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A man over fifty years old suffered from wind-stroke, unable to speak. His physique was robust with excessive fire-heat, he was unconscious, and his jaw was tightly clenched, preventing the administration of medicine. Jili root (Tribuli Radix) was stir-fried until yellow, ground into powder, mixed with a decoction of Yizao (Galla Chinensis), and instilled into the nostrils. After one or two hours, he vomited half a dou of phlegm and saliva, after which he could finally produce sounds. Subsequently, several doses of Ditang Tang (Phlegm-Draining Decoction) were administered, leading to recovery.

A woman over sixty years old had a fat physique, numbness and weakness in her right hand and foot, inability to move, and a stiff tongue. This was caused by damp-phlegm. Cangzhu (Atractylodis Rhizoma) and Weilingxian (Clematidis Radix et Rhizoma) were decocted into a paste and...

Danxi stated: Generally, it is mostly due to phlegm accumulation, repressed anger, wind-heat, or invasion by evil pathogens. The disease of dian-kuang (mania and depression) is also called Xin Feng (Wind affecting the Heart). It is generally because of fright, depression, anger, and wind-evil invading the heart; or due to excessive thinking causing qi stagnation and rebellion; or due to heart deficiency allowing evil pathogens to invade, generating accumulated heat and phlegm that knots between the heart and lungs. This causes the spirit to lose its residence, resulting in mental confusion, hallucinations, delirious speech, manic shouting, singing and laughing incessantly, cursing and running about, even ignoring kinship ties and behaving abnormally. All these are caused by phlegm confusing the orifices of the heart. If symptoms appear, treatment should be sought immediately; otherwise...

The Classic says: When Dian disease begins, the patient feels unhappy, stares fixedly, and suddenly falls rigid. When Kuang disease begins, the patient sleeps little, does not feel hungry, considers themselves virtuous, clever, and noble, laughs without reason, enjoys singing and music, and speaks nonsense incessantly. This patient’s condition was likely similar to wind-stroke due to phlegm-heat and excessive heat, hence named Xin Feng (Wind affecting the Heart). Treatment should focus on smoothing qi, descending fire, resolving phlegm, and nourishing the heart. In severe cases, emesis should be induced to remove phlegm, or purgation should be used to unblock qi, clearing the phlegm so the heart spirit naturally calms.

Danxi said: For wind-mania, if the pulse is deficient and floating, it is easy to treat; if excess and large, it is difficult to cure. "Double Yang leads to Kuang" refers to the appearance of surging, large, slippery, and rapid pulses in the yang positions, known as Double Yang pulse, which inevitably leads to mania. "Double Yin leads to Dian" refers to the appearance of deep, choppy, fine, and short pulses in the yin positions, known as Double Yin pulse, which inevitably leads to depression.

The Pulse Canon states: A slippery and rapid pulse at the Cun position indicates phlegm accumulating in the heart, manifesting as Xin Feng. It also states: The pulse of pathogen invasion fluctuates, appearing suddenly large, small, short, or long.

1. For Dian-Feng-Kuang diseases, first assess the patient's Yuan Qi (primordial qi) deficiency or excess, and the duration of the illness, to avoid misdiagnosis and error in treatment.

2. For Kuang disease with deviated eyes, delirious speech, manic walking, robust physique, and excess qi, induce vomiting to expel phlegm using Lilu San (Veratrum Powder) or Sansheng San (Three Sages Powder).

3. Xin Feng involves heart invasion by pathogenic heat, causing mental confusion, manic laughter, and excessive talking. This arises from prolonged thoughts stirring heart fire, generating heat, which then produces phlegm. Use Qingxin Yangshen Tang (Heart-Clearing and Spirit-Nourishing Decoction) and Zhuifeng Qutan Wan (Wind-Chasing and Phlegm-Resolving Pill).

4. For Kuang-Feng with robust physique, cursing, running, ignoring kinship, and reckless behavior, use strong purgation with Tun Tan Wan (Rolling Phlegm Pill), Xiexin Tang (Drain the Heart Decoction), or Baoming Dan (Life-Preserving Elixir).

5. For Dian-Kuang with excessive phlegm, inability to recognize people, incessant singing, mental confusion, manic disorder, and disregard for fire and water, first induce vomiting to expel phlegm, then use Dingzhi Huotan Tang (Will-Calming and Phlegm-Resolving Decoction) or Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill).

6. For Feng-Dian disease presenting with staring eyes, retching, and tinnitus like cicadas, this indicates heart deficiency and blood insufficiency. Nourish the heart and resolve phlegm using Yangxin Tang (Heart-Nourishing Decoction).

7. For illness caused by fright and anger, manifesting as unpredictable manic disorder, unsettled spirit, and mental agitation, use Yinsheng Guishe Dan (Spirit-Guiding Home Return Elixir).

8. For chronic Xin Feng manic disorder, after vomiting and purgation, if there is heart and gallbladder deficiency timidity, unstable speech, spirit depletion, and weak pulse, use Buxin Tang (Heart-Supplementing Decoction) combined with Wendan Tang (Warm the Gallbladder Decoction).

9. For Qi-Xin Feng caused by long-term anger and depression generating phlegm, with evil pathogens lodging in the heart and lungs, manifesting as delirious speech, manic shouting, chest fullness, lack of appetite, deviated eyes, and angry speech, this indicates liver qi injuring the heart meridian. Use Pinggan Shunqi Tang (Liver-Calming and Qi-Smoothing Decoction).

10. For Xin Feng pathogenic diseases, moxibustion therapy is required.