（俗所谓慢脾风者是也）
按此证必先由于吐泻，有脾胃两伤者、有专伤脾阳者、有专伤胃阳者、有伤及肾阳者，参苓白术
散、四君、六君、异功、补中益气、理中等汤，皆可选用。虚寒甚者，理中加丁香、肉桂、肉果、诃子之
类，因他病伤寒凉药者，亦同此例。叶案中有阴风入脾络一条，方在小儿痫痉厥门中，其小儿吐泻门
中，言此证最为详细。案后华岫云驳俗论最妙，学人不可不静心体察焉！再参之钱仲阳、薛立
斋、李东垣、张景岳诸家，可无余蕴矣。再按此证最险，最为难治，世之讹传妄治已久，四海同
风，历有年所，方中行驳之于前，诸君子畅论于后。至今日而其伪风不息，是所望于后之强有力者，悉
取其伪书而焚耳。细观叶案治法之妙，全在见吐泻时，先防其痉，非于既痉而后设法也。故余前治
六淫之痉，亦同此法，所谓上工不治已病治未病。圣人不治已乱治未乱也。
（俗称谓惊吓是也）
按小儿神怯气弱，或见非常之物，听非常之响，或失足落空，跌扑之类，百证中或有一、二，非
小儿所有痉病，皆因于惊吓也。证现发热，或有汗，或无汗，面时青时赤，梦中呓语，手足蠕动，宜
复脉汤去参、桂、姜、枣，加丹参、丹皮、犀角，补心之体，以配心之用。大便结者，加元参，溏者加牡
蛎；汗多神不宁有恐惧之象者，加龙骨、整琥珀、整朱砂块（取其气而不用其质，自无流弊），必细询病
家确有所见者，方用此例。若语涉支离，猜疑不定者，静心再诊，必得确情，而后用药。
愚儿三岁，六月初九日辰时，倚门落空，少时发热，随热随痉，昏不知人，手足如冰，无脉，至戌
时而痉止，身热神昏无汗；次日早，余方与复脉汤去参、桂、姜、枣，每日一帖，服三、四杯。不饮不
食，至十四日巳时，得战汗而愈。若当痉厥神昏之际，妄动乱治，岂有生理乎！盖痉厥则阴阳逆乱，
少不合拍则不可救，病家情急，因乱投药饵，胡针乱灸而死者，不可胜纪。病家中无主宰，医者又无
主宰，儿病其何堪哉！如包络热重，唇舌燥，目白睛有赤缕者，牛黄清心丸，本论牛黄安宫丸，紫雪
丹辈，亦可酌而用之。
（这就是民间所说的慢脾风。）
按：这种病症必定先由呕吐和腹泻引起，有的是脾胃两伤，有的是专门损伤脾阳，有的是专门损伤胃阳，有的甚至伤及肾阳。参苓白术散、四君子汤、六君子汤、异功散、补中益气汤、理中汤等方剂，都可以酌情选用。如果是虚寒严重的情况，在理中汤基础上加入丁香、肉桂、肉豆蔻、诃子等药物；如果是因其他疾病误用伤寒凉药导致的，也遵循同样的治疗原则。叶天士医案中有一条关于“阴风入脾络”的记载，方剂收录在小儿痫证、痉病、厥证门类中，而在小儿吐泻门类中对此证的论述最为详细。医案后的华岫云驳斥世俗谬论非常精妙，学习中医的人不可不静心体察！再参考钱乙（钱仲阳）、薛己（薛立斋）、李杲（李东垣）、张介宾（张景岳）等医家的观点，对此病的认识就可以没有遗漏了。另外，此证最为凶险，最难治疗，世间讹传和误治已久，四海之内风气相同，已有多年。方有执在前提出驳斥，各位君子在后进一步阐发。直到今天，这种伪邪之风仍未止息，这是希望后来有影响力的人，能将这些伪书全部烧毁。仔细研读叶天士的治疗法则之妙处，全在于见到呕吐腹泻时，预先防止其发展为痉病，而不是等到已经发生痉病后再想办法救治。所以我之前治疗外感六淫引起的痉病，也采用同样的方法，这就是所谓的高明医生不治疗已发生的疾病，而是预防疾病的发生；圣人治理国家，不治理已发生的动乱，而是预防动乱的产生。
（这就是民间所说的惊吓所致。）
按：小儿心神怯弱、正气不足，或者看到不寻常的事物，听到不寻常的声音，或者失足踏空、跌倒撞击等情况，在所有病症中只有一小部分属于此类，并非所有小儿痉病都是由于惊吓引起的。症状表现为发热，或有汗，或无汗，面色时而青紫时而赤红，睡梦中说胡话，手足蠕动，宜用复脉汤去掉人参、桂枝、生姜、大枣，加入丹参、牡丹皮、犀角，以滋补心之阴血（体），从而配合心之阳气（用）。大便干结的，加玄参；大便稀溏的，加牡蛎；出汗多且神志不安、有恐惧表现的，加龙骨、整块琥珀、整块朱砂（取其气味而不用其质地，自然不会有副作用）。必须详细询问患儿家属，确认确实有受惊吓的经历，才使用此法。如果家属叙述支离破碎、猜疑不定，应静心再次诊察，务必弄清真实病情，然后再用药。
我的儿子三岁，六月初九日辰时，倚靠门框时失足踏空，过了一会儿发热，随即出现痉病，昏迷不省人事，手足冰冷，无脉搏，到了戌时痉病停止，身体发热、神志昏沉、无汗；第二天早上，我给予复脉汤去掉人参、桂枝、生姜、大枣，每日一剂，分三到四次服用。患儿不饮不食，到了十四日巳时，通过战汗而痊愈。如果在痉厥神志昏迷之际，胡乱折腾治疗，哪里还有生机呢！大概痉厥会导致阴阳逆乱，稍微不合拍就无法挽救，家属情急之下，因此乱投药物，胡乱针灸而导致死亡的，数不胜数。病人家中没有主见，医生又没有主见，小孩子怎么能承受得住呢！如果心包络热重，嘴唇舌头干燥，眼白部分有血丝的，可用牛黄清心丸，本书中的牛黄安宫丸、紫雪丹之类，也可以酌情使用。
(This is what is commonly referred to as Slow Spleen Wind.)
Note: This syndrome must initially stem from vomiting and diarrhea. It may involve injury to both the Spleen and Stomach, or specifically injure the Yang of the Spleen, or specifically injure the Yang of the Stomach, or even injure the Kidney Yang. Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), Si Jun Zi Tang (Four Gentlemen Decoction), Liu Jun Zi Tang (Six Gentlemen Decoction), Yi Gong San (Extraordinary Power Powder), Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), and Li Zhong Tang (Regulate the Middle Decoction) are all selectable formulas. In cases of severe deficiency-cold, Ding Xiang (Clove), Rou Gui (Cinnamon Bark), Rou Dou Kou (Nutmeg), and He Zi (Chebula Fruit) can be added to Li Zhong Tang. If caused by the misuse of cold-natured medicines for other diseases, the same principle applies. Ye Tianshi’s medical records contain a case on "Yin Wind Entering the Spleen Collaterals," with the formula listed in the section on pediatric epilepsy, spasms, and syncope; the discussion in the pediatric vomiting and diarrhea section is the most detailed. Hua Xiuyun’s refutation of popular misconceptions at the end of the record is exquisite; students of medicine must carefully contemplate it. By also consulting the works of Qian Yizhi (Qian Yi), Xue Lijia (Xue Ji), Li Dongyuan (Li Gao), and Zhang Jingyue (Zhang Jiebin), one will have no further doubts. Furthermore, this condition is extremely dangerous and difficult to treat. Misinformation and erroneous treatments have persisted for a long time, becoming a widespread custom over many years. Fang Youzhi refuted this earlier, and subsequent scholars elaborated upon it. Yet today, this false notion remains unextinguished; I hope that future influential figures will burn these spurious texts entirely. Careful observation of Ye Tianshi’s therapeutic brilliance reveals that its essence lies in preventing spasms when vomiting and diarrhea first appear, rather than devising treatments after spasms have already occurred. Thus, my previous treatment of spasms caused by the Six Exogenous Pathogens followed the same method. This is what is meant by: "A superior physician treats disease before it arises"; just as sages govern chaos before it occurs.
(This is what is commonly referred to as fright-induced.)
Note: Children have fragile spirits and weak Qi. They may be frightened by unusual sights or sounds, or by falling into empty space, stumbling, or being struck. Among all syndromes, only one or two cases fall into this category; not all pediatric spasms are caused by fright. The presentation includes fever, with or without sweating, complexion alternating between cyanotic and red, muttering in sleep, and writhing of hands and feet. One should use Mai Mai Dong Tian Dong Fu Ling Ren Shen Gan Cao Sheng Di Huang Gui Ban Jia Mu Dan Pi Zhe Bei Mu E Jiao Tang (Replenish the Pulse Decoction) minus Ren Shen (Ginseng Root), Gui Zhi (Cinnamon Twig), Sheng Jiang (Fresh Ginger), and Da Zao (Jujube), adding Dan Shen (Salvia Miltiorrhiza Root), Mu Dan Pi (Moutan Cortex), and Xi Jiao (Rhinoceros Horn). This nourishes the substance of the Heart to harmonize with its function. For constipation, add Yuan Shen (Scrophularia Root); for loose stools, add Mu Li (Oyster Shell). For excessive sweating with restlessness and signs of fear, add Long Gu (Dragon Bone), whole Hu Po (Amber), and whole Zhu Sha (Cinnabar) [taking their qi/energy rather than their physical substance avoids adverse effects]. One must carefully inquire with the family to confirm a specific frightening incident before applying this method. If the account is disjointed and uncertain, remain calm and re-examine the patient to ascertain the true situation before prescribing.
My son was three years old. On the morning of the ninth day of the sixth lunar month (Chen hour), he fell while leaning against a door frame. After a short while, he developed fever, which was immediately followed by spasms. He fell into a coma, his limbs were ice-cold, and his pulse was imperceptible. By Xu hour, the spasms ceased, but he remained febrile, comatose, and anhidrotic. The next morning, I prescribed Replenish the Pulse Decoction minus Ginseng, Cinnamon Twig, Fresh Ginger, and Jujube, one dose daily, administered in three to four cups. The child refused food and drink. On the fourteenth day at Si hour, he recovered through a shivering sweat. Had we acted rashly during the height of the spasms and coma, there would have been no chance of survival. Spasms and syncope cause a reversal and disorder of Yin and Yang; any slight mismatch in treatment is incurable. Desperate families often administer random medications or undergo indiscriminate acupuncture and moxibustion, leading to countless deaths. When neither the family nor the physician has clear judgment, how can the child endure? If the Pericardium Heat is heavy, manifested by dry lips and tongue and red streaks in the whites of the eyes, Niu Huang Qing Xin Wan (Calculus Bovis Clear the Heart Pill), Ben Lun Niu Huang An Gong Wan (An Gong Niu Huang Pill from this Treatise), or Zi Xue Dan (Purple Snow Pellet) may be considered.