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(Admonitory speech (Zhanyu, 谵语), refers to the patient speaking nonsense in a delirious state without logical coherence. Some speak only to themselves as if seeing ghosts; some mutter in their sleep. These all indicate mild heat pathogen. If the voice is loud and harsh, and speech is incessant, it indicates severe heat. If the patient raves, shouts, curses, fails to distinguish relatives from strangers, and suffers from mental confusion, this represents the most severe heat. All these conditions arise because excessive heat in the Stomach ascends to harass the Heart, causing the Heart to be obscured by heat. A short pulse indicates death; a harmonious pulse indicates recovery. Additionally, slight body heat with a floating and large pulse suggests survival; cold extremities with a deep pulse suggest death. Alternatively, rebellious Qi causing wheezing and chest fullness, or Qi deficiency leading to spontaneous diarrhea, are all adverse conditions.)

In Yangming disease, presenting with admonitory speech (Zhanyu, 谵语) and tidal fever (Chaore, 潮热), with a slippery and rapid pulse, administer Xiao Chengqi Tang (Minor Order the Yellow Decoction). If flatus occurs after administration, give another dose; if no flatus occurs, do not administer.

In Yangming disease, with a floating pulse, spontaneous sweating, slight aversion to cold, and muscle cramping/spasms, mistakenly treating with Guizhi Tang (Cinnamon Twig Decoction) to attack the exterior leads to disharmony of the Stomach and results in admonitory speech (Zhanyu, 谵语). (Treatment should employ Tiaowei Chengqi Tang (Regulate the Stomach and Order the Yellow Decoction)).

In combined disease of the Three Yang, presenting with abdominal fullness, heaviness of the body, numbness/insensitivity of the mouth, greasy facial complexion, enuresis, spontaneous sweating, and admonitory speech (Zhanyu, 谵语). (Treatment should employ Baihu Tang (White Tiger Decoction)).

In Cold Damage (Shanghan, 伤寒) lasting four or five days, with a deep pulse, wheezing, and chest fullness. A deep pulse indicates interior involvement. Mistakenly inducing sweating causes fluids to leak out, leading to difficult defecation. Exterior deficiency with interior excess, persisting for a long time, results in admonitory speech (Zhanyu, 谵语). (Treatment should employ Da Chengqi Tang (Major Order the Yellow Decoction)).

With a wiry pulse, headache, and fever, the condition belongs to Shaoyang. Sweating is contraindicated. Inducing sweating leads to admonitory speech (Zhanyu, 谵语); excessive sweating depletes Yang Qi, resulting in admonitory speech (Zhanyu, 谵语), at which point purgation is contraindicated. (Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) can be used to harmonize Ying and Wei to facilitate fluid circulation, leading to self-recovery).

After purgation, presenting with chest fullness, vexation, and fright, difficulty in urination, admonitory speech (Zhanyu, 谵语), and pain throughout the body. (Treatment should employ Chaihu Jia Longgu Muli Tang (Bupleurum plus Dragon Bone and Oyster Shell Decoction)).

Heat entering the Blood Chamber (Xueshi, 血室). In men, manifesting as Yangming disease with bloody stool and admonitory speech (Zhanyu, 谵语). (Treatment should employ Xiaochaihu Tang (Minor Bupleurum Decoction) added with Huanglian (Coptis Rhizome) and Gualou (Trichosanthes Fruit)). In women, Wind-Cold with fever and aversion to cold, where menstruation has just begun, clear consciousness during the day but admonitory speech (Zhanyu, 谵语) at night. (Treatment should employ Xiaochaihu Tang (Minor Bupleurum Decoction) added with Sheng Dihuang (Rehmannia Root), Mudanpi (Tree Peony Bark), and Danggui (Angelica Sinensis)).

Thirteen days have passed, the disease has crossed the meridians and remains unresolved, presenting with admonitory speech (Zhanyu, 谵语), indicating heat that should be treated with decoctions for purgation. If urination is free, the stool should be hard, yet diarrhea occurs instead. With a harmonious pulse, it is known that previous treatment involved pill-based purgatives, which was incorrect therapy. If there is spontaneous diarrhea, the pulse should be faint and cold; now that it is harmonious, it indicates interior excess. (Treatment should employ Tiaowei Chengqi Tang (Regulate the Stomach and Order the Yellow Decoction)).

Diarrhea accompanied by admonitory speech (Zhanyu, 谵语) and a slippery, rapid pulse indicates dry feces retained in the intestine. This is "heat binding with side-flow" (Rejie Pangliu, 热结旁流), where only watery stool is discharged. Purgation is indicated. (Treatment should employ Chengqi Tang (Order the Yellow Decoction)).

Speaking alone due to Qi deficiency, with a forceless pulse. (Treatment should employ Buzhong Yiqi Tang (Center-Supplementing and Qi-Boosting Decoction)).

Deficiency manifests as Zhengsheng (repetitive speech). Zhengsheng refers to speaking repeatedly and tediously about the same matter, unlike Zhanyu (admonitory speech) which changes topics frequently. Cheng Wuji's annotation describing Zhengsheng as "Zheng-Wei sounds" is erroneous. Sini Pulse (Sini Mai, 四逆脉) with faint pulse and Zhengsheng. (Severe cases: Sijunzi Tang (Four Gentlemen Decoction); even more severe: Shenfu Tang (Ginseng and Aconite Decoction) administered with Heixi Dan (Black Tin Pill)).

Analysis: Excess leads to Zhanyu (admonitory speech); deficiency leads to Zhengsheng (repetitive speech). These two are not difficult to differentiate. However, both Yang excess with interior excess and Yin excess repelling Yang can cause confused speech. One must distinguish them via other symptoms. For example, body heat, vexation, thirst, constipation, and dark urine indicate Yang excess with interior excess. Clear and copious urination, loose stools, and irritability indicate Yin excess repelling Yang.