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Delirium (Zhenyu) is characterized by a loud, long voice and incoherent speech that frequently changes topics; monologue (Zhengsheng) is characterized by a short, thin voice and repetitive muttering. When appearing in Yang meridians (Yang Jing), both belong to Heat syndromes; when appearing in Yin meridians (Yin Jing), they generally belong to Cold syndromes. For Yang meridian patterns, if there are no indications for purgation, one should employ clearing and resolving methods; for Yin meridian patterns, if warming tonification is not applicable, one should employ clearing and tonifying methods.

[Note] Speech is governed by the Heart. When Heart Qi is excessive and hot, leading to surplus Shen (Spirit), Delirium occurs. As Delirium is an Excess condition, the voice is loud and long, with incoherent speech changing topics frequently. When Heart Qi is deficient and hot, leading to insufficient Shen, Monologue occurs. As Monologue is a Deficiency condition, the voice is short and thin, merely repeating a single phrase mutteringly. This is because surplus Shen allows for adaptability and random speech, while insufficient Shen lacks adaptability and clings to a single sound. Whenever Delirium or Monologue appears concurrently with Yang meridian symptoms, it belongs to Heat syndromes and can be treated with purgation; when appearing concurrently with Yin meridian symptoms, it belongs to Cold syndromes and can be treated with warming methods. However, if it appears with Yang meridian symptoms but lacks indications for purgation, do not purge; instead, use clearing and resolving methods. If it appears with Yin meridian symptoms but lacks indications for warming, do not warm; instead, use clearing and tonifying methods.

The three methods (sweating, vomiting, purging) damage Jin-Ye (Body Fluids) causing stomach dryness and thirst; similarly, Yang pathogens invading Yin meridians also cause thirst. When thirsty and desiring water, give small amounts frequently; do not allow fluid retention to become a Yin pathology. For Taiyang disease presenting with difficulty in urination, use Wu Ling San (Five-Ingredient Powder with Poria). For Yangming disease presenting with continuous copious drinking, use Bai Hu Tang (White Tiger Decoction). For Shaoyang disease presenting with alternating chills and fever accompanied by irritability and thirst, use Xiao Chai Hu Tang (Minor Bupleurum Decoction), removing Ban Xia (Pinellia Rhizome) and adding Hua Fen (Trichosanthes Root).

[Note] Thirst diseases often result from sweating, vomiting, or purging damaging Body Fluids, leading to dryness in the Stomach and thus a desire to drink. When Yang pathogens invade the Three Yin meridians, they manifest as dry throat in Taiyin, dry mouth in Shaoyin, and wasting-thirst in Jueyin. Thirst in the Three Yin meridians involves Yang pathogens acting as heat damaging Body Fluids, hence it is said that thirst arises similarly. The treatment for thirst in the Three Yin meridians is detailed within the chapters on the Three Yin meridians. For those desiring water, it should be given in small amounts frequently to moisten stomach dryness; once Stomach Qi harmonizes, the illness resolves. If water is given indiscriminately and excessively, not only will thirst not resolve, but water may stagnate and cause pathology. Thirst in Taiyang disease uses Wu Ling San because water stagnates in the Lower Jiao causing difficult urination. Thirst in Yangming disease uses Bai Hu Tang because Stomach heat causes continuous, unquenchable drinking. In Shaoyang disease, where alternating chills and fever etc. are present, accompanied by irritability and thirst, Xiao Chai Hu Tang is used to harmonize the Shaoyang; Ban Xia is removed to avoid dryness, and Hua Fen is added to generate Body Fluids.