经曰∶心藏神，有余则笑不休。又曰∶在脏为心，在声为笑，在志为喜。又火太过曰赫曦，
赫曦之纪，其病笑谑狂妄。又云∶少阴所至为喜笑。又云∶精气升于心则喜。此数者，皆言
属心火也。若笑不休，呻而为腹痛，此水乘于火，阴击于阳，阳伏热生，狂妄谵语不可闻，
心之损矣。扁鹊云∶其人唇口赤色者，可治；青黑者，死。若肾水亏涸不胜心火，而喜笑不
休者，用六味地黄丸。肝火炽盛，能生心火，而喜笑不休者，用柴胡清肝散。余兼别症，各
从其症而参治之。
治验
一小儿喜笑，常作不安，面赤饮冷，手足并热，先用黄连泻心汤，未二服稍定，又用六味地
黄丸料煎服，顿愈。常服此丸则安，月许不服，仍前复作，又服愈矣。
一小儿患前症，面青赤，此肝心二经风热所致也，用柴胡栀子散、六味地黄丸渐愈。又因乳
母大怒发热，先用加味柴胡汤，又用加味逍遥散，母子服之并愈。
一小儿患前症，因乳母大怒，患血崩寒热，先用加味逍遥散一剂，用当归补血汤三剂，如此
治之各数剂，母子并愈。
一小儿年十四岁，用心过度，饮食失节，患喜笑不休，脉洪大而虚，面色赤而或白，余用补
中益气汤而愈。次秋科举，饮食劳倦，前症复作，或兼谵语，脉洪大，按之微细如无，用人参一两，
姜、枣煎服稍定，又三剂而愈。又劳役用心，自汗作渴，烦躁似痫症，先用当归补血汤，二
剂顿安，又十全大补汤而寻愈。
一女子十六岁，面色痿黄，素沉静，喜笑不休，月经先期，用柴胡栀子散、加味逍遥散而愈
。次年出嫁，不时复作，但作时面赤勇力，发后面黄体倦，朝用补中益气汤，夕用加味逍遥
散而愈。后每发悉用前药即愈。
当归补血汤
柴胡栀子散
柴胡清肝散（三方见发热）
黄连泻心汤（方见烦躁）
地黄丸（方见肾脏）
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The Heart stores the Shen (Spirit); when there is excess, one laughs incessantly. It also states: In the Zang organs, it corresponds to the Heart; in the vocal sounds, it corresponds to laughter; in the emotional activities, it corresponds to joy. Furthermore, excessive Fire is called "He Xi" (Radiant Brilliance). In the era of He Xi (years of excessive Fire Qi), the diseases manifest as laughing, babbling, mania, and delirium. It is also said: When the Shaoyin (Lesser Yin) channel qi is disturbed, it leads to joy and laughter. Additionally, when Essence and Qi ascend to the Heart, joy arises. All these statements indicate that such symptoms belong to Heart Fire. If a person laughs incessantly, groans, and suffers from abdominal pain, this indicates Water encroaching upon Fire, with Yin attacking Yang. Yang becomes trapped and generates heat, leading to mania, delirious speech, and incoherent muttering, which signifies damage to the Heart. Bian Que stated: If the patient's lips and mouth are red, the condition is treatable; if they are blue-black, death is imminent. If Kidney Water is deficient and dried up, failing to control Heart Fire, resulting in incessant laughter, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). If Liver Fire is blazing and generating Heart Fire, resulting in incessant laughter, use Chaihu Qinggan San (Bupleurum Liver-Clearing Powder). For other accompanying symptoms, treatment should be adjusted according to each specific presentation.
Clinical Cases
A child exhibited incessant laughter and constant restlessness, with a red face, a desire for cold drinks, and hot hands and feet. Initially, Huanglian Xiexin Tang (Coptis Decoction to Drain the Heart) was administered. After less than two doses, the symptoms subsided slightly. Subsequently, the ingredients of Liuwei Dihuang Wan were decocted and taken orally, resulting in immediate recovery. Regular consumption of this pill ensured stability; if not taken for a month, the symptoms would recur as before, but resuming medication led to cure.
Another child presented with the aforementioned symptoms, showing a complexion that was greenish-red. This was caused by Wind-Heat affecting the Liver and Heart channels. Chaihu Zhizi San (Bupleurum and Gardenia Powder) and Liuwei Dihuang Wan were used, leading to gradual recovery. Additionally, due to the wet nurse's extreme anger causing fever, Jiawei Chaihu Tang (Modified Bupleurum Decoction) was first administered, followed by Jiawei Xiaoyao San (Modified Free Wanderer Powder). Both mother and child recovered after taking the medications.
A third child suffered from the same condition due to the wet nurse's anger. The child experienced metrorrhagia (uterine bleeding) and alternating chills and fever. One dose of Jiawei Xiaoyao San was given first, followed by three doses of Danggui Buxue Tang (Angelica Tonifying Blood Decoction). After several courses of this treatment, both mother and child recovered.
A fourteen-year-old boy, having overused his mind and disregarded dietary regulations, suffered from incessant laughter. His pulse was large and forceful yet empty upon pressure, and his complexion was either red or pale. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) cured him. In the following autumn, during the imperial examinations, due to dietary irregularities and fatigue, the previous symptoms recurred, sometimes accompanied by delirious speech. The pulse was large, but fine and imperceptible upon deep pressure. Ren Shen (Ginseng Root) 1 liang, decocted with Sheng Jiang (Fresh Ginger Rhizome) and Da Zao (Jujube Fruit), alleviated the symptoms initially, and three more doses resulted in full recovery. Later, due to physical labor and mental exertion, he experienced spontaneous sweating, thirst, and irritability resembling epilepsy. Danggui Buxue Tang was administered first, bringing instant relief after two doses, followed by Shiquan Dabu Tang (Ten Significant Tonifying Decoction) for complete recovery.
A sixteen-year-old girl, with a sallow complexion and a naturally quiet temperament, suffered from incessant laughter and early menstruation. Chaihu Zhizi San and Jiawei Xiaoyao San cured her. The following year, after marriage, the symptoms recurred intermittently. During episodes, her face was red and she appeared vigorous; afterwards, her face turned yellow, and she felt fatigued. She took Bu Zhong Yi Qi Tang in the morning and Jiawei Xiaoyao San in the evening, achieving recovery. Subsequent recurrences were also cured using these same formulas.
Danggui Buxue Tang (Angelica Tonifying Blood Decoction)
Chaihu Zhizi San (Bupleurum and Gardenia Powder)
Chaihu Qinggan San (Bupleurum Liver-Clearing Powder) [See Fever section for formulas]
Huanglian Xiexin Tang (Coptis Decoction to Drain the Heart) [See Irritability section for formula]
Dihuang Wan (Rehmannia Pill) [See Kidney section for formula]