颠者异常也。平日能言。颠则沉默。平日不言。颠则呻吟。甚则僵仆直视。心常不乐。
狂者
。且好杀人。然颠为心血不足。狂为痰火实盛。治狂专于下痰降火。治颠则兼乎安神养血。
若神脱目瞪。如愚痴者不治。
安神养志丸 治颠症。
当归 生地 枣仁 黄连 玄参 白术（各三两） 人参 甘草 胆南星（各一两二钱）
上为末。荷叶汤为丸。每服二钱。空心白滚汤送下。
紫金锭 治颠狂二症。姜汤磨服二钱（方见痰门）
虎睛丸 治失心风颠发狂。精神恍惚。时作谵语。
虎睛（一对微炒） 大黄（酒蒸） 远志（各一两） 山栀（炒六钱）
上为末蜜丸。每服一钱五分。白滚汤送下。
坠痰丸 治痰火凝结于胸膈。以致颠狂。谵语妄言。
大黄（酒煨一两） 贝母（去心） 胆星 青礞石（ 过） 石菖蒲（各一两） 麝香（一钱）
蛇含石（ 红醋淬七次五钱）
上为末。姜汁为丸。每服一钱。空心白滚汤下。
凡人染邪祟。皆因精神衰乏。邪从而入。其脉乍大乍小。乍长乍短是也。
灸鬼眼穴。以两手大指并缚定。用大艾炷骑缝灸之。务令两甲角。及甲后四处。着火方效。
（附嘈杂 附呃逆）
痞者否塞之意也。从病从否。故有痞之名焉。又以其坚实有形。故又名之曰痞块。然是
物也
自成块。各自成块者易
治。并而成块者难消然果何以辨之。察其脉视其形而已矣。脉弦为痰。脉滑为食。脉芤为血
。三脉俱见。则并而成块也。以其形而言之。宿食成块者。居于中脘视之则无形。按之则有
质。在肠胃之间。以人之饮食。皆入于胃。故不在皮里膜外。其在皮里膜外者。皆痰与血。
盖痰能流注于脂膜血能营运于皮肉。痰积而不流。则脂膜之间为其所据。而有形可见。血
瘀而不行。则皮肉之间为其所碍。而亦有形可见也。欲辨痰与血之异亦审其痛之何如耳
。痛甚者为血。痛不甚者为痰。又手推不动者为血。手推易动者为痰。以热物熨之而痛缓者
为血。熨之而无所觉者为痰。此痰与血之辨也。若痰血相成者。何以辨之。块之所渐而大者
是也。盖先有死血。而又有痰。以裹之则以渐而大。先有积痰。而又有血。以并之亦以渐而
大。若单是血。或单是痰。无相并相裹之物。只如初起之形而已。何至以渐而大乎。然宿食
成块。亦未有不资于痰与血者。是何也。盖饮食所伤者。惟中脘作痛。或按之硬实而已。初
未尝如弹丸之形者。使不资于痰与血。何以成块乎。必先有硬饭。或鱼与肉。或馄饨米团之
类。一时失嚼误咽。
停于胃中。经月不能消化。碍其道路。血流过其处。
又裹一层。痰与血共相裹之。则不能不成块矣。裹一层则大一层。故始
如弹丸。久则如杯如碗。其初尚隐于胃中。犹有质而无形。其后渐大。则腹皮顶起。而形外
见矣。又有时升时降。时隐时见者。乃气块也。或左或右。或上或下。按之不见块。不按又
若有形。而漉漉作声。乃停饮也。非块也。此才论其块云耳。然以其在人而言。则虽各有
专
病。又不可拘也。如妇人之块。多恶血而亦有气成者。小儿之块。多食积而亦有痰成者。易
怒之人。多气癖而亦有血成者肥胖之人。多痰饮而亦有食成者。当问其得病之由。或偶伤食
。自此日而起始也。或殴受气者。自此而起。或偶因负重劳力。自此日而起者。或平素有郁
痰胶固。偶发作而起者。在妇人。必审其月事之通闭。在小儿。必审其饮食之多寡。皆当以
意求之不能尽述也。
癫证表现为神志异常。平时能说话的人，发病时却沉默不语；平时不说话的人，发病时却呻吟不止。严重的会出现身体僵直仆倒、两眼直视、心中常感不乐。
狂证则表现为喜欢杀人（指暴力倾向）。然而，癫证是由于心血不足所致，狂证则是由于痰火实盛引起。治疗狂证专在于下痰降火，治疗癫证则需兼顾安神养血。如果出现神气涣散、眼睛瞪大如呆痴状，属于不治之症。
安神养志丸：用于治疗癫证。
药材包括：当归、生地、枣仁、黄连、玄参、白术（各三两）；人参、甘草、胆南星（各一两二钱）。
将上述药材研为细末，用荷叶煎汤泛丸。每次服用二钱，空腹时用白开水送服。
紫金锭：用于治疗癫证和狂证两种病症。用姜汤磨服二钱（方剂详情见“痰门”章节）。
虎睛丸：用于治疗失心风引起的癫狂发作。症状包括精神恍惚、时常说胡话（谵语）。
药材包括：虎睛（一对，微炒）、大黄（酒蒸）、远志（各一两）；山栀（炒六钱）。
将上述药材研为细末，用蜂蜜制成丸剂。每次服用一钱五分，用白开水送服。
坠痰丸：用于治疗痰火凝结于胸膈，从而导致癫狂、说胡话及妄言。
药材包括：大黄（酒煨一两）、贝母（去心）、胆星、青礞石（煅过）、石菖蒲（各一两）；麝香（一钱）；蛇含石（用红醋淬炼七次，五钱）。
将上述药材研为细末，用姜汁制成丸剂。每次服用一钱，空腹时用白开水送服。
凡是人感染邪祟，都是因为精神衰败匮乏，邪气乘虚而入。其脉象表现为忽大忽小，忽长忽短。
灸鬼眼穴的方法：将两手大拇指并拢绑紧，用大艾炷在拇指缝隙处施灸。务必使两个指甲角以及指甲后方四处着火，这样才有效。
（附：嘈杂 附：呃逆）
痞，意为否塞不通。从病字旁，从“否”字，所以有“痞”这个名称。又因为其实坚实而有形，所以又名之为“痞块”。然而，这种物事如果是各自独立成块的，容易治疗；如果融合在一起成块的，难以消除。那么究竟如何辨别呢？通过观察脉象和形体就可以了。脉弦主痰，脉滑主食积，脉芤主血虚或出血。如果这三种脉象同时出现，就是融合而成的痞块。
从形体方面来说，宿食形成的痞块，位于中脘部位，看外表没有形状，按压下去则有实质感。因为它位于肠胃之间，人的饮食都进入胃中，所以不在皮里膜外。那些位于皮里膜外的，都是痰和血。因为痰能流注于脂膜，血能营运于皮肉。痰积聚而不流动，就会占据脂膜之间的空间，从而形成可见的有形之物；血瘀滞而不运行，就会阻碍皮肉之间，也形成可见的有形之物。想要辨别是痰还是血，只需审察疼痛的情况即可。疼痛剧烈的属于血证，疼痛不剧烈的属于痰证。用手推不动的属于血证，用手推容易移动的属于痰证。用热物熨烫后疼痛缓解的属于血证，熨烫后毫无感觉的属于痰证。这就是痰与血的辨别方法。
如果是痰和血相互结合形成的痞块，如何辨别呢？这是指痞块逐渐变大的情况。先是有了死血，又有痰包裹它，所以逐渐变大；先有了积痰，又有血与之合并，也会逐渐变大。如果只是单纯的血，或者单纯的痰，没有相互合并包裹的物质，就只保持初起时的形状，怎么会逐渐变大呢？然而，宿食形成的痞块，也未尝不借助于痰和血。为什么呢？因为饮食所伤，只是在中脘部位作痛，或者按压时感觉硬实而已。起初并没有像弹丸那样的形状。如果不借助于痰和血，怎么能成块呢？必定是先有硬饭，或者鱼、肉、馄饨、米团之类，一时咀嚼不当误咽下去，停滞在胃中，经过一个月都不能消化，阻碍了道路。血液流经此处时，又包裹了一层，痰与血共同包裹它，这样就必然成块了。每包裹一层就增大一层，所以开始像弹丸，久了就像杯碗一样大。起初还隐藏在胃中，虽然有实质但没有外形；后来逐渐变大，腹皮被顶起，外形就显露在外面了。
有时痞块位置升降不定，时而隐藏时而显现的，那是气块。或在左或在右，或在上或在下，按压时看不见块状，不按又好像有形，并且发出漉漉的声音，那是停饮（水饮停留），不是痞块。以上只是论述了痞块的情况。然而，就人体而言，虽然各有专门的病因，也不可以拘泥不变。比如妇女的痞块，多是恶血所致，也有因气形成的；小儿的痞块，多是食积所致，也有因痰形成的；易怒的人，多因气癖（气滞）而成，也有因血形成的；肥胖的人，多因痰饮而成，也有因食积形成的。应当询问得病的缘由，或是偶然伤食，从此日开始发作；或是受气恼怒，从此日开始发作；或是偶然因负重劳力，从此日开始发作；或是平素就有郁结之痰胶固，偶然发作而起的。对于妇人，必须审察其月经的通闭情况；对于小儿，必须审察其饮食的多寡。这些都应当用心推求，不能一一详尽叙述。
Dian syndrome (epileptic psychosis / depression-type psychosis) manifests as abnormal mental state. A person who can normally speak becomes silent during an episode; a person who is usually silent begins to moan. In severe cases, the patient may experience rigid collapse, fixed staring of the eyes, and persistent dissatisfaction or sadness in the heart/mind.
Kuang syndrome (manic psychosis) is characterized by violent tendencies, such as a desire to kill others. However, Dian syndrome is caused by insufficiency of Heart Blood, whereas Kuang syndrome is caused by excessive accumulation of Phlegm-Fire. The treatment for Kuang syndrome focuses specifically on purging Phlegm and descending Fire, while the treatment for Dian syndrome must concurrently calm the Spirit (Shen) and nourish Blood. If there is escape of the Spirit (Shen), wide-open staring eyes, and a demeanor resembling idiocy, it is considered incurable.
Anshen Yangzhi Wan (Calm Spirit and Nourish Will Pill): Used to treat Dian syndrome.
Ingredients: Danggui (Angelicae Sinensis Radix), Shengdi (Rehmanniae Radix), Zaoren (Ziziphi Spinosae Semen), Huanglian (Coptidis Rhizoma), Xuanshen (Scrophulariae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 3 liang); Renshen (Ginseng Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Dantanxing (Arisaematis Cum Bile Rhizoma) (each 1 liang 2 qian).
Grind the above ingredients into fine powder. Use decoction of lotus leaves to form pills. Take 2 qian per dose, administered with plain warm water on an empty stomach.
Zijin Ding (Purple Gold Pellet): Used to treat both Dian and Kuang syndromes. Grind 2 qian with ginger juice and take orally (Formula details are found in the "Phlegm Section").
Hujing Wan (Tiger Eye Pill): Used to treat Dian and manic episodes caused by "Loss of Heart Wind." Symptoms include spiritual confusion, vagueness of mind, and occasional delirious speech (Zhanyu).
Ingredients: Hujing (Tiger's Eyes) (one pair, lightly stir-fried), Dahuang (Rhei Radix et Rhizoma) (steamed with wine), Yuanzhi (Polygalae Radix) (each 1 liang); Shanzhi (Gardeniae Fructus) (stir-fried, 6 qian).
Grind the above ingredients into fine powder and mix with honey to form pills. Take 1.5 qian per dose, administered with plain warm water.
Zhuitan Wan (Sinking Phlegm Pill): Used to treat Dian and Kuang syndromes caused by Phlegm-Fire congealing in the chest and diaphragm, leading to delirious speech and妄言 (delusional talk).
Ingredients: Dahuang (Rhei Radix et Rhizoma) (roasted with wine, 1 liang), Beimu (Fritillariae Bulbus) (heart removed), Danxing (Arisaematis Cum Bile Rhizoma), Qingmengshi (Calcaris Auripigmenti) (calcined), Shichangpu (Acori Tatarinowii Rhizoma) (each 1 liang); Shexiang (Moschus) (1 qian); Shehanshi (Ophicalcitum) (quench seven times in red vinegar, 5 qian).
Grind the above ingredients into fine powder and mix with ginger juice to form pills. Take 1 qian per dose, administered with plain warm water on an empty stomach.
When a person contracts evil influences (Xie Sui), it is because their Spirit (Shen) and Qi are depleted, allowing the evil to enter. The pulse presents as alternating between large and small, long and short.
To moxa the Guiyan Acupoint (Ghost Eye Point): Bind the two thumbs together tightly. Apply a large cone of moxa directly on the seam between the thumbs. It is essential that the fire ignites at the corners of the two fingernails and at four points behind the nails for efficacy.
(Attached: Zaocha [Gastric Discomfort/Burning Sensation] Attached: Eni [Hiccups])
Pi (Distension/Blockage) implies obstruction or blockage. It takes its name from the character "Pi" (否), meaning obstruction. Because it is solid, firm, and has a tangible form, it is also called Pikuai (Pi Mass). However, if these masses form independently and separately, they are easy to treat; if they merge into one mass, they are difficult to dissipate. How then can they be distinguished? By observing the pulse and the physical form. A wiry (Xian) pulse indicates Phlegm; a slippery (Hua) pulse indicates Food Stagnation; a hollow (Kou) pulse indicates Blood deficiency or bleeding. If all three pulses appear simultaneously, it indicates a merged mass.
Regarding the physical form: Masses formed by retained food are located in the Zhongwan region. They have no visible external shape but feel solid upon palpation. Since they reside within the intestines and stomach, where food enters the stomach, they are not located in the subcutaneous tissue or fascia. Those located in the subcutaneous tissue and fascia are either Phlegm or Blood. Phlegm can flow into the fatty membranes, and Blood circulates in the skin and muscles. When Phlegm accumulates and fails to flow, it occupies the space between the fatty membranes, becoming visibly tangible. When Blood stasis fails to move, it obstructs the space between the skin and muscles, also becoming visibly tangible. To distinguish between Phlegm and Blood, examine the nature of the pain. Severe pain indicates Blood; mild pain indicates Phlegm. A mass that cannot be moved by hand pressure indicates Blood; a mass that moves easily indicates Phlegm. Pain that alleviates with hot compresses indicates Blood; no sensation with hot compresses indicates Phlegm. This is the distinction between Phlegm and Blood.
How to distinguish when Phlegm and Blood combine? This is identified by the gradual enlargement of the mass. If there is initially dead blood (Blood Stasis) which is then wrapped by Phlegm, it gradually enlarges. If there is initially accumulated Phlegm which is then combined with Blood, it also gradually enlarges. If it is solely Blood or solely Phlegm, without mutual combination or wrapping, it would remain only in its initial form and not enlarge gradually. However, masses formed by retained food also invariably rely on Phlegm and Blood. Why? Injury from diet typically causes pain in the Zhongwan region or hardness upon palpation, but initially lacks the shape of a pellet. Without the assistance of Phlegm and Blood, how could a mass form? There must first be indigestible items like hard rice, fish, meat, dumplings, or rice balls, swallowed improperly due to poor chewing. These stagnate in the stomach and fail to digest for months, obstructing the pathways. As blood flows past this obstruction, it wraps around it, and Phlegm and Blood jointly encase it, inevitably forming a mass. Each layer of wrapping increases the size. Thus, it starts the size of a pellet, and over time grows to the size of a cup or bowl. Initially, it remains hidden within the stomach, having substance but no external form. Later, as it enlarges, it pushes up the abdominal wall, making the form externally visible.
If the mass shifts position, rising and falling, appearing and disappearing intermittently, it is a Qi Mass. If it appears on the left or right, upper or lower, with no visible lump upon pressing but a sensation of form when not pressed, accompanied by gurgling sounds, it is Fluid Retention (Ting Yin), not a true mass. This concludes the discussion on masses. However, regarding the human body, although there are specific diseases, one should not be rigid. For example, masses in women are often due to Evil Blood (Stasis), but some are formed by Qi. Masses in children are often due to Food Accumulation, but some are formed by Phlegm. People prone to anger often have masses due to Qi Stagnation (Qi Pi), but some are formed by Blood. Obese people often have masses due to Phlegm-Fluids, but some are formed by Food. One must inquire about the origin of the disease: Did it start after accidental dietary injury? After emotional trauma or anger? After heavy lifting or labor? Or did it arise from pre-existing stagnant Phlegm that suddenly manifested? For women, one must examine the regularity and closure of menstruation. For children, one must examine the quantity of food intake. All these require careful deduction and cannot be exhaustively listed.