龚信曰。眼睛翻转。口中出血。两足摆跳。肚腹搐动。摸体寻衣。神昏气促。喷药不下。通关不嚏。心中热。忽大
叫者。皆急惊不治之症也。四肢厥冷。吐泻咳嗽。面黯神惨。胃痛鸦声。两胁动气。口生白疮。发直摇头。眼睛不转。
涎鸣喘噎。项软。二便不禁。手足一边牵引。皆慢惊不治之症也。
罗谦甫曰。患慢惊者。若似搐而不甚搐。似睡而精神散漫。四肢与口中气皆冷。睡中露睛。或胃痛而啼哭如鸦声。
此症已危。盖脾胃虚损故也。
杨士瀛曰。慢惊欲绝之候。虚痰上攻。咽喉引气。呼吸粗大。脉来浮数。是谓阴盛强阳。错认以为阳气已复。与药
下痰。痰随药下。气随痰绝。殊不知覆灯将绝之时。虽不下药。亦无生意矣。
慢脾风。身冷粘汗。直卧如尸。喘嗽头软。背直口噤头摇。二便不禁。唇缩气粗。痰如牵锯之声者。不治。慢脾风。
若一脏绝。即不可下药。如眼无光。指甲黑四肢垂 。五体俱冷。并不须下药。
滑伯仁曰。诸惊搐而不休。休而再搐。惊叫发搐。汗出足冷。痰满胸喉。口开目直者。皆不治。
仆地作声。醒吐HT 涎。异于惊病。命之曰痫。小儿恶候。痫其一焉。所以然者。气骨不坚。脏腑尚弱。血脉未全。
乳哺失节。客气相干。惟风惊食。乃痫之原。风属外感。惊属内缘。不内不外。食所是专。盖此三因。三痫各缠。别其
经络。脾与心肝。然古痫症。称有五端。五脏配合。六畜殊看。一曰马痫。马叫连连。此其所属。心火熬煎。二曰羊痫。
羊叫绵绵。此其所属。肝风作愆。三曰鸡痫。鸡鸣关关。此其所属。肺部邪干。四曰猪痫。猪叫漫漫。此其所属。右肾
病传。五曰牛痫。牛吼 。此其所属。脾土湿湮。应声而发。俱各仆颠。心则面赤。吐啮舌尖。肝则面青。手足掣挛。
肾则面黑。体直尸眠。肺则面白。惊跳头旋。脾则面黄。四肢缓瘫。古人分辨。若是班班。然诸痫症。莫不有痰。咽喉
梗塞。声出多般。致疾之由。惊食风寒。血滞心窍。邪犯心官。随声所发。轻重断联。虽似六畜。讵竟确然。奚分五脏。
附会戋戋。 通心主。血脉调宣。豁痰顺气。治法真诠。医者识此。慎毋改迁。痫为心病。痉乃肝 。风邪所袭。太阳
最先。肝风内煽。相与招延。内外风合。强直难扳。角弓反张。发则如弦。不搐不搦。目惟上观。有刚有柔。悉心以探。
大约气虚。病根内拴。兼痰挟火。病势难安。治痉之法。其旨甚元。摇头噤口。相类为缘。乘脾合胆。区别其间。
Gong Xin stated: Eyes rolling upward or deviating, bleeding from the mouth, jumping of both feet, abdominal convulsions, hands groping for clothes, coma with shortness of breath, inability to swallow sprayed medicine, failure to sneeze after using Tongguan San (Opening the Orifices Powder), heat in the heart, and sudden loud screaming are all symptoms of untreatable acute wind-stroke (Ji Jing). Cold extremities, vomiting, diarrhea, coughing, dark complexion with a miserable spirit, stomach pain with crying sounds like a crow, qi moving in both hypochondriac regions, white sores in the mouth, upright hair with head shaking, immobile eyes, phlegm rales with wheezing and choking, flaccid neck, incontinence of urine and feces, and unilateral traction and convulsion of hands and feet are all symptoms of untreatable chronic wind-stroke (Man Jing).
Luo Qianfu stated: In patients suffering from chronic wind-stroke, if it appears as convulsion but is not severe, appears as sleep but the spirit is scattered, coldness in both extremities and the mouth, sleeping with eyes open (sleeping with exposed eyeballs), or stomach pain with crying sounding like a crow, this condition is already critical. This is due to deficiency and damage of the Spleen and Stomach.
Yang Shiying stated: The signs of impending death in chronic wind-stroke involve deficiency-phlegm attacking upwards, qi being drawn into the throat, coarse breathing, and a floating and rapid pulse. This is termed Yin excess forcing Yang outward (Yin Sheng Ge Yang). Mistakenly believing that Yang Qi has recovered, one administers medicine to resolve phlegm. As the phlegm moves downward with the medicine, the Qi also perishes along with the phlegm. Little do they know that when an oil lamp is about to go out, even without administering medicine, there is no vitality left.
In slow spleen wind (Man Pi Feng), the body is cold with sticky sweat, lying straight like a corpse, wheezing and coughing with a soft head, back straight, jaw clenched, and head shaking, incontinence of urine and feces, retracted lips, coarse breathing, and phlegm sounds like sawing wood are untreatable. In slow spleen wind, if the Qi of one Zang organ has perished, medication should not be administered. For instance, if the eyes lack luster, fingernails are black, limbs hang down, and the whole body is cold, no medication is necessary.
Hua Borun stated: Various wind-strokes with continuous convulsions, convulsions recurring after cessation, screaming upon fright followed by convulsions, sweating with cold feet, fullness of phlegm in the chest and throat, and open mouth with fixed gaze are all untreatable.
Falling to the ground making a sound, waking up and spitting out thin saliva, which differs from wind-stroke disease, is named Epilepsy (Xian). This is a malignant sign in children, and epilepsy is one of them. The reason is that the Qi and bone are not firm, the Zang-Fu organs are still weak, and the blood vessels are not fully developed. Irregular nursing leads to interference by pathogenic factors. Only Wind, Fright, and Food are the origins of epilepsy. Wind belongs to external contraction, Fright belongs to internal cause, neither purely internal nor purely external, but specifically caused by food. Due to these three causes, three types of epilepsy entangle each other; their meridians must be distinguished, associating with the Spleen, Heart, and Liver. However, ancient texts describe five categories of epilepsy corresponding to the Five Zang organs and viewing them through six animals. 1. Horse Epilepsy: continuous neighing, associated with the Heart, caused by Heart Fire simmering. 2. Sheep Epilepsy: continuous bleating, associated with the Liver, caused by Liver Wind acting improperly. 3. Chicken Epilepsy: crowing sounds, associated with the Lung, caused by pathogenic invasion of the Lung. 4. Pig Epilepsy: continuous grunting, associated with transmission from the Right Kidney disease. 5. Cow Epilepsy: bellowing, associated with dampness stagnation in Spleen Earth. Upon hearing a sound, they fall and stumble. Heart involvement presents with red face, tongue protrusion, and biting the tip of the tongue. Liver involvement presents with green face, jerking and spasms of hands and feet. Kidney involvement presents with black face, rigid body, and corpse-like sleep. Lung involvement presents with pale face, startled jumps, and dizziness. Spleen involvement presents with yellow face, and flaccid paralysis of four limbs. The ancients distinguished these clearly. However, all epilepsy cases inevitably involve phlegm, obstruction in the throat, and various sounds. The causes of illness lie in Fright, Food, Wind, and Cold, leading to blood stasis in the Heart orifice and pathogenic invasion of the Heart organ, manifesting according to the sound produced, with severity linked together. Although resembling the six animals, is it truly accurate? Why insist on distinguishing the Five Zang organs and making trivial analogies? One should only unblock the Master of the Heart, harmonize and circulate the blood vessels, resolve phlegm, and smooth Qi flow; this is the true essence of treatment. Physicians who understand this must not deviate. Epilepsy belongs to the Heart disease, while Spasm (Jing) belongs to the Liver disease, attacked by Wind Pathogen, starting with the Taiyang channel. Internal stirring of Liver Wind attracts and extends externally. Internal and external winds combine, causing rigidity difficult to bend, opisthotonos (arching back like a bow), and stiffness like a string during attacks. There is no convulsion or clenching, only upward gaze. There are rigid and flexible types, requiring careful exploration. Generally, it is due to Qi deficiency, with the root of disease tied internally, complicated by phlegm and fire, making the disease course unstable. The principle of treating spasm is profound. Head shaking and jaw clenching are similar in origin, involving the Spleen and Gallbladder, which must be distinguished.