螈者。筋脉拘急也。 者。筋脉弛纵也。俗谓之搐。小儿吐泻之后。脾胃亏损。津液耗散。
故筋急而搐。为慢惊也。俗不知风乃虚象。因名误实。反投牛黄、抱龙等祛风药致夭枉者。不知
其几。大抵发汗后失血后产后痈疽溃后。气血津液过伤。不能养筋而然。与筋惕肉 颤振相类。
分气血缓急。兼补养为治。庶有生理。若妄加灼艾。或饮以发表之剂。死不旋踵矣。
螈之证。多属心脾肝三经。若自汗少气。脉急按之则减小者。此心气之虚也。辰砂妙香散。若
气盛神昏。筋挛。脉满大。此心火之旺也。导赤散。加芩、连、山栀、茯神、犀角。若体倦神昏
不语。脉迟缓。四肢欠温者。脾虚生风也。归脾汤加钩藤、羌活。若寒热往来。目上视摇头。脉
弦急者。肝热生风也。加味逍遥散加桂枝。热伤元气。四肢困倦。手指麻木。时时螈 。补中益
气汤去白术加白芍、五味。暑风搐搦。如小儿惊风状。缘先伤于暑。毛孔开而风乘之。局方香薷
饮加羌、防、 、芍。风虚昏愦。不自知觅。手足螈 。口眼 动。或渴或自汗。续命煮散。痈
疽脓水过多。金疮出血过多。及呕血衄血下血后。或虚弱人误汗误下。气血津液受亏而致此者。
大剂保元汤加芎、归、钩藤。兼生阴血。则阳火自退。不应。六君子加芎、归、钩藤。以补脾土。
故小儿吐泻之后。脾胃亏损。亦多患之。乃虚象也。无风可逐。无痰可消。当大补脾土为急。若
阳气脱陷者。补中益气加姜、桂。阳气虚败者。十全大补汤加姜、附。亦有得生者。然筋搐颤掉。肢
体恶寒。脉微细。人皆知为虚也。是为真象。至于脉大无力。发热烦渴。是为假象。惟当固本为
善。若无力抽搐。戴眼反折。汗出如珠。俱不治。产后阴血去多。多有螈 。详妇人本门。
〔诊〕螈 之脉。虚微缓弱者可治。弦紧急疾者难愈。在暴病得之。为风痰及肝火袭于经脉之
象。即久病见之。亦属痰火乘虚肆虐之兆。凡新病得之。脉满大数实者。搜涤风痰。最为要着。
久病得之。补中寓搜。在所必需。设久病而脉实满。暴病而脉虚微。法无可疗之机也。
抽搐，是指筋脉拘急挛缩。瘛疭（chì zòng），是指筋脉弛纵松弛。民间俗称“搐”。小儿在呕吐腹泻之后，脾胃功能受损亏损，津液耗散流失，因此筋脉拘急而发生抽搐，这属于慢惊风。世俗之人不了解“风”在此处是虚损的表现，误以为实证，反而投用牛黄、抱龙丸等祛风药物，导致患者夭折的，不知有多少。大抵而言，发汗后、失血后、产后、痈疽溃破后，气血津液过度损伤，不能濡养筋脉，从而出现此类症状。这与筋惕肉瞤（肌肉跳动）和颤振相似。治疗时应分辨气血的缓急情况，兼用补养之法，才有一线生机。如果妄加艾灸，或饮用发表解表的药剂，患者很快就会死亡。
抽搐的症状，多归属于心、脾、肝三经。如果有自汗、气短，脉搏急促但重按则减小的，这是心气虚弱。可用辰砂妙香散。如果气盛、神志昏沉、筋脉拘挛，脉搏盛大满实的，这是心火旺盛。可用导赤散，加入黄芩、黄连、山栀、茯神、犀角。如果身体疲倦、神志昏沉、不语，脉搏迟缓，四肢欠温的，这是脾虚生风。可用归脾汤，加入钩藤、羌活。如果有寒热往来、眼球上视、摇头，脉搏弦急的，这是肝热生风。可用加味逍遥散，加入桂枝。如果热邪损伤元气，四肢困倦，手指麻木，时时发生抽搐，可用补中益气汤，去掉白术，加入白芍、五味子。如果是暑风引起的抽搐，像小儿惊风的样子，是因为先受暑邪伤害，毛孔张开，风邪乘虚而入，可用局方香薷饮，加入羌活、防风、细辛、白芍。如果是风虚导致的昏愦无知，手足抽搐，口眼歪斜抽动，或者口渴或者自汗，可用续命煮散。如果是痈疽脓水过多，金创出血过多，以及呕血、鼻衄、便血之后，或者是虚弱之人误用发汗或攻下法，导致气血津液亏损而引发此症的，可用大剂量的保元汤，加入川芎、当归、钩藤，以兼补阴血，这样阳火自然消退。如果无效，可用六君子汤，加入川芎、当归、钩藤，以补益脾土。所以小儿呕吐腹泻之后，脾胃亏损，也常患此症，这属于虚象。没有实风可驱，没有实痰可消，应当以大补脾土为紧急。如果是阳气脱陷的，可用补中益气汤，加入干姜、肉桂。如果是阳气虚败的，可用十全大补汤，加入干姜、附子。也有能救活的。然而，筋脉抽搐颤抖，肢体恶寒，脉搏微细，人们都知道这是虚证，这是真象。至于脉搏大而无力，发热烦躁口渴，这是假象。只应当固护根本才是好的。如果是无力抽搐，戴眼（两眼固定向上凝视），反折（角弓反张），汗出如珠，都是不治之症。产后阴血失去过多，多有抽搐症状，详见妇人科门。
【诊法】抽搐的脉象，如果虚微缓弱，是可以治疗的。如果弦紧急疾，则难以痊愈。如果在暴病中出现，是风痰及肝火侵袭经脉的现象。即使是久病出现，也是痰火乘虚肆虐的征兆。凡是新病出现，脉搏满大数实的，搜剔涤除风痰，是最关键的措施。久病出现，在补益中寓含搜剔之法，是所必需的。如果久病而脉搏实满，暴病而脉搏虚微，就没有可治疗的机会了。
Chou (convulsion) refers to the spasm and contraction of tendons and vessels. Chi Zong (spasm and relaxation alternating) refers to the flaccidity and relaxation of tendons and vessels. Commonly known as "Chu" in folk medicine. After vomiting and diarrhea in infants, the Spleen and Stomach are damaged and depleted, body fluids are consumed and scattered; thus, the tendons become tight and convulse, which is classified as Slow Convulsion (Man Jing). Laypeople do not understand that "Wind" here is a manifestation of deficiency; mistakenly treating it as an excess syndrome, they administer wind-dispelling medicines such as Niuhuang Wan (Calculus Bovis Pill) or Baolong Wan, leading to premature death, a number too great to count. Generally speaking, after excessive sweating, blood loss, postpartum state, or ulceration of carbuncles and sores, Qi, Blood, and Body Fluids are excessively injured and cannot nourish the tendons, resulting in this condition. It is similar to Jin Ti Rou Run (tendinous twitching and muscle tremors) and Chan Zhen (trembling and shaking). Treatment should differentiate the slackness or urgency of Qi and Blood, and employ tonification and nourishment concurrently to preserve life. If moxibustion is recklessly applied, or diaphoretic formulas are drunk, death will follow swiftly.
The syndrome of Chou mostly involves the Heart, Spleen, and Liver meridians. If there is spontaneous sweating, shortness of breath, and a rapid pulse that becomes smaller upon deep palpation, this indicates Heart Qi Deficiency. Chen Sha Miao Xiang San (Cinnabar Wonderful Fragrance Powder) may be used. If there is abundant Qi, mental confusion, tendon spasms, and a full, large pulse, this indicates Exuberant Heart Fire. Dao Chi San (Guide Out the Red Powder) with added Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Shan Zhi (Gardeniae Fructus), Fu Shen (Poria Cum Radix), and Xi Jiao (Rhinocerotis Cornu) may be used. If there is physical fatigue, mental confusion, muteness, a slow pulse, and cool limbs, this is Wind generated by Spleen Deficiency. Gui Pi Tang (Restore the Spleen Decoction) with added Gou Teng (Uncariae Ramulus cum Uncis) and Qiang Huo (Notopterygii Rhizoma et Radix) may be used. If there are alternating chills and fever, upward gaze, head shaking, and a string-tight, urgent pulse, this is Wind generated by Liver Heat. Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) with added Gui Zhi (Cinnamomi Ramulus) may be used. If Heat damages Yuan Qi, causing four-limb fatigue, numbness in fingers, and frequent convulsions, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) without Bai Zhu (Atractylodis Macrocephalae Rhizoma), but with added Bai Shao (Paeoniae Radix Alba) and Wu Wei Zi (Schisandrae Chinensis Fructus) may be used. For convulsions caused by Summer-Heat Wind, resembling infantile convulsion, due to prior Summer-Heat injury where pores open and Wind enters, Ju Fang Xiang Ru Yin (Prescription Bureau Elsholtzia Decoction) with added Qiang Huo, Fang Feng (Saposhnikoviae Radix), Xi Xin (Asari Radix et Rhizoma), and Bai Shao may be used. For Wind-Deficiency causing dizziness and confusion, unawareness of surroundings, hand-foot convulsions, mouth and eye deviation/twitching, thirst or spontaneous sweating, Xu Ming Zhu San (Continuing Life Boiled Powder) may be used. For excessive pus from carbuncles/sores, excessive bleeding from metal wounds, or following hematemesis, epistaxis, or lower GI bleeding, or when weak individuals are erroneously treated with sweating or purging methods leading to Qi, Blood, and Body Fluid depletion causing this condition, a large dose of Bao Yuan Tang (Protect the Origin Decoction) with added Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), and Gou Teng may be used to simultaneously tonify Yin Blood, thereby naturally retreating Yang Fire. If ineffective, Liu Jun Zi Tang (Six Gentlemen Decoction) with added Chuan Xiong, Dang Gui, and Gou Teng may be used to tonify Spleen Earth. Thus, after infantile vomiting and diarrhea, Spleen-Stomach depletion often leads to this condition, which is a deficiency manifestation. There is no real Wind to dispel nor real Phlegm to resolve; urgently tonifying Spleen Earth is required. If Yang Qi collapses and sinks, Bu Zhong Yi Qi Tang with added Gan Jiang (Zingiberis Rhizoma) and Rou Gui (Cinnamomi Cortex) may be used. If Yang Qi is deficient and failing, Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) with added Gan Jiang and Fu Zi (Aconiti Lateralis Radix Preparata) may be used. Some cases can be saved. However, tendon convulsions and trembling, aversion to cold in limbs, and faint, fine pulses are known by all to be deficiency; this is the true manifestation. Conversely, a large but forceless pulse, fever, irritability, and thirst are false manifestations. One must only secure the Root. If there is forceless convulsion, Dai Yan (eyes fixed upward), Fan Zhe (opisthotonos), and sweat like pearls, these are untreatable. Postpartum excessive loss of Yin Blood often results in convulsions; see the Women's Diseases section for details.
[Diagnosis] The pulse in convulsion: if empty, minute, slow, and weak, it is treatable. If wiry, urgent, and rapid, it is difficult to cure. In acute diseases, its appearance indicates Wind-Phlegm and Liver Fire invading the meridians. Even in chronic diseases, its appearance signals Phlegm-Fire taking advantage of deficiency to run rampant. For new diseases, if the pulse is full, large, rapid, and solid, searching out and cleansing Wind-Phlegm is the most crucial measure. For chronic diseases, incorporating searching/cleansing methods within tonification is necessary. If a chronic disease presents with a full/solid pulse, or an acute disease presents with an empty/minute pulse, there is no mechanism for treatment.