小儿之病。最重惟惊。惊必发搐。惊必窜睛。惊必牙紧。惊必面青。惊必鱼口。惊必弓形。心经热积。肝部风生。
肝风心火。二脏交争。血乱气壅。痰涎与并。百脉凝滞。关窍不灵。或急或慢。随其所撄。急由阳盛。慢属阴凝。急缘
实病。慢自虚成。急惊之症。暴疾难名。种种恶候。一一并呈。迨其发定。了了神清。揆厥所原。调护失情。昼抱当风。
夜卧浓衾。多食辛辣。偶触鼓钲。跌扑嚷叫。人物雷霆。凡诸惊恐。动魄乱经。一旦疾作。讵比寻恒。慢惊之症。睡卧
靡宁。乍发乍静。神思昏瞑。大抵久病。逐渐热增。吐泻疟痢。消耗匪轻。脾虚胃弱。阳常不升。虚邪火旺。肝木来乘。
淹延困顿。遂致命倾。有慢脾风。症更堪憎。慢惊之后。虚极难胜。病全归脾。故慢脾称。脾家痰饮。凝聚胸膺。脾家
虚热。来往相仍。脾困气乏。肢冷目瞪。频呕腥臭。微搐焦声。无风可逐。无惊可平。十不救一。魂魄归冥。又有天吊。
状若祟凭。头目仰视。身热不停。爪青肢 。是真病情。邪热毒瓦斯。壅遏心精。颇难调治。医药速营。诸惊疾发。诊视
察听。表里虚实。尤贵详明。惊风之属。痫痉易醒。更多兼症。一一细评。毋轻心掉。毋躐等行。方治无误。医始称能。
钱乙曰。因潮热发搐在寅卯辰时者。此脾用事之时也。身体壮热。目上视。手足动摇。口内生热涎。项颈强急。此
肝旺也。当补肾治肝。补肾地黄丸。治肝泻青丸。因潮热发搐在巳午未时者。此心用事之时也。心惕。目上视。白睛赤
色。牙关紧急。口内涎生。手足动摇。此心旺也。当补肝治心。补肝地黄丸。治心导赤散、凉惊丸。因潮热发搐在申酉
戌时者。此肺用事之时也。不甚搐而喘。目微斜视。身热如火。睡露睛。手足冷。大便淡黄水。此肺旺也。当补脾治肝
治心。补脾益黄散。治肝泻青丸。治心导赤散。因潮热发搐在亥子丑时者。此肾用事之时也。不甚搐而卧不稳。身体温。
目睛紧。斜视。喉中有痰。大便银褐色。乳食不消。多睡不省。此肾旺也。当补脾治心。补脾益黄散。治心导赤散、凉
惊丸。
In pediatric diseases, the most severe is **Jing Feng** (Convulsive Disorder due to Wind). Contracting Jing Feng inevitably leads to **Chou Xu** (Convulsions), **Cuan Jing** (Gazing Upward/Eye Deviation), **Ya Jin** (Lockjaw), **Mian Qing** (Bluish Complexion), **Yu Kou** (Fish-mouth Anus/Anal Fissure with Swelling), and **Gong Xing** (Opisthotonos/Arched Back). This results from heat accumulation in the Heart Meridian and wind generation in the Liver region.
Liver wind and Heart fire contend with each other, causing blood chaos and Qi stagnation, with phlegm and saliva accumulating together. The hundred vessels become stagnant, and orifices lose their agility. The condition may be acute or chronic, depending on the pathogenic factor encountered. Acute cases stem from Yang excess; chronic cases belong to Yin coagulation. Acute Jing is caused by excess syndromes, while chronic Jing naturally arises from deficiency.
The symptoms of Acute Jing are sudden and difficult to describe; various ominous signs appear simultaneously. Once the episode subsides, consciousness clears immediately. Investigating the origin, it stems from improper nursing: holding the child in drafts during the day, wrapping them in thick quilts at night, consuming too much spicy food, occasional exposure to loud noises like drums and gongs, falls, shouting, or witnessing thunder and frightening figures. All such frights disturb the Soul (Po) and disrupt the meridians. When the disease strikes, how can it be compared to ordinary ailments?
The symptoms of Chronic Jing include restless sleep, alternating between episodes and quietness, and a dull, confused mental state. Generally, after prolonged illness, heat gradually increases. Conditions such as vomiting, diarrhea, malaria, and dysentery consume vital energy significantly. Spleen deficiency and Stomach weakness lead to frequent failure of Yang to ascend. Deficient pathogens stir up fire, and Liver Wood overacts on Spleen Earth. Prolonged suffering and exhaustion eventually lead to fatal collapse. Among these is "Slow Spleen Wind," a condition even more detestable. After Chronic Jing, deficiency becomes extreme and unbearable. The pathology fully resides in the Spleen, hence the name Slow Spleen Wind. Phlegm-fluids accumulate in the chest and diaphragm; deficient heat in the Spleen comes and goes continuously. The Spleen is trapped and Qi is exhausted, leading to cold limbs, staring eyes, frequent vomiting of foul-smelling matter, slight convulsions, and a hoarse voice. At this stage, there is no wind to dispel and no fright to calm; fewer than one in ten survives, with the Soul departing to the underworld.
There is also "Tian Diao" (Heavenly Suspension), resembling possession by spirits, with head and eyes looking upward, continuous body heat, cyanotic nails, and stiff limbs. This is a genuine pathological condition where evil heat and toxic vapors obstruct the Heart essence. It is difficult to treat, requiring swift medical intervention.
For the onset of various Jing disorders, diagnosis requires careful observation and listening. Exterior and interior, excess and deficiency must be clearly distinguished. Diseases categorized under Jing, such as Epilepsy (Xian) and Spasm (Jing), often allow for easier awakening but present with many concurrent symptoms that must be evaluated meticulously. Do not be negligent or careless; do not skip steps in treatment. Only when prescriptions are error-free can a physician be deemed competent.
Qian Yi stated: If convulsions triggered by tidal fever occur during the Yin, Mao, and Chen hours (5 AM–1 PM), this is the time when the Spleen is dominant. The body has high fever, eyes look upward, hands and feet tremble, hot saliva is produced in the mouth, and the neck is stiff and tight. This indicates Liver hyperactivity. One should tonify the Kidney and treat the Liver, using Shu Di Huang Wan (Rehmannia Pill for Tonifying the Kidney) for the Kidney and Xie Qing Wan (Drain Green Pill for Treating the Liver) for the Liver.
If convulsions triggered by tidal fever occur during the Si, Wu, and Wei hours (9 AM–3 PM), this is the time when the Heart is dominant. There is heart palpitations/fear, eyes look upward, the whites of the eyes are red, jaw is tight, saliva is produced in the mouth, and hands and feet tremble. This indicates Heart hyperactivity. One should tonify the Liver and treat the Heart, using Bu Gan Di Huang Wan (Tonify Liver Rehmannia Pill) for the Liver, and Dao Chi San (Guide Out Red Powder) and Liang Jing Wan (Cool Jing Pill) for the Heart.
If convulsions triggered by tidal fever occur during the Shen, You, and Xu hours (3 PM–9 PM), this is the time when the Lung is dominant. Convulsions are mild but accompanied by wheezing, eyes gaze slightly obliquely, body heat is intense like fire, eyes remain open during sleep (sleeping with eyes partially open), hands and feet are cold, and stool is pale yellow watery. This indicates Lung hyperactivity. One should tonify the Spleen and treat the Liver and Heart, using Yi Huang San (Yellow-Boosting Powder) for the Spleen, Xie Qing Wan for the Liver, and Dao Chi San for the Heart.
If convulsions triggered by tidal fever occur during the Hai, Zi, and Chou hours (9 PM–3 AM), this is the time when the Kidney is dominant. Convulsions are mild but sleep is unstable, body temperature is warm, eyes are fixed or gaze obliquely, there is phlegm in the throat, stool is silver-brown, milk and food are undigested, and the child sleeps excessively without regaining full consciousness. This indicates Kidney hyperactivity. One should tonify the Spleen and treat the Heart, using Yi Huang San for the Spleen, and Dao Chi San and Liang Jing Wan for the Heart.