Library

Whenever treating the five types of epilepsy (Xian Bing), treatment should follow the affected Zang organ. Each Zang corresponds to a specific animal, and the Five-Color Pills (Wu Se Wan) are used to treat the respective condition.

Canine Epilepsy (Gou Xian): Characterized by opisthotonos (body arching backward), upward head movement, and barking sounds; the pathology is in the Liver.
Ovine Epilepsy (Yang Xian): Characterized by eye abnormalities (such as staring or rolling up), tongue protrusion, and bleating sounds; the pathology is in the Heart.
Bovine Epileshi (Niu Xian): Characterized by fixed staring, abdominal distension, and mooing sounds; the pathology is in the Spleen.
Gallus Epilepsy (Ji Xian): Characterized by startle jumps, opisthotonos, flaccid hands, and crowing sounds; the pathology is in the Lung.
Porcine Epilepsy (Zhu Xian): Characterized by a corpse-like stillness, foaming at the mouth, and grunting sounds; the pathology is in the Kidney.

Severe cases of the five epilepsies result in death, as do cases where symptoms remain severe after the illness has passed.

Dry face with red cheeks and red eyelids, frequent yawning accompanied by drowsiness and heaviness, alternating chills and fever, coughing and sneezing, cold fingertips, night-time restlessness with palpitations and excessive sleepiness—these are all signs of variola/varioliform eruptions (Chuang Zhen). This is a disease caused by epidemic pathogenic factors (Tian Xing). Treatment should only employ mild cooling herbs; one must not recklessly use purgatives or incorrect diaphoretic methods, nor allow exposure to wind and cold.

Each Zang organ has its corresponding eruption manifestation: The Liver manifests as vesicles (Shui Pao); the Lung as pustules (Nong Pao); the Heart as macules (Ban); the Spleen as papules (Zhen); and if it enters the Kidney, it turns black.

Only after the recovery from macular/papular eruptions, or during an epileptic seizure, do other eruptions fail to emerge. This is because during seizures, Wood (Liver) overacts on Earth (Spleen), and Wood Qi returns to the Heart. For cold-type fright, use Liang Jing Wan (Cooling Fright Pill); for warm-type fright, use Fen Hong Wan (Pink Pill).

During the ten months in the womb, the infant consumes the blood impurities of the five Zang organs. After birth, these toxins must be expelled. Thus, the forms of eruptions represent the fluids of the five Zang organs. The Liver governs tears; the Lung governs nasal mucus; the Heart governs blood; the Spleen envelops/controls blood. There are five named eruption types:
1. Liver-related Vesicles (Shui Pao): Like tears flowing like water, small in size and greenish in color.
2. Lung-related Pustules (Nong Pao): Like thick, turbid nasal mucus, large in size and white in color.
3. Heart-related Macules (Ban): Governing heart blood, small in size, reddish in color, smaller than vesicles.
4. Spleen-related Papules (Zhen): Smaller than macules, governing enveloped blood, thus yellowish-red and pale.
Since nasal mucus and tears discharge in larger quantities, pustules and vesicles are larger. Blood circulates internally and discharges less, so macules and papules are smaller. If a patient has little nasal mucus or tears, it is akin to a bladder emptied of water becoming shrunken.

Initially, tidal fever lasts for more than three days. When heat travels to the skin, eruptions appear. If few appear, it is because heat remains between the skin and interstices. Tidal fever emerges according to the Zang organ; for instance, persistent tidal fever after morning meals indicates the vesicle type.

At the onset of eruptions, manifestations of the five Zang organs appear, except for the Kidney, which shows no specific external sign but rather a normal state, specifically coldness at the sacrum (Kun) and ears. Both the sacrum and ears belong to the Kidney. If the sacrum becomes hot, it is a fatal sign.

When eruptions appear, assess their severity. If they erupt fully at once, the condition is severe. If eruptions and rashes are mixed, the condition is moderate. Sparse eruptions indicate mildness. Internal sinking of eruptions accompanied by lethargy, profuse sweating, irritability, fever, thirst, abdominal distension, crying, wheezing, and obstruction of urination and defecation indicates critical danger. During eruptions, the nursing mother must control her diet; the infant must not go hungry nor be exposed to wind and cold. If eruptions turn black upon entering the Kidney, they are difficult to treat.

For high fever, promote urination; for low fever, resolve toxicity. If eruptions are dark purple, dry, and sunken, purge with Baixiang Wan (Hundred Auspicious Pills); if not dark, do not purge. Consider the season: Eruptions are Yang in nature; emergence is favorable (Shun). Thus, spring/summer onset is favorable, while autumn/winter onset is unfavorable (Ni). In winter, when Kidney Qi is strong and cold is severe, eruptions often turn black in the Kidney. Differentiate seasonal patterns: spring pustules, summer black sunken eruptions, autumn macules, winter papules—all are unfavorable. Even in severe cases, 40-50% may survive. Black eruptions are fatal regardless of season, with only 1 in 10 surviving. Symptoms may include chills with teeth grinding, yellowish-purple swelling. Urgently purge with Baixiang Wan. If chills persist after purging, body becomes cold with sweating, and ears/sacrum become hot, it is fatal. Why? Because Kidney Qi is excessively strong, and Spleen deficiency fails to control it. If after purging, the body is warm, temperature is mild, and thirst for water exists, it is curable; this indicates Spleen Earth overcoming Kidney Water, removing cold and restoring warmth. Treatment should focus on resolving toxicity, avoiding reckless purging, which causes internal deficiency allowing pathogens to retreat to the Kidney. If the patient can eat and scabs form and crust over, or if not yet black but with excess asthma, purging is appropriate. For fever, irritability, thirst, abdominal distension with asthma, obstructed urination/defecation, red face, confusion, and vomiting, promote urination. If ineffective, use Xuan Feng San (Disperse Wind Powder) to purge. If scabs do not crust over after 5-7 days, it is due to internal heat steaming the skin, preventing crusting. Use Xuan Feng San to guide out stagnation, and apply fresh Rhinoceros Horn Decoction (Xi Jiao) to resolve heat, ensuring heat does not proliferate and scabs form.

Eruptions arise from internal mutual overaction; only macules/papules cause convulsions. Papules are generated by the Spleen; Spleen deficiency allows Liver Wood to invade. Wood overcoming Earth, with heat clashing, disturbs the Heart Spirit. The Heart delights in heat, causing spiritual unrest, leading to convulsions and epilepsy. Macules are generated by the Heart; Heart heat generates wind, which belongs to the Liver. The two Zang organs contend, wind and fire clash, causing convulsions. Treatment requires draining Heart and Liver and tonifying their mothers, primarily using Gualou Tang (Trichosanthes Decoction).

If eruptions turn black and purging results in pus/blood and scabs, it is favorable (Shun). If undigested food/grain is discharged, it is unfavorable (Ni). Why? Black eruptions belong to the Kidney. If Spleen Qi is originally strong, or if spleen-tonifying herbs were previously taken, Spleen Qi is solid. Even if Kidney Qi is active, Spleen can control it. Now, if eruptions enter the abdomen, transform into pus/blood, and exit with scabs, it indicates Spleen strength overcoming Kidney retreat, meaning the pathogen exits and peace is restored. If rice/grain and milk are un-digested in diarrhea, it indicates Spleen deficiency failing to control Kidney, resulting in spontaneous diarrhea; this is difficult to treat.