庄在田曰∶慢惊之症，缘小儿吐泻得之为最多，或久疟久痢，或痘后，或疹后，或因风
寒饮食积滞过用攻伐伤脾，或秉赋本虚，或误服凉药，或因急惊而用药攻降太甚，或失于调
理，皆可致此症也。其症神昏气喘，或大热不退，眼开惊搐，或乍寒乍热，或三阳晦暗，或
面色淡白青黄，或大小便清白，或口唇虽开裂出血而口中气冷，或泻利冷汗，或完谷不化，
或四肢冰冷，并至腹中气响，喉内痰鸣，角弓反张，目光昏暗。此虚症也，亦危症也。俗名
天吊风、虚风、慢惊风、慢脾风，皆此症也。若再用寒凉，再行消导，或用胆星、抱龙以除
痰，或用天麻、全蝎以驱风，或用知、柏、芩、连以清火，或用巴豆、大黄以去积，杀人如
反掌，实可畏也。若治风而风无可治，治惊而惊亦无可治，此实因脾肾虚寒，孤阳外越，元
气无根，阴寒至极，风之所由动也。治宜先用辛热，再加温补。盖补土所以敌木，治本即所
以治标。凡小儿一经吐泻交作，即是最危之症。若其屡作不止，无论痘后、疹后、病后，不
拘何因，皆当急用参、术以救胃气，姜、桂、杞、熟等药以救肾气。不惟伤食当急救之，即
伤寒、伤暑亦当急救之。盖其先虽有寒暑实邪，一经吐泻，业已全除，脾胃空虚，仓廪空乏
，若不急救，恐虚痰上涌、命在顷刻也。庸医见之，皆误指为热为食，投以清火去积凉药，
立时生变，为之奈何，与其失之寒凉，断难生活，不若失之温补，犹可救疗。此语发明吐泻
惊风之理，最为明透，后之君子，愿无忽诸。今将慢惊辨证胪列于后∶
一慢惊吐泻，脾胃虚寒也。一慢惊身冷，阳气抑遏不出也。服凉药之后往往致此。一慢
惊鼻孔煽动，真阴失守，虚火烁肺也。一慢惊面色青黄及白，气血两虚也。一慢惊口鼻中气
冷，中寒也。一慢惊大小便清白，肾与大肠全无火也。一慢惊昏睡露睛，神气不足也。一慢
惊手足抽搐，血不行于四肢也。一慢惊角弓反张，血虚筋急也。一慢惊乍热乍凉，阴血虚少
，阴阳错乱也。一慢惊出汗如洗，阳虚而表不固也。一慢惊手足螈 ，血不足以养筋也。一
慢惊囟门下陷，虚至极也。一慢惊身虽发热，口唇焦裂出血，却不喜饮冷茶水，进以寒凉，
愈增危笃。以及所吐之乳，所泻之物皆不甚消化，脾胃无火可知，唇之焦墨乃真阴之不足也
明矣。
大凡因发热不退及吐泻而成者，总属阴虚阳越，必成慢惊，并非感冒风寒发热可比，故
不宜发散。治宜培元救本，加姜、桂以引火归元，必先用辛热冲开寒痰，再进温补方为得法
。经验二方列后。
逐寒荡惊汤∶此方药性温暖，专治小儿气体本虚，或久病不愈，或产后、疹后，或误服
寒凉，泄泻呕吐转为慢惊。清热散风，愈治愈危，速宜服此，能开寒痰，宽胸膈，止呕吐，
荡惊邪，所谓回元气于无何有之乡。一二剂后，呕吐渐止，即其验也。认明但系虚寒，即宜
服之，不必疑畏也。胡椒、炮姜、肉桂各一钱、丁香十粒，上四味，研为细末，以灶心土三
两煮水澄极清，煎药大半茶杯，频频灌之，接服后方，定获奇效。
加味理中地黄汤∶此方助气补血，却病回阳，专治小儿精神已亏，气血大坏，形状野狼狈
，瘦弱至极，皆可挽回。如法浓煎，频频与服，参天救本之功，有难以尽述者。熟地五钱，
焦术三钱，党参、当归、炙 、故纸、枣仁（炒研）、枸杞各二钱，炮姜、萸肉、炙草、肉
桂
药汁
如咳嗽不止者，加粟壳一钱，金樱子一钱；如大热不退，加白芍一钱；泄泻不止，加丁
香六分，只服一剂，即去附子，止用丁香七粒。隔二三日只服附子二三分，盖因附子太热，
中病即宜去之也。如用附子太多，则小便闭塞不出，如不用附子，则沉寒脏腑固结不开。如
不用丁香，则泄泻不止。若小儿虚寒至极，附子又不妨用至二三钱，此所谓神而明之，存乎
其人，用者审之。
此方乃救阴固本之要药，治小儿慢惊称为神剂。若小儿吐泻不至日甚，或微见惊搐，胃
中尚可受药，吃乳便利者，并不必服逐寒荡惊汤，只服此药一剂，而风定神清矣。如小儿尚
未成惊，不过昏睡发热不退，或时热时止，或日间安静夜间发热，以及午后发热等症，总属
阴虚，均宜服之。若新病壮实之小儿，眼红口渴者，乃实火之症，方可暂行清解。但果系实
火，必大便闭结，气壮声洪，且喜多饮冷茶水。若吐泻交作，则非实火可知矣。此方补造化
阴阳所不足，实回生起死有神功。倘大虚之后，服一剂无效，必须大剂，多服为妙。
近来所卖之抱龙、牛黄等丸，皆清热化痰之药，急惊最为对症，若慢惊之甚者，下喉即
死。
如乡村制药不及，急取鸡鸭窝（要养鸡鸭数十年者）粪泥下净土一撮（去粪数寸者，不
要
庄在田说：慢惊风这一病症，大多是因为小儿患吐泻病而引发的，或者是由于长期疟疾、长期痢疾，或者是在痘疹痊愈之后，又或是因为感受风寒、饮食积滞，过度使用攻伐药物损伤了脾胃，或者先天体质虚弱，或者误服了寒凉药物，或者因为急惊风用药攻下太过猛烈，或者护理不当，这些情况都可能导致此症。其症状表现为神志昏迷、气喘，或者高热不退，眼睛睁开且受惊抽搐，或者忽冷忽热，或者三阳经（太阳、阳明、少阳）晦暗无光，或者面色淡白或青黄，或者大小便颜色清稀白色，或者口唇虽然开裂出血但口中呼出的气息寒冷，或者腹泻伴有冷汗，或者大便中有未消化的食物，或者四肢冰冷，甚至腹部肠鸣作响，喉间有痰鸣声，身体向后反折如弓状（角弓反张），目光昏暗。这属于虚证，也是危重之证。俗称天吊风、虚风、慢惊风、慢脾风，都是指这种病症。如果再用寒凉药物，再进行消食导滞，或者使用胆南星、抱龙丸来化痰，或者使用天麻、全蝎来祛风，或者使用知母、黄柏、黄芩、黄连来清热泻火，或者使用巴豆、大黄来去除积滞，杀人就像翻手掌一样容易，实在令人畏惧。如果治风而风无法可治，治惊而惊也无法可治，这实际上是因为脾肾阳虚寒盛，孤阳外越，元气没有根基，阴寒达到极点，风气因此而动。治疗应当先用辛热药物，再加用温补药物。因为补益脾胃（土）可以制约肝木（木），治本也就是治标。凡是小儿一旦吐泻交作发作，就是最危险的病症。如果反复发作不止，无论痘后、疹后、病后，不论什么原因，都应当紧急用人参、白术来挽救胃气，用干姜、肉桂、枸杞、熟地黄等药物来挽救肾气。不仅仅是伤食需要急救，即使是伤寒、伤暑也应当急救。因为起初虽然有寒暑实邪，但一经吐泻，邪气已经全部排出，脾胃空虚，仓廪空乏，如果不紧急救治，恐怕虚痰上涌，性命就在顷刻之间。庸医见到这种情况，都错误地认为是热证或食积，投以清热泻火、去积的凉药，立刻产生变证，对此该怎么办呢？与其失误于使用寒凉药物，导致难以存活，不如失误于使用温补药物，还有可能救疗。这段话阐明了吐泻惊风的道理，最为透彻明白，后来的医者，希望不要忽视它。现在将慢惊风的辨证列举如下：
一是慢惊吐泻，这是脾胃虚寒。
二是慢惊身冷，这是阳气被抑制不能外出。服用凉药后往往导致这种情况。
三是慢惊鼻孔煽动，这是真阴失守，虚火灼烧肺脏。
四是慢惊面色青黄及白色，这是气血两虚。
五是慢惊口鼻中气息寒冷，这是中焦寒盛。
六是慢惊大小便清白，这是肾与大肠完全没有火力。
七是慢惊昏睡且眼睛半开露睛，这是神气不足。
八是慢惊手足抽搐，这是血液不能运行到四肢。
九是慢惊角弓反张，这是血虚导致筋脉拘急。
十是慢惊忽冷忽热，这是阴血亏少，阴阳错乱。
十一是慢惊出汗如雨，这是阳虚且表卫不固。
十二是慢惊手足蠕动（瘛疭），这是血液不足以滋养筋脉。
十三是慢惊囟门下陷，这是虚损到了极点。
十四是慢惊身体虽然发热，口唇焦裂出血，却不喜欢喝冷饮茶水，给予寒凉药物，会使病情更加危重。以及所呕吐的乳汁，所排泄的物质都不甚消化，可知脾胃没有火力，嘴唇焦黑显然是真阴不足所致。
大凡因为发热不退及吐泻而形成的，总属阴虚阳越，必然形成慢惊风，并不是普通的感冒风寒发热可以相比的，所以不宜使用发散解表的方法。治疗应当培补元气、挽救根本，加入干姜、肉桂以引火归元，必须先用辛热药物冲散寒痰，再进用温补药物才是正确的方法。经验方两个列在后面。
逐寒荡惊汤：这个方剂药性温暖，专门治疗小儿先天体质本虚，或者久病不愈，或者产后、疹后，或者误服寒凉药物，泄泻呕吐转为慢惊风。若用清热散风的方法，治愈后反而更危险，应迅速服用此方，能开通寒痰，宽畅胸膈，停止呕吐，驱荡惊邪，所谓“回元气于无何有之乡”。服用一二剂后，呕吐逐渐停止，就是验证。认清只要是虚寒证，就应当服用，不必怀疑畏惧。胡椒、炮姜、肉桂各一钱，丁香十粒，以上四味药，研成细末，用灶心土三两煮水澄清至极清，煎药至大半茶杯，频频灌服，接着服用后方，定能获得奇效。
加味理中地黄汤：这个方剂助气补血，祛除疾病、挽回阳气，专门治疗小儿精神已亏损，气血大坏，形体狼狈不堪，瘦弱至极，都可以挽回。依法浓煎，频频给患儿服用，具有参天救本的功效，难以尽述。熟地黄五钱，炒白术三钱，党参、当归、炙黄芪、故纸（补骨脂）、枣仁（炒研）、枸杞各二钱，炮姜、山茱萸、炙甘草、肉桂、附子（原文此处似缺字，根据上下文及常规配伍推测为附子，但严格按原文提取则无，此处依原文“炙 ”推测漏字，结合后文提到附子用法，此处实体提取时需注意，原文显示为“炙 ”，后文有“只去附子”，故推断前文应有附子或类似温阳药，但按严格原文提取，此处仅列出可见药材名，若“炙 ”后无字，则不计入，但通常理中汤类含人参/党参、白术、干姜、甘草，地黄汤含熟地等。原文“炙 ”后似乎缺失，结合后文“只服一剂，即去附子”，说明方中含有附子。但在提取时，我将依据可见文字和明确提到的药材）。*注：原文中“炙 ”后可能有缺字，根据后文“只去附子”，方中应含附子。* 熟地黄五钱，焦白术三钱，党参、当归、炙黄芪（推测）、补骨脂、炒枣仁、枸杞各二钱，炮姜、山茱萸、炙甘草、肉桂、附子（根据后文推断存在）。*修正：严格按原文提取，原文为“炙 ”，后接“故纸”，中间疑似缺字。后文提到“只去附子”，说明方中有附子。*
如果咳嗽不止，加粟壳一钱，金樱子一钱；如果高热不退，加白芍一钱；泄泻不止，加丁香六分，只服一剂，就去掉附子，只用丁香七粒。隔两三天只服用附子二三分，因为附子太热，中病（见效）后就应当去掉。如果使用附子太多，会导致小便闭塞不出；如果不用附子，则沉寒脏腑固结不开。如果不用丁香，则泄泻不止。如果小儿虚寒至极，附子不妨用到二三钱，这就是所谓的“神而明之，存乎其人”，使用者要审慎。
这个方子是救阴固本的要药，治疗小儿慢惊风被称为神剂。如果小儿吐泻不至于日益加重，或者轻微出现惊搐，胃中还可以受纳药物，吃奶正常，大便通畅的，并不一定非要服用逐寒荡惊汤，只服用此药一剂，风就会平息，神志就会清醒。如果小儿尚未形成惊风，不过是昏睡发热不退，或者时热时止，或者白天安静夜间发热，以及午后发热等症状，总属阴虚，都适宜服用。如果是新病壮实的小儿，眼睛红、口渴的，那是实火证，才可以暂时使用清热解表的方法。但如果是真正的实火，必定大便闭结，气壮声洪，并且喜欢多喝冷饮茶水。如果吐泻交作，那就不是实火，这是显而易见的。这个方子补益造化阴阳的不足，确实有起死回生的神奇功效。如果在极度虚弱之后，服用一剂无效，必须使用大剂量，多服用为好。
近来所售卖的抱龙丸、牛黄丸等，都是清热化痰的药物，急惊风最为对症，如果是慢惊风严重的患者，服下喉咙就会死亡。
如果在乡村制药不及，急需取鸡鸭窝（要养鸡鸭数十年者）粪泥下的净土一撮（去掉表层粪便数寸者，不要...
Zhuang Zaitian stated: The syndrome of Slow Convulsion (Man Jing) is most commonly caused by vomiting and diarrhea in infants. It may also result from prolonged malaria or dysentery, occurring after the eruption of smallpox or chickenpox, or due to wind-cold invasion, food stagnation, and excessive use of purgative drugs that damage the Spleen and Stomach. It can also be caused by congenital deficiency, misadministration of cold-natured medicines, excessive downward-draining treatment for Fast Convulsion (Ji Jing), or improper nursing care. All these factors can lead to this syndrome. The symptoms include unconsciousness, panting, persistent high fever, eyes open with convulsions upon fright, alternating chills and fever, dullness of the Yang channels (Taiyang, Yangming, Shaoyang), pale white or greenish-yellow complexion, clear and colorless urine and stool, cracked and bleeding lips but with cold breath, diarrhea accompanied by cold sweat, undigested food in stool, cold limbs, abdominal borborygmus, phlegm rale in the throat, opisthotonos (body arched backward like a bow), and dim vision. This is a deficiency syndrome and also a critical condition. Commonly known as Tiandiao Feng, Xu Feng, Man Jing Feng, or Man Pi Feng, all refer to this same syndrome. If cold-natured medicines are used again, or if digestive-promoting methods are applied, or if Nanxing (Arisaema Cum Bile) and Baolong Wan are used to resolve phlegm, Tianma (Gastrodia Rhizome) and Quanxie (Scorpio) are used to dispel wind, Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix), and Lianzi (Coptidis Rhizoma) are used to clear fire, or Badou (Crotonis Fructus) and Dahuang (Rhei Radix et Rhizoma) are used to remove accumulation, death will occur as easily as turning one's palm, which is truly terrifying. If treating wind finds no wind to treat, and treating convulsion finds no convulsion to treat, it is actually because of Spleen and Kidney Yang deficiency and cold, floating isolated Yang, Yuan Qi lacking a root, and extreme Yin cold causing the movement of wind. Treatment should first employ pungent-hot herbs, followed by warming and tonifying methods. Tonifying Earth (Spleen/Stomach) controls Wood (Liver); treating the root is treating the branch. Whenever an infant suffers from simultaneous vomiting and diarrhea, it is the most critical condition. If it recurs frequently, regardless of whether it follows smallpox, chickenpox, or other illnesses, and regardless of the cause, Shenqi (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) should be urgently used to rescue Stomach Qi, while Jiang (Zingiberis Rhizoma), Guirui (Cinnamomi Ramulus), Gouqi (Lycii Fructus), and Shudi (Rehmanniae Radix Praeparata) should be used to rescue Kidney Qi. Not only food stagnation requires urgent rescue, but also Shanghan (Cold Damage) and Shangshu (Summerheat Injury) require urgent rescue. Although there may initially be excess pathogens of cold or summerheat, once vomiting and diarrhea occur, the pathogens are largely expelled, leaving the Spleen and Stomach empty and the granaries depleted. Without urgent rescue, floating phlegm may surge upward, and life may hang in the balance. Quack doctors, seeing this, mistakenly diagnose it as heat or food stagnation, administering cooling and clearing-purgative medicines, leading to immediate complications. What can be done? Rather than erring on the side of cold-natured medicines, making survival difficult, it is better to err on the side of warming and tonifying, which still offers a chance for recovery. This statement elucidates the principles of convulsion due to vomiting and diarrhea most clearly. Future practitioners should not ignore this. The differentiation of Slow Convulsion is listed below:
1. Slow Convulsion with vomiting and diarrhea: Spleen and Stomach deficiency-cold.
2. Slow Convulsion with cold body: Yang Qi suppressed and unable to emerge. Often caused by taking cold medicines.
3. Slow Convulsion with flaring nostrils: True Yin failing to hold fast, deficient fire scorching the Lung.
4. Slow Convulsion with greenish-yellow and white complexion: Deficiency of both Qi and Blood.
5. Slow Convulsion with cold breath from mouth and nose: Middle Jiao cold excess.
6. Slow Convulsion with clear and colorless urine and stool: Complete lack of Fire in the Kidney and Large Intestine.
7. Slow Convulsion with drowsiness and staring eyes: Insufficiency of Shen Qi (Spirit Qi).
8. Slow Convulsion with twitching of hands and feet: Blood failing to circulate to the four limbs.
9. Slow Convulsion with opisthotonos: Blood deficiency causing tendon tension.
10. Slow Convulsion with alternating hot and cold: Insufficient Yin Blood, disorder of Yin and Yang.
11. Slow Convulsion with profuse sweating: Yang deficiency and insecure exterior.
12. Slow Convulsion with clonic spasms of hands and feet: Blood insufficient to nourish the tendons.
13. Slow Convulsion with sunken fontanelle: Extreme deficiency.
14. Slow Convulsion with fever despite burning and cracking lips with bleeding, yet no desire for cold drinks: Administering cold medicines worsens the critical condition. The vomited milk and excreted matter are poorly digested, indicating lack of Fire in the Spleen and Stomach; the blackened lips indicate insufficiency of True Yin.
Generally, cases resulting from persistent fever and vomiting/diarrhea belong to Yin deficiency with floating Yang, inevitably leading to Slow Convulsion. They are not comparable to common colds with wind-cold fever, so dispersing methods are inappropriate. Treatment should focus on nurturing Yuan Qi and saving the root, adding Jiang (Zingiberis Rhizoma) and Guirui (Cinnamomi Ramulus) to guide fire back to its source. One must first use pungent-hot herbs to disperse cold-phlegm, then proceed with warming and tonifying methods. Two empirical formulas are listed below.
Zh Han Dang Jing Tang (Eliminate Cold and Dispel Convulsion Decoction): This formula has warm properties and is specifically for infants with congenital deficiency, prolonged illness, postpartum/post-rash states, or those who took cold medicines incorrectly, leading to slow convulsion from diarrhea and vomiting. Using heat-clearing and wind-dispersing methods will make the condition worse; this formula should be taken quickly. It can open cold-phlegm, widen the chest and diaphragm, stop vomiting, and dispel convulsive pathogens, effectively "returning Yuan Qi to the realm of nothingness." After one or two doses, vomiting gradually stops, which is the verification. Recognizing it as a deficiency-cold syndrome, it should be taken without hesitation. Hu jiao (Piperis Longi Fructus), Paogjiang (Prepared Zingiberis Rhizoma), Rougui (Cinnamomi Cortex) each 1 qian, Dingxiang (Caryophylli Flos) 10 grains. Grind the above four ingredients into fine powder. Boil 3 liang of Zaoshintu (Furnace Soil) in water until extremely clear, decoct the medicine in half a teacup of this liquid, and administer frequently. Follow with the next formula for miraculous effects.
Jiawei Lizhong Dihuang Tang (Modified Regulate the Middle and Rehmannia Decoction): This formula boosts Qi and nourishes Blood, expels disease, and restores Yang. It is specifically for infants whose spirit is depleted, Qi and Blood are severely damaged, appearing emaciated and wretched, who can still be saved. Decoct strongly according to method and administer frequently. Its merit in rescuing the root is hard to describe fully. Shudi (Rehmanniae Radix Praeparata) 5 qian, Jiaozhu (Charred Atractylodis Macrocephalae Rhizoma) 3 qian, Dangshen (Codonopsis Radix), Danggui (Angelicae Sinensis Radix), Zhishaoyao (Prepared Paeoniae Radix Alba - *Note: Text says 'Zhi ', likely missing character, context implies tonifying herb*), Guzhi (Psoraleae Fructus), Zaoren (Ziziphi Spinosomi Semen, stir-fried and ground), Gouqi (Lycii Fructus) each 2 qian, Paogjiang (Prepared Zingiberis Rhizoma), Yurou (Corni Fructus), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma), Rougui (Cinnamomi Cortex), Fuzi (Aconiti Lateralis Radix Praeparata - *implied by later text*).
If cough persists, add Sukewan (Papaveris Pericarpium) 1 qian, Jinyingzi (Chrysanthemi Fructus - *Note: Jinyingzi is Euryales Semen*) 1 qian. If high fever persists, add Baishao (Paeoniae Radix Alba) 1 qian. If diarrhea persists, add Dingxiang (Caryophylli Flos) 6 fen; take only one dose, then remove Fuzi (Aconiti Lateralis Radix Praeparata) and use only seven Dingxiang grains. Every two or three days, use only 2-3 fen of Fuzi, because Fuzi is too hot and should be removed once the disease is addressed. Too much Fuzi causes urinary retention; no Fuzi leaves deep cold in the organs unresolved. No Dingxiang leads to persistent diarrhea. If the infant's deficiency-cold is extreme, Fuzi can be used up to 2-3 qian. This illustrates that "divinity lies in the practitioner," so users must exercise caution.
This formula is a key medicine for saving Yin and consolidating the root, called a divine agent for treating infant slow convulsion. If the infant's vomiting and diarrhea do not worsen daily, or show only slight convulsions, can tolerate medicine, nurse normally, and have smooth bowel movements, Zh Han Dang Jing Tang is not necessary; taking just one dose of this formula will calm the wind and clarify the spirit. If the infant has not yet developed convulsion, but has drowsiness and persistent fever, intermittent fever, quiet during day but fever at night, or afternoon fever, all belong to Yin deficiency and are suitable for this formula. For newly ill, robust infants with red eyes and thirst, it is an excess-fire syndrome, and temporary heat-clearing and resolving methods can be used. But true excess-fire presents with constipation, strong voice, and preference for cold drinks. Vomiting and diarrhea together indicate it is not excess-fire. This formula supplements the insufficiency of creation's Yin and Yang, possessing miraculous powers to revive the dying. If ineffective after one dose following extreme deficiency, larger doses and multiple administrations are advisable.
The Baolong Wan and Niuhuang Wan sold recently are heat-clearing and phlegm-resolving medicines, most suitable for Fast Convulsion. For severe Slow Convulsion, they are fatal upon ingestion.
If pharmacy preparation is unavailable in rural areas, urgently take a pinch of pure soil from under the dung mud of chicken or duck nests (from nests used for decades), removing the top few inches of dung...