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True fetal epilepsy. When the infant is in the womb, the *Qi* and blood are not yet complete, and the spirit is not yet fully prepared; thus, all movements, breathing, and panting follow the mother. If the mother’s adjustments are inappropriate, or if she experiences abnormal anger or joy, or hears loud noises, or suffers physical impacts, causing external shock to the mother and internal sensation to the fetus, then within a hundred days after birth, upon encountering certain triggers, the latent disease is activated. This manifests as fever, vomiting, restlessness of the heart and mind, drowsy and restless sleep, constant crying without timing, cyanosis of the face, straightness of the waist, twitching and clonic spasms of the hands and feet, puckering of the mouth and shrinking of the cheeks, staring eyes with cold breath, or closed eyelids with sticky discharge, or diarrhea passing greenish-yellow watery stool. This is fetal epilepsy (*Tai Xian*). It arises from pathogenic invasion of the five zang organs, manifesting as true convulsions (*Zhen Chu*). However, this condition occurs infrequently but is difficult to treat; death usually ensues after only two or three episodes.

False wind epilepsy. Within a hundred days after leaving the womb, the infant’s skin and muscles are tender and fragile, and the *Qi* and blood are weak. Exogenous wind pathogens injure the body and lodge internally. Each time an trigger occurs, the infant cannot bear it, resulting in convulsions. The breath from the mouth is hot, accompanied by yawning and sneezing. These are signs of wind epilepsy (*Feng Xian*). In severe cases, there may be no yawning or sneezing, resembling fetal epilepsy. However, frequent attacks indicate a mild condition because mild cases resolve easily. Treatment should focus on dispersing wind pathogens. Previously, Qian Yi treated the grandson of Official Li, who developed convulsions at over one hundred days old, occurring three to five times daily. Many physicians were consulted; some diagnosed it as "heat-day hanging" (acute convulsive disorder), others as fetal shock, and still others as fright epilepsy, but none were effective. Qian Yi was then invited and stated: "The newborn has tender muscles and bones and is injured by wind pathogens, which the infant cannot tolerate, hence the convulsions. Frequent attacks indicate mildness due to exogenous wind lodging internally; each trigger causes intolerance and convulsion, which resolve easily, hence frequency. Infrequent attacks indicate internal organ pathology and are incurable." Qian Yi used a mild dose to disperse wind pathogens and combined it with fontanelle application and bathing methods, leading to recovery. Medication must not be overdosed, as infants are small and prone to rapid shifts between deficiency and excess; excessive use generates heat. One dose suffices. Combined with topical applications, efficacy is assured. The formulas used by Qian Yi mentioned above are recorded in this collection.

Regarding pediatric acute convulsive disorder (*Ji Jing*), even if convulsions are severe, one should not panic or disturb the child, nor need one fear it excessively. Regarding chronic convulsive disorder (*Man Jing*), although convulsions are mild, timely intervention is crucial as it is a critical sign. During convulsions, support and protect the child; do not forcibly restrain or grasp them. As wind pathogens are vigorous, they may invade the meridians and collaterals, causing flexion and stiffness of the limbs, potentially leading to contractures.

Regarding pediatric acute convulsive disorder, Yan Xiaozhong stated: When the intensity of convulsions subsides, administer one or two doses of herbs that calm the heart and clear heat, such as *Shexiang Wan* (Musk Pill), *Baolong Wan* (Embracing Dragon Pill), *Chensha Wan* (Cinnabar Pill), or *Zixue* (Purple Snow). Once the fright subsides, use medication to purge phlegm-heat, such as *Shexiang Wan*, *Ruanjindan* (Soft Gold Pill), or *Taozhi Wan*. This ensures the heart and mind become tranquil, leading to recovery.

Regarding pediatric chronic convulsive disorder, if caused by vomiting and diarrhea leading to deficiency and damage, Yan Xiaozhong stated: Rapidly restore stomach *Qi* using *Lizhong Wan* (Regulate the Middle Pill) mixed with powdered *Jinyedan* (Golden Liquid Pill), administered via ginger-infused rice gruel. Multiple doses are required for efficacy. Once stomach *Qi* recovers and extremities warm up, if mild tremors persist, reduce the dosage of *Jinyedan* slightly and increase *Qingzhou Baiwanzi* (Qingzhou White Pills) accordingly, mixing them as before. Gradually decrease *Jinyedan* and increase *Baiwanzi* based on clinical judgment. Supplement with *Yigong San* (Extraordinary Power Powder), *Qianghuo Gao* (Notopterygium Paste), or *Gouteng Yin* (Uncaria Decoction) for conditioning, and frequently provide rice gruel. Even in critical cases, survival is often achieved.

Acute and chronic convulsive disorders in children present distinct yin and yang patterns; differentiation is essential for treatment. Acute convulsions require cooling herbs, while chronic convulsions require warming herbs. Laypeople often use a single type of medicine indiscriminately, failing to differentiate, thereby harming many children. One must recognize that medicinal properties inherently possess warming or cooling natures and should not be applied generically. Chu Yushu stated that when treating yin and yang epilepsy, the addition or subtraction of cold and warm herbs within formulas prevents error. Furthermore, Yan Xiaozhong noted that *Longnao* (Borneol) should be removed from chronic convulsion formulas; if necessary, it must be used with warming herb assistants or in minimal amounts solely due to its cooling nature.

During cloudy weather with thunder, cover the infant's ears or create distracting noises to prevent sudden loud sounds from triggering convulsions.

When an infant experiences convulsions, if the child regains consciousness and the body remains soft during/after the episode, it is classified as epilepsy (*Xian*). If the child does not regain consciousness promptly and the body becomes stiff, it is classified as spasm (*Jing*, also known as *Jing*), which is a sign of wind-stroke (discussed in the Wind-Stroke chapter).

For various pediatric conditions including epilepsy, diarrhea, etc., if irritability and thirst are present, it indicates internal depletion of body fluids (*Jin Ye*). Regardless of yin or yang pattern, decoct *Qian Shi Baizhu San* (Master Qian’s Atractylodes Macrocephala Powder) and allow the child to drink freely. The more, the better.

In pediatric epilepsy medications, avoiding mercury (*Shuiyin*) and calomel (*Qingfen*) is preferable. If unavoidable, discontinue use immediately once the disease is resolved, as infants' gastrointestinal tracts are easily damaged, and these substances harm teeth and gums. The collected formulas herein largely exclude silver and mercury compounds. If usage is necessary, reduce dosages according to these guidelines.

If an infant developing exanthems (smallpox/measles) experiences convulsions, treat primarily based on the exanthem protocol. For other diseases co-occurring with epilepsy, if a single formula suffices, apply it according to method. If not, combine specific primary treatments for each condition.

For pediatric fright and convulsions, *Dung Beetle* (*Qiang Lang*) is the first-choice remedy. Most contemporary physicians lack knowledge of its use. If employed, select specimens not contaminated by water; water-contaminated specimens are unusable. Remove head, wings, and legs, roast until scorched, then incorporate into the prescription.

After vomiting and diarrhea, if the infant shows mental fatigue, excessive sleepiness, refusal of milk/food, and cold extremities, indicating potential progression to epilepsy, administer powdered *Shenqu* (Medicated Leaven) mixed with small amounts of *Naobing* (Borneol) and *Shexiang* (Musk), dissolved in warm water. If epilepsy has already manifested, characterized by crow-like cries, cyanotic-yellow complexion, limb tremors, and throat obstruction, add *Zhusha* (Cinnabar) powder. If epilepsy presents with loose stools, form *Shenqu* powder into honey pills the size of a corn kernel and dissolve in warm water for administration.

Another formula: 1 liang of *Shenqu* powder, 2 qian each of *Hupo* (Amber) and *Gancao* (Licorice), 1 fen each of *Zhusha* (Cinnabar) and *Xionghuang* (Realgar). Grind together, form honey pills the size of a corn kernel. Named *Taiyi Dan* (Great Unity Pill), it treats various pediatric ailments.