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Ao (mental restlessness and discomfort) refers to symptoms of vexation, dryness-heat, chest oppression, mental disturbance, and inability to remain calm. In severe cases, it resembles the condition caused by poisoning with drugs such as Crotonis Fructus (Badou, 巴豆) or Aconiti Kusnezoffii Radix (Caowutou, 草乌头).

Zhizi Tang (Gardenia Decoction) is used to treat Ao (mental restlessness and discomfort), vexation, tossing and turning, and insomnia; this occurs because dryness-heat is constrained within, preventing the free flow of Qi. The Classics state: "Blood and Qi are the spirit of man." Because Ying and Wei, Blood and Qi circulate, the Spirit resides within them. When the Spirit moves outward, Ying and Wei flow into the meridians, which is called "moving in Yang," causing wakefulness, just as the sun rising brings day. When the Spirit moves inward, the Five Zang organs generate each other in a smooth sequence, which is called "moving in Yin," causing sleep. Thus, if the Spirit has no external function and becomes confused, or if the Spirit is lost within, dreams occur, just as night follows sunset. Dry Metal governs astringency, while Damp Earth governs slipperiness. The constitutions of Dryness and Dampness must first be influenced by other climatic factors before forming combined transformations. For example, after extreme cold, things become dry; when Wind prevails, and Damp-Heat consumes body fluids, a dry constitution forms. If Heat is excessive, all things become moist and exude fluids. Therefore, in exterior Heat without Dryness, the circulation of Blood and Qi is unobstructed, leading to manic behavior, shouting, and great strength. In exterior Dryness-Heat, Blood and Qi are congested, leading to flaccidity and weakness. In interior Heat without Dryness, body fluids are moist, and Blood and Qi are slippery, leading to drowsiness and excessive sleep. For instance, the cold herbs in Xixin San (Heart-Washing Powder) treat excessive sleep. Children are vigorous during the day and sleep peacefully at night because their Blood is not depleted. When Dryness affects the interior, Blood and Qi become stagnant and sluggish, resulting in Ao (mental restlessness and discomfort), vexation, and insomnia. The Dryness-Heat of Shanghan (Cold Damage) arises from excessive sweating or purging, vomiting and diarrhea, profuse spontaneous sweating, or excessive Yang Heat damaging Yin and consuming fluids. Loss of fluids leads to Blood deficiency and Dryness-Heat. It may also result from moxibustion, hot compresses, cauterization, or mistakenly taking hot formulas, or erroneously using pills containing Mercury(II) Sulfide (Yinfen, 银粉) or Crotonis Fructus (Badou, 巴豆)—drugs that are extremely drying, hot, and toxic—to purge, thereby further damaging Yin and depleting fluids. Blood deficiency then causes extreme Dryness-Heat. Such errors are common. The Classics say: "The eyes see when they receive Blood; the ears hear when they receive Blood; fingers grasp when they receive Blood; palms hold when they receive Blood; feet walk when they receive Blood; Zang organs produce fluids when they receive Blood; Fu organs generate Qi when they receive Blood." Therefore, nothing in the body is more precious than Blood. Even if Yang Heat is severe, if Blood is not depleted, Ying and Wei flow freely, and the disease is mild. However, if Blood is depleted and weakened, constrained Dryness-Heat becomes severe. Consider alcohol heat: if Blood is not yet depleted, Qi and Blood flow smoothly and harmoniously. But if alcohol heat damages Yin and depletes fluids, leading to Blood deficiency, the alcohol heat dissipates gradually, causing constrained Dryness-Heat, vexation, and thirst—this is an alcohol-induced disease. Drinking again may bring relief because Qi and Body Fluids circulate, dispersing the constrained Dryness-Heat. If one cannot tolerate it and symptoms recur, the alcohol toxicity is severe, and Dryness-Heat cannot disperse. This is similar to the popular misconception that Yang Toxin is milder than Yin Toxin. This view assumes that extreme internal and external Dryness-Heat exists while Blood remains robust, causing excessive circulation of Qi and Blood, resembling a state of excess Yang (Yang Toxin). Conversely, if Blood is exhausted and Dryness-Heat is extreme, accumulating internally, Yang Qi cannot circulate to the exterior. The body becomes cold and blue, limbs are cold and inverted, the condition is critical and near death, yet this is mistakenly diagnosed as extreme Cold Yin Toxin. Treating this with urgent warming and tonifying of Yang internally and externally can cause sudden disaster. If the heat is mild but one mistakenly believes in the strong opening effects of acrid-hot remedies mentioned in the Suwen (Plain Questions), claiming personal skill in saving patients deemed doomed by Yin Toxin, the public will admire this and regret insufficient rescue efforts, misleading many. One should simply clear Heat, moisten Dryness, and resolve stagnation; once Qi and Body Fluids circulate freely, recovery occurs. Thus, the Classics state: "The Kidney suffers from Dryness; urgently consume Acrid flavors to warm it." This opens the interstices (Couli, 腠理), promotes Body Fluids, and unblocks Qi channels. When Qi flows harmoniously, Body Fluids circulate freely (as the Classics say: "When Qi is harmonious, Body Fluids are abundant, and the Spirit naturally arises").

If there is chest fullness and stagnation, slight sweating on the head, and severe vexation, Zhizi Tang (Gardenia Decoction) is the primary treatment. If there is shortness of breath, add 1 qian of Glycyrrhizae Radix et Rhizoma (Gancao, 甘草). If vomiting is present, or if the patient was initially incorrectly treated with pill-based purgatives, add 0.5 liang of Zingiberis Rhizoma Recens (Shengjiang, 生姜). For all cases of Ao (mental restlessness and discomfort) due to deficient vexation, Liangge San (Cooling the Diaphragm Powder) is very effective. Additionally, soaking the hands and feet in warm water helps disperse the constrained heat in the chest and heart.

Zhizi Nongpu Tang (Gardenia and Magnolia Bark Decoction) treats vexation, abdominal fullness, and restlessness in sitting or lying down.