典藏书目

The *Qianjin Fang* (Prescriptions Worth a Thousand Gold) states: If the patient first exhibits body heat, convulsions, fright, crying, and shouting before the onset of epilepsy, and the pulse is floating, it is classified as Yang Epilepsy. The disease location is in the Six Fu Organs, external to the skin and muscles, and is relatively easy to treat. If the patient first exhibits body coldness, without fright, convulsions, crying, or shouting, and upon onset the pulse is deep, it is classified as Yin Epilepsy. The disease location is in the Five Zang Organs, internal to the bone marrow, and is difficult to treat.

Commentary: This discussion on the Yin and Yang of epilepsy, where later generations interpreted it as a distinction between Cold and Heat, is erroneous. Generally, this disease is caused by Phlegm-Heat. If the pathogenic factor injures the Yang aspect, remaining superficial and shallow, it is called Yang Epilepsy, hence described as easy to treat. If the pathogenic factor injures the Yin aspect, penetrating inward and deep, it is called Yin Epilepsy, hence described as difficult to treat. The Yin and Yang discussed here refer to exterior-interior, Zang-Fu, and depth/shallowness, not to Cold and Heat.

The *Yuan Bing Shi* (Treatise on the Original Causes of Disease) states: The onset of Wind Epilepsy occurs due to excessive Heat combined with Wind-Dryness. Saliva overflows into the chest and diaphragm, dryness scorches the interior, leading to Qi stagnation, confusion, stiffness, falling, and collapse.

In the writings of Zihe (Zhang Congzheng): For epilepsy cases that do not present with eyes staring wide like a fool, administer *Sansheng San* (Three Holy Powders). Place a fire basin in a warm room to induce sweating, and apply the three methods of sweating, vomiting, and purging simultaneously. Subsequently, administer *Tongsheng San* (Universal Salvation Powder); recovery can be expected within a hundred days. However, for those whose eyes stare wide like fools, it is incurable. The *Neijing* (Inner Canon) states: "Shen not guarding its residence" refers to Shen disorder. Generally, this disease stems from Heat in the Liver Channel. After vomiting, one may administer *Xieqing Wan* (Drain Green Pills) to purge.

Commentary: Epilepsy is mostly caused by Wind-Phlegm firmly adhering to the upper and lower chest and diaphragm. Therefore, the general principle is to first employ vomiting. After vomiting, heat-clearing herbs such as Dongyuan's *Anshen Wan* (Calm Spirit Pills) or Shouzhen's *Longhui Wan* (Dragon Assembly Pills) may be used; it is not limited to *Tongsheng San*. If Phlegm is firmly rooted in the interior and does not resolve, phlegm-resolving and heat-clearing methods should be used; it is not limited to *Xieqing Wan*.

*Nan Zhi* (Difficult Knowledge) states: For Wind Epilepsy and Fright Epilepsy presenting with Hong (Surging), Chang (Long), or Fu (Deep/Hidden) pulses, accompanied by mania, aversion to people and fire, moxa the third and ninth vertebrae, and administer *Jufang Miaoxiang Wan* (Bureau Formula Wonderful Incense Pills). [Note: The text contains a bizarre instruction regarding needles and eyes, translated literally as:] Insert a needle into the eye, soak in cold water for a short time, then take. For various epilepsies presenting with Xian (Wiry), Xi (Thin), or Huan (Slow) pulses, with symptoms resembling mania, use Li He Nan's *Wusheng Wan* (Five Origins Pills).

Commentary: Here, medication is selected based on the Yin-Yang and Deficiency-Excess of the pulse, which is commendable. However, since epilepsy arises from Wind, Heat, and Phlegm, yet the medications vary in Cold and Heat properties, this is due to differences in Root/Branch, Deficiency-Excess, and transmission patterns.

Respectfully noted: Ancient formulas for epilepsy are variously named Wind Epilepsy, Fright Epilepsy, or Dian-Xian (Epilepsy). These names differ because this disease resembles Zhongfeng (Wind Stroke), Diankuang (Mania), and Ji-Man Jingfeng (Acute-Chronic Convulsive Disorders). Investigating the origins, some contracts occur from fright in the womb, or from hearing a sudden loud shock. Children have weak Shen-Qi; fright causes Shen to lose its residence. When the residence is empty, Phlegm-Saliva accumulates there. Alternatively, irregular diet damages the Spleen and Stomach, leading to accumulation and formation of Phlegm-Fluids, which confuse the Heart Orifice. Treatment must address Fire (Heat) and Phlegm. Ancients often used heavy-settling and Heart-clearing drugs, which can treat Heat and clear Phlegm. However, for stubborn Phlegm firmly adhered, these drugs are ineffective. For pathology located above, vomiting must be used first; only after vomiting should such drugs be administered. For Phlegm firmly rooted in the interior, purgation is also necessary. Usage depends on the severity of the disease. Someone asked: Why is there a distinction between Yin and Yang in epilepsy? I say: This can be discussed similarly to Acute and Chronic Convulsive Disorders. Yang Epilety is not caused by improper vomiting or purging, but by Phlegm and Heat lodging between the Heart and Stomach, triggered by a sudden fright. If Heat is excessive, it may arise spontaneously even without fright. Cold-natured drugs should be used to attack and treat it. Yin Epilepsy also originates from Phlegm-Heat, but becomes Yin syndrome due to doctors' excessive use of Cold-Cooling and purging methods, damaging the Spleen and Stomach. Warm and neutral, Stomach-tonifying, and Phlegm-drying drugs should be used for treatment. If one claims the Yin-Yang distinction exists not due to iatrogenic damage (bad outcomes) but inherently, it refers to the exterior-interior, Zang-Fu, and depth/shallowness where Phlegm-Heat lodges. Does Epilepsy originally possess Yin-Cold nature?