〔万〕烦者，扰扰而烦。躁者，愦躁之躁。合而言之，烦躁皆热也，析而分之，
烦阳也热之轻者，躁阴也热之甚者。《难知集》曰∶火入于肺烦也，火入于肾躁也，疮疹烦躁，须宜忌之。若吐利厥
逆，腹胀喘促而烦躁者，昏不知人，谵妄狂扰而烦躁者，谓之闷乱，皆不治之证。凡痘疮出不快，发不透，靥不
齐有烦躁者，此有二证，如面黄，大便色黑，烦躁喘渴，或如狂，或喜忘，腹胀或痛，此为有瘀血在里也，宜当
归丸（痘便闷）或四顺清凉饮（发热）并加桃仁泥、红花，甚者桃仁承气汤主之（失血）。如便血下
黑粪，而又睡不醒，心为血之主，睡不醒则心之神昏矣，玄参地黄汤（失血）加木通、麦门冬。若无面黄屎黑、如
狂喜忘之证，只大便不通、烦躁腹胀者，此有燥屎也，此却真狂谵妄，以三黄丸、四顺清凉饮（俱发热）、三乙承
气汤、当归丸、胆导法（俱便闷）看病轻重，择而用之，如偏执不可下之说，以致陷伏而死者，医之咎也。〔薛〕
东垣云∶火入于心则烦，入于肾则躁，皆心火为之。盖火旺则金烁水亏，故心肾合而为躁，宜用栀子豆豉汤。凡痘
疮盛作之时，必令心火有所导引，苟或毒瓦斯出而未尽，遂生烦躁，以生黑豆煎汤，或生犀磨汁饮之亦可。若津液不
足，虚烦不得卧者《活人》酸枣仁汤。此证多因脾胃气虚，或服克伐之剂所致，但当调补中气为善。
〔万〕如肺热而烦者，坐卧不安，审于何时，若初发热便烦者，此毒火内郁，人
参白虎汤（发热）加栀子仁主之。若疮发见犹烦者，此毒伏于内，未尽出也，消毒饮（见形）、夺命丹（起发）合而服
之。若疮出尽，又已起发犹烦者，此内热也，牛黄清心丸主之。如肾热而躁者，必曾自利，轻则陈氏木香散（泻
），甚则陈氏异功散（见形）主之。如扬手掷足，欲去衣被者，此热甚于表也，羌活汤主之，泻青丸去大黄、加甘
草。如神识昏迷、反复颠倒者，此热甚于里也，导赤散（心）牛黄清心丸合而治之。吐利不食而烦躁者，正气虚也
，陈氏木香散主之。如昼日烦躁，夜则安静者，此阳盛于昼，至夜则阳气退而安静也，人参白虎汤加栀子仁主之。
如昼日明了，夜则烦躁者，此阳陷入于阴，夜则阴盛，阴阳交争，故烦躁也，四物汤加栀子仁主之。
《活人》酸枣仁汤 治痘疹，虚烦惊悸不得眠。
酸枣仁（炒） 甘草（炙） 知母（炒） 白茯苓 麦门冬（去心） 川芎 干姜（炒各三分）
上，水煎，温服。儿大倍之。
栀子豆豉汤
山栀（四个） 豆豉（半两）
上，水二盏，先煮栀子一盏，内豆豉煎至七分，去滓温服。得快吐即止。
黄连解毒汤 治发 ，热甚心烦不得眠。
黄连 黄芩 黄柏 山栀（各等分）
上，每服四钱，水二钟，煎五分，温服。若 毒甚者，加青黛一钱，调入汤内
服之。凡脉弦数，内外热甚谵语者，合小柴胡汤主之。若脉洪数，内外热甚，舌燥烦渴者，合化 汤主之。
牛黄清心丸
黄连（五钱，生） 黄芩 山栀仁（各三钱） 郁金（二钱） 辰砂（一钱半） 牛黄（二分半）
共研细末，腊雪调面糊，丸如黍米大。每服七八丸，灯心汤送下。
人参蝉蜕散 治小便不利，痘疮不发，烦躁作渴，切牙喘满。
人参 蝉蜕 白芍药 木通 赤茯苓 甘草 紫草茸
上，每服三四钱，水煎。
人参竹叶汤 治虚烦不得寐，或兼自汗。
人参 竹叶 甘草（各二钱） 半夏（二钱五分） 小麦 麦门冬（各一钱五分）
上，每服二三钱，姜二片，粳米一撮，水煎服。
[Wan] "Fan" (restlessness of mind) refers to a state of mental disturbance and agitation. "Zao" (restlessness of body) refers to physical tossing and turning. In general terms, both Fan and Zao belong to heat syndromes; however, when analyzed separately, Fan is associated with Yang and represents a milder form of heat, whereas Zao is associated with Yin and represents a more severe form of heat. The *Nan Zhi Ji* states: "When Fire enters the Lung, Fan occurs; when Fire enters the Kidney, Zao occurs." In cases of smallpox or measles accompanied by Fan and Zao, careful differentiation and contraindications are required. If vomiting, diarrhea, cold limbs, abdominal distension, panting, and rapid breathing occur alongside Fan and Zao, or if there is unconsciousness, incoherent speech, mania, and wild agitation, this is termed "Men Luan" (stifling confusion), which indicates an incurable condition. If smallpox lesions emerge slowly, fail to fully erupt, or have uneven scabbing, and are accompanied by Fan and Zao, there are two possible patterns: 1) If the complexion is yellow, stool is black, and there is Fan, Zao, panting, thirst, manic behavior, or forgetfulness, along with abdominal distension or pain, this indicates blood stasis in the interior. The appropriate treatment is Dang Gui Wan (for stifled smallpox) or Si Shun Qing Liang Yin (for fever), added with Tao Ren Ni (Peach Kernel Paste) and Hong Hua (Safflower). For severe cases, Tao Ren Cheng Qi Tang is indicated. 2) If there is hematochezia with black stools, accompanied by excessive sleepiness that is difficult to rouse, this indicates clouding of the Heart spirit, as the Heart governs blood. Xuan Shen Di Huang Tang (for blood loss) added with Mu Tong (Akebia Caulis) and Mai Men Dong (Ophiopogon Tuber) should be used. If there are no signs of yellow complexion, black stool, mania, or forgetfulness, but only constipation, Fan, and abdominal distension, this indicates dry fecal matter in the intestines, representing true mania and delirium. Depending on the severity, one may choose San Huang Wan, Si Shun Qing Liang Yin, San Yi Cheng Qi Tang, Dang Gui Wan, or Dan Dao Fa (biliary enema). Insisting on the theory that purgation is forbidden, leading to death from pathogenic sinking, is the physician's fault.
[Xue] Li Dongyuan stated: "Fire entering the Heart causes Fan; Fire entering the Kidney causes Zao." Both are driven by Heart Fire. Generally, excessive Fire scorches Metal (Lung) and depletes Water (Kidney), causing the Heart and Kidney to interact pathologically resulting in Zao. Zhizi Dou Chi Tang is suitable. During the peak eruption of smallpox, it is essential to guide the Heart Fire appropriately. If toxins are not fully expelled, leading to Fan and Zao, decocting raw black soybeans or drinking fresh rhinoceros horn juice (now substituted with water buffalo horn in practice) can be effective. For deficiency-heat causing restlessness and insomnia, Suan Zao Ren Tang from the *Huo Ren Shu* is indicated. This syndrome often results from Spleen-Stomach Qi deficiency or the use of harsh draining medicines; thus, tonifying Middle Qi is the best approach.
[Wan] If Fan is caused by Lung Heat, characterized by restlessness in sitting and lying, observe the timing. If Fan appears at the onset of fever, it indicates internal depression of toxic fire; Ren Shen Bai Hu Tang added with Zhi Zi Ren (Gardenia Seed) is indicated. If Fan persists after lesions appear, it indicates latent toxins not yet fully erupted; Xiao Du Yin combined with Duo Ming Dan should be taken. If Fan persists after lesions have fully erupted and risen, it indicates internal heat; Niu Huang Qing Xin Wan is indicated. If Zao is caused by Kidney Heat, usually following spontaneous diarrhea, Chen Shi Mu Xiang San is for mild cases, and Chen Shi Yi Gong San is for severe cases. If the patient throws hands and feet about and desires to remove clothing/bedding, this indicates excess heat in the exterior; Qiang Huo Tang is indicated, or Xie Qing Wan without Da Huang and with added Gan Cao. If there is coma, confusion, and restless tossing, this indicates excess heat in the interior; Dao Chi San combined with Niu Huang Qing Xin Wan is indicated. Vomiting, diarrhea, anorexia, and Fan/Zao indicate deficiency of Righteous Qi; Chen Shi Mu Xiang San is indicated. If the patient is restless during the day but quiet at night, this is due to Yang abundance during the day and decline at night; Ren Shen Bai Hu Tang added with Zhi Zi Ren is indicated. If the patient is clear-minded during the day but restless at night, this is due to Yang sinking into Yin, with Yin abundance at night causing Yin-Yang conflict; Si Wu Tang added with Zhi Zi Ren is indicated.
*Suan Zao Ren Tang* from the *Huo Ren Shu*: Treats smallpox/measles with deficiency-heat, palpitations, and insomnia.
Suan Zao Ren (fried), Gan Cao (roasted), Zhi Mu (fried), Bai Fu Ling, Mai Men Dong (core removed), Chuan Xiong, Gan Jiang (fried, each 3 fen).
Decoct in water and take warm. Double the dose for older children.
*Zhizi Dou Chi Tang*:
Shan Zhi (4 pods), Dou Chi (0.5 liang).
Decoct Shan Zhi in 2 cups of water until 1 cup remains, add Dou Chi, and simmer until 0.7 cups remain. Strain and take warm. Stop taking if vomiting occurs.
*Huang Lian Jie Du Tang*: Treats smallpox with severe heat,心烦 (mental restlessness), and insomnia.
Huang Lian, Huang Qin, Huang Bo, Shan Zhi (equal parts).
Take 4 qian per dose, decoct in 2 zhong of water until 0.5 zhong remains. Take warm. If toxin is severe, add 1 qian of Qing Dai mixed into the decoction. For wiry-rapid pulse with severe internal/external heat and delirium, combine with Xiao Chai Hu Tang. For flooding-rapid pulse with severe internal/external heat, dry tongue, restlessness, and thirst, combine with Hua Ban Tang.
*Niu Huang Qing Xin Wan*:
Huang Lian (5 qian, raw), Huang Qin, Zhi Zi Ren (each 3 qian), Yu Jin (2 qian), Chen Sha (1.5 qian), Niu Huang (0.25 fen).
Grind into fine powder, mix with wax snow and wheat paste to form pills the size of millet seeds. Take 7-8 pills per dose, washed down with Deng Xin Tang (Juncus Decoction).
*Ren Shen Chan Tui San*: Treats difficulty urinating, non-erupting smallpox, restlessness with thirst, teeth grinding, panting, and chest fullness.
Ren Shen, Chan Tui, Bai Shao Yao, Mu Tong, Chi Fu Ling, Gan Cao, Zi Cao Rong.
Take 3-4 qian per dose, decoct in water.
*Ren Shen Zhu Ye Tang*: Treats deficiency-heat restlessness and insomnia, possibly with spontaneous sweating.
Ren Shen, Zhu Ye, Gan Cao (each 2 qian), Ban Xia (2.5 qian), Xiao Mai, Mai Men Dong (each 1.5 qian).
Take 2-3 qian per dose, add 2 slices of fresh ginger and a pinch of Jing Mi (rice), decoct in water, and take.