《千金》云∶小儿之痫有三，风痫，惊痫，食痫也。风痫，缘衣暖汗出，风因入
也，初时，先屈指如数物乃作。惊痫，起于惊怖大啼乃作。食痫，其先不哺乳，吐
而变热后发。然风痫、惊痫，时时有之，十儿之中未有一二，凡是先寒后发热者，
皆食痫也。惊痫皆按图灸之，风痫当以猪心汤，食痫当下乃愈，紫霜丸佳。
按∶此论三痫，盖有三因之分，风痫属外因，惊痫属内因，食痫属不内外
因也。
又按∶《全婴方》云。风痫因将养失度，血气不和，或浓衣汗出，腠理开舒，
风邪而入之，其病在肝，肝主风，验其证目青、面红、发搐，宜驱风膏、大青膏、
琥珀散、镇惊药，有热四顺饮，退后与利惊丸下其痰涎。惊痫因血气盛实，脏腑
生热，或惊怖大啼，精神伤动，外邪所入为之，其病在心，心主惊，验其证忽然
叫声发搐，宜琥珀散、红龙散、镇心丸，有热四顺饮、利惊丸下之，不生别病
也。食痫其病在脾，脾纳食，验其证嗳吐 气，即发搐，此病或大便酸臭，紫丸
子下之。以上三证，大同小异，并属阳也，各目睛鲜斜，手足潮搐，或作猪声，
发过即瘥，皆十生一死也。
《三因》云∶古方有五痫、五脏痫、六畜痫等，名证不同，难于备载。《别录》
有五痫之证，一曰马痫，作马嘶鸣，以马属在午，手少阴君火主之，故其病应于心。
二曰羊痫，作羊叫声，以羊属未，足太阴湿土主之，应乎脾。三曰鸡痫，作鸡叫声，
以鸡属酉，足阳明燥金主之，应乎胃。四曰猪痫，作猪叫声，以猪属亥，手厥阴心包
主之，应乎右肾。五曰牛痫，作牛吼声，以牛属丑，手太阴湿土主之，应乎肺。此
五痫应乎五畜，应乎五脏者也，发则旋晕颠倒，口眼相引，目睛上摇，手足搐搦，
背脊强直，食顷乃苏，各随所感，施以治法。〔钱〕凡治五痫，皆随脏治之，每脏
各一兽，犬痫反折上窜，犬叫，肝也。羊痫目瞪吐舌，羊叫，心也。牛痫目直视腹
满，牛叫，脾也。鸡痫惊跳反折手纵，鸡叫，肺也。猪痫如尸吐沫，猪叫，肾也。
五痫重者死，病后甚者亦死，轻者五色丸主之。〔薛〕面赤目瞪，吐舌啮舌，心烦
气短，其声如羊者，曰心痫。面青唇青，两眼上窜，手足挛掣反折，其声如犬者，
曰肝痫。面黑目振，吐涎沫，形体如尸，其声如猪者，曰肾痫。面如枯骨，目
白反视，惊跳反折，摇头吐沫，其声如鸡者，曰肺痫。面色痿黄，目直，腹
满自利，四肢不收，其声如牛者，曰脾痫。五痫，通用五色丸为主，仍参以各经之
药。心痫属血虚者用养心汤。发热饮冷为实热，用虎睛丸，发热饮汤为虚热，用
妙香散。肝痫者，虚证用地黄丸。抽搐有力为实邪，用柴胡清肝散。大便不通用
泻青丸。肾痫者，用地黄丸、紫河车丸之类，肾无泻法，故径从虚治之。肺
痫者，属气虚，用补肺散。面色痿黄者，土不能生也，用五味异功散。面色赤者，
阴火上冲于肺也，用地黄丸。脾痫者，用五味异功散。若面青泻利，饮食少思，
用六君子加木香、柴胡。
按∶《千金》叙六畜痫，无五脏之分属，钱氏始分之，而无马痫一证，曾氏谓
初发作羊犬声者，咽喉为风痰所梗，声自如此，其理甚明，言六畜者，特强名耳，故
丹溪谓于经既无所据，而治法亦未见有五者之分，所以不必分五也。
《千金方》说：小儿的痫证有三种，即风痫、惊痫和食痫。风痫，是因为穿衣过暖导致出汗，风邪乘虚而入所致，发作前最初表现为手指屈伸如同数物一般。惊痫，是由于受到惊吓恐惧大声啼哭后引发。食痫，起初不进食乳食，呕吐后出现发热随后发作。然而风痫和惊痫，时常发生，十个孩子中不到一两个，凡是先感到寒冷然后发热的，都是食痫。惊痫都可以按照图谱进行艾灸治疗，风痫应当使用猪心汤，食痫需要通下大便才能痊愈，紫霜丸效果较好。
按语：这种关于三种痫证的论述，大概分为三种病因，风痫属于外因，惊痫属于内因，食痫属于不内外因。
又按语：《全婴方》说：风痫因为调养失当，气血不和，或者衣着厚重出汗，腠理（皮肤毛孔）开泄，风邪侵入体内，病变在肝，肝主风，验证其症状为目青、面红、抽搐，适宜用驱风膏、大青膏、琥珀散、镇惊药，如果有热症用四顺饮，退热后再用利惊丸攻下痰涎。惊痫因为气血盛实，脏腑生热，或者因惊吓恐惧大声啼哭，精神受触动，加上外邪入侵所致，病变在心，心主惊，验证其症状为忽然叫声并发出抽搐，适宜用琥珀散、红龙散、镇心丸，如果有热症用四顺饮，再用利惊丸攻下，就不会再生其他疾病了。食痫病变在脾，脾负责纳食，验证其症状为嗳气呕吐，随即发生抽搐，此病如果大便酸臭，可用紫丸子攻下。以上三种证候，大同小异，都属于阳证，各自伴有眼睛斜视或上翻，手足阵发性抽搐，或者发出猪叫声，发作过后即缓解，都是十个人中有九个能活下来一个死亡的预后。
《三因极一病证方论》说：古方有五痫、五脏痫、六畜痫等名称，证候不同，难以全部记载。《别录》中有五痫的证候，一是马痫，发出马嘶鸣声，因为马对应地支午，手少阴君火主管它，所以病变应于心。二是羊痫，发出羊叫声，因为羊对应地支未，足太阴湿土主管它，应乎脾。三是鸡痫，发出鸡叫声，因为鸡对应地支酉，足阳明燥金主管它，应乎胃。四是猪痫，发出猪叫声，因为猪对应地支亥，手厥阴心包主管它，应乎右肾。五是牛痫，发出牛吼声，因为牛对应地支丑，手太阴湿土主管它，应乎肺。这五种痫证对应五种牲畜，也对应五脏。发作时头晕颠倒，口眼牵引歪斜，眼球上摇，手足抽搐痉挛，背脊强直，大约一顿饭的时间才苏醒，各自根据所感之邪，施以相应的治疗方法。〔钱乙〕凡是治疗五痫，都随所属脏腑进行治疗，每脏各对应一种兽类：犬痫反折身体向上窜动，发出犬叫，属肝；羊痫眼睛瞪大吐舌，发出羊叫，属心；牛痫眼睛直视腹部胀满，发出牛叫，属脾；鸡痫惊恐跳跃反折身体手部松弛，发出鸡叫，属肺；猪痫像尸体一样吐沫，发出猪叫，属肾。五痫重症者死，病后严重的也死，轻症者用五色丸为主治。〔薛己〕面色红赤眼睛瞪大，吐舌咬舌，心烦气短，声音像羊的，称为心痫。面色青唇色青，两眼上翻，手足挛缩抽搐反折，声音像狗的，称为肝痫。面色黑眼球震颤，吐涎沫，形体像尸体，声音像猪的，称为肾痫。面色如枯骨，眼白反视，惊恐跳跃反折，摇头吐沫，声音像鸡的，称为肺痫。面色萎黄，眼睛直视，腹部胀满自泻，四肢无力不收，声音像牛的，称为脾痫。五痫通用五色丸为主药，仍参酌各经的药物。心痫属于血虚的用养心汤。发热且想喝冷水的为实热，用虎睛丸；发热且想喝热水的为虚热，用妙香散。肝痫者，虚证用地黄丸。抽搐有力为实邪，用柴胡清肝散。大便不通的用泻青丸。肾痫者，用地黄丸、紫河车丸之类，肾没有泻法，所以直接从虚证治疗。肺痫者，属于气虚，用补肺散。面色萎黄的，是土不能生金，用五味异功散。面色红的，是阴火上冲于肺，用地黄丸。脾痫者，用五味异功散。如果面色青且腹泻，饮食减少思虑，用六君子汤加木香、柴胡。
按语：《千金方》叙述六畜痫，没有五脏的分属，钱乙开始进行分属，但没有马痫这一证候，曾世荣认为初发作时发出羊犬声的，是因为咽喉被风痰阻塞，声音自然如此，这个原理很明白，所谓六畜，只是勉强命名罢了，所以朱丹溪说在经典中既无依据，而且治疗方法也未见有五者的区分，所以不必强行区分五种。
The *Qianjin Fang* states: There are three types of epilepsy in children, namely Fengxian (Wind Epilepsy), Jingxian (Fright Epilepsy), and Shixian (Food Epilepsy). Fengxian is caused by excessive clothing leading to sweating, allowing Wind pathogen to enter; initially, the fingers flex as if counting objects. Jingxian arises after a child cries loudly due to fright or terror. Shixian occurs when the child refuses milk/food, vomits, develops fever, and then the seizure manifests. However, Fengxian and Jingxian occur frequently, affecting less than one or two out of ten children. Any case presenting with chills followed by fever is classified as Shixian. For Jingxian, moxibustion should be applied according to diagrams. Fengxian should be treated with Zhuxin Tang (Pig Heart Decoction). Shixian requires purgation to resolve; Zishuang Wan (Purple Frost Pill) is effective.
Commentary: This discussion on the three types of epilepsy categorizes them into three etiologies: Fengxian belongs to external causes, Jingxian to internal causes, and Shixian to neither-internal-nor-external causes.
Further Commentary: The *Quanying Fang* states: Fengxian results from improper nursing, disharmony of Qi and Blood, or heavy clothing causing sweating and opening of Couli (pores/skin texture), allowing Wind pathogen to invade. The pathology resides in the Liver, which governs Wind. Signs include blue eyes, red face, and convulsions. Treatment includes Qufeng Gao (Wind-Expelling Ointment), Daqing Gao (Great Blue Ointment), Hupo San (Amber Powder), and Zhenjing Yao (Calming Fright Medicine). If heat is present, Sishun Yin (Four Smooth Decoction) is used, followed by Lijing Wan (Resolving Fright Pill) to purge phlegm-saliva after the heat subsides. Jingxian results from excess Qi and Blood, heat generated in the Zang-Fu organs, or mental disturbance from fright/crying combined with external pathogens. The pathology resides in the Heart, which governs Fright. Signs include sudden crying accompanied by convulsions. Treatment includes Hupo San, Honglong San (Red Dragon Powder), and Xinxin Wan (Heart-Calming Pill). If heat is present, Sishun Yin is used, followed by Lijing Wan for purgation, preventing other diseases. Shixian pathology resides in the Spleen, which governs food intake. Signs include belching, vomiting, and subsequent convulsions. If stool is sour and foul-smelling, Zi Wanzi (Purple Pill) is used for purgation. These three syndromes are largely similar but slightly different, all belonging to Yang syndromes. Each presents with strabismus or upward deviation of eyes, periodic convulsions of hands and feet, or sounds resembling pigs. After the attack, the patient recovers. The prognosis is generally good, with only one death in ten cases.
The *San Yin Ji Yi Bing Zheng Fang Lun* states: Ancient formulas mention Wu Xian (Five Epilepsies), Wuzang Xian (Five Organ Epilepsies), and Liuchou Xian (Six Livestock Epilepsies), with varying names and syndromes difficult to fully record. The *Bielu* describes five epilepsies: 1. Maxian (Horse Epilepsy), making horse neighing sounds. Horse corresponds to Wu (noon), governed by Hand Shaoyin Jueyin Fire, thus corresponding to the Heart. 2. Yangxian (Sheep Epilepsy), making bleating sounds. Sheep corresponds to Wei, governed by Foot Taiyin Damp Earth, thus corresponding to the Spleen. 3. Jixian (Chicken Epilepsy), making crowing sounds. Chicken corresponds to You, governed by Foot Yangming Dry Metal, thus corresponding to the Stomach. 4. Zhu Xian (Pig Epilepsy), making grunting sounds. Pig corresponds to Hai, governed by Hand Jueyin Pericardium, thus corresponding to the Right Kidney. 5. Niuxian (Ox Epilepsy), making mooing sounds. Ox corresponds to Chou, governed by Hand Taiyin Damp Earth, thus corresponding to the Lung. These five epilepsies correspond to the five livestock and five Zang organs. During attacks, patients experience dizziness and falling, pulling of mouth and eyes, upward rolling of eyeballs, convulsions of limbs, and rigidity of the spine. They recover after about the time it takes to eat a meal. Treatments vary according to the specific pathogen. [Qian Yi] All treatments for the Five Epilepsies follow the organ involved, each associated with an animal: Quanxian (Dog Epilepsy) involves body arching backward and upward movement, barking, associated with the Liver. Yangxian involves staring eyes and tongue protrusion, bleating, associated with the Heart. Niuxian involves fixed gaze and abdominal distension, mooing, associated with the Spleen. Jixian involves jumping, arching backward, and relaxed hands, crowing, associated with the Lung. Zhu Xian resembles a corpse with foaming at the mouth, grunting, associated with the Kidney. Severe cases of the Five Epilepsies result in death, as do those with severe post-illness symptoms. Mild cases are treated primarily with Wuse Wan (Five-Colored Pill). [Xue Ji] Red face, staring eyes, tongue protrusion/biting, restlessness, shortness of breath, and sheep-like sounds indicate Xin Xian (Heart Epilepsy). Blue face/lips, upward eye deviation, limb spasm/arching, and dog-like sounds indicate Gan Xian (Liver Epilepsy). Black face, trembling eyes, foaming, corpse-like appearance, and pig-like sounds indicate Shen Xian (Kidney Epilepsy). Face like dry bone, white sclera visible, jumping, arching, head shaking, foaming, and chicken-like sounds indicate Fei Xian (Lung Epilepsy). Sallow yellow face, fixed gaze, abdominal distension, spontaneous diarrhea, flaccid limbs, and ox-like sounds indicate Pi Xian (Spleen Epilepsy). The Five Epilepsies generally use Wuse Wan as the main formula, supplemented by herbs for the respective meridians. For Xin Xian due to Blood deficiency, Yangxin Tang (Heart-Nourishing Decoction) is used. Fever with desire for cold drinks indicates Excess Heat, treated with Huqing Wan (Tiger Eye Pill); fever with desire for hot drinks indicates Deficiency Heat, treated with Miaoxiang San (Wonderful Incense Powder). For Gan Xian, Deficiency is treated with Dihuang Wan (Rehmannia Pill); strong convulsions indicate Excess Pathogen, treated with Chaihu Qinggan San (Bupleurum Clearing Liver Powder); constipation is treated with Xieqing Wan (Draining Green Pill). For Shen Xian, Dihuang Wan or Ziheche Wan (Placenta Pill) are used; since the Kidney has no purgative method, treatment focuses directly on deficiency. For Fei Xian due to Qi deficiency, Bufei San (Lung-Supplementing Powder) is used. Sallow yellow face indicates Earth failing to generate Metal, treated with Wuwei Yigong San (Five-Ingredient Extraordinary Merit Powder). Red face indicates Minfire rushing up to the Lung, treated with Dihuang Wan. For Pi Xian, Wuwei Yigong San is used. If the face is blue with diarrhea and poor appetite, Liujunzi Tang (Six Gentlemen Decoction) plus Muxiang and Chaihu is used.
Commentary: The *Qianjin Fang* describes Six Livestock Epilepsies without assigning them to Five Organs. Qian Yi began this classification but omitted Maxian (Horse Epilepsy). Zeng Shirong argued that initial sounds resembling sheep or dogs are due to wind-phlegm obstructing the throat, making the explanation clear. The term "Six Livestock" is merely a forced name. Therefore, Zhu Danxi stated that since there is no scriptural basis and no distinct therapeutic methods for the five types, it is unnecessary to distinguish them into five categories.