娄全善曰。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。各不同也。
钱乙曰。伤风搐者。因伤风得之。口中热气出。呵欠顿闷。手足动摇。当发散。大青膏。小儿生来怯弱者。多此病
也。伤食搐者。因伤食后得之。身温。多唾多睡。或吐不思乳食而发搐。当先定搐。如羌活防风煎汤下泻青丸。搐退。
白饼子下之。后服安神丸。
危亦林曰。惊者。虚惕怔忡。气怯神散。痰涎来去。其泻必青。积渐而生风也。
杨士瀛曰。惊邪入心。则面红脸赤。惕惕夜啼。入肝则面目俱青。眼睛窜视。入肾则面黑恶叫。咬乳切牙。入肺则
面淡白。喘息气乏。入脾则面淡黄。呕吐不食。凡乳儿欲发惊风者。先神志不定。恍惚惧人。扎眼上视。左顾右盼。伸
手握拳。闷郁努气。情态不如寻常。皆惊风先症也。
钱乙曰。切牙甚者发惊。目直视。面色青。身反折者生惊。呵欠面青者惊风。呵欠面黄者脾虚惊。目赤兼青者发搐。
肝脏实热。手寻衣领。乱捻物。目直视者。必发惊。肝有风。目连札。不搐。有热则目直视。亦不搐。得心热者则搐。
肝主风。风动而上行头目。目属肝。风入于目。上下左右。如风吹不定。儿不任。故目连札也。若热入于目。牵其筋脉。
两皆系。不能转动。故目直视也。若得心热则搐。其子母俱有实热。风火相搏故也。
虞抟曰。王氏云。木能胜土。热动心忡而生惊也。
娄全善说:惊搐这一病证,有早晨和傍晚的区别,也有表证和里证的差异。身体发热、力量大(抽搐剧烈)的是急惊风;身体发冷、力量小(抽搐微弱)的是慢惊风。倒地时发出声音,清醒后口吐白沫的,是痫病;头眼向上仰视的是天吊风;身体向后反折如弓状的是痉病。这些病症各不相同。
钱乙说:伤风引起的抽搐,是因为感受风邪所致。口中呼出热气,频繁打哈欠且感到烦闷,手足动摇不定,应当采用发散法治疗,可用大青膏。小儿生来体质怯弱多病的,容易患此病。伤食引起的抽搐,是因为饮食积滞所致。身体温热,口水多且嗜睡,或者呕吐、不思乳食而引发抽搐,应当先止住抽搐,可以用羌活、防风煎汤送服泻青丸。抽搐停止后,再用白饼子攻下积滞,最后服用安神丸调理。
危亦林说:惊风表现为虚怯惊恐、心悸怔忡,气短神散,痰涎流动,大便颜色必呈青色,这是由积滞逐渐化生风邪所致。
杨士瀛说:惊邪侵入心脏,则面色红赤,夜间惊恐啼哭;侵入肝脏,则面目俱青,眼睛斜视或窜动;侵入肾脏,则面色发黑,恶声大叫,咬奶头或磨牙;侵入肺脏,则面色淡白,喘息气短乏力;侵入脾脏,则面色淡黄,呕吐不能进食。凡是乳儿将要发生惊风的,先出现神志不安,恍惚怕人,眨眼向上看,左顾右盼,伸手握拳,胸闷郁结用力呼吸,情态与平时不同,这些都是惊风的先兆症状。
钱乙说:咬牙严重的会引发惊风;眼睛直视,面色发青,身体向后反折的会引发惊风;打哈欠且面色发青的是惊风;打哈欠且面色发黄的是脾虚惊;眼睛发红兼带青色的是发作抽搐。肝脏实热,手抓衣领,乱捻物品,眼睛直视的,必定会发惊。肝有风邪,眼睛眨动不停但不抽搐;有热邪则眼睛直视也不抽搐;若得心热则会抽搐。肝主风,风性主动而上行于头目,眼睛属于肝,风邪进入眼睛,上下左右晃动,像风吹一样不稳定,婴儿承受不了,所以眼睛眨动不停。如果热邪进入眼睛,牵拉筋脉,两者都连接在一起,不能转动,所以眼睛直视。如果得心热就会抽搐,这是因为心肝母子两脏都有实热,风火相互搏结的缘故。
Lou Quanshan stated: The condition of "jing chu" (convulsions due to fright) varies by time of day and differs between exterior and interior syndromes. When the body is hot and the convulsive force is strong, it is termed Ji Jing Feng (Acute Convulsion Syndrome); when the body is cold and the convulsive force is weak, it is termed Man Jing Feng (Chronic Convulsion Syndrome). If the child falls down making a sound and foams at the mouth upon waking, it is Xian Bing (Epilepsy). If the head and eyes look upward, it is Tian Diao Feng (Heavenly Hanging Wind). If the body arches backward like a bow, it is Jing Bing (Stiffness Syndrome). These conditions are all distinct from one another.
Qian Yi stated: Convulsions caused by Shang Feng (Wind Invasion) result from contracting wind pathogens. Symptoms include warm breath exhaled from the mouth, frequent yawning accompanied by a sense of stuffiness and irritability, and trembling or shaking of the hands and feet. Treatment should involve dispersing the pathogen, using Da Qing Gao (Great Blue Paste). Children born with weak constitutions are prone to this disease. Convulsions caused by Shang Shi (Food Injury) occur after dietary indiscretion. Symptoms include warmth of the body, excessive salivation, lethargy, or vomiting with refusal of milk/food followed by convulsions. One must first stop the convulsions; for example, administer Xie Qing Wan (Drain Green Pill) decocted with Qiang Huo (Notopterygii Rhizoma et Radix) and Fang Feng (Saposhnikoviae Radix) in soup form. After the convulsions subside, use Bai Bing Zi (White Pill) to purge the accumulation, followed by An Shen Wan (Calming the Spirit Pill) for recovery.
Wei Yilin stated: Jing Feng (Convulsion Syndrome due to Fright) manifests as timidity, palpitations, shortness of qi, scattered spirit, and flowing phlegm-saliva. Stool is invariably green. This arises gradually as stagnation transforms into wind.
Yang Shiyin stated: When Jing Xie (Fright Pathogens) enter the Heart, the face becomes red and flushed, and the infant cries fearfully at night. When they enter the Liver, both the face and eyes turn blue/green, and the eyes stare or dart around. When they enter the Kidney, the face turns black, the infant screams in terror, and bites the nipple or grinds teeth. When they enter the Lung, the face is pale white, with panting and Qi deficiency. When they enter the Spleen, the face is pale yellow, with vomiting and anorexia. In infants about to develop Jing Feng, early signs include unsettled spirit,恍惚 (fickle/vague consciousness), fearfulness, blinking with upward gaze, looking left and right, extending hands and clenching fists, chest tightness with strained breathing, and behavioral changes unlike their normal state. All these are prodromal symptoms of Jing Feng.
Qian Yi stated: Severe teeth-grinding leads to Jing Feng. Straight staring of the eyes, cyanotic complexion, and opisthotonos indicate impending Jing Feng. Yawning with a cyanotic face indicates Jing Feng; yawning with a yellowish face indicates Pi Xu Jing (Spleen Deficiency Jing). Red eyes combined with cyanosis indicate the onset of convulsions. Excess heat in the Liver, manifested by grasping at clothing collars, fumbling with objects, and straight staring, will definitely lead to Jing Feng. If the Liver has Wind, the eyes twitch continuously but without convulsions; if there is Heat, the eyes stare straight but without convulsions. Only if the Heart has Heat do convulsions occur. The Liver governs Wind; Wind moves actively and ascends to the head and eyes. Since the eyes belong to the Liver, when Wind enters the eyes, causing erratic movement up, down, left, and right like wind blowing, the infant cannot endure it, resulting in continuous eye twitching. If Heat enters the eyes, it pulls on the sinews, connecting rigidly so that movement is impossible, resulting in straight staring. If the Heart has Heat, convulsions occur because both the Mother (Heart) and Child (Liver) organs have excess heat, leading to a struggle between Wind and Fire.
Yu Tun stated: Wang Shi believed that Wood overcomes Earth; Heat agitates the Heart Spirit, causing palpitations and generating Jing Feng.