〔娄〕惊、搐，一也，而有晨夕之分，表里之异。身热力大者为急惊。身冷力
小者为慢惊。仆地作声，醒时吐沫者为痫。头目仰视者为天吊。角弓反张者为痉。而
治各不同也。
〔钱〕因潮热发搐在寅卯辰时者，此肝用事之时也，身体壮热，目上视，手足
动摇，口内生热涎，项颈强急，此肝旺也，当补肾治肝，补肾，地黄丸（方见肾部。）治肝，
泻青丸（方见。肝部） 〔薛〕寅卯辰时搐而发热作渴，饮冷便结，属肝胆经虚热，用柴芍参
苓散。作渴引饮，自汗盗汗，属肝胆经血虚，用地黄丸。口吻流涎，属肝木克脾土，
用六君子汤。一小儿寅卯时发热痰搐，服抱龙丸而愈。后复患，因自用前药，更
加咳嗽气喘，不时发搐，面赤或青黄，或浮肿，或流涎，余谓咳嗽气喘，乃脾肺气
虚，不时发搐，乃木乘土位，面青而黄赤，乃肝助心脾，浮肿流涎，乃脾气虚弱，
用益智丸以补心神，补中益气汤以养脾肺，顿愈。
〔钱〕因潮热发搐在巳午未时者，此心用事之时也，心惕，目上视，白睛赤色，
牙关紧急，口内涎生，手足动摇，此心旺也，当补肝治心，治心、导赤散、凉惊丸，
补肝、地黄丸。广亲宅七太尉，方七岁，潮热数日，欲愈。钱谓父二大王曰，七
使潮热将安。八使预防惊搐。王怒曰，但使七使愈，勿言八使病。钱曰，八使过来
日午间，即无苦也。次日午前果作搐，急召钱治之，三日而愈。盖预见其目直视而
腮赤，必肝心俱热，更坐石杌子，乃欲就冷，此热甚也，又肌肤素肥盛而本实，其
脉急促故发搐，克言午时者，自寅至午皆心肝用事之时，治之乃泻心肝补肾，自安
矣。〔薛〕巳午未时发搐，若兼作渴饮水，属风火相搏，以地黄丸补肝，导赤散、
凉惊丸治心。若作渴饮汤，体倦不乳，土虚而木旺也，用地黄丸以补肾，六君子汤
以补脾。一小儿巳午时搐热惊悸，发时形气倦怠而黄，懒食流涎饮汤。此心火虚
而不能生脾土也。不信，自服凉心之药，更加吐泻，睡而露睛，几成慢脾风。用六君、
姜、桂，佐以地黄丸而愈。一小儿七岁，惊搐发热不已，巳午未时益甚，形气殊
倦，热定饮汤。此心脾气虚。朝用补中益气汤加益智仁，夕用六君、当归、钓藤钩
寻愈。后饮食过多，复作吐泻，或治以保和丸，反加寒热发搐。此脾土复伤而肝木
所侮也。用六君、柴胡，寒热止而饮食进，但午未时仍泄，用补中益气汤加茯苓、
半夏、钓藤钩而全。
〔钱〕因潮热发搐在申酉戌时者，此肺用事之时也，不甚搐而喘，目微斜视，身
热如火，睡露睛，手足冷，大便淡黄水，是肝旺，当补脾、益黄散（方见脾部），治肝、
泻青丸，治心、导赤散。（洁古云∶脾病肝强，法当补脾，恐木贼害，宜先泻心肝以挫其强，
而后补脾为当。）徐氏子三岁，病潮热，每日西则发搐，身微热而目微斜、露睛，四肢冷
而喘，大便微黄。请钱与李同治，钱问李曰病何搐也？李曰有风。何身热微温？曰四肢所作。
何目斜睛露？曰搐则目斜。何肢冷？曰冷厥心内热。曰何喘？曰搐之甚也。曰何以治
之？曰凉惊丸鼻中灌之，必搐止。钱又问曰既谓风病温壮，搐引目斜露睛，内热支
冷，及搐甚而喘，并以何药治之？李曰皆此药也。钱曰不然，搐者心肝实也，身微
热者日西肺用事之时也，肺主身温，今且热者肺虚也，目微邪露睛者，肝肺相乘
胜也，四肢冷者，脾虚也，肺若虚甚、则脾母亦弱，木气乘脾、四肢即冷，治之当
先补脾肺，用益黄散、阿胶散，得脾虚证退，然后治其心肝，用泻青丸、导赤
散、凉惊丸治之，九日愈。〔薛〕申酉戌时微搐而喘，目微斜，身似热，睡而露睛，
大便淡黄，属脾肺虚热，用异功散。手足逆冷，或喘泻不食，属脾肺虚寒，用
六君、炮姜、木香。久病而元气虚者，用六君子、六味丸二药主之。
〔钱〕因潮热发搐在亥子丑时者，此肾用事之时也，不甚搐而卧不稳，身体温壮，
目睛紧斜视，喉中有痰，大便银褐色，乳食不消，多睡不省，当补脾治心，补脾、
益黄散，治心、导赤散、凉惊丸。（洁古云，皆因大病后脾胃虚损，多有此疾。）〔薛〕
亥子丑时微搐身热，目睛紧斜，吐泻不乳，厥冷多睡，属寒水侮土，用益黄散，未应，
用六君、姜、桂。
【娄】惊风与抽搐，本质相同，但有早晨傍晚之分，表证里证之异。身体发热、力量大的是急惊风。身体发冷、力量小的是慢惊风。倒地时发出声音，清醒时口吐白沫的是痫病。头眼向上仰视的是天吊风。身体向后反张如弓状的是痉病。而治疗方法各不相同。
【钱乙】如果在寅时、卯时、辰时（凌晨3点至上午9点）因潮热引发抽搐，这是肝气当令的时段。身体壮热，眼睛上视，手足动摇，口中产生热涎，项颈强直紧急，这是肝气旺盛的表现，应当补肾兼治肝。补肾用六味地黄丸（方剂见肾部章节），治肝用泻青丸（方剂见肝部章节）。
【薛己】如果在寅时、卯时、辰时出现抽搐并伴有发热口渴、喜饮冷水、大便干结，属于肝胆经的虚热，使用柴芍参苓散。如果口渴引水自饮，且有自汗或盗汗，属于肝胆经的血虚，使用六味地黄丸。如果口角流涎，属于肝木克制脾土，使用六君子汤。有一个小儿在寅时、卯时发热、生痰、抽搐，服用抱龙丸后痊愈。后来再次患病，因为自行服用前药，反而增加了咳嗽气喘，不时发生抽搐，面色红赤或青黄，或者浮肿，或者流涎。我认为咳嗽气喘，是脾肺气虚；不时抽搐，是肝木乘袭脾土之位；面色青中带黄赤，是肝助心脾（肝火扰心及脾）；浮肿流涎，是脾气虚弱。于是使用益智丸以补养心神，使用补中益气汤以滋养脾肺，顿时痊愈。
【钱乙】如果在巳时、午时、未时（上午9点至下午3点）因潮热引发抽搐，这是心气当令的时段。心中惊恐惕惧，眼睛上视，白眼球发红，牙关紧急，口中涎液滋生，手足动摇，这是心气旺盛的表现，应当补肝兼治心。治心用导赤散、凉惊丸，补肝用六味地黄丸。广亲宅七太尉，当时七岁，潮热数日，快要痊愈时。钱乙对父亲二大王说：“七使君的潮热将要安定。”又说：“八使君要预防惊搐。”王爷生气地说：“只要让七使君痊愈，不要提八使君的病。”钱乙说：“八使君过来日中午时分，就不会痛苦了。”第二天午前果然发生抽搐，急忙召请钱乙治疗，三天后痊愈。这是因为预先看到他眼睛直视且腮部发红，必定是肝心俱热，加上他坐在石凳子上，是想靠近凉爽之处，这说明热势很盛，又因为他肌肤本来肥盛而体质充实，脉象急促所以发生抽搐。预言他在午时发病，是因为从寅时到午时都是心肝当令的时段，治疗方法是泻心肝之火并补肾，自然平安无事。
【薛己】如果在巳时、午时、未时发生抽搐，如果兼有口渴饮水，属于风火相搏，用地黄丸补肝，用导赤散、凉惊丸治心。如果口渴想喝热汤，身体疲倦不愿吃奶，是脾土虚弱而肝木旺盛，用地黄丸补肾，用六君子汤补脾。有一个小儿在巳时、午时出现抽搐、发热、惊悸，发作时形体气息倦怠且面色发黄，懒食、流涎、想喝热汤。这是心火虚弱不能生助脾土所致。家属不信，自行服用清心凉药，更加严重导致吐泻，睡觉时眼睛睁开露睛，几乎形成慢脾风。使用六君子汤加生姜、肉桂，佐以六味地黄丸而痊愈。有一个七岁小儿，惊搐发热不止，在巳时、午时、未时更加严重，形体气息特别疲倦，热退后想喝热汤。这是心脾气虚。早上服用补中益气汤加益智仁，晚上服用六君子汤加当归、钩藤，不久痊愈。后来饮食过多，再次出现吐泻，有人用保和丸治疗，反而加重寒热并发生抽搐。这是脾土再次受伤而被肝木所侮（反克）。使用六君子汤加柴胡，寒热停止且饮食增进，但午时、未时仍然腹泻，使用补中益气汤加茯苓、半夏、钩藤而完全康复。
【钱乙】如果在申时、酉时、戌时（下午3点至晚上9点）因潮热引发抽搐，这是肺气当令的时段。抽搐不厉害但气喘，眼睛微微斜视，身体热如火，睡觉时眼睛睁开露睛，手足冰冷，大便呈淡黄色水样，这是肝气旺盛（实则因肺虚肝乘），应当补脾用益黄散（方剂见脾部章节），治肝用泻青丸，治心用导赤散。（洁古云：脾病而肝强，法度上应当补脾，恐怕肝木贼害脾土，适宜先泻心肝以挫其强势，然后再补脾才是恰当的。）徐氏之子三岁，患潮热，每天西时（申酉时）发生抽搐，身体微热且眼睛微斜、露睛，四肢冰冷且气喘，大便微黄。请钱乙与李医生共同治疗。钱乙问李医生：“这是什么原因引起的抽搐？”李医生说：“有风邪。”“为什么身体只是微温？”李医生说：“四肢寒冷所致。”“为什么眼睛斜视且露睛？”李医生说：“抽搐时眼睛就会斜视。”“为什么四肢冷？”李医生说：“这是冷厥，内心有热。”“为什么会气喘？”李医生说：“抽搐严重的表现。”“怎么治疗？”李医生说：“用凉惊丸灌入鼻中，抽搐一定会停止。”钱乙又问：“既然说是风病且温热壮盛，抽搐牵引眼睛斜视露睛，内热肢冷，以及抽搐严重而气喘，都用什么药治疗？”李医生说：“都是这个药。”钱乙说：“不对。抽搐是心肝实证，身体微热是因为正值西时肺气当令之时，肺主身之温煦，现在却发热，说明肺虚；眼睛微斜露睛，是肝肺相互乘胜（肝木侮肺金）；四肢冷，是脾虚；肺如果虚甚，则脾母亦弱，木气乘袭脾土，四肢即冷。治疗应当先补脾肺，使用益黄散、阿胶散，待脾虚证候消退后，然后治疗心肝，使用泻青丸、导赤散、凉惊丸治疗，九日后痊愈。”
【薛己】如果在申时、酉时、戌时轻微抽搐且气喘，眼睛微斜，身体似热，睡觉露睛，大便淡黄，属于脾肺虚热，使用异功散。如果手足逆冷，或者气喘腹泻不进食，属于脾肺虚寒，使用六君子汤加炮姜、木香。久病而元气虚弱者，使用六君子汤和六味地黄丸两药主治。
【钱乙】如果在亥时、子时、丑时（晚上9点至凌晨3点）因潮热引发抽搐，这是肾气当令的时段。抽搐不厉害但躺卧不稳，身体温热壮盛，眼睛紧紧斜视，喉中有痰鸣，大便呈银褐色，乳食不消化，多睡且神志不清，应当补脾兼治心。补脾用益黄散，治心用导赤散、凉惊丸。（洁古云：这都是因为大病之后脾胃虚损，多有此疾。）
【薛己】如果在亥时、子时、丑时轻微抽搐且身体发热，眼睛紧紧斜视，吐泻且不吸吮乳汁，四肢厥冷且多睡，属于寒水侮土（肾水反克脾土），使用益黄散，如果没有效果，使用六君子汤加生姜、肉桂。
[Lou] "Jing" (startle) and "Chu" (convulsion/tremor) are essentially the same, but differ in timing (morning vs. evening) and location (exterior vs. interior). Those with high body heat and strong convulsive force are classified as Ji Jing Feng (Acute Startle Wind/Convulsion). Those with cold body and weak force are classified as Man Jing Feng (Chronic Startle Wind/Convulsion). Those who fall to the ground making sounds and foam at the mouth upon waking are suffering from Xian Bing (Epilepsy). Those whose head and eyes look upward are suffering from Tian Diao Feng (Heavenly Suspended Wind). Those whose bodies arch backward like a bow are suffering from Jing Bing (Spasm/Stiffness). The treatments for each differ.
[Qian Yi] If convulsions occur due to tidal fever during Yin, Mao, and Chen hours (3:00–9:00 AM), this is the time when the Liver is dominant. Symptoms include robust body heat, upward gaze, trembling of hands and feet, production of hot saliva in the mouth, and stiffness/tightness of the neck. This indicates Liver Qi excess. Treatment should tonify the Kidney and regulate the Liver. To tonify the Kidney, use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia; see Kidney section). To regulate the Liver, use Xie Qing Wan (Drain Green Pill; see Liver section).
[Xue Ji] If convulsions occur during Yin, Mao, and Chen hours accompanied by fever, thirst, preference for cold drinks, and constipation, this belongs to Deficient Heat of the Liver and Gallbladder channels. Use Chaishao Shenling San. If there is excessive thirst with drinking, spontaneous sweating, or night sweats, this belongs to Blood Deficiency of the Liver and Gallbladder channels. Use Liuwei Dihuang Wan. If drooling occurs at the corners of the mouth, this belongs to Liver Wood overacting on Spleen Earth. Use Liujunzi Tang (Six Gentlemen Decoction). A child had fever, phlegm, and convulsions during Yin and Mao hours and recovered after taking Baolong Wan. Later, he relapsed. Because he self-administered the previous medicine, he developed increased coughing and wheezing, frequent convulsions, red or green-yellow complexion, edema, or drooling. I reasoned that coughing and wheezing indicate Qi deficiency of the Spleen and Lung; frequent convulsions indicate Liver Wood invading the Spleen position; a greenish-yellow-red complexion indicates Liver assisting Heart and Spleen (Liver fire disturbing Heart/Spleen); edema and drooling indicate Spleen Qi deficiency. Therefore, I used Yizhi Wan to tonify the Heart Spirit, and Buzhong Yiqi Tang to nourish the Spleen and Lung, resulting in immediate recovery.
[Qian Yi] If convulsions occur due to tidal fever during Si, Wu, and Wei hours (9:00 AM–3:00 PM), this is the time when the Heart is dominant. Symptoms include heart palpitations/fright, upward gaze, redness of the sclera, tight jaw, saliva production, and trembling of hands and feet. This indicates Heart Qi excess. Treatment should tonify the Liver and regulate the Heart. To regulate the Heart, use Daochi San (Guide Out Red Powder) and Liangjing Wan (Cool Startle Pill). To tonify the Liver, use Liuwei Dihuang Wan. The Seventh Taivell of Guangqin Residence was seven years old. He had suffered from tidal fever for several days and was nearly recovered. Qian Yi told his father, the Second Da Wang, "The Seventh Envoy's tidal fever will settle." He added, "The Eighth Envoy must prevent startle convulsions." The King angrily replied, "Just let the Seventh Envoy recover; do not speak of the Eighth Envoy's illness." Qian Yi said, "On the following day around noon, the Eighth Envoy will suffer no pain." The next day before noon, convulsions indeed occurred. Qian Yi was summoned urgently and treated him, curing him in three days. This was because he foresaw that direct staring and red cheeks indicated both Liver and Heart heat. Additionally, sitting on a stone stool showed a desire for coolness, indicating severe heat. His flesh was naturally plump and constitutionally solid, and his pulse was rapid, leading to convulsions. Predicting onset at Wu hour (noon) was because from Yin to Wu hours, both Liver and Heart are dominant. Treatment involved draining Heart and Liver heat and tonifying the Kidney, ensuring peace.
[Xue Ji] If convulsions occur during Si, Wu, and Wei hours, accompanied by thirst and drinking water, this belongs to Wind-Fire struggling against each other. Tonify the Liver with Dihuang Wan, and treat the Heart with Daochi San and Liangjing Wan. If there is thirst for warm drinks, fatigue, and refusal to nurse, this is Spleen Earth deficiency with Liver Wood excess. Tonify the Kidney with Dihuang Wan and tonify the Spleen with Liujunzi Tang. A child experienced convulsions, fever, and palpitations during Si and Wu hours. During attacks, the form and Qi were fatigued and yellow, with anorexia, drooling, and desire for warm drinks. This is Heart Fire deficiency failing to generate Spleen Earth. The family did not believe this and self-administered cooling Heart medicines, worsening symptoms to vomiting, diarrhea, sleeping with eyes open, nearly forming Man Pi Feng (Chronic Spleen Wind). Using Liujunzi Tang with Shengjiang (Fresh Ginger) and Ronggui (Cinnamon Twig), assisted by Dihuang Wan, resulted in recovery. Another seven-year-old child had persistent startle convulsions and fever, worsening during Si, Wu, and Wei hours. Form and Qi were extremely fatigued, and after fever subsided, he desired warm drinks. This is Heart and Spleen Qi deficiency. Morning administration of Buzhong Yiqi Tang plus Yizhiren (Bitter Apricot Seed), and evening administration of Liujunzi Tang plus Danggui (Angelica Sinensis) and Gouteng (Uncaria Rhynchophylla) led to recovery. Later, overeating caused recurrent vomiting and diarrhea. Treatment with Baohe Wan worsened chills, fever, and convulsions. This is Spleen Earth injury again, offended by Liver Wood. Using Liujunzi Tang plus Chaihu (Bupleurum) stopped chills and fever and improved appetite. However, diarrhea persisted during Wu and Wei hours. Complete recovery was achieved using Buzhong Yiqi Tang plus Fuling (Poria), Banxia (Pinellia), and Gouteng.
[Qian Yi] If convulsions occur due to tidal fever during Shen, You, and Xu hours (3:00–9:00 PM), this is the time when the Lung is dominant. Convulsions are mild but accompanied by wheezing, slight oblique gaze, body heat like fire, sleeping with eyes open, cold hands and feet, and pale yellow watery stool. This indicates Liver excess (actually due to Lung deficiency allowing Liver invasion). Treatment should tonify the Spleen with Yihuang San (Regulate Yellow Powder; see Spleen section), regulate the Liver with Xie Qing Wan, and regulate the Heart with Daochi San. (Jieguyun: When Spleen disease causes Liver strength, the method is to tonify the Spleen. Fearing Wood robbing Earth, it is appropriate to first drain Heart and Liver to curb their strength, then tonify the Spleen.) The son of Mr. Xu, aged three, suffered from tidal fever, with convulsions every afternoon (Shen/You hours). Symptoms included slight body heat, slight oblique gaze, exposed eyes, cold limbs, wheezing, and slightly yellow stool. They invited Qian Yi and Dr. Li to treat him together. Qian Yi asked Dr. Li, "What causes the convulsions?" Dr. Li said, "Wind." "Why is the body only slightly warm?" Dr. Li said, "Due to cold limbs." "Why oblique gaze and exposed eyes?" Dr. Li said, "Convulsions cause oblique gaze." "Why cold limbs?" Dr. Li said, "Cold reversal with internal heat." "Why wheezing?" Dr. Li said, "Severe convulsions." "How to treat?" Dr. Li said, "Instill Liangjing Wan into the nose; convulsions will stop." Qian Yi asked further, "Since you say it is Wind disease with warmth and heat, convulsions pulling eyes oblique and exposed, internal heat with cold limbs, and severe convulsions causing wheezing, what medicine treats all these?" Dr. Li said, "All this medicine." Qian Yi said, "Incorrect. Convulsions indicate Heart and Liver Excess. Slight body heat occurs because it is the time of Lung dominance in the West (afternoon). Lung governs body warmth; now there is heat, indicating Lung deficiency. Slight oblique gaze and exposed eyes indicate Liver and Lung mutual overcoming (Wood insulting Metal). Cold limbs indicate Spleen deficiency. If Lung is very deficient, its mother (Spleen) is also weak. Wood Qi invades Spleen, causing cold limbs. Treatment should first tonify Spleen and Lung using Yihuang San and Ejiao San. After Spleen deficiency signs recede, then treat Heart and Liver using Xie Qing Wan, Daochi San, and Liangjing Wan. Cured in nine days."
[Xue Ji] If mild convulsions and wheezing occur during Shen, You, and Xu hours, with slight oblique gaze, body seeming hot, sleeping with eyes open, and pale yellow stool, this belongs to Deficient Heat of Spleen and Lung. Use Yigong San. If hands and feet are reversed cold, or if there is wheezing, diarrhea, and anorexia, this belongs to Deficient Cold of Spleen and Lung. Use Liujunzi Tang with Paojiang (Prepared Ginger) and Muxiang (Aucklandia). For chronic illness with Yuan Qi (Original Qi) deficiency, use Liujunzi Tang and Liuwei Dihuang Wan as main treatments.
[Qian Yi] If convulsions occur due to tidal fever during Hai, Zi, and Chou hours (9:00 PM–3:00 AM), this is the time when the Kidney is dominant. Convulsions are mild but lying is unstable, body temperature is warm and robust, eyes are tightly obliquely gazing, phlegm is present in the throat, stool is silver-brown, milk and food are undigested, and there is excessive sleep with lack of awareness. Treatment should tonify the Spleen and regulate the Heart. Tonify Spleen with Yihuang San; regulate Heart with Daochi San and Liangjing Wan. (Jieguyun: These are mostly due to Spleen and Stomach damage after severe illnesses.)
[Xue Ji] If mild convulsions and body heat occur during Hai, Zi, and Chou hours, with tightly oblique eyes, vomiting, diarrhea, refusal to nurse, cold extremities, and excessive sleep, this belongs to Cold Water insulting Earth (Kidney Water counter-attacking Spleen Earth). Use Yihuang San. If ineffective, use Liujunzi Tang with Shengjiang and Ronggui.