钱仲阳曰∶角弓反张者，由风邪客于太阳经也。经曰∶风从上受。足太阳主周身之气，其脉
起于目内 而行于背。肝属木主风，所以风邪易侵也。夫小儿肌肤未密，外邪易伤，肝为相
火，其怒易发。若身反张强直发热不搐者，风伤太阳也，宜用人参羌活散、小续命汤。若因
暴怒而击动其肝火者，宜用泻青丸。若饮前剂，其症益甚者，此邪气已去而脾气亏也，宜用
异功散加芎、归补之。若因肝经虚热，或因克伐真气，虚热生风者，宜用异功散、地黄丸补
之。若因下而脾气困备，腹肚膨胀者，此中气损也，宜用白术散补之。若气血素弱，或服攻
伐之剂，而手寻衣领，切牙呵欠者，肝经虚甚也，急用地黄丸以补之，仍与肝脏参览。
治验
一小儿忽腰背反张，目上视，面青赤，曰青属肝主风，赤属心主火，此风火相搏，用柴胡栀
子散，倍加钩藤钩顿安，而痰如旧，又用抱龙丸而愈。
一小儿忽腰背反张，服治惊之药后，不时举发，面色黄白，肢体甚倦。余用五味异功散，十
余剂而愈。后因惊兼饮食不节，不时举发，随用前药即愈。遂日以参术末，每服五七分，炮
姜、大枣煎汤调下，服至二两而不发，以上二症，元气虚而病气实也。若用攻邪之药皆误矣
。
一小儿素患前症，痰盛面色素白而兼青。余谓∶肺气不能平肝，肝气乘脾，脾气虚而生痰耳
。先用抱龙丸二服以平肝；随用六君子汤，以补脾肺，月余而痊。半载之后复发，谓非逐痰
不能痊愈。遂用下剂，痰涎甚多，而咽喉如锯声。余曰∶乃脾不能摄涎也，咽间鸣乃肺气虚
甚也。遂用人参五钱、炮姜三分，水煎服而醒。至第四剂后，加枣二枚，人参服数两而愈。
后每发非独参汤不应。若执常方，鲜不有误者。
人参羌活散（方见惊风）
小续命汤（方见五硬）
钱仲阳说：角弓反张（身体向后弯曲如弓状），是由于风邪侵袭太阳经（足太阳膀胱经）所致。医经中说：风邪多从上部侵入。足太阳经主管全身之气，其经脉起于目内眦，沿背部下行。肝在五行中属木，主司风，所以风邪容易侵犯肝脏。小儿肌肤腠理不致密，外邪容易伤害身体；肝为相火（寄居于肝肾的少火），其怒气容易发作。如果身体向后反张、强直、发热但不抽搐的，是风邪损伤了太阳经，适宜用人参羌活散、小续命汤。如果是因突然大怒而触动肝火的，适宜用泻青丸。如果服用前面的方剂后，症状反而加重，这是邪气已经去除但脾气亏损的表现，适宜用异功散加川芎、当归来补益。如果是因肝经虚热，或因过度使用攻伐药物损伤真气，导致虚热生风的，适宜用异功散、地黄丸来补益。如果是因误用下法导致脾气困顿衰竭，腹部胀大的，这是中气受损，适宜用白术散来补益。如果气血本来虚弱，或服用了攻伐的药物，出现手抓衣领、咬牙、打哈欠等症状的，是肝经极度虚弱，急需用地黄丸来补益，同时参考肝脏相关论述。
治验案例：
有一个小孩突然腰背向后反张，眼睛向上看，面色青赤。我说：青色属肝，主风；赤色属心，主火。这是风火相互搏结，用柴胡栀子散，加倍加入钩藤钩，顿时安定下来，但痰症依旧，又用抱龙丸才痊愈。
另一个小孩突然腰背向后反张，服用治惊风药后，不时发作，面色黄白，肢体非常疲倦。我用五味异功散，服药十余剂后痊愈。后来因为受惊兼饮食不节制，不时发作，随即用前面的药就痊愈了。于是每天让患儿服用人参、白术粉末，每次五七分，用炮姜、大枣煎汤调服，服至二两后不再发作。以上两个病例，都是元气虚弱而病邪实盛。如果使用攻邪的药物都会出错。
还有一个小孩素来患有前症，痰多，面色素白且兼带青色。我说：肺气不能制约肝木，肝气乘袭脾土，脾气虚弱而生痰罢了。先用抱龙丸两服以平抑肝气；随后用六君子汤，以补益脾肺，一个多月后痊愈。半年后复发，我说非祛除痰涎不能痊愈。于是用泻下剂，痰涎非常多，咽喉发出像拉锯一样的声音。我说：这是脾不能摄纳涎液，咽间鸣响是肺气极度虚弱。于是用人参五钱、炮姜三分，水煎服后患儿苏醒。到第四剂后，加入大枣两枚，人参服数两后痊愈。后来每次发作，如果不是独参汤就不见效。如果拘泥于常规方剂，很少有不犯错的。
Qian Zhongyang stated: "Glossoponus (rigid extension of the back resembling a bow) is caused by wind pathogen invading the Taiyang channel (Taiyang Bladder Meridian). The medical classics state: 'Wind pathogen is mostly received from above.' The Foot-Taiyang channel governs the qi of the whole body, and its meridian originates at the inner canthus of the eye and runs along the back. The Liver belongs to Wood and governs Wind; therefore, wind pathogen easily invades the Liver. Children's skin and pores are not dense, making them susceptible to external pathogens; the Liver houses Ministerial Fire (Ministerial Qi residing in the Liver and Kidney), and its anger is prone to flare up. If the body extends backward rigidly with fever but without convulsions, it indicates wind damaging the Taiyang channel; Ren Shen Qiang Huo San (Ginseng and Notopterygium Decoction) or Xiao Xu Ming Tang (Minor Continuation of Life Decoction) should be used. If the condition arises from sudden rage stirring up Liver Fire, Xie Qing Wan (Drain Green Pill) should be used. If symptoms worsen after taking the aforementioned formulas, this indicates that the pathogenic factor has been expelled but Spleen Qi is deficient; Yi Gong San (Yi Gong Powder) combined with Chuan Xiong (Ligusticum Rhizome) and Dang Gui (Angelica Sinensis Root) should be used for tonification. If the condition stems from deficiency-heat in the Liver channel, or if excessive purgation damages True Qi leading to deficiency-heat generating wind, Yi Gong San (Yi Gong Powder) and Di Huang Wan (Rehmannia Pill) should be used for tonification. If improper use of purgatives leads to exhaustion of Spleen Qi and abdominal distension, this indicates damage to Middle Qi; Bai Zhu San (Atractylodes Macrocephala Powder) should be used for tonification. If Qi and Blood are inherently weak, or after taking purgative agents, symptoms such as grasping at clothing collars, grinding teeth, and yawning appear, this indicates severe deficiency of the Liver channel; Di Huang Wan (Rehmannia Pill) should be urgently administered for tonification, referring also to discussions on the Liver."
Clinical Cases:
Case 1: A child suddenly presented with rigid extension of the waist and back, upward deviation of the eyes, and a cyan-red complexion. I stated: "Cyan corresponds to the Liver and governs Wind; red corresponds to the Heart and governs Fire. This is a struggle between Wind and Fire." I prescribed Chai Hu Zhi Zi San (Bupleurum and Gardenia Powder) with doubled amount of Gou Teng Hook (Uncaria Rhynchophylla), which brought immediate relief. However, phlegm persisted, so Bao Long Wan (Embrace Dragon Pill) was subsequently used, resulting in recovery.
Case 2: Another child suddenly presented with rigid extension of the waist and back. After taking medicines for treating fright, the condition recurred intermittently. The complexion was yellowish-white, and the limbs were extremely fatigued. I prescribed Wu Wei Yi Gong San (Five-Ingredient Yi Gong Powder). After more than ten doses, the child recovered. Later, due to fright combined with irregular diet, the condition recurred intermittently. Using the previous formula again led to recovery. Thereafter, daily administration of powdered Ren Shen (Ginseng Root) and Bai Zhu (Atractylodes Macrocephala Rhizome), five to seven fen per dose, mixed with decoction of Pao Jiang (Prepared Ginger) and Da Zao (Jujube Fruit), resulted in no recurrence after two liang were consumed. In both cases, the root Qi was deficient while the pathogenic factor was excess. Using pathogen-expelling drugs would have been erroneous.
Case 3: A child who had previously suffered from the aforementioned condition presented with abundant phlegm and a pale complexion with a bluish tint. I reasoned: "The Lung Qi fails to subdue the Liver Wood; Liver Qi overacts on the Spleen Earth; Spleen Qi deficiency generates phlegm." I first administered two doses of Bao Long Wan (Embrace Dragon Pill) to calm the Liver. Subsequently, Liu Jun Zi Tang (Six-Gentlemen Decoction) was used to tonify the Spleen and Lung, leading to recovery after one month. Half a year later, the condition recurred. I stated that only by eliminating phlegm could full recovery be achieved. Thus, a purgative formula was used. Abundant salivary phlegm was discharged, accompanied by a sawing sound in the throat. I stated: "This is because the Spleen cannot control saliva; the noise in the pharynx indicates extreme deficiency of Lung Qi." I prescribed Ren Shen (Ginseng Root) five qian and Pao Jiang (Prepared Ginger) three fen, decocted in water. The child regained consciousness after ingestion. Two dates were added starting from the fourth dose. After consuming several liang of Ren Shen (Ginseng Root), the child recovered. Later, any recurrence did not respond unless Du Shen Tang (Single Ginseng Decoction) was used. Adhering strictly to standard formulas rarely avoids error.
Ren Shen Qiang Huo San (Ginseng and Notopterygium Decoction) (See Formula under Jing Feng/Fright Wind)
Xiao Xu Ming Tang (Minor Continuation of Life Decoction) (See Formula under Wu Ying/Five Stiffnesses)