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When epilepsy (Dian Ji, manic-depressive psychosis) first begins, the patient initially feels unhappy. (This indicates that the Shen [Spirit] is about to become disordered.) The head feels heavy and painful, and the eyes look upward with redness in the whites of the eyes. (This is due to Jue Qi [Rebellious Qi] moving upward.) When the condition becomes severe, the patient reaches a state of extreme agitation, followed by inner restlessness and vexation.

(This restlessness and inability to remain calm are signs that Dian Ji is about to manifest.) Observe the color changes on the face. (Yan refers to the forehead area; pathogenic colors must appear here.) Select points from the Hand-Taiyang Small Intestine Meridian (Zhi Zheng SI8, Xiao Hai SI81), Hand-Yangming Large Intestine Meridian (Pian Li LI6, Wen Liu LI7), and Hand-Taiyin Lung Meridian (Tai Yuan LU9, Lie Que LU7). Needling should continue until the blood changes color. (To drain pathogenic blood, needling must stop only after the blood color has changed.)

If, when Dian Ji first manifests, the patient pulls the corners of the mouth, cries out, pants, and experiences palpitations, observe the pulses of the Hand-Yangming Large Intestine and Hand-Taiyang Small Intestine meridians. (Points as mentioned previously.) If the left side is stiff, treat the right side; if the right side is stiff, treat the left side. Stop when the blood color changes. (Stiffness and rigidity with traction between left and right indicate the disease is mainly in the Luo [Collateral] vessels; therefore, the Mu Ci [Lateral Puncture] method is used.)

If, when Dian Ji first manifests, the patient first presents with opisthotonos (body arching backward) followed by spinal pain, observe the Foot-Taiyang Bladder Meridian (Wei Yang BL34, Fei Yang BL58, Pu Can BL60, Jin Men BL63), Foot-Yangming Stomach Meridian (Zu San Li ST36, Jie Xi ST41), Foot-Taiyin Spleen Meridian (Yin Bai SP1, Gong Sun SP4), and Hand-Taiyang Small Intestine Meridian (Zhi Zheng SI8, Xiao Hai SI81). Stop when the blood color changes.

In treating Dian Ji, the physician should reside with the patient frequently to observe and determine the appropriate points for treatment. When the disease strikes, observe the patient; if there is excess, apply draining methods. (Puncture to release blood.) Place the extracted blood in a gourd vessel. Wait until the next attack; observe if the blood in the vessel moves independently. If it does not move, moxa the Qiong Gu (Tailbone/Coccyx) for twenty moxa cones. Qiong Gu refers to the coccygeal bone. (A gourd vessel is called Hu Lu. If the blood in the gourd did not move during previous attacks, moxibustion may be performed.)

In cases of Bone Dian Ji, the teeth and all flesh spaces of the body are full/distended, bones protrude, sweating occurs, there is inner vexation, excessive vomiting of saliva/phlegm, and downward leakage of Qi. This is difficult to cure. (The pathogen is deep in the bone; the head, teeth, and muscle spaces are distended due to pathogenic congestion. The form is emaciated with only bones visible. Sweat exits externally while vexation remains internally, constituting a critical syndrome. If there is excessive vomiting of saliva and downward leakage of Qi, it indicates failure of both Spleen and Kidney, making it incurable.)

In cases of Sinew Dian Ji, the body is curled and spasmodic, and the pulses are tight and large. Puncture the major meridians at the neck, specifically Da Shu BL11. If there is excessive vomiting of saliva/phlegm and downward leakage of Qi, this is difficult to cure.

In cases of Pulse Dian Ji, the patient suddenly falls, and the pulses of the four limbs are full and flaccid. (Flaccidity refers to relaxation and weakness.) If the pulse channels are full, puncture all of them to release blood. (Fullness of the pulse channels requires puncturing to bleed.) If the pulse channels are not full, apply moxibustion. Moxa the Taiyang points along the neck (Tian Zhu BL10, Da Shu BL11), moxa the Dai Mai (Girdle Vessel) at the waist (Shaoyang meridian points), and the Ben Shu points in various muscle spaces. (All points in the muscle spaces of the meridians and the Shu points of the four limbs where distension and flaccidity occur should be selected.) If there is excessive vomiting of saliva/phlegm and downward leakage of Qi, this is difficult to cure.

If a Dian Ji patient exhibits symptoms like Kuang Bing (Mania) during an attack, it is a death sign and difficult to cure. (Dian originates from Yin, while Kuang originates from Yang. Yang is often in excess, so Kuang attacks without fixed timing and presents with acute/violent symptoms; Yin is often deficient, so Dian attacks with fixed timing and presents with quiet/sluggish symptoms. This distinguishes Dian from Kuang. Now, if Dian presents with Kuang-like symptoms, it indicates that Yang pathogens are extremely excessive and Yin essence is exhausted; thus, it leads to death and is incurable. ○ The above discusses Dian disease.)

When Kuang Bing (Mania) first begins, the patient initially feels self-sad. (This indicates deficiency of Shen.) They enjoy forgetting (Zhi [Will] is injured), suffer from anger (Liver overacting on Spleen), and fear easily (Blood is insufficient). These conditions arise from worry and hunger. (This damages Zang Qi.) Treatment involves selecting points from the Hand and Foot Taiyin and Yangming meridians. (Lung: Tai Yuan LU9, Lie Que LU7; Spleen: Yin Bai SP1, Gong Sun SP4; Large Intestine: Pian Li LI6, Wen Liu LI7; Stomach: Zu San Li ST36, Jie Xi ST41.) Stop when the blood color changes.

When Kuang Bing first manifests, the patient sleeps little, feels no hunger, considers themselves superior/worthy, claims to be wise/eloquent, and considers themselves noble. They curse others incessantly, day and night. Treatment involves selecting points from the Hand-Yangming, Hand-Taiyang, and Hand-Taiyin meridians. (Points as before.) Also select Lian Quan CV22 under the tongue and Shen Men HT7 of the Heart Meridian. Observe the vessels; if they are full, treat them. (Their blood vessels are abundant.) If not full, use manual techniques to gather Qi. (This applies to all treatments.)

Kuang patients speak in惊 (frightened tones), laugh excessively, enjoy singing/music, and walk wildly without stopping. This results from great fright. (Fright injures Zhi, causing the aforementioned symptoms.) Treatment involves selecting points from the Hand-Yangming, Hand-Taiyang, and Hand-Taiyin meridians. (Points as before.)

Kuang patients see things that are not there, hear sounds that are not there, and shout frequently. This is generated by Qi deficiency. (When Qi declines, Shen becomes confused, leading to hallucinations and shouting.) Treatment involves selecting points from the Hand-Taiyang, Hand-Taiyin, Hand-Yangming, and Foot-Taiyin meridians. (Points as before.) Also treat the temples on both sides of the head. (Meaning same as Bone Dian Ji.)

Kuang patients have increased appetite, see ghosts/spirits, and smile but do not express it outwardly. This results from excessive joy. (Seeing ghosts and smiling secretly are caused by injury to Shen.) Treatment involves selecting points from the Foot-Taiyin, Foot-Taiyang, and Foot-Yangming meridians, followed by the Hand-Taiyin, Hand-Taiyang, and Hand-Yangming meridians. (Points as before.)

For newly onset Kuang that has not yet presented with the symptoms described in the previous five sections, first select Qu Quan LR3 and the arterial pulses on both sides, and puncture any full vessels to bleed. After a while, if the illness ceases, stop; if not, treat according to the established methods. Moxa the Gu Feng (Bone Cleft/Chang Strong area) for twenty moxa cones. (If Kuang has just started and lacks the five sets of symptoms mentioned above, one should first select Qu Quan LR3 of the Foot-Jueyin Liver Meridian on both sides, puncture them, and bleed any full vessels in other meridians. The illness should resolve spontaneously. If it does not, follow the methods of the previous five sections to select points, and still moxa Chang Strong GV1 at the coccyx. The above discusses Kuang disease.)

Feng Ni (Wind Reversal): Wind affects the exterior, causing internal reversal of Jue Qi. There is sudden swelling of the four limbs, and the body shivers. (Skin and hair feel cold and chill.) There is occasional sobbing/choking and feeling cold. (Qi chokes, breathing draws in, and teeth chatter.) When hungry, there is irritability; when full, there is frequent change of condition. (Cold transformation. Commonly called "stomach qi discomfort".) Treatment involves selecting the Hand-Taiyin Lung Meridian and its interior-exterior pair, the Hand-Yangming Large Intestine Meridian, and the Foot-Shaoyin Kidney and Foot-Yangming Stomach meridians. For cold muscles, select Ying-Spring points (Yu Ji LU10, Er Jian LI2, Ran Gu KI2, Nei Ting ST44). For cold bones, select Jing-River points and Jing-Well points (Shao Shang LU11, Jing Qu LU8, Shang Yang LI1, Yang Xi LI5, Yong Quan KI1, Fu Liu KI7, Li Dui ST45, Jie Xi ST41).

Jue Ni (Reversal Cold/Heat) as a disease presents with sudden coldness of the feet, a sensation that the chest is about to split, and intestinal pain as if cut by a knife (Agony/Pain). There is vexation and inability to eat. (Qi rebels in the middle jiao.) If the body is warm, select Foot-Shaoyin Kidney points (Ma Zhu notes: Zhu Bin LR5). If the body is cold, select Foot-Yangming Stomach points. Cold requires tonification; warmth requires sedation. (Zhang Jingyue states: For Foot-Shaoyin, use Yong Quan KI1 and Ran Gu KI2; for Foot-Yangming, use Li Dui ST45, Nei Ting ST44, and Feng Long ST40; all treat Jue Ni.)

Jue Ni causing abdominal fullness, borborygmus, chest fullness, and difficulty breathing requires selecting points in the lower chest and bilateral hypochondrium, specifically those points where hand movement accompanies coughing. (Qi Men LR14 and Zhang Men LR13 of the Foot-Jueyin Liver Meridian.) Also select corresponding points on the back that feel comfortable when pressed. (Also select Fei Shu BL13 and Ge Shu BL17 of the Foot-Taiyang Bladder Meridian. ○ The above discusses Jue Ni disease.)

Internal closure preventing excretion. (Disease is in the Water Zang.) Puncture Foot-Shaoyin Kidney (Yong Quan KI1, Zhu Bin LR5) and Foot-Taiyang Bladder (Wei Yang BL34, Fei Yang BL58, Pu Can BL60, Jin Men BL63, etc.), and the Chang Qiang GV1 point on the Du Meridian using a long needle. (Long needle is the eighth type of needle; meaning is unclear.)

For Qi rebellion, select Hand-Taiyin Lung (Yin Bai SP1, Gong Sun SP4 - *Note: Text error in source likely meant LU points or Spleen/Stomach context, but text says Hand Taiyin/Yangming/Jueyin*), Hand-Yangming Stomach (Zu San Li ST36, Jie Xi ST41), and Foot-Jueyin Liver (Qi Men LR14, Zhang Men LR13). For severe cases, select the active pulses of the Foot-Shaoyin Kidney and Foot-Yangming Stomach meridians. (This means observing the diseased meridian and puncturing it.)

Shortness of Qi, body shivering, and weak speech. (Qi is timid/weak.) Bone soreness, heavy body, lethargy, and inability to move require tonifying Foot-Shaoyin Kidney. (These are all due to Essence deficiency failing to transform Qi; puncture Fu Liu KI7.) Shortness of Qi, short/discontinuous breathing, and exhaustion of Qi upon movement require tonifying Foot-Shaoyin Kidney and removing blood stasis. (Needling is as above, but if blood vessels/stasis are present, they should be removed. ○ The above discusses Jue Ni accompanying symptoms. The last two sections belong to Qi deficiency. Not tonifying Hand-Taiyin Lung but tonifying Foot-Shaoyin Kidney is because Yang roots in Yin, and Qi transforms from Essence. Treatment must seek the root; this illustrates that the principles of acupuncture and herbal medicine are the same.)