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Pediatric convulsions are categorized into acute (Ji) and chronic (Man) types of convulsive disorders. Ancient texts do not use the terms "acute" and "chronic convulsion"; instead, they refer to Yin Epilepsy and Yang Epilepsy. The terms "acute" and "chronic convulsion" were coined in later periods. Since Yang is active and rapid, Yang-type convulsions are termed Acute Convulsion; since Yin is quiet and slow, Yin-type convulsions are termed Chronic Convulsion. This distinguishes the convulsions arising from Yang and Yin epileptic conditions.

Yang Convulsion symptoms include: high fever of the body, redness of the face, desire for drinking, hot breath from the mouth, dark yellow urine and stool, eyes rolling upward with frequent blinking, spasms and stiffness of hands and feet, locked jaw, rigidity of the neck and back, and noisy accumulation of saliva/phlegm. This occurs because extreme Heart Heat generates Wind. Wind is associated with the Liver. As the Heart and Liver share a mother-son relationship, Wind and Fire combine and blaze intensely, causing movement and convulsions. Once the convulsion subsides, the child returns to normal. This pattern represents Excess Yang and Deficient Yin. Treatment should focus on relieving convulsions to dispel Wind-Heat. One must not use drastic purgatives like *Radix et Rhizoma Rhei* (Dahuang, 大黄) or *Fructus Crotonis Tiglii* (Baidu, 巴豆) for severe purging, as this may cause deficiency heat to accumulate and persist.

When phlegm turbidity obstructs and accumulated heat stagnates in the Heart of a child, hearing a loud noise or being startled can trigger convulsions. If the heat is extreme, convulsions may occur spontaneously even without auditory stimuli or startling. Children with strong constitutional foundation often present with this condition.

Tiandiao (a manifestation of Yang Convulsion): Stagnation in the Heart and Diaphragm, excessive phlegm, and accumulated heat prevent the free flow of Qi. This may result from the mother consuming excessive alcohol and meat, leading to toxic heat entering the breast milk. After nursing, the infant suffers from retained food stagnation that fails to digest. Heat toxins attack the Heart, triggering convulsions. Symptoms include rolling eyes, persistent high fever, and in severe cases, cyanosis of the fingernails, resembling supernatural possession. Hence it is called "Tiandiao." It does not mean heaven lifts a person, but refers to the eyes looking upward. Since all pediatric convulsions involve upward gaze, this is essentially a symptom of Yang Convulsion. Treatment should aim to eliminate phlegm and heat.

Previously, Qian Yi treated the eighth messenger, brother of the Seventh Taiwei of Guangqin Residence, for Yang Convulsion. The episodes lasted from Yin hour to Wu hour. Before an episode, Qian Yi observed fixed staring and red cheeks, diagnosing combined Heat in the Heart and Liver. He had the child sit on a cold stone stool, indicating intense heat. Given the child's robust constitution and rapid pulse, and noting that the episodes occurred during the hours governed by the Heart and Liver meridians, Qian Yi employed a method to drain the Heart and Liver while tonifying the Kidney. The disease was cured. This exemplifies "draining the excess and tonifying the deficient."

Yin Convulsion symptoms include: normal or low body temperature, pale complexion, hands and feet appearing to spasm but not fully contracting, occasional mild twitching, lethargy resembling sleep but lacking spirit, eyes showing sclera with slight upward gaze, stomach pain with crying sounding like a crow, inability to cry, white lips and mouth, and a deep, weak pulse. This results from damage to the Spleen and Stomach due to severe illness, excessive vomiting, or diarrhea, leading to internal Wind generation. The condition develops gradually. This pattern represents Excess Yin and Deficient Yang. Treatment should tonify the Spleen and Stomach and drain Liver Wind. Weak children may develop Yin Convulsion directly without prior vomiting or diarrhea. Children with innate timidity often present with this condition.

Slow Spleen Wind (a critical stage of Yin Convulsion): A child contracts wind-cold or suffers from vomiting and diarrhea. Physicians repeatedly use warming tonics, then switch to cooling medicines without resolution. Originally caused by wind-cold, improper treatment leads to Spleen Qi deficiency, unable to transform internally or resolve externally. After more than ten days, symptoms include lethargy, exposed eyes upon waking, loose unformed stools, and diarrhea. This indicates Wind invading due to Spleen deficiency. Wind residing between the Spleen and Stomach causes loose stools and occasional mild twitching. The body, limbs, and breath from the mouth and nose feel cold. Some cases arise from transmission after fright or progression of other diseases. All stem from Spleen-Stomach deficiency generating Wind, hence the folk name "Slow Spleen Wind." It is actually a critical sign of Yin Convulsion. Treatment should remove Wind from the Spleen; once Wind recedes, diarrhea stops, followed by tonifying the Spleen and Stomach.

Previously, Qian Yi treated a son of the Wang family who suffered from vomiting and diarrhea. Other physicians used purgatives, causing extreme deficiency and transformation into Yin Convulsion. Symptoms included sleeping with eyes open, mild limb twitching, and cold body. Qian Yi diagnosed "Slow Convulsion" and prescribed medicine to strengthen the Spleen and Stomach. The child opened his eyes and warmed up. Mr. Wang suspected urinary/fecal retention and asked another physician to administer laxatives/diuretics, causing the body to become cold again. Mr. Wang requested diuresis from Qian Yi. Qian Yi refused, stating that diuresis would cause coldness. When Mr. Wang noted the child was already cold, Qian Yi explained that the child could not eat due to Stomach deficiency. Further diuresis would exhaust both Spleen and Kidney, leading to death if eyes closed and body became cold. Fortunately, the child had strong prenatal Qi. Qian Yi continued to tonify the Spleen and Stomach, allowing slight intake of food. The rationale is that diuresis damages Spleen-Stomach warmth; thus, one must tonify the Spleen and avoid further attacking. Later, the child lost speech. Other physicians treated it as aphonia. Qian Yi questioned why the child could open eyes and eat if truly aphonic, noting no jaw locking. He explained that previous clearing and diuretic drugs exhausted Spleen and Kidney. With the Spleen now solid but Kidney still deficient, he prescribed Kidney-tonifying medicine. Following this protocol, the child spoke within half a month and recovered in one month.