总括 小儿 为啼时，食以酸咸又乳之，因是肺经伤水湿，风痰结聚早为医，诸病原来有药方，惟愁 最难当，
麻黄桑杏寻苏子，白果冬花更又良，甘草黄芩同半夏，水煎百沸必须姜，病患遇此仙方药，服后方知定喘方。
一症，本为寒湿所浸，未经发散，邪传心肺，变而为热。有热生风，有风生痰，痰结不化，因循日久，成为软
块，圆如豆粒，遂成痰母。推本其原，或啼哭未休，遽与乳食，或食以酸咸，气郁不利，致令生痰，或节令变迁，风寒
暑湿袭之，或堕水中，水入鼻口，传之于肺，故痰发而风随之，风痰潮紧，气促而喘，乃成痼疾，急宜去风化痰，以知
母汤、如意膏治之。
〔附方〕
知母汤 诃子 知母 贝母 羌活 滑石 大黄 麻黄 葶苈 甘草
如意膏 半夏 赤茯苓 枳壳 朴硝 用硝风化，以生姜打糊为丸，绿豆大，淡姜汤下。
总括 原来 病属膀胱，口噤如痫身反张；此是伤风感寒湿，故分病症有柔刚。
脉法 太阳病发，其脉沉而细者为痉。
《内经》曰∶诸痉项强皆属于湿。又曰∶诸暴强直皆属于风。《原病式》曰∶筋劲强直而不柔和也，夫肝木属风而
主筋。《经》曰，诸暴强直皆属于风，理宜然也。其所谓诸痉项强而属于湿者何与？盖太阳经湿甚则兼风，化亢则害，
承乃制也，故知痉之为病，湿为本，风为标耳，其症项背强直，腰身反张，垂头螈 ，口噤不语，发热腹痛，镇日不醒，
其状可畏，病在足太阳经。刚痉无汗，柔痉有汗。其症面红眼赤，牙紧口张，痰涎壅盛，昏溃烦渴，小便赤涩，先谵语
而发者，此刚痉也；其大便滑泄，不渴不语，先手足冷而发者，此柔痉也。柔痉为之解肌，刚痉为之发汗，并以小续命
汤加减疗之。其间一症，身体壮热，谵语，口干，手足反微寒，大便滑泄，此为刚柔不反之症。无汗干葛汤主之，有汗
桂枝加葛根汤主之。无汗则用麻黄，有汗慎勿用也。若痰塞气盛则南星、半夏、茯苓以消其痰，枳实、陈皮、紫苏以顺
其气。痰消则风止，气顺则神清，然后察热之轻重而解利之。热轻者败毒散，热重者小柴胡汤解之。壮热有汗、胸满、
口噤、切牙而大便秘者为内实，大承气汤下之，后用大柴胡汤解之。痉最难痊，十救其一，过三日则难治。
（自批∶痉则齐身强直，痫则手足冰冷。强直反如弓，神昏似中风，涎流唇口难，螈 与痫同。）
刚柔二痉，如阴隔阳、阳隔阴之类。
补遗∶
此痉多由亡血，筋无所荣，故邪得以袭之，所以伤寒汗下过多，与夫病疮人及产后致此病者概可见矣。
《内经》云∶太阳所谓强直引背者，阳气太上而争，故强上也，出“脉解”篇。足少阴之筋循脊内挟背上至项，其
病主痫 反痉，在外者不能俯，在内者不能仰。故阳病者，腰反折不能俯；阴病者，不能仰，治在燔针。
〔附方〕
小续命汤 麻黄 人参 黄芩 川芎 芍药 杏仁 防己 肉桂 防风 附子 甘草
葛根汤 见惊风症内。
败毒散 见痢疾症内。
小柴胡汤 见诸吐症内。
大承气汤 见痢疾症内。
大柴胡汤 见疟疾症内。
总括：小儿在啼哭时，如果喂食酸咸食物并喂奶，因此导致肺经受到水湿损伤，风痰结聚。应尽早请医生诊治，各种疾病原本都有对应的药方，只是担心这种病症最难对付。
治疗此症可用麻黄、桑叶、杏仁、苏子，白果和款冬花也疗效良好；甘草、黄芩配合半夏，用水煎煮至百沸，必须加入生姜。患者遇到这个仙方药物，服用之后才知道这是定喘的良方。
这一症状，本是由寒湿浸渍所致，未经发散，邪气传入心肺，变化为热。有热则生风，有风则生痰，痰结无法化解，拖延日久，形成软块，圆如豆粒，遂成为“痰母”。追溯其根源，或是啼哭未停，立即给予乳食，或是食用酸咸之物，导致气机郁滞不利，从而产生痰饮；或是季节气候变迁，风寒暑湿侵袭人体，或堕入水中，水进入鼻口，传变于肺，所以痰发作而风随之而来，风痰潮紧，气促而喘，于是成为顽固性疾病，急需祛风化痰，用知母汤、如意膏来治疗。
〔附方〕
知母汤：诃子、知母、贝母、羌活、滑石、大黄、麻黄、葶苈子、甘草。
如意膏：半夏、赤茯苓、枳壳、朴硝（将朴硝风化，用生姜打糊制成丸药，大小如绿豆，用淡姜汤送服）。
总括：原来病属膀胱经，牙关紧闭像癫痫，身体反张；这是因为伤风感受寒湿，所以分病症有刚痉和柔痉的区别。
脉法：太阳病发作，脉象沉而细的是痉病。
《内经》说：所有的痉病项背强直都归属于湿。又说：所有突然发生的强直都归属于风。《原病式》说：筋脉劲急强直而不柔和。肝木属于风而主司筋脉。《内经》说，所有突然发生的强直都归属于风，道理应该是这样的。那为什么说诸痉项强归属于湿呢？因为太阳经湿气很重就会兼夹风邪，化亢盛则为害，需要承制它，所以知道痉病，湿是根本，风是标象。其症状表现为项背强直，腰身反张，低头抽搐，牙关紧闭不语，发热腹痛，整天不醒，状貌可畏，病位在足太阳经。刚痉无汗，柔痉有汗。其症状见面红眼赤，牙齿紧闭嘴巴张开，痰涎壅盛，昏乱烦渴，小便赤涩，先出现谵语然后发病的，这是刚痉；其大便滑泄，不口渴不语，先出现手足冰冷然后发病的，这是柔痉。柔痉用解肌法，刚痉用发汗法，都用小续命汤加减来治疗。其中有一种症状，身体壮热，谵语，口干，手足反而微寒，大便滑泄，这是刚柔不分的症状。无汗用干葛汤主治，有汗用桂枝加葛根汤主治。无汗则用麻黄，有汗千万不要用。如果痰塞气盛，则用南星、半夏、茯苓来消除痰饮，用枳实、陈皮、紫苏来顺气。痰消则风止，气顺则神志清醒，然后观察热的轻重而解表利湿。热轻的用败毒散，热重的用小柴胡汤解之。壮热有汗、胸满、口噤、咬牙且大便秘结的是内实证，用大承气汤攻下，后用大柴胡汤和解。痉病最难痊愈，十人救其一，超过三天就难治了。
（自批注：痉病则是全身强直，痫病则是手足冰冷。强直反弓如弦，神志昏迷类似中风，口水流于唇口困难，抽搐与痫病相同。）
刚痉和柔痉，就像阴隔阳、阳隔阴这样的情况。
补遗：
这种痉病多由失血引起，筋脉失去荣养，所以邪气得以侵袭，因此伤寒汗下过多，以及患疮疡的人和产后导致此病的，概可见一斑。
《内经》说：太阳所谓的强直牵引背部，是因为阳气过盛而上争，所以上部强直，出自“脉解”篇。足少阴之筋沿着脊柱内侧挟持背上至项部，其病主要表现为主痫病、反折、痉病，在外侧者不能俯身，在内侧者不能仰头。所以阳病者，腰部反折不能俯身；阴病者，不能仰头，治疗用燔针。
〔附方〕
小续命汤：麻黄、人参、黄芩、川芎、芍药、杏仁、防己、肉桂、防风、附子、甘草。
葛根汤：见惊风症内。
败毒散：见痢疾症内。
小柴胡汤：见诸吐症内。
大承气汤：见痢疾症内。
大柴胡汤：见疟疾症内。
General Summary: When an infant is crying, if sour and salty foods are given along with breast milk, the Lung Meridian (Lung Channel) may be injured by water-dampness, leading to the accumulation of wind-phlegm. Medical attention should be sought early. Although there are prescriptions for various diseases, this particular condition is feared as the most difficult to manage.
For treating this condition, use Ephedrae Herba (Mahuang), Folium Mori Albas (Sangye), Semen Armeniacae Amarum (Xingren), and Fructus Perillae (Suzi). Semen Ginkgo (Baiguo) and Flos Dendranthemi Morifolii (Donghua) are also excellent. Combine Radix Glycyrrhizae (Gancao), Radix Scutellariae (Huangqin), and Rhizoma Pinelliae (Banxia). Decoct in water until boiling vigorously, and ginger must be added. Patients encountering this miraculous prescription will know after taking it that it is a formula for calming asthma.
This symptom originates from infiltration by cold-dampness. If not dispersed, the pathogenic factor transmits to the Heart and Lungs, transforming into heat. Heat generates wind, and wind generates phlegm. If phlegm accumulates and fails to resolve, over time it forms soft nodules, round like bean grains, becoming a "phlegm mother." Tracing the root cause: either feeding milk or food immediately while the child is still crying, or consuming sour and salty foods causing Qi stagnation and obstruction, thereby generating phlegm; or seasonal changes where wind-cold, summer-heat, or dampness invade the body; or falling into water, where water enters the nose and mouth and transmits to the Lungs. Thus, when phlegm arises, wind follows. Wind-phlegm becomes tidal and tight, causing shortness of breath and wheezing, resulting in a chronic disease. It is urgent to dispel wind and transform phlegm, treating it with Zhi Mu Tang (Anemarrhena Decoction) and Ru Yi Gao (Ru Yi Ointment).
[Attached Formulas]
Zhi Mu Tang (Anemarrhena Decoction): Fructus Terminaliae Chebulae (Hezi), Radix Anemarrhenae (Zhimu), Bulbus Fritillariae Cirrhosae (Beimu), Radix Notopterygii (Qianghuo), Talcum (Huashi), Radix Rheomi (Dahuang), Ephedrae Herba (Mahuang), Semen Lepidii seu Descurainiae (Tingli), Radix Glycyrrhizae (Gancao).
Ru Yi Gao (Ru Yi Ointment): Rhizoma Pinelliae (Banxia), Poria Cocos cum Ligno Quercus Rubra (Chifuling), Fructus Aurantii (Zhike), Natrii Sulfas (Piaoxiao -风化 means weathered). Make pills using ginger juice paste, size of mung beans, take with light ginger decoction.
General Summary: Originally, the disease belongs to the Bladder Meridian. The jaw is locked like epilepsy, and the body arches backward. This is due to wind-stroke combined with cold-dampness invasion, so the symptoms are classified into rigid spasm (Gang Jing) and flaccid spasm (Rou Jing).
Pulse Diagnosis: When Taiyang disease occurs, a deep and fine pulse indicates spasm (Jing).
The *Neijing* states: All spasms with neck stiffness belong to dampness. It also states: All sudden rigidity belongs to wind. The *Yuan Bing Shi* states: Sinews are tense, rigid, and lack flexibility. The Liver Wood belongs to wind and governs the sinews. The *Classic* says, all sudden rigidity belongs to wind, which is logical. Why then are spasms with neck stiffness attributed to dampness? Because when dampness is excessive in the Taiyang Meridian, it combines with wind. When transformation becomes hyperactive, it causes harm, requiring control. Thus, we understand that for spasm, dampness is the root, and wind is the branch. Symptoms include stiffness of the neck and back, arching of the waist and body, drooping head with twitching, locked jaw without speech, fever, abdominal pain, and unconsciousness throughout the day. The appearance is terrifying, and the disease is located in the Foot-Taiyang Meridian. Rigid spasm has no sweat; flaccid spasm has sweat. Symptoms of rigid spasm include red face and eyes, tight teeth with open mouth, abundant saliva/phlegm, confusion, irritability, thirst, dark and scanty urine, preceded by delirium. Symptoms of flaccid spasm include loose stools, no thirst, silence, preceded by cold hands and feet. Flaccid spasm is treated with muscle-releasing methods; rigid spasm with sweating methods. Both are treated with modifications of Xiao Xu Ming Tang (Minor Continuation of Life Decoction). In one case, there is high fever, delirium, dry mouth, slightly cold hands and feet, and loose stools; this is a mixed rigid-flaccid syndrome. For no sweat, Gan Ge Tang (Pueraria Decoction) is used; for sweat, Guizhi Jia Gegen Tang (Cinnamon Twig plus Pueraria Decoction) is used. Use Ephedrae Herba (Mahuang) only if there is no sweat; do not use if there is sweat. If phlegm obstructs and Qi is excessive, use Rhizoma Acori Tatarinowii (Nanxing), Rhizoma Pinelliae (Banxia), and Poria Cocos (Fuling) to eliminate phlegm; use Fructus Aurantii Immaturus (Zhishi), Pericarpium Citri Reticulatae (Chenpi), and Herba Perillae (Zisu) to regulate Qi. When phlegm is eliminated, wind stops; when Qi is regulated, spirit clears. Then observe the severity of heat and resolve it. For mild heat, Baidu San (Decoction for Rescuing from Toxicity) is used; for severe heat, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is used. For high fever with sweat, chest fullness, locked jaw, grinding teeth, and constipation, this is internal excess; Da Cheng Qi Tang (Major Order the Qi Decoction) is used to purge, followed by Da Chai Hu Tang (Major Bupleurum Decoction) to harmonize. Spasm is hardest to cure; only one in ten survives. After three days, it is difficult to treat.
(Self-commentary: Spasm involves whole-body rigidity, whereas epilepsy involves cold hands and feet. Rigidity bends like a bow, confusion resembles stroke, difficulty with saliva flowing from lips, twitching is similar to epilepsy.)
Rigid and flaccid spasms are like Yin separating Yang or Yang separating Yin.
Supplementary Notes:
This type of spasm often results from blood loss, leaving sinews without nourishment, allowing pathogens to invade. Therefore, it can be seen in cases of excessive sweating or purging during Cold Damage, in patients with sores/ulcers, and postpartum women.
The *Neijing* states: What Taiyang calls "rigidity pulling the back" is because Yang Qi is excessively high and contending, causing upper rigidity, from the "Mai Jie" chapter. The sinew of Foot-Shaoyin runs inside the spine, up to the nape. Its diseases primarily manifest as epilepsy, retrocollis, and spasm. Those on the exterior cannot bend forward; those on the interior cannot extend backward. Thus, Yang diseases result in backward bending inability to flex; Yin diseases result in inability to extend. Treatment involves burning needles (Cao Zhen).
[Attached Formulas]
Xiao Xu Ming Tang (Minor Continuation of Life Decoction): Ephedrae Herba (Mahuang), Radix Ginseng (Renshen), Radix Scutellariae (Huangqin), Radix Chuanxiong (Chuanxiong), Radix Paeoniae Alba (Shaoyao), Semen Armeniacae Amarum (Xingren), Radix Podocarpifolii seu Stephaniae Tetrandrae (Fangji), Cortex Cinnamomi (Rougui), Radix Saposhnikoviae (Fangfeng), Radix Aconiti Lateralis Preparata (Fuzi), Radix Glycyrrhizae (Gancao).
Ge Gen Tang (Pueraria Decoction): See Epilepsy/Jing Feng section.
Baidu San (Decoction for Rescuing from Toxicity): See Dysentery section.
Xiao Chai Hu Tang (Minor Bupleurum Decoction): See Vomiting section.
Da Cheng Qi Tang (Major Order the Qi Decoction): See Dysentery section.
Da Chai Hu Tang (Major Bupleurum Decoction): See Malaria section.