Library

The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: All restlessness, mania, and transgression belong to Fire. It also says: When Yin is excessive and triggers restlessness, it is called "Yin Restlessness" (Yin Zao). The patient desires to sit in a well (seeking coolness), and should be treated with hot-natured medicines. Why? Cheng Wuji explained: Although the patient desires to sit in a well, water cannot enter the mouth (because true cold within rejects cold fluids). Li Dongyuan stated: When Yin Restlessness reaches its extreme, desiring to sit in a well, it indicates that Yang Qi has already perished first. If physicians fail to comprehend this and instead diagnose it as Heat, administering cold-natured medicines will inevitably lead to death. Moreover, when cold-natured agents enter the abdomen, the Fire of the entire body will ascend and scatter upon encountering water. It is appropriate to treat with formulas such as Pili Decoction (Thunderbolt Decoction), Lizhong Decoction (Regulate the Middle Decoction), or Sini Decoction (Frigid Extremities Decoction).

Zhu Danxi discussed cases where deficiency diseases and phlegm diseases resemble demonic possession: Blood and Qi are the spirit of the body. If the spirit becomes depleted and deficient, pathogenic factors may take advantage to invade; theoretically, this is possible. If both Blood and Qi are deficient, and Phlegm lodges in the Middle Jiao, obstructing the ascending and descending mechanisms and preventing normal function, causing the Twelve Organs to lose their respective duties, resulting in false perceptions in vision, hearing, speech, and movement, treating with methods that attack pathogens will certainly cause the patient's death. Alas! How unjust is this; who shall bear the blame? The son of an official, Brother Fu, aged seventeen or eighteen, during the summer month, became thirsty due to great fatigue and desired to drink plum syrup. He then suffered three or four sudden frights, leading to delirious speech and hallucinations, resembling demonic possession. His pulse was examined as deficient, wiry, deep, and rapid in both hands. I said: A rapid pulse indicates Heat; a deficient, wiry pulse indicates great fright. Furthermore, the sourness of the plum syrup stagnates in the Zhongwan area. One should tonify deficiency, clear Heat, and guide out Phlegm stagnation for the illness to stabilize. Thus, Ginseng, Atractylodes Macrocephala, Tangerine Peel, Poria, Scutellaria, and Coptis were decocted thickly into a soup, with Bamboo Sap and Ginger Juice added. After ten days, there was no effect, and everyone blamed the prescription as incorrect. I palpated his pulse again and knew that his deficiency was not yet fully resolved and Phlegm had not been completely guided out. I continued with the previous formula, adding Honeysuckle Sap. After another ten days, he stabilized. My maternal uncle's relative, Mr. Qi, one day after drunkenness and overeating, spoke nonsense and hallucinated. Upon inquiry, he claimed his deceased brother possessed him, speaking accurately about past events. At that time, his uncle scolded him from the side, saying, "It is not a demon; it is caused by Phlegm due to consuming too many raw fish and drinking alcohol." A large bowl of salt water was administered, vomiting one or two sheng of Phlegm. Profuse sweating followed, and he stabilized after one night. Lady Jin of the Jin family, in her prime, returned from a banquet in the summer heat. Her mother-in-law asked if she had sat in the wrong order, and she felt ashamed and guilty, thus becoming ill. Her speech was disordered, often interjecting "I am not [guilty]." Her pulse was generally rapid and wiry. I said, "This is not a demon, but a disease." Treat only with spleen-tonifying, heat-clearing, and phlegm-guiding methods, and she will naturally stabilize in a few days. The family did not believe this, inviting several shamans to spray water and perform exorcisms. More than ten days later, she died. Someone asked: If the disease is not a demon but treated as one, why did she die so quickly? I said: In the summer, attending a banquet, the external environment was steaming hot, and spicy foods were palatable, creating internal stagnant Heat. Moreover, she had pre-existing accumulated Phlegm, compounded by shame and depression. The extent of Phlegm and Heat is incalculable. Now, startling her with talismanic water startles her Spirit, causing Blood to become unsettled. Spraying ritual water closes the body and pores, preventing sweat from venting. Without sweating, the internal steaming Heat burns fiercely; with unsettled Blood, Yin diminishes and Yang cannot stand alone. How could she not die? Someone asked: The *Waitai Miyao* (Essential Prescriptions Worth a Thousand Gold) has a section on incantations; can they be abolished? I said: Shifting essence and changing Qi (treating by altering mental focus) is a minor art, suitable only for minor illnesses. If there is internal deficiency-pathogen, one must use upright and proper methods, which have established norms and are clearly verifiable. However, talismanic water, for Heat diseases above the diaphragm, if swallowed cold, can temporarily relieve Stomach Heat and bring comfort. But for internal injury with deficiency, or in the severe cold of winter, swallowing talismanic water will freeze the Stomach Qi and cause harm. For conditions with stagnant Heat above and Heat pathogens at the exterior, resolution requires sweating. Suddenly receiving cold talismanic water solidifies the skin and pores; how can the Heat resolve? It will inevitably attack inward, causing Yin and Yang to separate and Blood and Qi to conflict, bringing one close to death. What is there to marvel at? Zhang Zhongjing said: Crying and weeping causing insecurity of Hun and Po is due to insufficient Blood and Qi. Insufficient Blood and Qi belongs to the Heart. Those with deficient Heart Qi are often fearful; closing their eyes, they wish to sleep, dreaming of traveling far. Thus, Spirit scatters, and Hun and Po wander falsely. Deficiency of Yin leads to Dian (depressive psychosis); deficiency of Yang leads to Kuang (manic psychosis). There are two types of Delirium according to the Six Qi theory: First, Fire Pathogen assisting the Heart. The Classics state: When the annual Fire is excessive, affecting Shaoyin and Shaoyang meridians, the patient suffers from delirium, mania, and transgression. It also states: Excessive Fire is called "He Xi"; its manifestation is burning, scorching, and chaotic disturbance. It also states: Manifestations of Shaoyin include delirium. It also states: Rebound of Shaoyin presents with tremors and delirium. It also states: Victory of Shaoyang presents with heart pain, vexation, susceptibility to fright, and delirium; treatment uses salty-cold substances. Second, Cold Pathogen injuring the Heart. The Classics state: When annual Water is excessive, Cold Qi spreads, and the pathogen harms Heart Fire. The patient suffers from body heat, vexation, restlessness, palpitations, Yin reversal, cold in the upper, middle, and lower regions, delirium, heart pain. If affecting the Taiyang meridian, there is thirst and confused wandering. It also states: During the governance of Yangming as the ruling Qi, in the fourth phase, cold rain descends, presenting with tremors and delirium; treatment uses sweet-hot substances.

[Stroke] Singing or crying, laughing or talking, without limit; use Modified Xuming Decoction.

[Zhong'e (Sudden Evil)] Sudden abdominal distension and fullness, inability to vomit or defecate, resembling Gan Huoluan (Dry Cholera). This arises because the person's Spirit is incomplete, and the Heart-Mind is prone to fear, allowing Evil Ghosts to strike or attach. The demeanor is heavy and silent, with delirious speech, slander, cursing, exposing private matters, disregarding ridicule. The mouth often speaks of future fortune or misfortune, which comes to pass exactly. The person may climb heights and traverse dangers as if on flat ground, or weep and moan, avoiding people, appearing drunk or mad. Symptoms are myriad; treat according to local customs and tests.

[Shizhu and other syndromes] Feishi (Flying Corpse) appears suddenly without gradual onset. Symptoms include stabbing pain in the heart and abdomen, panting,急促 breathing, and distension. Dunshi (Lurking Corpse) lingers in muscles and blood vessels; upon contact, it activates, causing abdominal distension, stabbing pain, panting, attacking the hypochondrium and striking the heart, recurring after recovery. Chenshi (Sunken Corpse) causes severe colic, distension, and panting upon onset. Even after remission, it remains deeply rooted in the zang-fu organs, causing aversion everywhere. Fengshi (Wind Corpse) circulates in the limbs and meridians. Symptoms are migratory and erratic, silent, unable to locate pain sites, triggered by wind exposure. Fushi (Hidden Corpse) lies dormant in the five zang organs for years. Before onset, the body feels fine; upon onset, stabbing pain, distension, and panting occur. There are also various Shizhu manifestations, which are Shizhu among the Five Corpses, carrying external ghostly Qi, flowing through the body, causing alternating chills and fever, or abdominal pain, distension, and panting, or lump formation, or pulling pain in the waist and spine, or general heaviness, mental confusion, and constant sense of absurdity. Changes in solar terms trigger severe illness. Accumulating over months and years, it leads to stagnation and death. After death, it transfers to others, potentially wiping out a family, hence called Shizhu. Treat all with Honeysuckle Vine and Leaf, chopped and boiled in large quantities, decocted thickly, taken as juice three times daily until cured. Taiyi Shenjing Pill and Suhexiang Wan are the premier treatments for this disease. Due to grief, fear, sorrow, and annoyance from funerals, contracting Corpse Qi causes varying symptoms, alternating cold and heat, triggered by wind. Use Xionzhu Powder. Previously in Huicheng, I regularly prepared Shenjing Pill. In the Gengshen year, a woman in my household dreamed of two dark-skinned servants, one ahead and one behind, holding an object. The front one asked, "Have you arrived?" The back one replied, "Arrived." They struck down with a loud bang, causing sleep paralysis. Upon waking, she felt unbearable pinpoint pain in the heart and dizziness for a while. I suddenly recalled that Shenjing Pill treats this syndrome, gave her three pills, and shortly after, she was well. She reported that pain ceased and spirit cleared after taking the medicine, and she is now normal. Later, acquaintances with slight evil qi responded well to one or two doses. The formula is in the *Qianjin Fang*, a key medicine for Stroke. However, modern practitioners lack Zengqing (Azurite) and Cishí (Magnetite), making preparation difficult.

[Postpartum Delirium] Chen stated: Postpartum manic speech and delirium is due to Heart Blood deficiency. Use Cinnabar powder mixed with wine, followed by Longhu Danshen Pill or Hupo Dihuang Pill. Xue Xinpu stated: For the aforementioned syndrome, the primary approach should be to consolidate Stomach Qi, assisted by herbs matching the symptoms. Attacking Phlegm exclusively would be a mistake. Guo discussed why postpartum patients see ghosts. He answered: The Heart governs the blood vessels. Childbirth consumes blood and vessels; Heart Qi deficiency allows failed blood to accumulate and harass the Heart. The Heart cannot tolerate this disturbance, leading to internal restlessness, inability to lie still or sit up, seeing ghosts, and inverted speech. Laypeople do not recognize this, calling it Wind Pathogen. In such cases, simply administer Tiaojing San, adding a pinch of Gentian per dose. Sleep brings relief. For postpartum fever, manic running, and a deficient-large pulse, use Siwu Tang plus Chaihu. If ineffective, add equal parts of Licorice, Chaihu, and Rehmannia, decocted and taken.