1.经言癫狂本一病, 狂乃阳邪癫是阴. 癫疾始发意不乐, 甚则神痴
语不伦. 狂怒凶狂多不卧, 目直骂詈不识亲. 痫发吐涎昏噤倒, 抽搐
省后若平人.
【注】李时珍曰: 经有言癫狂疾者, 又言癫疾为狂者, 是癫狂为兼病
也.邪入于阳者狂, 邪入于阴者癫. 盖癫疾始发, 志意不乐, 甚则精
神呆痴, 言语不伦, 而睡如平时, 以邪并于阴也. 狂疾始发多怒不卧
,甚则凶狂欲杀, 目直骂詈, 不识亲疏, 而夜多不卧, 以邪并于阳也
.然俱不似痫疾, 发则吐涎, 神昏猝倒无知, 口噤牙紧, 抽搐时之多
少不等, 而省后起居饮食皆若平人为别也. 痫虽分而为五, 曰: 鸡,
马,牛, 羊, 猪名者, 以病状偶类故也. 其实痰, 火, 气, 惊, 四者
而巳, 所以为治同乎癫狂也.
三圣散 青州白丸子 滚痰丸 遂心丹 矾郁丸 控涎丹 抱胆丸
镇心丹
2.癫狂痫疾三圣吐, 风痰白丸热滚痰, 痰实遂心气矾郁, 痰惊须用
控涎丹, 无痰抱胆镇心治, 发灸百会自然安, 初发皂角灌鼻内, 涎多
欲止点汤盐.
【注】癫狂痫疾初起多痰者, 先以三圣散吐之. 风盛有痰者, 用青州
白丸子. 热盛有痰者, 用礞石滚痰丸 ( 青礞石, 沉香, 百药煎, 川
大黄, 黄芩 ). 痰而形气实者用遂心散, 甘遂, 朱砂, 猪心也. 痰而
兼气郁者用矾郁丸, 白矾, 郁金也. 痰而兼惊者用控涎丹; 无痰神轻
因而惊悸者用镇心丹, 抱胆丸, 皆成方也. 痫病发时炙百会, 不拘壮
数,以苏为止. 再发再炙, 以愈为度. 初发用皂角汁灌鼻内, 其风涎
即从鼻口中涕唾而出, 若苏后其涎不止, 以盐汤服之自止.
1. 古籍记载：癫病与狂病本属同一类疾病，但狂病属于阳邪所致，而癫病属于阴邪所致。癫病发作初期表现为情绪低落、不快乐，严重时则出现精神呆滞痴傻、言语混乱无序。狂病发作时表现为愤怒凶暴、躁动不安且多不睡眠，双目直视、骂人詈语甚至不认识亲人。痫病发作时表现为呕吐涎沫、神志昏迷、牙关紧闭倒地，抽搐停止后苏醒，其状态如同常人一般。
【注释】李时珍说：医经中既有将“癫”和“狂”并列提及的，也有说“癫疾”即为“狂病”的，这说明癫和狂往往是兼夹出现的病症。邪气侵入阳分则发为狂病，邪气侵入阴分则发为癫病。大概癫病在初起时，患者意志消沉、心情不悦，严重时精神呆滞痴傻，言语不合常理，但睡眠情况如平时一样，这是因为邪气并聚于阴分所致。狂病在初起时多表现为易怒、失眠，严重时凶狂暴戾欲杀人，双目直视、骂人詈语、不分亲疏，且夜间大多无法入睡，这是因为邪气并聚于阳分所致。然而这些症状都不像痫病，痫病发作时则呕吐涎沫，突然昏倒无知觉，牙关紧闭，四肢抽搐，持续时间长短不一，而发作过后苏醒，起居饮食都如同正常人，以此作为区别。痫病虽然分为五种，称为鸡痫、马痫、牛痫、羊痫、猪痫，是因为病情表现偶然类似而得名。其实质不过是痰、火、气、惊这四种病因罢了，所以治疗方法与癫狂病相同。
三圣散（San Sheng San） 青州白丸子（Qingzhou Baiwanzi） 滚痰丸（Guntan Wan） 遂心丹（Suixin Dan） 矾郁丸（Fanyu Wan） 控涎丹（Kongyan Dan） 抱胆丸（Baodan Wan） 镇心丹（Zhenxin Dan）
2. 治疗癫、狂、痫三种疾病，若初起多痰者用三圣散催吐；风盛有痰者用青州白丸子；热盛有痰者用滚痰丸；痰实兼气郁者用遂心丹或矾郁丸；痰盛兼惊悸者须用控涎丹；若无痰因神志轻浮而惊悸者，用抱胆丸或镇心丹治疗；发作时艾灸百会穴自然安宁；初发时用皂角粉灌入鼻内，若涎液过多欲止时可用盐汤点服。
【注释】癫、狂、痫三种疾病在初起阶段若伴有较多痰浊者，先用三圣散进行催吐。风邪偏盛且有痰者，使用青州白丸子。热邪偏盛且有痰者，使用礞石滚痰丸（由青礞石、沉香、百药煎、川大黄、黄芩组成）。痰浊壅盛且形体正气充实者，使用遂心散（由甘遂、朱砂、猪心组成）。痰浊兼有气机郁结者，使用矾郁丸（由白矾、郁金组成）。痰浊兼有惊悸者，使用控涎丹；若无痰浊但因神志轻浮而惊悸者，使用镇心丹或抱胆丸，这些都是现成的方剂。痫病发作时艾灸百会穴，不拘泥于艾炷的数量，以患者苏醒为度。再次发作再行艾灸，以痊愈为标准。初发时用皂角汁灌入鼻腔，体内的风涎就会从鼻口流出涕唾，如果苏醒后涎液仍不止，服用盐汤即可自行停止。
1. Ancient texts state: Dian (catatonia) and Kuang (mania) originate from the same pathological basis, but Kuang is caused by Yang pathogenic factors, whereas Dian is caused by Yin pathogenic factors. The initial onset of Dian manifests as dysphoria or lack of joy; in severe cases, it presents with mental dullness, idiocy, and disordered speech. Kuang manifests as anger, ferocity, restlessness, insomnia, fixed gaze, cursing, and failure to recognize relatives. Dian (epilepsy/seizure disorder) manifests during attacks as vomiting of saliva/phlegm, coma, jaw clenching, and falling; after convulsions cease and consciousness returns, the patient appears normal.
[Annotation] Li Shizhen stated: Medical classics mention "Dian and Kuang" together, and also refer to "Dian disease" as "Kuang," indicating that Dian and Kuang often occur as combined disorders. When pathogenic factors enter the Yang aspect, Kuang results; when they enter the Yin aspect, Dian results. Generally, at the onset of Dian, the patient's will is depressed and mood is unhappy; severely, spirit becomes dull and idiotic, speech is illogical, yet sleep patterns remain normal because the pathogen aggregates in the Yin. At the onset of Kuang, there is irritability and insomnia; severely, the patient becomes ferocious, murderous, stares fixedly, curses, ignores kinship ties, and suffers from nighttime insomnia because the pathogen aggregates in the Yang. However, these differ from Dian seizures: Dian attacks involve vomiting phlegm, sudden loss of consciousness, jaw clenching, and convulsions of varying duration. Upon recovery, daily activities and diet return to normal, which serves as the distinguishing feature. Although Dian is classified into five types named Chicken, Horse, Ox, Sheep, and Pig based on superficial symptom resemblance, the underlying causes are merely Phlegm, Fire, Qi stagnation, and Shock. Therefore, treatment principles are similar to those for Dian and Kuang.
Formulas: San Sheng San (Three Sages Powder), Qingzhou Baiwanzi (Qingzhou White Pill), Guntan Wan (Rolling Phlegm Pill), Suixin Dan (Heart-Penetrating Pill), Fanyu Wan (Alum and Curcuma Pill), Kongyan Dan (Phlegm-Controlling Pill), Baodan Wan (Gallbladder-Embracing Pill), Zhenxin Dan (Heart-Calming Pill).
2. For the three diseases of Dian, Kuang, and Dian seizures: if phlegm is abundant at onset, use San Sheng San to induce vomiting; if Wind is prevalent with phlegm, use Qingzhou Baiwanzi; if Heat is prevalent with phlegm, use Guntan Wan; if Phlegm excess accompanies Qi stagnation, use Suixin Dan or Fanyu Wan; if Phlegm accompanies Shock, use Kongyan Dan; if there is no phlegm but spirit is light leading to palpitations/shock, use Baodan Wan or Zhenxin Dan. During an attack, moxibustion at Baihui (GV20) brings natural peace. At initial onset, insert Sichuan soapberry powder into the nose; if excessive salivation needs stopping, apply salted broth.
[Annotation] In the early stages of Dian, Kuang, and Dian seizures, if phlegm is abundant, first use San Sheng San to induce vomiting. If Wind predominates with phlegm, employ Qingzhou Baiwanzi. If Heat predominates with phlegm, employ Mengshi Guntan Wan (composed of Qing Meng Shi [Lapis Lazuli], Chen Xiang [Aquilaria Wood], Bai Yao Jian [Fermented Tea Brick], Chuan Da Huang [Rhubarb Root], Huang Qin [Scutellaria Root]). If Phlegm is excessive and constitutional Qi is strong, employ Suixin San (composed of Gan Sui [Radix Euphorbiae Lathyri], Zhu Sha [Cinnabar], Zhu Xin [Pig Heart]). If Phlegm accompanies Qi stagnation, employ Fanyu Wan (composed of Bai Fan [Alumen), Yu Jin [Curcuma Longa Rhizome]). If Phlegm accompanies Shock, employ Kongyan Dan. If there is no phlegm but spirit is light causing palpitations, employ Zhenxin Dan or Baodan Wan; these are established formulas. During a Dian seizure, apply moxibustion to Baihui (GV20); the number of moxa cones is not restricted, stopping when the patient regains consciousness. Reapply upon recurrence until cured. At initial onset, instill Sichuan soapberry juice into the nasal cavity so that Wind-phlegm exits via nose and mouth as sputum. If salivation persists after recovery, administer salted broth to stop it naturally.