急惊之后尚未清,痰热琥珀抱龙灵,神虚气弱痰兼热,清心涤痰大有功。
【注】急惊多用寒凉之药,亦急则治标之法。但是痰火稍退,即当调补气血。若过用
寒凉,必致转成慢惊等证。故惊邪一退,余热尚在者,当用琥珀抱龙丸主之;若脾虚多
痰者,宜清心涤痰汤主之。
琥珀抱龙丸
人参 琥珀 茯神(各五钱) 山药(炒,一两) 甘草(炙,四钱) 檀香(三钱) 天竺黄 枳
壳(麸炒) 枳实(麸炒,各五钱) 辰砂(三钱) 胆星(五钱) 赤金铂(二十片)
上为细末,炼蜜为丸,每丸重一钱,大儿一丸,小儿半丸,淡姜汤化下。
清心涤痰汤
竹茹 橘红 半夏(姜制) 茯苓 枳实(麸炒) 甘草(生) 麦冬(去心) 枣仁(炒) 人
参菖蒲 南星 川黄连
引用生姜,水煎服。
【方歌】清心涤痰汤效灵,补正除邪两收功,参苓橘半连茹草,枳实菖枣星麦冬。
慢惊多缘禀赋弱,或因药峻损而成,缓缓搐搦时止作,面白青黄身则温,昏睡眼合睛或露,脉迟神惨
大便青,气虚夹痰醒脾效,脾虚肝旺缓肝灵。
【注】慢惊一证,或缘禀赋虚弱,土虚木盛者有之;或由急惊过用峻利之药,以致转
成此证者有之。发时缓缓搐搦,时作时止,面色淡黄,或青白相兼,身必温和,昏睡眼合,
或睡卧露睛,脉来迟缓,神气惨惨,大便青色。此乃脾胃虚弱,治宜培补元气为主。虚
而夹痰者,醒脾汤主之;脾虚肝旺者,缓肝理脾汤主之。
醒脾汤
人参 白术(土炒) 茯苓 天麻 橘红 半夏(姜制) 全蝎(去毒) 僵蚕(炒) 甘草(炙) 木
香仓米 胆南星
引用生姜,水煎服。
【方歌】气虚夹痰醒脾治,参术天麻白茯苓,橘半全蝎僵蚕草,木香仓米胆南星。
缓肝理脾汤
广桂枝 人参 白茯苓 白芍药(炒) 白术(土炒) 陈皮 山药(炒) 扁豆(炒研) 甘
草(炙)
引用煨姜、大枣,水煎服。
【方歌】肝旺脾虚缓肝汤,桂枝参苓芍术良,陈皮山药扁豆草,煎服之时入煨姜。
急惊风发作后,病邪尚未完全清除,此时痰热内蕴,使用琥珀抱龙丸疗效显著。若患儿神气虚弱、元气不足且兼有痰热,使用清心涤痰汤大有功效。
【注】治疗急惊风多使用寒凉性质的药物,这是“急则治其标”的方法。但是,当痰火症状稍微减退后,就应当调理补益气血。如果过度使用寒凉药物,必然会导致病情转变为慢惊风等证候。因此,当惊风邪气退去,但余热尚存时,应当以琥珀抱龙丸为主进行治疗;若是脾虚导致痰湿较多者,适宜以清心涤痰汤为主进行治疗。
琥珀抱龙丸
人参、琥珀、茯神(各五钱)、山药(炒制,一两)、甘草(炙制,四钱)、檀香(三钱)、天竺黄、枳壳(麸皮炒制)、枳实(麸皮炒制,各五钱)、辰砂(三钱)、胆南星(五钱)、赤金箔(二十片)。
以上药材研成细末,用炼蜜制成丸剂,每丸重一钱,大儿童服用一丸,小儿童服用半丸,用淡姜汤送服化开。
清心涤痰汤
竹茹、橘红、半夏(生姜炮制)、茯苓、枳实(麸皮炒制)、甘草(生用)、麦冬(去心)、枣仁(炒制)、人参、石菖蒲、南星、川黄连。
引用生姜为引,加水煎煮后服用。
【方歌】清心涤痰汤效果灵验,扶正祛邪两相收功,人参、茯苓、橘红、半夏、黄连、竹茹、甘草,枳实、石菖蒲、枣仁、南星、麦冬。
慢惊风多由于先天禀赋薄弱所致,或者因为用药过于峻猛损伤正气而成。发作时抽搐缓慢,时断时续,面色苍白或青黄相间,身体温度正常,昏睡闭眼或睡眠中眼睛外露,脉象迟缓,神情凄惨,大便呈青色。对于气虚夹带痰湿者,醒脾汤疗效显著;对于脾虚肝旺者,缓肝理脾汤疗效显著。
【注】慢惊风这一证候,有的源于先天禀赋虚弱,土虚木盛(脾胃虚弱而肝气过旺);有的是因为急惊风阶段过度使用峻烈攻下的药物,以致转化为此证。发作时抽搐缓慢,时作时止,面色淡黄,或青白相间,身体必定温和,昏睡闭眼,或睡觉时眼睛露出,脉来迟缓,神情惨淡,大便青色。这是由于脾胃虚弱,治疗应当以培补元气为主。体虚而夹杂痰湿者,以醒脾汤为主治疗;脾虚肝旺者,以缓肝理脾汤为主治疗。
醒脾汤
人参、白术(土炒制)、茯苓、天麻、橘红、半夏(生姜炮制)、全蝎(去毒)、僵蚕(炒制)、甘草(炙制)、木香、仓米、胆南星。
引用生姜,加水煎煮后服用。
【方歌】气虚夹痰由醒脾汤治疗,人参、白术、天麻、白茯苓,橘红、半夏、全蝎、僵蚕、甘草,木香、仓米、胆南星。
缓肝理脾汤
广桂枝、人参、白茯苓、白芍药(炒制)、白术(土炒制)、陈皮、山药(炒制)、扁豆(炒制研碎)、甘草(炙制)。
引用煨姜、大枣,加水煎煮后服用。
After the acute convulsion (Ji Jing) has subsided but pathogenic factors are not yet cleared, if phlegm-heat is present, Hu Po Bao Long Wan (Amber Embracing Dragon Pill) is effective. If the child exhibits spirit deficiency and weak qi accompanied by phlegm-heat, Qing Xin Di Tan Tang (Clear Heart and Eliminate Phlegm Decoction) yields great results.
[Note] The treatment of acute convulsion often employs cold-natured herbs, which is a method of "treating the branch in emergencies." However, once the phlegm-fire symptoms subside slightly, one should proceed to regulate and tonify qi and blood. Overuse of cold herbs will inevitably lead to a transformation into slow convulsion (Man Jing) or other syndromes. Therefore, when the wind-pathogen causing the convulsion has retreated but residual heat remains, Hu Po Bao Long Wan (Amber Embracing Dragon Pill) should be used as the primary formula; for cases with spleen deficiency and excessive phlegm, Qing Xin Di Tan Tang (Clear Heart and Eliminate Phlegm Decoction) is appropriate.
Hu Po Bao Long Wan (Amber Embracing Dragon Pill)
Ren Shen (Ginseng Radix), Hu Po (Fossilized Resin), Fu Shen (Poria with Hostwood), Shan Yao (Dioscoreae Rhizoma, stir-fried), Gan Cao (Licorice Radix et Rhizoma, honey-fried), Tan Xiang (Santalum Album Lignum), Tian Zhu Huang (Bambusae Caulis in Taenia), Zhi Qiao (Aurantii Fructus Immaturus, bran-stir-fried), Zhi Shi (Aurantii Fructus Immaturus, bran-stir-fried), Chen Sha (Cinnabar), Dan Xing (Arisaematis Cum Bile), Chi Jin Bo (Gold Leaf).
Grind the above ingredients into fine powder, form pills with refined honey. Each pill weighs 3g (one qian). Older children take one pill; younger children take half a pill. Take with light ginger decoction.
Qing Xin Di Tan Tang (Clear Heart and Eliminate Phlegm Decoction)
Zhu Ru (Bambusae Folium), Ju Hong (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Rhizoma, processed with ginger), Fu Ling (Poria), Zhi Shi (Aurantii Fructus Immaturus, bran-stir-fried), Gan Cao (Licorice Radix et Rhizoma, raw), Mai Dong (Ophiopogonis Radix, heart removed), Zao Ren (Ziziphi Spinosae Semen, stir-fried), Ren Shen (Ginseng Radix), Chang Pu (Acori Tatarinowii Rhizoma), Nan Xing (Arisaematis Rhizoma), Chuan Lian Lian (Coptidis Rhizoma).
Add fresh ginger as a guide, decoct in water, and take orally.
[Fang Ge - Formula Song] Qing Xin Di Tan Tang (Clear Heart and Eliminate Phlegm Decoction) is highly effective, simultaneously supporting healthy qi and eliminating pathogens. It contains Ren Shen, Fu Ling, Ju Hong, Ban Xia, Lian, Zhu Ru, and Gan Cao; Zhi Shi, Chang Pu, Zao Ren, Nan Xing, and Mai Dong.
Slow convulsion (Man Jing) often arises from weak congenital endowment or damage caused by overly harsh medications. During attacks, spasms occur slowly, intermittently starting and stopping. The complexion is pale or yellowish-green, the body temperature is normal, the child sleeps deeply with eyes closed or exposed during sleep. The pulse is slow, the spirit appears despondent, and the stool is green. For qi deficiency with phlegm accumulation, Xing Pi Tang (Awaken the Spleen Decoction) is effective; for spleen deficiency with liver hyperactivity, Huan Gan Li Pi Tang (Soothe Liver and Regulate Spleen Decoction) is effective.
[Note] Slow convulsion may stem from congenital weakness, where earth deficiency leads to wood excess (spleen deficiency with liver hyperactivity); or it may result from the overuse of harsh purgatives during acute convulsion. At onset, spasms are slow, intermittent, with a pale yellow or greenish-white complexion, warm body, deep sleep with eyes closed or exposed, slow pulse, despondent spirit, and green stool. This syndrome is due to spleen and stomach deficiency; treatment should primarily focus on cultivating and supplementing primordial qi. For deficiency complicated by phlegm, Xing Pi Tang (Awaken the Spleen Decoction) is indicated; for spleen deficiency with liver hyperactivity, Huan Gan Li Pi Tang (Soothe Liver and Regulate Spleen Decoction) is indicated.
Xing Pi Tang (Awaken the Spleen Decoction)
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma, soil-stir-fried), Fu Ling (Poria), Tian Ma (Gastrodiae Rhizoma), Ju Hong (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Rhizoma, processed with ginger), Quan Xie (Scorpio, detoxified), Jiang Can (Bombyx Batryticatus, stir-fried), Gan Cao (Licorice Radix et Rhizoma, honey-fried), Mu Xiang (Aucklandiae Radix), Cang Mi (Oryza Sativa Germ), Dan Nan Xing (Arisaematis Cum Bile).
Add fresh ginger as a guide, decoct in water, and take orally.
[Fang Ge - Formula Song] Qi deficiency with phlegm is treated by Xing Pi Tang (Awaken the Spleen Decoction): Ren Shen, Bai Zhu, Tian Ma, Bai Fu Ling; Ju Hong, Ban Xia, Quan Xie, Jiang Can, Gan Cao; Mu Xiang, Cang Mi, Dan Nan Xing.
Huan Gan Li Pi Tang (Soothe Liver and Regulate Spleen Decoction)
Guang Gui Zhi (Cinnamomi Ramulus), Ren Shen (Ginseng Radix), Bai Fu Ling (Poria), Bai Shao Yao (Paeoniae Radix Alba, stir-fried), Bai Zhu (Atractylodis Macrocephalae Rhizoma, soil-stir-fried), Chen Pi (Citri Reticulatae Pericarpium), Shan Yao (Dioscoreae Rhizoma, stir-fried), Bian Dou (Lablab Seed, stir-fried and crushed), Gan Cao (Licorice Radix et Rhizoma, honey-fried).
Add Wei Jiang (roasted ginger) and Da Zao (Jujubae Fructus) as guides, decoct in water, and take orally.
[Fang Ge - Formula Song] For liver hyperactivity and spleen deficiency, use Huan Gan Tang (Soothe Liver Decoction): Gui Zhi, Ren Shen, Fu Ling, Shao Yao, Bai Zhu are excellent; Chen Pi, Shan Yao, Bian Dou, Gan Cao; add roasted ginger when decocting and taking.