脉诀启蒙曰脉弦为风痫○千金论云脉浮为阳痫脉沉为阴痫○凡颠狂脉虚者可治脉实者死
○难知云洪长伏三脉为风痫
原病式云风痫之发作者由热甚而风燥为其兼火化涎溢胸膈燥烁而螈 昏冒僵仆也千金云
病先
身热掣 惊啼叫唤而后发痫脉浮者为阳痫病在六腑外在肌肤尤易治也病先身冷不惊掣不啼
呼
而病发时脉沉者为阴痫病在五脏内在骨髓难治也内经曰神不守谓神乱也大抵热生于肝又三因
云夫癫痫病皆由惊动使脏气不平郁而生涎闭塞诸经厥而乃成或在母胎中受惊或幼小感风寒暑
湿或饮食不节逆于脏气而成大抵胎内受惊与饮食作痫者多而外感者间而有之
千金云小儿之痫有三风痫惊痫食痫也风痫缘衣暖汗出风因入也初时先屈指如数物乃作惊
痫起
于惊怖大啼乃作食痫其先不哺乳吐而变热后发然风痫惊痫时时有之十儿之中未有一二凡是先
寒后热热者皆食痫也惊痫皆按图灸之风痫当以猪心汤食痫当下乃愈紫霜丸佳
按此论三痫盖有三因之分风痫属外因惊痫属内因食痫属不内外因也又按全婴方云风痫因
将养失
度血气不和或浓衣汗出腠理开舒风邪而入之其病在肝肝主风验其证目青面红发搐宜驱风膏大
青膏琥珀散镇惊药有热四顺饮退后与利惊丸下其痰涎惊痫因血气盛实脏腑生热或惊怖大啼精
神伤动外邪所入为之其病在心心主惊验其证忽然叫声发搐宜琥珀散红龙散镇心丸有热四顺饮
利惊丸下之不生别病也食痫其病在脾脾纳食验其证嗳吐 气即发搐此病或大便酸臭紫丸子下
之以上三证大同小异并属阳也各目睛鲜斜手足潮搐或作猪声发过即瘥皆十生一死也
*Mai Jue Qi Meng* (Enlightenment on Pulse Secrets) states: A wiry pulse (Xian Mai, 弦脉) indicates wind epilepsy (Feng Xian, 风痫).
*Qian Jin Fang* (Essential Prescriptions Worth a Thousand Gold) discusses: A floating pulse (Fu Mai, 浮脉) indicates yang epilepsy (Yang Xian, 阳痫); a deep pulse (Chen Mai, 沉脉) indicates yin epilepsy (Yin Xian, 阴痫).
In cases of mania and insanity (Dian Kuang, 癫狂), if the pulse is deficient (Xu Mai, 虚脉), it is treatable; if the pulse is excess (Shi Mai, 实脉), it indicates death.
*Nan Zhi* states: Hong (surging), Chang (long), and Fu (hidden) pulses are associated with wind epilepsy.
*Bing Yuan Shi* (Treatise on the Origin of Diseases) states: The onset of wind epilepsy occurs due to extreme heat combined with wind and dryness. Fire transformation generates phlegm-fluids that overflow into the chest and diaphragm, scorching with dryness, leading to convulsions (Chan Yue, 瘛疭), coma, stiffness, and collapse.
*Qian Jin Fang* states: If the patient first experiences body heat, limb jerking, fright, crying, and shouting before the epilepsy onset, and the pulse is floating, it is called yang epilepsy. The disease location is in the six fu organs (Liu Fu, 六腑), manifesting externally on the skin and muscles, making it easier to treat. If the patient first experiences body coldness without fright, jerking, crying, or shouting, and upon onset the pulse is deep, it is called yin epilepsy. The disease location is in the five zang organs (Wu Zang, 五脏), penetrating deeply into the bone marrow, making it difficult to treat.
*Nei Jing* (The Inner Canon) states: "Spirit does not reside" refers to mental confusion. Generally, heat originates from the Liver.
*San Yin Fang* (Treatise on Causes and Manifestations of All Diseases) states: Epilepsy and related disorders arise from fright disturbance causing imbalance of zang qi, leading to stagnation and generation of phlegm, blocking the meridians, resulting in rebellious qi and thus forming epilepsy. This may result from fright received in the womb, exposure to wind, cold, summer-heat, or dampness in early childhood, or irregular diet disrupting zang qi. Generally, epilepsy caused by prenatal fright and dietary factors is common, while that caused by external pathogens is occasional.
*Qian Jin Fang* states: There are three types of pediatric epilepsy: wind epilepsy, fright epilepsy, and food epilepsy. Wind epilepsy arises because excessive clothing causes sweating, allowing wind pathogen to enter. Initially, the fingers curl as if counting objects, followed by fright epilepsy. Fright epilepsy arises from fear and fright, triggered by loud crying. Food epilepsy begins with refusal to nurse, vomiting, subsequent fever, and then onset. However, wind and fright epilepsies occur frequently; among ten children, fewer than one or two fit this pattern. Any case presenting with initial chills followed by fever is classified as food epilepsy. Fright epilepsy can be treated with moxibustion according to diagrams. Wind epilepsy should be treated with Pig Heart Decoction (Zhuxin Tang, 猪心汤). Food epilepsy requires purgation to cure; Zishuang Wan (Purple Frost Pill) is excellent.
Commentary: This discussion on the three epilepsies categorizes them by etiology: wind epilepsy belongs to external causes (Wai Yin, 外因); fright epilepsy belongs to internal causes (Nei Yin, 内因); food epilepsy belongs to neither internal nor external causes (Bu Nei Wai Yin, 不内外因).
Furthermore, *Quan Ying Fang* (Complete Infant Formulas) states: Wind epilepsy results from improper nursing leading to disharmony of blood and qi, or wearing thick clothes causing sweating and open pores, allowing wind pathogen to invade. The disease location is the Liver, which governs wind. Symptoms include blue eyes, red face, and hair convulsions. Suitable treatments include Fengqi Gao (Wind-Expelling Paste), Daqing Gao (Great Blue Paste), Hupo San (Amber Powder), and other calming-agitation medicines. If heat is present, Sishun Yin (Four Compliance Decoction) is used to reduce heat, followed by Lijing Wan (Relieve Agitation Pill) to purge phlegm-fluids. Fright epilepsy results from excess blood and qi, heat in the zang-fu, or spiritual damage from fright and loud crying, allowing external pathogens to enter. The disease location is the Heart, which governs fright. Symptoms include sudden shouting and convulsions. Suitable treatments include Hupo San, Honglong San (Red Dragon Powder), and Zhenxin Wan (Calm Heart Pill). If heat is present, Sishun Yin is used for heat reduction, followed by Lijing Wan for purgation, preventing further complications. Food epilepsy involves the Spleen, which governs food intake. Symptoms include belching, vomiting, and subsequent convulsions. If stool is sour and foul-smelling, Zi Wan (Purple Pill) is used for purgation. These three syndromes are largely similar but slightly different, all belonging to yang syndromes. Common signs include bright, deviated eyes, periodic twitching of hands and feet, or sounds like a pig. After the episode subsides, the patient recovers. Nine out of ten survive, while one dies.