治婴孩小儿四症已作八候未具者速宜与脉
金蝎(去毒炒) 白僵蚕(去丝炒) 天麻 白附子(炮) 天南星(炮各一分) 朱砂(一两)
赤脚蜈蚣(一条酒炙酥) 麝(一字)
上为末炼蜜为丸鸡头实大每服一二粒煎金银薄荷汤化下
治婴孩小儿急惊四症八候俱并作者宜服
天麻 白附子(炮) 天南星(炮各半两) 蝎稍(炒一分) 朱砂(一两) 代赭石(一两
米醋
浸七次) 雄黄(一两) 乳香(一两) 白花蛇头(一分酒炙) 脑(一字) 麝(一字) 赤脚蜈
蚣(一条酒炙)
上为细末每服半钱煎金银薄荷汤调下炼蜜如鸡头大亦佳
议曰搐症未作痰热壅盛故生其风风不自散流入筋脉又入经络遂发搐搦定其搐搦先用截风
风若
不加则搐搦自息矣且搐搦已作痰热有盛疾候传极其风不可得而截搐不可得而定由如遗漏炎
炽
猛烈难以摸减如此患者理宜下之大抵阳痫用下乃良阴痫何以加之儿分长幼用药惟有发风作搐
大小皆然风之为疾猖獗冲突乃五脏虚处受之察之在证疗之未前由惊而作或痰与热而为察其源
而定其疾者要也有其风即发搐有其搐即因风风定搐其议相续今述截风散不待搐搦才觉风痰惊
热
有作便与服之令不搐搦故曰截风既已搐搦并作宜与定搐散御之御之不散与服暖金丹其势加重
即与
下之且下之法医家出不得已而为劫风揭风青金三方量其轻重今人直便拟下更不截风定搐之药
得失之议皆由忽遽昏惑智者良工幸宜考较
For infants and young children presenting with signs of the four syndromes but not yet exhibiting all eight manifestations, pulse diagnosis should be performed promptly.
Scorpio (Jin Xie) [Diplocentris bidentata], detoxified and stir-fried, 1 liang; White Silkworm (Bai Jiang Can) [Bombyx batryticatus], silk removed and stir-fried, 1 liang; Gastrodia Rhizome (Tian Ma) [Gastrodiae Rhizoma], 1 liang; Prepared Aconite Rootlet (Bai Fu Zi) [Aconiti Kusnezoffii Radix], processed, 1 liang; Prepared Arisaema Tuber (Tian Nan Xing) [Arisaematis Rhizoma Preparatum], processed, each 1 liang; Cinnabar (Zhu Sha) [Cinnabaris], 1 liang; Red-footed Centipede (Chi Jiao Wu Gong) [Scolopendra subspinipes mutilans] (one piece, wine-roasted until crisp); Musk (She Xiang) [Moschus], one zi dose.
Grind the above ingredients into a fine powder. Form pills using refined honey, sized like a corn kernel. Administer one or two pills per dose, dissolved in a decoction of Honeysuckle Flower (Jin Yin Hua) [Lonicerae Japonicae Flos] and Mint (Bo He) [Menthae Haplocalycis Herba].
For infants and young children suffering from acute convulsive syndrome (Ji Jing Feng), where both the four syndromes and eight manifestations are present simultaneously, this formula is suitable:
Gastrodia Rhizome (Tian Ma) [Gastrodiae Rhizoma], half liang; Prepared Aconite Rootlet (Bai Fu Zi) [Aconiti Kusnezoffii Radix], processed, half liang; Prepared Arisaema Tuber (Tian Nan Xing) [Arisaematis Rhizoma Preparatum], processed, half liang; Scorpio Tail (Xie Shao) [Diplocentris bidentata tail], stir-fried, one fen; Cinnabar (Zhu Sha) [Cinnabaris], 1 liang; Hematite Ore (Dai Zhe Shi) [Hematitum], 1 liang (soaked seven times in rice vinegar); Realgar (Xiong Huang) [Realgar], 1 liang; Frankincense (Ru Xiang) [Olibanum], 1 liang; White Snake Head (Bai Hua She Tou) [Deinagkistrodon acutus head], one fen (wine-roasted); Brain (Nao) [Cervus Moschiferus brain or similar animal brain], one zi dose; Musk (She Xiang) [Moschus], one zi dose; Red-footed Centipede (Chi Jiao Wu Gong) [Scolopendra subspinipes mutilans] (one piece, wine-roasted).
Grind the above ingredients into an extremely fine powder. Administer half a qian per dose, mixed with a decoction of Honeysuckle Flower (Jin Yin Hua) [Lonicerae Japonicae Flos] and Mint (Bo He) [Menthae Haplocalycis Herba]; forming pills with refined honey the size of a corn kernel is also acceptable.
The physician discusses: When the convulsion has not yet occurred, phlegm-heat congestion generates wind. If the wind does not dissipate naturally, it flows into the sinews and meridians, eventually triggering convulsions. To arrest convulsions, one should first use the Jiefeng San (Wind-Cutting Powder). If the wind is subdued, the convulsions will cease spontaneously. However, once convulsions have already manifested, it indicates severe phlegm-heat accumulation and critical progression; at this stage, wind cannot be cut off, nor can convulsions be forcibly stopped. This is akin to neglecting a fire until it blazes fiercely, making it difficult to extinguish. For such patients, purgation (xia fa) is indicated. Generally, purgation is a sound method for Yang Epilepsy (Yang Xian); why apply it to Yin Epilepsy (Yin Xian)? Whether the child is older or younger, the treatment principle remains the same: disperse wind to stop convulsions. Wind pathogens are aggressive and conflictuous, invading areas of deficiency within the five zang organs. Before treating, one must examine whether the cause is fright (jing) or phlegm-heat, identify the root source, and determine the pathology—this is essential. The presence of wind leads to convulsions; the presence of convulsions is due to wind. When wind settles, convulsions stop; these principles are continuous. Now, regarding the Jiefeng San, it should be administered as soon as wind, phlegm, fright, or heat are suspected, preventing convulsions from occurring, hence the name "Cutting Wind." If convulsions have already begun, Dingchu San (Convulsion-Stabilizing Powder) should be used to counteract them. If counteraction fails to resolve the wind, Nuanjindan (Warm Golden Pill) may be taken, though this may worsen the condition, necessitating subsequent purgation. Purgation is a method employed by physicians out of necessity to劫 (seize/overcome) and remove wind, referencing the Qingjin San formulas, adjusted according to severity. Currently, people directly resort to purgation without attempting wind-cutting or convulsion-stabilizing methods. The debate over gains and losses stems from haste, confusion, and bewilderment; wise and skilled practitioners should carefully evaluate these approaches.