痫，痼疾也。患此者，虽不即毙，然往往勿获长寿。治惟疏风消痰清热，或温下之而已。不知亦有痧焉者，宜辨之。
治验∶
一朱建溪婢，犯羊痫疯三年矣。余诊之，六脉紧伏不匀。阅痧筋放之，付以沉香滚痰丸微温汤饮之，遂愈，永不再
发。
一盛昭先次子，患猪痫六年，脉伏紧而数，阅痧筋放之，脉遂平。付沉香滚痰丸微温汤饮之，亦不再发。
麻木酸痒，古人论治宜遵，余不更述。但痧症变幻，时亦有之。
治验∶
一翁尚景，遍身麻木，腿膝酸痒异常，脉微而细，放腿足痧四十余针，指头痧六针，未愈。付圆红散，微温汤服
之，用当归、金银花、连翘、秦艽、穿山甲末、僵蚕、角刺、红花二剂，如前服而痊。
世俗相传，有云∶男怕头虚，女怕脚肿。谓医治之难疗也。独是头虚之症，世岂无有消风热而得愈者乎。不知肿因
风热，乃可治效。若不因风热而因痧者，奚可更用发散升提之味耶？惟是头面虚肿，实因痧毒上攻三阳。先宜放刮，后
用清凉引下之剂治之，应无不愈，无令更变出凶险别病也。至若脚肿之疾，妇人犯此不数年而小腿肿，加之大腿亦肿，
渐渐入腹，睡即腿足不肿，内发胀闷。若当起坐行动，胸腹乃松，足腿复肿。如此日复一日，更不数年，势必小便不利，
大便亦阻，即成真臌。愚按此因湿毒之气，蒸淫于足，伤其血分，变为慢痧。不由鼻吸而入，故吃热汤热物俱无骤害，
脉亦有现有不现，及阅痧筋，或在腿，或在足面；或在足两旁。必多刺数次，出毒血为要。如不愈，当内服药饵乎。其
气血为主，大忌升发，燥热之品，恐毒瓦斯上腾也。若此之痧，有患五六年而毙，有患十余年而毙，有患二十余年而毙。
世鲜识者，受苦甚多，不可不悯，余故特为之着焉。
治验∶
一 茂甫，骤患头面红肿，心胸烦闷，口渴唇焦，六脉俱伏。放巅顶痧及手指、腿弯痧二十余针，不愈。用清凉至
宝饮减细辛加石膏、知母、茜草稍冷冻饮料之，三服而痊。
一方士彦，患头面渐肿，眉发尽落，已二年矣。脉洪数而紧盛，放指臂痧及两太阳痧二十余针，腿弯痧四针。服清
凉至宝饮减薄荷、细辛加穿山甲、天虫、乌药、续断、桑寄生、红花、归身微温饮之，十服而痊。
一秦馥生内室，素患脚肿及腿，渐升于腹，夜苦心中饱闷，饮食不宁，日间行动足腿复肿，十余年矣。诊脉细数，
令其家人，为之数放足面及两旁痧。用川楝子、金银花、木通、泽泻、槟榔、泽兰、青皮、枳壳、乌药、连翘温饮，八
服遂愈。
一张书瞻，病后足肿无力，少进饮食，两尺脉伏。阅足面痧及足旁痧、腿弯痧放之。用川楝子、槟榔、金银花、
连翘、白茯苓、泽泻、归身、续断、红花、白蒺藜、乌药而痊。
Epilepsy is a chronic, stubborn disease. Those suffering from it may not die immediately, but often fail to enjoy longevity. Treatment generally involves dispersing wind, resolving phlegm, clearing heat, or employing warm purgation. However, one must not overlook cases caused by Sha (a pathogenic factor associated with acute toxic conditions), which require differentiation.
Case Record 1:
A maid of Zhu Jianxi had suffered from sheep-type epilepsy for three years. Upon examination, her six pulses were tight, deep, and irregular. After identifying Sha vessels (superficial veins indicating Sha toxin) and performing bloodletting, she was administered Chenxiang Gutan Wan (Agarwood Pill for Descending Turbid Phlegm) with lukewarm water. She recovered completely and never relapsed.
Case Record 2:
The second son of Sheng Zhaoxian had suffered from pig-type epilepsy for six years. His pulse was deep, tight, and rapid. After identifying Sha vessels and performing bloodletting, his pulse normalized. He was administered Chenxiang Gutan Wan with lukewarm water and did not relapse.
Numbness, soreness, and itching are discussed in ancient texts regarding treatment principles, which should be followed; I will not elaborate further here. However, Sha syndrome can manifest with such variable symptoms.
Case Record 3:
Weng Shangjing suffered from whole-body numbness and extreme soreness and itching in the legs and knees. His pulse was faint and fine. Bloodletting was performed at forty-plus points on the legs and feet, and six points on the fingers, but he did not recover. He was prescribed Yuanhong San (Round Red Powder) taken with lukewarm water, along with a herbal decoction containing Danggui (Angelicae Sinensis Radix), Jinyinhua (Lonicerae Japonicae Flos), Lianqiao (Forsythiae Fructus), Qinjiao (Gentianae Macrophyllae Radix), Chanshanjia Mo (Pangolin Scale Powder), Jiangcan (Bombyx Batryticatus), Jiaoci (Spina Gleditsiae), and Honghua (Carthami Flos). Two doses were taken as described, leading to recovery.
It is commonly said among the populace: "Men fear head deficiency, women fear foot swelling," implying these are difficult to treat. However, are there no cases of head deficiency cured by dispersing wind-heat? If the swelling is due to wind-heat, it is treatable. But if it is due to Sha, using dispersing and ascending herbs would be inappropriate. Head and facial edema is actually caused by Sha toxin attacking the Three Yang meridians. Initially, bloodletting or scraping should be performed, followed by cooling and descending formulas. Recovery is assured if this approach is taken, preventing dangerous complications. Regarding foot swelling in women, within a few years, the calves swell, then the thighs, eventually spreading to the abdomen. The legs do not swell during sleep, but internal bloating occurs. Upon rising and moving, the chest and abdomen feel relaxed, but the legs and feet swell again. Day after day, over several years, this leads to difficulty urinating and constipation, resulting in true鼓胀 (Gu Zhang / abdominal distension). I believe this is caused by damp-toxin steaming and flooding the feet, damaging the blood level, transforming into slow Sha. Since it enters through the skin rather than inhalation, hot soups or foods do not cause immediate harm. Pulses may be present or absent, and Sha vessels may be found on the legs, dorsum of the foot, or sides of the foot. Multiple punctures to release toxic blood are essential. If ineffective, internal medication is needed, focusing on regulating Qi and Blood. Ascending and drying-hot substances are strictly contraindicated to prevent toxic vapors from rising. Such Sha cases have led to death after five to six years, ten to twenty years, etc. Few recognize this condition, causing much suffering. Pity is warranted, so I have written this specifically.
Case Record 4:
Maofu suddenly developed red and swollen head and face, chest distress, thirst, dry lips, and hidden six pulses. Bloodletting was performed at twenty-plus points on the vertex, fingers, and popliteal fossae without success. Qingliang Zhibao Yin (Cooling Precious Treasure Decoction) was modified by removing Xixin (Asari Radix et Rhizoma) and adding Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), and Qiancao (Rubiae Cordifoliae Radix). It was cooled slightly before drinking. Three doses resulted in recovery.
Case Record 5:
Fang Shiyan suffered from gradually swelling head and face, with complete loss of eyebrows and hair for two years. His pulse was surging, rapid, tight, and vigorous. Bloodletting was performed at twenty-plus points on the fingers, arms, and both Taiyang acupoints, and four points in the popliteal fossae. He took Qingliang Zhibao Yin modified by removing Bohe (Menthae Haplocalycis Herba) and Xixin, and adding Chanshanjia (Pangolin Scale), Tianchong (Bombyx Batryticatus), Wuyao (Linderae Radix), Xuduan (Dipsaci Radix), Sangjisheng (Taxilli Herba), Honghua (Carthami Flos), and Guishen (Angelicae Sinensis Radix). Taken with lukewarm water, ten doses led to recovery.
Case Record 6:
The wife of Qin Fusheng had long suffered from foot and leg swelling that gradually ascended to the abdomen. She suffered from nocturnal epigastric fullness and restlessness, with daytime activity causing leg swelling again. This persisted for over ten years. Her pulse was fine and rapid. Family members performed repeated bloodletting on the dorsum and sides of the feet. A decoction of Chuanlianzi (Meliosmae Fructus), Jinyinhua (Lonicerae Japonicae Flos), Mutong (Akebiae Caulis), Zexie (Alismatis Rhizoma), Binglang (Arecae Semen), Zelan (Lycii Cortex), Qingpi (Citri Reticulatae Pericarpium Viride), Zhike (Aurantii Fructus Immaturus), Wuyao (Linderae Radix), and Lianqiao (Forsythiae Fructus) was taken warm. Eight doses resulted in recovery.
Case Record 7:
Zhang Shuzhan suffered from weak, swollen feet after an illness, with slight food intake causing hidden Chi and Cun pulses on both sides. Bloodletting was performed on Sha vessels on the dorsum, sides of the feet, and popliteal fossae. He recovered using a formula of Chuanlianzi (Meliosmae Fructus), Binglang (Arecae Semen), Jinyinhua (Lonicerae Japonicae Flos), Lianqiao (Forsythiae Fructus), Baifuling (Poria), Zexie (Alismatis Rhizoma), Guishen (Angelicae Sinensis Radix), Xuduan (Dipsaci Radix), Honghua (Carthami Flos), Baijili (Tribuli Fructus), and Wuyao (Linderae Radix).