一 一人嗜火酒，能饮五升。五月间，入闽中，溪水骤涨，涉水至七里，觉腹痛之甚。半年
后，右丸肿大，渐如斗形。医者皆与肝经之剂，及湿热之品，半载无功。士材曰∶嗜火酒则湿热满
中，涉大水则湿寒外束，今病在右，正是脾肺之湿，下注睾丸。以胃苓汤加黄柏、栀子、枳壳、茴香。
十剂而略减。即以为丸，服至十八斤而安。不再发矣。
二 赵氏云∶余于舟中，误坐湿布风帆，因感寒湿。忽一日，患阴丸一枚肿痛发热。用泻肾汤，加
柴胡、吴茱萸，散肝经之寒湿，独活、桂枝散肾经之寒湿，一服热退，再服肿消，后每治偏坠颇效。
三 一妇冬月生产，寒入子户，腹下痛不可忍，医作瘀血下之。寇宗 非之曰∶此寒疝也。仲景
羊肉汤，治寒疝腹中痛，及胁痛里急，无不验者。孙思邈言羊肉止虚痛，利产妇。遂以羊肉为君，温补
荣卫。臣以生姜宣散寒邪，佐以当归温中活血，二剂，果愈。
癫者，语言不分次序，处境不辨秽洁，时如醉人，常作叹息、或歌或笑，或悲或哭，或不语，或不
食。此因志愿不遂，或因惊恐所致，积年难愈。虽有痰有火，乃心家不足之症。治宜清心、安神、豁痰
为主。因郁者开之，因惊者平之。狂者，狂妄不禁之谓，妄言骂詈，不避亲疏，甚则弃衣而走，登高而
歌，逾垣上屋。此属阳明痰热内实之症，宜吐
尽胸中之热痰。下尽肠胃中之积垢自愈。痫病乃间时而发，发久气虚，则日近日密。经言∶二阴〔心
肾。〕急为痫厥。故《难经》谓其脉阴阳俱盛也。此属龙雷之火，上乘于心。盖龙兴则水附，雷发则雨
随，故痰涎上涌，堵塞心窍，忽然神昏仆倒，摇头窜目，嚼舌吐沫，手足搐搦，身体伛偻，或背反
张，或作畜声，直至龙雷之火归原，人事方苏。如此一番，正气必虚，渐成痼疾。故斯症当清心、安
神、豁痰以治病之标，滋肾、壮水，导火归原，以治病之本，〔六味加牛膝、车前子。〕庶可得愈。有
因惊而发者，亦宜清心、安神、豁痰为主，兼平肝镇坠之剂。〔羚羊角、代赭石。〕有因随风热上涌而发
者，治宜祛风除热〔天麻、钩藤、甘菊、薄荷。〕豁痰。〔栝蒌、花粉、梨汁、竹沥。〕昔人论痫病，
专治于痰，因痰涎涌盛，火热冲动而作，以消痰降火为治。〔二陈、芩、连、栝蒌、枳壳。〕如人强壮
实者，可吐〔参芦汤。〕可下。〔礞石丸。〕余谓以上诸法，合宜则用，毋得拘执。
清心安神豁痰饮〔自制。〕
犀角〔一方治癫病，单用一两，加淡竹叶四两，煎饮四剂即愈。〕麦冬 钩藤〔清
心。〕远志 丹参〔安神。〕贝母 竹沥〔豁痰。〕痰多加牛黄，〔调服分许。〕 因郁加郁
金，因惊加珍珠、〔分许。〕琥珀、辰砂、〔各钱许。调服。〕金银器、羚羊角之属，火盛可加黄连。
此方癫病、痫病，通可治之。仲淳云∶癫、痫属心虚，气虚有热，总宜清心、安神、豁痰为主。
遂心丸 治痰迷心窍，发狂如神，
甘遂〔苦寒有毒，逐痰甚捷。焙研末，二钱。〕
〔猪心血为丸，白汤送下，分作四日服，或吐或下而愈。如狂甚不能服药者，用猪心血拌末二钱
晒干，量人之强弱增减，置饮食中，任彼自吃。食后吐泻兼作，轻者即愈，重者再服。〕
此祛痰泄水之峻厉药也。用以治狂，不嫌其峻厉者，以病势太甚，所谓有病病当之也。然当中病
即止，不可过剂，经所云∶大毒治病，十去其六是也。
六一顺气汤〔见伤寒。〕
宜加生铁锈。〔即炉治间捣落之铁屑。三、五钱。〕或铁锈、或针砂皆可。
此方狂病亦可用之。按经论狂病善怒，故曰怒狂。因肝气暴升，用生铁落煎饮，取其体重而降金
气以制之；宜节夺其食，不使胃火复助阳邪则愈。愈后只与米饮，若早与饮食饱之，病必再作也。
广笔记治痫症效方
茯神〔四两。〕远志〔安神定志。二两。〕天冬麦冬〔滋阴降火。〕白芍〔收阴
敛逆。酒炒，各三两。〕
皂荚〔性极尖利，无闭不开，洗涤痰涎垢腻。则去皮及弦，与子酥炙。〕半夏〔同姜
汁、明矾少许浸炒。〕旋复花
〔消痰祛饮。〕天竺黄〔豁痰利窍。〕真苏子〔炒，各二钱。〕香附〔三两，醋浸
童便炒。〕真沉香〔利气、除痰，一、二钱。〕
〔共为细末，怀山药粉作糊丸、如绿豆大，朱砂一两为衣，每服三钱，竹沥汤下。〕
此方大意亦以治痰为主，痫症颇效。
一、有一人嗜好烈性酒，每日能饮五升。五月间，他进入福建中部地区，溪水突然暴涨，他涉水行走了七里路，感到腹部剧烈疼痛。半年后，右侧睾丸肿大，逐渐像斗一样大。医生们都用疏肝经的药物以及清热利湿的药物治疗，半年没有效果。士材说：嗜食烈酒导致湿热充满体内，涉大水导致寒湿从外部束缚身体，现在病在右侧，正是脾肺的湿气下注到睾丸所致。使用胃苓汤加入黄柏、栀子、枳壳、小茴香。服用十剂后症状略有减轻。随后将其制成丸药，服用至十八斤后痊愈，不再复发。
二、赵氏说：我在船上时，误坐在潮湿的布制风帆上，因此感受了寒湿。忽然有一天，患侧阴囊的一颗睾丸肿痛发热。使用泻肾汤，加入柴胡、吴茱萸，以疏散肝经的寒湿；加入独活、桂枝，以疏散肾经的寒湿。服用一次后热退，再服用后肿胀消退，此后每次治疗偏坠（疝气）都颇为有效。
三、一位妇女在冬季生产，寒气侵入子宫，小腹疼痛难忍，医生误认为是瘀血而使用攻下法。寇宗奭批评这种做法说：这是寒疝。张仲景的羊肉汤，治疗寒疝引起的腹中痛，以及胁痛和里急后重，无不灵验。孙思邈说羊肉能止虚痛，利于产妇。于是以羊肉为君药，温补营卫。以生姜为臣药宣散寒邪，以当归为佐药温中活血，服用两剂，果然痊愈。
癫证，表现为言语不分次序，处境不辨秽洁，时常像醉酒的人，经常叹息，或者唱歌或者笑，或者悲伤或者哭泣，或者不说话，或者不吃东西。这通常是因为志愿未能实现，或者因为惊恐所致，积年累月难以治愈。虽然体内有痰有火，但这属于心气不足的病症。治疗应以清心、安神、豁痰为主。因郁结导致的要开郁，因惊恐导致的要平惊。狂证，是指狂妄不受控制，胡言乱语骂人，不顾及亲疏关系，严重时甚至脱衣奔跑，登高唱歌，翻墙爬屋。这属于阳明经痰热内实的病症，宜通过涌吐法吐出胸中的热痰，通过泻下法排出肠胃中的积滞垢物，即可自愈。痫病是间歇性发作，病程久了气虚，则发作间隔越来越近，频率越来越高。医经说：二阴（心、肾）急迫会导致痫厥。所以《难经》说其脉象阴阳俱盛。这属于龙雷之火上乘于心。大概龙兴起则水跟随，雷发作则雨随之而来，所以痰涎上涌，堵塞心窍，突然神志昏迷仆倒在地，摇头瞪眼，咬舌吐沫，手足抽搐，身体弯曲，或者背部反张，或者发出牲畜的声音，直到龙雷之火回归本源，人事才苏醒。经历这样一番发作，正气必然虚弱，逐渐形成顽固性疾病。所以对于这种病症，应当清心、安神、豁痰以治疗疾病的标症，滋肾、壮水、导火归原以治疗疾病的本症（六味地黄丸加牛膝、车前子），庶几可以痊愈。有因惊恐而发作的，也应以清心、安神、豁痰为主，兼用平肝镇坠的药物（羚羊角、代赭石）。有因随风热上涌而发作的，治疗宜祛风除热（天麻、钩藤、甘菊、薄荷）、豁痰（瓜蒌、花粉、梨汁、竹沥）。古人论述痫病，专门从痰论治，因为痰涎涌盛，火热冲动而发病，以消痰降火为治疗方法（二陈汤、黄芩、黄连、瓜蒌、枳壳）。如人体质强壮结实者，可用涌吐法（参芦汤），可用泻下法（礞石滚痰丸）。我认为以上各种方法，合宜则用，不要拘泥固执。
清心安神豁痰饮（自制方）。
犀角（一方治疗癫病，单用一两，加淡竹叶四两，煎服四剂即愈。）麦冬 钩藤（清心。）远志 丹参（安神。）贝母 竹沥（豁痰。）痰多加牛黄（调服少许分量的许。）因郁加郁金，因惊加珍珠（少许分量）、琥珀、辰砂（各钱许，调服。）金银器、羚羊角之类，火盛可加黄连。此方癫病、痫病，通用均可治疗。仲淳说：癫、痫属于心虚，气虚有热，总宜以清心、安神、豁痰为主。
遂心丸 治疗痰迷心窍，发狂如神效。
甘遂（苦寒有毒，逐痰非常迅速。焙干研末，二钱。）
（猪心血为丸，白开水送下，分作四日服用，或吐或下而愈。如果狂甚不能服药者，用猪心血拌末二钱晒干，根据人的强弱增减剂量，放在饮食中，任由患者自己吃。食后吐泻同时发生，轻者即愈，重者再服。）
这是祛痰泄水的峻烈药物。用来治疗狂病，不嫌弃其峻烈，是因为病情太严重，所谓有病当病受之。但是应当中病即止，不可过量，这就是医经所说的：大毒治病，去其六分即止。
六一顺气汤（见于伤寒著作。）
宜加生铁锈。（即炉灶间捣落的铁屑。三、五钱。）或者铁锈、或者针砂都可以。
此方狂病也可以使用。按医经论述，狂病易怒，所以叫怒狂。因为肝气暴升，用生铁落煎饮，取其体重而降金气以制约它；应当节制剥夺其饮食，不让胃火再次助长阳邪则痊愈。痊愈后只给米饮，如果过早给予饮食使其饱食，病必定会再发。
广笔记治疗痫症的有效方
茯神（四两。）远志（安神定志。二两。）天冬麦冬（滋阴降火。）白芍（收阴敛逆。酒炒，各三两。）
皂荚（性极尖利，无闭不开，洗涤痰涎垢腻。则去皮及弦，与子酥炙。）半夏（同姜汁、明矾少许浸炒。）旋复花（消痰祛饮。）天竺黄（豁痰利窍。）真苏子（炒，各二钱。）香附（三两，醋浸童便炒。）真沉香（利气、除痰，一、二钱。）
（共为细末，怀山药粉作糊丸，如绿豆大，朱砂一两为衣，每服三钱，竹沥汤下。）
此方大意也是以治痰为主，对痫症颇为有效。
1. There was a person who had a fondness for strong liquor, capable of drinking five sheng per day. In May, he entered central Fujian, where the stream water suddenly rose. He waded through the water for seven li and felt severe abdominal pain. Half a year later, his right testicle swelled, gradually becoming as large as a dou (a unit of volume). Physicians all prescribed formulas for the Liver meridian and herbs for clearing damp-heat, but after half a year there was no effect. Shicai said: "Fondness for strong liquor leads to damp-heat filling the interior; wading in large amounts of water leads to cold-damp binding the exterior. Now that the disease is on the right side, it is precisely the dampness of the Spleen and Lungs descending into the scrotum." Use Weiling Tang (Atractylodes Macrocephala and Poria Decoction) added with Huangbai (Phellodendri Cortex), Zhizi (Gardeniae Fructus), Zhike (Aurantii Fructus), and Huixiang (Foeniculi Fructus). After taking ten doses, symptoms slightly decreased. Then it was made into pills. After taking eighteen jin (a unit of weight), he recovered and did not relapse.
2. Zhao said: "While on a boat, I accidentally sat on a wet cloth sail, thereby contracting cold-damp. Suddenly one day, one of my scrotal testes became swollen, painful, and hot. I used Xieshen Tang (Kidney Draining Decoction), added Chaihu (Bupleuri Radix) and Wuzhuyu (Evodiae Fructus) to disperse cold-damp from the Liver meridian; added Duhuo (Angelicae Pubescentis Radix) and Guizhi (Cinnamomi Ramulus) to disperse cold-damp from the Kidney meridian. After one dose, the heat subsided; after two doses, the swelling disappeared. Since then, every time I treated hernia (pianzhui), it was quite effective."
3. A woman gave birth in winter. Cold entered the uterus (zi hu), causing unbearable lower abdominal pain. The physician mistook it for blood stasis and used purgatives. Kou Zongshi criticized this, saying: "This is cold hernia (han shan). Zhang Zhongjing's Lamb Soup (Yangrou Tang) treats abdominal pain due to cold hernia, as well as hypochondriac pain and urgency/tenesmus, and is invariably effective. Sun Simiao stated that lamb stops deficiency pain and benefits postpartum women." Thus, lamb was used as the sovereign herb to warm and tonify Ying and Wei. Ginger (Shengjiang) was used as the minister herb to disseminate cold pathogens. Danggui (Angelicae Sinensis Radix) was used as the assistant herb to warm the middle and invigorate blood. After two doses, she was indeed cured.
Dian syndrome (epilepsy-like psychosis) manifests as speech lacking order, inability to distinguish cleanliness from filth in one's surroundings, often appearing like a drunkard, frequently sighing, or singing, laughing, grieving, crying, remaining silent, or refusing to eat. This is caused by unfulfilled ambitions or fright/shock, persisting for years and difficult to cure. Although there is phlegm and fire present, this is essentially a deficiency syndrome of the Heart. Treatment should focus on clearing the Heart, calming the Spirit, and resolving phlegm. For cases due to stagnation, use dispersing methods; for cases due to fright, use calming methods. Kuang syndrome (mania) refers to uncontrollable madness, speaking nonsense and cursing without regard for kinship or distance, and in severe cases, stripping clothes and running, climbing high to sing, or jumping over walls and roofs. This belongs to the syndrome of internal excess of phlegm-heat in the Yangming channel. It is appropriate to induce vomiting to expel hot phlegm from the chest and purge to remove accumulated filth from the intestines and stomach, leading to self-healing. Epileptic seizures (Xianbing) occur intermittently. As the duration increases and Qi becomes deficient, the intervals between attacks shorten and frequency increases. The Classics state: "Urgency of the Two Yin (Heart and Kidney) leads to epileptic convulsions." Therefore, the *Nanjing* states that the pulse is both Yin and Yang full/excessive. This belongs to Dragon-Liver Fire ascending to the Heart. Generally, when the Dragon rises, water follows; when Thunder strikes, rain accompanies. Thus, saliva/phlegm surges upward, blocking the Heart orifices. Suddenly, consciousness is lost and the patient collapses, shaking the head, rolling eyes, biting the tongue, foaming at the mouth, twitching hands and feet, bending the body, or experiencing opisthotonos, or making animal sounds. Only when the Dragon-Liver Fire returns to its origin does consciousness recover. After such an episode, Righteous Qi must be deficient, gradually forming a chronic stubborn disease. Therefore, for this condition, one should clear the Heart, calm the Spirit, and resolve phlegm to treat the branch (symptoms), and nourish the Kidney, strengthen Water, and guide Fire back to its source to treat the root (etiology) [Liuwei Dihuang Wan added with Niuxi and Cheqianzi]. Only then can recovery be expected. For cases triggered by fright, treatment should also focus on clearing the Heart, calming the Spirit, and resolving phlegm, combined with herbs that pacify the Liver and anchor/descend [Lingyangjiao, Daizheshi]. For cases triggered by wind-heat surging upward, treatment should dispel wind and clear heat [Tianma, Gouteng, Ganju, Bohe] and resolve phlegm [Gualou, Huafen, Lizhi, Zhuli]. Ancients discussed epilepsy, treating it specifically via phlegm, because excessive saliva/phlegm and stirring fire cause the disease, using methods to eliminate phlegm and descend fire [Erchen Tang, Huangqin, Huanglian, Gualou, Zhike]. For robust individuals, emesis [Shenlu Tang] or purgation [Mengshi Wan] may be used. I believe the above methods should be used appropriately according to the situation, without rigid adherence.
Qingxin Anshen Huotan Yin (Self-made Formula).
Xijiao (One formula for Dian syndrome uses single ingredient Xijiao, 1 liang, added with Danzhuye 4 liang, decocted and drunk for four doses for cure.) Maidong, Gouteng (Clear Heart.) Yuanzhi, Danshen (Calm Spirit.) Beimu, Zhuli (Resolve Phlegm.) If phlegm is heavy, add Niuhuang (take a small amount mixed with liquid.) If due to stagnation, add Yujin; if due to fright, add Zhenzhu (small amount), Hupo, Chensha (each about 1 qian, taken mixed with liquid.) Silverware, Lingyangjiao, etc. If fire is excessive, add Huanglian. This formula can generally treat both Dian and Xian syndromes. Zhongchun said: Dian and Xian belong to Heart deficiency, Qi deficiency with heat. Total treatment should focus on clearing the Heart, calming the Spirit, and resolving phlegm.
Suixin Wan Treats phlegm confusing the Heart orifices, mania, with miraculous efficacy.
Gansui (Bitter-cold and toxic, rapidly expels phlegm. Roasted and powdered, 2 qian.)
(Pills formed with Pig Heart Blood, taken with plain boiled water, divided into four days' dosage. Cure occurs via vomiting or purging. If mania is severe and the patient cannot take medicine, mix 2 qian of powder with Pig Heart Blood, dry it, adjust dosage based on the patient's strength, and place it in food for the patient to eat voluntarily. After eating, vomiting and purging occur simultaneously. Mild cases heal immediately; severe cases require another dose.)
This is a harsh and potent drug for expelling phlegm and draining water. It is used to treat mania without fear of its harshness because the disease pathogen is too severe, meaning 'the disease bears the burden of the drug.' However, stop once the disease is addressed; do not overdose. This aligns with the Classic statement: "When using highly toxic drugs to treat disease, stop when six-tenths of the disease is eliminated."
Liuyi Shunqi Tang (See Shanghan Lun.)
It is suitable to add Sheng Tie Xiu (rust from iron smelting furnaces, i.e., iron filings scraped from the furnace. 3-5 qian). Or rust, or Zhensha (iron oxide powder) are both acceptable.
This formula can also be used for mania. According to the Classics, mania involves anger, hence called 'Anger Mania.' Because Liver Qi rises violently, use Sheng Tieluo (Fallen Iron) decoction, utilizing its heavy nature to descend Metal Qi to restrain it; dietary intake should be restricted so that Stomach Fire does not further assist Yang pathogens, leading to cure. After recovery, only provide rice water. If solid food is given too early to satisfy hunger, the disease will definitely recur.
Guang Biji Effective Formula for Treating Epilepsy
Fushen (4 liang.) Yuanzhi (Calm Spirit and stabilize Will. 2 liang.) Tiandong, Maidong (Nourish Yin and descend fire.) Baishao (Collect Yin and restrain rebellion. Stir-fried with wine, each 3 liang.)
Zaojiao (Nature is extremely sharp and penetrating, opens all obstructions, washes away phlegm and greasy filth. Remove skin and strings, stir-fry with butter.) Banxia (Soak and stir-fry with Ginger Juice and a little Mingfan.) Xin Yi Hua (Eliminate phlegm and drain fluid.) Tianzhu Huang (Resolve phlegm and open orifices.) Zhen Suzi (Stir-fried, each 2 qian.) Xiangfu (3 liang, soaked in vinegar and stir-fried with child's urine.) Zhen Chenxiang (Promote Qi movement and eliminate phlegm, 1-2 qian.)
(Grind into fine powder, make pills using Huai Shan Yao paste, size of mung beans. Coat with 1 liang of Zhusha. Take 3 qian per dose, washed down with Zhuli soup.)
The main idea of this formula is also to treat phlegm, and it is quite effective for epilepsy.