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Tian Diao (Heavenly Hook, a pediatric emergency resembling convulsions) is characterized by high fever, palpitations with fright, eyes rolling upward or moving restlessly, twitching of the fingers and toes, intermittent crying or laughing, and irregular mood. In severe cases, the fingernails turn cyanotic, resembling possession by evil spirits. Therefore, it is appropriate to employ the method of harmonizing and dispersing wind-heat, using Gouteng San (Uncaria Decoction) as the primary formula.

Gouteng (56.25g), Baifuling (Poria, 56.25g), Fangfeng (Saposhnikovia Root, 7.5g), Zhusha (Cinnabar, 7.5g, prepared), Dahuang (Rhubarb Root and Rhizome, 8.33g, steamed in wine wrapped in paper). Decoct and take orally. This is a modified variation of Xieqing Wan (Drain Green Pill).

Pan Chang (Coiled Intestine, referring here to severe spasticity with neck and back stiffness, similar to tetanus or opisthotonos) is characterized by stiffness and rigidity of the neck and back, hyperextension of the waist and body, head shaking accompanied by limb twitching, lockjaw with inability to speak, fever with abdominal pain, and prolonged lethargy without waking. The presentation is terrifying.

The pathogenesis differs from Tian Diao. Wind-stroke syndrome presents with spontaneous sweating and should not be treated with further diaphoresis; excessive sweating leads to convulsions. Dampness-stroke requires mild diaphoresis but not profuse sweating; excessive sweating also leads to convulsions. This condition is divided into Gang Jing (Stiff Spasm) and Rou Jing (Flaccid Spasm). Absence of sweat indicates Gang Jing, for which Mahuang Gegen Tang (Ephedra and Pueraria Decoction) is indicated. Presence of sweat indicates Rou Jing, for which Guizhi Gegen Tang (Cinnamon Twig and Pueraria Decoction) is indicated. Both types of Jing can be treated with Renshen Baidu San (Ginseng Detoxification Powder) added with Fangfeng.

Mahuang Gegen Tang Formula:
Mahuang (Ephedra Stem, 56.25g, nodes removed), Chishaoyao (Red Peony Root, 56.25g), Gegen (Kudzu Root, 75g), Congbai (Scallion White, 2 stalks), Chi (Fermented Soybean, 15ml). Crush into coarse powder. Take 6g per dose, decoct in water, and drink.

Guizhi Gegen Tang Formula:
Guizhi (Cinnamon Twig, Shaoyao (White Peony Root), Gancao (Licorice Root, each 9.38g), Gegen (Kudzu Root, 75g), Shengjiang (Fresh Ginger, 30g), Dazao (Jujube, 4 pieces). Crush into coarse powder. Take 9g per dose, decoct in water, and drink.

Nei Diao (Internal Hook, a pediatric emergency of abdominal pain caused by cold pathogen) is characterized by abdominal pain with frequent crying, black lips, scrotal swelling, flexion or hyperextension of the body, and red veins with petechiae in the eyes. This is due to the accumulation and binding of cold qi. It is appropriate only to use Moyao (Myrrh), Muxiang (Aucklandia Root), Chenxiang (Agarwood), Bo Shang Huixiang (Fennel Fruit, stir-fried), Gouteng (Uncaria Ramulus cum Uncis, equal parts), Ruxiang (Olibanum/Chinese Frankincense), and Quanxie (Scorpion, half dosage). Grind into powder. Mix with mashed garlic to form pills the size of Sophora seeds. Take two pills per dose, washed down with Gouteng Tang.

Pan Chang Qi Tong (Qi Pain of Coiled Intestine, abdominal pain caused by cold qi attacking the small intestine) is characterized by dry crying (crying without tears) and sweating on the forehead. This is caused by cold qi assaulting the Small Intestine. Jinlingzi San (Melia Toosendan Powder) is indicated.

Jinlingzi San Formula:
Jinlingzi (Toosendan Fruit, 7.5g), Bo Shang Huixiang (Fennel Fruit, salt-stir-fried), Muxiang (Aucklandia Root, each 3.75g). Grind into fine powder. Take 1.5g to 3.75g per dose, taken with wine.

Danggui San: Treats cold pathogen invading the Kidney Meridian, presenting with acute pain in the lower abdomen, bluish complexion, and cold hands and feet.
Dangguishen (Angelica Sinensis Root Body), Muxiang (Aucklandia Root), Rougui (Cinnamon Bark), Renshen (Ginseng Root), Zhi Gancao (Honey-fried Licorice Root), plus Po Gu Zhi (Cibotium Rhizome, stir-fried) and Xiao Huixiang (Fennel Fruit, stir-fried). Grind all ingredients, in equal parts, into powder. Take with Ginger and Jujube decoction, or form into pills.

Someone asked: Regarding Tian Diao, Nei Diao, and Pan Chang, which organs do these diseases belong to, and how are they differentiated?
The answer is: The Classics state that the upper half of the body is governed by Heaven Qi, and the lower half by Earth Qi. Thus, Tian Diao is located in the upper part, caused by wind-heat, and is suitable for dispersing methods. Nei Diao is located in the lower part, caused by cold, and is suitable for warming methods. Both "Diao" diseases belong to the Foot Jueyin Liver Meridian. The Foot Jueyin meridian runs externally alongside the Du Mai (Governing Vessel), following the spine upward to enter the vertex of the head. Therefore, when diseased, it manifests as upward rolling of the eyes and backward arching of the back, resembling opisthotonos. Internally, it follows the genitalia into the lower abdomen, causing severe lower abdominal pain and scrotal swelling. All wind syndromes characterized by tremors and dizziness belong to Liver Wood. Hence, both Diao diseases present with twitching and convulsions resembling fright. However, Tian Diao may involve crying or laughing, whereas Nei Diao is characterized primarily by frequent crying, which distinguishes them.

Pan Chang disease (referring here to opisthotonos-like conditions) belongs to the Foot Taiyang Bladder Meridian. This meridian originates between the eyes, ascends to the head, descends along the neck, travels along the back, and then descends along the waist, where it aligns with the descending course of the Jueyin meridians. Thus, the symptom of opisthotonos is similar. However, Tian Diao presents with twitching and convulsions, while Pan Chang disease does not.

Pan Chang Qi Tong belongs to the Hand Taiyang Small Intestine Meridian, which internally connects to the lower abdomen. This internal pathway differs from that of the Jueyin meridian, resulting in sudden lower abdominal pain. However, Nei Diao presents with muscle twitching (Yong), while Pan Chang Qi Tong does not, allowing for differentiation.