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[Lou] "Jing" (startle) and "Chu" (convulsion/tremor) are essentially the same, but differ in timing (morning vs. evening) and location (exterior vs. interior). Those with high body heat and strong convulsive force are classified as Ji Jing Feng (Acute Startle Wind/Convulsion). Those with cold body and weak force are classified as Man Jing Feng (Chronic Startle Wind/Convulsion). Those who fall to the ground making sounds and foam at the mouth upon waking are suffering from Xian Bing (Epilepsy). Those whose head and eyes look upward are suffering from Tian Diao Feng (Heavenly Suspended Wind). Those whose bodies arch backward like a bow are suffering from Jing Bing (Spasm/Stiffness). The treatments for each differ.

[Qian Yi] If convulsions occur due to tidal fever during Yin, Mao, and Chen hours (3:00–9:00 AM), this is the time when the Liver is dominant. Symptoms include robust body heat, upward gaze, trembling of hands and feet, production of hot saliva in the mouth, and stiffness/tightness of the neck. This indicates Liver Qi excess. Treatment should tonify the Kidney and regulate the Liver. To tonify the Kidney, use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia; see Kidney section). To regulate the Liver, use Xie Qing Wan (Drain Green Pill; see Liver section).

[Xue Ji] If convulsions occur during Yin, Mao, and Chen hours accompanied by fever, thirst, preference for cold drinks, and constipation, this belongs to Deficient Heat of the Liver and Gallbladder channels. Use Chaishao Shenling San. If there is excessive thirst with drinking, spontaneous sweating, or night sweats, this belongs to Blood Deficiency of the Liver and Gallbladder channels. Use Liuwei Dihuang Wan. If drooling occurs at the corners of the mouth, this belongs to Liver Wood overacting on Spleen Earth. Use Liujunzi Tang (Six Gentlemen Decoction). A child had fever, phlegm, and convulsions during Yin and Mao hours and recovered after taking Baolong Wan. Later, he relapsed. Because he self-administered the previous medicine, he developed increased coughing and wheezing, frequent convulsions, red or green-yellow complexion, edema, or drooling. I reasoned that coughing and wheezing indicate Qi deficiency of the Spleen and Lung; frequent convulsions indicate Liver Wood invading the Spleen position; a greenish-yellow-red complexion indicates Liver assisting Heart and Spleen (Liver fire disturbing Heart/Spleen); edema and drooling indicate Spleen Qi deficiency. Therefore, I used Yizhi Wan to tonify the Heart Spirit, and Buzhong Yiqi Tang to nourish the Spleen and Lung, resulting in immediate recovery.

[Qian Yi] If convulsions occur due to tidal fever during Si, Wu, and Wei hours (9:00 AM–3:00 PM), this is the time when the Heart is dominant. Symptoms include heart palpitations/fright, upward gaze, redness of the sclera, tight jaw, saliva production, and trembling of hands and feet. This indicates Heart Qi excess. Treatment should tonify the Liver and regulate the Heart. To regulate the Heart, use Daochi San (Guide Out Red Powder) and Liangjing Wan (Cool Startle Pill). To tonify the Liver, use Liuwei Dihuang Wan. The Seventh Taivell of Guangqin Residence was seven years old. He had suffered from tidal fever for several days and was nearly recovered. Qian Yi told his father, the Second Da Wang, "The Seventh Envoy's tidal fever will settle." He added, "The Eighth Envoy must prevent startle convulsions." The King angrily replied, "Just let the Seventh Envoy recover; do not speak of the Eighth Envoy's illness." Qian Yi said, "On the following day around noon, the Eighth Envoy will suffer no pain." The next day before noon, convulsions indeed occurred. Qian Yi was summoned urgently and treated him, curing him in three days. This was because he foresaw that direct staring and red cheeks indicated both Liver and Heart heat. Additionally, sitting on a stone stool showed a desire for coolness, indicating severe heat. His flesh was naturally plump and constitutionally solid, and his pulse was rapid, leading to convulsions. Predicting onset at Wu hour (noon) was because from Yin to Wu hours, both Liver and Heart are dominant. Treatment involved draining Heart and Liver heat and tonifying the Kidney, ensuring peace.

[Xue Ji] If convulsions occur during Si, Wu, and Wei hours, accompanied by thirst and drinking water, this belongs to Wind-Fire struggling against each other. Tonify the Liver with Dihuang Wan, and treat the Heart with Daochi San and Liangjing Wan. If there is thirst for warm drinks, fatigue, and refusal to nurse, this is Spleen Earth deficiency with Liver Wood excess. Tonify the Kidney with Dihuang Wan and tonify the Spleen with Liujunzi Tang. A child experienced convulsions, fever, and palpitations during Si and Wu hours. During attacks, the form and Qi were fatigued and yellow, with anorexia, drooling, and desire for warm drinks. This is Heart Fire deficiency failing to generate Spleen Earth. The family did not believe this and self-administered cooling Heart medicines, worsening symptoms to vomiting, diarrhea, sleeping with eyes open, nearly forming Man Pi Feng (Chronic Spleen Wind). Using Liujunzi Tang with Shengjiang (Fresh Ginger) and Ronggui (Cinnamon Twig), assisted by Dihuang Wan, resulted in recovery. Another seven-year-old child had persistent startle convulsions and fever, worsening during Si, Wu, and Wei hours. Form and Qi were extremely fatigued, and after fever subsided, he desired warm drinks. This is Heart and Spleen Qi deficiency. Morning administration of Buzhong Yiqi Tang plus Yizhiren (Bitter Apricot Seed), and evening administration of Liujunzi Tang plus Danggui (Angelica Sinensis) and Gouteng (Uncaria Rhynchophylla) led to recovery. Later, overeating caused recurrent vomiting and diarrhea. Treatment with Baohe Wan worsened chills, fever, and convulsions. This is Spleen Earth injury again, offended by Liver Wood. Using Liujunzi Tang plus Chaihu (Bupleurum) stopped chills and fever and improved appetite. However, diarrhea persisted during Wu and Wei hours. Complete recovery was achieved using Buzhong Yiqi Tang plus Fuling (Poria), Banxia (Pinellia), and Gouteng.

[Qian Yi] If convulsions occur due to tidal fever during Shen, You, and Xu hours (3:00–9:00 PM), this is the time when the Lung is dominant. Convulsions are mild but accompanied by wheezing, slight oblique gaze, body heat like fire, sleeping with eyes open, cold hands and feet, and pale yellow watery stool. This indicates Liver excess (actually due to Lung deficiency allowing Liver invasion). Treatment should tonify the Spleen with Yihuang San (Regulate Yellow Powder; see Spleen section), regulate the Liver with Xie Qing Wan, and regulate the Heart with Daochi San. (Jieguyun: When Spleen disease causes Liver strength, the method is to tonify the Spleen. Fearing Wood robbing Earth, it is appropriate to first drain Heart and Liver to curb their strength, then tonify the Spleen.) The son of Mr. Xu, aged three, suffered from tidal fever, with convulsions every afternoon (Shen/You hours). Symptoms included slight body heat, slight oblique gaze, exposed eyes, cold limbs, wheezing, and slightly yellow stool. They invited Qian Yi and Dr. Li to treat him together. Qian Yi asked Dr. Li, "What causes the convulsions?" Dr. Li said, "Wind." "Why is the body only slightly warm?" Dr. Li said, "Due to cold limbs." "Why oblique gaze and exposed eyes?" Dr. Li said, "Convulsions cause oblique gaze." "Why cold limbs?" Dr. Li said, "Cold reversal with internal heat." "Why wheezing?" Dr. Li said, "Severe convulsions." "How to treat?" Dr. Li said, "Instill Liangjing Wan into the nose; convulsions will stop." Qian Yi asked further, "Since you say it is Wind disease with warmth and heat, convulsions pulling eyes oblique and exposed, internal heat with cold limbs, and severe convulsions causing wheezing, what medicine treats all these?" Dr. Li said, "All this medicine." Qian Yi said, "Incorrect. Convulsions indicate Heart and Liver Excess. Slight body heat occurs because it is the time of Lung dominance in the West (afternoon). Lung governs body warmth; now there is heat, indicating Lung deficiency. Slight oblique gaze and exposed eyes indicate Liver and Lung mutual overcoming (Wood insulting Metal). Cold limbs indicate Spleen deficiency. If Lung is very deficient, its mother (Spleen) is also weak. Wood Qi invades Spleen, causing cold limbs. Treatment should first tonify Spleen and Lung using Yihuang San and Ejiao San. After Spleen deficiency signs recede, then treat Heart and Liver using Xie Qing Wan, Daochi San, and Liangjing Wan. Cured in nine days."

[Xue Ji] If mild convulsions and wheezing occur during Shen, You, and Xu hours, with slight oblique gaze, body seeming hot, sleeping with eyes open, and pale yellow stool, this belongs to Deficient Heat of Spleen and Lung. Use Yigong San. If hands and feet are reversed cold, or if there is wheezing, diarrhea, and anorexia, this belongs to Deficient Cold of Spleen and Lung. Use Liujunzi Tang with Paojiang (Prepared Ginger) and Muxiang (Aucklandia). For chronic illness with Yuan Qi (Original Qi) deficiency, use Liujunzi Tang and Liuwei Dihuang Wan as main treatments.

[Qian Yi] If convulsions occur due to tidal fever during Hai, Zi, and Chou hours (9:00 PM–3:00 AM), this is the time when the Kidney is dominant. Convulsions are mild but lying is unstable, body temperature is warm and robust, eyes are tightly obliquely gazing, phlegm is present in the throat, stool is silver-brown, milk and food are undigested, and there is excessive sleep with lack of awareness. Treatment should tonify the Spleen and regulate the Heart. Tonify Spleen with Yihuang San; regulate Heart with Daochi San and Liangjing Wan. (Jieguyun: These are mostly due to Spleen and Stomach damage after severe illnesses.)

[Xue Ji] If mild convulsions and body heat occur during Hai, Zi, and Chou hours, with tightly oblique eyes, vomiting, diarrhea, refusal to nurse, cold extremities, and excessive sleep, this belongs to Cold Water insulting Earth (Kidney Water counter-attacking Spleen Earth). Use Yihuang San. If ineffective, use Liujunzi Tang with Shengjiang and Ronggui.