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Treating mania, insanity, and loss of mind (Dian Kuang Shi Xin), where the pulse is slippery and solid/excess.
Sheng Zhe Shi (Raw Ooidite, 2 liang, finely crushed) Da Huang (Rhubarb Root and Rhizome, 1 liang) Pu Xiao (Mirabilite, 6 qian) Qing Ban Xia (Processed Pinellia Tuber, 3 qian) Yu Jin (Curcuma Aromatica Rhizome, 3 qian).

To treat the aforementioned condition, if it is severe phlegm coagulation (Wan Tan Ning Jie), this formula should not be administered lightly unless the syndrome is a true excess pattern. This formula is the previous one with Gan Sui powder (Kansui Root) added in an amount of 2 qian; after decocting the other herbs, mix the powder into the herbal soup for administration.
When using Gan Sui, it is appropriate to grind it into powder and take it with water. Alternatively, mix the powder into the herbal soup. If decocted together in a soup, it will inevitably cause vomiting. Furthermore, any prescription containing Gan Sui should not be taken on consecutive days; there must be an interval of two or three days before re-administration, otherwise vomiting is likely. Also, note that Gan Sui is incompatible with Gan Cao (Licorice Root); users must keep this in mind.
Gan Sui has a fierce nature and moves rapidly; later Materia Medica texts describe its function as attacking and resolving blockages, calling it the supreme medicine for draining water. Since phlegm is also a form of fluid, its power to resolve phlegm is a hundred times greater than other herbs. I once treated a young man with mania/insanity; a physician prescribed 6 liang of Da Huang, which he took for two doses without bowel movement. Later, I examined him and prescribed this formula, changing only the dosage of Gan Sui to 3 qian. The patient's family said, "Previously, taking such a large amount of Da Huang yielded no effect; now you use only about 1 liang of Da Huang in this formula, how can it be effective?" I replied, "Just take it, do not worry." After ingestion, the patient had seven or eight bowel movements, expelling a significant amount of phlegm-saliva, and the mania/insanity was instantly cured. Observers found this miraculous, as they did not know that the power of 3 qian of Gan Sui far exceeds that of 6 liang of Da Huang.

Phlegm syndromes often present with a slippery pulse, but this does not necessarily indicate stubborn phlegm (Wan Tan). I have treated many such cases. In severe cases of mania/insanity, the pulse is often obstructed by stasis, or even all six pulses are imperceptible. Upon administering phlegm-resolving medications to unblock the obstruction, the pulse becomes palpable, indicating that stubborn phlegm can close off the pulse channels.
The syndrome of mania/insanity arises from phlegm-fire surging upward and obstructing the orifices and collaterals connecting the Heart and Brain, leading to a lack of communication between the Heart and Brain, causing total confusion of the Shen (Spirit/Mind). Therefore, the formula heavily utilizes Zhe Shi (Ooidite), borrowing its heavy and descending property to guide the phlegm-fire downward, thereby unblocking the obstructed orifices and collaterals. Consequently, the Heart and Brain can assist each other in regulation, and the Shen naturally returns to its normal state. Thus, when I treat severe cases of this syndrome, I often use up to 4 liang of Zhe Shi, which also calms Gan Sui to ensure it acts downwards, preventing vomiting.
"Dian" (Epilepsy-like insanity) refers to inverted temperament and loss of clarity in distinguishing right from wrong. "Kuang" (Mania) refers to fearlessness, reckless behavior, nonsensical speech, and even hallucinations. Generally, this syndrome begins with slight signs of Dian, followed by the onset of Kuang. If Kuang persists untreated, it gradually transforms into Dian, potentially leading to complete loss of consciousness. This syndrome typically stems from excessive worry and thought, causing Heart Qi to knot and fail to disperse, with phlegm-saliva condensing accordingly. Additionally, excessive thinking consumes Heart Blood, generating internal heat. Phlegm refined by heat becomes increasingly sticky; heat is trapped by phlegm, making resolution impossible. Thus, phlegm-fire overflows, completely obstructing the orifices and collaterals connecting the Heart and Brain, resulting in chaotic Shen. Initially, when slight signs of Dian appear, the phlegm-fire is not yet severe. When phlegm-fire accumulates and intensifies, Kuang develops. Therefore, in severe Kuang, when medication is used to purge phlegm, the expectorated phlegm is often red, indicating intense heat. As the disease progresses, the stagnant phlegm transforms into stubborn phlegm. Extreme chaos of Shen leads to a gradual loss of perception, transforming into Dian. Moreover, as the desire for perception vanishes, previous worries diminish, and internal heat gradually subsides. Without fire to fuel mania, it transforms into Dian. However, transformation from Dian to Kuang initially is easier to treat, while transformation from Kuang to Dian later is difficult. Thus, if this syndrome persists for three or four years, few patients recover.
Human Shen resides originally in both the Heart and the Brain. Zheng Jingxi stated: "When a person sees an object, an image remains in the brain. Children who forget easily have unfilled brain marrow; the elderly who forget easily have gradually emptying brain marrow." Wang En explained: "When people recall past events, they often close their eyes and look upward, concentrating spirit in the brain, which is clear evidence that images remain in the brain." From this, we see that the brain governs memory. If a person has unfulfilled longing, exhausting spirit through imagination, or regrets past mistakes painfully, they may damage the Shen in the brain. If one studies too intensely, worries excessively about future difficulties, hesitates too long, or thinks bitterly, they often damage the Shen in the heart. Ultimately, the Heart and Brain are connected throughout, jointly serving as the residence of Shen. Damage to Shen in one location affects both. Damage to Shen in the brain can affect the Nao Qi Jin (Brain Qi Tendons/Nerves). Damage to Shen in the heart can also affect the Nao Qi Jin. Injury to the Nao Qi Jin can cause inversion and chaos of Shen; injury to the heart can also cause inversion and chaos of Shen.
I once treated a young woman with mania/insanity who could not swallow forced medication. I instructed her to substitute salt with Pu Xiao (Mirabilite) in her meals, which she did unknowingly. She recovered after more than a month. Indeed, Pu Xiao is salty and cold, belonging to Water, and is the corresponding organ medicine for the Heart. Using Water to overcome Fire and Cold to overcome Heat allows the fire-heat in the Heart to dissipate completely, nourishing the Shen in the Heart. This is not merely relying on Pu Xiao's ability to resolve phlegm.