脉∶癫痫之脉，阳浮阴沉。数热滑痰，狂发于心；惊风肝痫，弦急可寻；浮病腑浅，沉
病脏深。癫脉搏大滑者生，沉小紧急者不治。热狂脉实大者生，沉小者死。癫脉虚可治，实
则死。
狂者，大开目与人语所未尝见之事，为狂也。谵语者，合目自言日用常行之事，为谵语
。又蓄血证则重复语之。郑声者，声颤无力，不相接续，造字出于喉中，为郑声也。阴附阳
则狂，阳附阴则癫；脱阳者见鬼，脱阴者目盲。癫者，心血不足也。又云癫者，喜笑不常，
颠倒错乱之谓也。
养血清心汤
人参（去芦） 白术（去芦） 茯苓（去皮） 远志（去心） 酸枣仁（炒） 川芎 生地黄 石
菖蒲（各一钱） 当归（一钱半） 甘草（五分）
上锉一剂。水煎服。
遂心丹 治癫痫风疾，妇人心风血邪。
甘遂一钱（坚实者）
为末；用猪血心取管血三条和遂末，将心刀批作两边，以遂末入在内；将线缚定，外用
绵纸裹湿，慢火煨熟，不可焦了；取末研细，入辰砂末一钱和匀，分作四丸。每服一丸，将
煨猪心煎汤化下。大便下出恶物，取效。
狂者，痰火实盛也。又云狂者，狂乱而无正定也。防风通圣散，治一切大风癫狂之疾
（方见中风）。根据本方加牡丹皮、生地黄、桃仁。
清心丸 治心受邪热，精神恍惚，狂言叫呼，睡卧不宁。
胆星 全蝎稍 天麻 人参 郁金 生地黄（各等分）
上为末，汤泡蒸为丸，如梧桐子大。每服三十丸，人参汤下。
喜笑不休者，心火之盛也。以食盐二两，火烧令红赤，研细；以河水一大碗，煎至三、
五沸。待温，分三次啜之，以钗探于喉中，吐出热痰。次服黄连解毒汤（方见伤寒）。根据本方
加半夏、竹沥、竹叶、姜汁少许，而笑即止。
妇人癫疾，歌唱无时，逾墙上屋者，乃营血迷于心包所致也。
加味逍遥散
当归 白芍（炒） 白术（去芦） 茯苓（去皮） 柴胡 生地 远志（去心） 桃仁（去皮尖）
苏木 红花 甘草
上锉一剂。煨姜一片，水煎，温服。有热者，加入小柴胡汤、生地、辰砂，用水煎服。
牛黄膏 治妇人热入血室，发狂不认人者。
牛黄（二钱半） 朱砂 郁金（各三钱） 脑子 甘草（各一钱） 牡丹皮（三钱）
上为细末，炼蜜为丸，如皂子大。每服一丸，新水化下。
治失心风，用紫河车煮烂，杂于猪牛肚内吃，神效。河车不必拘首生，但无病妇人者佳
。
邪崇之症，似癫而非癫，有时明，有时昏。但心者，一身之主，清净之府，外有包络以
罗之；其中精华之聚萃者，名之曰神。通阴阳、察纤毫，无所紊乱。稍有浊痰沉入其中，以
主宰，故昧其明，言语交错；或精气赤汁流通，逐去浊物，其言犹复旧也。此名为痰迷心窍
之患，非邪崇也。若以符水治邪崇，用密其肤以客其外，不治。此乃上膈之痰，理宜先用吐
法，后当清痰顺气安神之药调之，病即安矣。痰多者，口有声有沫；火者，有热，面赤脉数
是也。痫乃痰疾，病似马羊鸡犬猪，故有五痫应五脏，不必多配，大率主痰也。重阳者狂，
骂詈不避亲疏；重阴者癫，语言交错不常。二病虽分阴阳，多主于热与痰耳。
一妇人发狂，弃衣而走，逾屋上垣，不识亲疏，狂言妄语，人拿不住。诸医措手。余令
家人将凉水乱泼不记其数，须臾倒仆。诊其脉，六部俱弦数有力，此乃热极则生风也。用防
风通圣散加生地黄、黄连、桃仁、红花、牡丹皮，三剂而安。后服祛风至宝丹痊愈。
脉象：癫痫病的脉象，阳部浮而阴部沉。数脉主热，滑脉主痰；狂证病位在心；惊风和肝痫，脉象弦急可辨；浮脉表示病在腑且病位浅，沉脉表示病在脏且病位深。癫病脉象见大、滑者预后良好，脉象沉小紧急者难治。热性狂证脉象实大者预后良好，脉象沉小者预后不良（死）。癫病脉象虚者可治，脉象实则预后不良（死）。
所谓狂证，是指患者睁大眼睛与人交谈从未见过的事物，这称为狂证。谵语，是指闭着眼睛自言自语日常生活中的事情，这称为谵语。又有蓄血证表现为重复言语。郑声，是指声音颤抖无力，气息不相接续，字音从喉中发出，这称为郑声。阴气依附阳气则发为狂证，阳气依附阴气则发为癫证；阳气脱失者会看见鬼怪，阴气脱失者双目失明。癫证，是心血不足所致。又说癫证，是指喜笑无常，精神颠倒错乱而言。
养血清心汤
人参（去芦头） 白术（去芦头） 茯苓（去皮） 远志（去心） 酸枣仁（炒） 川芎 生地黄 石菖蒲（各一钱） 当归（一钱半） 甘草（五分）
以上药材锉碎为一剂。加水煎煮后服用。
遂心丹 治疗癫痫风疾，以及妇人心风血邪。
甘遂一钱（选用质地坚实的）
研成粉末；用猪心取管血三条与甘遂粉混合，将猪心用刀剖开两边，把甘遂粉放入其中；用线捆扎固定，外面用湿绵纸包裹，用慢火煨熟，注意不要烧焦；取出药末研细，加入辰砂末一钱混合均匀，分成四丸。每次服用一丸，用煨过的猪心煎汤送服。大便排出恶物，即可见效。
狂证，是痰火实证盛所致。又说狂证，是指狂乱而没有正常定性的状态。防风通圣散，治疗一切大风癫狂之疾（方剂见中风章节）。根据此方加牡丹皮、生地黄、桃仁。
清心丸 治疗心脏受邪热侵袭，精神恍惚，胡言乱语叫喊，睡眠不安宁。
胆南星 全蝎梢 天麻 人参 郁金 生地黄（各等分）
以上药材研成粉末，用汤水浸泡蒸制后制成丸药，如梧桐子大小。每次服用三十丸，用人参汤送下。
喜笑不止，是心火旺盛所致。用食盐二两，火烧至红赤，研细；用一大碗河水，煎至三、五沸。待温度适宜，分三次饮用，并用钗子探入喉中催吐，吐出热痰。随后服用黄连解毒汤（方剂见伤寒章节）。根据此方加半夏、竹沥、竹叶、少许姜汁，笑声即可停止。
妇人患癫疾，无时歌唱，翻墙爬屋的，这是营血迷于心包所致。
加味逍遥散
当归 白芍（炒） 白术（去芦头） 茯苓（去皮） 柴胡 生地 远志（去心） 桃仁（去皮尖） 苏木 红花 甘草
以上药材锉碎为一剂。加一片煨姜，加水煎煮，温服。有热象者，加入小柴胡汤、生地、辰砂，用水煎服。
牛黄膏 治疗妇人热入血室，发狂不认识人的症状。
牛黄（二钱半） 朱砂 郁金（各三钱） 脑子（冰片） 甘草（各一钱） 牡丹皮（三钱）
以上药材研成细末，炼蜜为丸，如皂荚子大小。每次服用一丸，用新汲水化开服下。
治疗失心风，用紫河车煮熟烂，夹杂在猪肚或牛肚内食用，效果神奇。紫河车不必拘泥于初产妇的胎盘，只要是健康无病妇女的即可。
邪祟之症，看似癫证而非癫证，有时清醒，有时昏沉。但心脏，是身体的主宰，清净之府，外有心包络包裹保护它；其中精华聚集之处，称之为神。神能通达阴阳，洞察细微，无所紊乱。稍有浊痰沉入其中，扰乱了主宰功能，所以使神明昏暗，言语交错；如果精气通畅，逐去浊物，言语就能恢复旧状。这称为痰迷心窍之患，并非邪祟作怪。如果用符水治疗邪祟，是用密闭肌肤的方法来抵御外邪，无法治愈疾病。这是上膈之痰，理应先用吐法，之后当用清痰顺气安神的药物调理，病即可痊愈。痰多者，口中有声且有泡沫；火证者，有热象，面赤脉数是也。痫病乃是痰疾，发病时症状似马、羊、鸡、犬、猪叫，故有五痫对应五脏，不必过多配伍，大体上都以治痰为主。重阳者发狂，骂詈不避亲疏；重阴者发癫，言语交错无常。这两种病虽分阴阳，但大多主因于热与痰。
有一位妇人发狂，脱衣奔跑，翻越屋顶围墙，不认识亲人还是外人，胡言乱语，人抓不住她。众医束手无策。我让家人将凉水随意泼洒，次数不计其数，片刻后妇人倒地仆倒。诊察其脉象，六部脉皆弦数有力，这是热极生风的表现。使用防风通圣散加生地黄、黄连、桃仁、红花、牡丹皮，服用三剂后病情安定。后来服用祛风至宝丹痊愈。
Pulse: The pulse of epilepsy (epilepsy) is floating on the Yang position and sunken on the Yin position. A rapid pulse indicates heat, a slippery pulse indicates phlegm; mania (mania) originates in the Heart; convulsive wind and liver epilepsy present with wiry and urgent pulses. A floating pulse indicates disease in the Fu organs and superficial location, while a sunken pulse indicates disease in the Zang organs and deep location. In epilepsy, if the pulse is large and slippery, prognosis is good; if sunken, small, and urgent, it is difficult to treat. In heat-type mania, if the pulse is full and large, prognosis is good; if sunken and small, prognosis is poor (fatal). In epilepsy, if the pulse is deficient, it is treatable; if excess, prognosis is poor (fatal).
Mania refers to the condition where the patient opens their eyes wide and speaks to others about things never seen before. Delirium refers to closing the eyes and speaking alone about daily routine matters. Additionally, blood stasis syndrome manifests as repetitive speech. Zheng sheng refers to trembling and weak voice, discontinuous breath, with words emerging from the throat. When Yin attaches to Yang, mania occurs; when Yang attaches to Yin, epilepsy occurs. Loss of Yang leads to seeing ghosts; loss of Yin leads to blindness. Epilepsy is caused by insufficiency of Heart Blood. It is also said that epilepsy involves abnormal laughter and confusion/disorder of spirit.
Yangxue Qingxin Tang (Nourish Blood and Clear Heart Decoction)
Ren Shen (Ginseng Radix et Rhizoma, remove rhizome) Bai Zhu (Atractylodis Macrocephalae Rhizoma, remove rhizome) Fu Ling (Poria, remove bark) Yuan Zhi (Polygalae Radix, remove heart) Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried) Chuan Xiong (Ligusticum Chuanxiong Rhizoma) Sheng Di Huang (Rehmanniae Radix Recens) Shi Chang Pu (Acori Tatarinowii Rhizoma) (each 1 qian) Dang Gui (Angelicae Sinensis Radix) (1.5 qian) Gan Cao (Licorice Radix et Rhizoma) (0.5 qian)
Crush these ingredients for one dose. Decoct in water and take orally.
Suixin Dan (Heart-Penetrating Pill) Treats epilepsy, wind disorders, and women's heart wind and blood pathogenic factors.
Gan Sui (Kansui Radix) 1 qian (select firm ones)
Grind into powder; take three strips of blood from the tube of a pig heart and mix with the Gan Sui powder. Slice the pig heart open on both sides, insert the powder inside, tie securely with thread, wrap externally with wet cotton paper, and slow-roast until cooked, ensuring not to burn. Grind the roasted material into fine powder, mix with 1 qian of Chen Sha (Cinnabar), divide into four pills. Take one pill per dose, dissolved in decoction of slow-roasted pig heart. Efficacy is achieved when foul matter is discharged via stool.
Mania is caused by excessive accumulation of phlegm-fire. Mania is also described as chaotic behavior without normal stability. Fangfeng Tongsheng San (Saposhnikovia and Gardenia Powder) treats all severe wind-related epilepsy and mania (formula see Stroke chapter). Add Mu Dan Pi (Moutan Cortex), Sheng Di Huang (Rehmanniae Radix Recens), and Tao Ren (Persicae Semen) to this formula.
Qingxin Wan (Clear Heart Pill) Treats Heart affected by pathogenic heat, resulting in vague spirit, manic speech and shouting, and restless sleep.
Dan Xing (Arisaematis Cum Bile Rhizoma) Quan Xie Shao (Scorpio tip) Tian Ma (Gastrodiae Rhizoma) Ren Shen (Ginseng Radix et Rhizoma) Yu Jin (Curcumae Longae Radix) Sheng Di Huang (Rehmanniae Radix Recens) (equal parts)
Grind into powder, soak in decoction, steam, and form pills the size of Sophora seeds. Take 30 pills per dose, washed down with Ren Shen decoction.
Unremitting laughter is due to excessive Heart Fire. Use 2 liang of salt, fire-burn until red-hot, grind finely; add one large bowl of river water, boil three to five times. When warm, drink in three doses. Stimulate the throat with a hairpin to induce vomiting of hot phlegm. Subsequently administer Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity) (formula see Cold Damage chapter). Add Ban Xia (Pinelliae Rhizoma), Zhu Li (Bambusae Succus), Zhu Ye (Bambusae Folium), and a little Jiang Zhi (Zingiberis Rhizoma Recens Juice) to this formula; laughter will cease.
Women suffering from epilepsy who sing at any time or climb walls and roofs are suffering from Ying (Nutritive) Blood confusing the Pericardium.
Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder)
Dang Gui (Angelicae Sinensis Radix) Bai Shao (Paeoniae Radix Alba, stir-fried) Bai Zhu (Atractylodis Macrocephalae Rhizoma, remove rhizome) Fu Ling (Poria, remove bark) Chai Hu (Bupleuri Radix) Sheng Di (Rehmanniae Radix Recens) Yuan Zhi (Polygalae Radix, remove heart) Tao Ren (Persicae Semen, remove skin and tips) Su Mu (Sappan Lignum) Hong Hua (Carthami Flos) Gan Cao (Licorice Radix et Rhizoma)
Crush for one dose. Add one slice of slow-roasted ginger, decoct in water, and take warm. If heat signs are present, add Xiao Chaihu Tang (Minor Bupleurum Decoction), Sheng Di Huang, and Chen Sha, decoct in water, and take.
Niuhuang Gao (Calculus Bovis Ointment/Paste) Treats women with heat entering the Blood Chamber, causing mania and inability to recognize people.
Niu Huang (Calculus Bovis) (2.5 qian) Zhu Sha (Cinnabar) Yu Jin (Curcumae Longae Radix) (each 3 qian) Nao Zi (Borneolum Syntheticum) Gan Cao (Licorice Radix et Rhizoma) (each 1 qian) Mu Dan Pi (Moutan Cortex) (3 qian)
Grind into fine powder, bind with refined honey into pills the size of soap pods. Take one pill per dose, dissolved in fresh water.
To treat Shixin Feng (Loss-of-Heart Wind), cook Zi He Che (Placenta Humana) until soft, mix with pig or cow stomach, and eat. This is highly effective. Zi He Che need not be limited to the first birth; placenta from healthy, disease-free women is best.
Symptoms of evil influence resemble epilepsy but are not epilepsy; consciousness fluctuates between clear and confused. The Heart is the master of the body and the palace of purity, surrounded by the Pericardium. The essence gathered within is called Shen (Spirit), which connects Yin and Yang, perceives subtleties, and remains orderly. If turbid phlegm sinks into it, disturbing the master, clarity is lost, and speech becomes disordered. If Jing (Essence) and Qi flow freely, expelling turbid matter, speech returns to normal. This is termed "Phlegm Confusing the Heart Orifices," not evil influence. Treating with talisman water attempts to seal the skin against external pathogens, which fails to cure the disease. This is phlegm in the upper jiao; initially, emesis should be used, followed by medications to clear phlegm, regulate Qi, and calm the Spirit. Disease will resolve. Excess phlegm presents with sounds and foam in the mouth; Fire presents with heat, red face, and rapid pulse. Epilepsy is a phlegm disorder; symptoms mimic the cries of horses, sheep, chickens, dogs, and pigs, hence Five Epilepsies correspond to Five Zang organs. Generally, treatment focuses on resolving phlegm. Extreme Yang leads to mania (cursing regardless of kinship); extreme Yin leads to epilepsy (disordered and irregular speech). Although divided into Yin and Yang, both diseases are primarily due to Heat and Phlegm.
A woman suffered from mania, discarding clothes and running, climbing over roofs and walls, failing to recognize relatives or strangers, speaking wildly and incoherently, unable to be restrained. Physicians were helpless. I instructed family members to splash cold water on her repeatedly until she collapsed. Her pulse was wiry, rapid, and forceful in all six positions, indicating extreme heat generating wind. Prescribed Fangfeng Tongsheng San with added Sheng Di Huang, Huang Lian, Tao Ren, Hong Hua, and Mu Dan Pi. After three doses, she stabilized. She subsequently recovered after taking Qufeng Zhibao Dan (Wind-Expelling Precious Pill).