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(This is what is commonly referred to as Slow Spleen Wind.)

Note: This syndrome must initially stem from vomiting and diarrhea. It may involve injury to both the Spleen and Stomach, or specifically injure the Yang of the Spleen, or specifically injure the Yang of the Stomach, or even injure the Kidney Yang. Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), Si Jun Zi Tang (Four Gentlemen Decoction), Liu Jun Zi Tang (Six Gentlemen Decoction), Yi Gong San (Extraordinary Power Powder), Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), and Li Zhong Tang (Regulate the Middle Decoction) are all selectable formulas. In cases of severe deficiency-cold, Ding Xiang (Clove), Rou Gui (Cinnamon Bark), Rou Dou Kou (Nutmeg), and He Zi (Chebula Fruit) can be added to Li Zhong Tang. If caused by the misuse of cold-natured medicines for other diseases, the same principle applies. Ye Tianshi’s medical records contain a case on "Yin Wind Entering the Spleen Collaterals," with the formula listed in the section on pediatric epilepsy, spasms, and syncope; the discussion in the pediatric vomiting and diarrhea section is the most detailed. Hua Xiuyun’s refutation of popular misconceptions at the end of the record is exquisite; students of medicine must carefully contemplate it. By also consulting the works of Qian Yizhi (Qian Yi), Xue Lijia (Xue Ji), Li Dongyuan (Li Gao), and Zhang Jingyue (Zhang Jiebin), one will have no further doubts. Furthermore, this condition is extremely dangerous and difficult to treat. Misinformation and erroneous treatments have persisted for a long time, becoming a widespread custom over many years. Fang Youzhi refuted this earlier, and subsequent scholars elaborated upon it. Yet today, this false notion remains unextinguished; I hope that future influential figures will burn these spurious texts entirely. Careful observation of Ye Tianshi’s therapeutic brilliance reveals that its essence lies in preventing spasms when vomiting and diarrhea first appear, rather than devising treatments after spasms have already occurred. Thus, my previous treatment of spasms caused by the Six Exogenous Pathogens followed the same method. This is what is meant by: "A superior physician treats disease before it arises"; just as sages govern chaos before it occurs.

(This is what is commonly referred to as fright-induced.)

Note: Children have fragile spirits and weak Qi. They may be frightened by unusual sights or sounds, or by falling into empty space, stumbling, or being struck. Among all syndromes, only one or two cases fall into this category; not all pediatric spasms are caused by fright. The presentation includes fever, with or without sweating, complexion alternating between cyanotic and red, muttering in sleep, and writhing of hands and feet. One should use Mai Mai Dong Tian Dong Fu Ling Ren Shen Gan Cao Sheng Di Huang Gui Ban Jia Mu Dan Pi Zhe Bei Mu E Jiao Tang (Replenish the Pulse Decoction) minus Ren Shen (Ginseng Root), Gui Zhi (Cinnamon Twig), Sheng Jiang (Fresh Ginger), and Da Zao (Jujube), adding Dan Shen (Salvia Miltiorrhiza Root), Mu Dan Pi (Moutan Cortex), and Xi Jiao (Rhinoceros Horn). This nourishes the substance of the Heart to harmonize with its function. For constipation, add Yuan Shen (Scrophularia Root); for loose stools, add Mu Li (Oyster Shell). For excessive sweating with restlessness and signs of fear, add Long Gu (Dragon Bone), whole Hu Po (Amber), and whole Zhu Sha (Cinnabar) [taking their qi/energy rather than their physical substance avoids adverse effects]. One must carefully inquire with the family to confirm a specific frightening incident before applying this method. If the account is disjointed and uncertain, remain calm and re-examine the patient to ascertain the true situation before prescribing.

My son was three years old. On the morning of the ninth day of the sixth lunar month (Chen hour), he fell while leaning against a door frame. After a short while, he developed fever, which was immediately followed by spasms. He fell into a coma, his limbs were ice-cold, and his pulse was imperceptible. By Xu hour, the spasms ceased, but he remained febrile, comatose, and anhidrotic. The next morning, I prescribed Replenish the Pulse Decoction minus Ginseng, Cinnamon Twig, Fresh Ginger, and Jujube, one dose daily, administered in three to four cups. The child refused food and drink. On the fourteenth day at Si hour, he recovered through a shivering sweat. Had we acted rashly during the height of the spasms and coma, there would have been no chance of survival. Spasms and syncope cause a reversal and disorder of Yin and Yang; any slight mismatch in treatment is incurable. Desperate families often administer random medications or undergo indiscriminate acupuncture and moxibustion, leading to countless deaths. When neither the family nor the physician has clear judgment, how can the child endure? If the Pericardium Heat is heavy, manifested by dry lips and tongue and red streaks in the whites of the eyes, Niu Huang Qing Xin Wan (Calculus Bovis Clear the Heart Pill), Ben Lun Niu Huang An Gong Wan (An Gong Niu Huang Pill from this Treatise), or Zi Xue Dan (Purple Snow Pellet) may be considered.