（易去惊字）
惊风二字，千古疑城。嘉言欲打破人鬼关，其实未易能也。盖从前有此名目，后人莫敢翻其成案，惟从惊
风摹拟，究竟愈摹愈失，愈论愈晦，其实由于仲阳立名之不慎也。在伊芳当日，或适因婴儿伤寒病痉，乍有反张
搐搦之态，故偶立惊风之名，亦犹方脉中之惊悸、惊惕、惊慌等类，初亦未尝即欲以此两字示法来兹，而门人
继述不善，遂以惊字为惊吓之惊，风字即惊字之变文，观幼科书中，凡青为风者，皆曰青为惊可知矣。谬为
小儿之病，悉由惊而生风。误以伤寒无汗之表证为急惊，以伤风自汗之解肌证为慢惊，以脾败胃伤竭绝之证为
慢脾。妄立诸惊名色，眩惑后人，何尝有一毫实际裨于治疗。而诸家旋祖其术，极力敷演，亦不过随波逐浪，
猜度摹拟，初无理要可以服人。是仲阳偶以一字之乖讹，而后世受祸如此其烈也。至于见证立名，更为舛谬。
如小儿伤寒病痉，外证有头项强，背反张，目上视，此《金匮》所谓能仰不能俯者，属太阳，则称天吊惊；眼
目下窜，即《金匮》之颈项KT KT （音殊），海
藏之低头下视，属二阳合病，则称看地惊；两脚掣跳，海藏所谓肘膝相构属阳明，则称马蹄惊；两手牵引，海藏
所谓左右搐搦，属少阳，则称弯弓惊；伤寒病痉，误用惊药，耗其津液，而筋脉受伤，遂致两手拘挛，已为不治
之证，乃犹称鹰爪惊，虚证肆行攻伐，乃致脾败胃绝，四肢 曳，奄奄待尽，犹复称撒手惊。至于阴寒腹痛，面
青口撮，口吐白沫，曰鲫鱼惊；脾虚生热，舌络紧急，不时舔舌，曰蛇丝惊；蛔虫贯膈，大叫一声，即昏闷不
省，曰乌鸦惊；儿病作热，本为常候，曰潮热惊；食饮停滞，胸腹饱闷，曰膨胀惊。更有诸多不通名项，莫能枚举。
夫以上诸证，皆表里寒热分明，证候显然可据。而若辈不究病源，妄立名色，悉以惊字目之。设也人病阳明内实，
逾垣上屋，则将名飞天惊。阴极发燥，欲卧泥水中，则将名擗地惊；少阴昏沉嗜寐，则将名瞌睡惊；中消多食无
厌，则又名饕餮惊乎？荒唐鄙野，虽奚童爨婢有所不言，而医者公然笔之于书。后人见其证皆惊证，纹悉惊纹，
相与依样葫芦，一倡百和，以为一遵古法，谁曰不然。不知论证可任其牵强，而治疗不容于假借。如伤寒病痉，
由风寒湿三气合邪，病在太阳、阳明、少阳，与心惊、肝风、脾痰、肺热，风中牛马，若以惊风治之，则无辜心
肝脾肺，枉受剥肤，而风寒湿外至之邪， 然磐石。此岂有一可乎？
予欲为之更改之以为非，易去惊风二字，仍恐流祸无已，将欲以痉字、 字易之，又虑其不入俗。因思幼科
以搐掣名惊，今即以搐字易惊字，屏去祸害之惊，祛除笼统之风，总名之曰搐，庶不骇听，而又不失病痉之本
来。复以急惊、慢惊、慢脾之入石堆者，易之为误搐、类搐、非搐之三宝筏，提携沉溺，稳步康衢，将于是乎在
焉。
何谓误搐？盖伤寒小儿最多，由医者治不如法，抑遏其表邪，莫能外解，故壮热不退，遂尔变而为痉，则有
搐搦反张之候。要知此证由风寒湿所致，虽有身热，俱皆表邪，
非火热之比，且与《内经》诸痉项强，诸风掉眩，诸寒收引之例，恰正相符。因剔出风、寒二痉归于误搐条下，
俾临证者，知为伤寒病痉，不致有开关镇治之害。何为类搐？盖伤暑疟痢，咳嗽丹毒，疮痘霍乱，客忤中恶，
其证显然可见，辨认既明，一药可愈，何至作搐？由医者迁延时日，或抑遏邪气，无所发泄，间有变为搐者，搐
非固有，所以谓之类搐。要知此证由火热居多，实非风寒，惟咳嗽疟疾微兼表邪，治者宜审。今遵《内经》诸热
瞀，皆属于火之例，共一十条，总归于类搐条下，逐证注明，各从本门为治，以免截风定搐之患。何谓非搐？
盖小儿大吐大泻，久病病后，脾败胃绝，昏睡露睛，虚痰来往，此竭绝之证，而幼科以为慢脾风。更以大惊卒
恐，神魂离散之证，为急惊风。不知以上二证，死生呼吸，犹敢以惊风称之耶！因体东垣非风之意，竟以非搐
名之，使后人知此等证候，全非风搐，而治风治搐之法，远摈三舍，庶可以保全竭绝，而不致于夭折无辜也。以
上三门，逐证分晰，其所用药方，一遵经旨，罔敢立异。要使幼科之证，毫无遗漏，而惊风二字，不屏自却，
人鬼关岂徒打破，行将化为琼楼玉宇矣。
周虚中曰，雄辞闳辨，驳得诸家之言惊者，无可置喙，快极快极！
（建议去掉“惊”字）
“惊风”这两个字，是千古以来的疑难症结。喻嘉言想要打破这层人鬼难分的迷雾，其实并不容易。因为从前已经有了这个病名，后人不敢推翻既定的成案，只是顺着“惊风”的样子去模仿推演，结果越模仿越偏离真相，越论述越晦涩不明。这实际上是由于钱乙（字仲阳）当初确立这个名字时不够谨慎造成的。在他那个时代，或许恰好遇到婴儿患伤寒病出现痉挛，突然有身体反张、抽搐的症状，所以偶然立下了“惊风”之名。这也就像内科中的惊悸、惊惕、惊慌等类别一样，起初并没有打算用这两个字作为后世治疗的法则。但是他的门人继承阐述得不好，于是就把“惊”字理解为惊吓的惊，“风”字就成了“惊”字的变体。看儿科书中的记载，凡是青色都归为风，也都说是惊，就可以知道了。这种谬误认为小儿的疾病，全部是由惊吓而生风引起的。错误地把伤寒无汗的表证当作急惊风，把伤风自汗的解肌证当作慢惊风，把脾败胃伤竭绝的危重证候当作慢脾风。胡乱设立各种惊风的名称，迷惑了后人，哪里有一点点对治疗实际有帮助呢？而各家医生相继沿袭这种医术，极力铺陈演绎，也不过是随波逐流，猜测模仿，本来就没有足以让人信服的理论依据。这是钱乙偶然因一个字的差错，导致后世遭受如此严重的祸害。至于根据症状命名，更是错谬百出。
比如小儿患伤寒病出现痉挛，外在症状有头项强直、背部反张、眼睛向上看，这就是《金匮要略》所说的能仰不能俯，属于太阳经，就称为天吊惊；眼睛向下窜视，就是《金匮要略》中说的颈项拘急（音殊），海藏所说的低头下视，属于二阳合病，就称为看地惊；两脚抽跳，海藏所说的肘膝相凑属于阳明经，就称为马蹄惊；两手牵引，海藏所说的左右抽搐，属于少阳经，就称为弯弓惊；患伤寒病痉挛，误用了治惊的药物，耗伤了津液，导致筋脉受伤，于是造成两手拘挛，这已经是无法医治的证候，竟然还称为鹰爪惊；虚证肆意使用攻伐药物，导致脾败胃绝，四肢松弛下垂，奄奄一息等待死亡，竟然还称为撒手惊。至于阴寒腹痛，面色青紫，口唇撮缩，口吐白沫，称为鲫鱼惊；脾虚生热，舌络紧急，不时舔舌，称为蛇丝惊；蛔虫穿过膈部，大叫一声，随即昏闷不省人事，称为乌鸦惊；小儿生病发热，本是常见情况，称为潮热惊；饮食停滞，胸腹饱闷，称为膨胀惊。更有许多不通顺的名称，无法一一列举。
像以上这些证候，都是表里寒热分明，证候明显有据。但那些人不去探究病源，胡乱设立名称，统统用“惊”字来称呼。假如有人患阳明内实证，做出翻墙爬屋的动作，难道就要命名为飞天惊吗？阴寒极盛出现躁动，想睡在泥水中，难道就要命名为擗地惊吗？少阴病昏沉嗜睡，难道就要命名为瞌睡惊吗？中消症多食不厌，难道又要命名为饕餮惊吗？荒唐粗鄙，即使是童仆婢女都不会说出口的话，而医生却公然写在书上。后人看到他们的证候都说是惊证，指纹也都是惊纹，大家互相效仿，一唱百和，以为完全遵循古法，谁说不是这样呢？却不知道论证可以任其牵强附会，但治疗不容许弄虚作假。比如伤寒病痉挛，是由风寒湿三种邪气结合致病，病位在太阳、阳明、少阳，与心惊、肝风、脾痰、肺热，以及风中牛马等情况不同，如果用治惊风的方法去治疗，那么无辜的心肝脾肺就会白白受到剥肤之痛，而风寒湿这些外来的邪气却像磐石一样坚固不动。这怎么会有任何可取之处呢？
我想替他们改正这些错误，去掉“惊风”二字，又担心流弊无穷无尽；想用“痉”字、“搐”字来代替，又担心不符合世俗习惯。于是想到儿科以抽搐掣动来命名惊风，现在就用“搐”字来替换“惊”字，屏除带来祸害的“惊”，祛除笼统模糊的“风”，总称为“搐”，这样既不骇人听闻，又不失掉病痉的本意。再把那些被归入急惊、慢惊、慢脾这类顽固错误的，改为误搐、类搐、非搐这三宝筏，用来提携陷入困境的患者，稳步走上康复的大道，希望就寄托在这里了。
什么叫误搐？大概伤寒小儿最多见，由于医生治疗不得法，遏制了表邪，不能向外发散，所以高热不退，于是转变为痉挛，就有抽搐、反张的症状。要知道这个证候是由风寒湿引起的，虽然有身热，都属于表邪，不能与火热相比，而且与《内经》中诸痉项强、诸风掉眩、诸寒收引的例子，恰好相符。因此将风、寒两种痉证剔除出来，归入误搐条下，使临证医生知道这是伤寒病痉挛，不至于犯有关开关窍、镇惊治疗的危害。
什么叫类搐？大概是伤暑、疟疾、痢疾、咳嗽、丹毒、疮痘、霍乱、客忤、中恶等病，证候明显可见，辨认清楚后，一药即可痊愈，怎么会发生抽搐呢？由于医生拖延时日，或者遏制邪气，使其无处发泄，偶尔有转变为抽搐的，抽搐并非疾病固有，所以称为类搐。要知道这些证候大多由火热引起，确实不是风寒，只有咳嗽、疟疾轻微兼有表邪，治疗者应当仔细审察。现在遵循《内经》诸热瞀瘛皆属于火的例子，共十条，总归入类搐条下，逐个证候注明，各自从本门治疗，以免犯下截风定搐的错误。
什么叫非搐？大概是小儿大吐大泻，久病之后，脾败胃绝，昏睡露睛，虚痰往来，这是竭绝的危重证候，而儿科医生却认为是慢脾风。再加上大惊卒恐，神魂离散的证候，被认为是急惊风。不知道以上两种证候，生死只在呼吸之间，还敢用惊风来称呼吗！因此体会李东垣关于“非风”的意思，干脆用“非搐”来命名，使后人知道这些证候完全不是风搐，而治风治搐的方法远远排斥在外，这样就可以保全竭绝之体，不至于让无辜的生命夭折。以上三门，逐个证候分析清楚，所用方药，一律遵循经典旨意，不敢标新立异。要使儿科的证候毫无遗漏，而“惊风”二字，不用摒弃自然退却，人鬼之间的界限岂止是打破，简直要将它化为琼楼玉宇般美好的境界了。
(Suggestion to remove the character "Jing")
The term "Jing Feng" (Convulsive Disorder with Startle) has been a perplexing enigma for millennia. Yu Jia Yan attempted to break through this barrier between life and death, yet it proved difficult. Since this nomenclature existed previously, later generations dared not overturn established precedents. Instead, they merely imitated "Jing Feng," resulting in deviations that grew wider with each imitation and obscurity that deepened with each discussion. This reality stems from the imprudence of Qian Yi (courtesy name Zhongyang) in establishing this name. In his time, he may have encountered infants suffering from Taiyang disease (Disease of the Bladder and Small Intestine channels) presenting with spasms, suddenly exhibiting opisthotonos (backward arching of the body) and convulsions, thus coincidentally coining the name "Jing Feng." This is akin to terms like Jing Ji (Palpitations due to Fright), Jing Ti (Frightened Tremors), and Jing Huang (Panic) in internal medicine; initially, there was no intention to establish these two characters as a legalistic standard for future generations. However, his disciples failed to inherit and expound upon them correctly, leading to the interpretation of "Jing" as fright/startle and "Feng" as a variation of "Jing." Observing pediatric texts, where any bluish discoloration attributed to Wind is also called Jing, confirms this error. This fallacy assumes that all pediatric diseases arise from startle generating wind. It erroneously classifies the exterior syndrome of Shang Han (Cold Damage) without sweat as Ji Jing (Acute Convulsion), the muscle-releasing syndrome of Shang Feng (Wind Strike) with spontaneous sweating as Man Jing (Chronic Convulsion), and the critical syndrome of Spleen failure and Stomach exhaustion as Man Pi (Chronic Spleen). It arbitrarily creates various names for different types of Jing, confusing later generations, offering no practical benefit to treatment. Subsequent physicians followed this method, elaborating extensively, but merely drifting with the tide, guessing and imitating, lacking theoretical substance to convince others. Thus, a single erroneous character by Zhongyang caused such severe harm to posterity.
Regarding the naming of syndromes based on manifestations, the errors are even more egregious. For instance, when an infant suffers from Shang Han disease with spasms, external signs include stiffness of the head and neck, opisthotonos, and upward deviation of the eyes. This corresponds to the *Jin Gui Yao Lue* description of "able to look up but not down," belonging to the Taiyang channel, yet it is termed Tian Diao Jing (Heaven-Hanging Convulsion). Downward gazing corresponds to the *Jin Gui* description of neck stiffness (sound 'shu') and Hai Zang's description of looking down, belonging to the combined disease of Yangming and Taiyang, yet it is termed Kan Di Jing (Earth-Gazing Convulsion). Jerking of both legs, described by Hai Zang as elbows and knees meeting, belonging to Yangming, is termed Ma Ti Jing (Horse-Hoof Convulsion). Pulling of both hands, described by Hai Zang as left-and-right convulsions, belonging to Shaoyang, is termed Wan Gong Jing (Bow-Bending Convulsion). If Shang Han spasms are mistakenly treated with Jing medicines, consuming body fluids and damaging sinews, leading to fixed flexion of the hands, this is already an incurable condition, yet it is still called Ying Zhao Jing (Eagle-Claw Convulsion). If deficiency syndromes are subjected to aggressive purging, causing Spleen failure and Stomach extinction, with limbs flaccidly dragging and imminent death, it is still called Sa Shou Jing (Hand-Slipping Convulsion). Regarding cold abdominal pain with bluish face, puckered mouth, and foaming at the mouth, it is called Ji Yu Jing (Carper Convulsion); Spleen deficiency generating heat with tight tongue meridians and frequent tongue licking is called She Si Jing (Snake-Thread Convulsion); Ascaris penetrating the diaphragm causing a scream followed by unconsciousness is called Wu Ya Jing (Crow Convulsion); fever in sick children, which is common, is called Chao Re Jing (Tidal Fever Convulsion); food stagnation causing chest and abdominal fullness is called Peng Zhang Jing (Distension Convulsion). There are many more illogical names that cannot be enumerated.
All the above syndromes have clear distinctions of interior/exterior and cold/heat, with evident symptoms. Yet these practitioners do not investigate the disease origin, arbitrarily creating names and labeling everything with "Jing." If someone suffers from Yangming interior excess and climbs walls or roofs, would it be named Fei Tian Jing (Flying Heaven Convulsion)? If extreme Yin cold causes restlessness and a desire to lie in mud, would it be named Pi Di Jing (Striking Earth Convulsion)? If Shaoyin disease causes drowsiness and lethargy, would it be named Ke Shui Jing (Dozing Convulsion)? If Middle Xiao (Middle Jiao Wasting-Thirst) causes insatiable eating, would it be named Tao Tie Convulsion? These are absurd and vulgar; even servants would not utter such words, yet physicians write them openly in books. Later generations see these as "Jing" syndromes and "Jing" pulse patterns, copying each other, one倡 hundred echoing, believing they strictly follow ancient methods. Who would disagree? They fail to realize that while diagnosis can be forced, treatment must not be fabricated. For example, Shang Han spasms result from the combination of Wind, Cold, and Dampness pathogens affecting the Taiyang, Yangming, and Shaoyang channels. This differs from Heart Fright, Liver Wind, Spleen Phlegm, Lung Heat, or Wind striking cattle and horses. Treating this with Jing-Fang methods causes innocent Heart, Liver, Spleen, and Lungs to suffer unjustly, while the external Wind-Cold-Damp pathogens remain as solid as a rock. How can this be acceptable?
I wished to correct these errors and remove "Jing Feng," fearing endless repercussions. I considered replacing it with "Jing" (Spasm) or "Chu" (Twitching), but worried it might not suit popular usage. Recalling that pediatrics names Jing based on twitching and jerking, I now propose using "Chu" to replace "Jing," discarding the harmful "Jing" and removing the vague "Feng," collectively naming it "Chu." This avoids shock while preserving the essence of Spasm. I will further categorize the stubborn cases of Ji Jing, Man Jing, and Man Pi into three categories: Wu Chu (Mistaken Twitching), Lei Chu (Resembling Twitching), and Fei Chu (Not Twitching), serving as a life-saving raft to guide drowning patients safely to recovery.
What is Wu Chu? It is most common in children with Shang Han. Due to improper medical treatment suppressing exterior pathogens without allowing their release, high fever persists, transforming into spasm with convulsions and opisthotonos. Note that this syndrome is caused by Wind, Cold, and Dampness. Although there is fever, it remains an exterior pathogen, distinct from Fire-Heat. It aligns perfectly with the *Nei Jing* principles: "All spasms and neck stiffness belong to Wind"; "All wind-induced tremors and vertigo belong to Wind"; "All cold-induced contraction belongs to Cold." Therefore, Wind and Cold spasms are extracted and placed under Wu Chu, ensuring clinicians recognize Shang Han spasms and avoid the harm of opening orifices and sedating fright.
What is Lei Chu? It refers to conditions like Summerheat, Malaria, Dysentery, Cough, Erysipelas, Sores/Pox, Cholera, Guest Qi invasion, and Evil Penetration. These have obvious symptoms; once identified, a single remedy suffices. Why would they cause twitching? Because physicians delay treatment or suppress pathogens preventing their expulsion, occasionally leading to twitching. The twitching is not inherent, hence "Lei Chu" (Resembling Twitching). Note that these syndromes are mostly caused by Fire-Heat, not Wind-Cold. Only cough and malaria mildly involve exterior pathogens, requiring careful examination. Following the *Nei Jing* principle "All heat-induced confusion and twitching belong to Fire," ten specific items are grouped under Lei Chu, annotated per syndrome, and treated according to their primary nature to avoid the error of stopping wind and settling convulsions.
What is Fei Chu? It refers to children with severe vomiting and diarrhea, or post-prolonged illness, presenting with Spleen failure, Stomach extinction, lethargy with exposed eyes, and wandering deficiency phlegm. This is a critical exhaustion syndrome, yet pediatrics labels it Man Pi Feng (Chronic Spleen Wind). Additionally, syndromes of sudden great fright and terror causing dispersion of Soul and Spirit are labeled Ji Jing Feng (Acute Convulsion). Not realizing that these two syndromes determine life and death in a breath, how dare they call them Jing Feng? Emulating Li Dong Yuan's concept of "Non-Wind," I name them Fei Chu, so later generations know these are entirely non-wind/twitching syndromes, keeping wind-treating and convulsion-stopping methods far away, thereby preserving exhausted bodies and preventing innocent premature death.
These three categories analyze each syndrome clearly. All prescribed formulas strictly follow classic principles, daring not to deviate. This ensures no pediatric syndrome is overlooked, and the terms "Jing Feng" will naturally fade without being explicitly banned. The barrier between human and ghost will not only be broken but transformed into a realm of jade towers and palaces.
Zhou Xuzhong commented: "His arguments are grand and eloquent, refuting all previous theories on Jing so thoroughly that critics have no room to interject. Truly satisfying!"