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Jing (Spasm), Jue (Syncope/Fainting), Dian (Manic-Depressive Psychosis/Depression-type Schizophrenia), and Xian (Epilepsy) are four conditions that all present with sudden collapse and loss of consciousness. However, their disease names differ because their pathogenesis and pathological locations vary.

Jing (Spasm: a condition characterized by stiffness of the neck and back, and opisthotonos) arises from dryness and belongs to the Taiyang (Taiyang Meridian: the Foot-Taiyang Bladder meridian). Therefore, there is inevitably stiffness in the neck and back; in severe cases, opisthotonos occurs. This is a disease of the sinews. The *Neijing* and Zhang Zhongjing attribute Jing to dampness when tracing its origin. Whether it is cold-damp or heat-damp, it must transform into dryness before Jing occurs; this is due to the coagulation of body fluids.

Jue (Syncope/Fainting: a condition characterized by sudden loss of consciousness) can be divided into cold and heat types, but the body does not become stiff. It is a disease caused by the rebellion and disorder of Wei Qi (Defensive Qi), located outside the vessels, and all belong to excess patterns. If Jue is due to deficiency, it is simply a direct collapse of Zheng Qi (Upright Qi). Although there are cold and heat distinctions, ultimately they are unified under heat. Some cases result from external cold forcing internal heat; in all such cases, Ying Qi (Nutritive Qi) is consumed, and Wei Qi has nothing to cling to, leading it to rush and obstruct the Pericardium (the outer covering of the heart, acting on behalf of the heart's functions).

Dian (Manic-Depressive Psychosis/Depression-type Schizophrenia: a mental disorder characterized by depression, silence, and stupidity) has no distinction between cold and heat, but differs in duration (chronic vs. acute). It is a disease of blocked Ying Qi (Nutritive Qi), located within the vessels. The classics state that "the Heart governs Ying Qi, and the Lung governs Wei Qi," and further that "the Heart governs perception." If the meridians of the Pericardium are blocked by phlegm and blood stasis, the spirit and consciousness of the Heart stagnate, resulting in unconsciousness. This is caused by the accumulation and excess of Ying Qi, while the power of Wei Qi is insufficient to push it away, leading to this condition over time. Furthermore, the Heart and Small Intestine are connected by their meridians. If stagnant phlegm and blood stasis exist in the Small Intestine meridians, obstructing Heart Qi, Dian may also occur.

The pathology of Jue is excess Qi and deficient Blood; the pathology of Dian is excess Blood and deficient Qi. In both, the pathogenic factors are excess, and the healthy Qi is deficient. As for Xian (Epilepsy: a paroxysmal disorder characterized by sudden loss of consciousness, convulsions, foaming at the mouth, and abnormal sounds), it arises from blood heat and manifests as Liver Wind. Symptoms include twitching of the hands and feet and the emission of sounds resembling five animals. Ancients associated these five animal sounds with the Five Zang Organs but ultimately attributed them to the Liver, because the Liver stores Blood, heat generates wind, and wind is inherently moving. This is a disease of the Zang organs extending to the collaterals, where both Qi and Blood are excess, yet its root must lie in cold. Qian Zhongyang (Qian Yi) classified pediatric acute and chronic convulsive disorders as Yin and Yang Xian, which is a separate syndrome; although the name is the same, the substance is different. Acute convulsion arises from Liver heat generating wind and drying out fluids; its symptoms lie between Xian and Jing. It differs from Jing in that the limbs are cramped but do not necessarily exhibit opisthotonos; it differs from Xian in that the limbs twitch but absolutely lack the animal sounds. Chronic convulsion entirely belongs to the dual deficiency of Yin and Yang in the Spleen. Thus, Yin pathogens resist internally, and deficient Yang forces upward; Qi mechanisms suddenly obstruct, leading to sudden loss of consciousness. Deficiency makes collapse easy, hence it is called difficult to treat. Fang Zhongxing wrote *Jing Shu* (Book on Spasm), attributing pediatric convulsions to it; this can only be identified as similar to Jing, not directly equated with Jing. The *Qianjin Fang* states: "In warm diseases, if heat enters the Kidney, it also causes Jing; if children suffer from severe heat in Xian, it also causes Jing." Its intent is to regard Xian as convulsive disorder, while reserving Jing specifically for conditions of cramping and tightening.

The *Jingui Yaolue* states: "In Ben Tun (Rushing Pig Disease: a condition characterized by a sensation of gas rushing from the lower abdomen to the throat), qi rises from the lower abdomen, rushes up to the throat, the patient feels like dying during attacks, and then it subsides. This arises from fright and terror." The *Suwen* states: "Some people are born with Dian; this is acquired in the womb when the mother suffers a great fright. Qi moves upward and does not descend; essence and Qi gather together, causing the child to develop Dian." Thus, both Ben Tun and Dian originate from fright. The *Jingui Yaolue* extensively discusses miscellaneous diseases but omits Dian and Xian; I suspect that Ben Tun is actually Xian. Most Xian patients emit pig-like sounds. The pig is associated with water accumulation and belongs to the Kidney; Ben Tun also originates from the Kidney. Volume 14 of the *Qianjin Fang*, in the section on Wind and Vertigo, before the formula for Xiao Xuming Tang, quotes Xu Sibin: "Phlegm and heat interact to generate wind; wind and Heart confuse each other, causing oppression and dizziness, hence it is called Wind Vertigo. In adults, it is called Dian; in children, it is called Xian. In reality, they are one and the same. Using this formula for treatment yields universal cures." However, Ben Tun afflictions often involve急促 breathing during attacks and death is incurable. Therefore, this single formula illustrates the principle of treating severity appropriately. From this, it is inferred that Ben Tun is regarded as a severe form of Dian/Xian.

I have privately discussed this: Jing and Jue are acute, sudden diseases. Their cause is the consumption of fluids and drying of blood, leading to fierce Qi and obstruction of the vessel tubes. Treatment requires heavy doses of cooling and moistening agents to generate fluids, acrid and aromatic agents to dissipate Qi, assisted by blood-invigorating and phlegm-resolving substances, so the disease can be cured quickly. Dian and Xian are stubborn, chronic diseases. They may be triggered by cold, anger, or fatigue. Their mechanism does not exceed the phrase from the *Neijing*: "Qi moves upward and does not descend." The reason for Qi not descending must be due to cold-damp invading from below, penetrating diffusely through the meridians of the shins, feet, waist, and thighs. This first prevents Kidney Yang from descending, allowing pathogens to gradually enter the spine and back, pressing upward against the Heart and Stomach. Yang Qi cannot descend. Therefore, even when Dian/Xian patients are not having an attack, they often cannot look down, their legs move with difficulty, their testicles occasionally ache隐痛ly resembling hernia pain, and urination and defecation are not smooth. Deduced from this, the treatment method must use acrid-warm herbs, such as Xixin (Asari Radix et Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), Gaoben (Ligustici Rhizoma et Radix), Weilingxian (Syringae Ramulus et Folium), Sheng Fuzi (Aconiti Lateralis Radix Praeparata), Wuzhuyu (Evodiae Fructus), and Xiaohuixiang (Foeniculi Fructus) to unblock cold in the meridians; combined with Niuxi (Achyranthis Bidentatae Radix) to guide downward, and blood-breaking herbs such as Mengchong (Blattidae), Shéngzhéng (Hirudo), Qilao (Scytodidae), Yanhusuo (Corydalis Rhizoma), Wulingzhi (Trogopteri Dung), Dangguixu (Angelicae Sinensis Radix), Chanshanjia (Manis Squama), Sharen (Amomi Fructus Rotundus), Xionghuang (Realgar), and Kufan (Alumen) to warm-transform and unblock blood stasis in the Small Intestine and spinal meridians, assisted by Erchou (Semen Phasi) to guide expulsion downward. Prepared as pills or powders, taken slowly and long-term, gradual recovery may be achieved. There are also cases where cold-damp extinguishes Heart Yang from the Lung and Stomach, causing Heart Qi to suddenly suppress and extinguish, leading to coma resembling death. This is cold-damp injuring Brain Qi, known as "fog and dew pathogens among Yang." It resembles Cold Strike (Zhong Han). Treatment uses acrid-warm dispersants to raise water vapor from above, which differs from cold-damp reversing upward from below. This is mostly seen in acute diseases, but occasionally in chronic ones. Such patients often keep their heads bowed, eyelids droop as if sleeping, and the complexion is deep black from the forehead to the zygomatic arch. Among diseases in the world, there are those with heat that cannot be cleared, and deficiency that cannot be tonified; perhaps only Dian and Xian fit this description!