痫病宜虚，实急者恶。浮阳沉阴，滑痰数热。
痫之始发，卒然跌仆，手足牵掣，口噤作声，或吐沃沫痰涎。一饭顷，气平苏
醒。与癫、 二证，似是而非。癫证则如上文所云， 证则多身强直，如弓反张，
亦无痫证之作声也。然有阴阳二种，正如小儿之急惊、慢惊。阳痫先身热，螈 惊
啼而后发。其脉浮洪，病属六腑，外在肌肤，轻浅易治。（宜集验龙脑安神丸、河间犀角丸之类。）
阴痫身冷，不惊掣，不啼叫，卒然而发，略无先兆。其脉沉搏，病属五脏，内在骨
髓，深重难治。（宜清心牛黄丸、神应丹之类。）昔贤皆谓有痰有热，客于心胃之间，因闻大惊
而作。若热盛，虽不闻惊亦作。是谓先有痰热而后发痫也，恐未必然，总不如三因
之论为的。其论以惊动脏气不平，郁而生涎，闭塞诸经，厥而乃成。或在母腹受惊，
或感六气，或饮食不节，逆于脏气而成。盖忤气得之外，惊恐得之内，饮食得之属
不内外。所因不同，治法亦异。如惊者，安神丸以平之。挟痰者，三圣散以吐之。
挟火者，清神汤以凉之。可下者，即以承气汤下之。其脉总宜虚而不宜实。实则邪
盛。若实而急，是无胃气。唯强急而不柔和，凶恶之征也。浮则痫发于阳，沉则痫
发于阴，滑则痫发多痰，数则痫发多热。因病见脉，因脉知病，亦理之自然耳。
痫病的脉象应当表现为虚象，若脉象实而急迫则预后不良。浮脉主阳邪外越，沉脉主阴邪内伏，滑脉主痰湿，数脉主热盛。
痫病发作之初，患者突然跌倒，手足抽搐拘挛，牙关紧闭并发出叫声，或者呕吐大量泡沫状痰涎。大约一顿饭的功夫，气息平复后苏醒。这与癫证、痓证（痉挛强直之证）相似但本质不同。癫证如前文所述，痓证则多表现为身体强直僵硬，像弓一样反张，也没有痫病发作时发出的声音。
然而痫病又分为阴痫和阳痫两种，正如小儿的急惊风和慢惊风。阳痫发作前先有身体发热、抽搐惊啼等症状，随后发病。其脉象浮洪，病位属于六腑，病势在肌肤表层，病情轻浅容易治疗。（适宜使用集验龙脑安神丸、河间犀角丸之类的方剂。）
阴痫发作时身体寒冷，没有抽搐惊掣，也不啼叫，突然发作，毫无先兆。其脉象沉搏有力，病位属于五脏，病势深入骨髓，病情深重难以治疗。（适宜使用清心牛黄丸、神应丹之类的方剂。）
以前的医家都认为痫病是因为有痰有热，客居在心胃之间，因为受到大惊刺激而发作。如果热邪炽盛，即使没有听到惊吓也会发作。这被称为先有痰热而后引发痫病，恐怕未必如此，总不如“三因学说”的观点更为确切。三因学说认为，惊恐扰动脏腑之气使其不平，气机郁结而生成涎沫，闭塞诸条经脉，气机逆乱才形成痫病。这种病因可能是在母腹中受惊，或感受六淫邪气，或饮食不节制，导致气机逆乱于脏腑而成。大致上，忤逆之气得之于外，惊恐得之于内，饮食不当属于不内外因。由于致病原因不同，治疗方法也各异。如因惊所致，用安神丸来平定；兼夹痰浊者，用三圣散来催吐；兼夹火邪者，用清神汤来清热凉血；可以攻下的，就用承气汤来泻下。
痫病的脉象总体宜虚不宜实。脉实表示邪气盛。如果脉象实而且急迫，说明没有胃气。只有强劲急迫而不柔和，这是凶险恶毒的征象。脉浮表示痫病发于阳分，脉沉表示痫病发于阴分，脉滑表示痫病发作多伴有痰浊，脉数表示痫病发作多伴有热邪。根据病症发现脉象，通过脉象了解病情，这也是事理的自然规律罢了。
The pulse in epilepsy should be deficient; if it is excess and rapid, the prognosis is poor. A floating pulse indicates hyperactive Yang or external pathogenic factors; a deep pulse indicates internal Yin pathology; a slippery pulse indicates phlegm-dampness; and a rapid pulse indicates heat.
At the onset of an epileptic seizure, the patient suddenly falls, with spasms and convulsions of the hands and feet, lockjaw accompanied by vocalization, or vomiting of profuse frothy saliva and phlegm. After approximately the time it takes to eat one meal, the breath levels out, and the patient regains consciousness. This condition resembles but differs from Dian syndrome (mental disorder characterized by depression) and Chi syndrome (stiffness and convulsions). As described earlier, Dian syndrome presents differently, whereas Chi syndrome typically manifests as severe body rigidity, with the back arched like a bow, and lacks the vocalizations characteristic of epilepsy.
However, epilepsy is divided into two types: Yang Epilepsy and Yin Epilepsy, analogous to acute and chronic convulsive disorders in infants. In Yang Epilepsy, the patient first experiences fever, convulsions, and crying due to fright before the seizure occurs. The pulse is floating and surging (Hong), the disease involves the Six Fu Organs, the pathology is superficial in the skin and muscles, and the condition is mild, shallow, and easier to treat. (Formulas such as Jiyi Longnao Anshen Wan [Collected Experience Brain Camphor Calming Pill] or Hejian Xijiao Wan [He Jian's Rhinoceros Horn Pill] are appropriate.)
In Yin Epilepsy, the body is cold, there are no convulsions or crying, the onset is sudden without any prodromal symptoms, and the pulse is deep and forceful. The disease involves the Five Zang Organs, the pathology is deep within the bones and marrow, and the condition is severe, profound, and difficult to treat. (Formulas such as Qingxin Niuhuang Wan [Clear Heart Calculus Bovis Pill] or Shenying Dan [Divine Response Elixir] are appropriate.)
Ancient physicians generally believed that epilepsy arises from phlegm and heat lodging between the Heart and Stomach, triggered by sudden fright. If heat is excessive, seizures may occur even without auditory shock. This view suggests that phlegm-heat precedes the epilepsy, which may not necessarily be accurate. The theory of Three Causes (San Yin) is more precise. It posits that fright disturbs the Qi of the Zang organs, causing imbalance; Qi stagnation generates saliva/phlegm, which blocks the meridians, leading to counterflow of Qi and resulting in epilepsy. Etiology may include fright received in utero, invasion by the Six Exogenous Pathogens (Liu Qi), or irregular diet causing Qi counterflow in the Zang organs. Roughly speaking, adverse Qi comes from external sources, fright comes from internal emotional responses, and dietary issues belong to neither purely internal nor external causes. Since the etiologies differ, the treatment methods also vary. For cases caused by fright, Anshen Wan (Calming Spirit Pill) is used to pacify the mind; for cases complicated by phlegm, Sansheng San (Three Sages Powder) is used to induce vomiting; for cases complicated by fire, Qingshen Tang (Clear Spirit Decoction) is used to cool and clear heat; for cases requiring purgation, Chengqi Tang (Chengqi Decoction) is used to purge downward.
The pulse in epilepsy should generally be deficient rather than excess. An excess pulse indicates abundant pathogenic factors. If the pulse is both excess and rapid, it indicates the absence of Stomach Qi. A pulse that is merely strong and rigid without softness is a sign of ominous prognosis. A floating pulse indicates epilepsy originating in the Yang aspect; a deep pulse indicates epilepsy originating in the Yin aspect; a slippery pulse indicates epilepsy associated with abundant phlegm; and a rapid pulse indicates epilepsy associated with abundant heat. Observing the pulse based on the disease, and understanding the disease through the pulse, is a natural principle of medical logic.