〔薛〕《医药纲目》云∶螈者筋脉急也， 者筋脉缓也。急则引而缩，缓则纵而伸。或
缩或伸，动而不止者，名曰螈 ，俗谓之发搐是也。凡癫痫、风痉、破伤风三证，皆能
螈。但癫痫则仆地不省，风痉螈 则角弓反张，破伤风螈 则有疮口。窃谓螈者属肝
经风热血燥，或肝火妄动血伤， 者属肝经血气不足，或肝火汗多亡血，以致手足伸缩
不已，抽搐不利。若因风热血燥，用羚羊角散（妊娠痉。）加钓藤、山栀。若肝火妄动，用加
味四物汤（即四物加柴胡、丹皮、山栀。）加钓藤钩、山栀。若肝经血气不足，用八珍
汤（即杂病虚劳门八物汤。）加钓藤钩、山栀。若肝火亡血，用加味逍遥散（调经。）加钓藤
钩、山栀。如不应须用六味丸（杂病虚劳。）以补肾水，生肝木为主，佐以前剂治之。若
其脉长弦者，是肝之本脉，则易治。其脉短涩者，是肺金克肝木也，则难治。其面
色青中见黑者，是水生木也，当自
愈。青中见白者，是金克木也，必难愈。一妇人素口苦，月经不调，或寒热，妊娠五
月，两臂或拘急、或缓纵，此肝火伤血所致也，用四物加柴胡、山栀、丹皮、钓藤钩而
愈。一妊妇因怒寒热颈项动掉，四肢抽搐，此肝火血虚风热，用加味逍遥加钓藤钩，数
剂痊。
【薛己】《医药纲目》中说：瘛（chì，筋脉拘急收缩）是筋脉拘急的表现，疭（zòng，筋脉弛缓舒张）是筋脉松弛的表现。拘急则牵引而收缩，松弛则放纵而伸展。时而收缩时而伸展，动作不止的，称为瘛疭，俗称发搐。凡是癫痫、风痉、破伤风这三种病证，都能引起瘛疭。但是癫痫发作时病人会跌倒在地不省人事，风痉引起的瘛疭会出现角弓反张（身体向后弯曲如弓状），破伤风引起的瘛疭则有伤口。我认为，瘛属于肝经风热血燥，或者肝火妄动损伤血液；疭属于肝经气血不足，或者肝火旺盛导致汗多亡血，致使手足伸缩不停，抽搐不利。如果是因风热血燥所致，使用羚羊角散（治疗妊娠期间发生的痉病）加钩藤、山栀。如果是肝火妄动所致，使用加味四物汤（即四物汤加入柴胡、丹皮、山栀）加钩藤、山栀。如果是肝经气血不足所致，使用八珍汤（即杂病虚劳门中的八物汤）加钩藤、山栀。如果是肝火导致亡血，使用加味逍遥散（调理月经）加钩藤、山栀。如果上述方法无效，必须使用六味丸（治疗杂病虚劳）以补肾水、生肝木为主，配合前面的方剂进行治疗。如果脉象长而弦，这是肝的本脉，则容易治疗。如果脉象短而涩，这是肺金克制肝木，则难治。如果面色青中见黑，这是水生木（肾水生肝木），应当自愈。如果面色青中见白，这是金克木（肺金克肝木），必定难以痊愈。有一位妇女平时口苦，月经不调，有时寒热往来，怀孕五个月时，两臂有时拘急、有时松弛，这是肝火伤血所致，用四物汤加柴胡、山栀、丹皮、钩藤而治愈。还有一位孕妇因愤怒出现寒热、颈项抖动，四肢抽搐，这是肝火血虚风热所致，用加味逍遥散加钩藤，几剂药后痊愈。
[Xue Ji] *Yi Gang Mu* (Outline of Medicine) states: "Chi" (spasm/tetany, characterized by muscle contraction) refers to the tension of sinews and vessels; "Zong" (clonic movement, characterized by muscle relaxation) refers to the laxity of sinews and vessels. Tension causes pulling and shrinking, while laxity allows for extension and stretching. When there is alternating shrinking and stretching with ceaseless movement, it is named Chi-Zong, commonly known as convulsions. The three conditions of epilepsy, wind-spasm, and tetanus can all cause Chi-Zong. However, in epilepsy, the patient falls to the ground and loses consciousness; in wind-spasm causing Chi-Zong, opisthotonos (rigid arching of the back) occurs; and in tetanus causing Chi-Zong, there are open wounds. I believe that Chi belongs to wind-heat and blood dryness in the Liver channel, or reckless movement of Liver fire damaging blood; Zong belongs to deficiency of Qi and Blood in the Liver channel, or excessive sweating due to Liver fire leading to loss of blood, resulting in ceaseless extension and flexion of the limbs and difficulty in convulsions. If caused by wind-heat and blood dryness, use Lingyang Jiao San (Antelope Horn Decoction, used for spasms during pregnancy) added with Gouteng (Uncariae Ramulus cum Uncis) and Shanzhi (Gardeniae Fructus). If caused by reckless movement of Liver fire, use Jiawei Siwu Tang (Modified Four Substances Decoction, i.e., Siwu Tang added with Chaihu, Danpi, and Shanzhi) added with Gouteng and Shanzhi. If caused by deficiency of Qi and Blood in the Liver channel, use Bazhen Tang (Eight Treasures Decoction, i.e., the Eight-Ingredient Decoction from the Deficiency and Emaciation section of miscellaneous diseases) added with Gouteng and Shanzhi. If caused by Liver fire leading to blood loss, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder, used for regulating menstruation) added with Gouteng and Shanzhi. If these do not work, Liujun Wan (Six Ingredient Pill, used for deficiency and emaciation in miscellaneous diseases) must be used to primarily tonify Kidney Water and generate Liver Wood, assisted by the aforementioned formulas. If the pulse is long and wiry, this is the proper pulse of the Liver, indicating an easy cure. If the pulse is short and choppy, this indicates Metal of the Lung overcoming Wood of the Liver, indicating a difficult cure. If the complexion is green with black tinges, this indicates Water generating Wood (Kidney Water nourishing Liver Wood), and it should heal spontaneously. If the complexion is green with white tinges, this indicates Metal overcoming Wood (Lung Metal suppressing Liver Wood), and it will certainly be difficult to cure. A certain woman who usually had a bitter taste in her mouth and irregular menstruation, experiencing occasional chills and fever, at five months of pregnancy had arms that were sometimes tense and sometimes relaxed. This was caused by Liver fire damaging blood. She was cured using Siwu Tang added with Chaihu, Shanzhi, Danpi, and Gouteng. Another pregnant woman, due to anger, experienced chills and fever, trembling of the neck and nape, and convulsions of the four limbs. This was caused by Liver fire, blood deficiency, and wind-heat. She recovered after several doses of Jiawei Xiaoyao San added with Gouteng.