Child Suddenly Collapses with Convulsions and Foaming at the Mouth: Imperial Physician Doctor Gong Tingxian’s Treatment of Epilepsy (Zhuifeng Qutan Wan, Cured Within Half a Year)

Patient search terms: child convulsions / suddenly collapses and convulses / foaming at the mouth / unconsciousness / epilepsy / several attacks a month / attacks triggered by exertion

Medical terms for this condition: xian bing (epilepsy, seizure disorder) · epilepsy · wind-phlegm congestion · qi and blood deficiency · internal stirring of deficiency wind · abnormal electrical discharge in the brain

Opening: a perfectly healthy child suddenly goes down with a thud

Today’s physician is Doctor Gong Tingxian (龚廷贤, 1538–1635), the celebrated imperial physician of the Ming dynasty — a doctor of the Imperial Academy of Medicine (Tai Yi Yuan), who treated the imperial family. How extraordinary was he?

💬 Note from Doctor Luo: I always say this physician was remarkable — of the very highest skill, and truly worthy of our study. I admire him deeply. Not only was his scholarship excellent and his treatment results outstanding, but he also looked after himself exceptionally well — he truly applied theory to practice, and protected his own health brilliantly. You see people who know everything but cannot do anything — that is not convincing. Gong Tingxian lived to 97 in the Ming dynasty — extraordinarily long-lived, truly a figure on the level of an immortal. So let us study his medical thinking closely.

The disease he will treat today is epilepsy (xian bing). You may think epilepsy has nothing to do with you — but what we are going to study is his way of thinking about treatment.

What does an epileptic attack look like? You have probably seen it: a person suddenly falls to the ground with a thud, the whole body convulses, foam comes out of the mouth, and he or she is unconscious. The family panics — some pinch the philtrum, some press hard on the arms — but in fact none of this helps.

💬 Note from Doctor Luo: During an attack, the correct approach is: turn the person’s face to the side — to stop him biting his tongue, and to stop the foam blocking his throat so he can’t breathe. Don’t press hard on his arms — that only adds pain and can injure him. Lay him down safely, keep an eye on him, make sure he’s out of danger, and in a little while he will recover by himself. This is not actually a life-threatening state, but the scene is frightening: falling down with a thud, unconscious, foaming at the mouth, convulsing all over. Some people think it’s a heart attack — no, it’s not. This is xian bing, epilepsy.

What exactly is epilepsy? First, get the name straight

When ordinary people say “dian xian,” they mean xian bing. And “dian” is a different disease entirely — the manic, wild-running kind of mental illness, not the same as xian.

What is xian bing? In modern medical terms: abnormal electrical discharge in the brain neurons, which causes convulsions, loss of consciousness and similar symptoms. Even today the cause is not fully understood — childhood injury, all kinds of stimuli may play a part, and the treatment results are only moderate.

Eighteen years old, epileptic for seven years: the Wang family’s boy worn down by the disease

The first patient was the son of Mr. Wang Dashan, 18 years old. How long had the boy been ill? Seven years — seven years of going from doctor to doctor, many physicians, not the slightest effect.

His attack pattern: sometimes once a month, sometimes four or five times a month. When it struck, he would suddenly spit bloody foam, fall to the ground with a crash, lose consciousness, and after a short while wake up again — a classic epileptic attack.

After seven years, with every idea exhausted, the family called in Doctor Gong Tingxian.

One touch of the pulse: slippery and rapid in all six positions — qi and blood deficient, wind-phlegm congested

Doctor Gong Tingxian took the pulse — six positions slippery and rapid (liu mai hua shuo): it jumped along gurgling, rolling like beads, with force. He pronounced his diagnosis: “This is qi and blood deficiency, and wind-phlegm surging up and congesting (ci qi xue xu er you feng tan yong sheng ye).”

What does that mean? Tan xian yong sheng — phlegm and saliva surge up together and block the clear orifices. This is what Doctor Gong Tingxian always stressed: the key to epilepsy lies in phlegm, so transforming phlegm is very important.

💬 Note from Doctor Luo: The ancients believed that the reason the brain goes wrong and the body convulses is that sticky phlegm obstructs the clear orifices — blocking them, and so causing the abnormality. What to do? Transform the phlegm — dissolve it and restore the free passage of the clear orifices. In practice, this improves the circulation of qi and blood in the body, changes the internal environment, and lets the body restore itself. That is one way of thinking.

Zhuifeng Qutan Wan: a phlegm-transforming pill for all the “wind epilepsies”

What formula did Doctor Gong Tingxian use? Zhuifeng Qutan Wan (Wind-Chasing Phlegm-Expelling Pill).

What does this formula treat? All the various “zhu feng xian” (wind epilepsies) — not only epilepsy but all kinds of twitching, states where wind seems to roll through the body. Doctor Gong Tingxian said: those who suffer this disease are many, and I have used this formula with wide success — trust it and use it (huan ci bing zhe shen duo, wo yong ci fang de xiao shen guang, xin er yong zhi).

How is the formula built? Let’s take it apart:

• Fang Feng (Saposhnikovia root) — expels wind;
• Tian Ma (Gastrodia) — gathers wind and frees the collaterals;
• Jiang Can (stiff silkworm) — extinguishes wind and frees the collaterals;
• Bai Fu Zi (giant typhonium rhizome) — extinguishes wind, transforms phlegm and expels wind, with a fairly strong phlegm-transforming action;
• Quan Xie (scorpion) — gathers wind and frees the collaterals;
• Mu Xiang (Aucklandia root) — moves qi;
• Ya Zao (toothpick acacia pod) — transforms phlegm;
• Bai Fan (alum) — transforms phlegm;
• Nan Xing (Arisaema) — transforms phlegm, with careful preparation: half soaked in alum water, half soaked in soap-pod water, each soaked overnight;
• Ban Xia (Pinellia) — transforms phlegm.

The whole formula is phlegm-transforming at its core: the herbs are ground into fine powder, made into pills with ginger juice, and coated with Zhu Sha (cinnabar) — what does cinnabar (chen sha) do? It calms the spirit and settles the mind. The method of taking it also matters: take it well away from meals, sent down with ginger soup or mint soup.

Dispensary warning: Bai Fu Zi is NOT Fu Zi — don’t ever mix them up

Here Doctor Luo gives a special warning about something that can cost a life:

💬 Note from Doctor Luo: Bai Fu Zi (giant typhonium) and Fu Zi (aconite) are not the same thing! Bai Fu Zi is somewhat toxic — some people who take it will convulse, their heart will race, they will have a reaction. The Fu Zi we talk about — in the pharmacy it’s called bai fu pian or hei fu pian — that is aconite, a completely different substance from Bai Fu Zi! Bai Fu Zi transforms phlegm and expels wind; its phlegm-transforming action is fairly strong. Fu Zi warms yang. These two herbs in Chinese medicine are especially easy to mix up: if the pharmacy clerk is a beginner, and you ask for “bai fu zi,” he may hand you “fu zi” (bai fu pian) instead — you could be poisoned after taking it home, that would be unbearable. In the past, facial paralysis was treated with Bai Fu Zi — remember, this is a separate, individual herb; make it absolutely clear when you go to the pharmacy.

More than just phlegm: add ginseng and angelica to build up the root of qi and blood

So the phlegm-transforming strategy is set. But Doctor Gong Tingxian asks one more question: why is your phlegm so profuse?

💬 Note from Doctor Luo: Everyone should ask this question — why is there so much phlegm in your body? What is the reason? Deficiency of upright qi, deficiency of qi and blood! When your upright qi is insufficient, it lacks the strength to push qi and blood along; where it cannot push, things stop and linger, and slowly condense into phlegm. A metaphor: what was originally a good thing (the body’s fluids) slowly turns into a pathological product — like a river: when the water gets low it stops flowing, and where it stops it turns foul and congeals. When qi is deficient and blood is deficient, the blood can’t circulate properly — tissues stop moving and congeal into phlegm. Also, when qi and blood are deficient, some of the body’s fluids cannot be governed and transformed — they can’t be excreted, and slowly they too congeal into phlegm. So what is the true root of epilepsy? Qi and blood deficiency.

So what did Doctor Gong Tingxian add on top of the Zhuifeng Qutan Wan? Ren Shen (ginseng), Dang Gui (Chinese angelica), and Huang Lian (Coptis), one liang (about 30 g) each:

• Ren Shen and Dang Gui — tonify qi and nourish blood: when qi and blood are deficient, add ginseng and angelica;
• Huang Lian — clears fire: this patient had fire, so Coptis stir-fried in ginger juice was used; if the stomach is deficient, add Bai Zhu (white Atractylodes) as well.

Anshen Wan: support the upright as the main line, calm the spirit to finish

Besides the Zhuifeng Qutan Wan, he also gave Anshen Wan (Calm-the-Spirit Pill). Anshen Wan is the truly “tonifying” one:

Dang Gui nourishes the blood, Ren Shen tonifies qi, Fu Ling removes dampness and strengthens the spleen, Suan Zao Ren nourishes the blood and calms the spirit, Sheng Di Huang nourishes yin, Huang Lian clears heat, Chen Pi transforms phlegm, Nan Xing transforms phlegm, Tian Zhu Huang transforms phlegm, Niu Huang clears heat and transforms phlegm, Zhen Zhu (pearl) calms the spirit, Hu Po (amber) calms the spirit, and finally a touch of Zhu Sha (cinnabar) to settle the spirit and weigh down the heart-mind.

💬 Note from Doctor Luo: Do you see? — Supporting the upright is the main line: first support the upright, add a little fire-clearing and phlegm-transforming, and finish with the spirit-calming pearl, amber and cinnabar. A physician of Doctor Gong Tingxian’s caliber looks at your present illness on the one hand, and on the other hand at how the illness came about — deficient upright qi, some organ not at peace — and helps you regulate it. This is the idea of treating the root of the disease (zhi bing qiu ben).

Within half a year, cured; and several others after him, cured by the same method

What was the result? Wei ji ban nian er yu — the boy was completely well in less than half a year. What’s more, several later patients treated by this same method all recovered.

💬 Note from Doctor Luo: This was, we may say, a mature method for treating epilepsy in Doctor Gong Tingxian’s hands. Look at the thinking: it is not “see the disease and transform phlegm — push the phlegm hard” — that is the ordinary level of “treat the disease when you see the disease.” What the famous physician sees is: qi and blood deficient, wind-phlegm congested — transform phlegm and expel wind on one side, build up qi and blood on the other — treat both branch and root at once.

Case two: a boy married at fifteen — epilepsy earned by exhaustion

Straight after that comes another case: a youth, 15 years old.

How did he fall ill? “Yu nü hou fu lao yi” — after sexual intercourse, then heavy labor. In ancient times people married early — a boy might already be married at twelve or thirteen. At 15 this boy had already “yu nü” (had intercourse), and after that his kidney qi was damaged; then he bore corvée labor — the family had many affairs and made him work; and he also failed his examinations — at 15 he was still sitting the imperial examinations.

💬 Note from Doctor Luo: Fifteen — to us he seems hardly grown up, but the children of the old days truly had a hard lot: married at 15, managing family affairs, doing labor, taking the examinations. This boy’s illness was earned by exhaustion.

And the result? He had suffered epilepsy (xian zheng) for three years. What did it look like? Yu lao ji fa — whenever he overexerted himself, the epilepsy attacked: he collapsed to the ground convulsing.

Shi Quan Da Bu Tang: Four Gentlemen plus Four Substances, then Astragalus and Cinnamon

What did Doctor Gong Tingxian see? — This is a deficiency pattern; upright qi insufficient. So don’t bother distinguishing phlegm — just tonify directly!

With what? Shi Quan Da Bu Tang (Ten Complete Great Tonification Decoction), plus Jiawei Guipi Tang (Modified Spleen-Restoring Decoction).

What is Shi Quan Da Bu Tang? Take it apart: Si Jun Zi Tang (Four Gentlemen Decoction) (tonifies qi) plus Si Wu Tang (Four Substances Decoction) (nourishes blood) — together called Ba Zhen Tang (Eight Treasures Decoction) — tonifying both qi and blood; and Ba Zhen Tang plus Huang Qi (Astragalus) and Rou Gui (cinnamon bark) makes Shi Quan Da Bu (Ten Complete Great Tonification).

💬 Note from Doctor Luo: Huang Qi strengthens the qi-tonifying action; Rou Gui warms you a little, and it also leads fire back to its origin (yin huo gui yuan) — it draws the fire downward. This formula is excellent: for a body that is truly weak, Shi Quan Da Bu will slowly build it back up. Guipi Tang also tonifies both qi and blood. Today’s pharmacies sell Shi Quan Da Bu Wan — the pill form of the same formula.

Placenta steamed with glutinous rice: pills made from the afterbirth to rebuild the root

Decoctions alone were not enough — Doctor Gong Tingxian gave another powerful move: moreover, Zi He Che — what is Zi He Che? The human placenta — steamed into glutinous rice and made into pills, the size of parasol-tree seeds (wu tong zi), one hundred pills per dose, taken three to five times a day.

Later the boy developed nocturnal emission, night sweats and fever — he continued the previous medicines and added Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill).

💬 Note from Doctor Luo: Zi He Che is a “blood-and-flesh sentient substance” (xue rou you qing zhi pin) — it greatly tonifies essence and blood. Notice: in this second case, from beginning to end not a single wind-extinguishing or phlegm-transforming herb was used — it was pure tonification. Because he was deficient. Once you build him up, the disease resolves. This is xu feng nei dong — internal stirring of deficiency wind: deficiency of upright qi is the true root of the wind moving and the body convulsing.

The story of Qian Yi: the prince’s convulsions cured by Yellow Earth Decoction — “when earth is deficient, the wood shakes”

Doctor Gong Tingxian summed it up himself: this method cures epilepsy regardless of sex or age (bu ju nan nü lao you jie xiao) — the earlier formula and this one together. In treating epilepsy, most physicians transform phlegm — large doses of phlegm-transforming and sedating herbs to press the illness down; but Doctor Gong Tingxian’s focus was different.

And he told a story about Qian Yi:

💬 Note from Doctor Luo: Long ago, Qian Yi treated the emperor’s child — the prince suffered chi zong (a convulsive state, somewhat like infantile fright). No matter what formulas the imperial physicians prescribed, nothing worked. Finally Qian Yi came and used Huangtu Tang (Yellow Earth Decoction) to tonify the spleen. Why can tonifying the spleen cure this? Qian Yi said: “Tu xu ze mu yao” — when the spleen-earth is deficient, the liver-wood begins to shake. Earth deficiency is the root; the shaking wood is the result. So soothing the liver, transforming phlegm and extinguishing wind day after day brings only mediocre results; setting to work on supporting the upright and tonifying the spleen-stomach is treating the root. The later physicians like Doctor Gong Tingxian regarded Qian Yi as their teacher — Qian Yi laid the foundation for them, and they studied him in earnest; there are many places where they discuss how Qian Yi treated disease.

What to take away: learning from a famous doctor means learning to treat the root

With this episode done, Doctor Luo sums up Doctor Gong Tingxian’s core thinking:

💬 Note from Doctor Luo: For stroke-like and wind-movement diseases — the wind may look fierce, and we can suppress wind, extinguish wind, transform phlegm — all of it can be treated. But the fundamental point is deficiency of upright qi and deficiency of qi and blood. Tonify the upright according to the degree of qi-blood deficiency — that is treating the root. We see many strange diseases; once you think “how should this be treated?” — you must think of what the root is: why does this person have this condition? Find the root and regulate the body, and the body restores itself. This is the Chinese-medicine way of thinking. Epilepsy — most of you may rarely encounter it in daily life, but people really do ask me how to treat it — it really is hard to treat. Yet the ancients have already pointed the way: support the upright as the main line, plus expel wind, settle the spirit and transform phlegm — in this way the body can be regulated back to health. When you meet other wind-movement diseases, all the convulsive conditions, the root is right here — this is the Chinese-medicine way of thinking.

Compiled from Doctor Luo Dalun’s commentary on the medical cases of Doctor Gong Tingxian. The case records come from Wan Bing Hui Chun (A Return to Spring for Ten Thousand Illnesses), written by Doctor Gong Tingxian in the Ming dynasty and published in 1587.