脐风发搐者难治。
初生月内。非脐风证。发搐者。此胎惊也。宜至圣保命丹。金银磨水送下。
或用全蝎一枚。薄荷叶包。炙为末。朱砂末三分和匀。猪乳调服。
常发者。名胎痫。不可治也。如变蒸发热甚。发搐者。只用导赤散泻青丸主之。效。
疮疹未出发搐者。此吉兆也。宜用导赤散煎调朱砂服之。效。或将靥发搐者。凶兆也。
气攻心。宜急解救之。用真牛黄脑子各一分朱砂末五分和匀。猪尾尖血和丸小粟粒大。每一
丸。灯草煎汤化下。
丹瘤发搐。视其先后何如。先发丹后发搐者不治。此胎毒自外入里也。先发搐后发丹。
此名惊丹可治。此胎毒自内而外也。宜用大连翘饮主之。
连翘（一钱） 瞿麦（一钱） 滑石（一钱） 车前子（一钱） 大力子（一钱炒） 赤芍（一钱）
木
二钱） 荆芥穗（一钱） 蝉蜕（一钱） 上为细末。再加大黄。灯心水煎。
虫疥浸淫疮入腹。发搐。难治。急用雄黄解毒丸。升麻煎汤下。疮再发。儿搐止者吉。
发搐。视其病之新久。如初咳嗽时。痰盛气促。连声不止。而不能治。发搐者。宜葶苈丸。
苏叶煎汤下。利去其痰。咳止搐亦止矣。如久嗽不止者难治。宜用小阿胶散。服五分至一钱
。煎去渣灌下。如发搐后变嗽者。此风邪入肺也。宜人参荆芥散再发之。
陈皮（去白） 荆芥穗 桔梗 半夏 桂枝 细辛 木通 甘草（炙） 杏仁（去皮尖） 上
各等分。水煎姜引。
泄痢发搐。如先吐泻。或痢疾久不止。以致脾胃虚弱者。此慢惊风也。难治。如先发搐
发泄痢者。此因发搐之时。多用利惊下痰之药。或多用寒凉之药。伤其胃气。泄痢不止。宜
补涩之。钱氏异功散。加木香砂仁肉豆蔻诃子肉为末。山药粉糊丸。米饮水调之。
疟疾发搐。疟作热时发搐者。此宜截去其疟。疟止搐亦止矣。小柴胡汤加常山槟榔乌梅
日服。以截其疟。发过服辰砂五苓散。以定其搐。神效。如发搐后变疟者。此脾风之证也。
宜平疟养脾丸主之。
蕲水李中庵。吾婿也。一儿未周岁。因伤食发疟。间一日一发。在子丑时。疟发搐亦发
发时切牙呻唤。大便黄绿。努黄而出。用口吮母口。得乳即止。疟后汗出心下跳。腹中鸣。
退后顶上有小热。其父母爱惜之心。疟退搐退。则喜而称愈。疟搐俱发。则忧惧不胜。其母
又不禁口。病未十日成疳矣。面色 白。囟陷发疏。儿渐羸瘦，请予治之。予曰。此儿先受
暑湿。暑则为疟。湿则为痰。又伤饮食。助其暑湿之邪。暑则伤心。湿则伤脾。暑生热。湿
生痰。脾土一衰。肝木随旺。疟曰食疟。疳曰食疳。当从虚治。且大哭手撤。皆肝胆之病。
子时属胆。切牙者心肝俱热也。肝木心火。子母病也。大叫哭者。肝病也。呻唤者。肾病也
。肾水肝木。母以子病也。肝者厥阴风木也。心跳者。少阴君火也。水火相搏。则内作搐。
故大便努黄而出。用口吮母之口。此内热作渴也。儿口不能言。得乳自解。汗出者。初发之
时。邪气拂郁。及其退而有汗。此真气外泄也。故治疟之法。无汗要有汗。散邪为主。有汗
要无汗。养正为主。此儿汗泄于外。便泄于内。心下跳。腹中鸣。皆火盛证也。肝胆从火
治。此其法也。退后顶热。儿顶出颠。亦厥阴肝经之脉也。予制一方两治之。于平疳止搐方
中加治疳之药。于补脾消疟方中。加止搐之药。调理五日。疟搐俱止。儿亦渐肥。而疳瘦除
矣。附其方于下。其平疳止搐加减于当归龙荟丸。用归身人参炙甘草柴胡川芎各一钱。青皮
芦荟木香各七分。胆草酒洗栀仁各五分。半夏大者三个。一本有黄芩陈皮神曲糊丸黍米大。
每服二十五丸。寅卯时竹叶煎汤下。治疟补脾。加味参苓白术散。人参黄 蜜炙归身九肋鳖
甲使君子白芍药酒炒各一钱。炙甘草青皮去白各八分。浓桂泽泻木香夜明砂柴胡各五分。陈
皮七分。一本有干蟾莲肉共碾末。山药糊丸粟米大。每服三十丸。巳戌二时服。炒米汤下。
乳母服加味四物汤。当归川芎赤芍药生地黄柴胡升麻麦门冬木通黄芩酒炒桔梗各五分。薄荷
叶七分。灯草水煎服。
Convulsions caused by neonatal tetanus (Umbilical Wind) are difficult to treat.
For infants within one month of birth, if the convulsions are not due to Umbilical Wind, this condition is termed Fetal Startle (Tai Jing). It is appropriate to use Zhi Sheng Bao Ming Dan (Supreme Life-Preserving Pill), administered with water ground from gold or silver.
Alternatively, use one whole scorpion (Quan Xie), wrapped in mint leaves (Bo He Ye), roasted and powdered. Mix evenly with three fen of cinnabar powder (Zhu Sha Mo), and administer mixed with pig milk.
Frequent attacks are named Fetal Epilepsy (Tai Xian) and are incurable. If convulsions occur during the period of metabolic transformation (Bian Zheng) accompanied by severe fever, only Dao Chi San (Guide Out the Red Powder) and Xie Qing Wan (Drain Green Pill) should be used as the main treatment, which yields effective results.
Convulsions occurring before the eruption of sores and rashes indicate a favorable omen. It is appropriate to decoct Dao Chi San and mix it with cinnabar for administration, yielding effective results. Conversely, convulsions occurring when sores and rashes form crusts (Ye) indicate an unfavorable omen.
If pathogenic qi attacks the heart, urgent rescue is required. Use one fen each of real borneol (Nao Zi) and rhinoceros horn substitute/calculus bovis (Niu Huang - note: text says Niu Huang, traditionally rhino but often musk/borneol context in pediatrics, here strictly Niu Huang/Calculus Bovis or Musk depending on interpretation, WHO term Calculus Bovis/Musk mix often used, sticking to text: Niu Huang [Calculus Bovis] and Nao Zi [Borneol]), mixed with five fen of cinnabar powder. Form pills the size of small millet seeds using blood from the tip of a pig's tail. For each pill, dissolve in a decoction of juncus effusus (Deng Cao) and administer.
Convulsions caused by erysipelas (Dan Liu) depend on the sequence of onset. If erysipelas appears first followed by convulsions, it is incurable; this indicates fetal toxin moving from exterior to interior. If convulsions appear first followed by erysipelas, it is named Startled Erysipelas (Jing Dan) and is treatable; this indicates fetal toxin moving from interior to exterior. The main treatment is Da Lian Qiao Yin (Large Forsythia Decoction).
Ingredients: Lian Qiao (Forsythiae Fructus) 1 qian, Qu Mai (Dianthi Herba) 1 qian, Hua Shi (Talcum) 1 qian, Che Qian Zi (Plantaginis Semen) 1 qian, Da Li Zi (Arctii Fructus) 1 qian (stir-fried), Chi Shao (Paeoniae Radix Rubra) 1 qian, Mu Tong (Akebiae Caulis) 2 qian, Jing Jie Sui (Schizonepetae Spica) 1 qian, Chan Tui (Cicadae Periostracum) 1 qian. Grind all into fine powder, add Da Huang (Rhei Radix et Rhizoma), and decoct with Deng Xin Cao (Junci Medulla) water.
Convulsions caused by insect bites, impetigo (Chong Jie, Jin Yin Chuang) invading the abdomen are difficult to treat. Urgently use Xiong Huang Jie Du Wan (Realgar Detoxification Pill), administered with a decoction of Sheng Ma (Cimicifugae Rhizoma). If the sores reappear and the infant's convulsions cease, it is a favorable sign.
When assessing convulsions, observe whether the disease is recent or chronic. If initially there is coughing with abundant phlegm and rapid breathing, continuous and untreatable, leading to convulsions, Ting Li Wan (Descurainiae Seed Pill) is appropriate, administered with Perilla Leaf (Su Ye) decoction. This promotes the discharge of phlegm; once coughing stops, convulsions also cease. If chronic coughing persists, it is difficult to treat. Xiao E Jiao San (Small Donkey-Hide Gelatin Powder) is appropriate; administer 5 fen to 1 qian, decoct, remove dregs, and灌 (administer orally). If coughing develops after convulsions, this indicates wind-pathogen invading the lungs. Ren Shen Jing Jie San (Ginseng and Schizonepeta Powder) should be used to disperse the pathogen.
Ingredients: Chen Pi (Citri Reticulatae Pericarpium, white part removed), Jing Jie Sui, Jie Geng (Platycodonis Radix), Ban Xia (Pinelliae Rhizoma), Gui Zhi (Cinnamomi Ramulus), Xi Xin (Asari Radix et Rhizoma), Mu Tong, Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma), Xing Ren (Pruni Semen, skin and tips removed). All in equal parts. Decoct in water with fresh ginger (Sheng Jiang) as a guide.
Convulsions caused by diarrhea and dysentery (Xie Li): If vomiting and diarrhea occur first, or if dysentery persists for a long time causing spleen and stomach deficiency, this is Slow Convulsive Wind (Man Jing Feng), which is difficult to treat. If convulsions occur first, followed by diarrhea/dysentery, this is because excessive use of drugs for calming startle and resolving phlegm, or excessive use of cold-cooling drugs during convulsions, has damaged stomach qi, leading to persistent diarrhea/dysentery. Treatment should involve tonifying and astringing. Use Qian Shi Yi Gong San (Master Qian's Extraordinary Working Powder), added with Mu Xiang (Aucklandiae Radix), Sha Ren (Amomi Fructus), Rou Dou Kou (Myristicae Semen), and He Zi Rou (Terminaliae Chebulae Mesocarp), ground into powder. Form pills using yam powder paste, and administer mixed with rice water.
Convulsions caused by malaria: If convulsions occur during the fever phase of malaria, it is appropriate to arrest the malaria; once malaria ceases, convulsions will also cease. Administer Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Chang Shan (Polygalae Radix), Bing Lang (Arecae Semen), and Wu Mei (Mume Fructus) daily to arrest the malaria. After the attack subsides, administer Chen Sha Wu Ling San (Cinnabar Five-Ingredient Powder with Poria) to stabilize convulsions; this is highly effective. If malaria develops after convulsions, this is Spleen Wind (Pi Feng) syndrome. Ping Mie Yang Pi Wan (Malaria-Canceling Spleen-Nourishing Pill) is the main treatment.
Li Zhong'an of Qishui, my son-in-law, had a son under one year old who developed malaria due to food stagnation. The malaria occurred every other day at Zi and Chou hours. During malaria attacks, convulsions also occurred, characterized by grinding teeth and groaning. Stool was yellow-green, passed with effort, appearing yellow. The infant sucked the mother's nipple, and symptoms ceased upon receiving milk. After the malaria subsided, sweating occurred, palpitations in the epigastrium, borborygmus in the abdomen, and slight heat on the vertex after fever reduction. The parents, out of affection, rejoiced when malaria and convulsions subsided, declaring recovery; they were overwhelmed with fear when both recurred. The mother failed to maintain dietary restrictions, and within ten days, the child developed Infantile Malnutrition (Gan Syndrome). The complexion was pale, fontanelle sunken, hair sparse, and the child became emaciated. I was consulted. I said: This child first contracted summerheat-dampness. Summerheat manifests as malaria; dampness manifests as phlegm. Food injury further aided the summerheat-dampness pathogens. Summerheat injures the Heart; dampness injures the Spleen. Summerheat generates heat; dampness generates phlegm. As Spleen Earth declines, Liver Wood flares up. Malaria due to food is called Food Malaria; Gan due to food is called Food Gan. Treatment must address deficiency. Crying and hand withdrawal are disorders of the Liver and Gallbladder. Zi hour belongs to the Gallbladder; grinding teeth indicates Heat in both Heart and Liver. Liver Wood and Heart Fire represent a mother-child pathological relationship. Loud crying indicates Liver disease; groaning indicates Kidney disease. Kidney Water and Liver Wood represent a mother-suffering-child relationship. The Liver is Jueyin Wind-Wood; heart palpitations are Shaoyin Sovereign-Fire. Water and Fire contend internally, generating convulsions. Hence, stool is passed with effort and yellow color. Sucking the mother's nipple indicates internal heat causing thirst. The infant cannot speak; milk provides relief. Sweating occurs because initially, pathogenic qi was constrained; upon resolution, sweat indicates leakage of true qi. Therefore, the method for treating malaria is: if no sweat, induce sweat to scatter pathogen; if sweating, stop sweat to nourish righteousness. This child leaks sweat externally and stool internally; palpitations and borborygmus are signs of excess fire. Treat Liver and Gallbladder according to fire principles. Heat on the vertex after fever reduction relates to the Jueyin Liver meridian passing through the vertex. I formulated a prescription to treat both conditions simultaneously. In the Ping Gan Zhi Chu formula, I added herbs for Gan; in the Bu Pi Xiao Mie formula, I added herbs for stopping convulsions. After five days of regulation, malaria and convulsions ceased, the child gained weight, and Gan emaciation resolved. The formulas are attached below.
The Ping Gan Zhi Chu formula is modified from Dang Gui Long Hui Wan: Dang Gui Shen (Angelicae Sinensis Radix Root Part), Ren Shen (Ginseng Radix), Zhi Gan Cao (Prepared Licorice Root), Chai Hu (Bupleuri Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma) each 1 qian; Qing Pi (Citri Reticulatae Pericarpium Viride), Lu Hui (Aloe), Mu Xiang (Aucklandiae Radix) each 7 fen; Dan Cao (Scutellariae Radix, wine-washed), Zhi Ren (Gardeniae Semen) each 5 fen; Ban Xia (Pinelliae Rhizoma), 3 large pieces. Another version includes Huang Qin (Scutellariae Radix), Chen Pi, Shen Qu (Medicated Leaven). Form pills with Shen Qu paste, size of millet seeds. Take 25 pills per dose, administered with bamboo leaf (Zhu Ye) decoction at Yin and Mao hours.
For treating malaria and tonifying spleen, use Jia Wei Shen Ling Bai Zhu San (Modified Ginseng, Poria, and Atractylodes Macrocephala Powder): Ren Shen, Huang Qi (Astragali Radix, honey-fried), Dang Gui Shen, Jiu Lei Bie Jia (Trionycis Carapax, nine-rib variety), Shi Jun Zi (Quisqualis Fructus), Bai Shao Yao (Paeoniae Radix Alba, wine-fried) each 1 qian; Zhi Gan Cao, Qing Pi (white part removed) each 8 fen; Nong Gui (Cinnamomi Cortex), Ze Xie (Alismatis Rhizoma), Mu Xiang, Ye Ming Sha (Vermis Lucidae), Chai Hu each 5 fen; Chen Pi 7 fen. Another version includes Gan Chan (Bufo Skin) and Lian Rou (Nelumbinis Semen), ground together. Form pills with yam paste, size of millet seeds. Take 30 pills per dose, administered at Si and Xu hours with stir-fried rice water.
The wet nurse should take Jia Wei Si Wu Tang (Modified Four Substances Decoction): Dang Gui, Chuan Xiong, Chi Shao Yao (Paeoniae Radix Rubra), Sheng Di Huang (Rehmanniae Radix), Chai Hu, Sheng Ma (Cimicifugae Rhizoma), Mai Men Dong (Ophiopogonis Radix), Mu Tong, Huang Qin (Scutellariae Radix, wine-fried), Jie Geng each 5 fen; Bo He Ye (Menthae Haplocalycis Folium) 7 fen. Decoct with Deng Cao (Junci Medulla) and water.