结胸证悉具，烦躁者死。
发热下利，厥逆，躁不得卧者死。
少阴病，吐利烦躁，四逆者死。
少阴恶寒而蜷，四逆脉不出，不烦而躁者死。
少阴六七日自利，复烦躁不得卧寐者死。
谓郁闷不舒畅也，无奈也，比之烦闷而甚。
由下后，表邪未解，阳邪内陷，结伏于心胸之间，邪热郁于胸中，宜栀子豉汤吐之。
或发汗吐下后，及阳明病下之，其外有热，手足温，不结胸，饥不饮食，头
汗，邪热结于胸中，宜承气茵陈下之。
阳明下之，胃中有燥屎，及阳明病无汗、小便不利、心懊 ，必发黄。
眠者，常睡熟也。不得眠者，虽睡不熟，且安静不烦也。卧者，欲睡着而复
醒也。不得卧者，欲安卧而烦闷不能安也。二者皆由汗吐下而生。胃虚则不得
眠。心虚则不得卧。汗吐下后不得眠，枝豉主之。日烦夜静，姜附主之。
不眠。少阴病，心烦不得眠，宜黄连阿胶汤。大热错语不眠，宜黄连解毒
汤。下利而渴不眠，宜猪苓汤利其水。吐下后，虚烦不得眠，酸枣仁汤导其热。
下后不眠同前。
不卧。身热目疼，不卧有汗，宜桂枝柴胡汤；无汗，宜麻黄加白虎。误服青
龙，汗多亡阳，先与防风白术牡蛎散，收其汗，次用小建中，养其心血。风温误
汗不卧者死。热病余热入心包络，不卧，宜知母麻黄汤小汗之，次用小柴胡乌梅
栀子汤，散心经之热，差后阴未复不卧，宜栀子乌梅汤。
In the condition of Jie Xiong (Chest Binding), if all symptoms are present and irritability (Fan Zao) occurs, it is a fatal sign.
If there is fever accompanied by diarrhea, cold extremities (Jue Ni), and restlessness preventing lying down, it is a fatal sign.
In Shao Yin disease (Shaoyin Disease), if vomiting, diarrhea, irritability, and cold extremities occur, it is a fatal sign.
In Shao Yin disease, if there is aversion to cold with the body curled up, cold extremities, an imperceptible pulse, and although there is no mental agitation (Fan), there is physical restlessness (Zao), it is a fatal sign.
In Shao Yin disease, after six or seven days, if spontaneous diarrhea occurs again followed by irritability and inability to lie down or sleep, it is a fatal sign.
"Ao" refers to a state of depression and discomfort, feeling helpless, which is more severe than ordinary vexation.
This arises because after improper purgation, the exterior pathogen has not resolved, and the Yang pathogen has sunk inward, becoming trapped between the heart and chest, with evil heat stagnating in the chest. It is appropriate to use Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) to induce vomiting.
Alternatively, after sweating, vomiting, or purging, or after improper purgation in Yang Ming disease (Yangming Disease), if there is residual heat on the exterior, warm hands and feet, no formation of Jie Xiong, hunger without desire to eat, and sweating only on the head, this indicates evil heat binding in the chest. It is appropriate to use Cheng Qi Yin Chen (Rheum and Capillaris Decoction modified) to purge downward.
After improper purgation in Yang Ming disease, if there are dry feces in the stomach, or if Yang Ming disease presents with no sweating, difficult urination, and mental "Ao", jaundice will inevitably develop.
"Mian" refers to sleeping soundly. "Bu De Mian" (Insomnia/Inability to Sleep Soundly) means that although one attempts to sleep, it is not deep, yet the mind is quiet without vexation. "Wo" refers to attempting to fall asleep but waking up again. "Bu De Wo" (Inability to Lie Down Restfully) means desiring to lie down comfortably but being unable to do so due to vexation and discomfort. Both conditions arise from improper sweating, vomiting, or purging. Deficiency of the Stomach leads to Bu De Mian. Deficiency of the Heart leads to Bu De Wo. After sweating, vomiting, or purging, if Bu De Mian occurs, Zhi Zi Chi Tang is the primary treatment. If there is irritability during the day and calmness at night, Jiang Fu (Ginger and Aconite Decoction) is used.
For insomnia: In Shao Yin disease, if there is mental distress and inability to sleep, Huang Lian E Jiao Tang (Coptis and Donkey-Hide Gelatin Decoction) is appropriate. If high fever causes delirium and insomnia, Huang Lian Jie Du Tang (Coptis Decoction for Detoxification) is appropriate. If diarrhea with thirst causes insomnia, Zhu Ling Tang (Polyporus Decoction) is used to promote diuresis. After vomiting and purging, if deficiency-vexation causes insomnia, Suan Zao Ren Tang (Sour Jujube Seed Decoction) is used to guide out the heat. Insomnia following purgation is treated similarly as above.
For inability to lie down restfully: If there is body heat, eye pain, inability to lie down with sweating, Gui Zhi Chai Hu Tang (Cinnamon Twig and Bupleurum Decoction) is appropriate; if there is no sweating, Ma Huang added to Bai Hu Tang (Ephedra added to White Tiger Decoction) is appropriate. If Da Qing Long Tang (Major Green Dragon Decoction) is mistakenly taken, causing excessive sweating and loss of Yang Qi, first use Fang Feng Bai Zhu Mu Li San (Saposhnikovia, Atractylodes and Oyster Shell Powder) to stop sweating, then use Xiao Jian Zhong Tang (Minor Construct the Middle Decoction) to nourish Heart Blood. If Wind-Warmth disease is mistakenly treated with sweating, leading to inability to lie down, it is a fatal sign. If residual heat from a Heat Disease enters the Pericardium Meridian (Pericardium), causing inability to lie down, Zhi Mu Ma Huang Tang (Anemarrhena and Ephedra Decoction) is used to induce slight sweating, followed by Xiao Chai Hu Wu Mei Zhi Zi Tang (Minor Bupleurum, Dark Plum and Gardenia Decoction) to dissipate heat from the Heart Meridian. If inability to lie down persists after recovery due to incomplete restoration of Yin, Zhi Zi Wu Mei Tang (Gardenia and Dark Plum Decoction) is appropriate.