手厥阴经心胞络。热邪壅滞谵妄作。正收收后兼凉血。发热正出用疏托。
谵语妄言。其症皆由热邪炽盛。火毒壅滞于心胞络而作。若初发热而烦躁狂言。或麻隐而不
出者。以宣毒发表汤（见第五条）去升麻、桔梗、甘草煎汁。调辰砂、滑石末治之。（有用第二条纳
荆防败毒散去柴胡、川芎、羌活、人参、甘草。加木通、豆根、骨皮治之者。并注记听用。）若发热
未出正出之际而谵妄者。俱为火邪内伏。不得透表而致。药宜疏托。佐以清凉分治之品。以葛根
解肌汤（见第五条）去赤芍、甘草。加麦冬、赤茯苓、石膏、知母、枳壳治之。甚则加蜜酒炒麻黄以
发越之。使麻得以尽出肌肤。而谵语自止。若麻已出之后。狂言乱语者。以淡竹叶、灯心煎汤。调
辰砂、滑石末治之。正敛及敛后谵语者。药宜清凉解毒。佐以分利凉血之剂。以白虎解毒汤（见二
十六条）去天花粉。加牛蒡子、连翘、木通、赤苓。以清解凉血而分利之。（有以竹叶石膏汤去人
参、半夏、甘草梢、粳米，加生地黄治之者，实为无济。）使火退毒清。而谵语自止矣。慎勿迟延。以
致不救。如热轻余毒未除者。必先见诸气色。宜预防之。始终以消毒饮（见二十二条）除甘草。加
连翘、枳壳、木通、赤苓以分利之。（有用苏葛汤、加减黄连解毒古方治之者，并注记听用。）若麻
收后余热内攻。循衣摸床。谵语妄言。神昏志衰者。死症也。
朱曰 谵语有轻有重。伤寒胃中热甚。上乘于心。心为热冒。谵语不休。其证至重。故必
下之。此则仅仅妄言证之轻者。故可以辰砂、生地、木通或白虎辈清之。
手厥阴心包络经。热邪壅滞导致谵语妄言发作。麻疹正收（疹点开始消退）后兼用凉血法。发热且疹子正在发出时，使用疏托法。
谵语是指胡言乱语。这些症状皆由热邪炽盛，火毒壅滞在心的包络（心包）所致。如果初起发热就烦躁狂言，或者麻疹隐伏不出，用宣毒发表汤（见第五条）去掉升麻、桔梗、甘草煎汁，调入辰砂、滑石粉末治疗。（有用第二条的荆防败毒散去柴胡、川芎、羌活、人参、甘草，加木通、豆根、地骨皮治疗的，一并记录供选用。）如果在发热未出或正出的时候出现谵妄，都是因为火邪内伏，不能透达体表所致。用药宜用疏托法，佐以清凉分治的药物。用葛根解肌汤（见第五条）去掉赤芍、甘草，加麦冬、赤茯苓、石膏、知母、枳壳治疗。严重的则加蜜酒炒制的麻黄以发散郁热，使麻疹得以完全透出肌肤，而谵语自然停止。如果麻疹已经发出之后，出现狂言乱语，用淡竹叶、灯心草煎汤，调入辰砂、滑石粉末治疗。在麻疹正收敛及收敛后出现谵语的，用药宜清凉解毒，佐以分利和凉血的药剂。用白虎解毒汤（见二十六条）去掉天花粉，加牛蒡子、连翘、木通、赤茯苓，以清解凉血并分利湿热。（有用竹叶石膏汤去人参、半夏、甘草梢、粳米，加生地黄治疗的，实际上并无帮助。）使火热退去、毒邪清除，而谵语自然停止。千万不要拖延，以致无法救治。如果热势轻但余毒未除，必须先观察各种气色变化，宜预防处理。始终以消毒饮（见二十二条）去掉甘草，加连翘、枳壳、木通、赤茯苓以分利湿热。（有用苏葛汤、加减黄连解毒古方治疗的，一并记录供选用。）如果麻疹收没后余热内攻，出现循衣摸床（手指无意识地抓摸衣被）、谵语妄言、神志昏迷精神衰败的，是死症。
朱氏说：谵语有轻有重。伤寒病中胃中热甚，热气上乘于心，心被热邪蒙蔽，谵语不停，这种证候非常严重，所以必须用下法攻逐。这里所说的仅仅是妄言证中较轻的情况，所以可以用辰砂、生地、木通或白虎汤之类来清解。
The Pericardium Meridian of Hand-Jueyin. When heat pathogens stagnate and obstruct, delirious speech and madness arise. After the rash begins to recede, blood-cooling methods should be combined. When fever is present and the rash is erupting, dispersing and supporting methods should be used.
Delirious speech refers to incoherent talking. These symptoms are all caused by excessive heat pathogens, where fire toxins stagnate and obstruct in the pericardium (the protective sac surrounding the heart). If restlessness and manic speech occur at the initial stage of fever, or if the measles rash remains hidden and fails to erupt, Xuan Du Fa Biao Tang (Dispel Toxins and Release the Exterior Decoction) (see Item 5), with Shengma (Cimicifugae Rhizoma), Jiegeng (Platycodonis Radix), and Gancao (Glycyrrhizae Radix et Rhizoma) removed, should be decocted in water. The resulting liquid is mixed with Chen Sha (Cinnabar) and Huashi (Talcum Powder) for treatment. (Some use Jing Fang Bai Du San (Jingjie and Fangfeng Decoction to Overcome Toxicity) from Item 2, removing Chaihu (Bupleuri Radix), Chuanxiong (Chuanxiong Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), Renshen (Ginseng Radix et Rhizoma), and Gancao (Glycyrrhizae Radix et Rhizoma), and adding Mutong (Akebiae Caulis), Dougen (Stemona Root), and Gupi (Moutan Cortex) for treatment; this is recorded for reference.) If delirium occurs when fever has not yet erupted or is currently erupting, it is due to fire pathogens lying latent internally, unable to penetrate the exterior. Medication should employ dispersing and supporting methods, assisted by cooling agents that separate and treat the condition. Ge Gen Jie Ji Tang (Puerariae Radix to Relieve Muscle Tension Decoction) (see Item 5), with Chi Shao (Paeoniae Radix Rubra) and Gancao (Glycyrrhizae Radix et Rhizoma) removed, plus Maidong (Ophiopogonis Radix), Chi Fuling (Poria with Hostwood), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), and Zhike (Aurantii Fructus Immaturus), should be used. In severe cases, Mahuang (Ephedrae Herba) fried with honey and wine is added to disperse and vent the pathogen, allowing the measles to fully emerge on the skin surface, after which delirious speech will naturally cease. If manic and incoherent speech occurs after the measles have already erupted, Dan Zhu Ye (Lophatheri Herba) and Deng Xin Cao (Junci Medulla) are decocted in water, mixed with Chen Sha (Cinnabar) and Huashi (Talcum Powder) for treatment. For delirium occurring during the recession of the rash or after its complete recession, medication should focus on clearing heat and detoxifying, assisted by agents that promote diuresis and cool the blood. Bai Hu Jie Du Tang (White Tiger Detoxification Decoction) (see Item 26), with Tian Hua Fen (Trichosanthis Radix) removed, plus Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus), Mutong (Akebiae Caulis), and Chi Fuling (Poria with Hostwood), should be used to clear heat, cool the blood, and promote diuresis. (Some use Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) with Renshen (Ginseng Radix et Rhizoma), Banxia (Pinelliae Rhizoma), Gancao Gao (tip of Glycyrrhizae Radix et Rhizoma), and Jingmi (Oryza Sativa Germen) removed, and Sheng Dihuang (Rehmanniae Radix Recens) added; however, this is practically ineffective.) Once the fire subsides and toxins are cleared, delirious speech will naturally stop. Do not delay, lest the condition become incurable. If the heat is mild but residual toxins remain, one must first observe various complexion changes and take preventive measures. Always use Xiao Du Yin (Detoxification Drink) (see Item 22) with Gancao (Glycyrrhizae Radix et Rhizoma) removed, plus Lianqiao (Forsythiae Fructus), Zhike (Aurantii Fructus Immaturus), Mutong (Akebiae Caulis), and Chi Fuling (Poria with Hostwood) to promote diuresis. (Some use Su Ge Tang (Perilla and Pueraria Decoction) or a modified ancient formula of Huang Lian Jie Du Tang (Coptis Decoction to Relieve Toxicity); these are recorded for reference.) If after the measles have receded, residual heat attacks internally, leading to picking at clothes and bedclothes (unconscious grasping movements), delirious speech, coma, and mental decline, it is a fatal sign.
Zhu stated: Delirious speech varies in severity. In Shanghan (Cold Damage) diseases, excessive heat in the stomach rises upward to affect the heart. The heart is obscured by heat, causing incessant delirium. This syndrome is extremely severe, so purgative methods must be used. The case described here is merely a mild form of manic speech, so it can be treated with clearing methods using Chen Sha (Cinnabar), Sheng Dihuang (Rehmanniae Radix Recens), Mutong (Akebiae Caulis), or formulas similar to Bai Hu Tang (White Tiger Decoction).