急惊之候，亦曰真搐，牙关紧急，壮热涎潮，窜视反张，搐搦颤动，唇口眉眼
眨引频并，口中气冷，脸赤唇红，大小便黄赤，其脉浮数洪紧，此内挟实热，外感
风邪，心家受热积惊，肝家生风发搐，肝风心火，二脏交争，血乱气并，痰涎壅盛，
百脉凝滞，关窍不通，风气蕃盛，无所发泄，故暴烈也。又有搐搦反张、斜视、而
牙关不紧，口无痰涎而气热，未可直指以为惊风，恐是伤风、伤寒、夹食、夹惊、疹
痘等证，此即钱氏假搐之说，又各根据本证施治矣。又急惊搐搦，不可把握，但扶
持之，否则风痫逆入经络，遂使手足拘挛成废疾。〔钱〕急惊，因闻大声或大惊，
而后发搐，发过则如故，此无阴也，当下，利惊丸主之。急惊，本因热生于心，
身热面赤引饮，口中气热，大小便黄赤，剧则发搐，盖热甚则风生，风属肝，此阳
盛阴虚也，故利惊丸主之，以除其痰热，不可用巴豆及温药大下之，恐搐虚热不消
也，小儿热痰客于心胃，因闻大声非常，则动而惊搐矣，若热极，虽不闻声及惊，
亦自发搐。〔阎〕氏云∶急惊，内有热即生风，又或因惊而发，则目上连札，潮涎
搐搦，身体与口中气皆热，及其发定或睡起，即了了如故，此急惊证也，当其搐势
渐减时，与镇心治热之药一二服，如麝香丸、镇心丸、抱龙丸、辰砂丸、紫雪之
类，候惊势已定须臾，以药下其痰热，如利惊丸、软金丹、桃枝丸之类，利下痰
热，心神安宁，即愈。洁古云∶急惊者，阳证也，俱府受病，热痰客于心肺，是
少阳相火旺，经云∶热则生风。因闻大声而作，盖谓东方震卦，得火气而发搐，火
本不动，焰得风而动，当用利惊丸、导赤散、泻青丸、地黄丸，搐止，宜服安神丸。
〔垣〕治惊，大忌防风丸，防风辛温之药，必杀人，何也？辛散浮温热者，火也，能
令母实助子之气盛，皆杀人也。如因惊而泻青色，先镇肝以朱砂之类，勿用寒凉之
药，大禁凉惊丸，风木旺必克脾胃，当先实其土，后泻其子。〔丹〕急惊风发热口
噤，手足心伏热，痰嗽痰喘并用涌法，重则用瓜蒂散，轻则用苦参、赤小豆末，以
酸齑汁调服，候少定，用通圣散蜜丸服之，间以桑树上桑牛、阴干研末调服，以平
其风，（桑牛，比杨牛则色白黄者是。）又以北薄荷叶、寒水石、各一两，青黛、白僵蚕、辰砂
各一钱，全蝎二枚，猪牙皂角、槐角各五分，并为末，灯心汤和乳汁灌之。角弓反
张，目直视，因惊而致，宜南星、半夏入姜汁、竹沥灌之，更灸印堂。初惊用防
风导赤散∶生干地黄、川木通、防风、甘草等分，用竹叶三钱煎服。须用宁神膏∶
麦门冬去心、天竹黄、茯神、朱砂各一两，麝香一钱，各捣研极细，炼蜜和，捏作
小饼子，临卧，薄荷汤化下，一夜一饼。老医常言、小儿惊搐多是热证，若先便
用惊风药白附子、全蝎、僵蚕、川乌之类，便是坏证。后有医幼科者，只用导赤散
加地黄、防风，进三服，导去心经邪热，其搐便止，次服宁神膏，神效。（从孙道润，幼
时患惊搐甚危，延京口诸有名幼科医疗之，益困笃，其祖易庵兄求方于余，以是授之，
二服立愈，自后常以救人，无不效者，
恐人忽易，故着之。）〔曾〕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，啮齿咬乳，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，二阳相鼓，风火相搏，肝藏魂，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，是以能抑肝之气，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，惟可用平和汤散调理，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，然所谓蓄
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，辗转经时，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，煎五和汤、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。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。《钤方》治法，大要用药有次
序，有轻重，通关以后，且与截风定搐，风搐既定，却下痰热，理为至当。若患在
痰热，未有惊风，只可退热化痰，不可妄投惊风药，盖药中多用寒凉，恐引痰
热入经络。凡病在热，不可妄治痰，止当解表。病在惊，不可妄治风，盖惊由痰热
得，只可退热化痰，而惊自止。病在痰，不可便治惊，急须退热化痰。病在风，不
可便治搐，盖风由惊作，只可利惊化痰，其风自散。若也有搐，须用截风散惊，至
妙之道。若治惊而痰不化，热亦不退，惊安得自止。化其痰，热若不退，风亦不散，
痰安得去。是知不治之治，所以治之之谓欤。急惊初传，风搐得定，而痰热一泄，
又须急与和胃定心之剂，若搐定而痰热无多，则但用轻药消痰除热可也。然急惊虽
当下，切不可过用寒凉，及水银、轻粉、巴豆、芒硝等荡涤太骤，或当剂之，皆
不得已，但使疾去即止，或不当用而用，或可用而过焉，由此遂成慢惊矣。且如只
下痰热，不必太骤，但斟酌处用大黄一品足矣，且急惊证源在于去肝风，降心火，
《幼幼书》以为至要之说也。〔薛〕急惊之候，牙关紧急，壮热涎涌，窜视反张，搐
搦颤动，口中气热，颊赤唇红，脉浮洪数者，此肝经血虚，火动生风，盖风生则阴
血愈散，阴火愈炽，火动则肺金愈亏，肝木愈盛，宜滋肝血，养脾气，若屡服祛风
化痰，泻火辛散之剂，便宜认作脾虚血损，急补脾土。若风火相搏，抽搐目 ，筋
急痰盛者，用四物汤以生肝血，加钓藤钩、山栀仁以清肝火，更用四君子以补脾，
六味丸以滋肾。若肺金克木而兼呵欠者，用泻白散以泄肺邪，地黄丸以益肝血。若
邪入肝，则用柴胡清肝散加龙胆草亦可。邪入心，用栀子清肝散加炒黄连亦通。邪
入肾，用六味地黄丸。邪入肺，用地骨皮散。邪入脾，用六君子加柴胡、山栀。若
不养肝血，不补脾气，纯用祛风化痰之药不已，则脾益虚，血益损，邪气延绵，必
传慢惊矣。初有痰热，未有惊风，先且解表，祛肝风，降心火。
《和剂》香苏散 解肌加干葛（见伤寒太阳症。）
参苏饮 解惊风烦闷，痰热作搐，咳嗽气逆，脾胃不和。
人参（去芦） 紫苏（和梗） 前胡（去芦） 干葛 半夏 赤茯苓（去皮。各七钱半）
枳壳 陈皮（去白） 桔梗（锉，炒） 甘草（各五钱） 《钤方》去人参，加川芎。
上锉。每服二钱，水一钟，姜二片，煎七分。无时温服。
人参羌活散 治初作急惊，散风邪，除风热。
羌活 独活 柴胡 川芎 人参 甘草（炙） 白茯苓（各一两） 前胡 桔梗 地骨皮
天麻（酒浸，焙。各半两） 枳壳（一两，麸炒）
上 咀。每服一钱，水半盏，姜一片，薄荷一叶，枣半个，煎服。疹痘未发，亦
可服。《直指方》每服三字末，紫苏、薄荷汤调。搐制紧急者，去节麻黄煎汤调。
或惺惺散加荆芥、防风亦可，免得遽施脑、麝。
惺惺散 除风热，及伤寒时气，疮疹发热。
白茯苓（净） 细辛 桔梗 栝蒌根 人参 甘草（炙） 白术 川芎（各等分）
上为末。每服一钱，水半盏，姜一片，薄荷三叶，同煎。汤氏，细辛减半。
独活汤 治胎惊，发散风邪。
羌活 独活（各一分） 槟榔 天麻 麻黄（去节） 甘草（炙。各半分）
上锉散，每服半钱，水煎。于内加南星末蜜调，可贴囟门。
木通散 治小儿肝心有热惊悸，用此药泻肝风、降心火、利惊热。
羌活 山栀子（各二钱） 大黄（煨） 木通 赤茯苓 甘草（各一钱）
上锉碎，每服二钱，入紫苏叶些少，用水一盏，煎至五分，不拘时服。
已风丹 祛风退惊。
天竹黄（细研） 防风 钓藤（各一两） 白僵蚕 干全蝎 白附子（各半两）
上为细末，炼蜜和如芡实大。每服一粒至二粒，麝香、荆芥汤化下。
加味导赤散
生地黄（上） 木通（上） 防风（中） 甘草（中） 山栀子（中） 薄荷叶（下） 麦门冬（中）
入灯心草、竹叶，水煎。
〔仁斋〕犀角汤 治心惊热盛。
犀角 防风 木通 赤茯苓 桑白皮（炒） 甘草（炙，各等分）
上锉细。每三字，水煎服。
急惊初传，且可通关、定惊搐。诸风搐搦，关窍不通，痰涎潮塞，气实使之。
先用苏合香丸，以姜自然汁浸，薄荷汤调与服，使气下则痰下，关窍自通。
通关散 治小儿惊风搐搦，关窍不通。
南星（炮） 僵蚕（炒。各一钱） 麝香（一字） 猪牙皂角（二定） 赤脚蜈蚣（一条，炙）
上为末，以手点姜汁，蘸药少许擦牙，或用物引滴入药两三点。涎自出，口自
开。皂角，略烧存性，为末。
嚏惊散
半夏（一钱） 猪牙皂角（半钱）
上为末。用一豆许，用管子吹入鼻。立醒。
茅先生夺命散
铜青 朱砂（各二钱） 腻粉（半钱） 麝香（少许） 蝎尾（十四个，去针）
上为末。每服半钱，薄荷、腊茶清调下。此治天钓、脐风、客忤、卒死、撮口、
鹅口、木舌、喉痹、胙腮、风壅吐涎，后根据证调理。
钱氏凉惊丸
草龙胆 防风 青黛（各三钱） 钓藤（二钱） 黄连（五钱） 牛黄 麝香 龙脑（各一字）
面糊丸粟米大。每服三、五丸，金银汤下。
《局方》天麻防风丸 治小儿惊风，身热喘粗，多睡惊悸，手足搐搦，精神昏愦。
天麻 防风 人参（各一两） 甘草 朱砂 雄黄（各二钱半） 蝎尾（炒） 僵蚕（炒。各半两） 牛
黄麝香（各一钱）
上为末。炼蜜丸樱桃大，朱砂为衣。每一丸，薄荷汤化下。
《三因方》治阳痫惊风热证，面赤、身热、发搐、直视、牙紧。
芦荟 白附子 甘草（各二钱） 胡黄连 朱砂（各一钱） 腻粉 麝香（各半钱） 蝎稍 僵蚕
（炒。各七个） 金箔（七片） 赤脚娱蚣（一条，炙）
上为末。二岁以上服半钱，金箔、薄荷汤下。
《全婴方》睡红散 治小儿急、慢惊风，手足搐搦，目瞪神昏。
牛黄 硼砂 脑子 真珠 水银（砂子。各半钱） 青黛 蝎尾（炒） 京墨（烧） 南星 半夏
（同上，姜制一宿） 蛇含石（淬。各一钱） 金银箔（各十片） 麝香（一字） 乌蛇尾（并项下七寸，
酒浸一宿，取出，去皮骨，炙，一钱）
上为末。三岁一字，薄荷汤下。
按∶此治风热痰药，通关透肌骨之剂也，非风邪下陷者，不可轻用。
定搐散 治小儿急惊，定搐。
赤脚蜈蚣（大者一条，酒浸，炙） 麻黄（去节） 南星（炮） 白附子 直僵蚕（炒） 羌活 代赭石（醋
淬七次） 蝎稍 川姜黄（各二钱） 朱砂（一钱）
上为末。每服一字，荆芥、紫苏煎汤调下。如搐不止，加乌蛇肉。
顺搐散 解男右女左搐不顺者。
枳壳（制） 钓藤（去钩） 荆芥 羌活 防风（去芦） 甘草（各半两）
The syndrome of Ji Jing (Acute Convulsion), also known as Zhen Chu (True Spasm), is characterized by tightness of the jaw, high fever, surging phlegm-saliva, wandering gaze, opisthotonos, spasmodic convulsions, tremors, frequent blinking and twitching of the lips, mouth corners, eyebrows, and eyes, cold breath from the mouth, red face and red lips, yellow-red urine and stool, and a pulse that is floating, rapid, full, and tight. This indicates internal excess heat combined with external wind pathogen invasion. Heat accumulates in the Heart causing fright; wind generates in the Liver triggering spasms. The Liver wind and Heart fire struggle between these two viscera, leading to chaotic blood flow and rebellious Qi, abundant phlegm-saliva, stagnation of all meridians, blockage of orifices, flourishing wind qi with no outlet for discharge, thus resulting in violent and fierce attacks. There are cases presenting with spasms, opisthotonos, and squinting, but without tight jaw, and with hot breath but no phlegm-saliva in the mouth; such cases cannot be directly diagnosed as Jing Feng (Wind-Fright). It may instead be Wind-Cold, Cold Damage, food retention, fright-accumulation, or rash-and-pox syndromes. This refers to Qian Yi's concept of "Fake Spasms," and treatment should be based on the specific underlying syndrome. Furthermore, during acute convulsions, one must not forcibly grasp the limbs; rather, support and protect them. Otherwise, wind-phlegm evil may rebel into the meridians, leading to contracture of the limbs and permanent disability.
[Qian Yi] stated: Ji Jing arises after hearing loud noises or experiencing sudden fright, followed by convulsions. After the attack subsides, the child returns to normal. This represents a condition of Yin deficiency (Yang hyperactivity) and requires purgation, primarily using Li Jing Wan (Drain Fright Pill). The root cause of Ji Jing is heat generated in the Heart, manifesting as body heat, red face, thirst for drinking, hot breath, yellow-red urine and stool. In severe cases, convulsions occur because extreme heat generates wind, and wind belongs to the Liver. This is a pattern of Yang excess and Yin deficiency, treated with Li Jing Wan to clear phlegm-heat. Do not use drastic purgatives like Ba Dou (Croton Seed) or warm medicines, lest the spasms cease but the deficient heat remains. When hot phlegm lodges in the Heart and Stomach, hearing loud noises triggers fright and convulsions; if heat is extreme, spontaneous convulsions may occur even without noise or fright.
[Yan Shi] stated: Ji Jing involves internal heat generating wind, often triggered by fright. Symptoms include upward rolling of the eyes, tidal phlegm, and spasms. The body and breath are hot. Upon cessation of the attack or upon waking, the child becomes lucid and normal. This is the syndrome of Ji Jing. As the intensity of spasms decreases, administer one or two doses of herbs that calm the Heart and clear heat, such as She Xiang Wan (Musk Pill), Zhen Xin Wan (Settle Heart Pill), Bao Long Wan (Embrace Dragon Pill), Chen Sha Wan (Cinnabar Pill), or Zi Xue (Purple Snow). Once the fright subsides, use formulas to purge phlegm-heat, such as Li Jing Wan, Ruan Jin Dan (Soft Golden Pill), or Tao Zhi Wan (Peach Twig Pill). Purging phlegm-heat calms the Heart Spirit, leading to recovery.
Jie Gu stated: Ji Jing is a Yang syndrome involving the Fu organs, where hot phlegm lodges in the Heart and Lungs, indicating hyperactivity of the Shaoyang Ministerial Fire. The Classic states: "Heat generates wind." Attacks triggered by loud noises relate to the East (Zhen Trigram); fire does not move on its own, but flames move when stirred by wind. Treat with Li Jing Wan, Dao Chi San (Guide Out Red Powder), Xie Qing Wan (Drain Green Pill), or Di Huang Wan (Rehmannia Pill). After spasms stop, take An Shen Wan (Calm Spirit Pill).
[Li Gao] warned against using Fang Feng Wan (Saposhnikovia Pill) for treating fright. Fang Feng is acrid and warm; it can be fatal. Acrid dispersants and warm-heat agents belong to Fire, which can overfill the Mother organ and exacerbate the Son organ's Qi, leading to death. If fright causes diarrhea with green stools, first settle the Liver with Cinnabar; do not use cold medicines. Strictly forbid Liang Jing Wan (Cool Fright Pill) because excessive Wood-Wind will overact on Spleen-Stomach Earth; one must first strengthen Earth before draining the Son (Heart).
[Zhu Danxi] stated: For Ji Jing with fever, locked jaw, latent heat in palms/soles, and phlegm-cough/wheezing, use emesis methods. Severe cases use Gua Di San (Melon Pedicle Powder); mild cases use Ku Shen (Sophora Root) and Chi Xiao Dou (Adzuki Bean) powder mixed with sour vinegar juice. Once stabilized, use Tong Sheng San (Universal Benefit Powder) honey pills. Intermittently use Sang Niu (Mulberry Caterpillar), dried and powdered, mixed for administration to pacify wind. Also, use Bei Bo He Ye (Northern Mint Leaf) and Han Shui Shi (Calcitum) each 1 liang, Qing Dai (Indigo Naturalis), Bai Jiang Can (Bombyx Batryticatus), and Chen Sha (Cinnabar) each 1 qian, Quan Xie (Scorpion) 2 pieces, Zhu Ya Zao Jiao (Gleditsia Sinensis Fruit) and Huai Jiao (Sophora Angustifolia Fruit) each 5 fen. Grind to powder, mix with Deng Xin Cao Tang (Juncus Decoction) and milk for administration. For opisthotonos and fixed gaze due to fright, use Nan Xing (Arisaema Cum Bile) and Ban Xia (Pinellia Rhizome) with Ginger Juice and Bamboo Sap for administration, and moxa the Yintang point. For initial fright, use Fang Feng Dao Chi San: Sheng Gan Di Huang (Rehmannia Root), Chuan Mu Tong (Akebia Caulis), Fang Feng (Saposhnikovia Root), and Gan Cao (Licorice Root) in equal parts, decocted with 3 qian of Zhu Ye (Bamboo Leaf). Must also use Ning Shen Gao (Calm Spirit Paste): Mai Men Dong (Ophiopogon Tuber) dehearted, Tian Zhu Huang (Bambusa Textilis Node), Fu Shen (Poria with Hostwood), and Chen Sha each 1 liang, She Xiang (Musk) 1 qian. Grind finely, mix with refined honey, form small cakes. Dissolve one cake in Bo He Tang (Mint Decoction) before sleep.
Old physicians often say pediatric convulsions are mostly heat patterns. Using drugs like Bai Fu Zi (Typhonii Rhizoma), Quan Xie, Jiang Can, or Chuan Wu early leads to complicated conditions. Later pediatricians used Dao Chi San added with Di Huang and Fang Feng for three doses to drain Heart heat, stopping spasms, followed by Ning Shen Gao, yielding miraculous results. [Recorded case: Sun Daorun suffered severe pediatric convulsions. Local doctors failed. I prescribed this formula; two doses cured him.]
[Zeng Shirong] noted that previous texts did not record Ji Jing, calling it Yang Xian (Yang Epilepsy). It generally results from neglect, exposure to drafts or heat, excessive spicy food by day, thick bedding by night, causing stagnant evil heat accumulating in the Heart and transmitting to the Liver. Further triggered by startling noises (thunder, drums, animals), falls, or cries. Before onset, sleep is restless, crying/laughing in sleep, grinding teeth, sweating on nose/forehead, shortness of breath, and phlegm-wheeze. Suddenly, the child faints, eyes roll up, jaw locks, mouth closes, and limbs spasm. This is due to extreme heat, distinguishable by red face and rapid pulse. Heart has heat, Liver has wind; both are Yang within Yang. Wind moves; fire flares with wind. Liver stores Hun (Ethereal Soul), Heart stores Shen (Spirit); heat agitates them, causing fright. Heart governs Shen and is not easily touched; fright causes heat, extreme heat generates wind, causing spasms—named Ji Jing. Treatment: First, Wu Ling San (Five-Ingredient Powder with Poria) added with Huang Qin (Scutellaria Root) and Gan Cao, or Bai Jie San (Release Exterior Powder). Then, Mu Tong San (Akebia Powder) or San Jie San (Three-Resolution Powder) to unblock Heart Qi, soothe Liver, calm Hun, and reduce heat. Use Niu Bang Tang (Arctium Decoction) or Fang Feng Tang. After resolution, mild cases use Ban Xia Wan (Pinellia Pill); severe cases use Shui Jing Dan (Crystal Pill) to remove phlegm and prevent dementia. Avoid drastic cold medicines; removing heat may invite cold. If sudden simultaneous wind-fright occurs, use Wu Ling San with Chen Sha powder, mixed with Mint Decoction. Ze Xie in Wu Ling San guides dampness via urination; Heart and Small Intestine are exterior-interior pairs; free Small Intestine flow unblocks Heart Qi, reducing fright. Gui Zhi (Cinnamon Twig) dries Wood, suppressing Liver Qi and stopping wind. Chen Sha calms Spirit. After clearing heat and cooling Heart/Liver, use gentle Tang San (Powders) for regulation. Avoid hot tonics.
I lament that physicians often confuse the root and branch of convulsions, indiscriminately using heavy metals, camphor, musk, centipedes, silkworms, snakes, scorpions, and drastic cold wind-dispelling drugs, damaging True Qi and worsening the condition. One must understand: Fright originates in Heart, Wind in Liver, Spasms begin with Qi. Chen Shi’s theory on Qi accumulation causing spasms is logical. I treat this with Kuan Qi Yin (Broaden Qi Decoction), mainly using Zhi Ke (Aurantii Fructus) and Zhi Shi (Aurantium Fructus Immaturum). Qi must flow freely; stagnation causes disease. Pediatric crying causes Qi accumulation; if internal ascent/descent fails and external release is blocked, prolonged stagnation causes spasms. Careful diagnosis of root source ensures success. Differentiate Yin/Yang and Deficiency/Excess. Yang Excess: Wu He Tang (Five-Harmony Decoction) or San Jie San. Yin Deficiency: Gu Zhen Tang (Solidify Truth Decoction) or Kuan Qi Yin. Sudden onset without differentiation: Combine Wu Ling San, Kuan Qi Yin, and Kuan Re Yin (Broaden Heat Drink) with Ginger Juice and boiling water. Broadening Qi is key; smooth Qi stops spasms.
Dai Shi said: Treating fright is不如 tonifying Kidney. Heart is Fire (dry); Liver Wind makes it flare. Tonifying Kidney raises Water and descends Fire, preventing evil heat invasion. Even with Liver Wind, no fright occurs. Administer Bu Shen Di Huang Wan (Tonify Kidney Rehmannia Pill) or Hu Po Bao Long Wan (Amber Embracing Dragon Pill) at Shen hour (3-5 PM). Water is born in Shen; medication supports Kidney Water, calming Heart Fire.
*Qian Jin Fang* emphasizes order and weight in medication: After opening orifices, stop wind and settle spasms; once settled, purge phlegm-heat. If only phlegm-heat exists without fright, clear heat and resolve phlegm; do not use fright drugs (often cold) which may drive phlegm-heat into meridians. If disease is in Heat, resolve exterior; do not treat phlegm. If in Fright, dispel wind; fright comes from phlegm-heat, so clear heat/phlegm to stop fright. If in Phlegm, urgently clear heat/phlegm. If in Wind, benefit fright and resolve phlegm to disperse wind. If spasms exist, stop wind and scatter fright. If treating fright fails to transform phlegm or reduce heat, fright won't stop. Transforming phlegm without reducing heat won't disperse wind. Thus, "non-treatment" is the method of treatment. In early Ji Jing, once wind-spasms settle and phlegm-heat is drained, quickly harmonize Stomach and calm Heart. If little phlegm-heat remains, use light drugs. Although Ji Jing requires purgation, avoid excessive cold or drastic purgatives like Mercury, Calomel, Croton, or Mirabilite, lest it turn into Man Jing (Slow Convulsion). Use Da Huang (Rhubarb) cautiously. The source of Ji Jing lies in dispelling Liver Wind and descending Heart Fire (*You You Shu*).
[Xue Ji] stated: Ji Jing presents with tight jaw, high fever, surging saliva, wandering gaze, opisthotonos, spasms, hot breath, red cheeks/lips, and floating-full-rapid pulse. This is Liver Blood deficiency with Fire stirring Wind. Wind scatters Yin Blood; Yin Fire blazes; Fire damages Lung Metal; Liver Wood flourishes. Nourish Liver Blood, nourish Spleen Qi. If repeated use of wind-dispelling/phlegm-resolving/draining-fire/acrid-dispersant drugs fails, recognize Spleen deficiency and Blood damage; urgently tonify Spleen Earth. If Wind-Fire struggle causes spasms, oblique eyes, stiff sinews, and abundant phlegm, use Si Wu Tang (Four Substances Decoction) to generate Liver Blood, add Gou Teng (Uncaria Ramulus) and Shan Zhi Ren (Gardeniae Semen) to clear Liver Fire, Si Jun Zi Tang (Four Gentlemen Decoction) to tonify Spleen, and Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) to nourish Kidney. If Lung Metal overacts on Wood with yawning, use Xie Bai San (Drain White Powder) to drain Lung Evil and Di Huang Wan to benefit Liver Blood. If evil enters Liver, use Chai Hu Qing Gan San (Bupleurum Liver-Clearing Powder) with Long Dan Cao (Gentiana Root). If entering Heart, use Zhi Zi Qing Gan San (Gardenia Liver-Clearing Powder) with fried Huang Lian (Coptis Rhizome). If entering Kidney, use Liu Wei Di Huang Wan. If entering Lung, use Di Gu Pi San (Lycium Bark Powder). If entering Spleen, use Liu Jun Zi Tang with Chai Hu and Shan Zhi. Failure to nourish Liver Blood and Spleen Qi while purely using wind-dispelling drugs leads to Spleen deficiency, Blood damage, lingering evil, and transmission to Man Jing. Initially, with phlegm-heat but no fright, resolve exterior, dispel Liver Wind, descend Heart Fire.
Formulas listed:
*Xiang Su San* (Fragrant Perilla Powder): Releases muscle layer, add Ge Gen (Kudzu Root).
*Shen Su Yin* (Ginseng Perilla Decoction): Relieves fright irritability, phlegm-heat spasms, cough, reverse Qi, Spleen-Stomach disharmony. Ingredients: Ren Shen, Zi Su, Qian Hu, Ge Gen, Ban Xia, Chi Fu Ling, Zhi Ke, Chen Pi, Jie Geng, Gan Cao. *Qian Jin Fang* version adds Chuan Xiong.
*Ren Shen Qiang Huo San*: Treats initial Ji Jing, dispels wind-pathogen and wind-heat. Ingredients: Qiang Huo, Du Huo, Chai Hu, Chuan Xiong, Ren Shen, Gan Cao, Bai Fu Ling, Qian Hu, Jie Geng, Di Gu Pi, Tian Ma, Zhi Ke.
*Xing Xing San*: Disperses wind-heat, Cold Damage, seasonal Qi, rash/pox fever. Ingredients: Bai Fu Ling, Xi Xin, Jie Geng, Gua Lou Gen, Ren Shen, Gan Cao, Bai Zhu, Chuan Xiong.
*Du Huo Tang*: Treats Tai Jing (Fetal Fright), disperses wind-pathogen. Ingredients: Qiang Huo, Du Huo, Bing Lang, Tian Ma, Ma Huang, Gan Cao. Add Nan Xing powder with honey to paste fontanelle.
*Mu Tong San*: Treats pediatric Liver-Heart heat fright palpitations, drains Liver Wind, descends Heart Fire, benefits fright-heat. Ingredients: Qiang Huo, Shan Zhi Zi, Da Huang, Mu Tong, Chi Fu Ling, Gan Cao.
*Yi Feng Dan*: Dispels wind, retreats fright. Ingredients: Tian Zhu Huang, Fang Feng, Gou Teng, Bai Jiang Can, Gan Quan Xie, Bai Fu Zi. Honey pills.
*Jia Wei Dao Chi San*: Added Flavor Guide Out Red Powder. Ingredients: Sheng Di Huang, Mu Tong, Fang Feng, Gan Cao, Shan Zhi Zi, Bo He Ye, Mai Men Dong. Add Deng Xin Cao and Zhu Ye.
*Xi Jiao Tang* (Rhinoceros Horn Decoction): Treats Heart fright with intense heat. Ingredients: Xi Jiao, Fang Feng, Mu Tong, Chi Fu Ling, Sang Bai Pi, Gan Cao.
*Tong Guan San* (Open Orifices Powder): Treats pediatric fright spasms with blocked orifices. Ingredients: Nan Xing, Jiang Can, She Xiang, Zhu Ya Zao Jiao, Chi Jiao Wu Gong. Apply ginger juice and powder to teeth.
*Ti Jing San* (Startle-Sneeze Powder): Ban Xia, Zhu Ya Zao Jiao. Powder blown into nose to induce sneeze and wakefulness.
*Mao Xian Sheng Duo Ming San* (Mr. Mao's Life-Seizing Powder): Tong Qing, Zhu Sha, Ni Fen, She Xiang, Xie Wei. Treats Tian Diao, Qi Feng, Ke Wu, sudden death, mouth closure, goose-mouth, wooden tongue, throat obstruction, mumps, wind-stuffiness with salivation.
*Qian Shi Liang Jing Wan* (Qian's Cool Fright Pill): Cao Long Dan, Fang Feng, Qing Dai, Gou Teng, Huang Lian, Niu Huang, She Xiang, Long Nao. Honey pills.
*Tian Ma Fang Feng Wan* (Tianma Saposhnikovia Pill): Treats pediatric fright with fever, coarse breathing, somnolence, palpitations, limb spasms. Ingredients: Tian Ma, Fang Feng, Ren Shen, Gan Cao, Zhu Sha, Xiong Huang, Xie Wei, Jiang Can, Niu Huang, She Xiang.
*San Yin Fang* Formula for Yang Xian/Fright-Heat: Face red, body hot, spasms, fixed gaze, tight jaw. Ingredients: Lu Hui, Bai Fu Zi, Gan Cao, Hu Huang Lian, Zhu Sha, Ni Fen, She Xiang, Xie Shao, Jiang Can, Jin Bo, Chi Jiao Wu Gong.
*Shui Hong San* (Sleeping Red Powder): Treats Ji/Man Jing, limb spasms, staring eyes. Ingredients: Niu Huang, Peng Sha, Nao Zi, Zhen Zhu, Shui Yin, Qing Dai, Xie Wei, Jing Mo, Nan Xing, Ban Xia, She Han Shi, Jin Yin Bo, She Xiang, Wu She Wei.
*Ding Chu San* (Settle Spasm Powder): Treats Ji Jing, settles spasms. Ingredients: Chi Jiao Wu Gong, Ma Huang, Nan Xing, Bai Fu Zi, Zhi Jiang Can, Qiang Huo, Dai Zhe Shi, Xie Shao, Chuan Jiang Huang, Zhu Sha.
*Shun Chu San* (Smooth Spasm Powder): Resolves spasms in boys (right) and girls (left) that are不顺 (not smooth). Ingredients: Zhi Zhi Ke, Gou Teng, Jing Jie, Qiang Huo, Fang Feng, Gan Cao.