癫、痫、狂，三证不同，而方书或言癫痫，或言风痫，或言风癫，或言风狂，每致混淆
无别
。盖痫归于五脏于心，故立言之家。癫狂可以合论者，以癫为阴而狂为阳，则对待立名，互
相阐发也，痫证则自有阴阳之分，迥与二证不同，所宜特立一门也，姑撮其要言之。癫者，
或悲或笑，或歌或泣，如醉如痴，言语不分次序，处境不分秽净，积年愈难，此志愿不遂者
多有之。狂者，猖狂刚暴，妄见妄言，骂詈不避亲疏，抵触不畏水火，甚则弃衣而走，登高
而歌，逾墙上层，非力所能，如有邪附，此伤寒阳明内实才多有之。盖心热甚则多喜而为癫
，笑语失序，癫倒错乱之谓也。肝热甚则多怒而为狂，躁扰奔越，狂妄不禁之谓也。二者俱
属痰热内实之证，信乎河间之卓识？然以《难经》重阴重阳之说为非理，又不然矣。如《内
经》云∶暴怒伤肝，以肝气逆而血乱也；暴喜伤阳，以心气缓而神逸也。又云多阳者多喜，
多阴者多怒，是以《难经》亦以喜怒分阴阳，而未尝以寒热分阴阳也。癫狂之证，皆名失心
，心主不明，则十二官危，故视听言动，皆失其职。初病者，宜泻其实；久病者，宜安其神
，此治法之大概也。痫者，皆以风热痰而得之，在表而浅名阳痫，故言易治；在里而深名阴
痫，故云难治。此又以表里浅深名阴阳，亦非以寒热分阴阳也。其证发即仆地，闷乱无知，
嚼舌吐沫，背反张，目上视，手足搐搦，或作六畜声，一月数发者易治，经年一发者难治。
吴山甫云∶风、阳气也。《内经》云∶阳之气，以天地之疾风名之，故其发也暴。然所以令
人仆地者，厥气并于上，上实下虚，清浊倒置，令人闷乱无知者，浊邪干乎天君，而神明壅
窒也。舌者心之苗，而脾之经络连于舌本，阳明之经络，入上下齿缝中，故风邪入于心脾，
则舌自挺。风邪入于阳明，则口自噤。一挺一噤，故令人啮舌吐沫，风热入于内也，此风来
潮涌之象。背反张目上视者，风在太阳经也。足太阳经起于睛明，挟脊而下，风邪干之，则
实
而劲急，故目上视而背反张。手足搐搦者，风属肝木，肝木主筋，风热甚于肝，则一身之筋
牵搐，故令手足搐搦也。搐者，四肢屈曲之名；搦者，十指开握之义，或作六畜声者，风痰
鼓其气窍，而声自变也。譬之弄笛焉，六孔闭塞不同，而宫商别异是也。治法宜疏风豁痰，
清热安魂，实者即攻，虚者先补，其纯因情志者，从《内经》五志相胜法解之。
癫、痫、狂，这三种病证各不相同，但医方书籍中有的称“癫痫”，有的称“风痫”，有的称“风癫”，有的称“风狂”，常常导致混淆而无法区分。大概因为痫证归属于五脏，其中心脏最为关键，所以立论的医家认为：癫和狂可以合并论述，是因为癫属阴而狂属阳，这是相对立的名称，可以互相阐发；而痫证自有阴阳之分，与这两种病证截然不同，应当单独设立一门类。姑且撮取其主要内容来说明。
癫证，有时悲伤，有时欢笑，有时唱歌，有时哭泣，像喝醉了一样，又像痴呆一样，言语不分次序，行为不分洁净或污秽，多年难以治愈，这多是志愿未能实现的人容易患上的。
狂证，猖狂刚暴，胡乱看见、胡乱说话，骂人时不避亲疏，抵触他人时不畏水火，严重时甚至脱衣奔跑，登上高处歌唱，翻越高墙，这些并非体力所能做到，好像有邪气附着在身上，这在伤寒阳明腑实证中常见。
大概心火过盛则多喜而发为癫，表现为笑语失去次序，颠倒错乱，这就是癫的含义。肝火过盛则多怒而发为狂，表现为烦躁扰乱、奔跑跳跃，狂妄不受节制，这就是狂的含义。这两种病都属于痰热内实的证候，确实证明了刘河间（刘完素）见识卓越？然而，《难经》中关于重阴重阳的说法是不合道理的，这种观点也是不对的。如《内经》说：暴怒伤肝，是因为肝气上逆导致血行紊乱；暴喜伤心（阳），是因为心气弛缓导致神志逸散。又说：阳气多者多喜，阴气多者多怒，因此《难经》也用喜怒来区分阴阳，而未曾用寒热来区分阴阳。
癫狂这两种病证，都称为“失心”，心主神明功能不明，则十二脏腑都会危险，所以视、听、言、动，都失去了它们的职能。初发病时，适宜泻其实邪；久病时，适宜安神定志，这是治疗方法的概略。
痫证，都是由风、热、痰引起的，在表且病位浅的称为阳痫，所以说容易治疗；在里且病位深的称为阴痫，所以说难治。这也是以表里浅深来命名阴阳，而非以寒热来区分阴阳。
痫证的发作是突然仆倒在地，胸闷烦乱不知人事，咬破舌头吐白沫，背部向后反张，眼睛向上看，手足抽搐痉挛，有时发出六畜的声音。一个月发作几次的容易治疗，经过一年才发作一次的难治。
吴山甫说：风，属于阳气。《内经》说：阳气，可以用天地间的疾风来命名，所以它的发作很猛烈。然而使人仆倒在地的原因，是厥气并聚于上部，导致上实下虚，清浊之气倒置，使人胸闷烦乱不知人事的原因是浊邪干扰了天君（心神），导致神明壅塞窒滞。
舌是心的苗窍，而脾的经络连接于舌根，阳明的经络进入上下齿缝中，所以风邪侵入心脾，舌头就会自然挺出。风邪侵入阳明经，嘴巴就会自然紧闭。一挺一闭，所以使人咬破舌头吐白沫，这是风热侵入体内的表现，如同风来如潮水涌动的景象。
背部反张、眼睛上视，是因为风邪在太阳经。足太阳膀胱经起于睛明穴，沿脊柱两侧下行，风邪侵犯它，经脉就会变得坚实劲急，所以眼睛上视而背部反张。
手足抽搐痉挛，是因为风属于肝木，肝木主管筋脉，风热在肝脏过盛，就会导致全身筋脉牵拉抽搐，所以使手足抽搐痉挛。“搐”是指四肢弯曲，“搦”是指十指开合的动作。有时发出六畜声音，是因为风痰鼓动气窍，声音自然改变。就像吹笛子一样，六个孔闭塞情况不同，发出的宫商音律也就不同。
Dian (Manic-Depressive Psychosis), Xian (Epilepsy), and Kuang (Mania) are three distinct syndromes. However, medical texts sometimes refer to "Dian-Xian," "Feng-Xian" (Wind Epilepsy), "Feng-Dian" (Wind Manic-Depression), or "Feng-Kuang" (Wind Mania), often causing confusion and lack of distinction. Generally, Xian is attributed to the five Zang organs, with the Heart being central; thus, authors argue that Dian and Kuang can be discussed together because Dian belongs to Yin and Kuang to Yang, establishing opposing names that elucidate each other. In contrast, Xian has its own Yin-Yang differentiation and is significantly different from the other two syndromes, warranting a separate category. Here, we summarize the essentials.
Dian syndrome involves episodes of sorrow or laughter, singing or crying, appearing intoxicated or foolish, with speech lacking order and behavior disregarding cleanliness or filth. It is difficult to cure after many years and is common among those whose aspirations remain unfulfilled.
Kuang syndrome is characterized by unruly and violent behavior, hallucinations, delusions, cursing without regard for kinship or distance, and resistance without fear of fire or water. Severe cases may involve discarding clothes and running, singing while climbing high places, or jumping over walls—actions beyond normal physical capability, as if possessed by evil spirits. This is frequently seen in Yangming Fu-organ excess patterns of Shanghan (Cold Damage).
Excessive Heat in the Heart leads to excessive joy, resulting in Dian, characterized by disordered laughter and speech, and chaotic inversion. Excessive Heat in the Liver leads to excessive anger, resulting in Kuang, characterized by restlessness, agitation, running, jumping, and uncontrollable madness. Both syndromes belong to internal excess of Phlegm-Heat, confirming Liu Hejian's profound insight. However, the theory of "Heavy Yin and Heavy Yang" in the Nanjing (Classic of Difficult Issues) is unreasonable and incorrect. As stated in the Neijing (Inner Canon): Violent anger injures the Liver, causing Liver Qi to rebel and Blood to become chaotic; violent joy injures Yang (Heart Qi), causing Heart Qi to slacken and Spirit to dissipate. It also states: Those with much Yang tend toward joy; those with much Yin tend toward anger. Thus, the Nanjing distinguishes Yin and Yang through Joy and Anger, not through Cold and Heat.
Both Dian and Kuang syndromes are named "Loss of Heart [Spirit]." When the Heart Master is unclear, the twelve Officials are endangered, causing vision, hearing, speech, and movement to lose their functions. For acute onset, draining excess is appropriate; for chronic cases, calming the Spirit is appropriate. This is the general principle of treatment.
Xian syndromes arise from Wind, Heat, and Phlegm. Those on the exterior and shallow are called Yang Xian, hence considered easy to treat; those on the interior and deep are called Yin Xian, hence considered difficult to treat. This again uses exterior-interior and shallow-deep to define Yin-Yang, not Cold-Heat.
The symptoms of Xian include sudden collapse to the ground, chest oppression and confusion with loss of consciousness, biting the tongue, foaming at the mouth, opisthotonos (back arching backward), upward deviation of the eyes, and spasmodic convulsions of the hands and feet. Sometimes animal-like sounds are produced. Cases occurring several times a month are easier to treat; those occurring once a year are difficult.
Wu Shanfu stated: Wind is Yang Qi. The Neijing says: Yang Qi is named after the swift wind of heaven and earth, so its onset is sudden. The reason for collapsing is that Jue Qi converges upward, leading to excess above and deficiency below, with clear and turbid Qi reversing positions. Loss of consciousness occurs because Turbid Evil disturbs the Heavenly Ruler (Shen/Spirit), causing obstruction and stagnation of the Spirit.
The tongue is the sprout of the Heart, and the Spleen meridians connect to the root of the tongue; the Yangming meridians enter the gaps between the upper and lower teeth. Therefore, when Wind Evil invades the Heart and Spleen, the tongue protrudes naturally. When Wind Evil invades the Yangming meridian, the mouth clenches naturally. One protruding and one clenched cause the patient to bite their tongue and foam, indicating the influx of Wind-Heat, resembling a surging tide.
Opisthotonos and upward eye deviation indicate Wind in the Taiyang Meridian. The Foot-Taiyang Bladder Meridian originates at Jingming (BL1) and descends along the spine. When invaded by Wind Evil, it becomes firm and tense, causing upward eye deviation and back arching.
Spasms and convulsions occur because Wind belongs to Liver-Wood, which governs the sinews. Excessive Wind-Heat in the Liver causes the sinews of the whole body to contract and twitch, resulting in hand and foot spasms. "Chu" refers to the flexion of the four limbs; "Nuo" refers to the opening and closing of the ten fingers. Animal-like sounds arise because Wind-Phlegm agitates the Qi orifices, altering the voice. This is like playing a flute: different blockages of the six holes produce different musical tones (Gong and Shang).
Treatment should focus on dispersing Wind and resolving Phlegm, clearing Heat and calming the Soul. For excess patterns, purge immediately; for deficiency patterns, tonify first. If caused purely by emotional factors, resolve them according to the Five Emotions Mutual Overcoming method from the Neijing.