痉 者，虽似于痫，而实更重于痫也。其症有二∶一曰刚 。刚 者，发时谵语，
面红眼赤，摇头螈 ，牙紧手张，项背强直，痰涎壅盛，卒为噤口，昏愦烦渴，小便
赤涩，身热无汗，而反恶寒者是也。一曰柔 。柔 者、大便滑泻，不语不渴，必手
足冷而后身热汗出，而不恶寒者是也。《经》曰∶肺移热于肾为柔 。夫肺主气，肾主
骨，有因伤寒四五六日，寒已伏内而为热，热移于肺，肺为肾母，故传于子，肾又传
子，而热移肝，是以筋骨受热，乃迟缓不收，手足无力，而为柔 矣。如发热无汗，
此为表实，治宜汗之。发热汗出，是为表虚，此不可汗。若再汗之，必致阳亡。《经》
曰∶阳气者，精则养神，柔则养筋。过汗则阳亡，阳亡则不能养筋，而 病愈甚矣。
况《经》曰∶诸暴强直，皆属于风；诸痉项强，皆属于湿。此原不可以散风发汗为治
也。又有谵语口干，痰涎烦渴，大便滑泻，手足微寒，此乃刚柔不分之症，治法须顺气
消痰，痰消则风散，气顺则神清。又曰∶举身强直，谵语昏睡反张，终日不醒者，为痉
为刚。如手足冰冷而无力，大便滑泻不语不渴者，为 为柔，总至重之候，十难救一二也。
颠狂者，似痫非痫，似痉 又非痉 ，发则异常，或啼或哭，乍喜乍悲，是谓之
颠。如妄言不食而歌，弃衣而走，是谓之狂。书曰∶多喜为颠，多怒为狂。又曰∶重
阴则颠，重阳则狂怒也。如发时卧地，嚼舌吐沫，或作猪羊等声，发而身软时醒者，此
亦痫症也。然五痫痉 颠狂等证，名虽异而原则同，并宜急治。如少缓之，则风涎流
滞经络而不退，必致损伤于心，心伤则神去，神去则死，纵得侥幸于万一，亦必语滞
少神，已亡其智而为废人矣。
痉病，虽然看起来像痫病，但实际上比痫病更严重。它的症状分为两类：一类叫刚痉。刚痉的表现是：发作时胡言乱语，面色红、眼睛赤红，摇头抽搐，牙关紧闭、双手张开，颈项和背部僵硬挺直，痰涎壅盛堵塞咽喉，突然不能开口说话，神志昏迷、烦躁口渴，小便短赤涩痛，身体发热且无汗，反而怕冷。另一类叫柔痉。柔痉的表现是：大便稀溏滑泄，不说话也不口渴，一定是手脚冰冷之后才出现身体发热出汗，而且不怕冷。《黄帝内经》说：肺部的热邪转移到肾脏，就形成柔痉。因为肺主气，肾主骨，有的因为伤寒病经过四五六天，寒邪潜伏在体内化为热邪，热邪移注于肺，肺为肾之母（金生水），所以传给了子脏（肾），肾又传给其子脏（肝），导致热邪移入肝脏，因此筋骨受热，变得迟缓松弛无法收持，手脚无力，从而形成柔痉。如果发热但无汗，这属于表实证，治疗应当用发汗法。如果发热且有汗出，这属于表虚证，此时不可用发汗法。如果再强行发汗，必然导致阳气亡失。《黄帝内经》说：阳气，精微部分滋养精神，柔和部分滋养筋脉。过度发汗会导致阳气亡失，阳气亡失就不能滋养筋脉，那么痉病就会更加严重。况且《黄帝内经》又说：所有的突然发生的强直症状，都归属于风；所有的痉病颈项强直，都归属于湿。这说明原本就不可以用疏散风邪、发汗的方法来治疗。又有表现为胡言乱语、口干、痰涎多、烦躁口渴、大便稀溏滑泄、手脚微微发冷的，这是刚痉与柔痉界限不清的症状，治疗方法必须顺气消痰，痰消则风邪自散，气顺则神志清醒。又说：全身强直，胡言乱语、昏睡且身体反张，整天不醒的，称为痉病中的刚痉。如果手脚冰冷且无力，大便稀溏滑泄、不说话也不口渴的，称为柔痉，这都是极其危重的征候，十个人中难得救活一两个。
癫狂病，看起来像痫病但不是痫病，看起来像痉病又不是痉病，发作时表现异常，有时啼哭有时欢笑，忽喜忽悲，这叫做癫。如果胡言乱语、不吃东西却唱歌，扔掉衣服到处跑，这叫做狂。医书说：多喜笑的为癫，多愤怒的为狂。又说：阴气过重则发癫，阳气过重则发狂怒。如果发作时卧倒在地，咬破舌头吐沫，或者发出猪羊等动物的叫声，发作后身体松软时而清醒的，这也是痫病。然而五痫、痉病、癫狂等证候，名称虽然不同，但根本原则相同，都应当紧急治疗。如果稍微拖延，风邪和痰涎就会流滞于经络而不能消退，必定会损伤心脏，心脏受损则神气离去，神气离去则死亡，即使万幸保住性命，也必定言语迟钝、神采缺失，已经丧失智慧成为废人。
Jing (Spasm) disease, although resembling Xian (Epilepsy), is in reality more severe than Xian. Its symptoms are divided into two types: one is called Gang Jing (Rigid Spasm). The manifestations of Gang Jing include: delirium during attacks, red face and red eyes, head shaking with convulsions, clenched teeth and open hands, stiffness and rigidity of the neck and back, excessive accumulation of phlegm and saliva, sudden inability to speak (Jin Kou), coma, irritability, and thirst, scanty and painful urination, fever without sweat, and aversion to cold. The other type is called Rou Jing (Flexible Spasm). The manifestations of Rou Jing include: loose and slippery diarrhea, silence, absence of thirst, coldness of the hands and feet preceding fever and sweating, and absence of aversion to cold. The *Classic* states: "When heat from the Lung transfers to the Kidney, it forms Rou Jing." The Lung governs Qi, and the Kidney governs bones. In cases of Shanghan (Cold Damage) lasting four to six days, cold pathogens may have latent inside and transform into heat; this heat transfers to the Lung. Since the Lung is the mother of the Kidney (Metal generates Water), the pathogen transmits to the Kidney, and then to its offspring, the Liver. Thus, heat transfers to the Liver, causing the sinews and bones to be affected by heat, resulting in flaccidity and inability to contract, weakness of the limbs, thereby forming Rou Jing. If there is fever without sweat, this indicates a Excess pattern at the Exterior level, and treatment should employ diaphoresis (sweating method). If there is fever with sweating, this indicates a Deficiency pattern at the Exterior level, and diaphoresis must not be used. If diaphoresis is forced again, it will inevitably lead to the loss of Yang Qi. The *Classic* states: "Yang Qi, when refined, nourishes the Shen (Spirit); when soft, it nourishes the sinews." Excessive sweating leads to the loss of Yang Qi; once Yang Qi is lost, it cannot nourish the sinews, and the Jing disease becomes more severe. Moreover, the *Classic* states: "All sudden rigidity belongs to Wind; all spasms with neck stiffness belong to Dampness." This implies that dispersing Wind and inducing sweating are not appropriate treatments. Another presentation involves delirium, dry mouth, excessive phlegm, irritability, thirst, loose diarrhea, and slightly cold hands and feet; this represents an indistinct boundary between Gang and Rou Jing. The treatment method must regulate Qi and resolve phlegm; when phlegm resolves, Wind dissipates, and when Qi regulates, Shen clarifies. It is also stated: "Generalized rigidity, delirium, lethargy, opisthotonos, and unconsciousness throughout the day constitute Gang Jing. Cold hands and feet with weakness, loose diarrhea, silence, and absence of thirst constitute Rou Jing. These are both critical conditions, where only one or two out of ten may be saved."
Dian Kuang (Mania and Depression) resembles Xian but is not Xian, and resembles Jing but is not Jing. During attacks, abnormal behaviors occur, such as crying or laughing, alternating between joy and sorrow; this is called Dian (Depression/Manic Depression). If the patient speaks nonsense, refuses food yet sings, discards clothes, and runs around, this is called Kuang (Mania). Medical texts state: "Excessive joy constitutes Dian; excessive anger constitutes Kuang." It is also said: "Excess Yin leads to Dian; Excess Yang leads to Kuang and anger." If during an attack the patient lies on the ground, bites the tongue, foams at the mouth, or makes sounds like pigs or sheep, and becomes flaccid and occasionally lucid after the attack, this is also considered Xian disease. However, for the five types of Xian, Jing, Dian, and Kuang, although the names differ, the underlying principles are the same, and urgent treatment is required. If treatment is delayed even slightly, Wind and Phlegm will stagnate in the meridians and fail to recede, inevitably damaging the Heart. When the Heart is damaged, the Shen departs; when the Shen departs, death ensues. Even if one miraculously survives, they will likely suffer from slurred speech and lack of spirit, having lost their intellect and become incapacitated.