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According to *Bencao Gangmu* (Compendium of Materia Medica): Dian and Xian refer to dizziness. When phlegm stays in the diaphragm, the dizziness is mild and does not cause collapse; when phlegm fills the upper diaphragm, the dizziness is severe, causing collapse to the ground and loss of consciousness, which is called Epilepsy (Dian-Xian). In adults it is called Dian, in children it is called Xian, but in essence they are the same disease. However, it differs from the collapse caused by Wind-Stroke (Zhongfeng), Cold-Strike (Zhonghan), Summerheat-Strike (Zhongsu), and Corpse-Jue (Shijue). Whenever an epileptic seizure causes collapse, there is a sound made in the mouth, saliva is expectorated as the patient is about to wake up, and after waking, the seizure recurs; it comes and goes intermittently without rest. In contrast, for Wind-Stroke, Cold-Stroke, Summerheat-Stroke, and Corpse-Jue, there is no sound during collapse, no saliva upon waking, and no recurrence afterwards. Even if there is occasional recurrence, it is not like the frequent attacks seen in epilepsy.

Epilepsy (Xian) and Spasm (Jing) are slightly similar but essentially different. When the disease manifests with a soft body and intermittent consciousness, it is called Xian; when the body is stiff and arched backward like a bow, with infrequent recovery of consciousness, it is called Jing. The Xian disease occurs with the tide-like action of phlegm, so there are times of consciousness; Jing disease is more severe than Xian and may involve deficiency, so many die due to stupor and loss of consciousness. Therefore, Zhu Danxi said: This is Qi deficiency combined with Fire and Phlegm. It is appropriate to use substances like Ginseng (Renshen) and Bamboo Sap (Zhuli). One must absolutely not treat it as a Wind syndrome and use Wind-dispelling herbs.

Xian is caused by Phlegm-Fire. Some predecessors called it Wind-Xian. Liu Hejian believed it arises from excessive Heat leading to Wind-Dryness, which acts as a concurrent transformation, causing saliva to overflow the chest and diaphragm, resulting in convulsions (Chouye), stupor, stiffness, and collapse. However, patients with Xian have saliva coming from the mouth, cold sweat from the body, and clear mucus from the nose. This is because the pathogens of the Yang Qiao Mai, Yin Qiao Mai, Du Mai, and Chong Mai ascend. Generally, this is due to the Kidney failing to withstand the boiling and scalding, causing upward movement. Daytime attacks belong to the Yang Qiao Mai, and nighttime attacks belong to the Yin Qiao Mai. This is a disease of the extraordinary vessels, not confined by the Five Elements, Yin-Yang, or the twelve regular meridians. It should be treated according to the methods for extraordinary pathogens affecting the Du, Chong, and two Qiao vessels.

Note: Ancient formulas for Xian sometimes mention Wind, sometimes Jing-Xian, sometimes Dian-Xian. This is because this disease is similar to Wind-Stroke, Dian-Kuang (Manic-Depressive Disorder), and Ji-Man Jing Feng (Acute and Chronic Convulsive Disorders), hence the different names. Tracing its origin, it may result from fright received in the womb, or from being startled by a sudden loud noise. Since children's Shen (Spirit) and Qi are still weak, fright causes the Shen to lose its residence. When the residence is empty, Phlegm-Saliva gathers there. Alternatively, irregular diet damages the Spleen and Stomach, accumulating into Phlegm-Fluids, which confuse the Heart orifices and cause the disease. Treatment must focus on identifying Fire and Phlegm. Predecessors often used sedative and heart-clearing drugs, which can indeed treat Heat and clear Phlegm. However, for stubborn, glued-up Phlegm, these drugs cannot easily expel it. If the Phlegm is in the upper part, emesis (Vomiting therapy) must be used first, followed by liver-calming formulas such as Qingdai Chaihu Longhui Wan. If the Phlegm is firmly rooted internally, purgation (Downward-draining therapy) is also necessary. Therefore, Zhu Danxi said: Xian belongs to Fright and Phlegm; there is no need to divide it into five categories. Generally, moving Phlegm is the main approach. Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Gualuo (Trichosanthis Fructus), Banxia (Pinelliae Rhizoma), and Nanxing (Arisaematis Rhizoma Preparatum) are used according to the amount of Phlegm-Fire.

Note: The root of Xian syndrome is Phlegm-Heat, so acrid-cold agents are suitable. Why then is Fuzi (Prepared Aconiti Lateralis Radix) used? Generally, Xian involves Phlegm and Blood-Stasis knotting between the Heart and Chest. Whenever Fire stirs, the disease erupts. Unless Fuzi, with its hot nature that moves freely and does not stay put, can circulate stagnation and disperse stubborn Phlegm! This is a "following treatment" method, belonging to drastic remedies (Jieji), used only out of necessity. Similarly, Wind-Stroke is fundamentally a Wind-Fire Yang pathogen, yet Wutou (Aconiti Radix) and Fuzi are used. Therefore, acrid-hot medicines are only suitable for fat, white-skinned individuals with much Phlegm, when other drugs fail. For black, thin individuals with much Fire, they are not suitable.

Chan Zhen (Tremor and Vertigo) is not chattering teeth due to cold, but rather Liver-Wood Fire flourishing excessively, with insufficient Kidney Yin. This results in lower deficiency and upper excess: the excess is Phlegm-Fire, and the deficiency is Kidney depletion. The principle is to clear the upper and tonify the lower.

Yi (Spasm/Contraction) refers to shrinking. Chan (Extension) refers to stretching. Continuous contraction and extension, with hands pulling like a saw, is similar to Chu Nuo (Clonic Jerking). Tendon urgency and shrinking constitute Yi; tendon relaxation and slackness constitute Chan; continuous contraction and extension constitute Yi Chan, commonly known as convulsions. Excessive sweating without cessation indicates Deficiency; absence of sweating with ability to eat indicates Excess.

It is stated that Heat, Mao (Obscuration/Stupor), and Yi all belong to Fire. When Heat prevails and combats Wind, merging into the collaterals, Wind acts dynamically and restlessly. Wind and Fire multiply each other, thus generating Mao Yi. Treatment uses agents that dispel Wind and purge Heat. Clearing the Fire-Heat will immediately cure Mao Yi. If cauterization is recklessly applied, or diaphoretic agents are drunk, death will follow instantly.