眩仆曰癫，失心曰狂，《灵枢》、《难经》其义判然矣。如《素问》云癫疾欲走呼之类，别是一义，而后世
或以癫为失心，殆非是也。癫与痫不过大人小儿之别，而痫字倘用之大人，则亦即癫已。盖癫狂二病，其状虽
异，而其因相近，治方亦相出入。故今析其证，而仍并为一门，学人宜互通酌耳。
癫狂辨异 阴附阳则狂，阳附阴则癫。（《脉经》）（按∶原文此上曰∶凡脉大为阳，浮为阳，数为阳云
云。又曰∶关前为阳，关后为阴。又《巢源》曰∶脉浮大附阴者癫疾。据此阴附阳，言关前见阴脉，阳附阴，言关
后见阳脉。以见阴犯阳者为狂、阳犯阴者为癫之理，与《金匮》阴气衰者为癫，阳气衰者为狂，其意相发，乃首
揭之。又《沙篆》、《续焰》并有释义，欠确，故不录。）
狂病之候，观其人初发之时，不欲眠卧，又不肯饮食，自言贤智尊贵，歌笑行走不休，皆阳气盛所为。故
经言重阳
者狂，此之谓也。今人以为癫疾，谬矣。癫，颠也，发则僵仆焉，故有颠蹶之言也，阴气太盛，故不得行立而
倒仆也。今人以为痫病，误矣。（杨玄操《难经注》）（按∶《资生经》载此说曰∶其剖析癫狂之病，晓然如
此，而人终不信，岂亦传习之误，难以改欤。先兄曰∶颜师古《急就篇注》曰∶颠疾，性理颠倒失常，亦谓之狂
也。是杨氏所非。又按∶《万全方》以癫为狂而《集成》从之，《准绳》就失心中分癫与狂，今并不取。又杨
氏辨以癫为痫之误，盖言癫与小儿惊风不同也。）
狂谓妄言妄走也，癫谓僵仆不省也，各自一证。然经有言狂癫疾者，有言狂互引颠者，又言颠疾为狂者，
此则又皆狂颠兼病。今病有妄言妄走顷时前后僵仆之类，有僵仆后妄见鬼神半日方已之类，是以颠狂兼病者也。
（《纲目》）
经云∶重阳者狂，重阴者癫。盖狂者狂言妄动，逾垣上屋，登高而歌，弃衣而走，骂詈不避亲疏，而自高
贤，好歌乐，此皆心火独盛，阳气有余，以致神不守舍，痰火壅盛而然。癫者沉默嗔忿，悒悒不乐，僵仆直视，
变易常情，此是阴虚血少，心火不宁以致此也。有怒气忿郁，一时不得舒越，以成狂癫者，须先开达肝火。
（《病源集》）
《难经》谓重阴者癫，重阳者狂。《素问注》云多喜为颠，多怒为狂。然则喜属于心而怒属于肝，乃二脏
相火有余之证。《难经》阴阳之说，恐非理也。大抵狂为痰火实盛，颠为心血不足，多为求望高达不得者有之。
（《正传》）
癫狂之病，病本不同。狂病之来，狂妄以渐，而经久难已。癫病之至，忽然僵仆，而时作时止。狂病常醒，
多怒而暴。癫病常昏，多倦而静。由此观之，则其阴阳寒热，自有冰炭之异。故《难经》曰∶重阳者狂，重阴者
癫。义可知也。
后世诸家，有谓癫狂之病，大概是热，此则未必然也。此其形气脉气，自亦有据，不可不辨察阴阳，分而治之。
（《景岳》）
Fainting due to dizziness is termed Dian (epilepsy/severe mental disorder), while loss of mind and mental confusion is termed Kuang (mania). The meanings of these two terms are clearly distinct in the *Ling Shu* and *Nan Jing*. For instance, the symptoms described in the *Su Wen*, such as a desire to run and shout in Dian Ji (epileptic disease), belong to a different meaning. Later generations equating Dian with Shi Xin (loss of mind/confusion) are likely incorrect. The difference between Dian and Xian (pediatric epilepsy) is merely that of adult versus pediatric onset; if the term "Xian" were applied to adults, it would essentially be Dian. Generally, although the manifestations of Dian and Kuang differ, their etiologies are similar, and their treatment methods overlap. Therefore, this text analyzes their respective syndromes but combines them into one category for study, urging learners to understand and apply them flexibly.
**Differentiation between Dian and Kuang**: When Yin attaches to Yang, Kuang occurs; when Yang attaches to Yin, Dian occurs (*Mai Jing*).
*(Note: The original text states above: "Generally, a large pulse indicates Yang, a floating pulse indicates Yang, and a rapid pulse indicates Yang." It also states: "The area anterior to the Guan position is Yang, and the area posterior to the Guan position is Yin." Additionally, the *Zhu Bing Yuan Hou Lun* states: "A pulse that is floating, large, and attaching to the Yin position indicates Dian Ji." Based on this, 'Yin attaching to Yang' refers to observing Yin-type pulses at the anterior Guan position (Yang position); 'Yang attaching to Yin' refers to observing Yang-type pulses at the posterior Guan position (Yin position). This illustrates the principle that Yin invading Yang leads to Kuang, and Yang invading Yin leads to Dian. This aligns with the *Jin Gui Yao Lue*'s statement that "deficiency of Yin Qi leads to Dian, and deficiency of Yang Qi leads to Kuang," reinforcing the initial proposition. Other texts like *Sha Zhuan* and *Xu Yan* offer explanations that are deemed insufficiently accurate and are thus omitted.)*
The signs of Kuang disease, observed at its onset, include insomnia, refusal to eat, self-proclaimed wisdom and nobility, continuous singing, laughing, and walking. These are all caused by an excess of Yang Qi. Hence, the classics state that "Double Yang results in Kuang," which refers to this condition. Modern practitioners who classify this as Dian Ji are mistaken. Dian (also written as Dian/Dian) implies falling or overturning; upon attack, the body becomes stiff and falls, hence the term "Dian Jue" (falling/collapsing). This is caused by excessive Yin Qi, leading to an inability to stand or walk, resulting in collapse. Modern practitioners who classify this as Xian disease are also mistaken. (Yang Xuancao, *Commentary on Nan Jing*)
*(Note: The *Zi Sheng Jing* records this view, stating that the analysis of Dian and Kuang is so clear, yet people remain unconvinced. Is this due to entrenched errors in transmission? My elder brother remarked: Yan Shigu, in his commentary on the *Ji Jiu Pian*, stated that Dian Ji involves inverted and abnormal mental faculties, also called Kuang. This contradicts Yang's view. Furthermore, the *Wan Quan Fang* equates Dian with Kuang, a view adopted by the *Yi Zong Jin Jian*, while the *Zhun Sheng* distinguishes them within the context of Shi Xin. These views are not adopted here. Yang's distinction clarifies that Dian is not equivalent to Xian (pediatric convulsions).)*
Kuang is characterized by delirious speech and aimless wandering; Dian is characterized by stiffness, collapse, and unconsciousness. These are distinct syndromes. However, the classics mention "Kuang-Dian Ji," "Kuang intermingled with Dian," and "Dian Ji manifesting as Kuang," indicating cases where both conditions coexist. Current clinical presentations include patients who wander and speak deliriously, followed shortly by stiffness and collapse; or those who collapse, hallucinate spirits for half a day, and then recover. These represent combined Kuang and Dian diseases. (*Ben Cao Gang Mu*)
The classics state: "Double Yang results in Kuang; Double Yin results in Dian." Generally, Kuang manifests as delirious speech and hyperactivity, such as climbing walls and roofs, singing from heights, discarding clothes, running about, and cursing without regard for kinship or strangers, while holding oneself in high esteem and enjoying music. These are caused by solitary exuberance of Heart Fire and surplus of Yang Qi, leading to unsettled Shen (Spirit) and accumulation of Phlegm-Fire. Dian manifests as silence, irritability, depression, stiffness, collapse, fixed gaze, and alteration of normal temperament. These are caused by Yin deficiency and Blood insufficiency, leading to restless Heart Fire. Additionally, some cases arise from sudden anger and frustration that cannot be discharged, forming Kuang or Dian; in such cases, one must first soothe and unblock Liver Fire. (*Bing Yuan Ji*)
The *Nan Jing* states: "Double Yin results in Dian; Double Yang results in Kuang." The *Su Wen Zhu* states: "Excessive joy indicates Dian; excessive anger indicates Kuang." Since joy belongs to the Heart and anger belongs to the Liver, these are syndromes of excess Xiang Huo (Ministerial Fire) in these two organs. The Yin-Yang theory in the *Nan Jing* may not be entirely logical. Generally, Kuang is due to excess Phlegm-Fire, while Dian is due to insufficiency of Heart Blood, often occurring in individuals whose high aspirations go unfulfilled. (*Dan Xi Xin Fa: Zheng Zhuan*)
The root causes of Dian and Kuang are different. Kuang develops gradually with increasing madness and is difficult to cure over time. Dian strikes suddenly with stiffness and collapse, occurring intermittently. Patients with Kuang are usually awake, irritable, and violent. Patients with Dian are usually unconscious, fatigued, and quiet. Thus, their Yin-Yang and Cold-Heat natures are as opposite as ice and charcoal. Hence, the *Nan Jing* states: "Double Yang results in Kuang; Double Yin results in Dian," making the rationale clear.
Later scholars have suggested that Dian and Kuang are generally heat syndromes, which is not necessarily true. One must examine the patient's constitution and pulse qualities to distinguish Yin and Yang and treat them accordingly. (Zhang Jingyue, *Jing Yue Quan Shu*)