小儿惊药，皆些小丸散，多峻厉，取其易于成功，以之治肝心有余之症，对病则可，中病宜即止，不可
以为常也。病势轻浅，只用轻剂，病退便宜和中调理。如牛黄丸三、四十味，乱杂殊甚；凉惊丸非气壮实、
肝火旺者，不宜；抱龙丸亦多不见效，且麝、脑香辛太甚，走散真气，又伤脾胃，元气虚则病愈生矣。
愚按小儿之症，有余便属肝经，不足便属脾经。盖有余是病气也，不足是元气也。凡病气有余，元气
不足，当补不当泻，况脆嫩脏腑，安能受峻厉之药？前论厥有旨哉！
一小儿，数岁，每停食辄服峻厉之剂，后患肚腹膨胀，或呕吐泄泻。余先用六君子汤，诸症渐愈，又
用补中益气汤，胃气渐复。
惊后目微动及切牙，固为肝虚，亦虚中有热。虚者，血不足；热者，气有余。水不足无以制火，而火动故
也。但牙床属胃，脾胃虚而有热，亦见微咬，不可专归肝肾。当以补脾为主，加黄连、芍药、川芎，便是泻
肝气、补肝血也。生地黄凉心血，故导赤散宜用之；熟地黄补肾血，故地黄丸宜用之。凡肝肾虚症见者，于
脾胃药加地黄可也。或以目札、切牙为肝肾虚，专服地黄丸，岂不泥膈生痰，适有以妨于脾胃也。
愚按前症亦有肝热生风，风入于目，目系牵动，则目连札；热入于目，筋脉拘紧，则目直视。若面赤
仰卧，摇头切牙，此则心热之所致也。又当别其虚实∶肝实则泻青丸，虚则地黄丸；心实则导赤散，虚则粉
红丸；若脾胃虚热，补中益气汤加芍药、山栀，以实脾土、制肝木；若肝肾虚热，用六味地黄丸，以补肾
水、生肝木。
奚氏女，六岁，忽然发惊，目动，切牙，或睡中惊搐，痰涎壅盛，或用化痰、祛风等药益甚。余曰∶
面青而见前症，乃属肝木克制脾土，不能摄涎而上涌也。当滋肾水、生肝血，则风自息而痰自消矣。遂用
六味丸而愈。
一小儿，患前症，痰涎自流，用惊风之药，其症益甚，脾胃益虚。视其面色痿黄，口吐痰涎。用六君
子、补中益气而愈。
小儿惊风用药，多为细小的丸剂或散剂，药性大多峻猛猛烈，是为了追求容易见效。用这些药来治疗肝心有余的病症，虽然对症可以，但一旦病邪去除就应当立即停药，不能将其作为常规用法。如果病势轻浅，只需使用轻缓的药剂；病情消退后，适宜用调和脾胃的方法进行调理。例如牛黄丸包含三四十味药材，配伍杂乱严重；凉惊丸如果不是气壮实、肝火旺盛的患者，不宜使用；抱龙丸也往往不见疗效，且其中的麝香、冰片香气辛烈太过，会耗散真气，又损伤脾胃，元气虚弱则疾病会更加滋生。
我认为小儿的疾病，有余便属于肝经，不足便属于脾经。所谓“有余”是指病气，“不足”是指元气。凡是病气有余而元气不足的，应当采用补法而不应当采用泻法，何况小儿脏腑脆嫩，怎么能承受峻猛的药物？前文论述厥证时说得很有道理！
有一个几岁的小儿，每次停食（积食）就服用峻猛的药剂，后来患上肚腹膨胀，有时呕吐泄泻。我先用六君子汤，各种症状逐渐痊愈，接着用补中益气汤，胃气逐渐恢复。
惊风之后眼睛微动及咬牙，固然是肝虚的表现，也是虚中有热。虚，是指血不足；热，是指气有余。水不足无法制约火，导致火动，所以出现这种情况。但是牙床属于胃，脾胃虚而有热，也会出现轻微咬合，不能专门归咎于肝肾。应当以补脾为主，加入黄连、芍药、川芎，这就是泻肝气、补肝血的方法。生地黄能凉心血，所以导赤散适宜用它；熟地黄能补肾血，所以地黄丸适宜用它。凡是见到肝肾虚的症状，在脾胃药中加入地黄即可。有人把眨眼、咬牙当作肝肾虚，专门服用地黄丸，难道不会导致膈间生痰，反而妨害脾胃吗？
我认为上述病症也有因肝热生风，风进入眼睛，牵动目系，导致眼睛连眨；热进入眼睛，筋脉拘紧，导致眼睛直视。如果面色红赤、仰卧、摇头咬牙，这是心热所致。又应当辨别虚实：肝实则用泻青丸，虚则用地黄丸；心实则用导赤散，虚则用粉红丸；若是脾胃虚热，用补中益气汤加芍药、山栀，以实脾土、制肝木；若是肝肾虚热，用六味地黄丸，以补肾水、生肝木。
奚家的女儿，六岁，忽然发惊，眼睛动，咬牙，有时睡中惊搐，痰涎壅盛，有人用化痰、祛风等药，病情反而加重。我说：“面色青且出现前述症状，乃属肝木克制脾土，不能摄持涎液而上涌。应当滋肾水、生肝血，则风自息而痰自消。”于是用六味地黄丸而痊愈。
另一个小儿，患上述病症，痰涎自流，用治惊风的药，症状更加严重，脾胃更加虚弱。看其面色萎黄，口吐痰涎。用六君子汤、补中益气汤而痊愈。
Pediatric medications for convulsions are mostly small pills or powders, often possessing harsh and potent properties, intended to achieve quick results. When used to treat conditions characterized by excess in the Liver and Heart meridians, they may be effective against the specific disease, but one should cease administration immediately once the pathogen is eliminated; they should not be used as a routine practice. If the pathological condition is mild and superficial, only light and gentle preparations should be used; after the symptoms subside, it is appropriate to regulate and harmonize the Spleen and Stomach. For instance, Niuhuang Wan (Calculus Bovis Pill) contains thirty to forty ingredients and is excessively chaotic in its formulation; Liangjing Wan (Cooling Convulsion Pill) is unsuitable for patients who do not have robust qi and vigorous Liver fire; Baolong Wan (Embracing Dragon Pill) also often fails to show efficacy. Moreover, the musk and borneol contained within are overly pungent and aromatic, which scatters true qi and damages the Spleen and Stomach; when Yuanqi (Original Qi) is deficient, the illness will inevitably worsen.
I observe that pediatric conditions involving excess belong to the Liver meridian, while those involving deficiency belong to the Spleen meridian. "Excess" refers to pathological qi, whereas "deficiency" refers to Yuanqi (Original Qi). Whenever there is excess of pathological qi and deficiency of Yuanqi, tonification should be employed rather than purgation. How can delicate and tender internal organs withstand harsh and potent medicines? The previous discussion on Jue syndrome (Cold Extremities Syndrome) was indeed profound!
A child of several years old, upon experiencing food stagnation, would invariably take harsh purgative agents. Subsequently, he developed abdominal distension, accompanied by occasional vomiting and diarrhea. I initially prescribed Liu Junzi Tang (Six Gentlemen Decoction), after which all symptoms gradually resolved. Thereafter, I administered Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), leading to the gradual recovery of Stomach qi.
Following a convulsive episode, slight eye movements and teeth grinding indicate Liver deficiency, yet this deficiency harbors heat. Deficiency here denotes insufficient blood; heat denotes surplus qi. Insufficient Water (Kidney Yin) fails to control Fire, causing Fire to flare up. However, the gums belong to the Stomach; deficiency with heat in the Spleen and Stomach can also manifest as slight gnashing of teeth, so it cannot be exclusively attributed to the Liver and Kidneys. Treatment should primarily focus on tonifying the Spleen, adding Huanglian (Coptidis Rhizoma), Shaoyao (Paeoniae Radix Alba), and Chuanxiong (Ligustici Chuanxiong Rhizoma); this constitutes draining Liver qi and nourishing Liver blood. Shengdihuang (Rehmanniae Radix) cools Heart blood, making it suitable for Daochi San (Guide Out Redness Powder); Shudihuang (Prepared Rehmanniae Radix) tonifies Kidney blood, making it suitable for Dihuang Wan (Rehmannia Pill). In cases where Liver and Kidney deficiency symptoms appear, adding Dihuang to Spleen-regulating formulas is appropriate. Some attribute blinking and teeth grinding solely to Liver and Kidney deficiency and prescribe Dihuang Wan exclusively; does this not lead to phlegm accumulation in the diaphragm, thereby hindering the Spleen and Stomach?
I further note that such symptoms may also arise from Liver heat generating Wind. When Wind enters the eyes, it pulls the ocular tendons, causing frequent blinking; when Heat enters the eyes, it causes tendon and vessel contraction, resulting in staring eyes. If the face is red, the patient lies supine, shakes their head, and grinds their teeth, this is caused by Heart heat. One must distinguish between excess and deficiency: for Liver excess, use Xieqing Wan (Drain Green Pill); for Liver deficiency, use Dihuang Wan (Rehmannia Pill); for Heart excess, use Daochi San (Guide Out Redness Powder); for Heart deficiency, use Fen Hong Wan (Pink Pill); for Spleen-Stomach deficiency-heat, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with added Shaoyao (Paeoniae Radix Alba) and Zhizi (Gardeniae Fructus) to solidify Earth and restrain Wood; for Liver-Kidney deficiency-heat, use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to tonify Water and generate Wood.
The daughter of Mr. Xi, aged six, suddenly experienced convulsions, eye movements, and teeth grinding, with occasional nocturnal spasms and excessive phlegm-saliva. Previous treatments using phlegm-resolving and wind-dispelling herbs exacerbated her condition. I stated: "Her complexion is green, and given the aforementioned symptoms, this belongs to Liver Wood overacting on Spleen Earth, failing to control saliva, which surges upward. One should nourish Kidney Water and generate Liver blood, so that Wind will subside naturally and Phlegm will dissipate." Consequently, she was treated with Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) and recovered.
Another child suffered from the aforementioned symptoms, with spontaneous drooling of phlegm-saliva. Treatment with anti-convulsant medicines worsened the symptoms and further weakened the Spleen and Stomach. Observing his sallow complexion and spitting of phlegm-saliva, I treated him with Liu Junzi Tang (Six Gentlemen Decoction) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), resulting in recovery.