Introduction: Experiences of various TCM experts in treating epilepsy.

Zhao Xiwu

Based on previous experience, in long-term clinical practice, Chaihu Longgu Muli Decoction has been consistently used to treat epilepsy.

For general epilepsy cases that initially respond to Western medication like phenytoin sodium but relapse after discontinuation, remain uncontrolled, or are incurable, often presenting with paroxysmal convulsions or accompanied by headaches and dizziness, the treatment approach should focus on subduing yang, harmonizing the liver, promoting bowel movements, and dispelling phlegm.

Modified Chaihu Longgu Muli Decoction is prescribed: Bupleurum root 20g, raw dragon bone 20g, raw oyster shell 20g, pinellia tuber 12g, poria 12g, peony root 10g, honey-fried licorice root 10g, scutellaria root 10g, cinnamon twig 10g, rhubarb 10g, fresh ginger 10g, salvia root 30g, jujube (split) 10 pieces.

The modified Chaihu Longgu Muli Decoction serves as a versatile formula because it addresses a broad range of conditions. In the formula, Bupleurum root, dragon bone, and oyster shell work to harmonize the liver, subdue yang, and extinguish wind, making it suitable for wind-type epilepsy. Salvia root combined with dragon bone and oyster shell nourishes blood and calms fright, treating fright-type epilepsy. Rhubarb, licorice root, and pinellia tuber also aid in digestion and resolve food stagnation, treating food-induced epilepsy.

If there is a large amount of phlegm during the seizure, first take 9g of Mengshi Guntan Pills morning and evening for 2 consecutive days to eliminate the phlegm, and then start using the above general formula on the third day.

Thick phlegm is referred to as "tan," while thin phlegm is called "yin." Usually or after a seizure, in addition to thin phlegm, symptoms such as breathlessness and a feeling of fullness in the chest are characteristic. It is advisable to first resolve the yin and dispel the phlegm, and Xiaoqinglong Decoction can also be used to achieve a cure.

Medicinal ingredients: Ephedra 6g, Asarum 6g, Pinellia 12g, Cinnamon Twig 10g, White Peony Root 10g, Licorice Root 10g, Schisandra 10g, Dried Ginger 10g. For cases of long-term illness that have not healed or seizures occurring once every few days, if symptoms such as phlegm or yin are present, treat the symptoms first.

Due to the prolonged illness often leading to deficiency, it is advisable to gradually treat the root cause. Long-term use of the "Root-Treatment Formula" can be effective. Medicinal ingredients: Cimicifuga 120g, Fritillaria 60g, Dried River Snail Shell (baked) 60g, Crucian Carp (baked) 1 piece. Grind into fine powder, mix with honey to form pills, each pill weighing 6g. Take one pill morning and evening.

For frequent-onset epilepsy with relatively frequent seizures, even several times a day, often accompanied by headache and dizziness, it is advisable to first use the modified Yin Feng Tang. The prescription includes: 20g of raw Longgu (dragon bone), 20g of raw Muli (oyster shell), 20g of raw Shigao (gypsum), 20g of Chishizhi (red halloysite), 30g of Zishiying (fluorite), 12g of Huashi (talc), 12g of Hanshuishi (calcite), 12g of Dihuang (rehmannia root), 10g of Ganjiang (dried ginger), 10g of Guizhi (cinnamon twig), 10g of Gancao (licorice root), 6g of Dahuang (rhubarb), and 3g of Quanxie (scorpion).

Once symptoms have alleviated, switch to the general formula. If seizures occur only once after taking medication for more than half a month, or if the condition does not worsen after discontinuing Western medications such as phenytoin sodium, switch to this formula.

For cerebral cysticercosis epilepsy, characterized by severe headache, white patches on the face, red spots on the tip of the tongue resembling a raspberry tongue (also known as a strawberry tongue), treatment should focus on expelling parasites. For severe headache, choose Renshen Baidu San with realgar or administer 30g of Wumei Wan, or 3g of Huachong Wan, taken twice daily.

Huachong Wan formula: 30g of realgar, 30g of dried alum, 30g of dried lacquer, 60g of hesishi (carpesium fruit), 60g of binglang (areca nut), 20g of leiwan (omphalia), and 90g of baibu (stemona root). Grind into fine powder and form into pills with water.

——Selected from "Zhao Xiwu's Medical Experience"

Li Shoushan

In treating this disease, I first differentiate between yin and yang.

Yang epilepsy often presents as major seizures, more common in adults. In acute cases, treat the symptoms first by clearing heat, extinguishing wind, eliminating phlegm, and calming epilepsy.

For frequent seizures with headache, dizziness, red tongue, and large pulse before the attack, the modified Fengyin Decoction is commonly used: Cinnamon Twig 10g, Rhubarb 7.5g, Dried Ginger 7.5g, Gypsum 30g, Calcite 15g, Talcum Powder 15g, Fluorite 30g, Salvia 25g, Dragon Bone 25g, Oyster Shell 25g, Halloysite 20g, Uncaria 30g, Scorpion 5g, Centipede 2 pieces. Decoct in water, one dose daily.

After symptoms are alleviated and the frequency of attacks is reduced, continue with the empirical formula Zhi Xian Dan: Turmeric 15g, Arisaema cum Bile 15g, Pinellia 15g, Dragon's Blood 15g, Black Snake 1-5g, Scorpion 1-5g, Centipede 15g, Cinnabar 5g, Alum 7.5g, Gleditsia 7.5g, Borneol 3g, Musk 0.2g, Bezoar 0.2g. Grind into fine powder. Adults take 3g each time, twice daily in the morning and evening. Reduce dosage for children as appropriate.

For Yin-type epilepsy, use Chaihu Jia Longgu Muli Tang.

Yin-type epilepsy often presents as minor seizures, more common in adolescent patients. Treatment focuses on calming the liver to extinguish wind, and tranquilizing the mind to control seizures.

For frequent seizures with pre-attack anxiety, irritability, pale tongue, and thready pulse, the modified Chaihu Jia Longgu Muli Tang (Bupleurum, Dragon Bone, and Oyster Shell Decoction) is commonly used: Bupleurum root 15g, Pinellia tuber 15g, Scutellaria root 10g, wine-processed rhubarb 10g, cinnamon twig 10g, poria 20g, raw dragon bone 25g, raw oyster shell 25g, magnetite 50g, salvia root 30g, fresh ginger 10g, jujube 5 pieces. Decoct in water, one dose daily.

After seizure frequency and symptoms have alleviated, continue with Wuwei Zhixian San (Five-Ingredient Seizure-Stopping Powder): equal parts of scorpion, silkworm, salvia root, centipede, and cicada slough, ground into fine powder. Take 3g each time, once in the morning and once in the evening. Reduce dosage for children as appropriate.

—Selected from *Contemporary Master Physicians' Clinical Insights: Mania and Epilepsy Special Edition*

Peng Jingshan

Epilepsy, commonly known as "sheep epilepsy," typically manifests with a sudden scream, loss of consciousness, foaming at the mouth, and rigidity or twisting of the limbs and torso.

The etiology often involves disorders of the five internal organs, internal stirring of liver wind, and obstruction by phlegm turbidity, which may also affect the Yin, Yang, Wei, Qiao, and Du meridians. The *Inner Canon* states: "Sudden urgency of the second Yin leads to epilepsy and syncope." The symptoms often include sudden collapse and unconsciousness, lasting only one or two minutes or slightly longer before recovery. Since doctors rarely witness the episodes, it is difficult to differentiate the type of epilepsy or identify the affected internal organs.

In adults, epilepsy is often triggered by fright or anger, while in children, it is typically congenital. Although not life-threatening, it is a lifelong condition with no definitive cure. The intervals between episodes vary, and effective treatments remain limited.

Treatment should focus on calming convulsions and stopping spasms. In clinical practice, the self-formulated Zhijing Chuxian Powder is commonly used: 60g of raw Os Draconis (calcined), 60g of raw Concha Ostreae (calcined), 45g of Fluoritum, 45g of Gypsum Rubrum, 45g of Halloysitum Rubrum, 45g of Halloysitum Album, 45g of raw Gypsum Fibrosum, 45g of Talcum, 60g of raw Haematitum, 15g of Ramulus Cinnamomi, 60g of Lignum Dalbergiae Odoriferae, 60g of Ramulus Uncariae cum Uncis, 15g of Rhizoma Zingiberis, 15g of Radix et Rhizoma Rhei, and 15g of Radix et Rhizoma Glycyrrhizae.

Usage: Grind into a very fine powder. Adults take 5g each time, 2-3 times daily. Children under 3 years old may take 0.5–1g, and those aged 5–10 may be increased to 2g as appropriate. It must be taken continuously for 1–3 months without interruption.

This formula is effective for various types of epilepsy. It is derived from the Wind-Dispersing Decoction (Feng Yin Tang) from the *Synopsis of the Golden Chamber* (*Jin Gui Yao Lue*).

—Selected from *A Collection of Effective and Secret Formulas from the First Group of Nationally Recognized Senior TCM Physicians*

Jiang Yuren

Epilepsy due to insufficiency of the heart and spleen often occurs in timid and easily frightened children, with fear being the main cause of the seizures, belonging to the category of "fright epilepsy."

This type of epilepsy similarly presents with varying degrees of convulsions and transient loss of consciousness. Although clinical manifestations include signs of "wind" and "phlegm" syndromes, the cause should not be attributed to wind or phlegm disturbances, but rather to deficiency of heart and spleen qi.

Therefore, the treatment principle must focus on nourishing the heart to calm the spirit and tonifying the heart and spleen, using the Modified Licorice, Wheat, and Jujube Decoction.

Composition: Prepared Licorice Root 20g, Wheat 60g, Arborvitae Seed 60g, Magnetite 100g, Calcined Dragon Bone 100g, Calcined Oyster Shell 100g, Polygala Root 60g, Longan Aril 100g, Lotus Seed 100g.

Since daily decoction of herbal medicine over a long period is extremely inconvenient and may affect appetite, the above formula for 10 doses can be simmered twice over low heat to obtain approximately 800-1000ml of medicinal liquid. Add 250g of rock sugar and 250g of honey to make a syrup. Take 1 spoonful each time, diluted with boiling water, once in the morning and once in the evening.

It can be stored in the refrigerator or kept in a cool place. To prevent mold, the medicine should be steamed over water once every 5 days. Generally, taking the above prescription continuously for 6 months to 1 year can achieve good therapeutic effects.

—Selected from *The Golden Mirror of Ancient and Modern Famous Physicians' Clinical Practice: Mania and Epilepsy Volume*

Yin Huihe

Dr. Yin is skilled in using Didang Decoction to treat epilepsy. The prescription composition is: leech 10g, ground beetle 12g, peach kernel 12g, rhubarb 4g.

Indications: dysmenorrhea, epilepsy, etc. Contraindications: This prescription should not be used for epilepsy without a clear history of trauma.