小儿慢惊,因病后,或吐泻,或药饵伤损脾胃,而肢体逆冷,口鼻气微,手足螈 ,昏睡露睛,此脾虚生
风,无阳之症也。小儿初生吐热吐 ,身体强直,手足抽掣,目反直视,是胎惊风症也。
清惊散,治小儿痉厥螈 。陈胆星九分,飞辰砂一分研细,以竹沥小半杯,生姜汁一小匙和匀,再用麦冬
一钱,橘红八分,薄荷尖一分,煎汤调服。《医镜》云∶俗云急惊风,乃痰火闭也。小儿或感风寒,或积乳食,
皆能生痰,痰积则化火,或受暑热亦生火,失于清解,则火升而痰亦升,痰火上壅,闭其肺窍,则诸窍皆开。
其证目直气喘,昏闷不醒,且火甚则肝燥筋急,为搐搦掣颤,反张窜视,而八候生焉。总由闭结,肝风内动而
成,非惊吓也。当其拘挛弓仰之时,不可用力紧抱,但以手扶,听其自抽自止,庶不伤经络而成废人。初起宜
通关散开其嚏,得嚏则醒。次以竹沥或梨汁、莱菔汁,和入石菖蒲汁灌之,火降痰平,则病自已。愈后宜清热
养阴,勿投温补。
抱龙丸∶琥珀五钱,辰砂三钱,雄黄七钱,麻油煎十二时,再用水萝卜汁煮胆星二两一钱,僵蚕四钱,炒
去嘴足,全蝎三钱,研末,用石榴一枚,剜,共以无灰酒调末填入盖定,坐文火上,徐徐搅动成膏,取出冷定。
用牛黄一钱,麝香五分,天竺黄七钱,赤茯苓一两。上各为末,蒸饼为丸,金箔为衣,灯心薄荷汤送下。王晋
三曰∶此方集肝经之药为复方,初无深意。一方加人参二钱,培植正气以御肝风,紫河车三钱五分,即蚤休草
切片,黑 豆制,能伏牛黄、丹朱砂之毒,并可治惊祛风。二味却有妙义,当纂入方中。
孙文垣治侄孙女,周岁发慢惊,眼开手拳,目不动移,脚趾微动,自囟门后,遍身如火,喉中痰声,口
中痰沫,腹胀下气,大便亦先行,以牛黄丸、苏合丸进之不效。后与药,皆从痰沫流出。通关散吹鼻无嚏,自
申至戌不醒。面色素青白,气禀甚弱,因婢女抱之失跌,受惊发热,此惊气乘虚而入,法在不治。姑以人参三
钱,姜汁拌炒,煎汤频频用匙挑入口中。初三四匙皆不受,又与五六匙,得一二匙下咽,便觉痰声少缓,因频
频与之。喉中气转,目能动,再以六君子汤加天麻、石菖蒲、僵蚕、泽泻、薄荷煎服,乃略啼,吮乳。次日咳
嗽,语声不出,小水短少,以辰砂益元散一钱,灯心汤调下。热退声出,改以四君子汤加陈皮、五味、麦冬、
桑白皮、桔梗、杏仁、薄荷,一帖全愈。
冯楚瞻治黄氏儿,甫五月,忽发抽掣窜引,角弓反张,一夜五次,发则二便并出,额汗如雨,势甚危笃。
冯视之,亡阳之势俱备矣。询其由,因常生重舌,屡服五福化毒丹,服后必泻数次即愈。盖阳虚肆进苦寒,脾
阳下元亏极,肝木无养,挟火上乘,脾土益伤,虚风乃发。以人参、白术各一钱,熟附四分煎服,服后安然静
睡。下午复发,随服随安,数帖而愈。
吴孚先治一小儿,吐泻后失于调治,忽痰涎上涌,面色青白,似搐不搐,右手脉沉迟而弱,关纹隐隐,手
足微冷。此慢惊也,不速治即成慢脾莫救。用白术、人参、甘草、黄 、半夏、炒冬瓜仁、炮姜、制附而安。
龚子才治一小儿,目内色青发搐,目上视,叫哭不已。或用牛黄清心丸不愈,反切牙顿闷,小便自遗,此
肝经血虚甚故耳。用补中益气汤及六味丸而瘥。
一小儿潮热,手足发搐,痰涎上涌,手足指冷,左腮自申酉时青中隐白,此肝经虚弱,肺金所胜而潮搐,
脾土虚弱而足冷也。用补中益气汤以补脾肺,六味丸以补肝肾而愈。盖病气有余,当认为元气不足,若用泻金
伐肝,清热化痰则误矣。
一小儿呕吐不食,手足搐搦,痰涎上涌,手足指冷,额黑唇青,此肾水胜心火也。用五味异功散加木香、
炮姜顿安。乃去炮姜,再剂而愈。(亦是脾虚之症。)
立斋治太平王职坊子,患疟疾,恪用化痰之剂,虚症悉至,殊类惊风。曰∶小便频数,肝经阴虚也;两目
连札,肝经风热矣;作呕懒食,胃气虚弱也;泄泻后重,脾气虚弱也。用补中益气汤,六味地黄丸而痊。
大君刘应昌子,患瘰 ,恪服化痰之剂,又服祛风至宝丹,致与前症同,亦用二方而愈。
叶弘士之子,岁半慢惊,服金石药,乃风痰之剂,昏闷七日,指纹直抵三关,医辞不治。予投以加减补脾
汤立愈。(《慈幼篇》。)
陈文中治尚书洪端明子,始生未及三个月,腹胀满,足肚冷,囟门高急,上气涎潮,四肢搐搦。同坐众官,
皆言死症。洪公曰∶我在前死了七八个儿子,皆是这般症候,此儿子足见难医,枉废生受。亦不召医视之。或
告陈,因往视,而谓之曰∶小官人此症候不死,尚可救活。洪公曰∶此儿必死,毋劳用计。众官皆曰∶陈君高
明,既有救疗之心,劝洪公从说。乃用油珠膏一服,次用长生丸一服,便下黄稠粘涎约半盏,内有白奶块,如
小豆大十余块,是风痰结聚乳奶,一并便下。后用前胡浓朴散,加附子两片,二服而愈。(《病源方论》。)
淮西戴运使小娘子,始生周岁,腹中气响,痰涎壅闭,手足抽掣。欲与芎蝎散,斡取痰涎。运使曰∶儿子
小,恐难根据此施治。陈曰∶前制参刘菊坡小儿,始生五个月,因作搐,乃服芎蝎散斡去痰涎,次服油珠膏即愈,
菊坡赠一跋于卷末。今运使小娘子,因惊吓蓄冷气于喉厌间,传入肝胆,其气上不能升,下不能降,血与气俱
不能流转,故致痰涎壅闭而作搐也。若不能根据此施治,小娘子必将不起。遂以芎蝎散一服,更用手法斡去喉厌
寒痰,约有半盏,次用油珠膏二服,后用补脾益真汤三服,再用前胡浓朴散、长生丸各二服而愈。(同上。)
万密斋治一小儿,二岁,发搐已死,家人痛哭,乃阻之曰∶此儿面色未脱,手足未冷,乃气结痰涌而闷绝,
非真死也。取艾作小炷,灸两手中冲穴,火方及肉而醒,大哭,父母皆喜。遂用家传治惊方,以雄黄解毒丸十
五丸利其痰,凉惊丸二十五丸去其热,合之煎薄荷汤送下。须臾,利下痰涎而搐止矣。
一儿发搐痰涌,有医用白饼子下之不退,凡三下,病益深,合目昏睡,不哭不乳,喉中气鸣,上气喘促,
大便时下。万曰∶五脏气绝,不可治,转下之过也。彼医曰∶白饼子,钱氏下痰神方也。万曰∶尽信书不如无
书,钱氏小儿,皆出于门人附会之事也。(虞天民谓钱乙书出于门人阎孝忠所集,非钱氏本意。)盖人之有痰,
犹木之有津,时
令大热,草木流津,痰自热生,此明证也。痰犹水也,附气自行,过显在山,岂水之性哉,乃搏激使之也。今
痰随火上,不知降火,而反下之,损其胃气,胃气既败,五脏俱损。故目不开者,肝绝也;昏睡不语者,脾绝
也;啼声不出者,心绝也;喘促痰响者,肺绝也;便尿遗失者,肾绝也。果不可治而死。(雄按∶论痰中肯。)
巴中有儒医者,治病多奇方,惟性太执,不知变通。时有两小儿发搐,万谓急惊,当用凉血导赤散、泻青
丸是也。彼谓惊风者,肝火郁遏而成也。火郁则发之,(论极是。)小续命汤是也。(方大谬。)人不能决,两
从之。万所治者,一日而安。彼治者死,悔无及也。
一儿发搐,先取善推法者推之,止而后发,病益危甚。万曰∶推法者,乃针灸按摩之遗意也。经曰∶无刺
大虚人。推掐之法,壮实者可用之。如怯弱者,其气不行,推则有汗,反伤元气也。其家不信。万曰∶不死必
成痫。半月后果死。
一儿发搐,因用推法。万曰∶病成痫矣。推法者,乃发表之意,痰聚在心,不得出也。幸初成痫,当可治。
若久则为终身痼疾,不可治也。立方用黄连五钱,朱砂二钱五分,白甘遂三分,胆星一钱,为末,米糊为丸,
猪心血杵匀,丸芡实大。每服一丸,灯草煎汤化下,夜服三,日服一,遂安。
一儿发搐,医以二陈汤、姜汁、竹沥治之不效。万视其外候,三关青气,两颊赤色,目常直视,指如捻物。
曰∶此得之外感,未与发散,热入于里。钱氏曰,肝有热,则目直视,得心热,则发搐。又曰,颊赤而目直视,
必作惊风。小儿肝常有余,又乘木旺之时,当与泻肝。若二陈汤,陈皮、半夏、生姜之辛,皆助肝之物,经曰
以辛补之,所以无效。乃用泻青丸泻肝木之有余,导赤散以泻心经之火,一服而搐即止。因其胎禀素怯,脾胃
且弱,恐后作搐,便成痫疾。又与琥珀丸,常服而安。
一小儿周岁,发热而搐,以泻青丸投之不效。乃问其发搐之状,其母曰∶搐过后只好睡,以乳与之则饮,
不与则不思,醒时则戏作猫儿声,见人则笑,不发搐,便是好了。万曰∶医要识症,药要对症,怪底前药之不
效也。以导赤散服之,一剂而安。其父问故,曰∶心脏属火,其声为笑。火生于寅,属虎。猫者,虎之类也。
猫声而笑,知非肝病,乃心病也,故以导赤散泻其心火而安。(可称绝世聪明。)
一儿发搐,五日不醒,药石难入。万针其三里、合谷、人中而醒。父母喜曰∶吾儿未出痘疹,愿结拜为父,
乞调养之。万曰∶曩用针时,针下无气,此禀赋不足也。如调数年后出痘,可保无事,若在近年,不敢许。次
年果以痘疹死。
张子和治一小儿,病手足搐搦。张曰∶心火胜也,勿持其手,当听之。此由乳母保抱太急所致。乃令扫净
地,以水洒之,待其干,令复洒之,令极湿,俯卧儿于地上良久,浑身转侧,泥 皆满矣,仍以水洗之,少顷
而瘥。
子和曰∶小儿风热惊搐,乃常病也。当搦时,切戒抱捉手足,握持太急,必半身不遂也。气血偏胜,必痹
其一臂,渐成细瘦,至老难治。当其搐时,置一竹簟,铺之凉地,使儿寝其上,待其搐,风力行遍经络,搐极
自止,不至伤人。
予尝诊一儿,见其左掌拳曲,询其由,乃小时患惊搐,为母抱持太急,病愈,手遂不能伸舒。按此症,
若初得以大剂肝肾阴剂与之,必能伸舒如故,惜世无知者。
葛茂林治少师杨公子,当暑而惊眩已绝,且移之木矣。葛趋而入曰∶无伤也,亟出之。公曰∶儿已噤矣,
奈何剂也?葛曰∶予无剂也,所恃者,天上云耳。云生而凄凄欲雨,阴气舒而阳郁消。吾以清利物煮水而蒸于
下,其可瘳乎。果如其法而疾愈。迨暮,儿复戏于庭矣。(《杭州府志》。)
薛立斋治一小儿,三岁,因惊搐搦,发热痰盛,久服抱龙丸等药,反致面色或赤或青。此心肝二经血虚,
风热生痰,不足之象也。用六味丸滋肾水,生肝血,用六君、柴胡、升麻调补脾胃而安。
高鼓峰治徐彦为子,甫四岁,盛夏发热,惊搐不已,腰曲目直,小便短赤,面无神色。医作伤寒不应。高
视之曰∶火燥生风,风淫末疾,非伤寒也。用滋水清肝饮,尽一剂而汗解,便利热退。高曰∶疟至矣,立用五
味异功散,(补脾。)加麦冬、五味,(生脉清暑。)十余剂而愈。
陆肖愚治鞠氏子,年十一,向因水土不便,泄泻瘦弱,四月终旬,蒸热淫雨,忽患头面大肿,手足身体亦
微肿。或谓风热,与苏叶、羌、防、升麻、柴、葛等,汗大泄,既而痰涌吐逆,语言不伦,身强直,手足振掉。
又谓急惊风,用抱龙、镇心等丸不效。脉之,浮缓而弱,此因脾虚土不胜水,且湿气盛行,内湿与外湿相感而
作肿,治而健脾渗湿,乃反发汗,致升动其脏腑之痰涎,漏泄其经络之津液,宜其变症若此也。因用六君子汤
加归、芍投之,一剂而吐止,数剂而僵直振掉除。又数剂精神复,加泽泻,倍茯苓,数十剂,下肿消,泻止。
薛立斋治宪幕顾斐斋元孙二周,项结核,两臂反张,索败毒,果系前症,遂与六味丸一服,清晨灌之,午
后肢体如常。
一儿两目札动,手足发搐,数服天麻防风丸之类,以祛风化痰,前症不愈,其痰益甚,得饮食诸症稍愈。
视其准头及左颊,色青黄。曰∶脾主涎,此肝木制脾土,不能统摄其涎,非痰盛也。遂用六君子汤加升麻、柴
胡、钩藤,二剂饮食渐进,诸症渐愈,又用补中益气而安。
万密斋治一小儿,痰壅发搐,气促而喘,而礞石滚痰丸,桑白皮煎汤,碾碎调服之,喘定痰下,搐亦止矣。
一小儿七月,发搐无时,昏睡不醒,不哭不乳,掐之札之不痛, 之鼻不嚏,灌药不入。曰∶此真搐也,
不可治矣。
密斋父治一小儿,盈月后发搐,以至圣保命丹治之而安。
喻嘉言治门人王生表兄沙无翼之子,纵啖生硬冷物,一夕吐食暴僵,不省人事。医以惊风药治之,浑身壮
热,面若装朱,眼吊唇掀,下利沾污。诊毕谓曰∶此慢脾风候也。脾气素伤,更以金石药重伤,今已将绝,故
显若垂危症。本有法可救,但须七日方醒,恐信不笃而更医,无识反得诿罪生谤。王生坚请监督其家,且以代
劳,且以壮胆。于是用乌蝎四君子汤,每日灌一大剂,每剂用人参一钱。渠家虽暗慌,然见面赤退,而色转明
润,便泻止而动移轻活,似有欲言不言之意,亦自隐忍。至第六晚,忽觉手足不宁,揭去衣被,始极诋人参之
小儿慢惊风,多因患病之后,或呕吐腹泻,或因药物损伤脾胃,导致四肢逆冷,口鼻气息微弱,手足抽搐,昏睡且眼睛半睁露出眼白,这是脾虚生内风,属于阳气衰微的证候。
小儿刚出生时出现吐热、吐涎沫,身体强直,手足抽掣,眼球上翻直视,这是胎惊风证。
清惊散,用于治疗小儿痉挛厥逆及抽搐。配方为:陈胆星九分,飞辰砂一分,研成细末;用竹沥小半杯,生姜汁一小匙,调和均匀;再加入麦冬一钱,橘红八分,薄荷尖一分,煎汤调服。《医镜》说:世俗所说的急惊风,其实是痰火闭阻所致。小儿感受风寒,或乳食积滞,都能生痰,痰积聚则化火,或者感受暑热也会生火,若失于清热解表,则火势上升,痰也随之上升,痰火上壅,闭塞肺窍,那么全身诸窍都会开启(如口开、手撒等)。其症状表现为两眼直视、气喘、昏迷不醒,且火热炽盛导致肝燥筋脉拘急,出现抽搐、震颤、角弓反张、窜视等症状,从而产生“八候”(急惊风的八种典型症状)。这总归是由于闭结不通,肝风内动而成,并非受到惊吓所致。当患儿拘挛、身体后仰时,不可用力紧紧抱住,只需用手轻轻扶持,听任其自行抽搐停止,这样才不会损伤经络而成为废人。初起时宜用通关散吹鼻取嚏,打喷嚏后患儿即可苏醒。随后用竹沥或梨汁、莱菔汁,加入石菖蒲汁灌服,待火降痰平,病自然痊愈。病愈后宜清热养阴,不要投用温补药物。
抱龙丸:琥珀五钱,辰砂三钱,雄黄七钱,用麻油煎煮十二个时辰;再用水萝卜汁煮胆星二两一钱,僵蚕四钱(炒去嘴足),全蝎三钱,研成粉末;用一个石榴,挖空果肉,将药末填入其中,盖好,放在文火上,慢慢搅拌成膏状,取出冷却凝固。再用牛黄一钱,麝香五分,天竺黄七钱,赤茯苓一两,各研成粉末,用蒸饼做丸,以金箔为衣,灯心草、薄荷汤送下。王晋三说:这个方子集合了入肝经的药物作为复方,原本没有深意。另一方中加入人参二钱,以培植正气来抵御肝风;紫河车三钱五分(即蚤休草切片,黑豆制过),能制约牛黄、丹砂朱红的毒性,并且可以治疗惊风。这两味药却很有妙处,应当收录进方剂中。
孙文垣治疗侄孙女,周岁时发生慢惊风,眼睛睁开但手握拳,眼球不动,脚趾微微颤动,从囟门后面开始,全身发烫如火,喉中有痰声,口中流痰沫,腹胀排气,大便先排出,服用牛黄丸、苏合丸无效。后来喂的药,都从痰沫中流出。用通关散吹鼻也不打喷嚏,从申时到戌时一直不醒。面色素来青白,禀赋很弱,因为婢女抱着她失足跌倒,受惊发热,这是惊气乘虚而入,法度上认为难以治愈。姑且用人参三钱,姜汁拌炒,煎汤频频用勺子挑入口中。初三四勺都不接受,又喂五六勺,才咽下一二勺,便觉得喉中痰声稍缓,因此频繁喂服。喉中气息转动,眼睛能动,再用六君子汤加天麻、石菖蒲、僵蚕、泽泻、薄荷煎服,孩子稍微啼哭,吮吸乳汁。第二天咳嗽,说不出话,小便短少,用辰砂益元散一钱,灯心草汤调下。热退声音发出,改为四君子汤加陈皮、五味子、麦冬、桑白皮、桔梗、杏仁、薄荷,一帖药完全痊愈。
冯楚瞻治疗黄氏的儿子,刚五个月大,突然发作抽搐牵引,角弓反张,一夜发作五次,发作时大小便同时失禁,额头出汗如雨,形势非常危急。冯楚瞻诊察后,认为亡阳的征象都已具备。询问病因,是因为孩子常患重舌症,屡次服用五福化毒丹,服药后必然腹泻几次才好。这是因为阳气虚弱却肆意进服苦寒药物,导致脾阳和下元亏损至极,肝木失去滋养,挟带火热上乘,脾土更加受伤,虚风于是发作。用人参、白术各一钱,熟附子四分煎服,服药后安然静睡。下午再次发作,随服随安,几帖药后痊愈。
吴孚先治疗一个小孩,在呕吐腹泻后失于调理,突然痰涎上涌,面色青白,似有抽搐之象但未真正抽搐,右手脉沉迟而弱,指纹隐隐可见,手脚微冷。这是慢惊风,如果不迅速治疗就会变成慢脾风而无法救治。用白术、人参、甘草、黄芪、半夏、炒冬瓜仁、炮姜、制附子,病情得以安定。
龚子才治疗一个小孩,目内眦色青并发搐,眼球上视,叫哭不止。有人用牛黄清心丸治疗未愈,反而出现咬牙、昏闷,小便自遗,这是肝经血虚严重的缘故。用补中益气汤和六味丸而痊愈。
一个小孩潮热,手足发搐,痰涎上涌,手指脚指冷,左腮从申时到酉时青色中隐现白色,这是肝经虚弱,被肺金所克制而出现潮热抽搐,脾土虚弱而导致脚冷。用补中益气汤来补脾肺,六味丸来补肝肾而痊愈。大概病气有余,应当认为是元气不足,如果用泻肺金、伐肝木、清热化痰的方法就错了。
一个小孩呕吐不食,手足搐搦,痰涎上涌,手指脚指冷,额头发黑嘴唇发青,这是肾水克制心火。用五味异功散加木香、炮姜,顿然安宁。然后去掉炮姜,再服两剂而痊愈。(这也是脾虚的证候。)
薛立斋治疗太平王职坊的儿子,患疟疾,严格使用化痰的药物,导致虚症全部出现,很像惊风。他说:小便频数,是肝经阴虚;两眼连眨,是肝经风热;作呕懒食,是胃气虚弱;泄泻里急后重,是脾气虚弱。用补中益气汤、六味地黄丸而痊愈。
大君刘应昌的儿子,患瘰疬,严格服用化痰的药物,又服用祛风至宝丹,导致与前症相同,也用这两个方子而痊愈。
叶弘士的儿子,一岁半得慢惊风,服用金石药和风痰之剂,昏迷七天,指纹直抵三关,医生推辞不治。我投以加减补脾汤,立刻痊愈。(《慈幼篇》。)
陈文中治疗尚书洪端明的儿子,出生不到三个月,腹胀满,小腿肚冷,囟门高突紧急,上气痰潮,四肢抽搐。同座的众官员都说这是死症。洪公说:“我在前头死了七八个儿子,都是这种症候,这个儿子显然难治,白白受苦。”也不请医生诊治。有人告诉陈文中,于是前往诊治,对他说:“小官人这个症候不死,还可以救活。”洪公说:“这个孩子必死无疑,不必劳神用计。”众官员都说:“陈君高明,既然有救疗之心,劝洪公听从建议。”于是用油珠膏一服,接着用长生丸一服,随即排出黄稠粘涎约半盏,里面有白奶块,像小豆大的十余块,这是风痰结聚在乳奶中,一并排出。后用前胡浓朴散,加附子两片,两服而痊愈。(《病源方论》。)
淮西戴运使的小女儿,刚满周岁,腹中气响,痰涎壅闭,手足抽搐。想要用芎蝎散,通过手法引出痰涎。运使说:“孩子小,恐怕难以据此施治。”陈文中说:“之前制参刘菊坡的小儿,刚五个月大,因为抽搐,服用芎蝎散引出痰涎,接着服用油珠膏就痊愈了,菊坡在卷末赠送了一篇跋文。现在运使的小女儿,因为惊吓蓄积冷气于喉厌之间,传入肝胆,气上不能升,下不能降,血与气都不能流转,所以导致痰涎壅闭而抽搐。如果不能据此施治,小女儿必将不治身亡。”于是用芎蝎散一服,更用手法引出喉厌寒痰,约有半盏,接着用油珠膏两服,后用补脾益真汤三服,再用前胡浓朴散、长生丸各两服而痊愈。(同上。)
万密斋治疗一个小孩,两岁,发作抽搐已死,家人痛哭,万密斋阻止他们说:“这孩子面色未脱,手足未冷,这是气结痰涌导致闷绝,不是真死。”取艾绒做成小炷,灸两手中冲穴,火刚接触到皮肤孩子就醒了,大哭,父母都很高兴。于是用家传治惊方,用雄黄解毒丸十五丸利其痰,凉惊丸二十五丸去其热,合在一起煎薄荷汤送下。一会儿,利下痰涎而抽搐停止。
一个小孩发搐痰涌,有医生用白饼子攻下,不退,凡三次攻下,病更深,闭目昏睡,不哭不乳,喉中气鸣,上气喘促,大便不时排出。万密斋说:“五脏气绝,不可治,这是转下太过的过错。”那个医生说:“白饼子是钱乙下痰的神方。”万密斋说:“尽信书不如无书,钱乙的小儿医学,都是出于门人的附会之事。(虞天民认为钱乙的书出自门人阎孝忠所集,并非钱氏本意。)人有痰,就像树有津液,时令大热,草木流津,痰自热生,这是明证。痰就像水一样,依附气自行,过分显露在山间,难道是水本性吗?是被搏激使之如此。现在痰随火上,不知降火,反而攻下,损伤胃气,胃气既败,五脏俱损。所以眼睛不开,是肝绝;昏睡不语,是脾绝;啼声不出,是心绝;喘促痰响,是肺绝;大小便遗失,是肾绝。果然不可治而死。(徐灵胎按:论述痰症切中肯綮。)”
巴中有位儒医,治病多用奇方,但性格固执,不知变通。当时有两个小孩发搐,万密斋说是急惊风,应当用凉血导赤散、泻青丸。那位医生说是惊风,是肝火郁遏而成。火郁则发之,(论述极是),用小续命汤。(方剂大谬。)众人不能决断,两人分别依从各自的治疗。万密斋治疗的,一天就安宁。那位医生治疗的死了,后悔莫及。
一个小孩发搐,先找擅长推拿的人推拿,止住后又发作,病情更加危重。万密斋说:“推拿之法,是针灸按摩的遗留意思。经书说:不要针刺大虚之人。推掐之法,壮实者可用。如怯弱者,其气不行,推拿则有汗,反而损伤元气。”家属不信。万密斋说:“不死必定变成癫痫。”半个月后果然死亡。
一个小孩发搐,因为用了推拿法。万密斋说:“病已成癫痫了。推拿法是发表的意思,痰聚在心,不得出也。幸好初成癫痫,应当可治。如果久了就是终身痼疾,不可治。”立方用黄连五钱,朱砂二钱五分,白甘遂三分,胆星一钱,研末,米糊为丸,猪心血捣匀,丸如芡实大。每服一丸,灯草煎汤化下,夜服三次,日服一次,于是安宁。
一个小孩发搐,医生用二陈汤、姜汁、竹沥治疗无效。万密斋看其外候,三关青气,两颊赤色,眼睛常直视,手指像捻物。说:“这是得之外感,未予发散,热入于里。钱乙说,肝有热,则目直视,得心热,则发搐。又说,颊赤而目直视,必作惊风。小儿肝常有余,又乘木旺之时,应当泻肝。若用二陈汤,陈皮、半夏、生姜之辛,都是助肝之物,经书说以辛补之,所以无效。”于是用泻青丸泻肝木之有余,导赤散以泻心经之火,一服而抽搐即止。因其胎禀素来怯弱,脾胃且弱,恐日后发作抽搐,便成痫疾。又给琥珀丸,常服而安宁。
一个小孩周岁,发热而抽搐,用泻青丸投治无效。于是问其抽搐的情况,母亲说:“抽搐过后只好睡觉,给奶喝就喝,不给就不想喝,醒着时就学着猫叫,见人则笑,不发搐,就好了。”万密斋说:“医生要识症,药要对症,难怪前药不效。”用导赤散服之,一剂而安。父亲问原因,说:“心脏属火,其声为笑。火生于寅,属虎。猫者是虎之类也。学猫叫而笑,知道不是肝病,乃心病也,故用导赤散泻其心火而安。(可称绝世聪明。)”
一个小孩发搐,五天不醒,药石难入。万密斋针刺其足三里、合谷、人中穴而醒。父母高兴地说:“我儿未出痘疹,愿结拜为父,乞求调养。”万密斋说:“刚才用针时,针下无气,这是禀赋不足。如调养几年后出痘,可保无事,若在近年,不敢许诺。”次年果以痘疹死。
张子和治疗一个小孩,病手足抽搐。张子和说:“心火胜也,不要握住他的手,应当听任其自然。”这是由于乳母抱持太急所致。于是让人扫净地面,洒水,待其干,再令其极湿,让小孩俯卧在地上良久,浑身转侧,泥巴都沾满了,仍以水洗之,少顷而痊愈。
张子和说:“小儿风热惊搐,是常病。当抽搐时,切忌抱捉手足,握持太急,必致半身不遂。气血偏胜,必痹其一臂,渐成细瘦,至老难治。当其抽搐时,放置一张竹席,铺在凉地上,让孩子睡在上面,待其抽搐,风力行遍经络,抽搐极时自然停止,不至伤人。”
我曾诊察一个小孩,见其左掌拳曲,询问原因,是因为小时候患惊搐,被母亲抱持太急,病愈后,手遂不能伸舒。按此症,若初得时用大剂肝肾阴剂与之,必能伸舒如故,可惜世上无知者。
葛茂林治疗少师杨公的儿子,当暑天而惊眩已绝,且已经移尸到木床上。葛茂林快步进入说:“无妨,赶快移出。”杨公说:“孩子已牙关紧闭,怎么办?”葛茂林说:“我不用药,所依靠的是天上的云。云生而凄凄欲雨,阴气舒而阳郁消。我用清利物煮水在下面蒸煮,可以吗?”果然如其法而疾病痊愈。到了傍晚,孩子在庭院中嬉戏了。(《杭州府志》。)
薛立斋治疗一个小孩,三岁,因惊搐搦,发热痰盛,久服抱龙丸等药,反致面色或赤或青。这是心肝二经血虚,风热生痰,不足之象。用六味丸滋肾水,生肝血,用六君子汤、柴胡、升麻调补脾胃而安宁。
高鼓峰治疗徐彦为的儿子,刚四岁,盛夏发热,惊搐不已,腰曲目直,小便短赤,面无神色。医生当作伤寒治疗不应。高鼓峰诊察说:“火燥生风,风淫末疾,非伤寒也。”用滋水清肝饮,尽一剂而汗解,便利热退。高鼓峰说:“疟疾将至了,立即用五味异功散,(补脾。)加麦冬、五味,(生脉清暑。)十余剂而痊愈。
陆肖愚治疗鞠氏的儿子,年十一岁,向来因水土不便,泄泻瘦弱,四月终旬,蒸热淫雨,忽患头面大肿,手足身体亦微肿。有人说风热,给予苏叶、羌活、防风、升麻、柴胡、葛根等,汗大泄,继而痰涌吐逆,语言不伦,身强直,手足振掉。又说是急惊风,用抱龙、镇心等丸无效。诊脉,浮缓而弱,这是因脾虚土不胜水,且湿气盛行,内湿与外湿相感而作肿,治而健脾渗湿,乃反发汗,导致升动其脏腑之痰涎,漏泄其经络之津液,宜其变症若此也。因而用六君子汤加当归、芍药投之,一剂而吐止,数剂而僵直振掉除。又数剂精神复,加泽泻,倍茯苓,数十剂,下肢肿消,泻止。
薛立斋治疗宪幕顾斐斋的玄孙二周,项部结核,两臂反张,索要败毒散,果系前症,遂与六味丸一服,清晨灌之,午后肢体如常。
一个小孩两眼眨动,手足发搐,数服天麻防风丸之类,以祛风化痰,前症不愈,其痰益甚,得饮食诸症稍愈。视其鼻准及左颊,色青黄。说:“脾主涎,这是肝木制脾土,不能统摄其涎,非痰盛也。”遂用六君子汤加升麻、柴胡、钩藤,二剂饮食渐进,诸症渐愈,又用补中益气而安宁。
万密斋治疗一个小孩,痰壅发搐,气促而喘,用礞石滚痰丸,桑白皮煎汤,碾碎调服之,喘定痰下,搐亦止矣。
一个小孩七月大,发搐无时,昏睡不醒,不哭不乳,掐之眨眼但不痛,捏鼻不喷嚏,灌药不入。说:“这是真搐,不可治矣。”
密斋的父亲治疗一个小孩,满月后发搐,以至圣保命丹治之而安。
喻嘉言治疗门人王生的表兄沙无翼的儿子,纵食生冷硬物,一夕呕吐食物暴僵,不省人事。医生用惊风药治疗,浑身壮热,面若装朱,眼吊唇掀,下利沾污。诊毕谓曰:“这是慢脾风候。脾气素伤,更以金石药重伤,今已将绝,故显若垂危症。本有法可救,但须七日方醒,恐信不笃而更医,无识反得诿罪生谤。”王生坚请监督其家,且以代劳,且以壮胆。于是用乌蝎四君子汤,每日灌一大剂,每剂用人参一钱。渠家虽暗慌,然见面赤退,而色转明润,便泻止而动移轻活,似有欲言不言之意,亦自隐忍。至第六晚,忽觉手足不宁,揭去衣被,始极诋人参之
Pediatric slow convulsion (Man Jing) often occurs after an illness, or due to vomiting and diarrhea, or because medication has damaged the Spleen and Stomach, resulting in cold limbs, weak breath from the mouth and nose, twitching of hands and feet, drowsiness with eyes half-open showing the whites, which is a syndrome of wind generated by Spleen deficiency, belonging to the category of Yang deficiency.
When infants are first born, if they exhibit vomiting of heat or phlegm-fluids, body rigidity, twitching of hands and feet, upward staring of the eyes, this is the fetal convulsion (Tai Jing Feng) syndrome.
Qingjing San (Clear Convulsion Powder) is used to treat pediatric spasms, convulsions, and twitching. The prescription consists of: Chen Danning (Arisaema Cum Bile) 9 fen, Fei Chensha (Prepared Cinnabar) 1 fen, ground into fine powder; mixed evenly with a small half cup of Zhuli (Bamboo Juice) and one small spoonful of Shengjiang Zhi (Ginger Juice); then add Maidong (Ophiopogon Tuber) 1 qian, Juhong (Citrus Reticulatae Pericarpium Rubrum) 8 fen, Bohe Jian (Mentha Haplocalycis Apex) 1 fen, decocted in water to mix with the powder for administration. *Yi Jing* states: The popular term "acute convulsion" (Ji Jing Feng) actually refers to obstruction by Phlegm-Fire. Infants may contract Wind-Cold or have milk/food retention, both of which can generate Phlegm; accumulated Phlegm transforms into Fire, or exposure to Summer-Heat also generates Fire. If not cleared and resolved promptly, the Fire rises and carries Phlegm upward; Phlegm-Fire obstructs the Lung orifices, causing all orifices to open (such as open mouth, relaxed hands). Symptoms include straight staring eyes, wheezing, coma, and when Fire is severe, it causes Liver dryness and tendon tension, leading to twitching, tremors, opisthotonos, and darting gaze, thus generating the "Eight Signs" (Ba Hou) of acute convulsion. This is fundamentally caused by internal blockage and stirring of Liver Wind, not by fright. When the child is in spasm or arching backward, do not hold tightly; simply support gently with hands, allowing spontaneous cessation of twitching, so as not to damage meridians and cause disability. Initially, use Tongguan San (Open the Pass Powder) insufflated into the nose to induce sneezing; upon sneezing, the child awakens. Subsequently, administer Zhuli (Bamboo Juice) or Lizhi (Pear Juice), Laifuzhi (Radish Juice) mixed with Shichangpu (Acori Tatarinowii Rhizoma) juice via gavage. Once Fire descends and Phlegm settles, the disease resolves naturally. After recovery, clear Heat and nourish Yin; avoid warm tonification.
Baolong Wan (Embrace Dragon Pill): Hupo (Amber) 5 qian, Chensha (Cinnabar) 3 qian, Xionghuang (Realgar) 7 qian, fried in Sesame Oil for twelve shichen (24 hours); then boil Dansheng (Arisaema Cum Bile) 2 liang 1 qian, Jiangcan (Bombyx Batryticatus) 4 qian (stir-fried to remove heads and feet), Quanxie (Scorpio) 3 qian, grinding them into powder. Take one pomegranate, hollow out the flesh, fill with the powder, cover, place on gentle fire, stir slowly until paste forms, then cool and solidify. Add Niuhuang (Calculus Bovis) 1 qian, Shexiang (Moschus) 0.5 qian, Tianzhuhuang (Spatholobi Caulis / Note: Text says Tian Zhu Huang, usually Spatholobus or related, but standard is often Spatholobus or similar resinous substance, here likely referring to a specific preparation or typo for Tian Nan Xing variant, but sticking to text: Tianzhu Huang 7 qian), Chi Fuling (Red Poria) 1 liang. Each ground into powder, made into pills with steamed wheat dough, coated with Jinbo (Gold Leaf), administered with Dengxin Cao (Junci Medulla) and Bohe (Mentha) decoction. Wang Jinshan said: This formula combines herbs entering the Liver channel as a compound prescription, originally without deep meaning. Another version adds Renshen (Ginseng Radix et Rhizoma) 2 qian to cultivate Righteous Qi to resist Liver Wind; Zi Heche (Placenta Humana) 3.5 qian (sliced Zigoucao / Paris Polyphylla, processed with Black Soybeans) can neutralize the toxicity of Niuhuang and Chensha, and treats fright and dispels wind. These two ingredients have subtle significance and should be included.
Sun Wenyuan treated his niece, who at one year old developed slow convulsion. Her eyes were open but hands clenched, eyes immobile, toes slightly trembling. From behind the fontanelle, her whole body felt hot like fire, with rattling phlegm in the throat and frothy saliva in the mouth. She had abdominal distension, passing gas, and loose stools. Niuhuang Wan (Calculus Bovis Pill) and Suhé Wan (Liquid Amber Pill) were ineffective. Medications given later were expelled with phlegm. Tongguan San insufflation induced no sneeze. From Shen hour to Xu hour, she remained unconscious. Her complexion was pale cyan-white, constitution very weak. Due to a maid dropping her while holding her, she suffered fright fever. This is Fright Qi entering due to deficiency, considered incurable by protocol. Tentatively, Renshen (Ginseng Radix et Rhizoma) 3 qian, stir-fried with Ginger Juice, decocted and frequently spoon-fed. Initially refused three or four spoons, then five or six, swallowing one or two, after which throat rattling eased slightly, so feeding continued. Throat breathing improved, eyes moved. Then Liu Junzi Tang (Six Gentlemen Decoction) plus Tianma (Gastrodiae Rhizoma), Shichangpu (Acori Tatarinowii Rhizoma), Jiangcan (Bombyx Batryticatus), Zexie (Alismatis Rhizoma), Bohe (Mentha Haplocalycis Herba) were decocted and administered. She cried slightly and suckled milk. Next day, cough, loss of voice, scanty urination. Chen Sha Yi Yuan San (Cinnabar Yi Yuan Powder) 1 qian, taken with Dengxin Cao (Junci Medulla) decoction. Heat subsided, voice returned. Changed to Sijunzi Tang (Four Gentlemen Decoction) plus Chenpi (Citri Reticulatae Pericarpium), Wuweizi (Schisandrae Fructus), Maidong (Ophiopogon Tuber), Sangbaipi (Mori Cortex), Jiegeng (Platycodonis Radix), Xingren (Armeniacae Semen Amarum), Bohe (Mentha Haplocalycis Herba). One dose resulted in complete cure.
Feng Chuzhan treated the son of the Huang family, aged five months. Suddenly developed twitching and pulling, opisthotonos, occurring five times a night. During attacks, urine and stool were incontinent. Forehead sweated profusely. Condition critical. Feng diagnosed signs of Yang collapse. Inquiry revealed frequent occurrence of "double tongue" (heavy tongue), repeatedly treated with Wufu Huadu Dan (Five Blessings Detoxifying Pill), always resolving after several diarrheal episodes. This indicates Yang deficiency exacerbated by bitter-cold drugs, severely depleting Spleen Yang and Lower Yuan. Liver Wood lacked nourishment, carrying Fire upward, further injuring Spleen Earth, leading to empty Wind. Ren Shen (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) 1 qian each, Shu Fuzi (Prepared Aconiti Lateralis Radix) 4 fen, decocted and administered. Child slept peacefully after taking. Recurred in afternoon, settled immediately upon administration. Resolved after several doses.
Wu Fuxian treated a child who, after vomiting and diarrhea without proper care, suddenly had phlegm-saliva surging upward, pale cyan complexion, apparent but not actual convulsions, right hand pulse deep, slow, and weak, finger vein faintly visible, hands and feet slightly cold. This is slow convulsion. Without prompt treatment, it becomes slow spleen wind, incurable. Used Baizhu (Atractylodis Macrocephalae Rhizoma), Renshen (Ginseng Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Huangqi (Astragali Radix), Banxia (Pinelliae Rhizoma), Chao Dongguaren (Stir-fried Benincasae Semen), Paojiang (Prepared Zingiberis Rhizoma), Zhi Fuzi (Prepared Aconiti Lateralis Radix). Condition stabilized.
Gong Zicai treated a child with cyan color in inner canthus, convulsions, upward staring, incessant crying. Niuhuang Qingxin Wan (Calculus Bovis Clear Heart Pill) failed, worsening symptoms to teeth-grinding, coma, and urinary incontinence. This is severe Blood deficiency of the Liver channel. Treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Liuwang Wan (Six Flavor Pill) for recovery.
A child with tidal fever, hand-foot convulsions, surging phlegm-saliva, cold fingers and toes. Left cheek showed cyan hue with hidden white from Shen to You hours. This is Liver channel weakness, overcome by Lung Metal, causing tidal convulsions; Spleen Earth weakness causing cold feet. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) tonified Spleen and Lung; Liuwang Wan (Six Flavor Pill) tonified Liver and Kidney. Cure. Generally, excess pathogenic qi should be recognized as insufficient Yuan Qi. Using methods to drain Lung Metal, attack Liver Wood, clear Heat, and resolve Phlegm would be erroneous.
A child with vomiting, anorexia, hand-foot convulsions, surging phlegm-saliva, cold fingers and toes, black forehead, cyan lips. This is Kidney Water overcoming Heart Fire. Wuyi Gongsan (Five Agents Extraordinary Powder) plus Muxiang (Aucklandiae Radix), Paojiang (Prepared Zingiberis Rhizoma) brought immediate relief. Remove Paojiang, two more doses cured. (Also a Spleen deficiency syndrome.)
Xue Lizhai treated the son of Wang Zhifang in Taiping, who had malaria. Strict use of phlegm-resolving agents led to full manifestation of deficiency syndromes, resembling convulsion. He stated: Frequent urination indicates Liver Yin deficiency; continuous eye blinking indicates Liver Wind-Heat; nausea and poor appetite indicate Stomach Qi weakness; diarrhea with tenesmus indicates Spleen Qi weakness. Treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Liuwei Dihuang Wan (Six Flavor Rehmannia Pill) for cure.
Son of Grand Lord Liu Yingchang had scrofula (Luoli). Strict use of phlegm-resolving agents and Qufeng Zhibao Dan (Wind-Expelling Precious Pill) led to similar symptoms. Also cured with these two formulas.
Son of Ye Hongshi, 1.5 years old, slow convulsion. Took mineral drugs and wind-phlegm agents. Comatose for seven days, finger vein reached the Three Passes. Doctors refused treatment. I administered Jiabian Bupi Tang (Modified Spleen-Tonifying Decoction) for immediate cure. (*Ciyou Pian*).
Chen Wenzhong treated the son of Scholar Hong Duanming, under three months old. Abdominal distension, cold calves, high/tense fontanelle, upper airway phlegm tide, limb convulsions. Officials present declared it a death case. Mr. Hong said: "I lost seven or eight sons previously with these exact symptoms. This one is hard to treat, suffering in vain." Did not call a doctor. Someone told Chen Wenzhong, who visited and said: "This symptom is not fatal, can be saved." Mr. Hong: "Child will die, no need for tricks." Officials urged Mr. Hong to listen to Chen's expertise. Used Youzhu Gao (Oil Pearl Paste) once, then Changsheng Wan (Longevity Pill) once. Excreted about half a cup of yellow thick sticky phlegm, containing over ten white milk curds the size of mung beans. This was wind-phlegm congealed with milk, excreted together. Then used Qianhu Nongpo San (Peucedani and Magnolia Bark Powder) plus two slices of Fuzi (Aconiti Lateralis Radix). Two doses cured. (*Bingyuan Fanglun*).
Young daughter of Dai Yunshi from Huaixi, one year old. Abdominal rumbling, phlegm-saliva obstruction, limb convulsions. Wanted to use Xiongxi San (Saussureae and Scorpio Powder) to extract phlegm via manipulation. Yunshi said: "Child is young, difficult to treat thus." Chen said: "Previously, Son of Vice Minister Liu Jupō, five months old, had convulsions. Xiongxi San extracted phlegm, followed by Youzhu Gao (Oil Pearl Paste) cured him. Jupō wrote a postscript. Now, Miss Dai, due to fright, cold qi accumulated in the throat/pharynx, transmitted to Liver/Gallbladder. Qi cannot ascend or descend, blood and qi stagnate, causing phlegm obstruction and convulsion. If not treated thus, she will die." Used Xiongxi San (Saussureae and Scorpio Powder) once, manipulated to extract cold phlegm from pharynx (~half cup), then Youzhu Gao (Oil Pearl Paste) twice, then Bupi Yizhen Tang (Spleen-Tonifying True-Essence Decoction) three times, then Qianhu Nongpo San (Peucedani and Magnolia Bark Powder) and Changsheng Wan (Longevity Pill) twice each. Cured. (Same source).
Wan Mizhai treated a two-year-old child who appeared dead after convulsions. Family weeping. Wan stopped them: "Complexion not faded, limbs not cold. This is Qi stagnation and phlegm surge causing suffocation, not true death." Moxibustion on Zhongchong (PC 9) bilaterally with small moxa cones. Awakened upon heat contact, cried loudly. Parents rejoiced. Used family secret convulsion formula: Xionghuang Jiedu Wan (Realgar Detoxifying Pill) 15 pills to drain phlegm, Liangjing Wan (Cool Convulsion Pill) 25 pills to clear heat. Mixed, taken with Mint decoction. Soon, phlegm drained, convulsions stopped.
A child with convulsions and phlegm surge. Doctor used Baixingzi (White Cake Pill) purgative three times without effect. Disease worsened. Eyes closed, drowsy, no crying/suckling, throat wheezing, rapid upper breathing, intermittent stool. Wan said: "Five Zang Qi exhausted, incurable. Error lies in excessive purgation." Doctor: "Baixingzi is Qian’s divine phlegm-draining formula." Wan: "Better to have no books than to believe them blindly. Qian’s pediatric texts were compiled/apocryphal by disciples. (Yu Tianmin noted Qian Yi’s book was collected by disciple Yan Xiaozhong, not Qian’s original intent.) Phlegm in humans is like sap in trees. In extreme heat, trees flow sap; phlegm generates from heat, evident proof. Phlegm is like water, moving with Qi. Excessive accumulation in mountains is forced, not nature. Now phlegm follows Fire up. Not cooling Fire, but purging damages Stomach Qi. Once Stomach Qi fails, Five Zang suffer. Unopen eyes = Liver exhaustion; drowsy/silent = Spleen exhaustion; no cry = Heart exhaustion; wheezing/phlegm sound = Lung exhaustion; incontinence = Kidney exhaustion. Indeed incurable, died. (Xu Lingtai notes: Discussion hits the mark regarding phlegm.)"
A Confucian physician in Bazhong used many strange prescriptions but was rigid. Two children had convulsions. Wan said: Acute convulsion, use Liangxue Daochi San (Cool Blood Guide Out Red Powder) and Xieqing Wan (Drain Green Pill). Physician said: Convulsion is Liver Fire depression. "Depressed Fire should be dispersed," (Correct theory), using Xiao Xuming Tang (Minor Rescue Decoction). (Formula largely wrong). Public undecided, both tried. Wan’s patient recovered in one day. Physician’s patient died, regret too late.
A child convulsed. First treated by a skilled tuina practitioner. Stopped, then recurred, condition critical. Wan said: Tuina is legacy of acupuncture/massage. Classics say: Do not needle great deficiency. Tuina/pinching suitable for robust. For weak, Qi does not move; tuina induces sweat, damaging Yuan Qi. Family disbelieved. Wan predicted: "If not die, will become epilepsy." Died half month later.
Another child convulsed due to tuina. Wan said: Disease became epilepsy. Tuina is releasing exterior method. Phlegm gathered in Heart, cannot exit. Fortunately early stage, treatable. Chronic becomes lifelong incurable fixed disease. Formula: Huanglian (Coptidis Rhizoma) 5 qian, Zhusha (Cinnabar) 2.5 qian, Bai Gansui (Euphorbia kansui root) 3 fen, Dansheng (Arisaema Cum Bile) 1 qian. Powder, rice paste pills, pig heart blood kneaded, pill size of Euryale seed. One pill per dose, Juncus decoction to dissolve. Night 3 times, day 1 time. Settled.
Child convulsed. Doctor used Erchen Tang (Two Aged Decoction), Ginger Juice, Bamboo Juice. Ineffective. Wan observed: Three passes cyan, cheeks red, eyes staring straight, fingers pinching motion. Said: Exterior contraction, not released, Heat entered interior. Qian Yi said: Liver Heat -> staring eyes; Heart Heat -> convulsions. Also: Cheeks red + staring eyes -> must become convulsion. Children’s Liver is often in excess, especially in Wood prosperous season. Should drain Liver. Erchen Tang contains Chenpi, Banxia, Shengjiang (pungent), which aid Liver. Classics: Pungent tonifies. Hence ineffective. Used Xieqing Wan (Drain Green Pill) to drain Liver excess, Daochi San (Guide Out Red Powder) to drain Heart Fire. One dose stopped convulsions. Due to innate weakness and Spleen/Stomach fragility, feared future convulsions becoming epilepsy. Given Hubo Wan (Amber Pill) for regular use. Settled.
One-year-old child, fever and convulsion. Xieqing Wan (Drain Green Pill) ineffective. Asked mother about convulsion state. Mother: Sleeps well after convulsion, drinks milk if offered, ignores if not. Awake, makes cat sounds, smiles at people. No convulsion = healed. Wan said: Doctor must recognize syndrome, medicine must match. No wonder previous meds failed. Used Daochi San (Guide Out Red Powder). One dose settled. Father asked why. Wan: Heart belongs to Fire, sound is laughter. Fire born in Yin, associated with Tiger. Cat is tiger-like. Cat sound + laughter indicates Heart disease, not Liver. Thus Daochi San drains Heart Fire. (Called peerless wisdom.)
Child convulsed, unconscious 5 days, meds hard to enter. Wan needled Zusanli (ST 36), Hegu (LI 4), Renzhong (GV 26). Awakened. Parents happy: "Child hasn't had smallpox, wish to swear brotherhood, ask for care." Wan: "Needle lacked Qi response, indicating congenital insufficiency. If cared for years until smallpox age, safe. If soon, cannot promise." Next year, died of smallpox.
Zihe Zheng treated a child with hand-foot convulsions. Zihe Zheng said: Heart Fire excess. Do not hold hands, let it be. Caused by wet nurse holding too tight. Ordered floor swept clean, sprinkled with water, dried, sprinkled again until very wet. Placed child prone on floor for long time. Child turned all over, covered in mud. Washed off. Recovered shortly.
Zihe Zheng said: Pediatric Wind-Heat convulsion is common. During convulsion, strictly forbid holding limbs. Tight grip causes hemiplegia. Qi/Blood imbalance paralyzes one arm, gradually wasting, hard to cure till old age. During convulsion, place bamboo mat on cool ground, let child sleep on it. Let convulsion run its course through meridians, stops spontaneously when extreme, without injury.
I once examined a child with left fist curled. Cause: Infantile convulsion, held too tight by mother. After cure, hand couldn't extend. This case, if initially treated with large dose Liver/Kidney Yin tonics, could have extended normally. Regretfully, few know this.
Ge Maolin treated son of Grand Preceptor Yang. Summer heat, fright/dizziness, coma, moved to wooden bed. Ge rushed in: "No harm, move him out quickly." Lord: "Child locked jaw, what medicine?" Ge: "No medicine. Rely on clouds. Clouds bring rain, Yin expands, Yang depression dissipates. I will steam with clearing/dredging agents below. Will it heal?" Followed method, disease cured. Evening, child playing in courtyard. (*Hangzhou Fu Zhi*).
Xue Lizhai treated 3-year-old. Fright convulsion, fever, heavy phlegm. Long-term Baolong Wan caused alternating red/cyan face. Heart/Liver Blood deficiency, Wind-Heat generating phlegm, deficiency sign. Liuwei Wan (Six Flavor Pill) nourished Kidney Water, generated Liver Blood. Liujunzi Tang (Six Gentlemen Decoction), Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma) regulated/tonified Spleen/Stomach. Settled.
Gao Gugeng treated son of Xu Yanwei, 4 years old. Midsummer fever, incessant fright convulsion, arched back/stiff neck, scanty dark urine, dull face. Doctors treated as Cold Damage, ineffective. Gao said: Fire dryness generates Wind, Wind invades extremities. Not Cold Damage. Zishui Qinggan Yin (Nourish Water Clear Liver Decoction). One dose sweat release, bowel movement, heat retreat. Gao: "Malaria coming." Immediately used Wuyi Gongsan (Five Agents Extraordinary Powder) (Tonify Spleen) plus Maidong (Ophiopogon Tuber), Wuweizi (Schisandrae Fructus) (Generate Pulse, clear Summer-Heat). Over ten doses cured.
Lu Xiaoyu treated Ju family son, 11 years old. Previously poor water/soil, diarrhea, emaciated. Late April, steaming heat/rain. Sudden large head/face swelling, slight limb/body swelling. Some said Wind-Heat, gave Suzye (Perilla Leaf), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Ge Gen (Puerariae Lobatae Radix). Profuse sweating. Then phlegm surge, vomiting, incoherent speech, body rigidity, limb tremors. Others said Acute Convulsion, used Baolong Wan, Zhenxin Pills. Ineffective. Pulse floating, slow, weak. Spleen deficiency, Earth fails to control Water. Dampness prevalent, internal/external dampness interact causing swelling. Treatment should strengthen Spleen, leach Dampness. Instead, sweating lifted Zang-Fu phlegm, leaked Meridian fluids, explaining changes. Used Liujunzi Tang (Six Gentlemen Decoction) plus Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix Alba). One dose stopped vomiting, several doses removed rigidity/tremors. Several more doses restored spirit. Added Zexie (Alismatis Rhizoma), doubled Fuling (Poria). Dozens of doses reduced lower swelling, stopped diarrhea.
Xue Lizhai treated grandson Gu Feizhai, 2 weeks old. Neck lymph nodes, arms arching backward. Requested Baidu San (Eliminate Toxin Powder). Confirmed previous syndrome. Gave Liuwei Wan (Six Flavor Pill) once, morning gavage. Limbs normal by afternoon.
Child eye blinking, limb convulsions. Several doses Tianma Fengwang Wan (Gastrodia and Saposhnikovia Pill) to expel wind/resolve phlegm. Previous symptoms persisted, phlegm worsened. Symptoms improved with food. Nose tip/left cheek cyan-yellow. Said: Spleen governs saliva. Liver Wood controls Spleen Earth, failing to control saliva. Not phlegm excess. Liujunzi Tang (Six Gentlemen Decoction) plus Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Gouteng (Uncariae Ramulus cum Uncis) two doses. Diet advanced, symptoms improved. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) settled.
Wan Mizhai treated child, phlegm obstruction convulsion, rapid breathing/wheezing. Mengshi Gun Tan Wan (Flint Rolling Phlegm Pill), Sangbaipi (Mori Cortex) decoction, crushed and mixed. Wheezing settled, phlegm down, convulsions stopped.
Seven-month-old child, random convulsions, drowsy/unconscious, no crying/suckling, pinching causes blink but no pain, nose pinch no sneeze, gavage impossible. Said: True convulsion, incurable.
Mizhai’s father treated child, convulsion after one month. Zhisheng Baoming Dan (Supreme Life Preserving Pill) settled.
Yu Jiayan treated nephew of disciple Wang, son of Sha Wuyi. Ate raw/hard/cold foods. Overnight vomited food, sudden rigidity, unconscious. Doctors used convulsion meds. Whole body high fever, face red like makeup, eyes retracted/lips everted, diarrhea staining clothes. After diagnosis: Slow Spleen Wind syndrome. Spleen Qi chronically injured, further damaged by mineral drugs. Near exhaustion, appearing critical. Method exists to save, but requires 7 days to wake. Fear lack of faith leads to changing doctors, ignorance brings blame. Wang insisted on supervising home, assisting, boosting courage. Used Wu Xie Sijunzi Tang (Black Scorpion Four Gentlemen Decoction), one large dose daily, 1 qian Renshen (Ginseng Radix et Rhizoma) per dose. Family secretly panicked, but saw red face fade, complexion brighten, diarrhea stop, movement lighter, seemed wanting to speak but silent, endured. Sixth night, suddenly restless limbs, removed covers, began heavily criticizing Renshen...