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Zhuang Zaitian stated: The syndrome of Slow Convulsion (Man Jing) is most commonly caused by vomiting and diarrhea in infants. It may also result from prolonged malaria or dysentery, occurring after the eruption of smallpox or chickenpox, or due to wind-cold invasion, food stagnation, and excessive use of purgative drugs that damage the Spleen and Stomach. It can also be caused by congenital deficiency, misadministration of cold-natured medicines, excessive downward-draining treatment for Fast Convulsion (Ji Jing), or improper nursing care. All these factors can lead to this syndrome. The symptoms include unconsciousness, panting, persistent high fever, eyes open with convulsions upon fright, alternating chills and fever, dullness of the Yang channels (Taiyang, Yangming, Shaoyang), pale white or greenish-yellow complexion, clear and colorless urine and stool, cracked and bleeding lips but with cold breath, diarrhea accompanied by cold sweat, undigested food in stool, cold limbs, abdominal borborygmus, phlegm rale in the throat, opisthotonos (body arched backward like a bow), and dim vision. This is a deficiency syndrome and also a critical condition. Commonly known as Tiandiao Feng, Xu Feng, Man Jing Feng, or Man Pi Feng, all refer to this same syndrome. If cold-natured medicines are used again, or if digestive-promoting methods are applied, or if Nanxing (Arisaema Cum Bile) and Baolong Wan are used to resolve phlegm, Tianma (Gastrodia Rhizome) and Quanxie (Scorpio) are used to dispel wind, Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix), and Lianzi (Coptidis Rhizoma) are used to clear fire, or Badou (Crotonis Fructus) and Dahuang (Rhei Radix et Rhizoma) are used to remove accumulation, death will occur as easily as turning one's palm, which is truly terrifying. If treating wind finds no wind to treat, and treating convulsion finds no convulsion to treat, it is actually because of Spleen and Kidney Yang deficiency and cold, floating isolated Yang, Yuan Qi lacking a root, and extreme Yin cold causing the movement of wind. Treatment should first employ pungent-hot herbs, followed by warming and tonifying methods. Tonifying Earth (Spleen/Stomach) controls Wood (Liver); treating the root is treating the branch. Whenever an infant suffers from simultaneous vomiting and diarrhea, it is the most critical condition. If it recurs frequently, regardless of whether it follows smallpox, chickenpox, or other illnesses, and regardless of the cause, Shenqi (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) should be urgently used to rescue Stomach Qi, while Jiang (Zingiberis Rhizoma), Guirui (Cinnamomi Ramulus), Gouqi (Lycii Fructus), and Shudi (Rehmanniae Radix Praeparata) should be used to rescue Kidney Qi. Not only food stagnation requires urgent rescue, but also Shanghan (Cold Damage) and Shangshu (Summerheat Injury) require urgent rescue. Although there may initially be excess pathogens of cold or summerheat, once vomiting and diarrhea occur, the pathogens are largely expelled, leaving the Spleen and Stomach empty and the granaries depleted. Without urgent rescue, floating phlegm may surge upward, and life may hang in the balance. Quack doctors, seeing this, mistakenly diagnose it as heat or food stagnation, administering cooling and clearing-purgative medicines, leading to immediate complications. What can be done? Rather than erring on the side of cold-natured medicines, making survival difficult, it is better to err on the side of warming and tonifying, which still offers a chance for recovery. This statement elucidates the principles of convulsion due to vomiting and diarrhea most clearly. Future practitioners should not ignore this. The differentiation of Slow Convulsion is listed below:

1. Slow Convulsion with vomiting and diarrhea: Spleen and Stomach deficiency-cold.
2. Slow Convulsion with cold body: Yang Qi suppressed and unable to emerge. Often caused by taking cold medicines.
3. Slow Convulsion with flaring nostrils: True Yin failing to hold fast, deficient fire scorching the Lung.
4. Slow Convulsion with greenish-yellow and white complexion: Deficiency of both Qi and Blood.
5. Slow Convulsion with cold breath from mouth and nose: Middle Jiao cold excess.
6. Slow Convulsion with clear and colorless urine and stool: Complete lack of Fire in the Kidney and Large Intestine.
7. Slow Convulsion with drowsiness and staring eyes: Insufficiency of Shen Qi (Spirit Qi).
8. Slow Convulsion with twitching of hands and feet: Blood failing to circulate to the four limbs.
9. Slow Convulsion with opisthotonos: Blood deficiency causing tendon tension.
10. Slow Convulsion with alternating hot and cold: Insufficient Yin Blood, disorder of Yin and Yang.
11. Slow Convulsion with profuse sweating: Yang deficiency and insecure exterior.
12. Slow Convulsion with clonic spasms of hands and feet: Blood insufficient to nourish the tendons.
13. Slow Convulsion with sunken fontanelle: Extreme deficiency.
14. Slow Convulsion with fever despite burning and cracking lips with bleeding, yet no desire for cold drinks: Administering cold medicines worsens the critical condition. The vomited milk and excreted matter are poorly digested, indicating lack of Fire in the Spleen and Stomach; the blackened lips indicate insufficiency of True Yin.

Generally, cases resulting from persistent fever and vomiting/diarrhea belong to Yin deficiency with floating Yang, inevitably leading to Slow Convulsion. They are not comparable to common colds with wind-cold fever, so dispersing methods are inappropriate. Treatment should focus on nurturing Yuan Qi and saving the root, adding Jiang (Zingiberis Rhizoma) and Guirui (Cinnamomi Ramulus) to guide fire back to its source. One must first use pungent-hot herbs to disperse cold-phlegm, then proceed with warming and tonifying methods. Two empirical formulas are listed below.

Zh Han Dang Jing Tang (Eliminate Cold and Dispel Convulsion Decoction): This formula has warm properties and is specifically for infants with congenital deficiency, prolonged illness, postpartum/post-rash states, or those who took cold medicines incorrectly, leading to slow convulsion from diarrhea and vomiting. Using heat-clearing and wind-dispersing methods will make the condition worse; this formula should be taken quickly. It can open cold-phlegm, widen the chest and diaphragm, stop vomiting, and dispel convulsive pathogens, effectively "returning Yuan Qi to the realm of nothingness." After one or two doses, vomiting gradually stops, which is the verification. Recognizing it as a deficiency-cold syndrome, it should be taken without hesitation. Hu jiao (Piperis Longi Fructus), Paogjiang (Prepared Zingiberis Rhizoma), Rougui (Cinnamomi Cortex) each 1 qian, Dingxiang (Caryophylli Flos) 10 grains. Grind the above four ingredients into fine powder. Boil 3 liang of Zaoshintu (Furnace Soil) in water until extremely clear, decoct the medicine in half a teacup of this liquid, and administer frequently. Follow with the next formula for miraculous effects.

Jiawei Lizhong Dihuang Tang (Modified Regulate the Middle and Rehmannia Decoction): This formula boosts Qi and nourishes Blood, expels disease, and restores Yang. It is specifically for infants whose spirit is depleted, Qi and Blood are severely damaged, appearing emaciated and wretched, who can still be saved. Decoct strongly according to method and administer frequently. Its merit in rescuing the root is hard to describe fully. Shudi (Rehmanniae Radix Praeparata) 5 qian, Jiaozhu (Charred Atractylodis Macrocephalae Rhizoma) 3 qian, Dangshen (Codonopsis Radix), Danggui (Angelicae Sinensis Radix), Zhishaoyao (Prepared Paeoniae Radix Alba - *Note: Text says 'Zhi ', likely missing character, context implies tonifying herb*), Guzhi (Psoraleae Fructus), Zaoren (Ziziphi Spinosomi Semen, stir-fried and ground), Gouqi (Lycii Fructus) each 2 qian, Paogjiang (Prepared Zingiberis Rhizoma), Yurou (Corni Fructus), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma), Rougui (Cinnamomi Cortex), Fuzi (Aconiti Lateralis Radix Praeparata - *implied by later text*).

If cough persists, add Sukewan (Papaveris Pericarpium) 1 qian, Jinyingzi (Chrysanthemi Fructus - *Note: Jinyingzi is Euryales Semen*) 1 qian. If high fever persists, add Baishao (Paeoniae Radix Alba) 1 qian. If diarrhea persists, add Dingxiang (Caryophylli Flos) 6 fen; take only one dose, then remove Fuzi (Aconiti Lateralis Radix Praeparata) and use only seven Dingxiang grains. Every two or three days, use only 2-3 fen of Fuzi, because Fuzi is too hot and should be removed once the disease is addressed. Too much Fuzi causes urinary retention; no Fuzi leaves deep cold in the organs unresolved. No Dingxiang leads to persistent diarrhea. If the infant's deficiency-cold is extreme, Fuzi can be used up to 2-3 qian. This illustrates that "divinity lies in the practitioner," so users must exercise caution.

This formula is a key medicine for saving Yin and consolidating the root, called a divine agent for treating infant slow convulsion. If the infant's vomiting and diarrhea do not worsen daily, or show only slight convulsions, can tolerate medicine, nurse normally, and have smooth bowel movements, Zh Han Dang Jing Tang is not necessary; taking just one dose of this formula will calm the wind and clarify the spirit. If the infant has not yet developed convulsion, but has drowsiness and persistent fever, intermittent fever, quiet during day but fever at night, or afternoon fever, all belong to Yin deficiency and are suitable for this formula. For newly ill, robust infants with red eyes and thirst, it is an excess-fire syndrome, and temporary heat-clearing and resolving methods can be used. But true excess-fire presents with constipation, strong voice, and preference for cold drinks. Vomiting and diarrhea together indicate it is not excess-fire. This formula supplements the insufficiency of creation's Yin and Yang, possessing miraculous powers to revive the dying. If ineffective after one dose following extreme deficiency, larger doses and multiple administrations are advisable.

The Baolong Wan and Niuhuang Wan sold recently are heat-clearing and phlegm-resolving medicines, most suitable for Fast Convulsion. For severe Slow Convulsion, they are fatal upon ingestion.

If pharmacy preparation is unavailable in rural areas, urgently take a pinch of pure soil from under the dung mud of chicken or duck nests (from nests used for decades), removing the top few inches of dung...