仁斋曰∶大概血滞心窍，邪气在心，积惊成痫，通行心经，调平血脉，顺气豁
痰，乃其要也。假令小儿有热有痰，不欲乳哺，眠睡不安，常常惊悸，此皆发痫之
渐，即以紫霜丸导之（方见变蒸热，）时间量与紫霜丸，减其盛气，则无惊风痫钓之患。痫
证方萌，耳后高骨间必有青纹纷纷如线，见之则为爪破，须令出血啼叫，尤得气通。
诸痫发不能言者，盖咽喉为气之道路，风伤其气，以掩声音道路之门，抑亦血滞于
心，心窍不通所致耳，南星炮为末，雄猪胆汁调和，少许啖之，辄效。若夫钱氏五
痫丸并南星散，以菖蒲煎汤调下。甘遂猪心汤和苏合香丸一丸，皆治痫之要药
也。〔刘〕小儿神尚弱，惊则神不守舍，舍空则痰涎归之，或饮食失节，脾胃有
伤，积为痰饮，以致痰述心窍而作者，治法当寻火、寻痰，而前人多用镇坠清心之药，
固可以治热，可以清痰，若有顽痰胶固者，此药未易驱逐，在上者必用吐，吐后方
宜服此药，有痰实在里者，亦须下之，随病轻重而用之也。〔洁〕如有客痰发热而
有声，煎大黄、荆芥汤下五色丸。潮热有时，积热也，桃枝丸主之（方见积热）。壮
热不退，当用地骨皮散（方见潮热）下五色丸。风热，当用防风、黄芩汤下大青膏。身
温不热，当用白虎汤加苍术下五色丸。〔薛〕此皆元气不足之证，须以紫河车
（即小儿胞衣）丸为主，而以补药佐之，设若泛行克伐，复伤元气，则必不时举发，久而变
危，多至不救。一老人生子方周岁，秋初暴冷，忽发搐似惊痫，过则气息奄奄。
此元气虚弱所致，与补中益气汤而愈。一小儿十岁，一小儿七岁，各有痫证，岁
发二次，后因出痘及饮食停滞，举发频数，用六君子、补中益气、二汤而愈。一
小儿患前证，每发吐痰困倦，半饷而苏，诸药不应，年至十三而频发。用紫河车、
生研烂，入人参、当归末、丸桐子大，每服三五十丸，日进三五服，乳化下，一月
渐愈，又佐以八珍汤全愈。一小儿七岁发惊痫，每作，先君令其恣饮人乳，后发
渐疏而轻。至十四岁复发，仍用人乳，不应，余令用肥浓紫河车研烂，人乳调如泥，
日服二三次，至数具而愈，后常用加减八味丸而安。至二十三岁发而手足厥冷，仍
用前法，佐以八味丸、十全大补汤而痊。
仁斋说：大抵是血液瘀滞在心窍，邪气留驻于心，因积惊而发展为痫证。治疗的关键在于疏通心经，调和血脉，顺气并豁除痰浊。假如小儿体内有热且有痰，不愿吃奶，睡眠不安稳，经常受到惊吓或心悸，这些都是癫痫发作的先兆，应立即用紫霜丸来导泻（方剂见“变蒸热”章节）。适时适量地给予紫霜丸，以削弱其亢盛的病势，就能避免惊风和癫痫的祸患。
当癫痫症状刚刚萌芽时，耳后高骨之间必定会出现像线条一样纷乱的青色纹路，见到这种情况就用爪甲划破皮肤，必须让它出血并啼哭，这样更能使气机通畅。各种癫痫发作时不能说话的人，是因为咽喉是气息通行的道路，风邪损伤了气机，闭塞了声音通道的门户，这也是血液瘀滞于心、心窍不通所致。将天南星炮制后研成粉末，用雄猪胆汁调和，给患儿少量服用，往往见效。至于钱乙的五痫丸和南星散，用石菖蒲煎汤送服。甘遂猪心汤配合苏合香丸一丸，都是治疗癫痫的重要药物。
刘完素认为：小儿的神志尚且虚弱，受惊则神不守舍，神舍空虚则痰涎汇聚其中；或者饮食失节，损伤脾胃，积聚成为痰饮，导致痰迷心窍而发病。治疗方法应当寻找火邪、寻找痰浊。但前人多用镇坠清心的药物，虽然可以治疗热证、清除痰浊，但对于顽固胶结的痰浊，这些药难以驱逐。病位在上者必须使用催吐法，吐后才适宜服用此类药物；痰浊实在里部者，也必须使用攻下法，根据病情的轻重来选择应用。
李东垣认为：如果有外感痰热发热且伴有声响，可用大黄、荆芥煎汤送服五色丸。潮热定时发作，属于积热，用桃枝丸主治（方剂见“积热”章节）。壮热不退，应当用地骨皮散（方剂见“潮热”章节）送服五色丸。风热证，应当用防风、黄芩汤送服大青膏。身体温热但不发热，应当用白虎汤加苍术送服五色丸。
薛己认为：这些都是元气不足的证候，必须以紫河车（即小儿胞衣）制成的丸剂为主，并用补益药物辅助。如果泛泛地使用攻伐药物，再次损伤元气，则必然会导致疾病不时发作，久而久之变得危重，多至无法救治。有一位老人生子刚满周岁，初秋突然遭遇寒冷，忽然发生抽搐类似惊痫，发作过后气息微弱。这是元气虚弱所致，服用补中益气汤而痊愈。有一个十岁的小儿和一个七岁的小儿，各有癫痫证，每年发作两次，后来因为出痘疮及饮食停滞，发作频繁，用六君子汤和补中益气汤两方治愈。有一个小儿患上述病症，每次发作都呕吐痰液并感到困倦，片刻后苏醒，各种药物无效，到了十三岁时频繁发作。用紫河车生研烂，加入人参、当归粉末，制成梧桐子大小的丸剂，每次服用三五十丸，每天进服三到五次，用乳汁化开送服，一个月后逐渐好转，又辅以八珍汤完全治愈。有一个七岁小儿发惊痫，每次发作前，先父让他尽情喝人乳，后来发作逐渐稀疏且轻微。到了十四岁复发，仍然用人乳，没有效果，我让他用肥厚的紫河车研烂，用人乳调成泥状，每天服用二三次，直到数次后痊愈，之后常用加减八味丸而安定。到了二十三岁再次发作且手足厥冷，仍用前面的方法，辅以八味丸、十全大补汤而痊愈。
Ren Zhai stated: Generally speaking, blood stasis in the heart orifice and pathogenic factors residing in the Heart lead to epilepsy arising from accumulated fright. The key to treatment lies in unblocking the Heart meridian, regulating the blood vessels, promoting Qi circulation, and resolving phlegm. If a child has internal heat and phlegm, refuses breastfeeding, sleeps restlessly, and frequently experiences fright or palpitations, these are all precursors to epilepsy. One should immediately administer Zishuang Wan (Purple Frost Pill) to guide out stagnation (see formula under "Bianzheng Heat"). Administering Zishuang Wan appropriately and in moderation can reduce excessive pathogenic qi, thereby preventing the complications of wind-stroke and epilepsy.
When epilepsy symptoms first emerge, there will inevitably be messy, thread-like cyanotic veins between the high bone behind the ear. Upon seeing this, scratch the skin with fingernails until it bleeds and causes crying, which further promotes Qi circulation. In cases where various types of epilepsy cause inability to speak, it is because the throat is the pathway for Qi; wind injury obstructs this pathway, blocking the gate of voice production. This is also caused by blood stasis in the Heart and blockage of the Heart orifice. Prepare Nanxing (Arisaema Rhizome, *Pinelliae Tuber*) by stir-frying and grinding into powder, mix with bile from a male pig, and feed a small amount to the patient, which often yields effective results. As for Qian Yi's Wu Xian Wan (Five Epilepsy Pills) and Nanxing San (Nanxing Powder), they should be taken with decoction of Shichangpu (Acorus Rhizome, *Acori Tatarinowii Rhizoma*). Gansui Zhu Xin Tang (Kansui and Pig Heart Decoction) combined with one pill of Suhe Xiang Wan (Styrax Pill) are both essential medicines for treating epilepsy.
Liu Wansu opined: A child's Shen (Spirit) is still weak; upon fright, the Shen does not remain in its residence. When the residence is empty, phlegm-saliva gathers there. Alternatively, irregular diet damages the Spleen and Stomach, accumulating into phlegm-fluid retention, leading to phlegm confusing the Heart orifice and causing disease. The treatment method should target Fire and Phlegm. However, predecessors mostly used sedative and Heart-clearing drugs. While these can treat heat and clear phlegm, they are difficult to expel stubborn, adhesive phlegm. For pathogens located above, emesis must be used first; only after vomiting should such drugs be administered. For phlegm firmly rooted in the interior, purgation is also required, applied according to the severity of the illness.
Li Dongyuan stated: If there is exogenous phlegm-heat fever accompanied by abnormal sounds, administer Wu Se Wan (Five Colors Pill) with a decoction of Dahuang (Rhubarb Root, *Rhei Radix et Rhizoma*) and Jingjie (Schizonepeta Spike, *Schizonepetae Spica*). Periodic tidal fever indicates accumulated heat, treated primarily with Tao Zhi Wan (Peach Twig Pill) (see formula under "Accumulated Heat"). Persistent high fever requires using Digupi San (Dogwood Bark Powder, *Corni Fructus* related formula, see formula under "Tidal Fever") to take Wu Se Wan. For wind-heat, use Fangfeng Huangqin Tang (Saposhnikovia and Scutellaria Decoction) to take Da Qing Gao (Great Blue Ointment). If the body is warm but not hot, use Baihu Tang (White Tiger Decoction) added with Cangzhu (Atractylodes Rhizome, *Atractylodis Rhizoma*) to take Wu Se Wan.
Xue Ji stated: These are all syndromes of insufficient Yuan Qi (Original Qi). Treatment must focus on Ziheche (Placenta Human, *Human Placenta*) pills as the main therapy, assisted by tonifying herbs. If indiscriminate purgative methods are used, further damaging Yuan Qi, the disease will inevitably recur intermittently, eventually becoming critical and often incurable. An old man had a son who was just one year old. In early autumn, due to sudden cold, he suddenly developed convulsions resembling epileptic fits, followed by faint breath afterward. This was caused by deficient Yuan Qi; he recovered after taking Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi). Another case involved two children, aged ten and seven respectively, each suffering from epilepsy with twice-yearly attacks. Later, due to smallpox eruption and food stagnation, attacks became frequent. They were cured using Liujunzi Tang (Six Gentlemen Decoction) and Buzhong Yiqi Tang. Another child suffered from the aforementioned condition, vomiting phlegm and feeling fatigued with each attack, recovering after a short while. Various medications failed. By age thirteen, attacks became frequent. We used Ziheche (Human Placenta, *Human Placenta*), raw and ground thoroughly, mixed with Ren Shen (Ginseng Root, *Panacis Ginseng Radix*) and Dang Gui (Angelica Sinensis Root, *Angelicae Sinensis Radix*) powders, formed into pills the size of paulownia seeds. Each dose consisted of 30–50 pills, taken 3–5 times daily, dissolved in breast milk. Gradual improvement occurred within one month, and complete recovery was achieved with the addition of Bazhen Tang (Eight Treasures Decoction). A seven-year-old child suffered from fright-epilepsy. Before each onset, his father allowed him to drink human breast milk freely; subsequently, attacks became less frequent and milder. At age fourteen, it recurred. Breast milk alone was ineffective. I prescribed thick Ziheche (Human Placenta, *Human Placenta*) ground into a paste, mixed with breast milk, taken 2–3 times daily. Recovery occurred after several doses. Thereafter, Jiajian Bawei Wan (Modified Eight Flavor Pill) was commonly used to maintain stability. At age twenty-three, it recurred with cold limbs. The previous method was repeated, assisted by Bawei Wan (Eight Flavor Pill) and Shiquan Dabu Tang (Ten Significant Tonifying Decoction), resulting in full recovery.