经曰∶心藏神，有余则笑不休。又曰∶在脏为心，在声为笑，在志为喜。又火太过曰赫曦，
赫曦之纪，其病笑谑狂妄。又云∶少阴所至为喜笑。又云∶精气升于心则喜。此数者，皆言
属心火也。若笑不休，呻而为腹痛，此水乘于火，阴击于阳，阳伏热生，狂妄谵语不可闻，
心之损矣。扁鹊云∶其人唇口赤色者，可治；青黑者，死。若肾水亏涸不胜心火，而喜笑不
休者，用六味地黄丸。肝火炽盛，能生心火，而喜笑不休者，用柴胡清肝散。余兼别症，各
从其症而参治之。
治验
一小儿喜笑，常作不安，面赤饮冷，手足并热，先用黄连泻心汤，未二服稍定，又用六味地
黄丸料煎服，顿愈。常服此丸则安，月许不服，仍前复作，又服愈矣。
一小儿患前症，面青赤，此肝心二经风热所致也，用柴胡栀子散、六味地黄丸渐愈。又因乳
母大怒发热，先用加味柴胡汤，又用加味逍遥散，母子服之并愈。
一小儿患前症，因乳母大怒，患血崩寒热，先用加味逍遥散一剂，用当归补血汤三剂，如此
治之各数剂，母子并愈。
一小儿年十四岁，用心过度，饮食失节，患喜笑不休，脉洪大而虚，面色赤而或白，余用补
中益气汤而愈。次秋科举，饮食劳倦，前症复作，或兼谵语，脉洪大，按之微细如无，用人参一两，
姜、枣煎服稍定，又三剂而愈。又劳役用心，自汗作渴，烦躁似痫症，先用当归补血汤，二
剂顿安，又十全大补汤而寻愈。
一女子十六岁，面色痿黄，素沉静，喜笑不休，月经先期，用柴胡栀子散、加味逍遥散而愈
。次年出嫁，不时复作，但作时面赤勇力，发后面黄体倦，朝用补中益气汤，夕用加味逍遥
散而愈。后每发悉用前药即愈。
当归补血汤
柴胡栀子散
柴胡清肝散（三方见发热）
黄连泻心汤（方见烦躁）
地黄丸（方见肾脏）
《黄帝内经》说：心藏神，心气有余就会笑个不停。又说：在五脏中对应心，在五声中对应笑，在五志中对应喜。又说：火气太过称为“赫曦”，处于赫曦之纪（火运太过之年），其病症表现为笑闹、谵妄、狂乱。又云：少阴经气异常可导致喜笑。又云：精气上升于心则产生喜悦之情。以上这些论述，都说明这些症状归属于心火。如果笑个不停，呻吟并伴有腹痛，这是水气乘袭火气，阴邪击伤阳热，阳气被郁伏而化热生火，出现狂妄、胡言乱语且不可听闻的症状，这是心脏受损的表现。扁鹊说：患者嘴唇和口部呈赤色的，可以治愈；呈青黑色的，预后不良，主死。如果是肾水亏虚枯竭，不能制约心火，而导致喜笑不停的，使用六味地黄丸。如果是肝火炽盛，能够助长心火，而导致喜笑不停的，使用柴胡清肝散。其余兼有其他症状的，根据各自的症状参合治疗。
治验案例
一个小孩喜欢笑，经常表现出不安，面色红赤，想喝冷水，手足发热，先用黄连泻心汤，不到两服后症状稍定，接着用六味地黄丸的药料煎服，顿时痊愈。经常服用这个丸剂就能安稳，一个月不服用，症状又会像以前一样发作，再次服用就痊愈了。
另一个小孩患上述症状，面色青中带赤，这是肝、心二经受风热侵袭所致，使用柴胡栀子散、六味地黄丸逐渐痊愈。又因为乳母大怒导致发热，先用加味柴胡汤，再用加味逍遥散，母子同服都痊愈了。
第三个小孩患上述症状，因乳母大怒，患儿出现血崩、寒热往来，先用一剂加味逍遥散，再用三剂当归补血汤，如此治疗各数剂，母子均痊愈。
第四个小孩十四岁，因用心过度，饮食不节制，患喜笑不休，脉象洪大但按之无力，面色红赤或苍白，我用补中益气汤治愈。次年秋天参加科举考试，因饮食和劳倦，前症复发，有时兼有胡言乱语，脉象洪大，但重按微细若无，用人参一两，生姜、大枣煎服，症状稍定，再服三剂而愈。后来又因劳累和用心过度，出现自汗、口渴、烦躁类似痫症，先用当归补血汤，两剂后顿时安宁，再用十全大补汤不久痊愈。
第五个女子十六岁，面色萎黄，平时性格沉静，却喜笑不休，月经提前，用柴胡栀子散、加味逍遥散治愈。次年出嫁，不时复发，但发作时面色红赤、有力，发过后则面色黄、身体疲倦，早晨服用补中益气汤，晚上服用加味逍遥散而愈。后来每次发作都用前面的药物即愈。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The Heart stores the Shen (Spirit); when there is excess, one laughs incessantly. It also states: In the Zang organs, it corresponds to the Heart; in the vocal sounds, it corresponds to laughter; in the emotional activities, it corresponds to joy. Furthermore, excessive Fire is called "He Xi" (Radiant Brilliance). In the era of He Xi (years of excessive Fire Qi), the diseases manifest as laughing, babbling, mania, and delirium. It is also said: When the Shaoyin (Lesser Yin) channel qi is disturbed, it leads to joy and laughter. Additionally, when Essence and Qi ascend to the Heart, joy arises. All these statements indicate that such symptoms belong to Heart Fire. If a person laughs incessantly, groans, and suffers from abdominal pain, this indicates Water encroaching upon Fire, with Yin attacking Yang. Yang becomes trapped and generates heat, leading to mania, delirious speech, and incoherent muttering, which signifies damage to the Heart. Bian Que stated: If the patient's lips and mouth are red, the condition is treatable; if they are blue-black, death is imminent. If Kidney Water is deficient and dried up, failing to control Heart Fire, resulting in incessant laughter, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). If Liver Fire is blazing and generating Heart Fire, resulting in incessant laughter, use Chaihu Qinggan San (Bupleurum Liver-Clearing Powder). For other accompanying symptoms, treatment should be adjusted according to each specific presentation.
Clinical Cases
A child exhibited incessant laughter and constant restlessness, with a red face, a desire for cold drinks, and hot hands and feet. Initially, Huanglian Xiexin Tang (Coptis Decoction to Drain the Heart) was administered. After less than two doses, the symptoms subsided slightly. Subsequently, the ingredients of Liuwei Dihuang Wan were decocted and taken orally, resulting in immediate recovery. Regular consumption of this pill ensured stability; if not taken for a month, the symptoms would recur as before, but resuming medication led to cure.
Another child presented with the aforementioned symptoms, showing a complexion that was greenish-red. This was caused by Wind-Heat affecting the Liver and Heart channels. Chaihu Zhizi San (Bupleurum and Gardenia Powder) and Liuwei Dihuang Wan were used, leading to gradual recovery. Additionally, due to the wet nurse's extreme anger causing fever, Jiawei Chaihu Tang (Modified Bupleurum Decoction) was first administered, followed by Jiawei Xiaoyao San (Modified Free Wanderer Powder). Both mother and child recovered after taking the medications.
A third child suffered from the same condition due to the wet nurse's anger. The child experienced metrorrhagia (uterine bleeding) and alternating chills and fever. One dose of Jiawei Xiaoyao San was given first, followed by three doses of Danggui Buxue Tang (Angelica Tonifying Blood Decoction). After several courses of this treatment, both mother and child recovered.
A fourteen-year-old boy, having overused his mind and disregarded dietary regulations, suffered from incessant laughter. His pulse was large and forceful yet empty upon pressure, and his complexion was either red or pale. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) cured him. In the following autumn, during the imperial examinations, due to dietary irregularities and fatigue, the previous symptoms recurred, sometimes accompanied by delirious speech. The pulse was large, but fine and imperceptible upon deep pressure. Ren Shen (Ginseng Root) 1 liang, decocted with Sheng Jiang (Fresh Ginger Rhizome) and Da Zao (Jujube Fruit), alleviated the symptoms initially, and three more doses resulted in full recovery. Later, due to physical labor and mental exertion, he experienced spontaneous sweating, thirst, and irritability resembling epilepsy. Danggui Buxue Tang was administered first, bringing instant relief after two doses, followed by Shiquan Dabu Tang (Ten Significant Tonifying Decoction) for complete recovery.
A sixteen-year-old girl, with a sallow complexion and a naturally quiet temperament, suffered from incessant laughter and early menstruation. Chaihu Zhizi San and Jiawei Xiaoyao San cured her. The following year, after marriage, the symptoms recurred intermittently. During episodes, her face was red and she appeared vigorous; afterwards, her face turned yellow, and she felt fatigued. She took Bu Zhong Yi Qi Tang in the morning and Jiawei Xiaoyao San in the evening, achieving recovery. Subsequent recurrences were also cured using these same formulas.
Danggui Buxue Tang (Angelica Tonifying Blood Decoction)
Chaihu Zhizi San (Bupleurum and Gardenia Powder)
Chaihu Qinggan San (Bupleurum Liver-Clearing Powder) [See Fever section for formulas]
Huanglian Xiexin Tang (Coptis Decoction to Drain the Heart) [See Irritability section for formula]
Dihuang Wan (Rehmannia Pill) [See Kidney section for formula]