〔钱〕伤风发搐,因伤风后得之,口中气出热,呵欠顿闷,手足动摇,当发散,大青
膏主之。小儿生来怯弱者多此病也。〔洁〕伤风发搐,因伤风而得之,证同大
人伤风寒痰之类,当辨有汗无汗,阴阳二证,用大青膏、小续命之类,开发则愈。
(大青膏,阴证;小续命,阳证也。)〔薛〕伤风发搐,口气不热,肢体倦怠,用异功散补
脾土,钓藤饮清肝木。若因风邪内郁,发热而变诸证者,当理肺金,清风邪。若外邪既解,
而内证未除,当理肺补脾。若肺经亏损,而致惊搐等证者,当补脾肺,以平肝心,
则惊搐自止矣。一小儿月内发搐鼻塞,乃风邪所伤。以六君子汤加桔梗、细辛,
子母俱服,更以葱头七茎,生姜一片,细擂,摊纸上,合置掌中令热,急贴囟门,
少顷,鼻利搐止。
大青膏
天麻(末,一分) 白附子(末,生,一钱半) 青黛(一钱,研) 蝎尾(去毒,生末) 乌蛇稍肉(酒浸,焙
干,取末。各半钱) 朱砂(研) 天竺黄(研)
上同再研细,生蜜、和成膏。每服半皂子大至一皂子大,月中儿粳米大,同牛
黄膏、温薄荷水,化一处服之,五岁以上,同甘露散服之。
小续命汤(方见中风)
〔钱〕伤食发搐,因伤食后得之,身体温,多唾多睡,或吐不思乳食而发搐,当
先定搐,搐退,白饼子(方见癖)下之,后服安神丸(方见心脏。)〔洁〕伤食发搐,谓不因
他证,忽然而搐,此因饮食过度,致伤脾胃,故儿多睡多吐,不思饮食,脾胃既虚,引动
肝风则发搐,当先定其搐,如羌活、防风、煎下泻青丸,后用白饼子下其食,渐渐
用调中丸(方见腹痛)、异功散(方见吐泻)养其气。〔薛〕停食发搐,呕吐乳食者,宜用消食
丸。若食既消而前证仍作,或变他证者,脾土伤而肝木乘之也,用六君子加钓藤钩,以
健脾平肝。(消食丸方见伤食。)
〔垣〕外物惊,宜镇平之,以黄连安神丸,若气动所惊,宜寒水石安神丸。〔娄〕
外物惊者,元气本不病,故治以黄连安神之苦寒,气动惊者,不因外物惊,元气自
有病,故治以寒水石安神之甘寒也。
黄连安神丸
黄连(净,酒炒,一钱半) 朱砂(细研,水飞) 生地黄 当归(各一钱) 甘草(炙,五分)
上为极细末,蒸饼和丸如黄米大。每服十丸,津下。
寒水石安神丸(即钱氏安神丸,方见心脏)
镇心丸 凉心经,治惊热痰盛。
甜硝(白者) 人参(去芦,取末,各一两) 甘草(炙) 寒水石(烧,各一两半) 干山药(白者) 白茯苓
(各二两) 朱砂(一两) 龙脑 麝香(各一钱,三味俱研)
上为末,熟蜜丸如鸡头大。如要红,入坯子胭脂二钱(即染胭脂),温水化下半丸至一
二丸,食后。
【钱乙】伤风引起的抽搐,是在感受风邪之后发生的。表现为口中呼出的气发热,频繁打哈欠且神情呆滞,手足动摇不定。治疗应当采用发散风邪的方法,以大青膏为主方。小儿先天体质虚弱者,多患此病。
【张元素】伤风引起的抽搐,是因感受风邪所致。其证候与成人因风寒痰浊引起的症状相似。治疗时应当辨别患者有汗还是无汗,区分阴证和阳证两种类型,分别使用大青膏或小续命汤等方剂。通过开发腠理、疏散外邪,病症即可痊愈。(注:大青膏适用于阴证;小续命汤适用于阳证。)
【薛己】伤风引起的抽搐,若口中气息不热,肢体倦怠无力,应使用异功散(Yi Gong San, Modified Five-Ingredient Powder with Astragalus)来补益脾土,使用钓藤饮(Gouteng Yin, Uncaria Decoction)来清泻肝木。如果是由于风邪内郁,导致发热并引发其他变证,则应当调理肺金,清风邪。如果外邪已经解除,但内部证候仍未消除,应当调理肺气并补益脾气。如果是肺经亏损,导致惊悸抽搐等症状,应当补益脾肺,以平抑肝心之火,那么惊搐自然就会停止。有一个一月大的婴儿出现抽搐和鼻塞,这是被风邪所伤。让母子共同服用六君子汤(Liu Jun Zi Tang, Six-Gentlemen Decoction)加桔梗(Jiegeng, Platycodon Root)、细辛(Xixin, Asarum Root),并用葱头七根、生姜一片,细细研磨后摊在纸上,合掌捂热,迅速贴敷于囟门处。不久之后,鼻窍通畅,抽搐停止。
大青膏处方:
天麻(研磨成粉,一分) 白附子(生用,研磨成粉,一钱半) 青黛(一钱,研细) 蝎尾(去毒,生用,研磨成粉) 乌蛇梢肉(酒浸,焙干,取末。各半钱) 朱砂(研细) 天竺黄(研细)
以上药物共同再次研磨极细,用生蜂蜜调和成膏状。每次服用半个皂荚子大小至一个皂荚子大小,一个月大的婴儿服用如粳米大小。可与牛黄膏一同,用温薄荷水化开混合服用。五岁以上儿童,可与甘露散(Gan Lu San, Sweet Dew Powder)同服。
【钱乙】伤食引起的抽搐,是在饮食积滞之后发生的。表现为身体温热,口水多,嗜睡,或者呕吐、不思乳食而引发抽搐。治疗应当先止住抽搐,待抽搐缓解后,用白饼子(Baibing Zi, White Pill; 处方见癖积章节)攻下积滞,随后服用安神丸(Anshen Wan, Calming the Spirit Pill; 处方见心脏章节)。
【张元素】伤食引起的抽搐,是指没有其他证候,突然发生抽搐。这是因为饮食过度,损伤了脾胃,所以患儿多睡多吐,不思饮食。脾胃既已虚弱,引动肝风从而引发抽搐。治疗应当先制止抽搐,如用羌活(Qianghuo, Notopterygium Root)、防风(Fangfeng, Saposhnikovia Root)煎汤送服泻青丸(Xie Qing Wan, Draining Green Pill),然后用白饼子攻下积食,逐渐改用调中丸(Tiao Zhong Wan, Regulating the Middle Pill; 处方见腹痛章节)、异功散(Yi Gong San, Modified Five-Ingredient Powder with Astragalus; 处方见吐泻章节)来调养正气。
【薛己】停食引起的抽搐,伴有呕吐乳食的,宜用消食丸(Xiaoshi Wan, Digestive Pill; 处方见伤食章节)。如果食物已消化但前述证候仍然发作,或转变为其他证候的,是脾土受伤而肝木乘虚克制所致,应使用六君子汤加钓藤钩,以健脾平肝。(消食丸处方见伤食章节。)
【李东垣】因外界事物惊吓引起的抽搐,适宜镇静止惊,使用黄连安神丸(Huanglian Anshen Wan, Coptis Calming the Spirit Pill)。若是因体内气机逆乱导致的惊悸,适宜使用寒水石安神丸(Hanshuishi Anshen Wan, Halloysite Calming the Spirit Pill)。
【娄全善】因外界事物惊吓的,元气原本没有病变,所以用黄连安神丸的苦寒之性来治疗;因气机逆乱导致惊悸的,并非由外物惊吓引起,而是元气自身有病,所以用寒水石安神丸的甘寒之性来治疗。
黄连安神丸处方:
黄连(净选,酒炒,一钱半) 朱砂(细研,水飞法处理) 生地黄(Sheng Dihuang, Raw Rehmannia Root) 当归(Danggui, Angelica Sinensis Root)(各一钱) 甘草(炙,五分)
以上药物研磨成极细粉末,用蒸饼和丸,如黄米粒大小。每次服用十丸,津液送服。
镇心丸(Zhenxin Wan, Heart-Calming Pill):凉心经,治疗惊热痰盛。
甜硝(白色者) 人参(Ren Shen, Ginseng Root)(去芦,取末,各一两) 甘草(炙) 寒水石(烧制,各一两半) 干山药(Shanyao, Dioscorea Rhizome)(白色者) 白茯苓(Bai Fuling, Poria)(各二两) 朱砂(一两) 龙脑(Longnao, Borneol) 麝香(Muxiang, Musk)(各一钱,这三味药共同研细)
以上药物研成粉末,用熟蜜和丸,如鸡头大小。若要制成红色,可加入坯子胭脂二钱(即染色用的胭脂),温水化开,服用半丸至一二丸,饭后服用。
[Qian Yi] Convulsions caused by wind-cold (Shang Feng Fa Chu) occur after contracting a wind-pathogen. The manifestations include hot breath exhaled from the mouth, frequent yawning accompanied by lethargy or stupor, and trembling of the limbs. Treatment should employ methods to disperse the pathogen externally, primarily using Daqing Gao (Cyan Blue Paste). Infants with congenital weakness are prone to this condition.
[Zhang Yuansu] Convulsions due to wind-cold result from contracting a wind-pathogen. The symptoms resemble those in adults suffering from wind-cold-phlegm patterns. One must differentiate between sweating and non-sweating presentations to distinguish between Yin and Yang syndromes. Treatments such as Daqing Gao (Cyan Blue Paste) or Xiao Xuming Tang (Minor Continuation of Life Decoction) may be used to open the pores and expel the pathogen, leading to recovery. (Note: Daqing Gao is indicated for Yin syndromes; Xiao Xuming Tang is indicated for Yang syndromes.)
[Xue Ji] In convulsions caused by wind-cold, if the breath is not hot and the limbs feel fatigued and weak, use Yigong San (Modified Five-Ingredient Powder with Astragalus) to tonify Spleen Earth, and Gouteng Yin (Uncaria Decoction) to clear Liver Wood. If the condition arises from internal stagnation of wind-pathogens causing fever and subsequent varied symptoms, one should regulate Lung Metal and clear wind-pathogens. If external pathogens have been resolved but internal symptoms persist, regulate Lung Qi and tonify Spleen Qi. If Lung Meridian deficiency leads to fright and convulsions, tonify Spleen and Lung to pacify Liver and Heart fire, which will naturally stop the convulsions. A case involved an infant within one month of age presenting with convulsions and nasal congestion due to wind-pathogen invasion. The mother and child both took Liujunzi Tang (Six-Gentlemen Decoction) supplemented with Jiegeng (Platycodon Root) and Xixin (Asarum Root). Additionally, seven scallion bulbs and one slice of ginger were finely ground, spread on paper, warmed between palms, and rapidly applied to the fontanelle. Shortly thereafter, nasal patency was restored and convulsions ceased.
Daqing Gao Prescription:
Tianma (Gastrodiae Rhizoma, powdered, 1 fen) Baifuzi (Aconiti Kusnezoffii Radix, raw, powdered, 1.5 qian) Qingdai (Indigo Naturalis, 1 qian, ground) Xiewei (Scorpion tail, venom removed, raw, powdered) Wushe Shaorou (Deinagkistrodon acutus meat, wine-soaked, dried, powdered; each 0.5 qian) Zhusha (Cinnabar, ground) Tianzhuhuang (Calami Tuber, ground)
Grind all ingredients together until extremely fine. Mix with raw honey to form a paste. Dosage: half to one size of a soap pod for older children; for infants under one month, the size of a rice grain. Administer dissolved in warm Bohe Shui (Mentha Water), possibly combined with Niuhuang Gao (Calculus Bovis Paste). For children over five years old, administer with Ganlu San (Sweet Dew Powder).
Xiao Xuming Tang (Prescription see Stroke section)
[Qian Yi] Convulsions caused by food retention (Shang Shi Fa Chu) occur after dietary injury. Manifestations include warm body temperature, excessive salivation, somnolence, vomiting, anorexia, and subsequent convulsions. Treatment should first arrest the convulsions. Once subsided, use Baibing Zi (White Pill; prescription see Mass accumulation section) to purge the retention, followed by Anshen Wan (Calming the Spirit Pill; prescription see Heart section).
[Zhang Yuansu] Convulsions due to food retention refer to sudden convulsions without other preceding symptoms. This results from excessive intake damaging the Spleen and Stomach, leading to somnolence, vomiting, and anorexia. Spleen-Stomach deficiency triggers Liver Wind, causing convulsions. First, arrest the convulsions, for example, by decocting Qianghuo (Notopterygii Rhizoma et Radix) and Fangfeng (Saposhnikoviae Radix) to administer Xieqing Wan (Draining Green Pill). Subsequently, use Baibing Zi to purge food retention. Gradually switch to Tiaozhong Wan (Regulating the Middle Pill; prescription see Abdominal Pain section) and Yigong San (Modified Five-Ingredient Powder with Astragalus; prescription see Vomiting and Diarrhea section) to nourish healthy Qi.
[Xue Ji] For convulsions due to food stagnation accompanied by vomiting of milk/food, use Xiaoshi Wan (Digestive Pill; prescription see Food Retention section). If symptoms recur or transform into other conditions after digestion, it indicates Spleen Earth injury with Liver Wood encroachment. Use Liujunzi Tang (Six-Gentlemen Decoction) plus Gouteng (Uncariae Ramulus cum Uncis) to strengthen the Spleen and pacify the Liver. (Xiaoshi Wan prescription see Food Retention section.)
[Li Dongyuan] For fright caused by external objects, use calming and pacifying methods with Huanglian Anshen Wan (Coptis Calming the Spirit Pill). For fright caused by internal Qi disturbance, use Hanshuishi Anshen Wan (Halloysite Calming the Spirit Pill).
[Lou Quanshan] For fright induced by external objects, the Yuan Qi (Original Qi) is fundamentally intact; thus, treat with the bitter-cold properties of Huanglian Anshen Wan. For fright induced by Qi disturbance, there is no external trigger, but the Yuan Qi itself is diseased; thus, treat with the sweet-cold properties of Hanshuishi Anshen Wan.
Huanglian Anshen Wan Prescription:
Huanglian (Coptidis Rhizoma, cleaned, wine-fried, 1.5 qian) Zhusha (Cinnabar, finely ground, water-floating method) Shengdihuang (Rehmanniae Radix Recens) Danggui (Angelicae Sinensis Radix) (each 1 qian) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 fen)
Grind into an extremely fine powder. Form pills using steamed bread dough, sized like yellow millet seeds. Dosage: ten pills per administration, swallowed with saliva.
Hanshuishi Anshen Wan (Same as Qian Yi's Anshen Wan, prescription see Heart section)
Zhenxin Wan (Heart-Calming Pill): Cools the Heart Meridian, treats fright-heat and profuse phlegm.
Tianxiao (Sal Nitri, white variety) Renshen (Ginseng Radix) (remove rhizome, take powder; each 1 liang) Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) Hanshuishi (Halloysitum Rubrum, calcined; each 1.5 liang) Shanyao (Dioscoreae Rhizoma, white variety) Baifuling (Poria) (each 2 liang) Zhusha (Cinnabar, 1 liang) Longnao (Borneolum Syntheticum) Muxiang (Moschus) (each 1 qian; these three ingredients ground together)
Grind into powder. Form pills using cooked honey, sized like a corn kernel. To make red pills, add 2 qian of Pi Zi Yanzhi (Carthamus Seed Rouge/Dye). Dissolve in warm water. Dosage: half to one or two pills, taken after meals.