小儿偏风者。少阳厥阴肝胆二经证也。口噤者。由风木太甚而乘于脾。则筋燥而急。然燥令
主于收敛劲切。或左或
右。其因一也。若足阳明胃经气虚。风邪所乘。其筋脉偏急者属内因。若脾肺虚弱。腠理不密。
外邪所乘。或吐泻后。内亡津液。不能养肝致口眼 斜。皆属肝血不足。内火生风。宜滋肾水养
肝血壮脾土。治法。脾胃虚而动风者。异功散加柴胡、钩藤钩。肝肺虚而外邪所乘者。钩藤饮。
若兼目紧上视。寒热往来。小便淋沥。面青胁胀。皆肝经本病也。或唇口 斜。腹痛少食。目胞
浮肿。面色青黄。肢体倦怠。皆肝木乘脾证也。当审五脏相胜而主之。设执其见证。概投风药。
反成坏证矣。
角弓反张。即是痉病。经脉空疏。虚风袭入。而致筋脉拘急。或因惊骇停食。肝脾受困。内
动虚风。皆能致此。若身反张强直。发热不搐者。风伤太阳也。人参败毒散、小续命汤。因惊骇
目直。呵欠项强顿闷者。为木风内病。钩藤散。因暴怒击动肝火者。泻青丸。若服前剂。其证益
甚者。此邪气已去而脾气亏也。异功散加芎、归补之。若气血素弱。或服攻伐之剂。而手循衣领。
切牙呵欠者。肺经虚甚也。兼进六君子、地黄丸补之。
钱氏云。小儿急惊。因闻大声或惊而发搐。搐止如故。此热生于心。身热面赤引饮。口中气
热。二便黄赤。甚则发搐。盖热盛生风。阳盛而阴虚也。经曰。热则生风。风则痰动。痰热客于
心膈间。风火相搏。故抽搐发动。当用抱龙丸、泻青丸
除其痰热。不可用巴豆之药。楼全善云。急惊属木火土实。木实则搐有力及目上视。火实则动札
频睫。土实则身热面赤而不吐泻。偃睡合睛。治法。宜凉宜泻。用利惊丸等。亦有因惊而发者。
牙关紧急。壮热涎潮。窜视反张。搐搦颤动。唇口眉毛眨引。口中热气。颊赤唇红。二便秘结。
脉浮洪数紧。此内有实热。外挟风邪。当截风定搐。若痰热尚作。仍微下之。痰热既泄。急宜调
养脾气。此肝胆血虚。火动生风。盖风生则阴血愈散。阴火愈炽。若屡服祛风化痰泻火辛散之剂
不愈。便宜认作脾虚血损。急以六君子汤补其脾胃。否则必变慢惊也。急惊而儿目睛翻转。足摆
跳搐。忽大叫吐逆。药不得入。搐鼻无嚏者不治。
小儿偏风，是少阳经和厥阴经（肝胆二经）的证候。口噤（牙关紧闭），是由于风木之气过盛而克制脾土，导致筋脉干燥而拘急。然而燥气主收敛、劲切，无论是左侧还是右侧发病，其病因是一致的。如果是足阳明胃经气虚，风邪乘虚而入，导致一侧筋脉拘急，这属于内因。如果是脾肺虚弱，腠理不固，外邪乘虚而入，或者在吐泻之后，体内津液耗伤，不能滋养肝脏而导致口眼歪斜，这些都归属于肝血不足，内生虚火生风。治疗原则应当滋补肾水以养肝血，壮补脾土。对于脾胃虚弱而动风的，用异功散加柴胡、钩藤钩。对于肝肺虚弱而受外邪侵袭的，用钩藤饮。如果兼有眼睛紧闭上视、寒热往来、小便淋漓不尽、面色青、胁肋胀满，这都是肝经的本病。如果出现口眼歪斜、腹痛、食欲不振、眼睑浮肿、面色青黄、肢体倦怠，这都是肝木乘克脾土的证候。应当审查五脏之间的相胜关系来主治。如果固执于表面见证，一概投用祛风药物，反而会变成坏证。
角弓反张，就是痉病。由于经脉空虚疏松，虚风袭入，导致筋脉拘急。或者因为惊吓、停食，导致肝脾受困，内动虚风，都能导致此病。如果身体向后反张强直，发热但不抽搐，这是风邪伤了太阳经，用人参败毒散、小续命汤。因为惊吓导致眼睛直视、打哈欠、项强突然昏闷的，为木风内病，用钩藤散。因为暴怒击动肝火的，用泻青丸。如果服用前面的方剂后，症状反而加重，这是邪气已去而脾气亏损，用异功散加川芎、当归来补益。如果气血素来虚弱，或者服用了攻伐的药物，出现手抓衣领、磨牙、打哈欠的，这是肺经极度虚弱，兼用六君子汤、地黄丸来补益。
钱乙说：小儿急惊，是因为听到大声或受到惊吓而引发抽搐，抽搐停止后如常。这是因为热生于心，表现为身体发热、面赤、想喝水，口中气息热，大小便黄赤，严重时发生抽搐。大概是因为热盛生风，阳气盛而阴气虚。经书说：热则生风，风则痰动。痰热客居在心膈之间，风火相互搏结，所以抽搐发动。应当用抱龙丸、泻青丸来清除痰热，不可使用巴豆这类药物。楼全善说：急惊属于木、火、土实证。木实则抽搐有力且眼睛上视；火实则眨眼频繁；土实则身体发热、面赤而不吐泻，嗜睡闭目。治疗方法，宜凉宜泻，用利惊丸等。也有因为惊吓而发作的，牙关紧急，高热涎多，眼球窜视、角弓反张，抽搐颤动，嘴唇口角眉毛抽动，口中热气，脸颊红唇红，大小便秘结，脉象浮洪数紧，这是内有实热，外挟风邪，应当截风定搐。如果痰热仍然作祟，仍轻微通下。痰热既已泄出，急宜调养脾气。这是因为肝胆血虚，火动生风，风生则阴血愈散，阴火愈炽。如果屡次服用祛风化痰泻火辛散的药物无效，就应当认定为脾虚血损，急用六君子汤补益脾胃，否则必然转变为慢惊。急惊症如果患儿眼睛翻转，脚摆动跳跃抽搐，忽然大叫呕吐逆气，药无法进入，搐鼻无喷嚏者，属不治之症。
Pediatric Piān Fēng (Hemiplegic Wind) is a syndrome of the Shàoyáng (Lesser Yang) and Juéyīn (Terminal Yin) meridians, specifically involving the Liver and Gallbladder. Kǒu Jìn (Lockjaw) occurs when excessive Wind-Wood pathogenic factor overacts on Spleen-Earth, causing dryness and tension in the tendons. Although Dryness governs contraction and rigidity, whether affecting the left or right side, the etiology remains consistent. If Qi deficiency in the Foot-Yangming Stomach Meridian allows Wind pathogen to invade, resulting in unilateral tendon tension, it belongs to internal causes. If Spleen and Lung deficiency leads to loose interstices allowing external pathogens to invade, or if post-emesis/diarrhea depletes body fluids failing to nourish the Liver, causing facial deviation, these all fall under insufficient Liver Blood generating internal Fire that produces Wind. The treatment principle should be to nourish Kidney Water to benefit Liver Blood and strengthen Spleen Earth. For Wind stirring due to Spleen-Stomach deficiency, use Yì Gōng Sǎn (Benefiting the Working Powder) with Cháihú (Bupleuri Radix) and Gōuténg Gōu (Uncariae Ramulus cum Uncis). For Liver-Lung deficiency with external pathogen invasion, use Gōuténg Yǐn (Uncaria Decoction). If accompanied by eyes tightly closed and looking upward, alternating chills and fever, dribbling urination, bluish complexion, and hypochondriac distension, these are primary diseases of the Liver Meridian. If accompanied by facial deviation, abdominal pain, poor appetite, eyelid edema, bluish-yellow complexion, and limb fatigue, these are syndromes of Liver-Wood overacting on Spleen-Earth. One must examine the mutual overcoming relationships among the Five Zang organs to treat accordingly. Adhering rigidly to observed symptoms and indiscriminately administering wind-dispelling drugs will instead result in complicated disorders.
Jiǎo Gōng Fǎn Zhāng (Opisthotonos) is synonymous with Jìng Bìng (Spasm Disease). It results from empty and sparse meridians invaded by deficient Wind, leading to tendon tension. Alternatively, fright or food stagnation may confine the Liver and Spleen, internally stirring deficient Wind, both capable of causing this condition. If the body arches backward rigidly with fever but without convulsions, it indicates Wind damaging the Taiyang (Greater Yang) meridian; treat with Rénshēn Bàidú Sǎn (Ginseng Powder for Overcoming Toxins) or Xiǎo Xùmíng Tāng (Minor Xu-Ming Decoction). Due to fright causing fixed gaze, yawning, sudden neck stiffness and dizziness, it is an internal Wood-Wind disease; treat with Gōuténg Sǎn (Uncaria Powder). Due to violent anger stirring Liver-Fire, treat with Xiè Qīng Wán (Draining Blue Pill). If symptoms worsen after taking previous prescriptions, it indicates the pathogen has departed but Spleen Qi is deficient; treat with Yì Gōng Sǎn plus Chuānxiōng (Ligustici Chuanxiong Rhizoma) and Dāngguī (Angelicae Sinensis Radix) to tonify. If constitutionally weak in Qi and Blood, or after using attacking/draining agents, presenting with hand grasping at clothing, teeth grinding, and yawning, this indicates severe Lung Meridian deficiency; combine with Liù Jūnzǐ Tān (Six Gentlemen Decoction) and Dìhuáng Wán (Rehmannia Pill) to tonify.
Qian Yi stated: Pediatric Jí Jīng (Acute Convulsion) arises from hearing loud noises or being frightened, triggering convulsions which cease leaving the child normal. This heat originates in the Heart, manifesting as fever, red face, thirst, hot breath, and yellow-red urine and stool; severe cases involve convulsions. Generally, excessive heat generates wind, where Yang is excess and Yin is deficient. The Classics state: Heat generates wind; wind stirs phlegm. Phlegm-heat lodges between the Heart and Diaphragm, with wind and fire battling, thus initiating convulsions. Use Bàolóng Wán (Dragon-Holding Pill) and Xiè Qīng Wán to clear phlegm-heat; do not use Bàdòu (Croton Seed). Lou Quanshan stated: Acute convulsion belongs to Excess patterns of Wood, Fire, and Earth. Wood excess causes forceful convulsions and upward eye deviation; Fire excess causes frequent blinking; Earth excess causes fever, red face, without vomiting/diarrhea, lethargy with closed eyes. Treatment should be cooling and draining, using Lìjīng Wán (Calming Convulsion Pill), etc. Some arise from fright, presenting with tight jaw, high fever, salivary flooding, wandering eyes, opisthotonos, tremors, twitching of lips/mouth/eyebrows, hot breath, red cheeks/lips, constipation, and floating-rapid-tight pulse. This indicates internal excess heat with external wind pathogen; one should intercept wind and stop convulsions. If phlegm-heat persists, mild purgation is still appropriate. Once phlegm-heat is drained, urgently regulate Spleen Qi. This is because Liver-Gallbladder blood deficiency allows Fire to stir Wind; as Wind generates, Yin-Blood scatters further and Yin-Fire flares. If repeated use of wind-dispelling, phlegm-resolving, fire-draining, and acrid-warm dispersing agents fails, recognize it as Spleen deficiency and blood damage; urgently use Liù Jūnzǐ Tān to tonify Spleen and Stomach, otherwise it will inevitably transform into Màn Jīng (Chronic Convulsion). In acute convulsion, if the infant's eyes roll back, legs jerk and kick, suddenly cries out and vomits preventing medicine intake, and nasal insufflation yields no sneeze, it is untreatable.