诸热惊悸不安多啼。此心脏本病也。宜导赤散加朱砂主之。甚者凉惊丸。三黄泻心丸。
兼见肝证。则发热而搐。宜木通散主之。
兼见脾证。则嗜卧梦中切牙多惊。宜钱氏安神丸主之。
兼见肺证。则发热作搐而喘。宜清宁散主之。
兼见肾证为惊痫。发则忽然卧仆。切牙搐搦。手足逆冷。发过即醒。精神恍惚。
盖心藏神。惊则伤神。肾藏志。恐则伤志。小儿神志怯弱。有所惊恐。则神志失守。而
矣。如书传所谓请僧寄名。僧为摩顶诵咒。儿被吓而成痫。后见穿皂衣人即发是也。亦有惊
久成痫者。初起即可治。定志丸主之。父母怠忽。久而不治。遂成终身之患。
一小儿惊后成痫。予制一方。天水散一料。研为细末。分作三剂。二两三钱。入真青黛
碾匀。名清魂散。寅卯时煎竹叶汤调服一钱。以平肝火。一剂二两三钱。入朱砂末水飞五钱
。名安神散。巳午时煎灯草汤调服。以镇其神。一剂二两三钱。入真轻粉二钱研匀。名定魂
散。申酉时煎淡姜汤服。以去其痰。旬日而安。
一小儿十岁。久得痫疾。予视两目浑白。无有睛光。语言謇涩。举动痴迷。乃语其父曰
。不可治矣。后请医治之。竟无功。
惊久成痫。乃痰迷心窍之病。最为难治。或分五痫。以牛马狗猪羊名之者。未见其方。
拘也。钱氏五痫丸。祖训未用。予亦不敢轻用也。儿有者。当先观其状貌。而后治之可也。
如伶俐聪明者可治之。若成痴呆。言语错乱。不必治之。如强治之。终无成功。间有聪明伶
俐。治之无效。非真痫也。此宜琥珀抱龙丸主之。或辛香者。不如抱龙丸犹稳。
蕲水周维峰。有子病痫。予见神气昏滞。语言含糊。状类痴呆。告其父曰。不能治也。
黄州府万鲁庵。有子病痫。予见容貌俊伟。性格聪明。告其父曰。可治。乃与琥珀抱龙
丸方。使自制服之。
本县汪前川儿惊病。一月之间。尝发二三次。予曰。不治必成痫也。求治于予。乃立一
用枳实黄连半夏白茯苓各等分。折半。朱砂飞又折半。同前碾末。神曲糊丸。芡实大。朱砂
衣。每服一丸。用 猪心一个。劈开入药在内。线扎定。放瓦罐中煮熟。取出猪心。和药食
之。以汤送下。后竟不发。名曰断痫丸。
各种热证引起的惊悸、心神不安、多啼哭,这是心脏的本病。适宜用导赤散加朱砂来主治。病情严重的,使用凉惊丸或三黄泻心丸。
如果兼见肝脏的证候,则出现发热并伴有抽搐。适宜用木通散来主治。
如果兼见脾脏的证候,则表现为嗜睡、梦中磨牙、容易受惊。适宜用钱氏安神丸来主治。
如果兼见肺脏的证候,则出现发热、抽搐并伴有气喘。适宜用清宁散来主治。
如果兼见肾脏的证候而发展为惊痫,发作时突然昏倒卧地,磨牙且手足抽搐,四肢逆冷。发作过后随即清醒,但精神恍惚不定。
大概因为心藏神,受惊则损伤神;肾藏志,恐惧则损伤志。小儿的神志怯弱,一旦受到惊恐,就会导致神志失守,从而发病。就像书传中记载的,请僧人给孩子寄名,僧人为孩子摩顶诵咒,孩子因被惊吓而成痫病,后来见到穿黑衣的人就发作,就是这种情况。也有因惊吓日久转化为痫病的。在初起阶段即可治疗,宜用定志丸主治。如果父母怠慢疏忽,日久不治疗,就会成为终身的病患。
有一个小儿受惊后发展成痫病,我配制了一个方子:天水散一料,研成细末,分成三剂。第一剂取二两三钱,加入真青黛碾匀,名为清魂散。在寅卯时(凌晨3-7点),煎竹叶汤调服一钱,以平抑肝火。第二剂取二两三钱,加入水飞过的朱砂末五钱,名为安神散。在巳午时(上午9-下午1点),煎灯草汤调服,以镇摄心神。第三剂取二两三钱,加入真轻粉二钱研匀,名为定魂散。在申酉时(下午3-7点),煎淡姜汤送服,以祛除痰浊。服药旬日后病情安定。
有一个十岁的小儿,患痫疾已久。我观察他双眼浑浊发白,没有睛光,语言謇涩,举动痴迷。于是告诉他的父亲说:“无法治愈了。”后来请其他医生医治,最终也没有效果。
惊吓日久转化为痫病,是痰迷心窍的疾病,最为难治。有人将痫分为五种,以牛、马、狗、猪、羊命名,但我未见其有效方剂,认为这种分类拘泥于形式。钱乙的五痫丸,虽为祖训所传,但我也不敢轻易使用。对于患病的孩子,应当先观察其状貌,然后再进行治疗。如伶俐聪明的可以治疗;若已成痴呆,言语错乱,则不必治疗。如果强行治疗,最终也不会成功。偶尔有聪明伶俐者,治疗无效,这并非真正的痫病,而是其他病症,适宜用琥珀抱龙丸主治。或者使用辛香开窍的药物,不如抱龙丸稳妥。
蕲水人周维峰,有个儿子患痫病。我见他神气昏滞,语言含糊,状似痴呆,便告诉他的父亲说:“不能治愈。”
黄州府万鲁庵,有个儿子患痫病。我见他容貌俊伟,性格聪明,便告诉他的父亲说:“可以治愈。”于是给予琥珀抱龙丸的方子,让他自制服用。
本县汪前川的儿子受惊患病,一个月之内发作了两三次。我说:“如果不治疗,必定会发展成痫病。”于是求治于我。我便立下一个方子:用枳实、黄连、半夏、白茯苓各等分,减半用量;朱砂水飞后再减半用量。一同碾成细末,用神曲糊制成丸药,大小如芡实,外披朱砂衣。每次服用一丸,用一个猪心,剖开将药放入其中,用线扎紧,放在瓦罐中煮熟。取出猪心,连同药物一起吃下,并用汤送服。此后竟然不再发作,此方名为断痫丸。
Various heat syndromes causing jingji (palpitations with fright), restlessness, and excessive crying are primary diseases of the Heart. It is appropriate to use Daochi San (Guide Out the Red Powder) with Zhusha (Cinnabar) as the main treatment. For severe cases, Liangjing Wan (Cooling Fright Pill) or Sanhuang Xie Xin Wan (Three Yellows Draining the Heart Pill) should be used.
If accompanied by Liver symptoms, fever with convulsions occurs. Mutong San (Akebia Decoction) is appropriate for treatment.
If accompanied by Spleen symptoms, there is drowsiness, teeth grinding in dreams, and easy fright. Qian's Anshen Wan (Calming the Spirit Pill by Qian Yi) is appropriate for treatment.
If accompanied by Lung symptoms, fever with convulsions and wheezing occur. Qingning San (Clearing Tranquility Decoction) is appropriate for treatment.
If accompanied by Kidney symptoms, it develops into Jingxian (Fright Epilepsy). Upon onset, the child suddenly falls down, grinds teeth, and experiences convulsions of the limbs with cold extremities. After the episode, the child wakes up but appears mentally vacant and distracted.
This is because the Heart stores Shen (Spirit); fright injures the Shen. The Kidney stores Zhi (Will); fear injures the Zhi. Children have weak Shen and Zhi; upon experiencing fright or fear, their Shen and Zhi lose their residence, leading to illness. As recorded in texts, when a monk is invited to name a child and chants spells while touching the head, the child may become epileptic due to fright, subsequently relapsing upon seeing someone wearing black robes. There are also cases where prolonged fright transforms into epilepsy. If treated at the initial stage, it can be cured using Dingzhi Wan (Stabilizing Will Pill). However, if parents neglect it and delay treatment, it becomes a lifelong affliction.
One child developed epilepsy after being frightened. I formulated a prescription: one dose of Tianshui San (Heavenly Water Powder), ground into fine powder, divided into three doses. For the first dose, take 2 liang 3 qian, mix evenly with genuine Qingdai (Indigo Naturalis), named Qinghun San (Clear Soul Powder). At Yin-Mao hours (3:00-7:00 AM), decoct Zhu Ye Tang (Bamboo Leaf Decoction) to take 1 qian with this powder, to calm Liver Fire. For the second dose, take 2 liang 3 qian, mix with 5 qian of Zhusha mo (water-washed Cinnabar powder), named Anshen San (Calming Spirit Powder). At Si-Wu hours (9:00 AM-1:00 PM), decoct Dengcao Tang (Juncus Decoction) to take with this powder, to anchor the Shen. For the third dose, take 2 liang 3 qian, mix evenly with 2 qian of Qingfen (Calomel), named Dinghun San (Stabilizing Soul Powder). At Shen-You hours (3:00-7:00 PM), take with Dan Jiang Tang (Mild Ginger Decoction) to eliminate phlegm. The condition stabilized after ten days.
One ten-year-old child had suffered from epilepsy for a long time. I observed his eyes were cloudy and white, lacking luster, his speech was slurred, and his movements were dull and confused. I told his father, "It cannot be cured." Later, other doctors treated him, but to no avail.
Epilepsy resulting from prolonged fright is a disease of Phlegm confusing the Heart orifices, and is most difficult to treat. Some classify epilepsy into five types named after ox, horse, dog, pig, and sheep, but I have not seen effective prescriptions for them, considering such classification rigid. Although Qian's Wuxian Wan (Five Types of Epilepsy Pills) is an ancestral instruction, I dare not use it lightly. For children with this condition, one should first observe their appearance and constitution before treating. Those who are sharp and intelligent can be treated; those who have become demented with confused speech need not be treated. Forced treatment will ultimately fail. Occasionally, some sharp and intelligent patients do not respond to treatment; these are not true epilepsy but other conditions, suitable for treatment with Hupo Baolong Wan (Amber Dragon-Hugging Pill). Or aromatic herbs may be used, but Baolong Wan is still more stable.
Zhou Weifeng from Qishui had a son suffering from epilepsy. I observed his spirit was dull and sluggish, his speech was indistinct, resembling dementia, and told his father, "It cannot be cured."
Wan Lu'an from Huangzhou Prefecture had a son suffering from epilepsy. I observed he was handsome and intelligent, and told his father, "It can be cured." I then provided the formula for Hupo Baolong Wan (Amber Dragon-Hugging Pill), instructing him to prepare and administer it himself.
The son of Wang Qianchuan in our county was sick after fright, having two or three episodes within a month. I said, "If untreated, it will certainly develop into epilepsy." He sought my treatment. I established a prescription: Zhi Shi (Immature Bitter Orange), Huanglian (Coptis Rhizome), Banxia (Pinellia Tuber), and Baifuling (Poria with Hostwood) in equal parts, halved in dosage; Zhusha (Cinnabar) washed and halved again. All were ground into powder, bound with Shenqu (Medicated Leaven) paste into pills the size of Euryale seeds, coated with Zhusha. Each dose consists of one pill. Take one pig heart, split it open, insert the medicine inside, tie securely with thread, and boil in a clay pot until cooked. Remove the pig heart and consume it along with the medicine, washing it down with soup. The seizures ceased completely thereafter. This formula is named Duanxian Wan (Severing Epilepsy Pill).