天钓邪热积心胸，痰涎壅盛气不通，螈 壮热同惊证，头目仰视若钓形。九龙控涎医搐掣，牛黄
散用善驱风，螈 减参钩藤饮，爪甲青色苏合精。
【注】小儿天钓证，由邪热痰涎壅塞胸间，不得宣通而成，发时惊悸壮热，眼目上翻，手
足螈 ，爪甲青色，证似惊风，但目多仰视，较惊风稍异。痰盛兼搐者，九龙控涎散主之；
惊盛兼风者，牛黄散主之；搐盛多热者，钩藤饮主之；爪甲皆青者，苏合香丸主之。
九龙控涎散
赤脚蜈蚣（酒涂炙干，一条） 滴乳 天竺黄（各一钱，二味研匀） 腊茶 雄黄 炙甘草（各
二两） 荆芥穗（炒） 白矾（枯，各一钱） 绿豆（半生半熟，一百粒）
上为末，每服五分，人参薄荷汤调下。
牛黄散
牛黄（细研，一钱） 朱砂（水飞细研，一钱） 麝香（五分） 天竺黄（二钱） 蝎梢（一钱） 钓
藤钩（二钱）
研匀，每服一字，新汲水调下。
钩藤饮
人参 全竭（去毒） 羚羊角 天麻 甘草（炙） 钓藤钩
水煎服。
【按】天钓乃内热痰盛，应减人参。
【方歌】天钓须用钩藤饮，螈 连连无止歇，人参羚羊与钩藤，炙草天麻共全蝎。
苏合香丸（方见肛门内合）
内钓肝脏病受寒，粪青潮搐似惊痫，伛偻腹痛吐涎沫，红丝血点目中缠。螈 甚者钩藤饮，急啼腹
痛木香丸，肢冷甲青唇口黑，养脏温中或保全。
【注】内钓者，多因肝脏素病，外受寒冷，其候粪青潮搐者，作止有时也。伛偻腹痛者，
曲腰而痛也，口吐涎沫，证虽与惊痫相类，但目有红丝血点。螈 甚者，钩藤饮主之；急
啼腹痛者，木香丸主之；若肢冷甲青，唇口黑者，养脏散主之。然内钓至此，乃中寒阴
盛不治之证，用此救治，庶或保全。
钩藤饮（方见天钓）
木香丸
没药 木香（煨） 茴香（炒） 钓藤钩 全蝎 乳香（各等分）
先将乳香没药研匀，后入诸药末和毕，取大蒜少许研细，和丸如桐子大，晒干，每次二丸，钩藤汤下。
养脏散
当归 沉香 木香（煨） 肉桂 川芎（各半两） 丁香（二钱）
上为末，每服一钱，淡姜汤调服。
Tian Diao (a pediatric syndrome characterized by convulsions and upward deviation of the eyes) is caused by pathogenic heat accumulating in the chest and heart, with excessive phlegm-fluids obstructing the flow of Qi. It presents with twitching, high fever, and symptoms similar to Jing Feng (convulsive disorders), where the head and eyes look upward as if being hooked. For cases with excessive phlegm accompanied by twitching, Jiulong Kongyan San (Nine Dragons' Phlegm-Draining Powder) is used; for cases with severe convulsions accompanied by wind, Niuhuang San (Calculus Bovis Powder) is used; for cases where twitching subsides and heat decreases, Shengou Teng Yin (Gastrodia and Uncaria Decoction) is used; and for cases where the fingernails are cyanotic, Suhexiang Wan (Styrax Pill) is used.
[Note] The Tian Diao syndrome in children arises from pathogenic heat and phlegm-fluids obstructing the chest and diaphragm, preventing their dispersion and descent. Upon onset, it manifests as palpitations, high fever, upward deviation of the eyes, twitching of the hands and feet, and cyanosis of the nails. The presentation resembles Jing Feng (convulsive disorders), but differs slightly in that the eyes tend to gaze upward. For cases with excessive phlegm and twitching, Jiulong Kongyan San (Nine Dragons' Phlegm-Draining Powder) is the primary formula; for cases with severe convulsions and wind, Niuhuang San (Calculus Bovis Powder) is the primary formula; for cases with severe twitching and prominent heat, Gouteng Yin (Uncaria Decoction) is the primary formula; and for cases where all fingernails are cyanotic, Suhexiang Wan (Styrax Pill) is the primary formula.
Jiulong Kongyan San (Nine Dragons' Phlegm-Draining Powder)
Geococcus (Chijiao Wugong, 赤脚蜈蚣) (coated with wine, roasted until dry, one piece); Milkwort Resin (Diru, 滴乳, i.e., Frankincense); Himalayan Beechwood (Tianzhuhuang, 天竺黄) (each one qian, these two ingredients ground together evenly); Winter Tea (Lacha, 腊茶); Realgar (Xionghuang, 雄黄); Roasted Licorice Root (Zhigancao, 炙甘草) (each two liang); Schizonepeta Spike (Jingjiesui, 荆芥穗) (stir-fried); Alum (Baifan, 白矾) (calcined, each one qian); Mung Bean (Lvdou, 绿豆) (half raw, half cooked, one hundred grains).
Grind the above into powder. Each dose is five fen, taken with Ginseng and Mint Decoction (Renshen Bohe Tang, 人参薄荷汤).
Niuhuang San (Calculus Bovis Powder)
Calculus Bovis (Niuhuang, 牛黄) (finely ground, one qian); Cinnabar (Zhusha, 朱砂) (wet-ground, one qian); Moschus (Shexiang, 麝香) (five fen); Himalayan Beechwood (Tianzhuhuang, 天竺黄) (two qian); Scorpion Tail (Xieshao, 蝎梢); Uncaria Hook (Goutenggou, 钓藤钩) (two qian).
Grind evenly. Each dose is one zi volume, taken with fresh cool water.
Gouteng Yin (Uncaria Decoction)
Codonopsis Root (Renshen, 人参); Whole Scorpion (Quanxie, 全蝎) (de-toxicated); Aries Cornu (Lingyangjiao, 羚羊角); Gastrodia Rhizome (Tianma, 天麻); Roasted Licorice Root (Zhigancao, 炙甘草); Uncaria Hook (Goutenggou, 钓藤钩).
Decoct in water and take.
[Commentary] Tian Diao is caused by internal heat and excessive phlegm; therefore, Ginseng should be reduced or omitted.
[Formula Song] To treat Tian Diao, Gouteng Yin must be used; for continuous twitching without cessation, use Ginseng, Aries Horn, and Uncaria, combined with Roasted Licorice, Gastrodia, and Whole Scorpion.
Suhexiang Wan (Styrax Pill) (See the section on Anorectal Conditions for the formula)
Nei Diao (a pediatric syndrome characterized by abdominal pain, crying, and convulsions) results from pre-existing liver pathology compounded by cold invasion. Symptoms include greenish stool, paroxysmal convulsions resembling Jing Xian (epilepsy), stooping posture due to abdominal pain, vomiting of saliva/foam, and red blood vessels/spots visible in the eyes. For severe twitching, Gouteng Yin (Uncaria Decoction) is used; for urgent crying and abdominal pain, Muxiang Wan (Costus Pill) is used; for cold limbs, cyanotic nails, and black lips/mouth, Yangzang San (Viscera-Nourishing Powder) may be used to preserve life.
[Note] Nei Diao is often caused by a pre-existing liver condition combined with external cold invasion. Its manifestations include greenish stool and paroxysmal convulsions, which occur at regular intervals. Stooping and abdominal pain refer to bending the waist in pain. Vomiting saliva/foam makes the presentation resemble Jing Xian (epilepsy), but the presence of red blood vessels/spots in the eyes distinguishes it. For severe twitching, Gouteng Yin (Uncaria Decoction) is the primary formula; for urgent crying and abdominal pain, Muxiang Wan (Costus Pill) is the primary formula; for cold limbs, cyanotic nails, and black lips/mouth, Yangzang San (Viscera-Nourishing Powder) is the primary formula. However, when Nei Diao progresses to this stage, it represents a critical condition of cold damage with excess Yin, which is generally considered incurable. Using this formula for rescue may offer a chance of survival.
Gouteng Yin (Uncaria Decoction) (See the section on Tian Diao for the formula)
Muxiang Wan (Costus Pill)
Myrrh (Moyao, 没药); Costus Root (Muxiang, 木香) (roasted); Fennel Seed (Huixiang, 茴香) (stir-fried); Uncaria Hook (Goutenggou, 钓藤钩); Whole Scorpion (Quanxie, 全蝎); Frankincense (Ruxiang, 乳香) (equal parts).
First, grind Frankincense and Myrrh evenly, then mix with the powders of the other herbs. Take a small amount of garlic, grind it finely, and mix it with the herbal powder to form pills the size of tung tree seeds. Dry them in the sun. Each dose is two pills, taken with Gouteng Decoction (Gouteng Tang, 钩藤汤).
Yangzang San (Viscera-Nourishing Powder)
Angelica Root (Danggui, 当归); Agarwood (Chenxiang, 沉香); Costus Root (Muxiang, 木香) (roasted); Cinnamon Bark (Rougui, 肉桂); Szechuan Lovage Rhizome (Chuanxiong, 川芎) (each half liang); Clove (Dingxiang, 丁香) (two qian).
Grind the above into powder. Each dose is one qian, taken with light Ginger Decoction (Danjiang Tang, 淡姜汤).