《脉诀》曰∶大肠共肺为传送。盖肺与大肠为表里，肛者大肠之门，肺实热则闭结不
通，肺虚寒则肠头出露。有因痢久，里急后重，努力肛开，为外风所吹，或伏暑作泻，肠
滑不禁，或禀赋怯弱，易于感冷，亦致大肠虚脱。凡小儿所患泻痢，皆因暑湿风热乘脾
胃虚而得，盖风属木，本胜则制土，土主脾胃，虚而受制，又湿喜伤脾，因虚受湿，不
能分别清浊，水谷交杂，则为洞泄。洞泄既久，大肠亦虚，大肠乃手阳胆燥金，而土虚
不能生金，金气既虚，则传送之道亦虚，又为风冷所袭，故肛门脱而不收。法宜补脾温
胃，使金得受母之益而气实，宜藿香饮、匀气散、平胃散主之，次则内投固肠之剂，用
健脾饮、养脏汤，服饵，外以敷贴之法，用伏龙肝散傅之，及萆麻膏贴囟门，使引气上，
令其自收，如收尽仍以水洗去其膏。又有邪热积滞于大肠，未经疏涤，亦成此疾。其肛
门色红而软，肺脉浮数，右手指纹紫见，身微有热，时或烦躁先投清肺饮疏解，次用薄
菏散、蟠龙散为治，间服万安饮，亦佳。
古人议痫最多，大概在乎观形切脉，明辨阴阳，对证用药，不致妄投汤剂为上。阴
痫者，因慢惊后去痰不尽，痰入心包而得，四肢逆冷，吐舌摇头，口嚼白沫，牙关紧闭，但
不甚惊搐作啼，面色或白或青，脉息沉微，故《婴孩宝书》云∶睡中吐舌更摇头，正此之谓。
治以固真汤加日生汤同煎，调宽气饮和解。阳痫者，因感惊风三次发搐，不与去风下痰，则
再发。然三次者，非一日三次也，或一月、或一季、一发惊搐，必经三度，故曰三次。所
谓惊风三发便为痫，即此义也。其病主身热自汗，两目上视，嚼沫切牙，手足掣搦，面
色红紫，六脉浮数，以百解散加五和汤，水煎疏解，次下痰，用水晶丹或半夏丸。胎痫
者因未产前，腹中被惊，或母食酸咸过多，或为七情所汨，致伤胎气，儿生百日内有者是
也。发时心不宁，面微黄，气逆痰作，目上视，身反张，啼声不出，先用参苏饮和解，次
以不惊丹，或琥珀抱龙丸间投，轻者可愈，重则亦危。六畜痫者，发时作牛马猪羊鸡犬声，
便致僵仆，口吐涎沫，不省人事。张氏论此。盖初发作羊犬声者，咽喉为风痰所梗，声自
如此，其理甚明。若言六畜者，特强名耳。凡得此证，宜多投疏风顺气化痰等剂，早为治
疗则免终身之患。
食痫者，因中焦不和，饮食时偶被惊搐，则惊气停滞中脘，食不克化，淹留日久，气
郁痰结，痰结则风热生，由此致疾。陈氏有曰∶结气而成痫，此其义也，宜宽中顺气，去
风痰，疗惊积，和脾胃，则安矣。狂痫者，亦属阳。《难经》云∶重阳则狂，至长成小儿才
发。时妄言不食而歌。甚则逾墙上屋。弃衣而走。或一日二日方醒。始因冒热感风，风
热内蓄，久则风痰郁结，上迷心包，盖心乃神之舍，偶为邪热攻逼，则神失所守而昏乱，
名曰狂痫。然心火肝木皆为物，火不自炎，因风吹起烟焰，木不自动，因风撼而自动摇，风
火合德。两阳相搏，其热可知。心藏神，肝主惊，因风生痰，以致于此。医者为治疗，既
能清心平肝，疏风退热，得病暂安，不与镇心下痰，则痰涎结实，停滞心络，病至再三，
加以发搐频数，难为治疗，必成废人，有曰惊痫即与此证相类，若乍感真疾，日月稍近，
法当解表散惊，及凉心肝，次下风痰，解表散惊百解散，凉心肝三解散、防风汤，下风
痰水晶丹、碧玉丸，更须临证参详，乃无失也。
《脉诀》说：大肠与肺共同负责传导排泄。因为肺与大肠互为表里，肛门是大肠的门户，如果肺实热则导致大便闭结不通，肺虚寒则导致直肠脱出外露。有的因为痢疾日久，出现里急后重，用力排便导致肛门脱出，被外风侵袭；或者因伏暑引起腹泻，肠道滑利不能固摄；或者先天禀赋怯弱，容易感受寒冷，也导致大肠虚脱。凡是小儿患的泻痢，都是因为暑湿风热乘脾胃虚弱而致病。因为风属木，木气过盛则克制土，土主脾胃，脾胃虚弱受制，加上湿气容易伤脾，因虚受湿，不能分别清浊，水谷混杂，就形成洞泄（急性水样腹泻）。洞泄久了，大肠也会虚弱。大肠属于手阳明燥金，土虚不能生金，金气既已虚弱，那么传导的功能也就虚弱，再加上被风冷侵袭，所以肛门脱出而不能收回。治法应当补脾温胃，使金得到母脏（脾土）的滋养而气实，宜用藿香饮、匀气散、平胃散为主治疗；其次内服固肠的药物，使用健脾饮、养脏汤；外用敷贴的方法，用伏龙肝散外敷，以及蓖麻膏贴在囟门，引导气机上提，使其自行回纳，如果完全收回了，仍用水洗去药膏。又有邪热积滞在大肠，未经疏通涤荡，也会造成这种病证。其肛门颜色红且软，肺脉浮数，右手食指指纹紫现，身体微有发热，时而烦躁，先投清肺饮疏解，其次用薄荷散、蟠龙散治疗，间服万安饮，也很好。
古人讨论痫证最多，大概在于观察形态切按脉搏，明确辨别阴阳，对证用药，不妄投汤剂为上策。阴痫，是因为慢惊风后痰未尽去，痰入心包所致，症状为四肢逆冷，吐舌摇头，口嚼白沫，牙关紧闭，但不怎么惊搐啼哭，面色或白或青，脉息沉微，所以《婴孩宝书》说：“睡中吐舌更摇头”，正是说的这种情况。治疗用固真汤加日生汤同煎，调宽气饮和解。阳痫，是因为感受惊风三次发作抽搐，如果不给予祛风下痰的治疗，就会再次发作。所谓的“三次”，并非一天三次，可能是一个月一次，或一个季度一次，每次惊搐发作，必须经过三次，所以叫三次。所谓“惊风三发便为痫”，就是这个意思。此病主要症状是身体发热自汗，两目上视，嚼沫切牙，手足抽搐掣动，面色红紫，六脉浮数，用百解散加五和汤，水煎疏解，其次下痰，用水晶丹或半夏丸。胎痫，是因为未出生前，腹部受到惊吓，或者母亲食用酸咸过多，或被七情所扰，导致损伤胎气，婴儿出生后一百天内发病的。发作时心神不宁，面色微黄，气逆痰作，眼睛上视，身体反张，啼哭不出声，先用参苏饮和解，其次用不惊丹，或琥珀抱龙丸间服，轻者可愈，重则也有危险。六畜痫，发作时发出牛马猪羊鸡犬的声音，随即僵仆倒地，口吐涎沫，不省人事。张氏对此有论述。大概初发作时发出羊犬叫声的，是因为咽喉被风痰阻塞，声音自然如此，道理很明白。如果说像六种牲畜，只是勉强命名的罢了。凡是得此证候，宜多投疏风顺气化痰等药剂，早为治疗则可免除终身之患。
食痫，是因为中焦不和，饮食时偶然受到惊吓抽搐，导致惊气停滞在中脘，食物不能消化，滞留日久，气郁痰结，痰结则风热产生，由此致病。陈氏曾说：“结气而成痫”，就是这个意思，宜宽中顺气，去风痰，疗惊积，和脾胃，就能安宁。狂痫，也属于阳证。《难经》说：重阳则狂，直到长成的小儿才发作。时常胡言乱语，不吃东西却唱歌。严重时翻墙爬屋，扔掉衣服奔跑。有时一两天才清醒。起初是因为冒热感风，风热内蓄，久了则风痰郁结，上迷心包，因为心是神的居所，偶尔被邪热攻逼，则神失去守持而昏乱，名叫狂痫。然而心火肝木都是物质，火不会自己燃烧，因为风吹起烟焰；木不会自己摇动，因为风吹而自动摇，风火合德。两阳相搏，其热度可知。心藏神，肝主惊，因风生痰，以致于此。医生在治疗时，既能清心平肝，疏风退热，使病情暂时安定，如果不配合镇心下痰，则痰涎结实，停滞在心络，病至再三，加上抽搐频繁，难以治疗，必成废人。有人说惊痫与此证相似，如果是刚感受真正的疾病，日子尚近，治法应当解表散惊，及凉心肝，其次下风痰。解表散惊用百解散，凉心肝用三解散、防风汤，下风痰用水晶丹、碧玉丸，更须临证详细参详，才不会失误。
The *Mai Jue* (Pulse Resolution) states: The Large Intestine and Lung jointly govern transmission and excretion. Since the Lung and Large Intestine are exterior-interiorly related, and the anus is the gate of the Large Intestine, if there is excess heat in the Lung, it leads to constipation and blockage; if there is deficiency cold in the Lung, it leads to prolapse of the rectum. Some cases arise from prolonged dysentery with tenesmus, straining during defecation causing anal prolapse, which is then blown by external wind; or due to latent summerheat causing diarrhea, where the intestines become slippery and unable to retain contents; or due to innate frailty making one susceptible to cold, also leading to deficiency collapse of the Large Intestine. All diarrheal and dysenteric conditions in children result from summerheat-dampness, wind-heat attacking the deficiency of the Spleen and Stomach. Wind belongs to Wood; when Wood is excessive, it overacts on Earth. Earth governs the Spleen and Stomach; when deficient and controlled, combined with dampness easily injuring the Spleen, and receiving dampness due to deficiency, the body fails to separate the clear from the turbid. Water and grain mix together, resulting in *dongxie* (profuse watery diarrhea). Prolonged *dongxie* weakens the Large Intestine. The Large Intestine belongs to Hand Yangming Dry Metal; when Earth is deficient, it cannot generate Metal. Once Metal Qi is deficient, the pathway of transmission becomes weak, and being attacked by wind-cold, the anus prolapses and cannot retract. The treatment method should tonify the Spleen and warm the Stomach, allowing Metal to receive benefit from its mother (Earth) so that Qi becomes substantial. One should primarily use Huoxiang Yin (Agastache Decoction), Yunqi San (Qi-Balancing Powder), and Pingwei San (Stomach-Calming Powder). Secondly, internally administer intestinal-astringing agents such as Jianpi Yin (Spleen-Tonifying Decoction) and Yangzang Tang (Nourishing Viscera Decoction). Externally apply Fu Long Gan San (Dragon’s House Earth Powder) or castor paste to the fontanelle to guide Qi upward, allowing spontaneous retraction. Once fully retracted, wash off the paste with water. Another cause is pathogenic heat and stagnation in the Large Intestine not having been cleared, which also results in this condition. The anus appears red and soft, the Lung pulse is floating and rapid, the purple pattern is visible on the right index finger vein, there is slight fever, and occasional irritability. Initially administer Qingfei Yin (Lung-Clearing Decoction) to disperse and resolve, followed by Bohe San (Mint Powder) and Panlong San (Coiling Dragon Powder), with intermittent administration of Wan’an Yin (Ten-Thousand Peace Decoction), which is also excellent.
Ancients discussed epilepsy (*xian*) extensively, emphasizing observing physical signs and palpating pulses, clearly differentiating Yin and Yang, and prescribing medication according to patterns, avoiding reckless decoction administration. Yin epilepsy arises from incomplete elimination of phlegm after slow convulsion syndrome, where phlegm enters the Pericardium. Symptoms include cold extremities, protruding tongue, head shaking, chewing white foam, locked jaw, but without severe convulsions or crying. Complexion may be pale or greenish, and the pulse is deep and faint. Thus, the *Ying’er Bao Shu* (Treasured Book for Infants) states: “Protruding tongue and head shaking while sleeping” refers precisely to this. Treatment involves Guozhen Tang (Solidify True Decoction) combined with Risheng Tang (Daily Generation Decoction), harmonized with Kuanqi Yin (Broadening Qi Decoction). Yang epilepsy results from experiencing convulsive wind three times; if wind-dispelling and phlegm-draining treatments are not applied, it recurs. The term "three times" does not mean three times a day, but rather occurring once a month or season, requiring three episodes of convulsion to establish the diagnosis. Hence, “convulsive wind becoming epilepsy after three attacks.” Main symptoms include fever with spontaneous sweating, eyes rolling upward, chewing foam and grinding teeth, limb spasms, reddish-purple complexion, and floating-rapid pulses throughout. Use Baijie San (Hundred Releases Powder) plus Wuhe Tang (Five Harmonies Decoction) decocted in water to disperse and resolve, followed by Phlegm-draining agents like Shuijing Dan (Crystal Pill) or Banxia Wan (Pinellia Pill). Fetal epilepsy occurs due to fright experienced by the fetus in utero, excessive consumption of sour/salty foods by the mother, or emotional disturbances damaging fetal Qi, manifesting within 100 days after birth. During attacks, there is mental restlessness, slightly yellow complexion, rebellious Qi with phlegm production, upward gaze, opisthotonos, and inability to cry. First use Shenru Yin (Ginseng and Evodia Decoction) to harmonize, then intermittently administer Bu Jing Dan (No-Fright Pill) or Hupo Baolong Wan (Amber Embracing Dragon Pill). Mild cases recover; severe cases are critical. Six-animal epilepsy manifests with sounds resembling cattle, horses, pigs, sheep, chickens, or dogs during attacks, followed by sudden collapse, foaming at the mouth, and unconsciousness. Zhang’s treatise discusses this. When initially producing sheep or dog sounds, it is because the throat is obstructed by wind-phlegm, explaining the sound naturally. Referring to six animals is merely a forced name. For any such syndrome, frequent administration of wind-dispersing, Qi-regulating, and phlegm-resolving agents is suitable; early treatment prevents lifelong disability.
Food-induced epilepsy arises from middle-jiao disharmony, where accidental fright during eating causes Qi stagnation in the Middle Jiao, preventing food digestion. Prolonged retention leads to Qi stagnation and phlegm accumulation; phlegm accumulation generates wind-heat, causing disease. Chen stated: “Accumulated Qi forms epilepsy,” which aligns with this mechanism. Treatment should broaden the middle and regulate Qi, dispel wind-phlegm, treat fright-stagnation, and harmonize the Spleen and Stomach. Manic epilepsy also belongs to Yang. The *Nan Jing* (Classic of Difficult Issues) states: “Extreme Yang leads to mania,” typically appearing in older children. Symptoms include incoherent speech, anorexia with singing, climbing walls or roofs, discarding clothes and running, sometimes remaining unconscious for one or two days. Initially caused by exposure to heat and wind, leading to internal accumulation of wind-heat; long-term stagnation causes wind-phlegm to confuse the Pericardium. Since the Heart houses the Spirit, pathogenic heat forces the Spirit to lose its residence, resulting in confusion, named manic epilepsy. Heart Fire and Liver Wood are material entities; fire does not ignite itself but requires wind to spread flames; wood does not move itself but requires wind to sway. Wind and Fire act together. Two Yangs clashing indicates intense heat. The Heart stores Spirit, the Liver governs Fright; wind generates phlegm, leading to this condition. Physicians must clear the Heart and calm the Liver, disperse wind and reduce heat to achieve temporary stability. Without calming the Heart and draining phlegm, phlegm-saliva becomes solidified and stagnates in the Heart collaterals. Recurrent attacks with frequent convulsions become difficult to treat, potentially leading to permanent disability. Some argue convulsive epilepsy is similar to this. If recently contracted, the method should involve releasing the exterior and dispersing fright, cooling the Heart and Liver, followed by draining wind-phlegm. Release exterior and disperse fright using Baijie San; cool Heart and Liver using Sansanjie San (Three Releases Powder) or Fangfeng Tang (Saposhnikovia Decoction); drain wind-phlegm using Shuijing Dan or Biyu Wan. Clinical consultation is essential to avoid error.