谵语者，经云∶邪气盛则实，精气夺则虚，故实则谵语，虚则郑声。胃中实热，上乘于心，心
为热冒，则神识昏迷，妄有所见而言也，轻则睡中呢喃，重则不睡亦语。有谵语者，有独语者，有
语言不休者，有言乱者，此数者，见其热之轻重也。大抵热入于胃，水涸粪燥，必发谵语，为实也。
有被火劫取汗而谵语者，有亡阳谵语者，有下利清谷，不渴，谵语者，此为虚也。或脉来沉实，洪
数有力，大便不通，小水赤，燥渴，谵语狂妄，腹中胀满硬痛，或潮热自汗，或下利纯清水，心腹
硬痛者，皆里证，邪热燥屎也，俱大承气下之。下后利不止，与夫喘满气逆而上奔，自利气脱而下
夺，皆为逆也。其三阳合病，脉实，身重难转，口中不仁，面
垢遗尿，白虎汤。或大便结，大热干呕，错语呻吟不眠，犀角解毒汤。初得病无热，狂言，烦躁不
安，精采不与人相当，与五苓散三钱，以新汲水探吐；一法用桂苓汤。狂言，漱水不欲咽，大便黑，
小水不利，身黄胀满，此因当下失下，是瘀血谵语，桃仁承气，下尽黑物则愈。妇人经水适来适断，
续得寒热，此为热入血室谵语，小柴胡汤。阳明证，喜忘，如狂者，亦瘀血也，照前桃仁承气，下尽
黑物则愈矣。
郑声者，如郑卫之音，谓不正也。盖汗下后，若病久本音失而正气虚，则语散不知高下，乃精
气夺之候。其脉微细，大小便自利，小柴胡汤也。
谵语，经典记载说：邪气亢盛则表现为实证，精气耗损则表现为虚证，所以实证会出现谵语，虚证会出现郑声。胃中实热上扰于心，心被热邪蒙蔽，导致神识昏迷，胡言乱语、出现幻觉，轻则在睡眠中喃喃自语，重则即使不睡觉也胡言乱语。有的患者表现为谵语，有的表现为独语（自言自语），有的表现为言语不休，有的表现为语言错乱，这些情况反映了热邪的轻重程度。大抵热邪入胃，津液枯竭，大便燥结，必然引发谵语，这属于实证。也有因用火法强行发汗而导致谵语的，有因亡阳而导致谵语的，有因下利清谷（泻下未消化的食物）、口不渴而谵语的，这些属于虚证。如果脉象沉实、洪数有力，大便不通，小便赤涩，烦躁口渴，谵语狂妄，腹部胀满硬痛，或者潮热自汗，或者下利纯清水且心腹硬痛，这些都是里证，由邪热与燥屎互结所致，均应用大承气汤攻下。若攻下后腹泻不止，或者气喘胸闷、气逆上冲，或者自利且气脱下陷，都属于逆证（预后不良）。如果是三阳合病，脉实，身体沉重难以转动，口中感觉迟钝，面色垢浊，遗尿，用白虎汤治疗。如果大便干结，大热干呕，错语呻吟无法入睡，用犀角解毒汤治疗。刚得病时没有发热，但胡言乱语，烦躁不安，精神萎靡不与常人相当，可用五苓散三钱，以新汲水探吐；另一种方法是用桂苓汤。胡言乱语，想含水漱口但不愿咽下，大便色黑，小便不利，身体发黄腹胀，这是因为该用下法而未用，导致瘀血引起的谵语，用桃仁承气汤治疗，排出黑色瘀血物后即可痊愈。妇女月经适来或适断，随后出现寒热往来，这是热入血室引起的谵语，用小柴胡汤治疗。阳明病证，喜欢遗忘，像发狂一样，也是瘀血所致，照前述使用桃仁承气汤，排出黑色瘀血物后即可痊愈。
郑声，如同郑卫之音（古代被视为不正的音乐），指声音不正。大概是在发汗或攻下之后，如果病程长久，原本的声音失去控制且正气虚弱，那么说话散乱不知高低轻重，这是精气耗损的表现。其脉象微细，大小便自利（正常），用小柴胡汤治疗。
Delirious speech (Zhanyu, 谵语) is described in the classics: "When pathogenic factors are exuberant, it manifests as excess; when essential qi is depleted, it manifests as deficiency." Therefore, excess conditions lead to delirious speech, while deficiency conditions lead to feeble speech (Zhengsheng, 郑声). When excessive heat in the Stomach (Wei, 胃) ascends to disturb the Heart (Xin, 心), and the Heart is obscured by heat, consciousness becomes confused, leading to妄有所见而言 (hallucinations and inappropriate speech). Mild cases involve muttering in sleep, while severe cases involve speaking even when awake. Some patients exhibit delirious speech, some speak only to themselves (Duyu, 独语), some cannot stop talking, and some speak incoherently; these variations indicate the severity of the heat. Generally, when heat enters the Stomach, fluids are depleted and feces become dry, inevitably causing delirious speech, which is an excess condition. There are also cases of delirious speech caused by forced sweating via fire therapy, cases caused by Yang collapse (Wangyang, 亡阳), and cases involving purging of undigested food (Xialiqinggu, 下利清谷) without thirst, which are deficiency conditions. If the pulse is deep, solid, surging, rapid, and forceful, accompanied by constipation, dark urine, dryness and thirst, delirious and wild behavior, abdominal distension with hardness and pain, tidal fever with spontaneous sweating, or purging of pure clear water with epigastric and abdominal hardness and pain, these are all interior syndromes caused by pathogenic heat and dry fecal matter. All should be treated with Da Chengqi Tang (Great Order the Qi Decoction) to purge. If diarrhea persists after purging, or if there is wheezing and fullness with rebellious Qi rushing upward, or spontaneous purging with Qi collapse sinking downward, these are adverse signs (Ni, 逆). In combined syndromes of the three Yang channels, with a solid pulse, heavy body difficult to turn, insensitivity in the mouth, greasy facial complexion, and enuresis, Baihu Tang (White Tiger Decoction) is used. If there is dry stool, high fever, dry retching, incoherent speech, groaning, and insomnia, Xijiao Jiedu Tang (Rhinoceros Horn Detoxification Decoction) is used. If upon initial onset there is no fever but there is wild speech, restlessness, and spirit lacking vitality compared to normal, Wuling San (Five-Ingredient Powder with Poria) three qian can be administered, followed by induced vomiting using fresh well water; alternatively, Guiling Tang (Cinnamon Twig and Polyporus Decoction) may be used. Wild speech, desire to rinse the mouth with water but unwillingness to swallow, black stool, difficult urination, yellowing of the body, and abdominal distension indicate that delirious speech due to blood stasis occurred because purgation was indicated but not applied initially. Taoren Chengqi Tang (Peach Kernel Order the Qi Decoction) should be used; recovery occurs once black material is expelled. In women, if menstruation has just started or stopped, followed by alternating chills and fever, this is delirious speech due to heat entering the Blood Chamber (Xueshi, 血室), treated with Xiaochaihu Tang (Minor Bupleurum Decoction). In Yangming syndrome, forgetfulness and manic-like behavior indicate blood stasis; treat as previously described with Taoren Chengqi Tang until black material is expelled.
Feeble speech (Zhengsheng, 郑声) refers to improper sound, akin to the music of Zheng and Wei states. After sweating or purging, if the illness has been prolonged, the original voice loses control due to deficiency of righteous Qi, resulting in scattered speech lacking proper tone or volume. This is a sign of depletion of essence and Qi. The pulse is fine and minute, and urination and defecation are normal; treat with Xiaochaihu Tang (Minor Bupleurum Decoction).