议急惊风症候上窜反张搐搦口流痰涎壮热并有之其或有视左视右者有僵有仆（僵仰也属
阳
仆覆也属阴）举握指有里有外医分男女定阴阳顺逆之理有左右引搐连及脚手身体颤动初则搐
搦俱作久而搐住只搦有急有缓但只肩动口螈 螈 者候之轻也搐则盛也搦又重也反张牙关
紧急喉中
有涎即是惊风候如牙关不紧口无痰涎只反张搐搦上窜者未可便作惊风候盖夹惊夹食伤寒疹豆
或三焦蕴热五脏不宣流入经络热在筋脉亦作搐搦钱氏云搐有真假不言病也前有云急惊量其分
数者是约热之轻重而与利之
议急惊若是正候气粗延潮其症候猛紧不只徐徐而来搐即急促唇口肩眼眨引连并俗谚云急
惊惊爷娘慢惊惊乐王然虽是说治之有法轻重调理
议急惊先当定搐搐由风也风由热也搐既已作方可下热退惊热若不退惊亦不散不移其时搐
搦又
作所谓过街候乃是医家不明才见搐定便言安乐仆谓急惊风难治有三只有初惊时其风痫发作斟
酌轻重云风定搐随而愈之斯恐庸医或常人热见妄便下之既下了诸症犹存者一难治也又其儿正
搐亲人一向执捉不令渠搐且风痫不得纵恣逆入经络药力不及虽病减疟根在血脉或注经络二难
治也又儿患候有顺有逆顺即易理逆即难疗惟恐病延既久不得良饵症候传变越去元由而作它症
者三难治也
议治急惊风候用药非谓难也专至审察病候循其法度不荒不佞次第下药无不愈之理多是病
家
仓皇不求善医信乎山野庸鄙之言病候延久不无传变传即症重变即候恶凡经二三乎医药不效儿
受困苦无能安乐士夫之家收方录症一日儿病症候危恶紧急临时以何方对治告急无门众口
皆
言有药不明端的一向攻击信乎见识浅陋担负不起有乎得失用药不及则无妨事可以疗理若也大
过实时害生
议疗婴孩岂可以药有惧技之大过或不及由尚不可况越症候乃为枉冤儿童虽分长幼有患脏
腑昏令
怯弱易冷易热易虚易实若攻之相重其不任彼药孰言疾不瘳反为它害曷不谨欤今者议急慢惊风
及慢脾风方药即是老汉指准应备缓急至要克效之者待更轶可否之理
议患惊风痰热痫痉 癫此八种候惟 与 少有识者类同惊风发作之状 脚手冰冷痉举身
僵仆痫癫不殊目瞪流涎手足搐搦十岁以下常作惊风即谓之痫至十岁以上所发则曰癫
议惊风痰热已论在前且惊与风其痰与热各自有本症候受病急风为疾四者并聚有惊有风有
痰有
热或因惊而有风生痰作热或有热而作惊成风生痰或积痰而发热热盛生惊变风或久有风候痰涎
常有因惊而发热调理婴孩童稚四者形症一不可有
善明脉医上于暴作者亦当知之理惊截风退热化痰久盛二者医风散热疗痰镇惊四症相须药宜并
理古人处方亦合此意然学医者不可不究其源远若见候将作寻常用方轻忽病无少安症传它候不
逆且恶祸不旋踵
议婴孩急惊风候便须先审察四症四症之中而作八候八候者一搐二搦三掣四颤五反六引七
窜八
视一搐者臂肘搐缩二搦者十指开合搦之不已即成握拳男子看大拇指其指握在外为顺在里为逆
女子反看之三掣者有膊搐掣或连身跳起四颤者或手或脚或头或身四体颤动五反者身首反张六
引者以手有如挽弓状男左手直有曲为顺右直左曲为逆女子反看之七窜者眼上窜觑高男子上窜为
顺
下窜为逆女子反看之八视者男子斜目视左为顺视右为逆女子反看之既有四症八候次第随生若
只去得惊风且痰热不散未可言安痰与热聚将来必致痫疾所治之治其痰与热须察之可下即下痰
热既下惊风未尽消去则病根据前又有发作所言四症相须不可留一若理得惊风已定随便下了痰热
且惊风不复有作此理至为妙也
议婴孩有患在痰热未有惊风者只可退热化痰不宜妄投惊风药何也惊风之药其味多寒凉经
络本自无事稍有攻击透其痰热入于经络却成风痰之疾搐搦致之
议婴孩五脏经络虚即生风既虚所受且惊自然而有作惊风有作八候次第而生所谓儿童无病
不可与服攻击所治之药
议婴孩有小大有壮弱惊风发作有浅深但轻重大者加分剂重者多与服数乃合其理
议婴孩闻响即掣跳者乃肝肺不足魂魄不稳故神有不安即闻响掣跳者非谓惊也犀角地黄丸
主之又儿心气虚怯神不安定连并掣跳者宜与四君子汤加辰砂脾胃气壮神魂俱清自然不恐
议婴孩欲发惊风候先神不定顾左复右觑上及下或已定其晴凝其神恍恍惚惚怕物惧人不若
常日
嬉戏者急当疗之如有热先退热有惊散惊热退不生痰惊散不作风良久自然安定神情和悦气脉舒
畅若待风变而理惊痰盛而退热事由至缓不若四症俱全由可治疗
议婴孩急惊风发搐手足不可热捉及以手用力灸之即伤经络经络既伤亦无所益则废肢害体
议医急惊风候有大有小有轻有重有顺有逆有偏有正详审久暴只第进药且病家无不仓皇惊
恐医家须是正定无自昏惑
议急惊即曰用医其惊气和平方可调理若以急惊之谓调理事致缓也慢医准此消息
议医急惊初用药在我则我医症候遵法度参传变审缓紧治之切不可信病家及左右人说其所
欲稍顺人情有乎得失主治在我岂可妄信致之荒缪罪累谁耶
议急惊初无痰而复痰盛初有搐而复不搐者此症所传候之至盛人少知之盖由初医纵恣病家
不谨经三五家用药或庸士所见不同有太过不及之害如此曷不谨欤
议医急惊须量轻重下之得其中为良且惊风顿去痰热已化不作复患所下之药稍多巴霜腻粉
为重即传慢候无疑
议婴孩有患风 风 风中等症候皆上窜拳搐号曰天吊言载甚多初无痰复有痰初作搐复不
搐不拳身直皆风之恶候已是传过若作惊风更与下之为害必也
议急惊欲下之理须在急惊上窜斜视反张所作之时可下若传过或已搐定少缓之间未可直便
紧下有乎得失
议急惊用药先与服截风定搐次与下热热去则无风风散败不搐是知以药之功在我意设不至
恣妄为咎到此显功方知难易
议急惊有上窜者有搐有搦有引有反有区有仆有叫者有泪者有痰涎潮盛有温壮发作各随四
症
轻重而受之急惊截风定搐为要风搐既定诸症渐息定搐须用通关（非搐鼻之谓通）截风乃用调络
议凡定上窜左视乃于男女之顺候忽反是则逆也人抵逆则难治顺则易理不以逆症候为不可
治
古人言难治谓阴阳相反症候乖生须用审究其症详察其候以意尽力致之取效而弗瘳者为之奈何
议世方有云治急慢惊风候者言之失意急惊乃阳痫慢惊乃阴痫正恐治阳作阴治阴反阳岂一药以
全两症又有云治阴阳二症伤寒之说能晓此理可谓通变
议急惊候至为要急在于片时之间若或羌殊直有得失一时所见见其端的用药无疑尚在疑情
未须投药药发无疑其意静善疑在未发药之前良具妙矣
议急惊头额心背元被灸了者决定发痫不可常药仆尝谓风痫可灸惊热不可灸盖风与痫痰涎
壅盛
胃触胸膛昏乱迷闷不能省知心如所失既灸着穴痰化心开即渐安愈惊之与热心神常存闻知被灸
忍痛不能惊悸转盛其疾涩重所以用艾在先药必未有益
议惊风疾愈未尝见因发而活每见老妪鄙妇无术只投艾炷儿生三五日之间便以艾烧之不惟
失穴因痛增悸经络未全如何愈病智者消详不可枉冤
议初生尚为腐血三五七日有患吊肠锁肚世言八带锁匙相冲愚曰非也容忤所致初生气弱不
任其
邪肚紧青筋胁肋胀满气促禁口不乳斯症但用真珠天风丸下之才通即愈屡救初生无不获安若经
患服药得痊长大皆肥壮重实未详其意请较之答曰初生之儿方离淤结分降之后偶被邪气干乱脏
腑微怯不受其触故作痰曰吊肠撮口锁壮乃以天麻丸推下恶毒虚邪之气悉去血脉顺得流行脏腑
和调充实自然朋长气壮形神俱备体质醇浓诚为可爱
议婴孩又有脐风因断脐不如法有伤脐带受湿秉风由此成患皆能撮口乳食不下膨胀青筋脚直
无力只根据脐风治法
议发急惊风吼叫两三声者难治心受惊触痛绝于内乃伤其根本之谓
议发急惊风未投药四症俱全已服药四肢脑 者难治
议急惊喷药者难治又药不下者难治
议急惊搐搦之后四体俱软者难治
议急惊发作之后脚作摆跳者难治
议急惊搐后目睛翻转者不可治
议惊风搐搦已住神情缓慢手寻娘衣或寻自身体者亦不可治
议惊风诸症候尽皆已住但神情昏慢气促者未可保治
议惊风症俟已住其儿拈物不舍情性缓缓于中非谓十全必有再发之理如或再发不可调治矣
议急惊风鼻中出血者易治口中出血者难治鼻中出血者其热已散故易治口中出血者心血妄
行故难治
议惊风尿尿已遗者难治大小便闭者易治
讨论急惊风的症候：症状包括气向上冲、角弓反张、抽搐、口流痰涎、高热等同时出现。有的患儿眼睛向左或向右看，有的身体僵硬（僵指仰面朝天，属阳证），有的身体仆倒（仆指俯卧在地，属阴证）。举手握拳时，手指有向内扣（里）和向外展（外）的区别。医生需根据患儿的性别来判断阴阳的顺逆之理。有的左右肢体牵引抽搐，牵连到手脚，身体颤动。初期是抽搐与拘挛同时发作，时间久了则只有拘挛而抽搐停止。病情有急有缓，有的仅表现为肩部抖动、口角抽动（螈螈者，病情较轻；搐者，病情较重；搦者，病情最重）。如果牙关紧闭，喉中有痰涎声，这就是惊风的征候。如果牙关不紧，口中无痰涎，仅有身体向后反张、抽搐、气上冲，则不能立即断定为惊风，因为这可能是夹惊、夹食、伤寒、出疹痘疮，或者是三焦蕴热、五脏气机不畅，热气流入经络，热在筋脉所致，也会引起抽搐。钱乙（钱氏）说抽搐有真假之分，但未说明病因。前文提到“急惊”是根据热邪的轻重程度来给予泻下治疗。
讨论急惊风如果是典型的症候，呼吸粗重，潮热往来，症状猛烈紧迫，不是慢慢到来的。抽搐急促，嘴唇、口角、肩膀、眼睛眨眼牵引联动。俗谚说：“急惊惊爷娘，慢惊惊乐王”，虽然是在说治疗方法各有章法，但需要根据轻重进行调理。
讨论急惊风，首先应当控制抽搐。抽搐由风引起，风由热引起。既然抽搐已经发生，才可以采用泻下法退热熄惊。如果热不退，惊也不会散。如果不及时控制，抽搐再次发作，这就叫做“过街候”，这是因为医生不明理，一见抽搐停止就说平安无事。我认为急惊风难治有三种情况：一是只有在初惊时，风痫发作，斟酌轻重，如果风定后抽搐随即缓解，这还算好办；但如果庸医或常人见热就妄用泻下药，泻下后诸症仍在，这是第一种难治。二是当患儿正在抽搐时，亲人一直紧紧抓住不让其抽搐，导致风痫之气不得舒展，反而逆入经络，药力达不到病所，虽然病症减轻，但病根留在血脉或注入经络，这是第二种难治。三是患儿患病有顺证和逆证之分，顺证易治，逆证难疗。唯恐病情拖延日久，未能得到良医良药，症候传变，偏离原发病因而产生其他病症，这是第三种难治。
讨论治疗急惊风候，用药并非难事，关键在于审慎观察病候，遵循法度，不荒谬不迷信，按次序下药，没有不愈的道理。多是病家惊慌失措，不求良医，轻信山野庸俗之言。病情拖延久了，难免传变，传变则症重，变化则候恶。凡是经过两三次医药治疗无效，患儿受苦，家人无法使其安乐。士大夫之家收集方剂记录症候，一旦患儿病症危重紧急，临时寻找何方对治，告急无门，众人皆言有药但不明端绪，一味攻击，见识浅陋，担负不起治病救人的责任。用药不及则无妨事，可以调理；如果用药太过，实时就会害人性命。
讨论治疗婴孩，岂能因为用药而恐惧？技艺过大或不及尚且不可，何况超越症候乱治，那是冤枉儿童。儿童虽分长幼，但脏腑昏弱，怯懦，易冷易热，易虚易实。如果攻伐过重，他们承受不了药物，不仅疾病不愈，反而造成其他危害，怎么不谨慎呢？现在讨论急惊、慢惊风及慢脾风的方药，即是老夫所指出的，应备缓急之需，追求疗效。至于是否有更优的理论，有待进一步探讨。
讨论患惊风、痰热、痫、痉、癫这八种症候，其中痫与癫少有识者区分，其表现类似惊风发作的样子。手足冰冷的是痉，全身僵硬仆倒是痉，目瞪流涎、手足抽搐的是痫和癫。十岁以下常作惊风处理，即称之为痫；十岁以上发作则称为癫。
惊风、痰热已在前面论述。惊与风，痰与热，各自有其本源症候。受病急者为风疾，四者并聚，有惊、有风、有痰、有热。或因惊而生风，生痰作热；或有热而致惊，成风生痰；或积痰而发热，热盛生惊变风；或久有风候，痰涎常有，因惊而发热。调理婴孩童稚之体，四者的形症一个都不能有。
善于诊脉的医生，对于突然发作的病症也应当知晓道理。惊、截风、退热、化痰，久盛二者，医风散热、疗痰、镇惊，四症相互关联，药物宜一并调理。古人处方也符合此意。然而学医者不可不探究其源头。若见症候将作，寻常用方轻忽病情，若无稍许安宁，症候传变它处，且不逆且恶，祸患转瞬即至。
讨论婴孩急惊风候，便须先审察四症。四症之中演变为八候。八候者：一搐、二搦、三掣、四颤、五反、六引、七窜、八视。一搐，指臂肘抽搐收缩；二搦，指十指开合，搦之不已即成握拳。男子看大拇指，手指握在外侧为顺证，握在里侧为逆证；女子反之。三掣，指膊部抽搐牵拉，或连身跳起；四颤，指手、脚、头、身四体颤动；五反，指身体头部向后反张；六引，指手臂有如挽弓状。男左手直右手曲为顺，右直左曲为逆；女子反之。七窜，指眼向上窜视高处。男子上窜为顺，下窜为逆；女子反之。八视，指男子斜目视左为顺，视右为逆；女子反之。既有四症八候，次第随之产生。如果只去除了惊风，但痰热未散，不可言安。痰与热聚结，将来必致痫疾。所治之法，对于痰与热，须察之可下即下。痰热既下，惊风未尽消去，则病根据前又有发作。所言四症相须，不可留其一。若调理得惊风已定，随便下了痰热，且惊风不再发作，此理最为精妙。
讨论婴孩患有痰热，尚未出现惊风者，只可退热化痰，不宜妄投惊风药。为什么呢？惊风之药多味寒凉，经络本自无事，稍有攻击，透其痰热入于经络，却成了风痰之疾，导致抽搐。
讨论婴孩五脏经络虚即生风，既虚所受，且惊自然而有。作惊风有作八候次第而生。所谓儿童无病，不可与服攻击所治之药。
讨论婴孩有小大、有壮弱，惊风发作有浅深。但轻重大者加分量，重者多与服数，乃合其理。
讨论婴孩闻响即掣跳者，乃是肝肺不足，魂魄不稳，故神有不安。即闻响掣跳者，非谓惊也。犀角地黄丸主之。又儿心气虚怯，神不安定，连并掣跳者，宜与四君子汤加辰砂。脾胃气壮，神魂俱清，自然不恐。
讨论婴孩欲发惊风候，先神不定，顾左复右，觑上及下，或已定其睛凝其神，恍恍惚惚，怕物惧人，不若常日嬉戏者，急当疗之。如有热先退热，有惊散惊，热退不生痰，惊散不作风，良久自然安定，神情和悦，气脉舒畅。若待风变而理惊，痰盛而退热，事由至缓，不若四症俱全由可治疗。
讨论婴孩急惊风发搐，手足不可热捉及以手用力灸之，即伤经络。经络既伤，亦无所益，则废肢害体。
讨论医急惊风候，有大有小，有轻有重，有顺有逆，有偏有正。详审久暴，只第进药。且病家无不仓皇惊恐，医家须是正定，无自昏惑。
讨论急惊即曰用医，其惊气和平方可调理。若以急惊之谓调理事致缓也，慢医准此消息。
讨论医急惊初用药，在我则我医症候，遵法度，参传变，审缓紧治之。切不可信病家及左右人说其所欲，稍顺人情，有乎得失。主治在我，岂可妄信致之荒缪，罪累谁耶？
讨论急惊初无痰而复痰盛，初有搐而复不搐者，此症所传候之至盛，人少知之。盖由初医纵恣，病家不谨，经三五家用药，或庸士所见不同，有太过不及之害。如此曷不谨欤？
讨论医急惊须量轻重下之，得其中为良。且惊风顿去，痰热已化，不作复患。所下之药稍多巴霜腻粉为重，即传慢候无疑。
讨论婴孩有患风、风、风中等症候，皆上窜拳搐，号曰天吊。言载甚多，初无痰复有痰，初作搐复不搐，不拳身直，皆风之恶候，已是传过。若作惊风更与下之为害，必也。
讨论急惊欲下之理，须在急惊上窜、斜视、反张所作之时可下。若传过或已搐定，少缓之间，未可直便紧下，有乎得失。
讨论急惊用药，先与服截风定搐，次与下热。热去则无风，风散败不搐。是知以药之功在我意，设不至恣妄为咎，到此显功，方知难易。
讨论急惊有上窜者，有搐有搦有引有反有区有仆有叫者，有泪者，有痰涎潮盛，有温壮发作。各随四症轻重而受之。急惊截风定搐为要，风搐既定，诸症渐息。定搐须用通关（非搐鼻之谓通），截风乃用调络。
讨论凡定上窜左视，乃于男女之顺候，忽反是则逆也。人抵逆则难治，顺则易理。不以逆症候为不可治。
古人言难治，谓阴阳相反，症候乖生，须用审究其症，详察其候，以意尽力致之。取效而弗瘳者，为之奈何？
讨论世方有云治急慢惊风候者，言之失意。急惊乃阳痫，慢惊乃阴痫，正恐治阳作阴，治阴反阳，岂一药以全两症？又有云治阴阳二症伤寒之说，能晓此理，可谓通变。
讨论急惊候至为要，急在于片时之间。若或羌殊，直有得失。一时所见，见其端的，用药无疑。尚在疑情，未须投药。药发无疑，其意静善疑在未发药之前，良具妙矣。
讨论急惊头额心背元被灸了者，决定发痫。不可常药。仆尝谓风痫可灸，惊热不可灸。盖风与痫痰涎壅盛，胃触胸膛，昏乱迷闷，不能省知，心如所失。既灸着穴，痰化心开，即渐安愈。惊之与热心神常存，闻知被灸，忍痛不能，惊悸转盛，其疾涩重。所以用艾在先，药必未有益。
讨论惊风疾愈，未尝见因发而活。每见老妪鄙妇无术，只投艾炷。儿生三五日之间，便以艾烧之。不惟失穴，因痛增悸。经络未全，如何愈病？智者消详，不可枉冤。
讨论初生尚为腐血，三五七日有患吊肠锁肚。世言八带锁匙相冲，愚曰非也，容忤所致。初生气弱，不任其邪，肚紧青筋，胁肋胀满，气促禁口不乳。斯症但用真珠天风丸下之，才通即愈。屡救初生无不获安。若经患服药得痊，长大皆肥壮重实。未详其意，请较之答曰：初生之儿方离淤结分降之后，偶被邪气干乱脏腑，微怯不受其触，故作痰曰吊肠、撮口、锁壮。乃以天麻丸推下恶毒虚邪之气，悉去血脉顺得流行，脏腑和调充实，自然朋长，气壮形神俱备，体质醇浓，诚为可爱。
讨论婴孩又有脐风，因断脐不如法，有伤脐带，受湿秉风，由此成患。皆能撮口，乳食不下，膨胀青筋，脚直无力。只根据脐风治法。
讨论发急惊风吼叫两三声者，难治。心受惊触痛绝于内，乃伤其根本之谓。
讨论发急惊风未投药，四症俱全，已服药四肢脑 者，难治。（注：原文此处可能有脱字或异体字，依语境推测为四肢厥冷或类似症状，但严格忠实原文提取实体，此处保留原文描述状态）
讨论急惊喷药者，难治。又药不下者，难治。
讨论惊风搐搦已住，神情缓慢，手寻娘衣或寻自身体者，亦不可治。
讨论惊风症俟已住，其儿拈物不舍，情性缓缓于中，非谓十全，必有再发之理。如或再发，不可调治矣。
Discussion on the Syndrome Manifestations of Acute Convulsive Disease (Ji Jing Feng): The symptoms include upward rushing of Qi, opisthotonos (body arching backward), convulsions, salivation with phlegm, and high fever occurring simultaneously. Some patients look to the left or right; some exhibit stiffness (stiffness refers to lying supine, belonging to Yang syndromes); some exhibit collapse (collapse refers to lying prone, belonging to Yin syndromes). When raising hands and grasping fingers, there are distinctions between inward curling (Li) and outward extension (Wai). Physicians must determine the principles of Yin-Yang, favorable (Shun), and unfavorable (Ni) prognoses based on the patient's gender. Some cases involve牵引 (traction/pulling) convulsions affecting both sides, extending to hands and feet, with body tremors. Initially, convulsions (Chu) and clamping/tetany (Nuo) occur together; after a long time, only clamping remains while convulsions cease. The condition varies in urgency and slowness; some present only with shoulder twitching and oral corner twitching (Yu Yu indicates a mild condition; Chu indicates a severe condition; Nuo indicates the most severe condition). If the jaw is tight and there is saliva in the throat, this is a sign of convulsive disease. If the jaw is not tight, there is no phlegm in the mouth, but only opisthotonos, convulsions, and upward Qi rush, it cannot be immediately diagnosed as convulsive disease, as it may be due to concurrent fright, food stagnation, cold damage (Shang Han), exanthematous diseases (such as measles or smallpox), or heat accumulation in the San Jiao (Triple Burner) and dysfunction of the Five Zang organs, where heat flows into the meridians and affects the sinews, also causing convulsions. Qian Yi (Qian Shi) stated that convulsions have true and false forms but did not specify the pathology. The previous text mentioned "Acute Convulsion" refers to purging based on the severity of heat.
Discussion on Acute Convulsive Disease: If it is a typical syndrome, breathing is coarse, tidal fever occurs, symptoms are fierce and urgent, not developing slowly. Convulsions are rapid, with traction involving lips, mouth corners, shoulders, and eye blinking. As the proverb says: "Acute convulsion startles parents, slow convulsion startles Le Wang." Although treatment methods vary, regulation depends on severity.
Discussion on Acute Convulsive Disease: First, control the convulsions. Convulsions arise from Wind, and Wind arises from Heat. Once convulsions have started, purgatives can be used to clear heat and extinguish fright. If heat is not cleared, fright will not dissipate. If not controlled promptly, convulsions recur, known as "Crossing the Street Syndrome," due to physicians' lack of understanding who declare safety upon cessation of convulsions. I consider acute convulsive disease difficult to treat in three aspects: First, only during initial fright when wind-phlegm seizures occur, assessing severity, if wind settles and convulsions stop, it is manageable; however, if quacks or laypeople see heat and recklessly use purgatives, leaving symptoms intact post-purgation, this is the first difficulty. Second, when the child is convulsing, relatives hold them tightly preventing movement, causing wind-phlegm qi to reverse into meridians rather than disperse, rendering medication ineffective; although symptoms lessen, the root remains in blood vessels or meridians, this is the second difficulty. Third, diseases have favorable (Shun) and unfavorable (Ni) trajectories; favorable are easy to treat, unfavorable are hard. Fear of prolonged illness without proper treatment leads to syndrome transmission and deviation from original etiology, creating other symptoms, this is the third difficulty.
Discussion on Treating Acute Convulsive Disease: Medication is not difficult; the key lies in careful observation of symptoms, adhering to protocols, avoiding absurdity and superstition, and administering drugs sequentially. Most difficulties arise from panicked families seeking unqualified practitioners and believing rural folk remedies. Prolonged illness leads to transmission, worsening severity. Ineffective treatments cause suffering. Scholars collect prescriptions, but in emergencies, they lack direction, leading to blind attacks based on shallow knowledge. Improper dosing is harmless for regulation, but excessive dosage causes immediate death.
Discussion on Infant Treatment: One should not fear medication. Skillful over-treatment or under-treatment is inadvisable, let alone treating beyond the syndrome scope, which wrongs the child. Children, regardless of age, have weak Zang-Fu organs, are timid, and prone to cold/heat, deficiency/excess extremes. Over-aggressive attack overwhelms them, failing to cure and causing harm. How can one not be cautious? Now discussing formulas for acute/slow convulsions and slow spleen wind, these are my recommendations for emergency preparedness. Further theoretical discussion awaits.
Discussion on Eight Syndromes: Convulsive disease, Phlegm-Heat, Epilepsy (Xian), Tetanus (Jing), and Mania (Dian). Xian and Dian are often confused with convulsions. Cold hands/feet indicate Tetanus (Jing); whole-body stiffness/collapse indicates Tetanus; staring eyes, salivation, hand-foot convulsions indicate Epilepsy (Xian) and Mania (Dian). Under ten years old, treated as convulsions, termed Xian; over ten years old, termed Dian.
Phlegm-Heat discussed previously. Fright and Wind, Phlegm and Heat have distinct origins. Acute onset favors Wind pathology. These four factors aggregate: Fright generates Wind, Phlegm, Heat; Heat generates Fright, Wind, Phlegm; Phlegm accumulation generates Heat, Heat generates Fright/Wind; Chronic Wind with Phlegm-Saliva generates Heat via Fright. In infants, none of these four pathological states should exist.
Skilled pulse diagnosticians must understand sudden onset mechanisms. Treatments involve calming fright, subduing wind, clearing heat, and resolving phlegm. These four aspects are interrelated; medications should address them comprehensively. Ancient prescriptions align with this. Students must investigate roots. Neglecting early signs leads to transmission and worsening conditions.
Discussion on Four Symptoms and Eight Signs: Examine four symptoms evolving into eight signs: 1. Chu (Convulsion/Twitching): Arm/elbow contraction. 2. Nuo (Clamping/Gripping): Finger opening/closing, forming a fist. For males, thumb outside is Shun (favorable), inside is Ni (unfavorable); females reverse. 3. Che (Traction/Pulling): Shoulder twitching or body jumping. 4. Chan (Tremor): Limb/head/body shaking. 5. Fan (Opisthotonos): Backward arching. 6. Yin (Drawing/Pulling): Arms like drawing a bow. Males: Left straight/right curved is Shun; Right straight/left curved is Ni; females reverse. 7. Cuan (Rushing/Upward Gaze): Eyes looking up. Males: Up is Shun, down is Ni; females reverse. 8. Shi (Gazing): Oblique gaze. Males: Left is Shun, Right is Ni; females reverse. If only wind is cleared but phlegm-heat remains, peace is not achieved; phlegm-heat aggregation leads to epilepsy. Purge phlegm-heat if indicated. If convulsions persist after purging, recurrence is likely. All four symptoms must be addressed. Ideal outcome: convulsions stop, phlegm-heat purged, no recurrence.
Infants with Phlegm-Heat but no convulsions should only receive heat-clearing and phlegm-resolving herbs, not convulsion-specific drugs. Convulsion drugs are often cold/cool, damaging healthy meridians and transforming phlegm-heat into wind-phlegm disorders.
Infant Zang-Fu meridian deficiency generates wind. Fright arises naturally. Do not give attacking drugs to healthy children.
Dosage depends on infant size/strength and severity/shallowness of convulsions. Adjust dosage accordingly.
Startling at noise indicates Liver/Lung deficiency and unstable Hun/Shen, not necessarily fright. Use Xi Jiao Di Huang Wan. Heart Qi deficiency with trembling requires Si Jun Zi Tang plus Chen Sha. Strengthen Spleen/Stomach to clarify Shen.
Pre-convulsion signs: Restlessness, looking around, fixed gaze, hallucinations, fear. Treat urgently. Clear heat first, then calm fright. Heat clearance prevents phlegm; fright calming prevents wind. Wait for stability. If waiting for full syndrome development, treatment is delayed.
Do not apply hot compresses or forceful moxibustion on convulsing limbs, as it damages meridians and causes disability.
Physicians must remain calm amidst family panic. Differentiate severity, favorability, and trajectory. Administer drugs steadily.
Acute convulsions require harmonizing Qi before regulation. Slow treatment suits slow convulsions.
Initial medication must follow protocols and transmission patterns. Do not yield to family demands. Physician holds responsibility.
Sudden appearance of phlegm or cessation of convulsions indicates severe transmission, often due to prior improper treatment. Caution is needed.
Purgatives for acute convulsions must be balanced. Overuse of heavy metals (Ba Shuang, Ni Fen) transforms acute to chronic syndromes.
"Tian Diao" (Heavenly Hanging) involves upward gaze and clenched fists. Initial absence of phlegm followed by presence, or initial convulsions stopping, indicates severe wind transmission. Do not purge if misdiagnosed as convulsion.
Purge only during active upward gaze, oblique vision, or opisthotonos. Do not purge immediately after convulsions stop.
Medication sequence: Subdue wind/calming convulsions first, then clear heat. Heat removal stops wind. Success depends on precise judgment.
Key symptoms: Upward gaze, convulsions, clamping, traction, opisthotonos, collapsing, crying, tearing, profuse saliva, fever. Prioritize subduing wind and calming convulsions. Use Tong Guan method (not nasal irritation) to open orifices, then regulate collaterals.
Leftward gaze in males is favorable; reversal is unfavorable. Unfavorable syndromes are harder to treat but not untreatable.
Ancient texts cite "difficult to treat" for Yin-Yang opposition and chaotic symptoms. Careful investigation is required.
Worldly formulas distinguish acute (Yang Epilepsy) and slow (Yin Epilepsy) convulsions. Beware of confusing Yin/Yang treatments. Understanding Shang Han principles aids adaptation.
Urgency is critical. Accurate diagnosis allows decisive treatment. Hesitation delays therapy.
Moxibustion on head/chest/back for acute convulsions induces epilepsy. Wind-phlegm obstruction benefits from moxa; heat-fright does not. Moxa aggravates heat-fright pain and palpitations.
Historical misuse of moxa on newborns causes harm. Newborns have incomplete meridians. Wise practitioners avoid this.
Newborn issues like "Hanging Intestine" or "Locked Belly" are not caused by astrological clashes but by residual blood/phlegm. Symptoms: tight abdomen, blue veins, distension, refusal to nurse. Treat with Zhen Zhu Tian Feng Wan. Successful treatment leads to robust growth.
Umbilical Wind (Qi Feng) results from improper cord cutting, dampness, and wind invasion. Symptoms: locked mouth, inability to feed, distension, stiff legs. Follow Umbilical Wind protocols.
Roaring 2-3 times during acute convulsion indicates heart damage and poor prognosis.
Four symptoms present but limbs become cold after medication indicates poor prognosis.
Spitting out medication or inability to swallow indicates poor prognosis.
Flaccidity of four limbs after convulsions indicates poor prognosis.
Leg jerking after convulsions indicates poor prognosis.
Eye rolling after convulsions is incurable.
Slow spirit, seeking mother/clothes after convulsions is incurable.
Comatose state with rapid breathing after symptom cessation is unsafe.
Child holding objects loosely with slow demeanor suggests recurrence risk; if recurrent, untreatable.
Nasal bleeding indicates dispersed heat (easy to treat); oral bleeding indicates wild Heart Blood flow (hard to treat).
Incontinence indicates poor prognosis; constipation indicates easier treatment.