Differentiation and Treatment of Wet-Heat Syndrome – Jueyin ‘Convulsions’

【Article】Wet-Heat Syndrome, with strong fever and thirst, yellow or scorched red tongue, convulsions, delirium, or laughter, evil heat burning the pericardium, and depletion of nutritive and blood. The treatment should include Xījiǎo (Rhinoceros Horn), Língyángjiǎo (Antelope Horn), Liánqiáo (Forsythia), Shēngdì (Raw Rehmannia), Yuánshēn (Radix Scrophulariae), Gōuténg (Uncaria), Yínhuā (Honeysuckle Flower), and Xiānchāngpǔ (Acorus) among others. (Article 5)

【Article】Wet-Heat Syndrome, with convulsions, delirium and laughter, rapid and strong pulse, ineffective purging, indicates that wet-heat is obstructing the chest. The treatment should follow the principles of Liánggěsǎn (Cool the Diaphragm Powder). If there is constipation for several days, it indicates heat evil obstructing the intestines and stomach, and the treatment should follow the principles of Chéngqì Wēixià (Mild Purging). (Article 6)

【Article】Wet-Heat Syndrome, with strong fever and thirst, rashes, chest fullness, diarrhea, delirium, and convulsions, indicates heat evil filling the three jiaos. The treatment should include large doses of Xījiǎo (Rhinoceros Horn), Língyángjiǎo (Antelope Horn), Shēngdì (Raw Rehmannia), Yuánshēn (Radix Scrophulariae), Yínhuā (Honeysuckle Flower), Zǐcǎo (Lithospermum), and other herbs. (Article 7)

【Article】Wet-Heat Syndrome, with convulsions and delirium, cold and contracted lower extremities. If the lower body is externally affected by cold, the treatment should still focus on wet-heat, using only warm and pungent herbs for decoction and fumigation. (Article 30)

【Article】Wet-Heat Syndrome, with thirst, yellow and prickly tongue coating, wiry and weak pulse, and a contracted tongue. Delirium, unawareness of surroundings, and spasms of both hands, with dryness of fluids and stagnation of evil. The treatment should include fresh Shēngdì (Raw Rehmannia), Lúgēn (Reed Root), Shēngshǒuwū (Fresh Fleeceflower Root), and fresh rice root among others. If the pulse is strong and there is constipation, Dàhuáng (Rhubarb) can also be added. (Article 35)

【Article】Wet-Heat Syndrome, with convulsions, delirium and laughter, dry yellow tongue coating with prickles, or turning black, and constipation indicates heat evil obstructing the intestines. The treatment should use Chéngqì Tāng (Purge the Qi Decoction). (Article 36)

The causes of delirium can be analyzed from the perspective of Zhang Zhongjing’s treatment theories, which can be categorized into three aspects: first, “Stomach Excess”, where dry stool is impacted and qi is obstructed, similar to Chéngqì-type syndromes; if there is heat, thirst, and sweating, with smooth bowel movements, use Bái Hǔ Tāng (White Tiger Decoction); second, Shaoyang and Yangming coexisting diseases, such as Chái Hú Jiā Lóng Gǔ Mǔ Liè Tāng (Bupleurum Decoction with Dragon Bone and Oyster); third, heat entering the blood chamber. It can be seen that Zhang Zhongjing recognized the locations of delirium as being distinct between Yangming and blood chamber, with differences in pathogenic nature (qi-related Chéngqì-type syndromes, qi pathology) and blood (heat entering the blood chamber), which is not closely related to the heart and pericardium. The treatment often borrows from Yangming as a pathway, focusing on unblocking the intestines and eliminating excess, such as Chéngqì-type formulas and Dǐdǎng Tāng (Resist the Counterflow Decoction). Xue’s application of Chéngqì-type treatment for convulsions is an inheritance of Zhang Zhongjing, where dryness of fluids and stagnation of evil is treated by nourishing yin and promoting downward movement, which can be considered an elaboration of Zhang Zhongjing’s purging method for treating convulsions, while clearing heat, calming the liver, cooling the blood, opening the orifices, and extinguishing wind methods can be seen as entirely innovative.

Stay tuned for more exciting content in the next issue!

Issue 01 | ‘Classical TCM Lectures’: Xue Shengbai and His Works

Issue 02 | ‘Classical TCM Lectures’: ‘Wet-Heat Disease’ Outline

Issue 03 | ‘Classical TCM Lectures’: ‘Wet-Heat Disease’ Light Syndrome of Upper Jiao

Issue 04 | ‘Classical TCM Lectures’: ‘Wet-Heat Disease’ Heavy Syndrome of Upper Jiao

Issue 05 | ‘Classical TCM Lectures’: ‘Wet-Heat Disease’ Hidden Syndrome of Middle Jiao

Issue 06 | ‘Classical TCM Lectures’: ‘Differentiation of Wet-Heat’ Wet Flow Downward Syndrome

Issue 07 | ‘Classical TCM Lectures’: ‘Differentiation of Wet-Heat’ Wet Stagnation Yangming Syndrome

Issue 08 | ‘Classical TCM Lectures’: ‘Differentiation of Wet-Heat’ Wet Obstruction of Membrane Source Syndrome

Issue 09 | ‘Classical TCM Lectures’: ‘Differentiation of Wet-Heat’ Half Wet Syndrome

Issue 10 | ‘Classical TCM Lectures’: ‘Differentiation of Wet-Heat’ Obstruction of Upper and Middle Jiao Syndrome

Issue 11 | ‘Classical TCM Lectures’: ‘Differentiation of Wet-Heat’ Obstruction of Taiyin and Yangming Syndrome

Issue 12 | ‘Classical TCM Lectures’: ‘Differentiation of Wet-Heat’ ‘Changes’

Issue 13 | ‘Classical TCM Lectures’: ‘Differentiation of Wet-Heat’ ‘Changes’ Convulsion Syndrome

Issue 14 | ‘Classical TCM Lectures’: ‘Differentiation of Wet-Heat’ ‘Changes’ Shaoyang Nausea and Vomiting

Editor: Qu LuReviewed by: Yi HengQuality Control: Cai YuanjunReviewed by: Meng NaRevised by: Li Yan

Don’t miss out on more surprises, follow us!