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Wan Mizhai treated the son of Xu Daoshu who suffered from convulsive disease (Jingfeng, 惊风). Initially, a physician named Zhang was consulted but proved ineffective. Upon Wan's arrival, the illness had persisted for seven days; the child experienced frequent spasms (chou chu, 抽搐), phlegm rattle in the throat, and rapid breathing, presenting a critical condition. According to the principles of treating convulsive disease, one must first resolve phlegm, then stop spasms, and finally tonify deficiency. In essence, this boils down to treating fire pathogen. Therefore, he prescribed Hejian Liangge San (Cooling the Chest Powder) by substituting Poxiao (Mirabilite) with Mayaxiao (Crystal Mirabilite), decocting it in water to make a soup, and mixing in Qingmengshi powder (Oreochroa Gypsum) for oral administration. After the phlegm was expelled and wheezing ceased, he combined Xieqing Wan (Draining Green Pill) and Daochi San (Guiding Out Red Powder), decocted them together as a soup, which stopped the spasms. As residual heat remained, Dr. Zhang advocated using Xiaochaihu Tang (Minor Bupleurum Decoction), Zhuye Tang (Bamboo Leaf Decoction), and Liangjing Wan (Cooling Convulsion Pill), all of which Wan rejected. Instead, he used Sijunzi Tang (Four Gentlemen Decoction) added with stir-fried black Ganjiang (Dried Ginger). After one dose, the body temperature normalized. When Xu asked for the rationale, Wan explained: Generally, children have an excess of Liver Qi and a deficiency of Spleen Qi. The Liver governs wind; spasms and rebellious Qi belong to the Liver. The Classics state: Excess leads to overcoming what it controls and insulting what it cannot control. Thus, when Liver Wood is hyperactive, it overacts on Spleen Earth and insults Lung Metal. Liver fire is called "Dragon Thunder Fire," which Water cannot subdue and Cold cannot overcome. Therefore, using stir-fried Ganjiang combined with the sweet-warm properties of Renshen (Ginseng), Baizhu (Atractylodes Macrocephala), and Gancao (Licorice) achieves cure through tonification acting as purgation.

Commentary: The treatment method still uses cold-natured herbs to subdue the branch symptoms and sweet-warm herbs to consolidate the root. If one relies solely on the latter explanation, does it not create a contradiction?

The daughter of Magistrate Zhu from Luotian County, under one year old, suffered from convulsive disease. Wan used Xieqing Wan, a secret formula for treating convulsions. However, after ingestion, the spasms worsened. This was because there was phlegm in the throat, and the coarse pill powder was trapped by stubborn phlegm, causing stagnation. Consequently, it was decocted into a liquid, filtered through thin cotton paper to remove dregs, and administered once, resulting in a cure. (Xieqing Wan: Qianghuo, Dahuang, Chuanxiong, Shanzhiren, Longdancao, Danggui, Fangfeng, honey-pilled size of Euryale seed. Dosage: half a pill per time, taken with Zhuye Tang dissolved with rock sugar. Xiong notes: Medication must be administered according to the pathogenesis. By analogy, the notion that Shudi (Rehmannia) clogs the chest applies to those with heavy phlegm; how can it be universally deemed incorrect?)

The son of Zeng, the Instructor of Luotian County, suffered from convulsive disease. A physician was consulted first, followed by Wan Mizhai. The physician advocated Xiao Xuming Tang (Minor Continuation of Life Decoction), which contains many acrid-drying herbs that would likely aggravate the fire pathogen and worsen the illness. Tongsheng San (Unobstructed Holy Powder) would have been more effective; the patient recovered before finishing one dose. (For treating wind diseases, three doses are appropriate.)

The son of Zhang Shilu suffered from convulsive disease for seventeen days. His eyes looked to the right and twitched (Zha, 眨, eye movement), his mouth corner opened to the right and moved, and his limbs were pulled to the right. There was a black coating on the tongue, indicating a critical situation. He ordered fresh Bohe (Mint) to be decocted strongly to wash the tongue. He said: If the black coating disappears and the tongue becomes red, the disease is treatable; otherwise, it is not. After washing, the black coating completely disappeared. A large dose of Xieqing Tang (Draining Green Decoction) was administered, stabilizing the mouth and eyes and stopping limb spasms. Liangjing Wan (Cooling Convulsion Pill) and Zhisheng Baoming Dan (Supreme Sacred Preservation of Life Pill) were used for ten days of conditioning until recovery.

The son of the Wen family, aged six, suffered from convulsive disease. When Wan arrived, the child appeared dead due to suffocation, showing ominous signs. Observing that the complexion and form had not changed, Wan administered half a pill of Shenxian Taiyi Dan (Immortal Supreme One Pill), pried open the mouth, and poured it in. The child revived immediately. (Formula see Gu Men.)

The daughter of Jin Ershou, residing in the capital, suffered from severe convulsive disease. All physicians declared her incurable, but she recovered after self-administering one pill of Huoluo Dan (Meridian-Activating Pill). (From *Waike Luhui*.)

Chen Sansan treated a child with acute convulsive disease characterized by protruding eyes, a tongue extending three inches, and opisthotonos. Pediatricians fled upon seeing him. Chen stated: This is caused by wind and fire fanning each other, leading to the surging of wind-phlegm upward. He used Xixian San (Saliva-Inducing Powder) mixed with vinegar juice. After vomiting several mouthfuls of phlegm-saliva, the eyes and tongue retracted. Three days later, symptoms recurred because the sticky phlegm in the intestines and stomach had not been discharged. Shenxiao Wan (Divine Effect Pill) was administered with ginger soup, expelling two to three sheng of sticky phlegm, leading to recovery.

Zeng Shirong treated the young son of Commander Yang Hou, aged four. In the twelfth lunar month, he suffered from convulsive spasms. After various treatments, previous symptoms resolved, but the child remained comatose, refused food, and had slightly cold limbs for five days. Previous physicians had used numerous spleen-arousing and yang-treating medicines. Upon Zeng's pulse diagnosis, only the Spleen pulse was deep and slippery, while others were faint and slow. A deep and slippery Spleen pulse indicates accumulation in the Spleen, constituting Pi Yue (Spleen Confinement), manifesting as constipation, rather than Yin Jue (Yin Collapse). The father agreed. Zeng prescribed Xiehuang San (Draining Yellow Powder) with added Dahuang (Rhubarb), decocted in water. After three doses, mental clarity returned, appetite improved, and the child recovered. This demonstrates the efficacy of using Dahuang in mid-winter. Using medicine is like using troops; when action is required, hesitation is inadmissible. Just as crossing the Lu River in May or capturing Caizhou on a snowy night did not wait for autumn, one should not rigidly adhere to seasonal restrictions, or neither troops nor medicines will succeed. (From *Youyou Xinshu*.)

In the summer of Wuxu year of the Dade era, Zeng Shirong traveled five miles outside the city and saw a couple crying by the road holding their child. They explained that their three-year-old son suddenly developed convulsive disease and lost consciousness. His complexion was dark blue, eyes closed, and spirit confused. Pulse examination revealed no palpable pulses at the six positions, but the Taichong pulse was deep and faint. Zeng reassured them: Do not worry; this child can be saved. Since there were no houses nearby, he picked up half a broken bowl by the roadside, chewed a piece of ginger finely, squeezed the juice into the bowl, and mixed it with Wuling San (Five-Ingredient Powder with Poria), Suhexiang Wan (Styrax Pill), and Kuanqi Yin (Broadening Qi Drink) diluted with water. After administering this mixture more than ten times, the child gradually regained breath, voice, and opened his eyes, eventually recovering. (Ibid.)

Hu Shengzhai, Vice Prefect of Hengzhou, whose son was cured of convulsive disease by Zeng, asked: Why did Wuling San cure this ailment? Zeng replied: Fuling (Poria) in this formula calms the Spirit of the Heart; Zexie (Alisma) guides urine out. When the Small Intestine is unblocked, Heart Qi flows freely. Gui (Cinnamon Twig) causes Wood to wither, thereby suppressing Liver Qi and stopping wind. Hence, it is often used for convulsive disease. Its application in other conditions also has theoretical basis. Mr. Hu deeply agreed. This illustrates the skillful use of Wuling San. (Ibid.)

Wang Biaosheng's second son, aged two, contracted wind pathogen, presenting with fever, tremors, and opisthotonos. Daily administration of medications containing metallic/phlegm-resolving agents for convulsions, along with Qianghuo, Fangfeng, Dansheng (Arisaema with Bile), and Quanxie (Scorpion), led to lethargy bordering on death. This occurred because the physician failed to recognize that children have immature Qi and Blood, cannot tolerate wind-cold, and develop spasm easily upon exposure. Tonifying Qi and Blood would have dispelled wind and restored spirit. Instead, such drugs opened the Wind Gate, leaving Ying and Wei without governance, exacerbating the condition. I prescribed Wuwei Yigong San (Five-Ingredient Extraordinary Power Decoction) with added Chaihu (Bupleurum) 2 fen, Guizhi (Cinnamon Twig) 1 fen, and Fuzi (Prepared Aconite) 1 fen. Two doses resulted in recovery. (From *Ciyou Pian*. This aligns with Yu Jiayan's theory. Xiong notes: The dosage precision reflects mastery of formulation.)

Chen Ziming treated a child who had been unconscious for six days with convulsive spasms, unresponsive to various medicines, though hands and feet remained warm. He told the parents: I can save him. He needled Yongquan (KI-1) on both soles. After a long while, the child revived and thanked him gratefully. Chen explained: This illness resulted from food retention transforming into phlegm, which obstructed and caused spasms. Although the acute symptoms resolved, the retained phlegm remains, risking recurrence and eventual development of epilepsy if not eradicated. He proposed making pills to remove the root. The parents suspected profit motive and refused. The following August, the child indeed developed phlegm-confusion, losing control of bowels and bladder, avoiding neither fire nor water. Seeking treatment again, Chen prescribed a formula: Huanglian (Coptis) and Shanzhi (Gardenia) to drain floating fire; Dansheng (Arisaema with Bile) and Paofuzi (Prepared White Aconite) to eliminate accumulated phlegm; Fushen (Poria with Wood), Yuanzhi (Polygala), Shichangpu (Acorus), and Zhusha (Cinnabar) to calm the Spirit; and Shexiang (Musk) to open the heart orifices. These were mixed with pig heart blood and Shenqu (Medicated Leaven) paste, formed into millet-sized pills, and taken with Dengxin Tang (Juncus Decoction). After half a year of conditioning, there was no recurrence. Additionally, Fengchi (GB-20), Quchi (LI-11), and Zusanli (ST-36) points were moxa-ed to ensure stability. (Convulsive disease evolved into epilepsy.)

Gong Zicai treated a child with writhing and crying, and a bluish-black forehead, indicating convulsive disease where Liver Wood overacts on Spleen, causing abdominal pain. Six Junzi Tang (Six Gentlemen Decoction) was used initially, added with Muxiang (Costus), Chaihu (Bupleurum), and Goutenggou (Uncaria Rhynchophylla Hook). Crying gradually subsided. Danggui (Angelica Sinensis) was added, and the child recovered after two doses.

Another child presented with lethargy, fever, convulsions, and refusal to nurse. The nail-fold vein pattern resembled chaotic fish bones, indicating wind-heat acute convulsive disease. A small amount of Baolong Wan (Embrace Dragon Pill) was given first to disperse wind and resolve phlegm. Subsequently, Six Junzi Tang with Chaihu was used to strengthen Spleen and soothe Liver, resulting in resolution of fever and spasms.

Zhou Bida in *Er Lao Tang Zazhi* states: Kaiyuan Tongqian (Kaiyuan coins) effectively treats pediatric acute convulsions when ground in water and taken in small amounts. My interpretation is that pediatric convulsions arise from Heart Heat causing fright, and Liver Wind causing spasms. This follows the principle of Metal controlling Wood to counteract Wood insulting Earth, which seems reasonable. (From *Xu Yi Shuo*.)

Wang Shuquan records: A scholar's son in Liyang developed scalp swelling after convulsive disease. Physicians applied a paste of Banxia (Pinellia) and Nanxing (Arisaema) mixed with fresh water, achieving cure. If moxibustion were indicated, Qanding (DU-20) and other points should be used. (From *Zisheng Jing*.)

Xue Lizhai treated the son of Scholar Du Kehong, who presented with fever, spasms, locked jaw, and phlegm surging. This was identified as excess fire in the Liver and Gallbladder meridians, i.e., acute convulsive disease. Xieqing Wan was administered once, followed by Liuwei Wan (Six-Ingredient Pill) twice, resolving all symptoms. Then, Xiaochaihu Tang with Chuanxiong, Danggui, Shanzhi, and Goutenggou stabilized the condition, and finally, Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) completed the cure.

The son of Zhu Xiaoxi, Winter Official, presented with neck lumps, sallow complexion, emaciation, teeth grinding, spasms, head shaking, and eye twitching. This was Liver Wood attacking Spleen Earth. Treatment with Liujunzi Tang and Jiwei Lvhui Wan (Nine-Ingredient Aloe Pill) resulted in recovery.

Wang Wenyuan, a Confucian scholar, had a son suffering from scrofula with heavy phlegm and spasms. Administration of metallic and acrid-drying drugs led to tendon contraction in limbs, indicating further injury to Liver Blood resulting in acute convulsive disease. Jiawei Xiaochaihu Tang (Modified Minor Bupleurum Decoction) with Goutenggou, Shanzhi, Chuanxiong, and Danggui was given for one dose. Subsequently, Liuwei Wan ingredients with Wuweizi (Schisandra) and Maidong (Ophiopogon) were decocted and taken, leading to recovery.

Xi's daughter, aged six, suddenly developed fright, eye movements, teeth grinding, and nocturnal spasms with profuse salivation. This was Liver Wood restraining Spleen Earth, failing to control saliva, causing it to surge upward. Nourishing Kidney Water and generating Liver Blood would dispel wind and eliminate phlegm. Liuwei Wan (Six-Ingredient Pill) was prescribed, resulting in recovery.

Xue Kai (father of Lizhai) treated a seven-year-old child recovering from acute wind disease but presenting with fever, palpitations, and fright. Use of wind-dispersing and phlegm-resolving agents exacerbated spasms, causing vomiting, wheezing, abdominal distension, poor appetite, and aversion to cold. Baolong Wan and others led to dysentery-like stools. Alternating chills and fever resembled wind syndrome. Diagnosis identified Spleen Qi deficiency, leaving meridinals without nourishment. Sijunzi Tang with small amounts of Shengma (Cimicifuga) and Chaihu was used to raise and tonify Yang Qi, resulting in recovery.

Wan Mizhai stated: A child post-convulsion presented with right arm stiffness, clenched fingers unable to grasp objects, drooling, and slurred speech. This indicates damp-phlegm in the Spleen, Spleen deficiency allowing Liver Wood to overact. It is untreatable.

Gao Gugeng treated the son of Lv Tanren, aged a few months, who suddenly developed acute convulsive disease with spasms, fixed gaze, fever, and refusal to nurse. Physicians used Baolong Wan and decoctions of Qianghuo, Fangfeng, Bohe, and Jiangcan. Lv consulted Gao, who said: Incorrect. This is Spleen Earth deficiency and Liver Wood excess. Urgently administer Wuwei Yigong San (to tonify Spleen) with roasted Jiang (Ginger) (to restrain Liver). After administration, the child slept soundly, sweated slightly, fever subsided, and nursing resumed.