经云。狂始生。先自悲也。喜忘苦怒善恐者。得之忧饥。狂始发。少卧不饥。自高贤也。自
辩智也。自尊贵也。善骂詈。日夜不休。狂言。惊善笑。好歌乐。妄行不休者。得之大恐。狂。
目妄见。耳妄闻。善呼者。少气之所生也。狂者。多食善见鬼神。善
笑而不发于外者。得之有所大喜。足阳明之脉病。恶人与火。闻木音则惕然而惊。病甚则弃衣而
走。登高而歌。甚至不食数日。逾垣上屋。四肢者诸阳之本也。阳盛则四肢实。实则能登高也。
热盛于身。故弃衣欲走也。阳盛则妄言。骂詈不避亲疏。而不欲食。不欲食故妄走也。有怒狂者。
生于阳也。阳者因暴折而难决。故善怒也。病名阳厥。阳明者常动。巨阳少阳不动。不动而动大
疾。此其候也。夺其食则已。夫食入于阴。长气于阳。故夺其食则已。使之服以生铁洛为饮。夫
生铁洛者。下气疾也。
此阳气怫郁。不得疏越。少阳胆木挟三焦相火。太阳阴火上逆。故使人易怒如狂。夺其食者。
不使火助邪也。饮以生铁洛者。金以制木。木平则火降。故曰下气疾也。
狂之为病。皆由阻物过极。故猖狂刚暴。若有邪附。妄为不避水火。骂詈不避亲疏。或言未
尝见之事。非力所能。病反能也。上焦实者。从高抑之。生铁洛饮。阳明实则脉伏。大承气汤去
浓朴加当归、铁洛饮。以大利为度。在上者。因而越之。来苏膏。或戴人三圣散涌吐。其病立安。
后用洗心散、凉膈散调之。形证脉气俱实。当涌吐兼利。胜金丹一服神效。虽数年狂痴。无不克
应。但不可误施于癫痫之证。经云。悲哀动中。则伤魂。魂伤则狂妄不精。不精则不正。当以喜
胜之。以温药补魂之阳。龙齿清魂散。经云。喜乐无极则伤魄。魄伤则狂。狂者意不存。当以恐
胜之。以凉药补魄之阴。清神汤。肺虚喘乏。加沙参。胃虚少食。加人参。肝虚惊恐。加羚羊角。
热入血室。发狂不识人。小柴胡加犀角、生地黄。挟血如见祟状。当归活血汤加酒大黄微下之。
肝盛多怒狂妄者。针大敦。在足大指上。屡验。
一妇人狂言叫骂。歌笑非常。似祟凭根据。一边眼与口角吊起。或作痫治。或作心风治。皆不
效。乃是旧有头风之疾。
风痰作之使然。用芎辛汤加防风。数服顿愈。
妇科郑青山。因治病不顺。沉思辄夜。兼受他医讽言。心甚怀愤。天明病者霍然。愤喜交集。
病家设酌酬之。而讽者已遁。愤无从泄。忽然大叫发狂。同道诸名家治之罔效。一日。目科王道
来往候。索已服未服等方视之。一并毁弃。曰。此神不守舍之虚证。岂豁痰理气清火药所能克效
哉。遂令觅上好人参二两。一味煎汤服之顿安。三啜而病如失。更与归脾汤调理而康。
《黄帝内经》说：狂病刚开始发生时，患者先表现为悲伤。如果容易忘记事情、痛苦愤怒且善于恐惧，这是因忧愁和饥饿所致。
狂病刚发作时，睡眠少且不觉得饥饿，自认为贤能，自认为善辩有智慧，自认为尊贵，喜欢辱骂他人，日夜不停。出现胡言乱语、易受惊吓、喜欢笑、喜好唱歌娱乐、行为妄动不止等症状，这是因大惊恐所致。
狂病表现为眼睛看到不存在的东西，耳朵听到不存在的声音，喜欢呼喊，这是由于气虚所生。狂病患者多吃东西，容易看见鬼神，喜欢笑但笑声不发自内心，这是因大喜所致。
足阳明胃经发生病变时，厌恶人和火光，听到木器的声音就会惊恐不安。病情严重时，会脱掉衣服奔跑，爬上高处歌唱，甚至几天不吃饭，翻越墙垣、登上屋顶。四肢是诸阳经的根本，阳气盛则四肢充实有力，所以能登高。体内热盛，所以脱衣想跑。阳气盛则胡言乱语，骂人不避亲疏，不想吃东西，不想吃东西所以妄动奔跑。
有的怒狂病，生于阳气亢盛。阳气因为突然受挫而难以决断，所以容易发怒。这种病名叫“阳厥”。阳明经通常有脉搏跳动，太阳经和少阳经通常没有明显搏动。如果没有搏动却出现剧烈搏动，这就是其征象。治疗方法是减少饮食即可痊愈。因为食物进入阴分，会助长阳气，所以减少饮食就能使阳气平息。让患者服用以生铁洛（生铁落）为主的药饮。生铁洛具有迅速降气的作用。
这是因为阳气郁结，不能疏泄条达。少阳胆木挟带三焦相火上逆，太阳阴火也上逆，所以使人易怒如狂。减少饮食，是不让食物助长邪火。饮用生铁洛，是利用金克木的原理，木气平和则火势下降，所以说它能迅速降气。
狂病这种病症，都是由外界事物刺激过度引起的，所以表现得猖狂刚暴，好像有邪气附着一样，胡乱行事不避水火，骂人不避亲疏，或者谈论从未见过的事情，本非人力所能做到，但病人反而能做到。
如果是上焦实证，应当用抑制的方法，使用生铁洛饮。如果是阳明腑实证，脉象沉伏，可用大承气汤去掉厚朴，加入当归和铁洛饮，以大便通利为度。病邪在上部的，应当用涌吐法，如来苏膏，或张从正（戴人）的三圣散进行涌吐，病立刻就能好转。之后再用洗心散、凉膈散来调理。
如果形体、证候、脉象、气息都属实证，应当涌吐兼用泻下法，服用胜金丹一剂，效果神奇。即使是几年的狂痴病，没有不能治愈的。但不可误用于癫痫证。
《内经》说：悲哀触动内脏，就会损伤魂。魂受伤则狂妄不精明，不精明则行为不正。应当用喜胜悲的方法来治疗，用温药补益魂的阳气，方用龙齿清魂散。
《内经》又说：喜乐无节制就会损伤魄。魄受伤则发狂，狂者意念不存。应当用恐胜喜的方法来治疗，用凉药补益魄的阴气，方用清神汤。
肺虚喘乏的，加沙参；胃虚食少的，加人参；肝虚惊恐的，加羚羊角。
热邪侵入血室，导致发狂不识人，用小柴胡汤加犀角、生地黄。如果挟带瘀血，像见到鬼祟一样的症状，用当归活血汤加酒大黄轻微泻下。
有一个妇人胡言乱语、叫骂、歌笑异常，好像被鬼神附身，一边眼睛和口角向上吊起。有人按痫病治疗，有人按心风治疗，都不见效。这其实是旧有的头风疾病，由风痰引发所致。用芎辛汤加防风，服几剂后立刻痊愈。
妇科医生郑青山，因为治病不顺心，沉思至深夜，又兼受其他医生讽刺言语，心中非常愤恨。天亮时病人霍然痊愈，郑医生既愤恨又喜悦交集。病人家属设宴酬谢他，而讽刺他的人已经逃遁。他的愤恨无处发泄，忽然大叫发狂。同道的各位名医治疗都没有效果。一天，眼科医生王道来访探视，索要已服和未服的药方查看，一并销毁扔掉，说：“这是神不守舍的虚证，哪里是豁痰、理气、清火的药物所能奏效的呢？”于是让人寻找上等好人参二两，单味煎汤服用，立刻安宁。连服三次，病如同消失。再给予归脾汤调理而康复。
The *Classic of Difficult Issues* (Nan Jing) states: When mania (Kuang) first arises, the patient initially presents with sadness. If the patient suffers from forgetfulness, painful anger, and frequent fear, this is caused by worry and hunger.
When mania first erupts, the patient sleeps little and feels no hunger, considers themselves virtuous, claims to be eloquent and wise, and regards themselves as noble. They frequently curse others, day and night without rest. Presenting with delirious speech, easily startled, laughing excessively, enjoying singing and music, and engaging in aimless continuous movement, this is caused by great fright.
Mania manifests as visual hallucinations (seeing what is not there), auditory hallucinations (hearing what is not there), and frequent shouting; these are generated by deficiency of Qi. Manic patients eat large amounts, often see spirits or ghosts, laugh but do not express genuine joy externally; this is caused by excessive joy.
When the Foot-Yangming Stomach Meridian is diseased, the patient dislikes people and fire, and is startled upon hearing the sound of wood. In severe cases, they discard their clothes and run, climb high places and sing, and may even go several days without eating, jumping over walls and climbing onto roofs. The four limbs are the root of all Yang meridians. When Yang is excess, the four limbs become solid and strong, thus enabling climbing. Heat excess in the body causes the desire to discard clothes and run. Yang excess leads to delirious speech and cursing without regard for kinship or distance. The lack of desire to eat leads to aimless running.
Some cases of rage-manial disorder arise from Yang excess. Yang, having been suddenly frustrated and unable to resolve smoothly, leads to irritability. This disease is named "Yang Jue" (Yang Reversal). The Yangming meridian normally has a palpable pulse, whereas the Taiyang and Shaoyang meridians do not typically show distinct pulsation. If the latter show vigorous pulsation where none should exist, this is the clinical sign. The treatment is to restrict food intake, which resolves the condition. Since food enters the Yin aspect and generates Qi in the Yang aspect, restricting food allows the Yang to subside. Administer a decoction containing Sheng Tie Luo (Ferrum Depuratum, Desiccated Iron). Sheng Tie Luo has the effect of rapidly descending rebellious Qi.
This occurs because Yang Qi is constrained and depressed, unable to diffuse freely. Shaoyang Gallbladder Wood carries Sanjiao Ministerial Fire upward, and Taiyin Yin Fire also rebels upward, causing irritability resembling mania. Restricting food prevents nourishment from aiding the pathogenic fire. Drinking Sheng Tie Luo utilizes Metal to control Wood; when Wood is balanced, Fire descends. Hence it is said to rapidly descend Qi.
Mania arises from extreme stimulation by external objects, resulting in reckless and violent behavior, as if possessed by evil spirits. Patients act recklessly without avoiding fire or water, curse without regard for relationships, or speak of things never seen. These actions exceed normal human capability but are performed by the patient.
If the Upper Jiao is full/excess, suppress it using Sheng Tie Luo Yin. If Yangming Fu-organ excess is present with a submerged pulse, use Da Cheng Qi Tang (Major Order the Qi Decoction) removing Hou Po (Magnolia Bark), adding Dang Gui (Angelica Sinensis) and Tie Luo Yin (Iron Decoction), aiming for significant purgation. For pathogens located superiorly, induce vomiting using Lai Su Gao or Dai Ren’s San Sheng San (Three Holy Powders); the illness will immediately improve. Subsequently regulate with Xi Xin San (Wash the Heart Powder) and Liang Ge San (Cool the Diaphragm Powder).
If physical form, symptoms, pulse, and Qi are all excess, employ both emesis and purgation. One dose of Sheng Jin Dan (Winning Gold Pill) yields miraculous results. Even chronic mania lasting years can be cured. However, do not mistakenly apply this to epilepsy.
The *Classic* states: Sadness moving internally injures Hun (Ethereal Soul). Injury to Hun leads to madness and lack of clarity; lack of clarity leads to improper conduct. Treat by overcoming sadness with joy, using warm medicines to tonify the Yang of Hun. Use Long Chi Qing Hun San (Dragon Tooth Clearing Hun Powder).
The *Classic* further states: Unrestrained joy injures Po (Corporeal Soul). Injury to Po leads to mania, where intent is lost. Treat by overcoming joy with fear, using cool medicines to tonify the Yin of Po. Use Qing Shen Tang (Clear Spirit Decoction).
For Lung deficiency with panting and fatigue, add Sha Shen (Glehnia Root). For Stomach deficiency with poor appetite, add Ren Shen (Ginseng Root). For Liver deficiency with fright and anxiety, add Ling Yang Jiao (Antelope Horn).
When heat enters the Blood Chamber (Xue Shi), causing mania and inability to recognize persons, use Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Xi Jiao (Rhinoceros Horn - note: substitute with Buffalo Horn in modern practice) and Sheng Di Huang (Rehmannia Root). If accompanied by blood stasis presenting as seeing malevolent spirits, use Dang Gui Huo Xue Tang (Angelica Invigorating Blood Decoction) added with Jiu Da Huang (Wine-processed Rhubarb) for mild purgation.
For Liver excess with much anger and mania, needle Da Dun (LR1, Great Surge), located on the dorsal side of the big toe. This has proven effective repeatedly.
A woman presented with delirious speech, cursing, and abnormal laughter, appearing possessed. One eye and the corner of her mouth were drawn upward. Treatment as epilepsy or Heart Wind was ineffective. This was actually an old headache disorder exacerbated by Wind-Phlegm. Using Xiong Xin Tang (Ligusticum and Asarum Decoction) added with Fang Feng (Saposhnikovia Root), she recovered after a few doses.
Zheng Qingshan, a gynecologist, became deeply contemplative due to unsuccessful treatments and suffered verbal abuse from other physicians. At dawn, his patient recovered abruptly. Zheng felt a mix of resentment and joy. While the family hosted a banquet to thank him, the abuser had fled. With no outlet for his resentment, he suddenly shouted and went mad. Renowned colleagues failed to treat him. Wang Dao, an ophthalmologist, visited, examined the prescribed and unprescribed formulas, destroyed them, and stated: "This is a deficiency syndrome where the Spirit does not reside in its house; how could phlegm-resolving, Qi-regulating, or fire-clearing herbs succeed?" He ordered two taels of high-quality Ren Shen (Ginseng Root), decocted alone and administered. The patient calmed immediately. After three doses, the illness vanished. He was then regulated with Gui Pi Tang (Restore the Spleen Decoction) until recovery.