脉
脉虚弦,为惊,为风痫。
证
夫痫者,有五等而类五畜,以应五脏。发则卒然倒仆,口眼相引,手足搐搦,背脊强直,口吐涎沫,声类畜
叫,食顷乃苏。原其所由,或因七情之气郁结,或为六淫之邪所干,或因受大惊恐,神
气不守,或自幼受惊感触而成。皆是痰迷心窍,如痴如愚。
治
治之不须分五,俱宜豁痰顺气,清火平肝,而以黄连、栝蒌、南星、半夏之类,寻火寻痰,分多分少治之,
无有不愈。有热者,以凉药清其心;有痰,必用吐法,吐后用东垣安神丸,及平肝之药青黛、柴胡、川芎之类。
方
清心温胆汤(云林制) 平肝解郁,清火化痰,益心生血。
陈皮(一钱) 半夏(制,一钱) 茯苓(一钱) 枳实(一钱) 竹茹(一钱) 白术
(炒,一钱) 石菖蒲(一钱) 黄连(姜汁炒,一钱) 白芍(炒,一钱) 当归(酒洗,一钱
)香附(炒,一钱) 麦门冬(去心,八分) 川芎(六分) 人参(六分) 远志(六分) 甘草(四分)
上锉一剂,生姜煎服。
育魂丹(杜御史方)〔批〕(按此治痫攻补兼施之剂) 治一切惊痫、癫邪等症。
胆星(六钱) 半夏(制,六钱) 茯神(六钱) 黄连(炒,六钱) 远志(水泡,六钱)
白术(炒,六钱) 枣仁(炒,六钱) 柏子仁(炒,六钱) 干山药(一两) 竹茹(五钱)
白附(煨,五钱) 天麻(酒洗,五钱) 陈皮(三钱) 全蝎(三钱二分) 川芎(五钱) 犀
角(镑,三钱五分) 枳实(炒,一钱) 辰砂(二钱二分) 牛黄(二钱二分) 羚羊角(三钱
五分) 白矾(生用,三钱) 麝香(一钱) 飞金(二十四帖)
上为细末,竹沥打甘草膏为丸,如芡实大。每服,空心淡姜汤送下,或用薄荷汤调下。
加减寿星汤(吴都堂传) 治痫症。
南星(四两,胆制) 半夏(二两) 防风(一两) 荆芥(七钱) 天麻(一两)皂荚
(一两) 香附(一两) 青皮(一两) 猪苓(一两) 泽泻(一两) 赤茯苓(一两) 白茯神
(一两) 白术(一两) 细辛(七钱) 麦门冬(一两)
上锉,每剂一两,姜水煎服。
清神丹(秘方) 治症同前。
石菖蒲(去毛,二两) 辰砂(六钱,研细,水飞过,以一半为衣)
上为末,猪心血打面糊为丸,如桐子大。每服七八十丸,空心白汤送下,服前育魂丹除根。
壮胆星朱丹(太医院传)
朱砂(一两,水飞) 胆星(二两) 石菖蒲(二两) 牛黄(五钱) 麝香(五分) 猪
心(七具,用血)
上为细末,竹沥、猪心血和丸,如梧桐子大。每服七八十丸,空心白汤送下。
丑宝丸(太医院传)〔批〕(按此方治痫专攻之剂) 祛风清火,顺气豁痰,
益志除惊,安魂定魄。一切怔忡痫 ,难状之疾,并皆调治。
牛黄(五钱) 琥珀(一钱) 辰砂(一钱,为衣) 雄黄(一钱) 胆星(一两) 礞石
(五钱,火 ) 沉香(一钱五分) 犀角(一钱五分) 黄芩(二两,炒) 大黄(二两,酒蒸)
天麻(五钱,姜炒) 石菖蒲(一两) 僵蚕(七钱,姜炒) 蝉蜕(五钱,去足) 猪心(二具,用血)
上为末,竹沥、猪心血和丸,如绿豆大。每服六七十丸,临卧薄荷汤下。
证候
所谓痫病,分为五种类型,分别类比五种动物,以对应五脏。发作时突然昏倒,口眼歪斜牵引,手足抽搐痉挛,背部和脊柱强直僵硬,口中吐出涎沫,发出的声音类似牲畜叫声,约一顿饭的时间后苏醒。追溯其病因,或因七情之气郁结,或被六淫邪气所侵扰,或因遭受巨大惊恐,导致神气不能守舍,或自幼受惊感触而形成。这些病症都是由于痰迷心窍,患者表现为痴呆愚钝的样子。
治法
治疗时不必区分五种类型,都适宜使用豁痰顺气、清火平肝的方法,选用黄连、栝蒌、南星、半夏等药物,根据火与痰的多少进行辨证施治,没有不痊愈的。有热象的,用凉药清心;有痰浊的,必须使用吐法,吐法之后服用东垣安神丸,以及青黛、柴胡、川芎等平肝药物。
方剂
清心温胆汤(云林制):具有平肝解郁、清火化痰、益心生血的功效。
陈皮(一钱)、半夏(制,一钱)、茯苓(一钱)、枳实(一钱)、竹茹(一钱)、白术(炒,一钱)、石菖蒲(一钱)、黄连(姜汁炒,一钱)、白芍(炒,一钱)、当归(酒洗,一钱)、香附(炒,一钱)、麦门冬(去心,八分)、川芎(六分)、人参(六分)、远志(六分)、甘草(四分)。
以上药材锉碎为一剂,加生姜煎服。
育魂丹(杜御史方)〔批注〕(按:这是治疗痫病攻补兼施的方剂):治疗各种惊痫、癫邪等症状。
胆星(六钱)、半夏(制,六钱)、茯神(六钱)、黄连(炒,六钱)、远志(水泡,六钱)、白术(炒,六钱)、枣仁(炒,六钱)、柏子仁(炒,六钱)、干山药(一两)、竹茹(五钱)、白附子(煨,五钱)、天麻(酒洗,五钱)、陈皮(三钱)、全蝎(三钱二分)、川芎(五钱)、犀角(镑,三钱五分)、枳实(炒,一钱)、辰砂(二钱二分)、牛黄(二钱二分)、羚羊角(三钱五分)、白矾(生用,三钱)、麝香(一钱)、飞金(二十四帖)。
以上研为细末,用竹沥调和甘草膏制成丸药,大小如芡实。每次服用,空腹时用淡姜汤送下,或用薄荷汤调服。
加减寿星汤(吴都堂传):治疗痫症。
南星(四两,胆制)、半夏(二两)、防风(一两)、荆芥(七钱)、天麻(一两)、皂荚(一两)、香附(一两)、青皮(一两)、猪苓(一两)、泽泻(一两)、赤茯苓(一两)、白茯神(一两)、白术(一两)、细辛(七钱)、麦门冬(一两)。
以上锉碎,每剂取一两,加姜水煎服。
清神丹(秘方):治疗症状同前。
石菖蒲(去毛,二两)、辰砂(六钱,研细,水飞过,取一半作为丸衣)。
以上研为细末,用猪心血调和面糊制成丸药,大小如梧桐子。每次服用七八十丸,空腹时用白开水送下,服用此方可配合前面的育魂丹以除根。
壮胆星朱丹(太医院传)
朱砂(一两,水飞)、胆星(二两)、石菖蒲(二两)、牛黄(五钱)、麝香(五分)、猪心(七具,取血)。
以上研为细末,用竹沥和猪心血和匀制成丸药,大小如梧桐子。每次服用七八十丸,空腹时用白开水送下。
丑宝丸(太医院传)〔批注〕(按:此方是专于攻逐痫病的方剂):祛风清火,顺气豁痰,益智除惊,安魂定魄。一切怔忡、痫病等难以形容的疾病,均可调理治疗。
牛黄(五钱)、琥珀(一钱)、辰砂(一钱,作为丸衣)、雄黄(一钱)、胆星(一两)、礞石(五钱,火煅)、沉香(一钱五分)、犀角(一钱五分)、黄芩(二两,炒)、大黄(二两,酒蒸)、天麻(五钱,姜炒)、石菖蒲(一两)、僵蚕(七钱,姜炒)、蝉蜕(五钱,去足)、猪心(二具,取血)。
以上研为细末,用竹沥和猪心血和匀制成丸药,大小如绿豆。每次服用六七十丸,临睡前用薄荷汤送下。
Pulse
A deficiency and wiry pulse indicates fright and wind epilepsy.
Symptoms
Epilepsy is divided into five categories, corresponding to five animals and the five Zang organs. Upon onset, the patient suddenly collapses, with mouth and eyes deviated and pulling, hands and feet twitching and convulsing, back and spine stiff and rigid, foaming at the mouth, and emitting sounds resembling animal calls. After approximately the time it takes to eat a meal, the patient regains consciousness. Tracing the etiology, it may result from the stagnation of Qi due to the Seven Emotions, invasion by the Six Exogenous Pathogens, severe fright causing the Shen (Spirit) to lose its residence, or early childhood exposure to fright. These conditions are all caused by Phlegm confusing the Heart orifices, presenting as if in a state of dementia or foolishness.
Treatment
Treatment does not require differentiation among the five types; all should be treated with methods to resolve Phlegm, regulate Qi, clear Fire, and calm the Liver. Herbs such as Huanglian (Coptidis Rhizoma), Gualou (Trichosanthis Fructus), Nanxing (Arisaematis Rhizoma cum Bile), and Banxia (Pinelliae Rhizoma) should be selected to treat based on the degree of Fire and Phlegm. There is no case that will not heal. For those with Heat, cool herbs should be used to clear the Heart; for those with Phlegm, emetic therapy must be employed, followed by Dongyuan Anshen Wan and liver-calming herbs such as Qingdai (Indigo Naturalis), Chaihu (Bupleuri Radix), and Chuanxiong (Ligustici Chuanxiong Rhizoma).
Formulas
Qingxin Wendan Tang (Prepared by Yunlin): Calms the Liver, resolves depression, clears Fire, transforms Phlegm, benefits the Heart, and generates Blood.
Chenpi (Tangerine Peel, 1 qian), Banxia (Pinelliae Rhizoma, processed, 1 qian), Fuling (Poria, 1 qian), Zhishi (Immature Bitter Orange, 1 qian), Zhuru (Bamboo Shavings, 1 qian), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried, 1 qian), Shichangpu (Acori Tatarinowii Rhizoma, 1 qian), Huanglian (Coptidis Rhizoma, stir-fried with Ginger Juice, 1 qian), Baishao (Paeoniae Radix Alba, stir-fried, 1 qian), Danggui (Angelicae Sinensis Radix, washed with Wine, 1 qian), Xiangfu (Cyperi Rhizoma, stir-fried, 1 qian), Maimendong (Ophiopogonis Radix, heart removed, 8 fen), Chuanxiong (Ligustici Chuanxiong Rhizoma, 6 fen), Renshen (Ginseng Radix et Rhizoma, 6 fen), Yuanzhi (Polygalae Radix, 6 fen), Gancao (Licorice Root, 4 fen).
Decoct these ingredients as one dose with fresh ginger.
Yuhun Dan (Formula from Censor Du) [Commentary: This is a formula for treating epilepsy that combines purgative and tonifying actions]: Treats all types of fright epilepsy, mania, and related disorders.
Danxing (Arisaematis Rhizoma cum Bile, 6 qian), Banxia (Pinelliae Rhizoma, processed, 6 qian), Fushen (Poria with Hostwood, 6 qian), Huanglian (Coptidis Rhizoma, stir-fried, 6 qian), Yuanzhi (Polygalae Radix, soaked in water, 6 qian), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried, 6 qian), Zaoren (Ziziphi Spinosomi Semen, stir-fried, 6 qian), Baiziren (Platycladi Semen, stir-fried, 6 qian), Dry Yam (Dioscoreae Rhizoma, 1 liang), Zhuru (Bamboo Shavings, 5 qian), Baifu (Typhonii Rhizoma, roasted, 5 qian), Tianma (Gastrodiae Rhizoma, washed with wine, 5 qian), Chenpi (Tangerine Peel, 3 qian), Quanxie (Scorpio, 3 qian 2 fen), Chuanxiong (Ligustici Chuanxiong Rhizoma, 5 qian), Xijiao (Rhinocerotis Cornu, shaved, 3 qian 5 fen), Zhishi (Immature Bitter Orange, stir-fried, 1 qian), Chensha (Cinnabar, 2 qian 2 fen), Niuhuang (Calculus Bovis, 2 qian 2 fen), Lingyangjiao (Saiga Tataricae Cornu, 3 qian 5 fen), Baijian (Alumen, raw, 3 qian), Shexiang (Musk, 1 qian), Feijin (Gold Leaf, 24 sheets).
Grind into fine powder. Use Zhu Li (Bamboo Sap) to mix with Gancao paste to form pills the size of Euryale Seed (Qianshi). Take orally on an empty stomach with light Ginger Decoction, or mixed with Mint Decoction.
Jiajian Shouxing Tang (Passed down by Wudutang): Treats epilepsy.
Nanxing (Arisaematis Rhizoma, 4 liang, prepared with Gallbladder), Banxia (Pinelliae Rhizoma, 2 liang), Fangfeng (Saposhnikoviae Radix, 1 liang), Jingjie (Schizonepetae Spica, 7 qian), Tianma (Gastrodiae Rhizoma, 1 liang), Zhaojiao (Stemonitis Rhizoma, 1 liang), Xiangfu (Cyperi Rhizoma, 1 liang), Qingpi (Citri Reticulatae Pericarpium Viride, 1 liang), Zhuling (Polyporus, 1 liang), Zexie (Alismatis Rhizoma, 1 liang), Chi Fuling (Poria with Red Coir, 1 liang), Bai Fushen (Poria with Hostwood, 1 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 liang), Xixin (Asari Radix et Rhizoma, 7 qian), Maimendong (Ophiopogonis Radix, 1 liang).
Cut into pieces. Decoct 1 liang per dose in water with ginger.
Qingshen Dan (Secret Formula): Treats symptoms identical to the above.
Shichangpu (Acori Tatarinowii Rhizoma, hairs removed, 2 liang), Chensha (Cinnabar, 6 qian, ground finely, washed with water; use half as coating).
Grind into powder. Use Pig Heart Blood to mix with flour paste to form pills the size of Sophora Seed. Take 70-80 pills orally on an empty stomach with plain warm water. Taking this can eradicate the root when combined with the preceding Yuhun Dan.
Zhuangdan Xingzhu Dan (Passed down from the Imperial Medical Bureau)
Zhusha (Cinnabar, 1 liang, washed with water), Danxing (Arisaematis Rhizoma cum Bile, 2 liang), Shichangpu (Acori Tatarinowii Rhizoma, 2 liang), Niuhuang (Calculus Bovis, 5 qian), Shexiang (Musk, 5 fen), Pig Heart (7 units, using blood).
Grind into fine powder. Mix with Bamboo Sap and Pig Heart Blood to form pills the size of Sophora Seed. Take 70-80 pills orally on an empty stomach with plain warm water.
Choubao Wan (Passed down from the Imperial Medical Bureau) [Commentary: This is a formula specifically for attacking epilepsy]: Disperses Wind, clears Fire, regulates Qi, resolves Phlegm, benefits intelligence, removes fright, calms the Soul, and stabilizes the Po. It treats all difficult-to-describe conditions such as palpitations and epilepsy.
Niuhuang (Calculus Bovis, 5 qian), Hupo (Amber, 1 qian), Chensha (Cinnabar, 1 qian, for coating), Xionghuang (Realgar, 1 qian), Danxing (Arisaematis Rhizoma cum Bile, 1 liang), Mengshi (Calcareous Schist, 5 qian, calcined), Chenxiang (Aquilaria Lignum Resinatum, 1 qian 5 fen), Xijiao (Rhinocerotis Cornu, 1 qian 5 fen), Huangqin (Scutellariae Radix, 2 liang, stir-fried), Dahuang (Rhei Radix et Rhizoma, 2 liang, steamed with wine), Tianma (Gastrodiae Rhizoma, 5 qian, stir-fried with ginger), Shichangpu (Acori Tatarinowii Rhizoma, 1 liang), Jiangcan (Bombyx Batryticatus, 7 qian, stir-fried with ginger), Chantui (Cicadae Periostracum, 5 qian, legs removed), Pig Heart (2 units, using blood).
Grind into powder. Mix with Bamboo Sap and Pig Heart Blood to form pills the size of Mung Bean. Take 60-70 pills before bedtime with Mint Decoction.