急惊之论，前代书所不载，惟曰阳痫，大概失所爱护，或抱于当风，或近于热地，昼
则食多辛辣，夜则衾盖太浓，郁蒸邪热积于心，传于肝，再受人物惊触，或跌扑叫呼，雷
声鼓乐，鸡鸣犬吠，一切所惊，未发之时，夜卧不稳，困中或笑或哭，啮（五结切）齿咬（五巧切）
乳，鼻额有汗，气促痰喘，忽尔闷绝，目直上视，牙关紧急，口噤不开，手足搐掣，此
热甚而然。况兼面红脉数可辨。盖心有热而肝有风，二脏乃阳中之阳，心火也，肝风也。
风火阳物也，风主乎动，火得风则烟焰起，此五行之造化。二阳相豉，风火相搏，肝藏魄，
心藏神，因热则神魂易动，故发惊也。心主乎神，独不受触，遇有惊则发热，热极生风，
故能成搐，名曰急惊。治之之法，先以五苓散加黄芩、甘草，水煎，或百解散发表，次
通心气。木通散、三解散，疏涤肝经，安魂退热。牛蒡汤、防风汤主之。惊风既除之后，
轻者投半夏丸，重者下水晶丹，与之去痰，免成痴疾，但不可用大寒凉药治之，热去则寒
起，亢则害，承乃制。若仓卒之间，惊与风证俱作，只用五苓散加辰砂末，薄荷汤调服，
少解其证。盖五苓散内有泽泻导小便，心与小肠为表里，小肠流利，心气得通，其惊自
减。内有桂，木得桂则枯，是以有抑肝之气，其风自停。况佐以辰砂，能安神魂，两得其
宜，大略要解热凉心肝，后用平和汤散调理，稍热之剂则难用，医者宜审之。愚尝感慨诸
人，每见惊风搐作，不明标本，混为一证，遽然全用金石、脑、麝、蜈、蚕、蛇、蝎，大
寒搜风等剂投之，耗伤真气，其证愈甚，多致弗救。殊不知惊生于心，风生于肝，搐始
于气，是为三证。其惊与风，首已详及，然所谓畜气而成搐，陈氏之论，最为明理，但
未着其方。余于此证，则用宽气饮治之，只以枳壳、枳实为主，盖其气也，四时平和则
身安，一息壅滞则疾作。况小儿啼哭不常，其气蕴蓄，内则不能升降，外则无由发泄，
展转经时，亦能作搐。善医者审察病源，从而疗之，万无一失。更辨阴阳虚实，不可轻
忽。若阳实证，煎平和汤调三解散主之，此急惊有搐之类。若阴虚证，煎固真汤调宽气
饮治之，此慢惊有搐之类。若暴感此证，未别阴阳虚实，先用五苓散和宽气饮，及少加
宽热饮，三药合用，姜汁沸汤调灌即解，大抵治搐之法，贵以宽气为妙，气顺则搐停，
此自然之理。男左女右，手足搐者，即为顺证；男右女左，手足搐者，即为逆证，故难
治也。有男右女左，证轻者投顺搐散，使分左右，庶好疗之，天钓者，初得时顿顿呵欠，
眼忽下泪，身热脉浮洪实，是风痰壅聚，上贯心包，致经络闭而不通，目睛翻视，颈项强
仰。两手掣转向后，大哭如怒，脚曲腰直，发热痰鸣，爪甲皆青，状如鬼祟，名曰天钓。
治法同前急惊内药与服，先解风热，次理痰气，斯为当矣。暑风一证，因夏月感冒风寒太
甚，致面垢唇红，脉沉细数，忽发惊搐，不省人事，治用消暑清心饮辰砂五苓散及琥珀抱
龙丸，自发。切勿以温剂调补，热气得补则复盛，尤宜戒之。又有急惊天钓之后，变作潮
热，手足逆冷，有似疟疾，盖因病愈之时，不善将护，外感风邪，乘虚而入于经络，再未
解散，以致如此。经曰∶重阳必阴，重阴必阳。又曰∶亢则害，承乃制。此其义也。宜服
柴胡加桂汤及当桂散，气实者，则以乌犀丸，水晶丹，略与通利，匀气散止补，后以参苓
白术散调理，自然平愈。此证所用药品，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。大凡幼稚欲令常时惊悸不作，在乎肾脏和平，故戴氏曰∶
治惊不若补肾，谓心属火，火性燥，得肝风则烟焰起，致生惊悸，补肾则水升火降，邪热无
侵，虽有肝风，不生惊骇。其法当于申时，进补肾地黄丸一服，或琥珀抱龙丸。用
申时者，盖水生于申，佐之以药，则肾水得平，心火不炎，自无惊矣。
The discussion on Ji Jing (Acute Convulsion) was not recorded in previous medical texts, only referred to as "Yang Epilepsy" (Yang Xian). The etiology is generally due to lack of proper care, such as holding the child in a draft or near heat sources; consuming too much spicy food during the day, or covering with thick quilts at night. These factors cause pathogenic heat to stagnate in the Heart, then transmit to the Liver, compounded by external frights such as falling, shouting, thunder, drums, barking dogs, and all kinds of startling events. Before the onset of symptoms, the infant sleeps restlessly at night, laughing or crying in sleep, grinding teeth or sucking the breast, sweating on the nose bridge and forehead, with rapid breathing and phlegm rales, suddenly fainting, eyes staring upward, jaw clenching, mouth locked, and convulsions of hands and feet. This occurs due to extreme heat. Additionally, a red face and rapid pulse are distinguishable signs.
This is because the Heart suffers from heat while the Liver generates wind. Both the Heart and Liver belong to "Yang within Yang"; the Heart corresponds to Fire, and the Liver to Wind. Wind and Fire are both Yang entities; wind governs movement, and fire ignites smoke and flames when encountering wind, which is the transformation of the Five Elements. Two Yangs mutually stimulate each other, wind and fire clash. The Liver stores the Po (Corporeal Soul), and the Heart stores the Shen (Spirit). Due to heat, the Hun and Shen easily become agitated, thus causing Jing Feng (Convulsive Disorder). The Heart governs the Spirit and does not directly receive fright, but upon being startled, it generates heat; extreme heat generates wind, leading to convulsions, named Ji Jing (Acute Convulsion).
The treatment method involves first administering Wu Ling San (Five-Ingredient Powder with Poria) added with Huang Qin (Scutellaria Root) and Gan Cao (Licorice Root), decocted in water; or using Bai Jie San (Hundred-Release Powder) to release the exterior, followed by unblocking Heart Qi. Mu Tong San (Akebia Decoction) and San Jie San (Three-Release Powder) are used to clear and purify the Liver Meridian, calm the soul, and reduce heat. Niu Bang Tang (Arctium Decoction) and Fang Feng Tang (Saposhnikovia Decoction) may also be used. After the convulsions subside, for mild cases, Ban Xia Wan (Pinellia Pill) is given; for severe cases, Shui Jing Dan (Crystal Pill) is administered to eliminate phlegm and prevent the development of dementia. However, strongly cold and cooling medicines must not be used, as removing heat may lead to the rise of cold ("Excess leads to harm, balance brings control"). If, in an emergency, both fright and wind symptoms occur simultaneously, Wu Ling San (Five-Ingredient Powder with Poria) mixed with Chen Sha (Cinnabar) powder, taken with Bo He Tang (Mint Decoction), can slightly relieve the symptoms.
This is because Wu Ling San contains Ze Xie (Alisma Rhizome) to guide urine excretion; the Heart and Small Intestine are interior-exterior pairs. When the Small Intestine is smooth, Heart Qi flows freely, and the fright naturally diminishes. The formula contains Gui Zhi (Cinnamon Twig); wood withers when exposed to cinnamon, implying that Gui Zhi suppresses Liver Qi, so the wind stops. Furthermore, Chen Sha (Cinnabar) calms the spirit and soul, achieving a dual benefit. Generally, the key lies in clearing heat and cooling the Heart and Liver, followed by regulation with mild formulas. Slightly warm agents are difficult to use; physicians should examine carefully.
I have often lamented that many practitioners, seeing convulsions from fright, fail to understand the root and branch, treating them indiscriminately. They immediately administer strong cold, wind-searching agents containing minerals, Borneol, Musk, Centipede, Silkworm, Snake, and Scorpion, depleting True Qi and worsening the condition, often leading to death. It is unknown that Fright arises from the Heart, Wind from the Liver, and Convulsion begins with Qi stagnation; these are three distinct syndromes. Fright and Wind were detailed earlier. Regarding the accumulation of Qi leading to convulsions, Mr. Chen's theory is most logical, though he did not provide a formula. For this syndrome, I use Kuan Qi Yin (Qi-Widening Decoction), primarily using Zhi Ke (Bitter Orange) and Zhi Shi (Immature Bitter Orange), as they regulate Qi. When Qi is peaceful across the four seasons, the body is healthy; once Qi stagnates, disease arises. Infants cry frequently, causing Qi to accumulate internally without ascending/descending or externally without venting. Prolonged stagnation can also cause convulsions. Skilled physicians investigate the source and treat accordingly, ensuring safety. One must distinguish Yin/Yang and Deficiency/Excess.
For Excess Yang patterns, Ping He Tang (Peaceful Harmony Decoction) combined with San Jie San (Three-Release Powder) is used; this belongs to Ji Jing (Acute Convulsion) with convulsions. For Yin Deficiency patterns, Gu Zhen Tang (Solidify Truth Decoction) combined with Kuan Qi Yin (Qi-Widening Decoction) is used; this belongs to Man Jing (Chronic Convulsion) with convulsions. If suddenly contracted without distinguishing Yin/Yang or Deficiency/Excess, first use Wu Ling San (Five-Ingredient Powder with Poria) with Kuan Qi Yin (Qi-Widening Decoction) and a small amount of Kuan Re Yin (Heat-Widening Decoction). Mix the three, administer with Ginger Juice and boiling water to resolve. Generally, treating convulsions relies on widening/smoothing Qi; when Qi flows smoothly, convulsions stop, which is natural law. Male left/female right hand convulsions are favorable (Shun Zheng); male right/female left are unfavorable (Ni Zheng) and difficult to treat. For mild male-right/female-left cases, Shun Chu San (Smooth Convulsion Powder) is used to correct the direction.
Tian Gou (Sky Hook Syndrome) initially presents with frequent yawning, sudden tearing, fever, and floating, large, full, and solid pulse. This is Wind-Phlegm congestion penetrating the Pericardium, blocking meridians, causing eye rolling, neck stiffness, and backward extension. Hands spasm backward, crying angrily, legs bent, back straight, fever, phlegm sounds, blue nails, resembling demonic possession, named Tian Gou. Treatment follows the same internal medicines for Ji Jing (Acute Convulsion): first resolve Wind-Heat, then regulate Phlegm-Qi.
Shu Feng (Summer Wind) results from excessive exposure to Cold-Wind in summer, causing dirty complexion, red lips, deep/thin/rapid pulse, sudden fright convulsions, and unconsciousness. Treat with Xiao Shu Qing Xin Yin (Summer-Heat Clearing Heart Decoction), Chen Sha Wu Ling San (Cinnabar Five-Ingredient Powder with Poria), and Hu Po Bao Long Wan (Amber Dragon-Holding Pill) to induce spontaneous sweating. Do not use warm tonics, as heat will rebound with tonification.
After Ji Jing (Acute Convulsion) or Tian Gou, tidal fever and cold extremities resembling Malaria (Nué Ji) may occur due to improper care after recovery, allowing Wind-Evil to enter deficient meridians without resolution. The Classic states: "Extreme Yang transforms to Yin, Extreme Yin transforms to Yang." And "Excess leads to harm, balance brings control." This explains the principle. Administer Chai Hu Jia Gui Tang (Bupleurum plus Cinnamon Twig Decoction) and Dang Gui San (Angelica Powder). For excess Qi, use Wu Xi Wan (Black Rhinoceros Horn Pill) or Shui Jing Dan (Crystal Pill) for mild purgation, then Yun Qi San (Qi-Balancing Powder) to stop supplementation, followed by Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) for regulation, leading to natural recovery. Some medicines used here include bitter-cold flavors to extinguish excessive Yang Fire. When Lung Metal prevails, Liver Wood levels itself, and Wind-Evil disperses, which is a good method.
Generally, for infants to avoid daily palpitations and fright, Kidney harmony is essential. Dai Shi said: "Treating Fright is better done by Tonifying the Kidney." The Heart belongs to Fire, which is dry; encountering Liver Wind causes flames to rise, generating fright. Tonifying the Kidney raises Water and lowers Fire, preventing pathogenic heat invasion. Even with Liver Wind, fright does not arise. This method involves administering Bu Shen Di Huang Wan (Kidney-Tonifying Rehmannia Pill) or Hu Po Bao Long Wan (Amber Dragon-Holding Pill) at Shen Hour (3-5 PM). Shen Hour is chosen because Water is born in Shen; aided by medicine, Kidney Water balances, Heart Fire does not flare, and fright ceases.