凡辨症须于同中求异，如痱与喑俳是也。《灵》热病痱之为病，身无痛者，四肢不收，
智乱
不甚，其言微知可治，甚则不能言，不可治也。是痱之名，名于四肢不收，不收则废也。《
素》脉解内夺而厥，则为喑俳，此肾虚也。少阴不至者厥也。注∶俳，废也。肾之络与冲脉
并出于气街，循阴股内廉，斜入 中，循 骨内廉及内踝之后，入足下，故肾气内夺而不顺
则足废。是痱与俳之名，并名于废也。但痱为肿，喑俳则不肿，痱至喑不可治，喑俳则以喑
为正，以此为异。故治痱用续命汤，而喑俳宜地黄饮子，补泻天渊已。乃《宣明方》反云地
黄饮子治中风舌喑不能言，足废不能行，此少阴气厥不足，名曰风痱。则混痱与俳，自河间
始；以地黄饮子概治中风之误，自河间之混痱于俳始。
少阴不至，谓太溪脉绝，仲景原尸厥云，少阴脉不至，本此经以太溪绝为诊厥之法，故
云少阴不至者厥也。河间“少阴气厥不至”六字殊误，气厥正是至，何云不至也？
古之所谓癫者二∶一 仆之癫，《灵》、《素》所谓巅疾，王注谓上巅之疾是也。与狂
对举
，其病自足太阳经来，其名以“巅疾”二字称，其义取颠顶为说，此其可治者也；惟由胎惊
得之则难治。一昏乱之癫，《难经》所谓重阴者癫，《金匮》所谓阴气衰为癫是也。虽亦与
狂对举，要之即狂之甚者，其病自心、肝两脏来，其名以一“癫”字称，其义以颠越为说，
此则必不可治。后人概加 旁，而二癫乃不能别，而诸书之论，亦不可尽晓，必如此分别，
斯各各相通矣。《灵·本神》喜乐无极则伤魄，魄伤则狂，狂者意不存人；悲哀动中则伤魂
，魂伤则狂忘不精明，不敢正当人。彼二狂不同，故经文自为之注。其魂伤者则癫也，正《
金匮》之所本。《素》调经血并于阴，气并于阳，乃为惊狂。此一狂乃是浑称。其血并于阴
者则癫也，正《难经》之所本。泉尝遍考而核之曰∶古之巅疾，今之痫也；古之癫，今之痴
也。执是说也，庶不至谓古方不可治今病乎！
大凡辨析病症，必须在相似中寻求差异，例如痱病与喑俳（yīn pái）就是这样的例子。《灵枢》记载的热病中的痱病，其症状是身体没有疼痛感，四肢无法收持运用，神志虽然有些混乱但尚不严重，如果说话声音微弱还能听懂，尚可治疗；如果严重到不能说话，就无法治疗了。所以“痱”这个名称，是基于四肢无法收持而言的，无法收持就意味着废用。《素问·脉解篇》提到：“内夺而厥，则为喑俳”，这是肾虚所致。少阴经气不至就会发生厥逆。注解说：俳，意为废用。肾的络脉与冲脉一起出于气街穴，沿着大腿内侧前缘下行，斜入膝腘窝中，沿着胫骨内侧及内踝后方，进入足底，所以肾气内部亏损而不顺畅，就会导致足部废用。因此，“痱”和“俳”这两个名称，都是基于“废用”这一概念命名的。但是，痱病伴有肿胀，而喑俳则不肿胀；痱病发展到失语阶段就不可治，而喑俳以失语为主要特征，以此作为区别。所以治疗痱病使用续命汤，而喑俳适宜使用地黄饮子，补法与泻法的区别已经非常悬殊了。然而，《宣明方论》反而说地黄饮子治疗中风导致的舌强失语、足废不能行走，这属于少阴经气厥逆不足，命名为风痱。这就混淆了痱与俳的概念，这种混淆始于刘河间；用地黄饮子笼统治疗中风的错误，也是从刘河间混淆痱与俳开始的。
所谓“少阴不至”，是指太溪脉绝迹。张仲景在论述尸厥时原话是“少阴脉不至”，正是依据这部经典将太溪脉绝作为诊断厥证的方法，所以说“少阴不至者厥也”。刘河间所说的“少阴气厥不至”六个字特别错误，气厥正是经气至而逆乱，怎么能说“不至”呢？
古代所说的癫病有两种：一种是仆倒发作的癫，《灵枢》、《素问》中所说的巅疾，王冰注解说是发生在头顶部的疾病。它与狂病相对举，病邪来自足太阳经，名称取“巅疾”二字，含义是以颠顶为立足点，这种是可以治疗的；只有因胎惊获得的才难治。另一种是神志昏乱的癫，《难经》所说的重阴者癫，《金匮要略》所说的阴气衰为癫。虽然也与狂病相对举，但总之就是严重的狂病，病邪来自心、肝两脏，名称用一个“癫”字，含义是以颠越（精神错乱、行为失常）为解释，这种则绝对不可治疗。后人一概加上“疒”旁，导致这两种癫病无法区分，各种书籍的论述也就不能完全理解，必须像这样分别清楚，才能各自相通。《灵枢·本神》篇说：喜乐无节制就会伤魄，魄受伤就会发狂，狂者心中没有他人；悲哀触动内心就会伤魂，魂受伤就会狂妄遗忘、不明智，不敢正常待人。那两种狂病不同，所以经文自己做了注释。那些魂受伤的就会变成癫，这正是《金匮要略》所依据的。《素问·调经论》说：血并于阴分，气并于阳分，就会发生惊狂。这一种狂是泛指。那些血并于阴分的就会变成癫，这正是《难经》所依据的。我泉曾遍考并核实说：古代的巅疾，就是现在的痫病；古代的癫，就是现在的痴病。坚持这种说法，或许就不会认为古方的理论不能治疗今天的疾病了！
In general, differentiating symptoms requires seeking differences within similarities, such as the distinction between Fei (flaccidity syndrome) and Yin Pai (aphasia with flaccidity). The *Ling Shu* describes Fei in heat diseases: the body has no pain, the four limbs cannot be controlled or held, mental confusion is not severe. If speech is faint but understandable, it is treatable; if severe to the point of inability to speak, it is untreatable. Thus, the name "Fei" derives from the inability to control the limbs; inability to control implies dysfunction. The *Su Wen* (Chapter on Pulse Resolution) states: "Internal depletion and Jue (syncope/cold extremities) lead to Yin (aphasia) and Pai (flaccidity); this is Kidney deficiency." When Shaoyin (Lesser Yin) Qi does not reach, Jue occurs. The commentary notes: "Pai means dysfunction." The meridians of the Kidney run together with the Chong Mai (Penetrating Vessel) out of the Qichuan acupoint, along the medial aspect of the thigh, obliquely into the popliteal fossa, along the medial aspect of the tibia and behind the medial malleolus, entering the sole of the foot. Therefore, when Kidney Qi is internally depleted and fails to flow smoothly, the feet become dysfunctional. Consequently, both "Fei" and "Pai" are named based on "dysfunction." However, Fei involves swelling, whereas Yin Pai does not. Fei becomes untreatable when aphasia sets in, while Yin Pai takes aphasia as its primary characteristic; this serves as the distinction. Therefore, treatment for Fei uses Xuming Tang (Life-Continuing Decoction), while Yin Pai is suitable for Dihuang Yinzi (Rehmannia Mouth-Washing Decoction); the difference between tonification and purgation is vast. However, *Xuanming Fanglun* claims that Dihuang Yinzi treats stroke-induced aphagia and foot flaccidity, attributing this to insufficient Shaoyin Qi Jue, naming it Fengfei (Wind Fei). This confuses Fei and Pai, a confusion starting with Liu Hejian; the error of using Dihuang Yinzi indiscriminately for stroke also stems from Liu Hejian's conflation of Fei and Pai.
"Shaoyin Bu Zhi" (Shaoyin does not reach) refers to the absence of the Taixi pulse. Zhang Zhongjing originally described Shi Jue (Corpse-like Syncope) stating "Shaoyin pulse does not reach," basing this diagnostic method for Jue on the cessation of the Taixi pulse mentioned in the classic, hence saying "When Shaoyin does not reach, there is Jue." Liu Hejian's phrase "Shaoyin Qi Jue Bu Zhi" (Shaoyin Qi Jue does not reach) is particularly erroneous; Qi Jue implies the arrival of Qi in a reversed state, how can it be said to "not reach"?
There are two types of Dian (epilepsy/madness) in ancient texts: One is the Dian characterized by falling/prostration, referred to as Dian Ji (Dian Disease) in the *Ling Shu* and *Su Wen*. Wang Bing’s commentary identifies this as disease of the vertex (top of the head). It is contrasted with Kuang (mania), originating from the Foot-Taiyang Meridian, named "Dian Ji" referring to the vertex, which is treatable; only those acquired from fetal fright are difficult to treat. The second type is Dian characterized by mental confusion, referred to as "Chong Yin Dian" (Heavy Yin Dian) in the *Nan Jing* and "Yin Qi Shuai Wei Dian" (Yin Qi Deficiency leads to Dian) in the *Jin Gui Yao Lue*. Although also contrasted with Kuang, it is essentially severe Kuang, originating from the Heart and Liver organs, named simply "Dian" referring to erratic behavior/loss of control, which is absolutely untreatable. Later generations added the "bing" radical (疒) to both, making them indistinguishable, and rendering various book discussions incomprehensible. Only by distinguishing them clearly can they be understood separately. The *Ling Shu · Ben Shen* chapter states: "Unrestrained joy injures Po (Corporeal Soul); injury to Po leads to Kuang, where the patient disregards others. Sorrow moving the interior injures Hun (Ethereal Soul); injury to Hun leads to Kuangwang (mad forgetfulness) and lack of clarity, where the patient dares not behave normally." These two types of Kuang are different, so the text provides its own annotations. Those with injured Hun develop Dian, which is the basis for the *Jin Gui Yao Lue*. The *Su Wen · Tiao Jing Lun* states: "Blood pooling in Yin, Qi pooling in Yang, results in Jingkuang (Frightened Mania)." This type of Kuang is a general term. Blood pooling in Yin leads to Dian, which is the basis for the *Nan Jing*. I, Quan, have extensively examined and verified: Ancient Dian Ji is modern Xian (Epilepsy); ancient Dian is modern Chi (Imbecility/Mental Retardation). Adhering to this view prevents the assertion that ancient formulas/theories cannot treat modern diseases!