脉诀启蒙曰脉弦为风痫○千金论云脉浮为阳痫脉沉为阴痫○凡颠狂脉虚者可治脉实者死
○难知云洪长伏三脉为风痫
原病式云风痫之发作者由热甚而风燥为其兼火化涎溢胸膈燥烁而螈 昏冒僵仆也千金云
病先
身热掣 惊啼叫唤而后发痫脉浮者为阳痫病在六腑外在肌肤尤易治也病先身冷不惊掣不啼
呼
而病发时脉沉者为阴痫病在五脏内在骨髓难治也内经曰神不守谓神乱也大抵热生于肝又三因
云夫癫痫病皆由惊动使脏气不平郁而生涎闭塞诸经厥而乃成或在母胎中受惊或幼小感风寒暑
湿或饮食不节逆于脏气而成大抵胎内受惊与饮食作痫者多而外感者间而有之
千金云小儿之痫有三风痫惊痫食痫也风痫缘衣暖汗出风因入也初时先屈指如数物乃作惊
痫起
于惊怖大啼乃作食痫其先不哺乳吐而变热后发然风痫惊痫时时有之十儿之中未有一二凡是先
寒后热热者皆食痫也惊痫皆按图灸之风痫当以猪心汤食痫当下乃愈紫霜丸佳
按此论三痫盖有三因之分风痫属外因惊痫属内因食痫属不内外因也又按全婴方云风痫因
将养失
度血气不和或浓衣汗出腠理开舒风邪而入之其病在肝肝主风验其证目青面红发搐宜驱风膏大
青膏琥珀散镇惊药有热四顺饮退后与利惊丸下其痰涎惊痫因血气盛实脏腑生热或惊怖大啼精
神伤动外邪所入为之其病在心心主惊验其证忽然叫声发搐宜琥珀散红龙散镇心丸有热四顺饮
利惊丸下之不生别病也食痫其病在脾脾纳食验其证嗳吐 气即发搐此病或大便酸臭紫丸子下
之以上三证大同小异并属阳也各目睛鲜斜手足潮搐或作猪声发过即瘥皆十生一死也
《脉诀启蒙》说：脉象弦，是风痫的征象。
凡是癫狂病，脉象虚弱的可以治疗，脉象实大的则预后不良（主死）。
《难知》说：洪大、长直、伏匿这三种脉象，见于风痫病。
《原病式》说：风痫发作，是由于热邪极盛而风燥作为兼夹因素，火气转化导致痰涎生成，溢满胸膈，燥热灼伤津液，从而出现抽搐、昏迷、僵倒等症状。
《千金方》说：发病前先有身体发热、肢体抽搐、惊叫啼哭，然后才发作癫痫，脉象浮的，称为阳痫。病位在六腑，病势在体表肌肤，比较容易治疗。发病前先有身体发冷、没有惊恐抽搐和啼呼，等到发病时脉象沉的，称为阴痫。病位在五脏，病势深入骨髓，难以治疗。
《三因方》说：癫痫这一类疾病，都是由惊吓扰动引起，使得脏气不平衡，郁结而生出痰涎，闭塞诸条经脉，气机逆乱上冲，于是形成癫痫。这有的因为在母胎中受到惊吓，有的在年幼时感受风寒暑湿，或者饮食不节制，逆乱了脏气而形成。大抵来说，在胎内受惊和因饮食引发的癫痫较多，而由外感引起的偶尔才有。
《千金方》说：小儿的癫痫有三种：风痫、惊痫、食痫。风痫是因为穿衣过暖出汗后，风邪乘虚而入所致。初起时先屈指像是在数东西，然后引发惊痫。惊痫起于惊恐害怕，大声啼哭后引发。食痫则是起初不哺乳，呕吐后变热，随后发作。然而风痫和惊痫时常都有发生，十个孩子中不到一两个是这种情况。凡是先寒后热，且伴有发热的，都是食痫。惊痫都可以按照图谱进行艾灸治疗。风痫应当用猪心汤送服药物，食痫应当用泻下法治疗才能痊愈，紫霜丸效果较好。
按语：这段关于三种癫痫的论述，大概分为三种病因：风痫属于外因，惊痫属于内因，食痫属于不内外因。
又按《全婴方》说：风痫是因为调养失度，血气不和，或者衣服穿得太厚出汗，腠理开泄，风邪侵入所致。其病位在肝，肝主风，验证其症状为目青面红、头发搐动，适宜用驱风膏、大青膏、琥珀散等镇惊药，如果有热症，用四顺饮退热，之后再用利惊丸下其痰涎。惊痫是因为血气盛实，脏腑生热，或者因惊恐大哭导致精神受损，外邪侵入所致。其病位在心，心主惊，验证其症状为忽然叫声大作、发作抽搐，适宜用琥珀散、红龙散、镇心丸，如果有热症，用四顺饮退热，再用利惊丸下之，这样就不会再生其他病了。食痫的病位在脾，脾主纳食，验证其症状为嗳气呕吐，随即发作抽搐。此病如果大便酸臭，可用紫丸子下之。以上三种证候大同小异，都属于阳证。各自表现为眼睛鲜亮偏斜、手足定时抽搐，或者发出猪叫声，发作过后即痊愈，十个人中有九个能活下来，只有一个人死亡。
*Mai Jue Qi Meng* (Enlightenment on Pulse Secrets) states: A wiry pulse (Xian Mai, 弦脉) indicates wind epilepsy (Feng Xian, 风痫).
*Qian Jin Fang* (Essential Prescriptions Worth a Thousand Gold) discusses: A floating pulse (Fu Mai, 浮脉) indicates yang epilepsy (Yang Xian, 阳痫); a deep pulse (Chen Mai, 沉脉) indicates yin epilepsy (Yin Xian, 阴痫).
In cases of mania and insanity (Dian Kuang, 癫狂), if the pulse is deficient (Xu Mai, 虚脉), it is treatable; if the pulse is excess (Shi Mai, 实脉), it indicates death.
*Nan Zhi* states: Hong (surging), Chang (long), and Fu (hidden) pulses are associated with wind epilepsy.
*Bing Yuan Shi* (Treatise on the Origin of Diseases) states: The onset of wind epilepsy occurs due to extreme heat combined with wind and dryness. Fire transformation generates phlegm-fluids that overflow into the chest and diaphragm, scorching with dryness, leading to convulsions (Chan Yue, 瘛疭), coma, stiffness, and collapse.
*Qian Jin Fang* states: If the patient first experiences body heat, limb jerking, fright, crying, and shouting before the epilepsy onset, and the pulse is floating, it is called yang epilepsy. The disease location is in the six fu organs (Liu Fu, 六腑), manifesting externally on the skin and muscles, making it easier to treat. If the patient first experiences body coldness without fright, jerking, crying, or shouting, and upon onset the pulse is deep, it is called yin epilepsy. The disease location is in the five zang organs (Wu Zang, 五脏), penetrating deeply into the bone marrow, making it difficult to treat.
*Nei Jing* (The Inner Canon) states: "Spirit does not reside" refers to mental confusion. Generally, heat originates from the Liver.
*San Yin Fang* (Treatise on Causes and Manifestations of All Diseases) states: Epilepsy and related disorders arise from fright disturbance causing imbalance of zang qi, leading to stagnation and generation of phlegm, blocking the meridians, resulting in rebellious qi and thus forming epilepsy. This may result from fright received in the womb, exposure to wind, cold, summer-heat, or dampness in early childhood, or irregular diet disrupting zang qi. Generally, epilepsy caused by prenatal fright and dietary factors is common, while that caused by external pathogens is occasional.
*Qian Jin Fang* states: There are three types of pediatric epilepsy: wind epilepsy, fright epilepsy, and food epilepsy. Wind epilepsy arises because excessive clothing causes sweating, allowing wind pathogen to enter. Initially, the fingers curl as if counting objects, followed by fright epilepsy. Fright epilepsy arises from fear and fright, triggered by loud crying. Food epilepsy begins with refusal to nurse, vomiting, subsequent fever, and then onset. However, wind and fright epilepsies occur frequently; among ten children, fewer than one or two fit this pattern. Any case presenting with initial chills followed by fever is classified as food epilepsy. Fright epilepsy can be treated with moxibustion according to diagrams. Wind epilepsy should be treated with Pig Heart Decoction (Zhuxin Tang, 猪心汤). Food epilepsy requires purgation to cure; Zishuang Wan (Purple Frost Pill) is excellent.
Commentary: This discussion on the three epilepsies categorizes them by etiology: wind epilepsy belongs to external causes (Wai Yin, 外因); fright epilepsy belongs to internal causes (Nei Yin, 内因); food epilepsy belongs to neither internal nor external causes (Bu Nei Wai Yin, 不内外因).
Furthermore, *Quan Ying Fang* (Complete Infant Formulas) states: Wind epilepsy results from improper nursing leading to disharmony of blood and qi, or wearing thick clothes causing sweating and open pores, allowing wind pathogen to invade. The disease location is the Liver, which governs wind. Symptoms include blue eyes, red face, and hair convulsions. Suitable treatments include Fengqi Gao (Wind-Expelling Paste), Daqing Gao (Great Blue Paste), Hupo San (Amber Powder), and other calming-agitation medicines. If heat is present, Sishun Yin (Four Compliance Decoction) is used to reduce heat, followed by Lijing Wan (Relieve Agitation Pill) to purge phlegm-fluids. Fright epilepsy results from excess blood and qi, heat in the zang-fu, or spiritual damage from fright and loud crying, allowing external pathogens to enter. The disease location is the Heart, which governs fright. Symptoms include sudden shouting and convulsions. Suitable treatments include Hupo San, Honglong San (Red Dragon Powder), and Zhenxin Wan (Calm Heart Pill). If heat is present, Sishun Yin is used for heat reduction, followed by Lijing Wan for purgation, preventing further complications. Food epilepsy involves the Spleen, which governs food intake. Symptoms include belching, vomiting, and subsequent convulsions. If stool is sour and foul-smelling, Zi Wan (Purple Pill) is used for purgation. These three syndromes are largely similar but slightly different, all belonging to yang syndromes. Common signs include bright, deviated eyes, periodic twitching of hands and feet, or sounds like a pig. After the episode subsides, the patient recovers. Nine out of ten survive, while one dies.