天钓之状。发时头目仰视。惊悸壮热。两目反张。泪出不流。手足搐掣。不时悲笑。如
鬼祟
所附。甚者爪甲皆青。由乳母浓味积热。贻儿为患。或外感风邪所致。宜内服钓藤饮。外用
双金散吹鼻。至于内钓。其状则腹痛多喘。唇黑囊肿。伛偻反张。眼尾赤色。或五内抽
掣。作痛狂叫。或泄泻缩脚。亦由乳母起居不慎。或为寒气所乘而致。宜钓藤饮。五味异功
散。
加干姜木香。甚者宜加肉桂。进乳食者可治。若因乳母郁怒伤肝。宜兼治其母。宜用逍遥散
加熟地。或加味归脾汤。俱加漏芦。子母同服。
小儿痫症。多因禀受先天不足。或因妊母七情所伤。传儿为患。发之之状。其候则神气
怫郁
。眼瞪面目牵引。口噤涎流。肚腹膨胀。手足搐掣。或项背反张。或腰脊强直。或仆地作声
。醒时吐沫。但当以四体柔弱。发而时醒者。是即痫症也。第五脏不同。治法各异。阴阳
有别。难易殊途。宜详言之。假如面赤目瞪。吐舌啮唇。心烦气短。其声如羊者。此心痫也
。宜养心汤。妙香散主之。假如面青唇青两眼上窜。手足挛掣反折。其声如犬者。此肝痫也
。宜地黄丸主之。若搐而有力。宜柴胡清肝散主之。假如面黑目振。口吐涎沫。形体如尸。
其声如猪者。此肾痫也。宜地黄丸大剂煎汤主之。假如面如枯骨。目白反视。惊跳反折。摇
头吐沫。其声如鸡者。此肺痫也。宜补肺散主之。若面色萎黄。土不生金也。宜异功散主之
。若面赤色。阴火上冲于肺也。宜地黄丸主之。假如面色萎黄。目直腹满。四肢不收。其声
如牛者。此脾痫也。宜异功散主之。若面青泻利。饮食少思。木来乘土也。宜六君子加木香
柴胡主之。以上五脏所属。主治之大法也。至若阴阳难易。则以发热。抽掣仰卧。面色光泽
。脉浮者为阳。易治。若身冷。不搐。覆卧。面色黯黑。脉沉者为阴。难治。要皆元气不足
之症也。通宜用紫河车研膏。加人参当归末。糯米粥糊丸。多服取愈。若妄用祛风化痰克
伐之剂。或初发时。误作惊风施治者。必死。大凡小儿平日。宜察其耳后高骨间。若有青脉
纹者。宜即抓破出血可免斯患。此外又有因汗出当风。或脱换衣服。风邪乘虚暗袭。致见目
青面红。迷闷搐掣。涎潮屈指。如计数者。名曰风痫。宜先用消风丸少少与之。继即用补中
益气汤。兼六味地黄丸。或八珍汤之类主之。兼宜服紫河车丸。又有因伤食过甚。以致嗳吐
气。发搐。大便 臭者。名曰食痫。即俗所谓食厥者是也。宜详伤食发搐条。兹不再
。上凡十条。其候虽各有不同。而其搐搦之状。似与世之所谓惊风者相仿佛。其实病各不同
。主治亦互异。真不啻有霄壤之别。冰炭之分焉。究其相沿。概谓惊风之说。由于不细心
探
讨前人之书。但概谓之惊风。则其法为较通俗而易耳。殊不知此门一开。遂令天下业幼科者
。只抱数方。便为神术。或更独标其名曰惊科。大可叹也。吾今而立是说。非发前人所未发
。实启后来之大觉耳。吾于操缦者有浓望焉。
The manifestations of *Tiandiao* (Heavenly Hook) are: during an attack, the head and eyes look upward, there is palpitation with high fever, the eyes roll back, tears flow but do not drain freely, the hands and feet twitch and spasm, and the child laughs or cries inappropriately as if possessed by a spirit. In severe cases, the fingernails and toenails turn blue. This condition arises from accumulated heat due to the wet nurse's rich and greasy diet affecting the infant, or from external contraction of wind pathogenic factors. It is appropriate to administer internally *Diaoteng Yin* (Hookwire Decoction) and externally apply *Shuangjin San* (Double Gold Powder) blown into the nasal cavity.
As for *Neidiao* (Internal Hook), the symptoms include abdominal pain with frequent panting, black lips, scrotal swelling, a curved posture or opisthotonos (backward arching of the body), redness at the corners of the eyes, internal spasms of the five viscera causing pain and wild screaming, or diarrhea with retracted legs. This is also caused by the wet nurse's careless daily life or invasion by cold pathogenic factors. It is appropriate to prescribe *Diaoteng Yin* (Hookwire Decoction) and *Wuwei Yigong San* (Five-Ingredient Extraordinary Merit Powder), adding *Ganjiang* (Dried Ginger) and *Muxiang* (Aucklandiae Radix). For severe cases, *Rougui* (Cinnamon Bark) should be added. Infants who can take milk and food are treatable. If the cause is the wet nurse's frustration and anger injuring the Liver, the mother should be treated simultaneously. It is appropriate to use *Xiaoyao San* (Free and Easy Wanderer Powder) with *Shudi* (Prepared Rehmannia Root) or *Jiawei Guipi Tang* (Modified Restore the Spleen Decoction), both added with *Loulu* (Euphorbiae Humifusae Herba). Mother and child should take the medicine together.
Pediatric epilepsy (*Xianzheng*) is mostly due to congenital insufficiency or emotional injuries sustained by the pregnant mother that are transmitted to the fetus. The manifestations upon onset include: depressed spirit, staring eyes with facial muscle traction and twitching, locked jaws with drooling, abdominal distension, hand and foot spasms, opisthotonos, rigid spine, falling down making sounds, and foaming at the mouth upon waking. However, if the limbs are flaccid and the child regains consciousness after the episode, this is indeed epilepsy. The five types corresponding to the five Zang organs differ, and their treatment methods vary; Yin and Yang distinctions make the prognosis different, so they must be explained in detail.
If the face is red, eyes are staring, the tongue protrudes and bites the lips, there is mental restlessness and shortness of breath, and the cry resembles that of a sheep, this is Heart Epilepsy (*Xin Xian*). It is appropriate to use *Yangxin Tang* (Nourish Heart Decoction) and *Miaoxiang San* (Wonderful Incense Powder) as the main treatment. If the face and lips are cyanotic, eyes roll upward, hands and feet contract and spasm with reversal, and the cry resembles that of a dog, this is Liver Epilepsy (*Gan Xian*). It is appropriate to use *Dihuang Wan* (Rehmannia Pill) as the main treatment. If the spasms are forceful, *Chaihu Qinggan San* (Bupleurum Clearing Liver Powder) is appropriate. If the face is black, eyes tremble, saliva foams out, the body is stiff like a corpse, and the cry resembles that of a pig, this is Kidney Epilepsy (*Shen Xian*). It is appropriate to use a large dose of *Dihuang Wan* (Rehmannia Pill) decocted in water as the main treatment. If the face looks like dry bone, whites of the eyes are visible due to upward gaze, there is startled jumping and reversal, head shaking with foaming, and the cry resembles that of a chicken, this is Lung Epilepsy (*Fei Xian*). It is appropriate to use *Bufei San* (Tonify Lung Powder) as the main treatment. If the complexion is sallow, it indicates Earth failing to generate Metal (Spleen deficiency failing to nourish the Lung); *Yigong San* (Extraordinary Merit Powder) is appropriate. If the face is red, it indicates ministerial fire rushing up to the Lung; *Dihuang Wan* (Rehmannia Pill) is appropriate.
If the complexion is sallow, eyes are fixed, abdomen is full, limbs cannot hold themselves, and the cry resembles that of an ox, this is Spleen Epilepsy (*Pi Xian*). *Yigong San* (Extraordinary Merit Powder) is appropriate. If the face is green with diarrhea and poor appetite, it indicates Wood overacting on Earth (Liver invading Spleen); *Liujunzi Tang* (Six Gentlemen Decoction) added with *Muxiang* (Aucklandiae Radix) and *Chaihu* (Bupleuri Radix) is appropriate. The above represents the general principles for treating the five Zang epilepsies. Regarding the distinction between Yin/Yang and difficult/easy cases: fever, spasms, supine position, lustrous complexion, and floating pulse indicate Yang patterns, which are easy to treat. Cold body, absence of spasms, prone position, dark complexion, and deep pulse indicate Yin patterns, which are difficult to treat. All these are essentially syndromes of insufficient Yuan Qi (Original Qi). Generally, it is appropriate to use *Ziheche* (Placenta Hominis) ground into paste, mixed with powders of *Renshen* (Ginseng Radix) and *Danggui* (Angelicae Sinensis Radix), formed into pills with rice porridge paste, taken in large amounts until recovery. If one recklessly uses wind-dispelling, phlegm-resolving, or draining agents, or mistakenly treats early attacks as convulsive disorders (*Jingfeng*), death is certain.
Generally, for children in daily life, one should observe the area behind the ear near the mastoid process; if blue vascular markings are present, pricking them to bleed can prevent this affliction. Additionally, there is Wind Epilepsy (*Feng Xian*) caused by exposure to wind while sweating or changing clothes, where wind pathogens invade secretly due to deficiency, leading to blue eyes, red face, coma, spasms, tidal salivation, and fingers curling as if counting. It is appropriate to first give small doses of *Xiaofeng Wan* (Wind-Dispersing Pill), followed immediately by *Buzhong Yiqi Tang* (Center-Supplementing Qi-Boosting Decoction), combined with *Liuwei Dihuang Wan* (Six-Ingredient Rehmannia Pill) or *Bazhen Tang* (Eight Treasures Decoction). Taking *Ziheche Wan* (Placenta Pill) is also appropriate. There is also Food Epilepsy (*Shi Xian*) caused by excessive eating, leading to belching, vomiting, spasms, and foul-smelling stool, commonly known as Food Syncope (*Shi Jue*). Refer to the section on "Convulsions due to Food Injury" for details; this will not be repeated here.
The above ten types, although presenting different symptoms, have spasmodic states that seem similar to what the world calls "Convulsive Disorder" (*Jingfeng*). In reality, the diseases are different, and treatments vary; the difference is vast, like heaven and earth, or ice and charcoal. Investigating the origin of this nomenclature, labeling everything as "Convulsive Disorder" stems from a lack of careful study of predecessors' works, simply using a popular and easy term. Little do they know that opening this door allows pediatric practitioners to rely on only a few formulas, claiming them as divine arts, or even branding themselves solely as "Convulsive Disorder Specialists," which is truly lamentable. I establish this theory now not to uncover secrets unknown to predecessors, but to awaken future generations. I place great hope in those who practice pediatrics.