Child Convulsions, Vomiting and Diarrhea? Doctor Zhang Xichun’s Heavy Shu Di with Fu Zi and Rou Gui for Chronic Infantile Convulsions (Leading Fire Back to Its Origin)

Patient search terms: child convulsions / seizures in children / chronic infantile convulsions / eyes rolling up / vomiting and diarrhea / loose stools from cold / kidney deficiency Medical terms for this condition: chronic infantile convulsions · infantile convulsions · kidney essence deficiency · spleen-kidney yang deficiency · deficiency yang floating upward (leading fire back to its origin)

Opening: when it comes to herbs that nourish kidney essence, Doctor Zhang Xichun ranked Shu Di number one

The herb we are talking about today is shu di huang (prepared rehmannia). Doctor Luo Dalun explains that prepared rehmannia is superb at strongly supplementing the essence of the liver and kidney — especially nourishing kidney yin and kidney essence. If you had to rank the herbs that build kidney essence, prepared rehmannia would be number one; most of the others basically work around it.

💬 Note from Doctor Luo: Why is prepared rehmannia so important? Because kidney essence is the root of all yin and yang in the body. When the kidney essence is sufficient, the water and fire inside the kidney can stay balanced. Doctor Zhang Xichun used prepared rehmannia with remarkable flexibility — his signature move was a large dose of prepared rehmannia as the foundation, paired with just a tiny pinch of yang-warming herbs, and that alone could turn the whole situation around. Today’s case is about a 5-year-old child who was in immediate, life-threatening danger.

Who was the patient? A child who had been given too many cooling, purging medicines

Whose child was this? He was the 5-year-old son of Hou Shouping, a section chief in the Fengtian provincial governor’s office. You will notice that when Doctor Zhang Xichun recorded his cases, he often named the patient and gave their position — that sense of real, verifiable detail is one of the hallmarks of his case records.

💬 Note from Doctor Luo: Fengtian was the Republican-era name for what we now call Shenyang — actually the whole Liaoning/Shenyang region was called Fengtian back then. A section chief in the provincial governor’s office was roughly a mid-ranking official in the provincial government. When Hou Shouping’s son fell ill, the family called in Doctor Zhang Xichun, who was practicing in Fengtian at the time.

The cause of this child’s illness is a bit heartbreaking: he had taken too much cold and purging medicine.

The cause: the doctor wanted to drain heat, but the cooling herbs hit too hard

What happened? The doctor who saw him first decided the child had heat inside and needed to be drained, so he prescribed some cooling and purging medicines.

💬 Note from Doctor Luo: In Chinese medicine, when we speak of “cool and purging” medicines, we mean things that push downward — herbs like da huang (rhubarb). The medicine was used too aggressively, and the child’s spleen-stomach yang was badly damaged. That was when things took a serious turn — he developed man jing feng, chronic infantile convulsions.

What exactly are chronic infantile convulsions? After his yang was injured, the child showed chills with vomiting and diarrhea: his stomach was cold, so the moment he ate anything cold it was intolerable — he vomited on one end and had gushing diarrhea on the other. On top of that he convulsed frequently, and during the seizures his eyes rolled upward. His spirit was affected too — he was clouded and confused. Doctor Zhang Xichun said the child was already in danger by the minute — the kind of sight that terrifies most parents.

Acute versus chronic infantile convulsions: one word apart, worlds apart in danger

Here Doctor Luo Dalun carefully distinguishes the two kinds of infantile convulsions:

💬 Note from Doctor Luo: Acute infantile convulsions (ji jing feng) usually happen during a high fever from an external invasion — the child suddenly convulses, and it comes on fast. Chronic infantile convulsions (man jing feng), by contrast, usually appear because the child was treated improperly during an illness and the upright qi was damaged. Afterward the child keeps having episodes of coma, convulsions, and even paralysis. Chronic infantile convulsions generally means the child’s upright qi is already severely depleted; the prognosis is very poor, and it is a critical, dangerous condition. So this child was seriously ill.

So what was to be done? When Doctor Zhang Xichun was called in, he saw a child whose eyes were rolling up, whose spirit had nearly collapsed, and who convulsed constantly — a very grave case. He produced a formula, and the thinking behind it was extremely refined.

The prescription: two liang of Shu Di as the foundation, with only a pinch of yang-warming herbs

Here is the formula Doctor Zhang Xichun wrote:

• Shu di huang (prepared rehmannia), 2 liang (about 60 g) — look at that: a full two liang of prepared rehmannia. This is the commanding general of the whole formula;
• Dried shan yao (Chinese yam), 1 liang (about 30 g) — when Doctor Zhang Xichun used prepared rehmannia, he often paired it with Chinese yam, which is also a superb tonic for the spleen and kidney;
• Gan jiang (dried ginger), fu zi (prepared aconite) and rou gui (cinnamon bark), 2 qian (about 6 g) each — all yang-warming herbs, but note: only a tiny amount;
• Shan yu rou (cornus fruit) and ye tai shen (wild codonopsis, a kind of party root), 3 qian (about 9 g) each — cornus fruit astringes and secures against collapse; party root supplements the qi.

💬 Note from Doctor Luo: Look how carefully balanced the proportions are. Two liang of prepared rehmannia and one liang of yam — large amounts. Dried ginger, aconite and cinnamon at 2 qian each — 6 g, a very small amount. Why? Because the child’s upright qi was severely damaged, so first you must supplement the kidney essence and the upright qi. But because he had been chilled, you also have to warm the yang. How do you combine those? Large doses of prepared rehmannia and yam to nourish the essence, plus a tiny bit of dried ginger, aconite and cinnamon to warm the yang — that is where Doctor Zhang Xichun’s genius lies.

Even the decoction method was particular: after the herbs were prepared, they were boiled down to one and a half cups, left to cool to warm, and given to the child a little at a time.

One and a half cups in, the convulsions stopped — but there was a small twist

What happened? After drinking that one and a half cups, the child’s vomiting, diarrhea and convulsions all stopped, and his spirit seemed a bit stronger.

💬 Note from Doctor Luo: But then a small problem appeared: the child was a little irritable. Doctor Zhang Xichun saw it and adjusted decisively — he removed the dried ginger from the formula and added 4 qian (about 12 g) of bai shao (white peony). Why? Irritability is a sign that the warming has gone slightly too far. Removing the dried ginger and adding white peony softens the liver and astringes the yin, calming the formula down.

And after that adjusted dose, the little boy was completely well — one more dose, and he was cured.

Where did this approach come from? Jin Gui Shen Qi Wan set the rule long ago

This “large prepared rehmannia plus a tiny bit of yang-warming herbs” pairing was not invented out of thin air by Doctor Zhang Xichun. Doctor Luo Dalun traced its source:

💬 Note from Doctor Luo: The idea is already in Doctor Zhang Zhongjing’s Jin Gui Shen Qi Wan (Kidney Qi Pill from the Essentials of the Golden Cabinet). Jin Gui Shen Qi Wan is essentially Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) with two extra herbs — rou gui (cinnamon) and fu zi (prepared aconite). In the Six-Ingredient Rehmannia Pill, prepared rehmannia is the largest, most important ingredient — then you add that little bit of cinnamon and aconite, just a pinch. So “large prepared rehmannia with a small amount of cinnamon and aconite” was a rule already laid down in Doctor Zhang Zhongjing’s Essentials of the Golden Cabinet (《金匮要略》).

And why this combination? Doctor Luo Dalun offered a wonderfully clear analogy:

💬 Note from Doctor Luo: Think of it this way — prepared rehmannia is like a barrel of gasoline. Sitting there, it nourishes yin and essence. Now, how do you supplement yang? You don’t pile up a heap of firewood to burn it — no need. Cinnamon and aconite are like a single match — strike it, and the barrel of oil goes up with a whoosh. That’s the feeling. Without cinnamon and aconite, prepared rehmannia merely nourishes yin and essence — it gets absorbed but never becomes yang. Add that tiny bit of cinnamon and aconite, and you can generate yang from within yin — suddenly the yang is vigorous.

Leading fire back to its origin: the specialty of Chen Shiduo and Fu Qingzhu

Many later physicians were especially skilled with this pairing, above all the Daoist-trained doctors of the Ming dynasty, such as Chen Shiduo and Fu Qingzhu. What did they use it for? A technique called yin huo gui yuan — leading fire back to its origin.

💬 Note from Doctor Luo: Why is “leading fire back to its origin” needed? When our kidney essence is insufficient, problems constantly arise. The kidney is the organ of water and fire — water and fire represent yin and yang. Inside the kidney they exist in equal measure, generating each other, rooting each other, maintaining a balance. But if the kidney essence is insufficient and the water decreases, the fire appears to be more than it should — and the excess fire has nowhere to go, so it tends to shoot upward. Here is an analogy: imagine keeping a dragon in a pond. When the water level drops, the dragon can no longer stay put — it rises and flies out. This is called long lei zhi huo shang ben — the dragon-thunder fire rushing upward.

What happens when the dragon-thunder fire rushes upward?

💬 Note from Doctor Luo: People with kidney essence deficiency can suddenly develop heat in the upper burner: eyes suddenly turn red, the throat suddenly swells, sudden toothache, a mouthful of canker sores, sudden dizziness — sometimes seizure-like; some people suddenly get trigeminal neuralgia. And at the same time the lower body is especially cold — all the fire has gone up, so if you touch this person, their knees may be colder than both their upper body and their feet. This strange pattern of “heat above, cold below” is exactly what deficiency fire running upward looks like.

So what do you do? Doctor Luo Dalun also shared his own experience:

💬 Note from Doctor Luo: My experience is 30 g of prepared rehmannia paired with 3 g of cinnamon. There are also established formulas — for example, Doctor Zhang Jingyue’s Zhen Yin Jian (Suppressing Yin Decoction), and Doctor Chen Shiduo’s Yin Huo Tang (Fire-Guiding Decoction). The core of all of them is the same: a large dose of prepared rehmannia (some go as high as 60 g or 90 g), paired with just a few grams of cinnamon or aconite. Once the kidney essence is replenished, the cinnamon leads the fire back to its origin, and the fire comes down quickly. When I see someone with a suddenly swollen, red, painful throat where detoxifying herbs don’t do much, I often have them drink 30 g of prepared rehmannia with 3 g of cinnamon boiled in water, and gradually the fire is led back down. For trigeminal neuralgia, Doctor Chen Shiduo’s Fire-Guiding Decoction generally stops it in three doses.

Doctor Luo’s closing note: Doctor Zhang Xichun brought prepared rehmannia to life

After telling this case, Doctor Luo Dalun remarked: in this case, Doctor Zhang Xichun wielded the principle of “leading fire back to its origin” with great mastery — it shows how deeply Doctor Zhang Xichun understood prepared rehmannia, and how flexibly he applied it.

💬 Note from Doctor Luo: The lesson of this story is this: sometimes kidney essence deficiency, kidney essence injury, can cause convulsions above and sudden fire above. If, at such a moment, we can apply prepared rehmannia properly, paired with a little cinnamon, we can reverse the situation — that is the principle we are talking about today.

So everyone, remember this: when you suddenly develop fire — a swollen throat, toothache, mouth ulcers that keep coming back — and it comes together with cold hands and feet and cold knees, don’t only think about clearing heat and detoxifying. Ask yourself: could this be kidney essence deficiency with deficiency fire floating upward? At that point, the prepared rehmannia plus cinnamon approach may be the real answer.

What to take away

• Chronic infantile convulsions (man jing feng) is a critical condition of depleted upright qi — it differs completely from the acute, fever-driven convulsions of ji jing feng. Improper treatment with cold, purging herbs is a classic way to produce it.
• The kidney is the organ of water and fire. When kidney essence runs low, the water decreases and the fire looks excessive — deficiency fire (the “dragon-thunder fire”) shoots upward, producing sudden sore throat, red eyes, toothache, mouth ulcers, dizziness, even trigeminal neuralgia — while the lower body, especially the knees, turns cold.
• The classic fix is “leading fire back to its origin”: a large dose of prepared rehmannia to replenish the essence, plus a tiny pinch of cinnamon (or aconite) to warm the yang and pull the fire back down — the structure already set by Doctor Zhang Zhongjing’s Jin Gui Shen Qi Wan. Doctor Luo Dalun’s everyday version: 30 g of prepared rehmannia with 3 g of cinnamon.
• For recurring upper-burner “heat” with cold limbs, don’t reflexively clear heat — consider kidney essence deficiency with floating deficiency fire before reaching for the cooling, detoxifying herbs.

Compiled from Doctor Luo Dalun’s commentary on Doctor Zhang Xichun’s case records; the case is from Records of Chinese Medicine with Western Reference (《医学衷中参西录》).