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Dian (Manic-Depressive Psychosis), Xian (Epilepsy), and Kuang (Mania) are three distinct syndromes. However, medical texts sometimes refer to "Dian-Xian," "Feng-Xian" (Wind Epilepsy), "Feng-Dian" (Wind Manic-Depression), or "Feng-Kuang" (Wind Mania), often causing confusion and lack of distinction. Generally, Xian is attributed to the five Zang organs, with the Heart being central; thus, authors argue that Dian and Kuang can be discussed together because Dian belongs to Yin and Kuang to Yang, establishing opposing names that elucidate each other. In contrast, Xian has its own Yin-Yang differentiation and is significantly different from the other two syndromes, warranting a separate category. Here, we summarize the essentials.

Dian syndrome involves episodes of sorrow or laughter, singing or crying, appearing intoxicated or foolish, with speech lacking order and behavior disregarding cleanliness or filth. It is difficult to cure after many years and is common among those whose aspirations remain unfulfilled.

Kuang syndrome is characterized by unruly and violent behavior, hallucinations, delusions, cursing without regard for kinship or distance, and resistance without fear of fire or water. Severe cases may involve discarding clothes and running, singing while climbing high places, or jumping over walls—actions beyond normal physical capability, as if possessed by evil spirits. This is frequently seen in Yangming Fu-organ excess patterns of Shanghan (Cold Damage).

Excessive Heat in the Heart leads to excessive joy, resulting in Dian, characterized by disordered laughter and speech, and chaotic inversion. Excessive Heat in the Liver leads to excessive anger, resulting in Kuang, characterized by restlessness, agitation, running, jumping, and uncontrollable madness. Both syndromes belong to internal excess of Phlegm-Heat, confirming Liu Hejian's profound insight. However, the theory of "Heavy Yin and Heavy Yang" in the Nanjing (Classic of Difficult Issues) is unreasonable and incorrect. As stated in the Neijing (Inner Canon): Violent anger injures the Liver, causing Liver Qi to rebel and Blood to become chaotic; violent joy injures Yang (Heart Qi), causing Heart Qi to slacken and Spirit to dissipate. It also states: Those with much Yang tend toward joy; those with much Yin tend toward anger. Thus, the Nanjing distinguishes Yin and Yang through Joy and Anger, not through Cold and Heat.

Both Dian and Kuang syndromes are named "Loss of Heart [Spirit]." When the Heart Master is unclear, the twelve Officials are endangered, causing vision, hearing, speech, and movement to lose their functions. For acute onset, draining excess is appropriate; for chronic cases, calming the Spirit is appropriate. This is the general principle of treatment.

Xian syndromes arise from Wind, Heat, and Phlegm. Those on the exterior and shallow are called Yang Xian, hence considered easy to treat; those on the interior and deep are called Yin Xian, hence considered difficult to treat. This again uses exterior-interior and shallow-deep to define Yin-Yang, not Cold-Heat.

The symptoms of Xian include sudden collapse to the ground, chest oppression and confusion with loss of consciousness, biting the tongue, foaming at the mouth, opisthotonos (back arching backward), upward deviation of the eyes, and spasmodic convulsions of the hands and feet. Sometimes animal-like sounds are produced. Cases occurring several times a month are easier to treat; those occurring once a year are difficult.

Wu Shanfu stated: Wind is Yang Qi. The Neijing says: Yang Qi is named after the swift wind of heaven and earth, so its onset is sudden. The reason for collapsing is that Jue Qi converges upward, leading to excess above and deficiency below, with clear and turbid Qi reversing positions. Loss of consciousness occurs because Turbid Evil disturbs the Heavenly Ruler (Shen/Spirit), causing obstruction and stagnation of the Spirit.

The tongue is the sprout of the Heart, and the Spleen meridians connect to the root of the tongue; the Yangming meridians enter the gaps between the upper and lower teeth. Therefore, when Wind Evil invades the Heart and Spleen, the tongue protrudes naturally. When Wind Evil invades the Yangming meridian, the mouth clenches naturally. One protruding and one clenched cause the patient to bite their tongue and foam, indicating the influx of Wind-Heat, resembling a surging tide.

Opisthotonos and upward eye deviation indicate Wind in the Taiyang Meridian. The Foot-Taiyang Bladder Meridian originates at Jingming (BL1) and descends along the spine. When invaded by Wind Evil, it becomes firm and tense, causing upward eye deviation and back arching.

Spasms and convulsions occur because Wind belongs to Liver-Wood, which governs the sinews. Excessive Wind-Heat in the Liver causes the sinews of the whole body to contract and twitch, resulting in hand and foot spasms. "Chu" refers to the flexion of the four limbs; "Nuo" refers to the opening and closing of the ten fingers. Animal-like sounds arise because Wind-Phlegm agitates the Qi orifices, altering the voice. This is like playing a flute: different blockages of the six holes produce different musical tones (Gong and Shang).

Treatment should focus on dispersing Wind and resolving Phlegm, clearing Heat and calming the Soul. For excess patterns, purge immediately; for deficiency patterns, tonify first. If caused purely by emotional factors, resolve them according to the Five Emotions Mutual Overcoming method from the Neijing.