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The pulse in epilepsy should be deficient; if it is excess and rapid, the prognosis is poor. A floating pulse indicates hyperactive Yang or external pathogenic factors; a deep pulse indicates internal Yin pathology; a slippery pulse indicates phlegm-dampness; and a rapid pulse indicates heat.

At the onset of an epileptic seizure, the patient suddenly falls, with spasms and convulsions of the hands and feet, lockjaw accompanied by vocalization, or vomiting of profuse frothy saliva and phlegm. After approximately the time it takes to eat one meal, the breath levels out, and the patient regains consciousness. This condition resembles but differs from Dian syndrome (mental disorder characterized by depression) and Chi syndrome (stiffness and convulsions). As described earlier, Dian syndrome presents differently, whereas Chi syndrome typically manifests as severe body rigidity, with the back arched like a bow, and lacks the vocalizations characteristic of epilepsy.

However, epilepsy is divided into two types: Yang Epilepsy and Yin Epilepsy, analogous to acute and chronic convulsive disorders in infants. In Yang Epilepsy, the patient first experiences fever, convulsions, and crying due to fright before the seizure occurs. The pulse is floating and surging (Hong), the disease involves the Six Fu Organs, the pathology is superficial in the skin and muscles, and the condition is mild, shallow, and easier to treat. (Formulas such as Jiyi Longnao Anshen Wan [Collected Experience Brain Camphor Calming Pill] or Hejian Xijiao Wan [He Jian's Rhinoceros Horn Pill] are appropriate.)

In Yin Epilepsy, the body is cold, there are no convulsions or crying, the onset is sudden without any prodromal symptoms, and the pulse is deep and forceful. The disease involves the Five Zang Organs, the pathology is deep within the bones and marrow, and the condition is severe, profound, and difficult to treat. (Formulas such as Qingxin Niuhuang Wan [Clear Heart Calculus Bovis Pill] or Shenying Dan [Divine Response Elixir] are appropriate.)

Ancient physicians generally believed that epilepsy arises from phlegm and heat lodging between the Heart and Stomach, triggered by sudden fright. If heat is excessive, seizures may occur even without auditory shock. This view suggests that phlegm-heat precedes the epilepsy, which may not necessarily be accurate. The theory of Three Causes (San Yin) is more precise. It posits that fright disturbs the Qi of the Zang organs, causing imbalance; Qi stagnation generates saliva/phlegm, which blocks the meridians, leading to counterflow of Qi and resulting in epilepsy. Etiology may include fright received in utero, invasion by the Six Exogenous Pathogens (Liu Qi), or irregular diet causing Qi counterflow in the Zang organs. Roughly speaking, adverse Qi comes from external sources, fright comes from internal emotional responses, and dietary issues belong to neither purely internal nor external causes. Since the etiologies differ, the treatment methods also vary. For cases caused by fright, Anshen Wan (Calming Spirit Pill) is used to pacify the mind; for cases complicated by phlegm, Sansheng San (Three Sages Powder) is used to induce vomiting; for cases complicated by fire, Qingshen Tang (Clear Spirit Decoction) is used to cool and clear heat; for cases requiring purgation, Chengqi Tang (Chengqi Decoction) is used to purge downward.

The pulse in epilepsy should generally be deficient rather than excess. An excess pulse indicates abundant pathogenic factors. If the pulse is both excess and rapid, it indicates the absence of Stomach Qi. A pulse that is merely strong and rigid without softness is a sign of ominous prognosis. A floating pulse indicates epilepsy originating in the Yang aspect; a deep pulse indicates epilepsy originating in the Yin aspect; a slippery pulse indicates epilepsy associated with abundant phlegm; and a rapid pulse indicates epilepsy associated with abundant heat. Observing the pulse based on the disease, and understanding the disease through the pulse, is a natural principle of medical logic.