发狂之有虚实也发狂多是热邪之作祟然亦间有虚火之发狂又不可不知也发狂之实症与治
实狂
之方法前文已载兹不再论但论阴虚而发狂者此症妇人居多郁气不伸思慕不遂一时忧愤遂成此
症或披发行歌或出门呼唤见男子则思其心上之人见女子则嗔其目中之刺或吞炭而食泥或毁容
而割体人生抱病至此亦可怜也此皆肝气实郁肝血干燥两关之脉必然沿出寸口所谓欲得男子
而不可得者也此等之病必须大补肾中之水足以生肝而少加之以安心祛痰之药又益之以解郁
降火之味自然羞愧顿生前狂自定方名解羞汤一剂即见神功二剂全愈不必三剂也吾传方至此亦
怜妇人之郁而成此病也倘见左关之脉沿出寸口人未发狂之前即以吾方减十之六七早为治之又
何至有花颠之患哉远公可记之汝将来有治此等之病者故吾先传此方也
解羞汤
熟地（二两） 白芍（三两） 柴胡（三钱） 炒栀子（三钱） 生枣仁（五钱） 菖蒲（一钱） 白芥子
（三
钱） 茯神（一两） 麦冬（一两） 北五味（二钱） 山茱萸（五钱） 丹皮（五钱） 当归（五钱） 香附（
二钱） 郁金（一钱）水煎服
耳聋之宜知虚实也耳虽属于肾耳聋自然是肾水之虚以致肾火之旺故气塞而不通老人多有
此症
补其水而少加开窍之药渐渐耳聪亦不能一时奏效其症饮食如常手按之更觉无蝉鸣之响者是也
至于实症或作蝉鸣或如涛响或发寒作热饮食少思吐痰成 面目青黄赤白之不同时而汗出时而
汗止汗出觉轻汗止则重遇食转加遇热更甚此乃实聋之症也肾虽开窍于耳而胃为肾之关胃热而
反感风邪则火热于中而邪壅于外肾气且随胃气而助焰其窍反致遏塞故耳亦聋也重者常若有千
军万马汹腾之状手按之其聋十倍者是也若用补肾补脾之药益添其壮盛之气而聋且倍常治之法
宜用发散降火之剂我今留一方一治虚聋一治实聋也虚聋方名为清音汤此方不特补肾而兼去补
肺补心补肝者谓何盖肾水不能自生必得肺金之气下降而后能生也心肾相通而耳之窍始不闭欲
心之通窍舍肝气之
相生又何以通之耶故必补肝以生心火也况肝有补而后能泻不致耗窃肾气则肾水更有生气矣此
耳聋之所能自愈也但此方必须多服为妙盖阴不能骤生而补阴不易遽补也实聋方名为止沸汤
此方降胃中之火舒肝木之气消上壅之痰不治耳聋而耳聋自聪也
清音汤
熟地（一两） 菖蒲（一钱） 茯神（五钱） 丹皮（三钱） 玄参（五钱） 薏仁（五钱） 山茱萸（五
钱） 麦冬（五钱） 北五味（一钱） 柴胡（五分） 当归（五钱） 白芍（五钱） 白芥子（三钱）水煎服
止沸汤
柴胡（一钱五分） 白芍（五钱） 石膏（三钱） 知母（一钱） 甘草（一钱） 青蒿（五钱） 半夏（
一钱） 陈皮（一钱） 茯神（三钱） 神曲（五分） 蔓荆子（一钱）水煎服
发狂病症有虚证和实证之分。发狂大多是由热邪作祟引起，但偶尔也有因虚火导致的发狂，这一点不可不知道。关于发狂的实证及其治疗方法，前文已经记载，这里不再论述，只讨论因阴虚而发狂的情况。这种症状在女性中较为多见，多因郁气无法舒展、思慕之情不能如愿，一时之间忧愤交加而形成此症。患者有时披散头发唱歌，有时出门呼唤；见到男子就思念心上人，见到女子就瞪眼视其为眼中钉；有时吞食炭灰或泥土，有时毁坏容貌或割伤身体。人生病到这种地步，也是令人同情的。这都是因为肝气实性郁结、肝血干燥所致，左右关脉必然上溢至寸口，这就是所谓的“想要得到男子却不可得”的表现。这类疾病必须大补肾中之水，以滋养肝脏，并少量加入安心祛痰的药物，再辅以解郁降火的药材，自然羞愧感顿消，先前的狂躁状态自会安定。方剂名为解羞汤，服用一剂即可见效，两剂全愈，不必服用第三剂。我传授这个方子到这里，也是怜悯妇人因郁结而成此病。如果看到左关脉上溢至寸口，在人尚未发狂之前，就用我的方子减去十分之六七的药量，尽早治疗，又怎会有花癫（精神错乱）的祸患呢？远公你要记好，你将来可能会有治疗此类疾病的需要，所以我预先传授这个方子。
解羞汤
熟地黄（二两） 白芍（三两） 柴胡（三钱） 炒栀子（三钱） 生酸枣仁（五钱） 石菖蒲（一钱） 白芥子（三钱） 茯神（一两） 麦冬（一两） 北五味子（二钱） 山茱萸（五钱） 牡丹皮（五钱） 当归（五钱） 香附（二钱） 郁金（一钱），水煎服。
耳聋病症宜分辨虚实。耳朵虽然归属于肾，但耳聋自然是因肾水不足导致肾火旺盛，致使气机闭塞而不通。老年人多有此症，通过补水并少量加入开窍药物，逐渐能使听力恢复，但不能指望立刻见效。其症状表现为饮食正常，用手按压耳部时，蝉鸣声反而减轻，这是虚证的表现。至于实证，有的像蝉鸣，有的如波涛轰鸣，有的伴有寒热交替，食欲减退，吐痰，面目呈现青、黄、赤、白等不同颜色，时而出汗，时而汗止，出汗时感觉轻松，汗止时感觉沉重，进食后加重，遇热更甚，这是实证耳聋的症状。肾脏虽开窍于耳，但胃是肾的关口，若胃中有热且反受风邪侵袭，则火热在内，邪气壅滞在外，肾气随胃气而助长火势，导致耳窍反而被遏塞，所以也会耳聋。重症者常感觉如有千军万马汹涌奔腾之声，用手按压耳部，耳聋程度增加十倍。如果使用补肾补脾的药物，只会增添其壮盛之气，使耳聋加倍。治疗方法宜用发散降火的药剂。我现在留下方子一个治虚聋，一个治实聋。虚聋方剂名为清音汤，此方不仅补肾，还兼补肺、补心、补肝，为什么呢？因为肾水不能自行生成，必须依靠肺金之气下降后才能生成。心肾相通，耳窍才能不闭锁；想要心窍通畅，舍去肝气的相生作用，又怎能通达呢？所以必须补肝以生心火。况且肝得到滋补后才能疏泄，不至于耗窃肾气，这样肾水才有生气，这也是耳聋能自愈的原因。但这个方子必须长期服用才妙，因为阴精不能骤然生成，补阴也不容易迅速奏效。实聋方剂名为止沸汤，此方降低胃中之火，舒展肝木之气，消除上部壅滞之痰，不直接治疗耳聋，但耳聋自然聪敏。
清音汤
熟地黄（一两） 石菖蒲（一钱） 茯神（五钱） 牡丹皮（三钱） 玄参（五钱） 薏苡仁（五钱） 山茱萸（五钱） 麦冬（五钱） 北五味子（一钱） 柴胡（五分） 当归（五钱） 白芍（五钱） 白芥子（三钱），水煎服。
止沸汤
柴胡（一钱五分） 白芍（五钱） 石膏（三钱） 知母（一钱） 甘草（一钱） 青蒿（五钱） 半夏（一钱） 陈皮（一钱） 茯神（三钱） 神曲（五分） 蔓荆子（一钱），水煎服。
The condition of mania (mania) has both deficiency and excess patterns. Mania is mostly caused by the interference of heat pathogens, but occasionally it can also be caused by deficient fire, which must not be overlooked. The treatment methods for excess-type mania have been recorded in previous texts and will not be discussed here; instead, we will discuss mania caused by yin deficiency. This syndrome is more common in women, often resulting from unrelieved qi stagnation and unfulfilled desires, leading to sudden worry and indignation. Patients may walk with disheveled hair singing, or go out calling out; upon seeing men, they think of their beloved; upon seeing women, they glare at them as if they were thorns in their eyes; sometimes they swallow charcoal or eat mud, and sometimes they disfigure themselves or cut their bodies. It is pitiable for a person to fall ill to such an extent. These are all due to excessive liver qi stagnation and dryness of liver blood. The pulse at the guan position (middle position on the radial artery) inevitably overflows towards the cunkou (inch position), which is described as "desiring to obtain a man but being unable to do so." Such illnesses require substantial tonification of kidney water to generate liver wood, along with small additions of herbs that calm the mind and resolve phlegm, supplemented by flavors that relieve depression and descend fire. Naturally, feelings of shame will vanish instantly, and the previous manic state will settle down. The formula is named Jie Xiu Tang (Unashamed Decoction). One dose yields miraculous results, and two doses lead to complete recovery; a third dose is unnecessary. Having transmitted this formula thus far, I also pity women who suffer from such diseases due to depression. If one observes the left guan pulse overflowing to the cunkou before the onset of mania, using my formula with a reduction of sixty to seventy percent of the dosage for early treatment would prevent the calamity of floral madness (delirious insanity). Yuan Gong, please remember this. You may encounter such cases in the future, so I transmit this formula in advance.
Jie Xiu Tang (Unashamed Decoction)
Shu Di Huang (Prepared Rehmanniae Radix, 2 liang) Bai Shao (White Peony Root, 3 liang) Chai Hu (Bupleuri Radix, 3 qian) Chao Zhi Zi (Stir-fried Gardeniae Fructus, 3 qian) Sheng Suan Zao Ren (Raw Ziziphi Spinosae Semen, 5 qian) Shi Chang Pu (Acori Tatarinowii Rhizoma, 1 qian) Bai Jie Zi (Sinapis Semen, 3 qian) Fu Shen (Poria Cum Ramo et Ligno, 1 liang) Mai Dong (Ophiopogonis Radix, 1 liang) Bei Wu Wei Zi (Schisandrae Chinensis Fructus, 2 qian) Shan Zhu Yu (Corni Fructus, 5 qian) Dan Pi (Moutan Cortex, 5 qian) Dang Gui (Angelicae Sinensis Radix, 5 qian) Xiang Fu (Cyperi Rhizoma, 2 qian) Yu Jin (Curcumae Longae Radix, 1 qian). Decoct in water and take orally.
One should understand the distinction between deficiency and excess in deafness. Although the ears belong to the kidneys, deafness is naturally caused by kidney water deficiency leading to hyperactive kidney fire, resulting in qi obstruction and blockage. This is common in the elderly. Tonifying water and adding a small amount of orifice-opening herbs will gradually restore hearing, but immediate effects cannot be expected. The symptoms include normal diet and appetite, and pressing on the ears reduces the tinnitus sound, indicating a deficiency pattern. As for excess patterns, there may be cicada-like ringing or roaring sounds like waves, accompanied by alternating chills and fever, reduced appetite, expectoration, and varying facial colors (blue, yellow, red, white). Sweating occurs intermittently; feeling light when sweating and heavy when sweating stops. Symptoms worsen after eating and intensify with heat exposure. This is an excess deafness pattern. Although the kidneys open into the ears, the stomach serves as the gate for the kidneys. If stomach heat arises and is counteracted by wind pathogens, fire burns internally while pathogens obstruct externally. Kidney qi follows stomach qi to fuel the flames, causing the orifice to become blocked, leading to deafness. In severe cases, patients feel as if thousands of troops and horses are surging within. Pressing on the ears increases deafness tenfold. Using kidney- and spleen-tonifying herbs would only add to their vigorous qi, worsening the deafness. The treatment method should employ dispersing and fire-descending agents. I now leave one formula for deficiency deafness and one for excess deafness. The deficiency deafness formula is named Qing Yin Tang (Clear Sound Decoction). This formula not only tonifies the kidneys but also supplements the lungs, heart, and liver. Why? Because kidney water cannot generate itself; it requires lung metal qi to descend to facilitate its generation. The heart and kidneys communicate, allowing the ear orifices to remain unblocked. To ensure the heart orifices are open, relying on the mutual generation of liver qi is essential. Therefore, one must tonify the liver to generate heart fire. Moreover, only after the liver is tonified can it vent properly, preventing the depletion of kidney qi, thereby giving life to kidney water. This is how deafness can heal itself. However, this formula must be taken for a long time to be effective, as yin cannot be generated suddenly, and tonifying yin does not yield quick results. The excess deafness formula is named Zhi Fei Tang (Boiling Stopping Decoction). This formula descends stomach fire, soothes liver wood qi, and eliminates upper congestion of phlegm. It does not directly treat deafness, but hearing naturally becomes clear.
Qing Yin Tang (Clear Sound Decoction)
Shu Di Huang (Prepared Rehmanniae Radix, 1 liang) Shi Chang Pu (Acori Tatarinowii Rhizoma, 1 qian) Fu Shen (Poria Cum Ramo et Ligno, 5 qian) Dan Pi (Moutan Cortex, 3 qian) Xuan Shen (Scrophulariae Radix, 5 qian) Yi Yi Ren (Coicis Semen, 5 qian) Shan Zhu Yu (Corni Fructus, 5 qian) Mai Dong (Ophiopogonis Radix, 5 qian) Bei Wu Wei Zi (Schisandrae Chinensis Fructus, 1 qian) Chai Hu (Bupleuri Radix, 5 fen) Dang Gui (Angelicae Sinensis Radix, 5 qian) Bai Shao (White Peony Root, 5 qian) Bai Jie Zi (Sinapis Semen, 3 qian). Decoct in water and take orally.
Zhi Fei Tang (Boiling Stopping Decoction)
Chai Hu (Bupleuri Radix, 1.5 qian) Bai Shao (White Peony Root, 5 qian) Shi Gao (Gypsum Fibrosum, 3 qian) Zhi Mu (Anemarrhenae Rhizoma, 1 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian) Qing Hao (Artemisiae Annuae Herba, 5 qian) Ban Xia (Pinelliae Rhizoma Praeparatum, 1 qian) Chen Pi (Citri Reticulatae Pericarpium, 1 qian) Fu Shen (Poria Cum Ramo et Ligno, 3 qian) Shen Qu (Massa Medicata Fermentata, 5 fen) Man Jing Zi (Vittariae Spicae, 1 qian). Decoct in water and take orally.