〔钱〕疮疹搐由风火相胜也，惟 疹能作搐，疹为脾所生，脾虚而肝旺乘之，木
来胜土，热气相击，动于心神，心喜为热，神气不安，因搐成痫。 子为心所生，心生热，热则生风，风属于肝，
二脏相搏，风火相争，故发搐也。治之当泻心肝补其母，栝蒌汤主之（方见惊）。海藏云∶诸痛痒疮，皆属于心。火
无论虚实，皆从心火上说，脾虚则肝乘之，肝与心火相合，故用栝蒌汤。若脾土实，火旺逆乘而成痫者，
此实邪也，便结者泻青丸，便软者泻青汤，亦当以脉别之。〔翁〕经曰∶诸风掉眩，皆属肝木。然痘出之始，虽有
四脏，心实主之，心火热盛，肺金受克，不能制伏肝木，热则生风，风火相搏，神气不安，故发惊搐。医者当辨痘疹
惊搐，不可遽投凉心之药，苟不审而概以惊药治之，则心寒而肌敛，毒瓦斯内陷，痘何由而出也。治法，
当平肝木利小便为切要，泻肝则风去，利小便则心热退，风热既定，则痘随出而惊搐自愈矣。然痘先惊者多吉，痘
后惊者多凶，何也，痘未出之先，热蕴于内，故作惊搐，痘出惊止而内无凝滞，故吉。痘出之后，气血虚弱，复感风
寒，热毒反滞，又毋敢轻易发散清利，故凶。然有非痘证而慢惊者亦属于肝，而治法专理脾土何也。盖由平日或吐
或泻，脾土虚弱，不能当肝木所克，此非肝木之本病也，治法只须温补脾土为主，而肝木自宁，譬如土薄而上有大
木不能乘载，故无风而自动，栽培者
当浓填其土，使根深本固，而自无风邪之害也。痘后有此证者，亦由气血虚极使然也，必为难治。《疮疹论》挟热
吐泻，不可投燥药。伤寒身热，不可投凉药。疮疹发搐，不可投惊药。此皆外同而内异，盖疮疹出于心，惊
搐亦出于心也。疮疹本热，热则动心，此理之自然，夫心火独盛于上，肺金受火克而不能制伏肝木，热则生风，
木气盛则脾土衰，热气动于心神，心喜为热，心肚 ，脾肚疹，泻肝则风去，利小肠则热退也，风热既退，则惊搐
自愈矣。昧者不知，投以银粉、脑、麝、青黛、朱砂、硝石凉心损胃之药则误矣。故见证似惊风，用药当作疮疹防
之。盖疮疹之初，似惊风者多，大抵疮疹发惊，必先咳嗽痰涎，心悸烦躁，呕吐唇红，颊赤发渴，耳
冷足冷，脉数舌白，如有此数证，则银粉等凉药切不可用。盖心凉则并损胃而毒瓦斯敛伏，又况心主血，寒则血凝而不
行，且中焦既冷，上焦热愈不降，何由运出。又有小儿平常无病，忽然发搐者，必是疮疹，尤当审谛。盖毒瓦斯内盛，但
当发散，如惺惺散、消毒散、升麻汤、红绵散，兼以快气、利小便、祛风等药与之，待其热气得泄，心气亦自定矣。或
有风寒与内热相搏而惊搐者，各随证治如前法，但加匀
气药为妙，张氏云∶疮疹气匀即出快，气匀则荣卫无滞，有毒亦散，疮疹当自出矣
（诸方并见初热）。如大吐，面青，唇眼动，手足时搐，慢脾风证也。宜小异功散加升、柴、木香、干姜、治之。
〔洁〕凡未出而发搐者，是外感风寒之邪、内发心热之所作也，当用茶粉下解毒丸、犀角地黄汤主之。〔世〕
治疮痘欲出，身热烦躁，忽发惊搐，宜驱风膏、小如圣饮。小便不通，八正散。涎盛，利惊丸、抱龙丸量证施之。
〔丹〕欲发疮疹，先身热惊跳搐搦，此非惊风，宜发散药。〔薛〕前证，痘疹未见而先发搐者，乃毒瓦斯自心经出也，
若病势轻缓，或形气虚弱者，不宜用峻厉之剂，恐元气内损，则毒瓦斯内陷，而疮不能起发也。或外感风寒之邪，
内因疮疹之热而相搏，或肝血虚，火动而内生风，当补元气为主，佐以见证之剂。然前方多峻厉之剂，
审有是证方可用，须察其色赤白，而以脾胃为主，虚则用温补，实则用解毒。〔张〕痘疮始作，未形见之间，忽发惊
搐，是毒瓦斯自心经而出也，苟不以内外证辨明之，便用银粉、青黛、等药，则心寒而毒瓦斯内陷，往往气绝之际，或
隐方出，已无及矣。治法，但当以导赤散加防风、辰砂末，与泻青丸合而治之。搐甚者，抱龙丸。
如再不止，小便利者可治以导赤散送下牛黄清心丸或粉红丸。小便不利者，勿治。
惺惺散（初热） 升麻汤（初热）
红绵散 解表之药。
全蝎（五个） 麻黄（去节） 僵蚕 白芷 川芎 桔梗 天麻（各二钱） 甘草 苏木（各一钱）
上为末。每服一钱，加红绵少许，水煎。有热，加荆芥稍热服。一方，入薄荷叶三片，好酒四五点同煎。
羌活散 调三制辰砂末，加防风、荆芥表之。（方见初热证治）
〔世〕麻痘风搐方
人参 羌活 防风 僵蚕（醋炒） 南星（姜制） 白附子（姜制） 甘草（炙）
上等分，生姜三片，水煎服。其搐立止。
上皆解表之剂，洁古所谓外感风寒之邪，丹溪所谓宜发散药者是也。
解毒丸
寒水石（研） 石膏（研，各一两） 青黛（半两）
上，以二石细研如粉，入青黛和均，汤浸蒸饼为丸，如芡实大。每服一丸，食
后，新汲水化下，或细嚼姜水下亦可。三岁儿服半丸，量岁数加减服之。
犀角地黄汤（失血）
柴胡二连丸 治肝经实火。
柴胡 宣黄连 胡黄连
上为末。糊丸桐子大。每服二三十丸，白汤下。
上解毒、凉血、泻肝火之剂，有热者宜之。
导赤散（心脏） 八正散（小便不利） 六一散（热）
上利小便之剂，小便不利者宜之，然泻丙火以泻肝之子，乃治惊搐第一要法，不独小便不利者为当用也。
紫草快 散（即加减大紫草散有木通、无黄 ，方见痘灰白） 东垣消毒散（即消毒救苦汤，见大法）
参 四圣散（灌脓） 八物汤（虚羸） 柴胡栀子散（即栀子清肝散，见五脏热） 地黄丸（肾脏）
小异功散（即四君子汤、加陈皮） 益气汤（即补中益气汤）
上皆薛氏所用方，大抵主于养脾补肾，乃补虚例也。
抱龙丸 牛黄清心丸（并见惊搐） 粉红丸（即温惊丸，见慢惊条）
上镇惊豁痰例，痰涎潮壅，及曾被外物惊者，用之。
〔钱〕 疹病后欲发痫，余疮难发痫，以木胜脾，木归心故也。若凉惊，用凉惊
丸。温惊，用粉红丸。〔万〕痘后非时搐搦者有二证，一则心热留而不去，热盛生风，风火相传，其人必喉
中有痰，目直上视，面赤引饮，居处喜冷，宜导赤散、泻青丸清心泻肝，后以抱龙丸调之。一则病后多食，胃弱不
能胜谷，谓之食蒸发搐，其人必潮热，大便酸臭，秘泄不调，或呕吐腹痛，先以备急丸、丁香脾积丸利之，
后用木香大安丸、钱氏异攻散调理取愈。〔薛〕一小儿痘痂脱尽，因其秽气，用葱椒煎汤浴之，发搐痰喘。用八珍加
白僵蚕、蝉蜕一剂，痰喘顿止，又用四君、芎、归、钓藤钩而搐止。一小儿痘疮色赤，四肢发搐，眉唇牵动。此心
肝二经热甚乘脾所致也。用四君、防风、钓藤钩而痊。一小儿痘后四肢发搐，眉棱尤动，小便频
数，脸目青赤。此肝经风热。用四物、柴胡、山栀少愈。但四肢倦怠，饮食少思，大便不实。此脾气受伤而未复也。用
四君、升麻、当归而痊。一小儿痘后寅卯申酉时热甚，或兼搐。余谓寅卯时发热，此肝火本证，申酉时发搐，乃肝木侮
金。先以四物、白术、茯苓、钓藤钩、煎送柴胡二连丸而愈，夕用地黄丸，朝用四君、山栀、柴胡及四君子加当归而痊。
一小儿痘疮色赤，发搐痰盛。服抱龙丸而顿愈。又因母大怒，儿仍搐，母服柴胡栀子散、加味逍遥散，母子并愈。一小
儿痘愈后发搐，左
额青赤，唇口牵动。余谓肝心二经风热所致。先用柴胡栀子散加钓藤钩，后用加味逍遥散而搐止，再用五味
异功散而痘愈。一小儿痘将愈，发搐痰涌，头目不清。脾气虚弱，肝木侮之。先用五味异功散加柴胡、钓藤钩，搐
愈而靥。
凉惊丸 温惊丸（并见惊搐） 导赤散（心脏） 泻青丸（肝脏） 备急丸 丁香脾积丸 木香
大安丸（并见伤食） 柴胡二连丸（见前） 补中益气汤 四君子汤 四神丸 十一味木香散（并见泄泻）
栝蒌散 治痘、热极生风发搐。
栝蒌根（二钱） 白僵蚕（一钱）
上，慢火同炒老黄色，为末。每服二三分，薄荷汤下。
保命丹 一切惊风发热。
天麻 郁金 全蝎（去尾） 白附子（炒） 僵蚕（姜汁炒） 薄荷 蝉蜕 茯神 桔梗（各五钱）
防风 甘草 青黛（各三钱） 大半夏（炒，滚汤浸晒干，又用姜汁浸，晒干，又炒） 南星（制、同上。各一
两） 钩藤 牛黄（研。各二钱） 麝香（五分） 辰砂（飞，五钱，为衣）
上末，炼蜜、为丸芡实大。每服一丸，灯心汤下。
【钱乙】疮疹引发的抽搐是由于风火相互克制所致。只有出疹才会引起抽搐，因为疹是由脾所生，当脾虚而肝气旺盛乘袭时，木来克土，热气相互激荡，扰动心神，心喜热，神气不安，因而形成抽搐并发展为痫证。子（指肾水）由心所生，心生热，热则生风，风归属于肝，心与肝两脏相互搏结，风火相争，所以发生抽搐。治疗应当泻心肝之火，补其母脏，主方用栝蒌汤（方剂见惊搐门）。海藏说：各种疼痛、瘙痒和疮疡，都归属于心。火无论虚实，都要从心火的角度来论述，脾虚则肝木乘之，肝与心火相合，所以使用栝蒌汤。如果脾土实盛，火旺逆乘而成痫证，这是实邪，大便干结的用泻青丸，大便稀软的用泻青汤，也应当通过脉象来辨别。
【翁氏】经书说：各种风病引起的摇动眩晕，都归属于肝木。然而痘疹发出之初，虽然涉及四脏，但心实际上起主导作用。心火热盛，肺金受克，不能制约肝木，热则生风，风火相搏，神气不安，所以发生惊搐。医生应当辨别痘疹惊搐，不可立即投用凉心药物，如果不加审察而一概用治惊药治疗，就会导致心寒而肌肉收敛，毒瓦斯内陷，痘疹如何能发出来呢？治疗方法，平抑肝木、通利小便最为关键，泻肝则风去，利小便则心热退，风热既定，则痘疹随之外出，惊搐自然痊愈。然而痘疹先出现惊搐的多为吉兆，痘疹出完后出现惊搐的多为凶兆，为什么呢？痘疹未出之前，热蕴积在体内，所以发生惊搐，痘疹发出后惊搐停止且体内无凝滞，所以为吉。痘疹发出之后，气血虚弱，又感受风寒，热毒反而停滞，此时不敢轻易使用发散清利药物，所以为凶。然而有不是痘疹病症而是慢惊风的，也归属于肝，但治疗方法专门调理脾土，为什么呢？大概是因为平日或吐或泻，导致脾土虚弱，不能承受肝木的克制，这并非肝木的本病，治疗方法只需以温补脾土为主，肝木自然安宁，譬如土地浅薄而上有大树无法承载，所以无风而自动，栽培者应当加厚填实土壤，使根深本固，自然就没有风邪的危害了。痘疹后出现这种证候的，也是由于气血极度虚弱造成的，必定难以治疗。《疮疹论》说：挟热吐泻，不可投用燥药。伤寒身热，不可投用凉药。疮疹发搐，不可投用惊药。这些都是外表症状相同而内在机理不同，大概因为疮疹出于心，惊搐也出于心。疮疹本是热证，热则动心，这是自然的道理。心火独盛于上，肺金受火克而不能制约肝木，热则生风，木气盛则脾土衰，热气动于心神，心喜热，心肚红，脾肚疹，泻肝则风去，利小肠则热退，风热既退，惊搐自愈。愚昧的人不知道这些，投用银粉、脑、麝、青黛、朱砂、硝石等凉心损胃的药物就错了。所以见到类似惊风的证候，用药当作疮疹来防备。大概疮疹初起，像惊风的情况很多，大抵疮疹发惊，必须先有咳嗽痰涎、心悸烦躁、呕吐唇红、脸颊赤红、发热口渴、耳朵冷脚冷、脉数舌苔白等症状，如果有这些证候，那么银粉等凉药切不可用。因为心凉则会损伤胃气，导致毒瓦斯收敛潜伏，况且心主血，寒则血凝而不行，且中焦既冷，上焦热更不降，如何能运化排出。又有小儿平时没有病，忽然发生抽搐的，必定是疮疹，尤其应当仔细审察。因为毒瓦斯内盛，只应当发散，如惺惺散、消毒散、升麻汤、红绵散，兼用理气、利小便、祛风等药物给予服用，待其热气得以宣泄，心气自然安定。或者有风寒与内热相搏结而惊搐的，各随证候治疗如前法，但加入匀气药为妙，张氏说：疮疹气机调匀即出得快，气机调匀则营卫无滞，有毒亦能散发，疮疹应当自然发出（诸方并见初热阶段）。如果出现大吐，面色青，嘴唇眼睛跳动，手足时时抽搐，这是慢脾风证候。宜用小异功散加升麻、柴胡、木香、干姜治疗。
【李杲】凡痘疹未出而发搐的，是外感风寒之邪、内发心热所致，应当用茶粉送服解毒丸、犀角地黄汤主治。
【世医】治疗疮痘欲出，身热烦躁，忽然发惊搐，宜用驱风膏、小如圣饮。小便不通，用八正散。痰涎多，用利惊丸、抱龙丸根据证候施用。
【朱震亨】欲发疮疹，先身热惊跳抽搐，这不是惊风，宜用发散药。
【薛己】前述证候，痘疹未见而先发搐的，是毒瓦斯自心经发出，若病势轻缓，或形气虚弱者，不宜用峻烈药剂，恐怕元气内损，则毒瓦斯内陷，而疮不能起发。或者外感风寒之邪，内因疮疹之热而相搏，或者肝血虚，火动而生内风，应当以补元气为主，佐以对症药物。然而前方多为峻烈药剂，审察确有此证方可用，须观察其色赤白，而以脾胃为主，虚则用温补，实则用解毒。
【张氏】痘疮始作，尚未显现之间，忽然发惊搐，是毒瓦斯自心经而出，如果不以内外证候辨明，便用银粉、青黛等药，则心寒而毒瓦斯内陷，往往在气绝之际，或者隐伏不出，已经来不及了。治疗方法，只应当用导赤散加防风、辰砂末，与泻青丸合而治之。抽搐严重的，用抱龙丸。如果再不止，小便通利的可用导赤散送下牛黄清心丸或粉红丸。小便不利的，不要治疗。
惺惺散（初热阶段） 升麻汤（初热阶段）
红绵散 解表药物。
全蝎（五个） 麻黄（去节） 僵蚕 白芷 川芎 桔梗 天麻（各二钱） 甘草 苏木（各一钱）
以上研为末。每服一钱，加少许红绵，水煎。有热，加荆芥稍热服。一方，入薄荷叶三片，好酒四五点同煎。
【世医】麻痘风搐方
人参 羌活 防风 僵蚕（醋炒） 南星（姜制） 白附子（姜制） 甘草（炙）
以上等分，生姜三片，水煎服。其抽搐立即停止。
以上都是解表剂，洁古所谓外感风寒之邪，丹溪所谓宜发散药的是此类。
解毒丸
寒水石（研） 石膏（研，各一两） 青黛（半两）
以上，将二石细研如粉，入青黛和均，汤浸蒸饼为丸，如芡实大。每服一丸，食后，新汲水化下，或细嚼姜水下亦可。三岁儿服半丸，量岁数加减服之。
犀角地黄汤（失血）
柴胡二连丸 治肝经实火。
柴胡 宣黄连 胡黄连
以上研为末。糊丸桐子大。每服二三十丸，白开水送下。
导赤散（心脏） 八正散（小便不利） 六一散（热）
以上利小便之剂，小便不利者适宜，然而泻丙火以泻肝之子，乃是治惊搐第一要法，不独小便不利者为当用也。
紫草快散（即加减大紫草散有木通、无黄芩，方见痘灰白） 东垣消毒散（即消毒救苦汤，见大法）
参 四圣散（灌脓期） 八物汤（虚羸） 柴胡栀子散（即栀子清肝散，见五脏热） 地黄丸（肾脏）
小异功散（即四君子汤、加陈皮） 益气汤（即补中益气汤）
以上皆薛氏所用方，大抵主于养脾补肾，乃补虚例也。
抱龙丸 牛黄清心丸（并见惊搐） 粉红丸（即温惊丸，见慢惊条）
以上镇惊豁痰例，痰涎潮壅，及曾被外物惊者，用之。
【钱乙】疹病后欲发痫，余疮难发痫，以木胜脾，木归心故也。若凉惊，用凉惊丸。温惊，用粉红丸。
【万全】痘后非时抽搐有二证，一则心热留而不去，热盛生风，风火相传，其人必喉中有痰，目直上视，面赤引饮，居处喜冷，宜导赤散、泻青丸清心泻肝，后以抱龙丸调之。一则病后多食，胃弱不能胜谷，谓之食蒸发搐，其人必潮热，大便酸臭，秘泄不调，或呕吐腹痛，先以备急丸、丁香脾积丸利之，后用木香大安丸、钱氏异攻散调理取愈。
【薛己】一小儿痘痂脱尽，因其秽气，用葱椒煎汤浴之，发搐痰喘。用八珍加白僵蚕、蝉蜕一剂，痰喘顿止，又用四君、芎、归、钓藤钩而搐止。一小儿痘疮色赤，四肢发搐，眉唇牵动。此心肝二经热甚乘脾所致也。用四君、防风、钓藤钩而痊。一小儿痘后四肢发搐，眉棱尤动，小便频数，脸目青赤。此肝经风热。用四物、柴胡、山栀少愈。但四肢倦怠，饮食少思，大便不实。此脾气受伤而未复也。用四君、升麻、当归而痊。一小儿痘后寅卯申酉时热甚，或兼搐。余谓寅卯时发热，此肝火本证，申酉时发搐，乃肝木侮金。先以四物、白术、茯苓、钓藤钩、煎送柴胡二连丸而愈，夕用地黄丸，朝用四君、山栀、柴胡及四君子加当归而痊。一小儿痘疮色赤，发搐痰盛。服抱龙丸而顿愈。又因母大怒，儿仍搐，母服柴胡栀子散、加味逍遥散，母子并愈。一小儿痘愈后发搐，左额青赤，唇口牵动。余谓肝心二经风热所致。先用柴胡栀子散加钓藤钩，后用加味逍遥散而搐止，再用五味异功散而痘愈。一小儿痘将愈，发搐痰涌，头目不清。脾气虚弱，肝木侮之。先用五味异功散加柴胡、钓藤钩，搐愈而靥。
凉惊丸 温惊丸（并见惊搐） 导赤散（心脏） 泻青丸（肝脏） 备急丸 丁香脾积丸 木香大安丸（并见伤食） 柴胡二连丸（见前） 补中益气汤 四君子汤 四神丸 十一味木香散（并见泄泻）
栝蒌散 治痘、热极生风发搐。
栝蒌根（二钱） 白僵蚕（一钱）
以上，慢火同炒老黄色，为末。每服二三分，薄荷汤下。
保命丹 一切惊风发热。
天麻 郁金 全蝎（去尾） 白附子（炒） 僵蚕（姜汁炒） 薄荷 蝉蜕 茯神 桔梗（各五钱）
防风 甘草 青黛（各三钱） 大半夏（炒，滚汤浸晒干，又用姜汁浸，晒干，又炒） 南星（制、同上。各一两） 钩藤 牛黄（研。各二钱） 麝香（五分） 辰砂（飞，五钱，为衣）
以上研末，炼蜜为丸芡实大。每服一丸，灯心汤下。
[Qian Yi] Convulsions caused by smallpox/rash are due to the mutual overcoming of wind and fire. Only rashes can cause convulsions; rashes are generated by the Spleen. When the Spleen is deficient and the Liver qi is hyperactive, it overcomes (the Spleen), Wood conquers Earth. The heat qi strikes each other, disturbing the Heart Spirit (Shen). The Heart delights in heat, causing the Shen to be unsettled, thus forming convulsions that develop into epilepsy (Xian). Water (Kidney) is born from Fire (Heart); when the Heart generates heat, heat generates wind. Wind belongs to the Liver. The two organs (Heart and Liver) struggle against each other, wind and fire contend, hence convulsions occur. Treatment should involve purging the Heart and Liver and tonifying their mothers. The principal formula is Gualou Tang (Trichosanthes Decoction) (see section on Convulsions). Haizang stated: "All pain, itching, and sores belong to the Heart." Fire, whether deficiency or excess, is discussed in terms of Heart Fire. When the Spleen is deficient, Liver Wood overcomes it; the Liver combines with Heart Fire, hence Gualou Tang is used. If the Spleen Earth is excessive, and Fire is hyperactive, counter-attacking to form epilepsy, this is an Excess pathogen. For constipation, use Xieqing Wan (Drain the Green Pill); for loose stools, use Xieqing Tang (Drain the Green Decoction). Pulse diagnosis should also be employed to differentiate.
[Weng Shi] The Classics state: "All wind diseases characterized by tremors and dizziness belong to Liver Wood." However, at the initial stage of smallpox eruption, although four Zang organs are involved, the Heart actually takes the lead. When Heart Fire is hyperactive, Lung Metal is overcome and cannot restrain Liver Wood. Heat generates wind; wind and fire contend, unsettling the Shen, hence惊搐 (Jing Chu - startle convulsions) occurs. Physicians must differentiate smallpox/rash Jing Chu and must not hastily administer cooling Heart medications. If one fails to examine carefully and generally treats with anti-startle medicines, the Heart becomes cold, muscles contract, and the toxin (Du Wa) sinks inward, making it impossible for the rash to erupt. The treatment method lies primarily in calming Liver Wood and promoting urination. Purging the Liver removes wind; promoting urination clears Heart heat. Once wind and heat are settled, the rash will follow its course outward, and Jing Chu will heal itself. However, Jing Chu appearing before the rash is mostly auspicious, while appearing after the rash is mostly ominous. Why? Before the rash emerges, heat is trapped internally, causing Jing Chu. After the rash emerges, if Jing Chu stops and there is no internal stagnation, it is auspicious. After the rash emerges, Qi and Blood are weak; if exposed to wind-cold, heat toxins become stagnant. One dare not lightly use dispersing or clearing-draining methods, hence it is ominous. However, slow convulsions (Man Jing) not caused by smallpox also belong to the Liver, yet the treatment focuses solely on regulating the Spleen Earth. This is because daily vomiting or diarrhea has weakened the Spleen Earth, which cannot withstand the overcoming by Liver Wood. This is not a primary disease of Liver Wood. The treatment requires warming and tonifying the Spleen Earth as the main approach, allowing Liver Wood to settle naturally. It is like thin soil unable to support a large tree, causing it to shake without wind. Cultivators should thicken the soil to ensure deep roots and a solid base, eliminating the harm of wind pathogens. Cases of this syndrome after smallpox are also due to extreme deficiency of Qi and Blood and are difficult to treat. *Czhen Lun* states: For vomiting and diarrhea with heat, do not use drying drugs. For typhoid with body heat, do not use cooling drugs. For rash convulsions, do not use anti-startle drugs. These cases have similar external manifestations but different internal mechanisms. Rash originates from the Heart; Jing Chu also originates from the Heart. Rash is fundamentally a heat condition; heat moves the Heart, which is natural. When Heart Fire alone is hyperactive above, Lung Metal is overcome by Fire and cannot restrain Liver Wood. Heat generates wind; when Wood qi is hyperactive, Spleen Earth declines. Heat qi moves the Heart Spirit; the Heart delights in heat. The heart belly is red, the spleen belly has rashes. Purging the Liver removes wind; draining the Small Intestine clears heat. Once wind and heat recede, Jing Chu heals itself. Ignorant practitioners, unaware of this, administer silver powder, borneol, musk, Qingdai (Indigo Naturalis), cinnabar, and saltpeter—drugs that cool the Heart and damage the Stomach—which leads to error. Therefore, when witnessing symptoms resembling wind-stroke, one must medicate with caution regarding rash. Generally, early rash resembles wind-stroke often. Typically, rash-induced Jing Chu is preceded by coughing and phlegm-saliva, palpitations, irritability, vomiting, red lips, flushed cheeks, fever, thirst, cold ears and feet, rapid pulse, and white tongue coating. If these signs are present, silver powder and other cooling drugs must absolutely not be used. Cooling the Heart damages the Stomach and causes toxin retention. Moreover, the Heart governs Blood; cold causes blood coagulation and stasis. If the Middle Jiao is cold, Upper Jiao heat cannot descend, making expulsion impossible. Furthermore, children who are normally healthy but suddenly experience convulsions likely have rash; this must be examined meticulously. Since toxins are abundant internally, only dispersing methods should be used, such as Xingxing San, Xiaodu San, Shengma Tang, Hongmian San, combined with Qi-regulating, diuretic, and wind-dispelling herbs. Once heat is vented, Heart Qi settles naturally. If wind-cold combats internal heat causing Jing Chu, treat according to previous methods, adding Qi-balancing herbs is excellent. Zhang Shi said: When Qi is balanced in rash, eruption is swift; balanced Qi means no stagnation in Ying and Wei, toxins disperse, and rash erupts naturally (all formulas see Early Heat phase). If severe vomiting, cyan face, lip/eye twitching, intermittent limb convulsions occur, this is Man Pi Feng (Slow Spleen Wind) syndrome. Use Xiao Yigong San plus Shengma, Chaihu, Muxiang, Ganjiang for treatment.
[Li Gao] Convulsions occurring before eruption are caused by external contraction of wind-cold pathogens and internal emergence of Heart heat. Treat with Jiefang Wan (Detoxification Pill) administered with tea powder, or Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction).
[Worldly Physicians] For treating smallpox/chickenpox about to erupt, presenting with body heat, irritability, and sudden Jing Chu, use Qufeng Gao (Wind-Driving Paste) or Xiao Rusheng Yin (Small Like-Sage Drink). For urinary obstruction, use Bazheng San (Eight-Ingredient Powder). For excessive saliva/phlegm, use Lijing Wan (Startle-Relieving Pill) or Baolong Wan (Dragon-Holding Pill) based on the syndrome.
[Zhu Danxi] Prior to rash eruption, if there is body heat, startle, jumping, and convulsions, this is not wind-stroke; use dispersing herbs.
[Xue Ji] In the aforementioned syndromes, if convulsions occur before rash appearance, it is toxins emerging from the Heart Meridian. If the disease progression is mild or the constitution is weak, harsh agents should not be used, lest they damage Yuan Qi internally, causing toxins to sink inward and preventing the rash from rising. Alternatively, external wind-cold pathogens combine with internal rash heat, or Liver Blood deficiency causes Fire agitation generating internal wind. Treatment should prioritize tonifying Yuan Qi, assisted by syndrome-specific agents. However, the preceding formulas are mostly harsh; they should only be used after confirming the syndrome. Observe the color (red/white) and focus on the Spleen and Stomach: use warming-tonifying for deficiency, detoxifying for excess.
[Zhang Shi] At the onset of smallpox, before visible signs appear, sudden Jing Chu indicates toxins emerging from the Heart Meridian. If internal and external syndromes are not clearly differentiated, and silver powder, Qingdai, etc., are used, the Heart becomes cold and toxins sink inward. Often, patients die before the rash appears or remains hidden, rendering treatment futile. The treatment method should use Daochi San (Guide Out Red Powder) plus Fangfeng and Chen Sha (Cinnabar powder), combined with Xieqing Wan. For severe convulsions, use Baolong Wan. If convulsions persist and urination is unobstructed, use Daoyi San to deliver Niuhuang Qingxin Wan (Calvescent Gallbladder Heart-Clearing Pill) or Fenhong Wan (Pink Red Pill). If urination is obstructed, do not treat.
Xingxing San (Early Heat) Shengma Tang (Early Heat)
Hongmian San: Exterior-releasing agent.
Quanxie (Scorpion, 5 pieces), Mahuang (Ephedra, de-segmented), Jiangcan (Bombyx Batryticatus), Baizhi (Angelica Dahurica), Chuanxiong (Ligusticum Chuanxiong), Jiegeng (Platycodon Grandiflorus), Tianma (Gastrodia Elata) (each 2 qian), Gancao (Licorice), Sumu (Sappanwood) (each 1 qian).
Grind into powder. Take 1 qian per dose, add a little Hongmian, decoct in water. If heat is present, add Jingjie (Schizonepeta) and take warm. Another prescription adds 3 leaves of Bohe (Mint) and 4-5 drops of good wine to the decoction.
Qianghuo San: Mix Sanzhi Chen Sha (Three-processed Cinnabar) with Fangfeng and Jingjie to release the exterior. (See Early Heat Syndrome Treatment).
[Worldly Physicians] Formula for Wind-Convulsion in Smallpox/Chickenpox
Renshen (Ginseng), Qianghuo (Notopterygium), Fangfeng (Saposhnikovia), Jiangcan (Bombyx Batryticatus, vinegar-fried), Nanxing (Arisaema, ginger-processed), Baifuzi (Typhonium, ginger-processed), Gancao (Licorice, honey-fried).
Equal parts. Decoct with 3 slices of fresh ginger. Convulsions stop immediately.
These are all exterior-releasing agents, corresponding to Jiegu's "external wind-cold" and Danxi's "dispersing herbs."
Jiedu Wan (Detoxification Pill)
Hanshuishi (Calcitum, ground), Shigao (Gypsum Fibrosum, ground, each 1 liang), Qingdai (Indigo Naturalis, 0.5 liang).
Grind the two minerals finely into powder, mix evenly with Qingdai. Make pills using steamed dough soaked in water, size of Euryale Seed. Take 1 pill after meals, dissolve in fresh well water, or chew finely with ginger water. Children aged three take half a pill; adjust dosage by age.
Xijiao Dihuang Tang (Blood Loss)
Chaihu Erlian Wan: Treats Excess Fire of Liver Meridian.
Chaihu (Bupleurum), Xuanhuanglian (Scutellaria Baicalensis), Hu Huanglian (Coptis Teeta).
Grind into powder. Make pills with paste, size of Sesame seed. Take 20-30 pills with plain boiled water.
These are detoxifying, blood-cooling, and liver-fire-draining agents, suitable for heat conditions.
Daochi San (Heart) Bazheng San (Urinary Difficulty) Liuyi San (Heat)
These are diuretic agents, suitable for urinary difficulty. However, draining Bing Fire (Small Intestine) to drain the son of Liver (Wood produces Fire, Small Intestine is the paired organ) is the primary method for treating Jing Chu, not limited to cases of urinary difficulty.
Zicao Kuai San (Modified Large Zicao San with Mutong, without Huangqin, see Pale Rash) Dongyuan Xiaodu San (Xiaodu Jiuku Tang, see General Principles)
Can Si Sheng San (Suppuration Phase) Bawu Tang (Emaciation) Chaihu Zhizi San (Zhi Zi Qing Gan San, see Five Organs Heat) Dihuang Wan (Kidney)
Xiao Yigong San (Si Junzi Tang + Chenpi) Yiqi Tang (Buzhong Yiqi Tang)
These are formulas used by Xue Shi, primarily focusing on nourishing Spleen and tonifying Kidney, representing the category of tonifying deficiency.
Baolong Wan Niuhuang Qingxin Wan (See Jing Chu) Fenhong Wan (Wen Jing Wan, see Slow Jing Section)
These are for settling startle and resolving phlegm, used for tidal phlegm accumulation or cases startled by external objects.
[Qian Yi] Epilepsy may develop after rash illness, but rarely after other sores, because Wood overcomes Spleen and Wood returns to Heart. For Cold Startle, use Liangjing Wan. For Warm Startle, use Fenhong Wan.
[Wan Quan] Non-timed convulsions after smallpox have two syndromes: First, Heart heat lingers and does not depart; excessive heat generates wind, wind and fire transmit. Symptoms include phlegm in throat, eyes staring upward, flushed face, desire for drinking, preference for cold environments. Use Daochi San and Xieqing Wan to clear Heart and drain Liver, followed by Baolong Wan for regulation. Second, post-illness overeating with weak Stomach unable to digest grain, called Food-Stagnation Induced Convulsion. Symptoms include tidal fever, sour-smelling stool, irregular constipation/diarrhea, or vomiting/abdominal pain. First use Beijji Wan and Dingxiang Pi Ji Wan to purge, then regulate with Muxiang Da'an Wan and Qian Shi Yigong San to recover.
[Xue Ji] Case 1: A child's scabs fell off completely; bathing in green onion and pepper decoction due to foul air caused convulsions, phlegm, and wheezing. One dose of Bazhen Tang plus Bai Jiangcan and Chantui stopped phlegm/wheezing instantly. Then Si Junzi Tang, Xiong (Chuanxiong), Gui (Danggui), Gouteng (Uncaria Rhynchophylla) stopped convulsions. Case 2: Child with red smallpox, limb convulsions, eyebrow/lip twitching. Caused by severe heat in Heart/Liver meridians overcoming Spleen. Treated with Si Junzi Tang, Fangfeng, Gouteng for recovery. Case 3: Child with post-smallpox limb convulsions, prominent eyebrow twitching, frequent urination, blue-red face/eyes. Liver Meridian Wind-Heat. Treated with Siwu Tang, Chaihu, Zhizi for slight improvement. But limbs were fatigued, poor appetite, loose stools. Spleen Qi injured and unrecovered. Treated with Si Junzi Tang, Shengma, Danggui for recovery. Case 4: Child with intense fever between Yin/Mao/Shen/You hours, or with convulsions. I stated: Fever at Yin/Mao is Liver Fire proper; convulsions at Shen/You indicate Liver Wood insulting Metal. First treated with Siwu Tang, Baizhu, Fuling, Gouteng, decocted to send Chaihu Erlian Wan, recovered. Evening: Dihuang Wan. Morning: Si Junzi Tang, Zhizi, Chaihu, and Si Junzi Tang plus Danggui for recovery. Case 5: Child with red rash, convulsions, heavy phlegm. Took Baolong Wan and recovered instantly. Mother was angry, child convulsed again. Mother took Chaihu Zhizi San and Jiawei Xiaoyao San; both mother and child recovered. Case 6: Child with post-rash convulsions, blue-red left forehead, lip/mouth twitching. Liver/Heart Wind-Heat. First Chaihu Zhizi San plus Gouteng, then Jiawei Xiaoyao San stopped convulsions, then Wuwei Yigong San healed rash. Case 7: Child near recovery from rash, convulsions, surging phlegm, unclear head/eyes. Spleen Qi weak, Liver Wood insults. First Wuwei Yigong San plus Chaihu, Gouteng; convulsions stopped, scabs formed.
Liangjing Wan Wenjing Wan (See Jing Chu) Daochi San (Heart) Xieqing Wan (Liver) Beijji Wan Dingxiang Pi Ji Wan Muxiang Da'an Wan (See Food Stagnation) Chaihu Erlian Wan (See Above) Buzhong Yiqi Tang Si Junzi Tang Sishen Wan Shiyiwei Muxiang San (See Diarrhea)
Gualou San: Treats smallpox, extreme heat generating wind/convulsions.
Gualou Gen (Trichosanthes Root, 2 qian), Bai Jiangcan (Bombyx Batryticatus, 1 qian).
Stir-fry slowly until old yellow, grind to powder. Take 2-3 fen per dose with Mint Tea.
Baoming Dan: All wind-stroke fevers.
Tianma (Gastrodia), Yujin (Curcuma Longa), Quanxie (Scorpion, tail removed), Baifuzi (Typhonium, fried), Jiangcan (Bombyx Batryticatus, ginger juice fried), Bohe (Mint), Chantui (Cicada Slough), Fushen (Poria with Hostwood), Jiegeng (Platycodon) (each 5 qian).
Fangfeng (Saposhnikovia), Gancao (Licorice), Qingdai (Indigo Naturalis) (each 3 qian). Ban Xiaren (Pinellia, fried, soaked in boiling water, dried, soaked in ginger juice, dried, fried again), Nanxing (Arisaema, processed same as above) (each 1 liang). Gouteng (Uncaria Rhynchophylla), Niuhuang (Calvescent Gallstone, ground) (each 2 qian). Shexiang (Musk, 0.5 fen). Chen Sha (Cinnabar, refined, 5 qian, as coating).
Grind to powder, refine honey to make pills size of Euryale Seed. Take 1 pill with Nux Jugis Decoction (Centipede Grass Decoction).