论
《内经》曰∶巨阳之厥，则肿首头重，足不能行，发为 仆（ 摇其目而暴仆也）。是盖阳气逆乱，故令人卒然暴仆
而
不知人，气复则苏，此则痫之类也。又曰∶阳明之厥，则癫疾欲走呼，腹满不得卧，面赤而热，妄见妄言。又曰∶甚则
弃衣而走，登高而歌，逾垣上屋，骂詈不避亲疏。是盖得之于阳气太盛，胃与大肠实热燥火郁结于中而为之耳，此则癫
狂之候也。曰癫曰狂，分而言之，亦有异乎？《难经》谓重阴者癫，重阳者狂。素问注云∶多喜为癫，多怒为狂。然则
喜属于心而怒属于肝，乃二脏相火有余之证，《难经》阴阳之说，恐非理也。大抵狂为痰火实盛，癫为心血不足，多为求
望高远不得志者有之。痫病独主乎痰，因火动之所作也。治法，痫宜乎吐，狂宜乎下，癫则宜乎安神养血，兼降痰火。
虽然此三证者，若神脱而目瞪如愚痴者，纵有千金我酬，吾未如之何也已矣。
脉法
脉大坚疾者癫狂，脉虚弦为惊，为风癫。脉沉数为痰热。脉大滑者自已。沉小急疾者死。虚而弦急者死。寸口沉大
而滑，沉则为实，滑则为气，实气相搏，入脏则死，入腑则愈。丹溪曰∶癫狂，脉虚易治，实者难治。
方法
丹溪曰∶痫证大率属痰与火，不必分五等。大法∶行痰为主药，用黄连、南星、栝蒌、半夏。寻火寻痰分多少，治
无不愈者。有热者，用凉药以清心。有痰者，必用吐，吐后用东垣安神丸及平肝之药青黛、柴胡、川芎之类。
癫狂原病式所论甚精，盖以世以重阴为癫，重阳为狂，误也，大概皆是热耳。
卢氏曰∶重阴重阳之分，难经之言也。河间谓素问注云，多喜为癫，多怒为狂，五志所发皆为热也，心热甚则多喜，
火旺制金不得平木，则肝实而多怒也。又发热于中，则多干阳明，经谓阳明之厥则癫疾，又谓服膏粱芳草石药，则热气
悍，发为癫狂。此原病式本素问之论，以明癫狂俱是热病，而重阴之说非也。
大率多因痰结于心胸间，宜开痰镇心神。亦有中邪者，以治邪法治之。
神不守舍，狂言妄作，经年不愈，如心经蓄热，当清心除热，如痰迷心窍，当去痰宁心，宜大吐大下愈。
一方 治痫证，用大蝙蝠一个，以朱砂三钱填入腹内，以新瓦盛火炙，令皮焦酥为度，候冷为细末，每一个分
作四服，气弱及年幼者作五服，空心白汤调下。
（以上丹溪方法凡五条）
龙脑安神丸（宝鉴） 治男女五般癫痫，无问远近，发作无时。
茯神（三两） 人参 地骨皮 甘草 麦门冬 桑白皮（各二两） 马
牙硝（二钱） 龙脑 麝香（各三分） 牛黄（五钱） 朱砂（二钱五分） 乌犀角（一两） 金箔（三十五片）
上为细末，炼蜜为丸，如弹子大，金箔为衣。如风痫病，冬月温水化下，夏月凉水化下，不拘时。二、三岁者，日
进一服。大人每服一丸，小儿一丸，分作二丸服。虚劳发热咳嗽，新汲水化下。
神应丹（宝鉴） 治诸痫。
辰砂（不拘多少，研细）
上以猪心血和得所，以蒸饼裹剂蒸熟，取出为丸如梧桐子大，每服一丸，食后、临卧煎人参汤下。
五色丸（钱氏） 治诸痫。
朱砂（五钱，另研） 水银（二钱五分） 雄黄（一两，熬） 珍珠（一两，另研末） 铅（三两，用水银同熬）
上和匀再研极细，面糊为丸如麻子大，每服三四丸，别煎金银薄荷汤送下。
二白丸（元戎） 治痰涎为病患，以致癫痫狂妄惊悸等证。
白矾（一两） 轻粉（一字或五分，量虚实加减）
上用生蒸饼剂裹，蒸熟去皮，可丸，入轻粉，丸如梧桐子大，每服二、三十丸，生姜汤下，小儿如黍米大。
妙香丸（拔萃） 治时毒伤寒，解五毒潮热积热，及小儿惊痫等证。
辰砂（九两，另研） 龙脑 腻粉 麝香（研，各五钱） 牛黄（五钱） 金箔（九十片，研） 巴豆（二百二十
五粒，去皮心及油）
上合研匀，炼蜜为丸，每两分作三十丸，米饮下。
朱砂滚涎丸（子和） 治五痫等证。
朱砂 白矾（生用） 赤石脂 硝石（各等分）
上为细末，研蒜膏为丸，如绿豆大，每服三十丸，食后荆芥汤下。
碧霞丹（局方） 治痰涎壅塞，牙关紧急，目睛上视，癫痫狂妄等证。
石绿（五钱，研九度飞） 附子尖 乌头尖 蝎稍（各二十个）
上为末，入石绿令匀，面糊为丸，如鸡头实大，每服一丸，薄荷汤化下，更以温酒半合饮之，须臾吐出痰涎，然后
随证以他药治之。如口噤者， 开灌之。
控涎丹（三因） 治痰迷心窍，狂言谵语，如有所见。（方见痰饮门。）
牛黄泻心汤（御药院方） 治心经邪热，狂言妄语，心神不安。
脑子（另研） 牛黄（另研） 朱砂（另研，各一钱五分） 大黄（生，一两）
上各研为细末，和匀再研，每服三钱，煎生姜、蜜水调下。
牛黄清心丸（局方） 治心气不足，神志不定，惊恐癫狂，语言谵妄，虚烦少睡，甚至弃衣而走，登高而歌，
逾垣上屋等证。
羚羊角末（一两） 人参（去芦，二两五钱） 白茯苓（一两二钱） 川芎（一两二钱半） 防风（去芦，一两五
钱） 阿胶（炒，七钱五分） 干姜（炒，七钱五分） 白术（一两五钱） 牛黄（研，一两二钱） 麝香（研，一两）
犀角末（二两） 雄黄（研飞，八钱） 龙脑（研，一两） 金箔（一千四百片，内除四百片为衣） 白芍药（一两五
钱） 柴胡（去芦，一两二钱） 甘草（锉炒，五两） 干山药（七两） 麦门冬（去心，一两五钱） 桔梗（去芦，
一两二钱） 杏仁（去皮尖及双仁者，麸炒黄色，一两二钱半，另研） 黄芩（一两五钱，去朽） 神曲（炒，二两五
钱） 大枣（一百个，蒸熟去皮核，研成膏） 白蔹（七钱五分） 蒲黄（炒，二两五钱） 当归（去头，一两五钱） 大
豆黄卷（一两七钱半，炒） 肉桂（去皮，一两七钱半）
上除枣杏仁金箔外，牛黄、龙胸、麝香、雄黄四味研为细末，入余药和匀，炼蜜入枣膏为丸，每两作十丸，金箔为
衣，每服一丸，食后温水化下。
（丹溪活套）云∶五志之火，因七情而起，郁而成痰，故为癫痫狂妄之证，宜以人事制之，非药石所能疗也。须诊
察其由以平之∶怒伤于肝者，为狂为痫，以忧胜之，以恐解之。喜伤于心者，为癫为痫，以恐胜之，以怒解之。忧伤于
肺者，为痫为癫，以喜胜之，以思解之。思伤于脾者，为痫为癫为狂，以怒胜之，以喜解之。恐伤于肾者，为癫为痫，
以思胜之，以忧解之。惊伤于胆者为癫，以忧胜之，以恐解之。悲伤于心胞者为癫，以恐胜之，以怒解之。此法惟贤者
能之耳。
（祖传方）
治癫痫，神效。
九节菖蒲一味（不拘多少，不闻鸡犬声者佳，去毛焙干）
上以木臼杵为细末，不可犯铁器，用黑 猪心，以竹刀批开，沙罐煮汤送下，每日空心服二、三钱。
Treatise
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: When the Taiyang (Greater Yang) channel experiences Jue (rebellious Qi reversal), there will be swelling of the head and heaviness in the head, inability to walk with the feet, and sudden collapse (manifesting as shaking of the eyes and sudden falling). This is due to rebellious and chaotic Yang Qi, causing sudden collapse and loss of consciousness; when Qi recovers, the patient revives. This belongs to the category of Xian Bing (Epilepsy). It also states: When the Yangming (Yang Brightness) channel experiences Jue, there will be Dian Ji (mental disorder/epilepsy) with a desire to run and shout, abdominal fullness preventing sleep, red and hot face, hallucinations, and delirious speech. It further states: In severe cases, patients may discard clothes and run, climb high places and sing, jump over walls and roofs, and curse without distinguishing between relatives and strangers. This is generally caused by excessive Yang Qi, with excess heat, dryness, and fire郁结 (stagnating) in the stomach and large intestine. This represents the syndrome of Dian Kuang (Mania and Epilepsy/Mental Disorder). Speaking of Dian and Kuang separately, are they different? The *Nanjing* (Classic of Difficult Issues) posits that heavy Yin leads to Dian, and heavy Yang leads to Kuang. The commentary on the *Suwen* (Basic Questions) states: Excessive joy indicates Dian, excessive anger indicates Kuang. Since joy belongs to the Heart and anger belongs to the Liver, these are syndromes of excess Xiang Huo (Ministerial Fire) in these two organs. The Yin-Yang theory in the *Nanjing* seems inconsistent with medical principles. Generally, Kuang syndrome is characterized by excess Phlegm-Fire, while Dian syndrome is characterized by deficiency of Heart Blood, often occurring in those who pursue lofty goals but fail to achieve them. Xian Bing (Epilepsy) is primarily governed by Phlegm, triggered by Fire agitation. Treatment methods: Xian Bing is suitable for emesis (vomiting therapy); Kuang is suitable for purgation (downward draining); Dian is suitable for calming the Spirit and nourishing Blood, combined with descending Phlegm-Fire. Nevertheless, for these three syndromes, if the Shen (Spirit) is scattered and the eyes are fixed like a fool, even with a thousand gold pieces as reward, I would be powerless.
Pulse Diagnosis
A pulse that is large, firm, and rapid indicates Dian Kuang. A pulse that is deficient and wiry indicates Jing (Fright) or Feng Dian (Wind-induced Epilepsy). A deep and rapid pulse indicates Tan Re (Phlegm-Heat). A large and slippery pulse indicates spontaneous recovery. A deep, small, and urgent pulse indicates death. A deficient and wiry-urgent pulse also indicates death. If the Cun Kou (radial artery at the wrist) pulse is deep, large, and slippery: deep indicates Excess, slippery indicates Qi stagnation. When Excess and Qi stagnation contend, if it enters the Zang (Organs), it is fatal; if it enters the Fu (Hollow Organs), it heals. Zhu Danxi said: For Dian Kuang, a deficient pulse is easy to treat, while an excess pulse is difficult.
Methods
Zhu Danxi said: Xian Bing (Epilepsy) generally belongs to Phlegm and Fire, and need not be divided into five categories. The general principle: Use phlegm-resolving herbs as the main treatment, such as Huang Lian (Coptis Rhizome), Nan Xing (Arisaema Cum Bile), Gua Lou (Trichosanthes Fruit), and Ban Xia (Pinellia Tuber). Determine the degree of Fire and Phlegm to treat; there is no case that does not heal. If there is Heat, use cooling herbs to clear the Heart. If there is Phlegm, emesis must be used; after emesis, use Dongyuan Anshen Wan (Dongyuan Calming Spirit Pill) and liver-calming herbs such as Qing Dai (Indigo Naturalis), Chai Hu (Bupleurum Root), and Chuan Xiong (Ligusticum Rhizome).
The discussion in Liu Wansu's *Yuanbing Shi* (Original Causes of Diseases) is very precise. It is generally believed that people mistakenly think heavy Yin is Dian and heavy Yang is Kuang; in fact, it is mostly Heat.
Mr. Lu said: The distinction of heavy Yin and heavy Yang comes from the *Nanjing*. Liu Wansu cited the *Suwen* commentary: excessive joy is Dian, excessive anger is Kuang. All emissions of the Five Emotions are Heat. Excessive Heart Heat causes excessive joy; Fire excess controls Lung Metal, failing to subdue Liver Wood, leading to Liver Excess and excessive anger. Furthermore, internal heat often affects the Yangming channel. The classic states that Yangming Jue causes Dian Ji, and consuming rich foods, fragrant herbs, and mineral drugs makes the Heat fierce, causing Dian Kuang. This *Yuanbing Shi* bases its argument on the *Suwen* to clarify that both Dian and Kuang are Heat diseases, refuting the heavy Yin theory.
Generally, it is mostly due to Phlegm knotting between the Heart and Chest. One should open the Phlegm and calm the Heart Spirit. There are also cases of evil invasion, treated according to evil-invading methods.
If the Shen (Spirit) does not reside in its house, with delirious speech persisting for years, if it is Heart Channel Accumulated Heat, one should clear the Heart and remove Heat; if it is Phlegm confusing the Heart Orifices, one should remove Phlegm and calm the Heart, suitable for major emesis and purgation to cure.
One prescription for treating Xian Bing uses one large bat. Fill its abdomen with three qian of Cinnabar (Zhusha). Roast it on a new tile over fire until the skin is scorched and crisp. Cool and grind into fine powder. Divide each bat into four doses. For those with weak Qi or young children, divide into five doses. Take on an empty stomach mixed with plain boiled water.
(Above are five methods from Danxi)
Longnao Anshen Wan (from *Weisheng Baojian*) Treats various types of epilepsy in men and women, regardless of duration, with unpredictable onset.
Fushen (Three liang) Renshen (Ginseng Radix) Digupi (Groundcherry Bark) Gancao (Licorice Root) Maimendong (Ophiopogon Tuber) Sangbaipi (Mulberry Root Bark) (Each two liang) Mayaxiao (Sodium Sulfate) Longnao (Borneol) Shexiang (Musk) (Each three fen) Niuhuang (Calculus Bovis) (Five qian) Zhusha (Cinnabar) (Two qian five fen) Wuxijiao (Rhinoceros Horn) (One liang) Jinbo (Gold Leaf) (Thirty-five pieces)
Grind all into fine powder. Make pills with refined honey, size of a bullet, coated with gold leaf. For Feng Xian (Wind Epilepsy), dissolve in warm water in winter, cool water in summer, at any time. For two- or three-year-olds, take one dose daily. Adults take one pill per dose; children take one pill, divided into two doses. For deficiency consumption with fever and cough, dissolve in fresh well water.
Shenyin Dan (from *Weisheng Baojian*) Treats various epilepsies.
Chensha (Cinnabar) (Any amount, finely ground)
Mix adequately with pig heart blood. Wrap in steamed dough cake, steam until cooked. Remove and make pills the size of paulownia seeds. Take one pill per dose, after meals and before bed, with Ginseng decoction.
Wuse Wan (from Qian Yi) Treats various epilepsies.
Zhusha (Cinnabar) (Five qian, ground separately) Shuiyin (Mercury) (Two qian five fen) Xionghuang (Realgar) (One liang, roasted) Zhenzhu (Pearl) (One liang, ground separately) Qian (Lead) (Three liang, roasted with mercury)
Mix evenly and grind extremely fine. Make pills with flour paste, size of hemp seeds. Take three or four pills per dose, accompanied by decoction of Silver, Gold, and Bohe (Mint).
Er Bai Wan (from *Rumen Shishi*) Treats pathogenic Phlegm-Saliva causing epilepsy, mania, fright, and palpitations.
Bai Fan (Alum) (One liang) Qingfen (Calomel) (One zi or five fen, adjust based on deficiency/excess)
Wrap in raw steamed dough cake, steam until cooked, peel off skin. Mix in Qingfen. Make pills size of paulownia seeds. Take twenty to thirty pills per dose, with Ginger decoction. For children, size of millet grain.
Miaoxiang Wan (from *Bacui Fang*) Treats seasonal toxic Shanghan (Cold Damage), resolves Five Poisons, tidal fever, accumulated heat, and pediatric fright epilepsy.
Chensha (Cinnabar) (Nine liang, ground separately) Longnao (Borneol) Nifen (Calomel) Shexiang (Musk) (Ground, each five qian) Niuhuang (Calculus Bovis) (Five qian) Jinbo (Gold Leaf) (Ninety pieces, ground) Badou (Croton Seed) (Two hundred twenty-five grains, peeled, core removed, oil removed)
Grind together evenly. Make pills with refined honey. Each liang makes thirty pills. Take with rice drink.
Zhusha Gunxian Wan (from Zhang Hezi) Treats five types of epilepsy.
Zhusha (Cinnabar) Bai Fan (Alum) (Raw) Chishizhi (Red Halloysite) Xiaoshi (Niter) (Equal parts)
Grind into fine powder. Make pills with garlic paste, size of mung beans. Take thirty pills per dose, after meals, with Schizonepeta (Jingjie) decoction.
Bixia Dan (from *Ju Fang*) Treats Phlegm-Saliva obstruction, locked jaw, upward gaze, epilepsy, and mania.
Shilv (Malachite) (Five qian, ground nine times and floated) Fuzi Jian (Tip of Aconite Root) Wutou Jian (Tip of Monkshood Root) Xie Shao (Scorpion Tail Tip) (Each twenty)
Grind into powder. Mix with Shilv evenly. Make pills with flour paste, size of corn kernels. Take one pill per dose, dissolved in Mint decoction. Drink half he of warm wine immediately afterward. Expect vomiting of Phlegm-Saliva within moments, then treat according to symptoms. If the jaw is locked, pry open and administer.
Kongxian Dan (from *Sanyin Fang*) Treats Phlegm confusing the Heart Orifices, delirious speech, visual hallucinations. (Formula see Phlegm-Fluids section.)
Niuhuang Xiexin Tang (from *Yuyao Yuan Fang*) Treats Heart Channel Evil Heat, delirious speech, restlessness.
Naohzi (Borneol) (Ground separately) Niuhuang (Calculus Bovis) (Ground separately) Zhusha (Cinnabar) (Ground separately, each one qian five fen) Dahuang (Rhubarb Root) (Raw, one liang)
Grind each into fine powder separately. Mix evenly and grind again. Take three qian per dose, mixed with Ginger and Honey water decoction.
Niuhuang Qingxin Wan (from *Ju Fang*) Treats Heart Qi deficiency, unstable Shen (Spirit), fright, epilepsy, mania, delirious speech, vexation, insomnia, up to discarding clothes and running, climbing high places and singing, jumping over walls and roofs.
Lingyangjiao Mo (Antelope Horn Powder) (One liang) Renshen (Ginseng Radix) (Remove rhizome, two liang five qian) Baifuling (Poria) (One liang two qian) Chuanxiong (Ligusticum Rhizome) (One liang two qian five fen) Fangfeng (Saposhnikovia Root) (Remove rhizome, one liang five qian) Ejiao (Donkey-hide Gelatin) (Stir-fried, seven qian five fen) Ganjiang (Dried Ginger) (Stir-fried, seven qian five fen) Baizhu (Atractylodes Rhizome) (One liang five qian) Niuhuang (Calculus Bovis) (Ground, one liang two qian) Shexiang (Musk) (Ground, one liang) Xijiao Mo (Rhinoceros Horn Powder) (Two liang) Xionghuang (Realgar) (Ground and floated, eight qian) Longnao (Borneol) (Ground, one liang) Jinbo (Gold Leaf) (One thousand four hundred pieces, four hundred for coating) Baishaoyao (White Peony Root) (One liang five qian) Chaihu (Bupleurum Root) (Remove rhizome, one liang two qian) Gancao (Licorice Root) (Cut and stir-fried, five liang) Ganshanyao (Dried Yam) (Seven liang) Maimendong (Ophiopogon Tuber) (Remove heart, one liang five qian) Jiegeng (Platycodon Root) (Remove rhizome, one liang two qian) Xingren (Apricot Seed) (Remove skin, tips, and double-kernel ones, stir-fried with bran until yellow, one liang two qian five fen, ground separately) Huangqin (Scutellaria Root) (One liang five qian, remove rotten parts) Shenqu (Medicated Leaven) (Stir-fried, two liang five qian) Dazao (Jujube) (One hundred pieces, steamed, peeled, pitted, ground into paste) Bailian (Belamcanda Rhizome) (Seven qian five fen) Puhuang (Pollen Typhae) (Stir-fried, two liang five qian) Danggui (Angelica Sinensis Root) (Remove head, one liang five qian) Dadouhuangjuan (Soja Glycines Sprout) (One liang seven qian five fen, stir-fried) Rougui (Cinnamon Bark) (Remove bark, one liang seven qian five fen)
Except for dates, apricot seeds, and gold leaf, grind Niuhuang, Longnao, Shexiang, and Xionghuang into fine powder. Mix with remaining herbs. Add refined honey and date paste to make pills. Each liang makes ten pills. Coat with gold leaf. Take one pill per dose, after meals, dissolved in warm water.
(Danxi Huotao) says: The Fire of the Five Emotions arises from the Seven Emotions, stagnates, and transforms into Phlegm, thus causing epilepsy and mania. It is best controlled by human affairs, not merely by medicine. One must diagnose the cause to pacify it: Anger injuring the Liver causes Kuang or Xian; overcome with Worry, resolve with Fear. Joy injuring the Heart causes Dian or Xian; overcome with Fear, resolve with Anger. Sorrow injuring the Lung causes Xian or Dian; overcome with Joy, resolve with Thought. Thinking injuring the Spleen causes Xian, Dian, or Kuang; overcome with Anger, resolve with Joy. Fear injuring the Kidney causes Dian or Xian; overcome with Thought, resolve with Sorrow. Fright injuring the Gallbladder causes Dian; overcome with Worry, resolve with Fear. Sadness injuring the Pericardium causes Dian; overcome with Fear, resolve with Anger. Only the wise can practice this method.
(Ancestral Prescription)
Treats epilepsy, miraculous effect.
Jiejie Changpu (Rhizoma Acori Tatarinowii) alone (Any amount, preferably from areas free of chicken and dog sounds, remove hairs and bake dry)
Grind in a wooden mortar into fine powder. Do not touch iron vessels. Use a black pig heart, slice open with a bamboo knife, boil in a clay pot. Take with the soup. Take two to three qian on an empty stomach daily.