Child Twitching, Blinking Eyes or Sucking in the Belly? Doctor Zhang Xichun Treats Chronic Infantile Convulsion (Slow Convulsion) by Warming the Spleen

What people search for: child tics / child convulsions / blinking eyes / sucking in the belly / vomiting and diarrhea / legs too weak to stand / sleeping with the eyes half open Medical terms: chronic infantile convulsion (man pi feng, slow convulsion) · spleen-stomach deficiency cold in children · tic disorder · infantile vomiting and diarrhea

Opening: a few mouthfuls of autumn fruit sent a four-year-old into illness

When autumn fruit comes in, parents see their child loves it and their hearts swell with joy: “Sweetie, eat up — have as much fruit as you like!” Who would ever imagine that this outpouring of love could make a four-year-old child start vomiting and diarrhea, burning hot all over, even going into convulsions?

💬 Note from Doctor Luo: Dear friends, fruit is a good thing — but everything in moderation. You must not eat it recklessly, gorging on whatever tastes good. Some doctors of Chinese medicine even point out that many fruits are cool to cold in nature — watermelon, for example, is extremely cold, and eating too much of it does harm. In the heat of summer a little is fine, but by autumn the weather has already turned cold; giving a child these cold foods then goes against the changes of nature. So some TCM doctors suggest: if your child wants a pear, boil it in water first; apples too — cook them, and it is much better for the little one.

Who was the patient? The grandson of the director of the Liaoning Survey Bureau — the record names names

This little patient came from an influential family — he was the young grandson of the director of the Liaoning Survey Bureau, four years old. This is a case Doctor Zhang Xichun treated while he was in Shenyang.

💬 Note from Doctor Luo: The most important years of Doctor Zhang Xichun’s life were spent in Shenyang — it was there that he established the first hospital of Chinese medicine in China, the Lida Hospital of Chinese Medicine, which is why so many of his cases happened in Shenyang. And his case records have a distinctive habit: he names names. We today usually blur identities out of concern for privacy, but Doctor Zhang wrote down the institution and the position — the grandson of the director of the Liaoning Survey Bureau: could anyone make that up? So cases like this carry a very high degree of authenticity.

How did this child fall ill? Simply by eating a lot of fruit in autumn — the child wanted it, and the parents indulged him. Eating too much fruit injured the spleen and stomach, weakening his digestion; and since no one understood the cause, he kept eating. After the Mid-Autumn Festival, the pattern of man pi feng (slow convulsion) emerged.

How sick was he? No appetite, vomiting and diarrhea, a body burning to the touch

Doctor Luo Dalun lays out the symptoms one by one: his appetite dropped sharply — he had almost no desire to eat or drink; if you forced a little food into him, he could not digest it. The doctors called in earlier saw the indigestion and prescribed medicines to promote digestion and resolve stagnation — which only made his spleen and stomach weaker still. Gradually the child began vomiting and diarrhea, with convulsions from time to time — sometimes he would go into spasms.

By the time Doctor Zhang Xichun was consulted: his whole body was burning hot — his skin felt scalding to the touch; on taking the pulse, it was faint and almost imperceptible — his upright qi was so depleted it was barely there; when he slept his eyes would not close — the whites showed through; his spirit was feeble — utterly listless.

💬 Note from Doctor Luo: Remember this, everyone: sleeping with the eyes open, unable to close the lids, is a very typical sign of spleen deficiency. We have pointed out this feature again and again. This child’s illness is exactly like the case we told yesterday — both are problems of the spleen and stomach.

What did Doctor Zhang think? Cold on the inside, heat on the outside — true cold, false heat

The child’s body was scorching — was it excess fire? Doctor Zhang was perfectly clear in his own mind: not heat — on the contrary, it was cold.

Because the autumn weather was cool and the child had been wolfing down raw, cold fruit, his spleen and stomach had become deficient and cold. Think of the spleen and stomach as a cooking pot that must “steam” the food and drink (rotting and ripening it, fu shu) before it can be digested — now the fire beneath the pot had been doused by cold things, so the food could not be cooked: whatever the child swallowed came back up as vomit, and what came out below was undigested food. And when the spleen and stomach are deficient and cold, yang qi cannot vaporize and transport the fluids, so cold fluid (han yin) stagnates in the chest and stomach and pushes the yang of the heart and lungs outward — and that is why the child’s whole body burned hot. This is what we call true cold with false heat (zhen han jia re): cold evil entrenched within, yang qi driven out to the surface.

💬 Note from Doctor Luo: And why the convulsions? As we explained before, this is tu xu ze mu yao — when the earth (the spleen) is deficient, the wood (the liver) shakes. When the spleen-earth is deficient, liver wind easily stirs — that is how liver wind moving internally arises; once the wind moves, all kinds of twitching and trembling appear. Doctor Zhang Xichun’s own explanation leaned toward Western medicine: he said it was qi and blood insufficiency, unable to reach the brain to moisten and regulate the brain nerves, hence the convulsions. Both angles work — the deficiency of the spleen and stomach caused the child’s twitching. Let me set that thought aside for now and come back to it: many of today’s children’s problems are connected to exactly this.

The prescription: red halloysite to check vomiting and diarrhea, the Four Gentlemen Decoction as the base, with three yang-warming herbs

Doctor Zhang’s method can be summed up in eight characters: warm the spleen and stomach, fortify the spleen and stomach, to dissolve the cold fluid. The moment he opened the formula, the first herb was very interesting — chi shi zhi (red halloysite), ground fine, in a dose of one liang (30 g).

💬 Note from Doctor Luo: We discussed chi shi zhi before: it stops diarrhea, it warms the spleen, and because it is heavy, it can settle the qi mechanism — above it checks vomiting, below it stops diarrhea. This was one of Doctor Zhang Xichun’s favorite herbs. It is a mineral, a kind of hydrated kaolin clay, and it is very safe. When Western medicine meets a child with diarrhea, what does it prescribe? Smecta — montmorillonite powder — which is much the same thing, a French kaolin clay. You see — all of humanity arrived at the same answer on this one.

Next came sheng huai shan yao (Chinese yam), six qian (18 g) — the dried Huai yam slices, to tonify the spleen. Doctor Zhang said that each of the five viscera has its own essence — the heart, liver, spleen, lung and kidney each have their vital essence — and what tonifies the essence of the spleen? Huai yam. Then shu huai di huang (prepared rehmannia), six qian (18 g) — the prepared rehmannia from Wen County, Jiaozuo, Henan, also in no small dose; this one tonifies the kidney essence. Doctor Luo Dalun points out a special trait: when Doctor Zhang Xichun treated this kind of illness, he always used prepared rehmannia to tonify the kidney — the spleen essence must be replenished, and the kidney essence too.

Then came bai zhu (atractylodes) (to fortify the spleen and drain dampness), fu ling (poria) (to fortify the spleen and dispel dampness), and gan cao (licorice) (to harmonize the middle). Do you see it? Bai zhu, fu ling and gan cao — together with the ginseng that follows — form the great qi-tonifying main formula, the Four Gentlemen Decoction (si jun zi tang)! With the Four Gentlemen Decoction as the base, Huai yam to tonify the spleen and prepared rehmannia to tonify the kidney, then fu zi (aconite), two qian (6 g), rou gui (cinnamon bark), two qian (6 g), and gan jiang (dried ginger), one and a half qian (4.5 g) — these three yang-warming, middle-warming herbs — and finally chi shi zhi to settle the vomiting and diarrhea: the whole formula warms the spleen and stomach, tonifies qi and supports upright qi. The logic could not be clearer.

One detail: Korean ginseng ground to powder and taken with the strained decoction

The ginseng in this formula was Korean ginseng (gao li shen), and its preparation was very particular: it was ground to a coarse powder, and after the other herbs had finished decocting, the powder was taken with the strained liquid.

💬 Note from Doctor Luo: Why did Doctor Zhang do this? He said that for treating vomiting and diarrhea of this kind, powders and pills are superior to decoctions — the powdered ginseng lingers in the stomach and intestines more easily, giving a better effect. And frankly, it is also a way of stretching the herbs further. You see — even the dosage form of a master’s medicine carries hidden reasoning.

The result: one dose stopped the vomiting, cut the diarrhea by half, and the convulsions never came back

How did the formula work? After one dose, the vomiting stopped; the diarrhea reduced by more than half; and the convulsions did not recur. There you have it — the diagnosis was accurate, and a single dose basically brought the situation under control.

💬 Note from Doctor Luo: Do you see? This illness really was caused by deficiency and cold. Both of yesterday’s and today’s cases are the same — the root lies in the spleen and stomach. Get that right, and the medicine works like a charm.

Since the vomiting had stopped and the burning heat had largely subsided, Doctor Zhang removed the gan jiang and raised bai zhu to four qian (12 g) — increasing the strength for tonifying the spleen. After one more dose, the diarrhea stopped too. Finally he halved the fu zi in the original formula and added gou qi zi (wolfberry) to tonify the liver and kidney. Two more doses, and the illness was cured.

Doctor Zhang added one note: this child’s vomiting had not been severe. If the vomiting had been violent, he said, first use the Zhu Han Dang Jing Tang (Cold-Dispelling Convulsion-Settling Decoction) from the Fu You Bian (Compilation for Nurturing the Young) that we discussed yesterday, to open up the cold fluid — then drink this formula, and the effect is even better.

The second child: eating watermelon as a meal — at eight years old his legs were too weak to stand

After finishing that case, Doctor Zhang appended another: an eight-year-old child from a melon-growing family. When the autumn melons ripened, the boy watched over them in the fields, and when he got hungry he ate melons as his meal — watermelons and such cold, raw things as a staple meal: how could the spleen and stomach endure it? Before long the signs of man pi feng appeared: food was not digested, he vomited frequently, his bowel movements were many, and the grain came out undigested in the diarrhea.

This child’s symptoms differed from the previous two: he did not convulse — instead his legs were weak. He could not walk; he could not even stand, and could only sit on the ground, with his whole body burning hot. How to treat it? Again warm and tonify the spleen and stomach: sheng huai shan yao (Chinese yam), one liang (30 g), bai zhu, shu di huang (prepared rehmannia), long yan rou (dried longan), gan jiang, sheng ji nei jin (raw chicken gizzard lining), bai shao (white peony), and gan cao (licorice). After taking it twice he felt much better, except that his legs were still a little unsteady — so Doctor Zhang modified the formula: added hu tao ren (walnut) and chuan xu duan (dipsacus) (to strengthen the sinews and bones). After two more doses, he was cured.

💬 Note from Doctor Luo: Legs too weak to walk — the Huang Di Nei Jing (Yellow Emperor’s Inner Classic) stated it long ago: zhi wei du qu yang ming — “in treating flaccidity, focus solely on the yang ming (stomach channel).” Yang ming means the stomach channel — you must regulate the spleen and stomach. So you see, when a child’s spleen and stomach become deficient, the problems take a thousand strange forms: some convulse, some get weak legs — but the root is always in the spleen and stomach. Doctor Zhang Xichun saw this clearly, so he held fast to the spleen and stomach, and the illness was cured. And once the child recovered, Doctor Zhang instructed the parents: never let the child eat raw, cold fruit again, to prevent a relapse.

Doctor Luo’s extension: the blinking-eye and belly-sucking children of today share the same root

After the two cases, Doctor Luo Dalun turned the discussion to the present day. If you went looking for the disease name “man pi feng” in modern society, he said, you might not find even two cases in a whole year. But! You will find that in today’s world there really are many children with twitching and tic problems: some children blink their eyes for no reason, some involuntarily suck in their belly, some give a little twitch here and a little twitch there… Go into any school, and you can find such a child in nearly every class.

💬 Note from Doctor Luo: Among the parents who consult me about their children’s health, very many describe exactly this kind of problem. In the past, everyone treated tics by focusing on the liver: settling liver wind, nourishing liver wind, softening and soothing the liver… But let me tell you: the liver and the spleen are intimately connected. Once you understand the mechanism from these two days of cases, you will see that many of children’s tic-type problems are actually closely tied to the spleen and stomach.

Why are there so many such children today? Doctor Luo Dalun analyzed two reasons. First, pressure — first-graders already face weekly examinations; some schools stop teaching for a whole month before finals just to drill problem sets; parents, longing for their children to excel, sign them up for a pile of tutoring classes. The child’s liver qi becomes bound up: on one hand liver wind moves internally, and on the other liver wood runs sideways and attacks the spleen-earth — all the pressure is transferred onto the spleen and stomach. Second, the spleen and stomach themselves have been eaten into damage — many families stuff their children with food, and food stagnation injures the spleen. Doctor Luo has seen it with his own eyes: at a winter hotel buffet breakfast, a parent gave the child a plate of iced watermelon, thinking the fruit was healthy and the child liked it — and wrecked the child’s spleen and stomach in the process. With liver wind stirring on one side and the spleen and stomach weakened on the other, once the spleen-earth is deficient, tu xu ze mu yao — when the earth is deficient, the wood shakes — and the liver wind stirs all the more. The spleen and liver interact like this. All things considered, this kind of problem in today’s children may well be more severe than in Doctor Zhang Xichun’s time.

The approach: tonify the spleen as the core, soothe the liver as the helper

So how should it be regulated? Doctor Luo says he pondered this problem for many years — he has seen a great many such children. He too began by regulating the liver like everyone else: there was some effect, but not a good one — many children saw no improvement. Gradually he came to understand: you should tonify the spleen and stomach.

💬 Note from Doctor Luo: Gradually use shan yao (Chinese yam), lian zi (lotus seeds) and qian shi (euryale seed) to restore the child’s spleen, and you will find the children recover well. I have written about such cases in my books: children with all kinds of tics who, by slowly eating spleen-tonifying foods, stopped twitching. So Doctor Zhang Xichun’s approach to man pi feng can be borrowed and applied today without change of principle — he was treating man pi feng; today our children have tic disorder. The forms differ, but the inner pattern is the same: liver and spleen out of harmony (gan pi bu he). Once you understand the principle and harmonize the liver and spleen, you can cure other illnesses with it too. Tonifying the spleen is the core: isn’t it “when the earth is deficient, the wood shakes”? I shore up the spleen-earth, and let the liver wind extinguish itself; then add a little liver-soothing, liver-softening medicine — the bai shao (white peony) that Doctor Zhang always used to soften the liver; you can also add sheng mai ya (sprouted barley) to engender the liver qi, yin chen (artemisia capillaris), sheng mu li (raw oyster shell) — some doctors like a little gou teng (uncaria) — all with the same meaning. The results are quite good.

Finally, Doctor Luo raised two more points. First: a child’s tics are directly tied to emotions and the family environment — medicine alone is not enough. You must reduce the child’s pressure and take him out to play more; tune the atmosphere of the home, let the parents radiate warmth, let the child be happy — only then will the various tics truly resolve. Second: today’s children are more complicated than those of the past — Doctor Zhang Xichun’s cases were all spleen-yang deficiency, but today’s children eat a great deal of meat, and very many of them have spleen-yin deficiency. When regulating, you must consider directions like resolving food stagnation and nourishing spleen yin — you cannot copy the old cases wholesale. Understand the mechanism of the cases, extrapolate from one to many, and connect it to modern society — that is the greatest harvest from reading Doctor Zhang Xichun.

What to take away

1. True cold can look like heat. The child burned all over, but the root was cold: autumn fruit had chilled the spleen and stomach, cold fluid stagnated in the chest, and yang was pushed to the surface — true cold with false heat. Warm and fortify the spleen and stomach (the Four Gentlemen Decoction base with fu zi, rou gui and gan jiang, plus chi shi zhi to settle vomiting and diarrhea), and one dose turned the case around.

2. When the earth is deficient, the wood shakes — tics often live in the spleen, not just the liver. Spleen deficiency lets liver wind stir, producing convulsions, twitching, blinking eyes, sucking in the belly, or even weak legs that cannot stand. Doctor Zhang treated all of these by holding fast to the spleen and stomach — and he always added prepared rehmannia to tonify the kidney essence as well.

3. Sleeping with the eyes half open is a classic spleen-deficiency sign, and undigested food in the stool tells you the “pot” has no fire beneath it. In a vomiting-and-diarrhea crisis, powder the ginseng and take it with the strained decoction — powders linger in the gut longer than a plain decoction.

4. For today’s tic children: tonify the spleen as the core, soothe the liver as the helper. Use yam, lotus seeds and euryale seed to rebuild the spleen, with a little bai shao, sprouted barley, yin chen or oyster shell to harmonize the liver. And never forget: pressure and family atmosphere feed this illness — lighten the child’s load, let him play, and let the home radiate warmth. Modern children who eat a lot of meat may be spleen-yin deficient rather than spleen-yang deficient, so tailor the approach rather than copying the classics wholesale.

Compiled from Doctor Luo Dalun’s lectures on the case records of Doctor Zhang Xichun. Case source: Records of Chinese Medicine with Western Reference (《医学衷中参西录》), published in installments between 1918 and 1934.