治慢惊者,考之古书,亦无所据,惟载阴痫而已。盖慢惊属阴,阴主静而搐缓。故
曰慢。其候皆因外感风寒,内作吐泻,或得于大病之余,或传误转之后,目慢神昏,手
足偏动,口角流涎,身微温,眼上视,或斜转,及两手握拳而搐,或兼两足动掣,各辨
男左女右,搐者为顺,反此为逆,口气冷缓,或囟门陷,此虚极也。脉沉无力,睡则扬睛,
谓两目半开半合,此真阳衰耗,而阴邪独盛。阴盛生寒,寒为水化,水生肝本,木为风化,
木克脾土,胃为脾之府,故胃中有风,螈(音炽) (音纵)渐生。其螈 证状,两肩微耸,两手垂
下,时复动摇不已,名为慢惊。宜以青州白丸子、苏合香丸,入姜汁杵匀,米饮调下,虚
极者加金液丹,次用冲和饮同七宝散,水煨姜煎服,使气顺风散,少解吐泻,间以胃苓
汤救其表里。若吐不止,可投定吐饮,泻不减,宜服六柱散或日生汤,去胃风,定螈 ,
清神气。五苓散导其逆,调荣卫,和阴阳,若痰多唇白,四肢如冰,不省人事,此虚慢之
极,用固真汤速灌之,以生胃气。胃气既回,投醒脾散、沉香饮调理。有慢脾风者,自慢
惊传变,始因吐泻,经久不治,故胃弱脾虚,脾虚生风,风入经络,则手足无时摇动,昏
沉不省,面带痿色,风势太甚,乃虚之极,急用青金丹、天麻饮灌服,或六柱散、固真汤,
不问有热有痰,皆风入脾经,亦是危证。若痰如牵锯之声,面无风气犹甚缩,气粗顽软搐甚,不可治也。
治疗慢惊风,考证古代医书,也没有确切的依据,只记载了阴痫这一病证。大概慢惊风属于阴证,阴主静,所以抽搐缓慢。因此称为“慢”。其症状表现都是因为外感风寒,内部引发呕吐腹泻,或者在大病之后,或者因误治传变之后出现,表现为眼神呆滞、神志昏沉,手足偏侧抽动,口角流涎,身体微热,眼睛向上视或斜转,以及两手握拳而抽搐,或者兼有双脚抖动掣动。需要分别辨别男左女右的情况,抽搐为顺证,反之则为逆证。口气冷缓,或者囟门凹陷,这是极度虚弱的表现。脉象沉而无力,睡觉时眼睛半开半合(称为“扬睛”),这是真阳衰耗,而阴邪独盛。阴气盛则生寒,寒与水相应,水生肝木之本,肝木主风化,木克脾土,胃是脾的腑,所以胃中有风,导致肢体抽搐(螈)逐渐产生。这种抽搐的症状,表现为两肩微微耸起,两手下垂,时常不停地动摇,名为慢惊风。适宜使用青州白丸子、苏合香丸,加入姜汁捣匀,用米汤调服;极度虚弱者加用金液丹;随后使用冲和饮配合七宝散,用水煨姜煎服,使风气随风消散,稍微缓解呕吐腹泻,间歇性使用胃苓汤来救表里之邪。如果呕吐不止,可投用定吐饮;腹泻不减,宜服用六柱散或日生汤,以去除胃中风邪,制止抽搐,清宁神气。五苓散引导逆气,调和营卫,平衡阴阳。如果痰多、唇色苍白、四肢冰冷、不省人事,这是虚慢到了极点,需用固真汤迅速灌服,以恢复胃气。胃气既已恢复,再投用醒脾散、沉香饮进行调理。有慢脾风者,是由慢惊风传变而来,起初因呕吐腹泻,经久不愈,导致胃弱脾虚,脾虚生风,风邪侵入经络,则手足不时摇动,昏沉不省人事,面色呈现萎黄之色。如果风势太甚,则是极度虚弱,急需使用青金丹、天麻饮灌服,或者六柱散、固真汤,无论是否有热或有痰,都是风邪侵入脾经,也属于危重证候。如果出现痰声如拉锯的声音,面部无风邪却仍然收缩,呼吸粗重、顽钝、抽搐严重,则不可治愈。
In the treatment of slow convulsion (Man Jing), examination of ancient texts reveals no definitive basis, with only "Yin Epilepsy" (Yin Xian) being recorded. Generally, slow convulsion belongs to the Yin syndrome; since Yin governs stillness, the convulsions are slow, hence the name "slow." The manifestations arise from external contraction of wind-cold and internal onset of vomiting and diarrhea, or they occur after a severe illness or following erroneous treatment progression. Symptoms include dull eyes and confused spirit, unilateral movement of hands and feet, drooling at the mouth corners, slight body warmth, upward or oblique deviation of the eyes, clenching of both fists with convulsions, or accompanied by jerking of both legs. One must distinguish between males (left side) and females (right side); convulsions in this pattern indicate a favorable prognosis (Shun), while the opposite indicates an unfavorable one (Ni). Cold and slow breath, or a sunken fontanelle, signify extreme deficiency. The pulse is deep and powerless, and during sleep, the eyes remain half-open and half-closed (Yang Jing), indicating depletion of True Yang and dominance of Yin pathogenic factors. Excess Yin generates cold; cold transforms into water; water nourishes the root of Liver Wood; Wood governs wind transformation; Wood overacts on Spleen Earth. As the Stomach is the Fu organ of the Spleen, wind enters the Stomach, leading to gradual twitching and convulsions (Rong). The symptoms of these convulsions include slightly shrugging shoulders, hands hanging down, and continuous trembling, named slow convulsion. It is appropriate to use Qingzhou Bai Wan Zi (White Pills of Qingzhou) and Su He Xiang Wan (Styrax Pill), mixed evenly with ginger juice, and taken with rice water. For extreme deficiency, add Jin Ye Dan (Golden Elixir Pill). Subsequently, use Chong He Yin (Harmonizing Decoction) combined with Qi Bao San (Seven Treasures Powder), decocted with water-warmed ginger, to disperse wind qi and slightly relieve vomiting and diarrhea. Intermittently use Wei Ling Tang (Stomach and Five Zang Decoction) to address exterior and interior conditions. If vomiting persists, Ding Tu Yin (Anti-Vomiting Decoction) may be administered; if diarrhea does not cease, Liu Zhu San (Six Pillars Powder) or Ri Sheng Tang (Daily Rising Decoction) should be taken to remove wind from the Stomach, stop convulsions, and clear the spirit. Wu Ling San (Five Ingredient Powder with Poria) guides rebellious qi, harmonizes Ying and Wei (Nutritive and Defensive levels), and balances Yin and Yang. If there is excessive phlegm, pale lips, ice-cold limbs, and unconsciousness, this represents the extreme of deficiency-slow convulsion; Gu Zhen Tang (Solidify Truth Decoction) should be rapidly infused to restore Stomach Qi. Once Stomach Qi returns, Xing Pi San (Awaken Spleen Powder) and Chen Xiang Yin (Aged Tangerine Peel Decoction) can be used for regulation. Slow spleen wind (Man Pi Feng) evolves from slow convulsion. Initially caused by prolonged vomiting and diarrhea without timely treatment, it leads to weak Stomach and deficient Spleen. Spleen deficiency generates wind; wind enters the meridians, causing constant shaking of hands and feet, drowsiness, unconsciousness, and a sallow complexion. If the wind pathogen is too severe, it indicates extreme deficiency; urgently administer Qing Jin Dan (Green Gold Pill) or Tian Ma Yin (Gastrodia Decoction), or Liu Zhu San or Gu Zhen Tang. Regardless of the presence of heat or phlegm, this is wind entering the Spleen meridian and constitutes a critical condition. If the sound of phlegm resembles sawing, the face contracts despite the absence of obvious wind signs, breathing is coarse and labored, and convulsions are severe and stubborn, the condition is incurable.