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The *Neijing* states: When Yang qi is excessively redundant, mania (Kuang) occurs; when Yin qi is excessively redundant, melancholia (Dian) occurs. It also states: When pathogenic factors enter the Yang aspect, mania occurs; when they enter the Yin aspect, melancholia occurs. Furthermore: When Yang pathogens combine with Yang, mania occurs; when Yin pathogens combine with Yin, melancholia occurs. Additionally: Heat toxins in the Stomach merge into the Heart, disturbing the Shen (Spirit) and destabilizing the will, thereby inducing mania. This is generally due to the failure to induce sweating in Yang-patterns (Exterior syndromes), allowing Yang-heat to penetrate deeply, combined with the failure to purge, causing Yang qi to become excessive while Yin qi suddenly exhausts, resulting in a state of solitary Yang without Yin. Initially, there is little sleep, frequent rising, delirious speech, and inappropriate laughter. In severe cases, patients climb high places singing, discard clothing, run about, scale walls and roofs, with heat that cannot be restrained. Treatment should employ cold-natured agents to overcome the heat. In Taiyang disease progressing to mania, pathogenic heat reaches its extreme; only a major emetic can resolve it. If the hands and feet are warm, the spirit is clear, the pulse is surging (Hong), and the eyes have luster, this is treatable. Conversely, if the eyes stare fixedly, the four limbs are cold, the six pulses are deep and minute (Chen Wei), and the patient speaks deliriously without eating, this indicates inevitable death.

For cases of mania with uncontrollable running, place a fire basin near the patient. Pour one bowl of vinegar onto hot charcoal, allowing the vapor to enter the patient's nose. Then spray ginger juice on the head, face, body, and extremities to calm the patient. Only then can one distinguish between Yang-manic and Yin-restless patterns to apply appropriate treatment.

In febrile diseases manifesting as mania, bed curtains must never be closed; they should be opened to allow fresh air to circulate for a considerable time. Then, press a copper mirror against the chest and heart area until the heat subsides slightly, then remove it. If the heat is excessive and dryness-thirst persists unceasingly, grind one jin (approx. 500g) of Natrii Sulfas (Xiaoshuo, 芒硝) finely. Mix with a basin of water, soak three to five pieces of blue cloth in the solution, wring them out until semi-dry, and apply to the patient's chest and heart. Change frequently. Recovery occurs when the patient sleeps and sweats.

"Ru Kuang" (Mania-like) refers to a milder condition where the patient can still be restrained, unlike true mania which is fierce and uncontrollable. The patient experiences restlessness in lying down and sitting but has not reached the stage of full mania. Mild presentations state: "Heat binding in the Bladder causes the person to appear manic; this is Blood Stasis syndrome." Treatment utilizes Didang Tang or Taoren Chengqi Tang.

Jing Kuang (Startled Mania) is mania arising from Yang collapse with fright and palpitations, distinct from the running mania of excessive Yang. It typically arises because an exterior Yang pathogen was subjected to repeated sweating attempts without success, leading to exhaustion of internal fluids and dispersion of righteous Qi. Alternatively, it may result from placing fire under the bed or using moxibustion/needling to forcibly extract sweat, transforming into this syndrome. Consequently, the patient rises suddenly, moves with fright, suffers mental confusion, and exhibits limb restlessness. In excess patterns, there is incessant irritability; in deficiency patterns, there is collapse of True Yang. The method involves using Chai Hu Huang Qin Tang (Bupleurum and Scutellaria Decoction) to clear heat, and Long Gu Mu Li (Dragon Bone and Oyster Shell) to anchor the Spirit. Treatment must be adjusted according to excess or deficiency.