〔曾〕又有急惊天钓之后,变作潮热,手足逆冷有似疟疾,盖因病愈之时,不善
将护,外感风邪,乘虚而入于经络,再未解散,以致如此。经曰∶重阳必阴。又曰∶
亢则害,承乃制。此其义也。宜服柴胡加桂汤及当归散,气实者则以乌犀丸、水晶
丹略与通利,匀气散止补,后以参苓白术散调理,自然平愈。此证所用药品,间
使苦寒之味,务在消阳盛之火,肺金得胜,肝木自平,而风邪亦散,斯为良法。
柴胡加桂汤(见伤寒) 当归散(见痢) 乌犀丸 水晶丹(并见癖积) 匀气散(见腹痛)
参苓白术散(见泄泻)
海藏云∶心神不安,四君子加辰砂半分,枣汤调下。又有一证,欲发疮疹,
先身热惊跳,或发搐搦,此非惊风,当用发散药。〔曾〕暑风一证,因夏月感冒风
热太甚,致面垢唇红,脉沉细数,忽发惊搐,不省人事,治用消暑清心饮、辰砂五
苓散及琥珀抱龙丸自安,切勿以温剂调补。
消暑清心饮 解伏热中暑,烦躁作渴,神气不清,及有惊搐,名暑风证,投之即效。
香薷(去老梗) 泽泻(去粗皮。各一两) 扁豆(炒熟,去壳,研) 净黄连 羌活
猪苓(去皮) 浓朴(去粗皮,姜汁浸透,炒) 白术 干葛 赤茯苓(去皮) 升麻 川芎
(各半两) 甘草(三钱)
上锉。每服二钱,水一盏,煎七分,无时,带凉服。治暑风证先投此剂得效,
次服却暑丹,其搐不发矣。
薛氏于急慢惊痫之外,又出惊风一证,其候虚惕怔忡,气怯神散,痰涎来去,
泄泻色青,盖惊之轻而虚者也。若惊入心,则面赤夜啼,用栀子清肝散加黄连。入
肝则面青眼窜,用柴胡清肝散。入脾则面黄呕吐,虚汗嗜卧,用六君加柴胡、山栀。
入肺则面白喘急,用异功散加柴胡、桔梗。入肾则面黑,啮奶切牙,用六味地黄丸。
若因乳母恚怒肝火,或膏粱积热,遗儿为患,或儿吐泻伤脾,清气不升,风木陷入
太阴传变等因,皆能致此,当随主治,否则必成慢脾也,须预慎防为善。
【曾氏论述】又有在急惊、天钓(一种以颈项强直、角弓反张为特征的儿科急症)之后,转变为潮热(发热如潮汐般定时发作),手足逆冷且症状类似疟疾的情况。这主要是因为病愈之时,护理不当,外感风邪,乘身体虚弱之际侵入经络,未能及时解散,从而导致上述症状。医经说:阳气重极必转化为阴证。又说:亢盛则产生危害,有所承制才能平衡。说的就是这个道理。适宜服用柴胡加桂汤及当归散;体质气实者,可稍用乌犀丸、水晶丹略作通利治疗;使用匀气散止住补益药可能带来的滞碍,随后用参苓白术散进行调理,自然能够平复痊愈。此证所用药物,间杂苦寒之品,务必在于消除阳盛之火,使肺金之气得以胜复,肝木之气自然平和,风邪也随之消散,这才是良法。
柴胡加桂汤(见《伤寒论》相关章节) 当归散(见痢疾章节) 乌犀丸 水晶丹(均见于癖积章节) 匀气散(见腹痛章节) 参苓白术散(见泄泻章节)
海藏先生云:心神不安,可在四君子汤中加入辰砂半钱,用枣汤调服。又有一种证候,欲发疮疹时,先出现身热惊跳,或发生抽搐,这不是惊风,应当使用发散药治疗。【曾氏论述】暑风一证,因夏季感冒风热太甚,导致面色垢浊、嘴唇红赤,脉象沉细数,忽然发生惊搐,不省人事,治疗宜用消暑清心饮、辰砂五苓散及琥珀抱龙丸,即可安宁,切勿使用温补药剂。
消暑清心饮:解除伏热中暑,烦躁口渴,神气不清,以及伴有惊搐,名为暑风证,投药即效。
香薷(去除老梗) 泽泻(去除粗皮,各一两) 扁豆(炒熟,去壳,研碎) 净黄连 羌活 猪苓(去皮) 浓朴(去除粗皮,姜汁浸透后炒制) 白术 干葛 赤茯苓(去皮) 升麻 川芎(各半两) 甘草(三钱)
以上药材切碎。每次服用二钱,加水一盏,煎至七分,不拘时候,带凉服用。治疗暑风证先投此剂见效后,再服用却暑丹,抽搐便不再发作。
薛氏在急慢惊痫之外,又提出惊风一证,其表现为虚怯易惊、怔忡,气短神散,痰涎往来,大便泄泻色青,这是惊证较轻而兼有虚损的表现。若惊邪入心,则面赤夜间啼哭,用栀子清肝散加黄连。入肝则面青眼球上窜,用柴胡清肝散。入脾则面黄呕吐,虚汗嗜睡,用六君子汤加柴胡、山栀。入肺则面白喘急,用异功散加柴胡、桔梗。入肾则面黑,咬奶切牙,用六味地黄丸。若是因乳母愤怒导致肝火,或饮食膏粱积热,遗患于婴儿,或婴儿吐泻损伤脾胃,清气不升,风木陷入太阴传变等原因,皆能导致此证,应当随证主治,否则必然演变为慢脾风,必须预先谨慎防范才好。
[Mr. Zeng's Discussion] Furthermore, after acute convulsion (Ji Jing) or Tian Gou (a pediatric emergency characterized by neck stiffness and opisthotonos), the condition may transform into tidal fever (Chao Re, fever that occurs at regular intervals resembling the tide), with cold extremities and symptoms resembling malaria. This is primarily because during recovery, improper nursing led to external wind pathogen invasion, which entered the meridians taking advantage of the body's deficiency, and failed to be dispersed, resulting in such symptoms. The classics state: "When Yang reaches its extreme, it transforms into Yin." And again: "Excess leads to harm; balance is achieved through control." This illustrates this principle. It is appropriate to administer Chaihu Jia Gui Tang (Bupleurum and Cinnamon Twig Decoction) and Danggui San (Angelica Powder); for those with excess Qi, Wuxi Wan (Black Rhinoceros Horn Pill) and Shuijing Dan (Crystal Pill) can be slightly used to promote mild purgation; Yunqi San (Harmonizing Qi Powder) should be used to prevent stagnation from tonifying herbs, followed by Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) for regulation, leading to natural recovery. The medications used in this syndrome include bitter-cold substances interspersed among others, aiming to eliminate excessive Yang fire, allowing Lung Metal to regain dominance, Liver Wood to naturally calm, and wind pathogens to disperse, which constitutes a good method.
Chaihu Jia Gui Tang (See Shanghan Lun) Danggui San (See Dysentery section) Wuxi Wan Shuijing Dan (Both seen in Pi Ji section) Yunqi San (See Abdominal Pain section) Shenling Baizhu San (See Diarrhea section)
Mr. Haizang stated: For unsettled heart spirit, add half a qian of Chen Sha (Cinnabar) to Sijunzi Tang (Four Gentlemen Decoction), taken with jujube soup decoction. There is another syndrome where, prior to the eruption of sores/rashes, there is initial body heat with startle/jumping or convulsions; this is not wind-stroke but should be treated with dispersing herbs. [Mr. Zeng's Discussion] The syndrome of Summer-Wind (Shu Feng) arises from severe contraction of wind-heat in summer, causing a greasy complexion, red lips, a deep, fine, and rapid pulse, sudden convulsions, and loss of consciousness. Treatment involves Xiaoshu Qingxin Yin (Summer-Heat Clearing Heart Infusion), Chen Sha Wuling San (Cinnabar Five-Ingredient Powder), and Hupo Baolong Wan (Amber Embracing Dragon Pill) to restore peace; warm tonics must strictly be avoided.
Xiaoshu Qingxin Yin: Resolves latent heat and summer-heat stroke, irritability, thirst, unclear spirit, and accompanying convulsions; named Summer-Wind Syndrome, effective upon administration.
Xiangru (Elsholtzia Herba, remove old stems) Zexie (Alismatis Rhizoma, remove coarse skin, each 1 liang) Bian Dou (Faba Seed, stir-fried, shelled, ground) Jing Huanglian (Coptidis Rhizoma, purified) Qianghuo (Notopterygii Rhizoma et Radix) Zhuling (Polypori Umbellati Sclerotium, remove skin) Houpo (Magnoliae Officinalis Cortex, remove coarse skin, soaked in ginger juice, stir-fried) Baizhu (Atractylodis Macrocephalae Rhizoma) Gange (Puerariae Lobatae Radix) Chi Fuling (Polypori Umbellati Sclerotium, red, remove skin) Shengma (Cimicifugae Rhizoma) Chuanxiong (Ligusticum Chuanxiong Rhizoma, each half liang) Gancao (Glycyrrhizae Radix et Rhizoma, 3 qian)
Crush the above ingredients. Take 2 qian per dose, add one lamp of water, decoct to 0.7 parts, take at any time while cool. Treating Summer-Wind Syndrome, first administer this formula for effect, then take Que Shu Dan (Summer-Heat Dispelling Pill), and convulsions will cease.
Mr. Xue, besides acute and chronic convulsions/epilepsy, proposed another syndrome called Wind-Stroke (Jing Feng), characterized by timidity due to deficiency, palpitations, shortness of breath and scattered spirit, fluctuating phlegm-saliva, and green-colored diarrhea. This is a mild form of shock combined with deficiency. If shock enters the Heart, there is red face and night crying; use Zhizi Qinggan San (Gardenia Liver-Clearing Powder) added with Huanglian. If entering the Liver, there is blue face and upward staring eyes; use Chaihu Qinggan San (Bupleurum Liver-Clearing Powder). If entering the Spleen, there is yellow face, vomiting, spontaneous sweating, and lethargy; use Liujun Zi Tang (Six Gentlemen Decoction) added with Chaihu and Shanzhi. If entering the Lung, there is pale face and wheezing/urgency; use Yigong San (Yi Gong Powder) added with Chaihu and Jiegeng. If entering the Kidney, there is black face, biting milk/chattering teeth; use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). If caused by the wet nurse's anger leading to Liver Fire, or accumulation of heat from rich/greasy food passed to the infant, or infant vomiting/diarrhea damaging the Spleen causing clear Qi not to ascend, with Wind-Wood sinking into Taiyin transformation, etc., all can cause this. One must treat according to the specific manifestation; otherwise, it will inevitably become Slow Spleen Wind (Man Pi Feng). Precautionary prevention is essential.