小儿急慢惊风，古谓阴、阳痫也，急者属阳，阳盛而阴亏。慢者属阴，阴盛而阳
亏。阳动而躁疾，阴静而迟缓，皆因脏腑虚而得之。虚能发热，热则生风，是以风
生于肝，痰生于脾，惊出于心，热出于肝，而心亦热，以惊、风、痰、热合为四
证，搐、搦、掣、颤、反、引、窜、视，为八候，凡眨眼摇头，张口出舌，唇红脸
赤，面眼唇青，及泻皆青，发际印堂青筋，三关虎口纹红紫或青者，皆惊风候也。
大抵肝风、心火，二者交争，必挟心热而后发，始于搐，故热必论虚实，证先分
逆顺，治则有后先，盖实热为急惊，虚热为慢惊，慢惊当无热，其发热者虚也，急
惊属阳，用药以寒，慢惊属阴，用药以温，然又必明浅深轻重、进退疾徐之机，故
曰热论虚实者此也。男搐左视左，女搐右视右，男眼上窜，女眼下窜，男握拇指出
外，女握拇指入里，男引手挽、左直右曲，女引手挽、右直左曲，凡此皆顺，反之
则逆，亦有先搐左而后双搐者，但搐顺则无声，搐逆则有声，其指纹、弯弓入里者
顺，反外者逆，出入相半者难痊，故曰证分逆顺者此也。阳病阴脉，阴病阳脉，亦
为反。凡热盛生痰，痰盛生惊，惊盛生风，风盛发搐，治搐先于截风，治风先于利
惊，治惊先于豁痰，治痰先于解热，其若四证俱有，又当兼施并理，一或有遗，必
生他证，故曰治有先后者此也。纲领如此，若分三者言之，暴烈者为急惊，沉重者
为慢惊，至重者肝风木之克脾土，则为慢脾风矣。〔娄〕急惊，证属木火土实也，
木实则搐而力大，目上目札，所谓木太过曰发生，其动掉眩，癫痫是也。火实则身
热面赤。土实则不吐泻，睡合睛。故其治法合凉泻而用凉惊丸、利惊丸之类。慢惊，
证属木火土虚也，木虚则搐而力小，似搐而不甚搐，经所谓木不及曰委和，其病摇
动注恐是也，谓手足搐动，腹注泄，心恐悸也。火虚则身冷口气冷，土虚则吐泻，
睡露睛，故其治法合温补而用羌活膏、益黄散，有热者用东垣黄 益黄散，其东垣、
非钱氏羌活膏。治慢惊者谓土虚泄泻，火木乘之，谓手掌与腹俱热之证，若火木土
俱虚而摇动恐悸、注泻、手腹冷者，非羌活膏不能治之。〔丹〕小儿惊风有二，急
惊属痰热宜凉泻，慢惊属脾虚所主，多死，宜温补。急惊用降火下痰丸，养血药作
汤下之。慢惊当补脾，兼用朱砂安神丸，清米汤下，更于血药中求之，（如四物、四君、
东垣黄 益黄散之类。）世以一药通治之，甚妄。
小儿急惊风和慢惊风，古代称为阴痫和阳痫。急惊属于阳证，表现为阳气盛而阴气亏；慢惊属于阴证，表现为阴气盛而阳气亏。阳主动且躁急，阴主静且迟缓，这两种病证都是因为脏腑虚弱而引发的。虚损会导致发热，发热则生风，因此风生于肝，痰生于脾，惊出于心，热源于肝（同时心也受热）。惊、风、痰、热合称为“四证”；搐（抽搐）、搦（手指开合）、掣（牵拉）、颤（颤抖）、反（角弓反张）、引（手臂牵引）、窜（目睛上视）、视（斜视），合称为“八候”。凡是眨眼摇头、张口伸舌、嘴唇红脸颊赤、面部眼睛嘴唇发青，以及大便色青，发际和印堂处青筋显露，三关虎口纹呈红紫或青色者，都是惊风的征候。
大体而言，肝风和心火二者相互交争，必定挟带心热而后发作，起始于抽搐。因此，必须辨析热的虚实，证候先分逆顺，治疗则有先后次序。实热导致的是急惊，虚热导致的是慢惊。慢惊本应无热，若出现发热则是虚热所致。急惊属阳，用药宜寒凉；慢惊属阴，用药宜温补。然而又必须明了病情的浅深轻重、进退疾徐的机理，所以说“辨热之虚实”就是这个道理。男孩抽搐时眼球向左看左侧，女孩向右看右侧；男孩眼球向上窜动，女孩向下窜动；男孩握拳时拇指伸出在外，女孩握拳时拇指收在里侧；男孩引手挽曲时左手伸直右手弯曲，女孩引手挽曲时右手伸直左手弯曲。凡此种种皆为顺证，反之则为逆证。也有先抽搐左侧而后双侧都抽搐的情况，但抽搐顺证时没有声音，抽搐逆证时有声音。其指纹弯曲入里者为顺，向外者为逆，出入相半者难以痊愈，所以说“证分逆顺”就是这个道理。阳病出现阴脉，阴病出现阳脉，也是逆证。
凡是热盛生痰，痰盛生惊，惊盛生风，风盛发搐。治疗抽搐首先要截断风势，治疗风首先要利惊，治疗惊首先要豁痰，治疗痰首先要解热。如果四证俱备，应当兼施并治，若有遗漏，必然产生其他变证，所以说“治疗有先后”就是这个道理。纲领如此，若分为三类来说：暴烈者为急惊，沉重者为慢惊，至重者因肝风木克伐脾土，则成为慢脾风。
【娄】急惊，证候属于木、火、土三脏实证。木实则抽搐有力，眼球上翻或眨动，即所谓“木太过曰发生”，其表现动摇眩晕，如癫痫之类。火实则身体发热、面色红润。土实则不吐不泻，睡眠时眼睛闭合。所以治疗方法应当采用凉泻法，使用凉惊丸、利惊丸之类的方剂。
慢惊，证候属于木、火、土三脏虚证。木虚则抽搐无力，似抽非抽，正如经书所说“木不及曰委和”，其病症为摇动、注泄、恐惧，即手足抽搐、腹部泄泻、心中惊恐悸动。火虚则身体寒冷、口气冷；土虚则呕吐泄泻，睡眠时眼睛睁开露出黑睛。所以治疗方法应当采用温补法，使用羌活膏、益黄散。若有热象，使用东垣黄芪益黄散（注意：这里的东垣黄芪益黄散并非钱氏的羌活膏）。治疗慢惊者认为，若是土虚泄泻，被火、木二脏乘袭，表现为手掌与腹部俱热之证；若火、木、土三脏俱虚，出现摇动恐惧、泄泻、手足腹部冰冷者，非羌活膏不能治愈。
【丹】小儿惊风有两种，急惊属于痰热，适宜用凉泻法；慢惊属于脾虚所主，多致死，适宜用温补法。急惊使用降火下痰丸，配合养血药煎汤送服。慢惊应当补脾，兼用朱砂安神丸，用清米汤送服，更应在养血药物中寻求治法（如四物汤、四君子汤、东垣黄芪益黄散之类）。世人用一种药通治惊风，是非常荒谬的。
Pediatric acute and chronic convulsions (Ji Man Jing Feng) were historically referred to as Yin epilepsy (Yin Xian) and Yang epilepsy (Yang Xian). Acute convulsions belong to the Yang category, characterized by excess Yang and deficiency of Yin. Chronic convulsions belong to the Yin category, characterized by excess Yin and deficiency of Yang. Yang is active and restless, while Yin is still and slow. Both conditions arise from the deficiency of Zang-Fu organs. Deficiency can generate fever; fever generates wind. Thus, wind originates in the Liver, phlegm in the Spleen, fright in the Heart, and heat in the Liver (with the Heart also affected). The combination of Fright, Wind, Phlegm, and Heat constitutes the "Four Syndromes" (Si Zheng); Convulsion (Chu), Finger Flexion/Extension (Nuo), Tugging (Che), Trembling (Chan), Opisthotonos (Fan), Arm Pulling (Yin), Gazing Upward (Cuan), and Strabismus (Shi) constitute the "Eight Signs" (Ba Hou). Any manifestation such as blinking and shaking the head, opening the mouth and protruding the tongue, red lips and flushed face, cyanosis of the face, eyes, and lips, greenish stool, visible blue veins at the hairline and Yintang point, or red-purple/blue nail bed patterns at the Three Passages Tiger's Mouth are all signs of convulsions.
Generally, Liver Wind and Heart Fire contend with each other, inevitably accompanied by Heart Heat before onset, starting with convulsions. Therefore, one must distinguish between Excess and Deficiency heat, and first determine whether the syndrome is Favorable (Shun) or Unfavorable (Ni), which dictates the sequence of treatment. Excess heat leads to Acute Convulsions, while deficiency heat leads to Chronic Convulsions. Chronic convulsions should theoretically be without heat; if heat is present, it is due to deficiency. Acute convulsions belong to Yang, treated with cold-natured herbs; chronic convulsions belong to Yin, treated with warm-natured herbs. However, one must also understand the mechanisms of depth, severity, progression, and speed. Hence, the statement "distinguishing heat by excess or deficiency" refers to this principle. In boys, convulsions involve looking to the left; in girls, to the right. Boys' eyes gaze upward; girls' eyes gaze downward. Boys' thumbs extend outward when clenched; girls' thumbs tuck inward. When pulling the arms, boys have the left arm straight and right curved; girls have the right arm straight and left curved. These are all Favorable signs; the reverse indicates Unfavorable signs. There are cases where convulsions start on the left and then affect both sides. If the convulsion pattern is Favorable, there is no sound; if Unfavorable, there is sound. Nail bed patterns curving inward are Favorable; outward are Unfavorable. Patterns showing equal inward and outward movement indicate a difficult prognosis for recovery. Hence, "distinguishing favorable and unfavorable signs" refers to this. Yang disease presenting with Yin pulse, or Yin disease presenting with Yang pulse, are also considered Unfavorable (reverse).
When heat is excessive, it generates phlegm; when phlegm is excessive, it generates fright; when fright is excessive, it generates wind; when wind is excessive, it causes convulsions. To treat convulsions, one must first intercept the wind; to treat wind, one must alleviate fright; to treat fright, one must resolve phlegm; to treat phlegm, one must clear heat. If all four syndromes are present, they must be treated simultaneously. Neglecting any aspect will lead to other complications. Hence, "treatment has a sequence" refers to this. The general principles being thus, if divided into three categories: violent cases are Acute Convulsions; heavy/profound cases are Chronic Convulsions; the most severe cases, where Liver Wind (Wood) overacts on Spleen Earth, become Chronic Spleen Wind (Man Pi Feng).
[Lou] Acute convulsions belong to Excess syndromes of Wood, Fire, and Earth. Wood excess results in forceful convulsions, upward eye deviation or blinking, known as "Wood excess leads to growth," manifesting as tremors, vertigo, and epilepsy. Fire excess results in body fever and flushed face. Earth excess results in no vomiting or diarrhea, and closed eyes during sleep. Therefore, the treatment method should employ cooling and purging, using formulas such as Liang Jing Wan (Cooling Convulsion Pill) or Li Jing Wan (Alleviating Convulsion Pill).
Chronic convulsions belong to Deficiency syndromes of Wood, Fire, and Earth. Wood deficiency results in weak convulsions, appearing as slight trembling, described in classics as "Wood deficiency is called Wei He," manifesting as trembling, diarrhea, and fear—specifically hand-foot convulsions, abdominal diarrhea, and cardiac palpitations with fear. Fire deficiency results in cold body and cold breath; Earth deficiency results in vomiting and diarrhea, and open eyes during sleep. Therefore, the treatment method should employ warming and tonifying, using Qiang Huo Gao (Qianghuo Paste) or Yi Huang San (Yellow Protecting Powder). If heat is present, use Dongyuan Huang Qi Yi Huang San (Dongyuan Astragalus Yellow Protecting Powder)—note that this is not Qian Shi's Qiang Huo Gao. Treating chronic convulsions involves recognizing that if Earth deficiency causes diarrhea, it is attacked by Fire and Wood, presenting with heat in palms and abdomen. If Fire, Wood, and Earth are all deficient, presenting with trembling, fear, diarrhea, and cold hands/abdomen, only Qiang Huo Gao can treat it.
[Dan] Pediatric convulsions have two types: Acute convulsions belong to Phlegm-Heat, suitable for cooling and purging; Chronic convulsions are governed by Spleen Deficiency, often fatal, suitable for warming and tonifying. For acute convulsions, use Jiang Huo Xia Tan Wan (Fire-Reducing Phlegm-Lowering Pill), administered with decoctions of blood-nourishing herbs. For chronic convulsions, tonify the Spleen and concurrently use Zhu Sha An Shen Wan (Cinnabar Calming Spirit Pill), taken with clear rice soup. Further, seek remedies within blood-nourishing formulas (such as Si Wu Tang [Four Substances Decoction], Si Jun Zi Tang [Four Gentlemen Decoction], Dongyuan Huang Qi Yi Huang San [Dongyuan Astragalus Yellow Protecting Powder]). It is highly absurd for people to use a single formula to treat all convulsions universally.