谵。多言也。言为心声。由火燔而鸣。故心热则多言。犹醉而心热。故多言也。或寐而多言
者。俗云睡语。热之征也。若热甚虽寤而神昏不清。则谵语也。妄。虚妄也。火为阳。故外清明
而内浊昧。其主动乱。故神志失常。如见鬼神也。夫血气者。身之神也。神既衰乏。痰客中焦。
妨碍升降。不得运用。以致十二官各失其职。视听言动。皆有虚妄。盖虚病痰病。有似鬼祟。宜
清神汤。或平补镇心丹去肉桂、山药、五味。加琥珀、胆星、麝香。大便不通。心腹胀满刺痛。
口噤气急者。此为实。凉膈、承气选用。若作邪祟。治之以金石。必死。产后谵妄。见妇人本门。
石顽治文学黄稚洁讳振藻。谵妄颠仆。数月以来。或六七日一发。或二三日一发。或一日二
三发。发则大吐涎水血沫。或一日半日而苏。或二三时而苏。医祷不灵。近于邪祟。昼夜恒见亡
婢仆妇。或时昏愦不省。或时妄言妄见。精气不时下脱。不能收摄。服二冬、二地、连、柏、金
樱、石莲之属无算。反加作泻不食。后延石顽诊之。脉来寸盛尺微。前大后小。按之忽无。举之
忽有。知为神气浮散之候。因与六君子加龙齿、菖蒲、远志。送养正丹。间续而进。前后共
六七服。自后谵妄颠仆。绝不复发。邪祟亦不复见。惟梦泄为平时固疾。不能霍然。更与平补镇
心丹。两月而安。其尊人及昆弟亲戚。咸谓金石之药。能镇鬼神。曷知从前谵妄。皆神气浮散之
故。得养正镇摄之功。当无神魂飞越之患矣。因识此。以破杯影弓蛇之惑。
谵，指多言。言语是心声的外露，因火热炽盛而发出声响，所以心热就会导致多言，就像醉酒时心中烦热一样，因此会多言。有的人在睡眠中多言，俗称“睡语”，这是热象的表现。如果热势严重，即使清醒也神志昏乱、不清醒，这就称为“谵语”。
妄，指虚妄不实。火属于阳邪，所以外表看似清明，内部却浑浊晦暗，其性质主动乱，导致神志失常，出现如见鬼神般的幻觉。血气是人体的精神主宰，既然神气衰败匮乏，又有痰浊客居在中焦，妨碍了气机的升降出入，导致无法正常运行，致使十二脏腑各自失去职能，视、听、言、动等行为都出现虚妄表现。大概虚证和痰证，症状类似鬼祟作怪，适宜使用清神汤，或者平补镇心丹去掉肉桂、山药、五味子，加入琥珀、胆星、麝香。如果大便不通，心腹胀满且刺痛，口噤不开、呼吸急促的，这属于实证，可选用凉膈散或承气汤类方剂治疗。如果将其当作邪祟来治，使用金石类药物（重镇安神药），必然导致死亡。产后出现的谵妄，详见妇人病章节。
石顽医生诊治文学黄稚洁（名振藻）。患者出现谵妄、颠仆，持续数月之久。有时六七天发作一次，有时两三天发作一次，有时一天发作两三次。发作时大量吐出涎水和血沫，有时半天或一天后苏醒，有时两三个时辰后才苏醒。求医问卜都不灵验，接近于邪祟作怪。昼夜常看见已故的女婢仆妇，有时昏迷不省人事，有时胡言乱语、幻视幻听。精气不时下脱，无法收敛固摄。服用了无数像天冬、麦冬、生地、熟地、黄连、黄柏、金樱子、石莲子之类的药物，反而加重了腹泻、不能进食的症状。后来请石顽医生诊脉，脉象寸部盛大、尺部微弱，前大后小，重按忽然无脉，轻举忽然有脉。判断为神气浮散的证候。于是给予六君子汤加龙齿、石菖蒲、远志，送服养正丹。间断连续服用，前后共六七剂。从此以后，谵妄颠仆不再复发，邪祟也不再出现。只有梦遗成为平时的固有疾病，不能立刻痊愈。又给予平补镇心丹，两个月后病情安定。他的父亲及兄弟亲戚，都认为金石类药物能镇压鬼神，哪里知道之前的谵妄，都是神气浮散的缘故。得到培养正气、镇摄心神的作用，才没有神魂飞越的祸患。因此记录此案例，以破除那些因疑神疑鬼而产生的困惑。
Chan (Delirious Speech): Refers to excessive talking. Speech is the expression of the heart's mind, emitted due to blazing fire. Therefore, Heart Heat causes excessive talking, similar to being drunk with internal heat. Some individuals talk excessively while sleeping, commonly known as "sleep-talking," which is a sign of Heat. If the Heat is severe, even when awake, the spirit is confused and unclear, this is called Chan Yu (Delirious Speech).
Wang (Delusion/Falsehood): Refers to false and illusory perceptions. Fire belongs to Yang; thus, externally it appears clear, but internally it is turbid and obscure. Its nature is active and chaotic, causing the spirit and will to lose control, such as seeing ghosts and deities. Blood and Qi are the spirit of the body. When the spirit is depleted and deficient, and Phlegm lodges in the Middle Jiao, obstructing the ascending and descending mechanisms and preventing normal function, the Twelve Officials (organs) each lose their duties. Vision, hearing, speech, and movement all exhibit falsehood. Generally, deficiency diseases and Phlegm diseases may resemble demonic possession. The appropriate treatment is Qingshen Tang (Clear Spirit Decoction), or Pingbu Zhenxin Dan (Calm and Tonify Heart Pill) with Cinnamon Twig (Rougui), Chinese Yam (Shanyao), and Schisandra Fruit (Wuweizi) removed, adding Amber (Hupo), Calaminate (Danning), and Musk (Shexiang). If there is constipation, abdominal distension and fullness with stabbing pain, locked jaw, and rapid breathing, this is an Excess pattern. Liangge San (Cool the Diaphragm Powder) or Chengqi Tang formulas should be selected. If treated as demonic possession using mineral drugs (Jinshi), death is inevitable. Postpartum delirium and delusion are discussed in the Women's Diseases section.
Shiwan [Zhou Lin] treated Huang Zhijie (courtesy name Zhenzao), a literary scholar. He suffered from delirium, delusion, and falling down for several months. Attacks occurred every six or seven days, or every two or three days, or two to three times a day. During attacks, he vomited large amounts of saliva and bloody foam, recovering consciousness after half a day, one day, or two to three shichen (4-6 hours). Medical prayers were ineffective, resembling demonic possession. Day and night, he saw deceased female servants and maids. Sometimes he was comatose and unconscious, sometimes speaking and seeing things falsely. Essence and Qi leaked out intermittently without retention. He had taken countless doses of herbs such as Asparagus Root (Dongguai/Tianmai), Rehmannia Root (Dihuang), Coptis Rhizome (Lian), Phellodendron Bark (Bai), Cornus Fruit (Jinying), and Nelumbo Seed (Shilian), which worsened his diarrhea and loss of appetite. Later, Shiwan examined his pulse: the Cun (inch) position was vigorous, the Chi (cubit) position was faint; the front was large, the back small; pressing heavily made the pulse disappear suddenly, lifting lightly made it appear suddenly. This indicated floating and scattering of Shen Qi (Spiritual Energy). He prescribed Liu Junzi Tang (Six Gentlemen Decoction) with Dragon Teeth (Longchi), Acorus Rhizome (Changpu), and Polygala Root (Yuanzhi), administered with Yangzheng Dan (Nourish Righteousness Pill). Taken intermittently over time, totaling six or seven doses. Afterward, delirium, delusion, and falling down never recurred, and visions of spirits disappeared. Only nocturnal emission remained a chronic condition, not completely cured. He was then given Pingbu Zhenxin Dan, and after two months, he stabilized. His father, brothers, and relatives all believed that mineral drugs could suppress ghosts and gods. They did not realize that the previous delirium and delusion were caused by the floating and scattering of Shen Qi. Through the effect of nourishing righteousness and stabilizing the spirit, the danger of the soul flying away was avoided. This case is recorded to dispel confusion arising from paranoia and superstition.