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Pediatric acute convulsion syndrome (Ji Jing Feng) fundamentally arises from heat generating in the Heart, manifesting as fever, flushed face, thirst, hot breath, yellow and dark urine and stool; in severe cases, convulsions occur.

Since excessive heat generates wind, and wind is associated with the Liver, this represents an excess of Yang and deficiency of Yin. The primary treatment is Lijing Wan (Detoxifying Convulsion Pill) to eliminate phlegm-heat. One must not use Crotonis Fructus (Badou, 巴豆) or warm medicines for drastic purgation, lest the convulsions cease but the deficient heat remains unresolved.

If hot-phlegm lodges in the Heart and Stomach, or if the child is startled by loud, inappropriate noises causing fright, convulsions will ensue, returning to normal after the episode; this indicates a lack of Yin. If heat is extreme, spontaneous convulsions may occur even without auditory stimuli or fright.

The manifestations of acute convulsion include upward rolling of the eyes, opisthotonos, limb spasms, salivation, and high fever. Some children exhibit erratic gaze, some have stiff bodies (Stiffness refers to rigid extension, belonging to Yang), some collapse (Collapse refers to falling forward, belonging to Yin), and clenched fists may be directed inward or outward. Physicians must differentiate based on gender and determine the principles of Yin-Yang auspiciousness and inauspiciousness. Symptoms may involve traction-like convulsions affecting hands and feet with body tremors; initially, both convulsions and spasms occur, but later only spasms remain. These can be rapid or slow, sometimes limited to shoulder movement. There is also "chong chu" (twitching), which indicates a mild condition; "chu" (convulsion) indicates severity; "nuo" (finger clenching/spasm) indicates greater severity. If opisthotonos, locked jaw, and phlegm rattle in the throat are present, it is diagnosed as a convulsion syndrome. If the jaw is not locked, there is no salivation, and only opisthotonos and convulsions occur, it cannot be immediately classified as convulsion syndrome. This is because conditions involving mixed fright and food stagnation, cold-heat disorders, smallpox/rubella, or heat accumulation in the Triple Burner, with dysfunction of the Five Zang organs allowing heat to flow into collaterals and affect sinews, can also cause convulsions and urinary/fecal issues. Qian Yi distinguished between true and false acute convulsions, advising to assess the degree of heat and apply purgative methods accordingly.

A floating, rapid, full, or tight pulse indicates acute convulsion. A blue-purple pattern in the Tiger's Mouth vein suggests either convulsion or accumulation, but primarily points to acute convulsion.

Li Gao (Jiegu) stated: Acute convulsion is a Yang syndrome, involving the Fu organs. Hot-phlegm lodges in the Heart and Lung, causing hyperactivity of Shaoyang Ministerial Fire. The Classics state: Extreme heat generates wind. Onset triggered by fire sounds implies that the East (Zhen Trigram) reacting to fire energy causes convulsions. Fire is inherently still but moves when acted upon by wind. Treatment should utilize Lijing Wan, Daochi San, Xieqing Wan, and Dihuang Wan; Anshen Wan should be taken after convulsions cease.

Before the onset of pediatric convulsion, the spirit becomes unsettled first: looking left then right, up then down. Even if the essence seems settled, the demeanor is vague and hesitant, fearing objects and people, unlike usual playfulness. Immediate treatment is required. If there is heat, clear it first; if there is fright, disperse it first. Once heat clears, phlegm does not generate; once fright disperses, wind does not arise, leading to natural stabilization.

The rationale for purging in acute convulsion applies when symptoms suddenly appear with upward eye rolling, lateral gaze, and opisthotonos; rapid purgation is indicated. If the pathogen has transmitted or convulsions have stopped, one should wait briefly before purging to avoid adverse outcomes. The acute convulsion stage is critical; the crisis occurs in moments. If the diagnosis is uncertain, hesitation leads to untreatable conditions. Clear judgment requires immediate medication.

Prognosis of Acute Convulsion Treatment:
Acute convulsion with epistaxis is easier to treat; smooth urination and defecation indicate easier treatment. If four major signs are complete before medication, but limbs become flaccid after medication, prognosis is poor. Difficulty in administering medication via spray or oral route indicates poor prognosis. Flaccidity of limbs after convulsions indicates poor prognosis. Eye reversal after convulsions indicates poor prognosis. If convulsions stop but the spirit is sluggish, seeking the mother's clothes or self-touching, the condition is incurable. If convulsions stop but consciousness is clouded and breathing is rapid, it is untreatable. Blood from the mouth during convulsion indicates poor prognosis. Incontinence of urine and feces during convulsion indicates poor prognosis.