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(Excerpt from Zhuang Yikui's *Fu You Pian*)

Zhuang Yikui stated: The syndrome of Man Feng (Slow Wind, a critical pediatric condition characterized by convulsions and coma) is most often caused by vomiting and diarrhea in children. It may also result from chronic malaria or chronic dysentery, occurring after smallpox or chickenpox, due to wind-cold and food stagnation, excessive use of purgative drugs damaging the intestines and spleen, innate constitutional deficiency, misuse of cold-natured medicines, excessive downward-draining treatment for Ji Jing Feng (Acute Convulsive Wind), or improper nursing and regulation. All these can lead to this syndrome. Symptoms include unconsciousness and panting, persistent high fever, upward rolling of eyes with convulsions, alternating chills and fever, dimness of the three Yang meridians (Taiyang, Yangming, Shaoyang), pale white-greenish-yellow complexion, clear and colorless urine and stool, cracked and bleeding lips despite cold breath exhaled from the mouth, dysentery or diarrhea accompanied by cold sweat, undigested food, cold limbs, abdominal borborygmus, phlegm rattle in the throat, opisthotonos (body bent backward like a bow), and dim vision. This is a deficiency syndrome and also a critical condition. Commonly known as Tian Diao Feng (Heaven-Hanging Wind), Xu Feng (Deficiency Wind), or Man Pi Feng (Slow Spleen Wind), all refer to this same syndrome. If one further uses cold-natured medicines or digestive-promoting medicines, or employs Dan Xing (Arisaema cum Bile) and Bao Long Wan (Embrace Dragon Pill) to resolve phlegm, or uses Tian Ma (Gastrodia Rhizome) and Quan Xie (Scorpion) to dispel wind, or uses Zhi Mu (Anemarrhena Rhizome), Huang Bai (Phellodendron Bark), Huang Qin (Scutellaria Root), and Lian Zi (Lotus Plumule) to clear fire, or uses Ba Dou (Croton Seed) and Da Huang (Rhubarb Root) to remove accumulation, killing people would be as easy as turning over a palm; this is truly terrifying. If treating wind finds no wind to treat, and treating惊 (fright/convulsion) finds no惊 to treat, it is because the root cause is Spleen-Stomach Deficiency-Cold, lone Yang floating outward, Yuan Qi (Original Qi) lacking a root, and extreme Yin-Cold causing the movement of wind. Treatment should first employ acrid-hot medicines, followed by warming and tonifying medicines. Tonifying Earth (Spleen/Stomach) serves to counter Wood (Liver/Wind); treating Wood is treating the branch. Whenever a child suffers frequent vomiting and diarrhea, it is a dangerous condition. If it recurs incessantly, regardless of whether it follows smallpox, chickenpox, or other illnesses, and irrespective of the cause, Shen Qi (Ginseng) and Bai Zhu (Atractylodes Macrocephala Rhizome) should be urgently used to rescue Stomach Qi, while Jiang (Ginger), Gui (Cinnamon Twig), Gou Qi (Goji Berry), and Shu Di (Prepared Rehmannia Root) should be used to rescue Kidney Qi. Not only food stagnation requires urgent rescue; even Shang Han (Cold Damage) or Shang Shu (Summerheat Injury) require urgent rescue. Although there may initially be excess pathogens of cold or summerheat, once vomiting and diarrhea occur, they are largely eliminated, leaving the Spleen and Stomach empty and the granaries depleted. If not urgently rescued, deficient phlegm may surge upward, and life may be lost in an instant. Quack doctors, failing to understand this, mistakenly diagnose it as food stagnation or heat, administering medicines to clear fire, remove accumulation, and cool blood, leading to immediate deterioration. What can be done? Rather than erring on the side of cold-cooling, which makes survival difficult, it is better to try warming-tonifying, which still offers hope for cure. This passage elucidates the principle of vomiting and diarrhea leading to Slow Wind most clearly. Future scholars should not neglect this. Below, the differentiation of Slow Wind symptoms is listed.

Slow Wind with vomiting and diarrhea indicates Spleen-Stomach Deficiency-Cold.
Slow Wind with cold body indicates Yang Qi being suppressed and unable to emerge. (This often occurs after taking cold-natured medicines.)
Slow Wind with flaring nostrils indicates True Yin failing to hold fast, with deficient fire scorching the Lung.
Slow Wind with greenish-yellow and white complexion indicates dual deficiency of Qi and Blood.
Slow Wind with cold air from mouth and nose indicates Middle Jiao Cold.
Slow Wind with clear and colorless urine and stool indicates complete lack of Fire (Yang Qi) in the Kidney and Large Intestine.
Slow Wind with drowsiness and exposed eyes during sleep indicates insufficiency of Shen Qi (Spiritual Qi).
Slow Wind with twitching of hands and feet indicates Blood failing to circulate to the four limbs.
Slow Wind with opisthotonos indicates Blood deficiency causing tendon tension.
Slow Wind with alternating hot and cold indicates insufficient Yin-Blood and disorder of Yin and Yang.
Slow Wind with profuse sweating indicates Yang deficiency and insecure exterior defense.
Slow Wind with clonic spasms of hands and feet indicates Blood insufficient to nourish the tendons.
Slow Wind with apparent fever but cracked, bleeding lips that do not desire cold drinks, worsening with cold medicines, and undigested vomit/stool, indicates lack of Fire in the Spleen and Stomach; blackened lips indicate insufficiency of True Yin.
Slow Wind with sunken fontanelle indicates extreme deficiency.

Zhuang Yikui said: Generally, cases resulting from persistent fever and vomiting/diarrhea are always due to Yin deficiency with Yang floating outward, inevitably forming Slow Wind. This is not comparable to fever caused by wind-cold invasion, so dispersing methods are unsuitable. Treatment should cultivate the Source and rescue the Root, adding Ginger and Cinnamon Twig to guide fire back to its origin. One must first use acrid-hot medicines to break open cold-phlegm, then proceed with warming-tonification. This is the correct method.

Tu Weisheng said: What Zhuang Yikui calls "Slow Wind" is what I call "Cold Wind," opposite to "Hot Wind." In fact, both Cold Wind and Hot Wind have acute-onset and slow-onset types. This refers to the slow-onset type of deficiency-cold, gradually progressing to severity. In Zhuang's original text, under the character "Man" (Slow), there was originally a character "Jing" (Fright). I changed it entirely to "Wind" because it differs from "Wind." This was not arbitrary; I intended to clarify the nature of Wind syndromes. If Zhuang were alive, he would likely forgive me. Regarding his explanation of drowsiness and exposed eyes due to Spleen-Stomach Deficiency-Cold as "insufficiency of Shen Qi," this is slightly incomplete. The upper and lower eyelids belong to the Spleen-Stomach; when Spleen-Stomach is deficient and cold, contraction occurs, causing the eyelids to retract and expose the eyes.

**Zhuang Yikui's Zhu Han Dang Feng Tang (Expel Cold and Eliminate Wind Decoction)**
Hu Jiao (Black Pepper), Pao Jiang (Baked Ginger), Rou Gui (Cinnamon Bark), Ding Xiang (Clove).
For these four herbs, adjust the dosage according to the child's size. Boil San Zao Xin Tu (Caolistae Terra) in water, clarify the liquid, decoct the herbs until half a teacup remains, and administer frequently. Follow with the subsequent formula for miraculous effect.

Zhuang Yikui said: This formula has warm properties and specifically treats children with innate constitutional deficiency, prolonged illness, post-smallpox/chickenpox states, or conditions transformed into Slow Wind due to mistaken use of cold medicines causing diarrhea and vomiting. Clearing heat and dispersing wind will only make treatment harder and the condition more critical. Take this quickly; it can open cold-phlegm, widen the chest and intestines, stop vomiting, and eliminate wind pathogens, thereby rescuing Yuan Qi from non-existence. Cessation of vomiting after one or two doses is the verification. Recognize it as a deficiency-cold pattern and administer without hesitation.

**Zhuang Yikui's Modified Li Zhong Di Huang Tang (Modified Regulate the Middle and Replenish Earth Decoction)**
Shu Di Huang (Prepared Rehmanniae Radix, 1 qian), Dang Gui (Angelicae Sinensis Radix, 1 qian), Yu Rou (Corni Fructus, 1 qian), Gou Qi Zi (Lycii Fructus, 1 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 qian), Pao Jiang (Zingiberis Rhizoma Preparatum, 1 qian), Dang Shen (Codonopsis Radix, 1 qian), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma, 1 qian), Suan Zao Ren (Ziziphi Spinosae Semen, 1 qian), Rou Gui (Cinnamomi Cortex, 6 fen), Zhi Huang Qi (Astragali Radix Preparata, 1 qian).
Add Sheng Jiang (Fresh Ginger), Da Zao (Jujubae Fructus), and He Tao Ren (Juglandis Semen) as guides. Still use San Zao Xin Tu (Caolistae Terra) water for decoction, obtaining one cup of thick juice. Separately decoct Fu Zi (Aconiti Lateralis Radix Preparata) in water and mix in. Administer according to the child's size in divided doses. If cough persists, add Ying Su Qiao (Papaveris Pericarpium) and Jin Ying Zi (Chrysanthemi Fructus). If high fever persists, add Bai Shao (Paeoniae Radix Alba). For persistent diarrhea, add Ding Xiang (Caryophylli Flos). After one dose, remove Fu Zi and use only a few grains of Ding Xiang. Because Fu Zi is extremely hot, it should be removed once the disease is addressed. Too much Fu Zi causes urinary retention; omitting it leaves deep cold in the organs unresolved; omitting Ding Xiang results in persistent diarrhea. For extreme deficiency-cold, Fu Zi may be used up to 1-2 qian. As the saying goes, "Divinity lies in the practitioner"; users must exercise judgment. This formula is essential for saving Yin and securing the Root, called a divine agent for treating pediatric Slow Wind. If a child has severe persistent diarrhea with slight convulsions, yet the stomach can accept medicine and digestion is normal, Zhu Han Dang Feng Tang may be skipped; one dose of this formula alone will stop wind and clarify spirit. If the child has not yet developed full wind syndrome but shows drowsiness, fever (intermittent, night-time, or afternoon), all indicating Yin deficiency, this formula is suitable. For newly ill, robust children with red eyes and thirst (excess fire patterns), temporary clearing and resolving methods may be used. Excess fire presents with constipation, strong voice, and preference for cold drinks. Vomiting and diarrhea together rule out excess fire. This formula supplements insufficient Yin and Yang, possessing miraculous powers to revive the dying. If ineffective after one dose in extreme deficiency, larger doses should be used.

Zhuang Yikui said: This formula boosts Qi and nourishes Blood, expels disease and restores Yang. It specifically treats children with depleted spirit and severely damaged Qi and Blood, appearing emaciated and wretched, capable of recovery. Decoct strongly and administer frequently. Its merit in supplementing Heaven and rescuing the Root is beyond description.

Tu Weisheng said: Zhuang Yikui's discussion on syndromes and formulas in this section yields great efficacy, proving his extensive experience and insight. It serves as a standard reference for treating wind diseases. Medication is like warfare; flexible methods are preferred over rigid ones. Knowing wind has cold and hot types implies that cold-patterns should not be treated with heat, nor heat-patterns with cold. Similarly, deficiency should not be purged, nor excess tonified. Understanding natural timing is brilliant; understanding human affairs is wise. Insisting on rigid classifications of wind types and shapes is like climbing a tree to catch fish or gluing the tuning pegs of a zither—ultimately futile and inflexible.