《经》谓∶其人肠胃大，则卫气之入于阴者留久，皮肤湿，分肉不解，（肤腠因湿而
密致也。）则卫气之行于阴者迟，（则其还于表者亦迟可知。）留久而行迟，其气不精，
（气钝而不向导
也。视出阳入阴爽利而不滞者，异矣。）故多卧。大抵精明之人卧少，昏浊之人卧多。
饱食终日，
无所用心，静而不扰，则多卧。若因湿盛而然者，则必怠惰，四肢不收，或大便溏
泄，脉缓，去湿为主。亦有属热者。火主动，本应不得卧，然火盛弥漫壅闭，闭则
不通，不通反不扰，精神为热所耗而昏，故沉困嗜卧也，然必卧不能安，除热为主。
热病愈后，阴气得复，必恬睡，醒则清爽，与热证昏睡醒亦沉迷者不同。食入则困
倦欲睡者，脾弱得食不能即运，不运则静矣，静故欲睡也，六君（见气）加麦芽、山楂、
神曲之类。
狂者，猖狂刚暴，裸体詈骂，不避亲 ，甚则持刀杀人，逾垣上屋，飞奔疾走，
不问水陆，多怒不卧，目直叫呼，时或高歌大笑，妄自尊贵，妄自贤智者是也。癫
者，如醉如呓，或悲或泣，或笑或歌，言语有头无尾，秽洁不知，左顾右盼，如见
鬼神，有时正性复明，深自愧沮，少顷状态复露者是也。痫者，发则昏不知人，卒
倒无知，口噤牙紧，将醒时吐痰涎，甚则手足抽搐，口眼相引，目睛上视，口
作六畜之声，醒后起居饮食皆若平人，心地明白，亦有久而神呆者，然终不似癫狂
者常时迷惑也。（诸中卒仆似之，而仆时无声，醒时无涎沫）《内经》论狂为阳证，
其词不一而
足，病为火邪无疑。观伤寒热入胃府，往往发狂可见。然伤寒乃暴病，不过一时火
热乘心，心神狂越，热除则已。若经年累月病狂不省者，则岂徒火之为哉？必
有痰涎迷留心窍，乃成固疾也。盖火气乘心则心血必虚，兼之心神浮越，不守其舍，
以故痰涎得乘虚入踞耳。癫亦同此而痰火不甚，不似狂之火盛而暴也。痫病亦属痰
热，而有发有止，则痰未入心，不过伏于心下，气动则发而上乘，气平则止而下退，
与癫狂之痰常迷心窍者异矣。三证各别，皆属于热。而《难经》以痫为癫，有重阳
者狂。重阴者癫之说。于是后人以痫为阴寒之证，亦有分痫为阴阳二证，以阴痫为
寒者。夫痫证，或因误治而转为虚寒者有之，未有初起即属阴寒者。刘宗浓谓∶阴
阳痫，如小儿急慢惊。阳痫不因吐下，由痰热客心胃间，因惊而作。（旧有胎痫之说，谓
儿在母胎，母受惊恐，惊气传子，生后尚未即发，因遇大惊，与所受于母之惊气相搏而作，
作则神越舍空，
痰得入心而成此疾。刘氏说本此。）若热盛，虽不惊亦作，治宜寒药。阴痫亦本痰热，因寒凉
攻下太过，变而成阴，宜温平补胃燥痰之药。若谓不因坏证而有阴阳之分，则是指痰
热所客脏腑表里浅深而言，痫病岂本有阴寒者哉？按《难经》谓脉居阴部，（尺也。
沉分亦是。）而反见阳脉者，（常见浮滑长大数脉。）为阳乘阴也。（阴虚阳入乘之，主发热。）脉虽时
浮滑而长，此为阴中伏阳也。（阳脉虽临时一见，不如乘阴之常见，然此为阴中伏阳，至夏必病
矣。）脉居阳部，而反见阴脉者，为阴乘阳也。（主恶寒。）脉虽时沉涩而短，此为阳中伏阴
也。（至冬必病。原文错简，今订正。）重阳者狂，重阴者癫，（不论阴阳部皆见阳脉，为重阳；皆见阴
脉，为重阴。）其说如此。然《难经》又云∶癫病始发，意不乐，直视僵仆，（癫只痴呆，无
直视僵仆。直视僵仆，乃痫证也。《难经》以痫为癫，故其词如此。）其脉三部阴阳俱盛是也。既云
三部阴阳俱盛，则重阴者癫一言，固未可泥定矣。
治狂，《内经》谓∶宜夺食。以食入于阴，长气于阳也。生铁落饮、抱胆丸。阳
明实则下之，当归承气汤（见大便不通），后用黄连解毒汤（见喜。）吐痰，瓜蒂散；下痰，清
心滚痰丸。（并见痰。）病久而虚者，宁志膏、一醉膏、灵苑辰砂散。盖此病少卧，卫气
不行于阴，故阳盛阴虚今昏其神，使得睡则卫气得入于阴，阳不偏盛，阴不偏
虚，阴阳均平矣。《经》谓∶悲哀动中则伤魂，（魂属阳，主动主升。悲哀则敛抑，违其性故为伤。）
故狂当以喜胜之。又谓∶喜乐无节则伤魄，（魄主静主降，喜则气浮越故伤。）故狂当以恐腾之。
按此系举七情之致狂者言耳，夫致狂亦多端矣。
治癫，星香散（见中风）加石菖蒲，人参，和竹沥、姜汁，下寿星丸。或涌去痰
涎，后服宁神之剂。因惊而得者，抱胆丸。思虑所致者，酒调天门冬地黄膏，多服
取效。郁金七两、明矾三两为末，簿荷汁，丸桐子大，每服五六十丸，汤水任下，
最能去心窍郁痰。孙兆治一僧，令食咸物使渴，与药，调酒饮之，愈。问其治法，
曰∶医能安神矣，而不能使神昏得睡，此乃灵苑辰砂散也，人不能用耳。若脉乍大
乍小，乍有乍无，忽而如平人，忽而如雀啄、屋漏、遐游、鱼翔，此鬼祟也。秦
承祖灸鬼法，及针鬼宫等十三穴。（见针灸。）
治痫，赵以德曰∶痫疾浅者，止在经脉，气不通，眩运仆倒；深者，入肾，邪
留于阴不行，不行则阴气蓄满，郁极乃发，发则相火自下逆上，填塞其声音，惟迫
其羊鸣者一二声而出，遍身之涎沫皆迫而上胸臆，流于口，诸经脉筋骨皆不胜其冲
逆，故卒倒无知，少顷火气退散乃醒，不治则邪不散，遂成常证。《经》谓∶癫者
（《内经》亦以痫为癫，宜当痫字看。）气下泄，及发如狂者死。盖邪入于阴者，
阴气满，闭塞于
下而逆上，令气下泄，则肾气下脱故死。又心之阳不胜其阴气之冲逆，阳气暴绝，
故如狂亦死也。然不可一概论，盖阴脱者尺脉不应，如狂者寸脉不应，若尺寸俱盛，
则是阴阳俱实，不可断为必死也。先身热螈 ，惊啼叫呼乃发，脉浮，病在腑也，
为阳痫易治。先身冷，不惊掣，不啼呼，忽然而发，脉沉，病在脏，为阴痫难治。
久则有六畜之声，反折上窜，声如犬吠属肝；目瞪口呆，声如羊叫属心；直视腹满，
声如牛叫属脾；惊跳反折，声如鸡鸣属肺；如尸，吐沫，声如猪叫属肾。然治
法则一，总以行痰为主，逐痰饮∶南星、半夏、竹沥、姜汁、栝蒌、僵蚕、天麻、
龙齿、石菖蒲、远志，加附子少许。犬加柴胡，羊加黄连，牛加白芍，鸡加黄芩，
猪加知母。痰盛必用吐，先一餐勿食，次早捣茶子煎汤，束小腹饮之即叶。虚
者先补后攻。妙功丸、（久而有虫亦用此丸。）妙香散、（见心痛。）牛黄丸、杨氏五痫丸选用。昼
发灸阳跷，夜发灸阴跷，为二跷能行下焦之气也。（二跷为病主癫痫，见奇经八脉。）各二七壮。
凡灸痫，必须先下之乃可灸，否则气不通能杀人。平旦发者足少阳，晨朝发者足厥
阴，日中发者足太阳，黄昏发者足太阴，人定发者足阳明，半夜发者足少
阴，加引经药。愈后，痰热药中加养血宁神之品。脉虚弦属惊，沉数属实热。
虚者脉宜虚缓，若急实沉小，或虚而弦急，皆难治。
《黄帝内经》说：如果一个人的肠胃较大，那么卫气进入阴分（夜间行于内脏）时停留的时间就长；如果皮肤湿润，肌肉纹理因湿邪而致密不解（肤腠因湿而密致也），那么卫气在阴分运行就会迟缓（则其还于表者亦迟可知）。停留时间长且运行迟缓，导致气机不精纯（气钝而不向导也。视出阳入阴爽利而不滞者，异矣。），所以容易多睡。大抵而言，精神清明的人睡得少，昏浊的人睡得多。整天吃饱了饭，不用心思考，安静而不受干扰，就容易多睡。如果是由于湿气过盛导致的，一定伴有倦怠懒惰、四肢无力不收，或者大便溏泄、脉象缓弱，治疗以祛湿为主。也有属于热证的。火性主动，本来应该让人无法入睡，但如果火势盛大弥漫、壅塞闭阻，闭塞则气机不通，不通反而不扰动心神，加上精神被热邪耗损而昏沉，所以会出现身体沉重困倦、嗜睡的症状，但必定是睡不安稳，治疗以清热为主。热病痊愈后，阴气恢复，必然恬静安睡，醒来后神志清爽，这与热证导致的昏睡、醒来依然沉迷不同。进食后就感到困倦想睡觉的，是因为脾气虚弱，进食后不能立即运化，不运化则气机静止，静止故想睡觉，可用六君子汤（见气虚章节）加麦芽、山楂、神曲等药物。
狂证，表现为猖狂刚暴，裸体骂人，不顾及亲属关系，严重时持刀杀人，翻墙爬屋，飞奔疾走，不问水陆地形，多怒不睡，眼睛直视叫喊，有时高声歌唱大笑，妄自尊大，自认为贤能智慧。癫证，表现为像醉酒或梦呓一样，有时悲伤哭泣，有时欢笑歌唱，言语有头无尾，不知秽洁，左顾右盼，好像看见鬼神，有时正气恢复神志清醒，深深感到羞愧沮丧，片刻后状态又暴露出来。痫证，发作时昏迷不知人事，突然跌倒无知，牙关紧闭，将要醒时吐出痰涎，严重时手足抽搐，口眼歪斜牵引，眼球上视，口中发出六畜的声音，醒后起居饮食都像正常人，心地明白，也有时间久了神志呆滞的，但最终不像癫狂患者那样时常迷惑。（各种中风暴仆与此相似，但仆倒时无声，醒时无痰沫。）《黄帝内经》论述狂证为阳证，言辞不一但足以说明，此病无疑是火邪所致。观察伤寒热邪传入胃腑，往往出现发狂，可见一斑。然而伤寒是急性病，不过是一时火热乘袭心神，导致心神狂越，热除则病愈。如果经年累月患狂病不省人事的，难道仅仅是火邪造成的吗？一定有痰涎迷留心窍，才形成顽固疾病。大概火气乘袭心脏，心血必然虚弱，兼之心神浮越，不能守舍，因此痰涎得以乘虚侵入占据。癫证也类似，但痰火不甚，不像狂证那样火盛而暴烈。痫病也属于痰热，但有发作和停止的时候，说明痰未入心，只是潜伏在心下，气动则发作而上乘，气平则停止而下退，与癫狂之痰常迷心窍不同。这三种证候各不相同，都属于热证。而《难经》将痫归为癫，有“重阳者狂，重阴者癫”的说法。于是后人将痫视为阴寒之证，也有将痫分为阴阳二证，认为阴痫为寒的。其实痫证，有的因为误治而转为虚寒的有之，但没有初起就属于阴寒的。刘宗浓说：阴阳痫，就像小儿急慢惊风。阳痫不因吐下引起，由痰热客居心胃之间，因惊吓而发作。（旧有胎痫之说，谓胎儿在母胎中，母亲受到惊恐，惊气传给儿子，出生后尚未立即发作，遇到大惊，与从母亲处受到的惊气相搏而发作，发作则神越舍空，痰得入心而成此疾。刘氏之说本于此。）如果热盛，即使不惊吓也会发作，治疗宜用寒凉药。阴痫也本于痰热，因寒凉攻下太过，变证而成阴证，宜用温平补胃燥痰的药物。如果说不是因坏证而有阴阳之分，那是指痰热所客脏腑表里浅深而言，痫病难道原本就有阴寒的吗？按《难经》所说：脉居阴部（尺部。沉分也是），而反见阳脉者（常见浮滑长大数脉），为阳乘阴也。（阴虚阳入乘之，主发热。）脉虽然时而浮滑而长，此为阴中伏阳也。（阳脉虽临时一见，不如乘阴之常见，然此为阴中伏阳，至夏必病矣。）脉居阳部，而反见阴脉者，为阴乘阳也。（主恶寒。）脉虽然时而沉涩而短，此为阳中伏阴也。（至冬必病。原文错简，今订正。）重阳者狂，重阴者癫，（不论阴阳部皆见阳脉，为重阳；皆见阴脉，为重阴。）其说法如此。然而《难经》又说：癫病始发，意不乐，直视僵仆，（癫只痴呆，无直视僵仆。直视僵仆，乃痫证也。《难经》以痫为癫，故其词如此。）其脉三部阴阳俱盛是也。既然说三部阴阳俱盛，那么“重阴者癫”这一句话，固然不可拘泥定论。
治疗狂证，《黄帝内经》说：应当剥夺饮食。因为食物进入阴分，助长阳气。可用生铁落饮、抱胆丸。阳明腑实应当攻下，用当归承气汤（见大便不通章节），后用黄连解毒汤（见喜证章节）。吐痰，用瓜蒂散；下痰，用清心滚痰丸。（并见痰证章节。）病久体虚者，用宁志膏、一醉膏、灵苑辰砂散。大概此病少卧，卫气不行于阴分，所以阳盛阴虚，如今昏乱其神，使其能够睡觉，则卫气得入于阴分，阳不偏盛，阴不偏虚，阴阳均平了。《黄帝内经》说：悲哀动中则伤魂，（魂属阳，主动主升。悲哀则敛抑，违其性故为伤。）所以狂证应当以喜胜之。又说：喜乐无节则伤魄，（魄主静主降，喜则气浮越故伤。）所以狂证应当以恐胜之。按此系列举七情导致狂证的情况而言，导致狂证的原因也有很多种。
治疗癫证，用星香散（见中风章节）加石菖蒲、人参，和竹沥、姜汁，送服寿星丸。或者涌吐去痰涎，后服用宁神之剂。因惊吓而得的，用抱胆丸。思虑所致的，用酒调天门冬地黄膏，多服取效。郁金七两、明矾三两研末，薄荷汁，制成梧桐子大小的丸药，每次服用五六十丸，汤水任下，最能去除心窍郁痰。孙兆治疗一个僧人，让他吃咸物使他口渴，给药，调酒饮之，痊愈。问其治法，说：医生能安神了，而不能使神昏得睡，这就是灵苑辰砂散，人们不会用罢了。如果脉象乍大乍小，乍有乍无，忽而像正常人，忽而像雀啄、屋漏、遐游、鱼翔，这是鬼祟作怪。秦承祖灸鬼法，以及针鬼宫等十三穴。（见针灸章节。）
治疗痫证，赵以德说：痫疾浅的，只在经脉，气不通，眩晕仆倒；深的，入肾，邪留于阴分不行，不行则阴气蓄满，郁极乃发，发作则相火自下逆上，填塞其声音，只有迫使其羊鸣一二声而出，遍身之涎沫都迫而上胸臆，流于口，诸经脉筋骨都不胜其冲逆，所以突然跌倒无知，片刻后火气退散乃醒，不治疗则邪不散，遂成常证。《黄帝内经》说：癫者（《内经》亦以痫为癫，宜当痫字看。）气下泄，及发如狂者死。大概邪入于阴分，阴气满，闭塞于下而逆上，令气下泄，则肾气下脱故死。又心之阳不胜其阴气之冲逆，阳气暴绝，故如狂亦死也。然而不可一概而论，大概阴脱者尺脉不应，如狂者寸脉不应，若尺寸俱盛，则是阴阳俱实，不可断为必死也。先身热螈疭，惊啼叫呼乃发，脉浮，病在腑也，为阳痫易治。先身冷，不惊掣，不啼呼，忽然而发，脉沉，病在脏，为阴痫难治。久了则有六畜之声，反折上窜，声如犬吠属肝；目瞪口呆，声如羊叫属心；直视腹满，声如牛叫属脾；惊跳反折，声如鸡鸣属肺；如尸，吐沫，声如猪叫属肾。然而治法则一，总以行痰为主，逐痰饮：南星、半夏、竹沥、姜汁、栝蒌、僵蚕、天麻、龙齿、石菖蒲、远志，加附子少许。犬加柴胡，羊加黄连，牛加白芍，鸡加黄芩，猪加知母。痰盛必须用吐法，先一顿勿食，次日早晨捣茶子煎汤，束小腹饮之即吐。虚者先补后攻。妙功丸、（久而有虫亦用此丸。）妙香散、（见心痛章节。）牛黄丸、杨氏五痫丸选用。昼发灸阳跷脉，夜发灸阴跷脉，因为二跷能行下焦之气也。（二跷为病主癫痫，见奇经八脉章节。）各灸十四壮。凡灸痫，必须先攻下才可灸，否则气不通能杀人。平旦发者足少阳，晨朝发者足厥阴，日中发者足太阳，黄昏发者足太阴，人定发者足阳明，半夜发者足少阴，加引经药。痊愈后，在痰热药中加养血宁神之品。脉虚弦属惊，沉数属实热。虚者脉宜虚缓，若急实沉小，或虚而弦急，皆难治。
The *Classic of Internal Medicine* (*Huangdi Neijing*) states: If a person's stomach and intestines are large, the Wei Qi (Defensive Qi) entering the Yin (nighttime circulation within the zang-fu organs) stays for a long time. If the skin is damp and the muscle tissues are dense due to dampness (the interstices become tight because of dampness), then the movement of Wei Qi in the Yin is slow (it can be known that its return to the exterior is also slow). Because it stays long and moves slowly, the Qi becomes impure (the Qi is dull and lacks guiding force; this is different from the smooth and unobstructed transition between Yang and Yin). Therefore, there is excessive sleep. Generally speaking, people with clear spirit sleep less, while those with turbid spirit sleep more. Those who eat until full all day without mental exertion, remaining quiet and undisturbed, tend to sleep excessively. If caused by excessive dampness, there must be lethargy, flaccidity of the four limbs, or loose stools, with a slow pulse; treatment focuses on resolving dampness. There are also cases belonging to Heat. Fire has an active nature and should normally prevent sleep. However, if Fire is abundant, spreading and obstructing, obstruction leads to blockage, which paradoxically does not disturb, and since the Spirit is consumed by Heat causing confusion, one feels heavy, weary, and sleepy. However, sleep will be restless, and treatment focuses on clearing Heat. After recovery from a Heat disease, when Yin Qi is restored, there is peaceful sleep; upon waking, the mind is clear, which differs from the drowsiness after waking from Heat-induced stupor. Feeling sleepy and tired after eating indicates Spleen deficiency; the Spleen cannot transport immediately after eating, stagnation leads to stillness, and stillness induces sleep. Treatment uses Liu Jun Zi Tang (Six Gentlemen Decoction) plus Mai Ya (Sprouted Barley Fruit), Shan Zha (Hawthorn Fruit), Shen Qu (Medicated Leaven), etc.
Kuang syndrome (Mania) is characterized by reckless violence, nudity, cursing, disregard for relatives, and in severe cases, holding knives to kill, climbing walls and roofs, running wildly regardless of terrain, excessive anger, insomnia, staring straight ahead, shouting, sometimes singing loudly or laughing wildly, arrogant self-aggrandizement, and delusions of wisdom. Dian syndrome (Depressive Psychosis) presents as being like a drunkard or sleep-talking, alternating between sadness/crying and laughter/singing, speech lacking coherence, unaware of cleanliness or filth, looking around left and right as if seeing ghosts and spirits. Sometimes the true nature returns and consciousness clears, leading to deep shame and depression, but shortly after, the symptoms reappear. Xian syndrome (Epilepsy) involves sudden loss of consciousness and collapse, clenched jaws, expectoration of phlegm-saliva upon awakening, and in severe cases, convulsions of hands and feet, deviation of mouth and eyes, upward deviation of the eyeballs, and sounds resembling livestock. Upon waking, daily activities and diet return to normal, and the mind is clear. Some may have lingering mental dullness over time, but they do not remain perpetually confused like those with Dian or Kuang. (Sudden collapses from various wind-strokes are similar, but occur silently without sound, and awaken without phlegm.) The *Inner Canon* discusses Kuang as a Yang syndrome, indicating undoubtedly that Fire Evil is the cause. Observing that in Shang Han (Cold Damage) diseases where Heat enters the Stomach Fu, mania often occurs confirms this. However, Shang Han is an acute illness, involving only temporary Fire-Heat harassing the Heart Spirit, causing spiritual deviation; once the Heat is removed, the condition resolves. If mania persists for years without lucidity, it cannot be solely attributed to Fire. There must be Phlegm-Saliva confusing the orifices of the Heart, forming a chronic condition. When Fire-Qi harasses the Heart, Heart Blood must be deficient, and combined with the floating and overflowing of the Heart Spirit, failing to reside in its house, Phlegm-Saliva takes advantage of the deficiency to invade and occupy. Dian syndrome is similar but with less Phlegm-Fire, unlike the violent abundance of Fire in Kuang. Xian syndrome also belongs to Phlegm-Heat, but has periods of onset and cessation, indicating the Phlegm has not entered the Heart but lies latent below the Heart. When Qi moves, it ascends and triggers an attack; when Qi calms, it descends and stops. This differs from Dian and Kuang where Phlegm constantly confuses the Heart orifices. These three syndromes are distinct but all belong to Heat. However, the *Nan Jing* classifies Xian under Dian, stating "Double Yang results in Kuang, Double Yin results in Dian." Consequently, later practitioners viewed Xian as a Cold-Damp syndrome, or divided it into Yin and Yang types, considering Yin Xian as Cold. In fact, while some Xian cases may turn into Deficiency-Cold due to mismanagement, none originate as Yin-Cold. Liu Zongnong stated: Yin and Yang Xian are like infantile acute and chronic convulsions. Yang Xian arises not from vomiting or purging, but from Phlegm-Heat lodging between the Heart and Stomach, triggered by fright. (Old theories suggest fetal epilepsy, where maternal fright transmits to the fetus, manifesting later after a major fright combines with the transmitted fright energy, emptying the spirit's residence and allowing Phlegm to enter the Heart. Liu's theory is based on this.) If Heat is abundant, attacks occur even without fright, treated with cold medicines. Yin Xian also originates from Phlegm-Heat but transforms into Yin due to excessive cold-purgative treatment; it requires warm, neutral, stomach-tonifying, and phlegm-drying medicines. If distinguishing Yin and Yang is not due to pathological transformation, it refers to the depth and location (exterior/interior) of the Phlegm-Heat. Can Xian originally be Cold? According to the *Nan Jing*: If the pulse is in the Yin position (Cun/Guan/Chi at Chi level, or deep position) but shows Yang pulses (floating, slippery, large, rapid), it is Yang invading Yin (Yin deficiency allows Yang to invade, indicating fever). If the pulse is occasionally floating, slippery, and long, it is Yang hidden within Yin (though Yang pulses appear temporarily, they are less common than Yang invading Yin; however, this indicates Yang hidden in Yin, likely to manifest in summer). If the pulse is in the Yang position but shows Yin pulses (deep, choppy, short), it is Yin invading Yang (indicating aversion to cold). If the pulse is occasionally deep, choppy, and short, it is Yin hidden within Yang (likely to manifest in winter. Original text order is corrected here). "Double Yang results in Kuang, Double Yin results in Dian" means seeing Yang pulses everywhere indicates Double Yang; seeing Yin pulses everywhere indicates Double Yin. However, the *Nan Jing* also says: Dian begins with unhappiness, staring straight, and stiff collapse. (Dian involves only dementia, not staring/collapse; these are signs of Xian. The *Nan Jing* conflates Xian with Dian, hence the description.) Its pulse shows both Yin and Yang positions are abundant. Since both Yin and Yang are abundant, the statement "Double Yin results in Dian" cannot be rigidly applied.
Treatment for Kuang: The *Classic* advises withholding food, as food enters Yin and generates Yang. Use Sheng Tie Luo Yin (Raw Iron Filings Drink) or Bao Dan Wan (Gallbladder-Calming Pill). For Yang Ming excess, purge using Dang Gui Cheng Qi Tang (Angelica Sinensis and Rhubarb Decoction), followed by Huang Lian Jie Du Tang (Coptis Decoction for Relieving Toxicity). To induce vomiting for phlegm, use Gua Di San (Melon Sepal Powder); to purge phlegm, use Qing Xin Gun Tan Wan (Heart-Clearing Rolling Phlegm Pill). For chronic deficiency, use Ning Zhi Gao (Spirit-Calming Paste), Yi Zui Gao (One Intoxication Paste), or Ling Yuan Chen Sha San (Lingyuan Cinnabar Powder). This disease involves little sleep because Wei Qi does not enter Yin, leading to Yang excess and Yin deficiency, confusing the spirit. Inducing sleep allows Wei Qi to enter Yin, balancing Yang and Yin. The *Classic* states: Sadness moving internally injures Hun (Ethereal Soul, associated with Liver, Yang, active, ascending). Sadness suppresses, contrary to its nature, causing injury. Thus, Kuang should be treated by overcoming it with Joy. It also states: Unrestrained joy injures Po (Corporeal Soul, associated with Lung, Yin, static, descending), as joy causes Qi to float and overflow. Thus, Kuang should be overcome by Fear. Note: This refers only to emotional causes of Kuang; there are many other causes.
Treatment for Dian: Use Xing Xiang San (Star Fragrance Powder) plus Shi Chang Pu (Acorus Rhizome), Ren Shen (Ginseng Root), Zhu Li (Bamboo Sap), and Jiang Zhi (Ginger Juice), administered with Shou Xing Wan (Longevity Star Pill). Or induce vomiting to remove phlegm-saliva, then administer spirit-calming agents. For cases caused by fright, use Bao Dan Wan. For cases caused by overthinking, use Tian Men Dong Di Huang Gao (Asparagus and Rehmannia Paste) mixed with wine, taken frequently for effect. Yu Jin (Curcuma Tuber) 7 liang, Ming Fan (Alum) 3 liang, powdered, formed into pills with Bo He Zhi (Mint Juice), size of paulownia seeds. Take 50-60 pills with water. This best removes stagnant phlegm from Heart orifices. Sun Zhao treated a monk by making him eat salty food to induce thirst, then administered medicine mixed with wine, curing him. Asked about the method, he said: "Doctors can calm the spirit, but cannot make the confused spirit sleep. This is Ling Yuan Chen Sha San, which people fail to use correctly." If the pulse is fluctuating (large/small, present/absent), suddenly normal, then like bird-pecking, roof-leaking, distant wandering, or fish-swimming, this is considered demonic influence. Use Qin Chengzu's Ghost-Moxibustion method or needle Guigong and 12 other acupoints.
Treatment for Xian: Zhao Yi-de stated: Superficial Xian affects meridians, Qi blockage causes dizziness and collapse. Deep Xian affects Kidney, evil lingers in Yin, stagnation fills Yin, extreme stagnation triggers eruption. Minfire rises counterflow from below, blocking voice, producing sheep-like bleats. Saliva rushes to chest/mouth. Meridians and sinews cannot withstand the counterflow, causing sudden collapse and unconsciousness. Awakening occurs when fire dissipates. Untreated, it becomes chronic. The *Classic* states: Dian with downward Qi leakage or appearing like Kuang during attack is fatal. When evil enters Yin, Yin fills, blocks below, and counterflows above. Downward Qi leakage indicates Kidney Qi sinking, leading to death. Heart Yang cannot withstand Yin counterflow, leading to sudden Yang exhaustion, thus appearing like Kuang is also fatal. However, this is not absolute. Yin collapse shows no response at Chi pulse; Kuang-like state shows no response at Cun pulse. If both Cun and Chi are abundant, it indicates Excess in both Yin and Yang, not necessarily fatal. Preceded by fever, convulsions, crying, and shouting, with floating pulse indicates disease in Fu organs, Yang Xian, easy to treat. Preceded by cold body, no convulsions/crying, sudden onset, with deep pulse indicates disease in Zang organs, Yin Xian, difficult to treat. Long-standing cases produce livestock sounds: Dog-like bark indicates Liver; Sheep-like bleat indicates Heart; Cow-like moo indicates Spleen; Chicken-like crow indicates Lung; Pig-like grunt indicates Kidney. Treatment principle remains the same: primarily resolve phlegm. Remove phlegm-fluids using Nan Xing (Arisaema Rhizome), Ban Xia (Pinellia Tuber), Zhu Li (Bamboo Sap), Jiang Zhi (Ginger Juice), Gua Lou (Trichosanthes Fruit), Jiang Can (Bombyx Batryticatus), Tian Ma (Gastrodia Rhizome), Long Chi (Dragon Tooth), Shi Chang Pu (Acorus Rhizome), Yuan Zhi (Polygala Root), with a small amount of Fu Zi (Aconite Lateral Root). Add Chai Hu (Bupleurum Root) for dog-type, Huang Lian (Coptis Rhizome) for sheep-type, Bai Shao (White Peony Root) for cow-type, Huang Qin (Scutellaria Root) for chicken-type, Zhi Mu (Anemarrhena Rhizome) for pig-type. Severe phlegm requires emesis. Fast for one meal, next morning decoct Cha Zi (Tea Seeds), bind lower abdomen, drink to induce vomiting. For deficiency, tonify first, then purge. Select Miao Gong Wan, Miao Xiang San, Niu Huang Wan (Calculus Bovis Pill), or Yang Shi Wu Xian Wan. For daytime attacks, moxa Yang Qiao Mai; for nighttime attacks, moxa Yin Qiao Mai, as these vessels govern lower Jiao Qi. Moxa 14 moxa cones each. Before moxa for Xian, purgation is mandatory; otherwise, Qi blockage can be fatal. Attacks at dawn relate to Foot Shaoyang; morning to Foot Jueyin; noon to Foot Taiyang; dusk to Foot Taiyin; nightfall to Foot Yangming; midnight to Foot Shaoyin. Add guiding herbs. After recovery, add blood-nourishing and spirit-calming herbs to phlegm-clearing formulas. Pulse deficient and wiry indicates Fright; deep and rapid indicates Excess-Heat. Deficient patients should have slow, weak pulses; if rapid, solid, deep, small, or deficient and wiry/tense, prognosis is poor.