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Qian Yi stated: Pediatric acute convulsion (Ji Jing) occurs after the child hears a loud noise or suffers a great fright, followed by convulsions. After the convulsion subsides, the child returns to normal. This indicates Yin deficiency (Yin Xu). The primary treatment should be Lijing Wan (Detoxify Convulsion Pill). This condition originates from excessive heat in the Heart, manifesting as fever, flushed face, thirst, hot breath, and yellow-red urine and stool; severe cases develop convulsions. Generally, extreme heat generates wind, and wind is associated with the Liver; this represents Yang excess and Yin deficiency. Therefore, Lijing Wan is used to eliminate phlegm-heat. One must not use Crotonis Fructus (Badou) or warm purgatives for aggressive downward draining, lest the convulsions stop but the deficient heat remain unresolved. When pediatric phlegm-heat lodges in the Stomach, unusual sounds trigger agitation and convulsions. If heat is extreme, convulsions may occur spontaneously even without auditory stimuli. Yan Xiaozhong stated: When the intensity of convulsions begins to subside, administer one or two doses of formulas that calm the Heart and clear heat. Once the fright stabilizes slightly, use medications to purge phlegm-heat. When the Heart-Mind becomes tranquil, recovery ensues. Zhang Yuansu stated: Acute convulsion is a Yang syndrome involving the Fu organs. Phlegm-heat in children lodges in the Heart and Lung, indicating hyperactivity of Shaoyang Ministerial Fire. The Classic states "extreme heat generates wind," triggered by loud noises. This is likened to the Zhen trigram (East) receiving Fire energy to induce convulsions; fire does not move on its own but moves when stirred by wind. Treatments include Lijing Wan, Daochi San, Xieqing Wan, and Dihuang Wan. After convulsions cease, administer Anshen Wan.

Yan Xiaozhong stated: Chronic convulsion (Man Jing) arises after severe illness, following vomiting and diarrhea, or due to mismanagement causing Spleen-Stomach deficiency. Wind pathogens invade the deficiency, presenting symptoms resembling convulsions but less intense, termed Chongzong (wasting-and-binding syndrome with limb twitching); the child appears drowsy yet is not fully asleep, with lethargic spirit, cold limbs and breath, open eyes during sleep, stomach pain with crying, and sudden crow-like vocalizations. This condition is critical due to Spleen-Stomach deficiency. Zhang Yuansu stated: Chronic convulsion is a Yin syndrome involving the Zang organs. Prolonged vomiting and diarrhea in children damage the Spleen and Stomach; if untreated early, it develops into chronic convulsion, termed Chongzong. Symptoms resemble convulsions but are mild. Due to Spleen deficiency, stools are unformed. First, expel wind from the Spleen using Xuanfeng San (Disperse Wind Powder), followed by Shijunzi Wan and Yihuang San to stop dysentery. If treatment is delayed, Spleen and Lung become deficient, allowing Liver Wood to overact upon them, resulting in chronic convulsion. Treatment requires warming and tonification, primarily using Qianghuo Gao.

Yang Shima (Renzhai) described slow spleen wind (Man Pi Feng): The presentation includes cyanotic complexion, sweating on the forehead, curled tongue, drooping head, tightly closed eyes, drowsiness, head shaking, protruding tongue, frequent vomiting of foul-smelling matter, teeth grinding, slight involuntary movements of hands and feet, cold body or fever with cold extremities, deep and faint pulse, extreme Yin excess, and extreme Stomach Qi deficiency. Only one or two out of ten may survive. This typically follows chronic convulsion where vomiting and diarrhea damage the Spleen, progressing to extreme depletion centered on the Spleen. Since there is no actual wind to dispel nor fright to calm, the pathology involves saliva-phlegm and deficient heat circulating. Closed eyes indicate Spleen fatigue, Qi exhaustion, coma, and phlegm obstruction. This is considered difficult to treat. However, slow spleen is also called deficient wind. After vomiting and diarrhea, if the complexion is sallow, there is high fever and deficiency, and subsequent symptoms include head shaking, lateral gaze, touching others, lethargy, forehead sweating, sticky body sweat, fading voice, and irritability, these are signs of spleen wind. This does not always result from the progression of chronic convulsion. Key treatments to generate Stomach Qi and restore Yang include Heifu Tang, Jin Ye Dan, Bai Wan Zi, raw Fuzi, and Sizijunzi Tang, used judiciously. Once Stomach Qi recovers, Yigong San can be used for gentle regulation. If eyes are half-open/half-closed and limbs are not cold, suggesting residual chronic convulsion, avoid Yang-restoring herbs. If已进入 slow spleen stage but Yang has not completely collapsed, avoid Shihuang (Sulfur) and Fuzi. If extremities warm up after taking Yang-restoring decoctions, continue with Xingpi San to regulate. For mild phlegm in slow spleen, use Shenbao Jiji Dan. For refractory cases of chronic convulsion or slow spleen with adverse prognoses, if the Taichong pulse is present, moxa can be applied to Baihui point. This summarizes the major principles for treating slow spleen wind.

Commentary: Liu stated that the aforementioned discussions cover the essentials of diagnosis and treatment. Generally, convulsion disorders are governed by Wind-Wood. Jia Wood belongs to Yang and Fu organs, making it easier to treat; Yi Wood belongs to Yin and Zang organs, making it harder. For instance, fright in adults causes diarrhea because Jia Wood controls Wu Earth (Stomach). Children have immature Zang organ Qi and incomplete Spirit, making them prone to internal disease. Etiologies vary: post-illness or post-vomiting-diarrhea Spleen-Stomach deficiency; or patterns involving combined Fire, Phlegm, or Food retention. Internal invasion of Wind pathogens affects Fu or Zang organs, resembling external wind-stroke. Treatment must follow Qian’s principles of tonifying deficiency and draining excess to avoid contraindications and errors of excessive or insufficient medication.