Seizure and Mania

癲狂

Diān kuáng

This is the earliest systematic account in Chinese medicine of what the tradition would later split into epilepsy and psychosis, and it keeps them under two words: dian, the falling sickness, and kuang, mania. The distinction is made by onset and by conduct. Dian begins with joylessness, heaviness of the head, staring eyes and redness, and its variants are named by the tissue they lodge in — bone, sinew, vessel — each with the same grim prognosis once frothy vomiting and downward leakage of qi appear. Kuang begins with self-praise and cursing, or with sorrow and suspicion, and the text sorts it by the emotion that brought it on: grief and hunger, great terror, great joy.The technique is unusually concrete. The physician is told to live with the patient and watch for the moment of attack, to bleed whatever is full until the colour of the blood changes, and to keep the drawn blood in a gourd. If the blood stirs at the time of the next attack, the diagnosis is confirmed; if it does not, the sacrum is cauterised. Whatever one makes of the test, it is a rare instance of a prognostic procedure described step by step rather than asserted.The chapter's first paragraph is easy to skip and should not be. Before any disease is named, the canthi are defined — sharp canthus outward, inner canthus by the nose, upper for outer and lower for inner. Every later statement about the eye in this book depends on that grid, and the passage on yin and yang qiao in the previous chapter closes on the same point.The tail of the chapter leaves seizure and mania behind and becomes a short register of reversals: wind reversal with swollen limbs, jue reversal with a chest about to split, retention of urine, and deficient qi with a broken voice. The collation keeps the base text's 祭 for 察, 抒 for 杼, and 凊 for 清, each noted rather than smoothed.

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目眦外決于面者,爲鋭眦,在内近鼻者,爲内眦。上爲外眦,下爲内眦。 目眦外决于面者,为锐眦,在内近鼻者,为内眦。上为外眦,下为内眦。
mù zì wài jué yú miàn zhě, wéi ruì zì, zài nèi jìn bí zhě, wéi nèi zì. shàng wéi wài zì, xià wéi nèi zì.
目眦向外开张于面部的,是锐眦;在内靠近鼻子的,是内眦。上部是外眦,下部是内眦。
The canthus that opens outward on the face is the sharp canthus; the one inside, near the nose, is the inner canthus. Above is the outer canthus, below the inner canthus.
癲疾始生,先不樂,頭重痛,視舉目赤,甚作極,已而煩心,候之于顔,取手太陽、陽明、太陰,血變而止。 癫疾始生,先不乐,头重痛,视举目赤,甚作极,已而烦心,候之于颜,取手太阳、阳明、太阴,血变而止。
diān jí shǐ shēng, xiān bù lè, tóu zhòng tòng, shì jǔ mù chì, shèn zuò jí, yǐ ér fán xīn, hòu zhī yú yán, qǔ shǒu tài yáng, yáng míng, tài yīn, xuè biàn ér zhǐ.
癫疾初起,先是不快乐,头重而痛,两眼上视,目赤,发作得很厉害,过后心烦。要在面部观察病色,取手太阳、手阳明、手太阴,等到血色变正常就停针。
When seizure disease first arises, the patient is joyless, the head is heavy and painful, the eyes are raised and red, the attacks are extreme, and afterwards the heart is vexed. Observe the colour of the face and take hand taiyang, yangming and taiyin; stop when the blood changes colour.
癲疾始作,而引口啼呼喘悸者,候之手陽明、太陽,左强者,攻其右;右强者,攻其左,血變而止。 癫疾始作,而引口啼呼喘悸者,候之手阳明、太阳,左强者,攻其右;右强者,攻其左,血变而止。
diān jí shǐ zuò, ér yǐn kǒu tí hū chuǎn jì zhě, hòu zhī shǒu yáng míng, tài yáng, zuǒ qiáng zhě, gōng qí yòu; yòu qiáng zhě, gōng qí zuǒ, xuè biàn ér zhǐ.
癫疾开始发作,口角牵引,啼哭呼叫,气喘心悸的,在手阳明、手太阳经上诊察。左侧拘强的,刺右侧;右侧拘强的,刺左侧,血色变正常就停针。
When the seizure begins with the mouth drawn aside, crying out, panting and palpitation, examine hand yangming and taiyang. If the left is rigid, attack the right; if the right is rigid, attack the left. Stop when the blood changes colour.
癲疾始作,先反僵,因而脊痛,𠉀之足太陽、陽明、太陰、手太陽,血變而止。 癫疾始作,先反僵,因而脊痛,𠉀之足太阳、阳明、太阴、手太阳,血变而止。
diān jí shǐ zuò, xiān fǎn jiāng, yīn ér jí tòng, hòu zhī zú tài yáng, yáng míng, tài yīn, shǒu tài yáng, xuè biàn ér zhǐ.
癫疾开始发作,先角弓反张,接着脊背疼痛的,在足太阳、足阳明、足太阴、手太阳经上诊察,血色变正常就停针。
When the seizure begins with opisthotonos and the spine then hurts, examine foot taiyang, yangming and taiyin and hand taiyang. Stop when the blood changes colour.
治癲疾者,常與之居,祭其所當取之處,病至,視之有過者寫之,置其血于瓠壺之中,至其發時,血獨動矣;不動,灸窮骨二十壯。窮骨者,骶骨也。 治癫疾者,常与之居,祭其所当取之处,病至,视之有过者写之,置其血于瓠壶之中,至其发时,血独动矣;不动,灸穷骨二十壮。穷骨者,骶骨也。
zhì diān jí zhě, cháng yǔ zhī jū, jì qí suǒ dāng qǔ zhī chù, bìng zhì, shì zhī yǒu guò zhě xiè zhī, zhì qí xuè yú hù hú zhī zhōng, zhì qí fā shí, xuè dú dòng yǐ; bù dòng, jiǔ qióng gǔ èr shí zhuàng. qióng gǔ zhě, dǐ gǔ yě.
治疗癫疾,要常和病人住在一起,观察应当取穴的部位。病发作时,看到邪气过盛之处就泻它。把泻出的血放在葫芦里,到下次发作时,血会独自摇动;如果不摇动,就灸穷骨二十壮。穷骨,就是骶骨。
In treating seizure disease, stay with the patient and watch for the place that should be taken. When an attack comes, drain whatever is excessive. Put the blood drawn into a gourd vessel: at the time of the next attack the blood will stir of itself. If it does not stir, cauterise the exhausted bone twenty times. The exhausted bone is the sacrum.
骨癲疾者,顑齒諸腧分肉皆滿而骨居,汗出煩悗,嘔多沃沫,氣下泄,不治。 骨癫疾者,顑齿诸腧分肉皆满而骨居,汗出烦悗,呕多沃沫,气下泄,不治。
gǔ diān jí zhě, kǎn chǐ zhū shù fēn ròu jiē mǎn ér gǔ jū, hàn chū fán náo, ǒu duō wò mò, qì xià xiè, bù zhì.
骨癫疾,腮齿各部腧穴与分肉都胀满,邪气深居骨中,汗出心烦,呕吐大量涎沫,气从下泄的,不能治。
In bone seizure the cheek, the teeth, the transports and the interstices are all full, and the bone holds the evil deep; there is sweat, vexation, copious frothy vomiting and qi leaking downward. Not treated.
筋癲疾者,身倦攣急大,刺項大經之大抒脉,嘔多沃沫,氣下泄,不治。 筋癫疾者,身倦挛急大,刺项大经之大抒脉,呕多沃沫,气下泄,不治。
jīn diān jí zhě, shēn juàn luán jí dà, cì xiàng dà jīng zhī dà shū mài, ǒu duō wò mò, qì xià xiè, bù zhì.
筋癫疾,身体倦怠,筋脉拘挛拘急而粗大,刺项部大经的大抒脉。若呕吐大量涎沫,气从下泄的,不能治。
In sinew seizure the body is weary, the sinews are drawn tight and large; needle the great shu vessel of the great channel of the nape. With copious frothy vomiting and qi leaking downward, not treated.
脉癲疾者,暴仆,四肢之脉皆脹而縱,脉滿,盡刺之出血;不滿,灸之挾項太陽,灸帶脉于腰,相去三寸,諸分肉本輸,嘔多沃沫,氣下泄,不治。 脉癫疾者,暴仆,四肢之脉皆胀而纵,脉满,尽刺之出血;不满,灸之挟项太阳,灸带脉于腰,相去三寸,诸分肉本输,呕多沃沫,气下泄,不治。
mài diān jí zhě, bào pū, sì zhī zhī mài jiē zhàng ér zòng, mài mǎn, jìn cì zhī chū xuè; bù mǎn, jiǔ zhī xié xiàng tài yáng, jiǔ dài mài yú yāo, xiāng qù sān cùn, zhū fēn ròu běn shù, ǒu duō wò mò, qì xià xiè, bù zhì.
脉癫疾,突然仆倒,四肢的脉都胀满而纵缓。脉满的,全部刺出血;脉不满的,灸挟项两旁的太阳经,再灸腰部的带脉,相距三寸,以及各分肉的本输穴。若呕吐大量涎沫,气从下泄的,不能治。
In vessel seizure the patient falls suddenly and the vessels of the four limbs swell and slacken. If the vessels are full, prick them all to bleed; if not full, cauterise the taiyang beside the nape, cauterise the belt vessel at the waist three cun apart, and the root transports of the interstices. With copious frothy vomiting and qi leaking downward, not treated.
癲疾者,疾發如狂者,死不治。 癫疾者,疾发如狂者,死不治。
diān jí zhě, jí fā rú kuáng zhě, sǐ bù zhì.
癫疾发作像狂一样的,是死证,不能治。
When the seizure breaks out like mania, it is fatal and is not treated.
狂始生,先自悲也,喜忘、苦怒、善恐者,得之憂饑,治之取手太陰、陽明,血變而止,及取足太陰、陽明。 狂始生,先自悲也,喜忘、苦怒、善恐者,得之忧饥,治之取手太阴、阳明,血变而止,及取足太阴、阳明。
kuáng shǐ shēng, xiān zì bēi yě, xǐ wàng, kǔ nù, shàn kǒng zhě, dé zhī yōu jī, zhì zhī qǔ shǒu tài yīn, yáng míng, xuè biàn ér zhǐ, jí qǔ zú tài yīn, yáng míng.
狂病初起,先是自己悲伤,喜忘事,易发怒,常恐惧,这是忧愁饥饿所得。治疗取手太阴、手阳明,血色变正常就停针,再取足太阴、足阳明。
When mania first arises the patient is sorrowful, forgetful, easily angered and often afraid; it comes from grief and hunger. Treat by taking hand taiyin and yangming, stopping when the blood changes colour, then take foot taiyin and yangming.
狂始發,少臥不饑,自高賢也,自辯智也,自尊貴也,善駡詈,日夜不休。治之取手陽明、太陽、太陰、舌下少陰,視之盛者,皆取之,不盛,釋之也。 狂始发,少卧不饥,自高贤也,自辩智也,自尊贵也,善骂詈,日夜不休。治之取手阳明、太阳、太阴、舌下少阴,视之盛者,皆取之,不盛,释之也。
kuáng shǐ fā, shǎo wò bù jī, zì gāo xián yě, zì biàn zhì yě, zì zūn guì yě, shàn mà lì, rì yè bù xiū. zhì zhī qǔ shǒu yáng míng, tài yáng, tài yīn, shé xià shào yīn, shì zhī shèng zhě, jiē qǔ zhī, bù shèng, shì zhī yě.
狂病开始发作,少睡不吃,自以为贤能,自以为聪明,自以为尊贵,善于辱骂,日夜不停。治疗取手阳明、手太阳、手太阴与舌下少阴,看到脉盛的都取,不盛的就放下不取。
When mania first breaks out the patient sleeps little and does not eat, calls himself worthy, calls himself wise, calls himself noble, and curses without stopping day or night. Treat by taking hand yangming, taiyang and taiyin and the lesser yin below the tongue; whatever is full, take it all; whatever is not full, let it be.
狂言、驚、善笑、好歌樂,妄行不休者,得之大恐,治之取手陽明、太陽、太陰。狂,目妄見,耳妄聞,善呼者,少氣之所生也,治之取手太陽、太陰、陽明,足太陰、頭兩顑。 狂言、惊、善笑、好歌乐,妄行不休者,得之大恐,治之取手阳明、太阳、太阴。狂,目妄见,耳妄闻,善呼者,少气之所生也,治之取手太阳、太阴、阳明,足太阴、头两顑。
kuáng yán, jīng, shàn xiào, hào gē yuè, wàng xíng bù xiū zhě, dé zhī dà kǒng, zhì zhī qǔ shǒu yáng míng, tài yáng, tài yīn. kuáng, mù wàng jiàn, ěr wàng wén, shàn hū zhě, shǎo qì zhī suǒ shēng yě, zhì zhī qǔ shǒu tài yáng, tài yīn, yáng míng, zú tài yīn, tóu liǎng kǎn.
狂言、惊骇、善笑、好唱歌作乐、妄行不止的,是大恐所得,治疗取手阳明、手太阳、手太阴。狂病,两眼妄见异物,两耳妄闻异声,善呼叫的,是少气所生,治疗取手太阳、手太阴、手阳明,以及足太阴与头部两侧的腮部。
For mad speech, fright, constant laughter, love of singing and music, and restless wandering without stop, the cause is great terror; treat with hand yangming, taiyang and taiyin. For mania with false seeing, false hearing and constant crying out, it is born of deficient qi; treat with hand taiyang, taiyin and yangming, foot taiyin, and the two cheekbones.
狂者多食,善見鬼神,善笑而不發于外者,得之有所大喜,治之取足太陰、太陽、陽明,後取手太陰、太陽、陽明。狂而新發,未應如此者,先取曲泉左右動脉,及盛者見血,有頃已,不已,以法取之,灸骨骶二十壯。 狂者多食,善见鬼神,善笑而不发于外者,得之有所大喜,治之取足太阴、太阳、阳明,后取手太阴、太阳、阳明。狂而新发,未应如此者,先取曲泉左右动脉,及盛者见血,有顷已,不已,以法取之,灸骨骶二十壮。
kuáng zhě duō shí, shàn jiàn guǐ shén, shàn xiào ér bù fā yú wài zhě, dé zhī yǒu suǒ dà xǐ, zhì zhī qǔ zú tài yīn, tài yáng, yáng míng, hòu qǔ shǒu tài yīn, tài yáng, yáng míng. kuáng ér xīn fā, wèi yīng rú cǐ zhě, xiān qǔ qū quán zuǒ yòu dòng mài, jí shèng zhě jiàn xuè, yǒu qǐng yǐ, bù yǐ, yǐ fǎ qǔ zhī, jiǔ gǔ dǐ èr shí zhuàng.
狂病多食,常看见鬼神,善笑而不露于外的,是有所大喜所得,治疗先取足太阴、足太阳、足阳明,后取手太阴、手太阳、手阳明。狂病新发,还没有出现上述症状的,先取曲泉左右跳动的脉,脉盛的就放血,过一会儿病就好了;不好的,依法取穴,再灸骶骨二十壮。
When the manic patient eats much, sees ghosts, and laughs without showing it, the cause is great joy; treat with foot taiyin, taiyang and yangming, then hand taiyin, taiyang and yangming. If the mania is newly arisen and has not yet reached this, first take the pulsing vessels beside Quguan; where full, let blood, and after a short while it stops. If it does not stop, take the points by rule and cauterise the sacrum twenty times.
風逆暴四肢腫,身漯漯,唏然時寒,饑則煩,飽則善變,取手大陰表裏,足少陰、陽明之經。肉凊取滎,骨凊取井、經也。 风逆暴四肢肿,身漯漯,唏然时寒,饥则烦,饱则善变,取手大阴表里,足少阴、阳明之经。肉凊取荥,骨凊取井、经也。
fēng nì bào sì zhī zhǒng, shēn tà tà, xī rán shí hán, jī zé fán, bǎo zé shàn biàn, qǔ shǒu dà yīn biǎo lǐ, zú shào yīn, yáng míng zhī jīng. ròu qìng qǔ xíng, gǔ qìng qǔ jǐng, jīng yě.
风逆,突然四肢浮肿,身体汗出湿润,唏嘘吸气而时时发寒,饥饿时心烦,饱食后容易多变。取手太阴的表里经,以及足少阴、足阳明经。肌肉清冷的取荥穴,骨中清冷的取井穴与经穴。
In wind reversal the four limbs suddenly swell, the body is damp with sweat, the breath sighs and chills come from time to time; hunger brings vexation, and repletion brings changeableness. Take the exterior and interior of hand taiyin, and the channels of foot shaoyin and yangming. For cold flesh take the spring points; for cold bone take the well and river points.
厥逆爲病也,足暴凊,胸若將裂,腸若將以刀切之,煩而不能食,脉大小皆濇,暖取足少陰,凊取足陽明。凊則補之,温則寫之。厥逆腹脹滿,腸鳴,胸滿不得息,取之下胸二脅,欬而動手者,與背腧,以手按之,立快者,是也。 厥逆为病也,足暴凊,胸若将裂,肠若将以刀切之,烦而不能食,脉大小皆涩,暖取足少阴,凊取足阳明。凊则补之,温则写之。厥逆腹胀满,肠鸣,胸满不得息,取之下胸二胁,欬而动手者,与背腧,以手按之,立快者,是也。
jué nì wéi bìng yě, zú bào qìng, xiōng ruò jiāng liè, cháng ruò jiāng yǐ dāo qiè zhī, fán ér bù néng shí, mài dà xiǎo jiē sè, nuǎn qǔ zú shào yīn, qìng qǔ zú yáng míng. qìng zé bǔ zhī, wēn zé xiè zhī. jué nì fù zhàng mǎn, cháng míng, xiōng mǎn bù dé xī, qǔ zhī xià xiōng èr xié, kài ér dòng shǒu zhě, yǔ bèi shù, yǐ shǒu àn zhī, lì kuài zhě, shì yě.
厥逆这种病,两足突然清冷,胸中像要裂开,肠中像被刀切,心烦不能进食,脉不论大小都涩。属暖的取足少阴,属冷的取足阳明。清冷的用补法,温暖的用泻法。厥逆而腹部胀满,肠鸣,胸中满闷呼吸不利,取胸下两胁间按之欬而应手而动的地方,以及背部的腧穴;用手按压立刻觉得畅快的,就是应取的穴位。
In jue reversal the feet are suddenly cold, the chest feels about to split, the intestines as if cut with a knife, with vexation and inability to eat, and the pulse, large or small, is uniformly rough. For warmth take foot shaoyin; for cold take foot yangming. Cold is tonified, warmth is drained. For jue reversal with abdominal fullness, bowel rumbling and chest fullness that prevents breathing, take the two ribs below the chest where coughing moves the hand, and the transports of the back; where pressing with the hand gives immediate relief, that is the point.
内閉不得溲,刺足少陰、太陽與骶上,以長鍼。氣逆則取其太陰、陽明、厥陰,甚取少陰、陽明動者之經也。 内闭不得溲,刺足少阴、太阳与骶上,以长针。气逆则取其太阴、阳明、厥阴,甚取少阴、阳明动者之经也。
nèi bì bù dé sōu, cì zú shào yīn, tài yáng yǔ dǐ shàng, yǐ cháng zhēn. qì nì zé qǔ qí tài yīn, yáng míng, jué yīn, shèn qǔ shào yīn, yáng míng dòng zhě zhī jīng yě.
内闭而小便不通,刺足少阴、足太阳与骶上,用长针。气逆的取太阴、阳明、厥阴,病重的取少阴、阳明经中跳动的地方。
For inner closure with no urine, needle foot shaoyin and taiyang and above the sacrum with a long needle. For qi rebellion take taiyin, yangming and jueyin; if severe, take the moving channels of shaoyin and yangming.
少氣,身漯漯也,言吸吸也。骨痠體重,懈惰不能動,補足少陰。短氣,息短不屬,動作氣索,補足少陰,去血絡也。 少气,身漯漯也,言吸吸也。骨酸体重,懈惰不能动,补足少阴。短气,息短不属,动作气索,补足少阴,去血络也。
shǎo qì, shēn tà tà yě, yán xī xī yě. gǔ suān tǐ zhòng, xiè duò bù néng dòng, bǔ zú shào yīn. duǎn qì, xī duǎn bù shǔ, dòng zuò qì suǒ, bǔ zú shào yīn, qù xuè luò yě.
少气,身体汗出湿润,说话气息微弱而断续。骨酸身体沉重,懈怠不能动,补足少阴。短气,呼吸短促不相接续,一动作就气乏,补足少阴,并去掉血络。
For deficient qi the body is damp with sweat and the voice is faint and broken. For aching bones, heavy body and slackness that prevents movement, tonify foot shaoyin. For short breath that does not continue and qi that fails on movement, tonify foot shaoyin and remove the blood luo.

Textual notes

Readings follow the base edition; significant variants are recorded here.

  1. 目眦外決于面者,爲鋭眦外決于面

    「決」讀 jué,開也,謂目眦向外開張於面。鋭眦即外眦,内眦即近鼻者。此段先定眦之部位,下文癲狂諸證皆候於目。

  2. 祭其所當取之處察其所當取之處

    「祭」於義無取,通行本作「察」,謂觀察當取之穴。此從底本照錄,義從通行本,讀仍作 jì。

  3. 置其血于瓠壺之中置其血於瓠壺之中

    瓠壺,剖瓠所爲之器。古法以瀉出之血置器中,驗其動靜以卜病之發:動則病將作,不動則灸窮骨。此爲古法,後世罕用。

  4. 大抒脉大杼脉

    大杼,足太陽經穴,在項後第一椎下。底本作「抒」,形近而訛。此從底本照錄,讀 shū,義從通行本。

  5. 身倦攣急大身倦攣急大

    倦,懈倦也;攣急,筋脈拘攣;大,謂筋粗大。筋癲疾以筋病爲主,故刺項之大經以緩其急。

  6. 善駡詈善罵詈

    駡即罵,詈亦罵也,連言以見其甚。狂者自高自賢,故日夜罵詈不休,此陽氣有餘之候。

  7. 少氣之所生也少氣之所生也

    狂而妄見妄聞善呼,非實邪有餘,乃氣不足而神不守,故曰少氣所生。治取手足太陽、太陰、陽明,補其氣。

  8. 肉凊取滎,骨凊取井、經也肉清取滎,骨清取井、經也

    「凊」讀 qìng,涼也,與「清」通。肉涼取滎穴,骨涼取井穴與經穴,此五腧分主皮肉筋骨之例。

  9. 脉大小皆濇脉大小皆澀

    「濇」爲「澀」之異體。脉不論大小皆濇,血氣不利之象,故暖取足少陰以溫之,寒取足陽明以通之。

Cite this page

APA

Huangdi Neijing · Lingshu 黃帝內經靈樞 (Compiled over the same span as the Suwen; the present text was put in order in the Tang.). Diān kuáng 癲狂 [Seizure and Mania], Chapter 22. In Classica Sinica Medica. Base text: 《黃帝素問靈樞經》十二卷八十一篇,宋·史崧校定并音釋。據上海涵芬樓《四部叢刊》子部影印明趙府居敬堂刊本錄入,卷首牌記題「上海涵芬樓景明趙府居敬堂刊本」,並記原書版匡高營造尺六寸三分、寬四寸四分。目錄末行作「元二十四卷今併爲十二卷計八十一篇」。底本與影印本均屬公有領域。 Retrieved 29 October 2026, from https://classicstcm.com/classics/huangdi-neijing-lingshu/seizure-and-mania/

MLA

"Diān kuáng 癲狂 [Seizure and Mania]." Huangdi Neijing · Lingshu 黃帝內經靈樞, chapter 22, Classica Sinica Medica, 2026, https://classicstcm.com/classics/huangdi-neijing-lingshu/seizure-and-mania/. Accessed 29 Oct. 2026. Base text: 《黃帝素問靈樞經》十二卷八十一篇,宋·史崧校定并音釋。據上海涵芬樓《四部叢刊》子部影印明趙府居敬堂刊本錄入,卷首牌記題「上海涵芬樓景明趙府居敬堂刊本」,並記原書版匡高營造尺六寸三分、寬四寸四分。目錄末行作「元二十四卷今併爲十二卷計八十一篇」。底本與影印本均屬公有領域。

Chinese scholarly

《黃帝內經靈樞·癲狂》(Huángdì Nèijīng Língshū)。《黃帝素問靈樞經》十二卷八十一篇,宋·史崧校定并音釋。據上海涵芬樓《四部叢刊》子部影印明趙府居敬堂刊本錄入,卷首牌記題「上海涵芬樓景明趙府居敬堂刊本」,並記原書版匡高營造尺六寸三分、寬四寸四分。目錄末行作「元二十四卷今併爲十二卷計八十一篇」。底本與影印本均屬公有領域。Classica Sinica Medica,2026 年 10 月 29 日 存取,https://classicstcm.com/classics/huangdi-neijing-lingshu/seizure-and-mania/。

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