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Huang Jinfang stated: The ancients discussed the symptoms of deficiency-type epilepsy (Xian Bing, epilepsy caused by deficiency). Daytime attacks are attributed to deficiency of the Yang Qiao Mai (Yang Heel Vessel, one of the eight extraordinary vessels governing limb movement and eyelid opening/closing), treated with Shi Bu Tang (Ten Tonifying Decoction) plus Yizhi Ren (Alpinia Oxyphylla Fruit). Nighttime attacks are attributed to deficiency of the Yin Qiao Mai (Yin Heel Vessel, one of the eight extraordinary vessels governing medial lower limb movement and sleep), treated with Liu Wei Wan (Six-Ingredient Rehmannia Pill) plus Lu Jiao Jiao (Deer Antler Glue), or alternatively using Zi He Che (Human Placenta), Dang Gui (Angelica Sinensis Root), and Ren Shen (Ginseng Root). Generally, the Yang Qiao Mai, together with the Yang Wei Mai (Yang Linking Vessel), maintains the defensive yang of the exterior. This vessel originates from the middle of the heel, ascends to merge with the three yang meridians, starts from the depression five cun below the lateral malleolus on the Foot Taiyang Bladder Meridian at the Shenmai (BL62) acupoint, passes through the shoulder into the neck, connects with the inner canthus, and merges with the Taiyang meridian. It governs the exterior above the muscles, penetrates the six fu organs, and ensures the agility and non-stagnation of left and right joints. It is called Yang Qiao because its origin, course, entry, and termination all lie within yang meridians. When this vessel is diseased, it presents as falling to the ground, body flaccidity with sounds during epilepsy, and sometimes pulse slow with extension indicating spasm (Jing Zheng). If Wei Qi (Defensive Qi) cannot enter the yin aspect, it leads to insomnia (Bu Mei); the pulse presents as floating, fine, and tight in both Cun positions. Treatment should tonify the yang of the left and right sides. The Yin Qiao Mai, together with the Yin Wei Mai (Yin Linking Vessel), maintains the interior yin. This vessel also originates from the middle of the heel, branches from the Foot Shaoyin Kidney Meridian at the Ran Gu (KI1) acupoint, ascends medially to connect with the ankle, enters the thigh into the chest and abdomen, ascends to the throat at the Jing Ming (BL1) acupoint, and merges with the Taiyang meridian. Yang Qiao and Yin Qiao both nourish the eyes, govern the area from the muscles down to the ankles, penetrate the five zang organs, and ensure joint agility. It is called Yin Qiao because its origin, course, circulation, entry, and destination all belong to yin meridians. When this vessel is diseased, it presents as inverted speech, erroneous movements, and muscle spasms with contraction (Chou Yuan/Convulsion); the pulse presents as deep, fine, and tight in both Chi positions. Treatment should tonify the yin of the left and right sides. I treated Patient Feng Xuxian who suffered from epilepsy, attacking day and night, with no external pathogenic factors. The pulses at the Cun, Guan, and Chi positions on both hands were elastic and forceful. This should be treated as a dual deficiency of the two Qiao vessels. I used Huang Qi (Astragalus Root) 2 qian, Ren Shen 1 qian, Dang Gui 2 qian, Di Huang (Rehmannia Root) 2 qian, Zi He Che 4 qian, Yizhi Ren 1 qian, Bai Zhu (Atractylodes Macrocephala Rhizome) 1 qian, and Shan Yao (Dioscorea Rhizome) 1 qian. The patient recovered after taking this prescription. If there is deficiency of the Yang Qiao combined with Yang Wei, add Gui Zhi (Cinnamon Twig) and Yizhi Ren to Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). If there is deficiency of the Yin Qiao combined with Yin Wei, add Lu Jiao, Lu Rong (Deer Antler), Ren Shen, Gu Zhi (Psoralea Fruit), Dang Gui, He Che, and Zi Shi Ying (Fluorite) to Liu Wei Wan. Furthermore, if the condition is not due to deficiency of the two Qiao vessels, but involves accompanying fire, phlegm, qi stagnation, or cold, treatment must be flexible according to symptoms and pulse. One must not rigidly adhere to these two formulas to mislead patients.

Bu Xin Ning Zhi Wan (Heart-Nourishing Spirit-Calming Pill) treats epilepsy. Tian Zhu Huang (Bambusa Textilis Internal Deposit) is separately ground into powder, 5 qian; Ni Xiang (Agarwood) is separately ground into powder, 3 qian; Tian Dong (Asparagus Root) heart removed, washed with wine and steamed, 2 liang; Bai Shao (White Peony Root) stir-fried with wine, 3 liang; Bai Fu Shen (Poria with Hostwood) heart removed, 4 liang; Yuan Zhi Rou (Polygala Root flesh) soaked in Licorice juice and steamed, 2 liang; Mai Dong (Ophiopogon Tuber) 2 liang; Zhi Gan Cao (Honey-fried Licorice Root) 6 qian; Xuan Fu Hua (Inula Flower) 1.5 liang; Zhen Su Zi (Perilla Seed) ground, 1 liang; Xiang Fu (Cyperus Rhizome) soaked in vinegar, dried, mixed with child's urine, stir-fried on tile, 3 liang; Ban Xia (Pinellia Tuber) mixed with Ginger juice, soaked with a little Ming Fan (Alum), 2 liang; Zao Jiao Ce (Gleditsia Sinensis Pod) skin removed, stir-fried with butter, seeds removed, powder taken 2 liang and mixed evenly. Use Huai Shan Yao powder and honey paste to make pills the size of pea grains. Coat with 1 liang of Zhu Sha (Cinnabar). Take 3 qian per dose, administered with bamboo sap added to decoction water. (From *Guang Bi Ji*).

Dou Cai treated a man who had suffered from epilepsy for over three years. After moxibustion on the Zhongwan (CV12) acupoint for fifty moxa cones, he was cured. Another woman who had suffered from epilepsy for ten years was also cured after fifty moxa cones on Zhongwan. For anyone suffering from this disease, only moxibustion yields results quickly; herbal medicine is inferior.

Zhang Zihe said: A woman suffered from wind-epilepsy, contracted from convulsions due to fright since age six or seven. Later, she experienced one or two attacks every two to three years, escalating to five or six attacks every five to seven years. By age thirty to forty, she had daily attacks, even more than ten times a day. She became confused, forgetful, and sought death. During a great famine, she gathered wild herbs to eat. By the water, she saw a herb resembling green onion, which she gathered, boiled, and ate. At dawn (Wu Geng), she suddenly felt uneasy in her heart, vomiting phlegm like glue continuously for several days, totaling about one to two dou. She sweated profusely and felt extremely drowsy. Three days later, she felt lighter and healthier, appetite improved, and all pulses harmonized. Inquiring about the herb eaten, it was identified as Han Cong Miao (Wild Leek Sprout), which is Lili Lu (Veratrum Nigrum Rhizome) in Materia Medica.

Gong Zicai treated the son of Wang Dacan, aged eighteen, who suffered from epilepsy. Upon each attack, he would fall to the ground, vomit saliva, and lose consciousness, recovering after a short while. Attacks occurred once a month or four to five times every two months. This persisted for seven years without effect from various doctors. Pulse diagnosis revealed slippery and rapid pulses in all six positions, and a tight, full Renying (ST9) pulse. This indicated deficiency of qi and blood with accumulation of cold-phlegm. He prescribed Zhui Feng Qu Tan Wan (Wind-Chasing Phlegm-Expelling Pill) added with Ren Shen, Dang Gui, and Huang Lian (Coptis Rhizome) one liang each, to be taken concurrently with An Shen Wan (Spirit-Calming Pill). Within half a year, he recovered. Several subsequent patients were cured with similar treatment.

Feng Chuzhan treated the son of the Jin family, aged fourteen, suffering from epilepsy. Acupuncture and moxibustion by other doctors were ineffective. Subsequent treatments with phlegm-resolving and sedating methods only increased the frequency of attacks. Pulse diagnosis showed surging and wiry strength, but weakness in both Chi positions. This indicated extreme yin deficiency, unanchored solitary yang, flaming upward fire, leading to stiff collapse and other symptoms, which is logical. Do not phlegm-resolving and sedating methods further deplete the yin? Therefore, he instructed the patient to take warm light salt water on an empty stomach and swallow 4-5 qian of Jia Wei Ba Wei Wan (Modified Eight-Ingredient Rehmannia Pill) to anchor the true yang. However, without yin to anchor, how can yang remain stored? Without water to control fire, floating will inevitably occur. Subsequently, heavy and substantial yin-nourishing agents were used to assist the sealing and storing function, thus balancing water and fire. In the afternoon, a tonic paste pill regulating qi and blood, nourishing the heart, clearing the lungs, and harmonizing the liver was taken. After two months of regulation, spirit greatly improved, and epilepsy healed without specific anti-epileptic treatment. Formula for Jia Wei Ba Wei Wan: Da Shu Di (Prepared Rehmannia Root) one jin; use eight liang clear water to decoct, strain residue, then cook the remaining eight liang of Shu Di in the juice until soft and mash; add Huai Shan Yao four liang, stir-fried yellow; Mu Dan Pi (Moutan Bark) four liang, baked; Bai Fu Ling (Poria) three liang, mixed thoroughly with human milk, dried and baked; Shan Yu Rou (Cornus Fruit) four liang, mixed with wine, steamed, dried and baked; Ze Xie (Alisma Rhizome) two liang, mixed with light salt water, dried and stir-fried; Wu Wei Zi (Schisandra Berry) two liang, sliced individually with copper knife, mixed with honey-wine, steamed, dried and baked dry; Niu Xi (Achyranthes Root) three liang, stir-fried with light salt wine; Rou Gui (Cinnamon Bark) bark removed, 1.5 liang; Zhi Fu Zi (Prepared Aconite Root) 1.5 liang. Use Shu Di paste and refined honey to make pills, dried. Take 4 qian every morning on an empty stomach with light salt water, accompanied by decoction, to store yang and secure yin. Decoction Formula: Da Shu Di one liang, Dan Shen (Salvia Root) 1.5 qian, Mai Dong 3 qian, Sheng Bai Shao (Raw White Peony Root) 2 qian, Fu Ling 1.5 qian, Yuan Zhi boiled thoroughly with Licorice water 1.2 qian, Niu Xi 3 qian, Wu Wei Zi 0.6 qian, Deng Xin (Juncus Pith) ten roots, Lian Zi (Lotus Seed) ten grains. Decoct to 80% volume, take warm, after taking Ba Wei Wan. All yin-nourishing medicines must avoid hot administration; heat causes them to move to the yang aspect and fail to nourish yin; cold causes them to go directly to the intestines and fail to permeate the meridians. Paste Pill Formula: Suan Zao Ren (Ziziphus Seed) stir-fried and crushed, four liang; Gui Shen (Angelica Body) wine-fried, four liang; Shu Di eight liang; Cha Shi Hu (Dendrobium Stem) two liang; Bai Shao honey-water fried, three liang; Mai Dong stir-fried with millet, millet removed, three liang; Niu Xi three liang; Yuan Zhi Rou boiled thoroughly in strong Licorice juice, two liang. First, decoct Jian Lian (Sacred Lotus Seed) one jin to obtain over thirty bowls of thick liquid, strain residue. Add previous herbs, decoct first extraction, strain residue, and boil into paste. Add Ren Shen three liang and Bai Fu Ling four liang, each ground to fine powder, mix into paste to form large pills, each weighing 4 qian. Dissolve one pill in white tea water far from meals in the afternoon.

Yang Chengliu treated a Mr. Wen suffering from epilepsy. Every day at Zi hour (11 PM - 1 AM), he would stiffly collapse, limbs rigid, eyes staring straight, unable to speak, appearing dead. He would not revive until Wu hour (11 AM - 1 PM). Upon revival, speech and movement were normal, diet unchanged, with no other ailments. This continued for three years without exception, resisting all treatments. Yang observed dull complexion, fixed gaze, expressionless face, dark circles under eyes, and red tongue lacking coating. Pulse: Right Guan position deficient, large, and slippery; Right Cun position seemed scattered. Yang stated: This is not epilepsy, but Tan Jue (Phlegm Syncope), likely caused by fright. The Heart is the monarch; fright scatters Pericardium qi and injures Minister Fire, causing Spleen Earth to fail to generate, leading to central deficiency failing to control water, thus generating phlegm. Phlegm rises and falls with qi. Heaven and earth qi rise at Zi and descend at Wu; the human body is the same. At Zi hour, one yang arises, qi rises, and phlegm rises with it. Entering deficiency, it confuses the Pericardium, causing loss of consciousness and stiff collapse. At Wu hour, one yin arises, qi descends, and phlegm descends with it. The Pericardium becomes clear, the Mind is calm, and the body obeys. Inquiry revealed severe fright years prior. Now, fright led to damage, damage led to phlegm. Calming fright and resolving phlegm are useless. Only tonifying fire and nourishing the Pericardium to prevent qi scattering will stop phlegm from invading. As Minister Fire strengthens, it generates Earth to control water, and phlegm resolves itself. Yang Rong Tang (Nourish the Vigor Decoction) minus Yuan Zhi, Zao Ren, Wu Wei Zi, and Bai Shao was prescribed. One dose stopped the attack that night. Ten doses over five days resulted in peaceful sleep. The prescription was left upon departure. (Since the disease was chronic and deficient, this treatment was appropriate; otherwise, it would have trapped the phlegm.)

Xue Lizhai diagnosed the wife of Honglu Wang, who had a history of epilepsy triggered by labor and anger, recovering after a long time. One day, due to improper diet and labor, she attacked and remained unconscious for half a day, unable to speak. Some attributed it to wind invading the zang organs and prescribed wind-dispelling, phlegm-resolving, and qi-regulating agents along with Niu Huang Qing Xin Wan (Calomel and Bezoar Heart-Clearing Pill), worsening the condition. Six pulses were floating and large; both Cun positions were deficient and weak. She refused food. Xue stated: This is injury to Spleen and Stomach qi. If wind invaded the zang organs, disaster would follow instantly. The patient did not believe him, continued using wind-dispelling drugs, and subsequently died suddenly.

Liu Hongbi treated a girl just coming of age, who suddenly contracted a strange illness unrecognized by physicians. Upon examination, jaw clenched, limbs convulsed, eyes rolled up, attacking twice day and night. (Is this not epilepsy?) After recovery, abdominal pain, desire to vomit but unable, profuse cold sweat. (All caused by Liver Wood pathogen.) The pathogen was neither in the exterior nor interior, but between upper and lower; upper had heat, lower had cold, chest and stomach conflicted, cold and heat battled. Prescribed Huang Lian Tang (Coptis Decoction), symptoms gradually subsided. After a few more doses, she recovered completely. Coptis treats heat, Ginger treats cold, Gui Zhi and Ban Xia dispel wind and resolve phlegm, Ginseng, Jujube, and Licorice support the heart and harmonize the middle, establishing righteous qi and dispersing pathogenic qi, achieving precise efficacy.

Commentary: Epilepsy often stems from Liver pathology, complicated by phlegm-fire. In the formula, Ginger and Pinellia resolve phlegm; Coptis and Cinnamon calm the Liver; Licorice moderates the Liver and harmonizes the Spleen; Ginseng and Jujube tonify the Spleen and strengthen the Lung. When Lung qi is strong, Wood naturally balances. Liu’s success with this formula was justified. However, labeling it "strange phlegm" and citing "upper heat, lower cold" shows knowledge of the phenomenon but not the underlying mechanism. Many case records lack such theoretical depth, succeeding merely by chance matching of formula to symptom, leaving practitioners unaware of why they worked.