眼生赤脉贯瞳人，囟门肿起又作坑。指甲黑色鼻干燥，鸦声忽作肚青筋。虚舌退场门切牙齿，目多直视
不转睛。鱼口气急啼不得，蛔虫既出死形真。手足掷摇惊过节，灵丹十救一无生。
脉
总见前。
病
小儿疾之最危者，无越惊风之证也。盖惊有急惊，有慢惊，有
慢脾风。三者之不同，急者属阳，阳盛而阴亏；慢者属阴，阴亏而阳盛；慢脾者，亦属阴，阴气极盛，胃气
极虚，阳动而躁疾，阴静而迟缓，其始也。多由小儿气血怯弱，肌肤软薄，神气未备，脏腑未全。在捧抱者，爱
护如执玉捧盈之类，不令疏虞可也。若被掀轰恶逆之音，凶猛怪诧之物，触犯小儿，则致面青口噤，或声
嘶而厥，发过则客色如故。良久复作，其身热面赤，口干引饮，口鼻中气热，大小便黄赤色，惺惺不睡，
牙关紧急，壮热涎潮，上窜反张，搐搦颤动、唇口眉眼，眨引频并，其脉浮数洪紧。盖热盛则生痰，痰盛则
生风，偶因惊而发耳，则急惊属于肝木，风邪痰热有余之证。治宜清冷苦寒泻气之药，以败毒散之类。慢惊
之候，多因饮食不节，损伤脾胃，以致吐泻日久，中气大虚而致发搐，发则无休止时。其身冷面黄不渴，口鼻
中气寒，大小便清白，昏睡露晴，目上视，手足螈 ，筋脉拘挛，其脉沉迟散缓。盖脾虚则生风，风盛
则筋急。俗云∶天吊风者，即此候也。此慢惊属于脾土，中气虚损，不足之候。治宜和中甘温补气之剂，以
补脾汤之类。慢脾风证，盖由慢惊传次而至。慢惊之后，吐泻损脾，病传已极，总归虚处，惟脾所受，故曰慢
脾，又名虚风。其病，则面赤额汗，舌短头低，眼合不开，困睡中摇头吐舌，频吐腥臭，噤口切牙，手足微
搐而不收，或身冷，或身温，而四肢厥冷，其脉沉微。
治法大要，生胃回阳，宜黑附汤之类。俟胃气渐复，则用异功散温平而调理之。若其眼半开半合，手足
不冷，证候尚在慢惊，则不用回阳。或已入慢脾而阳气未甚脱者，亦不可用硫黄、附子。凡服回阳汤剂，手
足渐暖者，仍以醒脾散等，继其后以调之。慢惊慢脾逆恶之候，急惊搐搦暴烈之证，大抵急惊易疗，而慢惊
难痊，至于慢脾危笃之疾，虽神工妙手，莫易治焉。医者宜分急、慢、脾风三证，要察虚实冷热四候，慎
毋混于一途而治。故曰∶虚则补
之，实则利之，冷者温之，热者凉之，是为活法。又易曰∶化而
裁之存乎变，神而明之存乎人，此之谓也。若以一例而施之，岂非刻舟求剑之术耶。
眼周出现赤色血脉贯穿瞳孔，囟门肿胀突起又凹陷如坑。指甲呈现黑色，鼻部干燥，突然发出类似乌鸦的叫声，腹部青筋暴露。舌头虚软无力伸出后缩回，肛门松弛脱出，牙齿紧咬，眼睛大多直视不动，眼球不转动。呼吸急促如鱼口开合，啼哭不出，蛔虫排出后显现出死亡的征象。手足剧烈掷动摇晃，惊厥超过关节限度，即使使用灵丹妙药，十人中也无法救活一人。
脉象总见前文所述。
疾病方面：小儿疾病中最危险的，没有超过惊风这一证候的了。大抵惊风有急惊、慢惊、慢脾风三种。这三者的不同在于：急惊属于阳证，阳气盛而阴气亏；慢惊属于阴证，阴气亏而阳气相对偏盛（注：此处原文逻辑似有矛盾或特指阴阳失衡状态，依原文直译）；慢脾风也属于阴证，阴气极盛，胃气极虚。阳气主动且躁疾，阴气主静且迟缓，这是其初始表现。多因小儿气血怯弱，肌肤柔软薄弱，神气尚未完备，脏腑功能未完全健全所致。在抚养照顾者，应像捧着玉器和装满水的容器那样爱护，不让其受到疏忽和意外即可。如果被喧闹恶劣的声音、凶猛怪异的事物所触犯惊吓，就会导致面色发青、牙关紧闭，或者声音嘶哑甚至昏厥，发作过后神色暂时恢复正常。过很久再次发作，此时身体发热、面色红赤、口干想喝水，口鼻中呼出的气热，大小便呈黄红色，精神清醒无法入睡，牙关紧急，高热伴有痰涎上涌，头向后仰身体反张，抽搐痉挛颤抖，嘴唇、口角、眉毛、眼睛频繁眨动牵引，脉象浮数洪紧。大抵热盛则生痰，痰盛则生风，偶尔因受惊而诱发，所以急惊属于肝木，是风邪、痰热有余的实证。治疗宜用清冷苦寒泻气的药物，以败毒散之类的方剂。
慢惊的症状，多因饮食不节制，损伤脾胃，导致呕吐腹泻日久，中气大虚而引发抽搐，发作时无休止之时。此时身体发冷、面色萎黄、口不渴，口鼻中呼出的气寒，大小便清白，昏睡且眼睑闭合不全（露睛），眼睛向上视，手足抽搐蠕动，筋脉拘挛，脉象沉迟散缓。大抵脾虚则生风，风盛则筋脉紧急。俗称为“天吊风”的，就是这种证候。此慢惊属于脾土，是中气虚损不足的证候。治疗宜用中和甘温补气的药剂，以补脾汤之类的方剂。
慢脾风证，大概是由慢惊传变而来。慢惊之后，吐泻损伤脾胃，病情传变至极点，总归于虚损之处，唯独脾脏受累，所以叫慢脾，又名虚风。其病症表现为：面色红赤、额头出汗，舌短头低，眼睛闭合不开，困倦嗜睡中摇头吐舌，频繁吐出腥臭之物，牙关紧闭咬齿，手足轻微抽搐而不能收回，或者身体发冷，或者身体温热但四肢厥冷，脉象沉微。
治疗的大要，在于生胃回阳，宜用黑附汤之类的方剂。等到胃气逐渐恢复，则用异功散温和平补来调理它。如果患者眼睛半开半合，手足不冷，证候尚在慢惊阶段，则不用回阳之法。或者已经转入慢脾但阳气尚未严重脱失的，也不可用硫黄、附子。凡是服用回阳汤剂，手足逐渐温暖的，仍以醒脾散等方剂继其后进行调理。慢惊、慢脾逆恶的证候，以及急惊抽搐暴烈的病证，大抵急惊容易治疗，而慢惊难以痊愈，至于慢脾这种危重的疾病，即使是神医妙手，也难以轻易治愈。医生应当区分急、慢、脾风三种证候，务必考察虚实冷热四种情况，千万不要混为一谈而统一治疗。所以说：虚证就补益它，实证就通利它，冷证就温煦它，热证就清凉它，这才是灵活的方法。又《易经》说：变化而裁断在于变通，神妙而明达在于人，说的就是这个道理。如果用一种固定的模式去施治，岂不是刻舟求剑的做法吗？
Red meridians appear around the eyes, penetrating the pupil; the fontanelle swells and protrudes, yet also sinks like a pit. The fingernails turn black, the nose is dry, a crow-like sound suddenly arises, and green veins are exposed on the abdomen. The tongue is flaccid, extending and retracting; the anus prolapses, teeth are clenched tightly. The eyes mostly stare straight without moving the eyeballs. Breathing is rapid with an open-mouthed gasp like a fish, crying is impossible, and after roundworms are expelled, the signs of death are evident. Hands and feet thrash and shake violently beyond the joints; even with miraculous pills, not one in ten can be saved.
The pulse conditions are as described previously.
Regarding diseases: Among pediatric ailments, none is more critical than **Jing Feng** (Convulsive Disorder). Generally, **Jing Feng** includes **Ji Jing Feng** (Acute Convulsion), **Man Jing Feng** (Chronic Convulsion), and **Man Pi Feng** (Chronic Spleen Wind). These three differ as follows: **Ji Jing Feng** belongs to Yang, characterized by excess Yang and deficiency of Yin; **Man Jing Feng** belongs to Yin, characterized by deficiency of Yin and relative excess of Yang (or imbalance); **Man Pi Feng** also belongs to Yin, characterized by extreme excess of Yin and extreme deficiency of Stomach Qi. Yang is active and restless, while Yin is quiet and slow, which marks the initial stage. This often stems from children having weak Qi and Blood, soft and thin skin, incomplete Shen Spirit, and immature Zang-Fu organs. Caregivers should protect them as if holding jade or full vessels, preventing any negligence or accident. If startled by loud, harsh noises or fierce, strange objects, the child may present with a cyan face, clenched jaw, hoarse voice, or syncope. After the episode, the complexion may temporarily return to normal. However, after a long interval, it recurs with fever, red face, dry mouth with desire for drinks, hot breath from mouth and nose, yellow-red urine and stool, wakefulness without sleep, tight jaw, high fever with tidal phlegm, opisthotonos (arching back), spasms, tremors, frequent blinking and twitching of lips, mouth, eyebrows, and eyes, with a floating, rapid, surging, or tight pulse. Generally, heat excess generates phlegm, phlegm excess generates wind, triggered occasionally by fright. Thus, **Ji Jing Feng** belongs to Liver Wood, representing an excess syndrome of Wind pathogen, Phlegm, and Heat. Treatment should employ cold, bitter, and cold-natured Qi-draining herbs, such as **Baidu San** (Poison-Resolving Powder).
**Man Jing Feng** symptoms often result from irregular diet damaging the Spleen and Stomach, leading to prolonged vomiting and diarrhea, causing severe deficiency of Middle Qi and subsequent convulsions, which occur incessantly. The body is cold, face sallow, no thirst, cold breath from mouth and nose, clear white urine and stool, deep sleep with staring eyes (exposed eyelids), upward gaze of eyes, twitching of hands and feet, tendon and vessel spasm, with a deep, slow, scattered, or moderate pulse. Generally, Spleen deficiency generates wind, wind excess causes tendon tension. Commonly called "Tian Diao Feng" (Heaven-Hanging Wind), this condition belongs to Spleen Earth, representing a deficiency syndrome of Middle Qi damage. Treatment should employ harmonizing, sweet, warm, and Qi-tonifying formulas, such as **Bupi Tang** (Spleen-Supplementing Decoction).
**Man Pi Feng** generally evolves from **Man Jing Feng**. Following **Man Jing**, vomiting and diarrhea damage the Spleen; when the disease progresses to its extreme, it converges on deficiency, specifically affecting the Spleen. Hence it is called **Man Pi** (Chronic Spleen) or Xu Feng (Deficiency Wind). Symptoms include red face, forehead sweating, short tongue, head drooping, eyes closed and unable to open, drowsiness with head shaking and tongue protrusion, frequent expulsion of foul-smelling vomit, clenched jaw and teeth grinding, slight involuntary movements of hands and feet that cannot be controlled, cold body or warm body with cold limbs, and a deep, faint pulse.
The main therapeutic principle is to generate Stomach Qi and restore Yang, using formulas like **Hei Fu Tang** (Black Aconite Decoction). Once Stomach Qi gradually recovers, use **Yigong San** (Extraordinary Assistance Powder) for gentle regulation. If the eyes are half-open and half-closed, hands and feet are not cold, and the syndrome remains within **Man Jing**, do not use Yang-restoring methods. Even if it has entered **Man Pi** but Yang Qi is not severely depleted, Sulfur (**Huang**) and Prepared Aconite Root (**Fuzi**) should not be used. For those taking Yang-restoring decoctions whose hands and feet gradually warm up, follow up with **Xingpi San** (Spleen-Awakening Powder) for regulation. Regarding the adverse conditions of **Man Jing** and **Man Pi**, and the violent convulsions of **Ji Jing**, generally **Ji Jing** is easier to treat, while **Man Jing** is difficult to cure. As for the critical illness of **Man Pi**, even divine physicians find it hard to treat easily. Physicians must distinguish between the three syndromes of **Ji**, **Man**, and **Pi** wind, carefully observing the four aspects of Deficiency/Excess and Cold/Heat. Do not treat them indiscriminately. Thus it is said: Tonify deficiency, drain excess, warm cold, cool heat; this is the flexible method. Furthermore, the *I Ching* states: Transformation and adaptation depend on change; divinity and clarity depend on the person. This is what is meant. To apply a uniform method to all cases would indeed be the technique of carving a mark on the boat to find the sword.