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Pediatric acute and chronic convulsions (Ji Man Jing Feng), known in ancient times as Yin epilepsy (Yin Xian) and Yang epilepsy (Yang Xian). Acute convulsion belongs to Yang, characterized by excess Yang and deficiency of Yin. Chronic convulsion belongs to Yin, characterized by excess Yin and deficiency of Yang. Yang is active and restless, while Yin is quiet and slow. Both arise from the deficiency of Zang-Fu organs. Deficiency generates heat (Re), and heat generates wind (Feng). Thus, wind originates from the Liver (Gan), phlegm (Tan) from the Spleen (Pi), fright (Jing) from the Heart (Xin), and heat originates from the Liver (with the Heart also affected). The combination of fright, wind, phlegm, and heat constitutes the "Four Syndromes" (Si Zheng). The manifestations of twitching (Chu), grasping/relaxing fingers (Nuo), shrugging (Che), trembling (Chan), opisthotonos (Fan), arm traction (Yin), upward deviation of eyes (Cuan), and staring (Shi) constitute the "Eight Signs" (Ba Hou). Any blinking, head shaking, opening mouth with tongue protrusion, red lips and flushed face, cyanosis of the face, eyes, and lips, greenish stool, cyanotic veins at the hairline and Yintang (Ex-HN14), or red-purple/cyanotic patterns on the Three Passages and Tiger's Mouth (San Guan Hu Kou) are all signs of convulsions.

Generally, Liver Wind (Gan Feng) and Heart Fire (Xin Huo) contend with each other, necessarily accompanied by Heart Heat before onset, starting with twitching. Therefore, one must distinguish between deficiency and excess of heat, and first determine if the syndrome is favorable (Shun) or unfavorable (Ni). Treatment follows a sequence. Excess heat causes acute convulsion; deficiency heat causes chronic convulsion. Chronic convulsion should ideally be without heat; if heat is present, it is due to deficiency. Acute convulsion belongs to Yang, treated with cold-natured herbs; chronic convulsion belongs to Yin, treated with warm-natured herbs. However, one must clearly understand the depth, severity, progression, and speed of the disease. Hence, "discussing the deficiency and excess of heat" refers to this principle. In boys, twitching is associated with looking left; in girls, looking right. Boys' eyes deviate upward; girls' eyes deviate downward. Boys' thumbs extend outward when clenched; girls' thumbs tuck inward. In boys, arm traction involves the left arm straight and the right curved; in girls, the right arm straight and the left curved. These are all favorable signs; the reverse indicates unfavorable signs. There may be cases starting with left-sided twitching followed by bilateral twitching. If the twitching is favorable, there is no sound; if unfavorable, there is sound. Finger vein patterns curving inward are favorable; those curving outward are unfavorable. Mixed patterns indicate difficult recovery. Hence, "distinguishing favorable and unfavorable syndromes" refers to this. Yang diseases presenting with Yin pulses, or Yin diseases presenting with Yang pulses, are also considered unfavorable.

When heat is excessive, it generates phlegm; when phlegm is excessive, it generates fright; when fright is excessive, it generates wind; when wind is excessive, it triggers twitching. To treat twitching, one must first intercept wind; to treat wind, one must benefit fright; to treat fright, one must resolve phlegm; to treat phlegm, one must clear heat. If all four syndromes are present, they must be treated simultaneously. Neglecting any aspect will lead to other complications. Hence, "treatment has a sequence" refers to this. The general principles are as follows: violent cases are acute convulsions; heavy/profound cases are chronic convulsions; the most severe cases involve Liver Wood overcoming Spleen Earth, known as Chronic Spleen Wind (Man Pi Feng).

[Lou] Acute convulsion belongs to excess syndromes of Wood, Fire, and Earth. Wood excess leads to strong twitching, upward eye deviation or blinking. This corresponds to "Wood Excess," termed "Fa Sheng," manifesting as tremors, vertigo, and epilepsy. Fire excess leads to body heat and flushed face. Earth excess leads to absence of vomiting/diarrhea and closed eyes during sleep. Thus, the treatment method should employ cooling and purging, using formulas such as Liang Jing Wan (Cooling Convulsion Pill) or Li Jing Wan (Benefiting Fright Pill).

Chronic convulsion belongs to deficiency syndromes of Wood, Fire, and Earth. Wood deficiency leads to weak twitching, appearing as mild convulsions. This corresponds to "Wood Deficiency," termed "Wei He," manifesting as tremors, diarrhea, and fear (specifically, hand-foot twitching, abdominal diarrhea, and heart palpitations/fear). Fire deficiency leads to cold body and cold breath. Earth deficiency leads to vomiting and diarrhea, and open eyes during sleep. Thus, the treatment method should employ warming and tonifying, using formulas such as Qiang Huo Gao (Notopterygium Paste) or Yi Huang San (Yellow Protecting Powder). If heat is present, use Dong Yuan's Tu Huang Yi Huang San (Earth-Yellow Protecting Powder by Li Dongyuan, distinct from Qian Yi's Qiang Huo Gao). Regarding the treatment of chronic convulsion: if Earth deficiency causes diarrhea, overcome by Fire and Wood, manifesting as heat in palms and abdomen, but if Fire, Wood, and Earth are all deficient, manifesting as tremors, fear, diarrhea, and cold hands/abdomen, only Qiang Huo Gao can treat it.

[Dan] Pediatric convulsions have two types. Acute convulsion belongs to Phlegm-Heat, suitable for cooling and purging. Chronic convulsion is governed by Spleen Deficiency, often fatal, suitable for warming and tonifying. For acute convulsion, use Jiang Huo Xia Tan Wan (Fire-Reducing Phlegm-Resolving Pill), administered with decoctions of blood-nourishing herbs. For chronic convulsion, tonify the Spleen, combined with Zhu Sha An Shen Wan (Cinnabar Calming Spirit Pill), taken with clear rice soup. Further, seek treatment within blood-nourishing formulas (such as Si Wu Tang [Four Substances Decoction], Si Jun Zi Tang [Four Gentlemen Decoction], Dong Yuan's Tu Huang Yi Huang San). It is highly absurd for people to use a single formula to treat all convulsions universally.