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Qian Zhongyang stated: Pediatric diseases arise because the child's qi and blood are not yet full, and their spirit (Shen) is not yet solid. They may be injured by wind pathogens or startled by strange objects/events. There are also cases caused by the mother's emotional disturbances and fright during pregnancy. If the eyes are fixed and deviated, the mouth is clenched with salivation, the abdomen is distended with convulsions, the neck and back are arched backward, the waist and spine are stiff and strong, resembling a corpse, and the child remains unconscious all day, this is termed Jing disease (spasm/cramp disorder).

Commentary: Qian Zhongyang's statement acknowledges the existence of Jing disease but incorrectly identifies prolonged unconsciousness as the defining feature. He fails to realize that Jing disease belongs to the exterior syndromes of the Three Yang meridians. In contrast, what pediatrics calls "Jing Xian" (startle epilepsy) belongs to the interior syndromes of the Heart, Liver, Spleen, and Lungs. His view erroneously prioritizes exterior and Fu-organ diseases over interior and Zang-organ diseases; it values meridians running through skin and muscle over those penetrating the internal organs and diaphragm; and it considers damage to transmission Fu-organs more severe than damage to the Zang-organs governing the Spirit. This perspective is inverted and absurd, causing confusion. If Qian Zhongyang could make such statements, how can we ensure later generations do not propagate errors?

Wan Mizhai stated: Xian disease (epilepsy) involves sudden collapse, rigid limbs, closed eyes, upward rolling of the eyeballs, clenched jaw, possible tongue biting, salivation (or lack thereof), pallor or cyanosis of the face (later scholars should observe this carefully), and sounds resembling livestock. The manifestations vary, constituting a severe pediatric condition. After a brief period of fainting, the child wakes up as usual. Attacks may occur at intervals of days, months, or years. Ancient texts mention "Three Xian" and "Five Xian," with numerous treatment methods, leading to inconsistent theories that confuse students. Although pediatric texts contain many formulas for treating Xian, none are satisfactory. Only my family's secret new formula, named Duan Xian Wan (Epilepsy-Cutoff Pill), is truly a miraculous prescription for this condition.

Commentary: Wan Mizhai's insights are not without merit, and I privately rejoice that he serves as a pillar of support. However, upon examining his Duan Xian formula, I found it consists entirely of cold, purgative, heavy-settling, and toxic drugs. I believe this approach is flawed. Xian disease is a chronic, entrenched illness, not an acute onset. It often results from initial misdiagnosis as startle disorder, where light use of settling drugs causes pathogens to become trapped and unable to disperse externally, lingering between the diaphragm and membranes. When triggered by wind, cold, or chilled beverages, phlegm is stirred, suddenly blocking the large collaterals of the Spleen and cutting off the pathways of ascending and descending Qi. This leads to a failure of Yin and Yang to connect smoothly, resulting in sudden collapse. At this stage, the depletion of True Yuan and damage to Qi and blood are evident and difficult to reverse. Yet, practitioners still treat it as a pathogenic accumulation, requiring forceful breakthrough methods. Alas, using harsh treatments on a delicate, deficient body is like dropping stones into a well; it contradicts the compassionate duty of physicians to protect children. Therefore, I record the original formulas to correct these misconceptions.

Duan Xian Wan (Note: This formula is heavy-settling, cold, and toxic; its use increases debility.)
Chuan Huanglian (Coptidis Rhizoma), Qing Mengshi (Fluorite), Shi Changpu (Acori Tatarinowii Rhizoma), Chen Zhusha (Cinnabar), Bang Zhenzhu (Margarita), Tiehua Fen (Ferrum Oxydatum), Dan Nanting (Arisaema cum Bile), Bai Gansui (Kansui Radix), Shang Chenxiang (Aquilariae Lignum Resinatum), Bai Fuling (Poria).
Separately decoct 1 qian of Renshen (Ginseng Radix et Rhizoma) and 3 qian of Baizhu (Atractylodis Macrocephalae Rhizoma) to make a paste for pill coating. Administer with Pig Heart Decoction.

Tongxin Wan (Note: This is not a Heart disease; why use Tongxin? Unjustly harming the innocent, this should not be a model.)
Chen Zhusha (Cinnabar), Mayaxiao (Natrii Sulfas), Ming Xionghuang (Realgar), Zhen Shexiang (Moschus), Bai Fuzi (Aconiti Kusnezoffii Radix), Chen Zhike (Aurantii Fructus Pericarpium), Zheng Chuanxiong (Ligustici Chuanxiong Rhizoma), Bai Fuling (Poria), Selected Renshen (Ginseng Radix et Rhizoma), Chuan Huanglian (Coptidis Rhizoma), Jinyinbo (Gold Leaf).
Honey pills, administered with Maidong Decoction (Ophiopogonis Decoction).

This is the so-called Duan Xian Wan. I consider this viewpoint to still reflect pediatric conventions. When disease progresses to Xian, it stems either from congenital deficiency or excessive damage from aggressive treatments. Commonly, children with Xian have fair skin, pale complexion, lethargy, and timid Qi. Even Wan Mizhai noted pallor or cyanosis. How can children with such complexions tolerate aggressive purgatives? The root cause is usually weak Middle Qi and impaired Spleen transformation. Consequently, nutrients from milk and food fail to transform into Ying and Wei Qi, instead becoming Phlegm. Upon encountering cold stagnation, it erupts suddenly. Does it necessarily require Phlegm confusing the Heart orifice to trigger an attack? If Phlegm truly confused the Heart orifice, the child would remain permanently dazed. Why do they return to clarity after an attack? Thus, this is not a syndrome of Phlegm confusing the Heart orifice. Misusing treatments for such a syndrome leads to further depletion of healthy Qi, more frequent attacks, and eventual invalidity. Those with insight struggle enough to remedy the situation; how dare they use heavy-settling drugs like Mengshi, Zhusha, Zhenzhu, and Tiehua Fen to damage Heart Qi, or highly toxic Gansui to harm Heart Blood, compounded by the bitter-cold Huanglian damaging Stomach Qi? One qian of Renshen is like a snowflake on a red-hot furnace—ineffective. The subsequent formula containing Zhusha, Yaxiao, Xionghuang, and Jinyinbo is equally problematic. Their rationale seems to be that heavy-settling drugs calm the Heart, bitter-cold drugs clear Fire, and toxic drugs attack Phlegm. Treating Xian this way is akin to King Nan of Zhou attacking Qin to save Zhao, only for Zhou and Zhao to be annexed by Qin; while theoretically justifiable, practically impossible. Therefore, I never use standard formulas for treating Xian, achieving ten cures out of ten. Such conditions require Congruent Treatment (treating according to the apparent nature of the disease); otherwise, success is unattainable. As for pediatricians who are self-satisfied and disdain profound theory, knowing only to treat symptoms as they appear, ignoring ancient wisdom such as "when seeing Phlegm, do not merely treat Phlegm; when seeing Bleeding, do not merely stop Bleeding; when there is Sweat, do not merely arrest Sweat; when there is Heat, do not merely reduce Heat; when there is Wheezing, do not merely descend Qi; when there is Essence loss, do not merely astringe," they treat these principles as trivialities. Is this how one entrusted with the responsibility of life should act? Those with true understanding know that by not directly treating Phlegm, Phlegm naturally ceases to generate; by not directly treating Xian, Xian naturally ceases to occur. This is the essence of divine healing.