癫者痴呆之状。哭笑无时。语言无序。其人当静。狂者骂詈不避亲疏。其人当动。痫者
忽然猝倒无知。口角流涎。手足抽掣。或作五畜声。数刻即愈。愈后即如平人。作止有间断。
所以名痫也。皆痰火为病。而痫病多由胎中受惊。一触而发也。治宜调中。服补北泻南不必
过求奇险。
脉实者吉。 沉细者凶。
一前症属于实痰实火者。宜
滚痰丸。（六十三）
肝火之为害。非泛常之药所可疗。时贤叶天士独得其秘。急用
当归芦荟丸。每服三十丸。一日两三服。不可迟疑败事。（九十八）
一前症属虚者。宜
磁砂丸。（二十六）
二加龙骨汤加铅丹二钱。或再加阿胶三钱。（二十二）
此二方神妙。非可以思议及者。
一前症既愈。即宜以和平之剂收功。宜
朱砂安神丸。（二十八）
口渴不止为上消。治以人参白虎汤。食入即饿为中消。治以调胃承气汤。饮一溲一为下
消。治以肾气丸。赵养葵大变其法。谓治消无分上中下。先以治肾为急。以六味丸料一斤。
入肉桂一两五味子一两。水煎六七碗。恣意冷冻饮料之。熟睡而渴如失矣。白虎承气皆非所宜也。
喻嘉言曰。肾者。胃之关也。关门不开。则水无输泄而为肿满。关门不 。则水无底止。而
为消渴。金匮肾气丸。蒸动精水。上承君火。而止其下入之阳光。彼症取其开。此症取其
。一开一合。具通天手眼。子和诋之。何其陋也。又白茯苓丸。治肾消方。用白茯苓复盆子
黄连栝蒌根萆 人参熟地黄元参各一两。石斛蛇床子各七钱半。鸡 三十具。微炒共为
末。炼蜜和捣三五百杵丸如梧子大。每服三十丸。食前磁石汤送下。喻嘉言治验加犀角一两
。又以六味丸加犀角收功。○抄此与八味地黄丸。一阴一阳。相为表里。皆为神方。
脉宜数大。 忌虚小。
癫证表现为神情痴呆，哭笑无常，言语错乱无序。患者通常表现为安静少动。狂证表现为骂人詈语，不分亲疏远近。患者通常表现为躁动不安。痫证表现为突然猝然倒地、意识丧失，口角流涎，手足抽搐掣动，有时发出类似五种牲畜的叫声，片刻后即可缓解，发作后如同常人一般，发作与停止之间有间歇期，因此称为“痫”。这些病症皆由痰火致病所致，而痫病多因胎儿在母体内受惊，出生后一触即发。治疗应当调理中焦，服用补北方（肾）泻南方（心）的方药不必过分追求奇险之法。
脉象实大者预后良好。脉象沉细者预后不良。
肝火为害，并非普通药物所能治愈。当代名医叶天士独得其秘法，紧急时使用当归芦荟丸，每次服用三十丸，每日二至三次，不可迟疑误事。（第九十八方）
或者使用二加龙骨汤加入铅丹二钱，或者再加阿胶三钱。（第二十二方）
这两个方子神妙无比，不是凭常理思议所能达到的。
若上述症状已经痊愈，就应当用平和的药剂来收功，适宜使用朱砂安神丸。（第二十八方）
口渴不止为上消，治疗用人参白虎汤。进食后即感饥饿为中消，治疗用调胃承气汤。饮水一分，排尿一分（饮一溲一）为下消，治疗用肾气丸。赵养葵大幅改变此法，认为治疗消渴不分上、中、下三消，首先以治肾为急务。用六味地黄丸料一斤，加入肉桂一两、五味子一两，水煎成六七碗，随意冷冻后饮用，熟睡之后口渴便如消失一般。此时白虎汤、承气汤都不适宜了。
喻嘉言说：肾是胃的关隘。如果关门不开，则水液无法输布排泄而形成肿胀满闷；如果关门不闭，则水液没有底止，而形成消渴。金匮肾气丸能蒸动精气之水，上承君火，从而制止下入的阳光（虚火）。那些症状取其“开”，此症取其“合”。一开一合，具备通天般的医术眼光。张子和诋毁这种方法，是多么浅陋啊。另外有白茯苓丸，是治疗肾消的方子。用白茯苓、复盆子、黄连、栝蒌根、萆薢、人参、熟地黄、玄参各一两，石斛、蛇床子各七钱半，鸡肫（鸡内金所在的部位，此处指代或需用鸡胗等，原文“鸡”后缺字，结合语境及常用方义，疑为“鸡肫”或“鸡内金”类，但依原文仅提取可见实体，故暂按原文“鸡”处理，实际应用中需考证，此处忠实于原文提取“鸡”作为药材/食材实体，或视为漏字，但在提取时保留原文字形“鸡”），微炒后共研为末，炼蜜调和捣制三五百杵，制成梧桐子大小的丸剂。每次服用三十丸，饭前用磁石汤送服。喻嘉言治疗验证时加入犀角一两，又以六味丸加犀角来收功。○抄录此方与八味地黄丸相对，一阴一阳，互为表里，都是神妙的方剂。
脉象宜数大，忌讳虚小。
Dian syndrome (Manic-Depressive Psychosis) is characterized by a dazed appearance, crying and laughing without timing, and disordered speech. The patient tends to remain quiet. Kuang syndrome (Psychotic Excitement) is characterized by cursing and scolding without distinction between relatives and strangers. The patient tends to be restless. Xian syndrome (Epilepsy) is characterized by sudden collapse with loss of consciousness, drooling from the corners of the mouth, spasmodic convulsions of the hands and feet, sometimes emitting sounds resembling those of five domestic animals, resolving after a few moments, and returning to normal after recovery, with intermittent episodes, hence named "Xian". All these diseases are caused by Phlegm-Fire, while Xian syndrome often originates from fright received in the womb, triggered upon contact after birth. Treatment should focus on regulating the Middle Jiao (Middle Burner). Using formulas to tonify the North (Kidney) and drain the South (Heart) need not overly seek bizarre or dangerous methods.
A solid pulse indicates a favorable prognosis. A deep and fine pulse indicates an unfavorable prognosis.
If the aforementioned symptoms belong to Excess Phlegm and Excess Fire, Gun Tan Wan (Rolling Phlegm Pill) is appropriate. (Formula 63)
The harm caused by Liver Fire cannot be treated with ordinary medicines. Contemporary expert Ye Tianshi alone mastered its secret. Urgently use Danggui Lue Wan (Angelica Root and Aloe Pill), taking thirty pills per dose, two to three times a day. Do not hesitate, lest you ruin the case. (Formula 98)
If the aforementioned symptoms belong to Deficiency, Ci Sha Wan (Magnetite and Cinnabar Pill) is appropriate. (Formula 26)
Alternatively, use Erjia Longgu Tang (Two-Added Dragon Bone Decoction) adding Qian Dan (Lead Carbonate) two qian, or additionally add Ejiao (Donkey-Hide Gelatin) three qian. (Formula 22)
These two formulas are miraculous and beyond ordinary reasoning.
Once the aforementioned symptoms have subsided, mild and harmonious agents should be used to conclude treatment. Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill) is appropriate. (Formula 28)
Unceasing thirst is Shang Xiao (Upper Consumption). Treat with Renshen Baihu Tang (Ginseng White Tiger Decoction). Hunger immediately after eating is Zhong Xiao (Middle Consumption). Treat with Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction). Drinking one part and urinating one part (Yin Yi Sou Yi) is Xia Xiao (Lower Consumption). Treat with Shenqi Wan (Kidney Qi Pill). Zhao Yangkui drastically changed this method, stating that treating Xiao Ke (Wasting-Thirst) does not distinguish between Upper, Middle, and Lower types; first, treating the Kidney is urgent. Use one jin of Liuwei Wan (Six-Ingredient Pill with Rehmannia) ingredients, add Rougui (Cinnamon Bark) one liang, Wuweizi (Schisandra Berry) one liang, decoct in water into six or seven bowls, and drink freely when cold. After falling into a deep sleep, the thirst disappears as if lost. At this point, Baihu Tang and Chengqi Tang are no longer suitable.
Yu Jiayan said: The Kidney is the gate of the Stomach. If the gate does not open, water cannot be transported and excreted, leading to swelling and fullness. If the gate does not close, water has no bottom limit, leading to Xiao Ke (Wasting-Thirst). Jin Kui Shenqi Wan (Golden Cabinet Kidney Qi Pill) steams and moves the essence-water, conveying it upward to support the Ministerial Fire, thereby stopping the downward-intruding solar heat (deficient fire). Those conditions utilize its "opening"; this condition utilizes its "closing". One opening and one closing demonstrate profound medical insight. Hezi Zhang disparaged this, how shallow he was. Additionally, there is Baifuling Wan (Poria Pill), a formula for treating Kidney Xiao. It uses Baifuling (Poria), Fupenzi (Rubus Fruit), Huanglian (Coptis Rhizome), Gualougen (Trichosanthes Root), Bibing (Dioscorea Hypoglauca), Renshen (Ginseng), Shudihuang (Prepared Rehmannia Root), Yuanshen (Scrophularia Root) each one liang, Shihu (Dendrobium Stem), Chuangzi (Cnidium Fruit) each seven qian and half, Ji [missing character, likely referring to Ji Zao or similar avian ingredient, text says "Ji"], stir-fried lightly, ground together into powder, mixed with refined honey and pounded three or five hundred times, formed into pills the size of mulberry seeds. Take thirty pills per dose, before meals, delivered with Cishi Tang (Magnetite Decoction). Yu Jiayan's verified treatments added Xijiao (Rhinoceros Horn) one liang, and concluded with Liuwei Wan added with Xijiao. ○ Copying this alongside Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill), one Yin and one Yang, mutually exterior and interior, both are divine formulas.
The pulse should be rapid and large. Avoid deficiency and small pulses.