枚举。设人病阳明内实，逾垣上屋，则将名飞天惊矣！阴极发躁，欲卧泥水中，则将名擗地惊矣！荒唐鄙野，
虽奚童、爨婢，有所不言；而医者公然笔之于书，后人见其证皆惊证，纹悉惊纹，相与依样葫芦，一倡百和。
不知论证可任其牵强，而治疗不容于假借。如伤寒病痉，由风、寒、湿三气合邪，病在太阳、阳明、少阳，与
心惊、肝风、脾痰、肺热，风中
牛马。若以为惊风治之，则无辜之心、肝、脾、肺，枉受剥肤，而风、寒、湿外至之邪， 然磐石，可乎？因
思幼科以搐掣名惊，今即以搐字易惊字，屏去祸害之惊，祛除笼统之风，总名之曰搐，庶不骇人听闻，而又不
失病痉之本来面目。复以急惊、慢惊、慢脾之三异端，易为误搐、类搐、非搐之三宝筏。何为误搐？盖小儿伤
寒最多，由医者治不如法，抑遏其邪，莫能外解，因而壮热不退，遂变为痉，则有搐搦反张之候。与《内经》
诸痉项强、诸风掉眩、诸寒收引之例相符。归于误搐条下，俾临证者，知为伤寒病痉，不致有开关镇惊之害也。
何为类搐？盖伤暑疟痢，丹毒霍乱，容忤中恶，其证显然，辨认既明，一药可愈，何至作搐？由医者迁延时日，
抑遏邪气，无所发泄，亦有变为搐者。搐非固有，所以谓之类搐。遵《内经》诸热瞀 ，皆属于火之例，归于
类搐条下。各从本门为治，以免截风定搐之患也。何为非搐？盖小儿吐泻病后，脾败胃绝，昏睡露睛，虚痰来
往之证，幼科以为慢脾风；更以大惊卒恐，神魂离散之证，为急惊风。不知此二证，死生呼吸，犹敢以惊风称
之耶？因体景岳非风之意，竟以非搐名之，使后人知此等证候，全非风搐，而治风、治搐之法，远屏三舍，庶
可保全性命，而不致于夭札无辜也。（陈飞霞）
发搐者，幼科之一大证，诸书皆以急惊、慢惊名之。后世因其名，而重视惊字，每用金石镇坠之品以治
惊，此非其治之误，乃名之不正也。盖小儿百病，皆可生惊。其名则同，其实则别。徒习其名，而不责其实，
何以为治？按急惊、慢惊之称，非指病者而言，实指视者而言也。试详论之∶急惊之来，先因于风，而生痰、
生热，或热数日而发，或热一、二日而发，或发于仓卒之间，其来也急而惊人，故曰急惊。慢惊多因于吐泻之
后，为土败木贼之证，其来也缓而难治，医家见之，无有不惊者，故曰慢惊。古云∶急惊惊爷娘，慢惊惊药王。
又《慢脾论》云∶若逐风，则无风可逐，若疗惊，则无惊可疗。即此二义，释尽惊字之误。若
以急、慢惊证，指小儿之抽掣，则何不曰急筋、慢筋乎？若以其证，因七情之受惊而致，然惊虽跳动，而不致
于抽掣。盖跳动者，全身一跃，心惊所主也；抽掣者，手足时搦，肝木生风也。以之相较，迥然不同。何世俗
之治此二证，于急惊，每不重在驱邪，而重在治惊；于慢惊，又不重在温补，而重在治惊。是皆名之不正，有
以误之也。予今为之正其名，而遵钱氏之称，曰发搐。○发搐一证，论之已详，犹有未尽其变者。以小儿经络空
虚，百病皆能致搐。搐虽同而所以致搐者，异也。略举所见数条参之∶其一，百日乳儿，初受惊风，痰涎入于
心包，临时虽愈，一遇惊风，即涎潮口噤，手足抽掣，少时痰滑，热生病解而愈。当于未发之前，治用橘红、
半夏、防风、僵蚕、天麻、胆星、菖蒲等分，或少加牛黄、辰砂、竹沥、姜汁，杵丹，淡姜汤化服。透其包络
之痰，名透涎丹。痰尽自不更作。若久而失治，必成痫证。其一，风挟寒邪中于经络，项背强直，腰身反张者，
名曰刚痉。古用小续命汤，予用羌活愈风汤加当归、附子多效。亦有唇口牵动，手足微搦，渐至痪瘫不收者，
热在络也，用愈风汤加栀子、羚羊角。此《百问》所谓风挟寒邪即挛急，风挟热邪即缓弛之类。亦有长夏先伏
暑邪于内，而后受风者，俗谓之暑风惊。治法，若独清暑，则风不解；若专疏风，则暑不除。亦用愈风汤去僵、
蝎加石膏，名暑风饮子。轻者一服可定，重者亦可少杀其势。盖石膏质重能降热，气轻能解肌，色白属金，得
西方之令，金能制木，木火交煽，此能平之。若伏暑吐泻而作搐者，当与虚风同治，不在此例。更有发热目窜，
忽然抽掣啼叫者，俗名响惊，易治。壮热痰涌，抽掣无声者，俗名哑惊，难治。发热抽掣，少时掣定，神气清
爽，能吮乳者，名假搐，无妨。抽掣虽定而神气昏闷者，名真搐，难治。○散惊与定惊，原是二义。散者疏其邪，
定者安其神。天麻、钩藤，所以散惊，势从外解，与柴胡、荆、防，同为疏散之用，肝主惊风是也；辰砂、琥
珀，所以定惊，质从内镇，与
丹参、茯神，同为镇静之用，心藏神是也。须要分辨。（许宣治）
惊风之要领有二∶一曰实证，一曰虚证，而尽之矣。盖急惊者，阳证也，实证也。乃肝邪有余，风生热，
热生痰，痰热客于心膈间，则风火相搏，故其形证急暴，是为急惊。当先治其标，后治其本。慢惊者，阴证也，
虚证也。此脾、肺俱虚，肝邪无制，因而侮脾生风，无阳之证也。故其形气、病气俱不足，是为慢惊。当专顾
脾、肾以救元气。虽二者俱名惊风，而虚实之有不同，所以急、慢之名亦异。凡治此者，不可罔顾名思义也。
○小儿惊风，肝病也，亦脾、肾、心、肺病也。盖小儿之真阴未足，柔不济刚，故肝邪易动；肝邪动，则木能
生火，火能生风，风热相搏，则血虚；血虚则筋急；筋急则为掉眩反张、搐搦强直之类，皆肝木之本病也。至
其相移，木邪侮土则脾病，而为痰、为吐泻；木盛金衰则肺病，而为喘促、为短气；木火上炎则心病，而为
惊叫、为烦热；木火伤阴则肾病，而为水涸、为血燥、为干渴、为汗不出、为搐、为 。此五脏惊风之大概也。
治法∶一曰风，二曰火，三曰痰，四曰阳虚，五曰阴虚。所谓风者，以其强直掉眩，皆属肝木，风木同气，故
云惊风，而实非外感之证。今人不明此义，但以为治风必须用散，不知外来之风则可散，而血燥之风不可散也。
所谓痰火者，痰凝则气闭，火盛则阴亏，此实邪之病本也。若痰因火动，则治火为先；火以痰留，则去痰为主。
凡惊风之实邪，惟痰火为最，风则次之。然邪实者易制，正败者必危。盖阳虚则阴邪不散而元气不复，阴虚则
营气不行而精血何来？所以惊风之重，重在虚证。不虚不重，不竭不危。治虚之法，当辨阴阳。阳虚者，宜燥、
宜刚；阴虚者，宜濡、宜润。然善治阳者，气中自有水；善治阴者，水中自有气。造化相须之妙，既不可混、
又不可离者如此。设谓∶此非小儿之药，此非惊风之药者，岂惊风之病不属阴阳，而小儿之体不由血气乎？（张景岳）
老医常言∶小儿惊搐，多是热证。若骤用惊风药饵，如白附、
全蝎、川乌之类，便医成坏证。只用导赤散加防风，连进三服，导去心经邪热，其搐即止。从孙道润，幼患惊
搐甚危，诸医疗治益困，予授是方，二服立愈。后常救人，人无不效者。恐人忽易，故着之。○幼稚欲令惊悸
不作，在乎肾脏和平。故戴氏曰∶治惊不若补肾。盖心属火，火性燥，得肝风则烟焰起，致生惊悸。补肾则水
升火降，邪热无侵，虽有肝风，惊自不作。（《证治准绳》）
选案
徐彦为子，四岁，盛夏发热，惊搐不已，腰曲目直，小便短赤，面无神色。医作伤寒治，不应。予视之，
曰∶火燥生风，风淫末疾，非伤寒也。用滋水清肝饮一剂，汗解、便利、热退。予曰∶疟至矣！翌日果然。改
用异功散加麦冬、五味服之而愈。（《己任编》）
袁仲卿乃郎，入水捉彭蜞为戏，偶仆水中，家人救出，少顷，大热呻吟。医以镇惊清热丸、散与服，二日，
昏迷不醒，胸高头侧，气已垂绝，脉止蛛丝。谓曰∶吾从来不惧外证之重，但脉已无根，不可救矣！此儿受病，
何至此极？静筹其故，良久，曰∶得之矣。其父且惊且喜，愿闻其说。余曰∶惊风一证，乃前人凿空妄谈。小
儿受其害者，不知几千百亿兆。后见方中行痉书，始知昔贤先得我心。此证因惊而得，其实跌仆水中，感冷湿
之气，为外感发热之病。食在胃中，因而不化，当比夹食伤寒例，用五积散治之。医者不明，以金石寒冷药镇
坠，外邪深入脏腑，神识因而不清。食停胃中，得寒凉而不运。所进之药，皆在胃脘之上，不能透入，转积转
多，以致胸高而突。宜以理中汤运转前药，倘得证减脉出，然后从伤寒门用药，尚有生理。于是煎理中汤一盏，
灌入。大爆一口，前药一齐俱出，胸突顿平、颈亦微硬，但脉仍不出，人亦不苏。余曰∶此食尚未动，关窍堵
塞之故。再灌前药，热已渐退。乃从伤寒下例，以元明粉化水，连灌三次，开其大肠燥结，夜下黑粪甚多。后
以生津药，频灌而苏。○沙无翼，王生之表兄也。得子甚迟，纵啖生冷。一夕吐食暴僵，医以惊风药治之。浑身壮
热，面若装朱，眼吊唇掀，下利不计其数。诊毕，谓曰∶此慢脾风候也。脾气素伤，更以金石药重伤，今已将
绝，故显若干危证。本有法可救，但须七日方醒。恐信不笃，而更医无识，反得诿罪生谤。王生坚请，监督其
家。于是用乌蝎四君子汤，日灌一剂，每剂用人参一钱。渠家虽暗慌，然见面赤退而色转明润，便泻止而动移
轻活，亦自隐忍。至第六晚，忽觉手足不定，揭去衣被，喜吞汤水，始诋人参之害。王生张皇，任其转请他医。
才用牛黄少许，从前危证复出。重服理脾药，又五日。方苏。（《寓意草》）
孙自范翁甥孙，患慢脾证，痰涎涌盛，咳嗽身热，肢搐自汗，嗜卧露睛，撮空手振，屡进补脾兼消痰逐风
之剂不应。翁商于予，予曰∶此证风自内出，本无可逐；痰因虚动，亦不必消；只补脾土，诸证自退。但据所
示兼证，则其面必 白，眼必散大，舌必胖滑，颈必软而头必垂矣。翁曰∶诚如所言。固知其虚也，乃救虚不
应，究何故耶？予曰∶证皆属寒，方只救虚，使天柱未倒，固自附应。然逐风消痰之品，尚须削除。今颈软头
垂，天柱已倒，虚上加寒，舍桂、附何以追已去之阳而苏垂绝之气哉？乃写参附养营汤方与之。嘱曰∶如阻以
稚幼纯阳无补阳之法，则危在旦夕。翁归，取药煎饮，一剂各证悉减，三剂全除。次用异功散加煨姜、白芍，
调理而健。（《潜村医案》）
一儿病手足搐搦，戴人视之曰∶心火胜也，由保护太过所致。令净扫地，以水洒湿，抱儿卧于地上，良久
转侧，浑身泥浆皆满，乃取井水洗之，即瘥。（张子和）
急惊
《经》云∶惊则伤胆，恐则伤肾。大凡可畏之事，猝然而至者，谓之惊。若从容而至，可以宛转思维者，
谓之恐。是惊急而恐缓也。夫惊证，大人亦有之，小儿最多。因其神志未坚，胆气未充，故每遇稍异之形声，
即陡然而惊矣。惊之所伤，由心猝及乎胆，由胆即及乎肝，遂致心主君火兼肝胆中相火风木骤然而起。
证见搐搦螈 ，神昏谵妄，肢冷厥逆，吐乳身热，目窜口噤，种种所患，无非心、肝、胆之见证，而实毫无外
感之风邪。此因外受之惊而动内之木火风也。故但当以一惊字立为病名，斯乃切当。因其内风沸起，遂加一风
字；因病来迅速，又加一急字，故遂有急惊风之病名。此已属牵强附会矣。至于今之混称为急惊风者，更属背
谬。总因小儿阴气未充，外感之风温、风热、风火，以及寒邪化热，并燥火诸证，最易伤阴，阴伤则血不营筋，
液伤则脉络滞涩，热盛亦能使内之木火风相继而起。所见之证，与受惊者，类亦相同，然实非因受惊而起。其
所治之法，大有区别。如果因惊者，治宜安养心神、镇惊定怯，甘凉清内热，柔润熄肝风，或少佐芳香，通其
窍络，舒其结闭。至于刚热、燥涩、表散之药，概不可用。若无惊而但感外邪者，有宜于凉散，有宜于温散，
有宜于苦寒清火，有宜于甘温扶阳。或补或泻，自当按六淫之邪而施治，与惊字毫无关涉。奈今之医者，每遇
非惊之证，因不能辨明六气中所伤何气，却定不出病名，遂强将一惊字混入，借口漫称为急惊风证，掩饰欺人。
病家亦酷信之，以为小儿防范难周，焉有无惊之理？其所订之方，错杂游移。不知治惊总以心、肝、胆为主。
若治时邪，须兼肺、胃、脾、肾、三焦、营卫、经络而论，大不相同也。更有一种称慢惊风之病名者，尤属
怪诞不经，必当亟为驳正。（《临证指南》）
小儿风热惊搐，乃常病也。搦时切戒把握手足，握持太急，气血偏胜，必伤其臂。搐时置一竹簟，铺之凉
地，使儿寝其上，待其搐力行遍经络，自止。（张子和）
小儿惊风发作之际，手足动掣，当听其自定。或父母见病势可畏，从而按伏之。岂知筋者，肝之合也。临
病发时，若按束其手足，则筋不舒伸，经络为风所闭，致成惊瘫、鹤膝，变为废人。（曾氏）
慢惊
小儿慢惊，或因病后、或因吐泻、或因药饵，伤损脾胃，以
Enumeration. Suppose a person suffers from Yangming Fu-organ excess syndrome (Yangming bowel obstruction with heat and accumulation), capable of climbing walls and jumping onto roofs; this would be named "Flying Sky Convulsion"! If extreme Yin cold causes restlessness, and the patient desires to lie in mud or water; this would be named "Ground-Slapping Convulsion"! These names are absurd and vulgar; even young servants or kitchen maids would not utter them. Yet physicians openly record them in books. Later generations, seeing these symptoms, all classify them as convulsive disorders, interpreting every sign as a convulsive pattern, imitating each other in a chorus of one hundred echoing one voice. They do not realize that while diagnostic reasoning may be arbitrarily forced, treatment must never be compromised by false nomenclature. For instance, spasm caused by Cold Damage disease arises from the combined pathogenic factors of Wind, Cold, and Dampness, affecting the Taiyang, Yangming, and Shaoyang meridians. This is distinct from internal injuries such as Heart fright, Liver wind, Spleen phlegm, or Lung heat. If these are treated as Wind-Convulsion, the innocent organs of the Heart, Liver, Spleen, and Lung will suffer unjustly, while the external pathogens of Wind, Cold, and Dampness remain stubborn like a rock, unremoved. How can this be acceptable? Therefore, considering that pediatrics names twitching as "Jing" (Fright/Convulsion), I propose replacing the character "Jing" with "Chu" (Twitching). We should discard the harmful term "Jing" and remove the vague term "Wind," collectively naming it "Chu." This avoids alarming terminology while preserving the true nature of spasm diseases. Furthermore, we should replace the heterodox concepts of Acute Jing, Chronic Jing, and Chronic Spleen Wind with the three correct pathways: Misguided Chu, Resembling Chu, and Non-Chu.
What is Misguided Chu? Generally, children most frequently suffer from Cold Damage. Due to improper medical treatment that suppresses the pathogen without allowing external release, high fever persists, transforming into spasm, presenting with twitching and opisthotonos. This aligns with the *Nei Jing* examples of "all spasms involve neck stiffness," "all wind involves tremors and dizziness," and "all cold involves contraction." By categorizing this under Misguided Chu, clinicians will recognize it as spasm due to Cold Damage, avoiding the harm of opening orifices and suppressing fright.
What is Resembling Chu? Conditions such as Summerheat injury, Malaria, Dysentery, Erysipelas, Cholera, Guest Qi invasion, or Evil poisoning have obvious symptoms that are clearly identifiable and curable with a single herb. Why would they become twitching? Because physicians delay treatment and suppress the pathogen, preventing its expulsion, twitching may occur. Since twitching is not inherent to these diseases, it is called Resembling Chu. Following the *Nei Jing* principle that "all heat confusion and twitching belong to Fire," this is categorized under Resembling Chu. Treatment should address the root cause to avoid the error of cutting wind and stopping twitching.
What is Non-Chu? After vomiting and diarrhea in children, if the Spleen fails and Stomach energy perishes, presenting with lethargy, exposed eyes, and wandering virtual phlegm, pediatrics labels this as Chronic Spleen Wind. Additionally, conditions caused by sudden great fright leading to scattered soul and spirit are labeled Acute Fright Wind. Not realizing that these two conditions determine life or death in an instant, how dare they be called Fright Wind? Emulating Zhang Jingyue’s concept of "Non-Wind," I name them Non-Chu, so later generations know these are entirely unrelated to Wind-Convulsion, keeping wind-treating and convulsion-stopping methods far away, thus preserving life and preventing unnecessary death. (Chen Feixia)
Twitching (Fa Chu) is a major pediatric syndrome. All books name it Acute Fright or Chronic Fright. Later generations, influenced by this name, overemphasize "Fright" and use heavy mineral sedatives to treat it. This is not an error in treatment, but an error in nomenclature. Essentially, any disease in children can produce fright-like symptoms. The name is the same, but the substance differs. Merely learning the name without investigating the substance makes treatment impossible. The terms Acute and Chronic Fright do not refer to the patient, but to the observer. Let us discuss in detail: Acute Fright arises initially from Wind, generating Phlegm and Heat. It may appear after several days of fever, one or two days, or suddenly. Its onset is rapid and startling, hence "Acute Fright." Chronic Fright often follows vomiting and diarrhea, representing Earth failure and Wood usurpation (Spleen deficiency with Liver hyperactivity). Its onset is slow and difficult to treat. Physicians see it and are invariably startled, hence "Chronic Fright." Ancient saying: "Acute Fright startles parents, Chronic Fright startles the Medicine King." The *Discussion on Chronic Spleen* states: "If you chase Wind, there is no Wind to chase; if you treat Fright, there is no Fright to treat." These two points explain the error of the word "Fright." If Acute and Chronic Fright referred to child twitching, why not call them Acute Sinew and Chronic Sinew? If these conditions were caused by emotional fright, although fright causes trembling, it does not cause twitching. Trembling is a whole-body jump, governed by the Heart; twitching is intermittent hand and foot clenching, generated by Liver Wood producing Wind. Compared, they are completely different. Why do secular treatments for these two conditions focus on treating Fright rather than expelling pathogens in Acute cases, or on warming and tonifying rather than treating Fright in Chronic cases? This is all due to incorrect naming leading to erroneous treatment. I now correct the name, following Qian Yi’s terminology, calling it Twitching (Fa Chu).
Regarding Twitching, although discussed in detail, variations remain unexplored. Because children’s meridians are empty and deficient, myriad diseases can cause twitching. Although the twitching appears similar, the causes differ. I briefly list a few observations: First, infants around 100 days old who initially suffer Wind-Fright, where phlegm-saliva enters the Pericardium. Although they recover temporarily, upon encountering fright, saliva floods, mouth locks, and limbs twitch. Soon, phlegm becomes slippery, heat dissipates, and the illness resolves. Before onset, treat with equal parts Ju Hong (Citrus Reticulatae Pericarpium), Ban Xia (Pinelliae Rhizoma), Fang Feng (Saposhnikoviae Radix), Jiang Can (Bombyx Batryticatus), Tian Ma (Gastrodiae Rhizoma), Dan Xing (Arisaematis Cum Bile), and Shi Chang Pu (Acori Tatarinowii Rhizoma), or add small amounts of Niu Huang (Bovis Calculus), Chen Sha (Cinnabar), Zhu Li (Bambusae Succus), and Jiang Zhi (Zingiberis Rhizoma Recens). Pounded into pills, taken with light Ginger Decoction. This penetrates phlegm in the Pericardium collateral, named Tou Xian Dan (Saliva-Penetrating Pill). Once phlegm is exhausted, recurrence ceases. If neglected long-term, it becomes Epilepsy. Second, Wind carrying Cold pathogen strikes the meridians, causing neck and back stiffness, and body opisthotonos, named Gang Jing (Rigid Spasm). Ancients used Xiao Xu Ming Tang (Minor Continuation of Life Decoction); I use Qiang Huo Yu Feng Tang (Notopterygii and Atractylodis Macrocephalae Decoction to Expel Wind) plus Dang Gui (Angelicae Sinensis Radix) and Fu Zi (Aconiti Lateralis Radix Praeparata), which is highly effective. Some present with lip and mouth twitching, slight hand and foot clenching, gradually progressing to flaccid paralysis; this is Heat in the collaterals, treat with Yu Feng Tang plus Zhi Zi (Gardeniae Fructus) and Ling Yang Jiao (Capricornis Cornu). This corresponds to the *Bai Wen* saying: "Wind carrying Cold causes cramping; Wind carrying Heat causes flaccidity." Some have latent Summerheat internally during late summer, then contract Wind, commonly called Summerheat Wind-Fright. Treatment: clearing only Summerheat leaves Wind unresolved; dispersing only Wind leaves Summerheat unremoved. Use Yu Feng Tang removing Jiang Can and Quan Xie (Scorpio), adding Shi Gao (Gypsum Fibrosum), named Shu Feng Yin Zi (Summerheat Wind Infusion). Mild cases resolve in one dose; severe cases reduce intensity. Shi Gao is heavy to descend heat, light to release muscle layer, white belonging to Metal, receiving Western autumn command; Metal controls Wood, quenching Wood-Fire interaction. If Summerheat causes vomiting/diarrhea and twitching, treat as Virtual Wind, not covered here. More cases show fever, eye rolling, sudden twitching and crying, commonly called Loud Fright, easy to treat. High fever with phlegm surging, twitching without sound, commonly called Mute Fright, difficult to treat. Fever with twitching, stopping shortly after, with clear spirit and ability to suckle, named False Twitching, harmless. Twitching stops but spirit remains dull, named True Twitching, difficult to treat.
Dispersing Fright and Settling Fright are two distinct meanings. Dispersing means venting pathogens; Settling means calming the spirit. Tian Ma and Gou Teng disperse Fright, resolving pathogenic momentum externally, similar to Chai Hu (Bupleuri Radix), Jing Jie (Schizonepetae Herba), and Fang Feng, serving dispersing functions, as Liver governs Wind-Fright. Chen Sha and Hu Po (Amber) settle Fright, stabilizing internally, similar to Dan Shen (Salviae Miltiorrhizae Radix) and Fu Shen (Poria cum Radice), serving sedating functions, as Heart stores Spirit. Distinction is necessary. (Xu Xuanzhi)
The essence of Wind-Fright lies in two categories: Excess Syndrome and Deficiency Syndrome. Acute Fright is a Yang syndrome and Excess syndrome. It arises from Liver pathogen excess, Wind generating Heat, Heat generating Phlegm. Phlegm-Heat lodges between the Heart and Diaphragm, causing Wind and Fire to clash, resulting in acute and violent manifestations. Treat the branch first, then the root. Chronic Fright is a Yin syndrome and Deficiency syndrome. It arises from Spleen and Lung deficiency, leaving Liver pathogen unchecked, which insults the Spleen and generates Wind, a condition devoid of Yang. Thus, physical qi and pathological qi are both insufficient. Focus on protecting Spleen and Kidney to rescue Yuan Qi. Although both are called Wind-Fright, their excess and deficiency differ, hence the names Acute and Chronic differ. Clinicians must not be misled by the name.
Pediatric Wind-Fright is primarily a Liver disease, but also involves Spleen, Kidney, Heart, and Lung. Children’s True Yin is insufficient, unable to soften the rigid, so Liver pathogen moves easily. When Liver pathogen moves, Wood generates Fire, Fire generates Wind. Wind-Heat clash leads to Blood deficiency; Blood deficiency leads to sinew tension; sinew tension causes dizziness, opisthotonos, twitching, and rigidity—all primary diseases of Liver Wood. Regarding transmission: Wood insulting Earth causes Spleen disease, manifesting as Phlegm, vomiting, diarrhea; Wood excess and Metal decline cause Lung disease, manifesting as panting, shortness of breath; Wood-Fire flaming upward causes Heart disease, manifesting as fright cries, irritability; Wood-Fire injuring Yin causes Kidney disease, manifesting as fluid depletion, blood dryness, dry thirst, anhidrosis, twitching, and clonic jerking. This is the general overview of Five-Organ Wind-Fright.
Treatment methods: 1. Dispel Wind, 2. Clear Fire, 3. Resolve Phlegm, 4. Tonify Yang Deficiency, 5. Tonify Yin Deficiency. "Wind" refers to rigidity and dizziness, all belonging to Liver Wood; Wind and Wood share the same qi, hence called Wind-Fright, though it is not an external contraction. Moderns do not understand this, believing all Wind requires dispersing. External Wind can be dispersed, but Wind from Blood Dryness cannot. "Phlegm-Fire": Phlegm condensation closes Qi; Fire excess injures Yin. This is the root of excess pathology. If Phlegm moves due to Fire, treat Fire first; if Fire stays due to Phlegm, remove Phlegm primarily. Among excess pathogens in Wind-Fright, Phlegm-Fire is most critical, Wind is secondary. However, excess pathogens are easier to control; collapse of healthy Qi is dangerous. Yang deficiency prevents dispersion of Yin pathogens and recovery of Yuan Qi; Yin deficiency prevents circulation of Ying Qi and generation of Essence-Blood. Thus, severe Wind-Fright focuses on deficiency syndromes. No deficiency, no severity; no exhaustion, no danger. Treating deficiency requires distinguishing Yin and Yang. Yang deficiency requires drying and firming; Yin deficiency requires moistening and lubricating. Skillful treatment of Yang contains Water within Qi; skillful treatment of Yin contains Qi within Water. The subtle interdependence of creation cannot be confused nor separated. To say "this is not medicine for children, not for Wind-Fright" implies Wind-Fright is unrelated to Yin-Yang, and children’s bodies are not composed of Blood-Qi? (Zhang Jingyue)
Old doctors often say: Pediatric convulsions are mostly Heat syndromes. If suddenly using Wind-Fright medicines like Bai Fu Zi (Typhonii Rhizoma), Quan Xie (Scorpio), Chuan Wu (Aconiti Radix), the disease becomes iatrogenic and complicated. Use Dao Chi San (Guide Out the Red Powder) plus Fang Feng, administered continuously for three doses, to guide out Heart meridian pathogenic heat, and convulsions stop. My grandson Sun Daorun suffered severe convulsions in childhood; various doctors’ treatments worsened his condition. I prescribed this formula; he recovered after two doses. I often used it to save others with universal efficacy. I record this lest people neglect it.
To prevent palpitations and fright in infants, the Kidney must be harmonious. Dai Shi said: Treating Fright is better done by tonifying the Kidney. Heart belongs to Fire; Fire is dry. With Liver Wind, flames rise, causing fright. Tonifying Kidney raises Water and descends Fire, excluding pathogenic heat; even with Liver Wind, Fright naturally does not arise. (*Zhengzhi Zhunsheng*)
Selected Cases
Xu Yanwei’s son, four years old, in midsummer had fever and continuous convulsions, curved waist and fixed eyes, scanty dark urine, and pale face. Doctors treated as Cold Damage without effect. I examined him and said: Fire dryness generates Wind, Wind invades extremities; this is not Cold Damage. Prescribed Zi Shui Qing Gan Yin (Nourish Water and Clear Liver Decoction) for one dose. Sweating occurred, urination and defecation normalized, fever subsided. I predicted: Malaria is coming! The next day, it appeared. Changed to Yi Gong San (Benefit the Work Powder) plus Mai Dong (Ophiopogonis Radix) and Wu Wei Zi (Schisandrae Fructus), cured. (*Jiren Bian*)
Yuan Zhongqing’s son played catching crabs in water, fell accidentally, was rescued, then developed high fever and groaning. Doctors gave Zhen Jing Qing Re Wan/San (Settle Fright and Clear Heat Pills/Powder). Two days later, he was comatose, chest elevated, head tilted, breathing nearly ceased, pulse thread-thin. I said: I am never afraid of severe external signs, but if the pulse has no root, it is incurable. How did this child reach such extremity? After deep thought, I said: I understand. His father was surprised and happy, asking for explanation. I said: Wind-Fright is a baseless theory invented by predecessors. Countless children have suffered from it. Later, reading Fang Zhongxing’s book on Spasm, I realized ancient sages anticipated my thoughts. This condition is named after Fright, but actually resulted from falling in water, contracting Cold-Dampness, an external fever disease. Food in the stomach failed to digest. Treat according to Cold Damage with Food Retention, using Wu Ji San (Five Accumulations Powder). Doctors misunderstood, using cold minerals to suppress, driving external pathogens deep into organs, clouding consciousness. Food stagnated in stomach, hindered by cold medicine. Medicines remained above the epigastrium, unable to penetrate, accumulating more, causing chest protrusion. Use Li Zhong Tang (Regulate the Middle Decoction) to move the previous medicines. If signs improve and pulse returns, then treat as Cold Damage, saving life is possible. Decocted Li Zhong Tang, administered orally. Child belched loudly, expelling previous medicines, chest flattened, neck stiffened slightly, but pulse still absent, unconscious. I said: Food stagnation remains, blocking orifices. Administered again, heat gradually subsided. Applied Cold Damage purgative method, dissolving Yuan Ming Fen (Mirabilite) in water, administered three times, opening large intestine dryness, passing much black stool at night. Afterwards, frequent administration of fluids restored consciousness.
Sha Wuyi, cousin of Wang Sheng, had a son late in life, indulged in raw/cold foods. One night, vomited food and became rigid. Doctors treated with Wind-Fright medicines. Whole body high fever, face red as vermilion, eyes retracted, lips everted, profuse diarrhea. Diagnosis: Chronic Spleen Wind syndrome. Spleen Qi was previously damaged, further injured by mineral medicines, nearing extinction, hence critical signs. Curable, but requires seven days to wake. Fear of disbelief and incompetent doctors causing blame. Wang Sheng insisted, supervising. Used Wu Xie Si Jun Zi Tang (Black Scorpion and Four Gentlemen Decoction), one dose daily, with one qian of Ren Shen (Ginseng Radix et Rhizoma). Family panicked but saw redness fade, complexion brighten, diarrhea stop, movement lighten, endured silently. On sixth evening, limbs restless, removed covers, desired soup, began blaming Ren Shen. Wang Sheng panicked, allowed switching doctors. Used small amount of Niu Huang. Critical signs recurred. Resumed Spleen-regulating medicines, five more days until recovery. (*Yuyi Cao*)
Sun Zifan’s nephew suffered Chronic Spleen syndrome, abundant phlegm-saliva, cough, fever, limb twitching, spontaneous sweating, lethargy with exposed eyes, grasping air, hand shaking. Multiple doses of Spleen-tonifying and Phlegm-resolving/Wind-expelling agents failed. Uncle consulted me. I said: Wind originates internally, nothing to expel; Phlegm moves due to deficiency, nothing to resolve; only tonify Spleen Earth, symptoms will retreat. Based on accompanying signs, face must be pale, eyes dilated, tongue swollen/slippery, neck soft/head drooping. Uncle agreed. Knowing it is deficiency, why did tonification fail? I said: Signs are Cold; formula only tonifies deficiency. If Tian Zhu (Heavenly Pillar/Cervical spine) is not collapsed, it fits expectations. But Wind-expelling and Phlegm-resolving agents must be stopped. Now neck soft, head drooping, Tian Zhu collapsed, Deficiency compounded by Cold. Without Gui Zhi (Cinnamon Twig) and Fu Zi, how to retrieve lost Yang and revive dying Qi? Prescribed Shen Fu Yang Ying Tang (Ginseng and Aconite Nourishing Blood Decoction). Warned: If obstructed by the notion that infants are Pure Yang and require no Yang-tonification, danger is imminent. Uncle returned, decocted and administered. One dose reduced all symptoms; three doses eliminated them. Subsequently used Yi Gong San plus roasted ginger and Bai Shao (Paeoniae Radix Alba), regulated health. (*Qiancun Yian*)
A child suffered limb twitching. Dai Ren (Zhang Hezi) examined and said: Heart Fire excess, caused by over-protection. Ordered floor cleaned and wetted with water, placed child on ground. After turning sideways for a while, body covered in mud. Washed with well water, immediately cured. (Zhang Hezi)
Acute Fright
*Classic* says: Fright injures Gallbladder, Fear injures Kidney. Anything terrifying arriving suddenly is called Fright. Anything approaching calmly, allowing time for reflection, is called Fear. Fright is urgent; Fear is slow. Fright syndromes occur in adults, but most in children. Because their spirit is not firm and Gallbladder Qi is not full, any unusual sight or sound causes sudden fright. Injury from Fright moves rapidly from Heart to Gallbladder, then to Liver, causing Heart Sovereign Fire and Liver/Gallbladder Minister Fire/Wind-Wood to surge suddenly.
Symptoms include twitching, clonic jerking, coma, delirium, cold limbs, reversal cold, vomiting milk, body heat, eye rolling, mouth locking. All these are manifestations of Heart, Liver, and Gallbladder, with absolutely no external Wind pathogen. This is internal Wood-Fire-Wind stirred by external Fright. Therefore, the disease name should simply be "Fright," which is appropriate. Adding "Wind" because internal Wind boils up, and "Acute" because onset is rapid, results in "Acute Wind-Fright." This is already forced. Calling it "Acute Wind-Fright" today is even more erroneous. Generally, children’s Yin Qi is insufficient. External Wind-Warmth, Wind-Heat, Wind-Fire, and Cold transforming to Heat, along with Dryness-Fire, easily injure Yin. Yin injury means Blood does not nourish sinews; Fluid injury means collaterals become stagnant. Excess Heat also causes internal Wood-Fire-Wind to rise sequentially. Symptoms resemble those of actual Fright, but the cause is different. Treatment differs greatly. If truly due to Fright, treat by nourishing Heart Spirit, settling fright, using sweet-cool to clear internal heat, soft-moist to extinguish Liver Wind, or adding aromatic herbs to open orifices and relieve blockage. Hard-hot, dry-astringent, and diaphoretic medicines must not be used. If no Fright, only external pathogens, treatment may suit cool-dispersing, warm-dispersing, bitter-cold clearing fire, or sweet-warm supporting Yang. Tonify or purge according to Six Excess pathogens, unrelated to "Fright." Yet modern doctors, unable to distinguish which of the Six Qi injured when facing non-Fright cases, force the word "Fright" into the diagnosis, masking ignorance as "Acute Wind-Fright." Patients believe this, thinking children are hard to protect, so how could there be no Fright? Their prescriptions are chaotic. They do not know that treating Fright focuses on Heart, Liver, Gallbladder. Treating seasonal pathogens involves Lung, Stomach, Spleen, Kidney, San Jiao, Ying-Wei, and meridians—completely different. Even more bizarre is the name "Chronic Wind-Fright," which must be refuted urgently. (*Lin Zheng Zhi Nan*)
For pediatric Wind-Heat convulsions, a common disease: When clenching, strictly avoid holding hands and feet tightly. Too tight grip causes Qi-Blood imbalance, injuring arms. During convulsions, place a bamboo mat on cool ground, let child sleep on it. Wait until convulsions traverse meridians, they will stop naturally. (Zhang Hezi)
When pediatric Wind-Fright attacks, limbs twitch. Allow them to settle naturally. If parents fear the severity and restrain the child, consider that sinews are the partnership of the Liver. Restraint during attack prevents sinew relaxation, blocks meridians with Wind, leading to Fright Paralysis or Crutch Knee, becoming disabled. (Zeng Shi)
Chronic Fright
Pediatric Chronic Fright, whether post-illness, due to vomiting/diarrhea, or medication, damages Spleen and Stomach...