杨氏曰∶痫证为小儿之恶候也。小儿血脉不壮,骨气未盛,为风邪所伤,为惊骇所触,
为乳哺失节,停滞结癖经络而得之。大抵治法当别阴阳为要。大概血滞心窍,邪气在心,痰积
遏经成痫,故宜顺气豁痰为良法也。凡小儿发痫,其候神气拂郁,瞪眼直视,面目牵引,口禁
涎流,腹胀,手足抽掣,似死似生。或声或哑,或项背反张,或腰脊强直,但四肢柔弱,时发
而时醒者,醒后当以平和气血,汤药调下苏合丸。未作之先,宜服五痫丸。发痫时,耳后高骨
间必有青纹见之,以针挑破血出啼叫,庶气血疏通而痫不作。十岁以下,皆可灸,以除其根,
十岁以上,可吐以断其源也。
安神散 治小儿截痫,安心神。
人参 茯苓 菖蒲 白藓皮 远志(各五钱) 石膏(二钱半) 犀角(锉) 甘草(炙。各一钱)
上咀,加麦门冬一撮煎服。
牛黄膏 治小儿风痫迷闷,抽搐潮涎。
胆南星 全蝎(去毒炒) 蝉蜕(去足。各二钱) 僵蚕(去嘴炒) 白附子 防风 天麻(煨。各一钱)
上为细末,蒸枣肉研膏丸,如小豆大,用荆芥淡姜汤调服。
太乙散 治小儿胎痫正发,未分瘥后。
天浆子(炒) 全蝎梢(各二十一个) 防风 麝香(一字) 天麻 辰砂(飞。各五钱)
上为细末,用乳汁调化,不时服。
(钱氏)五痫丸镇一切痫。
朱砂(半两) 水银(一钱) 铅(二两) 雄黄(一两) 珍珠(一两)
上为末,炼蜜丸,麻子大。每服一丸,金银煎汤下。
南星散 治痫后喑不能言。
天南星(湿纸裹煨)
上为末,每服一字,猪胆汁调下。
利惊丸 治食痫热痫者宜下之。(方见惊门。)
瓜蒂散 治小儿十岁以上可用吐法。(方见大人痰门。)
杨氏说:痫证是小儿的一种危重病症。小儿血脉不充盈,骨骼精气未旺盛,因受风邪侵袭,被惊恐触动,或因哺乳喂养不当,导致停滞结聚成癖,阻滞经络而发病。大抵治疗原则应当以辨别阴阳为关键。大致上是血滞于心窍,邪气在心,痰积阻滞经络而成痫证,所以适宜采用顺气豁痰作为良法。凡是小儿发作痫证,其症状表现为神气拂郁,瞪眼直视,面目肌肉牵引抽搐,牙关紧闭,口流涎水,腹胀,手足抽掣,似死非死,似生非生。或发声或失声,或颈项背部反张,或腰脊强直,但四肢柔弱,时发时醒者,清醒后应当用平和气血的汤药调服苏合丸。在发作之前,宜服用五痫丸。发作痫证时,耳后高骨之间必有青纹显现,用针挑破使血流出,患儿啼叫,这样气血疏通而痫证不再发作。十岁以下,都可以施灸,以除病根;十岁以上,可用吐法以断病源。
安神散:治疗小儿截断痫证,安定心神。
人参、茯苓、菖蒲、白藓皮、远志(各五钱)、石膏(二钱半)、犀角(锉碎)、甘草(炙。各一钱)。
以上药材切碎,加麦门冬一撮煎服。
牛黄膏:治疗小儿风痫迷闷,抽搐流涎。
胆南星、全蝎(去毒炒制)、蝉蜕(去足。各二钱)、僵蚕(去嘴炒制)、白附子、防风、天麻(煨。各一钱)。
以上研为细末,用蒸枣肉研磨成膏丸,如小豆大小,用荆芥淡姜汤调服。
太乙散:治疗小儿胎痫正在发作,或尚未分晓痊愈之后。
天浆子(炒制)、全蝎梢(各二十一个)、防风、麝香(一字)、天麻、辰砂(飞制。各五钱)。
以上研为细末,用乳汁调化,随时服用。
(钱乙)五痫丸:镇摄一切痫证。
朱砂(半两)、水银(一钱)、铅(二两)、雄黄(一两)、珍珠(一两)。
以上研为末,炼蜜为丸,如麻子大小。每服一丸,用金银煎汤送下。
Yang stated: Epilepsy (Xian Zheng) is a severe condition in children. Children's blood vessels are not robust, and their bone qi is not fully developed. It arises from injury by wind pathogens, contact with fright and alarm, or irregular nursing and feeding, leading to stagnation and accumulation forming masses that block the meridians. Generally, the treatment principle must prioritize distinguishing between Yin and Yang. Broadly speaking, when blood stagnates in the heart orifice and evil qi resides in the heart, phlegm accumulation obstructs the meridians resulting in epilepsy; therefore, promoting Qi circulation and resolving phlegm is an excellent method. When children suffer an epileptic seizure, symptoms include depressed spirit, staring eyes with fixed gaze, facial muscle traction, locked jaw with drooling, abdominal distension, and convulsions of the hands and feet, appearing as if dead yet alive. They may produce sounds or be mute, exhibit opisthotonos (neck and back arching), or rigid spine, while limbs remain flaccid. If the episodes occur intermittently followed by recovery, after waking up, one should administer decoctions to harmonize Qi and Blood along with Suhexiang Wan (Storax Pill). Before an attack occurs, Wuxian Wan (Five Epilepsy Pills) should be taken. During an epileptic fit, blue veins must appear behind the ear on the high bone; pricking these with a needle to release blood, causing the child to cry, will unblock Qi and Blood and prevent further seizures. For children under ten years old, moxibustion can be applied to eradicate the root cause; for those over ten, emesis can be used to cut off the source.
Anshen San (Calming Spirit Powder): Treats pediatric epilepsy interruption and calms the spirit.
Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Changpu (Acori Tatarinowii Rhizoma), Baixianpi (Dictamni Cortex), Yuanzhi (Polygalae Radix) (each 5 qian), Shigao (Gypsum Fibrosum) (2.5 qian), Xijiao (Rhinocerotis Cornu), Gancao (Licorice Root, honey-fried) (each 1 qian).
Coarsely crush the ingredients, add Maimendong (Ophiopogonis Radix) a pinch, decoct and take.
Niuhuang Gao (Calcined Cow-bezoar Ointment): Treats pediatric wind-epilepsy with confusion and drowsiness, convulsions, and tidal salivation.
Dannanxing (Arisaema cum Bile), Quanxie (Scorpio, detoxified and fried), Chantui (Cicada Slough, feet removed) (each 2 qian), Jiangcan (Bombyx Batryticatus, mouthparts removed and fried), Baifuzi (Typhonii Rhizoma), Fangfeng (Saposhnikoviae Radix), Tianma (Gastrodiae Rhizoma, baked) (each 1 qian).
Grind into fine powder, mix with steamed jujube flesh to form ointment pills, size of small beans. Take with Jingjie (Schizonepetae Herba) and mild ginger decoction.
Taiyi San (Supreme One Powder): Treats pediatric congenital epilepsy during active发作 or post-recovery uncertainty.
Tianjiangzi (Ficus Fruit), Quanxie Shao (Scorpio tip) (each 21 pieces), Fangfeng (Saposhnikoviae Radix), Shexiang (Musk), Tianma (Gastrodiae Rhizoma), Chencha (Cinnabar, washed) (each 5 qian).
Grind into fine powder, dissolve in breast milk, take as needed.
(Qian Yi) Wuxian Wan (Five Epilepsy Pills): Suppresses all types of epilepsy.
Zhusha (Cinnabar) (0.5 liang), Shuiyin (Mercury) (1 qian), Qian (Lead) (2 liang), Xionghuang (Realgar) (1 liang), Zhenzhu (Pearl) (1 liang).
Grind into powder, bind with refined honey into pills size of hemp seeds. Take one pill per dose, washed down with decoction of gold and silver.
Nanxing San (Arisaema Powder): Treats muteness following epilepsy.
Tian Nanxing (Arisaema Cum Bile, wrapped in wet paper and baked).
Grind into powder, take one zi dose, mixed with pig bile.
Lijing Wan (Relieve Fright Pill): Suitable for downward purgation in cases of food-stagnation epilepsy and heat-epilepsy. (Formula see Jie Men.)
Gudisan (Melon Stalk Powder): Emetic method suitable for children over ten years old. (Formula see Adult Phlegm Section.)