【歌】谵言歌走忽逾墙，妄自称尊号曰狂。颠者身僵心不乐，须知二证有阴阳。
【论】夫狂者，阳证，其状少卧而不饥，妄言歌笑，逾垣上屋，弃衣奔走，自高贤也，自贵倨也，自辨智
也。癫者，阴证，其状僵仆，直视，意不乐是也。丹溪云∶大率多因痰结于心胸间，治当镇心神，开结痰。有
中邪而得者，以治邪法治之。盖阳虚阴实则癫，阴虚阳实则狂。扁鹊云∶重阴者癫，重阳者狂。故癫狂二证，
阴阳之不同也。
【脉】癫痫之证，阳浮阴沉。数热滑痰，狂发于心。惊风肝痫，弦急可寻，浮病腑浅，沉病脏深。
癫脉搏大滑者生，沉小里急者不治。狂脉实大者生，沉小者死。癫脉虚可治，实则死。
癫证
癫者，癫狂如有所见，经年不愈，心经有损，是为真病。若悲哭呻吟，为邪所凭者，非狂也，用蚕故纸一
味烧灰，好酒调服二钱。癫风麻仁汤。颠疾失心者，宜助心气，用灵苑方。
癫风麻仁汤
麻仁（四升）
水六升，猛火煮七合服。
灵苑方
助心气。
朱砂（一两，研） 枣仁（半两，炒，研） 乳香（半两，研）
上作一服，温酒下，以醉为度，勿令吐，服后便令睡，待其自醒，则神魂安矣。万一惊触，不可复始。
狂证
狂邪者，发作无时，披头大叫，逾垣上屋，不避水火，弃衣奔走，欲杀人，苦参丸。卒狂妄言者，针大拇
指甲上去一韭叶许。大抵狂病，宜大吐、下则可愈，大黄一物汤。
苦参丸
治狂邪大叫。
苦参（不拘多少）
蜜丸，薄荷汤下五十丸。
大黄一物汤
大黄（四两，酒浸一宿）
水三升，煎之，分三服。必数日后，方可与食，但得宁
静，方为吉兆。不可见其瘦弱减食，便以温药补之，及以饮食饱之，病必再作，戒之！戒之！缓与之食，方为
得体，故曰∶损其谷气，则病易愈。所以然者，食入于阴，长气于阳故也。
按∶前二证，必有所因。或因大怒，动其肝风；或因大惊，动其心火；或素有痰，卒为火升，升而不降，
壅塞心窍，神明不得出入，主宰失其号令，心反为痰所役，一时发越。若逾垣上屋，持刃杀人，裸体骂詈，不
避亲疏，飞奔疾走，涉水如陆者，此肝气太旺，木来乘心，名之曰狂，又谓之大癫，法当抑肝镇心，降龙丹主
之。若抚掌大笑，语言不伦，左顾右盼，如见鬼神，片时正性复明，深为赧悔，少倾而状态如故者，此为上膈
顽痰泛滥洋溢，塞其道路，心为之碍。痰少降，则正性复明，痰复升，则又发，名之曰癫，法当利肺安心，安
神滚痰丸主之。
降龙丹
抑肝镇心。
黑铅（一两，熔开，投水银一两，不住手炒，炒至成粉为度，名曰银钞） 朱砂（五钱） 蛇含石（五
钱，火内 过） 金箔（五百片） 银箔（五百片）
研细，丸如芡实大，每服三丸，茯神汤磨化下。
安神滚痰丸
礞石（一两， ） 风化硝（一两） 朱砂（一两） 沉香（五钱） 珍珠（五钱）
共末，煎天麻膏，丸如芡实大，每服三丸，姜汁、竹沥调下。
【歌诀】胡言乱语、唱歌奔走或突然翻越墙垣，妄自称尊称为“狂”。癫证患者身体僵硬、心情不悦，必须知道这两种病证有阴阳的区别。
【论述】所谓狂证，属于阳证。其症状表现为睡眠少且不感到饥饿，胡言乱语、又唱又笑，翻越墙垣、登上屋顶，脱掉衣服奔跑，自认为比贤人还高明，自视高贵傲慢，自夸聪明智慧。所谓癫证，属于阴证。其症状表现为突然僵倒，两眼直视，心情不愉快。朱丹溪说：大率多因痰浊结聚在心胸之间，治疗应当镇安心神，开通结聚之痰。也有因中邪气而得病的，用治邪的方法治疗。大概阳虚阴实则发为癫证，阴虚阳实则发为狂证。扁鹊说：重阴者发为癫证，重阳者发为狂证。所以癫和狂两种病证，阴阳属性是不同的。
【脉诊】癫痫这类病证，阳脉浮而阴脉沉。脉数主热，脉滑主痰，狂证发作源于心经。惊风和肝痫，脉象弦急可以寻得；浮脉主病在腑且病位浅，沉脉主病在脏且病位深。癫证若脉搏大而滑的预后良好，脉搏沉小且里急的预后不良（不治）。狂证若脉实大的预后良好，脉沉小的预后不良（死）。癫证脉虚可治，脉实则预后不良（死）。
癫证
癫证患者，精神恍惚如见异物，经年不愈，这是心经受损，是真病。如果是悲哭呻吟，被邪气附身的，不是狂证，用蚕蜕烧成灰，用好酒调服二钱。使用癫风麻仁汤。对于颠疾导致失心的，应当助益心气，使用灵苑方。
灵苑方
功效：助心气。
朱砂（一两，研细） 酸枣仁（半两，炒，研细） 乳香（半两，研细）
以上为一服量，用温酒送下，以喝醉为限度，不要令其呕吐，服后便让其睡觉，等待其自行醒来，那么神魂就安定了。万一受到惊吓触动，就不能再重新开始治疗了。
狂证
狂邪发作没有固定时间，披头散发大叫，翻越墙垣、登上屋顶，不避水火，脱掉衣服奔跑，想要杀人，使用苦参丸。突然狂妄胡言的，针刺大拇指指甲边缘外约一片韭菜叶宽处。大抵狂病，宜用大吐、大下法即可痊愈，使用大黄一物汤。
苦参丸
治疗狂邪大叫。
苦参（不限多少）
制成蜜丸，用薄荷汤送服五十丸。
大黄一物汤
大黄（四两，酒浸泡一夜）
用水三升，煎煮，分三次服用。必须数日后，才可以进食，只要得到宁静，才是吉兆。不可见到病人瘦弱减少饮食，就用温药补益，以及用饮食使其吃饱，否则病必定复发，切记！切记！缓慢给予食物，才得体，所以说：“损耗其谷气，则病容易痊愈。”之所以这样，是因为食物进入体内化生阴精，滋养阳气的原因。
按语：前两种病证，必定有所起因。或者因为大怒，引动肝风；或者因为大惊，引动心火；或者素来有痰，突然因火气上升，升而不降，壅塞心窍，神明不能出入，主宰失去号令，心反被痰所役使，一时发泄出来。如果翻越墙垣、登上屋顶，持刀杀人，裸体骂詈，不避亲疏，飞奔疾走，涉水如履平地，这是肝气太旺，木来乘心，名叫狂，又称之大癫，治法应当抑制肝气、镇安心神，以降龙丹为主治。如果拍手大笑，言语不合常理，左顾右盼，如见鬼神，片刻之后正性恢复清明，深感羞愧后悔，过一会儿状态又如故，这是上膈顽痰泛滥洋溢，堵塞道路，心为之阻碍。痰稍下降，则正性恢复清明；痰再次上升，则又发病，名叫癫，治法应当利肺安心，以安神滚痰丸为主治。
降龙丹
功效：抑肝镇心。
黑铅（一两，熔化，投入水银一两，不停手翻炒，炒至成为粉末为止，名为银钞） 朱砂（五钱） 蛇含石（五钱，火内煅过） 金箔（五百片） 银箔（五百片）
研细，制成如芡实大小的丸药，每次服用三丸，用茯神汤磨化送下。
安神滚痰丸
礞石（一两，煅） 风化硝（一两） 朱砂（一两） 沉香（五钱） 珍珠（五钱）
共研为末，煎天麻膏，制成如芡实大小的丸药，每次服用三丸，用姜汁、竹沥调下。
[Verse] Delirious speech, singing, running about, or suddenly climbing over walls indicates "Kuang" (Mania). Dian patients have stiff bodies and unhappy hearts; one must know that these two conditions differ in Yin and Yang.
[Discussion] Kuang (Mania) is a Yang syndrome. Its manifestations include little sleep without hunger, delirious speech, singing and laughing, climbing over walls and roofs, discarding clothes and running about, considering oneself superior to sages, arrogant and noble, and boasting of wisdom. Dian (Episodic Psychosis) is a Yin syndrome. Its manifestations include sudden collapse, staring straight ahead, and unhappiness. Zhu Danxi stated: Generally, it is mostly due to phlegm knotting between the heart and chest. Treatment should focus on calming the Shen (Spirit) and resolving phlegm knots. Some cases arise from evil pathogens invading; treat with methods for dispelling evil. Roughly speaking, Yang deficiency with Yin excess leads to Dian; Yin deficiency with Yang excess leads to Kuang. Bian Que said: Heavy Yin leads to Dian; Heavy Yang leads to Kuang. Thus, Dian and Kuang differ in their Yin-Yang nature.
[Pulse Diagnosis] For Dian and Kuang syndromes, Yang pulses are floating and Yin pulses are deep. Rapid pulses indicate heat; slippery pulses indicate phlegm; Kuang originates from the Heart. Jing Feng (Convulsive Wind) and Gan Xian (Liver Epilepsy) present with wiry and rapid pulses; floating pulses indicate superficial disease in the Fu organs; deep pulses indicate deep disease in the Zang organs. Dian with large, slippery pulses indicates survival; deep, small pulses with internal tension indicate untreatability. Kuang with solid, large pulses indicates survival; deep, small pulses indicate death. Dian with deficient pulses is treatable; solid pulses indicate death.
Dian Syndrome
In Dian syndrome, the patient sees hallucinations, unrelenting for years, indicating damage to the Heart channel, constituting a true illness. If crying and moaning due to possession by evil spirits, it is not Kuang. Use one dose of silkworm pupa casing (Can Sha), burned to ash, mixed with good wine and taken orally (2 qian). Use Dian Feng Ma Ren Tang. For dian疾 causing loss of heart-mind, aid Heart Qi using Ling Yuan Fang.
Dian Feng Ma Ren Tang
Hemp Seed (Ma Ren, Semen Cannabisae): 4 sheng
Boil in 6 sheng of water, reduce to 7 he, and take.
Ling Yuan Fang
Function: Aid Heart Qi.
Cinnabar (Zhu Sha, Mineral Cinabaris): 1 liang, ground
Sour Jujube Seed (Suan Zao Ren, Semen Ziziphi Spinosae): 0.5 liang, stir-fried, ground
Frankincense (Ru Xiang, Resina Olibani): 0.5 liang, ground
Take as one dose, swallow with warm wine until intoxicated. Do not induce vomiting. Let the patient sleep immediately after ingestion; when they wake naturally, the Shen will be calm. If startled afterwards, treatment cannot be restarted.
Kuang Syndrome
Kuang evil attacks at any time, with disheveled hair, loud screaming, climbing walls and roofs, disregarding fire and water, discarding clothes and running, desiring to kill others. Use Ku Shen Wan. For sudden delirious speech, needle the area about the width of a leek leaf away from the nail of the great toe. Generally, Kuang can be cured by severe purgation and emesis. Use Da Huang Yi Wu Tang.
Ku Shen Wan
Treats Kuang evil with loud screaming.
Sophora Root (Ku Shen, Radix Sophorae Flavescentis): As needed
Make into honey pills. Take 50 pills with Mint Decoction (Bo He Tang).
Da Huang Yi Wu Tang
Rhubarb Root (Da Huang, Radix et Rhizoma Rhei): 4 liang, soaked in wine overnight
Boil in 3 sheng of water. Divide into three doses. Food should only be introduced after several days. Calmness is an auspicious sign. Do not use warming tonics or force-feed because the patient appears thin or has reduced appetite; otherwise, the disease will relapse. Remember! Remember! Provide food slowly to be appropriate. Thus it is said: "Depleting Gu Qi (Grain Qi) facilitates recovery." This is because food enters to nourish Yin and generates Yang.
Commentary: The preceding two conditions must have causes. They may arise from extreme anger stirring Liver Wind; or extreme fright stirring Heart Fire; or pre-existing Phlegm suddenly rising with Fire, ascending but not descending, obstructing the Heart orifices, preventing the Shen from entering and exiting, causing the ruler to lose command, and the Heart being enslaved by Phlegm, leading to sudden outburst. Symptoms like climbing walls, holding knives to kill, naked cursing, disregarding kinship, running fast, wading through water as if on land indicate excessive Liver Qi, where Wood overacts on Heart. This is called Kuang, also known as Da Dian. The method should suppress Liver and calm Heart, primarily using Jiang Long Dan. Symptoms like clapping hands and laughing, incoherent speech, looking left and right as if seeing ghosts, followed by brief clarity and shame, then returning to previous state, indicate stubborn Phlegm overflowing in the upper Jiao, blocking pathways and hindering the Heart. When Phlegm descends slightly, clarity returns; when it rises again, the attack recurs. This is called Dian. The method should benefit the Lung and calm the Heart, primarily using An Shen Gun Tan Wan.
Jiang Long Dan
Function: Suppress Liver and calm Heart.
Black Lead (Hei Qian, Plumbum): 1 liang, melted, add Mercury (Shui Yin, Hydrargyrum) 1 liang, stir-fry continuously until powder forms, named Yin Chao.
Cinnabar (Zhu Sha, Mineral Cinabaris): 5 qian
Snake-Containing Stone (She Han Shi, Lapis Cum Serpente): 5 qian, calcined in fire
Gold Leaf (Jin Bo): 500 pieces
Silver Leaf (Yin Bo): 500 pieces
Grind finely. Make pills the size of Euphorbia seeds. Take 3 pills per dose, dissolved and swallowed with Spirit of Poria Decoction (Fu Shen Tang).
An Shen Gun Tan Wan
Turquoise Ore (Meng Shi, Lapis Malachitae): 1 liang, calcined
Weathered Nitre (Feng Hua Xiao, Natrii Sulfas Efflorescens): 1 liang
Cinnabar (Zhu Sha, Mineral Cinabaris): 1 liang
Agarwood (Chen Xiang, Aquilariae Lignum Resinatum): 5 qian
Pearl (Zhen Zhu, Margarita): 5 qian
Grind into powder. Prepare Gastrodia Paste (Tian Ma Gao). Make pills the size of Euphorbia seeds. Take 3 pills per dose, mixed with Ginger Juice (Jiang Zhi) and Bamboo Sap (Zhu Li).