《孫真人備急千金要方》Vol. 10

Epilepsy or convulsive illness in infants and young children is caused by an imbalance in the Qi of the internal organs. If the illness appears at birth, it means the Five Organs are not yet able to contain and regulate their Qi; Qi and blood cannot gather and consolidate, the channels are obstructed, the bones are weak, and development is incomplete. Such children are therefore often difficult to save. If the illness appears after the first month and forty days, but before the child’s first birthday, it is usually due to improper feeding, which disrupts the harmony of Qi and blood, followed by an invasion of pathogenic Wind.

When fever, convulsions, and cries of fright or distress come before an attack, and the pulse is floating, the condition is called “Yang epilepsy.” The illness lies in the Six Fu organs, in a relatively shallow location between the skin and flesh, and is comparatively easy to treat. When the body first turns cold, without palpitations, convulsions, or crying, and the pulse is deep during the attack, the condition is called “Yin epilepsy.” The illness lies in the Five Zang organs, deep within the body and reaching the marrow, so it is difficult to treat.

If the body remains soft during an attack and the child wakes afterward, the condition is called “epilepsy.” If the body stiffens and arches backward, and the child remains unconscious for a long time, it is called “convulsive illness.” When the body arches so severely that an adult cannot fit even one hand between the child’s back and the floor—or, in the case of an infant, only three fingers can fit—the condition can no longer be treated.

A floating or deep pulse can help determine whether the illness lies in Yin or Yang, and in the exterior or interior. Beyond these, pulses may also be large or small, slippery or rough, deficient or replete, slow or rapid; treatment should follow the specific pulse pattern. The Shennong Bencao Jing says that children’s fright-induced epilepsy comes in 120 kinds. Although their symptoms vary somewhat, anything abnormal may indicate epilepsy. At birth, an infant’s Qi and blood have not yet settled, and the Five Organs are not fully developed. Even slight neglect in care can bring on illness, and sometimes the child may not survive to grow up. After the infant has passed through the “changing and steaming” stages—the phases of growth and transformation in Qi and blood described by the ancients—most other illnesses tend to ease. Only attacks of Wind strike with particular suddenness.

If a child’s limbs move poorly, or the child has palpitations, convulsions, or slightly abnormal breathing, as though an epileptic attack were about to begin—or if the symptoms have not eased after the expected period of changing and steaming—the child should take Longdan Tang. Childhood epilepsy is divided into three kinds: Wind epilepsy, fright epilepsy, and food epilepsy. Wind epilepsy and fright epilepsy are more commonly seen, but among ten children, fewer than one or two truly have either of these conditions. Any attack preceded first by chills and then by fever is food epilepsy. Fright epilepsy should be treated with moxibustion as shown in the illustration; Wind epilepsy should be treated in combination with pig heart…

After taking medicinal decoctions or food, the epileptic seizures should ease. Purple Pills, a purgative used to eliminate accumulated stagnation, work well.

Wind epilepsy in children is caused by dressing them too warmly: after they sweat, pathogenic wind takes advantage of their vulnerability and enters the body. Before a wind epilepsy seizure, children often bend their fingers as if counting, and then the seizure begins. Fright epilepsy is caused by a sudden fright: the child first becomes terrified and cries loudly, then has a seizure. If the symptoms are mild, quickly hold and soothe the child, and do not let them be frightened again; sometimes the seizure will stop on its own.

If a child first refuses milk and vomits, then develops a fever, and only afterward has an epileptic seizure, this is food epilepsy. Accumulated stagnation should be purged as early as possible, and the illness will then be easy to cure.

The Four-Ingredient Purple Pills are best suited to drive out phlegm-fluid accumulation and other stagnation in the body. They expel the illness quickly without harming the body. Red Pills—the accompanying note says that no formula for Red Pills appears among the prescriptions listed; if the Four-Ingredient Purple Pills cannot expel the pathogenic factor, one should switch to Red Pills. Their purgative action is stronger, so they should be used only in severe cases. The note also conjectures that these may be the same as the Purple Double Pills mentioned later—are for severe cases requiring rapid purgation.

Any child who cannot take milk should be purged with Purple Pills. At birth, a child’s vital energy is still vigorous; even the slightest discomfort should therefore be purged promptly. This causes no harm, and after recovery can bring great benefit. If purgation is delayed, the illness may develop into a serious condition that is difficult to treat once established.

For purgation, the Four-Ingredient Purple Pills are best. They expel the pathogenic factor without harming the body and are sufficient to dispel the illness. If they cannot expel it, use Red Pills; if those are still ineffective, the dose may be doubled. If purgation has already taken place but residual heat has not fully subsided, prepare Gentian Decoction according to the formula—a heat-clearing decoction—and give it in small amounts at frequent intervals. At the same time, apply Red Ointment externally; the formula appears at the end of this chapter.

Wind epilepsy should also be treated with purgation, using Pig Heart Decoction. For fright epilepsy, it is enough to apply moxibustion as shown in the diagram and use Sheng Ointment externally; vigorous purgation is unsuitable. Why? In patients with fright epilepsy, the heart Qi is unsettled (another reading says “the heart Qi is deficient”). Purgation would further weaken the body and worsen the illness. Severe fright epilepsy is especially difficult to treat. Therefore, care for children cautiously and protect them from fright. When a loud noise is heard, hold and soothe the child, moving calmly and gently so as not to alarm them. During a thunderstorm, cover the child’s ears while making soft sounds to distract them from the thunder.

In caring for children, one should…

Let the child experience a slight fright to help the blood vessels relax, but do not frighten the child severely. A severe fright may make the startled, rapid pulse more pronounced. If the pulse remains this way for fifty or sixty days in a row, moxibustion may make the palpitations worse. Wait until the child is one hundred days old before applying moxibustion.

If the child’s startled, rapid pulse improves but the child still has a fever, refuses milk, sleeps restlessly, and is often easily startled, this is the early stage of an epileptic seizure—the condition the ancients called “xian.” The pediatric medicine Zi Wan (Purple Pill) usually cures it; if there is no improvement, it may be given again. If the child is occasionally startled in sleep, Zi Wan may be given once a month to promote bowel movements and reduce pathogenic accumulation in the body, helping prevent the condition from developing into epilepsy.

If the child falls ill after the Beginning of Summer, treat with caution. Do not apply moxibustion casually or use emetics or purgatives lightly. You may bathe the child with Heat-Clearing Decoction and dust Heat-Clearing Powder over the body (the prescriptions appear under “Cold Damage” in the next section). Then massage the child with Heat-Clearing Red Ointment and apply the ointment to the navel. Keep the child in a cool place, do not restrict drinking, and frequently give the child fresh water.

If the child is dressed too lightly, the milk and food in the abdomen may not digest properly. When digestion is impaired, the stool is often sour and foul-smelling, a sign that abdominal accumulation, or “pi,” may be forming. At this point, a small dose of Zi Wan may be used to reduce the accumulation. Begin with a low dose, just enough to make the stool soft; do not cause excessive purging. Once the stool is soft, gradually reduce the dose. Stop giving the medicine when the stool is no longer sour and foul-smelling.

In general, purging a child in winter is unlikely to cause problems, while in summer recovery after purging is more difficult. But when illness is truly present, do not avoid purging altogether just because of the season. After purging, the abdomen may feel slightly distended, so reduce the amount of milk and do not increase the child’s food intake casually for a few days. Feed the child milk at regular times and in measured amounts; as the child gradually grows, slowly increase the amount. If the child takes less milk than before, this may mean there is some discomfort in the abdomen. Give a small amount of medicine, stop offering other foods, and feed only milk. For a severe illness, stop feeding for about ten days; for a milder one, stop for five or six days, then resume the usual feeding routine.

If the child refuses all other food and wants only milk, there may be an accumulation that needs to be purged promptly. If left untreated, the child may develop alternating chills and fever, vomit and suffer an epileptic seizure, or develop diarrhea. These signs indicate a serious illness. If treatment is delayed, it is often difficult to cure. Begin treatment while the illness is still mild: the child is less likely to be harmed, and recovery is usually quicker.

Yellow, foul-smelling stool indicates hidden heat in the abdomen; give an appropriate amount of Gentian Decoction. Pale, sour-smelling stool indicates lingering cold and undigested food; give Zi Wan. For mild symptoms, give a small dose so the accumulation can gradually disperse. For more severe symptoms, increase the dose slightly so that…

After a child has taken a mild laxative and begins to improve, their milk and food intake should still be restricted for several days so the Stomach Qi can return to a balanced state. Without this restraint, the illness can easily recur. If laxatives are used again after a recurrence, they will damage the Stomach Qi and cause abdominal distension. The child may be able to withstand purging two or three times, but more than that can harm the body.

When a child has food stagnation in the abdomen—commonly called “pi,” meaning food that has accumulated and failed to digest—and the pulse is also strong, epileptic seizures often follow. These seizures are attributed to food accumulation and tend to improve after purging. Carefully observe the pulse in the palm and at the three fingers. If the pulse rises and purging is not used in time, an attack may occur, making the illness difficult to treat. If purging is done early, the child will ultimately not become ill. While the pulse remains in the palm, treatment can still be given early; when it reaches the fingers, the illness is considered more severe.

When a child has an abdominal illness, the body may alternate between feeling cold and hot during an attack. These changes in temperature cause the blood vessels to pulse; the pulsing unsettles the mind and spirit, making the child prone to fright. Once frightened, the child is more likely to have a seizure.

How to Recognize Signs of Epilepsy

Epilepsy is a serious childhood illness. At times, a child may become critically ill before medical help can be reached. Yet the disease Qi must show signs before it erupts, so observe the child’s state of mind and spirit carefully, and watch for the following:

• Dark veins at the thenar eminence—the fleshy mound at the base of the thumb—are a sign of epilepsy. Red veins there indicate heat.
• Thick, blue-green veins indicate cold; fine blue-green veins are considered normal.
• A dry nose and lips, together with difficulty passing urine or stool, are signs of epilepsy.
• A cloudy gaze, eyes turned upward, and a preference for facing bright places are signs of epilepsy.
• Prominent blue-green veins over the raised bone behind the ear, along with restless sleep, are signs of epilepsy. The blue-green vein may be pricked to let blood.
• Hair standing on end, unusual laughing or crying, and a dull complexion that does not change are signs of epilepsy.
• A blue-green nose or lips, and frequent startle responses, are signs of epilepsy.
• A blue-green face when the eyes are closed, and frequent startle responses, are signs of epilepsy.
• A hot body and frequent sweating on the head are signs of epilepsy.
• A hot body accompanied by vomiting and labored breathing is a sign of epilepsy.
• A hot body and occasional fixed staring straight ahead are signs of epilepsy.
• Frequent yawning and eyes turned upward are signs of epilepsy.
• A hot body and an unfocused gaze are signs of epilepsy.
• Pupils that suddenly become noticeably larger and darker than usual are a sign of epilepsy.
• Restless sleep, waking easily in fright, and trembling hands and feet are signs of epilepsy.
• Laughing in sleep and moving the hands and feet are signs of epilepsy.
• Low spirits accompanied by unprovoked anger are signs of epilepsy.
• Difficulty swallowing milk is a sign of epilepsy.
• A hot body and difficulty urinating are signs of epilepsy.
• Persistent vomiting and diarrhea, sometimes accompanied by cold, painful hands and feet, are signs of epilepsy.
• Playing with the tongue and shaking the head are signs of epilepsy.

The more than twenty signs described above all appear at the onset of an epileptic seizure. When these signs are observed, apply moxibustion at the corresponding Yang-channel points and pinch firmly until the child suddenly cries out. Treat the “severed pulse” points on the feet in the corresponding manner, and give the decoction as prescribed.

If the child develops any of these eight conditions—staring with both eyes, moving pupils, abdominal distension with intestinal rumbling, bloody stools, a hot body, clenched jaws that prevent nursing, the body bending backward, a rigid back, sweating, fever, deep sleep with no response, convulsions of the hands and feet, or being easily startled—these indicate a more severe seizure. In such cases, decoctions and pinching alone can no longer save the child; moxibustion must be applied at once.

The treatise says: If the family seeks medical help as soon as the illness begins, the physician can examine the condition, determine its cause and pattern, and treat it step by step, usually bringing about recovery. If the family has already had the patient undergo several disordered treatments, the illness may change, and the original signs may alter. A physician who sees the patient later may be unable to cure the illness if they do not know whether the earlier pattern was deficient or excessive and treat only the signs now before them. The physician must therefore ask and observe carefully, learn what medicines the previous physician used and how they treated the patient, and then continue treatment in light of that history, so as not to act against the course of the illness.

The decoction prescribed by the previous physician may have required several doses before taking effect, but the family may give only one or two doses, see no improvement, decide the prescription is ineffective, and seek another physician. If the next physician does not establish the sequence in which cold and heat were treated, beginning treatment anew can easily disrupt the course of care. If purgation has already been used, subsequent treatment may need to be mild and restorative to follow on from it. If purgation was not used, or the pathogenic influence remains, treatment must be adjusted accordingly. If cold and heat were previously treated incorrectly, the next physician should find a way to correct this. Illnesses that have already been mistreated must be examined closely and treated flexibly if there is to be any hope of saving the patient. If treatment does not follow an appropriate sequence and the physician fails to examine the condition carefully, the illness will worsen.

Longdan Decoction is used when an infant has abundant Qi and Blood after birth, pronounced cold and heat, convulsions of the limbs, fever, or profuse vomiting. It is also used when a child has begun eating but develops a fever because food has accumulated and failed to digest; when “transformation and steaming” (the periodic fevers that, in ancient belief, accompany an infant’s growth and development) do not subside; when the child has been affected by “the ghost Qi of a stranger” (an ancient term for disturbance or malign influence from outside); and for various convulsions and epileptic seizures. Children under ten may take it.

This is the first formula for Longdan Decoction, intended specifically for newborn infants. As the child grows, the formula may be adjusted according to its principles. If the cause is known to be “guest invasion” or “Gui Qi” (terms for causes of illness in ancient medical texts), ginseng and Chinese angelica may be added, each in the same quantity as Longdan. For a child one hundred days old…

Dosage adjustments: increase by three zhu; for a child who is two hundred days old, increase by six zhu; for a one-year-old child, increase by half a liang. Adjust the remaining medicines in the same way.

Gentian, the skin of the Uncaria vine, bupleurum, scutellaria root, platycodon root, peony root, poria (some editions read “fu shen”), licorice (six zhu each), dung beetles (two), and rhubarb (one liang).

Cut the ten ingredients into pieces, decoct them in one sheng of water, and reduce the liquid to five he. This makes one dose.

Administer according to the following schedule. Adjust the dose as appropriate to the child’s constitution and strength; if there is not enough liquid, add water to make up the volume. For a child one to seven days old, give one he per dose, divided into three administrations. For a child eight to fifteen days old, give one and a half he per dose, divided into three administrations. For a child sixteen to twenty days old, give two he per dose, divided into three administrations. For a child twenty to thirty days old, give three he per dose, divided into three administrations. For a child thirty to forty days old, divide the five he of decoction into three administrations. Once the medicine has taken effect and caused a discharge, stop giving it; do not administer any more.

Rhubarb Decoction: Treats wind-related convulsions in young children, accumulations, abdominal pain, and conditions called “the twenty-five yao-jiao convulsions.”

Rhubarb, ginseng, asarum, dried ginger, Chinese angelica, and licorice peel (three zhu each).

Cut the six ingredients into pieces, decoct them in one sheng of water, and reduce the liquid to four he. Give about one date-sized portion per dose, three times a day.

White Sheep’s Fresh Decoction: Treats wind-related convulsions in children and disorders in the chest.

White sheep’s fresh herb (three zhu), cicadas (two), rhubarb (four zhu), licorice, the skin of the Uncaria vine, and asarum (two zhu each), bezoar (four pellets, each the size of a soybean), and snake slough (one cun).

Cut the eight ingredients into pieces, decoct them in two and a half sheng of water, and reduce the liquid to one sheng and two he. Divide it into five doses and administer three times a day. If the convulsions have not stopped after the medicine is finished, add one zhu each of rhubarb and Uncaria vine. First soak the ingredients in water for half a day, then decoct them.

Augmented and Reduced Life-Sustaining Decoction: Treats sudden windstroke in children, affliction by malign toxins, and chronic wind disorders that cause the limbs to stiffen and contract, the body to arch backward, or the limbs to become immobile; it also treats a tilted body and inability to walk.

Ephedra, licorice, and cassia twig (one liang each), Sichuan lovage, kudzu root, cimicifuga, Chinese angelica, and angelica pubescens.

(The following is a fragment listing ingredients from the preceding prescription; its name and some ingredients are not included here.) Ginseng, baical skullcap root, and gypsum, half a liang each; twenty apricot kernels.

Chop the twelve ingredients. First boil the ephedra in six sheng of water and skim off the foam. Add the remaining ingredients and continue boiling until one sheng and two ge of liquid remain. Give a three-year-old child the dose in four portions, all within one day. The child should sweat lightly; afterward, dust the body with powder.

Gypsum Decoction: Treats severe illness in children following windstroke, with inability to speak, a drooping mouth and eyes, and inability to move the limbs.

One ge of gypsum; eight zhu of ephedra; four zhu each of licorice, blackberry lily, cassia twig, peony, and Chinese angelica; two zhu of asarum.

Chop the eight ingredients. First boil the ephedra in three and a half sheng of water. After it has boiled three times, skim off the foam. Add the remaining ingredients and continue boiling until one sheng of liquid remains. Give a three-year-old child the dose in four portions, three times in one day.

Decoction for Treating Windstroke in Young Children Who Appear Near Death:

Twenty zhu each of rhubarb, oyster shell, dragon bone, snakegourd root, licorice, and cassia twig; six zhu each of red halloysite and cold water stone.

Chop the eight ingredients. Boil them in one sheng of water, using half a liang of the mixture, then let the liquid boil twice and strain out the herbs. A child six months old should take about an egg-sized amount of the liquid; older children should take the whole dose. It is said to take effect as soon as it is swallowed. After the child sweats, dust the body with powder. The source says this medicine is not toxic and may be taken twice a day. If there is fever, increase the rhubarb; if there is no sweating, add ephedra. If cold water stone is unavailable, use mirabilite instead.

Two-Ingredient Gypsum Decoction: Treats cramping and stiffness of the hands and feet following windstroke in young children.

One piece of gypsum, about the size of an egg, broken into pieces; one liang of pearl.

First boil the gypsum in two sheng of water for five or six boils. Add the pearl and continue boiling until one sheng of liquid remains. Give it slowly in several portions.

Cinnamon Twig Decoction: Treats a floating pulse, fever, spontaneous sweating, a stiff neck, noisy breathing through the nose, and dry retching following windstroke in young children.

One liang each of cassia twig, ginger, licorice, and peony; four jujubes.

Chop the five ingredients. Boil three of them in water: use three sheng of water and reduce it to one sheng. Give it in three portions. This prescription is the same as the one in the “Treatise on Cold Damage.”

“Fuji” means cutting, chewing, or pounding medicinal materials into coarse pieces for boiling. The terms “sheng,” “ge,” “liang,” and “zhu” in the source are ancient units of volume or weight.

The two-ingredient donkey-hair powder is used to treat windstroke in newborn infants.

Take a handful of hair from the donkey’s back, where the two ridges meet, roughly the size of a thumb. Take musk as well, about the size of two beans. Put both ingredients in a bronze vessel, mix them with breast milk, and fry over a low flame until thoroughly scorched. Remove and grind to a powder. If the child cannot take it directly, mix it with breast milk, place it in a reed tube, and drip it into the throat. Then feed the child breast milk so the medicine enters the stomach.

The Yin-yu Pill is used to treat wind epilepsy in infants and young children when the condition persists as they grow older. The illness may flare up in rainy weather or when the seasons change. Eating food that is too hard can also trigger it, and symptoms may include spasms throughout the body, unsteady walking, and difficulty speaking. This prescription is intended to prevent further attacks.

One liang each of Yin-yu leaves, red lead, Qin-jiao, uncaria bark, gypsum, Du-heng, and Fang-kui; one and a half liang each of sweet flag and Scutellaria root; half a liang of Usnea; ten dung beetles; and three liang of licorice.

Grind the twelve ingredients into powder and use honey to form pills the size of small beans. Children under three years old take five pills; those over three take seven; those over five take ten; and those over ten may take up to fifteen.

The Heart-Calming Pill is used to treat childhood fright epilepsy and various other ailments, and to calm the heart’s Qi.

Twelve zhu of silver filings, twenty zhu of mercury, and six zhu of bezoar; six fen of rhubarb and three fen of poria; two fen each of Fu-shen, Polygala root, Fang-ji, white peony root, realgar, ginseng, and peony; and four fen each of purple quartz, pearl, Fang-kui, and iron essence.

First mix the mercury and silver filings into a paste. Grind and combine the remaining ingredients separately, then form them into pills. For a two-year-old child, give two pills, each the size of a hemp seed; adjust the amount according to the child’s age. One transmitted version omits bezoar.

The Red Salve of Salvia is used to treat heat in the heart and abdomen of infants and young children, clearing heat pathogens.

One liang each of Salvia root, thunder ball fungus, mirabilite, Rong salt, and rhubarb.

Cut the five ingredients into pieces. First soak four of them overnight in half a sheng of bitter wine (vinegar). Then simmer them with one jin of refined pork fat, bringing the mixture to a boil and cooling it three times. Strain out the herbs, then add the mirabilite…

Once the salve is prepared, use it to massage the area below the heart. It can be used in both summer and winter. There is also a formula made with Salvia root alone; combined with Thunder Ball, it works very well.

Five-Ingredient Licorice Massage Salve: For newborns. A newborn’s skin is delicate and easily invaded by wind pathogens, which may cause a high fever. Strong winds can also bring on sudden movements and convulsions of the hands and feet.

Ingredients: One liang each of licorice and Saposhnikovia root; twenty zhu each of white atractylodes and platycodon root; and two and a half liang of Thunder Ball.

Coarsely chop the ingredients and place them in one jin of pork fat that has not come into contact with water. Simmer over low heat. Watch the fire carefully: when the liquid grows thick and cloudy, the salve is ready. Strain out the herbs. Take a portion of salve about the size of a pellet, warm it in your hands, and massage the child with it one hundred times. If the child’s body tends to be cold, the massage will warm it; if the body tends to be hot, it will cool it. Even when the child is not ill, the salve may be used each morning to massage the fontanelle—the unclosed seam between the bones at the top of an infant’s head—as well as the palms and soles. It is said to help ward off cold winds.

Moxibustion

The treatise says: Never casually needle or apply moxibustion to a newborn who is not ill. These treatments make the child suffer pain and disturb the Five Vessels, which may trigger convulsions.

The climate around Heluo and Guanzhong is cold, and children there are prone to convulsive disorders. For this reason, some people apply moxibustion on the third day after a child is born as a preventive measure; others apply it to the cheeks to prevent lockjaw. In lockjaw, the vessels beneath the tongue become tense, as do the chewing muscles. Because the local climate is cold, some people prick the vessels under the tongue to release blood and apply moxibustion to the cheeks to prevent lockjaw. The climate around Wu and Shu is warm, and such illnesses do not occur there. When old formulas were passed down, people failed to understand the differences between northern and southern climates and applied them indiscriminately, often harming children. Children in the countryside, left to grow naturally, tend to remain safe and do not die prematurely without cause.

If a child cries in fright, has limbs twitch in sleep, or is in the midst of “transformation and steaming”—the periodic fevers and other signs that the ancients believed accompanied an infant’s growth—and has not yet recovered, never needle, apply moxibustion, or scratch or pinch the child with a fingernail. These actions may disturb the channels throughout the body and, by frightening the child, trigger convulsions. Only in cases of yin-type convulsions, lockjaw, or a convulsive disorder may needling, moxibustion, or pinching and scratching be used.

When applying moxibustion for convulsions, the child must first be made to evacuate, so that the body is emptied; then moxibustion may be applied while the child is in this weakened state. If the child has not evacuated and pathogenic excess remains inside, moxibustion may cause Qi to become obstructed, blocking passage in both directions and even endangering the child’s life.

If convulsions occur at dawn, the affected location is on the Foot Shaoyang channel; if they occur in the early morning, on the Foot Jueyin channel; at midday, on the Foot Taiyang channel; at dusk, on the Foot Taiyin channel; late at night, on the Foot Yangming channel; and at midnight, on the Foot Shaoyin channel.

The point is that when convulsions occur, their timing should be used to determine the affected location, and moxibustion should be applied at the corresponding site.

Epilepsy is classified both by the five zang organs and by names drawn from the six domestic animals. Seizures may affect the limbs or occur in the abdomen. Carefully examine the symptoms and apply moxibustion according to where the disorder lies. Even a small amount of moxibustion may be effective; if the key points are mistaken, it may cause harm.

Types Associated with the Five Zang Organs

Liver epilepsy: During an attack, the face turns greenish, the eyes roll upward, and the hands and feet shake. Apply three cones of moxa to points on the Foot Shaoyang and Foot Jueyin channels.

Heart epilepsy: The face turns red, the area below the heart feels hot, and breathing is short, faint, and rapid. Apply three cones of moxa to Juque, the hollow below the second rib beneath the heart, and three cones each to points on the Hand Jueyin Pericardium and Hand Shaoyin Heart channels.

Spleen epilepsy: The face turns yellow, the abdomen swells, and diarrhea occurs readily. Apply three cones of moxa to the upper stomach area, two cones on each side of it, and two cones each to points on the Foot Yangming Stomach and Foot Taiyin Spleen channels.

Lung epilepsy: The face and the area around the eyes turn pale, and foam flows from the mouth. Apply three cones of moxa to Feishu, and two cones each to points on the Hand Yangming Large Intestine and Hand Taiyin Lung channels.

Kidney epilepsy: The face turns black, the eyes stare without moving, and the person looks like a corpse. Apply three cones of moxa two cun and two fen below the heart. Then apply two cones each to the arteries at the elbows and to points on the Foot Taiyang Bladder and Foot Shaoyin Kidney channels.

Diaphragm epilepsy: The eyes roll upward and the limbs cannot move. Apply moxa to Fengfu, then to the crown of the head, the nose, Renzhong, and Chengjiang beneath the lower lip. The number of cones depends on the patient’s age.

Intestinal epilepsy: During an attack, the body does not shake. Apply moxa to Chengshan on both sides, the soles of both feet, Laogong in both palms, and Wangu behind both ears, using a number of cones based on the patient’s age. Then apply fifty cones of moxa at the navel.

These are the symptoms and moxibustion methods for the types associated with the five zang organs and related forms.

Epilepsy Named for the Six Domestic Animals

Horse epilepsy: The mouth gapes, the head shakes, the person makes a sound like a horse, and the body arches backward. Apply three cones of moxa to Fengfu at the back of the neck and three at the navel. If the disorder lies in the abdomen, take powdered horse hoof burned to ash; this is said to work well.

Ox epilepsy: The eyes stare fixedly and the abdomen is swollen and full. Apply three cones of moxa to the area of the xiphoid process and three to Dazhui. Taking powdered ox hoof burned to ash is said to work well.

Sheep epilepsy: The eyes often turn upward and the tongue protrudes. Apply three cones of moxa above Dazhui.

Pig epilepsy: Foam often comes from the mouth. Apply seven cones of moxa one cun from Wangu on each side.

Dog epilepsy: Both hands curl into fists, and the tendons and vessels contract. Apply one cone of moxa to the center of each palm, and one cone each to the Foot Taiyang channel and the rib-gate point.

Chicken epilepsy: The head shakes and the body arches backward; the person is easily startled and moves involuntarily. Apply three cones of moxa to points on each of the Yang channels of the feet.

These are the symptoms and moxibustion methods for the forms of epilepsy named for the six domestic animals.

For a child who suddenly has a seizure, apply moxibustion at the nipples. For a girl, apply it two fen below the nipples.

To treat a child who suddenly has a seizure and whose body stiffens straight as if dead, or whose abdomen makes a thunderous rumbling sound, apply moxibustion at Taicang (the Zhongwan point, in the upper abdomen) and at the navel. Then apply it at four more points, one cun above, below, to the left, and to the right of these two points, for six points in all.

Another method for locating the points is to measure the position on the abdomen, then pass a cord around the neck and let it hang down to the navel. Bring the end of the cord around to the back and pull it straight down along the spine. Apply fifteen moxibustion cones at each of the two points one cun to either side of where the cord ends. (Each “cone” refers to one measured amount of burning moxa.)

If the child’s face is pale and neither the sound of the crying nor the complexion changes, apply moxibustion at points on the Foot Yangming and Taiyin meridians.

If the eyes roll upward and the pupils move, apply moxibustion at Xinzhu, the fontanel at the crown of the head—the place where an infant’s skull has not yet closed. To locate it, first measure the distance horizontally between the two corners of the mouth. Then measure horizontally between the two ends beneath the nose. Subtract the width of the nose from this second measurement, and take half of what remains. With the mouth closed, measure this distance from the hairline on the forehead toward the crown. Apply moxibustion at the fontanel, where the skull has not yet closed and a pulsating seam can be felt beneath the fingers. This is the most important point.

Next, apply moxibustion at the middle of the forehead, about two fen inside the hairline, in line with the bridge of the nose; then at points about two fen inside the hairline directly above the pupils; and then at the whorl on the crown. Apply moxibustion at Kexuzhu (now called the Shangguan point, in front of the ear), behind the outer end of the eyebrow where a pulse can be felt. The Ermen point is in the hollow that opens at the seam of the bone in front of the ear when the mouth is opened. Also apply moxibustion at the uppermost tip of the ear’s folded rim. Another way to locate the point is to measure three finger-widths above the ear for an adult, or use the child’s own finger-widths. Then apply moxibustion at the blue vessels above the Wangu points behind both ears; these may also be pricked with a needle to release blood. Apply moxibustion as well at Yuzhen, the prominent bone at the back of the neck; Fengchi, the hollows at the hairline on either side of the back of the neck; and Fengfu, at the middle of the hairline on the back of the neck. Fengfu and the two Fengchi points should be at the same height. Finally, apply moxibustion at the two lateral corners of the head, the raised bones on either side of the crown whorl.

There are nineteen points on the head in all. For a child ten days old, apply three cones at each point; for a child thirty days old, five cones; and for a child fifty days old, seven cones. If the condition is severe, apply moxibustion at all the points; if it is mild, treat only Xinzhu, Fengchi, and Yuzhen. The moxa should be kneaded until soft and shaped evenly, then placed snugly against the skin so that the heat reaches the affected area. If the moxa has not been kneaded until soft, is unevenly shaped, or does not fit closely against the skin, applying many cones will be of no benefit.

This passage records an ancient method of treatment with moxibustion. A “cone” is a unit for counting the amount of moxa used. The seizures and point treatments described here belong to ancient medical knowledge and should not be taken as modern medical guidance.

If abdominal distension, shortness of breath, or rumbling sounds in the abdomen occur, moxa may be applied in sequence to the following points: the Lung Front-Mu point (the Front-Mu point of the lungs on the chest, in the hollow of the second intercostal space above the breasts; the original text says to locate it by hanging a plumb line so that it aligns with the pupil), then Danzhong, Chest Hall, and the navel, followed by Xibai (in the hollow of the first intercostal space below the breasts). Next, moxa Jueque (for adults, one cun below Jiwei; for children, use the navel as the reference, divide the distance from the navel to Jiwei into six parts, and locate the point one cun below Jiwei), as well as the points on both sides of it. Then moxa the Stomach Tube, and finally Jinmen. Jinmen is at the midline in front of the perineum and behind the scrotum. Measure from beneath the scrotum to the opening in front of the anus, and take the midpoint.

These are the twelve abdominal points, including Chest Hall, Jueque, and the Stomach Tube. For a child ten days old, each point may receive three moxa cones; from one month of age onward, each may receive five. The midline cleft below the genitals may receive three cones, though some say the number should vary with age. A “cone” is the unit used to count one burning of a moxa cone.

If the body is rigid and arches backward, moxa Dazhui, then the Back-Shu points of the internal organs and the points along the spinal section of the Governing Vessel. Measure down the spinal midline from Dazhui to the tip of the coccyx, then measure the same distance downward from Dazhui. The lower endpoint is the location called Governing-Vessel Spine in the text.

These are the twelve points on the back. A child ten days old may receive three moxa cones at each point; from one month of age onward, five.

If the hands and feet twitch or spasm, accompanied by convulsions, moxa the points in sequence: Chize, Yangming, Shaoshang, Laogong, Xin Zhu, Hegu, Sanjian, and Shaoyang.

These are the sixteen points on the hands. The more important ones are Yangming, Shaoshang, Xin Zhu, Chize, Hegu, and Shaoyang. The number of cones is the same as above.

One may also moxa Futu, Sanli, the calf, Luxi, Yangming, Shaoyang, and Rangu in sequence.

These are the fourteen points on the feet. All are important points for moxibustion, and the number of cones is the same as above.

The text’s reference to hand and foot Yangming means the fourth finger. Children with convulsions may be treated with moxibustion at these points. If a wind disorder flares up, causing severe twitching and spasms of the hands and feet, moxa the tips of all ten fingers and toes, as well as the areas behind the joints.

— Essential Formulas Worth a Thousand Gold Pieces for Emergencies, Scroll Ten, by Sun the Perfected