汉东王先生论∶惊、痫、忤三候，大抵略相似，皆口面青黑，呕吐涎沫，头项强直，手足摇动。但惊即发
拳搐；痫即搐搦；忤即掣 。惊则喉中涎响；痫则口中涎出，亦涎响；忤则口吐青黄白沫。惊则双目直视；痫
则口眼相引而目睛上摇；忤则眼不上插；不可得而同也。然病初治之，亦可一法。
汉东王先生《家宝》∶治婴孩小儿惊、痫、忤，手足螈 ，头项强直，状似角弓。归魂散方
蝎梢（一钱半，炒） 蜈蚣（赤脚者半条，炙） 水银粉 麝脑（各一字） 花蛇肉（酒浸，炙黄色，秤一钱） 天
南星（切碎，用生姜自然汁浸一宿，令为末，秤半钱） 川乌头尖（七个，生）
上为末。每服婴孩半字或一字，二、三岁一字以上，四、五岁半钱，金银薄荷汤调下，量儿虚实加减。
《巢氏病源》欲发痫候∶夫小儿未发痫，欲发之候，或温壮连滞；或摇头弄舌；或睡里惊掣，数啮齿。如此，
是欲发痫之证也。
《千金》候痫法云∶夫痫，小儿之恶病也。或有不及求医而致困者也。然气发于内，必先有候，常宜审察其
精神而探其候也。
手白肉鱼际脉黑者，是痫候；鱼际脉赤者，热；脉青大者，寒；脉青细，为平也。鼻口干燥，大小便不
利，是痫候。眼不明上视，喜阳，是痫候。耳后完骨上有青络盛，卧不静，是痫候。青脉刺之，令血出也。
（《婴童宝鉴》云∶耳后高骨上有三伍路青脉，如线起者，宜为爪破，令其血出也。）小儿发逆上，啼笑面暗，色不变，
是痫候。鼻口青，时小惊，是痫候。目闭青，时小惊，是痫候。身热，头常汗出，是痫候。身热，吐 而喘，是痫候。
身热，目时直视，是痫候。卧惕惕而惊，手足振摇，是痫候。卧梦笑，手足动摇，是痫候。意气下而妄怒，是痫候。目
瞳子卒大，异于常，是痫候。喜欠，目上视，是痫候。咽乳不利，是痫候。身热，小便难，是痫候。身热，目视
不精，是痫候。吐痢不止，厥痛时起，是痫候。弄舌摇头，是痫候。
以上诸候二十条，皆痫之初也。见其候，便爪其阳脉所应灸。爪之皆重手，令儿骤啼乃绝，亦根据方与汤。
（《婴孺》云∶并服五石紫丸汤。）
直视，瞳子动；腹满，转转鸣；下血，身热；口噤不得乳；反张脊强；汗出发热；为卧不寤；手足掣 ，喜惊。
凡八条，痫之剧者也。如有此，非复汤爪所能救，盒饭时灸之。
《千金》又曰∶若病家始发，便来诣师。师可诊候，所解为法，根据次序治之，以其节度首尾取瘥也。病家已
经杂治无次序，不得制病，病则变异其本候，后师便不知其前证虚实，直根据其后证作治，亦不得瘥也。要应精
问察之，为前师所配根据，取其前踪迹以为治，乃无逆耳。前师处汤，本应数剂乃瘥，而病家服一二剂未效，便
谓不验，以后更间他师。师不寻前人为治寒温次序，而更为治，而不次前师治则弊也。或前以下之，后须平和
疗以接之，而得瘥也。或前人未下之；或不去者；或前治寒温失度，后人应调治之。是为治败病，皆须邀射之，
然后免耳。不根据次第及不审察，必及重弊也。
汉东王先生论述：惊、痫、忤这三种病候，大体上大致相似，都表现为口面部青黑，呕吐涎沫，头项强直，手足摇动。但惊风发作时立即出现握拳抽搐；痫证发作时出现肢体抽掣痉挛；忤证发作时出现肢体牵引掣动。惊风则喉中有痰鸣声；痫证则口中流出涎液，也有痰鸣声；忤证则口吐青、黄、白色的泡沫。惊风则双目直视；痫证则口眼相互牵引且眼球向上转动；忤证则眼球不向上翻插；因此不可混为一谈。然而疾病初起治疗时，也可以采用同一种方法。
汉东王先生的《家宝》记载：治疗婴幼儿惊风、痫证、忤证，出现手足抽搐（此处指肌肉跳动或抽搐），头项强直，症状像角弓反张一样。归魂散方：蝎梢（一钱半，炒制）、蜈蚣（赤脚者半条，炙烤）、水银粉、麝脑（各一字）、花蛇肉（酒浸后，炙至黄色，称取一钱）、天南星（切碎，用生姜自然汁浸泡一夜，制成粉末，称取半钱）、川乌头尖（七个，生用）。以上药物研为细末。每次服用，婴幼儿服半字或一字，二、三岁服一字以上，四、五岁服半钱，用金银薄荷汤调服，根据患儿的虚实情况加减剂量。
《巢氏病源》中关于欲发痫证的候象：小儿在尚未发作痫证之前，将要发作的征兆，有的表现为持续低热不退；有的表现为摇头弄舌；有的在睡眠中惊悸抽动，多次咬齿。如此种种，就是即将发作痫证的征象。
《千金方》中候痫的方法说：痫证，是小儿的恶疾。有的因为来不及求医而导致病情危重。然而病气发于体内，必定先有征兆，应当经常仔细审视其精神状态来探测这些征兆。
手掌大鱼际部位白肉处的脉色发黑的，是痫证的候象；脉色发红的，是热证；脉色青且大的，是寒证；脉色青且细的，为正常平脉。鼻口干燥，大小便不通利，是痫证的候象。眼睛不明亮且向上视，喜欢向阳处，是痫证的候象。耳后完骨上有明显的青色络脉显现，睡眠不安静，是痫证的候象。刺破青色脉络，令其出血。（《婴童宝鉴》说：耳后高骨上有三条如线状隆起的青色脉络，适宜用指甲划破，令其出血。）小儿头发逆上竖起，啼哭或欢笑时面色晦暗，肤色不变，是痫证的候象。鼻口周围发青，时常轻微惊悸，是痫证的候象。眼睑闭合呈青色，时常轻微惊悸，是痫证的候象。身体发热，头部经常出汗，是痫证的候象。身体发热，呕吐并伴有喘息，是痫证的候象。身体发热，眼睛不时直视，是痫证的候象。睡眠中惊恐不安，手足振摇，是痫证的候象。睡眠中做梦发笑，手足动摇，是痫证的候象。意气下沉而无故发怒，是痫证的候象。瞳孔突然变大，与平时不同，是痫证的候象。喜欢打哈欠，眼睛向上视，是痫证的候象。吃奶困难，是痫证的候象。身体发热，小便困难，是痫证的候象。身体发热，眼神涣散不聚焦，是痫证的候象。呕吐腹泻不止，厥冷疼痛时起，是痫证的候象。弄舌摇头，是痫证的候象。
以上二十条候象，都是痫证的初期表现。见到这些候象，就应当用指甲重按阳脉相应的穴位进行灸治。按压都要用力，使患儿突然啼哭为止，也依据方剂给予汤药。（《婴孺书》说：同时服用五石紫丸汤。）
直视，瞳孔颤动；腹部胀满，肠鸣音转；下血，身体发热；牙关紧闭不能吸乳；角弓反张脊背强直；出汗且发热；昏睡不醒；手足抽搐掣动，容易受惊。以上八条，是痫证严重的表现。如果有这些症状，不再是用汤药和指甲按压所能救治的，必须按时进行艾灸。
《千金方》又说：如果病家在孩子刚发病时就请来医生。医生可以诊察候象，懂得治疗方法，按照次序进行治疗，根据其节度从头到尾取得痊愈。如果病家已经经过杂乱无章的治疗，没有次序，导致无法控制病情，病症就会变异其原本的候象，后来的医生便不知道之前的证候虚实，只能根据后面的证候进行治疗，也无法痊愈。必须要详细询问检查，依据前一位医生所配制的方案，追溯其前后的踪迹来进行治疗，这样才不会违背病情。前一位医生开的汤药，本来应该数剂才能痊愈，而病家服用了一两剂未见效果，便认为无效，随后又更换其他医生。新医生如果不探寻前人为治疗寒温病的次序，而另行治疗，且不遵循前医生的治疗原则，就会产生弊端。或者前医使用了泻下法，后医需要用平和的方法接续治疗，从而痊愈。或者前人未使用泻下法；或者邪气未去；或者前医治疗寒温失当，后医应当调理治疗。这是治疗败坏之病，都必须邀请有经验的高明医生介入，然后才能免除祸患。不根据次第及不仔细审察，必然会导致严重的弊端。
Mr. Wang of Handong discusses: The three conditions of Jing (Fright), Xian (Epilepsy), and Wu (Contrary Qi) are generally somewhat similar, all presenting with a bluish-black complexion around the mouth and face, vomiting of saliva and phlegm, stiffness and rigidity of the head and neck, and shaking of the hands and feet. However, in Jing, convulsions with clenched fists occur immediately upon onset; in Xian, there is spasm and twitching; in Wu, there is pulling and jerking movements. In Jing, there is a rattling sound of phlegm in the throat; in Xian, saliva flows from the mouth accompanied by a rattling sound; in Wu, there is vomiting of blue, yellow, or white froth. In Jing, the eyes stare straight ahead; in Xian, the mouth and eyes are drawn together with the eyeballs rolling upward; in Wu, the eyes do not roll upward into the sockets; thus, they cannot be treated identically. Nevertheless, when treating these diseases at their initial stage, one method may suffice.
In Mr. Wang of Handong's *Jiabao*: To treat infantile Jing, Xian, and Wu, characterized by spasms of the hands and feet, stiffness and rigidity of the head and neck, resembling opisthotonos (arched back like a bow). Formula for Guihun San (Returning Soul Powder): Scorpion tail (1.5 qian, stir-fried), Centipede (half a red-footed centipede, roasted), Calomelas (Shuiyin Fen), Moschus (She Nao) (each 1 zi), Flower Snake meat (soaked in wine, roasted until yellow, weighed 1 qian), Rhizoma Pinelliae Preparatum (Tian Nan Xing) (chopped, soaked overnight in fresh ginger juice, ground into powder, weighed 0.5 qian), Radix Aconiti Lateralis Preparata (Chuan Wu Tou Jian) (seven tips, raw). Grind the above ingredients into fine powder. For each dose, infants take 0.5 zi or 1 zi; children aged two to three years take more than 1 zi; children aged four to five years take 0.5 qian. Mix with Yinjin Bohe Tang (Silver Leaf and Mint Decoction) for administration, adjusting the dosage according to the child's deficiency or excess condition.
In *Chao Shi Bing Yuan* regarding the prodromal signs of impending Xian: Before an infantile epileptic seizure occurs, the prodromal signs include either persistent low-grade fever, or shaking the head and playing with the tongue, or startle jerks during sleep with frequent teeth grinding. These are signs that Xian is about to manifest.
The method for observing Xian in *Qian Jin Fang* states: Xian is a malignant disease in children. Some cases become critical because medical help is sought too late. However, since the pathogenic qi originates internally, there must be prior signs. One should frequently examine the spirit and mental state to detect these signs.
If the pulse at the radial side of the thenar eminence (Yuji area) appears black, it is a sign of Xian; if red, it indicates Heat; if large and blue, it indicates Cold; if thin and blue, it is a normal pulse. Dryness of the nose and mouth, along with difficulty in urination and defecation, are signs of Xian. Dim vision with upward gaze, preference for sunny places, are signs of Xian. Prominent blue collateral vessels behind the ear at the mastoid process (Wangu), with restless sleep, are signs of Xian. Puncture the blue collaterals to let blood out. (*Ying Tong Bao Jian* states: There are three linear blue veins rising on the high bone behind the ear; it is appropriate to scratch them open with fingernails to let blood out.) If the hair stands on end, crying or laughing with a darkened facial complexion that does not change color, these are signs of Xian. Bluish discoloration around the nose and mouth, with occasional slight fright, are signs of Xian. Blue eyelids with occasional slight fright, are signs of Xian. Body heat with frequent sweating of the head, are signs of Xian. Body heat with vomiting and wheezing, are signs of Xian. Body heat with intermittent staring, are signs of Xian. Restless sleep with startles and shaking of hands and feet, are signs of Xian. Dream laughter during sleep with trembling of hands and feet, are signs of Xian. Low-spiritedness with irrational anger, are signs of Xian. Sudden enlargement of the pupils, different from usual, are signs of Xian. Frequent yawning with upward gaze, are signs of Xian. Difficulty in suckling milk, are signs of Xian. Body heat with difficult urination, are signs of Xian. Body heat with unfocused vision, are signs of Xian. Unstopping vomiting and diarrhea, with intermittent cold limbs and pain, are signs of Xian. Playing with the tongue and shaking the head, are signs of Xian.
The above twenty signs are all early stages of Xian. Upon seeing these signs, one should press firmly with fingernails on the corresponding Yang meridians and apply moxibustion. Press heavily until the child cries suddenly, and also administer decoctions according to formulas. (*Ying Ru Shu* states: Also administer Wushi Ziwan Tang [Five Minerals Purple Pill Decoction].)
Staring with trembling pupils; abdominal distension with rumbling sounds; bloody stool with body heat; trismus preventing suckling; opisthotonos with spinal rigidity; sweating with fever; coma/unresponsiveness; limb spasms and jerking, predisposition to fright. These eight conditions represent severe Xian. If such symptoms appear, they cannot be saved by decoctions or fingernail pressing alone; timely moxibustion is required.
*Qian Jin Fang* further states: If the family seeks a physician immediately upon the onset of the disease, the physician can diagnose and understand the treatment principles, following the correct sequence to achieve recovery based on the progression of the disease. If the family has already undergone disordered treatments without sequence, failing to control the disease, the original signs will alter. Subsequent physicians will not know the previous deficiency/excess patterns and will treat only based on later signs, which will fail to cure. It is essential to inquire carefully and investigate, adhering to the prescriptions of the preceding physician and tracing the course of the illness for treatment, thereby avoiding deviation. If the preceding physician prescribed a decoction intended for several doses to achieve recovery, but the family stops after one or two doses due to lack of immediate effect, deeming it ineffective, and then consults another physician, problems arise. If the new physician does not follow the temperature-regulating sequence established by the predecessor and treats differently, disregarding the previous protocol, errors will occur. Or, if the previous physician used purgatives, the subsequent physician should use mild methods to continue treatment, leading to recovery. Or, if the previous physician did not use purgatives, or if pathogens remain, or if the previous treatment of cold/heat was improper, the subsequent physician should regulate and treat. These constitute treating a deteriorated condition, requiring the intervention of skilled practitioners to avoid disaster. Failure to follow the sequence and careful examination will inevitably lead to serious complications.