《难经》曰∶狂之始发，少卧而不饥，自高贤也，自辩智也，自贵倨也，妄笑好歌乐，妄行不休
是也。《素问·病能》篇，帝曰∶有病怒狂者，此病安生？岐伯曰∶生于阳也。阳气者，暴折而难决，
故善怒，病名曰阳厥。曰何以知之？曰阳明者常
动，巨阳、少阳不动，不动而动大疾，此其候也。治之夺其食即已。夫食入于阴，长气于阳，故夺其
食即已。使之服以生铁落为饮，夫生铁落者，下气疾也。（阳气怫郁而不得疏越，少阳胆木挟三焦少
阳相火、巨阳阴火上行，故使人易怒如狂。其巨阳、少阳之动，脉可诊也。夺其食，不使胃火复助其
邪也。饮以生铁落，金以制木也。木平则火降，故曰下气疾速。气即火也。）阳明脉解篇，帝曰∶阳
明病甚则弃衣而走，登高而歌，或至不食数日，逾垣上屋，所上之处，皆非其素所能也，病反能者何
也？岐伯曰∶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
则使人妄言骂詈，不避亲疏，而不欲食，不欲食，故妄走也。（脉解篇云∶阳明所谓病甚则欲乘高而
歌，弃衣而走者，阴阳复争，而外并于阳，故使之弃衣而走也。）治法，上实者，从高抑之。生铁落
饮、抱胆丸、养正丹。在上者，因而越之。瓜蒂散、来苏膏。子和治一人落马发狂，以车轴埋之地中，
约高二丈许，上安中等车轮，其辋上 一穴，如作盆之状，缚病患在其上，使之伏卧，以软 衬之，
又令一人于下坐，机一枚，以棒搅之，转千百遭，病患吐出青黄涎沫一二斗许，病患自言不堪，因解
之，索水，与冰水饮数升而愈。阳明实则脉伏，宜下之，大承气汤、（海藏治许氏病
阳厥狂怒，骂詈亲疏，或哭或歌，六脉举按无力，身表如冰石，发即叫呼声高，因不与之食，用大承
气汤下之，得渣秽数升，狂稍宁，数日复发，复下，如此五七次，行大便数斗，疾瘥，身温脉生良愈。
此易老夺食之法也。）当归承气汤（《保命集》云∶若阳狂奔走，骂詈不知亲疏，此阳有余阴不足，
大黄、芒硝去胃中实热，当归补血益阴，甘草缓中，加姜枣者，胃属土，此引入胃中也。经所谓微者
逆之，甚者从之，此之谓也。）以大利为度。微缓以瓜蒂散，入防风末、藜芦末吐之，其病立安。后
用调心散、洗心散、凉膈散、解毒汤等调之。（子和治一人，以调胃承气大作汤，下数十行，三五日
复上涌一二升，三五日复下之。凡五六十日下百余行，吐亦七八度，如吐时，暖室置火，以助其汗。
此三法并施例也。）郁者发之。（子和治一叟，年六十，值徭役烦扰而暴发狂，口鼻觉如虫行，两手
爬搔，数年不已，诊其脉两手皆洪大如 ，断之曰，肝主谋，胆主决，徭役迫遽，财不能支，则肝屡
谋而胆屡不能决，屈无所伸，怒无所泄，心火盘薄，乘阳明金，然胃本属土，而肝属木，胆属相火，
火随木气而入胃，故暴发狂。乃命置燠室中涌而汗出，如此三次。《内经》曰∶木郁则达之，火郁则
发之，正谓此也。又以调胃承气汤半斤，用水五升，煎半沸，分作三服，大下二十行，血水与瘀血相
杂而下数升，来日乃康，以通圣散调其后。）虚者补之。宁志膏、一醉膏、辰砂散。盖狂之为病少卧，
少卧则卫独行阳不行阴，故阳盛阴虚。今昏其神得睡，则卫得入于阴，而阴得卫填不虚，阳无卫助不
盛，故阴阳均平而愈矣。经云∶悲哀动中则伤魂，魂伤则狂妄不精，不精则不正，此悲哀伤魂而狂，
当以喜胜之，以温药补魂之阳。
（娄云∶仲景防己地黄汤，《本事》惊气丸之类是也。）经云∶喜乐无极则伤魄，魄伤则狂，狂者意不
存人，此喜乐伤魄而狂，当以恐胜之，以凉药补魄之阴。（娄云∶辰砂、郁金、白矾之类是也。）初
虞世用苦参末蜜丸桐子大，每服十丸，薄荷汤化下。盖子午乃少阴君火对化，故药之味苦而气寒者，
类能助水而抑火。诸躁狂越，皆属于火。故苦参一味能疗之。戴院使主治痰宁心，用辰砂妙香散，加
金箔、真珠末，杂青州白丸子末，浓姜汤调下，吞十四友丸。滑石六一汤，加真珠末，白汤调下。热
入血室，发狂不认人，牛黄膏主之。《金匮》云∶病如狂状妄行，独语不休，无寒热，其脉浮，防己
地黄汤主之。有妇人狂言叫骂、歌笑不常，似祟凭根据，一边眼与口角吊起，或作狂治，或作心风治，
皆不效。乃是旧有头风疾，风痰使然。用芎辛汤加防风，数服顿愈。
《难经》说：狂病刚开始发作时，患者睡眠很少且不觉得饥饿，自认为贤能、自认为聪明机智、自视高贵傲慢，无故发笑、喜欢唱歌娱乐，行为妄为不停止。这就是狂病的表现。
《素问·病能论》篇中，黄帝问：有人患怒狂病，这种病是怎么产生的？岐伯回答：产生于阳分。阳气受到突然挫折而难以疏泄，所以容易发怒，这种病名叫“阳厥”。黄帝问：怎么知道是这种情况呢？岐伯说：阳明脉通常搏动，太阳脉和少阳脉通常不搏动，如果不搏动的脉出现剧烈搏动，这就是其征象。治疗的方法是限制饮食即可痊愈。因为食物进入胃中转化为阴气，会助长阳气，所以限制饮食就能使病情好转。（注：这是因为阳气郁结而不能疏泄，少阳胆木挟带三焦相火、太阳阴火上炎，所以使人易怒如狂。其太阳、少阳脉的异常搏动可以通过诊脉发现。限制饮食，是为了不让胃火再次助长邪气。服用生铁落饮，是利用金来克制木。木气平和则火势下降，所以说它能迅速降气。这里的“气”即指“火”。）
《灵枢·阳明脉解》篇中，黄帝问：阳明病严重时，患者会脱掉衣服奔跑，登上高处唱歌，或者几天不吃东西，翻墙越屋，所去的地方都是他平时做不到的，病情反而使他具备这些能力，这是为什么呢？岐伯回答：四肢是诸阳经的根本，阳气旺盛则四肢充实有力，有力就能登高。体内热盛，所以脱掉衣服想要奔跑。阳气旺盛会使患者胡言乱语、辱骂他人，不顾及亲疏关系，并且不想吃东西，不想吃东西所以四处乱跑。（注：《脉解篇》说：阳明病严重时想登高处唱歌、脱衣奔跑，是因为阴阳相互争斗，阳气外并于体表，所以使人脱衣奔跑。）
治疗方法：对于上部实证的，采用从高处置抑的方法。可用生铁落饮、抱胆丸、养正丹。对于病邪在上的，采用因势利导涌吐的方法。可用瓜蒂散、来苏膏。
张子和曾治疗一个从马上摔下后发狂的人，他在地下埋入一根车轴，大约高二丈，上面安装一个中等大小的车轮，轮辐上有一个洞，形状像盆一样，将病人绑在上面，让他俯卧，下面垫软物。又让一人在下面坐着，手持机关，用棒子搅动车轮，转动千百次，病人吐出青黄色的涎沫一两斗左右，病人自己说受不了，于是解开束缚，索要水喝，给他喝了几升冰水，病就好了。
阳明实证脉象沉伏，适宜用泻下法，可用大承气汤。（海藏治疗许氏患阳厥狂怒，骂人不分亲疏，有时哭有时歌，六脉举按无力，身体表面像冰石一样冷，发病时叫声高亢，因此不给他吃东西，用大承气汤泻下，排出污秽物几升，狂躁稍平，几天后复发，再次泻下，如此反复五六次，排大便数斗，疾病痊愈，身体回暖，脉象恢复，良愈。这是李东垣夺食疗法的应用。）当归承气汤（《保命集》说：如果阳狂奔走，骂人不知亲疏，这是阳有余而阴不足，大黄、芒硝去除胃中实热，当归补血益阴，甘草缓和药性，加生姜大枣，是因为胃属土，以此引入胃中。经文所说的“病轻者逆治，病重者从治”，就是这个意思。）以大便通畅大量排泄为度。若脉象微缓，用瓜蒂散加入防风末、藜芦末进行涌吐，病立即安定。之后用调心散、洗心散、凉膈散、解毒汤等调理。（张子和治疗一人，用调胃承气汤做成浓剂，泻下几十次，三五天后再次涌吐一二升，三五天后再泻下。总共五十多天泻下一百多次，呕吐七八次。呕吐时，在温暖的房间生火，以助出汗。这是攻下、涌吐、发汗三法并用的例子。）
对于气机郁结的，采用发散的方法。（张子和治疗一位六十岁的老人，正值徭役烦扰而突发狂病，口鼻感觉像有虫子爬，双手抓挠，几年不好。诊察他的脉象，两手都洪大有力。诊断说：肝主谋虑，胆主决断。徭役紧迫，财力不能支撑，导致肝屡次谋虑而胆屡次无法决断，委屈无处伸展，愤怒无处发泄，心火郁结，侵犯阳明金气。然而胃本属土，肝属木，胆属相火，火随木气进入胃中，所以突发狂病。于是让人准备暖室，进行涌吐并令其出汗，如此三次。《内经》说：“木郁则达之，火郁则发之”，正是说的这种情况。又用调胃承气汤半斤，用水五升，煎煮至半沸，分三次服用，大泻二十次，血水与瘀血混杂而下数升，第二天就康复了，后用通圣散调理善后。）
对于虚证的，采用补益的方法。可用宁志膏、一醉膏、辰砂散。大概狂病表现为睡眠少，睡眠少则卫气独行于阳分而不行于阴分，所以阳气盛而阴虚。现在通过安神使其入睡，则卫气得以进入阴分，阴气得卫气填充而不虚，阳气没有卫气辅助就不盛，所以阴阳平衡而痊愈。经文说：悲哀触动内心则伤魂，魂伤则狂妄不精明，不精明则行为不正，这是悲哀伤魂导致的狂病，应当用喜胜悲，用温药补魂之阳。（娄全善说：仲景的防己地黄汤，《本事方》的惊气丸之类就是这类方法。）经文说：喜乐无节制则伤魄，魄伤则狂，狂者心中无人，这是喜乐伤魄导致的狂病，应当用恐胜喜，用凉药补魄之阴。（娄全善说：辰砂、郁金、白矾之类就是这类方法。）
初虞世用苦参末制成蜜丸，大小如梧桐子，每次服十丸，薄荷汤送下。因为子午之时对应少阴君火，所以药物味苦气寒的，大多能助水抑火。各种躁动狂越的症状，都属于火。所以单味苦参就能治疗。戴院使主治痰浊宁心，用辰砂妙香散，加入金箔、真珠末，混合青州白丸子末，用浓姜汤调服，吞服十四友丸。滑石六一汤，加入真珠末，白开水调服。热邪侵入血室，发狂不认识人，用牛黄膏主治。《金匮要略》说：病人像发狂的样子，胡乱行走，独自说话不停，没有寒热症状，脉象浮，用防己地黄汤主治。有个妇人胡言乱语、叫骂、歌笑无常，好像被鬼神附体，一边眼睛和嘴角吊起，有人按狂病治，有人按心风治，都不见效。这其实是旧有的头风疾，由风痰引起。用芎辛汤加防风，几服药后立刻痊愈。
The *Nan Jing* (Classic of Difficult Issues) states: When mania first begins, the patient sleeps little and feels no hunger; they consider themselves virtuous, clever, and wise, and arrogant and noble; they laugh foolishly, enjoy singing and music, and engage in erratic behavior without cessation. This is the manifestation of mania.
In Chapter "Bing Neng" (Disease Capabilities) of the *Su Wen* (Basic Questions), the Yellow Emperor asked: There is a person suffering from anger-induced mania; how does this disease arise? Qibo replied: It arises from Yang. The Yang Qi suffers sudden frustration and is difficult to resolve, thus leading to frequent anger; this disease is named "Yang Jue" (Yang Reversal). The Yellow Emperor asked: How do we know this? Qibo said: The Yangming pulse usually throbs, while the Taiyang and Shaoyang pulses usually do not. If the non-throbbing pulses exhibit vigorous throbbing, this is the sign. The treatment is to deprive the patient of food, which will cure it. Because food enters the Yin [stomach/intestines] and generates Qi for the Yang, depriving the patient of food will resolve the condition. (Note: This is because Yang Qi is stagnant and cannot be dispersed. The Shaoyang Gallbladder Wood carries the Sanjiao Ministerial Fire and the Taiyang Yin Fire upward, causing irritability akin to mania. The abnormal throbbing of the Taiyang and Shaoyang pulses can be diagnosed via pulse taking. Depriving food prevents Stomach Fire from further assisting the pathogen. Administering Sheng Tie Luo Yin [Raw Iron Filings Decoction] utilizes Metal to control Wood. When Wood is balanced, Fire descends, hence it is described as rapidly descending Qi. Here, "Qi" refers to "Fire".)
In Chapter "Yangming Mai Jie" (Explanation of the Yangming Pulse) of the *Ling Shu* (Spiritual Pivot), the Yellow Emperor asked: When Yangming disease is severe, the patient discards clothes and runs, climbs high places and sings, or goes several days without eating, climbing walls and roofs—places they could never reach before. The illness paradoxically enables these abilities. Why is this? Qibo replied: The four limbs are the root of all Yang meridians. When Yang is excessive, the four limbs become solid and strong, enabling one to climb high. Heat is excessive in the body, so the patient discards clothes and wishes to run. Excessive Yang causes the patient to speak wildly, curse others regardless of intimacy, and lack appetite. Due to the lack of appetite, they wander erratically. (Note: The "Mai Jie" chapter states: For Yangming disease where the patient desires to climb high and sing, or discard clothes and run, it is due to the struggle between Yin and Yang, with Yang merging outwardly on the exterior, causing the patient to discard clothes and run.)
Treatment methods: For excess patterns in the upper jiao, use suppression from above. Formulas include Sheng Tie Luo Yin [Raw Iron Filings Decoction], Bao Dan Wan [Gallbladder-Embracing Pill], and Yang Zheng Dan [Supporting Righteousness Pill]. For pathogens located in the upper jiao, use emesis according to their location. Formulas include Gua Di San [Melon Sepal Powder] and Lai Su Gao [Lai Su Ointment].
Zi Hehe once treated a patient who fell from a horse and developed mania. He buried a cart axle in the ground, approximately two zhang high, and placed a medium-sized wheel on top. One spoke hole was shaped like a basin. The patient was bound to the wheel, lying prone, cushioned with soft material. Another person sat below, operating a mechanism to rotate the wheel hundreds or thousands of times. The patient vomited one to two dou of green-yellow phlegm-saliva. The patient complained of unbearable discomfort, so he was released, requested water, and drank several sheng of ice water, after which he recovered.
For Yangming excess patterns with a deep pulse, purgation is appropriate. Use Da Cheng Qi Tang [Major Order the Qi Decoction]. (Haizang treated Mr. Xu for Yang Jue mania, cursing relatives and strangers, crying or singing intermittently. His six pulses were weak upon lifting and pressing. His body surface was cold as ice. Upon onset, his cries were loud. Therefore, food was withheld, and Da Cheng Qi Tang was administered to purge. Several sheng of fecal matter were expelled, and the mania subsided slightly. However, it recurred after a few days, requiring repeated purgation five or seven times. Several dou of stool were passed, and the disease resolved. The body warmed, and the pulse returned to normal, indicating good recovery. This applies Li Dongyuan's method of food deprivation.) Dang Gui Cheng Qi Tang [Angelica Sinensis Order the Qi Decoction] (*Bao Ming Ji* states: If the patient runs wildly in Yang mania, cursing without recognizing kin, this indicates excess Yang and insufficient Yin. Da Huang and Mang Xiao clear excess heat in the stomach; Dang Gui nourishes blood and benefits Yin; Gan Cao moderates the middle; Ginger and Jujube are added because the Stomach belongs to Earth, guiding the herbs there. As the classics state, "Treat mild cases by opposing them, treat severe cases by following them," this is what is meant. The goal is significant diarrhea. If the pulse is slightly slow, use Gua Di San with Fang Feng powder and Li Lu powder to induce vomiting, bringing immediate relief. Subsequently, regulate with Tiao Xin San [Regulate Heart Powder], Xi Xin San [Wash Heart Powder], Liang Ge San [Cool the Diaphragm Powder], and Jie Du Tang [Detoxify Toxins Decoction]. (Zi Hehe treated one patient by making Tiao Wei Cheng Qi Tang [Regulate the Stomach Order the Qi Decoction] into a strong decoction, purging dozens of times. After three to five days, he induced vomiting of one to two sheng. After another three to five days, he purged again. Over fifty to sixty days, he purged over a hundred times and vomited seven or eight times. During vomiting, he used a warm room with fire to promote sweating. This is an example of combining purgation, emesis, and diaphoresis.)
For stagnation, use dispersing methods. (Zi Hehe treated a sixty-year-old man who suddenly developed mania due to stressful corvée labor. He felt insects crawling on his nose and mouth and scratched his hands incessantly for years. His pulses were both large and forceful. Diagnosis: The Liver governs planning, and the Gallbladder governs decision-making. Under urgent pressure and financial strain, the Liver planned repeatedly but the Gallbladder failed to decide. Grievance had no outlet, anger had no release. Heart Fire stagnated and attacked Yangming Metal. Although the Stomach belongs to Earth, the Liver belongs to Wood, and the Gallbladder houses Ministerial Fire. Fire followed Wood Qi into the Stomach, causing sudden mania. Zi Hehe ordered a warm room for emesis and sweating, repeating this three times. The *Nei Jing* states: "When Wood is stagnant, vent it; when Fire is stagnant, disperse it." This applies. He then administered half a jin of Tiao Wei Cheng Qi Tang in five sheng of water, boiled briefly, divided into three doses. This caused massive purgation twenty times, expelling several sheng of bloody water mixed with stasis. The next day, he recovered, and Tong Sheng San [Unimpeded Harmony Powder] was used for convalescence.)
For deficiency, use tonification. Formulas include Ning Zhi Gao [Calm Spirit Paste], Yi Zui Gao [One Drunkenness Paste], and Chen Sha San [Cinnabar Powder]. Generally, mania involves little sleep. Little sleep causes Wei Qi to circulate only in the Yang aspect and not enter the Yin, resulting in Yang excess and Yin deficiency. By calming the spirit to induce sleep, Wei Qi enters the Yin, filling the Yin so it is not deficient. Without Wei Qi assistance, Yang does not become excessive. Thus, Yin and Yang balance, and the patient recovers. The classics state: Sorrow moving internally injures Hun [Ethereal Soul]. If Hun is injured, madness and lack of clarity occur, leading to aberrant behavior. This is mania caused by sorrow injuring Hun. It should be treated by using Joy to overcome Sorrow, and warming herbs to tonify the Yang of Hun. (Lou Quanshan notes: Fang Ji Di Huang Tang [Stephania and Rehmannia Decoction] by Zhang Zhongjing, and Jing Qi Wan [Startling Qi Pill] from *Ben Shi Fang* are examples.) The classics state: Unrestrained joy injures Po [Corporeal Soul]. If Po is injured, mania occurs. The manic patient lacks regard for others. This is mania caused by joy injuring Po. It should be treated by using Fear to overcome Joy, and cooling herbs to tonify the Yin of Po. (Lou Quanshan notes: Chen Sha [Cinnabar], Yu Jin [Curcuma Longa Rhizome], and Bai Fan [Alum] are examples.)
Chu Yushi used Ku Shen [Sophora Root] powder made into honey pills the size of tung tree seeds. Take ten pills per dose, dissolved in Bo He Tang [Mint Decoction]. This is because Zi and Wu hours correspond to Shao Yin Ruler Fire. Herbs that are bitter in taste and cold in nature generally assist Water to suppress Fire. All restlessness and maniacal overactivity belong to Fire. Therefore, single-herb Ku Shen can treat it. Dai Yuan Shi treated phlegm-related disorders to calm the heart, using Chen Sha Miao Xiang San [Cinnabar Miraculous Incense Powder] added with Jin Bo [Gold Leaf] and Zhen Zhu Mo [Pearl Powder], mixed with Qingzhou Bai Wan Zi Mo [Qingzhou White Pill Powder], taken with strong Ginger Decoction, swallowing Shi Si You Wan [Fourteen Friends Pill]. Hua Shi Liu Yi Tang [Talcum Six-to-One Decoction] with Pearl Powder, taken with plain water. When Heat enters the Blood Chamber causing mania and loss of recognition, Niu Huang Gao [Calculus Bovis Paste] is indicated. The *Jin Gui Yao Lue* states: Patients exhibiting mania-like behavior, wandering aimlessly, talking alone incessantly, without chills or fever, and with a floating pulse, should be treated with Fang Ji Di Huang Tang. A woman exhibited delirious speech, cursing, irregular singing and laughing, resembling possession. One eye corner and mouth corner were drawn up. Treatment as mania or Heart Wind yielded no results. This was actually an old Head Wind disorder caused by Wind-Phlegm. Xiong Xin Tang [Ligusticum and Asarum Decoction] with added Fang Feng [Saposhnikovia Root] cured her after a few doses.