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11. Delirious speech (Zhanyu) is characterized by a loud and robust voice, with incoherent rambling that frequently changes topics. Prostrate speech (Zhengsheng) is characterized by a short and faint voice, with frequent repetition of the same words accompanied by muttering. When appearing in Yang meridians (Yang Jing), both belong to Heat syndromes; when appearing in Yin meridians (Yin Jing), both generally belong to Cold syndromes. For Yang meridian conditions where purgation is not indicated, clear-heat and resolve the exterior should be employed; for Yin meridian conditions where warming and tonification are not indicated, clear-tonification should be used to cure the disease.

[Note] Speech is governed by the Heart. When Heart Qi is excess and hot, leading to an abundance of Shen (Spirit), delirious speech occurs. Delirious speech is an Excess condition, hence the long and robust voice, with incoherent rambling that frequently changes topics. When Heart Qi is deficient and hot, leading to a deficiency of Shen, prostrate speech occurs. Prostrate speech is a Deficiency condition, hence the short and faint voice, merely repeating one phrase in muttering. This is because an abundance of Shen allows for adaptability and thus incoherent rambling, while a deficiency of Shen lacks adaptability, resulting in sticking to a single phrase. Whenever delirious or prostrate speech appears concurrently with Yang meridian syndromes, it belongs to Heat syndromes and can be treated with purgation; when appearing concurrently with Yin meridian syndromes, it generally belongs to Cold syndromes and can be treated with warming methods. However, if it appears with Yang meridian syndromes but there are no indications for purgation, do not use purgation; instead, employ clear-heat and resolve the exterior. If it appears with Yin meridian syndromes but there are no indications for warming/tonifying, do not use warming/tonifying; instead, employ clear-tonification.

12. The three methods [sweating, vomiting, purging] damage body fluids, causing stomach dryness and thirst; thirst caused by Yang pathogens invading the Three Yin meridians is similar. When thirsty and desiring water, give small amounts frequently; do not allow fluid retention to cause illness due to drinking. For Taiyang syndrome with Wuling San (Five-Agaric Powder) indicating difficulty in urination, for Yangming syndrome with continuous drinking indicating Baihu Tang (White Tiger Decoction), and for Shaoyang syndrome presenting with irritability and thirst, use Xiaochaihu Tang (Minor Bupleurum Decoction), removing Banxia (Pinelliae Rhizoma) and adding Zhuafen (Trichosanthis Radix).

[Note] Thirst diseases are mostly caused by sweating, vomiting, or purging damaging body fluids, leading to dryness in the stomach, thus inducing the desire to drink. When Yang pathogens invade the Three Yin meridians, Taiyin manifests as dry throat, Shaoyin as dry mouth, and Jueyin as Xiao Ke (Wasting-Thirst Syndrome). Thirst in the Three Yin meridians is also caused by Yang pathogenic heat damaging body fluids, hence it is said "thirst is similar." The treatment methods for thirst in the Three Yin meridians are detailed in the chapters on the Three Yin meridians. For those desiring to drink water, it should be given in small amounts frequently to moisten stomach dryness; once the Stomach Qi harmonizes, the disease resolves. If water is given indiscriminately and excessively, not only will the thirst not resolve, but water may stagnate and cause illness. Thirst in Taiyang syndrome uses Wuling San because water stagnates in the Lower Jiao, causing difficulty in urination. Thirst in Yangming syndrome uses Baihu Tang because stomach heat causes continuous drinking without cessation. In Shaoyang syndrome, when symptoms such as alternating chills and fever are present along with irritability and thirst, Xiaochaihu Tang is used to harmonize the Shaoyang; Banxia is removed to avoid its drying nature, and Zhuafen is added to generate body fluids.