Child Convulsions After Catching Cold, Afternoon Fever, Vomiting and Diarrhea? Doctor Zhang Xichun Cured Slow Spleen Wind with Zhuhan Dangjing Tang and Modified Lizhong Dihuang Tang
Patient search terms: child convulsions / seizures after a cold / afternoon fever / fever at sunset / vomiting and diarrhea / twitching / arching the back / child with weak spleen Medical terms for this condition: slow spleen wind (man pi feng), a yang-deficiency form of chronic infantile convulsion (man jing feng) · true cold with false heat (zhen han jia re) · spleen-kidney yang deficiency
Opening scene: the moment a child convulses, a father’s heart breaks
A father in our community once said that when his child’s fever climbed so high that he started convulsing, the father cried from sheer panic. No parent can watch a child convulse without terror. But childhood convulsions actually come in different kinds, and the one in this case is more troublesome — and a far greater test of a physician’s skill — than the acute form: slow spleen wind (man pi feng).
Let us first make the terms clear. When a child catches an external pathogen and the fever climbs so high that he convulses — arching backward like a drawn bow — that is acute convulsion (ji jing feng). Give something like antelope horn (ling yang jiao) to settle the liver and extinguish wind, cure the external invasion, and it often resolves. The opposite is chronic convulsion (man jing feng): a gradually developed convulsive condition arising from internal disharmony — mostly from deficiency and weakness, with a long course. And chronic convulsion itself splits into yin and yang — there is the type driven by liver wind from yin deficiency, and the type from spleen-kidney yang deficiency. The yang-deficient chronic convulsion is called slow spleen wind (man pi feng). The child Doctor Zhang Xichun saw in this case was exactly that.
💬 Note from Doctor Luo: Acute convulsion comes on fast and fierce — external heat pathogen stirring up liver wind. Chronic convulsion and slow spleen wind are deficiency conditions — the internal organs themselves have gone wrong. Parents panic most when a child convulses, but you must distinguish acute from chronic, excess from deficiency, because the treatments are worlds apart.
Who was the patient? How was the illness made, step by step?
The little patient was the young son of Hou Shouping, a clerk at the Liaoning provincial government office — seven years old. The “provincial government office” of the Republican era was roughly the equivalent of today’s provincial government. The child fell ill in autumn — and guess how the illness came about? It was not sudden. It was made, step by step, by the treatment itself.
In early autumn the boy caught malaria. Malaria was very common in those days, and it took over a month to cure. After he recovered, the parents noticed that his left flank below the ribs had become hard — you could feel a lump, so they gave him more Chinese medicine — qi-regulating, mass-dissolving, stasis-breaking herbs. And what happened? Those harsh, dispersing medicines chilled his spleen and stomach into deficiency — he could no longer digest food — and it gradually turned into vomiting and diarrhea: vomiting up above, diarrhea below, and soon after, convulsions began. What the ancients called “chi zong” — twitching and cramping — is exactly this kind of seizure disorder.
How sick had he become? Every sign in the examination told the story
The child’s symptoms, taken one by one, read like a classic textbook lesson in diagnosis:
First, afternoon tidal fever with flushed cheekbones. Every day as the sun sank toward the west (the “ri bu” hour), the body would suddenly flush with heat like a rising tide, and both cheekbones turned red. Looking at this alone, many people would take it for yin-deficiency fever.
Second, sleeping with the eyes half open (lu jing). The child slept in a daze, but his eyes would not close properly — the eyeballs showed through the lids. This is a key point in inspection: when a child constantly sleeps with his eyes not quite closed, it mostly indicates spleen deficiency.
Third, frequent cramping of the hands and feet, and in severe spells, opisthotonos — arching the back like a drawn bow. The Du channel (governing vessel) runs along the midline of the back, and it governs the yang of the whole body. When the child’s Du channel contracts and the head flings backward — the folk name is opisthotonos (jiao gong fan zhang) — it is exactly like a bow when the string is released: the bow snaps backward into the opposite curve. The head arches back, the legs arch back, the body bends into a great arc. That is the most severe state of cramping.
Fourth, vomiting up everything eaten. Whether food or medicine, within half an hour it would come back up, bringing along mouthfuls of phlegm and saliva.
Fifth, frequent diarrhea — worse whenever he caught a chill; and the pulse was fine, rapid and weak, without a trace of strength.
💬 Note from Doctor Luo: Look at just that one sign — “sleeping with the eyes half open” — an experienced practitioner can see spleen deficiency at a glance. Inspection and color diagnosis in Chinese medicine are that powerful: look at the face, look at the eyes, look at the sleeping posture, and the disease mechanism is already rising to the surface.
What did Doctor Zhang Xichun make of it? The most decisive insight of the whole case
Doctor Zhang Xichun’s analysis peeled the case open layer by layer, and it is superb.
Layer one: the root was malaria injuring the spleen and stomach. He said malaria is a pathogen that strikes the liver and gallbladder. When the pathogen enters, a sick liver-wood bullies the spleen-earth — when the wood is diseased, it insults the earth (mu bing wu tu). So people who suffer prolonged malaria are mostly left with injured spleen and stomach.
Layer two: the wrong medicine destroyed the qi transformation of the middle burner. The lump under the child’s left flank had been treated with large doses of digestive, qi-regulating, dispersing, blood-breaking herbs — breaking qi and breaking blood — so the middle burner’s qi transformation was wounded even further, and the spleen and stomach’s yang qi became even more deficient.
Layer three: once yang is deficient, cold phlegm and retained fluids block the middle burner. The spleen governs water. When the spleen and stomach are injured and lack the strength to move fluids, water is retained in the body and slowly congeals into cold phlegm and retained fluids (han tan liu yin). The more it accumulates, the more it spills upward. Stomach qi keeps rising and gets stuck between the lungs and heart; lung qi cannot descend, heart fire cannot go down — this qi reaches the face, and the face turns red; when it pushes outward, the body flushes with heat in waves.
Layer four: why the fever came precisely in the afternoon, and why the cheekbones flushed? Because when the sun goes down, yang qi begins to weaken. As yang weakens, the cold phlegm in the chest becomes worse, and the deficient yang floats further upward and outward. This is true cold with false heat (zhen han jia re) — it looks like yin-deficiency fever, but in fact the body is cold inside, and deficient yang is escaping outward.
Layer five: why could he not eat, why the diarrhea, why the convulsions? The spleen and stomach were blocked by congealed cold phlegm, so he could not take food; the spleen and kidney yang were deficient and the lower burner’s qi transformation was not secure, hence the diarrhea — worse with any chill. As for the cramping hands and feet, Doctor Zhang Xichun explained it as blood deficiency unable to nourish the sinews and the liver: blood fails to nourish the liver, and liver wind stirs within.
💬 Note from Doctor Luo: Doctor Zhang Xichun’s reading of the afternoon tidal fever and flushed cheekbones as “deficient yang escaping outward, true cold with false heat” is the eye of this case. If you mistook it for yin deficiency and nourished yin, the direction would be completely reversed. On the cause of the convulsions, though, his phrase “blood deficiency unable to nourish the sinews and the liver” strikes me as not quite the best explanation — an ancient physician had already explained this matter more clearly.
The story of Doctor Qian Yi: when the earth is weak, the wood shakes
That ancient physician is Doctor Qian Yi, the founder of pediatric medicine in the Song dynasty. When Emperor Shenzong of Song had a child with chronic convulsion, cramping badly, the imperial physicians could not cure it no matter what they did, and the emperor was frantic — he had already lost several children. Then the Princess said: my child was cured by Qian Yi — summon him to the palace. Doctor Qian Yi examined the child and used Huang Tu Tang (Yellow Earth Decoction) — a spleen-strengthening formula, and a warming one at that — and with one dose the child was well.
Emperor Shenzong thought it miraculous and asked how he had done it. Doctor Qian Yi replied modestly: the imperial physicians had already done most of the work; I simply arrived in time for the recovery. The emperor said, don’t fool me — how did you really cure him? Only then did Qian Yi explain: this is what is called “when the earth is weak, the wood shakes” (tu xu ze mu yao). The child’s spleen was deficient, so the liver-wood began to sway and liver wind stirred within; I strengthened the spleen, and once the spleen-earth was full, the liver-wood settled down and stopped trembling.
💬 Note from Doctor Luo: The ancient Chinese attributed convulsive disorders to the liver, but Qian Yi’s “weak earth, shaking wood” is more reasonable than Doctor Zhang Xichun’s version: instead of directly settling liver wind, you fortify the spleen-earth to calm the liver-wood. As for the opisthotonos — the Du channel governs the yang of the whole body, and when yang is deficient the Du channel gives trouble; Doctor Zhang Xichun explained the Du channel’s connection with the brain and spinal nerves, easily over-stimulated into disorder — which in modern terms is exactly how pediatric convulsions reflect neurological changes from various internal disturbances. The two explanations line up.
The first formula: Zhuhan Dangjing Tang — four ingredients that are all kitchen spices
So how was it treated? Doctor Zhang Xichun used a formula he especially admired, from a Qing dynasty book devoted to pediatric convulsions — Fuyou Bian (Book for Blessing Children). The formula is called Zhuhan Dangjing Tang (Cold-Expelling, Convulsion-Quieting Decoction). Its job is first to dissolve the child’s cold phlegm — once he can take food again, he will slowly recover.
The first herb: hu jiao (black pepper), 1 qian. Doctor Zhang Xichun gave a special instruction: buy it at the market or the corner shop! He had learned from experience — pepper bought at a pharmacy had no effect when drunk, and he later figured out that the pharmacy’s stock had sat there so long, unused, that the medicinal qi had evaporated; the pepper at the market is bought daily, it is fresh, its qi is full. So Doctor Zhang Xichun particularly liked to tell patients: buy the pepper at the market — the effect is better.
Next gan jiang (dried ginger), 1 qian — the original formula used pao jiang (blast-fried ginger), but Doctor Zhang Xichun felt it was not strong enough and switched to dried ginger; rou gui (cinnamon bark), 1 qian, to warm yang; and ding xiang (cloves), ten buds, also warming yang. Look at the four herbs — every one is warming and drying. Black pepper, dried ginger, cinnamon, cloves — they are all our seasonings and condiments! They are in spicy hotpot, in tom yum soup, in Singapore bak kut teh. This is what is meant by “medicine and food share one origin” (yao shi tong yuan).
To these were added gao li shen (Korean ginseng) to support upright qi and gan cao (licorice) to harmonize. The first four herbs were pounded into coarse pieces, and the decoction method was special: first boil zao xin tu (stove-earth clay), 3 liang, in water and let the sediment settle; use that water in place of plain water to boil the ginseng and licorice first for seven or eight boils, then add the powdered pepper, dried ginger, cinnamon and cloves, boil another thirty boils together, strain out about seven or eight cups of clear liquid, and give it to the child slowly.
💡 Note from Doctor Luo: Remember this rule: warming, aromatic herbs must not be decocted long — when the fragrance escapes, the medicinal qi is gone — so they are added late and boiled only “thirty boils.” Ginseng and licorice need longer — seven or eight boils is roughly the modern equivalent of decocting for about twenty minutes. All of this is the ancients’ meticulous decoction craft.
What is zao xin tu? A marvel of a Chinese medicine
The water used for decoction was special: it came from zao xin tu (stove-earth clay), also called fu long gan — “Dragon Hidden in the Stove.” It is the piece of earth under a farmhouse kitchen stove, the clay that was baked year after year by the fire. What does it do? It warms and fortifies spleen yang, stops diarrhea and stops bleeding — and very effectively too.
💬 Note from Doctor Luo: I remember an old practitioner writing about his own childhood: once, as a boy, he had diarrhea so severe he was nearly dead — conditions were hard then. An old doctor came and prescribed zao xin tu, telling him to boil it in water and drink it. He took one sip — my goodness, how fragrant! What water was this fragrant? After drinking it, the diarrhea was cured. Some may ask: how can Chinese medicine use earth? Chinese medicine really does have its wonders — it is quite remarkable. And this herb has been used since ancient times — it appears in Doctor Zhang Zhongjing’s works, and Fuyou Bian uses it the same way: boil the stove-earth into a broth, and use that broth to decoct the powdered herbs.
A small detour: what exactly does “seven or eight boils” mean?
Classical texts constantly speak of “one boil, two boils, seven or eight boils,” and the Shang Han Za Bing Lun (Treatise on Cold Damage and Miscellaneous Diseases) uses the same unit. What is a “boil”? Do you count bubbles rolling seven or eight times? That would be far too short — the medicine would never extract.
You have to understand how the ancients decocted. Today we can adjust the flame — when the pot boils and bubbles, we turn the heat down and it keeps simmering. The ancients could not do that — they burned firewood, and once the pot boiled, could they pull the firewood out? Pull it out and it goes out. So when the medicine boiled and the foam threatened to overflow, what did they do? They lifted the pot off the fire, let it cool until the foam subsided, then set it back — it boiled up again, so they lifted it again. One lift-and-set-back counted as “one boil.”
💬 Note from Doctor Luo: Some say the Classic of Tea describes “one boil” as bubbles like little fish eyes, and “three boils” as a full rolling boil — but that is tea, nothing to do with medicine; tea finishes at three boils. In medicine you see five or six boils, seven or eight boils. The medical “boil” simply marks decoction time: seven or eight boils is already a fairly long decoction, roughly twenty-odd minutes; thirty boils is a short one — because those are fragrant herbs whose aroma would fly away if boiled long, so about ten minutes is enough.
One dose worked at once; then immediately the second formula
How did Zhuhan Dangjing Tang work? After that single administration, the vomiting stopped and the convulsions stopped, and the waves of tidal fever and the bowel troubles seemed to ease as well. Doctor Zhang Xichun said: good — now change the formula.
Fuyou Bian is an interesting book. Its prescribing philosophy is — warming, drying herbs must not be overused: use them once to dissolve the cold phlegm, then promptly switch to a tonic formula. Doctor Zhang Xichun followed the book exactly and immediately switched to Modified Lizhong Dihuang Tang (Modified Regulating-the-Middle Rehmannia Decoction), with slight adjustments. The main direction of this formula is to supplement qi and blood — heart, liver, spleen, lung and kidney all together:
Shu huai di huang (prepared Huaishan rehmannia), 5 qian — nourishes kidney essence; the prepared rehmannia of Wen County, Jiaozuo, Henan. Sheng huai shan yao (raw Huaishan yam), 5 qian — Doctor Zhang Xichun’s signature move: when fortifying the spleen he always uses Huaishan yam, the dried yam slices of Wen County, Jiaozuo, Henan. Jiao bai zhu (parched atractylodes), 3 qian, fortifies the spleen. Da gan gou qi (goji berry), 3 qian, nourishes the essence of liver and kidney. Ye dang shen (wild codonopsis) supplements qi. Zhi huang qi (honey-fried astragalus), 2 qian, supplements qi. Gan jiang (dried ginger), 2 qian, warms yang. Sheng bai shao (raw white peony), 2 qian, softens the liver — why, in the middle of all these warming herbs, one cooling peony? Because this is liver wind stirring within — the liver must be softened. Doctor Zhang Xichun said white peony cools the liver and gallbladder, promotes urination, and also draws back the floating, escaping yang to relieve tidal fever — you still flush with heat? I will call it back. Shan yu rou (cornus fruit), 2 qian — warm in nature, nourishes the essence of liver and kidney, especially liver essence, and nourishes liver blood. Rou gui (cinnamon bark), 1 qian, warms yang and leads fire back to its source. Hong zao (red dates), three, split open, harmonizes the spleen and stomach. Zhi gan cao (honey-fried licorice) harmonizes everything. Hu tao (walnut), one, crushed — it is in the original book: walnut kernel tonifies the kidney and anchors qi.
💬 Note from Doctor Luo: The design of this formula is exquisite: first use Zhuhan Dangjing Tang to warm the spleen yang back, then immediately supplement the heart, liver, spleen, lung and kidney all at once, with only a small amount of warming herbs — it is a very gentle tonic formula. Doctor Zhang Xichun praised it as “warm and hot used together” — the hot herbs supplement yang, the warm herbs supplement essence — the five organs’ essence is what is being supplemented. That gloss is mine, added for you. Also, in the original book this formula was to be decocted in stove-earth broth too, but Doctor Zhang Xichun decided that since the child was no longer vomiting, plain water would do.
Five doses, five days, a complete cure
After two doses of Modified Lizhong Dihuang Tang, the tidal fever and diarrhea were completely gone, and the pulse was stronger than before. Doctor Zhang Xichun said: remove the atractylodes, and reduce the dried ginger from 2 qian to 1 qian. Two more doses of this adjusted formula, and the child’s illness was completely cured.
Think about it: a child with chronic convulsion, wasted and weak to that degree — Doctor Zhang Xichun cured him with five doses in five days. That shows how exact his diagnosis was, and how steady his prescribing.
💬 Note from Doctor Luo: Today’s lessons: first, how slow spleen wind differs from chronic convulsion and acute convulsion. Second, how slow spleen wind forms — mostly a child catches cold, or is given cold, cooling medicines, or eats raw and cold fruit; the spleen and stomach are severely injured, yang qi becomes insufficient, and that is what triggers the convulsions. In the old days, when living conditions were poor, there were many such children. Third, how to treat it — Doctor Zhang Xichun recommended Fuyou Bian, and both formulas are classics: first warm yang and dissolve the cold phlegm, then immediately supplement, mending the deficiency of the organs, and the child recovers. Fourth, what zao xin tu is, and how to read “one boil, two boils.” Chat a little about Chinese medicine every day, and with time you will gradually walk through the gate.
A bonus food-therapy story
A side note: the formula’s black pepper, dried ginger, cinnamon and cloves are all kitchen spices — showing the tradition of “medicine and food share one origin.” Spicy hotpot, tom yum soup and bak kut teh all contain them. For families whose children have cold spleen and stomachs and easily catch chills that upset their digestion, using warming seasonings moderately in daily food is the most home-style way to warm yang. Of course, when a child truly reaches the point of convulsions, you must find a professional TCM practitioner to treat according to pattern — do not try to brew hotpot spices into medicine yourself.
Compiled from Doctor Luo Dalun’s explanation of Doctor Zhang Xichun’s case records; the case comes from Records of Chinese Medicine with Western Reference (《医学衷中参西录》), published in installments 1918–1934.