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[Pulse] Sudden collapse and falling, with blood stasis internally and abdominal distension and fullness: if the pulse is firm and strong, survival is likely; if the pulse is small and weak, death is likely.

[Syndrome] Disease caused by blood stasis, or phlegm-saliva rising upwards.

[Treatment] Follow the treatment principles for Stroke syndrome (Zhong Feng). When evil blood returns inward and remains in the Liver meridian, causing hypochondriac pain and spontaneous sweating, the treatment should involve breaking blood stasis and promoting circulation.

Zhang's Commentary: Falls and trauma cause heart injury, leading to the rising of phlegm-saliva. Treatment should focus on tonification. Pain from beating, bruising, or sprains all belong to blood stagnation syndromes and can be treated with purgatives. Enduring pain damages the blood.

Shenying San (Miraculous Response Powder): Treats blood stasis with constipation.
Da Huang (Rhubarb Root and Rhizome, soaked in wine, 1 liang) Tao Ren (Peach Seed), Hong Hua (Safflower, 2 qian), Dang Gui (Angelica Sinensis Root, 3 qian), Gua Lou Gen (Trichosanthes Root, 2 qian), Pao Chuan Shan Jia (Prepared Pangolin Scales, 2 qian).
Chai Hu (Bupleurum Root, as a guiding herb), She Xiang (Musk, for penetration).
Take with hot wine.

Zijin Dan (Purple Gold Pill): Treats pain from bone fractures and joint injuries.
Pao Chuan Wu (Prepared Aconitum carmichaelii root lateralis), Pao Cao Wu (Prepared Aconitum kusnezoffii root, each 1 liang), Wu Ling Zhi (Trogopterus Dung, 5 qian), Mu Bie Zi (Momordica Seed, shelled), Hei Qian Niu (Black Morning Glory Seed, each 5 qian), Wei Ling Xian (Clematis Root), Jin Mao Gou Ji (Drynaria Rhizome), Gu Sui Bu (Drynaria fortunei Rhizome), Mo Yao (Myrrh), She Xiang (Musk), Hong Niang Zi (Lytta Beetle, each 2.5 qian), Di Long (Earthworm), Wu Yao (Lindera Root), Qing Pi (Aurantii Fructus Immaturus Pericarpium), Chen Pi (Citrus Reticulatae Pericarpium), Hui Xiang (Fennel Fruit, each 0.5 qian).
Fang Feng (Saposhnikovia Root), Zi Ran Tong (Pyrite, calcined and quenched, 4 liang), Yu Yu Liang (Hematite, calcined and quenched, 4 liang).
Make pills with vinegar paste, size of wu-tzu seeds. Take 10 pills with wine per dose.

Sansheng San (Three Holy Powders): Induce vomiting to treat phlegm obstruction.

[Pulse] If the pulse is floating, choppy, and rapid, survival is likely; if it is minute and fine, death is likely. If it is surging and large but slow, survival is also possible.

[Treatment Method] For conditions located in the upper body, induce vomiting.

Jiedu Wan (Detoxifying Pill): Treats poisoning from ingested toxic substances, saving lives from imminent death.
Ban Lan Gen (Isatis Root, dried, 4 liang), Guan Zhong (Cyrtomium Rhizome, 1 liang, cleaned), Qing Dai (Indigo Naturalis), Gan Cao (Licorice Root).
Make honey pills. Qing Dai should be of high quality.

Secret Formula: Xu Sui Zi (Euphorbia Lathyris Seed), Gan Cao (Licorice Root), Wu Wei Zi (Schisandra Fruit).
Take one or two bowls with clear tea decoction.

[Pulse] A large, firm, and rapid pulse indicates Dian disease (Manic-Depressive Disorder - Depression type). A large and slippery pulse indicates self-healing; a small, urgent, and solid pulse indicates death; picking at bedclothes (Xun Yi Feng) indicates death; a deficient and wiry-urgent pulse indicates death. A deficient and wiry pulse indicates Jing (Shock/Fright); a deep and rapid pulse indicates Tan Re (Phlegm-Heat).

[Etiology] Phlegm, Fire, Fright.

Blood and Qi are the spirit of the body. When the spirit declines and becomes deficient, pathogens enter. If both blood and qi are deficient, and phlegm lodges in the Middle Jiao, obstructing movement and transformation, the twelve organs lose their functions. The spirit’s hearing, speech, and movement become delusional and false. Vomiting should be induced to stabilize the condition.

When the Lung is affected by Fire, verbal confusion (Zhan Yu) occurs. The Lung governs all qi; when agitated by qi and transmitted fire, the patient may exhibit "seeking clothes and grasping at empty air" (Xun Yi Cuo Kong). Excessive heat in the Stomach steaming into the Heart and Lung can also cause verbal confusion. Medicines that descend fire should be used.

Fright disturbs the spirit, preventing blood from settling. Accumulated phlegm and stagnant heat confuse the mind as they move, leaving the Heart Spirit without control, resembling possession by evil spirits. First, induce vomiting, then primarily use Anshen Wan (Calming the Spirit Pill), assisted by herbs that calm the Liver, because the Gallbladder governs courage and fright.

[Syndrome Differentiation] Differentiation between Kuang Yan (Manic Speech), Zhan Yu (Verbal Confusion), and Zheng Sheng (Monotonous Repetition).

Kuang (Mania): Opening eyes and speaking to others about things never seen before is called Kuang.

Zhan Yu (Verbal Confusion): Closing eyes and talking to oneself about daily routine matters is called Zhan Yu.

Zheng Sheng (Monotonous Repetition): Weakness of body movement, lack of continuity in speech, words emerging from the throat is called Zheng Sheng.

Additionally, Blood Accumulation Syndrome presents with repetitive speech.

[Treatment] For Phlegm, induce vomiting using Sansheng San; for Fire, purge using Chengqi Tang; for Fright, calm using Anshen Wan.

General Formula: Huang Lian (Coptis Rhizome) and Chen Sha (Cinnabar) descend fire; Gua Lou (Trichosanthes Fruit), Nan Xing (Arisaema Cum Bile), and Ban Xia (Pinellia Tuber) resolve phlegm; Qing Dai (Indigo Naturalis), Chai Hu (Bupleurum Root), and Chuan Xiong (Ligusticum Rhizome) calm the Liver.

Taoren Chengqi Tang (Peach Kernel and Rheum Decoction): Treats heat entering the Blood Chamber causing mania.

Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction): Treats madness due to blood stasis. Caused by incomplete sweating or incomplete hematemesis/epistaxis, leaving blood stasis inside. Symptoms include yellow complexion, pale lips, black stool, weak legs, asthma, and severe cases of manic stupor.
Xi Jiao (Rhinoceros Horn, 1 liang) [Note: Substitute with Water Buffalo Horn in modern practice], Sheng Di Huang (Rehmannia Root, 8 liang), Bai Shao (White Peony Root, 3 liang), Mu Dan Pi (Moutan Cortex), Da Huang (Rhubarb Root and Rhizome, 2 liang).
If the pulse is large and slow, and the abdomen is not full, there is no heat; reduce the dosage. Decoct and take.

For various epilepsy attacks with mania presenting with Hong (Surging), Chang (Long), or Fu (Hidden) pulses, use Miao Xiang Wan (Wonderful Fragrance Pill) from the Bureau Formulas. Pierce a hole through the pill with a needle and administer with cold water.

For epilepsy associated with Xian (Wiry), Xi (Fine), or Huan (Slow) pulses, use Li Heshang’s Wusheng Wan (Five Life Pills).

Formula for Epilepsy: Huang Dan (Red Lead), Bai Fan (Alumen). Equal parts.
Grind finely, pass through a sieve heated by poplar wood fire, and make into pills.

Another Formula: Chuan Xiong (Ligusticum Rhizome, 2 liang), Fang Feng (Saposhnikovia Root, 1 liang), Zao Jiao (Gleditsia Sinensis Fruit), Yu Jin (Curcuma Radix, each 1 liang), Ming Fan (Alumen, 1 liang), Huang Gong (Yellow Centipede), Chi Gong (Red Centipede, each one).
Grind into fine powder, mix with steamed dough, make into wu-tzu sized pills. Take 15 pills on an empty stomach with clear tea.