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The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: Those who suffer from dian disease (epilepsy/manic depression) from birth are said to have a congenital disease. This condition originates in the womb when the mother experiences fright, causing qi to ascend without descending, and essence and qi congregate above, thus causing the child to develop dian disease. At the initial onset of the illness, it occurs once a year; if untreated, it progresses to once a month; if still untreated, it occurs four or five times a month, which is termed dian. The pulse of dian disease, if large and slippery, will resolve spontaneously over time. If the pulse is small, firm, and rapid, it indicates a fatal prognosis that cannot be treated. For dian disease, a deficient pulse is treatable, whereas an excess pulse indicates death. Binding with yin meridians leads to dian disease.

Although dian is a yin syndrome, if the pulse is large and slippery, recovery is possible. If the pulse is small, firm, and rapid, it represents the extreme of yin pulses, indicating untreatability. A deficient pulse suggests that pathogenic factors are not yet vigorous, hence it is treatable; an excess pulse indicates pure pathogenic presence, hence fatal.

The *Nanjing* (Classic of Difficult Issues) states: Heavy yin conditions result in dian. When dian disease first begins, the patient feels unhappy, stares fixedly, and suddenly collapses stiffly. The pulse shows fullness in both yin and yang aspects across all three positions (cun, guan, chi).

The *Mai Jing* (Pulse Classic) states: Yin attaching to yang results in kuang (mania); yang attaching to yin results in dian. "Yang attaching to yin" refers to heat from the waist down to the feet, while cold above the waist. "Yin attaching to yang" refers to heat from the waist up to the head, while cold below the waist.

The syndrome of dian is mostly caused by emotional depression and frustration, leading to despondency. Symptoms include mental vagueness, disordered speech, singing or laughing at inappropriate times, weeping or crying, appearing intoxicated or manic, speaking without coherence, and lacking awareness of cleanliness or filth. Chronic cases lasting years are due to stagnant phlegm obstructing the pericardium, causing the spirit (shen) to lose its residence, commonly known as "phlegm confusing the heart orifices." Treatment primarily focuses on calming the spirit and resolving phlegm. Initially, Kongxian Dan (Control Saliva Pill) is used to induce vomiting of phlegm, followed by formulas to calm the spirit. If anger stirs liver fire, causing wind-phlegm to surge upward and trigger mania/dian, Daotan Tang (Phlegm-Guiding Decoction) is modified with Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Shichangpu (Acori Tatarinowii Rhizoma), and Yuanzhi (Polygalae Radix). After decoction, Zhusha (Cinnabar) powder and Chenxiang (Aquilariae Lignum Resinatum) juice are added. If speech lacks propriety, frequent laughter occurs without mania, this indicates heart deficiency; Dingzhi Tang (Will-Firming Decoction) is modified with Jiangzhi (Zingiberis Rhizoma Recens Juice) and Zhuli (Bambusae Caulis in Taenia). If there is slight pain in the diaphragm, blood stasis is present; add Hupo (Succinum) and Yujin (Curcumae Longae Radix) (if Yujin is unavailable, Ezhu [Curcumae Rhizoma] may substitute). For cases caused by excessive thinking, Xixian San (Thin Saliva Powder) is given first, followed by Guipi Tang (Restore the Spleen Decoction) supplemented with Chen Sha (Cinnabar) for tonification. If heat accumulates in the heart meridian, causing occasional irritability and heat sensation in eyes and nose, Dingzhi Wan (Will-Firming Pill) is modified with Huangqin, Huanglian, Maidong (Ophiopogonis Radix), and Niuhuang (Bovis Calculus). In excess patterns, Liangge San (Cool the Diaphragm Powder) is modified with Chuanlian (Coptidis Rhizoma), Maidong, and Shichangpu. For dian patients with disordered speech and confused spirit, Qianjin Fangji Dihuang Tang (Thousand Gold Fangji Rehmannia Decoction) is used. Due to unfulfilled obsessive thoughts causing the spirit to leave its residence, resulting in妄言妄见 (delusions and hallucinations) as if possessed by spirits, Banxia Fushen San (Pinellia and Poria Powder) is used initially, curing after several doses. If chronic and disturbed by herbal medicines, causing the spirit to wander and the residence empty, large doses of Dushen Tang (Single Ginseng Decoction) with Jiangzhi and Zhuli are required to replenish the spirit. Some dian patients cured solely by Siquqi Tang (Four-Seven Decoction) because qi stagnation creates phlegm-fluids that close off consciousness. Long-standing dian often leads to suspicion, sallow complexion, occasional foaming at the mouth, silence, and desire to sleep, indicating parasitic accumulation; Miaogong Wan (Miraculous Merit Pill) is indicated. If dian patients cry and moan, seemingly possessed but not manic, burned mulberry paper powder mixed with water and wine (one cun chi spoonful) is administered.

Li Shicai treated the daughter of Zhang Shaochun. Grieving the loss of her child, she was terrified during a thunderstorm with no shelter. The next day, she alternated between crying and laughing, talking to herself, and cursing, as if possessed. Her heart pulse was floating and slippery, while others were deep and fine. This indicated dual deficiency of qi and blood, with worry and fear injuring the heart; heart injury generates heat, and heat accumulation generates wind. Gun Tan Wan (Rolling Phlegm Pill) was administered, taken with a decoction of Jiegeng (Platycodonis Radix), Yanhusuo (Corydalis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), and Xingren (Armeniacae Semen Amarum). She recovered after expelling a large amount of phlegm accumulation.