痫虽有七种，历治惟从阴阳二痫治之为验。
一痫即死，切牙抽掣，痰壅喉内，不省人事
，在日发者为阳痫。面色光泽，病在六腑、肌表，如拿不醒，必灸肺俞各穴三壮，即用天保
采薇汤等分各一钱，连服二、三剂，自愈。
一痫初发，身无烧热，手足青冷，口噤惊啼，吐舌摇头，是为阴痫。面色黯晦或从夜发
，病在五脏、骨髓，此最难治，宜用固真汤加南星。
夏禹铸曰∶其症先有烧热，一痫而死，拿之即苏，汗出稍定，汗止又发，此乃阳疟兼阳
痫也。疟是本病，痫是标症。急则治标，先用天保采薇汤表散，倍加半夏三钱，连服二三
剂，再服清脾饮一二剂，标本俱清，即愈。
病皆因风湿而成，湿乃本而风则标。若面目赤色，无汗恶寒，牙关紧急，一身强硬，痰
涎壅盛，小便赤涩，一发终日不苏，先有谵语，名曰刚 。乃风性刚急，症属于风是也，治
宜小续命汤去附子。若四肢厥冷，有汗，不恶寒，大便滑泻，不渴不语，名曰柔 。是湿
性温和，症属于湿也，亦用小续命汤，去麻黄。
症如痰壅气盛，加南星、半夏、白茯以清痰，枳壳、陈皮、紫苏以顺气。内热便秘，用
承气汤以下之，柔 用附子理中汤以温之，六君子汤以补之。如缠绵不已则难治也。如病久而
复手足抽挛，如角弓反张，此乃血枯不能养筋，治用四物汤加附子、防风、羌活，切不可作
惊痫治，恐误则殒命矣。
余外孙与内侄孙兼患热疟，见之甚真，老妻见服清脾饮二剂不愈曰∶世上有此疟疾，
敢是老眼昏花错认了。余曰∶能挨至四剂自愈，果验。内侄孙亦以清脾饮方授，持归不服
，作别症医，病益甚，又来。强余往视，余怒极，老妻慰之行。一到仍检清脾饮二剂命服之。
余老友方桓绥讶曰∶有此奇症就有此奇医。俱随命服六君子汤三剂以防去路。此热疟认症既
真，不听阻挠之一验也。
乌沙夹邑庠程灼公子九岁时得病请余往治，群医在座，抱儿出，两手挑破筋肉，脓血淋
漓惨不忍见，每日夜抽掣数十余回，壮热不退。余戏问曰∶如此一症诸位填门治胡不愈，愿
闻各用之药。有以竹沥坠痰言者，有以牛黄镇惊丸言者，有以天麻、钩藤定惊言者，有归咎
于挑筋用火之为害者。余不禁掩口。胡卢此症君辈不知也。交口请以症示，曰∶此阳疟兼阳痫
也，如此治法症有万千吾不知从何处说起。中一人问曰∶先生认法得自何书。余曰∶唐许允
宗有曰，医者意也，思精则得之，自我作祖何书之有。众皆默然。用天保采薇汤各一钱五分
，半夏倍之，共三两许，一服抽定，烧热减半，随用清脾饮一剂，全愈。与诸医解座。此挑
筋无济望色通神之一验也。
邻邑石埭沈苍锡，年五十余，仅外家出一子方二岁，患病请救于余，即拿精威二穴，了不
出声，通身烧热，面白虽惨，宝色内存，皮不轻浮光溜，据面色不应无声。据无声却犯死症。因
问前可医过否。沈曰∶初起时蒙邻妪挑筋两次，又别请拿推数次，昨有人将桃柳柔枝遍身推
括，晚便无声矣。余揣病久肺气已虚，屡致惨哭气丧，丧气以致无声，惟照色用剂。以天保
采薇汤外加冬花一钱，薄暮煎服，夜半热退。此热疟兼痫望色审声之一验也。
徐圣绪子患惊痫不省人事约五六日，缘乃伯措，大伯孚曾与余同砚。席邀治。精威二穴，
拿之无声即向肺俞重揉，声虽不出却有累累贯珠挣不出来模样，灸肺俞各三壮，用天保采
薇汤倍加半夏，单向大方脉素与余友善徐仲石处检药，对圣绪云∶在禹铸人信砒霜俱用得，
然好也是这一服，不好也是这一服。余临别云∶服此一剂，鸡鸣便退烧热。果如期热退，二
服全愈。此阳痫已死揉肺俞探肺窍之一验也。
庠友张孔迩婿邑庠王绍宗年可二十余岁，一时痫死不知人事约半月余，他医纯用连芩之
剂毫不见瘳，邀余看治。余以症属大方脉，固辞。孔迩力迫之行，一见颜色便知痰患，拿精
威二穴不应，于老龙穴一掐直视乎余，有哄哄若瓮里音，用半夏四钱，桔梗二钱，枳壳、
防风、甘草各一钱，一剂稍苏，五剂全愈。足见肺虽无声非金碎，何不可药。此中痰望形审
窍大小皆同之一验也。
竹塘陈讳春者一子十一岁，患病十余日不省人事，初人见其不醒以为惊死，于鞋带穴人
中掐咬，破烂不堪，请余往治。见其唇口晦色如酱，不抽不掣不渴，肢冷如冰，治用灯火十
五元宵，随服小续命汤去麻黄一剂，即苏。此望色审窍而知为柔 之一验也。
癫痫虽然分为七种，但历代治疗都只从阳痫和阴痫两方面入手，这样才有效。
有一种情况是发作一次即死，表现为咬牙、肢体抽搐，喉间痰液壅塞，神志不清不省人事。如果在白天发作的，称为阳痫。患者面色光泽，病位在六腑和肌表。如果像昏迷一样叫不醒，必须艾灸肺俞穴各三壮（艾炷），随即服用天保采薇汤，每味药各一钱，连续服用两到三剂，即可自愈。
另一种情况是刚发作时，身体没有高热，手足青紫发冷，牙关紧闭、受惊啼哭，吐舌摇头，这称为阴痫。患者面色晦暗无光，或者在夜间发作，病位在五脏和骨髓，这是最难治的，适宜使用固真汤加入天南星。
夏禹铸说：这种病症先有高热，发作一次就导致死亡或类似死亡状态，掐捏刺激后能苏醒，出汗后症状稍定，汗止后又再次发作，这是阳疟兼阳痫。疟疾是本病，癫痫是标症。急则治其标，先用天保采薇汤解表散邪，加倍加入半夏三钱，连续服用两到三剂，再服用清脾饮一两剂，标本同治，即可痊愈。
这类疾病都是由风湿引起的，湿邪是本，风邪是标。如果面目发红，无汗怕冷，牙关紧急，全身僵硬，痰涎壅盛，小便赤涩，一旦发作整天不能苏醒，发作前有胡言乱语，称为“刚痓”（注：原文此处缺字，根据语境及下文“柔痓”推断为刚痓）。这是风性刚急，病症属于风，治疗适宜用小续命汤去掉附子。如果四肢厥冷，有汗，不怕冷，大便滑泻，不口渴不说话，称为“柔痓”。这是湿性温和，病症属于湿，也使用小续命汤，去掉麻黄。
如果症状如痰壅气盛，加入天南星、半夏、白茯苓以清除痰浊，枳壳、陈皮、紫苏以顺气。如果有内热便秘，用承气汤来攻下；柔痓用附子理中汤来温补，用六君子汤来益气健脾。如果病情缠绵不愈就很难治疗了。如果患病日久又出现手足抽搐挛急，像角弓反张一样，这是因为血枯不能滋养筋脉，治疗用四物汤加入附子、防风、羌活，切不可当作惊痫来治，恐怕误治会导致死亡。
我的外孙和内侄孙同时患有热疟，我看得非常真切。老伴看到服用清脾饮两剂后没好，说：“世上哪有这种疟疾？敢是我老眼昏花认错了。”我说：“能坚持服到四剂就会自愈。”果然验证了。内侄孙也拿着清脾饮的方子回去不服，当作其他病症医治，病情加重，又来找我们。强行请我去诊治，我非常生气，老伴安慰并劝我前往。一到那里，我仍然开出清脾饮两剂命令服用。我的老友方桓绥惊讶地说：“有这样的奇症就有这样的奇医。”大家都听从命令服用六君子汤三剂以防复发。这是热疟诊断准确、不听阻挠的一个验证。
乌沙夹县学的程灼公子九岁时生病，请我去诊治。众医生在场，抱着孩子出来，两手挑破筋肉，脓血淋漓，惨不忍睹，每天夜里抽搐几十次，高热不退。我开玩笑问：“这样一个病症，各位医生登门治疗为何不好？希望听听你们用的什么药。”有人说用竹沥坠痰，有人说用牛黄镇惊丸，有人说用天麻、钩藤定惊，有人归咎于挑筋用火造成的危害。我不禁掩口而笑。葫芦（指不明真相）啊，这个病症你们不知道。大家交口请求展示病症，我说：“这是阳疟兼阳痫，如此治疗方法，病症万千，我不知道从何说起。”其中一人问：“先生诊断方法得自哪本书？”我说：“唐代许允宗说过，医者意也，思考精微就能得到，我自己开创祖法，有什么书可参考呢？”众人都沉默了。我用天保采薇汤各一钱五分，半夏加倍，共约三两，一服后抽搐停止，高热减半，随后用清脾饮一剂，完全痊愈。向各位医生解释了解除座位的原因。这是挑筋无用、望色通神的一个验证。
邻县石埭的沈苍锡，五十多岁，仅在外家有一个儿子才两岁，患病向我求救。我立即掐拿精威二穴，孩子一点声音不出，全身发热，面色虽惨白，但宝色（生机）尚存，皮肤不轻浮光亮，根据面色本不应无声。根据无声却犯了死症。于是询问之前是否医治过。沈说：“初起时蒙邻居老妇人挑筋两次，又另外请人推拿数次，昨天有人用桃柳柔枝遍身推刮，晚上就没有声音了。”我推测病久肺气已虚，多次导致惨哭气丧，丧气导致无声，只有根据面色用药。用天保采薇汤外加冬花一钱，傍晚煎服，半夜热退。这是热疟兼痫望色审声的一个验证。
徐圣绪的儿子患惊痫，不省人事大约五六天，因为他的伯父措、大伯孚曾与我同窗。宴席上邀请诊治。掐拿精威二穴，孩子没有声音，随即重揉肺俞穴，声音虽然出不来，却有累累贯珠挣扎出来的样子，艾灸肺俞穴各三壮，用天保采薇汤加倍加入半夏，独自去大方脉素与我友善的徐仲石处取药，对圣绪说：“在禹铸这里，信得过，砒霜都用得，但这副药，好也是这一服，不好也是这一服。”我临别时说：“服用这一剂，鸡鸣时分就会退热。”果然如期热退，两剂后完全痊愈。这是阳痫已死揉肺俞探肺窍的一个验证。
县学朋友张孔迩的女婿、县学生王绍宗，年龄二十多岁，一时痫死不知人事大约半个月，其他医生纯用黄连、黄芩的药剂毫无效果，邀请我去诊治。我以病症属于成人科（大方脉）为由，坚决推辞。孔迩极力强迫我去，一见脸色便知是痰患，掐拿精威二穴无效，在老龙穴一掐，直视着我，发出嗡嗡若瓮里的声音，用半夏四钱，桔梗二钱，枳壳、防风、甘草各一钱，一剂稍苏醒，五剂完全痊愈。足见肺虽无声并非金碎（肺气绝），怎么不可以用药治疗。这是中痰望形审窍大小皆同的一个验证。
竹塘陈讳春的一个儿子十一岁，患病十多天不省人事，起初别人见他醒来以为是惊死，在鞋带穴和人中穴掐咬，破烂不堪，请我去诊治。见他唇口晦暗如酱色，不抽不掣不渴，四肢冰冷如冰，治疗用灯火灸十五元宵（注：此处疑为特定灸法或数量描述，直译为灯火灸十五次/个元宵大小的量），随即服用小续命汤去掉麻黄一剂，立即苏醒。这是望色审窍而知为柔痓的一个验证。
Although epilepsy is divided into seven types, historical treatments have only been effective when addressing Yang Epilepsy and Yin Epilepsy.
In one scenario, the patient dies after a single seizure, characterized by clenched teeth, limb convulsions, phlegm obstructing the throat, and loss of consciousness. If it occurs during the day, it is called Yang Epilepsy (Yang Xian). The patient's complexion is lustrous, indicating the disease is in the Six Fu Organs (Six Yang Organs) and the muscle-surface level. If the patient is unresponsive to stimulation, Moxibustion should be applied to each side of Feishu (BL13, Lung Shu) with three moxa cones. Immediately thereafter, Tianbao Caiwei Decoction (Tianbao Caiwei Tang) should be administered, with each herb at 1 qian (approx. 3-5g), taken continuously for two to three doses, which will lead to spontaneous recovery.
In another scenario, upon initial onset, there is no high fever, but the hands and feet are cyanotic and cold, the jaw is locked, the child cries in fright, protrudes the tongue, and shakes the head; this is called Yin Epilepsy (Yin Xian). The complexion is dull and dark, or it occurs at night, indicating the disease is in the Five Zang Organs (Five Yin Organs) and the bone marrow. This is the most difficult to treat. It is suitable to use Guzhen Decoction (Guzhen Tang) added with Tiantan (Arisaema Cum Bile).
Xia Yuzhu stated: In this condition, there is initially high fever, leading to death-like state after one seizure. Stimulation brings the patient back to consciousness. Symptoms subside slightly with sweating, but recur when sweating stops. This is Yang Malaria combined with Yang Epilepsy. Malaria is the root disease, while epilepsy is the branch symptom. In acute cases, treat the branch first. Use Tianbao Caiwei Decoction to release the exterior, adding Banxia (Pinelliae Rhizoma) doubled to 3 qian. Take continuously for two to three doses, then take Qingpi Yin (Qingpi Decoction) for one or two doses. When both root and branch are cleared, the patient recovers.
These diseases are caused by Wind-Dampness. Dampness is the root, and Wind is the branch. If the face and eyes are red, there is no sweat, aversion to cold, tight jaw, whole-body stiffness, abundant phlegm-saliva, red and scanty urine, and once the seizure starts, the patient remains unconscious for the whole day, preceded by delirium, it is called Gang Ji (Rigid Spasm). This reflects the rigid and urgent nature of Wind, so the syndrome belongs to Wind. Treatment is suitable with Xiao Xuming Decoction (Xiao Xuming Tang) without Fuzi (Aconiti Lateralis Radix Praeparata). If the limbs are cold, there is sweat, no aversion to cold, loose stools, no thirst, and silence, it is called Rou Ji (Soft Spasm). This reflects the mild nature of Dampness, so the syndrome belongs to Dampness. Xiao Xuming Decoction is also used, but without Mahuang (Ephedrae Herba).
If symptoms include phlegm obstruction and qi stagnation, add Tiantan (Arisaema Cum Bile), Banxia (Pinelliae Rhizoma), and Baifu Ling (Poria) to clear phlegm, and Zhike (Aurantii Fructus), Chenpi (Citri Reticulatae Pericarpium), and Zisu (Perillae Folium) to regulate qi. If there is internal heat and constipation, use Chengqi Tang (Chengqi Decoction) to purge. For Rou Ji, use Fuzi Lizhong Tang (Aconite and Atractylodes Macrocephala Decoction) to warm, and Liujunzi Tang (Six Gentlemen Decoction) to tonify. If the condition lingers, it becomes difficult to treat. If the disease persists for a long time and reappears with limb convulsions and spasms resembling opisthotonos, this is due to blood deficiency failing to nourish the tendons. Treatment uses Siwu Tang (Four Substances Decoction) added with Fuzi (Aconiti Lateralis Radix Praeparata), Fangfeng (Saposhnikoviae Radix), and Qianghuo (Notopterygii Rhizoma et Radix). Do not mistake this for Jing Xian (Convulsive Epilepsy); error may lead to death.
My grandson and nephew both suffered from Heat Malaria. I diagnosed it accurately. My wife, seeing that Qingpi Decoction failed after two doses, said, "Is there such a malaria in the world? Perhaps my old eyes are mistaken." I said, "Persist to four doses, and it will self-heal." It proved correct. The nephew took the Qingpi Decoction prescription home but did not take it, treating it as another disease instead. His condition worsened, and he returned. He insisted I visit. I was angry, but my wife comforted me and urged me to go. Upon arrival, I prescribed two doses of Qingpi Decoction again. My old friend Fang Huansui marveled, "Such a strange case requires such a strange doctor." Everyone followed orders and took Liujunzi Tang (Six Gentlemen Decoction) for three doses to prevent relapse. This verified the accuracy of diagnosing Heat Malaria despite opposition.
The son of Cheng Zhuo, a student from Wushajia, fell ill at age nine. I was invited to treat him. Many doctors were present. The child was brought out, his hands having been cut open by tendon-picking, with pus and blood streaming, too gruesome to behold. He convulsed dozens of times daily with unremitting high fever. I jokingly asked, "Why have you all failed to cure such a case? I wish to hear what medicines you used." Some mentioned Zhuli (Bamboo Sap) to descend phlegm, some Niuhuang Zhenjing Wan (Calculus Bovis Convulsion-Calming Pill), some Tianma (Gastrodiae Rhizoma) and Gouteng (Uncariae Ramulus cum Uncis) to calm wind, and some blamed the harm of tendon-picking and fire therapy. I covered my mouth laughing. You ignorant ones do not know this case. Requesting to see the symptoms, I said, "This is Yang Malaria combined with Yang Epilepsy. With thousands of such treatment methods, I don't know where to start." One asked, "From which book did you learn this diagnostic method?" I replied, "Xu Yunzong of the Tang Dynasty said, 'Medicine is intention.' Precise thinking leads to discovery. I create my own ancestors; why rely on books?" The crowd fell silent. I used Tianbao Caiwei Decoction, 1.5 qian of each herb, with doubled Banxia (Pinelliae Rhizoma), totaling about 3 liang. After one dose, convulsions stopped, and fever halved. Then, one dose of Qingpi Decoction led to full recovery. I explained to the other doctors why I left. This verified that tendon-picking is useless and observing color reveals divine insight.
Shen Cangxi from the neighboring county of Shidai, over fifty years old, had only one son from his wife's family, aged two. The illness prompted a plea for help. I immediately pinched the Jingwei acupoints. The child made no sound, had whole-body fever, pale but vibrant complexion, and skin that was not flaccid or glossy. Based on color, silence shouldn't occur. But based on silence, it indicated a fatal syndrome. I asked if prior treatment occurred. Shen said, "Initially, a neighbor picked his tendons twice, and others pushed/massaged several times. Yesterday, someone pushed/scraped his body with soft peach and willow branches, and he became silent that evening." I surmised that prolonged illness depleted Lung Qi, and frequent crying exhausted his spirit, causing silence. I treated based on color. I used Tianbao Caiwei Decoction plus Donghua (Dendrobii Caulis) 1 qian, decocted and taken at dusk. Fever subsided by midnight. This verified observing color and listening to voice in Heat Malaria combined with Epilepsy.
Xu Shengxu's son suffered from Convulsive Epilepsy, unconscious for five to six days. His uncle, Cuo, and eldest uncle, Fu Zeng, were former classmates of mine. Invited to treat at a banquet, I pinched Jingwei acupoints; the child was silent. I then heavily rubbed Feishu (BL13, Lung Shu). Although no sound came out, there was a struggle like pearls threading through beads. I applied Moxibustion to Feishu (BL13, Lung Shu), three cones each side. I used Tianbao Caiwei Decoction with doubled Banxia (Pinelliae Rhizoma). I went alone to Xu Zhongshi, a senior physician and friend, to retrieve herbs. I told Shengxu, "Trust Yu Zhu. Even Arsenic Trioxide (Pishuang) can be used here. This dose is either good or bad." Upon leaving, I said, "After one dose, fever will break at cockcrow." Indeed, fever broke as predicted. Two doses led to full recovery. This verified probing the Lung orifice via rubbing Feishu in fatal Yang Epilepsy.
Wang Shaozong, son-in-law of Zhang Kong'er (a xueyou) and a shengyuan, aged twenty-something, fell into epileptic coma for half a month. Other doctors used purely Huanglian (Coptidis Rhizoma) and Huangqin (Scutellariae Radix) formulas with no effect. They invited me. I declined, citing it as an adult case (Da Fang Mai). Kong'er forced me to go. Seeing his complexion, I knew it was Phlegm Obstruction. Pinching Jingwei acupoints failed. Pinching Laolong (GV14, Dazhui area or specific point depending on lineage, often associated with heart/spirit) made him stare at me, producing a humming sound like inside a jar. I used Banxia (Pinelliae Rhizoma) 4 qian, Jiegeng (Platycodonis Radix) 2 qian, Zhike (Aurantii Fructus), Fangfeng (Saposhnikoviae Radix), and Gancao (Glycyrrhizae Radix) 1 qian each. One dose brought slight revival; five doses led to full recovery. This shows that even if the Lung has no sound, it is not shattered metal; medication can still work. This verified diagnosing Phlegm Obstruction by form and orifices.
Chen Chunzhui of Zhutang had a son, eleven years old, unconscious for over ten days. Initially thought dead from fright, people pinched/bitten the Xiedai and Renzhong points until they were ruined. I was invited. His lips and mouth were dark like soy sauce, no convulsions, no thirst, limbs cold as ice. I treated with Fire-Light Moxibustion (Denghuo Jiu) fifteen applications, followed by one dose of Xiao Xuming Decoction without Mahuang (Ephedrae Herba). He revived immediately. This verified identifying Rou Ji (Soft Spasm) by observing color and checking orifices.