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Mr. Wang of Handong discusses: The three conditions of Jing (Fright), Xian (Epilepsy), and Wu (Contrary Qi) are generally somewhat similar, all presenting with a bluish-black complexion around the mouth and face, vomiting of saliva and phlegm, stiffness and rigidity of the head and neck, and shaking of the hands and feet. However, in Jing, convulsions with clenched fists occur immediately upon onset; in Xian, there is spasm and twitching; in Wu, there is pulling and jerking movements. In Jing, there is a rattling sound of phlegm in the throat; in Xian, saliva flows from the mouth accompanied by a rattling sound; in Wu, there is vomiting of blue, yellow, or white froth. In Jing, the eyes stare straight ahead; in Xian, the mouth and eyes are drawn together with the eyeballs rolling upward; in Wu, the eyes do not roll upward into the sockets; thus, they cannot be treated identically. Nevertheless, when treating these diseases at their initial stage, one method may suffice.

In Mr. Wang of Handong's *Jiabao*: To treat infantile Jing, Xian, and Wu, characterized by spasms of the hands and feet, stiffness and rigidity of the head and neck, resembling opisthotonos (arched back like a bow). Formula for Guihun San (Returning Soul Powder): Scorpion tail (1.5 qian, stir-fried), Centipede (half a red-footed centipede, roasted), Calomelas (Shuiyin Fen), Moschus (She Nao) (each 1 zi), Flower Snake meat (soaked in wine, roasted until yellow, weighed 1 qian), Rhizoma Pinelliae Preparatum (Tian Nan Xing) (chopped, soaked overnight in fresh ginger juice, ground into powder, weighed 0.5 qian), Radix Aconiti Lateralis Preparata (Chuan Wu Tou Jian) (seven tips, raw). Grind the above ingredients into fine powder. For each dose, infants take 0.5 zi or 1 zi; children aged two to three years take more than 1 zi; children aged four to five years take 0.5 qian. Mix with Yinjin Bohe Tang (Silver Leaf and Mint Decoction) for administration, adjusting the dosage according to the child's deficiency or excess condition.

In *Chao Shi Bing Yuan* regarding the prodromal signs of impending Xian: Before an infantile epileptic seizure occurs, the prodromal signs include either persistent low-grade fever, or shaking the head and playing with the tongue, or startle jerks during sleep with frequent teeth grinding. These are signs that Xian is about to manifest.

The method for observing Xian in *Qian Jin Fang* states: Xian is a malignant disease in children. Some cases become critical because medical help is sought too late. However, since the pathogenic qi originates internally, there must be prior signs. One should frequently examine the spirit and mental state to detect these signs.

If the pulse at the radial side of the thenar eminence (Yuji area) appears black, it is a sign of Xian; if red, it indicates Heat; if large and blue, it indicates Cold; if thin and blue, it is a normal pulse. Dryness of the nose and mouth, along with difficulty in urination and defecation, are signs of Xian. Dim vision with upward gaze, preference for sunny places, are signs of Xian. Prominent blue collateral vessels behind the ear at the mastoid process (Wangu), with restless sleep, are signs of Xian. Puncture the blue collaterals to let blood out. (*Ying Tong Bao Jian* states: There are three linear blue veins rising on the high bone behind the ear; it is appropriate to scratch them open with fingernails to let blood out.) If the hair stands on end, crying or laughing with a darkened facial complexion that does not change color, these are signs of Xian. Bluish discoloration around the nose and mouth, with occasional slight fright, are signs of Xian. Blue eyelids with occasional slight fright, are signs of Xian. Body heat with frequent sweating of the head, are signs of Xian. Body heat with vomiting and wheezing, are signs of Xian. Body heat with intermittent staring, are signs of Xian. Restless sleep with startles and shaking of hands and feet, are signs of Xian. Dream laughter during sleep with trembling of hands and feet, are signs of Xian. Low-spiritedness with irrational anger, are signs of Xian. Sudden enlargement of the pupils, different from usual, are signs of Xian. Frequent yawning with upward gaze, are signs of Xian. Difficulty in suckling milk, are signs of Xian. Body heat with difficult urination, are signs of Xian. Body heat with unfocused vision, are signs of Xian. Unstopping vomiting and diarrhea, with intermittent cold limbs and pain, are signs of Xian. Playing with the tongue and shaking the head, are signs of Xian.

The above twenty signs are all early stages of Xian. Upon seeing these signs, one should press firmly with fingernails on the corresponding Yang meridians and apply moxibustion. Press heavily until the child cries suddenly, and also administer decoctions according to formulas. (*Ying Ru Shu* states: Also administer Wushi Ziwan Tang [Five Minerals Purple Pill Decoction].)

Staring with trembling pupils; abdominal distension with rumbling sounds; bloody stool with body heat; trismus preventing suckling; opisthotonos with spinal rigidity; sweating with fever; coma/unresponsiveness; limb spasms and jerking, predisposition to fright. These eight conditions represent severe Xian. If such symptoms appear, they cannot be saved by decoctions or fingernail pressing alone; timely moxibustion is required.

*Qian Jin Fang* further states: If the family seeks a physician immediately upon the onset of the disease, the physician can diagnose and understand the treatment principles, following the correct sequence to achieve recovery based on the progression of the disease. If the family has already undergone disordered treatments without sequence, failing to control the disease, the original signs will alter. Subsequent physicians will not know the previous deficiency/excess patterns and will treat only based on later signs, which will fail to cure. It is essential to inquire carefully and investigate, adhering to the prescriptions of the preceding physician and tracing the course of the illness for treatment, thereby avoiding deviation. If the preceding physician prescribed a decoction intended for several doses to achieve recovery, but the family stops after one or two doses due to lack of immediate effect, deeming it ineffective, and then consults another physician, problems arise. If the new physician does not follow the temperature-regulating sequence established by the predecessor and treats differently, disregarding the previous protocol, errors will occur. Or, if the previous physician used purgatives, the subsequent physician should use mild methods to continue treatment, leading to recovery. Or, if the previous physician did not use purgatives, or if pathogens remain, or if the previous treatment of cold/heat was improper, the subsequent physician should regulate and treat. These constitute treating a deteriorated condition, requiring the intervention of skilled practitioners to avoid disaster. Failure to follow the sequence and careful examination will inevitably lead to serious complications.