Library

To treat infants and young children with acute convulsive disease (Jing Feng), if the eight signs and four symptoms have not fully manifested but wind, heat, phlegm, and saliva remain, and there is a tendency for the convulsive symptoms to recur, it is appropriate to administer Nuan Jin Dan (Warm Golden Pill).

Gastrodiae Rhizoma (Tianma, 1 fen) [Note: Original text says Tianma, WHO term Gastrodiae Rhizoma]
Bungarus multicinctus (Baihua She, 2 liang, roasted and meat taken; if Bungarus affinis/Wushao She is unavailable, use as substitute)
Scorpio (Quanxie, 21 pieces, stir-fried with flour)
Scolopendra (Wugong, 2 red-legged specimens, roasted to remove toxicity)
Aconiti Kusnezoffii Radix Praeparata (Baifuzi, 1 fen, processed)
Bombyx Batryticatus (Baijiangcan, 2 liang, silk removed and stir-fried)
Aconiti Lateralis Radix Praeparata (Heifuzi Jia, 3 pieces)
Calculus Bovis (Niuhuang, 1 fen; if unavailable, use Bos taurus domesticus Gallbladder/Niu Huangdan as substitute with increased dosage)
Acori Tatarinowii Rhizoma (Tiannanxing, 0.5 liang, processed)
Cinnabaris (Chensha, ground, 0.5 liang)
Moschus (Shexiang, 1 liang)

Grind the above ingredients into fine powder, mix with refined honey, and form pills the size of soap pods. To administer, decoct Flos Lonicerae Japonicae (Jinyinhua) and Folium Menthae Piperitae (Bohe), grind the pill in this liquid, and take orally.

Zeng Shirong discusses: The conditions of convulsive disease, phlegm, heat, and the four symptoms can all cause spasms, oblique gaze, and opisthotonos. Only spasms caused by convulsive disease are called "true spasms" because if the pathogen does not transmit, it manifests as phlegm-heat onset; or it may be triggered by diseases such as cold damage, generally termed "false spasms" because it involves transmission. At this time, relatives are panicked, and if physicians are confused and prescribe incorrectly, the condition becomes prolonged.

Regarding chronic convulsive disease (Man Jing Feng), if it is transmitted from acute convulsive disease and still retains Yang syndrome characteristics, the Yang Qi is already deficient. It is not necessary to specifically restore Yang or treat Yang deficiency alone; instead, one should only intercept wind, regulate the Spleen and Stomach, and balance Yin and Yang, applicable regardless of cold, heat, slow, or fast progression. If Aconiti Radix (Fuzi) and Realgar (Huangqi/Sulfur - *Note: Text says Huangqi which usually means Astragalus but context implies Sulfur/Huangshi or similar hot mineral given 'sulfur' in prompt translation thought, however text says 'Huangqi' which is likely a typo for Huangshi or just Huangqi used extremely hotly? Actually 'Sulfur' is Liu Huang. Text says 'Fu Zi Huang Qi'. In ancient texts, sometimes Huang Qi refers to minerals or it's a specific preparation. Given context 'make Yang return', it implies hot drugs. I will translate as Aconiti Radix and Sulfur/Liu Huang based on common pairing for restoring Yang, or strictly 'Astragalus' if literal. However, 'Huangqi' (Yellow Seal/Mineral?) No, standard Huangqi is Astragalus. But 'Fu Zi Huang Qi' together for Yang restoration suggests hot nature. Let's look at 'Huangqi' in Song/Yuan texts. Sometimes refers to realgar or sulfur? Unlikely. More likely it is a typo for 'Liu Huang' (Sulfur) or 'Huang Shi' (Realgar). Or perhaps 'Huang Qi' (Astragalus) is used here for its tonifying nature combined with Fu Zi. But 'make Yang return' strongly points to hot herbs. I will translate as Aconiti Radix and Sulfur (assuming textual variant or error for Liu Huang) or stick to literal Astragalus if unsure. Given 'Sulfur' is explicitly mentioned in my internal thought process as 'Liu Huang', and text says 'Huang Qi', I will translate literally as Astragali Radix but note the context implies warming. Actually, looking at 'Nuan Jin Dan' composition, it contains hot herbs. 'Huang Qi' might be a typo for 'Huang Bo'? No. Let's assume it means Astragali Radix but used in a warming context or it's a specific local name. Wait, 'Fu Zi Liu Huang' is a common pair. 'Fu Zi Huang Qi' is less common for 'returning Yang' urgently. I will translate as Aconiti Radix and Astragali Radix, but the function described is 'make Yang return'. I will add a note in thought that it might be Sulfur. For the output, I will use Astragali Radix (Huangqi) as per text, but the English description will reflect the warming intent if possible, or just list the herb. Actually, 'Huangqi' in some contexts can mean 'Yellow Seal' (Realgar)? No. I will stick to Astragali Radix.) ... *Correction*: In many classical texts, 'Huangqi' is Astragalus. However, in the context of 'restoring Yang' with 'Fuzi', it is often 'Liu Huang' (Sulfur). I will translate as Astragali Radix (Huangqi) but acknowledge the potential for it being a textual variant for Sulfur in medical history. For WHO accuracy, I will use Astragali Radix.

Students of medicine should know that once Yang syndrome transmits to Yin syndrome, one should administer Baoming Dan (Life-Preserving Pill) two or three doses, combined with Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill). If the four symptoms are present and the eight signs are slightly slowing, indicating impending Yin Epilepsy (Yin Xian), administer this medication. If the eight signs have passed and no longer manifest as the four symptoms, but the child remains unconscious, administer Dingming Yin (Destiny-Stabilizing Decoction). If hands and feet are cold, belonging to Sini Syndrome (Four Reversals), one may restore Yang. If eyes are closed, it indicates transmission to Slow Spleen Wind (Man Pi Feng). For infants with excessive phlegm-saliva obstruction and continuous spasms where purgation is contraindicated, Lingzhi Wan (Lipid Pill) is suitable. For excessive phlegm-heat obstruction with drooling from the mouth corners, Baiqiang Wan has significant efficacy. For convulsions where the body is warm but wind-phlegm cannot be resolved, Tiannanxing Wan is suitable.

Zeng Shirong discusses: There is no doubt regarding these syndromes in infants; simply follow the medications listed below, and recovery is assured. Do not delay, as infant Yang easily transforms into Yin, and Yin qi gradually fills up, making drug action ineffective and treatment difficult. Do not continuously administer medicines without pause; after each dose or two, examine the syndrome for severity and transmission. If slightly stable, slow down medication; if worsening, sequentially administer urgent medicines. Do not stick to one formula, nor immediately switch to decoctions and combine them. Observe the severity and decide whether to advance or stop. Now, effective prescriptions are provided, requiring no consultation; prepare according to method and treat symptomatically for guaranteed results.

Zeng Shirong discusses: If chronic convulsive disease is transmitted from acute convulsive disease, it indicates that predecessors failed to intercept wind and stop spasms, leading to Yang collapse and transmission to Yin, resulting in Yin excess and Yang deficiency. Wind and heat flow into the meridians. Additionally, excessive use of major cold-cooling medicines, purging accumulated matter causing diarrhea, or visceral coldness with profuse watery diarrhea are multiple causes recorded in previous chapters.

Zeng Shirong discusses: When treating chronic convulsive disease, one must understand Yin Epilepsy. The syndrome belongs to Yin Zang cold deficiency, possibly with unceasing diarrhea. Often, ignorant people treat only the convulsion without addressing the diarrhea, using cold-cooling medicines that further deplete Qi, causing unceasing diarrhea, worsening Yin syndrome, and increasing convulsions. If antidiarrheal medicines with slight heat are used, the eight signs reappear, and the four symptoms do not recede. Although chronic convulsive disease is said to be hard to cure, it is because physicians do not thoroughly investigate the disease, allowing it to deepen into severe harm.

Zeng Shirong discusses: In treating chronic convulsive disease, observation is key. Severe signs include: dull fixed eyes, wandering eyes, cold limbs, fixed pupils without blinking, blinking without lateral gaze, profuse sweating like flowing water, and sudden darkening of the face and mouth (most severe). Convulsions induced by wind, with eyes half-open and half-closed, indicate excessive Yin qi transmitting to the Zang organs and depleted Yang Qi. The Spleen Meridian belongs to Yin; transmission to the Spleen is thus called Slow Spleen Wind.

Zeng Shirong discusses: Treating chronic convulsive disease differs from acute convulsive disease; one cannot uniformly use antispasmodic medicines. Acute convulsive disease is considered due to blocked orifices, so Borneolum Syntheticum (Naobzi) and Moschus (Shexiang) are used to open orifices and stop spasms. Chronic wind involves Yin excess and Yang deficiency with empty meridians; opening orifices and cooling the Zang organs easily leads to Slow Spleen Wind.

Zeng Shirong discusses: Treating chronic convulsive disease should not involve aggressive attack. Acute Yang Epilepsy is easier to manage; chronic Yin syndrome is hardest to treat. Even after medication cures the symptoms, weakness and lack of clarity may persist for three to five days. Commonly called "Guojie Hou" (Street-Crossing Sign), attacks have no fixed pattern. Do not lightly prescribe attacking medicines, or previous efforts will be lost.

Zeng Shirong discusses: The principle of treating chronic convulsive disease requires investigating the cause. If transmitted from acute convulsive disease to Yin, becoming chronic convulsive disease, it is Yang Epilepsy transforming into Yin Epilepsy. Observe if Yang syndrome is impure and adjust medication. If caused by diarrhea, boys are more severely affected; if caused by vomiting, girls are more severely affected. This is Yang collapse and Yin excess. Infants vary in age, and Zang-Fu vary in deficiency/excess. Some develop wind syndrome after three to five diarrheal episodes due to deficiency turning into excess. Some after two to three days, or five to seven days of unceasing diarrhea. Acute diarrhea causing wind can be treated quickly, as restoring Yang, regulating the Middle, and tonifying Qi is easy. Chronic diarrhea gradually transmitting to wind is due to deficiency, making it difficult to treat.

Zeng Shirong discusses: Profuse diarrhea causing wind in infants should be treated with tonifying medicines (use Aconiti Radix preparations for cold-visceral profuse diarrhea, check pulse). Diarrhea causing wind due to purgative accumulation should be regulated with Spleen-warming and Qi-strengthening medicines (Guiyin Quanxie San is effective). Wind caused by cold-cooling medicines (too cold causing visceral cold, vomiting/diarrhea leading to wind) should be warmed with Qi-assisting and Spleen-awakening medicines (Wangshi Daxingxing Daheqi San is effective; for cold limbs to restore Yang, Zhufu Tang is effective). Yang Epilepsy transmitting to Yin Epilepsy (acute to chronic) should be treated with wind-intercepting medicines (The aforementioned wind-intercepting and spasm-stopping pills are appropriate for the first three chronic conditions because the disease arises from deficiency, hence the principle of regulation and tonification).

Zeng Shirong discusses: Medications for convulsive disease vary because attacks differ. Although four types are discussed, they are general principles. Wise practitioners analyze severity and appropriateness to apply treatments.

Zeng Shirong discusses: The principle of treating chronic convulsive disease lies in slow management, while acute convulsive disease lies in rapid management. Why? Acute convulsions arise from heat generating wind, falls, or external stimuli. Extreme heat transforms into wind spasms. If following standard methods to purge, symptoms subside. However, chronic convulsions are irregular and require careful observation and deliberation. One must not panic or fear loss/gain; hesitation is not the slowness of the disease itself. It is said that chronic convulsions should not be aggressively attacked, as treatment is very difficult.

Zeng Shirong discusses: Physicians treating chronic convulsive disease should not speak loosely or carelessly. Lack of sincerity and unclear vision also occur. Do not say it is difficult to avoid social repercussions, but preserve profound principles. Those who deeply understand the laws will surely cure with medication. Those who do not understand principles and judge poorly should never blindly follow human sentiments to prescribe. If your view is inadequate, consult skilled practitioners to avoid dead ends. If the syndrome is ruined, it damages virtue. Are there those who force treatment in panic?