脉
癫脉搏大滑者生，沉小紧急则不治。热狂脉实大生，沉小死。癫脉虚可治，实则死。
证
夫癫者，喜笑不常，而颠倒错乱之谓也。狂者，狂乱而无正定也。故心热盛，则多喜而为癫也；肝热盛，
则多怒而为狂也。甚则弃衣而走，登高而歌，逾垣上屋，骂詈不避亲疏。是盖得之阳气太
盛，胃与大肠实热燥火郁结于中而为之耳，此则癫狂之候也。大抵狂为痰火实盛也，治当大吐大下；癫为
心血不足，多为求望高远，不遂其志者有之。
治
治以安神养血，兼降痰火。
心风者何？盖君火者，心因怒发之，相火助盛，痰动于中，挟气上攻，迷其心窍，则为癫为狂。所怒
之事，胶固于心，辄自言谈，失其条序，谓之心风。与风何相干。若痰不盛者，则有感亦轻。
狂言、谵语、郑声辨。
狂者，大开目，与人语所未尝见之事，为狂也。
谵语者，合目自言日用常行之事，为谵语也。
郑声者，声颤无力，不相接续，造字出于喉中，为郑声也。
阳附阴则狂，阴附阳则癫。脱阳者见鬼，脱阴者目盲。又蓄血证，则重复语之。
方
防风通圣散（方见中风）〔批〕（按此方治癫狂初起，多有实热风邪宜之） 治一切癫狂风疾，暴发之症。
宁志化痰汤（陈白野方） 治癫狂心虚痰盛之症。
胆星（一钱） 半夏（制，一钱） 陈皮（一钱） 茯苓（一钱） 天麻（一钱） 人参（一
钱） 黄连（姜汁炒，一钱） 酸枣仁（一钱） 石菖蒲（一钱）
上锉一剂，生姜五片，水煎服，再服清心养血汤。
清心养血汤〔批〕（按此方补虚化痰，清心宁心之剂）
人参（一钱） 白术（一钱） 茯神（一钱） 远志（一钱，水泡，去骨） 枣仁（一钱，
炒） 当归（一钱五分） 川芎（一钱） 生地黄（一钱） 甘草（五分）
上锉一剂，加圆眼五个，水二盏，煎八分，空心服。
黄白丹（秘方） 治五癫五痫。
黄丹（一两） 白矾（一两）
上用砖一块，凿一窝，可容二两许，置丹在下，矾在上，用木炭五斤， 令炭尽，取为末，以不经
水猪心血为丸，如绿豆大。每服三十丸，陈皮汤下。
独参丸 治狂邪发作无时，披头大叫，不避水火。
苦参（不拘多少）
上为末，炼蜜为丸如梧子。每十五丸，薄荷汤下。
河车丸 治久患心风癫，气血两虚之症。
紫河车（不拘几个，焙极干）
上为末，炼蜜为丸，梧子大。每七十丸，空心酒下。
开迷散 治妇人癫疾，歌唱无时，逾垣上屋。乃荣血逆于心胞所致。
当归（一钱） 白术（炒，一钱） 白芍药（一钱） 柴胡（八分） 白茯苓（八分） 甘
草（炙，七分） 桃仁（一钱五分） 苏木（一钱） 红花（一钱） 远志（泡，去骨，一钱五分）
生地黄（一钱五分）
上锉，生姜煎服。或用此方炼蜜为丸，辰砂为衣。
一女子年十五，因气恼，患语言颠倒，欲咬人打物，偷藏东西，时哭时笑，心怕胆小，饮食不知
饥饱，身体发热。以防风通圣散加生地黄、牡丹皮，二服即安。
秦承祖灸鬼法 治一切惊狂谵语，为邪鬼恶物所附。此因气血两虚，邪乘虚入，如癫如痫之症。以病者
两手大拇指用细麻绳扎缚定，以大艾炷置于中两介甲及两指角肉，四处着火，一处不着即无效，灸七壮，神验。
脉象
患癫病的患者，若脉象表现为大、滑而有力，则预后良好；若脉象沉细且紧急，则属难治之症。患热狂病的患者，若脉象实大，则预后良好；若脉象沉细，则预后不良。患癫病的患者，若脉象虚弱，尚可治疗；若脉象实大，则预后凶险。
证候
所谓“癫”，是指患者喜笑无常，精神颠倒错乱的症状。所谓“狂”，是指患者行为狂乱，没有正常定性的症状。因此，心火炽盛，就会导致多喜笑而发为癫病；肝火炽盛，就会导致易愤怒而发为狂病。病情严重时，患者会脱掉衣服奔跑，登上高处歌唱，翻越墙垣屋顶，骂人时不分亲疏远近。这主要是因为阳气过于旺盛，胃与大肠内实热燥火郁结于体内所致，这就是癫狂的征候。大抵来说，狂病多因痰火实证亢盛所致，治疗应当采用强力催吐和泻下的方法；癫病多因心血不足引起，常是因为追求高远目标却未能如愿所致。
治法
治疗应以安神养血为主，兼以降泄痰火。
什么是“心风”？盖因君火（指心火）因愤怒而发动，相火（指肝肾之火）助长火势，导致痰浊内生，挟带气机上攻，迷蔽心窍，从而形成癫病或狂病。所愤怒的事情，顽固地留在心中，患者往往自言自语，失去条理顺序，这称为“心风”。这与外感风邪有什么关系呢？如果痰浊不严重，那么即使有感触，症状也较轻。
狂言、谵语、郑声的辨析。
狂者，睁大眼睛，与人谈论从未见过的事情，这称为狂。
谵语者，闭着眼睛自言自语，谈论日常生活中的平常事，这称为谵语。
郑声者，声音颤抖无力，语句不相接续，字词从喉中发出，这称为郑声。
阳气依附于阴分则发为狂，阴气依附于阳分则发为癫。阳气脱失者会出现幻觉看见鬼怪，阴气脱失者会导致双目失明。另外，蓄血证（瘀血阻滞）的患者，也会出现重复言语的症状。
方剂
防风通圣散（方剂见中风章节）[批注]（按：此方适用于癫狂初起，多有实热风邪侵袭的情况） 治疗一切癫狂风疾，突然发作的病症。
宁志化痰汤（陈白野方） 治疗癫狂伴有心虚痰盛的病症。
胆南星（一钱） 半夏（制，一钱） 陈皮（一钱） 茯苓（一钱） 天麻（一钱） 人参（一钱） 黄连（姜汁炒，一钱） 酸枣仁（一钱） 石菖蒲（一钱）
以上药材锉碎为一剂，加生姜五片，水煎服，随后再服用清心养血汤。
清心养血汤 [批注]（按：此方为补虚化痰、清心安神的药剂）
人参（一钱） 白术（一钱） 茯神（一钱） 远志（一钱，水泡，去骨） 枣仁（一钱，炒） 当归（一钱五分） 川芎（一钱） 生地黄（一钱） 甘草（五分）
以上药材锉碎为一剂，加桂圆肉五个，水两盏，煎至八分，空腹服用。
黄白丹（秘方） 治疗五种癫病和五种痫病。
黄丹（一两） 白矾（一两）
取一块砖，凿一个窝，容量约可容纳二两药，将黄丹置于底部，白矾置于上面，用五斤木炭煅烧，待炭烧尽后，取出研磨成粉末，以未经过水的猪心血作为粘合剂，制成如绿豆大小的丸药。每次服用三十丸，用陈皮汤送服。
独参丸 治疗狂邪随时发作，披头散发大叫，不避水火危险。
苦参（不限数量）
以上研为粉末，炼蜜为丸，如梧桐子大小。每次十五丸，用薄荷汤送服。
河车丸 治疗长期患有风邪癫病，气血两虚的病症。
紫河车（不限几个，焙至极干）
以上研为粉末，炼蜜为丸，如梧桐子大小。每次七十丸，空腹时用酒送服。
开迷散 治疗妇人癫疾，无时歌唱，翻越墙垣屋顶。这是由于营血逆乱于心包所致。
当归（一钱） 白术（炒，一钱） 白芍药（一钱） 柴胡（八分） 白茯苓（八分） 甘草（炙，七分） 桃仁（一钱五分） 苏木（一钱） 红花（一钱） 远志（泡，去骨，一钱五分） 生地黄（一钱五分）
以上药材锉碎，加生姜煎服。或者用此方炼蜜为丸，用辰砂为衣。
有一位十五岁的女子，因生气恼怒，出现语言颠倒错乱，想要咬人打物，偷藏东西，时而哭时而笑，内心害怕胆小，饮食不知饥饱，身体发热。使用防风通圣散加生地黄、牡丹皮，服用两剂后即痊愈。
秦承祖灸鬼法 治疗一切惊悸狂乱、谵语，因邪鬼恶物附身所致。这是因为气血两虚，邪气乘虚而入，症状如同癫病或痫病。用细麻绳扎缚病人的两手大拇指，将大艾炷置于两个拇指指甲根部及两指角的肌肉处，四处点火施灸，有一处未点燃即无效，每处灸七壮，效果神奇。
Pulse Diagnosis
In Dian disease (epilepsy/mental disorder), if the pulse is large, slippery, and forceful, the prognosis is good; if the pulse is deep, fine, and tight, it is difficult to treat. In Heat Kuang disease (mania), if the pulse is full and large, the prognosis is good; if the pulse is deep and fine, the prognosis is fatal. In Dian disease, if the pulse is deficient, it is treatable; if the pulse is excess and large, the prognosis is poor.
Symptoms
"Dian" refers to a condition characterized by abnormal laughter and joy, with mental confusion and disorientation. "Kuang" refers to a state of madness and chaos without normal restraint. Therefore, when Heart Fire is excessive, it leads to excessive joy and results in Dian disease; when Liver Fire is excessive, it leads to frequent anger and results in Kuang disease. In severe cases, patients may strip naked and run, climb to high places and sing, jump over walls and roofs, and curse others regardless of kinship or distance. This is primarily caused by excessive Yang Qi, where excess heat, dryness, and fire from the Stomach and Large Intestine are constrained within the body. These are the manifestations of Dian and Kuang. Generally speaking, Kuang disease is due to the excess and flourishing of Phlegm-Fire, and treatment should involve strong emesis and purgation. Dian disease is often due to a deficiency of Heart Blood, frequently occurring in individuals whose high aspirations remain unfulfilled.
Treatment Principles
Treatment should focus on calming the Spirit and nourishing the Blood, while simultaneously descending Phlegm and Fire.
What is "Wind of the Heart"? It arises because the Ministerial Fire (referring to Heart Fire) is triggered by anger, assisted by the Deficient Fire (referring to Liver and Kidney Fire), causing Phlegm to stir internally. This Phlegm, carrying Qi, attacks upward, clouding the Heart Orifices, thereby resulting in Dian or Kuang. The matters that caused anger become fixed in the mind, leading to self-talk that lacks logical order; this is called "Wind of the Heart." What does this have to do with external Wind? If Phlegm is not severe, even if there is an emotional trigger, the symptoms will be mild.
Differentiation of Kuang Yan (Manic Speech), Zhan Yu (Delirious Speech), and Zheng Sheng (Faltering Speech).
Kuang Yan: The patient keeps eyes wide open and discusses things never seen before with others; this is Kuang.
Zhan Yu: The patient closes eyes and speaks spontaneously about daily routine matters; this is Zhan Yu.
Zheng Sheng: The voice is trembling and weak, sentences are disjointed, and words seem to emerge from the throat; this is Zheng Sheng.
When Yang attaches to Yin, Kuang occurs; when Yin attaches to Yang, Dian occurs. Loss of Yang leads to hallucinations of seeing ghosts; loss of Yin leads to blindness. Additionally, in Blood Stasis syndrome, repetitive speech may occur.
Formulas
Fangfeng Tongsheng San (See formula under Stroke) [Commentary] (Note: This formula is suitable for the initial stage of Dian/Kuang where excess wind-heat pathogenic factors are present.) Treats all sudden-onset Dian and Kuang wind-diseases.
Ningzhi Huatan Tang (Formula by Chen Baiye) Treats Dian and Kuang accompanied by Heart deficiency and abundant Phlegm.
Dan Xing (Arisaema cum Bile, 1 qian) Ban Xia (Prepared Pinellia Rhizome, 1 qian) Chen Pi (Citrus Reticulatae Pericarpium, 1 qian) Fu Ling (Poria, 1 qian) Tian Ma (Gastrodiae Rhizoma, 1 qian) Ren Shen (Ginseng Radix et Rhizoma, 1 qian) Huang Lian (Coptidis Rhizoma, fried with ginger juice, 1 qian) Suan Zao Ren (Ziziphi Spinosae Semen, 1 qian) Shi Chang Pu (Acori Tatarinowii Rhizoma, 1 qian)
Crush these ingredients into one dose, add five slices of fresh ginger, decoct in water, and take orally. Subsequently, take Qingxin Yangxue Tang.
Qingxin Yangxue Tang [Commentary] (Note: This formula tonifies deficiency, resolves phlegm, clears the Heart, and calms the Spirit.)
Ren Shen (Ginseng Radix et Rhizoma, 1 qian) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 qian) Fu Shen (Poria with Hostwood, 1 qian) Yuan Zhi (Polygalae Radix, 1 qian, soaked in water, remove woody core) Zao Ren (Ziziphi Spinosae Semen, fried, 1 qian) Dang Gui (Angelicae Sinensis Radix, 1.5 qian) Chuan Xiong (Ligusticum Chuanxiong Rhizoma, 1 qian) Sheng Di Huang (Rehmanniae Radix, 1 qian) Gan Cao (Licorice Root, 0.5 qian)
Crush these ingredients into one dose, add five longan arils, two cups of water, decoct until reduced to 0.8 cup, and take on an empty stomach.
Huang Bai Dan (Secret Formula) Treats five types of Dian and five types of Xian (epilepsy).
Huang Dan (Minium, 1 liang) Bai Fan (Alumen, 1 liang)
Take a brick, carve a depression capable of holding approximately two taels of medicine. Place Minium at the bottom and Alumen on top. Calcine using five jin of charcoal until the charcoal is consumed. Grind into powder. Form pills using pig heart blood that has not been touched by water, making them the size of mung beans. Take thirty pills per dose, washed down with Chen Pi tea.
Dushen Wan Treats sudden onset of manic evil, where the patient runs wild with disheveled hair, shouting loudly, disregarding fire and water dangers.
Ku Shen (Sophorae Flavescentis Radix, as needed)
Grind into powder, bind with refined honey to form pills the size of wutong seeds. Take fifteen pills per dose, washed down with Bohe tea.
Heche Wan Treats chronic Wind-Dian disease with dual deficiency of Qi and Blood.
Zi He Che (Human Placenta, as needed, baked until extremely dry)
Grind into powder, bind with refined honey to form pills the size of wutong seeds. Take seventy pills per dose, washed down with wine on an empty stomach.
Kaimi San Treats female Dian disease, characterized by singing at random times and climbing over walls and roofs. This is caused by Ying Blood rebelling against the Pericardium.
Dang Gui (Angelicae Sinensis Radix, 1 qian) Bai Zhu (Atractylodis Macrocephalae Rhizoma, fried, 1 qian) Bai Shao Yao (Paeoniae Radix Alba, 1 qian) Chai Hu (Bupleuri Radix, 0.8 fen) Bai Fu Ling (Poria, 0.8 fen) Gan Cao (Licorice Root, roasted, 0.7 fen) Tao Ren (Persicae Semen, 1.5 qian) Su Mu (Sappan Lignum, 1 qian) Hong Hua (Carthami Flos, 1 qian) Yuan Zhi (Polygalae Radix, soaked, remove woody core, 1.5 qian) Sheng Di Huang (Rehmanniae Radix, 1.5 qian)
Crush these ingredients, decoct with fresh ginger, and take orally. Alternatively, use this formula to make honey pills coated with Chen Sha (Cinnabar).
Case Study
A fifteen-year-old girl, due to anger and frustration, suffered from inverted language, desire to bite people and throw objects, stealing and hiding items, alternating crying and laughing, timidity, lack of awareness of hunger and satiety regarding diet, and bodily fever. She was treated with Fangfeng Tongsheng San plus Sheng Di Huang and Mudan Pi. After two doses, she recovered.
Qin Chengzu’s Jiugui Moxibustion Method Treats all cases of fright, mania, and delirious speech caused by attachment of evil spirits or malevolent entities. This occurs due to dual deficiency of Qi and Blood, allowing pathogens to enter vacuity, presenting symptoms similar to Dian or Xian. Tie the patient's two thumbs tightly with thin hemp rope. Place large moxa cones on the nail roots of both thumbs and the fleshy areas at the angles of both fingers. Ignite all four points. If any point fails to ignite, the treatment is ineffective. Moxibustiate seven loads (zhuang) at each point. This method is highly effective.