〔娄〕惊、搐，一也，而有晨夕之分，表里之异。身热力大者为急惊。身冷力
小者为慢惊。仆地作声，醒时吐沫者为痫。头目仰视者为天吊。角弓反张者为痉。而
治各不同也。
〔钱〕因潮热发搐在寅卯辰时者，此肝用事之时也，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（方见肾部。）治肝，
泻青丸（方见。肝部） 〔薛〕寅卯辰时搐而发热作渴，饮冷便结，属肝胆经虚热，用柴芍参
苓散。作渴引饮，自汗盗汗，属肝胆经血虚，用地黄丸。口吻流涎，属肝木克脾土，
用六君子汤。一小儿寅卯时发热痰搐，服抱龙丸而愈。后复患，因自用前药，更
加咳嗽气喘，不时发搐，面赤或青黄，或浮肿，或流涎，余谓咳嗽气喘，乃脾肺气
虚，不时发搐，乃木乘土位，面青而黄赤，乃肝助心脾，浮肿流涎，乃脾气虚弱，
用益智丸以补心神，补中益气汤以养脾肺，顿愈。
〔钱〕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，治心、导赤散、凉惊丸，
补肝、地黄丸。广亲宅七太尉，方七岁，潮热数日，欲愈。钱谓父二大王曰，七
使潮热将安。八使预防惊搐。王怒曰，但使七使愈，勿言八使病。钱曰，八使过来
日午间，即无苦也。次日午前果作搐，急召钱治之，三日而愈。盖预见其目直视而
腮赤，必肝心俱热，更坐石杌子，乃欲就冷，此热甚也，又肌肤素肥盛而本实，其
脉急促故发搐，克言午时者，自寅至午皆心肝用事之时，治之乃泻心肝补肾，自安
矣。〔薛〕巳午未时发搐，若兼作渴饮水，属风火相搏，以地黄丸补肝，导赤散、
凉惊丸治心。若作渴饮汤，体倦不乳，土虚而木旺也，用地黄丸以补肾，六君子汤
以补脾。一小儿巳午时搐热惊悸，发时形气倦怠而黄，懒食流涎饮汤。此心火虚
而不能生脾土也。不信，自服凉心之药，更加吐泻，睡而露睛，几成慢脾风。用六君、
姜、桂，佐以地黄丸而愈。一小儿七岁，惊搐发热不已，巳午未时益甚，形气殊
倦，热定饮汤。此心脾气虚。朝用补中益气汤加益智仁，夕用六君、当归、钓藤钩
寻愈。后饮食过多，复作吐泻，或治以保和丸，反加寒热发搐。此脾土复伤而肝木
所侮也。用六君、柴胡，寒热止而饮食进，但午未时仍泄，用补中益气汤加茯苓、
半夏、钓藤钩而全。
〔钱〕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，是肝旺，当补脾、益黄散（方见脾部），治肝、
泻青丸，治心、导赤散。（洁古云∶脾病肝强，法当补脾，恐木贼害，宜先泻心肝以挫其强，
而后补脾为当。）徐氏子三岁，病潮热，每日西则发搐，身微热而目微斜、露睛，四肢冷
而喘，大便微黄。请钱与李同治，钱问李曰病何搐也？李曰有风。何身热微温？曰四肢所作。
何目斜睛露？曰搐则目斜。何肢冷？曰冷厥心内热。曰何喘？曰搐之甚也。曰何以治
之？曰凉惊丸鼻中灌之，必搐止。钱又问曰既谓风病温壮，搐引目斜露睛，内热支
冷，及搐甚而喘，并以何药治之？李曰皆此药也。钱曰不然，搐者心肝实也，身微
热者日西肺用事之时也，肺主身温，今且热者肺虚也，目微邪露睛者，肝肺相乘
胜也，四肢冷者，脾虚也，肺若虚甚、则脾母亦弱，木气乘脾、四肢即冷，治之当
先补脾肺，用益黄散、阿胶散，得脾虚证退，然后治其心肝，用泻青丸、导赤
散、凉惊丸治之，九日愈。〔薛〕申酉戌时微搐而喘，目微斜，身似热，睡而露睛，
大便淡黄，属脾肺虚热，用异功散。手足逆冷，或喘泻不食，属脾肺虚寒，用
六君、炮姜、木香。久病而元气虚者，用六君子、六味丸二药主之。
〔钱〕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，身体温壮，
目睛紧斜视，喉中有痰，大便银褐色，乳食不消，多睡不省，当补脾治心，补脾、
益黄散，治心、导赤散、凉惊丸。（洁古云，皆因大病后脾胃虚损，多有此疾。）〔薛〕
亥子丑时微搐身热，目睛紧斜，吐泻不乳，厥冷多睡，属寒水侮土，用益黄散，未应，
用六君、姜、桂。
[Lou] Jing (startle) and Chu (convulsion) are essentially the same, but differ in timing (morning vs. evening) and location (exterior vs. interior). Those with body heat and strong force are classified as Ji Jing (Acute Startle/Convulsion). Those with cold body and weak force are classified as Man Jing (Chronic Startle/Convulsion). Those who fall to the ground making sounds and foam at the mouth upon waking are suffering from Xian (Epilepsy). Those whose head and eyes look upward are suffering from Tian Diao (Heavenly Suspension). Those whose bodies arch backward like a bow are suffering from Jing (Spasm). The treatments for each are different.
[Qian] When convulsions occur due to tidal fever during the Yin, Mao, and Chen hours, this is the time when the Liver is dominant. The body is intensely hot, eyes look upward, hands and feet tremble, hot saliva is produced in the mouth, and the neck is stiff and tight. This indicates Liver Excess. One should tonify the Kidney and treat the Liver. To tonify the Kidney, use Dihuang Wan (Rehmannia Pill) (formula see Kidney section). To treat the Liver, use Xieqing Wan (Drain Green Pill) (formula see Liver section).
[Xue] If convulsions occur during the Yin, Mao, and Chen hours accompanied by fever, thirst, preference for cold drinks, and constipation, it belongs to Deficient-Heat of the Liver and Gallbladder meridians; use Chaishao Shenling San. If there is thirst with drinking, spontaneous sweating, or night sweats, it belongs to Blood Deficiency of the Liver and Gallbladder meridians; use Dihuang Wan. If saliva flows from the corners of the mouth, it belongs to Liver Wood overacting on Spleen Earth; use Liujunzi Tang (Six Gentlemen Decoction). A child had fever, phlegm, and convulsions during the Yin and Mao hours and recovered after taking Baolong Wan. Later, he relapsed. Because he self-administered the previous medicine, his cough and asthma worsened, and he suffered frequent convulsions. His face was red or green-yellow, sometimes swollen, or drooling. I reasoned that the cough and asthma were due to Qi Deficiency of the Lung and Spleen; the frequent convulsions were due to Wood overacting on Earth; the green, yellow, and red complexion indicated Liver assisting Heart and Spleen; the swelling and drooling indicated Spleen Qi Deficiency. I used Yizhi Wan to tonify the Heart Spirit, and Buzhong Yiqi Tang (Center-Benefiting Qi-Supplementing Decoction) to nourish the Lung and Spleen, resulting in immediate recovery.
[Qian] When convulsions occur due to tidal fever during the Si, Wu, and Wei hours, this is the time when the Heart is dominant. There is mental fright, eyes looking upward, redness of the white part of the eyes, tight jaw, saliva production in the mouth, and trembling of hands and feet. This indicates Heart Excess. One should tonify the Liver and treat the Heart. To treat the Heart, use Daochi San (Guide Out Red Powder) and Liangjing Wan (Cool Startle Pill); to tonify the Liver, use Dihuang Wan. The Seventh Taivellier of Guangqin Residence was seven years old. He had tidal fever for several days and was about to recover. Qian told his father, the Second Da Wang, "The tidal fever of the Seventh Envoy will settle. The Eighth Envoy must be prevented from developing startle/convulsion." The King was angry and said, "Just let the Seventh Envoy recover; do not speak of the Eighth Envoy's illness." Qian said, "On the following day around noon, the Eighth Envoy will suffer no pain." The next morning before noon, convulsions indeed occurred. Qian was summoned urgently and treated him, curing him in three days. This was because he foresaw that fixed staring and red cheeks indicated Heat in both Liver and Heart. Furthermore, sitting on a stone stool showed a desire for coolness, indicating severe Heat. Since his skin was plump and his root was solid, and his pulse was rapid, convulsions erupted. Predicting the Wu hour onset was because from Yin to Wu are the times when Heart and Liver are dominant. Treatment involved draining Heart and Liver and tonifying Kidney, leading to peace.
[Xue] If convulsions occur during the Si, Wu, and Wei hours accompanied by thirst and drinking water, it belongs to Wind-Fire struggling; use Dihuang Wan to tonify Liver, and Daochi San and Liangjing Wan to treat Heart. If there is thirst for warm drinks, fatigue, and refusal to nurse, it is Earth Deficiency with Wood Excess; use Dihuang Wan to tonify Kidney and Liujunzi Tang to tonify Spleen. A child had convulsions, fever, and palpitations during the Si and Wu hours. During attacks, the form and Qi were fatigued and yellow, with reluctance to eat, drooling, and desire for warm drinks. This is Heart Fire Deficiency failing to generate Spleen Earth. Disbelieving this, they self-administered Heart-cooling medicines, worsening vomiting and diarrhea, sleeping with eyes open (exposing pupils), nearly forming Man Pi Feng (Chronic Spleen Wind). Using Liujunzi Tang with Shengjiang (Fresh Ginger) and Ronggui (Cinnamon Twig), assisted by Dihuang Wan, resulted in recovery. A seven-year-old child had persistent startle, convulsions, and fever, worsening during Si, Wu, and Wei hours. The form and Qi were extremely fatigued, and after the fever subsided, he desired warm drinks. This is Heart and Spleen Qi Deficiency. In the morning, Buzhong Yiqi Tang with Yizhiren was used; in the evening, Liujunzi Tang with Danggui and Goutenggou (Uncaria Rhynchophylla) was used, leading to recovery. Later, excessive food intake caused recurrent vomiting and diarrhea. Treatment with Baohe Wan aggravated chills, fever, and convulsions. This is Spleen Earth re-injured and bullied by Liver Wood. Using Liujunzi Tang with Chaihu stopped chills and fever and improved appetite. However, diarrhea persisted during Wu and Wei hours. Using Buzhong Yiqi Tang with Fuling, Banxia, and Goutenggou led to full recovery.
[Qian] When convulsions occur due to tidal fever during the Shen, You, and Xu hours, this is the time when the Lung is dominant. Convulsions are mild but accompanied by asthma, slight eye deviation, body heat like fire, sleeping with eyes open (exposing pupils), cold hands and feet, and pale yellow watery stool. This indicates Liver Excess. One should tonify Spleen using Yihuang San, treat Liver using Xieqing Wan, and treat Heart using Daochi San. (Jiegou stated: In Spleen disease with strong Liver, the method is to tonify Spleen. Fearing Wood robbing Earth, it is appropriate to first drain Heart and Liver to curb their strength, then tonify Spleen.) The son of Mr. Xu, aged three, suffered from tidal fever, with convulsions every afternoon (West time). Body slightly hot, eyes slightly deviated, exposing pupils, cold limbs, asthma, and slightly yellow stool. They invited Qian and Dr. Li to treat jointly. Qian asked Dr. Li, "What causes the convulsions?" Dr. Li said, "Wind." "Why is the body only slightly hot/warm?" Dr. Li said, "Due to cold limbs." "Why deviated eyes and exposed pupils?" Dr. Li said, "Convulsions cause eye deviation." "Why cold limbs?" Dr. Li said, "Cold reversal due to internal heat." "Why asthma?" Dr. Li said, "Severe convulsions." "How to treat?" Dr. Li said, "Instill Liangjing Wan into the nose; convulsions will stop." Qian asked again, "Since it is wind disease with warmth, convulsions causing eye deviation/exposed pupils, internal heat with cold limbs, and severe convulsions with asthma, what medicine treats all these?" Dr. Li said, "All this medicine." Qian said, "Incorrect. Convulsions indicate Heart and Liver Excess. Slight body heat occurs because West time is Lung dominance; Lung governs body warmth, so heat indicates Lung Deficiency. Slight eye deviation and exposed pupils indicate Liver and Lung mutual overacting. Cold limbs indicate Spleen Deficiency. If Lung is very deficient, its mother (Spleen) is also weak. Wood Qi overacts on Spleen, causing cold limbs. Treatment should first tonify Spleen and Lung using Yihuang San and Ejiao San. After Spleen Deficiency symptoms recede, then treat Heart and Liver using Xieqing Wan, Daochi San, and Liangjing Wan. Cured in nine days."
[Xue] Mild convulsions and asthma during Shen, You, and Xu hours, slight eye deviation, body seeming hot, sleeping with exposed pupils, pale yellow stool, belong to Spleen and Lung Deficient-Heat; use Yigong San. Cold hands and feet reversed, or asthma/diarrhea/refusal to eat, belong to Spleen and Lung Deficient-Cold; use Liujunzi Tang with Paojiang (Roasted Ginger) and Muxiang. For chronic illness with Yuan Qi Deficiency, use Liujunzi Tang and Liuwei Wan (Six-Ingredient Pill with Rehmannia) as main treatments.
[Qian] When convulsions occur due to tidal fever during the Hai, Zi, and Chou hours, this is the time when the Kidney is dominant. Convulsions are mild but lying is unstable, body is warm/hot, eyes tightly deviated, phlegm in throat, silver-brown stool, undigested milk/food, excessive sleep without consciousness. One should tonify Spleen and treat Heart. Tonify Spleen with Yihuang San; treat Heart with Daochi San and Liangjing Wan. (Jiegou stated: All result from Spleen and Stomach deficiency/damage after major illnesses, often presenting this way.)
[Xue] Mild convulsions and body heat during Hai, Zi, and Chou hours, tightly deviated eyes, vomiting/diarrhea/refusal to nurse, cold extremities, excessive sleep, belong to Cold Water bullying Earth; use Yihuang San. If ineffective, use Liujunzi Tang with Shengjiang and Ronggui.