Library

[Lou's View] Jingxian (Startle Epilepsy) refers to syndromes including both acute and chronic convulsions. However, when Jingxian attacks, the child falls to the ground making sounds, and upon waking, vomits saliva; whereas acute or chronic convulsions do not produce sounds nor vomit saliva.

Ren Zhai stated: Xian (Epilepsy) is a severe prognosis in children. This is generally because children's blood vessels are not yet consolidated, and their Qi and bones are not fully gathered. They are touched by wind pathogens, or due to irregular breastfeeding and feeding, leading to the retention and accumulation of phlegm and food, forming masses. The manifestations include: depression of spiritual energy, staring with wide eyes, traction and twitching of the face and eyes, lockjaw with drooling, abdominal distension and swelling, twitching and clamping of hands and feet, appearing as if dead yet alive, sometimes vocalizing and sometimes mute, sometimes opisthotonos (backward arching of the neck and back), or rigidity of the waist and spine. As long as the four limbs remain soft and the child awakens temporarily after an attack, it is Xian (Epilepsy); if the whole body is stiff and rigid, unable to awaken for a full day, it is Jingsi (Spasm Syndrome).

When Yangxian (Yang Epilepsy) first occurs, the disease initially presents with fever, convulsive twitching (Rongyu), startle crying, and shouting before the onset. A floating pulse indicates Yangxian, which is Acute Startle Convulsion. The pathology is internal to the Six Fu Organs and external to the skin, making it easy to treat. If the disease initially presents with coldness of the body, without startle, crying, or calling, and a deep pulse, it is Yinxian (Yin Epilepsy), which is Chronic Startle Convulsion. The pathology is internal to the Five Zang Organs and external to the bone marrow; severe cases are difficult to treat.

[Zeng's View] Yangxian arises from contracting Startle Wind, undergoing three episodes of convulsions. If wind-dispelling and phlegm-resolving measures are not taken, it will recur. The term "three times" does not mean three times in one day, but rather that whether over a month or a season, once the startle convulsion has occurred three times, it is called "three times." Hence, "Startle Wind occurring three times becomes Epilepsy," which conveys this meaning. The main symptoms are: fever with spontaneous sweating, upward deviation of the eyes, chewing of saliva and grinding of teeth, clamping and grasping of hands and feet, red-purple complexion, and floating-rapid pulses throughout all six positions. Treatment involves using Baijie San (Hundred-Resolution Powder) added with Wuhe Tang (Five-Harmony Decoction), decocted in water to disperse and resolve externally, followed by resolving phlegm using Shuijing Dan (Crystal Pill) or Banxia Wan (Pinellia Pill).

Yinxian arises from incomplete resolution of phlegm after Chronic Startle Convulsion, allowing phlegm to enter the Pericardium. Symptoms include cold extremities, protrusion of the tongue and shaking of the head, chewing of white foam in the mouth, and locked jaw, but without severe startle convulsions or crying. The complexion may be white or cyanotic, and the pulse is deep and faint. Thus, *Yinghan Baoshu* (Treasure Book for Infants and Children) states: "Protruding the tongue and shaking the head while sleeping." This precisely describes this condition. Treatment involves decocting Guzhen Tang (Solidify the True Decoction) together with Yuesheng Tang (Increase Life Decoction), combined with Tiao Kuanqi Yin (Regulate and Broaden Qi Drink) for harmonization.