Epilepsy, commonly known as "sheep epilepsy," is characterized by sudden fainting, unconsciousness, convulsions in the limbs, frothing at the mouth, upward rolling of the eyes, and sounds resembling those of pigs or sheep from the throat. After waking, the person feels fatigued and weak, but their daily activities and diet return to normal. The episodes occur intermittently and at irregular intervals. Minor episodes may manifest as momentary confusion, staring straight ahead, temporary loss of vitality, or twitching at the corners of the mouth and sucking movements.

Epilepsy was first mentioned in Suwen, Daqi Lun, and Lingshu, specifically in the Jingmai chapter. However, in historical texts, it was sometimes referred to as "dian," such as in Suwen, Qibing Lun, where it was called "dian disease," or in the Tang dynasty's Qianjin Fang, where it was referred to as "five dian," all referring to epilepsy. In the Ming dynasty's Jisheng Fang, it was noted that "adults call it dian, children call it epilepsy, but it is essentially the same disease." Ye Tianshi stated, "Epilepsy and dian are different in symptoms," aligning with modern understanding.

Epilepsy shares symptoms such as sudden fainting, unconsciousness, spasms, and opisthotonos with conditions like "convulsive disease," "apoplexy," "acute infantile convulsions," and "chronic infantile convulsions." However, epilepsy is distinguished by the presence of sounds upon falling, frothing at the mouth, and a history of recurrent episodes. As Wang Kentang stated in Zhengzhi Zhunsheng, "Epilepsy and sudden convulsive disease are similar, but in epilepsy, there is sound upon falling, frothing upon waking, and recurrence after waking, with some experiencing multiple episodes in a day. Apoplexy, cold in the middle, and summerheat stroke, on the other hand, involve no sound upon falling, no frothing upon waking, and no recurrence after waking. Convulsive disease, although it occurs intermittently, involves rigid body posture and arching like a bow, unlike the soft body posture or animal-like sounds in epilepsy."

1. Phlegm-Fire︰Sudden fainting, convulsions of limbs, frothing at the mouth, coarse and rapid breathing, staring straight ahead, or making sounds like five animals, nightmares and fright with vigilance, obstruction in the chest and diaphragm, emotional depression with hypochondriac region distension and pain, restlessness and insomnia, headache with red eyes, flushed face, bitter taste in the mouth, constipation, dark urine, irregular onset—sometimes occurring three to five times a day, or recurring after several days or months—fatigue after waking, otherwise normal as usual. Emotions are often easily agitated, prone to outbursts. The tongue texture is red with yellow and greasy coating, and the pulse is wiry, slippery, rapid, and forceful. The distinguishing feature is the absence of signs of intense heat. During episodes, frothing or clear drool is characteristic of wind-phlegm, whereas sticky drool in phlegm-fire epilepsy results from heat scorching phlegm. The former presents with a red tongue texture, yellow and greasy coating, and a wiry, slippery, rapid, and forceful pulse. Treatment focuses on clearing heat and resolving phlegm, using the prescription biotite schist Rolling Phlegm Pill.
2. Wind Phlegm︰Before the onset, there are often brief episodes of dizziness, chest tightness, nausea, followed by sudden collapse, unconsciousness, convulsions and rigidity in the limbs, upward staring of the eyes, lockjaw, twitching of the mouth and eyes, and sounds resembling those of five animals in the throat. Upon waking, the person may froth at the mouth or drool clear saliva, feeling utterly exhausted afterward. Sometimes, the episodes recur shortly after waking, occurring intermittently—every few days or months—and more frequently when fatigued. Exposure to cold often triggers the episodes. In robust individuals, the pulse is typically slippery and large, with a white, thick, and greasy tongue coating. The condition is often caused by spleen deficiency leading to excessive phlegm, which accumulates and disrupts the smooth flow of qi, resulting in an imbalance in the ascending and descending movements of qi. Clear yang fails to rise, while turbid yin fails to descend, leading to phlegm clouding the seven orifices. Hence, before the onset, there is brief dizziness, and episodes are easily triggered by exposure to cold or after eating. The tongue coating is white, thick, and greasy but not yellow, and the pulse is slippery but neither wiry nor rapid. Treatment involves warming and resolving wind-phlegm, with the prescription of Xingxiang Two Old Ingredients Decoction. **Phlegm-Stasis Epilepsy vs. Wind-Phlegm Epilepsy** Phlegm-stasis epilepsy involves static blood combined with phlegm, disturbing mental activity. It often arises from traumatic brain injuries, forceps-induced head injuries during childbirth, falls during pregnancy, emotional depression, or qi stagnation and blood stasis, all of which can lead to internal static blood. If stasis obstructs the upper body, blocking the brain's collaterals, deficient wind arises, often causing headaches before episodes. If static blood combined with phlegm surges upward to the head, it clouds the mind, triggering epilepsy. Unlike wind-phlegm epilepsy, this condition is characterized by a history of head trauma, purplish face and lips, and a tongue texture that is purple with stasis spots—hallmarks of static blood. Treatment focuses on resolving stasis and clearing phlegm, using Astragalus Root Chifeng Decoction combined with Longma Zilai Pills.
3. Phlegm and Blood Stasis Intermingling︰At the onset, dizziness and headache occur, followed by a sudden scream, spasms and convulsions, frothing at the mouth, cyanosis of the face and lips, and dry mouth with water held in the mouth but no desire to swallow. There is often a history of head trauma, and episodes are prone to occur during cloudy or rainy weather. The tongue appears purple with static blood spots, and the pulse is wiry or wiry and choppy. This condition is caused by static blood mixed with phlegm, disturbing mental activity. It often arises from head trauma, such as forceps injury during childbirth, maternal falls during pregnancy, or emotional depression leading to qi stagnation and blood stasis, all of which can result in internal static blood. If the stasis obstructs the upper body and blocks the brain's collaterals, deficient wind may arise, often manifesting as headaches before an episode. If static blood mixed with phlegm surges upward to the head, it clouds the mind, leading to epilepsy. The key difference between this condition and wind-phlegm is the frequent history of head trauma, along with features like purple lips, a purple tongue with static blood spots, and other signs of static blood. Treatment focuses on resolving stasis and clearing phlegm, typically using Astragalus Root Chifeng Decoction combined with Longma Zilai Dan.
4. Blood Deficiency︰Epileptic seizures occur frequently, preceded by dizziness and palpitation, twitching of the hands and feet. During the episode, there is sudden fainting, loss of consciousness, lockjaw, closed eyes, and frothing at the mouth. Convulsions last for varying durations, and after waking, the person appears normal. Accompanying symptoms include palpitation, severe palpitation, dry eyes, etc. The seizures may also become more frequent around menstruation. The lips and nails are pale, the pulse is thin and slippery, the tongue texture is pale or the tip of the tongue is red, with thin, white, and scant coating. The condition is often triggered by blood deficiency and wind stirring, inducing epileptic seizures, and is mostly accompanied by signs of heart and liver blood deficiency, such as palpitation, severe palpitation, dry eyes, thin pulse, scant coating, etc. Epilepsy due to kidney deficiency often arises from long-standing epilepsy, severe damage to kidney qi. Suwen．Daqi Lun: "Rapid contraction of the two yin leads to epileptic syncope," where the two yin refer to the Foot Shaoyin Kidney. Alternatively, it may stem from congenital insufficiency, such as "fetal epilepsy" from childhood. Prolonged illness leads to the gradual decline of essential qi, resulting in kidney qi deficiency. Each seizure further depletes healthy qi, making it unable to overcome pathogenic factors, leading to increasingly frequent episodes, even multiple times a day. The kidney opens into the two yin and governs the opening and closing of the bladder. When kidney qi is impaired, this regulatory function fails, often causing incontinence of urine and stool during seizures. Unlike epilepsy due to blood deficiency, this type is distinguished by accompanying symptoms such as soreness and weakness of the lower back and knees, intellectual dullness, seminal emission, impotence, premature ejaculation, or persistent leucorrhea—all signs of kidney deficiency. Chronic epilepsy often transforms from excess to deficiency, commonly manifesting as blood deficiency or kidney deficiency, and ultimately tending toward kidney deficiency. Treatment should avoid reckless use of harsh methods to suppress apparent excess. As stated in *Ancient and Modern Medical Cases*: "Manic and depressive psychosis is mostly excess (80-90%), while epilepsy is mostly deficiency (80-90%)." Epilepsy due to blood deficiency is treated by nourishing blood and soothing the liver, supplemented by resolving wind-phlegm. A recommended formula is the Yin-Enriching Spirit-Calming Decoction. When epilepsy reaches the stage of kidney deficiency, ordinary kidney-tonifying herbs are insufficient. Instead, potent substances like Placenta Pill, which are rich in vital essence, are often required to achieve results.
5. Kidney Deficiency︰Recurrent episodes for years without cure, sudden fainting, mental confusion, pale complexion, limb convulsions, or head and eyes turning to one side, frothing at the mouth, involuntary urination and defecation, cold sweating, followed by snoring and deep sleep, gradually waking after some time. In daily life, there may be soreness and weakness in the lower back and knees, heel pain, or seminal emission, impotence, premature ejaculation, or excessive leucorrhea, or even gradual decline in intelligence. The pulse is deep, thin, and slippery, the tongue texture is pale, with thin and scant coating. $Blood deficiency epilepsy and kidney deficiency epilepsy! Blood deficiency epilepsy often occurs due to wind movement caused by blood deficiency, triggering epileptic seizures, mostly accompanied by signs of heart and liver blood deficiency, such as palpitation, severe palpitation, dry eyes, thin pulse, scant coating, etc. Kidney deficiency epilepsy mostly arises from long-standing epilepsy, severe damage to kidney qi, Suwen. Daqi Lun: "The urgency of the two yin leads to epilepsy and syncope," where the two yin refer to the Foot Shaoyin Kidney. Or it may stem from congenital insufficiency, "fetal epilepsy" from childhood, prolonged illness, and gradual decline of essential qi, all of which can lead to kidney qi deficiency. Each episode further depletes healthy qi, making it unable to overcome pathogenic factors, resulting in increasingly frequent seizures, even multiple times a day. The kidney opens into the two yin and governs the opening and closing of the bladder. When kidney qi is injured, the regulation of opening and closing is impaired, leading to involuntary urination and defecation during seizures. The difference from blood deficiency epilepsy lies in the accompanying symptoms of soreness and weakness in the lower back and knees, mental dullness, or seminal emission, impotence, premature ejaculation, or persistent leucorrhea—all signs of kidney deficiency. Epilepsy that persists without cure often converts from excess to deficiency, commonly manifesting as blood deficiency or kidney deficiency, and ultimately mostly transforming into kidney deficiency. Treatment should avoid reckless use of harsh methods due to accompanying excess. "Ancient and Modern Medical Cases": "Manic and depressive psychosis is mostly excess (eight or nine out of ten), while epilepsy is mostly deficiency (eight or nine out of ten)." Blood deficiency epilepsy is treated by nourishing blood and soothing the liver, supplemented by resolving wind-phlegm, with the formula Enriching Yin Calming Spirit Decoction. When epilepsy reaches the stage of kidney deficiency, ordinary kidney-tonifying herbs are insufficient; often, life-nourishing substances like Placenta Pill are required to achieve efficacy.

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1. Suwen-Daqi Lun: "The heart pulse is full and large, indicating epilepsy and muscular spasm; the liver pulse is small and rapid, indicating epilepsy and muscular spasm."
2. Zhengzhi Zhunsheng．Pediatrics: "Epilepsy occurring at dawn is related to Shaoyang, in the morning to Jueyin, at noon to taiyang, at dusk to Taiyin, at nightfall to Yangming, and at midnight to Shaoyin. Add guiding herbs to the decoction accordingly."