻日久，风邪入肠，乃大便不禁，面色虚黄，脾气已脱，真元已亏，继此发热，即
是慢脾。此不必皆由急惊传至，男子以泻得之为重，女子以吐得之为重。其候面青舌短，头低眼合，吐舌切牙，
声音沉小，睡中摇头，四肢微搐，冷而不收。身则有冷有热，痰涎凝滞，神志昏迷，沉沉喜睡。逐风则无风可逐，
疗惊则无惊可疗，乃至重之候，十难救一二也。治法大要∶生胃养脾，回阳益志，镇心定魄，化痰顺气。若眼半
开半合，手足不冷，二便涩滞，此尚有阳证，须温和化痰理气，不可即用回阳，然亦不可因阳证而用清凉之药。
此仅虚火往来，会成如阳证耳。在幼科所论者如此。
予见此等辨论，娓娓其辞，自相矛盾，乖误多端，惟有拊膝长嘘而已。孰料幼科谫劣，
一至此哉！既知慢脾为纯阴之证，又误以慢惊之虚热作实热，误下痰，误通窍，乃致变为慢脾。又有因吐泻日久，
风入肠胃，大便不禁，面色虚黄，脾气已脱，真元已亏，继此发热，即是慢脾，如此之候，即应急救真元，维持
竭绝，何得以眼之半开半合，手足不冷，二便涩滞，为尚有阳证，不可即用回阳？吁，此浅近之理，犹且未明，
而尚欲立言传世乎！盖眼之半开半合，名为昏睡露睛。此脾胃两伤，败极之证，安得目为有余？手足为诸阳之本，
四时皆宜温和，今手足不冷，犹幸有一线微阳，牵引接续，尚未至于厥逆，岂可谓之阳证？二便涩滞，由其气血
伤败，大肠枯焦，无以滋荣传送，又岂里实便秘之比哉？此等之证，治之得法，尚可挽回，而乃称为阳证，为之
顺气化痰，岂眼之半开半合，手足不冷，二便涩滞，果为阳热有余耶？抑由痰凝气滞耶？不然，化痰顺气，将焉
用之？呜呼，幼科浅陋，莫可挽救！凡小儿有热，不辨表热里热、虚热实热，阳浮作热，阴极发躁，一概称为
阳火。今慢脾之热，无非纯阴之证，真阳被逼，不能保存，浮越肌表，散漫无归，亡在倾刻，即急为收摄敛纳，
犹虑不及，而反谓之阳证，必欲其口鼻无气，两眼不开，四肢冰雪，二便长流，始可谓之阴证乎！立言者见地如
斯，继述者自可知矣。予故于此等之证，以非搐名之。使知一意挽救，不用猜度，且亦不须细辨。请以幼科夏禹
铸之言，以明斯证之误，亦可见予言之不虚也。
夏禹铸曰∶世人动曰慢惊，予独曰慢证，盖此证多成于大病之后。庸工一见病愈，遂不防守去路，或初误
汗误下，吐泻久而脾胃虚极，故成慢证。慢字缓字，虽对急字而言，然所以成此证者，亦由于父母怠慢之故。或
有汗多不止者听之，吐泻不止者听之，以致汗多亡阳，吐久亡胃，泻久绝脾，成难起之证，故曰慢证。慢证何惊
之有？以慢证而云惊，皆属庸医见儿眼翻手搐握拳，形状似惊，故以惊名之，一作惊治，或推或拿或火，是
犹儿以下井，而复落之以石也。慢证者，脾虚也。眼皮属脾，脾败故眼皮不能紧合，而睡则露睛；虚则脾失元气，
故两目无神而漂泛；脾败则枯涎无统，故凝滞咽喉而有牵锯之声；手足为脾胃所司，脾胃败，故四肢厥冷；虚必
生寒，寒则大便泻青而小便清利。便知为慢脾之候。若疗惊则无惊可疗，祛风则无风可祛，除痰则无痰可除，解
热则无热可解，惟脾间枯痰虚热往来耳。治此或以六君子汤加炮姜，或理中汤加附子。
此夏氏之见，超乎流俗。申明慢惊慢脾，一皆竭绝之证，而疗惊祛风、除痰解热之治，毫不可用，先得我心
之所同然者。今以夏氏所云吐泻脾败之证，列之于前，复以景岳所云大惊卒恐次之，归于非搐条下，以见此等
之证，总非风搐，庶不乞灵颅囟，枉害无辜也。以上治法，悉根据夏氏、张氏原方，予毋容复赘。
这种病证比客忤更为严重。因为客忤无非是外来人畜不正之气，而中恶则是中了恶毒之气。比如陈旧的棺木、荒废的墓地、淫祀的祠庙、古老的树木、冷清的庙宇、枯井、破败的房屋和阴暗的沟渠，这些地方都存有恶毒之气。小儿接触到这些，邪气从鼻子进入，肺先受到侵害，闭塞了清窍，填塞胸中，突然昏倒，四肢厥冷，两手握拳，上气喘急，这就是中恶的症状。
另外也有因接触中恶毒之物而发病的，也称为中恶。比如菌类、草毒、河豚、瘟死的牛马、自然死亡的六畜，以及水鸡、虾、蚌之类。邪气从口进入，则胃肠受到侵害，所以心腹刺痛，腹部皮肤青黑，烦闷混乱，痛苦欲死。前一种情况（吸入恶气）和后一种情况（食入毒物），都适宜先用霹雳散搐鼻，使其打喷嚏后，毒瓦斯排出，然后再用药治疗。前一种中毒瓦斯致死的情况，用返魂汤；后一种中毒物致死的情况，用雄黄解毒丸攻下毒物。
霹雳散：治疗中恶猝死，以及一切突然暴发的病证。
猪牙皂（三分） 北细辛（五分） 大川芎（五分，香者） 白芷（五分） 踯躅花（半分） 明雄黄（二分） 真麝香（半分）
以上药物研成极细末，每次取少许，用三寸长的灯芯蘸药点入鼻孔内，以引起喷嚏为有效标志。
返魂汤：治疗中恶猝死，宜用此方为主，即张仲景的麻黄汤。因为毒瓦斯闭塞肺窍，用此方来开通它。
净麻黄（去节，二钱） 光杏仁（去皮，七个） 炙甘草（一钱） 葱白（三寸）
用水一盏，煎至半盏，分几次服用。
雄黄解毒丸：方剂见卷二类搐疮疡门。
还有一种情况叫“非搐”，即儿科所说的慢惊风、慢脾风。
按语：儿科有说法称：“急惊传变为慢惊，慢惊发展为慢脾。”慢脾属于纯阴的病证。然而慢惊也有虚热的表现，常常伴有便秘、痰壅、气塞，容易被误认为是实热。妄用巴豆、大黄等下药来化痰通便；或者妄投冰片、麝香等通窍凉脏的药物。致使阴气更盛，阳气更弱，侥幸不死而变成这种病证。又有一种名为“虚风”，因吐泻日久，风邪入肠，导致大便失禁，面色虚黄，脾气已脱，真元已亏，随后出现发热，这就是慢脾风。这种情况并不一定都是由急惊传变而来，男子因腹泻得此病较重，女子因呕吐得此病较重。其症状表现为面青舌短，头低眼合，吐舌切牙，声音低沉细小，睡中摇头，四肢轻微抽搐，身体发冷且不能收摄。身体有时冷有时热，痰涎凝滞，神志昏迷，嗜睡喜卧。此时逐风则无风可逐，疗惊则无惊可疗，这是非常危重的病证，十难救一二。治疗的大要原则是：生胃养脾，回阳益志，镇心定魄，化痰顺气。如果眼睛半开半合，手足不冷，二便涩滞，这说明尚有阳证迹象，须温和地化痰理气，不可立即使用回阳救逆之法，但也不可因为是有阳证迹象就使用清凉药物。这仅仅是虚火往来，看似像阳证罢了。儿科对此病的论述就是这样。
我看到这些辨析言论，言辞娓娓动听，却自相矛盾，错误百出，只能拍膝长叹而已。没想到儿科医术浅薄，竟然到了这种地步！既然知道慢脾是纯阴的病证，却又误将慢惊的虚热当作实热，误用下药化痰，误用通窍药，以致演变为慢脾。又有因吐泻日久，风邪入肠胃，大便失禁，面色虚黄，脾气已脱，真元已亏，随后发热，这就是慢脾，如此危候，本应立即急救真元，维持即将竭绝的生命，怎么能根据眼睛半开半合、手足不冷、二便涩滞，就认为还有阳证，不可立即使用回阳救逆？唉，这种浅显的道理尚且不明白，还想立言传世吗？所谓眼睛半开半合，名为昏睡露睛。这是脾胃两伤，败坏至极的病证，怎么能说是有余之证？手足是诸阳之本，四季皆宜温和，现在手足不冷，幸好还有一线微阳牵引接续，尚未至于四肢厥逆，怎么能称之为阳证？二便涩滞，是因为气血损伤败坏，大肠枯焦，无法滋润传送，这又岂能比作里实便秘呢？这种病证，治疗得当，尚可挽回，却被称为阳证，为之顺气化痰，难道眼睛半开半合、手足不冷、二便涩滞，果真是阳热有余吗？还是由痰凝气滞引起的？如果不是，那化痰顺气的方法有什么用呢？呜呼，儿科见识浅陋，无可挽救！凡是小儿有热症，不辨别表热里热、虚热实热，也不辨阳浮作热、阴极发躁，一概称为阳火。如今慢脾的热症，无非是纯阴病证，真阳被逼，不能保存，浮越于肌表，散漫无归，死亡只在顷刻之间，此时应紧急收摄敛纳，还担心来不及，反而称之为阳证，一定要等到口鼻无气，两眼不开，四肢冰冷如冰雪，二便长流不止，才算是阴证吗？立言者的见解如此，后继者的行为自然可知。所以我在此类病证上，以“非搐”命名。让人知道只需一意挽救，不用猜度，也不必细细辨析。请引用儿科夏禹铸的话，来说明此证的谬误，也可看出我的话并非虚言。
夏禹铸说：世人动不动就说慢惊，我唯独称之为慢证，因为这个病证多在大病之后形成。庸医一见病愈，就不注意防守去路，或者起初误用汗法或下法，吐泻日久导致脾胃极度虚弱，所以形成慢证。“慢”字与“缓”字，虽然是相对于“急”字而言，但之所以形成这个病证，也由于父母怠慢的缘故。或者有汗多不止的听之任之，吐泻不止的听之任之，以致汗多亡阳，久吐亡胃，久泻绝脾，形成难以起复的病证，所以称为慢证。慢证哪里有惊呢？把慢证称为惊，都是因为庸医看见患儿眼翻手搐握拳，形状似惊，所以以惊命名，一旦按惊风治疗，或推拿或艾灸，这犹如将孩子推下井，再落石砸之。慢证就是脾虚。眼皮属脾，脾败故眼皮不能紧合，睡觉时露睛；虚则脾失元气，故两目无神而漂泛；脾败则枯涎失去统摄，故凝滞咽喉而有牵锯之声；手足由脾胃所司，脾胃败坏，故四肢厥冷；虚必生寒，寒则大便泻青而小便清利。由此可知是慢脾的征候。若按惊风治疗则无惊可疗，祛风则无风可祛，除痰则无痰可除，解热则无热可解，只有脾间枯痰虚热往来而已。治疗此证可用六君子汤加炮姜，或理中汤加附子。
这是夏氏的见解，超乎流俗。申明了慢惊、慢脾都是竭绝之证，而疗惊、祛风、除痰、解热的治法丝毫不可用，这与我的心意相同。现在将夏氏所言吐泻脾败之证列在前面，又将张景岳所言大惊卒恐之证列在后面，都归于“非搐”条下，以此说明这类病证总不是风搐，希望不要乞灵于颅囟之术，枉害无辜。以上治法，完全依据夏氏、张氏原方，我不需要再多赘述。
This condition is more severe than Ke Wu (Guest Intrusion, a disease caused by sudden exposure to strange or hostile energies). Ke Wu involves merely the improper qi of outsiders or animals, whereas Zhong E (Sudden Poisoning by Evil Qi) involves poisoning by toxic evil qi. For instance, old coffins, abandoned graves, illicit shrines, ancient trees, desolate temples, dry wells, ruined houses, and dark ditches all harbor toxic evil qi. When children encounter these, the pathogen enters through the nose; the Lung (Zang organ governing respiration and qi) is affected first, blocking the clear orifices and filling the chest. This results in sudden collapse, cold limbs (Jue Ni), clenched fists, and rapid, labored breathing.
Additionally, there are cases where one contracts the disease by ingesting toxic substances, also termed Zhong E. Examples include poisonous mushrooms, grass toxins, pufferfish, cattle or horses that died from plague, livestock that died naturally, as well as water frogs, shrimp, and clams. The pathogen enters through the mouth, affecting the Stomach and Intestines. Consequently, the patient experiences stabbing pain in the heart and abdomen, bluish-black discoloration of the abdominal skin, and extreme restlessness bordering on death. For both the preceding case (inhalation of evil qi) and this case (ingestion of toxic matter), Pi Li San (Thunderbolt Powder) should be applied to the nostrils to induce sneezing, thereby expelling the toxic vapors. Only after this should medicinal treatment proceed. For death caused by inhaling toxic vapors, Fan Hun Tang (Resurrection Decoction) is used; for death caused by ingesting toxic substances, Xiong Huang Jie Du Wan (Realgar Detoxification Pill) is used to purge the toxin.
Pi Li San (Thunderbolt Powder): Treats sudden death from Zhong E and all sudden, acute conditions.
Zhu Ya Zao (Gleditsiae Sinensis Fructus Spina, 3 fen), Bei Xi Xin (Asari Radix et Rhizoma, 5 fen), Da Chuan Xiong (Ligusticum Chuanxiong Rhizoma, 5 fen, aromatic variety), Bai Zhi (Angelicae Dahuricae Radix, 5 fen), Zhi Zhu Hua (Daphne Genkwa Flower, 0.5 fen), Ming Xiong Huang (Realgar, 2 fen), Zhen She Xiang (Moschus, 0.5 fen).
Grind all ingredients into an extremely fine powder. Use a small amount, dip a three-cun long lamp wick into the powder, and apply it inside the nostrils. Induction of sneezing indicates efficacy.
Fan Hun Tang (Resurrection Decoction): Treats sudden death from Zhong E; this formula serves as the primary treatment. It is essentially Zhang Zhongjing's Ma Huang Tang (Ephedra Decoction). Since toxic vapors block the lung orifices, this formula is used to open them.
Jing Ma Huang (Ephedrae Herba, de-stemmed, 2 qian), Guang Xing Ren (Armeniacae Semen Amarum, peeled, 7 seeds), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparata, 1 qian), Cong Bai (Allii Fistulosi Bulbus, 3 cun).
Boil one cup of water until half remains. Administer in divided doses.
Xiong Huang Jie Du Wan (Realgar Detoxification Pill): See Volume II, under the section for convulsive sores and ulcers.
Another category is "Fei Chu" (Non-Convulsion), which refers to Man Jing Feng (Slow Convulsion Wind) and Man Pi Feng (Slow Spleen Wind) in pediatrics.
Note: Pediatric texts state, "Acute Convulsion transmits to Slow Convulsion; Slow Convulsion develops into Slow Spleen." Slow Spleen is a syndrome of pure Yin deficiency. However, Slow Convulsion may also present with deficient heat, often accompanied by constipation, phlegm obstruction, and qi stagnation, leading to misdiagnosis as excess heat. Practitioners may recklessly use Ba Dou (Crotonis Fructus) and Da Huang (Rhei Radix et Rhizoma) to purge phlegm and stool, or mistakenly administer Nao Bing (Borneolum Syntheticum) and She Xiang (Moschus) to open orifices and cool the viscera. This exacerbates Yin and weakens Yang further. If the child survives, they develop this condition. Another name for this is "Xu Feng" (Deficient Wind), caused by prolonged vomiting and diarrhea allowing wind pathogens to enter the intestines, resulting in fecal incontinence, sallow complexion, exhaustion of Spleen Qi, depletion of True Yuan (Original Qi), followed by fever. This constitutes Slow Spleen Wind. This does not necessarily result from the transmission of Acute Convulsion; in males, it is more severe when acquired via diarrhea, and in females, via vomiting. Symptoms include a cyanotic face, short tongue, head drooping, eyes closed, protruding tongue, teeth grinding, low voice, head shaking during sleep, slight twitching of limbs, coldness without retraction, alternating body temperature, stagnant saliva, coma, and excessive sleepiness. At this stage, dispelling wind finds no wind to dispel, and treating convulsion finds no convulsion to treat. These are critical signs; only one or two out of ten may survive. The general treatment principle is: nourish the Stomach and Spleen, restore Yang and benefit will, calm the Heart and stabilize the spirit, resolve phlegm and regulate qi. If the eyes are half-open/half-closed, hands and feet are not cold, and urination/defecation are difficult, there are still signs of Yang; mild methods to resolve phlegm and regulate qi should be used, avoiding immediate restoration of Yang. However, cooling herbs should not be used simply because Yang signs appear. This is merely fluctuating deficient fire mimicking Yang excess. Such is the pediatric discourse.
I find these discussions verbose yet self-contradictory and riddled with errors, leaving me only to sigh deeply. I never expected pediatric medicine to be so inferior! If Slow Spleen is recognized as a pure Yin syndrome, how can one mistake the deficient heat of Slow Convulsion for excess heat, wrongly purging phlegm and opening orifices, thus causing Slow Spleen? Furthermore, in cases of prolonged vomiting/diarrhea with wind entering the gut, fecal incontinence, sallow face, exhausted Spleen Qi, depleted True Yuan, and subsequent fever—clearly Slow Spleen—one should urgently rescue True Yuan and sustain impending collapse. How can one claim Yang signs exist based on half-open eyes, warm limbs, and difficult excretion, thereby refusing immediate Yang restoration? Alas, such basic principles remain unclear, yet practitioners wish to leave writings for posterity! Half-open eyes signify "Hun Shui Lu Jing" (Sleeping with Exposed Eyes), indicating severe damage to both Spleen and Stomach, a sign of extreme depletion, not excess. Limbs are the root of Yang; they should always be kept warm. Warm limbs indicate a faint thread of Yang remaining, preventing full Jue Ni (cold extremities); this is not a Yang excess syndrome. Difficult excretion here results from damaged Qi and Blood, withered Large Intestine, and lack of lubrication, unlike excess internal constipation. With proper treatment, these conditions can be reversed. Yet, labeling them as Yang excess and treating with qi-regulating and phlegm-resolving herbs implies that half-open eyes, warm limbs, and difficult excretion are truly signs of Yang heat excess? Or are they due to phlegm stagnation? If so, what is the purpose of resolving phlegm and regulating qi? Alas, pediatric knowledge is so shallow as to be irredeemable! Whenever children have heat, whether exterior or interior, deficient or excess, floating Yang causing heat, or extreme Yin causing restlessness, it is indiscriminately labeled as Yang Fire. In Slow Spleen, the heat stems from a pure Yin syndrome where True Yang is forced outward, floating on the surface and dissipating without return. Death is imminent. Urgent consolidation and gathering of Yang is required, yet it is mistaken for Yang excess. Must one wait for cessation of breath, closed eyes, ice-cold limbs, and uncontrolled excretion to recognize Yin? Practitioners with such views ensure their successors follow suit. Therefore, I name these conditions "Fei Chu" (Non-Convulsion), urging practitioners to focus solely on rescue without speculation or detailed differentiation. I cite Xia Yuzhu to clarify these errors, proving my words are not baseless.
Xia Yuzhu states: People often speak of "Slow Convulsion," but I call it "Slow Syndrome." This condition usually arises after severe illness. Quack doctors, seeing recovery, neglect post-recovery care. Initial errors in sweating or purging, combined with prolonged vomiting/diarrhea causing extreme Spleen/Stomach deficiency, lead to Slow Syndrome. Although "Slow" contrasts with "Fast," the cause often lies in parental negligence. Allowing profuse sweating, persistent vomiting, or chronic diarrhea leads to loss of Yang from sweat, loss of Stomach Qi from vomiting, and exhaustion of Spleen from diarrhea, creating incurable conditions. Hence, "Slow Syndrome." Where is the "Convulsion"? Labeling it "Convulsion" occurs because quacks see eye-rolling, hand twitching, and fist-clenching, resembling convulsions. Treating it as such—via massage or moxibustion—is like pushing a child down a well and dropping stones. Slow Syndrome is Spleen Deficiency. Eyelids belong to the Spleen; Spleen failure prevents tight closure, causing exposed eyes during sleep. Deficiency causes loss of Spleen Yuan Qi, leading to dull, wandering eyes. Spleen failure loses control over fluids, causing stagnant saliva to obstruct the throat with a rattling sound. Limbs are governed by Spleen/Stomach; their failure causes cold extremities. Deficiency generates cold, leading to green stools and clear urine. These confirm Slow Spleen. Treating for convulsion finds none; dispelling wind finds none; resolving phlegm finds none; clearing heat finds none. Only dry phlegm and deficient heat fluctuate in the Spleen. Treatment may involve Liu Jun Zi Tang (Six Gentlemen Decoction) with Pao Jiang (Prepared Zingiberis Rhizoma), or Li Zhong Tang (Regulate the Middle Decoction) with Fu Zi (Aconiti Lateralis Radix Preparata).
Xia’s insight surpasses common practice. He clarifies that Slow Convulsion and Slow Spleen are syndromes of exhaustion, rendering treatments for convulsion, wind, phlegm, and heat entirely inappropriate. This aligns with my own views. Here, I place Xia’s description of Spleen failure from vomiting/diarrhea first, followed by Zhang Jingyue’s account of sudden fright, under the "Fei Chu" category. This demonstrates that these conditions are not wind-convulsions, hopefully preventing futile cranial treatments and unnecessary harm. The above treatments strictly follow the original formulas of Xia and Zhang; I need not add further commentary.