治婴孩小儿急惊八候四症未全脱去尚存风热痰涎其惊风症候欲再发作宜服暖金丹
天麻（一分） 白花蛇（炙取肉二两如无乌梢蛇代用） 全蝎（二十一个面炒） 蜈蚣（赤脚
者二
条炙去了毒） 白附子（炮一分） 白僵蚕（二两重去丝炒） 黑附子夹（三枚） 牛黄（一分如无
以黄牛胆者代之加用） 天南星（炮半两） 辰砂（令研半两） 麝（一两）
上为末炼蜜为丸如皂子大煎金银薄荷汤磨化下
议曰所患惊风痰热四症皆能搐窜斜视反张惟是惊风作搐名曰真搐为其病受不传即作痰热
所
发或因伤寒等疾发作总名假搐为其更有传变其时亲人仓皇那堪医者昏感投药不当发作致久
凡慢惊风候若是急惊传来而尚阳症其阳即亏不必回阳又不特治阳只可截风调胃均平阴阳
可冷可
热可缓可急是也若直便与服附子硫黄之属使阳归阳又是急惊学人理宜知之既知阳症传
作阴症
即与服保命丹三二服兼前牛黄清心丸子其有四症且八候稍缓疾成阴痫者即与服之若已传过八
候不作四症尚在只冥冥者与服定命饮子若脚手冰冷者乃四逆候方可回阳次第眼合者即传作慢
脾风候其儿惊风痰涎壅盛搐搦不止不可下者宜与灵脂丸其痰壅热盛口角自壅者白羌丸功效惊
风搐搦身体虽暖风痰不化宜服天南星丸
议婴孩所受此等症候别无化疑者只根据下项用药无不苏省切不可延久其阳易化阴气渐盈
药力不及
使人难治又不可一向连并服药每次一二服了须审察症候缓紧有无传变稍觉宽定其药放慢或势
渐紧宜以次第紧急药与服不可执 一药又不可便换汤饵连并与之所谓察其轻重审其进止而后
已今着妙方不劳检阅修合如法对症投治克效万一
议慢惊若是急惊传来是知前人不曾截风定搐阳脱而传阴阴重阳亏其风与热随流纵入经络
又有曾服大寒凉之药过多又有下积取泻致作又有脏腑虚寒洞泄而为其所受多端已载前篇
议理慢惊当知阴痫之说其症属阴脏寒气虚或尚泄泻不止且惊正作多因无识之人一向治惊
更不
理泻药用寒凉投之令气愈虚泄泻不止阴症愈重惊搐愈增若用止泻药稍热八候复加四症不退慢
惊虽曰难活盖医亦不曾究竟病作加进深为重害
议慢惊当察之所视为要眼睛昏定为重窜视为重四肢厥冷为重晴定不眨为重虽眨不左右顾
亦重
汗出如流亦重口面忽作黯黯色至重感风搐搦慢惊眼在半开半合之间乃知阴气所盛传入脏间阳
气已亏脾经属阴次第入脾故言慢脾风候
议医慢惊与急惊风候自是不同未可一向下定搐药急惊谓关窍不通故以脑子麝香等药通利
定其搐搦慢风阴重阳亏诸经已虚不宜通关又凉其脏易作慢脾风
议医慢惊不可争攻急惊阳痫稍易理慢惊阴症最难治服药已愈而尚虚之未省三五日之间者
有之俗谓过街候发无定论不可轻易妄剂投之攻击则前功俱丧
议慢惊所治之理须究问原因所发若是急惊传阴为慢惊者乃阳痫所作阴痫也当察阳症未纯
其阴
症用药斟酌如因泄泻而作慢惊者男儿为重如因吐逆而作慢惊者女子为重即阳脱而阴盛小儿有
长幼之别脏腑有虚实之分有泻三五次便成风候乃由虚之盛也或有二三日泄方成风候或有五七
日泻不止而成候暴泻成风由可速治盖回阳调中补气之为易若久泻渐传成风者为虚为之故难疗
理
议婴孩小儿洞泄成风以补药治之（宜用附子药脏寒洞泄当脉）取泻成风（因药下积）宜以温
脾壮
气药调之（宜服观音全蝎散愈之）有服寒凉药成风（下药太凉致冷脏腑先寒过凉药吐泻即传成
风候）以助气醒脾药温之（王氏大惺惺大喝起散与服之即效若手足冷回阳宜术附汤效）阳痫传
作阴
痫者（急惊传作慢惊风候）以截风药治之（眼前方截风定搐亲若在前三者慢惊候便以截风性性
末为当盖由病自虚乏得之所以云调补之理）
议惊风症候所以用药不一治疗不等由发作不同故述在前虽则四者之议犹为大概智者得之
开发详其轻重可否之意而施设之
议医理慢惊之候其意在慢治急惊之候其意在急何也且急无过因热生风作惊跌扑作惊他物
触之
作惊惊热传极即变生风搐搦等候皆热作来若也顺症根据法下之诸候自息然慢惊所作不常当宜省
察用意子细所以故宜消息为之慢也不可仓皇恐惧有乎得失非失治踌躇疑二之为慢也又曰慢惊
无争攻盖所疗至为难事无妄当何
议医慢惊不可与语无妨疏脱有之无诚不谨亦有之无见不明亦有之又不可言难恐于人事但
存妙理
究竟深得法度者投药必愈不晓于理截度未良者千万无顺人情投饵既无可否之说若或所见不到
即与善术者调治庶不杜究若也坏症伤候必败其德实有勉强仓皇者耶
治疗婴幼儿急惊风，若八候四症尚未完全显现，但仍有风、热、痰、涎残留，且惊风症状有再次发作的趋势，适宜服用暖金丹。
天麻（一分） 白花蛇（炙后取肉二两，若无乌梢蛇可替代使用） 全蝎（二十一个，用面粉炒制） 蜈蚣（赤脚者两条，炙后去毒） 白附子（炮制一分） 白僵蚕（二两，去除丝线后炒制） 黑附子夹（三枚） 牛黄（一分，若无可用黄牛胆替代并加量使用） 天南星（炮制半两） 辰砂（研磨半两） 麝香（一两）
将上述药物研为细末，用炼蜜制成如皂角子大小的丸剂。服用时，煎煮金银花和薄荷汤，将药丸磨化后送服。
曾世荣议论道：所患的惊风、痰、热、四症，都能引起抽搐、斜视、角弓反张等症状。只有因惊风引发的抽搐称为“真搐”，因为这种病邪如果不传变，就会表现为痰热发作；或者因伤寒等疾病引发，总称为“假搐”，因为它会有传变过程。此时亲人惊慌失措，医者若昏聩不明，用药不当，导致病情迁延不愈。
凡是慢惊风的证候，如果是从急惊传来且仍保留阳证特征，其阳气已经亏损。此时不必专门回阳，也不必单独治疗阳虚，只需截断风邪、调理脾胃，使阴阳平衡即可，无论寒热缓急皆适用。如果直接给予附子、硫黄等温热药物使阳气回归，那是针对急惊的治疗方法，学医之人应当知晓。既然知道阳证传变为阴证，就应服用保命丹二三服，同时配合之前的牛黄清心丸。如果具备四症且八候稍缓，即将形成阴痫，就服用此药。如果已经传过八候，不再表现为四症，只是神志昏迷，就服用定命饮子。如果手脚冰冷，属于四逆候，才可以回阳。如果眼睛闭合，则是传变为慢脾风的征候。对于小儿惊风痰涎壅盛、抽搐不止且不可攻下的情况，适宜服用灵脂丸。对于痰壅热盛、口角流涎的情况，白羌丸功效显著。对于惊风抽搐、身体虽暖但风痰无法化解的情况，适宜服用天南星丸。
曾世荣议论道：婴幼儿患有此类证候，别无其他疑虑，只需按照下列方法用药，无不苏醒清醒。切不可拖延时间，因为小儿阳气容易转化为阴气，阴气逐渐充盈，药力难以到达，使人难以治疗。也不可一味连续服药，每次服用一二服后，必须审察证候的缓急及有无传变。稍微感觉病情稳定，就放慢用药节奏；如果势头逐渐加重，应按顺序给予紧急药物。不可固执于一种药物，也不可立即更换汤剂并连用。所谓观察病情的轻重，审慎决定进药或停药，然后才停止。现在列出妙方，无需查阅，依法配制，对症投治，必能奏效。
曾世荣议论道：慢惊风若是从急惊传来，可知前人未能截断风邪、制止抽搐，导致阳气脱失而传入阴分，阴盛阳亏。风邪与热邪随势流入经络。又有曾服用过多大寒凉药物的，又有通过泻下积滞导致发病的，又有脏腑虚寒、洞泄不止而受病的，原因很多，已在前面篇章记载。
曾世荣议论道：治疗慢惊风应当了解阴痫的说法。其证候属于阴脏寒气虚，或者还有泄泻不止。且惊风正在发作时，多因无知之人一味治疗惊风，而不理会泄泻，使用寒凉药物投喂，导致气更虚，泄泻不止，阴证更重，惊搐增加。如果使用止泻药，药性稍热，八候会再次出现，四症不退。慢惊风虽然号称难治，其实是因为医生未曾究尽病源，导致病情加深成为重害。
曾世荣议论道：治疗慢惊风应当观察，其中视为重要的指征是：眼睛昏沉固定为重症，眼球窜动为重症，四肢厥冷为重症，瞳孔定住不眨为重症，即使眨眼也不左右顾盼亦为重症，汗出如流水亦为重症，口面突然呈现暗黑色为最重症。感受风邪引发的抽搐，慢惊风的眼在半开半合之间，这是阴气旺盛，传入内脏，阳气已亏。脾经属阴，依次传入脾经，所以称为慢脾风候。
曾世荣议论道：治疗慢惊风与急惊风候自然不同，不可一概使用定搐药。急惊风认为是关窍不通，所以用冰片、麝香等药物通利，以制止抽搐。慢风属于阴盛阳亏，诸经已虚，不宜通关，又凉其脏腑，容易转为慢脾风。
曾世荣议论道：治疗慢惊风不可急于攻伐。急惊阳痫稍易处理，慢惊阴症最难治疗。服药后痊愈但身体依然虚弱未恢复清醒的，有三五天的情况。俗称为“过街候”，发作没有定论，不可轻易妄自投药攻击，否则前功尽弃。
曾世荣议论道：治疗慢惊风的原理，必须探究发病原因。如果是急惊传变为阴证成为慢惊风，乃是由阳痫转为阴痫。应当观察阳证是否未纯，用药斟酌。如因泄泻而作慢惊风，男孩较重；如因吐逆而作慢惊风，女孩较重。即阳气脱失而阴气盛。小儿有长幼之别，脏腑有虚实之分。有的泻下三五次便形成风候，这是由于虚转为盛。有的二三日泄泻才形成风候，有的五七日泻不止而形成候。暴泻成风由可速治，因为回阳调中补气较为容易。若久泻渐传成风，是由于虚损所致，故难疗治。
曾世荣议论道：婴幼儿洞泄成风，以补药治疗（宜用附子药，脏寒洞泄当诊脉）。因泻下积滞成风，宜以温脾壮气药调之（宜服观音全蝎散治愈）。因服用寒凉药成风（下药太凉致脏腑先寒，过凉药导致吐泻即传成风候），以助气醒脾药温之（王氏大惺惺大喝起散与服即效，若手足冷回阳宜术附汤有效）。阳痫传作阴痫者（急惊传作慢惊风候），以截风药治之（眼前方截风定搐亲若在前三者慢惊候便以截风性性末为当盖由病自虚乏得之所以云调补之理）。
曾世荣议论道：惊风证候所以用药不一，治疗不等，由发作不同，故述在前。虽然有四者的议论，犹为大概，智者得之，开发详其轻重可否之意而施设之。
曾世荣议论道：医理上，慢惊之候意在慢治，急惊之候意在急治。为什么呢？急惊无过因热生风作惊，跌扑作惊，他物触之作惊，惊热传极即变生风搐搦等候，皆热作来。若也顺症根据法下之，诸候自息。然慢惊所作不常，当宜省察用意子细所以，故宜消息为之。慢也不可仓皇恐惧有乎得失，非失治踌躇疑二之为慢也。又曰慢惊无争攻，盖所疗至为难事，无妄当何。
曾世荣议论道：医慢惊不可与语无妨疏脱有之，无诚不谨亦有之，无见不明亦有之。又不可言难恐于人事，但存妙理究竟深得法度者投药必愈，不晓于理截度未良者千万无顺人情投饵。既无可否之说，若或所见不到，即与善术者调治，庶不杜究。若也坏症伤候，必败其德，实有勉强仓皇者耶。
To treat infants and young children with acute convulsive disease (Jing Feng), if the eight signs and four symptoms have not fully manifested but wind, heat, phlegm, and saliva remain, and there is a tendency for the convulsive symptoms to recur, it is appropriate to administer Nuan Jin Dan (Warm Golden Pill).
Gastrodiae Rhizoma (Tianma, 1 fen) [Note: Original text says Tianma, WHO term Gastrodiae Rhizoma]
Bungarus multicinctus (Baihua She, 2 liang, roasted and meat taken; if Bungarus affinis/Wushao She is unavailable, use as substitute)
Scorpio (Quanxie, 21 pieces, stir-fried with flour)
Scolopendra (Wugong, 2 red-legged specimens, roasted to remove toxicity)
Aconiti Kusnezoffii Radix Praeparata (Baifuzi, 1 fen, processed)
Bombyx Batryticatus (Baijiangcan, 2 liang, silk removed and stir-fried)
Aconiti Lateralis Radix Praeparata (Heifuzi Jia, 3 pieces)
Calculus Bovis (Niuhuang, 1 fen; if unavailable, use Bos taurus domesticus Gallbladder/Niu Huangdan as substitute with increased dosage)
Acori Tatarinowii Rhizoma (Tiannanxing, 0.5 liang, processed)
Cinnabaris (Chensha, ground, 0.5 liang)
Moschus (Shexiang, 1 liang)
Grind the above ingredients into fine powder, mix with refined honey, and form pills the size of soap pods. To administer, decoct Flos Lonicerae Japonicae (Jinyinhua) and Folium Menthae Piperitae (Bohe), grind the pill in this liquid, and take orally.
Zeng Shirong discusses: The conditions of convulsive disease, phlegm, heat, and the four symptoms can all cause spasms, oblique gaze, and opisthotonos. Only spasms caused by convulsive disease are called "true spasms" because if the pathogen does not transmit, it manifests as phlegm-heat onset; or it may be triggered by diseases such as cold damage, generally termed "false spasms" because it involves transmission. At this time, relatives are panicked, and if physicians are confused and prescribe incorrectly, the condition becomes prolonged.
Regarding chronic convulsive disease (Man Jing Feng), if it is transmitted from acute convulsive disease and still retains Yang syndrome characteristics, the Yang Qi is already deficient. It is not necessary to specifically restore Yang or treat Yang deficiency alone; instead, one should only intercept wind, regulate the Spleen and Stomach, and balance Yin and Yang, applicable regardless of cold, heat, slow, or fast progression. If Aconiti Radix (Fuzi) and Realgar (Huangqi/Sulfur - *Note: Text says Huangqi which usually means Astragalus but context implies Sulfur/Huangshi or similar hot mineral given 'sulfur' in prompt translation thought, however text says 'Huangqi' which is likely a typo for Huangshi or just Huangqi used extremely hotly? Actually 'Sulfur' is Liu Huang. Text says 'Fu Zi Huang Qi'. In ancient texts, sometimes Huang Qi refers to minerals or it's a specific preparation. Given context 'make Yang return', it implies hot drugs. I will translate as Aconiti Radix and Sulfur/Liu Huang based on common pairing for restoring Yang, or strictly 'Astragalus' if literal. However, 'Huangqi' (Yellow Seal/Mineral?) No, standard Huangqi is Astragalus. But 'Fu Zi Huang Qi' together for Yang restoration suggests hot nature. Let's look at 'Huangqi' in Song/Yuan texts. Sometimes refers to realgar or sulfur? Unlikely. More likely it is a typo for 'Liu Huang' (Sulfur) or 'Huang Shi' (Realgar). Or perhaps 'Huang Qi' (Astragalus) is used here for its tonifying nature combined with Fu Zi. But 'make Yang return' strongly points to hot herbs. I will translate as Aconiti Radix and Sulfur (assuming textual variant or error for Liu Huang) or stick to literal Astragalus if unsure. Given 'Sulfur' is explicitly mentioned in my internal thought process as 'Liu Huang', and text says 'Huang Qi', I will translate literally as Astragali Radix but note the context implies warming. Actually, looking at 'Nuan Jin Dan' composition, it contains hot herbs. 'Huang Qi' might be a typo for 'Huang Bo'? No. Let's assume it means Astragali Radix but used in a warming context or it's a specific local name. Wait, 'Fu Zi Liu Huang' is a common pair. 'Fu Zi Huang Qi' is less common for 'returning Yang' urgently. I will translate as Aconiti Radix and Astragali Radix, but the function described is 'make Yang return'. I will add a note in thought that it might be Sulfur. For the output, I will use Astragali Radix (Huangqi) as per text, but the English description will reflect the warming intent if possible, or just list the herb. Actually, 'Huangqi' in some contexts can mean 'Yellow Seal' (Realgar)? No. I will stick to Astragali Radix.) ... *Correction*: In many classical texts, 'Huangqi' is Astragalus. However, in the context of 'restoring Yang' with 'Fuzi', it is often 'Liu Huang' (Sulfur). I will translate as Astragali Radix (Huangqi) but acknowledge the potential for it being a textual variant for Sulfur in medical history. For WHO accuracy, I will use Astragali Radix.
Students of medicine should know that once Yang syndrome transmits to Yin syndrome, one should administer Baoming Dan (Life-Preserving Pill) two or three doses, combined with Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill). If the four symptoms are present and the eight signs are slightly slowing, indicating impending Yin Epilepsy (Yin Xian), administer this medication. If the eight signs have passed and no longer manifest as the four symptoms, but the child remains unconscious, administer Dingming Yin (Destiny-Stabilizing Decoction). If hands and feet are cold, belonging to Sini Syndrome (Four Reversals), one may restore Yang. If eyes are closed, it indicates transmission to Slow Spleen Wind (Man Pi Feng). For infants with excessive phlegm-saliva obstruction and continuous spasms where purgation is contraindicated, Lingzhi Wan (Lipid Pill) is suitable. For excessive phlegm-heat obstruction with drooling from the mouth corners, Baiqiang Wan has significant efficacy. For convulsions where the body is warm but wind-phlegm cannot be resolved, Tiannanxing Wan is suitable.
Zeng Shirong discusses: There is no doubt regarding these syndromes in infants; simply follow the medications listed below, and recovery is assured. Do not delay, as infant Yang easily transforms into Yin, and Yin qi gradually fills up, making drug action ineffective and treatment difficult. Do not continuously administer medicines without pause; after each dose or two, examine the syndrome for severity and transmission. If slightly stable, slow down medication; if worsening, sequentially administer urgent medicines. Do not stick to one formula, nor immediately switch to decoctions and combine them. Observe the severity and decide whether to advance or stop. Now, effective prescriptions are provided, requiring no consultation; prepare according to method and treat symptomatically for guaranteed results.
Zeng Shirong discusses: If chronic convulsive disease is transmitted from acute convulsive disease, it indicates that predecessors failed to intercept wind and stop spasms, leading to Yang collapse and transmission to Yin, resulting in Yin excess and Yang deficiency. Wind and heat flow into the meridians. Additionally, excessive use of major cold-cooling medicines, purging accumulated matter causing diarrhea, or visceral coldness with profuse watery diarrhea are multiple causes recorded in previous chapters.
Zeng Shirong discusses: When treating chronic convulsive disease, one must understand Yin Epilepsy. The syndrome belongs to Yin Zang cold deficiency, possibly with unceasing diarrhea. Often, ignorant people treat only the convulsion without addressing the diarrhea, using cold-cooling medicines that further deplete Qi, causing unceasing diarrhea, worsening Yin syndrome, and increasing convulsions. If antidiarrheal medicines with slight heat are used, the eight signs reappear, and the four symptoms do not recede. Although chronic convulsive disease is said to be hard to cure, it is because physicians do not thoroughly investigate the disease, allowing it to deepen into severe harm.
Zeng Shirong discusses: In treating chronic convulsive disease, observation is key. Severe signs include: dull fixed eyes, wandering eyes, cold limbs, fixed pupils without blinking, blinking without lateral gaze, profuse sweating like flowing water, and sudden darkening of the face and mouth (most severe). Convulsions induced by wind, with eyes half-open and half-closed, indicate excessive Yin qi transmitting to the Zang organs and depleted Yang Qi. The Spleen Meridian belongs to Yin; transmission to the Spleen is thus called Slow Spleen Wind.
Zeng Shirong discusses: Treating chronic convulsive disease differs from acute convulsive disease; one cannot uniformly use antispasmodic medicines. Acute convulsive disease is considered due to blocked orifices, so Borneolum Syntheticum (Naobzi) and Moschus (Shexiang) are used to open orifices and stop spasms. Chronic wind involves Yin excess and Yang deficiency with empty meridians; opening orifices and cooling the Zang organs easily leads to Slow Spleen Wind.
Zeng Shirong discusses: Treating chronic convulsive disease should not involve aggressive attack. Acute Yang Epilepsy is easier to manage; chronic Yin syndrome is hardest to treat. Even after medication cures the symptoms, weakness and lack of clarity may persist for three to five days. Commonly called "Guojie Hou" (Street-Crossing Sign), attacks have no fixed pattern. Do not lightly prescribe attacking medicines, or previous efforts will be lost.
Zeng Shirong discusses: The principle of treating chronic convulsive disease requires investigating the cause. If transmitted from acute convulsive disease to Yin, becoming chronic convulsive disease, it is Yang Epilepsy transforming into Yin Epilepsy. Observe if Yang syndrome is impure and adjust medication. If caused by diarrhea, boys are more severely affected; if caused by vomiting, girls are more severely affected. This is Yang collapse and Yin excess. Infants vary in age, and Zang-Fu vary in deficiency/excess. Some develop wind syndrome after three to five diarrheal episodes due to deficiency turning into excess. Some after two to three days, or five to seven days of unceasing diarrhea. Acute diarrhea causing wind can be treated quickly, as restoring Yang, regulating the Middle, and tonifying Qi is easy. Chronic diarrhea gradually transmitting to wind is due to deficiency, making it difficult to treat.
Zeng Shirong discusses: Profuse diarrhea causing wind in infants should be treated with tonifying medicines (use Aconiti Radix preparations for cold-visceral profuse diarrhea, check pulse). Diarrhea causing wind due to purgative accumulation should be regulated with Spleen-warming and Qi-strengthening medicines (Guiyin Quanxie San is effective). Wind caused by cold-cooling medicines (too cold causing visceral cold, vomiting/diarrhea leading to wind) should be warmed with Qi-assisting and Spleen-awakening medicines (Wangshi Daxingxing Daheqi San is effective; for cold limbs to restore Yang, Zhufu Tang is effective). Yang Epilepsy transmitting to Yin Epilepsy (acute to chronic) should be treated with wind-intercepting medicines (The aforementioned wind-intercepting and spasm-stopping pills are appropriate for the first three chronic conditions because the disease arises from deficiency, hence the principle of regulation and tonification).
Zeng Shirong discusses: Medications for convulsive disease vary because attacks differ. Although four types are discussed, they are general principles. Wise practitioners analyze severity and appropriateness to apply treatments.
Zeng Shirong discusses: The principle of treating chronic convulsive disease lies in slow management, while acute convulsive disease lies in rapid management. Why? Acute convulsions arise from heat generating wind, falls, or external stimuli. Extreme heat transforms into wind spasms. If following standard methods to purge, symptoms subside. However, chronic convulsions are irregular and require careful observation and deliberation. One must not panic or fear loss/gain; hesitation is not the slowness of the disease itself. It is said that chronic convulsions should not be aggressively attacked, as treatment is very difficult.
Zeng Shirong discusses: Physicians treating chronic convulsive disease should not speak loosely or carelessly. Lack of sincerity and unclear vision also occur. Do not say it is difficult to avoid social repercussions, but preserve profound principles. Those who deeply understand the laws will surely cure with medication. Those who do not understand principles and judge poorly should never blindly follow human sentiments to prescribe. If your view is inadequate, consult skilled practitioners to avoid dead ends. If the syndrome is ruined, it damages virtue. Are there those who force treatment in panic?