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Ping An: This chapter, from beginning to end, is found in Volume 5, Chapter 22 "Dian Kuang" (Mania and Epilepsy) of the *Ling Shu* (Spiritual Pivot), and also in Volume 11, Chapter 2 of the *Jia Yi Jing* (Systematic Classic of Acupuncture and Moxibustion).

To treat mania at its onset, when the patient first exhibits sadness, forgetfulness, mood swings, and susceptibility to fear, which are caused by worry and hunger, treatment involves selecting the Hand Taiyang Small Intestine Meridian (Shou Taiyang Xiaochang Jing) and the Hand Yangming Large Intestine Meridian (Shou Yangming Dachang Jing). Needling should cease when the blood color changes from dark to bright. Additionally, select the Foot Taiyin Spleen Meridian (Zu Taiyin Piyi Jing) and the Foot Yangming Stomach Meridian (Zu Yangming Weijing). (The etiology of mania often begins with severe emotional stagnation due to worry that cannot be resolved in the heart/mind, compounded by deficiency due to hunger, leading to a loss of spirit and mental control. This manifests as sadness, forgetfulness, mood swings, and fear, eventually developing into mania. Although the root cause is a loss of will/spirit, treatment targets the Hand Taiyang meridian associated with the Heart Fu organ and the Hand Yangming meridian associated with the Lung Fu organ. The Foot Taiyin and Foot Yangming meridians govern grain and food essence; tonifying these two meridians can replenish the deficiency caused by worry and hunger. Once the deficiency is resolved, the disease heals. Ping An notes: In the *Ling Shu* and *Jia Yi Jing*, there is a character "ye" (也) after "bei" (sadness). The three instances of "xi" (like/joy) in the *Jia Yi Jing* are written as "shan" (good/capable). The *Ling Shu* reads "ku nu shan kong" (bitter anger, capable of fear). The *Ling Shu* and *Jia Yi Jing* refer to the Hand Taiyin meridian instead of Hand Taiyang.)

When mania first erupts, the patient sleeps little, has no appetite, considers themselves virtuous, wise, and noble, and curses incessantly day and night. Treatment involves selecting the Hand Yangming Large Intestine Meridian, Hand Taiyang Small Intestine Meridian, Hand Taiyin Lung Meridian, and the Foot Shaoyin Kidney Meridian (Zu Shaoyin Shenjing) located under the tongue. Observe the pulses; if they are full/excess, apply reducing methods to all involved; if not full, do not treat. (The Hand Yangming meridian connects to the Lung, and the Hand Taiyang meridian connects to the Heart. The Hand Taiyin meridian belongs to the Lung and governs Qi. Symptoms such as reduced sleep and grandiosity are due to the loss of Po (Corporeal Soul) and excess Qi. Therefore, observe the full pulses and reduce them. Similarly, reduce the excess pulses of the Foot Shaoyin meridian under the tongue. Ping An notes: "Xi ma" (likes to curse) in the *Ling Shu* and *Jia Yi Jing* is written as "shan ma". The word "mai" (pulse) is absent after "shi" (observe) in the *Ling Shu*. In the commentary, the character "hu" (mutually) is written as "yi" (also) in the Yuan edition.)

For patients with mania who exhibit frequent startled laughter, enjoy singing and music, and engage in aimless, unceasing behavior, which is caused by great terror, treatment involves selecting the Hand Yangming Large Intestine Meridian, Hand Taiyang Small Intestine Meridian, and Hand Taiyin Lung Meridian. (These three meridians are the pathways through which mania, startling, laughter, singing, and aimless behavior manifest, which can be deduced. Ping An notes: In the *Ling Shu*, "xi jing xi xiao" (likes to startle and laugh) is written as "yan jing shan xiao". In the *Jia Yi Jing*, it is written as "shan jing shan xiao".)

For patients with mania who see things hallucinatorily, hear sounds hallucinatorily, and like to shout, which arises from deficient Qi, treatment involves selecting the Hand Taiyang Small Intestine Meridian, Hand Taiyin Lung Meridian, Hand Yangming Large Intestine Meridian, Foot Taiyin Spleen Meridian, as well as points on the head and both cheeks. (Mania accompanied by deficient Qi generates these three symptoms; therefore, these four meridians are selected for treatment. Ping An notes: In the *Jia Yi Jing*, "Zu Taiyin" is written as "Zu Taiyang". There is a character "ji" (and) before "tou" (head) in some versions. In the *Ling Shu*, "han" (cheek/jaw) is written as "he".)

Patients with mania who eat excessively, see ghosts and spirits, and smile but do not express it outwardly, are suffering from an episode of extreme joy. Treatment involves selecting the Foot Taiyin Spleen Meridian, Foot Yangming Stomach Meridian, and Foot Taiyang Bladder Meridian, followed by selecting the Hand Taiyin Lung Meridian, Hand Taiyang Small Intestine Meridian, and Hand Yangming Large Intestine Meridian. ("Not expressing it outwardly" means the illness does not manifest openly in front of others. Extreme joy, like severe worry, can trigger mania, but the presentation differs. The hand and foot Taiyin, Yangming, and Taiyang meridians are the therapeutic basis for this condition; thus, points are selected according to the principle of tonification and reduction. Ping An notes: In the *Ling Shu* and *Jia Yi Jing*, "xi jian xi xiao" is written as "shan jian shan xiao", and "fu qu" (again select) is written as "hou qu" (subsequently select).)

For newly erupted mania that has not yet developed the aforementioned symptoms, first select the Ququan point (Ququan, KI3) on either side where the artery is palpable, or any points with full pulses, and bleed them. After approximately the time it takes to eat a meal, if the condition persists, proceed with standard acupuncture and moxibustion protocols, applying twenty moxa cones to the area around the patella. (Ququan is an acupoint on the Foot Jueyin Liver Meridian. Ping An notes: In the *Ling Shu*, "shi qing" (time to eat a meal) is written as "you qing".)