人有终日不言不语，不饮不食，忽笑忽歌，忽愁忽哭，与之美馔则不受，与之粪秽则无
辞，与之衣不服，与之草木之叶则反喜，人以为此呆病，不必治也。然而呆病之成，必有其
因，大约其始也，起于肝气之郁；其终也，由于胃气之衰。肝郁则木克土，而痰不能化，胃
衰则土制水，而痰不能消，于是痰积于胸中，盘据于心外，使神明不清，而成呆病矣。治法
开郁逐痰，健胃通气，则心地光明，呆景尽散也。方用洗心汤∶
人参（一两） 茯神（一两） 半夏（五钱） 陈皮（三钱） 神曲（三钱） 甘草（一钱） 附子（一钱） 菖
蒲（一钱） 生枣仁（一两）
水煎半碗灌之，必熟睡。听其自醒，切不可惊醒，反至难愈也。
此等病似乎有祟凭之，然而实无祟也，即或有祟不可治邪，补正而邪自退。盖邪气之实
，亦因正气之虚而入之也。此方补其正气，而绝不去祛邪，故能一剂而奏效，再剂而全愈。
或谓此病既是正虚无邪，何以方中用半夏、陈皮如是之多乎?不知正虚必然生痰，不祛痰则
正气难补，补正气而因之祛邪，是消痰仍是补正也。虽然痰消而正气旺，是痰即邪也。补正
而佐以攻痰，引祛痰之药直入于心宫，以扫荡其邪，邪见正气之旺，安得不消灭于无踪哉。
或又谓呆病既成于郁，不解郁而单补正以攻痰，何以能奏功如此?不知呆病之来，其始虽成
于郁，然郁之既久而成呆，其从前之郁气，久则尽亡之矣。故但补胃气以生心气，不必又始
肝气以舒郁气也。
此症用还神至圣汤亦神。
人参（一两） 白术（二两） 茯神 生枣仁（各五钱） 广木香 天南星 荆芥（各三钱） 甘草 良
姜附子 枳壳（各一钱） 菖蒲（五分）
水煎灌之，听其自卧，醒来前症如失。
人有呆病终日闭户独居，口中喃喃，多不可解，将自己衣服用针线密缝，与之饮食，时
用时不用，尝数日不食，而不呼饥，见炭最喜食之，谓是必死之症，尚有可生之机也。夫呆
病而至于喜粪，尚为可救。岂呆病食炭，反忍弃之乎?盖喜粪乃胃气之衰，而食炭乃肝气之
燥，凡饮食之类，必入于胃，而后化为糟粕，是粪乃糟粕之余也。糟粕宜为胃之所不喜，何
以呆病而转喜之乎?不知胃病则气降而不升，于是不喜升而反喜降，糟粕正胃中所降之物也
。见粪而喜者，喜其同类之物也。然而呆病见粪则喜，未尝见粪则食也。若至于食粪，则不
可治矣，以其胃气太降于至极耳。夫炭乃木之烬也，呆病成于郁，郁病必伤肝木，肝木火焚
以伤心，则木为心火所克，肝中之血尽燥，而木为焦枯之木矣。见炭而喜食者，喜其同类而
食之，思救其肝木之燥耳。然而可生之机，全在食炭。夫炭本无滋味，今食之而如饴，是胃
气之未绝也。治其胃气，而祛其痰涎，则呆病可愈也。方用转呆丹∶
人参（一两） 白芍（三钱） 当归（一两） 半夏（一两） 柴胡（八钱） 生枣仁（一两） 附子（一钱） 菖
蒲
水十碗，煎一碗，使强有力者，抱住其身，另用二人执拿其两手，以一人托住其下颔，
一人将羊角去尖，插其口灌之。倘不肯服，不妨以杖击之，使动怒气，而后灌之，服后必然
骂詈，少顷必倦而卧，听其自醒，切不可惊动，自醒则全愈，否则止可半愈也。
此方大补其心肝之气血，加之祛痰开窍之药，则肝中枯竭得滋润而自苏，心内寡弱，得
补助而自旺，于是心气既清，肝气能运，力能祛逐痰涎，随十二经络而尽通之，何呆病而不
可愈哉!倘或惊之使醒，则气血不得尽通，而经络不得尽转，所以止可半愈也。然能再服此
汤，亦未有不全愈者矣。
此症用苏心汤亦神效。
白芍 当归（各三两） 人参 茯苓（各一两） 半夏 炒栀子 柴胡（各三钱） 附子（三分） 生枣
仁（五钱） 吴茱萸 黄连（各五分）
水十碗，煎一碗。灌之，听其自醒，醒来病如失。
人有一时而成呆病者，全不起于忧郁，其状悉与呆病无异，人以为有祟凭之也，谁知是
起居失节，胃气伤而痰迷之乎。夫胃属土，喜火之生者也。然而火能生土，而亦能害土，火
不来生，则土无生气，火过来生，则土有死气矣。虽然土中之火本生土者也，如何生土者反
能害土?岂火为外来之邪火，而非内存之正火乎!孰知邪火固能害土，而正火未尝不害土也。
正火者，土中之真火，如何能害土乎?盖正火而能养，则火且生土以消食，正火而相伤，则
火且害土以成痰。痰成而复伤其胃土，则火且迷心，轻则成呆，而重则发厥矣。起居失节，
则胃中劳伤，不生气而生痰。一时成呆者，乃痰迷于心脘之下，尚未直入于心包之中也。倘
入心包，则人且立亡矣。治法宜生其胃气，而佐之消痰之品，则痰迷可以再开，不必竟治其
呆也。方用启心救胃汤∶
人参（一两） 茯苓（一两） 白芥子（三钱） 菖蒲（一钱） 神曲（三钱） 半夏（二钱） 南星（二钱） 黄
连
（一钱） 甘草（一钱） 枳壳（五分）
水煎服。一剂而痰解，再剂而神清，三剂而呆病如失，不再呆也。
此方全去救心，正所以救胃也。盖胃为心之子，心气既清，而胃气安有不清者乎?母清
而子亦清也。设作呆病治之，亦用附子斩关直入，则火以助火，有顷刻发狂而死矣。总之呆
病成于岁月之久，而不成于旦夕之暂，若一时而成呆者，非真呆病也。故久病宜于火中补胃
以消痰，而猝病宜于寒中补胃以消痰，又不可不知也。
此症用指迷汤亦效。
人参（五钱） 白术（一两） 半夏 神曲（各三钱） 南星 甘草（各一钱） 陈皮 菖蒲（各五分） 附
子（三分） 肉豆蔻（一枚）
水煎服。四剂愈。
[Background Information]
Book: Bian Zheng Lu (Record of Syndrome Differentiation)
Author: Chen Shiduo
Dynasty: Qing
Chapter: Dai Bing Men (Chapter on Dullness Disease, Six Cases)
Category: Comprehensive
[Original Text Processing]
There are cases where a person does not speak or drink all day, nor eats. They suddenly laugh and sing, then suddenly become sorrowful and weep. When offered delicious food, they refuse it; when offered feces or filth, they do not decline. When given clothes, they do not wear them; when given leaves of grass and trees, they show preference. People consider this "Dai Bing" (Dullness Disease, characterized by mental dullness and intellectual impairment) and believe no treatment is necessary. However, the formation of Dai Bing must have its cause. Generally, it begins with Liver Qi stagnation (Liver Qi Stagnation) and ends with Spleen/Stomach Qi deficiency (Spleen/Stomach Qi Deficiency). Liver Qi stagnation leads to Wood overacting on Earth (Wood overacting on Earth), causing phlegm to fail to transform. Spleen/Stomach Qi deficiency leads to Earth failing to control Water (Earth failing to control Water), causing phlegm to fail to dissipate. Thus, phlegm accumulates in the chest, settles outside the Heart, clouding the Shen (Spirit/Mind), resulting in Dai Bing. The treatment method should involve resolving stagnation, expelling phlegm, strengthening the Stomach Qi, and unblocking Qi circulation. This will clear the mind, and the symptoms of dullness will completely dissipate. Use the formula Xi Xin Tang (Washing the Heart Decoction):
Ren Shen (Ginseng Radix et Rhizoma) (1 liang), Fu Shen (Poria with Hostwood) (1 liang), Ban Xia (Pinelliae Tuber) (5 qian), Chen Pi (Citri Reticulatae Pericarpium) (3 qian), Shen Qu (Massa Medicata Fermentata) (3 qian), Gan Cao (Licorice Root) (1 qian), Fu Zi (Aconiti Lateralis Radix Praeparata) (1 qian), Chang Pu (Acori Tatarinowii Rhizoma) (1 qian), Sheng Zao Ren (Ziziphi Spinosae Semen) (1 liang).
Decoct with water until half a bowl remains, and administer orally. The patient will surely fall into a deep sleep. Allow them to wake up naturally; do not startle them awake, as this may lead to difficult recovery.
Such illnesses seem to be possessed by spirits, but in reality, there are no spirits. Even if there were spirits, one should not treat the evil directly; rather, tonify the Righteous Qi (Zheng Qi), and the evil will retreat spontaneously. The invasion of Evil Qi occurs due to the deficiency of Righteous Qi. This formula tonifies Righteous Qi without specifically attacking evil, so it achieves effect after one dose and complete cure after two doses.
Some ask: Since this disease is caused by Righteous Qi deficiency without excess evil, why are Ban Xia and Chen Pi used in such large quantities? It is unknown that Righteous Qi deficiency inevitably generates phlegm. If phlegm is not expelled, Righteous Qi is hard to tonify. By tonifying Righteous Qi, evil is indirectly removed; thus, eliminating phlegm is still a form of tonifying Righteous Qi. Although phlegm is eliminated and Righteous Qi becomes robust, phlegm itself is also evil. Tonifying Righteous Qi while assisting with phlegm-expelling drugs guides these drugs directly into the Heart Palace to sweep away the evil. Seeing the robust Righteous Qi, how can the evil not be destroyed without a trace?
Others ask: Since Dai Bing forms from stagnation, how can resolving stagnation not be necessary, and only tonifying Righteous Qi to attack phlegm achieve such efficacy? It is unknown that although Dai Bing initially forms from stagnation, once stagnation persists for a long time and turns into Dai Bing, the previous stagnant Qi has been exhausted over time. Therefore, one only needs to tonify Stomach Qi to generate Heart Qi, without needing to soothe Liver Qi to relieve stagnation.
Using Huan Shen Zhi Sheng Tang (Returning Spirit Supreme Holy Decoction) for this syndrome is also miraculous.
Ren Shen (1 liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (2 liang), Fu Shen, Sheng Zao Ren (each 5 qian), Guang Mu Xiang (Costi Rhizoma), Tian Nanxing (Arisaematis Cum Bile), Jing Jie (Schizonepetae Herba) (each 3 qian), Gan Cao, Liang Jiang (Zingiberis Rhizoma), Fu Zi, Zhi Ke (Aurantii Fructus Immaturus) (each 1 qian), Chang Pu (0.5 qian).
Decoct with water and administer. Allow the patient to lie down naturally. Upon waking, previous symptoms will vanish as if lost.
There are patients with Dai Bing who stay indoors alone all day, muttering incoherently. They sew their own clothes tightly with needle and thread. Regarding food and drink, they sometimes eat and sometimes do not; they may go several days without eating without calling out hunger. They show great liking for eating charcoal. People consider this a fatal condition, but there is still a chance for survival. If Dai Bing involves liking feces, it is still salvageable. How could eating charcoal be abandoned? Liking feces is due to Spleen/Stomach Qi deficiency, while eating charcoal is due to Liver Qi dryness. All food and drink enter the Stomach and are transformed into waste residue; thus, feces are the remnants of waste residue. Waste residue should be disliked by the Stomach, why does Dai Bing prefer it? It is because Stomach disease causes Qi to descend rather than ascend; thus, disliking ascent and preferring descent, waste residue is what the Stomach descends. Liking feces is liking similar things. However, Dai Bing patients like feces but do not necessarily eat them. If they reach the point of eating feces, it is untreatable, as Stomach Qi has descended to the extreme. Charcoal is the ash of wood. Dai Bing forms from stagnation; stagnation diseases inevitably injure Liver Wood. Liver Wood fire burns and injures the Heart, so Wood is overcome by Heart Fire, the blood in the Liver becomes completely dry, and Wood becomes scorched and withered. Liking and eating charcoal is liking similar things, attempting to save the dryness of Liver Wood. However, the chance for survival lies entirely in eating charcoal. Charcoal originally has no taste, yet eating it feels like maltose; this indicates Stomach Qi is not yet extinct. Treating Stomach Qi and expelling phlegm-saliva can cure Dai Bing. Use the formula Zhuan Dai Dan (Turning Dullness Pill/Decoction):
Ren Shen (1 liang), Bai Shao (Paeoniae Radix Alba) (3 qian), Dang Gui (Angelicae Sinensis Radix) (1 liang), Ban Xia (1 liang), Chai Hu (Bupleuri Radix) (8 qian), Sheng Zao Ren (1 liang), Fu Zi (1 qian), Chang Pu.
Decoct ten bowls of water until one bowl remains. Have a strong person hold the patient's body, two others hold their hands, one supports their jaw, and another inserts a horn tip (without the sharp end) into the mouth to administer the medicine. If they refuse to take it, striking them with a stick to induce anger is acceptable, then administer. After taking the medicine, they will likely curse, then soon become tired and lie down. Allow them to wake up naturally; do not startle them. Waking naturally leads to full recovery; otherwise, only half recovery.
This formula greatly tonifies the Qi and Blood of the Heart and Liver, combined with phlegm-expelling and orifice-opening drugs. The depletion in the Liver is moistened and revives spontaneously; the weakness in the Heart is supplemented and prospers spontaneously. Thus, Heart Qi becomes clear, Liver Qi moves freely, powerfully expelling phlegm-saliva, which flows through the Twelve Meridians. What Dai Bing cannot be cured! If startled awake, Qi and Blood cannot fully circulate, and meridians cannot fully turn, so only half recovery occurs. However, if this decoction is taken again, full recovery is inevitable.
Using Su Xin Tang (Reviving Heart Decoction) for this syndrome is also miraculously effective.
Bai Shao, Dang Gui (each 3 liang), Ren Shen, Fu Ling (Poria) (each 1 liang), Ban Xia, Chao Zhi Zi (Gardeniae Fructus), Chai Hu (each 3 qian), Fu Zi (0.3 qian), Sheng Zao Ren (5 qian), Wu Zhu Yu (Evodiae Fructus), Huang Lian (Coptidis Rhizoma) (each 0.5 fen).
Decoct ten bowls of water until one bowl remains. Administer. Allow natural awakening; upon waking, the illness vanishes.
Some people develop Dai Bing suddenly, not originating from depression/sorrow. Their symptoms are identical to Dai Bing. People think it is spirit possession, but who knows it is due to irregular lifestyle injuring Stomach Qi and phlegm confusing the orifices? The Stomach belongs to Earth, which likes Fire to generate it. However, Fire can generate Earth but also harm Earth. If Fire does not come to generate, Earth lacks vital energy; if Fire comes to generate, Earth has deathly energy. Although the Fire within Earth generates Earth, how can the generator harm the generated? Is it external pathogenic Fire rather than internal proper Fire? Who knows that pathogenic Fire certainly harms Earth, but proper Fire also harms Earth. Proper Fire is the true Fire within Earth; how can it harm Earth? If proper Fire nourishes, it generates Earth to digest food; if proper Fire damages, it harms Earth to form phlegm. Once phlegm forms, it further injures Stomach Earth, causing Fire to confuse the Heart. Mildly, it forms Dai Bing; severely, it causes syncope. Irregular lifestyle causes labor injury in the Stomach, generating phlegm instead of Qi. Sudden Dai Bing is phlegm confusing below the epigastrium, not yet entering the Pericardium. If it enters the Pericardium, death would be immediate. Treatment should generate Stomach Qi and assist with phlegm-resolving agents. Then phlegm confusion can be opened again; there is no need to directly treat Dai Bing. Use the formula Qi Xin Jiu Wei Tang (Awakening Heart and Saving Stomach Decoction):
Ren Shen (1 liang), Fu Ling (1 liang), Bai Jie Zi (Sinapis Semen) (3 qian), Chang Pu (1 qian), Shen Qu (3 qian), Ban Xia (2 qian), Nan Xing (Arisaematis Rhizoma) (2 qian), Huang Lian (1 qian), Gan Cao (1 qian), Zhi Ke (0.5 fen).
Decoct with water and take orally. One dose resolves phlegm, two doses clarify the Spirit, three doses make Dai Bing vanish, and it does not recur.
This formula focuses on saving the Heart, which is precisely saving the Stomach. Because the Stomach is the Child of the Heart; if Heart Qi is clear, how can Stomach Qi not be clear? Mother clear, child also clear. If treated as Dai Bing using Fu Zi to break through directly, Fire aids Fire, leading to instant madness and death. In summary, Dai Bing forms over years, not overnight. Sudden Dai Bing is not true Dai Bing. Therefore, chronic disease requires tonifying Stomach in Fire to resolve phlegm, while acute disease requires tonifying Stomach in Cold to resolve phlegm. This must be known.
Using Zhi Mi Tang (Pointing Out Confusion Decoction) for this syndrome is also effective.
Ren Shen (5 qian), Bai Zhu (1 liang), Ban Xia, Shen Qu (each 3 qian), Nan Xing, Gan Cao (each 1 qian), Chen Pi, Chang Pu (each 0.5 fen), Fu Zi (0.3 fen), Rou Dou Kou (Myristicae Semen) (one piece).
Decoct with water and take orally. Four doses cure.