〔曾〕又有急惊天钓之后,变作潮热,手足逆冷有似疟疾,盖因病愈之时,不善
将护,外感风邪,乘虚而入于经络,再未解散,以致如此。经曰∶重阳必阴。又曰∶
亢则害,承乃制。此其义也。宜服柴胡加桂汤及当归散,气实者则以乌犀丸、水晶
丹略与通利,匀气散止补,后以参苓白术散调理,自然平愈。此证所用药品,间
使苦寒之味,务在消阳盛之火,肺金得胜,肝木自平,而风邪亦散,斯为良法。
柴胡加桂汤(见伤寒) 当归散(见痢) 乌犀丸 水晶丹(并见癖积) 匀气散(见腹痛)
参苓白术散(见泄泻)
海藏云∶心神不安,四君子加辰砂半分,枣汤调下。又有一证,欲发疮疹,
先身热惊跳,或发搐搦,此非惊风,当用发散药。〔曾〕暑风一证,因夏月感冒风
热太甚,致面垢唇红,脉沉细数,忽发惊搐,不省人事,治用消暑清心饮、辰砂五
苓散及琥珀抱龙丸自安,切勿以温剂调补。
消暑清心饮 解伏热中暑,烦躁作渴,神气不清,及有惊搐,名暑风证,投之即效。
香薷(去老梗) 泽泻(去粗皮。各一两) 扁豆(炒熟,去壳,研) 净黄连 羌活
猪苓(去皮) 浓朴(去粗皮,姜汁浸透,炒) 白术 干葛 赤茯苓(去皮) 升麻 川芎
(各半两) 甘草(三钱)
上锉。每服二钱,水一盏,煎七分,无时,带凉服。治暑风证先投此剂得效,
次服却暑丹,其搐不发矣。
薛氏于急慢惊痫之外,又出惊风一证,其候虚惕怔忡,气怯神散,痰涎来去,
泄泻色青,盖惊之轻而虚者也。若惊入心,则面赤夜啼,用栀子清肝散加黄连。入
肝则面青眼窜,用柴胡清肝散。入脾则面黄呕吐,虚汗嗜卧,用六君加柴胡、山栀。
入肺则面白喘急,用异功散加柴胡、桔梗。入肾则面黑,啮奶切牙,用六味地黄丸。
若因乳母恚怒肝火,或膏粱积热,遗儿为患,或儿吐泻伤脾,清气不升,风木陷入
太阴传变等因,皆能致此,当随主治,否则必成慢脾也,须预慎防为善。
曾氏指出:又有在急惊、天钓(一种以颈项强直、角弓反张为特征的惊风病)之后,转变为潮热(发热如潮汐般定时发作),手足逆冷且症状类似疟疾的情况。这主要是因为病愈之时,调养不当,外感风邪,乘人体虚弱之际侵入经络,未能及时解散,从而导致上述症状。《内经》说:“重阳必阴。”又说:“亢则害,承乃制。”说的就是这个道理。适宜服用柴胡加桂汤及当归散;体质气实者,可稍用乌犀丸、水晶丹略作通利治疗;随后服用匀气散以止泻补虚,最后以参苓白术散进行调理,自然能够平复痊愈。此证所用的药物,多含有苦寒之味,务必在于消除阳盛之火,使肺金功能旺盛,肝木自然平和,风邪也随之消散,这才是良法。
海藏云:心神不安,可用四君子汤加入辰砂半钱,用枣汤调服。又有一种证候,欲发疮疹时,先出现身体发热、惊跳,或发生抽搐,这不是惊风,应当使用发散药。
曾氏论暑风一证:因夏季感冒风热太甚,导致面色垢浊、嘴唇红赤,脉象沉细数,忽然发生惊搐,不省人事。治疗宜用消暑清心饮、辰砂五苓散及琥珀抱龙丸,使病情自安,切勿使用温补药剂。
薛氏在急慢惊痫之外,又提出惊风一证,其表现为虚怯惊惕、怔忡(心跳剧烈)、气短神散、痰涎往来、泄泻色青,这是惊风的轻症兼有虚证。若惊邪入心,则见面赤、夜间啼哭,用栀子清肝散加黄连;入肝则见面青、眼球上窜,用柴胡清肝散;入脾则见面黄、呕吐、虚汗、嗜睡,用六君子汤加柴胡、山栀;入肺则见面白、喘急,用异功散加柴胡、桔梗;入肾则见面黑、咬奶切牙,用六味地黄丸。若因乳母愤怒导致肝火,或饮食积热,遗患于婴儿,或婴儿吐泻损伤脾胃,清气不升,风木陷入太阴传变等原因,皆能导致此证,应当随证主治,否则必然发展为慢脾风,必须预先谨慎防范才好。
Zeng pointed out: There is another condition where, after acute convulsion (Ji Jing) or Tian Gao (a type of convulsive disease characterized by neck stiffness and opisthotonos), it transforms into tidal fever (Chao Re, fever that occurs at regular intervals like the tide), with cold extremities and symptoms resembling malaria. This is mainly because during recovery, improper care led to external wind-pathogen invading the meridians while the body was deficient, and failing to disperse it in time resulted in such symptoms. The Classics state: "Extreme Yang must transform into Yin." And again: "When things reach an extreme, they cause harm; only when controlled can balance be maintained." This explains the principle. It is appropriate to administer Chai Hu Jia Gui Tang (Bupleurum and Cinnamon Twig Decoction) and Dang Gui San (Angelica Powder); for those with excess Qi, Wuxi Wan (Black Rhinoceros Horn Pill) and Shuijing Dan (Crystal Pill) may be used slightly to promote unblocking and purging; subsequently, Yunqi San (Harmonizing Qi Powder) should be taken to stop diarrhea and tonify deficiency, followed by Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) for regulation, leading to natural recovery. The medicines used in this condition often contain bitter-cold flavors, aiming to eliminate excessive Yang fire, allowing Lung Metal to prevail, Liver Wood to naturally calm, and wind-pathogen to dissipate, which is a good method.
Haizang stated: For unsettled heart-mind, Si Jun Zi Tang (Four Gentlemen Decoction) added with Chen Sha (Cinnabar) half a qian, taken with jujube soup decoction. Another syndrome involves pre-eruption of sores and rashes, preceded by body heat, startle/jumping, or convulsions; this is not wind-stroke/convulsion, but should be treated with dispersing herbs.
Zeng discussed the Summer-Wind (Shu Feng) syndrome: Caused by severe summer exposure to wind-heat, leading to a greasy complexion, red lips, a deep, fine, and rapid pulse, sudden onset of convulsions, and loss of consciousness. Treatment should use Xiaoshu Qingxin Yin (Summer-Heat Clearing Heart Decoction), Chensha Wuling San (Cinnabar Five-Ingredient Powder), and Hupo Baolong Wan (Amber Embracing Dragon Pill) to stabilize the condition; warm tonifying agents must strictly be avoided.
Xue, besides acute and chronic convulsions and epilepsy, proposed another syndrome called Wind-Stroke Convulsion (Jing Feng). Its manifestations include timidity, palpitations (Zheng Chong), shortness of breath, scattered spirit, wandering phlegm-saliva, and green-colored diarrhea; this is a mild form of convulsion accompanied by deficiency. If the pathogen enters the Heart, presenting with red face and night crying, Zhi Zi Qing Gan San (Gardenia Clearing Liver Powder) plus Huang Lian is used. If it enters the Liver, presenting with blue-green face and upward-gazing eyes, Chai Hu Qing Gan San (Bupleurum Clearing Liver Powder) is used. If it enters the Spleen, presenting with yellow face, vomiting, spontaneous sweating, and lethargy, Liu Jun Zi Tang (Six Gentlemen Decoction) plus Chai Hu and Shan Zhi is used. If it enters the Lung, presenting with pale face and急促 breathing, Yi Gong San (Yi Gong Powder) plus Chai Hu and Jie Geng is used. If it enters the Kidney, presenting with black face and gnashing teeth, Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) is used. If caused by the wet nurse's anger leading to Liver Fire, or accumulation of heat from rich food affecting the infant, or infant vomiting/diarrhea damaging the Spleen causing clear Qi not to ascend and Wind-Wood sinking into Taiyin transmission, all these can lead to this condition. One must treat according to the specific presentation; otherwise, it will inevitably develop into Slow Spleen Wind (Man Pi Feng). Precautionary measures are essential.