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Chan (delirious speech) refers to excessive talking; Wang (hallucination) refers to falsehood. Chanwang (delirium and hallucination) refers to the patient experiencing illusory auditory and visual perceptions, accompanied by incoherent speech. This is typically caused by exuberant pathogenic factors, deficiency of healthy qi, resulting in unclear consciousness.

Speech is the external expression of the heart's mind. Heat in the Heart leads to excessive talking. Murmuring during sleep indicates mild heat; erroneous speech while awake indicates severe heat. There are also cases of delirious speech caused by Stomach Heat, where the stool must be hard, and there has been no bowel movement for several days, which fits this syndrome. [Xue Ji] Mr. Chen Wensu stated: For varicella with purple color and depressed tops, accompanied by mental restlessness, mania, panting, delirious speech, or seeing ghosts, if there is internal heat and constipation, Longnao Gaozi (Brain Camphor Pills) and Zhuwei Gao (Pig Tail Paste) are suitable. If there is no internal heat and the stool is loose, they should not be taken lightly. I believe that the aforementioned conditions are mostly caused by failing to resolve and vent the pathogen when heat was intense at the beginning; some are due to incomplete resolution of varicella toxins, some due to Heat in the Stomach Meridian, some due to Heat in the Lung and Stomach, and some due to Heat in the Heart and Spleen, leading to irritability, rupture and bleeding of varicella sores, hematochezia, epistaxis, black stool, and red urine, as detailed in respective syndromes. Generally, thirst, fever, coldness of the fingertips, or constipation indicate internal heat. One must absolutely not prohibit drinking water. Referencing Zhang Zihe's account of saving a child from water, this can be verified: when heat reaches its extreme, water allows survival. A child suffered from varicella with mania, panting, thirst preferring cold drinks, and difficult expectoration of phlegm. My father treated this using Shiliuwei Qingge Yin (Sixteen-Ingredient Phlegm-Clearing Decoction) and Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction), achieving recovery. Another child developed mania after varicella eruption, with thirst preferring cold drinks; this indicated blazing heat in the Upper Jiao. Using Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxins) and celery juice, the symptoms ceased. Then, Zicao Kuaiye Tang (Arnebia Rapid-Eruption Decoction) was used. When the sores were about to crust over, due to interrupting medication for three days, the sores turned black and inverted. Zicao San (Arnebia Powder) was used to stop thirst, followed by Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) for full recovery. Another child, after varicella recovery, occasionally experienced mania with panting. After episodes, the complexion was yellowish-white, and limbs were cold. This indicated Spleen and Stomach deficiency. I used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Bazhen Tang (Eight-Treasure Decoction), administering each for more than thirty doses. Some suggested first clearing fire pathogens and then tonifying original qi, so they administered Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), and Poxiao (Natrii Sulfas). This led to incessant sweating and vomiting, resulting in death.

At the initial stage of fever, if illusory perceptions occur, with delirious speech resembling seeing ghosts, this is an ominous sign. It is because toxins attack internally, confusing the mind and clouding consciousness. Moreover, children have weak Shen (Spirit), making them susceptible to invasion by malevolent entities. Malevolent ghosts often travel with epidemic qi, invading when human resistance is low. Therefore, any varicella case presenting with hallucinations, false hearing, delirious speech, or seeing ghosts is considered incurable. One must examine which Zang organ is affected: If eyes stare straight ahead and hands pick at clothes or fumble with objects, it originates from the Liver, indicating loss of Hun (Ethereal Soul). If there is chest oppression, panting, and hands scratching eyebrows, eyes, nose, and face, it originates from the Lungs, indicating loss of Po (Corporeal Soul). If there is upward staring, teeth grinding, frequent crying, fright, palpitations, or inability to speak, it originates from the Heart, indicating loss of Shen (Spirit). If there is lethargy, convulsions of limbs, and loss of appetite, it originates from the Spleen, indicating loss of Yi (Intellect). If eyes lack luster, fear light, and the body shrinks, it originates from the Kidneys, indicating loss of Zhi (Willpower). Thus it is said: Appearance of True Zang pulse indicates incurability. Or, if these symptoms do not appear during fever but appear due to constipation, this is internal heat. First use Xuanfeng San (Wind-Dispersing Powder) to clear heat, then administer Niuhuang Qingxin Wan (Calculus Bovis Clearing Heart Pill) via Daochi San (Guide Out Redness Powder) targeting the Heart. Or use Fenhong Wan (Pink Pill) to calm the Spirit. If the condition stops, it is treatable; if it continues incessantly, it is untreatable. If there are dry feces in the Stomach and no bowel movement for three to five days, purging the intestines and resolving toxins is appropriate, using Sishun Qingliang Yin (Four-Obedience Cooling and Refreshing Decoction) or Sanhuang Wan (Three-Yellow Pill) as the main treatment. If mania occurs at the initial fever stage with normal stools, Wuling San (Five-Agaric Powder) added with Zhensha (Cinnabar) is used. For constipation, mild cases use Sanhuang Wan, severe cases use Chengqi Tang (Chengqi Decoction).

If during the rising, pustule formation, or crusting stages, sudden confusion and delirium occur, it is because the sores were dense, causing exhaustion of essence and blood, failing to nourish the Spirit. Nourishing blood and purging fire is appropriate, using Anshen Wan (Spirit-Calming Pill).

Anshen Wan (Spirit-Calming Pill)
Huanglian (Coptidis Rhizoma), Danggui Shen (Angelicae Sinensis Radix Body), Maimendong (Ophiopogonis Tuber), Baifushen (Poria with Hostwood), Gancao (Licorice Root) (each 0.5 liang), Zhensha (Cinnabar) (1 liang), Longnao (Borneolum Syntheticum) (2.5 fen).
Grind into powder. Mix with steamed dough soaked in decoction, and knead evenly with pig heart blood. Form pills the size of millet seeds. Take ten pills each time, washed down with Dengxin Cao Tang (Juncus Effusus Decoction).

Zhiren Tang (Gardeniae Semen Decoction)
Indicated for irritability, delirious speech, fright, mania, and convulsions.
Zhiren (Gardeniae Semen), Huangqin (Scutellariae Radix), Shigao (Gypsum Fibrosum) (each 2 qian), Zhimu (Anemarrhenae Rhizoma), Xingren (Armeniacae Semen Amarum) (each 1.5 qian), Daqing (Isatidis Folium), Chaihu (Bupleuri Radix), Douchi (Sojae Semen Praeparatum), Chi Shaoyao (Paeoniae Radix Rubra) (each 1 qian), Shengma (Cimicifugae Rhizoma) (8 fen), Gancao (Licorice Root) (5 fen).
Decoct in water and take orally.

If the patient is comatose and incoherent, the prognosis is fatal. The Classics state: Disarray in clothing and speech without distinction between kin and strangers indicates chaos of the Shen (Spirit). Therefore, it is incurable. If at the initial fever stage, there are hallucinations resembling seeing ghosts with terror, it is incurable. This syndrome should not appear from start to finish. Its appearance indicates total loss of spirit and will, leaving only the physical shell, merely prolonging life.