〔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) refers to a state of mental agitation and disturbance. "Zao" (fidgeting) refers to physical restlessness and irritability. Generally speaking, both Fan and Zao belong to heat syndromes; however, analytically distinguished, 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 *Nanzhi Ji* states: When fire enters the Lung, it causes Fan; when fire enters the Kidney, it causes Zao. In cases of smallpox or chickenpox accompanied by Fan and Zao, one must exercise caution and differentiation. If vomiting and diarrhea are accompanied by cold extremities, abdominal distension, panting, and restlessness, or if there is unconsciousness, delirium, mania, and restlessness, this is termed "Menluan" (oppressive confusion), which constitutes an intractable condition. In cases where smallpox lesions erupt slowly, fail to fully emerge, or have uneven scabbing, accompanied by restlessness, there are two specific patterns: If the complexion is yellow, stools are black, and there is restlessness, panting, thirst, manic behavior, or forgetfulness, along with abdominal distension or pain, this indicates blood stasis within. One should use Danggui Wan (for smallpox with bowel obstruction) or Sishun Qingliang Yin (for fever) added with Peach Kernel Paste and Safflower; for severe cases, Tao Ren Chengqi Tang is indicated. If there is bloody stool with black feces, accompanied by lethargy and inability to wake, since the Heart governs blood, lethargy indicates clouding of the Heart spirit; Xuan Shen Dihuang Tang (for blood loss) added with Akebia Stem and Ophiopogon Tuber is used. If there are no signs of yellow complexion, black stools, manic behavior, or forgetfulness, but only constipation, restlessness, and abdominal distension, this indicates dry fecal matter accumulation. This constitutes true mania and delirium; based on severity, one may select Sanhuang Wan, Sishun Qingliang Yin (both for fever), Sanyi Chengqi Tang, Danggui Wan, or Gall Bladder Suppository method (all for bowel obstruction). Adhering rigidly to the theory that purgation is contraindicated, leading to death from pathogen entrapment, is the physician's fault.
[Xue] Li Dongyuan stated: Fire entering the Heart causes Fan, while fire entering the Kidney causes Zao; both are driven by Heart fire. Since excessive fire scorches Lung Metal and depletes Kidney Water, the Heart and Kidney interact to produce Zao; Zhizi Chidui Tang is appropriate. During the peak eruption of smallpox, it is essential to guide the Heart fire outward. If toxins are not fully expelled, resulting in restlessness, decocting raw black soybeans or drinking fresh rhinoceros horn juice may be effective. For insufficiency of body fluids causing empty restlessness and insomnia, Suanzao Ren Tang from the *Huoren Shu* is used. This syndrome often results from Spleen and Stomach Qi deficiency or the use of harsh draining medications; therefore, tonifying Middle Qi is the proper approach.
[Wan] For Fan caused by Lung heat, characterized by restlessness in sitting and lying, one must examine the timing. If Fan occurs at the initial stage of fever, it indicates internal depression of toxic fire; Renshen Baizhu Tang (for fever) added with Gardenia Seed is indicated. If Fan persists when lesions appear, it indicates toxins remaining internally and not fully erupted; Xiaodu Yin (for appearance stage) and Tuoming Dan (for eruption stage) should be taken together. If Fan continues after lesions have fully erupted and risen, it indicates internal heat; Niuhuang Qingxin Wan is indicated. For Zao caused by Kidney heat, which typically follows spontaneous diarrhea, Chen Shi Muxiang San is used for mild cases, and Chen Shi Yigong San (for appearance stage) for severe cases. If the patient throws hands and feet about and desires to remove clothing and bedding, this indicates intense heat on the exterior; Qianghuo Tang is indicated, or Xieqing Wan with Rhubarb removed and Licorice added. If there is mental confusion and tossing and turning, this indicates intense heat in the interior; Daochi San (for Heart) and Niuhuang Qingxin Wan should be combined. For vomiting, diarrhea, anorexia, and restlessness, this indicates deficiency of healthy Qi; Chen Shi Muxiang San is indicated. For restlessness during the day but quietness at night, this indicates excess Yang during the day, retreating at night leading to quietness; Renshen Baizhu Tang added with Gardenia Seed is indicated. For clarity during the day but restlessness at night, this indicates Yang sinking into Yin; at night, Yin is dominant, and the struggle between Yin and Yang causes restlessness; Siwu Tang added with Gardenia Seed is indicated.
Suansao Ren Tang from the *Huoren Shu* treats smallpox/chickenpox with empty restlessness, palpitations, and insomnia.
Suanzaoren (Fried), Gancao (Roasted), Zhimu (Fried), Baifuling, Maidong (Heart removed), Chuanxiong, Jiangjiang (Fried, each 3 fen).
Decoct in water and take warm. Double the dose for older children.
Zhizi Chidui Tang
Shanzhi (4 units), Douchi (0.5 liang).
Add 2 cups of water, first decoct Shanzhi until 1 cup remains, then add Douchi and decoct until 0.7 cup remains. Strain and take warm. Stop taking immediately if rapid vomiting occurs.
Huanglian Jiedu Tang treats smallpox with severe heat, restlessness, and insomnia.
Huanglian, Huangqin, Huangbai, Shanzhi (equal parts).
Take 4 qian per dose, decoct in 2 zhong of water until 0.5 zhong remains. Take warm. For severe toxin heat, add Qingdai (1 qian) and mix into the decoction. For wiry and rapid pulse with severe internal/external heat and delirium, combine with Xiao Chaihu Tang. For flooding and rapid pulse with severe internal/external heat, dry tongue, and thirst, combine with Huaban Tang.
Niuhuang Qingxin Wan
Huanglian (5 qian, raw), Huangqin, Shanzhiren (each 3 qian), Yujin (2 qian), Chensha (1.5 qian), Niuhuang (0.25 qian).
Grind into fine powder, mix with wax snow and wheat paste, form pills the size of millet seeds. Take 7-8 pills per dose, washed down with Dengxin Tang.
Renshen Chantui San treats difficulty in urination, non-erupting smallpox, restlessness with thirst, teeth grinding, and panting/distension.
Renshen, Chantui, Baishao, Mutong, Chifuling, Gancao, Zicaorong.
Take 3-4 qian per dose, decoct in water.
Renshen Zhuye Tang treats empty restlessness with insomnia, or accompanied by spontaneous sweating.
Renshen, Zhuye, Gancao (each 2 qian), Banxia (2.5 qian), Xiaomai, Maidong (each 1.5 qian).
Take 2-3 qian per dose, add 2 slices of ginger and a pinch of Jingmi, decoct in water and take.