烦躁狂言仍面赤。热潮咽痛号重阳。便于阳毒经中治。承气黄连白虎详。阴燥发
狂宜附子。血瘀承气地黄汤。
发狂者。谓湿毒在胃。并入于心。遂使神志不定而发狂也。狂之发作。少卧不饥。
妄语
笑。妄起行。登高而歌。弃衣而走。甚则逾垣上屋。此伤寒阳毒发狂之症也。经曰。邪入于
阳则狂。又曰。重阳则狂。是也。宜以大承气汤倍加芒硝急下之。有身热烦躁。不得发狂者
。表里俱热。宜三黄石膏汤。双解散治之。又有干呕、面赤、发斑、咽痛、下利黄赤、壮热
不得汗者。宜葶苈苦酒汤治之。亦有阴燥发狂者。此非狂也。为阴极发燥。周身之火。浮游
于外。或欲坐井中。或欲投泥水中卧。或欲向阴凉中坐。烦躁不安。亦如狂也。但手足逆冷
。脉息沉微迟细。虽烦躁不能饮水者也。宜附子汤救之。不可一例以阳狂治也。亦有瘀血发
狂者。血上逆则喜忘。血下蓄则如狂。宜桃仁承气汤及犀角地黄汤主之。其或重熨迫汗。灼
艾烧针。令人烦躁卧起不安。则谓之火邪惊狂凡是数者。各有条例。或狂言目反直视。为肾
绝。汗出辄复狂言。不能食。死症也。非药石所能及矣。
附子汤
附子（炮二枚） 茯苓（三两） 人参 白术 芍药
黄连解毒汤四味。黄柏黄芩栀子是。退黄清热更祛烦。吐血便红皆可治。
Restlessness, delirious speech, and a red face, accompanied by high fever and sore throat, are termed "Chong Yang" (Extreme Excess of Yang). Such conditions should be treated within the context of Yang Toxicity syndromes. Detailed references can be found in the applications of Dachengqi Tang (Major Order the Qi Decoction), Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity), and Baihu Tang (White Tiger Decoction).
For mania caused by Yin restlessness, Fuzi Tang (Aconite Decoction) is appropriate. For mania caused by blood stasis, Chengqi Tang combined with Dihuang Tang (Rehmannia Decoction, specifically Xijiao Dihuang Tang) is used.
Mania refers to damp-toxin accumulating in the Stomach and invading the Heart, causing mental instability and resulting in mania. The manifestations of mania include sleeping little, loss of appetite, speaking nonsense, laughing inappropriately, wandering aimlessly, climbing high places to sing, discarding clothes and running, and in severe cases, climbing over walls or roofs. These are symptoms of Yang toxicity-induced mania in Cold Damage diseases. The classics state: "When pathogenic factors enter the Yang aspect, mania occurs," and "Excessive Yang leads to mania." This is correct. It is suitable to use Dachengqi Tang with doubled Mangxiao (Natrii Sulfas) for urgent purgation. If there is body heat and restlessness but not yet reaching the stage of mania, indicating heat in both the exterior and interior, Sanhuang Shigao Tang (Three Yellows Gypsum Decoction) or Shuangjie San (Double Release Powder) should be used. Additionally, if dry retching, red face, skin macules, sore throat, diarrhea with yellow-red stool, high fever without sweating occur, Tingli Kujiu Tang (Descurainia Vinegar Decoction) is indicated.
There is also mania due to Yin restlessness. This is not true mania but rather dryness generated by extreme Yin cold, with floating fire roaming on the exterior. Patients may wish to sit in a well, lie in muddy water, or sit in cool places. They are restless and agitated, appearing similar to mania. However, their hands and feet are cold, and the pulse is deep, faint, slow, and fine. Although restless, they cannot drink water. Fuzi Tang should be used to rescue them; it must not be treated uniformly as Yang mania.
There is also mania caused by blood stasis. When blood rebels upward, forgetfulness occurs; when blood accumulates downward, a state resembling mania occurs. Tao Ren Chengqi Tang (Peach Kernel Major Order the Qi Decoction) and Xijiao Dihuang Tang (Rhinoceros Horn Rehmannia Decoction) are the primary treatments. If heavy hot compresses forcing sweat, moxibustion, or burning needles cause restlessness and inability to lie still or sit quietly, this is called "Fire Evil Startled Mania." Each of these categories has specific treatment protocols. If delirious speech is accompanied by eyes staring straight back, it indicates the exhaustion of Kidney Qi. If sweating is followed immediately by delirious speech and an inability to eat, it is a fatal sign beyond the reach of medicine.
Fuzi Tang
Fuzi (Prepared Aconiti Lateralis Radix, two pieces) Fuling (Poria, three liang) Renshen (Ginseng) Baizhu (Atractylodis Macrocephalae Rhizoma) Shaoyao (Paeoniae Radix)
Huanglian Jiedu Tang consists of four ingredients: Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix), and Zhizi (Gardeniae Fructus). It clears jaundice, eliminates heat, and dispels restlessness. It can treat hematemesis and hematochezia (red stool).