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Qian Yi stated: In boys, convulsions accompanied by deviation of the eyes to the left are silent, while those with deviation to the right produce sound; in girls, convulsions with deviation to the right are silent, while those with deviation to the left produce sound. This is due to the principle of mutual overcoming (in Five Elements theory).

Zhang Yuansu (Jiegu) stated: Boys belong to Wood. Looking left corresponds to the Wood position, and looking right corresponds to the Metal position. The clash between Metal and Wood produces sound. If a boy looks to the right or a girl looks to the left (reversing their typical patterns), sound will also be produced.

Convulsions occurring in the morning: Qian Yi stated that due to tidal fever during the Yin, Mao, and Chen hours (03:00–09:00), the body becomes intensely hot, the eyes look upward, the limbs tremor, hot saliva accumulates in the mouth, and the neck and nape become stiff. This indicates hyperactivity of the Liver Qi. Treatment should tonify the Kidney to regulate the Liver.

Zhang Yuansu stated: The Yin, Mao, and Chen hours correspond to the Wood phase. Tidal fever at this time indicates Liver hyperactivity. One should tonify Water to restrain Heart Fire and drain Liver Wood to stop convulsions.

Convulsions occurring at noon: Qian Yi stated that due to tidal fever during the Si, Wu, and Wei hours (09:00–15:00), convulsions occur accompanied by mental palpitations and fright, upward gaze, redness of the sclera, locked jaw, salivation, and limb tremors. This indicates hyperactivity of the Heart Qi. Treatment should tonify the Liver to regulate the Heart.

Zhang Yuorsu stated: The Si, Wu, and Wei hours correspond to the Fire phase. Tidal convulsions at this time indicate Heart Heat. Daochi San (Decoction for Redirecting the Urine) and Liangjing Wan (Cooling Convulsion Pill) may be used.

Convulsions occurring in the evening: Qian Yi stated that due to tidal fever during the Shen, You, and Xu hours (15:00–21:00), convulsions are mild but accompanied by panting, slight oblique gaze, sensation of low-grade fever, sleeping with eyes partially open, cold extremities, and pale yellow watery stool. This indicates hyperactivity of Lung Qi. Treatment should tonify the Spleen to regulate the Liver and Heart.

Zhang Yuansu stated: In the position of the Lung, if Liver Qi is strong, one must tonify the Spleen to prevent being overcome by Wood (Liver). First, drain the Heart and Liver to curb their momentum: use Daochi San to drain the Heart and Xieqing Wan (Draining Green Pill) to drain the Liver. Subsequently, tonify the Spleen using Yihuang San (Yellow-Boosting Powder).

Convulsions occurring at night: Qian Yi stated that during the Hai, Zi, and Chou hours (21:00–03:00), convulsions are mild but sleep is unstable, the body feels warm and hot, the eyes are tightly deviated, there is phlegm rattle in the throat, stool is silver-brown, milk/food is undigested, and the infant is lethargic and unresponsive. Treatment should tonify the Spleen and regulate the Heart, primarily using Daochi San and Liangjing Wan.

Zhang Yuansu stated: These cases often arise from deficiency and damage to the Spleen and Stomach after severe illness. The method is to tonify the Spleen and cool the Heart.

Convulsions following Shanghan (Cold Damage): Qian Yi stated that after contracting wind-cold, symptoms include hot breath, yawning, sudden dizziness/stupor, and limb tremors. Dispersing the pathogen is required, primarily using Daqing Gao (Great Cyan Ointment). Infants with inherently weak constitutions are prone to this condition.

Zhang Yuansu stated: Cases arising from wind-cold are similar to adult wind-cold injuries. One must differentiate between sweating and non-sweating presentations (Yin and Yang syndromes). Use Daqing Gao or Zhang Zhongjing’s Xiao Xuming Tang (Minor Continuation of Life Decoction) to release the exterior, which will lead to recovery.

Convulsions following food retention: Qian Yi stated that caused by improper diet, symptoms include warmth, excessive salivation, lethargy, vomiting, anorexia, and subsequent convulsions. One must first stop the convulsions. After they subside, administer Baibing Zi (White Cake Pill) to purge accumulation, followed by Anshen Wan (Calming Spirit Pill).

Zhang Yuansu stated: Convulsions due to food retention refer to sudden convulsions not caused by other diseases. Excessive intake damages the Spleen and Stomach, leading to lethargy, vomiting, and anorexia. Once the Spleen and Stomach are deficient, it draws out Liver Wind, causing convulsions. First, stop the convulsions by administering Xieqing Wan decocted with Qianghuo (Notopterygii Rhizoma) and Fangfeng (Saposhnikoviae Radix). Then use Baibing Zi to purge food. Gradually restore Qi using Tiaozhong Wan (Regulating Middle Pill) and Yigong San (Extraordinary Power Powder).

Convulsions in infants within 100 days: Qian Yi stated that true convulsions occur no more than two or three times before death. False convulsions occur frequently but are not critical. True convulsions originate from internal fright-epilepsy; false convulsions result from external wind-cold invasion. Because Qi and Blood are not yet solid, the body cannot withstand the pathogen, triggering convulsions. To identify false convulsions, check if the breath is hot. Treatment involves dispersing the exterior using Daqing Gao, along with fontanelle application and bathing methods.

Qian Yi stated: Only variola (smallpox/variolous rash) can cause convulsions, resulting from the struggle between Wind and Fire. Treatment requires draining the Heart and Liver and tonifying the Mother organ.

In miscellaneous diseases, red eyes combined with bluish discoloration suggest impending convulsions; severe teeth grinding indicates impending convulsions.

The Quan Ying Fang states: When the body is intensely hot, but the ears, nose tip, and extremities are slightly cold, and convulsions suddenly occur, this is not fright-wind but convulsions caused by variola/rash.

Fright-wind convulsions have Yin and Yang syndromes. In Yin syndrome, the thumb is turned inward; in Yang syndrome, the thumb is turned outward. Yang fist clenching is favorable; Yin fist clenching is unfavorable.

Symptoms such as bright red eyes, ptosis, abnormal sclera, blueish tint, strabismus, crossed eyes, eye rolling, staring, hoarse voice, trembling, light sounds, lip smacking, tongue playing, curled tongue, exposed veins, sighing, choking, lip puckering, choking on milk/food, sudden fixed gaze, salivation, foaming, neck twisting, back arching, head shaking, face rubbing, hiding head, photophobia, hand spasm, hand tremor, flexed legs, sudden agitation, trance, loss of spirit, restlessness, laughing in sleep, bruxism, irritability, crying/biting, facial color changes (red/blue), forced extension, and faint sounds are all prodromal signs of fright-convulsions. Preventive treatment should employ Qufeng Gao (Wind-Expelling Ointment) and Hupo San (Amber Powder), selecting further medications based on specific symptoms.

Yan Xiaozhong stated: Movements resembling convulsions but not severe are called "Chong" (twitching/wriggling).

Note: The above discussion covers convulsions caused by organ hyperactivity, wind-cold, or food retention. For excess conditions, drain the excess; for deficiency, tonify the deficiency. For wind-cold, disperse the exterior; for food retention, purge internally. This differs from convulsions caused by fright. Generally, convulsions from fright are mostly due to external pathogens. Internal causes include Spleen deficiency after vomiting/diarrhea or extreme heat generating wind. Other causes of convulsions are covered above. Although etiologies differ, laypeople rarely distinguish them clinically, leading to errors such as reinforcing excess or depleting deficiency, thereby causing harm.