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Pulse: The pulse of epilepsy (epilepsy) is floating on the Yang position and sunken on the Yin position. A rapid pulse indicates heat, a slippery pulse indicates phlegm; mania (mania) originates in the Heart; convulsive wind and liver epilepsy present with wiry and urgent pulses. A floating pulse indicates disease in the Fu organs and superficial location, while a sunken pulse indicates disease in the Zang organs and deep location. In epilepsy, if the pulse is large and slippery, prognosis is good; if sunken, small, and urgent, it is difficult to treat. In heat-type mania, if the pulse is full and large, prognosis is good; if sunken and small, prognosis is poor (fatal). In epilepsy, if the pulse is deficient, it is treatable; if excess, prognosis is poor (fatal).

Mania refers to the condition where the patient opens their eyes wide and speaks to others about things never seen before. Delirium refers to closing the eyes and speaking alone about daily routine matters. Additionally, blood stasis syndrome manifests as repetitive speech. Zheng sheng refers to trembling and weak voice, discontinuous breath, with words emerging from the throat. When Yin attaches to Yang, mania occurs; when Yang attaches to Yin, epilepsy occurs. Loss of Yang leads to seeing ghosts; loss of Yin leads to blindness. Epilepsy is caused by insufficiency of Heart Blood. It is also said that epilepsy involves abnormal laughter and confusion/disorder of spirit.

Yangxue Qingxin Tang (Nourish Blood and Clear Heart Decoction)
Ren Shen (Ginseng Radix et Rhizoma, remove rhizome) Bai Zhu (Atractylodis Macrocephalae Rhizoma, remove rhizome) Fu Ling (Poria, remove bark) Yuan Zhi (Polygalae Radix, remove heart) Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried) Chuan Xiong (Ligusticum Chuanxiong Rhizoma) Sheng Di Huang (Rehmanniae Radix Recens) Shi Chang Pu (Acori Tatarinowii Rhizoma) (each 1 qian) Dang Gui (Angelicae Sinensis Radix) (1.5 qian) Gan Cao (Licorice Radix et Rhizoma) (0.5 qian)
Crush these ingredients for one dose. Decoct in water and take orally.

Suixin Dan (Heart-Penetrating Pill) Treats epilepsy, wind disorders, and women's heart wind and blood pathogenic factors.
Gan Sui (Kansui Radix) 1 qian (select firm ones)
Grind into powder; take three strips of blood from the tube of a pig heart and mix with the Gan Sui powder. Slice the pig heart open on both sides, insert the powder inside, tie securely with thread, wrap externally with wet cotton paper, and slow-roast until cooked, ensuring not to burn. Grind the roasted material into fine powder, mix with 1 qian of Chen Sha (Cinnabar), divide into four pills. Take one pill per dose, dissolved in decoction of slow-roasted pig heart. Efficacy is achieved when foul matter is discharged via stool.

Mania is caused by excessive accumulation of phlegm-fire. Mania is also described as chaotic behavior without normal stability. Fangfeng Tongsheng San (Saposhnikovia and Gardenia Powder) treats all severe wind-related epilepsy and mania (formula see Stroke chapter). Add Mu Dan Pi (Moutan Cortex), Sheng Di Huang (Rehmanniae Radix Recens), and Tao Ren (Persicae Semen) to this formula.

Qingxin Wan (Clear Heart Pill) Treats Heart affected by pathogenic heat, resulting in vague spirit, manic speech and shouting, and restless sleep.
Dan Xing (Arisaematis Cum Bile Rhizoma) Quan Xie Shao (Scorpio tip) Tian Ma (Gastrodiae Rhizoma) Ren Shen (Ginseng Radix et Rhizoma) Yu Jin (Curcumae Longae Radix) Sheng Di Huang (Rehmanniae Radix Recens) (equal parts)
Grind into powder, soak in decoction, steam, and form pills the size of Sophora seeds. Take 30 pills per dose, washed down with Ren Shen decoction.

Unremitting laughter is due to excessive Heart Fire. Use 2 liang of salt, fire-burn until red-hot, grind finely; add one large bowl of river water, boil three to five times. When warm, drink in three doses. Stimulate the throat with a hairpin to induce vomiting of hot phlegm. Subsequently administer Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity) (formula see Cold Damage chapter). Add Ban Xia (Pinelliae Rhizoma), Zhu Li (Bambusae Succus), Zhu Ye (Bambusae Folium), and a little Jiang Zhi (Zingiberis Rhizoma Recens Juice) to this formula; laughter will cease.

Women suffering from epilepsy who sing at any time or climb walls and roofs are suffering from Ying (Nutritive) Blood confusing the Pericardium.

Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder)
Dang Gui (Angelicae Sinensis Radix) Bai Shao (Paeoniae Radix Alba, stir-fried) Bai Zhu (Atractylodis Macrocephalae Rhizoma, remove rhizome) Fu Ling (Poria, remove bark) Chai Hu (Bupleuri Radix) Sheng Di (Rehmanniae Radix Recens) Yuan Zhi (Polygalae Radix, remove heart) Tao Ren (Persicae Semen, remove skin and tips) Su Mu (Sappan Lignum) Hong Hua (Carthami Flos) Gan Cao (Licorice Radix et Rhizoma)
Crush for one dose. Add one slice of slow-roasted ginger, decoct in water, and take warm. If heat signs are present, add Xiao Chaihu Tang (Minor Bupleurum Decoction), Sheng Di Huang, and Chen Sha, decoct in water, and take.

Niuhuang Gao (Calculus Bovis Ointment/Paste) Treats women with heat entering the Blood Chamber, causing mania and inability to recognize people.
Niu Huang (Calculus Bovis) (2.5 qian) Zhu Sha (Cinnabar) Yu Jin (Curcumae Longae Radix) (each 3 qian) Nao Zi (Borneolum Syntheticum) Gan Cao (Licorice Radix et Rhizoma) (each 1 qian) Mu Dan Pi (Moutan Cortex) (3 qian)
Grind into fine powder, bind with refined honey into pills the size of soap pods. Take one pill per dose, dissolved in fresh water.

To treat Shixin Feng (Loss-of-Heart Wind), cook Zi He Che (Placenta Humana) until soft, mix with pig or cow stomach, and eat. This is highly effective. Zi He Che need not be limited to the first birth; placenta from healthy, disease-free women is best.

Symptoms of evil influence resemble epilepsy but are not epilepsy; consciousness fluctuates between clear and confused. The Heart is the master of the body and the palace of purity, surrounded by the Pericardium. The essence gathered within is called Shen (Spirit), which connects Yin and Yang, perceives subtleties, and remains orderly. If turbid phlegm sinks into it, disturbing the master, clarity is lost, and speech becomes disordered. If Jing (Essence) and Qi flow freely, expelling turbid matter, speech returns to normal. This is termed "Phlegm Confusing the Heart Orifices," not evil influence. Treating with talisman water attempts to seal the skin against external pathogens, which fails to cure the disease. This is phlegm in the upper jiao; initially, emesis should be used, followed by medications to clear phlegm, regulate Qi, and calm the Spirit. Disease will resolve. Excess phlegm presents with sounds and foam in the mouth; Fire presents with heat, red face, and rapid pulse. Epilepsy is a phlegm disorder; symptoms mimic the cries of horses, sheep, chickens, dogs, and pigs, hence Five Epilepsies correspond to Five Zang organs. Generally, treatment focuses on resolving phlegm. Extreme Yang leads to mania (cursing regardless of kinship); extreme Yin leads to epilepsy (disordered and irregular speech). Although divided into Yin and Yang, both diseases are primarily due to Heat and Phlegm.

A woman suffered from mania, discarding clothes and running, climbing over roofs and walls, failing to recognize relatives or strangers, speaking wildly and incoherently, unable to be restrained. Physicians were helpless. I instructed family members to splash cold water on her repeatedly until she collapsed. Her pulse was wiry, rapid, and forceful in all six positions, indicating extreme heat generating wind. Prescribed Fangfeng Tongsheng San with added Sheng Di Huang, Huang Lian, Tao Ren, Hong Hua, and Mu Dan Pi. After three doses, she stabilized. She subsequently recovered after taking Qufeng Zhibao Dan (Wind-Expelling Precious Pill).