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In treating mania (Kuang Zheng), one must distinguish between Yang Mania (Yang Kuang) and Yin Restlessness (Yin Zao) to ensure accurate medication. If the onset involves headache and fever, followed by the resolution of aversion to cold, then progressing to climbing high and singing, discarding clothes and running, jumping over walls and roofs, cursing and shouting, extreme thirst desiring death, with a forceful pulse, this indicates pathogenic heat transmitting inward, causing mania due to excessive Yang; it should be treated with cold purgatives. This is termed Yang Mania. If tongue retraction and testicular retraction are observed, the condition is incurable.

If the illness begins without headache, with slight body heat, flushed face, restlessness, and a deep, faint, and forceless pulse, this is restlessness caused by extreme cold. With bluish-black nails and complexion, incessant cold sweat, and abdominal hardness like stone, accompanied by restless thirst desiring death, this represents a Yin syndrome mimicking Yang (Yin Zheng Si Yang). It should be treated with hot warming agents. This is termed Yin Restlessness. Whenever cold extremities, diarrhea, delirious speech, urinary incontinence, fixed staring eyes, and restless inability to lie down are present, along with a pulse that is weak and nearly imperceptible, the condition is incurable. Thus it is said: "When organs receive cold pathogenic factors and fail to receive warmth, death ensues." Heaven's Qi is Yang; Qi deficiency leads to cold. Therefore, warming is also tonifying, hence called "rescuing the Interior" (Jiu Li), because Yang Qi deficiency is critically dangerous and requires urgent rescue.

If the disease arises spontaneously without fever, but with delirious speech, restlessness, and a spirit/mind that does not match normal standards, this is termed "like-manic" (Ru Kuang). It results from heat binding in the Bladder, representing an interior syndrome of the Taiyang Channel. It is appropriate to treat with draining/diuretic methods. Using purgatives will lead to death. If irritability precedes restlessness, it is treatable; if restlessness precedes irritability, it is fatal. If there is only restlessness without irritability, it is fatal. This is because restlessness without momentary peace indicates organ cold-jue (Zang Jue). Furthermore, those who cannot sleep or lie still suffer from dryness of Stomach fluids, failing to nourish the Hun and Po internally. Only by generating fluids to harmonize the Stomach can sleep naturally become peaceful.

"Delirious speech" (Kuang Yan) refers to speaking with wide-open eyes about things never seen before; this is Excess (Shi). "Rambling speech" (Chan Yu) refers to speaking with closed eyes about daily common matters; this is Deficiency (Xu). "Zheng Sheng" refers to trembling, weak voice unable to continue, with words forced out from the throat; this is severe Deficiency. If breath is not rapid, hands and feet are warm, and the pulse is deep and fine, urgently use Baihu Tang (White Tiger Decoction) added with Renshen (Ginseng Radix), Wuweizi (Schisandrae Fructus), and Maidong (Ophiopogonis Radix) to assist Yuan Qi, or prepare Nongjian Dushen Tang (Strongly Decocted Single Ginseng Decoction) for slow management. If the pulse is faint and fine, urination and defecation are spontaneous, and hands and feet are cold, warming and tonifying are especially indicated; Sini Tang (Frigid Extremities Decoction) and Lizhong Tang (Regulate the Middle Decoction) are both appropriate formulas.

Irritability during the day indicates disturbed deficient Yang manifesting as false heat externally. Quietness at night, without vomiting or thirst, with a deep, faint pulse and no significant heat, indicates dominant Yin Qi reflecting true cold internally. Extreme Yin deficiency leads to Yang jue; extreme Yang deficiency leads to Yin restlessness. One should use Jiang (Zingiberis Rhizoma) and Fu Zi (Aconiti Lateralis Radix Praeparata) to restore Yang directly from Yin, without hesitation due to daytime irritability. However, administration may involve cooling hot decoctions before drinking, or adding one or two Yin-nourishing herbs as guides for the hot herbs. The appropriateness of formulation depends on the practitioner. Thus, ancient formulas using acrid-hot herbs to restore Yang always accompany them with Gui (Angelicae Sinensis Radix) and Shao Yao (Paeoniae Radix) to astringe Yin, ensuring Yang returns without Yin being depleted. Regarding Chan Yu, if the pulse is floating and large, survival is likely; if the pulse is deep and small requiring Sini Tang, death is likely. This is what is meant by "Yang disease presenting with Yin pulse."