发痉之症，因伤风汗出，误发汗，或湿症汗多所致。若项背强直，腰背反张，摇头掣 ，噤
口不语，发热腹痛，病在足太阳也。若面目赤色，无汗恶寒，牙关紧急，肢体反张，痰涎壅
盛，昏愦烦渴，小便赤涩，先谵语而发者，名刚痉，当发汗。若大便滑泄，不语不渴，有汗
而不恶寒，先手足厥冷而发者，名柔痉，并以小续命汤加减主之。刚痉去附子用麻黄；柔痉
用附子去麻黄。若壮热谵语口干，手足微寒，大便滑泄，此兼刚柔，无汗用葛根汤，有汗用
桂枝加葛根汤。若痰塞气盛，用南星、半夏、茯苓以消痰；枳实、陈皮、紫苏以顺气。更审
其热，轻者用败毒散；热盛者用小柴胡汤；壮热有汗、胸满口噤、切牙便闭为内热，以大承
气汤下之，后用大柴胡汤解之，过三日则难治。此皆治六淫外伤元气，形病俱实之法也。若
小儿多因惊骇停食，或乳母六淫七情，饮食起居失宜所致，更当审之，兼治其母。大要因惊
目直呵欠，项强顿闷，属肝经实热，用抑肝散。切牙呵欠，手寻衣领，属肝经虚热，用地黄
丸。若肺金不能平木，用异功散。脾不能养肝，用六君子汤。水不能生木，用地黄丸。
治验
一小儿感冒发热，咳嗽切牙。余以为脾肺气虚。不信，乃用解散之药，果项强口噤，汗出不
止，手足并冷，遂用五味异功散加柴胡、木香治之，渐愈。但日晡微热，睡而露睛，用补中
益气汤而痊。
一小儿因惊发热，误行表散，出汗面白，日晡发痉。先兄谓脾肺气虚而肝胆邪盛，以六君子
加柴胡、升麻治之，乃发于寅卯时，此肝邪自旺也。用加味逍遥散一剂，其热顿退，又用补
中益气汤、六味地黄丸而愈。
一小儿患瘰 ，溃而发痉，顿闷切牙寒热，此属肝经风热，先用柴胡栀子散一剂，寒热顿止
；次用四物、参、 、白术、柴胡渐止；又用补中益气汤加芍药、茯苓而痊。
一小儿头患疮，溃而发痉，或寒热作渴，或手足厥冷，其脉洪大浮缓，按之皆微细，此元气
虚而邪气实也。用十全大补汤加柴胡、山栀，数剂诸症渐退而脉渐敛，又十余剂而愈。
一小儿惊风，服抱龙丸、保生锭，吐涎甚多，又汗出发痉，仍欲祛痰。余曰∶此肝脾血虚，
而内生风耳。吐痰不止，脾肺气虚，不能摄涎也。汗出发痉，脾肺气虚而亡阳也。用六君子
汤加炮姜、木香顿愈；又用四君子加归、 而安。
一小儿伤风发热，服解散之药，汗出不止， 症悉具，其脉洪大鼓指，按之微细，此汗多亡
阳，脾肺气虚之症也。用异功散加芎、归、黄 ，其汗顿止；又用补中益气汤而痊。
一小儿停食腹痛，发热呕吐，服峻厉之剂，更吐泻汗多，手足并冷，发痉不止，其脉浮洪，
按之如丝。用六君子汤加升麻、炮姜，痉症顿已，惟寒热往来，又用四君、升麻、柴胡而愈
少参王阳湖孙女年八岁，发痉，服降火消导之剂，其脉浮洪，寒热如疟。余用四君子加升麻
、柴胡、炮姜、钩藤钩，及补中益气汤，间服渐愈。但胁下作痛，去炮姜加木香、肉桂而痊
一小儿因乳母大怒，发热胁痛，亦患前症，兼汗出作呕，先用小柴胡汤一剂，子母俱服顿愈
。但日晡潮热，以异功散加升麻、柴胡治之，并愈。
一小儿因乳母发热吐泻，一小儿因乳母食厥昏愦，同患前症。各治其母，而子悉愈。
桂枝加干葛汤 治头痛、项背强KT KT ，汗出恶风者。
桂枝 芍药 甘草 葛根（四钱）
上每服二钱，姜枣水煎。
小柴胡汤 治身热恶寒风痉，项强直急，胸胁满痛，呕哕烦渴，寒热往来；或身面皆黄，小
便不利，大便秘涩；或惊过不解，潮热不除，及瘥后劳复，发热疼痛如疟，发作有时。（方见肝脏）
加味小柴胡汤（即小柴胡汤加山栀、牡丹皮）
保生锭子 治慢惊，尚有阳症。
全蝎 白附子（炮） 僵蚕 牛胆南星 蝉蜕 琥珀 辰砂（各一钱） 麝香（五分） 防风（一钱）
上为末，糊搜和捏成锭子，金银箔为衣，用薄荷汤磨服。
大柴胡汤 治表里热，大便秘涩，胸满胁痛。
柴胡 枳实（各二两二钱） 半夏（一两五钱） 赤芍药（一两八钱） 黄芩（二两） 大黄（三两七钱五分）
上生姜、红枣煎，不拘时服。
小续命汤（方见五硬）
抑肝散（方见肝脏）
地黄丸（方见肾脏）
败毒散（方见发热）
六君子汤
五味异功散（二方见内钓）
补中益气汤（方见虚羸）
加味逍遥散（方见内钓）
柴胡栀子散（方见发热）
四物汤（方见急惊）
十全大补汤（八珍汤加黄 、肉桂，即四君、四物二汤合用）
抱龙丸（方见伤寒）
四君子汤（方见内钓）
大承气汤 治刚痉，胸满内实，口噤切牙，大热发渴，大便秘涩。
大黄 芒硝（各五钱） 浓朴（一两） 枳实
葛根汤 治太阳病，项强KT KT ，恶风无汗，及恶寒刚痉。
葛根（四两） 麻黄（三钱） 桂（一两）
上每服二钱，水煎。
The syndrome of spasms (Jing Zheng) is caused by sweating after contracting wind pathogens, erroneous induction of sweating, or excessive sweating due to dampness syndromes. If there is stiffness and rigidity of the neck and back, opisthotonos (backward arching of the back), head shaking, convulsions, trismus (lockjaw) with inability to speak, accompanied by fever and abdominal pain, the disease is located in the Foot-Taiyang Meridian. If the face and eyes are red, there is no sweat and aversion to cold, the jaw is tight, the limbs are arched backward, phlegm-saliva is abundant, mental confusion, irritability, and thirst are present, urination is scanty and painful, and delirium occurs before the onset, it is named Gang Jing (Yang Spasm), and diaphoresis (sweating method) should be applied. If there is loose stool or fecal incontinence, silence and absence of thirst, sweating without aversion to cold, and coldness of the hands and feet precedes the onset, it is named Rou Jing (Yin Spasm). Both are primarily treated with modified Xiao Xuming Tang (Minor Continuation Life Decoction). For Gang Jing, remove Fuzi (Prepared Aconite Root) and use Mahuang (Ephedra); for Rou Jing, use Fuzi and remove Mahuang. If there is high fever, delirium, dry mouth, slightly cold hands and feet, and loose stools, this is a combination of Gang and Rou Jing. For those without sweat, use Gegen Tang (Kudzu Decoction); for those with sweat, use Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Kudzu). If phlegm obstruction and qi stagnation are severe, use Nanxing (Arisaema Rhizoma), Banxia (Pinellia Tuber), and Fuling (Poria) to resolve phlegm; use Zhishi (Immature Bitter Orange), Chenpi (Tangerine Peel), and Zisu (Perilla Leaf) to regulate qi. Further assess the heat: for mild cases, use Baidu San (Detoxification Powder); for severe heat, use Xiaochaihu Tang (Minor Bupleurum Decoction). For high fever with sweat, chest fullness, trismus, teeth grinding, and constipation, indicating internal heat, use Dachengqi Tang (Major Order the Qi Decoction) to purge, followed by Daxiehu Tang (Greater Bupleurum Decoction) to harmonize. If more than three days have passed, it becomes difficult to treat. These are methods for treating external damage to primordial qi by the six excess pathogens, where both the physical constitution and the pathology are excess patterns. In children, spasms are often caused by fright or food retention, or by the wet nurse being affected by the six excess pathogens and seven emotions, or by improper diet and lifestyle. One must carefully examine these factors and treat the wet nurse concurrently. Mainly, if fright causes staring eyes and yawning, neck stiffness and dizziness, it belongs to Liver Meridian Excess Heat, treated with Yigan San (Suppress Liver Powder). If teeth grinding, yawning, and hand grasping at clothing occur, it belongs to Liver Meridian Deficiency Heat, treated with Dihuang Wan (Rehmannia Pill). If Lung Metal fails to control Liver Wood, use Yigong San (Benefit Work Powder). If Spleen Earth fails to nourish Liver Wood, use Liujunzi Tang (Six Gentlemen Decoction). If Kidney Water fails to generate Liver Wood, use Dihuang Wan.
Case Records:
A child had a cold with fever and coughing with teeth grinding. I diagnosed Spleen and Lung Qi Deficiency. The family disagreed and used dispersing herbs. Indeed, neck stiffness, lockjaw, profuse sweating, and cold extremities ensued. I then treated with Wuwei Yigong San (Five-Ingredient Benefit Work Powder) added with Chaihu (Bupleurum Root) and Muxiang (Aucklandiae Radix), leading to gradual recovery. However, slight afternoon fever and sleeping with eyes partially open persisted, which was cured by Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction).
A child developed fever due to fright and was erroneously treated with diaphoretic herbs. After sweating, the complexion turned pale, and spasms occurred in the late afternoon. My elder brother diagnosed Spleen and Lung Qi Deficiency with exuberant Liver-Gallbladder pathogenic factors. He treated with Liujunzi Tang added with Chaihu and Shengma (Cimicifugae Rhizoma). The symptoms manifested during Yin-Mao hours (3-7 AM), indicating self-exuberance of Liver pathogenic factors. One dose of Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) rapidly reduced the fever, followed by Buzhong Yiqi Tang and Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) for complete recovery.
A child suffered from scrofula (Luoli). After ulceration, spasms developed with dizziness, teeth grinding, and alternating chills and fever. This belonged to Wind-Heat in the Liver Meridian. First, one dose of Chaihu Zhizi San (Bupleurum and Gardenia Powder) stopped the chills and fever. Next, Siwu Tang (Four Substances Decoction) added with Renshen (Ginseng Root), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling, and Chaihu gradually stopped the symptoms. Finally, Buzhong Yiqi Tang added with Shaoyao (Peony Root) and Fuling led to recovery.
A child had a head sore that ulcerated, triggering spasms, sometimes with chills, fever, and thirst, sometimes with cold extremities. The pulse was large, floating, and slow, but fine and weak upon deep pressure. This indicated deficiency of Yuan Qi (Primordial Qi) and excess of pathogenic factors. Ten Complete Great Tonifying Decoction (Shiquan Dabu Tang) added with Chaihu and Shanzhi (Gardeniae Fructus) was used. After several doses, symptoms receded and the pulse normalized. After another ten-plus doses, the child recovered.
A child with convulsive disorder took Baolong Wan (Emblem Dragon Pill) and Baosheng Ding (Life-Preserving Tablet), resulting in excessive salivation. Sweating then triggered spasms, and there was an intention to dispel phlegm. I stated: This is Liver and Spleen Blood Deficiency generating internal wind. Continuous salivation indicates Spleen and Lung Qi Deficiency failing to control fluids. Sweating-induced spasms indicate Spleen and Lung Qi Deficiency leading to Yang collapse. Six Gentlemen Decoction (Liujunzi Tang) added with Paojiang (Prepared Ginger) and Muxiang brought immediate relief. Four Gentlemen Decoction (Sijunzi Tang) added with Danggui (Angelica Sinensis Root) and Shudi (Prepared Rehmannia Root) stabilized the condition.
A child with wind-cold fever took dispersing herbs, causing profuse sweating. All spasm symptoms appeared. The pulse was surging and forceful on superficial pressure but fine on deep pressure. This indicated Yang collapse due to excessive sweating, belonging to Spleen and Lung Qi Deficiency. Yigong San added with Xiong (Ligusticum Rhizome), Gui (Angelicae Sinensis Radix), and Huangqi (Astragali Radix) stopped the sweating immediately. Buzhong Yiqi Tang completed the cure.
A child with food stagnation had abdominal pain, fever, and vomiting. Harsh purgatives were administered, worsening vomiting, diarrhea, and sweating, with cold extremities and persistent spasms. The pulse was floating and large but thread-like on deep pressure. Six Gentlemen Decoction added with Shengma and Paojiang stopped the spasms instantly. Only alternating chills and fever remained, which were cured by Sijunzi Tang, Shengma, and Chaihu.
The granddaughter of Vice Censor Wang Yanghu, aged eight, developed spasms after taking fire-clearing and digestion-promoting herbs. Her pulse was floating and large, with malaria-like chills and fever. I used Sijunzi Tang added with Shengma, Chaihu, Paojiang, and Gouteng (Uncariae Ramulus cum Uncis) alternately with Buzhong Yiqi Tang, leading to gradual improvement. Due to hypochondriac pain, Paojiang was removed and Muxiang and Rougui (Cinnamon Bark) were added, resulting in recovery.
A child developed fever and hypochondriac pain due to the wet nurse's anger, suffering from the aforementioned symptoms with sweating and vomiting. One dose of Xiaochaihu Tang given to both mother and child brought immediate relief. Due to afternoon tidal fever, Yigong San added with Shengma and Chaihu cured both.
Two children suffered from the same condition because their wet nurses respectively had fever with vomiting/diarrhea and fainted due to food syncope. Treating the mothers resulted in the complete recovery of the children.
Guizhi Jia Gange Tang (Cinnamon Twig Decoction plus Kudzu): Treats headache, neck and back stiffness, sweating, and aversion to wind.
Ingredients: Guizhi (Cinnamon Twig), Shaoyao (Peony Root), Gancao (Licorice Root), Gegen (Kudzu Root - 4 qian).
Usage: Take 2 qian per dose, decoct with ginger and jujube water.
Xiaochaihu Tang (Minor Bupleurum Decoction): Treats body heat, aversion to cold, spasms, stiff and urgent neck, chest and hypochondriac fullness/pain, vomiting, hiccups, irritability, and thirst; alternating chills and fever; yellowing of body and face; dysuria; constipation; unresolved fright; lingering tidal fever; relapse after recovery with fever and pain resembling malaria, occurring at fixed times. (See Liver Chapter for formula).
Jiawei Xiaochaihu Tang (Modified Minor Bupleurum Decoction): Xiaochaihu Tang added with Zhizi (Gardenia Fruit) and Mudanpi (Moutan Cortex).
Baosheng Dingzi (Life-Preserving Tablet): Treats slow convulsions presenting with Yang symptoms.
Ingredients: Quanxie (Scorpion), Baifu Zi (Typhonii Rhizoma - prepared), Jiangcan (Bombyx Batryticatus), Niudan Nanxing (Nigella Seed Arisaema Rhizoma), Chantui (Cicada Slough), Hupo (Amber), Chensha (Cinnabar) (each 1 qian), Shexiang (Moschus - 0.5 fen), Fangfeng (Saposhnikoviae Radix - 1 qian).
Usage: Grind into powder, mix with paste to form tablets, coat with gold/silver foil, take with mint decoction.
Dachengqi Tang (Major Order the Qi Decoction): Treats exterior-interior heat, constipation, chest fullness, and hypochondriac pain.
Ingredients: Chaihu (Bupleurum Root), Zhishi (Immature Bitter Orange) (each 2 liang 2 qian), Banxia (Pinellia Tuber - 1 liang 5 qian), Chi Shaoyao (Red Peony Root - 1 liang 8 qian), Huangqin (Scutellaria Root - 2 liang), Dahuang (Rhubarb Root - 3 liang 7 qian 5 fen).
Usage: Decoct with fresh ginger and red dates, take at any time.
Xiao Xuming Tang (Minor Continuation Life Decoction): (See Five Stiffness Chapter).
Yigan San (Suppress Liver Powder): (See Liver Chapter).
Dihuang Wan (Rehmannia Pill): (See Kidney Chapter).
Baidu San (Detoxification Powder): (See Fever Chapter).
Liujunzi Tang (Six Gentlemen Decoction).
Wuwei Yigong San (Five-Ingredient Benefit Work Powder): (Both formulas see Inner Hook Chapter).
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction): (See Emaciation Chapter).
Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder): (See Inner Hook Chapter).
Chaihu Zhizi San (Bupleurum and Gardenia Powder): (See Fever Chapter).
Siwu Tang (Four Substances Decoction): (See Acute Convulsion Chapter).
Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction): Bazhen Tang (Eight Treasure Decoction) added with Huangqi and Rougui, i.e., combination of Sijunzi Tang and Siwu Tang.
Baolong Wan (Emblem Dragon Pill): (See Cold Damage Chapter).
Sijunzi Tang (Four Gentlemen Decoction): (See Inner Hook Chapter).
Dachengqi Tang (Major Order the Qi Decoction): Treats Gang Jing, chest fullness with internal excess, trismus, teeth grinding, high fever with thirst, and constipation.
Ingredients: Dahuang (Rhubarb Root), Mangxiao (Mirabilite Natrii Sulfatis) (each 5 qian), Houpo (Magnolia Bark - 1 liang), Zhishi (Immature Bitter Orange).
Gegen Tang (Kudzu Decoction): Treats Taiyang Disease, neck and back stiffness, aversion to wind without sweat, and aversion to cold with Gang Jing.
Ingredients: Gegen (Kudzu Root - 4 liang), Mahuang (Ephedra Herb - 3 qian), Guizhi (Cinnamon Twig - 1 liang).
Usage: Take 2 qian per dose, decoct with water.