（谓颊车开而不合）
〔肃〕平江陈氏，因惊惧后常用手指甲掐拄两颊，遂两颊破损，心中懊 不安，脉数而实，诸药不愈。用
《活幼口义》牛黄清心、凉膈丸，数服如失。
〔无〕凡伸欠颊车蹉，但开不能合。以酒饮之，令大醉，睡中吹皂角末搐其鼻，嚏透即自正。
狂谓妄言妄走也，癫谓僵仆不省也，各自一症，今以狂入脾部，癫入肝部。然经有言狂癫疾者，有言狂互
引癫者，又言癫疾为狂者，此则又皆狂癫兼病。今病有妄言妄走，顷时前后僵仆之类，有僵仆后妄见鬼神半日方
已之类，是以癫狂兼病者也。
〔《难》〕癫狂之病，何以别之？然，狂之始发，少卧而不饥，自高贤也，自辨智也，自贵倨也，妄笑好
歌乐，妄行不休是也。癫疾始发，意不乐，直视僵仆，其脉三部阴阳俱盛是也。重阳者狂，重阴者癫。（二十难
王注云∶狂病之后，不欲眠卧，不肯饮食，自言贤智尊贵歌笑行走不休，今人以为癫疾谬矣。）
〔《素》〕二阴二阳皆交至，病在肾，骂詈妄行，癫疾为狂。（阴阳类论 王注云∶二阴肾水，二阳胃土，土
刑水，病在肾胃为狂。）
〔《灵》〕邪入于阳则为狂。转则为癫疾。（九针篇）
〔《素》〕癫疾厥狂，久逆之所生也。（通评虚实论）太阳所谓狂癫疾者，阳尽在上而阴气从下，下虚上
实，故狂癫疾也。（脉解篇）
针灸 狂癫有二法∶
其一取胃。经云∶足阳明之别，名曰丰隆，去踝八寸，别走太阴，其病实则狂癫，取之所别是也。
其二取膀胱。经云∶膀胱足太阳之脉所生病者狂癫，视盛虚热寒陷下取之也。
〔《甲》〕狂癫疾吐舌，太乙及滑肉、期门主之。狂仆，温溜主之。狂癫疾，阳谷及筑宾、通谷主之。
狂互引颠疾数发，后溪主之。狂癫，阴谷主之。
（指颊车穴部位张开而不能闭合）
〔肃〕平江陈氏，在受到惊吓恐惧后，常用手指甲掐按支撑两颊，导致两颊皮肤破损，心中烦闷不安，脉象数而有力，服用多种药物均无效。使用《活幼口义》中的牛黄清心丸、凉膈丸，服用数次后症状消失。
〔无〕凡是出现伸哈欠、颊车穴错位，只能张开不能闭合的情况。用酒饮用，使其大醉，在其睡眠中吹入皂角末刺激鼻腔，打喷嚏通透后，面部肌肉自然恢复正常。
狂症是指胡言乱语、胡乱奔走；癫症是指身体僵硬仆倒、神志不清。这是两种独立的病症，现在将狂症归入脾部论述，将癫症归入肝部论述。然而经典中有提到“狂癫疾”的，有说“狂症牵引引发癫症”的，又说“癫症发展为狂症”的，这又都是狂症和癫症兼有的情况。现在的病症有胡言乱语、胡乱奔走，片刻前后出现身体僵硬仆倒等情况的，也有身体僵硬仆倒后出现幻觉看见鬼神，半天才停止等情况的，所以是癫症和狂症兼有的病症。
〔《难经》〕癫症和狂症，如何区别？回答：狂症刚开始发作时，睡眠少且不觉得饥饿，自认为高尚贤能，自认为善于辩论智慧，自认为尊贵傲慢，无故发笑喜欢唱歌娱乐，胡乱行走不停歇，这就是狂症。癫症刚开始发作时，心情不快乐，两眼直视，身体僵硬仆倒，其寸关尺三部脉象阴阳俱盛，这就是癫症。阳气重叠则发狂，阴气重叠则发癫。（二十难王冰注云：狂病之后，不想睡觉躺卧，不肯饮食，自称贤智尊贵，唱歌笑骂行走不停，现在的人认为是癫症，这是错误的。）
〔《素问》〕二阴二阳之气都交杂而至，病位在肾，骂人乱行，由癫疾转为狂症。（阴阳类论 王冰注云：二阴指肾水，二阳指胃土，土克水，病位在肾和胃，表现为狂症。）
〔《灵枢》〕邪气侵入阳分则为狂症。邪气转化则为癫疾。（九针篇）
〔《素问》〕癫疾厥逆狂症，是由于长久气机逆乱所产生的。（通评虚实论）太阳经所说的狂癫疾，是因为阳气全部在上部，阴气从下部跟随，下虚上实，所以产生狂癫疾。（脉解篇）
针灸治疗狂癫有两种方法：
第一种取胃经穴位。经文说：足阳明胃经的络穴，名叫丰隆，距离外踝八寸，别走足太阴脾经，其病症如果是实证导致的狂癫，就取该络穴。
第二种取膀胱经穴位。经文说：足太阳膀胱经所生的病症包括狂癫，根据脉气的盛虚、热寒、陷下等情况来选取穴位治疗。
〔《甲乙经》〕狂癫疾吐舌，由太乙穴及滑肉门穴、期门穴主治。狂症仆倒，由温溜穴主治。狂癫疾，由阳谷穴及筑宾穴、通谷穴主治。狂症互相牵引引发的颠疾多次发作，由后溪穴主治。狂癫，由阴谷穴主治。
(Referring to the Jia Che [Stomach 6] area where the jaw is open and cannot close)
[Su] Chen from Pingjiang, after experiencing fright and fear, frequently used his fingernails to pinch and support both cheeks, resulting in damage to the cheek skin. He felt inner restlessness and discomfort, with a rapid and forceful pulse. Various medications failed to cure him. Using Niuhuang Qingxin Wan (Coral and Rhinoceros Horn Heart-Clearing Pill) and Liangge Wan (Cooling the Chest Pill) from *Huoyou Kouyi*, he recovered after taking them several times.
[Wu] In cases of yawning with subluxation of the Jia Che [Stomach 6] joint, where the mouth can only open but not close, administer wine to induce severe intoxication. While the patient sleeps, blow powder of Ginkgo Seed [Saponaceous Fruit of *Gleditsia sinensis*] into the nose. Once a sneeze is thoroughly expelled, the joint will naturally return to its correct position.
Kuang [Mania] refers to speaking nonsense and running about aimlessly; Dian [Catatonia/Epilepsy] refers to stiffening, falling down, and loss of consciousness. These are two distinct syndromes. Currently, Kuang is categorized under the Spleen section, and Dian under the Liver section. However, classics mention "Kuang-Dian disease," state that "Kuang triggers Dian," and say "Dian transforms into Kuang." This indicates cases where Kuang and Dian coexist. Current diseases include symptoms such as speaking nonsense, running about, followed by sudden stiffening and falling within a short time, or stiffening and falling followed by visual hallucinations of ghosts and deities lasting half a day before subsiding. Thus, these are combined Kuang and Dian syndromes.
*[Nan Jing]* How to distinguish between Dian and Kuang? Answer: When Kuang first manifests, the patient sleeps little, feels no hunger, considers themselves noble and virtuous, claims wisdom and eloquence, acts arrogantly, laughs without cause, enjoys singing and music, and walks about incessantly. This is Kuang. When Dian first manifests, the patient feels unhappy, stares fixedly, stiffens, and falls. The pulse at all three positions (Cun, Guan, Chi) shows excess in both Yin and Yang. Excess Yang leads to Kuang; excess Yin leads to Dian. (Wang Bing's commentary on Nan Jing Chapter 20 states: After Kuang illness, the patient does not wish to sleep, refuses food, claims to be wise and noble, sings, laughs, and walks ceaselessly. Modern people mistakenly identify this as Dian.)
*[Su Wen]* When Er Yin and Er Yang energies intersect and arrive simultaneously, the disease is in the Kidney. The patient curses, acts wildly, and Dian transforms into Kuang. (Yin Yang Lei Lun Commentary: Er Yin refers to Kidney Water, Er Yang refers to Stomach Earth. Earth overcomes Water. The disease involves the Kidney and Stomach, manifesting as Kuang.)
*[Ling Shu]* Pathogenic factors entering the Yang aspect result in Kuang. Transformation leads to Dian disease. (Jiu Zhen Pian)
*[Su Wen]* Dian, Jue [Reversal], and Kuang are generated by long-standing Qi reversal. (Tong Ping Xu Shi Lun) What Sun Taiyang calls Kuang-Dian disease occurs when Yang Qi is entirely above and Yin Qi follows from below, creating deficiency below and excess above, thus generating Kuang-Dian disease. (Mai Jie Pian)
Acupuncture treatment for Kuang and Dian has two methods:
The first targets the Stomach channel. The classic states: The Luo-connecting point of Foot-Yangming is named Fenglong [Stomach 40], located eight cun above the ankle, diverging to connect with the Taiyin channel. If the disease presents as excess-type Kuang or Dian, treat the Luo-point where it diverges.
The second targets the Bladder channel. The classic states: Diseases generated by the Foot-Taiyang Bladder channel include Kuang and Dian. Treat based on whether the pulse is full or empty, hot or cold, or if there is sinking/collapse.
*[Jia Yi Jing]* For Kuang-Dian with tongue protrusion, Taeyi [Stomach 21], Rouroumen [Stomach 87], and Qimen [Liver 14] govern. For Kuang with falling, Wenliu [Large Intestine 36] governs. For Kuang-Dian, Yanggu [Small Inteston 9], Zubin [Kidney 9], and Tonggu [Foot-Shaoyang Gallbladder 95] govern. For recurrent Kuang triggering Dian, Houxi [Small Inteston 3] governs. For Kuang-Dian, Yinggu [Kidney 2] governs.