典藏书目

According to the *San Yin Fang* (Treatise on Three Causes), ancient prescriptions included names such as "Five Epilepsies" (Wu Xian, epilepsy classified into five types based on animal sounds and organ correspondence), "Five Zang Epilepsies", and "Six Livestock Epilepsies". The syndromes differ, making it difficult to record them all. Another record lists the manifestations of the Five Epilepsies:

The first is called Horse Epilepsy (Ma Xian). During an attack, the patient makes a sound like a horse neighing. In the Earthly Branches, the Horse corresponds to Wu (noon), which is governed by the Hand Shaoyin Junfire (Heart Meridian). Therefore, this disease corresponds to the Heart.

The second is called Sheep Epilepsy (Yang Xian). During an attack, the patient makes a bleating sound. The Sheep corresponds to Wei, which is governed by the Foot Taiyin Damp-Soil (Spleen Meridian). Therefore, this disease corresponds to the Spleen.

The third is called Chicken Epilepsy (Ji Xian). During an attack, the patient makes a crowing sound. The Chicken corresponds to You, which is governed by the Foot Yangming Dry-Metal (Stomach Meridian). Therefore, this disease corresponds to the Stomach.

The fourth is called Pig Epilepsy (Zhu Xian). During an attack, the patient makes a grunting sound. The Pig corresponds to Hai, which is governed by the Hand Jueyin Pericardium (Pericardium). Therefore, this disease corresponds to the Right Kidney.

The fifth is called Ox Epilepsy (Niu Xian). During an attack, the patient makes a bellowing sound. The Ox corresponds to Chou, which is governed by the Hand Taiyin Damp-Soil (Lung Meridian). Therefore, this disease corresponds to the Lung.

These five epilepsies correspond to the five livestock and the five Zang organs. Upon onset, the patient suddenly experiences vertigo and falls, with the mouth and eyes pulling towards each other, eyes rolling upward, limbs twitching, and the back stiffening. After approximately the time it takes to eat a meal, the patient recovers. Treatment should be administered according to the specific pathogenic factors involved.

Qian Yi (Qian Shi) stated that in treating the Five Epilepsies, one must treat according to the corresponding Zang organ, with each organ associated with one animal: Dog Epilepsy involves body opisthotonos, upward jumping, and barking, corresponding to the Liver; Sheep Epilepsy involves staring, tongue protrusion, and bleating, corresponding to the Heart; Ox Epilepsy involves fixed gaze, abdominal distension, and lowing, corresponding to the Spleen; Chicken Epilepsy involves startled staring, body opisthotonos, limp hands, and crowing, corresponding to the Lung; Pig Epilepsy involves lying rigid like a corpse, foaming at the mouth, and grunting, corresponding to the Kidney. Severe cases of the Five Epilepsies result in death, as do those with severe relapses after illness. Mild cases are primarily treated with Wuse Wan (Five-Color Pill).

According to the *Qianjin Fang*, the Six Livestock Epilepsies include Horse, Ox, Sheep, Pig, Dog, and Chicken, without assigning them to the Five Zang organs. However, the *San Yin Fang*'s description of the Five Epilepsies lacks the Dog Epilepsy syndrome, while Qian Shi's description lacks the Horse Epilepsy syndrome. These two texts assign different animals to the Zang organs, and the origins of these differences are unknown. Although the *San Yin Fang* mentions Horse and Dog Epilepsies and posits that the Five Zang include the Stomach but exclude the Kidney, these claims are difficult to substantiate due to lack of documentation. Furthermore, Zhu Danxi noted that although there is a theory dividing the Five Epilepsies among the Five Zang, it lacks basis in classical texts, and treatment methods do not show distinct categories for the five types; thus, division into five is unnecessary.

Ren Zhai stated that this is a severe condition in children. It arises because children's blood vessels are not yet consolidated, Qi and bones are not fully gathered, making them susceptible to Wind pathogens. It can also result from irregular nursing leading to stagnation and accumulation. Symptoms include depressed Shen (Spirit), staring blankly, facial muscle twitching, locked jaw with drooling, abdominal distension, limb convulsions, appearing half-dead or half-alive, varying vocalization or aphonia, neck/back arching (opisthotonos), or spinal stiffness. If the four limbs are flaccid and the child regains consciousness intermittently during attacks, it is termed Epilepsy (Xian); if the whole body is rigid and the child remains unconscious throughout the day, it is termed Spasm (Jing). Generally, this is caused by Blood stasis blocking the Heart orifices, Evil Qi residing in the Heart, and accumulated Shock forming Epilepsy. The key treatment lies in unblocking the Heart Meridian, regulating Blood, smoothing Qi, and resolving Phlegm.

If a child has Heat and Phlegm, refuses milk, sleeps restlessly, and frequently startles, these are precursors to Epilepsy. One should immediately administer Zishuang Wan (Purple Frost Pill) to guide out the pathogen. Administering Zishuang Wan appropriately and in moderation to reduce excessive Qi will prevent complications of Wind Convulsion and Epileptic Hook. Since the Epilepsy syndrome is just emerging, one should look for green veins under the skin behind the high bone of the ear, appearing like threads. If seen, pricking to bleed is required; crying helps promote Qi circulation. When various Epilepsies occur and the patient cannot speak, it is because the throat is the pathway for Qi, and Wind damaging Qi blocks this gateway. This is also caused by Blood stasis in the Heart and blockage of the Heart orifices. Prepared Pinellia Rhizome (Banxia, processed) powder mixed with a small amount of male pig bile can be fed to the patient, often yielding effective results. Other important medicines for treating Epilepsy include Qian Shi's Five Epilepsy Pills, Banxia San (Pinellia Powder) taken with Anemarrhenae Decoction (Shichangpu decoction), Gansui Pig Heart Soup, and one pill of Suhexiang Wan (Styrax Pill).

Ancient prescriptions refer to Epilepsy as Feng Xian (Wind Epilepsy), Jing Xian (Shock Epilepsy), or Dian Xian (Manic Epilepsy). This disease is related to Stroke, Mania, and Acute/Chronic Convulsions, and may be triggered by hearing dog barks. Generally, because children's Shen is weak, shock causes the Shen to lose its residence; when the residence is empty, Phlegm-Saliva accumulates. Alternatively, irregular diet damages the Spleen and Stomach, accumulating into Phlegm-Dampness, which confuses the Heart orifices. Treatment should focus on identifying Fire and Phlegm. Previous physicians often used sedative and Heart-clearing drugs, which can treat Heat and clear Phlegm. However, if stubborn Phlegm is firmly adhered, these drugs are ineffective. For Phlegm in the Upper Jiao, emesis (vomiting therapy) must be used first, followed by such medications. For Phlegm firmly rooted in the interior, purgation (downward draining) is necessary. Treatment depends on the severity of the disease.

Someone asked: Is there a distinction between Yin and Yang in Epilepsy? I replied: This can be discussed similarly to Acute and Chronic Convulsions. Yang Epilepsy does not result from improper emesis or purgation but from Phlegm and Heat lodging between the Heart and Stomach, triggered by sudden fright. If Heat is intense, it may arise spontaneously even without fright. Cold-cooling herbs should be used to attack and treat it. Yin Epilepsy also originates from Phlegm-Heat, but becomes Yin-type due to excessive use of cold-cooling drugs by physicians, which damage the Spleen and Stomach. Warm and neutral herbs that tonify the Stomach and dry Phlegm should be used. If the distinction between Yin and Yang is not due to iatrogenic error (bad transformation), it refers to the depth of the pathogen (Phlegm-Heat), the deficiency of the exterior and interior, and the depth of the Zang-Fu organs. Can Epilepsy truly be purely Cold-Yin?