小儿诸病。但见两眼无精光。黑睛无转运。目睫无锋芒。如鱼眼猫眼之状。个个不治。
或神
藏于内。外若昏困者无妨。其有病笃而眼中神气不脱者。可以活。眼者五脏六腑神气之发。
神气已脱。脉虽仅存。亦未能保。
儿初生。叫声连延相属者寿。声绝而复扬急者不寿。啼声散。不成人。啼声深。不成
人。
脐中无血者好。脐小者不寿。通身软弱如无骨者不寿。鱼白长大者寿。自开目者不成人
小便凝如脂膏不成人。头四破者不成人。汗血者多死不寿。汗不流不成人。常摇手
足者不成人。头毛不周匝者不成人。儿生枕骨不成者。能言而死。尻骨不成者。能
倨而死。掌骨不成者。能匍匐而死。躅骨不成者。能行而死。膑骨不成者。能立而死
身不收者死。鱼口者死
股间无生肉者死。头下破者死。阴不起者死。阴囊下白者死。卵缝通达黑者寿。
脉诀启蒙曰。小儿脉促急为虚惊。
直指云。浮数洪紧为急惊。沉迟散缓为慢惊。虎口脉纹青紫为惊风。红者风热轻。赤者
盛。青者惊积。紫者惊热。青紫相半。惊积风热俱有。主急惊风。青而淡紫。伸缩来去。主
慢惊风。紫丝青丝或黑丝。隐隐相杂。似出而不出。主慢脾风。情势弯入里者顺。出外者逆。
急惊风者。因内有郁热。外挟风邪。心家受热而积惊。肝家生风而发热。夫木制在金。若
火盛则金受克。金衰不能平木。木能生火。火得风则焰烟起。故子母纵横。血乱气并。痰涎
壅塞。关窍不通。风火蕃盛而不得泄。暴烈而成急惊也。其症牙关紧急。壮热涎潮。窜视
反张搐搦。颤动唇口。眉眼眨引频并。六脉浮散洪紧。治先搐鼻通关。痰涎壅盛。以吐风散
吐之。次用败毒散。保命丹。或雄黄解毒丸下之。惊退而神志未定。投安神散。但喷药不
下
通关不嚏。眼睛翻转。口中出血。两足摆跳。肚腹搐动。或神缓而摸床寻衣。症笃而晨
昏气促。心中热痛。忽大声叫者不治。
嚏惊散
半夏 牙皂
等分为末。用少许吹入鼻中。
一论小儿急慢惊风。发热口噤。不省人事。手心伏热。痰涎咳嗽。上壅喘急。并宜涌法
吐风散
全蝎（炒一个） 瓜蒂（炒十个） 赤小豆（三十个）
上为末。每一岁儿服一丸。温米饮调下。未吐。再服。
一论小儿急惊风。初起发热。手足搐搦。眼上视等症。并一切感冒风寒。咳嗽鼻塞声重
头疼发热。及痘疹欲搐。发搐。并时行瘟疫等症。宜
加味败毒散
羌活 独活 前胡 柴胡 白茯苓（去皮） 人参 枳壳（去芦麸炒） 桔梗 天麻 全蝎
僵蚕 白附子 地骨皮 川芎 甘草
上作一剂。生姜三片。水煎。热服。
一论小儿急惊搐搦。眼翻口噤。摇头天吊。痰嗽喘热。服
南极寿星汤
胆星 防风 白附子 蝉蜕 薄荷 甘草
上锉。水煎服。
一小儿潮热惊啼。
木通 车前 赤茯苓 麦门冬 蝉蜕 防风 白芍 甘草 灯草
水煎服。
一小儿惊风。咳嗽痰喘。天南星一个。大者炮去皮。为末。每服一钱。生姜三片。水煎
温服。
一论小儿胎惊内吊。肚腹坚硬。目睛上视。手足搐搦。角弓反张。痰热咳嗽。一切急慢
惊风。并皆治之。
至圣保命丹
南星（炮去皮用白矾水浸一宿再出晒干再用生姜水浸一宿晒干再炒） 半夏（同上制） 薄
荷
青黛（各一两） 全蝎（去尾尖） 天麻 白附子（略炒） 僵蚕（姜汁炒） 防风 郁金 甘草（
各五钱） 麝香（少许） 朱砂（五钱）
上为末。炼蜜为丸。朱砂为衣。芡实大。每服一丸。灯心、薄荷汤化下。
一论小儿痰喘。急慢惊风欲死。但能开口灌下。无不活者。用
千金散 内阁秘传。
全蝎（炙熟） 直僵蚕（各三分） 朱砂（四分） 天麻（四分） 冰片（二分） 牛黄（六厘）
黄连（四分） 胆星 甘草（各三分）
上为细末。每服五七厘。薄荷、灯心、金银花煎汤。不拘时调下。
一论惊风退后。恍惚虚怯。安神定志。调理之剂。
安神散
人参 茯苓（去皮） 远志（去心） 天麻 白附子 麦门冬 全蝎 莲肉 茯神（去皮木）
朱砂（各等分）
上为细末。每服。灯心汤调下。
一小儿沉困发热。惊搐不乳。视其脉纹如乱鱼骨。此风热急惊之症也。先用抱龙丸少许
祛风化痰。后用六君子汤加柴胡。壮脾平肝。热遂退而惊定愈矣。
一小儿螈 啼叫。额间青黑。此惊风肝木乘脾。腹中作痛也。先以六君子汤加木香、柴
胡、钩藤钩。啼叫渐缓。更加当归。又二剂而安。
一小儿目内色青。发搐。目上视。叫哭不已。或用牛黄清心丸。不愈。反切牙顿闷。小
便自遗。此肝经血气虚甚故耳。余用补中益气汤及六味地黄丸而痊。
小儿的各种疾病，只要看到两眼没有神采，黑眼球转动不灵活，眼睑边缘缺乏锋芒，呈现出像鱼眼或猫眼的样子，都是无法治愈的。
或者神气内藏，外表看起来昏沉困倦的，无妨。那些病情危重但眼中神气未脱失的，可以存活。眼睛是五脏六腑神气外发的窗口。
如果神气已经脱失，即使脉象仅存一丝，也无法保全生命。
婴儿刚出生时，哭声连绵不断的长寿。声音中断后又突然急促响起的，寿命不长。啼声散乱的，不能成人。啼声深沉的，也不能成人。
脐带脱落处没有积血的，好。肚脐小的，寿命不长。全身软弱无力像没有骨头一样的，寿命不长。眼皮张开较大的，长寿。自己睁开眼的，不能成人。
小便凝结像脂膏一样的，不能成人。头部有四个破口的，不能成人。出汗带血的，大多死亡，寿命不长。不出汗的，不能成人。经常摇动手脚的，不能成人。头顶毛发不周密的，不能成人。婴儿出生时枕骨发育不全的，能说话后死亡。尾椎骨发育不全的，能坐立后死亡。掌骨发育不全的，能爬行后死亡。跖骨发育不全的，能行走后死亡。膝盖骨发育不全的，能站立后死亡。身体无法收束正常的死亡。鱼口（肛门松弛如鱼口状）的死亡。
大腿内侧没有生肉的死亡。头下部破损的死亡。阴器不起的死亡。阴囊发白的死亡。睾丸缝通达黑色的长寿。
《脉诀启蒙》说：小儿脉象促急，属于虚惊。
《直指》说：脉象浮数洪紧，属于急惊风；脉象沉迟散缓，属于慢惊风。虎口脉纹呈现青紫色，属于惊风。红色表示风热轻浅，赤色表示病势盛，青色表示惊积，紫色表示惊热。青紫各半，表示惊积与风热都有，主病为急惊风。青色而淡紫，伸缩来去不定，主病为慢惊风。紫色丝、青色丝或黑色丝，隐隐混杂，似出而未出，主病为慢脾风。纹路弯曲向内的为顺证，向外者为逆证。
急惊风，是因为体内有郁热，外部挟带风邪。心家受热而积聚惊邪，肝家生风而引发发热。木克制金，如果火气旺盛则金受克制，金衰不能平抑木气，木能生火，火得风助则烟焰升起。因此子母相生相克关系紊乱，血乱气并，痰涎壅塞，关窍不通，风火蕃盛而无法宣泄，暴烈发作而成急惊风。其症状表现为牙关紧急，高热痰涌，眼球上窜，角弓反张，抽搐痉挛，嘴唇口角颤动，眉眼频繁眨动牵引。六脉浮散洪紧。治疗先搐鼻通关，如果痰涎壅盛，用吐风散催吐。其次用败毒散、保命丹或雄黄解毒丸攻下。惊退后神志未定，投服安神散。但如果喷药不下，通关不打喷嚏，眼睛翻转，口中出血，两足摆跳，肚腹搐动，或者神志迟缓而摸床寻衣，病情危重且早晚气促，心中热痛，忽然大声叫喊的，无法治愈。
一篇论述小儿急慢惊风，发热口噤，不省人事，手心伏热，痰涎咳嗽，上壅喘急，都适宜用涌法（催吐）。
吐风散：全蝎（炒一个）、瓜蒂（炒十个）、赤小豆（三十个）。以上研为末。每一岁婴儿服一丸，温米饮调下。未吐，再服。
一篇论述小儿急惊风，初起发热，手足搐搦，眼上视等症状，以及一切感冒风寒，咳嗽鼻塞声重，头疼发热，及痘疹欲搐、发搐，以及时行瘟疫等症，适宜用加味败毒散。
加味败毒散：羌活、独活、前胡、柴胡、白茯苓（去皮）、人参、枳壳（去芦麸炒）、桔梗、天麻、全蝎、僵蚕、白附子、地骨皮、川芎、甘草。以上作一剂，生姜三片，水煎，热服。
一篇论述小儿急惊搐搦，眼翻口噤，摇头天吊，痰嗽喘热，服用南极寿星汤。
南极寿星汤：胆星、防风、白附子、蝉蜕、薄荷、甘草。以上锉碎，水煎服。
一篇论述小儿潮热惊啼，用木通、车前、赤茯苓、麦门冬、蝉蜕、防风、白芍、甘草、灯草，水煎服。
一篇论述小儿惊风，咳嗽痰喘，用天南星一个，大的炮制去皮，研为末。每服一钱，生姜三片，水煎温服。
一篇论述小儿胎惊内吊，肚腹坚硬，目睛上视，手足搐搦，角弓反张，痰热咳嗽，一切急慢惊风，都治疗。
至圣保命丹：南星（炮制去皮，用白矾水浸泡一夜，取出晒干，再用生姜水浸泡一夜，晒干后再炒）、半夏（同上方法炮制）、薄荷、青黛（各一两）、全蝎（去尾尖）、天麻、白附子（略炒）、僵蚕（姜汁炒）、防风、郁金、甘草（各五钱）、麝香（少许）、朱砂（五钱）。以上研为末，炼蜜为丸，朱砂为衣，大小如芡实。每服一丸，灯心、薄荷汤化下。
一篇论述小儿痰喘，急慢惊风濒死，只要能开口灌下，无不救活的。用千金散，内阁秘传。
千金散：全蝎（炙熟）、直僵蚕（各三分）、朱砂（四分）、天麻（四分）、冰片（二分）、牛黄（六厘）、黄连（四分）、胆星、甘草（各三分）。以上为细末。每服五七厘，薄荷、灯心、金银花煎汤，不拘时候调下。
安神散：人参、茯苓（去皮）、远志（去心）、天麻、白附子、麦门冬、全蝎、莲肉、茯神（去皮木）、朱砂（各等分）。以上为细末。每服，灯心汤调下。
一个小儿沉困发热，惊搐不吃奶，看其脉纹如乱鱼骨，这是风热急惊的症状。先用抱龙丸少许祛风化痰，后用六君子汤加柴胡，壮脾平肝，热遂退而惊定愈矣。
一个小儿抽搐啼叫，额间青黑，这是惊风肝木乘脾，腹中作痛。先以六君子汤加木香、柴胡、钩藤钩，啼叫渐缓，更加当归，又二剂而安。
一个小儿目内色青，发搐，目上视，叫哭不已。或用牛黄清心丸，不愈，反切牙顿闷，小便自遗，这是肝经血气虚甚的缘故。我用补中益气汤及六味地黄丸而痊愈。
Various diseases in infants and children: if the eyes lack luster, the black pupils do not move freely, the eyelids lack sharpness, resembling fish or cat eyes, these cases are generally incurable.
If the spirit is stored internally, appearing externally as drowsy and fatigued, there is no cause for concern. In critically ill patients, if the spirit remains present in the eyes, survival is possible. The eyes are the manifestation of the spirit of the five zang and six fu organs.
If the spirit has departed, even if a pulse is barely detectable, life cannot be preserved.
For newborns, continuous and prolonged crying indicates longevity. Crying that stops and then resumes abruptly indicates short life. Scattered crying indicates failure to mature into adulthood. Deep crying also indicates failure to mature.
Absence of blood at the umbilicus is auspicious. A small umbilicus indicates short life. Generalized softness resembling bonelessness indicates short life. Large, open eyelids indicate longevity. Spontaneous eye opening indicates failure to mature. Urine coagulating like paste indicates failure to mature. Four cracks on the head indicate failure to mature. Hemorrhagic sweating indicates high mortality and short life. Absence of sweating indicates failure to mature. Constant shaking of hands and feet indicates failure to mature. Sparse hair on the crown indicates failure to mature. Infants with incomplete occipital bone development will die after acquiring speech. Those with incomplete sacral bone development will die after learning to sit. Those with incomplete palmar bone development will die after learning to crawl. Those with incomplete tarsal bone development will die after learning to walk. Those with incomplete patellar bone development will die after learning to stand. Inability to maintain body posture indicates death. "Fish mouth" (anal sphincter laxity) indicates death.
Absence of flesh between the thighs indicates death. Damage to the lower part of the head indicates death. Non-erectile genitalia indicates death. Whitening of the scrotum indicates death. Testicular seams reaching black color indicate longevity.
*Maijue Qimeng* states: Rapid and hurried pulses in children indicate deficiency-type fright.
*Zhizhi* states: Floating, rapid, full, and tight pulses indicate acute convulsion; sinking, slow, scattered, and relaxed pulses indicate chronic convulsion. Blue-purple patterns in the Tiger's Mouth vein indicate wind-stroke due to fright. Red indicates mild wind-heat; crimson indicates excess; blue indicates fright accumulation; purple indicates heat from fright. Equal parts of blue and purple indicate both fright accumulation and wind-heat, primarily manifesting as acute convulsion. Blue with pale purple, moving in and out, indicates chronic convulsion. Purple, blue, or black threads mixed indistinctly, appearing but not fully emerging, indicate chronic spleen wind. Curving inward patterns are favorable; outward curving patterns are unfavorable.
Acute convulsion arises from internal stagnant heat combined with external wind pathogens. Heat in the Heart accumulates fright; wind generated in the Liver causes fever. Wood controls Metal; if Fire is excessive, Metal is suppressed. Weak Metal fails to balance Wood. Wood generates Fire; Fire fueled by wind creates smoke and flames. Thus, the mother-child generating cycle becomes chaotic, blood becomes disordered, Qi converges, phlegm-dampness obstructs, orifices become blocked, wind and fire flourish without release, leading to violent onset of acute convulsion. Symptoms include locked jaw, high fever with salivary overflow, upward gaze, opisthotonos, spasms, trembling of lips and mouth, frequent blinking and pulling of eyebrows and eyes. Pulses are floating, scattered, full, and tight. Treatment begins with nasal insufflation to open orifices. If phlegm-dampness is severe, use *Tufeng San* to induce vomiting. Subsequently, administer *Baidu San*, *Baoming Dan*, or *Xionghuang Jiedu Wan* to purge. After convulsions subside but spirit remains unsettled, administer *Anshen San*. However, if medication cannot be retained, sneezing does not occur upon insufflation, eyes roll back, bleeding occurs from the mouth, legs jerk, abdomen trembles, or spirit is sluggish with picking at bedsheets, condition is critical with morning and evening tachypnea, heart pain and heat, or sudden loud screaming—these are incurable.
*Tijing San*: Banxia (Pinelliae Rhizoma), Yazao (Gleditsiae Sinensis Spina), ground equally into powder. Blow a small amount into the nose.
A treatise on pediatric acute and chronic convulsions, fever with locked jaw, unconsciousness, latent heat in palms, phlegm-cough, upper obstruction causing wheezing, all suit emetic therapy.
*Tufeng San*: Quanxie (Scorpio, one roasted), Gudia (Cucumeris Fructus, ten roasted), Chixiaodou (Vigna angularis, thirty). Grind into powder. One pill per year of age, taken with warm rice water. If vomiting does not occur, administer again.
A treatise on pediatric acute convulsion, initial fever, hand-foot spasms, upward gaze, and all conditions involving wind-cold invasion, cough, nasal congestion, heavy voice, headache, fever, pre-spasmodic and spasmodic stages of variola, and epidemic diseases, suit *Jiawei Baidu San*.
*Jiawei Baidu San*: Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Qianhu (Peucedani Radix), Chaihu (Bupleuri Radix), Baifuling (Poria Cum Rizomo, peeled), Renshen (Ginseng Radix et Rhizoma), Zhike (Aurantii Fructus, de-umbilicated and stir-fried with bran), Jiegeng (Platycodonis Radix), Tianma (Gastrodiae Rhizoma), Quanxie (Scorpio), Jiangcan (Bombyx Batryticatus), Baifuzi (Aconiti Kusnezoffii Rhizoma), Digupi (Lycii Cortex), Chuanxiong (Ligustici Chuanxiong Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma). Prepare as one dose, add three slices of Shengjiang (Zingiberis Rhizoma Recens), decoct in water, and take hot.
A treatise on pediatric acute convulsion with spasms, eye rolling, locked jaw, head shaking, upward deviation, phlegm-cough, wheezing, and heat, administer Nanji Shouxing Tang.
*Nanji Shouxing Tang*: Danning (Arisaematis Cum Bile), Fangfeng (Saposhnikoviae Radix), Baifuzi (Aconiti Kusnezoffii Rhizoma), Chantui (Cicadae Periostracum), Bohe (Menthae Haplocalycis Herba), Gancao (Glycyrrhizae Radix et Rhizoma). Coarsely crush, decoct in water, and take.
A case of tidal fever and fright crying: Mutong (Akebiae Caulis), Cheqian (Plantaginis Semen), Chifuling (Poria, red), Maimendong (Ophiopogonis Radix), Chantui (Cicadae Periostracum), Fangfeng (Saposhnikoviae Radix), Baishao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma), Dengcao (Junci Medullia). Decoct in water and take.
A case of convulsion with cough and phlegm-wheezing: Tiannanxing (Arisaematis Rhizoma), one large tuber, processed and peeled, ground into powder. Take 1 qian per dose, with three slices of Shengjiang (Zingiberis Rhizoma Recens), decoct in water, and take warm.
A treatise on fetal fright with internal strangulation, hard abdomen, upward gaze, hand-foot spasms, opisthotonos, phlegm-heat cough, treating all acute and chronic convulsions: Zhisheng Baoming Dan.
*Zhisheng Baoming Dan*: Tiannanxing (Arisaematis Rhizoma, processed, peeled, soaked overnight in Baifan solution, dried, soaked overnight in Shengjiang solution, dried, then stir-fried), Banxia (Pinelliae Rhizoma, processed similarly), Bohe (Menthae Haplocalycis Herba), Qingdai (Indigo Naturalis) (each 1 liang), Quanxie (Scorpio, tail tip removed), Tianma (Gastrodiae Rhizoma), Baifuzi (Aconiti Kusnezoffii Rhizoma, lightly stir-fried), Jiangcan (Bombyx Batryticatus, stir-fried with ginger juice), Fangfeng (Saposhnikoviae Radix), Yujin (Curcumae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (each 5 qian), Shexiang (Moschus, a little), Zhusha (Cinnabaris, 5 qian). Grind into powder, bind with refined honey into pills coated with Zhusha, size of Euryale Seed. Take one pill per dose, dissolved in Dengxin (Junci Medullia) and Bohe tea.
A treatise on infantile phlegm-wheezing and impending death from acute/chronic convulsion: if the mouth can be opened for administration, all survive. Use *Qianjin San*, secret transmission from the Cabinet.
*Qianjin San*: Quanxie (Scorpio, roasted until cooked), Zhijiangcan (Bombyx Batryticatus, straight) (each 3 fen), Zhusha (Cinnabaris, 4 fen), Tianma (Gastrodiae Rhizoma, 4 fen), Bingpian (Borneolum Syntheticum, 2 fen), Niuhuang (Calculus Bovis, 6 li), Huanglian (Coptidis Rhizoma, 4 fen), Danning (Arisaematis Cum Bile), Gancao (Glycyrrhizae Radix et Rhizoma) (each 3 fen). Grind into fine powder. Take 5–7 li per dose, mixed with decoction of Bohe (Menthae Haplocalycis Herba), Dengcao (Junci Medullia), and Jinyinhua (Lonicerae Japonicae Flos), administered at any time.
A treatise on post-convulsion mental confusion and deficiency, for calming the spirit and stabilizing will: Anshen San.
*Anshen San*: Renshen (Ginseng Radix et Rhizoma), Fuling (Poria, peeled), Yuanzhi (Polygalae Radix, core removed), Tianma (Gastrodiae Rhizoma), Baifuzi (Aconiti Kusnezoffii Rhizoma), Maimendong (Ophiopogonis Radix), Quanxie (Scorpio), Lianrou (Nelumbinis Semen), Fushen (Poria cum Parati et Radix, bark and wood removed), Zhusha (Cinnabaris) (equal parts). Grind into fine powder. Take per dose, mixed with Dengcao (Junci Medullia) tea.
A child presented with lethargy, fever, convulsions, and refusal to nurse. The Tiger's Mouth vein pattern resembled disordered fish bones, indicating wind-heat acute convulsion. First, administer a small amount of *Baolong Wan* to dispel wind and resolve phlegm. Then, use *Liujunzi Tang* (Six Gentlemen Decoction) with added Chaihu (Bupleuri Radix) to strengthen Spleen and soothe Liver. Heat subsided, convulsions stopped, and recovery ensued.
A child exhibited twitching, crying, and bluish-black discoloration on the forehead, indicating Liver Wood overacting on Spleen due to convulsion, causing abdominal pain. Initially treated with *Liujunzi Tang* (Six Gentlemen Decoction) plus Muxiang (Aucklandiae Radix), Chaihu (Bupleuri Radix), and Goutenggou (Uncariae Ramulus cum Uncis). Crying gradually slowed. Added Danggui (Angelicae Sinensis Radix), and after two doses, peace was restored.
A child had bluish color inside the eyes, convulsions, upward gaze, and incessant crying. *Niuhuang Qingxin Wan* (Calculus Bovis Clearing Heart Pills) was used without success, leading to teeth grinding, sudden fainting, and urinary incontinence. This indicated severe deficiency of Blood and Qi in the Liver Meridian. I treated with *Buzhong Yiqi Tang* (Tonify the Middle and Augment the Qi Decoction) and *Liuwei Dihuang Wan* (Six-Ingredient Pill with Rehmannia), resulting in recovery.