《活人》云∶虚烦似伤寒，非伤寒也。成无己云∶伤寒有虚烦，有心中烦，有胸中烦。二说
不同，考之于书，成无己之言，实出仲景，《活人》无据。然往往有非因伤寒而虚烦者，今故两存
之。立虚烦一门于此心部，立伤寒烦一门于伤寒部。
〔无〕虚烦身不觉热，头目昏疼，口干咽燥不渴，清清不寐，皆虚烦也。
〔《保》〕起卧不安睡不稳，谓之烦。宜栀豉汤、竹叶石膏汤。（二方并见伤寒。）
〔《活》〕但独热者，虚烦也，诸虚烦热，与伤寒相似，但不恶寒，身不疼痛，故知非伤寒也，
不可发汗。头不痛，脉不紧数，故知非里实也，不可下。病此者，内外皆不可攻，攻之必遂烦渴，
当与竹叶汤。若呕者，与陈皮汤一剂，不愈，再与之。孙真人云∶此法数用有效。
陈皮汤
陈皮（一两半） 甘草（炙，五钱） 人参（一分） 竹茹（五钱）
上锉如麻豆大，每服五钱，水一盏半，姜三片，枣一枚，煎至七分去渣，食前服。
〔无〕淡竹茹汤治心虚闷，头疼短气，内热不解，心中闷乱，及妇人产后心虚，惊悸烦闷
欲绝。
麦门冬（去心） 小麦（各二两半） 甘草（炙，一两） 人参 白茯苓（各一两半） 半夏（汤洗，二两）
上锉散，每服四钱，水二盏，姜七片，枣三枚，淡竹茹一块如指大，煎至七分去渣，食前服。
〔垣〕朱砂安神丸治心乱烦热怔忡，心神颠倒，兀兀欲吐，胸中气乱而热，有似懊 之状，
皆膈上血中伏热，蒸蒸不安。宜用权法，以镇阴火之浮行，以养上焦之元气，用甘草之甘温补之，当
归、生地又为长生阴血之圣药，黄连去心烦，除湿热，朱砂纳浮游之火，而安神明。
朱砂（一钱，研，水飞） 黄连（净，酒炒，一钱半） 甘草（炙，五分） 生地 当归头（各一钱）
上为极细末，蒸饼为丸，如黄米大。每服十丸，津下。
〔仲〕下痢后更烦，按之心下濡者，为虚烦也，栀子豉汤主之。（方见伤寒部烦门。）
〔《素》〕帝曰∶有病身热汗出烦满，烦满不为汗解，此为何病？岐伯曰∶汗出而身热者，风也，
汗出而烦满不解者，厥也，病名曰风厥。帝曰∶愿卒闻之？岐伯曰∶巨阳主气，故先受邪，少阴
与其为表里，得热则上从之，从之则厥也。帝曰∶治之奈何？岐伯曰∶表里刺之，饮之服汤。（评
热论刺，谓针足太阳少阴也。饮之服汤，
谓仲景止逆下气麦门冬汤之类也。）
〔丹〕一女子年二十余岁，在室素强健，六月间发烦闷，困惫不食，发时欲入井，六脉皆沉
细而弱数，两日后微渴。众以为病暑，治不效，四五日加呕而人瘦，手心极热，喜在阴处，渐成伏脉，
时妄语。予急制《局方》妙香丸，如桐子大，以井水下一丸，半日许大便，药已出，病无退减。
遂以麝香水洗药，以针穿三窍，次日以凉水送下。半日许大便，下稠痰数升，是夜得睡，困顿伏
枕，旬日而愈。因记《金匮》云∶昔肥而今瘦者，痰也，遂作此药治之。
妙香丸丹溪云∶疏决肠胃，制伏木火药也。
辰砂（飞研，五两） 牛黄 龙脑 腻粉 麝香（研。各一两） 金箔（九十片） 巴豆（三百
十五粒，去尖膜，炒熟，研）
上令研匀，炼黄蜡六两，入好蜜三分，同炼令匀为丸。每两作三十丸。如要此药速行，针刺
一眼子，冷水浸少时服，效更速。小儿百病，丸如绿豆大。
〔无〕温胆汤 治大病后，虚烦不得眠。（方见不得眠门。）
〔仲〕酸枣汤 治虚劳虚烦不得眠。（方见不得眠门。）
上九法，治热烦。前五法，烦热怔忡，知热在心肺也，故用竹叶、石膏、辰砂镇坠其热，使下
行也。第六法，烦而下利，知热在上也，故用栀豉汤吐之。第七法，烦而汗出不解，知表里有邪也，
故用表里饮汤。
第八法，脉沉口渴手心热，知热不在表也，故用妙香丸下之。第九法，温胆、酸枣，治不得眠
也。
凡心虚则烦心，肝肾脾虚亦烦心。经云∶夏脉者心也，其不及者，令人烦心。又云∶肝虚、
肾虚、脾虚，皆令人体重烦冤者，是知烦多生于虚也。
运气 烦有五∶
一曰，热助心实而烦。经云∶少阴司天，热淫所胜，病胸中烦热嗌干。又云∶少阳司天，火
淫所胜，病烦心胸中热。又云∶少阳之胜，烦心心痛，治以咸寒是也。
二曰，心从制而烦。经云∶太阳司天，寒气下临，心气上从，寒清时举，火气高明，心
热烦是也。
三曰，金攻肝虚而烦。经云∶岁金太过，燥气流行，肝木受邪，民病体重烦冤是也。
四曰，土攻肾虚而烦。经云∶岁土太过，雨湿流行，肾水受邪，民病体重烦冤。又云∶岁
水不及，湿乃大行，民病烦冤足痿是也。
五曰，木攻脾虚而烦。经云∶岁木太过，风气流行，脾土受邪，民病体重烦冤。盖肝虚肾虚，
皆令人体重烦冤，故金太过则肝虚，土太过则肾虚，木太过则脾虚，凡此三太过之岁，则肝肾脾受
邪而虚，皆病体重烦冤也。
灸刺 烦心有四∶
其一，取心俞。经云∶心主手厥阴心包络之脉，所生病者，烦心心痛，掌中热，详盛虚热寒
陷下取之。又云∶气乱于心则烦心，密默，俯首静伏取之手少阴心主之 是也。
其二，取肾膀胱俞。经云∶肾足少阴之脉，所生病者，烦心心痛，痿厥，足下热痛，视盛虚
热寒陷下取之。又云∶舌纵涎下，烦 ，取足少阴。又云∶足少阴之别，名曰大钟，当踝后绕跟，
别走太阳，其病气逆则烦闷，取之所别也。又汗出烦满，不解表里，取之巨阳少阴也。
其三，取肺俞。经云∶手太阴之脉，所生病者，烦心胸满，视盛虚热寒陷下取之。又云∶振寒
洒洒鼓颔，不得汗出，腹胀烦冤，取手太阴是也。
其四，取脾俞。经云∶脾足太阴之脉，所生病者，烦心，心下急痛，溏瘕泄，水闭，视盛虚热
寒陷下取之是也。
The *Huoren Shu* (Book of Living People) states: Xu Fan (deficiency vexation) resembles Taiyang disease (a syndrome caused by pathogenic factors affecting the Taiyang channel), but it is not Taiyang disease. Cheng Wuji states: In Taiyang disease, there is Xu Fan (deficiency vexation), Xin Zhong Fan (vexation in the heart region), and Xiong Zhong Fan (vexation in the chest). These two theories differ; upon consulting texts, Cheng Wuji's words indeed originate from Zhang Zhongjing, whereas the *Huoren Shu* lacks evidence. However, there are often cases of Xu Fan (deficiency vexation) not caused by Taiyang disease, so both theories are retained here. A section on Xu Fan (deficiency vexation) is established in the Heart Department, and a section on Taiyang Vexation is established in the Taiyang Disease Department.
[No Name] The body feels no heat, the head and eyes are dizzy and painful, the mouth is dry and the throat parched without thirst, one remains clear-headed yet unable to sleep; these are all manifestations of Xu Fan (deficiency vexation).
*[Baoming Ji]* Restlessness in sitting and lying, unstable sleep, is called Fan (vexation). Zhi Chi Tang (Gardenia and Fermented Soybean Decoction) or Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) are appropriate. (Both formulas are found in the Taiyang Disease section.)
*[Huoren Shu]* If there is only isolated fever, it is Xu Fan (deficiency vexation). Various types of deficiency-related fever resemble Taiyang disease, but since there is no aversion to cold and no body pain, it is known not to be Taiyang disease, and sweating therapy should not be used. If the head does not hurt and the pulse is not tight and rapid, it is known not to be an interior excess syndrome, and purgative therapy should not be used. For those suffering from this condition, neither exterior nor interior attacks should be employed; attacking will inevitably lead to vexation and thirst. Instead, Zhuye Tang (Bamboo Leaf Decoction) should be given. If vomiting occurs, Chenpi Tang (Tangerine Peel Decoction) should be given for one dose; if not cured, administer again. Sun Simiao stated: This method has been effective when used multiple times.
Chenpi Tang (Tangerine Peel Decoction)
Chenpi (Citri Reticulatae Pericarpium, 1 liang 5 qian) Gancao (Licorice Root, roasted, 5 qian) Renshen (Ginseng Radix et Rhizoma, 1 fen) Zhuru (Bamboo Sap, 5 qian)
Crush the herbs to the size of hemp seeds. Take 5 qian per dose with 1.5 cups of water, add 3 slices of ginger and 1 jujube, decoct until reduced to 0.7 parts, remove the dregs, and take before meals.
[No Name] Danzhuru Tang (Bamboo Sap Decoction) treats heart deficiency with chest oppression, headache, shortness of breath, unresolved internal heat, mental restlessness, as well as postpartum heart deficiency in women causing palpitations, severe vexation, and despair.
Maimendong (Ophiopogonis Radix, heart removed) Xiaomai (Tritici Fructus, each 2.5 liang) Gancao (Licorice Root, roasted, 1 liang) Renshen (Ginseng Radix et Rhizoma) Baifuling (Poria, each 1.5 liang) Banxia (Pinelliae Tuber, washed with boiling water, 2 liang)
Crush into powder. Take 4 qian per dose with 2 cups of water, add 7 slices of ginger and 3 jujubes, plus a piece of Danzhu Ru (Bamboo Sap) the size of a finger, decoct until reduced to 0.7 parts, remove the dregs, and take before meals.
[Li Dongyuan] Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill) treats mental chaos, vexation-heat, palpitations, erratic spirit, dizziness with urge to vomit, chaotic and hot qi in the chest resembling Ao Nao (regretful distress), all caused by latent heat in the blood above the diaphragm causing steaming discomfort. It is appropriate to use a temporary method to anchor the floating Yin fire and nourish the Yuan Qi (primordial qi) of the upper Jiao (Upper Burner). Use Gancao (Licorice Root)'s sweet-warm nature to tonify; Danggui (Angelica Sinensis Radix) and Shengdi Huang (Rehmanniae Radix) are holy medicines for generating Yin blood; Huanglian (Coptidis Rhizoma) removes vexation and clears damp-heat; Zhusha (Cinnabaris) anchors wandering fire and calms the Shen (spirit).
Zhusha (Cinnabaris, 1 qian, ground, water-flown) Huanglian (Coptidis Rhizoma, cleaned, wine-fried, 1.5 qian) Gancao (Licorice Root, roasted, 5 fen) Shengdi Huang (Rehmanniae Radix) Danggui Tou (Angelica Sinensis Radix head, each 1 qian)
Grind into extremely fine powder, make pills with steamed wheat cake dough, the size of yellow millet grains. Take 10 pills per dose, swallowed with saliva.
[Zhang Zhongjing] After dysentery, if vexation increases and pressing the epigastrium yields softness, it is Xu Fan (deficiency vexation); Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) is the primary treatment. (Formula seen in the Taiyang Disease section, Vexation Gate.)
*[Suwen]* The Yellow Emperor asked: There is a disease where the body is hot, sweat is profuse, and there is vexation and fullness; the vexation and fullness do not resolve with sweating. What disease is this? Qibo replied: Sweating with body heat indicates Wind pathogen; sweating with unresolved vexation and fullness indicates Jue (reversal/cold extremities). The disease is named Feng Jue (Wind Reversal). The Yellow Emperor said: I wish to hear the details. Qibo said: Juyang (Taiyang/Bladder Channel) governs the qi and thus receives the pathogen first; Shaoyin (Kidney Channel) is its interior-exterior pair. When heat enters, it follows upward; following upward leads to Jue (reversal). The Yellow Emperor asked: How to treat it? Qibo said: Acupuncture the exterior and interior channels, and administer decoctions. (The acupuncture mentioned in the Ping Re Lun chapter refers to needling the Foot-Taiyang and Foot-Shaoyin channels. Administering decoctions refers to Zhang Zhongjing's Mai Men Dong Tang (Ophiopogon Decoction) which stops counterflow and directs qi downward.)
[Zhu Danxi] A woman in her twenties, unmarried and usually robust, developed vexation and oppression in June. She was exhausted, refused food, and during episodes wanted to jump into a well. Her six pulses were deep, thin, weak, and rapid. Two days later, she had slight thirst. Others diagnosed Summerheat, but treatment failed. By the fourth or fifth day, vomiting worsened, she emaciated, her palms were extremely hot, she preferred cool places, her pulse gradually became hidden (Fu), and she occasionally spoke deliriously. I urgently prepared Miaoxiang Wan (Wonderful Fragrance Pill) from the *Ju Fang*, sized like paulownia seeds, administered one pill with well water. After half a day, stool was passed, the medicine exited, but the illness did not subside. I then washed the medicine with musk-infused water, pierced three holes with a needle, and administered it the next day with cool water. After half a day, stool was passed, and several sheng of thick phlegm were expelled. That night she slept, resting heavily on her pillow, and recovered in ten days. Recalling the *Jinkui Yaolue*: "Those who were formerly fat but are now thin have Phlegm," I treated her with this formula.
Miaoxiang Wan Zhu Danxi stated: This is a formula to drain the intestines and stomach, and subdue Wood-Fire.
Chensha (Fly-ground Cinnabar, 5 liang) Niuhuang (Calculus Bovis) Longnao (Borneolum Syntheticum) Nifen (White Lead Powder) Shexiang (Moschus, ground, each 1 liang) Jinbo (Folium Aurum, 90 pieces) Badou (Crotonis Fructus, 315 seeds, tip and membrane removed, roasted, ground)
Grind uniformly. Refine 6 liang of yellow beeswax, add 3 parts good honey, refine together until uniform, and form pills. Each liang makes 30 pills. To make this medicine act quickly, pierce one hole, soak in cold water briefly before taking, for faster effect. For children's myriad diseases, make pills the size of mung beans.
[No Name] Wendan Tang (Warm Gallbladder Decoction) treats post-major illness Xu Fan (deficiency vexation) with inability to sleep. (Formula seen in the Insomnia Gate.)
[Zhang Zhongjing] Suanzaoren Tang (Sour Jujube Seed Decoction) treats deficiency consumption with Xu Fan (deficiency vexation) and inability to sleep. (Formula seen in the Insomnia Gate.)
The above nine methods treat Heat Vexation. The first five methods address vexation-heat and palpitations, indicating heat in the Heart and Lung; thus Zhuye (Bamboo Leaf), Shigao (Gypsum), and Zhusha (Cinnabar) are used to weigh down and direct the heat downward. The sixth method addresses vexation with diarrhea, indicating heat in the Upper Jiao; thus Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) is used to induce vomiting. The seventh method addresses vexation with unresolved sweating, indicating pathogens in both exterior and interior; thus exterior-interior resolving decoctions are used.
The eighth method addresses deep pulse, thirst, and hot palms, indicating heat is not in the exterior; thus Miaoxiang Wan (Wonderful Fragrance Pill) is used to purge. The ninth method, Wendan Tang (Warm Gallbladder Decoction) and Suanzaoren Tang (Sour Jujube Seed Decoction), treats insomnia.
Whenever the Heart is deficient, there is Heart Vexation; Liver, Kidney, and Spleen deficiency also cause Heart Vexation. The classics state: The Summer pulse belongs to the Heart; its insufficiency causes Heart Vexation. It also states: Liver, Kidney, and Spleen deficiency all cause heavy body and grievous vexation; thus it is known that vexation mostly arises from deficiency.
In the context of Climatic Factors (Yunqi), there are five types of Vexation:
First, Heat assists Heart Excess causing Vexation. The classics state: When Shaoyin governs the year, excessive Heat causes disease with chest vexation-heat and dry throat. Also: When Shaoyang governs the year, excessive Fire causes disease with vexation and heat in the chest and heart. Also: Shaoyang victory causes Heart Vexation and Heart Pain, treated with salty-cold substances.
Second, Heart follows constraint causing Vexation. The classics state: When Taiyang governs the year, Cold Qi descends, Heart Qi follows upward; cold and clear rise frequently, Fire Qi ascends high, causing Heart Heat Vexation.
Third, Metal attacks Liver Deficiency causing Vexation. The classics state: When Year Metal is excessive, Dry Qi prevails, Liver Wood suffers evil, people suffer heavy body and grievous vexation.
Fourth, Earth attacks Kidney Deficiency causing Vexation. The classics state: When Year Earth is excessive, Rain-Damp Qi prevails, Kidney Water suffers evil, people suffer heavy body and grievous vexation. Also: When Year Water is insufficient, Damp Qi prevails greatly, people suffer grievous vexation and flaccidity of the feet.
Fifth, Wood attacks Spleen Deficiency causing Vexation. The classics state: When Year Wood is excessive, Wind Qi prevails, Spleen Earth suffers evil, people suffer heavy body and grievous vexation. Since Liver and Kidney deficiency both cause heavy body and grievous vexation, excessive Metal leads to Liver Deficiency, excessive Earth leads to Kidney Deficiency, and excessive Wood leads to Spleen Deficiency. In these three years of excess, the Liver, Kidney, and Spleen suffer evil and become deficient, all resulting in heavy body and grievous vexation.
Regarding Moxibustion and Acupuncture, there are four approaches to Heart Vexation:
First, select Xinshu (BL-15). The classics state: The Pericardium Channel of Hand-Jueyin produces diseases such as Heart Vexation, Heart Pain, and heat in the palm; select points based on excess, deficiency, heat, cold, sinking, or depression. Also: When Qi is chaotic in the Heart, there is Heart Vexation, silence, and a desire to bow the head and lie still; select the Hand-Shaoyin and Jueyin channels.
Second, select Shenshu (BL-23) and Pangguangshu (BL-28). The classics state: The Kidney Channel of Foot-Shaoyin produces diseases such as Heart Vexation, Heart Pain, flaccidity, Jue (cold extremities), and heat/pain under the foot; select points based on excess, deficiency, heat, cold, sinking, or depression. Also: Tongue deviation with drooling, vexation, select Foot-Shaoyin. Also: The Luo-connecting vessel of Foot-Shaoyin is named Dazhong (KI-4), located behind the ankle winding around the heel, diverging to Taiyang; if Qi rebels, there is vexation and oppression; select its divergent point. Also: Sweating with vexation and fullness, unresolved exterior-interior, select Juyang (Taiyang) and Shaoyin.
Third, select Feishu (BL-13). The classics state: The Lung Channel of Hand-Taiyin produces diseases such as vexation, chest fullness; select points based on excess, deficiency, heat, cold, sinking, or depression. Also: Chills, shaking chattering of teeth, inability to sweat, abdominal distension with grievous vexation; select Hand-Taiyin.
Fourth, select Pishu (BL-20). The classics state: The Spleen Channel of Foot-Taiyin produces diseases such as Heart Vexation, urgent pain below the heart, loose stools, masses, diarrhea, water retention; select points based on excess, deficiency, heat, cold, sinking, or depression.