（论三首 方十三首 灸法二十六首）
论曰∶少小所以有痫病及痉病者，皆由脏气不平故也。新生即痫者，是其五脏不收敛，
血气不聚，五脉不流，骨怯不成也，多不全育。其一月四十日以上至期岁而痫者，亦由乳养
失理，血气不和，风邪所中也，病先身热，掣 惊啼叫唤而后发痫。脉浮者为阳痫，病在六
腑，外在肌肤，犹易治也。病先身冷，不惊掣，不啼呼，而病发时，脉沉者，为阴痫，病在
五脏，内在骨髓，极难治也。病发身软时醒者，谓之痫也。身强直反张如弓不时醒者，谓之
痉也，诸反张，大人脊下容侧手，小儿容三指者，不可复治也。凡脉浮之与沉，以判其病在
阴阳表里耳。其浮沉复有大小滑涩虚实迟快诸证，各根据脉形为治。
《神农本草经》说∶小儿惊痫有一百二十种，其证候微异于常，便是痫候也。初出腹，
血脉不敛，五脏未成，稍将养失宜，即为病也。时不成人，其经变蒸之后有病，余证并宽，
惟中风最暴卒也。小儿四肢不好惊掣，气息小异，欲作痫，及变蒸日满不解者，并宜龙胆汤
也。
凡小儿之痫有三种，有风痫，有惊痫，有食痫。然风痫、惊痫时时有耳，十儿之中未有
一二是风惊者。凡是先寒后热发者，皆是食痫也。惊痫当按图灸之，风痫当与猪心汤，食痫
当下，乃与紫丸佳，凡小儿所以得风痫者，缘衣暖汗出，风因入也。风痫者，初得之时，先
屈指如数，乃发作者，此风痫也。惊痫者，起于惊怖，大啼乃发作者，此惊痫也。惊痫微者
急持之，勿复更惊之或自止也。其先不哺乳，吐而变热后发痫者，此食痫，早下则瘥，四味
紫丸逐癖饮最良，去病速而不虚人，赤丸（方中本无赤丸，详后，癖结胀满篇第一方，紫双
丸用朱砂色当赤，疑即赤丸也）瘥快，病重者当用之。
凡小儿不能乳哺，当与紫丸下之。小儿始生，生气尚盛，但有微恶，则须下之，必无所
损，及其愈病，则致深益，若不时下，则成大疾，疾成则难治矣。凡下，四味紫丸最善，虽
下不损人，足以去疾。若四味紫丸不得下者，当以赤丸下之。赤丸不下，当倍之。若已下而
有余热不尽，当按方作龙胆汤稍稍服之，并摩赤膏（方见本篇末）。风痫亦当下之，然当以
猪
心汤下之。惊痫但按图灸之，及摩生膏（方见本篇末），不可大下也，何者？惊痫心气不定
（一
作足），下之内虚，益令甚尔。惊痫甚者，特为难治，故养小儿，常慎惊，勿令闻大声，抱
持之间，当安徐勿令惊怖。又天雷时，当塞儿耳，并作余细声以乱之也。
凡养小儿，皆微惊以长其血脉，但不欲大惊，大惊乃灸惊脉，若五六十日灸者，惊复更
甚，生百日后灸惊脉乃善。儿有热不欲哺乳，卧不安，又数惊，此痫之初也，服紫丸便愈，
不愈复与之。儿眠时小惊者，一月辄一，以紫丸下之，减其盛气，令儿不病痫也。
儿立夏后有病，治之慎勿妄灸，不欲吐下，但以除热汤浴之，除热散粉之（除热汤、散，
见下编伤寒条中），除热赤膏摩之，又以膏涂脐中，令儿在凉处，勿禁水浆，常以新水饮之。
小儿衣甚薄，则腹中乳食不消，不消则大便皆醋臭，此欲为癖之渐也，便将紫丸以微消
之，服法，先从少起，常令大便稀，勿大下也，稀后便渐减之，不醋臭，乃止药也。
凡小儿冬月下无所畏，夏月下难瘥，然有病者，不可不下，下后腹中当小胀满，故当节
哺乳数日，不可妄下。又乳哺小儿常令多少有常剂，儿渐大当小小增之，若减少者，此腹中
已有小不调也，便微服药，勿复哺之，但当与乳，甚者十数日，微者五六日止，哺自当如常。
若都不肯食哺，而但欲乳者，此是有癖，为疾重要，当下之，不可不下，不下则致寒热，或
吐而发痫，或更致下痢，此皆病重不早下之所为也，此即难治矣。但先治其轻时，儿不耗损
而病可速愈。
凡小儿屎黄而臭者，此腹中有伏热，宜微将服龙胆汤。若白而醋臭者，此挟宿食不消也，
当服紫丸，微者少与药，令内消，甚者小增药，令小下，皆复节乳哺数日，令胃气平和，若
不节乳哺，则病易复，复下之则伤其胃气，令腹胀满，再三下之尚可，过则伤矣。
凡小儿有癖，其脉大必发痫，此为食痫，下之便愈，当审候掌中与三指脉不可令起，而
不时下致于发痫，则难疗矣。若早下之，此脉终不起也，脉在掌中尚可早疗，若至指则病增
矣。
凡小儿腹中有疾生，则身寒热，寒热则血脉动，动则心不定，心不定则易惊，惊则痫发
速也。
（论述三篇，方剂十三首，灸法二十六首）
论述说：小儿之所以患痫病和痉病，都是由于脏腑之气不平衡的缘故。刚出生就患痫病的，是因为五脏功能尚未收敛，血气不能聚拢，五脉运行不畅，骨骼怯弱发育不全，大多难以存活到成年。出生后一个月四十天以上直到一周岁才患痫病的，也是由于哺乳养育失当，血气不和，风邪侵入所致。这种病先表现为身体发热，抽搐惊啼叫唤，然后发作痫病。脉象浮的属于阳痫，病位在六腑，病势在肌肤表面，比较容易治疗。病先表现为身体发冷，不抽搐，不啼哭呼叫，但在发病时脉象沉的，属于阴痫，病位在五脏，病势深入骨髓，极难治疗。发病时身体柔软、时而清醒的，称为痫病。身体强直、角弓反张像弓一样、不能随时清醒的，称为痉病。凡是出现角弓反张症状的，如果大人脊柱下能容纳一只手，小儿能容纳三指宽，就无法再治愈了。大凡脉象浮与沉，只是用来判断病在阴阳表里的区别罢了。至于浮沉脉中又包含大小、滑涩、虚实、迟快等各种证候，都要根据脉象形态来制定治疗方案。
《神农本草经》说：小儿惊痫有一百二十种，其证候与平常略有不同，就是痫病的征候。婴儿刚出生时，血脉未收敛，五脏未成形，稍加调养失宜，就会生病。当时还不会说话行走的人，在经脉变蒸之后患病，其他证候都较轻缓，只有中风最为急暴。小儿四肢不好动、有惊厥抽搐迹象、气息稍有异常，想要发作痫病，以及变蒸周期满后病症不解的，都适宜服用龙胆汤。
大凡小儿的痫病有三种：有风痫，有惊痫，有食痫。然而风痫、惊痫时常发生，十个孩子中没有一二个是风痫或惊痫。凡是先寒后热发作的，都是食痫。惊痫应当按图施灸，风痫应当给予猪心汤，食痫应当攻下，随后给予紫丸效果更佳。大凡小儿之所以得风痫，是因为衣服穿得太暖出汗，风邪乘虚而入。风痫初起时，先是手指屈伸如数数状，然后发作的，这是风痫。惊痫由惊恐引起，大声啼哭后发作的，这是惊痫。惊痫轻微的，急忙抱住安抚他，不要再让他受惊，或许就能自行停止。那些起初不哺乳，呕吐后变热再发作痫病的，这是食痫，早期攻下就能痊愈，四味紫丸逐癖饮效果最好，去病迅速且不伤正气。赤丸（原方本无赤丸，详见后文“癖结胀满”篇第一方，紫双丸用朱砂染色当作赤色，怀疑就是赤丸）见效快，病情重的应当使用它。
大凡小儿不能正常吃奶，应当用紫丸攻下。小儿刚出生，生机尚旺盛，只要有一点轻微不适，就必须攻下，必定没有损害，等到疾病治愈，则带来深远的益处，如果不及时攻下，就会发展成大病，病成则难治了。凡是攻下，四味紫丸最好，虽然攻下但不伤人，足以去除疾病。如果得不到四味紫丸进行攻下，应当用赤丸攻下。赤丸攻不下，应当加倍剂量。如果已经攻下但余热未尽，应当按方制作龙胆汤少量服用，并涂抹赤膏（方剂见本篇末尾）。风痫也应当攻下，但应当用猪心汤送服。惊痫只需按图施灸，并涂抹生膏（方剂见本篇末尾），不可大力攻下。为什么呢？因为惊痫导致心气不定（一作足），攻下会导致内虚，反而使病情加重。惊痫严重的，特别难治，所以养育小儿，要常慎防惊吓，不要让他听到大声，抱持之间，动作要安详缓慢，不要让他惊恐害怕。另外打雷时，要堵住孩子的耳朵，并发出其他细微声音来干扰掩盖。
大凡养育小儿，都要让他在轻微受惊中生长以长养血脉，但不要让他受到大惊，大惊就要灸惊脉，如果在五六十天时灸惊脉，惊症反而会加重，出生一百天后灸惊脉才好。孩子有热不想吃奶，睡不安稳，又多次受惊，这是痫病的初期，服用紫丸就会痊愈，不愈再给他服用。孩子睡觉时轻微惊跳的，每月一次，用紫丸攻下，减弱其盛气，让孩子不患痫病。
孩子在立夏后生病，治疗时要谨慎，不要随意施灸，不要催吐攻下，只用除热汤洗澡，撒除热散粉（除热汤、散，见下编伤寒条中），涂抹除热赤膏按摩，再用药膏涂在肚脐中，让孩子待在凉快的地方，不要禁止喝水浆，经常用新水喂他喝。
小儿衣服太薄，则腹中乳食不消化，不消化则大便都有酸臭味，这是形成癖积的开端，就立即用紫丸轻微消导它。服药方法，先从少量开始，常令大便稀溏，不要大力攻下，稀溏后便逐渐减少药量，大便不再酸臭，就停药。
大凡小儿冬天月份生病不可怕，夏天月份生病难痊愈，然而有病者，不可不攻下，攻下后腹中应当轻微胀满，所以应当节制哺乳几天，不可随意攻下。另外喂养小儿常令多少有固定标准，孩子渐渐长大应当稍微增加食量，如果减少，这是腹中已有轻微不调，就轻微服药，不再喂食，只给喂奶，严重的十几天，轻微的五六天停止，喂食自然恢复正常。如果完全不肯吃辅食，只想吃奶，这是有癖积，病情重要，必须攻下，不可不攻下，不攻下则导致寒热，或者呕吐而发作痫病，或者更导致下痢，这都是病情重不早攻下所造成的，这就难治了。但先在病情轻时治疗，孩子不耗损而病可快速痊愈。
大凡小儿大便黄而臭的，这是腹中有伏热，适宜轻微服用龙胆汤。如果白而酸臭的，这是夹杂宿食不消化，应当服用紫丸，轻微的少给药，令内部消散，严重的稍微增加药量，令轻微攻下，都要节制哺乳几天，令胃气平和，如果不节制哺乳，则病容易复发，再次攻下则损伤胃气，令腹胀满，再三攻下还可以，超过限度就损伤身体了。
大凡小儿有癖积，脉象大必然发作痫病，这是食痫，攻下便痊愈，应当仔细诊察掌中与三指脉，不要让脉象浮起，而不及时攻下导致发作痫病，就难治疗了。如果早攻下，此脉终不起，脉在掌中尚可早疗，若至指端则病增重了。
(Three Discourses, Thirteen Prescriptions, Twenty-six Moxibustion Methods)
Discourse states: The reason why infants and young children suffer from epilepsy (Xian Bing, 痫病) and tetanus/spasm (Jing Bing, 痉病) is all due to the imbalance of Zang-Fu Qi (Visceral Energy). Epilepsy occurring immediately after birth results from the failure of the Five Zang Organs (Five Viscera) to consolidate, the inability of Blood and Qi to gather, the stagnation of the Five Meridians, and skeletal weakness with incomplete development; such cases often fail to survive to adulthood. Epilepsy occurring between forty days and one year after birth is also caused by improper nursing and rearing, disharmony of Blood and Qi, and invasion of Wind Pathogen (Wind Evil). This condition initially presents with body heat, convulsions, startled crying, and shouting, followed by an epileptic seizure. A floating Pulse (Mai, 脉) indicates Yang Epilepsy (Yang Xian), where the disease resides in the Six Fu Organs (Six Bowels), manifests on the exterior skin and muscles, and is relatively easy to treat. Conversely, if the body is initially cold, without convulsions or crying, but the Pulse becomes deep during the attack, it is Yin Epilepsy (Yin Xian), where the disease resides in the Five Zang Organs, penetrates deeply into the bone marrow, and is extremely difficult to treat. When the body is soft and the child regains consciousness intermittently during an episode, it is called Epilepsy. When the body is rigid, arched backward like a bow, and does not regain consciousness, it is called Tetanus/Spasm. For those presenting with opisthotonos (backward arching of the spine), if the space under the adult's spine can accommodate a hand, or three fingers for a child, the condition is incurable. Generally, floating and deep Pulses are used merely to distinguish whether the disease is in the Yin/Yang or Exterior/Interior. Within these floating and deep categories, there are further variations such as large/small, slippery/choppy, empty/excess, and slow/fast signs; treatment must be tailored according to the specific pulse morphology.
The *Shennong Bencao Jing* (Divine Farmer's Materia Medica) states that there are one hundred and twenty types of infantile startled epilepsy. Their symptoms differ slightly from normal conditions, which constitutes the signs of epilepsy. Upon birth, when blood vessels have not yet consolidated and the Five Zang Organs are undeveloped, any slight impropriety in care will lead to illness. In infants who cannot yet speak or walk, diseases occurring after the meridian "Bian Zheng" (developmental fever stages) generally have mild symptoms, except for Wind Stroke (Zhong Feng, 中风), which is the most acute and sudden. If an infant's limbs are inactive, showing signs of startling and convulsions, with slight abnormalities in breathing, indicating impending epilepsy, or if symptoms persist after the Bian Zheng cycle is complete, Long Dan Tang (Gentian Decoction) is appropriate.
Generally, infantile epilepsy is divided into three types: Wind Epilepsy (Feng Xian), Startled Epilepsy (Jing Xian), and Food Stagnation Epilepsy (Shi Xian). However, Wind and Startled Epilepsies are common, whereas only one or two out of ten children suffer from them. Any case presenting with initial chills followed by fever is classified as Food Stagnation Epilepsy. Startled Epilepsy should be treated with moxibustion according to diagrams; Wind Epilepsy should be treated with Zhu Xin Tang (Pig Heart Decoction); Food Stagnation Epilepsy requires purgation, preferably followed by Zi Wan (Purple Pill). Infantile Wind Epilepsy occurs because excessive clothing causes sweating, allowing Wind Pathogen to enter. Initially, Wind Epilepsy presents with finger flexion resembling counting, followed by an attack. Startled Epilepsy arises from fright, manifesting after loud crying. Mild cases of Startled Epilepsy can be stopped by holding the child urgently and preventing further fright. Cases where the infant refused milk, vomited, developed heat, and then had an epileptic seizure are Food Stagnation Epilepsy; early purgation leads to recovery. Si Wei Zi Wan Zhu Pi Yin (Four-Ingredient Purple Pill for Expelling Accumulation) is most effective, removing disease rapidly without damaging healthy Qi. Chi Wan (Red Pill)—note: originally absent from this text, see the first prescription in the "Accumulation and Distension" chapter; likely identical to the Cinnabar-colored Purple Double Pill—acts quickly and should be used for severe cases.
For infants unable to nurse, Zi Wan should be administered to purge. Newborns possess vigorous Sheng Qi (Vital Energy); even minor discomfort warrants purgation, causing no harm and yielding profound benefits upon recovery. Failure to purge promptly may lead to serious illness, which becomes difficult to treat once established. Among purgatives, Si Wei Zi Wan is superior; it removes disease without injuring the body. If Si Wei Zi Wan is unavailable, use Chi Wan. If ineffective, double the dosage. If residual heat remains after purgation, administer Long Dan Tang in small amounts according to the formula, and apply Chi Gao (Red Ointment) (see end of this chapter). Wind Epilepsy also requires purgation, specifically using Zhu Xin Tang. Startled Epilepsy requires only moxibustion per diagrams and application of Sheng Gao (Life Ointment) (see end of this chapter); strong purgation is contraindicated. Why? Because Startled Epilepsy involves unstable Heart Qi; purgation causes internal deficiency, exacerbating the condition. Severe Startled Epilepsy is particularly difficult to treat. Therefore, when raising children, one must guard against fright, avoid loud noises, and handle them gently to prevent terror. During thunderstorms, plug the child's ears and make soft noises to mask the sound.
In raising children, slight fright helps develop blood vessels, but severe fright must be avoided. If severe fright occurs, moxa should be applied to the Jing Mai (Startle Meridian/Vessels). Applying moxa at 50-60 days may worsen the startle response; it is beneficial only after 100 days of age. If a child has heat, refuses nursing, sleeps restlessly, and is frequently startled, this is the onset of epilepsy; Zi Wan will cure it, and should be repeated if necessary. If a child startles slightly while sleeping once a month, administer Zi Wan to reduce excess Qi and prevent epilepsy.
If a child falls ill after the Start of Summer (Li Xia), treatment must avoid arbitrary moxibustion and emetic/purgative methods. Instead, bathe with Chu Re Tang (Heat-Removing Decoction), dust with Chu Re San (Heat-Removing Powder) (see Shang Han section below), massage with Chu Re Chi Gao (Heat-Removing Red Ointment), and apply ointment to the umbilicus. Keep the child in a cool place, do not restrict water intake, and frequently offer fresh water.
If a child wears thin clothing, milk and food in the abdomen will not digest. Undigested food causes sour-smelling stools, indicating the beginning of Pi Ji (Accumulation/Mass). Immediately use Zi Wan for mild digestion aid. Administer starting with a small dose, maintaining loose stools without strong purgation. Gradually reduce the dose as stools become less loose; stop medication when stools no longer smell sour.
Infants falling ill in winter months are easier to manage than those in summer, but purgation is still necessary when indicated. Post-purgation abdominal distension is expected; thus, nursing should be moderated for several days. Avoid arbitrary purgation. Feeding amounts should follow a standard, increasing gradually as the child grows. If intake decreases, it indicates mild abdominal disharmony; administer mild medication and withhold solid food, offering only milk. For severe cases, withhold food for over ten days; for mild cases, five to six days. Normal feeding will resume. If the child refuses all food and desires only milk, it indicates significant Pi Ji requiring urgent purgation. Failure to purge may lead to alternating chills and fever, vomiting with epilepsy, or dysentery. These outcomes result from delaying treatment in severe cases, making them difficult to cure. Early intervention prevents depletion and ensures rapid recovery.
Yellow, foul-smelling stools indicate latent heat in the abdomen; mildly administer Long Dan Tang. White, sour-smelling stools indicate retained undigested food; administer Zi Wan. For mild cases, give a small dose to resolve internally; for severe cases, slightly increase the dose for mild purgation. Moderately restrict nursing for several days to restore Stomach Qi harmony. Failure to moderate nursing leads to recurrence; subsequent purgation damages Stomach Qi, causing abdominal distension. Repeated purgation is tolerable up to a point, but excess causes injury.
If an infant has Pi Ji and the Pulse is large, epilepsy will likely ensue; this is Food Stagnation Epilepsy, cured by purgation. Carefully examine the palm and three-finger pulses; they should not rise. Failure to purge promptly leading to epilepsy makes treatment difficult. Early purgation prevents the pulse from rising. If the pulse is confined to the palm, early treatment is viable; if it extends to the fingertips, the disease has worsened.
When pathological factors arise in the infant's abdomen, alternating chills and fever occur. This agitates the blood vessels, destabilizing Heart Qi. Unstable Heart Qi leads to susceptibility to fright, which triggers rapid onset of epilepsy.