（按此一条，螈痉兼有，其因于寒湿者，则兼太阳寒水气，其泄泻太甚，下多亡阴者，木气来乘，则螈矣）
按中湿即痉者少，盖湿性柔而下行，不似风刚而上升也。其间有兼风之痉，《名医类案》中有
一条云∶“小儿吐 欲作痫者，五苓散最妙”；本论湿温上焦篇，有三仁汤一法；邪入心包，用清宫
汤去莲心、麦冬，加银花赤小豆皮一法；用紫雪丹一法；银翘马勃散一法；千金苇茎汤加滑石、杏仁
一法；而寒湿例中，有形似伤寒，舌白不渴，经络拘急，桂枝姜附汤一法，凡此非必皆现痉病而后治。
盖既感外邪，久则致痉，于其未痉之先，知系感受何邪，以法治之，而痉病之源绝矣，岂不愈于见痉
治痉哉！若儿科能于六淫之邪，见几于早，吾知小儿之痉病必少。湿久致痉者多，盖湿为浊邪，最善
弥漫三焦，上蔽清窍，内蒙膻中，学人当于前中焦下焦篇中求之。由疟痢而致痉者，见其所伤之偏
阴偏阳而补救之，于疟痢门中求之。
燥气化火，消烁津液，亦能致痉，其治略似风温，学人当于本论前三焦篇秋燥门中求之。但正
秋之时，有伏暑内发，新凉外加之证，燥者宜辛凉甘润，有伏暑则兼湿矣，兼湿则宜苦辛淡，甚则苦
辛寒矣，不可不细加察焉。燥气化寒，胁痛呕吐，法用苦温，佐以甘辛。
（按语：这一条论述中，抽搐和痉挛同时存在。如果病因是寒湿，则兼有太阳经寒水之气；如果泄泻过于严重，导致阴液大量流失，肝木之气就会乘虚侵袭，从而引发抽搐。）
一般来说，单纯因湿邪导致的痉挛很少见，因为湿性柔和且向下走，不像风邪那样刚劲且向上行。其中也有兼夹风邪而致痉的情况，《名医类案》中有一条记载：“小儿呕吐、想要发作癫痫的，用五苓散效果最好”；本书《湿温上焦篇》中，有一法使用三仁汤；邪气侵入心包，有一法使用清宫汤去掉莲心和麦冬，加入银花和赤小豆皮；有一法使用紫雪丹；有一法使用银翘马勃散；有一法使用千金苇茎汤加入滑石和杏仁；而在寒湿的例子中，症状看似伤寒，舌苔白且不口渴，经络拘急不舒，有一法使用桂枝姜附汤。以上这些方法，并不一定要等到出现痉挛病症后才进行治疗。大概是因为既然已经感受了外邪，时间久了就会导致痉挛，在尚未出现痉挛之前，知道是感受了什么邪气，针对邪气进行治疗，那么痉挛病的根源就被断绝了，这难道不比见到痉挛才治疗痉挛好吗！如果儿科医生能在六淫邪气致病初期就及早发现，我知道小儿的痉挛病一定会减少。湿邪久留导致痉挛的情况很多，因为湿是浊邪，最容易弥漫在三焦，上蔽清窍，内扰膻中，学习者应当在本书的中焦和下焦篇中寻找相关论述。由疟疾和痢疾导致痉挛的，要观察其损伤偏向阴还是阳来进行补救，在疟疾和痢疾的门类中寻求治法。
燥气化火，消耗灼伤津液，也能导致痉挛，其治疗方法大致类似风温，学习者应当在本书前三焦篇秋燥门类中寻求治法。但在初秋时节，有伏暑在内发动、新凉在外侵袭的病证，燥邪适宜用辛凉甘润之法，如果有伏暑则兼夹湿邪了，兼夹湿邪则适宜用苦辛淡渗之法，严重时甚至要用苦辛寒凉之法，不可不仔细加以考察。燥气转化为寒邪，出现胁痛呕吐，治法应用苦温，佐以甘辛。
(Note: In this clause, convulsions and spasms occur simultaneously. If the etiology is cold-dampness, it involves the Cold-Water Qi of the Taiyang (Greater Yang) channel; if diarrhea is excessively severe, leading to a massive loss of Yin fluids, the Wood Qi [Liver] will invade due to deficiency, resulting in convulsions.)
Generally, spasms caused solely by dampness are rare, because the nature of dampness is soft and descends, unlike wind which is rigid and ascends. Among these, there are cases where wind is combined with dampness to cause spasms. *Famous Medical Cases* records one case stating: "For infants suffering from vomiting and impending epilepsy, Wu Ling San (Five-Ingredient Powder with Poria) is most effective"; in the Upper Jiao chapter on Damp-Warmth of this treatise, there is a method using San Ren Tang (Three-Seed Decoction); when pathogenic factors enter the Pericardium, there is a method using Qing Gong Tang (Palace-Clearing Decoction) with Nelumbinis Plumula (Sacred Lotus Plumule) and Ophiopogonis Radix (Maidong) removed, plus Lonicerae Japonicae Flos (Jinyinhua) and Phaseoli Semen Rubrum (Chixiaodou) added; there is a method using Zi Xue Dan (Purple Snow Pill); there is a method using Yin Qiao Ma Bo San (Honeysuckle, Toadflax, and Alkanna Powder); there is a method using Qianjin Wei Jing Tang (Qianjin Reed Rhizome Decoction) plus Atractylodis Macrocephalae Rhizoma (Baizhu) and Armeniacae Semen Amarum (Xingren) added [Note: Original text says Huashi and Xingren, corrected to standard WHO terms for context but keeping original ingredients]: Coeli Fructus (Huashi) and Armeniacae Semen Amarum (Xingren); and in examples of Cold-Dampness, where symptoms resemble Taiyang disease, with a white tongue coating and no thirst, and stiffness/tension of the collaterals, there is a method using Guizhi Jiang Fu Tang (Cinnamon Twig, Ginger, and Aconite Decoction). All these methods do not necessarily require waiting for spasm symptoms to manifest before treatment. Essentially, once external pathogens have invaded, prolonged illness can lead to spasms. Before spasms occur, identifying the specific pathogen involved and treating accordingly cuts off the source of the spasm disease. Is this not superior to treating only after spasms appear? If pediatricians could detect the signs early regarding the Six Excesses (Six Pathogenic Factors), I believe infantile spasms would be significantly reduced. Spasms caused by long-standing dampness are common, as dampness is turbid pathogenic factor that easily diffuses throughout the Three Jiaos (Triple Burners), obscuring the clear orifices above and disturbing the Chest Center (Shanzhong) within. Students should seek relevant discussions in the Middle and Lower Jiao chapters of this treatise. For spasms resulting from malaria and dysentery, one should observe whether the injury leans toward Yin or Yang and provide remedial treatment, seeking methods within the sections on malaria and dysentery.
Dryness transforming into Fire, consuming and scorcing Body Fluids, can also cause spasms. Its treatment is slightly similar to Wind-Warmth. Students should seek methods in the Autumn Dryness section of the first three Jiao chapters of this treatise. However, during early autumn, there are conditions where latent Summerheat erupts internally while fresh Coolness attacks externally. For Dryness, acrid-cool and sweet-moistening methods are appropriate; if latent Summerheat is present, it combines with Dampness. When combined with Dampness, bitter-acrid and diaphoretic/diuretic methods are appropriate; in severe cases, bitter-acrid-cold methods are used. This requires careful examination. When Dryness transforms into Cold, presenting with hypochondriac pain and vomiting, the treatment method uses bitter-warm agents, assisted by sweet-acrid agents.