天钓者。壮热惊悸。眼目翻腾。手足指掣。或啼或笑。喜怒不常。甚者爪甲皆青。
如祟之状。故宜和解风热。钩藤散主之。
钩藤（一两五钱） 白茯苓（一两五钱） 防风（二钱） 朱砂（飞二钱） 大黄（酒湿纸煨二
钱五
煎服。此泻青丸变化加减也。
病项背强直。腰身反张。摇头掣 。噤口不语。发热腹痛。镇日不醒。其状可畏
受病与天钓不同。中风自汗。不可再汗。汗多则发 。中湿宜微汗。不可大汗。大汗过则发
。有刚柔二 。无汗曰刚 。宜麻黄葛根汤。有汗曰柔 。宜桂枝葛根汤。二 并宜人参
败毒散加防风主之。
麻黄葛根汤
麻黄（去节一两五钱） 赤芍药（一两五钱） 葛根（一两半） 葱白（二茎） 豉（半合） 上
锉散。每服二字煎服。
桂枝葛根汤
桂枝 白芍药 甘草（各二钱七分半） 葛根（一两半） 生姜（一两） 大枣（四枚） 上锉
散。每服三字。煎服。
内钓腹痛多啼。唇黑囊肿。伛偻反张。眼内有红筋斑血者是也。此寒气壅结。只宜
没药 木香 沉香 舶上茴香（炒） 钩藤（各等分） 乳香 全蝎（减半） 上为末。取大
蒜研烂和丸。梧桐子大。每服二丸。钩藤汤化下。
盘肠气痛干啼。额上有汗。是小肠为冷气所搏也。宜金铃子散主之。
金铃子（二钱） 舶上茴香（盐拌炒） 木香（各一钱） 上为末。每服五分至一钱。调酒服
当归散 治寒邪入肾经。小腹急痛。面青手足冷者。
归身 木香 肉桂 人参 炙甘草 加破故纸（炒） 小茴香（炒） 上各等分为末。姜枣
汤调服。枣为丸亦可。
或问。天钓内钓。病 盘肠。属何脏。何以辨之。曰。经云身半以上。天气主之。身半以下
。地气主之。故天钓在上。生于风热。宜发之。内钓在下。生于寒。宜温之。二钓者。皆足
厥阴肝病也。足厥阴之脉。外则与督脉同行。循脊而上。入于颠之顶。所以病则目上翻。背
后仰。如角弓之反张也。内则循阴器。而入于小腹。所以病则小腹切痛。为囊肿也。诸风掉
眩。皆属肝木。故二钓皆有搐掣似惊。但天钓或哭或笑。内钓则多啼为异耳。 病属足太阳
膀胱经。上起两目。上头循项而下。行于背。循腰而下。于是与厥阴之脉下行者同。所以角
弓反张之证。亦相似也。但天钓有搐掣。而 病无搐掣也。盘肠痛属手太阳小肠经。内行于
小腹。与厥阴之脉内行者不同。所以小腹忽痛也。但内钓有螈 。而盘肠痛无螈 。可辨也
天钓（一种类似惊风的儿科急症）的症状是：高热、惊悸，眼球上翻或转动不宁，手足手指抽搐，有时啼哭有时发笑，喜怒无常。严重的患者指甲都发青，像被邪祟附身一样。因此适宜采用和解风热的方法治疗，以钩藤散为主方。
钩藤（一两五钱）、白茯苓（一两五钱）、防风（二钱）、朱砂（飞研二钱）、大黄（酒浸后纸包煨熟二钱五分）。以上药材煎服。这是泻青丸的加减变化方。
盘肠（此处指伴有项背强直的严重痉挛病症，似破伤风或角弓反张）的症状是：颈项和背部僵硬挺直，腰身向后反折弯曲，摇头并伴有肢体抽动，口噤不能说话，发热且腹痛，整天昏睡不醒。这种症状令人畏惧。
该病与天钓的致病原因不同。中风证会有自汗出，不可再次使用发汗法，发汗过多则会导致抽搐；中湿证适宜微发汗，不可大汗淋漓，大汗过度也会导致抽搐。此病分为刚痉和柔痉两种。无汗的称为刚痉，适宜用麻黄葛根汤；有汗的称为柔痉，适宜用桂枝葛根汤。这两种痉病都适宜用人参败毒散加防风为主方治疗。
麻黄葛根汤方：
麻黄（去节一两五钱）、赤芍药（一两五钱）、葛根（一两半）、葱白（两根）、豆豉（半合）。以上药材切碎成散剂，每次服用两字量，加水煎服。
桂枝葛根汤方：
桂枝、白芍药、甘草（各二钱七分半）、葛根（一两半）、生姜（一两）、大枣（四枚）。以上药材切碎成散剂，每次服用三字量，加水煎服。
内钓（一种因寒邪引起的婴幼儿腹痛急症）的症状是：腹痛且多啼哭，嘴唇发黑，阴囊肿大，身体弯曲或向后反折，眼睛内有红筋和瘀血斑点。这是因为寒气壅结所致，只适宜使用没药、木香、沉香、舶上茴香（炒制）、钩藤（各等分）、乳香、全蝎（用量减半）的药末。取大蒜研烂，与药末混合制成梧桐子大小的丸剂。每次服用两丸，用钩藤汤送服。
盘肠气痛（小肠冷气搏结引起的腹痛）的症状是：干啼（哭而无泪），额头出汗，这是小肠受到冷气冲击所致。适宜用金铃子散为主方治疗。
金铃子散方：
金铃子（二钱）、舶上茴香（盐拌炒制）、木香（各一钱）。以上药材研为细末，每次服用五分至一钱，用酒调服。
当归散：治疗寒邪侵入肾经，小腹拘急疼痛，面色青紫，手足冰冷的情况。
当归身、木香、肉桂、人参、炙甘草，加入破故纸（炒制）、小茴香（炒制）。以上药材各等分研为细末，用姜枣汤调服，或者制成丸剂也可以。
有人问：天钓、内钓、盘肠这三种病，分别属于哪个脏腑？如何辨别它们？
回答说：《内经》说，身体上半部由天气主导，身体下半部由地气主导。所以天钓病位在上，由风热引起，适宜发散；内钓病位在下，由寒邪引起，适宜温补。这两种“钓”病，都属于足厥阴肝经的病变。足厥阴肝脉，向外与督脉并行，沿着脊柱向上，进入头顶。所以发病时会出现眼球上翻、背部后仰，像角弓反张一样的症状。向内则沿着生殖器进入小腹，所以发病时会出现小腹剧烈疼痛、阴囊肿大的症状。各种风证引起的动摇眩晕，都归属于肝木。所以这两种“钓”病都有抽搐掣动类似惊风的表现，但天钓有时哭有时笑，而内钓则是多啼哭，这是它们的区别。
盘肠病（此处指角弓反张类病症）属于足太阳膀胱经。该经脉起于两眼，上行头部，沿颈部向下，行于背部，再沿腰部下行，于是与厥阴脉下行的部分相同。所以角弓反张的症状也相似。但天钓有抽搐掣动，而盘肠病没有抽搐掣动。
盘肠气痛属于手太阳小肠经，内部联系于小腹，这与厥阴脉的内部循行不同，所以会出现小腹突然疼痛。但内钓有肌肉跳动（螈），而盘肠气痛没有肌肉跳动，可以据此辨别。
Tian Diao (Heavenly Hook, a pediatric emergency resembling convulsions) is characterized by high fever, palpitations with fright, eyes rolling upward or moving restlessly, twitching of the fingers and toes, intermittent crying or laughing, and irregular mood. In severe cases, the fingernails turn cyanotic, resembling possession by evil spirits. Therefore, it is appropriate to employ the method of harmonizing and dispersing wind-heat, using Gouteng San (Uncaria Decoction) as the primary formula.
Gouteng (56.25g), Baifuling (Poria, 56.25g), Fangfeng (Saposhnikovia Root, 7.5g), Zhusha (Cinnabar, 7.5g, prepared), Dahuang (Rhubarb Root and Rhizome, 8.33g, steamed in wine wrapped in paper). Decoct and take orally. This is a modified variation of Xieqing Wan (Drain Green Pill).
Pan Chang (Coiled Intestine, referring here to severe spasticity with neck and back stiffness, similar to tetanus or opisthotonos) is characterized by stiffness and rigidity of the neck and back, hyperextension of the waist and body, head shaking accompanied by limb twitching, lockjaw with inability to speak, fever with abdominal pain, and prolonged lethargy without waking. The presentation is terrifying.
The pathogenesis differs from Tian Diao. Wind-stroke syndrome presents with spontaneous sweating and should not be treated with further diaphoresis; excessive sweating leads to convulsions. Dampness-stroke requires mild diaphoresis but not profuse sweating; excessive sweating also leads to convulsions. This condition is divided into Gang Jing (Stiff Spasm) and Rou Jing (Flaccid Spasm). Absence of sweat indicates Gang Jing, for which Mahuang Gegen Tang (Ephedra and Pueraria Decoction) is indicated. Presence of sweat indicates Rou Jing, for which Guizhi Gegen Tang (Cinnamon Twig and Pueraria Decoction) is indicated. Both types of Jing can be treated with Renshen Baidu San (Ginseng Detoxification Powder) added with Fangfeng.
Mahuang Gegen Tang Formula:
Mahuang (Ephedra Stem, 56.25g, nodes removed), Chishaoyao (Red Peony Root, 56.25g), Gegen (Kudzu Root, 75g), Congbai (Scallion White, 2 stalks), Chi (Fermented Soybean, 15ml). Crush into coarse powder. Take 6g per dose, decoct in water, and drink.
Guizhi Gegen Tang Formula:
Guizhi (Cinnamon Twig, Shaoyao (White Peony Root), Gancao (Licorice Root, each 9.38g), Gegen (Kudzu Root, 75g), Shengjiang (Fresh Ginger, 30g), Dazao (Jujube, 4 pieces). Crush into coarse powder. Take 9g per dose, decoct in water, and drink.
Nei Diao (Internal Hook, a pediatric emergency of abdominal pain caused by cold pathogen) is characterized by abdominal pain with frequent crying, black lips, scrotal swelling, flexion or hyperextension of the body, and red veins with petechiae in the eyes. This is due to the accumulation and binding of cold qi. It is appropriate only to use Moyao (Myrrh), Muxiang (Aucklandia Root), Chenxiang (Agarwood), Bo Shang Huixiang (Fennel Fruit, stir-fried), Gouteng (Uncaria Ramulus cum Uncis, equal parts), Ruxiang (Olibanum/Chinese Frankincense), and Quanxie (Scorpion, half dosage). Grind into powder. Mix with mashed garlic to form pills the size of Sophora seeds. Take two pills per dose, washed down with Gouteng Tang.
Pan Chang Qi Tong (Qi Pain of Coiled Intestine, abdominal pain caused by cold qi attacking the small intestine) is characterized by dry crying (crying without tears) and sweating on the forehead. This is caused by cold qi assaulting the Small Intestine. Jinlingzi San (Melia Toosendan Powder) is indicated.
Jinlingzi San Formula:
Jinlingzi (Toosendan Fruit, 7.5g), Bo Shang Huixiang (Fennel Fruit, salt-stir-fried), Muxiang (Aucklandia Root, each 3.75g). Grind into fine powder. Take 1.5g to 3.75g per dose, taken with wine.
Danggui San: Treats cold pathogen invading the Kidney Meridian, presenting with acute pain in the lower abdomen, bluish complexion, and cold hands and feet.
Dangguishen (Angelica Sinensis Root Body), Muxiang (Aucklandia Root), Rougui (Cinnamon Bark), Renshen (Ginseng Root), Zhi Gancao (Honey-fried Licorice Root), plus Po Gu Zhi (Cibotium Rhizome, stir-fried) and Xiao Huixiang (Fennel Fruit, stir-fried). Grind all ingredients, in equal parts, into powder. Take with Ginger and Jujube decoction, or form into pills.
Someone asked: Regarding Tian Diao, Nei Diao, and Pan Chang, which organs do these diseases belong to, and how are they differentiated?
The answer is: The Classics state that the upper half of the body is governed by Heaven Qi, and the lower half by Earth Qi. Thus, Tian Diao is located in the upper part, caused by wind-heat, and is suitable for dispersing methods. Nei Diao is located in the lower part, caused by cold, and is suitable for warming methods. Both "Diao" diseases belong to the Foot Jueyin Liver Meridian. The Foot Jueyin meridian runs externally alongside the Du Mai (Governing Vessel), following the spine upward to enter the vertex of the head. Therefore, when diseased, it manifests as upward rolling of the eyes and backward arching of the back, resembling opisthotonos. Internally, it follows the genitalia into the lower abdomen, causing severe lower abdominal pain and scrotal swelling. All wind syndromes characterized by tremors and dizziness belong to Liver Wood. Hence, both Diao diseases present with twitching and convulsions resembling fright. However, Tian Diao may involve crying or laughing, whereas Nei Diao is characterized primarily by frequent crying, which distinguishes them.
Pan Chang disease (referring here to opisthotonos-like conditions) belongs to the Foot Taiyang Bladder Meridian. This meridian originates between the eyes, ascends to the head, descends along the neck, travels along the back, and then descends along the waist, where it aligns with the descending course of the Jueyin meridians. Thus, the symptom of opisthotonos is similar. However, Tian Diao presents with twitching and convulsions, while Pan Chang disease does not.
Pan Chang Qi Tong belongs to the Hand Taiyang Small Intestine Meridian, which internally connects to the lower abdomen. This internal pathway differs from that of the Jueyin meridian, resulting in sudden lower abdominal pain. However, Nei Diao presents with muscle twitching (Yong), while Pan Chang Qi Tong does not, allowing for differentiation.