〔《素》〕谵语者，气虚独言也。（全文见诊。愚用参、 、归、术等剂治谵语，得愈有百十数，岂可不
分虚实，一概用黄连解毒、大小承气等汤以治之乎。）
〔《难》〕脱阳者见鬼。（仲景谓亡阳谵语亦此义。）
〔海〕黄 汤 治伤寒，或时悲哭，或时嬉笑，或时太息，或语言错乱失次，世疑作谵语狂言者，非也，
神不守室耳。两手脉浮沉不一，举按全无力，浮之损小，沉之亦损小，皆阴脉也，甚者用调中丸或理中丸。
（二方并见发热下。）
〔丹〕浦江郑兄年二十岁，九月间发热头痛，妄言见鬼，医与小柴胡汤数帖，热愈甚。予视之，形肥，面
亦带白，却喜筋骨稍露，诊其脉弦大而数实，脉本不实，凉药所致。此因劳倦成病，与温补药自安。遂以参、
术为君，苓、芍为臣，黄 为佐，附子一片为使，与二帖而症不减。或曰∶脉既数大，狂热而又大渴，
用附子误矣。予曰∶此虚症而误投寒凉之药，人肥而脉左大于右，事急矣，非加附子、参、术，焉能有急
效。再与一帖，乃去附子，作大剂与服，至五十帖，得大汗而愈。自后又补养两月，气体方始平复。
一人五月内患谵语，大发热，肢体不能举，喜冷冻饮料。诊其脉洪大而数。用黄 、茯苓浓煎如膏，
却用凉水调与之，三四服后，病者昏睡如死状，但颜色不改，气息如常，至次早方醒，诸症悉退而安。
卢兄汗后，再发热妄言，吕仲修汗后热不退，亦妄言，陶明节热退后不识人，言语谬妄，皆用参、 、
术、归等补剂而愈。信哉，谵语属虚者，十居八九。
〔《活》〕大小便硬，手足冷，脉微细者，必郑声也，当服温药白通汤。海藏用黄 加干姜汤。（方见伤寒发
热下。）侯辅之脉极沉细，外热内寒，肩背胸胁斑出十数点，语言狂乱。或曰∶发斑谵语非热乎？予曰∶
非也。阳为阴逼，上入于肺，传之皮毛，故斑出。神不守舍，故错语如狂，非谵语也。肌表虽热，以手按之，
须臾冷透如冰。与姜附等药数日，约二十余两，得大汗而愈。后因再发，脉又沉迟，三四日不大便，
与理中丸，三日内约半斤，其病全愈。以此知侯公之狂，非阳狂之狂，乃失神之狂，即阴虚也。
〔《活》〕大便秘，小便赤，手足温，脉洪数者，必谵语也，宜用调胃承气汤。
〔海〕治老幼及虚人伤寒五六日，昏冒言妄，小便或淋或涩，起卧无度，或烦而不得眠，并宜白虎汤加山
栀一钱。
〔《斗》〕治热病及时疫，心躁狂乱奔走，状似癫痫，言语不定，久不得汗，及时疫不知人事者。以人中黄不
拘多少，入罐内用泥封固，武火 半日，去火候冷，取出于地上以盆盖半日许，研细如面，新汲水调下三钱，
或未退，再服愈。（人中黄即屎也。）
【《素问》】谵语，是指气虚导致的独自胡言乱语。（全文见诊法章节。我使用人参、[黄芪]、当归、白术等补益剂治疗谵语，治愈的有上百人，怎么能不分虚实，一概用黄连解毒汤、大承气汤或小承气汤来治疗呢？）
【《难经》】阳气脱失的人会出现幻觉看见鬼神。（张仲景所说的亡阳谵语也是这个意思。）
【李东垣/海藏】黄耆汤治疗伤寒，有时悲伤哭泣，有时嬉笑，有时长叹息，有时语言错乱没有次序，世人怀疑这是谵语狂言，其实不是，这是神志不能守舍。两手脉象浮沉不一，轻取重按都完全无力，浮取时脉损小，沉取时也损小，都是阴脉，严重的用调中丸或理中丸。（这两个方子并见发热下篇。）
【朱丹溪】浦江郑兄二十岁，九月间发热头痛，胡言乱语说看见鬼神，医生给他服用了数帖小柴胡汤，热势反而更重。我诊治他，形体肥胖，面色也带白色，却喜欢筋骨稍露（指肌肉不丰），诊其脉弦大而数实，但脉本不实，是凉药所致。这是因为劳倦成病，用温补药自然能安。于是以人参、白术为君药，茯苓、白芍为臣药，黄耆为佐药，附子一片为使药，给予两帖但症状不减。有人说：脉既已数大，又狂热且大渴，用附子是错误的。我说：这是虚证而误投了寒凉药，人肥而脉左大于右，情况紧急了，如果不加附子、人参、白术，怎么能有急救的效果？再给一帖，然后去掉附子，做成大剂量让他服用，直到五十帖，出大汗而痊愈。之后又补养两个月，身体才平复。
另一人在五月内患谵语，大发热，肢体不能抬举，喜欢喝冷冻饮料。诊其脉洪大而数。用黄耆、茯苓浓煎如膏状，却用凉水调匀给他喝，三四服后，病人昏睡如死状，但脸色不变，气息如常，到第二天早上才醒，各种症状全部消退而安宁。
卢兄出汗后，再次发热胡言乱语；吕仲修出汗后热不退，也胡言乱语；陶明节热退后不认识人，言语谬妄错误，都用参、[黄芪]、术、归等补益剂而痊愈。确实啊，谵语属于虚证的，十有八九。
【王好古/活法】大小便硬结，手足冷，脉微细的，一定是郑声，应当服用温药白通汤。海藏用黄耆加干姜汤。（方子见伤寒发热下篇。）侯辅之脉极沉细，外热内寒，肩背胸胁斑疹发出十几点，语言狂乱。有人说：发斑谵语不是热证吗？我说：不是。阳气被阴邪逼迫，上入于肺，传至皮毛，所以斑疹发出。神志不能守舍，所以错语如狂，这不是谵语。肌表虽然热，用手按压，片刻后冷透如冰。给予姜、附等药数日，约二十余两，出大汗而痊愈。后来因为复发，脉又沉迟，三四天不大便，给予理中丸，三日内约半斤，病全愈。由此可知侯公的狂，不是阳狂的狂，而是失神的狂，即阴虚。
【王好古/活法】大便秘结，小便赤涩，手足温，脉洪数的，一定是谵语，宜用调胃承气汤。
【李东垣/海藏】治疗老幼及虚人伤寒五六日，昏冒胡言，小便或淋或涩，起卧无度，或烦躁不得眠，都适宜用白虎汤加山栀一钱。
【斗门方】治疗热病及时疫，心躁狂乱奔走，状似癫痫，言语不定，久不得汗，及时疫不知人事者。用人中黄不拘多少，放入罐内用泥封固，武火煅烧半天，去火冷却，取出在地上用盆盖半天左右，研细如面粉，新汲水调下三钱，如果未退，再服痊愈。（人中黄即屎清。）
[Suwen] Delirious speech (Zhenyu) refers to incoherent talking due to Qi deficiency alone. (The full text is found in the Diagnosis section. I have treated delirious speech with formulas containing Ginseng Radix [Renshen], Astragali Radix [Huangqi], Angelicae Sinensis Radix [Danggui], and Atractodis Rhizoma [Baizhu], curing over a hundred cases. How can one indiscriminately use Coptidis Decoction for Heat Toxin [Huanglian Jiedu Tang], Da Chengqi Tang, or Xiao Chengqi Tang without distinguishing between deficiency and excess?)
[Nan Jing] When Yang Qi escapes, the patient sees ghosts. (Zhang Zhongjing's statement that "Yang exhaustion delirium" shares this meaning.)
[Li Dongyuan/Haizang] Huangqi Tang treats Shaoyang syndrome where the patient sometimes weeps bitterly, sometimes laughs playfully, sometimes sighs deeply, or speaks incoherently out of order. People suspect this is delirious speech or mania, but it is not; it is the Spirit failing to reside in its chamber. The pulse at both hands varies in floating and sunken qualities, lacking strength upon both light and heavy pressure; floating reveals a diminished/small pulse, and sunken also reveals a diminished/small pulse, all indicating Yin pulses. For severe cases, Tiaozhong Wan or Lizhong Wan is used. (Both formulas are listed under Fever below.)
[Zhu Danxi] Brother Zheng from Pujiang, aged twenty, suffered from fever and headache in September, speaking deliriously about seeing ghosts. Physicians administered several doses of Xiaochaihu Tang, yet the heat intensified. Upon examination, his body was fat, his complexion pale, yet he had somewhat exposed sinews and bones. His pulse was wiry, large, rapid, and seemingly solid, but fundamentally not solid; this was caused by cooling medicines. This illness resulted from fatigue and overwork, and would settle with warming and tonifying medicines. Thus, I used Ginseng Radix [Renshen] and Atractodis Rhizoma [Baizhu] as Sovereign herbs, Poria [Fuling] and Paeoniae Radix Alba [Shaoyao] as Minister herbs, Astragali Radix [Huangqi] as Assistant herb, and one slice of Aconiti Lateralis Radix Praeparata [Fuzi] as Guide herb. After two doses, symptoms did not subside. Someone said: "Since the pulse is rapid and large, accompanied by intense heat and great thirst, using Fuzi is a mistake." I replied: "This is a deficiency pattern mistakenly treated with cold-cooling medicines. The patient is fat, and the left pulse is larger than the right; the situation is urgent. Without adding Fuzi, Renshen, and Baizhu, how could there be an emergency effect?" Another dose was given, then Fuzi was removed, and a large dosage was administered. After fifty doses, profuse sweating occurred, and he recovered. Subsequently, after two months of nourishing supplementation, his physical state finally stabilized.
Another person suffered from delirious speech within May, with high fever and inability to raise limbs, preferring frozen drinks. His pulse was surging and rapid. I used Astragali Radix [Huangqi] and Poria [Fuling], decocted thickly like paste, but administered it mixed with cool water. After three or four doses, the patient fell into a coma-like sleep, yet his complexion remained unchanged and breathing was normal. He woke up the next morning, all symptoms having subsided peacefully.
Brother Lu, after sweating, developed recurrent fever and delirious speech; Zhongxiu Lv, after sweating, had persistent heat and also spoke deliriously; Mingjie Tao, after heat subsided, failed to recognize people and spoke erroneously. All were cured using tonifying formulas containing Renshen, [Huangqi], Baizhu, and Danggui. Indeed, nine out of ten cases of delirious speech belong to deficiency.
[Wang Haogu/Huofa] When stool and urine are hard, hands and feet are cold, and the pulse is faint and fine, it must be murmuring speech (Zhengsheng), and warming medicine Baitong Tang should be taken. Haizang uses Huangqi plus Ganjiang Tang. (Formula seen under Shaoyang Fever below.) Hou Fuzhi had an extremely deep and fine pulse, external heat and internal cold, with a dozen spots of macules appearing on shoulders, back, chest, and hypochondrium, and language was chaotic. Someone said: "Are macules and delirious speech not heat patterns?" I said: "No. Yang is forced by Yin, enters the Lung, and transmits to the skin and hair, hence macules appear. The Spirit fails to reside in its dwelling, hence confused speech resembling madness, but this is not delirious speech. Although the surface is hot, pressing with hand makes it cold as ice within moments. Administering Ginger and Aconite medicines for several days, totaling about two jin, resulted in profuse sweating and recovery. Later, due to recurrence, the pulse became deep and slow, with no bowel movement for three to four days. Lizhong Wan was given, totaling about half a jin within three days, and the disease was completely cured. From this, we know that Hou Gong's madness was not Yang mania, but Spirit-loss madness, which is Yin deficiency."
[Wang Haogu/Huofa] With constipation, red urine, warm hands and feet, and a surging and rapid pulse, it must be delirious speech, and Tiaowei Chengqi Tang is appropriate.
[Li Dongyuan/Haizang] To treat elderly, children, and deficient persons with Shaoyang syndrome for five to six days, presenting with dizziness and delirious speech, urinary dribbling or obstruction, restlessness day and night, or irritability with insomnia, Baihu Tang plus Gardeniae Fructus [Shanzhi] one qian is suitable.
[Doumen Fang] To treat febrile diseases and seasonal epidemics characterized by mental agitation, manic running, resembling epilepsy, indeterminate speech, prolonged lack of sweating, or loss of consciousness in seasonal epidemics. Use Renzhonghuang (Human Manure Wash) in any quantity, place in a jar, seal tightly with mud, calcine over strong fire for half a day, remove from fire and cool, take out and cover with a basin on the ground for about half a day, grind finely like flour, and administer three qian mixed with fresh well water. If symptoms do not recede, administer again until cured. (Renzhonghuang is clarified feces.)