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Fan (restlessness) refers to the unease of the Heart spirit. The Heart is a Fire organ, responsible for transforming and generating blood, and it relies on blood to nourish its internal fire. Therefore, the seal script character for "Heart" resembles an inverted "Fire"; when the fire descends, the Heart becomes tranquil.

In patients who have lost blood, excessive hemorrhage deprives the Heart fire of nourishment, leading to frequent restlessness. If the fire is excessively severe, black coating appears on the tongue, and insomnia occurs at night. This is primarily treated with Huanglian Ejiao Tang (Coptis Rhizome and Duck Egg Yolk Decoction).

A feeling of inner vexation and depression (Ao Nao) arises because the fire cannot be dispersed, resulting in stagnation and unhappiness. This is suitable for treatment with Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction), added with Qiaojiao (Forsythiae Fructus), Jiegeng (Platycodonis Radix), Dali (Millettiae Speciosae Caulis), Shengdi (Rehmanniae Radix), Yuanzhi (Polygalae Radix), Huanglian (Coptidis Rhizoma), and Cao Shao (Glycyrrhizae Radix et Rhizoma Praeparatum cum Melle).

If the fire is not severe but the blood deficiency is significant, causing a strange discomfort in the heart that is indescribable, this is termed "Xu Fan" (deficiency-type restlessness). It can be treated with Guipi Tang (Restore the Spleen Decoction) added with Zhusha (Cinnabar), Maidong (Ophiopogonis Radix), and Chao Zhizi (Stir-fried Gardeniae Fructus). Xiaoyao San (Free and Easy Wanderer Powder) added with Longgu (Fossilia Ossis Mastodi) and Zaoren (Ziziphi Spinosae Semen) is also effective. Zhang Zhongjing's Suanzaoren Tang (Sour Jujube Seed Decoction) is particularly an important formula for treating restlessness.

If restlessness is accompanied by agitation, with wild movements of the hands and feet, this indicates a condition where deficiency is complicated by excess, specifically dry stool retained internally. Symptoms must include irregular bowel movements and urination, fever, thirst, and a rapid, forceful pulse. In the context of Shanghan (Cold Damage), this corresponds to Chengqi syndrome; however, in patients who have lost blood, one must simultaneously address the deficiency. Yuzhu San (Jade Candle Powder) is suitable, or Yunü Jian (Middle-aged Woman Decoction) added with Yuanmingfen (Mirabilite).

When irritability reaches an extreme, manifesting as picking at clothes and bedrails (Xun Yi Mo Chuang), if urination is free, it indicates that Yin has not yet been completely exhausted, and there is still a chance for rescue. If urination is difficult, the prognosis is fatal. This differs from "Yin Zao" (Yin-type agitation). Yin Zao presents with agitation without restlessness and must be accompanied by definitive signs of Yin-cold; careful differentiation is required.

Furthermore, postpartum blood deficiency can cause restlessness and shortness of breath. Although this is also restlessness, during childbirth, blood flows downward, often leading to Qi depletion. The blood deficiency here stems from Qi deficiency; thus, restlessness is accompanied by shortness of breath. Suitable treatments include Guipi Tang, Danggui Buxue Tang (Angelica Sinensis Decoction for Tonifying Blood), and Yangrong Tang (Nourish the Vigor Decoction), which tonify Qi to generate blood, thereby resolving the restlessness naturally.

Regarding patients with hematemesis (vomiting blood), their Qi tends to rebel upward, typically presenting as Qi excess and Blood deficiency. The symptom of restlessness here is a severe manifestation of blood failing to nourish the Heart. If Qi is further supplemented, Qi will become more excessive and Blood more deficient, causing the Heart greater unrest. The treatment should focus on tonifying blood and clearing fire, using Zhusha Anshen Wan (Cinnabar Calm the Spirit Pill). Refer also to the section on Sleep Disorders, Palpitations, and Fright.