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Qian Yi said: The Heart governs fright. In excess patterns, there is crying and shouting, fever, and convulsions when drinking water; in deficiency patterns, there is fatigue and drowsiness, palpitations and restlessness, heart pain with frequent crying, and trembling of the hands and feet accompanied by fright and palpitations. When Heart Qi is hot, the chest and heart feel hot as well. The patient wishes to speak but cannot, and has a desire for coolness, hence sleeping with the face downward. To observe Heart heat, look at the child's sleep: if the breath from the mouth is warm, or if they sleep face down, or if there is upward rolling of the eyes, shaking of the head, and grinding of teeth, these are all signs of Heart heat. Dao Chi San (Cyan Powder Decoction) is the primary formula. In Heart excess, Qi stagnates above and below. Sleeping face down obstructs the flow of Qi, so the patient prefers supine position to allow Qi to circulate freely up and down. Xie Xin Tang (Drain the Heart Decoction) is the primary formula.

The Liver governs Wind. In excess patterns, there is staring straight ahead, loud crying, yawning, neck stiffness, and irritability; in deficiency patterns, there is teeth grinding and yawning. Liver Qi heat generates external Wind, while Liver Qi warmth generates internal Wind. Liver heat causes the hands to seek the collar and fumble with objects aimlessly. If the Liver has Wind, the eyelids twitch without convulsion; if combined with Heart heat, convulsions occur. To treat the Liver, use Xie Qing Wan (Drain the Green Pill); to treat the Heart, use Dao Chi San. If Liver heat is severe, causing retroversion of the eyes, rigidity, and convulsions, the treatment is the same as for Wind. Any disease, whether new or chronic, can draw out Liver Wind. When Wind moves, it manifests as twitching of the head and eyes. If Heat enters the eyes and pulls on the sinews, both corners of the eyes become tight, preventing rotation of the gaze, resulting in staring straight ahead. If combined with Heart heat, convulsions occur because both the mother (Heart) and child (Liver) organs have excess heat, leading to a struggle between Wind and Fire.

Zhang Yuansu said: The Liver governs strategy and courage. Heat causes seeking clothes, fumbling with objects, twitching eyelids, staring straight ahead unable to rotate the eyes, or in extreme cases, opisthotonos (backward arching of the body). These are all excess-heat patterns. The eyes are the opening of the Liver. The Liver belongs to Wood, and the nature of Wood is urgent/hasty, hence this presentation.

Qian Yi said: The Spleen governs lethargy. In disease, there is drowsiness, body heat, and thirst; in deficiency, there is vomiting, diarrhea, and generation of Wind.

The Lung governs panting. In excess patterns, there is chest oppression, confusion, and rapid breathing; some patients desire water, others do not. In deficiency patterns, there is belching and sighing. Lung heat causes the hands to pinch the eyebrows, eyes, nose, and face. If Lung excess is compounded by Wind-Cold, there is chest fullness and shortness of breath. If Qi is urgent, there is panting, coughing, and rebellious Qi rising. One should first dissipate Lung heat, then dissipate Wind-Cold. If the Lung is only affected by Cold pathogen, there is no chest fullness. Lung heat presents with deep red lips; treatment involves dissipating deficient heat. A pale white lip color indicates Lung deficiency and requires tonification. If there is chest oppression, confusion, coarse breathing, panting, and belching, the prognosis is poor due to Lung deficiency and damage. Chronic Spleen and Lung diseases lead to deficiency and pale lips. The Spleen is the mother of the Lung; when both are deficient and cannot nourish each other, it is called "Qie" (timidity/weakness). The Lung governs the lips. Pale white lips with luster indicate a good prognosis; dry lips like dead bone indicate death.

Zhang Yuansu said: The Lung governs Qi. Warm pathogens cause high fever, thirst, panting, chest oppression, dry nose, and hands touching the eyebrows and face. Bai Du San (Drain the White Decoction) is the primary formula. Chest fullness, shortness of breath, urgent panting, coughing, and rebellious Qi are all signs of Lung Qi excess compounded by Wind pathogen invasion, termed "Minor Pathogen." Treatment involves draining first, then dispersing.

Qian Yi said: The Kidney governs deficiency and has no excess patterns. Only in variola (smallpox), does Kidney excess present as black sunken lesions. Children with Kidney deficiency are inherently weak and timid. Due to incomplete prenatal Qi, Shen (Spirit) is insufficient, resulting in excessive white sclera, and fontanelles that open spontaneously. The complexion is pale. Such children are difficult to nurture and may not live past sixty-four years (8x8). If parents indulge in sexual desires excessively, many die before forty. Some cases arise from illness causing Kidney deficiency, not congenital factors. Additionally, insufficient Kidney Qi causes the lower limbs to retreat backward. Because bones are heavy, there is a desire to sink downwards and curl up. The Kidney is Water and Yin. Kidney deficiency leads to photophobia (fear of light) and requires tonification.

Zhang Yuansu said: Retraction of the lower limbs indicates insufficient Kidney Qi. Heat in the two feet and dislike of covering them with clothing. However, the area below the umbilicus is governed by the Kidney. This occurs because Heart Qi descends into the Kidney region. This represents Kidney insufficiency and Heart excess. Di Huang Wan (Rehmannia Pill) is indicated.

[Attached Formulas]
Dao Chi San (Cyan Powder Decoction) See under Five Strangury Syndromes.
Xie Xin Tang (Drain the Heart Decoction) See under Heat Syndromes.
Xie Qing Wan (Drain the Green Pill) See under Fright-Wind Syndromes.
Bai Du San (Drain the White Decoction) See under Cough Syndromes.