问曰∶谵语何以属阳明腑证？答曰∶心者，胃之母，肺者，胃之子，心主藏神，精明者
也，肺主出声，清肃者也。今胃中热盛，上乘心肺，故神气昏愦而语言错乱。轻则呢喃谬妄
重则喊叫骂詈，不避亲疏。由其热有轻重，故谵语亦有轻重也。又问曰∶经云谵语有虚有
实者，何也？答曰∶实则谵语，虚则郑声。谵语者，乱言无次，数数更端；郑声者，郑重其
辞，重迭频言，不换他说也。盖气有余，则能机变而乱语，气不足，则无机变而只守一音也
又问曰∶妇人伤寒，昼则明了，夜则谵语者，何也？答曰∶此热入血室证也，妇人经水适
来，血海空虚，邪气乘之，致有此证。治法无犯胃气，及上二焦，必自愈。宜用小柴胡汤
去半夏，加红花、桃仁、生地、丹皮之属。
问曰∶狂乱何以属阳明腑病？答曰∶重阴为颠，重阳为狂。诸经之狂，皆阳盛也。伤寒
阳热极盛，至于发狂，势亦危矣。狂之发也，少卧不饥，妄语妄行，或登高而歌，弃衣而走
甚至逾垣上屋，皆阳热亢极使之，非下不除。又太阳病不解，热结膀胱，其人如狂，此乃
下焦蓄血，少腹当硬满，小便自利，大便黑色，虽则如狂，初不若发狂之甚也。又有以火劫
汗，遂至亡阳，发为惊狂，有慌乱恐惧之象，实非狂也。是知如狂者，膀胱蓄血；惊狂者，
劫汗亡阳；发狂者，阳明胃腑实热也。又问曰∶寒证有发狂者，何也？答曰∶此阴盛隔阳之
证，其人烦躁，欲坐卧泥水中，是名阴燥，脉必沉迟，或见下利清谷诸寒证，急宜温补，不
可误用寒凉也。
问：为什么谵语归属于阳明腑证？
答：心是胃的母脏，肺是胃的子脏。心主藏神，是精神意识的主宰；肺主发声，具有清肃的功能。现在胃中热邪炽盛，向上侵犯心肺，导致神志昏沉混乱，语言错乱。轻者表现为低声喃喃、胡言乱语；重者则大喊大叫、骂人詈辱，不分亲疏远近。因为热邪有轻重之分，所以谵语的症状也有轻重之别。
又问：医经中说谵语有虚证和实证的区别，这是为什么呢？
答：实证出现谵语，虚证出现郑声。所谓谵语，是指言语杂乱无章，频繁更换话题；所谓郑声，是指言辞郑重，反复重复同一句话，不谈论其他内容。这是因为气有余（实）时，神机变动而胡言乱语；气不足（虚）时，神机呆滞，只能坚守单一的声音。
又问：妇女患伤寒病，白天神志清醒，夜晚却出现谵语，这是什么原因？
答：这是热入血室的证候。妇女月经适来，血海空虚，邪气乘虚而入，导致出现这种证候。治疗方法是不必损伤胃气，也不必攻上焦和中焦，病自然会痊愈。适宜使用小柴胡汤，去掉半夏，加入红花、桃仁、生地黄、牡丹皮等药物。
问：为什么狂乱归属于阳明腑病？
答：阴气过盛称为癫，阳气过盛称为狂。各经引起的狂症，都是由于阳热亢盛所致。伤寒病中阳热极盛，发展到发狂的程度，病情已经非常危险了。狂症发作时，睡眠少、不知饥饿，胡言乱语、行为失常，有的甚至爬上高处唱歌，扔掉衣服奔跑，乃至翻墙越屋，这都是阳热亢极所致，非用泻下法不能去除。另外，太阳病不解，热邪结于膀胱，患者出现如狂的状态，这是下焦蓄血证，小腹部应当硬满，小便自利，大便色黑，虽然表现为如狂，但起初并不像发狂那样严重。又有因用火法强行发汗，导致亡阳，引发惊狂，表现出慌乱恐惧的神态，这实际上并不是真正的狂症。由此可知，如狂是膀胱蓄血；惊狂是劫汗亡阳；发狂则是阳明胃腑的实热证。
又问：寒证也有发狂的情况，这是为什么呢？
答：这是阴盛格阳的证候。患者烦躁不安，想要坐在或躺在泥水中，这叫作阴燥。脉象必定沉迟，或者出现下利清谷等寒证表现，急需温补，不可误用寒凉药物。
Q: Why is delirium (Zhenyu) attributed to the Yangming Fu-organ syndrome?
A: The Heart is the mother of the Stomach, and the Lung is the child of the Stomach. The Heart governs the storage of the Spirit (Shen), which is the seat of mental clarity; the Lung governs vocalization and possesses a descending and purifying function. Currently, excessive heat in the Stomach ascends to invade the Heart and Lung, causing the Spirit to become confused and speech to become disordered. In mild cases, there is muttering and absurd talk; in severe cases, there is shouting, cursing, and abuse regardless of kinship or distance. Because the heat varies in severity, the delirium also varies in intensity.
Further question: The classics state that delirium can be either deficiency or excess. What does this mean?
Answer: Excess leads to delirium (Zhenyu), while deficiency leads to Zhengsheng. Delirium refers to chaotic speech without order, frequently changing topics; Zhengsheng refers to words spoken with solemnity, repeated frequently without shifting to other subjects. This is because when Qi is in excess, the mental mechanism changes rapidly leading to chaotic speech; when Qi is deficient, the mental mechanism lacks agility and only maintains a single tone.
Further question: When a woman suffers from Cold Damage (Shanghan), she is lucid during the day but experiences delirium at night. What is the cause?
Answer: This is the syndrome of Heat entering the Blood Chamber (Xueshi). When a woman's menstruation arrives, the Sea of Blood becomes empty, allowing pathogenic factors to take advantage of this void, resulting in this syndrome. The treatment method is to avoid damaging the Stomach Qi and not to attack the Upper and Middle Jiao; the disease will heal itself. It is appropriate to use Xiaochaihu Tang (Minor Bupleurum Decoction), removing Banxia (Pinelliae Rhizoma), and adding Honghua (Carthami Flos), Taoren (Persicae Semen), Shengdihuang (Rehmanniae Radix Recens), and Danpi (Moutan Cortex), among others.
Q: Why is mania (Kuangluan) attributed to Yangming Fu-disease?
A: Excessive Yin constitutes Dian (epilepsy/mental depression), while excessive Yang constitutes Kuang (mania). Mania arising from various meridians is always due to hyperactive Yang. In Cold Damage diseases, when Yang-heat reaches extreme excess, leading to mania, the condition is critical. The onset of mania involves little sleep, lack of hunger, nonsensical speech, and erratic behavior; some may climb high places to sing, discard clothes, and run, even jumping over walls or climbing onto roofs. All these are caused by extreme hyperactivity of Yang-heat, which cannot be resolved without purgation. Additionally, if Taiyang disease is not resolved, heat binds to the Bladder, and the person appears manic (Ru Kuang). This is blood stasis in the Lower Jiao, characterized by hardness and fullness in the lower abdomen, free urination, and black stool. Although appearing manic, it is initially not as severe as true mania. Furthermore, forcing sweat via fire therapy may lead to loss of Yang, causing Jingkuang (panic-stricken mania), presenting with panic and fear; this is essentially not true mania. Thus, it is known that Ru Kuang (appearing manic) is due to Bladder blood stasis; Jingkuang is due to loss of Yang from forced sweating; and Fa Kuang (developing mania) is due to excess heat in the Yangming Stomach-Fu organ.
Further question: Are there cases of mania arising from Cold syndromes? What is the reason?
Answer: This is the syndrome of Yin excess repelling Yang. The patient is restless and irritable, desiring to sit or lie in mud or water, known as Yin燥 (Yin dryness/restlessness). The pulse must be deep and slow, possibly accompanied by cold syndromes such as diarrhea with undigested food. Urgent warming and tonification are required; cold-cooling agents must not be mistakenly used.