钱仲阳云∶急惊者因闻大声，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。盖热甚生风，阳盛而阴虚也。宜以利惊丸除其痰热，不可用巴豆
之药。盖急惊者阳症也，俱府受病而属实，乃少阳相火旺。经曰∶热则生风，风生痰。痰热
客于心膈间，则风火相搏，故抽搐发动。经所谓∶木太过曰发生，其动掉眩颠疾是也。当用
利惊丸、导赤散、泻青丸等药，搐止与安神镇惊丸。娄全善亦曰∶急惊属木火土实。木实则
搐而有力，及目上视动札频睫；土实则身热面赤，而不吐泻，偃睡合睛。治法宜凉宜泻，而
用凉惊、利惊等丸。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
眼眨引，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，急宜调养胃气，搐定而痰热少退，即宜调补脾气。东
垣云∶若因外物惊者，宜黄连安神丸。因气动所惊者，宜安神镇惊丸之类，大忌防风丸。如
因惊而泻青色，宜朱砂丸，大忌凉惊丸。盖急惊者，风木旺也，风木属肝，盛则必传克于脾
，欲治其肝，当先实脾，后泻风木，若用益黄散则误矣。经曰∶邪气盛则实，正气夺则虚。
前所云实者，乃病气有余而形气不足也。当先泻而后补，虚甚急当补脾为先，少以攻邪之药
佐之。其所云虚者，乃病气、形气俱不足也，当纯补真气为要。若肝经风火相搏，抽搐目
，筋急痰盛者，当用四物汤以生肝血，加钩藤钩、山栀以清肝火，更用四君子以补脾，六味
丸以滋肾。若肺金克木而兼呵欠者，用泻白散以泄肺邪，地黄丸以益肝血。若邪入肝，则用
柴胡清肝散，加龙胆草亦可。邪入心，用栀子清肝散，加炒黄连亦通。邪入肾，用六味地黄
丸。邪入肺，用地骨皮散。邪入脾，用六君子加柴胡、山栀。大抵此症属肝胆经血虚，风火
相搏，而善行数变者为多，若不养肝血，不补脾气，纯用祛风化痰之药，则脾益虚，血益损
，邪气延绵，必传慢惊矣。
治验
一小儿九岁，因惊发热，抽搐顿闷，切牙作渴，饮冷便秘，面色青赤，而印堂左腮尤赤，此
心脾二经风热相搏，乃形病俱实之症也，先用泻青丸料炒黄连一剂，大便随利，热搐顿减；
继用抑青丸一服，诸症悉退。但面色痿黄，肢体倦怠，饮食少思，此病气去而脾气未复也，
用补中益气汤及地黄丸而痊愈。
一小儿发热抽搐，口噤痰涌，此胆经实火为惊风也。先用泻青丸一服，六味丸二服，诸症即
退；又用小柴胡汤加芎、归、山栀、钩藤钩，次以补中益气汤而痊。
一小儿忽然发热，目动切牙，惊搐痰盛，或与祛风化痰药益甚，面色青黄，乃肝木克脾，脾
之液为涎，虚则涎不能摄，上涌而似痰也。法当生肝补脾，则风自息痰自愈矣。遂用六味丸
及六君子汤而愈。
一女子十二岁，善怒，睡中抽搐，遍身作痒，饮食少思。此肝经风热脾土受克也，用参术柴
苓汤，以清肝健脾而愈。
一小儿三岁患急惊，面赤发热，作渴饮冷，用泻青丸一服，热衰大半。因见得效，翌早又自
制一服，反加吐泻发搐，面色青白，手足指冷，此热既去而妄自伤脾也。用六君子、姜、桂
、升麻、柴胡一剂得安。是以前哲谓小儿易为虚实，攻伐之药衰其大半乃止，不可过之，罗
谦甫约方约囊之论恪矣。
一小儿三岁，因惊抽搐，发热痰盛，久服抱龙丸等药，面色或赤或青，此心肝二经血虚风热
生痰也。用六味丸滋肾生血；用六君、柴胡、升麻调补脾胃而安。
一小儿潮热发热，左腮青赤，此心肝二经血虚之症也。用秘旨安神丸及四物汤加防风、酸枣
仁治之而愈。
一小儿潮热发搐，痰涎上涌，手足指冷，申酉时左腮青色隐白。用补中益气汤调补脾肺，六
味丸滋养肝肾而痊。
嘉兴王一山女七岁，因跌伤腿膝，两 肿溃，面色青洁，左关无脉。余谓∶惊则气散，而风
热郁滞于肝，故其脉隐伏。用四君、升麻、柴胡、钩藤钩一剂，脉至随愈。
一小儿印堂青黑，至夜啼搐。余谓∶脾土虚寒也，用钩藤饮而安；后因惊发搐夜啼，仍用前
药一剂，诸症复愈，又用异功散而痊。
一小儿七岁，患急惊将愈，而发热惊悸，误服祛风化痰之剂，更加惊搐，吐痰喘嗽，腹胀少
食恶寒。再用抱龙丸，大便似痢，寒热往来，殊类风症。先君治之以为脾气亏损，诸经无所
滋养而然，用四君子汤为主，少加升麻、柴胡，以升补阳气而愈。
一小儿惊风后痰嗽不止，睡卧不宁，诸药无效，余用牛黄清心丸少许顿止。后复伤风邪，痰
盛喘急，饮食不下。仍用牛黄丸少许而安；再用异功散加桔梗而愈。
利惊丸 治急惊痰盛发热潮搐。
青黛 轻粉（各二钱） 牵牛末（半两）
上为末，面糊丸寒豆大。每服十丸，薄荷汤化下。
安神镇惊丸 惊退后调理，安心神养，气血和平预防之剂也。
天竺黄（另研） 人参 茯神 南星（姜制。各五钱） 酸枣仁（炒） 麦门冬 当归（酒炒） 生地黄
（酒洗）
（。各二钱） 青黛（一钱，另研）
上为末，蜜丸绿豆大。每服三五丸，量儿大小加减，淡姜汤送下。
四物汤 治血虚发热烦躁，或晡热作渴，头目不清，若因脾虚不能生血者，用四君子汤。
当归 熟地黄（各二钱） 芍药 川芎（各一钱）
上水煎服。
参术柴苓汤
人参 白术 茯苓 陈皮（各一钱） 柴胡 升麻（各七分） 山栀（炒，八分） 钩藤钩（一钱） 甘草（炒五
分）
每服一二钱，姜枣水煎。
黄连安神丸 治心经血虚头晕，神魂惊悸。
黄连（酒洗，六钱） 甘草（炙五分） 生地黄 当归（各一钱五分） 朱砂（飞过，五钱）
上为末，饭糊丸梧桐子大。每服十五丸，空心白滚汤下。如二三服不应，当服归脾汤补之。
愦等症。或小儿风热上壅，抽搐发热，或急惊痰盛发搐，目反口噤。或大人伤寒，汗下之后
，烦躁发热不解，并宜服之。
牛黄（一钱二分半） 麝香 龙脑 羚羊角（各一钱） 当归 防风 黄芩 白术 麦门冬 白芍药
（各一钱半） 柴胡 桔梗 白茯苓 杏仁（去皮尖） 芎 肉桂 大豆黄卷 阿胶（各一钱二分半）
蒲黄 人参 神曲（各三钱半） 雄黄（八分） 甘草（五分） 白蔹（七分半） 犀角（二钱） 干山药（七钱
干姜（三钱） 金箔（一百三十片） 大枣（十个，蒸熟烂研）
上为末，炼蜜丸每两作十丸，金箔为衣。每服一丸，温水化下。
朱砂丸（方见发搐）
泻青丸（方见肝脏）
导赤散（方见心脏）
抑青丸（方见肝脏）
补中益气汤（方见虚羸）
地黄丸（方见肾脏）
小柴胡汤（方见发痉）
六君子汤（方见天钓）
秘旨安神丸（方见心脏）
异功散（方见天钓）
Qian Zhongyang stated: Acute convulsion (Ji Jing) is caused by hearing loud noises or being startled, leading to spasms. Once the spasms cease, the body returns to normal. This occurs because heat generates in the Heart meridian. Symptoms include fever, flushed face, thirst with desire to drink, hot breath, and yellow-red urine and stool. In severe cases, convulsions occur. Generally, excessive heat generates wind, representing a condition of excess Yang and deficient Yin. It is appropriate to use Li Jing Wan (Detoxifying Convulsion Pill) to eliminate phlegm-heat; drugs such as Croton seed (Badou) must not be used. Acute convulsion belongs to Yang syndromes, involving the Fu organs with excess patterns, characterized by hyperactivity of Ministerial Fire in the Shaoyang channel. The Classics state: "Heat generates wind, and wind generates phlegm." When phlegm-heat lodges between the heart and diaphragm, wind and fire contend, causing spasms. This corresponds to the Classic saying: "Excessive Wood energy is called 'Fa Sheng' (Sprouting), and its movement manifests as tremors, vertigo, and epilepsy." One should administer Li Jing Wan, Dao Chi San (Guide Out Red Powder), and Xie Qing Wan (Drain Green Pill). After spasms subside, An Shen Zhen Jing Wan (Calm Spirit and Subdue Convulsion Pill) should be given. Lou Quanshan also stated: Acute convulsion involves excess in Wood, Fire, and Earth. Excess Wood leads to forceful spasms, upward deviation of eyes, and frequent blinking; excess Earth leads to fever and flushed face without vomiting or diarrhea, lying prone with closed eyes. Treatment should employ cooling and purging methods, using pills such as Liang Jing Wan (Cooling Convulsion Pill) and Li Jing Wan. Some cases arise from fright, presenting with locked jaw, high fever, profuse saliva, darting gaze, opisthotonos, convulsions, trembling, twitching of lips/mouth/brows/eyes, hot breath, red cheeks and lips, constipation of stool and urine, and a floating, surging, rapid, and tight pulse. This indicates internal excess heat combined with external wind pathogen; treatment should arrest wind and stop spasms. If phlegm-heat persists, mild purgation is still indicated. Once phlegm-heat is drained, immediate care for Stomach Qi is required. When spasms cease and phlegm-heat recedes slightly, Spleen Qi should be tonified. Li Dongyuan said: If caused by external fright, Huang Lian An Shen Wan (Coptis Calming Spirit Pill) is suitable. If caused by Qi disturbance, An Shen Zhen Jing Wan is appropriate; Fang Feng Wan (Saposhnikovia Pill) is strictly contraindicated. If fright causes green loose stools, Zhu Sha Wan (Cinnabar Pill) is suitable; Liang Jing Wan is strictly contraindicated. Acute convulsion is due to hyperactive Wind-Wood, which belongs to the Liver. When excessive, it inevitably transmits to and overacts the Spleen. To treat the Liver, one must first strengthen the Spleen, then drain the Wind-Wood. Using Yi Huang San (Benefit Yellow Powder) would be an error. The Classics state: "When pathogenic qi is abundant, it is excess; when healthy qi is depleted, it is deficiency." The aforementioned "excess" refers to abundant pathogenic qi but insufficient formative qi. One should purge first, then tonify. If deficiency is severe, tonifying the Spleen is urgent, assisted by mild pathogen-draining herbs. The aforementioned "deficiency" refers to both pathogenic and formative qi being insufficient; pure tonification of True Qi is essential. If Liver channel wind-fire contend, causing spasms, fixed gaze, tendon stiffness, and profuse phlegm, Si Wu Tang (Four Substances Decoction) should be used to generate Liver blood, plus Uncaria hook (Gouteng) and Gardenia (Shanzhi) to clear Liver fire, followed by Si Jun Zi Tang (Four Gentlemen Decoction) to tonify the Spleen, and Liu Wei Wan (Six Flavor Pill) to nourish the Kidney. If Lung Metal overacts Liver Wood accompanied by yawning, use Bai Du San (White White Powder) to drain Lung pathogen and Di Huang Wan (Rehmannia Pill) to benefit Liver blood. If pathogen enters the Liver channel, use Chai Hu Qing Gan San (Bupleurum Clearing Liver Powder), adding Gentian root (Longdancao) is also effective. If pathogen enters the Heart, use Zhi Zi Qing Gan San (Gardenia Clearing Liver Powder), adding stir-fried Coptis (Huanglian) is also applicable. If pathogen enters the Kidney, use Liu Wei Di Huang Wan (Six Flavor Rehmannia Pill). If pathogen enters the Lung, use Di Gu Pi San (Lycium Bark Powder). If pathogen enters the Spleen, use Liu Jun Zi Tang (Six Gentlemen Decoction) plus Chai Hu and Shanzhi. Generally, this syndrome belongs to Blood deficiency in the Liver and Gallbladder channels, where wind-fire contend, and exhibits characteristics of rapid migration and change. If Liver blood is not nourished and Spleen Qi is not tonified, and only wind-dispelling and phlegm-resolving drugs are used purely, Spleen deficiency will worsen, Blood damage will deepen, pathogen will linger, and it will inevitably transmit to Chronic Convulsion (Man Jing).
Clinical Cases:
A nine-year-old child developed fever and sudden convulsive stupor after fright, grinding teeth, thirst, desire for cold drinks, constipation, blue-red complexion, especially redness at the Yintang point and left cheek. This was wind-heat contending in the Heart and Spleen meridians, a pattern of excess in both form and disease. First, one dose of Xie Qing Wan formula with stir-fried Huanglian was administered; stool moved freely, and fever/spasms reduced significantly. Then, one dose of Yi Qing Wan was given, and all symptoms subsided. However, the complexion became sallow, limbs were fatigued, and appetite was poor, indicating that pathogenic qi had departed but Spleen Qi had not yet recovered. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) and Di Huang Wan were used, resulting in recovery.
A child presented with fever, convulsions, locked jaw, and surging phlegm, indicating Gallbladder excess fire causing wind-stroke. One dose of Xie Qing Wan and two doses of Liu Wei Wan cleared all symptoms. Subsequently, Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Chuanxiong, Danggui, Shanzhi, and Gouteng was used, followed by Bu Zhong Yi Qi Tang for full recovery.
A child suddenly developed fever, eye movements, teeth grinding, fright-induced convulsions, and profuse phlegm. Administration of wind-dispelling and phlegm-resolving medicines worsened the condition. The complexion was blue-yellow, indicating Liver Wood overacting on Spleen Earth. Spleen fluids transform into saliva; when deficient, saliva cannot be controlled, surging upward resembling phlegm. The method should be to generate Liver blood and tonify Spleen, so wind naturally ceases and phlegm heals. Liu Wei Wan and Liu Jun Zi Tang were used, resulting in recovery.
A twelve-year-old girl suffered from irritability, convulsions during sleep, generalized itching, and poor appetite. This was Liver wind-heat with Spleen Earth under attack. Shen Zhu Chai Ling Tang (Ginseng, Atractylodes, Bupleurum, and Poria Decoction) was used to clear the Liver and fortify the Spleen, leading to recovery.
A three-year-old child suffered acute convulsion with red face, fever, thirst, and desire for cold drinks. One dose of Xie Qing Wan reduced the heat by more than half. Seeing the effect, the parent self-administered another dose the next morning, which instead caused vomiting, diarrhea, convulsions, blue-white complexion, and cold fingers/toes. This indicated that while heat was gone, the Spleen was wrongly damaged. Liu Jun Zi Tang plus Ginger, Cinnamon bark, Shengma, and Chai Hu resolved the issue. Hence, ancient sages stated that children easily shift between excess and deficiency; attacking medicines should stop when the disease declines by more than half and must not be overused. Luo Qianfu's arguments in *Yue Fang Yue Nang* were rigorous.
A three-year-old child had fright-induced convulsions, fever, and profuse phlegm. Long-term use of Bao Long Wan etc. resulted in alternating red/blue complexions, indicating Heart-Liver Blood deficiency generating wind-heat and phlegm. Liu Wei Wan was used to nourish Kidney and generate blood; Liu Jun Zi Tang plus Chai Hu and Shengma was used to regulate and tonify Spleen-Stomach, leading to peace.
A child with tidal fever and red-blue left cheek presented with Heart-Liver Blood deficiency. Mi Zhi An Shen Wan (Secret Instruction Calming Spirit Pill) and Si Wu Tang plus Fangfeng and Suanzaoren cured the case.
A child with tidal fever, convulsions, surging saliva, cold fingers/toes, and blue cheek turning white at Shen-You hours (3-7 PM) was treated with Bu Zhong Yi Qi Tang to tonify Spleen-Lung and Liu Wei Wan to nourish Liver-Kidney, resulting in recovery.
The seven-year-old daughter of Wang Yishan in Jiaxing fell and injured her legs/knees, causing swelling and ulceration. Her complexion was blue-clean, and the left Guan pulse was absent. I stated: Fright scatters Qi, and wind-heat stagnates in the Liver, causing the pulse to hide. Si Jun Zi Tang plus Shengma, Chai Hu, and Gouteng for one dose restored the pulse and healed the patient.
A child with blue-black Yintang cried and convulsed at night. I diagnosed Spleen Earth deficiency-cold and used Gouteng Yin to calm him. Later, fright-induced convulsions and night crying recurred; the previous prescription cured it again, followed by Yi Gong San for complete recovery.
A seven-year-old child recovering from acute convulsion developed fever and palpitations. Misadministration of wind-dispelling and phlegm-resolving agents worsened the fright and convulsions, causing phlegm vomiting, wheezing cough, abdominal distension, poor intake, and aversion to cold. Re-administration of Bao Long Wan led to dysentery-like stool, alternating chills and fever, resembling wind syndrome. My father treated it as Spleen Qi depletion causing lack of nourishment to all channels. Si Jun Zi Tang was the main formula, with slight additions of Shengma and Chai Hu to raise and tonify Yang Qi, resulting in recovery.
A child with persistent phlegm cough and restless sleep after wind-stroke did not respond to various medicines. I used a small amount of Niu Huang Qing Xin Wan (Calorie Clearing Heart Pill) to stop it immediately. Later, a new wind-pathogen invasion caused profuse phlegm, wheezing, and inability to eat. A small amount of Niu Huang Wan calmed him; Yi Gong San plus Jiegeng cured him.
Li Jing Wan (Detoxifying Convulsion Pill): Treats acute convulsion with profuse phlegm, fever, and tidal spasms.
Qingdai (Indigo Naturalis), Qingfen (Calomel) (each 2 qian); Qianniu end (Ban liang).
Grind into powder, make pills with wheat paste size of Phaseolus vulgaris seeds. Take 10 pills each time, dissolved in Mint decoction.
An Shen Zhen Jing Wan (Calm Spirit and Subdue Convulsion Pill): A conditioning formula after convulsion subsides, calming the spirit, nourishing Qi and Blood, harmonizing them for prevention.
Tianzhu Huang (Bambusa Textilis Sap), Renshen (Panax Ginseng), Fushen (Poria with Hostwood), Nanxing (Pinellia Tuber processed with Ginger) (each 5 qian); Suanzaoren (Ziziphus Seed stir-fried), Maimendong (Ophiopogon Root), Danggui (Angelica Sinensis wine-fried), Shengdihuang (Rehmannia Root wine-washed) (each 2 qian); Qingdai (1 qian, separately ground).
Grind into powder, make pills with honey size of Vigna angularis seeds. Take 3-5 pills each time, adjust according to age, taken with light Ginger decoction.
Si Wu Tang (Four Substances Decoction): Treats Blood deficiency fever, irritability, evening fever with thirst, unclear head and eyes. If caused by Spleen deficiency failing to generate Blood, use Si Jun Zi Tang.
Danggui (Angelica Sinensis), Shudihuang (Prepared Rehmannia Root) (each 2 qian); Shaoyao (Paeonia Root), Chuanxiong (Ligusticum Rhizome) (each 1 qian).
Decoct in water and take.
Shen Zhu Chai Ling Tang (Ginseng, Atractylodes, Bupleurum, and Poria Decoction)
Renshen (Panax Ginseng), Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria), Chenpi (Citrus Reticulata Peel) (each 1 qian); Chaihu (Bupleurum Root), Shengma (Cimicifuga Rhizome) (each 7 fen); Shanzhi (Gardenia Fruit stir-fried, 8 fen); Gouteng (Uncaria Rhynchophylla) (1 qian); Gancao (Licorice Root stir-fried, 5 fen).
Take 1-2 qian each time, decoct with Ginger and Jujube water.
Huang Lian An Shen Wan (Coptis Calming Spirit Pill): Treats Heart channel Blood deficiency dizziness, soul fright and palpitations.
Huanglian (Coptis Rhizome wine-washed, 6 qian); Gancao (Licorice Root roasted, 5 fen); Shengdihuang (Raw Rehmannia Root), Danggui (Angelica Sinensis) (each 1.5 qian); Zhusha (Cinnabar flown through, 5 qian).
Grind into powder, make pills with rice paste size of Firmament Seeds. Take 15 pills each time, with plain warm water on an empty stomach. If ineffective after 2-3 doses, Gui Pi Tang should be taken to tonify. Also suitable for restlessness etc. Or pediatric wind-heat congestion upward, convulsions fever, or acute convulsion with profuse phlegm, eyes rolling back, locked jaw. Or adult Taiyang disease after sweating/purging, unresolved irritability and fever. All are suitable for this pill.
Niuhuang (Calculus Bovis, 1.25 qian); Shexiang (Musk), Naobrn (Borneol), Lingyangjiao (Saiga Antelope Horn) (each 1 qian); Danggui (Angelica Sinensis), Fangfeng (Saposhnikovia Root), Huangqin (Scutellaria Root), Baizhu (Atractylodes Macrocephala Rhizome), Maimendong (Ophiopogon Root), Baishaoyao (White Peony Root) (each 1.5 qian); Chaihu (Bupleurum Root), Jiegeng (Platycodon Root), Bai Fuling (Poria), Xingren (Apricot Seed peeled and tip removed), Chuanxiong (Ligusticum Rhizome), Rougui (Cinnamon Bark), Dadou Huangjuan (Soja Glycines Germinatum), Ejiao (Donkey-hide Gelatin) (each 1.25 qian); Puhuang (Typha Pollen), Renshen (Panax Ginseng), Shenqu (Massa Medicata Fermentata) (each 3.5 qian); Xionghuang (Realgar, 8 fen); Gancao (Licorice Root, 5 fen); Bailian (Tiger Lily Bulb, 7.5 fen); Xijiao (Rhino Horn, 2 qian); Gan Shanyao (Dioscorea Rhizome dried, 7 qian); Ganjiang (Dried Ginger, 3 qian); Jinbo (Gold Leaf, 130 pieces); Dazao (Jujube, 10 pieces, steamed ripe and mashed).
Grind into powder, make pills with refined honey, 10 pills per liang, coated with Gold Leaf. Take 1 pill each time, dissolved in warm water.
Zhu Sha Wan (Cinnabar Pill) (Formula see "Convulsion")
Xie Qing Wan (Drain Green Pill) (Formula see "Liver")
Dao Chi San (Guide Out Red Powder) (Formula see "Heart")
Yi Qing Wan (Green Suppressing Pill) (Formula see "Liver")
Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) (Formula see "Emaciation")
Di Huang Wan (Rehmannia Pill) (Formula see "Kidney")
Xiao Chai Hu Tang (Minor Bupleurum Decoction) (Formula see "Spasm")
Liu Jun Zi Tang (Six Gentlemen Decoction) (Formula see "Heavenly Hook")
Mi Zhi An Shen Wan (Secret Instruction Calming Spirit Pill) (Formula see "Heart")
Yi Gong San (Extraordinary Skill Powder) (Formula see "Heavenly Hook")