〔钱〕疮疹搐由风火相胜也，惟 疹能作搐，疹为脾所生，脾虚而肝旺乘之，木
来胜土，热气相击，动于心神，心喜为热，神气不安，因搐成痫。 子为心所生，心生热，热则生风，风属于肝，
二脏相搏，风火相争，故发搐也。治之当泻心肝补其母，栝蒌汤主之（方见惊）。海藏云∶诸痛痒疮，皆属于心。火
无论虚实，皆从心火上说，脾虚则肝乘之，肝与心火相合，故用栝蒌汤。若脾土实，火旺逆乘而成痫者，
此实邪也，便结者泻青丸，便软者泻青汤，亦当以脉别之。〔翁〕经曰∶诸风掉眩，皆属肝木。然痘出之始，虽有
四脏，心实主之，心火热盛，肺金受克，不能制伏肝木，热则生风，风火相搏，神气不安，故发惊搐。医者当辨痘疹
惊搐，不可遽投凉心之药，苟不审而概以惊药治之，则心寒而肌敛，毒瓦斯内陷，痘何由而出也。治法，
当平肝木利小便为切要，泻肝则风去，利小便则心热退，风热既定，则痘随出而惊搐自愈矣。然痘先惊者多吉，痘
后惊者多凶，何也，痘未出之先，热蕴于内，故作惊搐，痘出惊止而内无凝滞，故吉。痘出之后，气血虚弱，复感风
寒，热毒反滞，又毋敢轻易发散清利，故凶。然有非痘证而慢惊者亦属于肝，而治法专理脾土何也。盖由平日或吐
或泻，脾土虚弱，不能当肝木所克，此非肝木之本病也，治法只须温补脾土为主，而肝木自宁，譬如土薄而上有大
木不能乘载，故无风而自动，栽培者
当浓填其土，使根深本固，而自无风邪之害也。痘后有此证者，亦由气血虚极使然也，必为难治。《疮疹论》挟热
吐泻，不可投燥药。伤寒身热，不可投凉药。疮疹发搐，不可投惊药。此皆外同而内异，盖疮疹出于心，惊
搐亦出于心也。疮疹本热，热则动心，此理之自然，夫心火独盛于上，肺金受火克而不能制伏肝木，热则生风，
木气盛则脾土衰，热气动于心神，心喜为热，心肚 ，脾肚疹，泻肝则风去，利小肠则热退也，风热既退，则惊搐
自愈矣。昧者不知，投以银粉、脑、麝、青黛、朱砂、硝石凉心损胃之药则误矣。故见证似惊风，用药当作疮疹防
之。盖疮疹之初，似惊风者多，大抵疮疹发惊，必先咳嗽痰涎，心悸烦躁，呕吐唇红，颊赤发渴，耳
冷足冷，脉数舌白，如有此数证，则银粉等凉药切不可用。盖心凉则并损胃而毒瓦斯敛伏，又况心主血，寒则血凝而不
行，且中焦既冷，上焦热愈不降，何由运出。又有小儿平常无病，忽然发搐者，必是疮疹，尤当审谛。盖毒瓦斯内盛，但
当发散，如惺惺散、消毒散、升麻汤、红绵散，兼以快气、利小便、祛风等药与之，待其热气得泄，心气亦自定矣。或
有风寒与内热相搏而惊搐者，各随证治如前法，但加匀
气药为妙，张氏云∶疮疹气匀即出快，气匀则荣卫无滞，有毒亦散，疮疹当自出矣
（诸方并见初热）。如大吐，面青，唇眼动，手足时搐，慢脾风证也。宜小异功散加升、柴、木香、干姜、治之。
〔洁〕凡未出而发搐者，是外感风寒之邪、内发心热之所作也，当用茶粉下解毒丸、犀角地黄汤主之。〔世〕
治疮痘欲出，身热烦躁，忽发惊搐，宜驱风膏、小如圣饮。小便不通，八正散。涎盛，利惊丸、抱龙丸量证施之。
〔丹〕欲发疮疹，先身热惊跳搐搦，此非惊风，宜发散药。〔薛〕前证，痘疹未见而先发搐者，乃毒瓦斯自心经出也，
若病势轻缓，或形气虚弱者，不宜用峻厉之剂，恐元气内损，则毒瓦斯内陷，而疮不能起发也。或外感风寒之邪，
内因疮疹之热而相搏，或肝血虚，火动而内生风，当补元气为主，佐以见证之剂。然前方多峻厉之剂，
审有是证方可用，须察其色赤白，而以脾胃为主，虚则用温补，实则用解毒。〔张〕痘疮始作，未形见之间，忽发惊
搐，是毒瓦斯自心经而出也，苟不以内外证辨明之，便用银粉、青黛、等药，则心寒而毒瓦斯内陷，往往气绝之际，或
隐方出，已无及矣。治法，但当以导赤散加防风、辰砂末，与泻青丸合而治之。搐甚者，抱龙丸。
如再不止，小便利者可治以导赤散送下牛黄清心丸或粉红丸。小便不利者，勿治。
惺惺散（初热） 升麻汤（初热）
红绵散 解表之药。
全蝎（五个） 麻黄（去节） 僵蚕 白芷 川芎 桔梗 天麻（各二钱） 甘草 苏木（各一钱）
上为末。每服一钱，加红绵少许，水煎。有热，加荆芥稍热服。一方，入薄荷叶三片，好酒四五点同煎。
羌活散 调三制辰砂末，加防风、荆芥表之。（方见初热证治）
〔世〕麻痘风搐方
人参 羌活 防风 僵蚕（醋炒） 南星（姜制） 白附子（姜制） 甘草（炙）
上等分，生姜三片，水煎服。其搐立止。
上皆解表之剂，洁古所谓外感风寒之邪，丹溪所谓宜发散药者是也。
解毒丸
寒水石（研） 石膏（研，各一两） 青黛（半两）
上，以二石细研如粉，入青黛和均，汤浸蒸饼为丸，如芡实大。每服一丸，食
后，新汲水化下，或细嚼姜水下亦可。三岁儿服半丸，量岁数加减服之。
犀角地黄汤（失血）
柴胡二连丸 治肝经实火。
柴胡 宣黄连 胡黄连
上为末。糊丸桐子大。每服二三十丸，白汤下。
上解毒、凉血、泻肝火之剂，有热者宜之。
导赤散（心脏） 八正散（小便不利） 六一散（热）
上利小便之剂，小便不利者宜之，然泻丙火以泻肝之子，乃治惊搐第一要法，不独小便不利者为当用也。
紫草快 散（即加减大紫草散有木通、无黄 ，方见痘灰白） 东垣消毒散（即消毒救苦汤，见大法）
参 四圣散（灌脓） 八物汤（虚羸） 柴胡栀子散（即栀子清肝散，见五脏热） 地黄丸（肾脏）
小异功散（即四君子汤、加陈皮） 益气汤（即补中益气汤）
上皆薛氏所用方，大抵主于养脾补肾，乃补虚例也。
抱龙丸 牛黄清心丸（并见惊搐） 粉红丸（即温惊丸，见慢惊条）
上镇惊豁痰例，痰涎潮壅，及曾被外物惊者，用之。
〔钱〕 疹病后欲发痫，余疮难发痫，以木胜脾，木归心故也。若凉惊，用凉惊
丸。温惊，用粉红丸。〔万〕痘后非时搐搦者有二证，一则心热留而不去，热盛生风，风火相传，其人必喉
中有痰，目直上视，面赤引饮，居处喜冷，宜导赤散、泻青丸清心泻肝，后以抱龙丸调之。一则病后多食，胃弱不
能胜谷，谓之食蒸发搐，其人必潮热，大便酸臭，秘泄不调，或呕吐腹痛，先以备急丸、丁香脾积丸利之，
后用木香大安丸、钱氏异攻散调理取愈。〔薛〕一小儿痘痂脱尽，因其秽气，用葱椒煎汤浴之，发搐痰喘。用八珍加
白僵蚕、蝉蜕一剂，痰喘顿止，又用四君、芎、归、钓藤钩而搐止。一小儿痘疮色赤，四肢发搐，眉唇牵动。此心
肝二经热甚乘脾所致也。用四君、防风、钓藤钩而痊。一小儿痘后四肢发搐，眉棱尤动，小便频
数，脸目青赤。此肝经风热。用四物、柴胡、山栀少愈。但四肢倦怠，饮食少思，大便不实。此脾气受伤而未复也。用
四君、升麻、当归而痊。一小儿痘后寅卯申酉时热甚，或兼搐。余谓寅卯时发热，此肝火本证，申酉时发搐，乃肝木侮
金。先以四物、白术、茯苓、钓藤钩、煎送柴胡二连丸而愈，夕用地黄丸，朝用四君、山栀、柴胡及四君子加当归而痊。
一小儿痘疮色赤，发搐痰盛。服抱龙丸而顿愈。又因母大怒，儿仍搐，母服柴胡栀子散、加味逍遥散，母子并愈。一小
儿痘愈后发搐，左
额青赤，唇口牵动。余谓肝心二经风热所致。先用柴胡栀子散加钓藤钩，后用加味逍遥散而搐止，再用五味
异功散而痘愈。一小儿痘将愈，发搐痰涌，头目不清。脾气虚弱，肝木侮之。先用五味异功散加柴胡、钓藤钩，搐
愈而靥。
凉惊丸 温惊丸（并见惊搐） 导赤散（心脏） 泻青丸（肝脏） 备急丸 丁香脾积丸 木香
大安丸（并见伤食） 柴胡二连丸（见前） 补中益气汤 四君子汤 四神丸 十一味木香散（并见泄泻）
栝蒌散 治痘、热极生风发搐。
栝蒌根（二钱） 白僵蚕（一钱）
上，慢火同炒老黄色，为末。每服二三分，薄荷汤下。
保命丹 一切惊风发热。
天麻 郁金 全蝎（去尾） 白附子（炒） 僵蚕（姜汁炒） 薄荷 蝉蜕 茯神 桔梗（各五钱）
防风 甘草 青黛（各三钱） 大半夏（炒，滚汤浸晒干，又用姜汁浸，晒干，又炒） 南星（制、同上。各一
两） 钩藤 牛黄（研。各二钱） 麝香（五分） 辰砂（飞，五钱，为衣）
上末，炼蜜、为丸芡实大。每服一丸，灯心汤下。
【钱乙】疮疹引起的抽搐是由于风与火相互克制所致。只有出疹才会引发抽搐，疹是由脾所生，当脾气虚弱而肝气旺盛乘虚侵袭时，木克土，热气相互激荡，扰动心神，心喜热，神气不安定，因而形成抽搐并演变为痫证。心之母子关系为肾（注：原文“子为心所生”此处语境似指五行相生或脏腑关联，结合下文“心生热”，通常理解为心火亢盛或心经热盛），心产生热，热则生风，风归属于肝，心与肝两脏相互搏结，风火相争，所以发生抽搐。治疗应当泻心、肝之火，补其母脏（注：根据前文“木来胜土...治之当泻心肝补其母”，此处指补脾以制肝，或补肾以滋水涵木，但后文栝蒌汤多清心脾之热，此处依原文直译），主方用栝蒌汤（方剂见惊搐门）。海藏说：“各种疼痛、瘙痒和疮疡，都归属于心。”火邪无论虚实，都要从心火的角度来论述。脾虚则肝气乘袭，肝与心火相合，所以使用栝蒌汤。如果脾土实盛，火旺逆乘而成为痫证，这是实邪，大便干结的用泻青丸，大便稀软的用泻青汤，也应当通过脉象来辨别。
【翁氏】经典记载：“各种风病引起的震颤眩晕，都属于肝木。”然而痘疹发出的初期，虽然涉及四脏，但实际上由心主导。心火热盛，肺金受克，不能制约肝木，热则生风，风火相搏，神气不安，所以发生惊搐。医生应当辨别痘疹引起的惊搐，不可立即投用寒凉清心的药物。如果不加审察而一概用治惊的药物，会导致心寒而肌表收敛，毒瓦斯内陷，痘疹如何能发出来呢？治疗方法，平抑肝木、通利小便最为关键。泻肝则风去，利小便则心热退，风热既定，痘疹自然发出，惊搐也就自愈了。然而，痘疹未出之前出现惊搐的多为吉兆，痘疹发出之后出现惊搐的多为凶兆。为什么呢？痘未出之前，热蕴积在体内，所以引起惊搐；痘出后惊搐停止且体内无凝滞，所以为吉。痘出之后，气血虚弱，又感受风寒，热毒反而停滞，此时不敢轻易使用发散清利的药物，所以为凶。但是，有非痘疹病症而是慢惊风的，也归属于肝，但治疗方法专门调理脾土，为什么呢？大概是因为平日或吐或泻，导致脾土虚弱，不能承受肝木的克制，这并非肝木的本病。治疗方法只需以温补脾土为主，肝木自然安宁。譬如土壤浅薄而上有大树无法承载，所以没有风也会自动摇晃，栽培者应当加厚填实土壤，使根深本固，自然就没有风邪的危害了。痘疹后出现这种证候的，也是由于气血极度虚弱造成的，必定难以治疗。《疮疹论》指出：挟热吐泻，不可投用燥药。伤寒身热，不可投用凉药。疮疹发搐，不可投用治惊药。这些都是外表症状相同而内在机理不同，因为疮疹出于心，惊搐也出于心。疮疹本质是热，热则动心，这是自然的道理。心火独盛于上，肺金受火克而不能制约肝木，热则生风，木气盛则脾土衰，热气动于心神，心喜热，心肚发斑，脾肚出疹，泻肝则风去，利小肠则热退，风热既退，惊搐自愈。愚昧的人不知道这些道理，投用银粉、冰片、麝香、青黛、朱砂、硝石等寒凉损胃的药物，就错了。所以见到类似惊风的证候，用药时要当作疮疹来防范。大概疮疹初期，像惊风的情况很多，大抵疮疹发惊，必须先有咳嗽痰涎、心悸烦躁、呕吐唇红、脸颊赤红、口渴、耳冷足冷、脉数舌苔白等症状，如果有这些证候，那么银粉等寒凉药物切不可用。因为心凉则会损伤胃气，使毒瓦斯收敛潜伏，况且心主血，寒则血凝而不行，且中焦既冷，上焦的热更无法下降，怎么能运化排出呢？又有小儿平时没病，忽然发生抽搐的，必定是疮疹，尤其应当仔细审察。因为毒瓦斯内盛，只应当发散，如惺惺散、消毒散、升麻汤、红绵散，兼用理气、利小便、祛风等药物给予服用，等待热气得以宣泄，心气自然安定。或者有风寒与内热相搏结而引起惊搐的，各随证状按前述方法治疗，但加入匀气药更为巧妙。张氏说：“疮疹气机调匀即能快出，气机调匀则营卫无滞涩，有毒也能消散，疮疹自然能发出。”（所有方剂均见初热门）。如果出现大吐、面色青、嘴唇眼睛跳动、手足时时抽搐，这是慢脾风证候。宜用小异功散加升麻、柴胡、木香、干姜治疗。
【李杲】凡痘疹未出而发抽搐的，是外感风寒之邪、内发心热所致，应当用茶粉送服解毒丸、犀角地黄汤主治。
【世医】治疗疮痘欲出，身热烦躁，忽然发惊搐，宜用驱风膏、小如圣饮。小便不通，用八正散。痰涎盛，用利惊丸、抱龙丸根据证状施用。
【朱震亨】欲发疮疹，先身热惊跳抽搐，这不是惊风，宜用发散药。
【薛己】上述证候，痘疹未见而先发抽搐的，是毒瓦斯自心经发出。如果病势轻缓，或形体气息虚弱者，不宜用峻猛激烈的药剂，恐怕元气内损，则毒瓦斯内陷，而疮不能起发。或者是外感风寒之邪，内因疮疹之热而相搏结，或者肝血虚，火动而生内风，应当以补元气为主，佐以针对证状的药剂。然而前方多为峻猛药剂，审察确有是证方可使用，须观察其色赤白，而以脾胃为主，虚则用温补，实则用解毒。
【张氏】痘疮刚开始发作，尚未显现形态之间，忽然发惊搐，是毒瓦斯自心经而出。如果不以内外证状辨明，便用银粉、青黛等药，则心寒而毒瓦斯内陷，往往在气绝之际，或者隐伏不出，已经来不及了。治疗方法，只应当用导赤散加防风、辰砂末，与泻青丸合起来治疗。抽搐严重的，用抱龙丸。如果仍不止，小便通利的可用导赤散送下牛黄清心丸或粉红丸。小便不利的，不要治疗。
惺惺散（初热阶段） 升麻汤（初热阶段）
红绵散 解表药物。
全蝎（五个） 麻黄（去节） 僵蚕 白芷 川芎 桔梗 天麻（各二钱） 甘草 苏木（各一钱）
以上研为细末。每次服用一钱，加少许红绵，水煎服。有热的，加荆芥稍热服。另一法，入薄荷叶三片，好酒四五滴同煎。
羌活散 调和三味制的辰砂末，加防风、荆芥发表。（方剂见初热证治）
【世医】麻痘风搐方
人参 羌活 防风 僵蚕（醋炒） 南星（姜制） 白附子（姜制） 甘草（炙）
以上等分，生姜三片，水煎服。抽搐立即停止。
以上都是解表的方剂，即洁古所谓的外感风寒之邪，丹溪所谓的宜用发散药的情况。
解毒丸
寒水石（研） 石膏（研，各一两） 青黛（半两）
以上，将两种石头细细研成粉，加入青黛混合均匀，用水浸蒸饼做成丸，如芡实大小。每次服用一丸，饭后，新汲水化开服用，或者细嚼姜水送下也可以。三岁儿童服用半丸，根据年龄加减服用。
犀角地黄汤（失血证）
柴胡黄连丸 治疗肝经实火。
柴胡 宣黄连 胡黄连
以上研为细末。糊丸如梧桐子大。每次服用二三十丸，白开水送下。
以上是解毒、凉血、泻肝火的药剂，有热者适宜。
导赤散（心脏） 八正散（小便不利） 六一散（热）
以上是利小便的药剂，小便不利者适宜，然而泻丙火（小肠火）以泻肝之子，乃是治疗惊搐的第一要法，不仅限于小便不利者才当用。
紫草快 散（即加减大紫草散，有木通，无黄芩，方见痘灰白） 东垣消毒散（即消毒救苦汤，见大法）
参 四圣散（灌脓期） 八物汤（虚羸） 柴胡栀子散（即栀子清肝散，见五脏热） 地黄丸（肾脏）
小异功散（即四君子汤，加陈皮） 益气汤（即补中益气汤）
以上都是薛己所用的方剂，大抵主要在于养脾补肾，属于补虚的类别。
抱龙丸 牛黄清心丸（均见惊搐门） 粉红丸（即温惊丸，见慢惊条）
以上镇惊豁痰的类别，痰涎潮涌壅塞，以及曾被外物惊吓者，使用此法。
【钱乙】疹病后欲发痫，其余疮难发痫，因为木胜脾，木归心故也。若凉惊，用凉惊丸。温惊，用粉红丸。
【万全】痘后非时抽搐有两种证候，一则心热留滞不去，热盛生风，风火相传，其人必喉中有痰，目直上视，面赤引饮，居处喜冷，宜用导赤散、泻青丸清心泻肝，后用抱龙丸调理。一则病后多食，胃弱不能胜谷，谓之食蒸发搐，其人必潮热，大便酸臭，秘泄不调，或呕吐腹痛，先用备急丸、丁香脾积丸通利，后用木香大安丸、钱氏异攻散调理取愈。
【薛己】一小儿痘痂脱尽，因其秽气，用葱椒煎汤洗澡，发搐痰喘。用八珍汤加白僵蚕、蝉蜕一剂，痰喘顿止，又用四君子汤、川芎、当归、钓藤钩而抽搐停止。一小儿痘疮色赤，四肢发搐，眉唇牵动。这是心肝二经热甚乘脾所致。用四君子汤、防风、钓藤钩而痊愈。一小儿痘后四肢发搐，眉棱尤动，小便频数，脸目青赤。这是肝经风热。用四物汤、柴胡、山栀少愈。但四肢倦怠，饮食少思，大便不实。这是脾气受伤而未恢复。用四君子汤、升麻、当归而痊愈。一小儿痘后寅卯申酉时热甚，或兼抽搐。我认为寅卯时发热，这是肝火本证，申酉时发搐，乃肝木侮金。先以四物汤、白术、茯苓、钓藤钩，煎送柴胡黄连丸而愈，夕用地黄丸，朝用四君子汤、山栀、柴胡及四君子汤加当归而痊愈。一小儿痘疮色赤，发搐痰盛。服抱龙丸而顿愈。又因母亲大怒，孩子仍抽搐，母亲服柴胡栀子散、加味逍遥散，母子并愈。一小儿痘愈后发搐，左额青赤，唇口牵动。我认为这是肝心二经风热所致。先用柴胡栀子散加钓藤钩，后用加味逍遥散而抽搐停止，再用五味异功散而痘愈。一小几痘将愈，发搐痰涌，头目不清。脾气虚弱，肝木侮之。先用五味异功散加柴胡、钓藤钩，抽搐愈而结靥。
凉惊丸 温惊丸（均见惊搐门） 导赤散（心脏） 泻青丸（肝脏） 备急丸 丁香脾积丸 木香大安丸（均见伤食门） 柴胡黄连丸（见前） 补中益气汤 四君子汤 四神丸 十一味木香散（均见泄泻门）
栝蒌散 治疗痘、热极生风发搐。
栝蒌根（二钱） 白僵蚕（一钱）
以上，慢火同炒至老黄色，研为细末。每次服用二三分，薄荷汤送下。
保命丹 一切惊风发热。
天麻 郁金 全蝎（去尾） 白附子（炒） 僵蚕（姜汁炒） 薄荷 蝉蜕 茯神 桔梗（各五钱）
防风 甘草 青黛（各三钱） 大半夏（炒，滚汤浸晒干，又用姜汁浸，晒干，又炒） 南星（制、同上。各一两） 钩藤 牛黄（研。各二钱） 麝香（五分） 辰砂（飞，五钱，为衣）
以上研末，炼蜜为丸如芡实大。每次服用一丸，灯心汤送下。
[Qian Yi] Convulsions caused by smallpox/rash are due to the mutual overcoming of wind and fire. Only rash can cause convulsions; rash is generated by the Spleen. When the Spleen is deficient and the Liver is hyperactive, it overcomes (Wood conquers Earth), heat qi strikes mutually, disturbing the Heart Spirit (Shen). The Heart delights in heat, causing the Shen to be unsettled, thus forming convulsions that evolve into epilepsy (Xian). [Note: Text implies a relationship where Heart generates Heat, which generates Wind belonging to the Liver.] The two organs struggle, wind and fire contend, hence convulsions occur. Treatment should involve draining the Heart and Liver and tonifying their mothers (Spleen/Kidney depending on interpretation, but text specifies Gualou Tang). Use Guazhou Tang (Trichosanthes Root Decoction) as the main formula (see section on Convulsions). Haizang said: "All pain, itching, and sores belong to the Heart." Fire, whether deficiency or excess, is discussed from the perspective of Heart Fire. Spleen deficiency leads to Liver invasion; Liver combines with Heart Fire, hence Guazhou Tang is used. If Spleen Earth is excess, and Fire is hyperactive reversing to invade causing epilepsy, this is an Excess pathogen. For constipation, use Xieqing Wan (Drain the Green Pill); for loose stools, use Xieqing Tang. Pulse diagnosis should also be employed.
[Weng Shi] The Classics state: "All wind diseases involving tremors and dizziness belong to Liver Wood." However, at the beginning of smallpox eruption, although four Zang organs are involved, the Heart actually dominates. Heart Fire is hyperactive, Lung Metal is overcome, unable to control Liver Wood. Heat generates wind, wind and fire collide, Shen is unsettled, hence惊搐 (Jing Chu - Startle and Convulsion). Physicians must distinguish smallpox-related Jing Chu and not hastily administer cooling Heart medicines. If unexamined and generally treated with anti-convulsant drugs, Heart Cold will cause skin contraction, toxin Qi will sink inward, and how can the rash erupt? The treatment method, calming Liver Wood and promoting urination is crucial. Draining Liver removes wind; promoting urination reduces Heart Heat. Once wind and heat are settled, the rash will follow eruption and Jing Chu will heal itself. However, Jing Chu before rash eruption is mostly auspicious; after eruption is mostly ominous. Why? Before eruption, heat is trapped inside, causing Jing Chu; after eruption, if Jing Chu stops and there is no stagnation inside, it is auspicious. After eruption, Qi and Blood are weak, re-exposed to wind-cold, heat-toxin stagnates, and one dares not easily use dispersing or clearing/draining methods, hence ominous. However, slow Jing Feng (Slow Convulsion) not due to smallpox also belongs to Liver, but treatment focuses on regulating Spleen Earth. This is because daily vomiting or diarrhea makes Spleen Earth weak, unable to withstand Liver Wood conquest. This is not the primary disease of Liver Wood. Treatment only needs to warm and tonify Spleen Earth primarily, and Liver Wood will naturally calm. Like thin soil supporting a large tree, causing it to shake without wind, cultivation requires thickening the soil to make roots deep and firm, eliminating wind evil harm. Smallpox cases with this syndrome are due to extreme Qi and Blood deficiency, difficult to treat. *Chuangzhen Lun* states: For vomiting/diarrhea with heat, do not use drying drugs. For Shanghan body heat, do not use cooling drugs. For Chuangzhen convulsions, do not use anti-startle drugs. These are externally similar but internally different; Chuangzhen comes from Heart, Jing Chu also comes from Heart. Chuangzhen is fundamentally heat; heat moves the Heart, this is natural principle. Heart Fire alone excels above, Lung Metal is conquered by Fire and cannot control Liver Wood; heat generates wind, Wood qi excess makes Spleen Earth decline, heat qi moves Heart Spirit, Heart likes heat, Heart belly shows spots, Spleen belly shows rash. Draining Liver removes wind, draining Small Intestine reduces heat. Once wind/heat recede, Jing Chu heals. Ignorant people do not know this, using Silver Powder (Calomel), Borneol, Musk, Qingdai (Indigo Naturalis), Cinnabar, Niter (Saltpeter) to cool Heart and damage Stomach, leading to error. Thus, seeing symptoms resembling Jing Feng, medication should prevent Chuangzhen. Generally, early Chuangzhen resembles Jing Feng greatly. Mostly, Chuangzhen startle must first have cough/phlegm, palpitations/irritability, vomiting/red lips, red cheeks/thirst, cold ears/feet, rapid pulse/white tongue coating. If these exist, Silver Powder etc. cooling drugs must absolutely not be used. Because Heart cooling damages Stomach and toxin Qi converges/sinks. Moreover, Heart governs Blood; Cold causes Blood coagulation/stagnation. If Middle Jiao is cold, Upper Jiao heat cannot descend, how can it be transported out? Also, children usually healthy suddenly having convulsions must be Chuangzhen, requiring careful examination. Because toxin Qi is abundant inside, only dispersing is needed, such as Xingxing San, Xiaodu San, Shengma Tang, Hongmian San, combined with Qi-regulating, diuretic, wind-dispersing drugs. Wait for heat to vent, Heart Qi settles. If wind-cold fights internal heat causing Jing Chu, treat according to previous methods, adding Qi-unifying drugs is excellent. Zhang Shi said: "When Chuangzhen Qi is unified, eruption is fast; unified Qi means Ying-Wei has no stagnation, toxic matter disperses, Chuangzhen erupts naturally." (All formulas see Initial Heat). If great vomiting, blue face, lip/eye twitching, intermittent hand/foot convulsions, this is Manpi Feng (Slow Spleen Wind) syndrome. Use Xiaoyigong San plus Shengma, Chaihu, Muxiang, Ganjiang.
[Li Gao] Any convulsion occurring before eruption is caused by external wind-cold pathogen and internal Heart Heat. Use Cha Fen (Tea Powder) to administer Jiedu Wan (Detoxification Pill) and Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) as main treatment.
[Worldly Physicians] To treat chancres/pox about to erupt, with body heat/irritability, sudden Jing Chu, use Qufeng Gao (Wind-Driving Ointment) and Xiao Rusheng Yin. For urinary obstruction, use Bazheng San. For excessive phlegm-saliva, use Lijing Wan, Baolong Wan according to syndrome.
[Zhu Danxi] To erupt chancres/pox, first body heat/startle/jumping/convulsions, this is not Jing Feng, use dispersing drugs.
[Xue Ji] For the above syndrome, convulsions starting before Chuangzhen appears, toxin Qi exits from Heart Meridian. If disease trend is mild/sluggish, or form/Qi is weak, do not use harsh/sharp agents, fearing internal damage to Yuan Qi, causing toxin Qi to sink inward, preventing eruption. Or external wind-cold fighting internal Chuangzhen heat, or Liver Blood deficiency, Fire moving generating internal Wind, should tonify Yuan Qi primarily, assisting with syndrome-specific agents. However, previous formulas are mostly harsh; use only if syndrome is confirmed. Observe red/white color, focus on Spleen/Stomach; deficiency uses warming/tonifying, excess uses detoxification.
[Zhang Shi] At the start of smallpox, before manifestation, sudden Jing Chu is toxin Qi exiting Heart Meridian. If not distinguishing internal/external syndromes, using Silver Powder, Qingdai etc., Heart becomes cold, toxin sinks inward, often leading to Qi exhaustion or hidden eruption, too late to treat. Method: Use Daochi San plus Fangfeng, Chen Sha powder, combined with Xieqing Wan. Severe convulsions: Baolong Wan. If still not stopping, if urination is smooth, treat with Daochi San delivering Niuhuang Qingxin Wan or Fenhong Wan. If urination is obstructed, do not treat.
Xingxing San (Initial Heat) Shengma Tang (Initial Heat)
Hongmian San Exterior-releasing drug.
Quanxie (5 pieces) Mahuang (de-node) Jiangcan Baizhi Chuanxiong Jiegeng Tianma (2 qian each) Gancao Sumu (1 qian each)
Grind to powder. Take 1 qian per dose, add little Hongmian, decoct in water. With heat, add Jingjie, take slightly warm. Another method: Add 3 mint leaves, 4-5 drops good wine, decoct together.
Qianghuo San Mix 3-processed Chen Sha powder, add Fangfeng, Jingjie to release exterior. (Formula see Initial Heat Syndrome/Treatment)
[Worldly Physicians] Ma Dou Feng Chu Formula
Renshen Qianghuo Fangfeng Jiangcan (vinegar fried) Nanxing (ginger processed) Baifuzi (ginger processed) Gancao (honey-fried)
Equal parts, 3 slices ginger, decoct in water. Convulsions stop immediately.
Above are all exterior-releasing agents, referring to Jiegu's "external wind-cold" and Danxi's "use dispersing drugs".
Jiedu Wan
Hanshuishi (ground) Shigao (ground, 1 liang each) Qingdai (0.5 liang)
Grind stones finely to powder, mix with Qingduni evenly. Soak steamed dough pills, size like Euryale seed. Take 1 pill per dose, after meal, dissolve in fresh water, or chew finely with ginger water. 3-year-old takes half pill, adjust by age.
Xijiao Dihuang Tang (Blood Loss)
Chaihu Lian'er Wan Treats Liver Meridian Excess Fire.
Chaihu Xuanhuanglian Huhuanglian
Grind to powder. Paste pills like tung tree seeds. Take 20-30 pills, white water down.
Above are detoxifying, cooling blood, draining Liver Fire agents, suitable for those with heat.
Daochi San (Heart) Bazheng San (Urinary Obstruction) Liuyi San (Heat)
Above are diuretic agents, suitable for urinary obstruction. However, draining Bing Fire (Small Intestine Fire) to drain Liver's son is the primary method for treating Jing Chu, not just for urinary obstruction.
Zicao Kuai San (Modified Da Zicao San with Mutong, without Huangqin, see Pale Rash) Dongyuan Xiaodu San (Xiaodu Jiuku Tang, see General Laws)
Can Four Saints San (Suppuration) Baye Tang (Emaciation) Chaihu Zhizi San (Zhizi Qinggan San, see Five Organs Heat) Dihuang Wan (Kidney)
Xiaoyigong San (Si Junzi Tang + Chenpi) Yiqi Tang (Buzhong Yiqi Tang)
Above are Xue Shi's formulas, mainly nourishing Spleen/Kidney, category of tonifying deficiency.
Baolong Wan Niuhuang Qingxin Wan (See Jing Chu) Fenhong Wan (Wen Jing Wan, see Slow Jing Section)
Above are calming startle, resolving phlegm categories, for phlegm-saliva flooding, or external fright.
[Qian Yi] Post-rash wanting to develop epilepsy, other sores rarely develop epilepsy, because Wood conquers Spleen, Wood returns to Heart. For Cool Jing, use Liangjing Wan. For Warm Jing, use Fenhong Wan.
[Wan Quan] Post-smallpox irregular convulsions have two syndromes: One is Heart Heat lingering, Heat excess generating Wind, Wind-Fire transmitting, person必有 phlegm in throat, eyes staring up, red face/thirst, preferring cold places, use Daochi San, Xieqing Wan to clear Heart/drain Liver, then regulate with Baolong Wan. Two is post-illness overeating, Stomach weak unable to digest grain, called Food-Evaporation Convulsion, person必有 tidal fever, sour-smelly stool, constipation/diarrhea alternating, or vomiting/abdominal pain, first use Beijii Wan, Dingxiang Pi Ji Wan to purge, then use Muxiang Da'an Wan, Qian Shi Yigong San to regulate/heal.
[Xue Ji] A child, post-scab shedding, bathed in scallion-pepper decoction due to filth, developed convulsions/phlegm-wheezing. Used Bazhen Tang + Bai Jiangcan, Chantui one dose, wheezing stopped; then Si Junzi Tang, Chuanxiong, Danggui, Gouteng hook, convulsions stopped. A child, red smallpox, limb convulsions, brow/lip pulling. Heart/Liver excess heat conquering Spleen. Used Si Junzi Tang, Fangfeng, Gouteng hook, healed. A child, post-smallpox limb convulsions, brow bone movement, frequent urination, blue-red face/eyes. Liver Meridian Wind-Heat. Used Siwu Tang, Chaihu, Shanzhi, improved. But limbs weary, poor appetite, loose stool. Spleen Qi injured/unrecovered. Used Si Junzi Tang, Shengma, Danggui, healed. A child, post-smallpox Yin/Mao/Shen/You hours high fever/convulsions. Yin/Mao fever is Liver Fire root syndrome; Shen/You convulsions is Liver Wood insulting Metal. First Siwu Tang, Baizhu, Fuling, Gouteng hook, decoct sending Chaihu Lian'er Wan, healed. Evening Dihuang Wan, Morning Si Junzi Tang, Shanzhi, Chaihu & Si Junzi Tang + Danggui, healed. A child, red smallpox, convulsions/excessive phlegm. Took Baolong Wan, instantly healed. Mother angry, child still convulsing, mother took Chaihu Zhizi San, Jia Wei Xiaoyao San, mother/child both healed. A child, post-healing convulsions, left forehead blue-red, lip/mouth pulling. Liver/Heart Wind-Heat. First Chaihu Zhizi San + Gouteng hook, then Jia Wei Xiaoyao San, convulsions stopped, then Wuwei Yigong San, rash healed. A child, near-healing convulsions/phlegm surge, head/eyes unclear. Spleen Qi weak, Liver Wood insults. First Wuwei Yigong San + Chaihu, Gouteng hook, convulsions stopped/scabs formed.
Liangjing Wan Wen Jing Wan (See Jing Chu) Daochi San (Heart) Xieqing Wan (Liver) Beijii Wan Dingxiang Pi Ji Wan Muxiang Da'an Wan (See Food Injury) Chaihu Lian'er Wan (See Above) Buzhong Yiqi Tang Si Junzi Tang Sishen Wan Shiyiwei Muxiang San (See Diarrhea)
Guazhou San Treats Dou, Extreme Heat Generating Wind Convulsions.
Guazhou Gen (2 qian) Bai Jiangcan (1 qian)
Slow fire stir-fry to old yellow, grind to powder. Take 2-3 fen per dose, Mint Water down.
Baoming Dan All Jing Feng Fever.
Tianma Yujin Quanxie (tail removed) Baifuzi (fried) Jiangcan (ginger juice fried) Bohe Chantui Fushen Jiegeng (5 qian each)
Fangfeng Gancao Qingdai (3 qian each) Ban Xiasha (fried, boiling water soak dry, ginger juice soak dry, fry again) Nanxing (processed, same as above. 1 liang each) Gouteng Niuhuang (ground. 2 qian each) Shexiang (0.5 fen) Chen Sha (flying, 5 qian, coat)
Grind to powder, refined honey pills like Euryale seed. Take 1 pill, Dengxin (Centella/Juncus) Water down.