张元素曰。身软时醒者为痫。身反张。强直如弓。不时醒者为 。十无一生。 与痉。亦惊风之属。
陈藏器曰。惊痫。即急惊之症。但惊痫发时。仆地作声。醒时吐涎沫。急慢惊。俱不作声。不吐沫也。
杨士瀛曰。 者。手足冰冷。痉者。举身强直。 痉本一病。当以阳刚阴柔别之。刚者无汗。柔者有汗。其症肢体
强直。腰身反张。甚于风痫。大抵不治。痫者。卒然晕倒。目瞪流涎。神气郁勃。四肢搐搦。沉默昏愦。似死似生。其
声恶叫。过后惺惺。治法惟以惊风食三种。阴阳二症。别而治之。如惊痫者。恐怖积惊而发。啼叫恍惚。宜定魄丸、沉
香天麻汤。风痫者。风邪外袭。先屈手指。如数物乃发。宜追风祛痰丸。食痫者。乳食时遇惊停积。或成癖。或大便酸
臭。宜紫霜丸。始也身热。抽搐啼叫。是为阳痫。易治。宜龙脑安神丸。始也身无热。手足清冷。不抽掣。不啼叫。是
为阴痫。难治。宜引神归舍丹。因急惊成痫。宜三痫丹。因慢惊成痫。宜来复丹。取利。胎中受惊成痫。宜烧丹丸。痫
病方萌。耳后高骨间。必有青纹纷纷如线。见之。急用爪破。须令血出啼叫。尤得气通。更易效也。
薛己曰。钱云。角弓反张者。由风邪客太阳经也。足太阳主周身之气。其脉起于目内 而行。肝属木主风。所以风
邪易侵也。夫小儿皮肤未密。外邪易伤。肝为相火。其怒易发。若身反张强直。发热不搐者。风传太阳也。宜人参羌活
汤。丹溪云。痉比痫为虚。宜带补。多是气虚有火兼痰。用人参、竹沥治之。不用兼风之药。此论实发前人所未发。前
辈虽云十无一生。盖未尝有此法施于人也。
Zhang Yuansu stated: When the body is soft and the patient regains consciousness intermittently, it is Epilepsy (Xian). When the body arches backward, stiff and rigid like a bow, and does not regain consciousness frequently, it is Tetanus/Jing (Jing). Tetanus has a mortality rate of nearly 100%. Both Tetanus and Epilepsy belong to the category of Convulsive Disorders due to Startle (Jing Feng).
Chen Cangqi stated: Startle Epilepsy corresponds to the symptoms of Acute Convulsive Disorder. However, during the onset of Startle Epilepsy, the patient falls to the ground making sounds, and salivates upon waking; whereas in both Acute and Chronic Convulsive Disorders, there are no sounds made, nor is saliva vomited.
Yang Shiyin stated: Tetanus presents with cold hands and feet, while Epilepsy presents with whole-body stiffness. Tetanus and Epilepsy originate from the same pathology but should be distinguished by Yang-Gang (Stiff) and Yin-Rou (Soft) types. The Stiff type has no sweat, while the Soft type has sweat. The symptoms involve limb rigidity and hyperextension of the waist and back, which is more severe than Wind Epilepsy and is generally incurable. Epilepsy involves sudden fainting, staring eyes with drooling, stagnant and vigorous spirit, convulsions and spasms of the four limbs, silence and confusion, appearing as if dead or alive, with shrill cries, followed by a return to clarity. The treatment method focuses on distinguishing between causes related to Startle/Food accumulation and differentiating between Yin and Yang syndromes for separate treatment. For Startle Epilepsy, caused by fear and accumulated startle, manifesting as crying and trance-like states, Dingpo Wan (Stabilize Soul Pill) and Chenxiang Tianma Tang (Aucklandia and Gastrodia Decoction) are suitable. For Wind Epilepsy, caused by external invasion of wind pathogen, manifesting first by curling fingers as if counting objects before onset, Zhuifeng Qutan Wan (Wind-Chasing and Phlegm-Expelling Pill) is suitable. For Food Epilepsy, where milk/food stagnation occurs due to startle during feeding, forming masses or causing sour-smelling stool, Zishuang Wan (Purple Frost Pill) is suitable. If the onset involves fever, convulsions, and crying, it is called Yang Epilepsy, which is easier to treat; Longnao Anshen Wan (Borneol Calming Spirit Pill) is suitable. If the onset involves no fever, cold hands and feet, no convulsions, and no crying, it is called Yin Epilepsy, which is difficult to treat; Yingsheng Guishe Dan (Guide Spirit Return Home Pill) is suitable. If Epilepsy results from Acute Convulsive Disorder, Sanxian Dan (Three Epilepsies Pill) is suitable. If it results from Chronic Convulsive Disorder, Laifu Dan (Revival Pill) is suitable. For cases requiring purgation, Shaodan Wan (Burnt Cinnabar Pill) is suitable. When Epilepsy is just beginning, green vein patterns resembling threads will appear between the high bone behind the ear; upon detection, one must urgently scratch the area until bleeding and crying occur, which facilitates Qi circulation and enhances efficacy.
Xue Ji stated: Qian Yi said that opisthotonos (arched back like a bow) is caused by wind pathogens lodging in the Taiyang Meridian. The Foot-Taiyang Bladder Meridian governs the Qi of the whole body, and its vessel originates from the inner canthus. The Liver belongs to Wood and governs Wind, so wind pathogens easily invade. Children have loose skin, making them susceptible to external pathogens. The Liver contains Ministerial Fire, and its anger is easily aroused. If the body arches backward and becomes stiff with fever but without convulsions, it indicates wind transmitting to the Taiyang meridian; Renshen Qianghuo Tang (Ginseng and Notopterygium Decoction) is suitable. Zhu Danxi stated: Tetanus is more deficient than Epilepsy, so treatment should include tonification. It is mostly Qi deficiency with fire and phlegm, treated with Ginseng and Bamboo Sap, avoiding drugs that also dispel wind. This theory indeed elucidated points previously unexpressed by predecessors. Although predecessors claimed "nine out of ten die," it was likely because this method had not been applied to patients.