男发左搐。或手大指屈外。或目左视无声者顺也。若发右搐。或手大指屈内。或目右视有声者逆也。女发右
搐。或手大指屈内。或目右视无声者顺也。若发左搐。或手大指屈外。或目左视有声者逆也。顺者相胜也。左肝
为木。右肺为金。一负一胜，故无声也。逆者战也。二脏俱实。木金相击。故有声也。顺者易治。逆者难治。
男逆稍易。女逆极难。更当参其发时。以补泻为治。昔钱乙治李寺丞子三岁。发搐自卯至巳。目右视。大叫哭。
乙见曰。逆也。男为阳。本发左视无声则顺。右视有声则逆。所以然者。左肝木也。右肺金也。逆则二脏相战。
金木相击。而有声也。治乃泻强补弱。假令女发搐。目左视。是肺来
胜肝。肝不能任。故叫哭也。当泻其肺。后治其心。续治其肝。若病在秋。（日西时同）肺兼旺位。当大泻其
肺。若病在春。（早晨时同）此肝旺之时。尚不能胜肺。是肺强而肝大弱也。当补其肝肾。大泻其肺。若男发搐目
右视。是肝来胜肺而叫哭。当泻其肝心。若病在春夏。（早晨日中时同）肝心旺时。当大泻其肝。若病在秋。
（日晡时同）
此肺旺之时。尚不能胜肝。是肝强而肺极虚也。当补其肺。大泻其肝。所以言目反视者。乃肝主目也。凡搐则是
风热相搏于内。风属肝。故引见于目也。今此病男反女。故稍易治于女也。先泻其肺。不闷乱。以知肺病退也。
后补其肾。续治其肝心。五日而愈。乙又治徐氏子三岁。每日西发搐。身微热。目微斜露睛。四肢冷而喘。大便
微黄。请乙与一李医同治。乙问李曰。病搐何如。以何药治之。李对不当。乙曰。搐者心肝实也。身微热者。日
西肺用事之时。肺主身温。今且热者。肺虚也。目微斜露睛者。肝肺相乘胜也。四肢冷者。脾虚也。肺若虚甚。
则脾母亦弱。木气乘之。四肢即冷。治当先补脾肺。得脾虚证退。然后治其心肝。九日乃愈。此亦逆搐。肝肺相
乘。目斜者必当右视也。今举此以明逆顺为治之法尔。
In boys, convulsions occurring on the left side, or with the thumb flexed outward, or with the eyes looking to the left and no sound, are considered favorable (Shun). If convulsions occur on the right side, or with the thumb flexed inward, or with the eyes looking to the right accompanied by sound, they are considered unfavorable (Ni). In girls, convulsions occurring on the right side, or with the thumb flexed inward, or with the eyes looking to the right and no sound, are considered favorable. If convulsions occur on the left side, or with the thumb flexed outward, or with the eyes looking to the left accompanied by sound, they are considered unfavorable. "Favorable" refers to the relationship of overcoming in Five Elements theory. The left corresponds to Liver Wood, and the right corresponds to Lung Metal. One is defeated and one overcomes, hence there is no sound. "Unfavorable" refers to struggle between the two Zang organs. Both Liver and Lung are excess; Metal and Wood strike each other, hence there is sound. Favorable cases are easy to treat; unfavorable cases are difficult to treat. Unfavorable cases in boys are slightly easier to treat, while unfavorable cases in girls are extremely difficult. Furthermore, one must consider the time of onset and employ tonification and purgation as treatment principles.
Previously, Qian Yi treated the three-year-old son of Official Li. The child suffered from convulsions from Mao hour to Si hour, with eyes looking to the right and loud crying. Upon seeing this, Qian Yi said, "This is an unfavorable case." Boys belong to Yang. Normally, leftward gaze without sound is favorable, while rightward gaze with sound is unfavorable. This is because the left corresponds to Liver Wood and the right to Lung Metal. In unfavorable cases, the two Zang organs battle, Metal and Wood strike each other, producing sound. Treatment should involve purging the excess and tonifying the deficiency.
For example, if a girl suffers convulsions with eyes looking to the left, it indicates that Lung Qi is overcoming Liver Wood, which cannot withstand it, resulting in crying. One should purge the Lung first, then treat the Heart, and subsequently treat the Liver. If the disease occurs in Autumn (similarly at dusk), when Lung is in a prosperous position, one should heavily purge the Lung. If the disease occurs in Spring (similarly in the morning), when Liver is prosperous, yet it still cannot overcome the Lung, it indicates that Lung is strong and Liver is very weak. One should tonify Liver and Kidney, and heavily purge the Lung.
If a boy suffers convulsions with eyes looking to the right, it indicates that Liver Qi is overcoming Lung Metal, causing crying. One should purge Liver and Heart. If the disease occurs in Spring and Summer (similarly in the morning and noon), when Liver and Heart are prosperous, one should heavily purge the Liver. If the disease occurs in Autumn (similarly at dusk), when Lung is prosperous, yet it still cannot overcome the Liver, it indicates that Liver is strong and Lung is extremely deficient. One should tonify Lung and heavily purge the Liver. The reason for retroversion of the eyes is that Liver governs the eyes. All convulsions result from Wind-Heat struggling internally. Wind belongs to Liver, hence it manifests in the eyes. Since this case presents opposite symptoms for males and females, it is slightly easier to treat than in females. Purge Lung first; if there is no distress or confusion, it indicates Lung pathology has receded. Then tonify Kidney, followed by treating Liver and Heart. Recovery occurs in five days.
Qian Yi also treated the three-year-old son of the Xu family. Every day at dusk, he suffered convulsions, slight fever, slightly deviated eyes with eyelids retracted, cold limbs, panting, and slightly yellow stool. He requested both Qian Yi and Physician Li to treat him. Qian Yi asked Physician Li, "How is the convulsion? What medicine do you propose?" Physician Li's response was inappropriate. Qian Yi said, "Convulsions indicate Heart and Liver Excess. Slight fever occurs because at dusk, Lung takes command; Lung governs body warmth. Current heat indicates Lung Deficiency. Slightly deviated eyes with retracted eyelids indicate Liver and Lung mutual overcoming. Cold limbs indicate Spleen Deficiency. If Lung is severely deficient, its mother, Spleen, will also be weak. Wood Qi will take advantage, causing cold limbs. Treatment should first tonify Spleen and Lung. Once Spleen deficiency signs recede, then treat Heart and Liver. Recovery occurs in nine days." This is also an unfavorable convulsion, with Liver and Lung mutual overcoming. Deviated eyes must look to the right. This case is cited to illustrate the method of treatment based on favorable and unfavorable patterns.