李 曰。小儿螈 不定。翻眼戴睛。状若神祟。头目仰视。手足抽掣。如鱼之上钓。故曰天钓。甚者爪甲亦青。此
由乳母过食热毒。心肺生热。加以外感风邪所致。宜用九龙控涎散、钩藤散。热胜则保命丹。痰盛则抱龙丸。又有惊风
内钓之症。腹痛多啼。面青唇黑。伛偻反张。外肾肿。尿如米泔。眼有红筋血点。乃寒气壅结也。宜钩藤膏。
阎孝忠曰。天吊。亦惊风症也。但天吊发时。头目必仰视。惊风则无此症状。
张涣曰。小儿心膈壅滞邪热。痰涎蕴积。不得宣通。或乳母饮酒食肉。烦毒之气。流入乳中。令儿宿滞不消。邪热
毒瓦斯。乘于心神。致使惊悸。眼目翻腾。壮热不休。螈 。病名天钓。甚者爪甲皆青。状如神祟。宜一字散、牛黄散。
薛己曰。内钓者。腹痛多喘。唇墨囊肿。伛偻反张。眼尾赤。此胎中受风及外惊所致。若五内抽掣作痛。狂叫。或
泄泻缩脚。内症一作。外症亦然。极难调理。内症服聚宝丹。外症服钩藤饮。进乳食者可治。若因乳母浓味。宜加味
清胃汤。若因乳母郁怒积热。加味逍遥散加漏芦。
曾氏曰。急惊天吊之后。有变作潮热似疟者。手足逆冷。盖因病愈时。不善将护。风邪乘虚而入经络所致。此症所
用药品。可间使苦寒之味。务在消阳盛之火。肺金得胜。肝木自平。而风邪亦散。斯为良法。
阎孝忠曰。惊风或泄泻等症。有烦渴者。皆津液内耗也。不问阴阳。宜钱氏白术散。使满意取足饮之。愈多愈好。
薛己曰。诸惊有目睛 动者。盖目者。肝之窍。肝胆属风木。二经兼为相火。肝藏血。血不足则风火内生。故目
动。宜用四物汤益其血。柴胡、山栀清其肝。阴血内荣。则虚风自息矣。有唇口蠕动者。唇为脾之华。口乃脾之窍。又
阳明之脉。环唇口而交人中。是以脾胃虚者。多有此症。不独病后而已。夫脾主涎。脾虚不能收摄。多兼流涎。或误认
为痰而祛逐之。则津液益枯。不能滋养筋脉。遂致四肢抽搐。病势愈甚。原其治法。与慢脾风相同。当大补脾胃。加升
柴。切勿用青皮、龙胆之类。有忽然惊搐目直者。皆肝之风热也。若肝虚生风。则目连札而不搐。及多欠切牙。若肝经
风实。则目直大叫。呵欠项急顿闷。若肝经有热。则目直视不搐。得心热则搐。气热则外生。气温则内生。其症手寻衣
领。及乱捻物。宜泻青丸。壮热喘闷。宜泻白散。有睡中惊动者。由心肾不足也。盖心主血与神。肝藏血与魂。肺主气
与魄。肾主精与恐。小儿脏腑脆弱。易于惊恐。恐则气下。惊则心无所根据。神无所归。且人之神气。寤则行于目。寐则
栖于肾。今心肾既虚。则不能宁摄精神。故睡中惊动。治宜清心安神。用茯苓补心汤加茯神、枣仁、五味。亦有惊吓而
作者。因击动其肝。故魂不安也。治宜镇惊定魄。用安神镇惊丸。有惊后目微动切牙者。皆病后亡津液。不能荣其筋脉
也。亦有肝经虚热而生风者。当审其气血有余不足而治之。有惊泄者。肝属木。盛则必传克于脾。脾土既衰。则乳食不
化。水道不调。故泄泻色青。或兼发搐者。盖青乃肝之色。搐乃肝之症也。亦有因乳母脾虚受惊。及怒动肝火而致者。
法当平肝补脾。若用峻攻之药。脾气益虚。肝邪弥甚。甚至抽搐反张者。亦肝火炽盛。中州亏损之变症也。凡见惊症。
即宜用四君、六君、异功等方。加白附子定风。柴胡平肝引经以杜渐。则必不至泻搐而自安矣。今已见泻吐惊搐。尚
不知补脾平肝。以保命丹、抱龙丸、镇惊丸等治之。其亦去生远矣。
Li said: Infants exhibit indefinite limb convulsions, eyes rolling upward and fixed, with symptoms resembling spirit possession. The head and eyes gaze upward, while the hands and feet undergo spasmodic jerking, similar to a fish struggling after being hooked; hence it is called "Tian Diao" (Sky Fishing). In severe cases, the fingernails and toenails also turn cyanotic. This is caused by the wet nurse overconsuming heat-toxic foods, leading to heat in the Heart and Lungs, compounded by external contraction of Wind pathogen. It is appropriate to use Jiulong Kongxian San (Nine Dragons Phlegm-Draining Powder) or Gouteng San (Uncaria Decoction). If Heat is predominant, Baoming Dan (Life-Preserving Pill) should be used. If Phlegm is excessive, Baolong Wan (Dragon-Holding Pill) is indicated. There is also a condition known as Jing Feng Nei Diao (Internal Hooking of Wind-Stroke), characterized by abdominal pain with frequent crying, bluish complexion, black lips, body curvature or opisthotonos, swelling of the external genitalia, urine turbid like rice washings, and red blood spots in the eyes. This results from Cold Qi stagnation and accumulation. Gouteng Gao (Uncaria Ointment) is suitable.
Yan Xiaozhong stated: Tian Diao is also a type of Jing Feng (Wind-Stroke) syndrome. However, during an attack of Tian Diao, the head and eyes must gaze upward, a symptom absent in ordinary Jing Feng.
Zhang Huan stated: When evil Heat stagnates in the chest and diaphragm of infants, and Phlegm-Saliva accumulates without being dispersed, or if the wet nurse consumes alcohol and meat, allowing foul and toxic Qi to enter the milk, causing retained food stagnation in the infant, the evil Heat and toxic vapors may assault the Spirit-Mind. This leads to palpitations and fright, rolling eyes, persistent high fever, and convulsions. The disease is named Tian Diao. In severe cases, all nails turn cyanotic, and the appearance resembles spirit possession. Yizi San (One Character Powder) and Niuhuang San (Calculus Bovis Powder) are appropriate.
Xue Ji stated: The symptoms of Nei Diao include abdominal pain with frequent panting, blackish lips, scrotal swelling, body curvature or opisthotonos, and reddened eye corners. This is caused by Wind contracted in the womb and external fright. If there are spasmodic pains in the five Zang organs, wild screaming, diarrhea with drawn-up legs, once the internal symptoms manifest, external symptoms will follow, making it extremely difficult to regulate. For internal symptoms, Jubao Dan (Treasure-Gathering Pill) is taken; for external symptoms, Gouteng Yin (Uncaria Decoction) is taken. Cases where the infant can consume milk and food are treatable. If caused by the wet nurse's consumption of rich flavors, Jiawei Qingwei Tang (Modified Stomach-Clearing Decoction) is suitable. If caused by the wet nurse's frustration and accumulated heat, Jiawei Xiaoyao San (Modified Free Wanderer Powder) with Loulu (Radix Euphorbiae Humifusae) is suitable.
Zeng Shi stated: After acute Jing Xing Tian Diao, some cases transform into tidal fever resembling malaria, with cold extremities. This occurs because, during recovery, improper nursing allows Wind pathogen to enter the meridians through deficiency. For this syndrome, medicines should be bitter and cold in nature. The goal is to eliminate excessive Yang Fire; once Lung Metal prevails, Liver Wood naturally balances, and Wind pathogen dissipates. This is the excellent method.
Yan Xiaozhong stated: In Jing Feng or diarrhea syndromes, if there is irritability and thirst, it indicates internal depletion of Body Fluids. Regardless of Yin or Yang patterns, Qian Shi Baizhu San (Master Qian's Atractylodes Macrocephala Powder) is appropriate, allowing the patient to drink to satisfaction; the more they drink, the better.
Xue Ji stated: Various Jing Feng syndromes accompanied by eyeball tremors occur because the eyes are the opening of the Liver. The Liver and Gallbladder belong to Wind-Wood, and these two meridians jointly govern Ministerial Fire. The Liver stores Blood; when Blood is insufficient, internal Wind and Fire arise, causing eye tremors. Siwu Tang (Four Substances Decoction) should be used to nourish the Blood, while Chaihu (Radix Bupleuri) and Shanzhi (Fructus Gardeniae) clear the Liver. When Yin-Blood is internally nourished, deficient Wind naturally subsides. Lip and mouth twitching occurs because the lips are the bloom of the Spleen, and the mouth is its opening; furthermore, the Yangming Meridian circles the lips and mouth and intersects at the Renzhong point. Thus, those with Spleen-Stomach deficiency often have this symptom, not only post-illness. The Spleen governs saliva; Spleen deficiency fails to control retention, often accompanied by drooling. If mistakenly treated as Phlegm and purged, Body Fluids become further depleted, failing to nourish the sinews, leading to limb convulsions and worsening condition. Its treatment principle is the same as Man Pi Feng (Slow Spleen Wind): strongly tonify the Spleen and Stomach, add Shengma (Rhizoma Cimicifugae) and Chaihu. Do not use Qingpi (Exocarpium Citri Reticulatae Viride) or Longdan (Radix Gentianae). Sudden convulsions with staring eyes indicate Liver Wind-Heat. If Liver deficiency generates Wind, the eyes blink repeatedly without convulsion, accompanied by yawning and teeth grinding. If Liver meridian has Excess Wind, the eyes stare straight, with loud crying, yawning, neck stiffness, and sudden dizziness. If Liver meridian has Heat, the eyes stare straight without convulsion. Heart Heat causes convulsions; Qi Heat manifests externally; Warmth generates internally. Symptoms include picking at clothes and randomly fiddling with objects; Xieqing Wan (Drain Green Pill) is indicated. High fever with wheezing and oppression requires Xiebai San (Drain White Powder). Fright during sleep is due to Heart-Kidney insufficiency. The Heart governs Blood and Spirit; the Liver stores Blood and Hun (Ethereal Soul); the Lungs govern Qi and Po (Corporeal Soul); the Kidneys store Essence and Fear. Infants' Zang-Fu are fragile and prone to fright. Fear causes Qi to sink; fright leaves the Heart without support and the Spirit without refuge. Human Spirit-Qi travels through the eyes when awake and rests in the Kidneys when asleep. With Heart-Kidney deficiency, Spirit cannot be calmed and secured, causing fright during sleep. Treatment requires clearing the Heart and calming the Spirit using Fuling Buxin Tang (Poria Tonifying Heart Decoction) plus Fushen (Poria with Hostwood), Zaoren (Semen Ziziphi Spinosae), and Wuweizi (Fructus Schisandrae Chinensis). Some cases arise from shock, disturbing the Liver so the Hun is unsettled. Treatment requires settling fright and stabilizing the soul using Anshen Zhenjing Wan (Spirit-Calming and Fright-Resolving Pill). Post-fright slight eye movement and teeth grinding indicate post-illness loss of Body Fluids failing to nourish sinews. Some cases involve Deficient Heat in the Liver meridian generating Wind; treatment must assess whether Qi and Blood are excess or deficient. Post-fright diarrhea occurs because the Liver belongs to Wood; when excessive, it transmits to overcome the Spleen. With weakened Spleen Earth, milk and food fail to transform, and water pathways are disordered, resulting in green-colored diarrhea. Convulsions may accompany this because green is the color of the Liver, and convulsions are the manifestation of the Liver. Some cases result from the wet nurse's Spleen deficiency with fright, or anger stirring Liver Fire. The method should soothe the Liver and tonify the Spleen. Using harsh purgatives will further weaken Spleen Qi and exacerbate Liver Evil, potentially leading to convulsions and opisthotonos, which are variations of blazing Liver Fire and central deficiency. Whenever Jing symptoms appear, one should immediately use Sijunzi Tang (Four Gentlemen Decoction), Liujunzi Tang (Six Gentlemen Decoction), or Yigong San (Extraordinary Aid Powder), adding Baifu Zi (Semen Trichosanthis) to settle Wind, and Chaihu to soothe the Liver and guide the meridian to prevent progression, ensuring safety from diarrhea and convulsions. Now that diarrhea, vomiting, and convulsions have appeared, yet there is no attempt to tonify the Spleen and soothe the Liver, but instead using Baoming Dan, Baolong Wan, or Zhenjing Wan, this moves far away from survival.