丹溪治一妇人。有孕六阅月。发痫。手足扬掷。面紫黑。合眼流涎昏愦。每苏。医与镇
灵丹五十帖。时作时止。至产后方自愈。其夫疑丹毒发求治。脉举弦按涩。至骨则沉滞数。
朱意其痫必于五月复作。应前旧时。至则果作。皆巳（脾）午（心）时。乃制防风通圣散减甘草。加
桃仁、红花。或服或吐。四五剂渐轻。发疥而愈。
一妇人积怒嗜酒。病痫。目上视。扬手掷足。筋牵喉响流涎。定则昏昧。腹胀疼。冲心
头至胸大汗。病与痫间作。昼夜不息。此肝有怒邪。因血少而气独行。脾受刑。肺胃间久
有酒痰。为肝气所侮。郁而为痛。酒性喜动。出入升降。入内则痛。出外则痫。乘其入内之
时。用竹沥、姜汁、参、术膏等药甚多。痫痛间作无度。乘痛时。灸大敦行间中脘。间以陈
皮、芍药、甘草、川芎汤。调膏与竹沥。服之无数。又灸大冲然谷巨阙及大指半甲肉。且言
鬼怪。怒骂巫者。朱曰。邪乘虚而入。理或有之。与前药。佐以荆沥除痰。又用秦承祖灸鬼
法哀告我自去。余证调理而安。
一少年夏间。因羞怒发昏。手搐如狂。时作时止。发则面紫黑。睾丸能动。左右相过。
医与金箔镇心丸、抱龙丸、妙香散、定志丸。不效。脉微弦。六至。轻重有。朱曰。此内素
有湿热。因激起厥阴相火。又时令相火。不宜服麝香之药。况肝病先当救脾土。诸药多燥血
坏脾者。遂以黄连为君。人参为臣。酒浸芍药和白陈皮为佐。生甘草为使。生姜一片。煎服
八帖而安。
一女八岁病痫。遇阴雨及惊则作。羊鸣吐涎。知其胎受惊也。但病深不愈。乃以烧丹丸
继以四物汤入黄连、生甘草。随时令加减。且令淡味以助药力。半年而愈。
汪石山治一人。年三十余。久病痫证。多发于晨盥时。或见如黄狗走前。则昏瞀仆地。
手足螈 。不省人事。良久乃苏。或作痰火治。而用苓、连、二陈汤。或作风痰治。而用全
蝎、僵蚕、寿星丸。或作痰迷心窍。而用金箔镇心丸。皆不中病。汪诊之。脉皆缓弱颇弦。
曰。此木火乘土之病也。夫早辰阳分。而狗阳物。黄土色。胃属阳土。虚为木火所乘矣。经
曰。诸脉皆属于目。故目击异物而病作矣。理宜实胃泻肝而火自息。越人云。泄其肝者缓其
中。遂以参、 、归、术、陈皮、神曲、茯苓、黄芩、麦冬、荆芥穗。煎服十余帖。病减。
再服月余而安。
震按痫证案虽少而法颇备。能细阅之。已可长进学问。临证指南痫案仅四条。皆用豁痰
清火。苦泄肝胆。辛通心络。以治实证则可。若予生平所见。多系虚证。河车六味丸、人参
定志丸、天王补心丹、龟鹿二仙胶。服者疾发之期远。势亦渐轻。因不敢浪用克代药。盖痫
与癫狂。虚实不同。癫狂实者八九。痫证虚者八九也。又常见息痫之人。少年多夭折。中年
得此病者。亦无高寿。其为虚也可知矣。
朱丹溪治疗一位妇人。怀孕六个月时，发作痫病。手足挥舞挣扎，面色紫黑，闭眼流涎，神志昏迷。每次苏醒后，医生给予镇灵丹五十帖。病情时好时坏，直到产后才自行痊愈。她的丈夫怀疑是丹毒发作而求治。脉象轻取弦紧，重按涩滞，沉取至骨则沉滞且数。朱丹溪推测她的痫病必定在五月复发，应验之前的旧疾。到了那时果然发作，都在巳时（脾经当令）和午时（心经当令）。于是制作防风通圣散减去甘草，加入桃仁、红花。或内服或催吐，服用四五剂后逐渐减轻，身上发出疥疮后痊愈。
另一位妇人因积怒且嗜酒，患痫病。眼睛上翻，挥手踢脚，筋脉牵引喉咙作响并流涎。发作停止后则神志昏蒙。腹胀疼痛，气冲心头直至胸部大汗淋漓。病症与痫病交替发作，昼夜不停。这是肝有怒邪，因为血少而气独自运行，脾受克制，肺胃之间久已有酒痰，被肝气所侮蔑，郁结而成痛。酒性喜动，出入升降，进入体内则发为痛，排出体外则发为痫。趁其入内之时，使用竹沥、姜汁、人参、白术膏等药很多。痫痛交替发作无度。趁疼痛时，灸大敦、行间、中脘穴。间或用陈皮、芍药、甘草、川芎汤，调服膏剂和竹沥。服用无数。又灸太冲、然谷、巨阙及大拇指指甲旁肌肉处。并且说见鬼怪，怒骂巫师。朱丹溪说：“邪气乘虚而入，道理上或许有这种情况。”给予前面的药物，佐以荆沥除痰。又用秦承祖的灸鬼法哀告自己离去。其余症状调理后安定。
一名少年在夏季，因羞愤导致昏厥，手部抽搐如狂状。时好时坏。发作时面色紫黑，睾丸能抽动，左右相互移动。医生给予金箔镇心丸、抱龙丸、妙香散、定志丸，无效。脉微弦，一息六至，轻重感觉不同。朱丹溪说：“此人内部素来有湿热，因激发厥阴相火，加上时令相火，不宜服用麝香类药物。况且肝病应当先救脾土，各种药物多燥血伤脾。”于是以黄连为君药，人参为臣药，酒浸芍药和白陈皮为佐药，生甘草为使药，生姜一片，煎服八帖而安。
一名八岁女孩患痫病，遇到阴雨天气及受惊则发作，发出羊叫声并吐涎沫。知道她是胎里受惊所致。但病深不愈，于是用烧丹丸继以四物汤加入黄连、生甘草。根据时令加减。并且让她吃清淡食物以助药力。半年后痊愈。
汪石山治疗一人。三十多岁，长期患痫证。多在早晨洗漱时发作。或者看见像黄狗跑在前面，就昏闷倒地。手足抽搐，不省人事。很久才苏醒。有人当作痰火治疗，而用茯苓、黄连、二陈汤。有人当作风痰治疗，而用全蝎、僵蚕、寿星丸。有人当作痰迷心窍治疗，而用金箔镇心丸，都不对症。汪石山诊察，脉皆缓弱颇弦。说：“这是木火乘土的病证。早晨属阳分，狗是阳物，黄土色，胃属阳土，虚弱被木火所乘。《内经》说：‘诸脉皆属于目’，所以目睹异物而发病。理应当实胃泻肝而火自息。《难经》说：‘泄其肝者缓其中’。”于是用人参、[缺字]、当归、白术、陈皮、神曲、茯苓、黄芩、麦冬、荆芥穗，煎服十余帖，病减。再服月余而安。
俞震按语：痫证医案虽然少但治法颇为完备。能仔细阅读它，已经可以增长学问。《临证指南医案》中痫案仅四条，都用豁痰清火，苦泄肝胆，辛通心络，来治疗实证是可以的。若像我生平所见，多系虚证。河车六味丸、人参定志丸、天王补心丹、龟鹿二仙胶，服用者疾病发作的周期远，势头也渐轻。因此不敢浪用克伐代损的药物。大概痫与癫狂，虚实不同。癫狂实证占八九成，痫证虚证占八九成。又常见患痫病的人，少年多夭折，中年得此病者，也没有高寿。其为虚证可知了。
Zhu Danxi treated a woman. She was six months pregnant when she suffered from epilepsy (Xian, 痫). Her limbs flailed and threw about, her face turned purple-black, her eyes closed, saliva flowed, and she was in a state of coma and confusion. After each recovery, physicians administered Zhenling Dan (Sedating Spirit Pill) for fifty doses. The condition came and went intermittently until it healed spontaneously after childbirth. Her husband suspected it was a toxic eruption (Dan Du, 丹毒) and sought treatment. The pulse was wiry on superficial pressure and choppy on deep pressure; at the bone level, it was deep, stagnant, and rapid. Zhu surmised that her epilepsy would recur in the fifth month, consistent with previous episodes. Indeed, it did recur, occurring during the Si hour (9-11 AM, associated with the Spleen) and Wu hour (11 AM-1 PM, associated with the Heart). He then formulated Fangfeng Tongsheng San (Wind-Protecting Universal Rescue Powder), removing Licorice Root (Gancao, 甘草), and adding Peach Kernel (Taoren, 桃仁) and Safflower (Honghua, 红花). Administered orally or to induce vomiting, after four or five doses, the condition gradually lightened, and she recovered after developing skin sores.
Another woman, suffering from accumulated anger and alcoholism, contracted epilepsy. Her eyes rolled upward, hands waved, feet kicked, tendons pulled causing throat sounds and salivation. Upon cessation, she was mentally dull. Her abdomen was distended and painful, with Qi rushing to the heart and chest causing profuse sweating. The illness alternated between this pain and epilepsy, ceaselessly day and night. This indicated Liver anger pathogen; due to blood deficiency, Qi moved independently, suppressing the Spleen. Phlegm from alcohol had long existed in the Lung and Stomach, bullied by Liver Qi, stagnating into pain. Alcohol’s nature is dynamic, moving in and out, ascending and descending; entering internally causes pain, exiting externally causes epilepsy. During its internal phase, much Zhuli (Bamboo Sap), Jiangzhi (Ginger Juice), Renshen (Ginseng), and Baizhu Gao (Atractylodes Paste) were used. Epilepsy and pain alternated uncontrollably. During pain, acupuncture points Dazhun (LR1), Xingjian (LR2), and Zhongwan (CV12) were moxa-ed. Intermittently, Chenpi (Tangerine Peel), Shaoyao (Peony), Gancao (Licorice), and Chuanxiong Decoction was used to mix with paste and bamboo sap. Innumerable doses were taken. Further moxa was applied to Taichong (LR3), Ran Gu (KI2), Juque (CV14), and the fleshy part beside the big toenail. She spoke of ghosts and cursed shamans. Zhu said, "Pathogens enter through deficiency; this may be true." He prescribed previous medicines assisted by Jingli (Schizonepeta Sap) to resolve phlegm. He also employed Qin Chengzu’s Ghost-Moxibustion method to beseech them to leave. Other symptoms were regulated and stabilized.
A young man in summer fainted due to shame and anger, his hand convulsing like madness. It came and went. Upon onset, his face turned purple-black, and his testicles could move, shifting left and right. Physicians administered Jinpo Zhenxin Wan (Gold Foil Calming Heart Pill), Baolong Wan (Embracing Dragon Pill), Miaoxiang San (Wonderful Incense Powder), and Dingzhi Wan (Calming Will Pill), without effect. The pulse was slightly wiry, six beats per breath, varying with pressure. Zhu said, "This patient has inherent damp-heat internally, triggered by Jueyin Ministerial Fire, compounded by seasonal Ministerial Fire. Musk-containing drugs are contraindicated. Moreover, for Liver disease, one must first protect the Spleen Earth. Most drugs are drying and damage blood and Spleen." Thus, Huanglian (Coptis Rhizome) was used as the Sovereign herb, Renshen (Ginseng) as the Minister, wine-soaked Shaoyao (Peony) and Bai Chenpi (White Tangerine Peel) as Assistants, Sheng Gancao (Raw Licorice) as the Envoy, with one slice of Shengjiang (Fresh Ginger). Decocted and taken, eight doses brought peace.
An eight-year-old girl suffered from epilepsy, triggered by cloudy/rainy weather and fright. She bleated like a sheep and vomited saliva. It was known she had been frightened in utero. However, the disease was deep and unhealed. Therefore, Shaodan Wan (Burnt Cinnabar Pill) was followed by Siwu Tang (Four Substances Decoction) added with Huanglian (Coptis) and Sheng Gancao (Raw Licorice), adjusted according to seasons. She was instructed to eat bland food to aid the medicine's power. She recovered after half a year.
Wang Shishan treated a man in his thirties, who had long suffered from epilepsy. It mostly occurred during morning washing. Or upon seeing something like a yellow dog running ahead, he would faint and fall. His limbs convulsed, and he lost consciousness, recovering only after a long time. Some treated it as Phlegm-Fire using Fuling (Poria), Huanglian (Coptis), and Erchen Tang (Two Aged Things Decoction). Some treated it as Wind-Phlegm using Quanxie (Scorpion), Jiangcan (Silkworm), and Shouxing Wan (Old Star Pill). Some treated it as Phlegm confusing the Heart Orifice using Jinpo Zhenxin Wan (Gold Foil Calming Heart Pill). None hit the mark. Wang diagnosed: the pulse was slow, weak, and somewhat wiry. He said, "This is Wood and Fire overacting on Earth. Morning belongs to Yang; dogs are Yang objects; yellow earth color; the Stomach is Yang Earth. Deficiency allows Wood and Fire to overact. The Classics say, 'All pulses belong to the eyes.' Thus, seeing foreign objects triggers the disease. One should tonify the Stomach and drain the Liver so Fire extinguishes itself. The Nanjing says, 'Draining the Liver requires soothing the Middle.'" Thus, Renshen (Ginseng), [missing character], Danggui (Angelica Sinensis), Baizhu (Atractylodes), Chenpi (Tangerine Peel), Shenqu (Medicated Leaven), Fuling (Poria), Huangqin (Scutellaria), Maidong (Ophiopogon), and Jingjie Sui (Schizonepeta Tip) were decocted. Taking more than ten doses reduced the illness. Continuing for over a month brought stability.
Yu Zhen commented: Although cases of epilepsy are few, the methods are comprehensive. Careful study can advance one's knowledge. *Lin Zheng Zhi Nan Yi An* (Guide to Clinical Practice Medical Cases) contains only four epilepsy cases, all treating excess patterns by resolving phlegm, clearing fire, bitter-draining Liver/Gallbladder, and pungent-unblocking Heart collaterals. This is acceptable for excess patterns. However, in my experience, most are deficiency patterns. Heche Liuhui Wan (Placenta Six-Flavor Pill), Renshen Dingzhi Wan (Ginseng Calming Will Pill), Tianwang Buxin Dan (Heavenly Emperor Nourishing Heart Pill), and Guilu Erxian Jiao (Tortoise-Deer Two Immortals Gel) were taken by patients, resulting in longer intervals between attacks and milder severity. Therefore, I dare not recklessly use harsh draining drugs. Generally, epilepsy and Dian-Kuang (Mania/Episodes) differ in excess and deficiency. Dian-Kuang is excess in eight or nine cases; epilepsy is deficiency in eight or nine cases. I often see those with epilepsy die young or fail to reach old age if contracted in middle age. Their deficiency is evident.