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The *Huoren Shu* (Book of Vitality) states: Xu Fan (deficiency vexation) resembles Taiyang disease (disease of 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 examination of texts, Cheng Wuji's words indeed originate from Zhang Zhongjing, while the *Huoren Shu* lacks evidence. However, clinically, there are often cases of Xu Fan (deficiency vexation) not caused by Taiyang disease, so both theories are retained here. Chen Wuyue states: Patients with Xu Fan (deficiency vexation) do not feel feverish in the body, but have dizziness and headache, dry mouth and throat without thirst, and remain awake unable to sleep; these are all manifestations of Xu Fan (deficiency vexation). The *Baoming Ji* (Collection for Preserving Life) states: Restlessness in sitting and lying, and unstable sleep, are called Fan (vexation). Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) and Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) are appropriate. The *Huoren Shu* states: Isolated fever indicates Xu Fan (deficiency vexation). Various deficiency-heat vexations resemble Taiyang disease, but lack aversion to cold and body pain, thus indicating it is not Taiyang disease; sweating therapy should not be used. Lack of headache and a pulse that is not tight or rapid indicates it is not an interior excess syndrome; purgative therapy should not be used. For this condition, neither exterior nor interior attacks should be employed; attacking will inevitably lead to vexation and thirst. One should administer Zhu Ye Tang (Bamboo Leaf Decoction). If vomiting occurs, Chen Pi Tang (Tangerine Peel Decoction) one dose should be given; if not improved, give another. Dan Zhu Ru Tang (Light Bamboo Sheath Decoction) from the *Sanyin Fang* (Three Causes Formulae) and Zhu Sha An Shen Wan (Cinnabar Calming the Spirit Pill) by Li Dongyuan are also mentioned. Zhang Zhongjing states: After diarrhea, increased vexation with a soft epigastrium upon palpation indicates Xu Fan (deficiency vexation); Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) governs it. In the *Suwen* (Basic Questions), the Yellow Emperor asks: There is a disease where the body is hot, sweat is present, and vexation/fullness persists, not resolving with sweat. What disease is this? Qibo replies: Body heat with sweat indicates Wind pathogen; vexation/fullness not resolving with sweat indicates Jue (reversal); the disease name is Feng Jue (Wind Reversal). The Yellow Emperor says: I wish to hear more. Qibo says: The Taiyang channel governs Qi and is thus first affected by pathogens; Shaoyin is its interior-exterior pair. When heat enters, it follows upwards, leading to Jue (reversal). The Yellow Emperor asks: How to treat? Qibo says: Needle both exterior and interior channels and administer decoctions. (Exterior refers to Taiyang, interior to Shaoyin; needle with wind-treating decoctions to stop rebellious Kidney Qi, similar to Zhang Zhongjing's Mai Men Dong Tang [Ophiopogon Decoction] for descending rebellious Qi.)

Zhu Danxi treated a woman, over twenty years old, unmarried, usually robust. In June, she developed vexation and oppression, fatigue, and anorexia. During attacks, she desired to jump into a well. Her six pulses were deep, fine, weak, and rapid. Two days later, slight thirst appeared. Others diagnosed Summerheat, but treatment failed. By day four or five, vomiting worsened, emaciation occurred, palms became extremely hot, and she preferred cool places. The pulse gradually became hidden (Fu Mai). She occasionally spoke deliriously. Urgently, he prepared Miao Xiang Wan (Wonderful Fragrance Pill) from the *Jufang*, sized like Sophora seeds, administered with well water. Half a day later, the pill was passed in stool without symptom relief. He then washed the pill with musk-water, pierced three holes with a needle, and administered it with cool water the next day. Half a day later, several liters of thick phlegm were passed in stool. That night, she slept, resting heavily on her pillow, and recovered in ten days. Recalling the *Jingui Yaolue*: "Those who were formerly fat but are now thin have Phlegm." Thus, he treated with this method. Wen Dan Tang (Warm the Gallbladder Decoction) treats Xu Fan (deficiency vexation) and insomnia after severe illness. (Use only if Fluid retention is confirmed; do not use if absent.) Jingui Suan Zao Ren Tang (Sour Jujube Decoction) treats deficiency exhaustion with Xu Fan (deficiency vexation) and insomnia.

The above nine methods treat Heat Vexation. The first five address vexation, heat, and palpitations, indicating Heat in the Heart and Lungs; thus, Zhu Ye (Bamboo Leaf), Shi Gao (Gypsum), and Zhu Sha (Cinnabar) are used to suppress and descend the Heat. The sixth method addresses vexation with diarrhea, indicating Heat in the Upper Jiao; thus, Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is used to induce vomiting. The seventh method addresses vexation with unremitting sweat, indicating Exterior and Interior pathogens; 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, Miao Xiang Wan (Wonderful Fragrance Pill) is used to purge. The ninth method uses Wen Dan Tang (Warm the Gallbladder Decoction) and Suan Zao Ren Tang (Sour Jujube Decoction) for 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 corresponds to the Heart; insufficiency causes Heart Vexation. It also states: Liver, Kidney, and Spleen deficiencies cause heaviness and vexation (Zhong Yuan), knowing that vexation mostly arises from deficiency. Generally, excessive loss of Jin Ye (Body Fluids) leads to dryness of the Five Zang organs and vexation; Ba Zhen Tang (Eight Treasures Decoction) plus Zhu Ye (Bamboo Leaf), Suan Zao Ren (Sour Jujube Seed), and Mai Men Dong (Ophiopogon Tuber) is used. Ying Blood (Nutritive Blood) insufficiency with Yang excess and Yin deficiency causing vexation is treated with Ren Shen (Ginseng), Sheng Di Huang (Rehmannia Root), Mai Men Dong (Ophiopogon Tuber), Di Gu Pi (Lycium Bark), Bai Shao Yao (White Peony Root), Zhu Ru (Bamboo Shavings), etc., or Ren Shen Yang Rong Tang (Ginseng Nourishing the Nutritive Decoction) administered with Zhu Sha An Shen Wan (Cinnabar Calming the Spirit Pill). Kidney Water depletion with Heart Fire flaming upward causing vexation is treated with Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) administered with Zi Shui Wan (Nourishing the Kidney Pill). Post-illness Xu Fan (deficiency vexation) with Fluid retention uses Wen Dan Tang (Warm the Gallbladder Decoction); without Fluid retention, Yuan Zhi Tang (Polygala Decoction) is used. Postpartum, post-chickenpox/smallpox, or post-dysentery Xu Fan (deficiency vexation) results from blood consumption and unsettled Spirit; this is critical. One should vigorously administer Du Shen Tang (Single Ginseng Decoction). Vexation with difficult urination uses Wu Ling San (Five-Ling Powder). Internal Heat accumulation causing vexation uses Qing Xin Lian Zi Yin (Clear Heart Lotus Seed Drink). Vexation with vomiting and anorexia uses Chen Pi Tang (Tangerine Peel Decoction).

Yun Qi (Climate Influence) causes five types of Vexation: 1. Heat assisting Heart Excess causing vexation. The Classics state: When Shaoyin governs the year, excessive Heat causes chest vexation and heat, dry throat. Also: When Shaoyang governs, excessive Fire causes Heart vexation and chest heat. Also: Shaoyang victory causes Heart vexation and pain, treated with Salty-Cold herbs. 2. Heart constrained by Water causing vexation. The Classics state: When Taiyang governs, Cold descends, Heart Qi follows upward; cold clarity rises, Fire ascends high, causing Heart Heat and vexation. 3. Metal attacking Liver Deficiency causing vexation. The Classics state: Excessive Metal year, Dryness prevails, Liver Wood is attacked, people suffer heaviness and vexation. 4. Earth attacking Kidney Deficiency causing vexation. The Classics state: Excessive Earth year, Rain/Dampness prevails, Kidney Water is attacked, people suffer heaviness and vexation. Also: Insufficient Water year, Dampness dominates, people suffer vexation and foot atrophy. 5. Wood attacking Spleen Deficiency causing vexation. The Classics state: Excessive Wood year, Wind prevails, Spleen Earth is attacked, people suffer heaviness and vexation. Since Liver and Kidney deficiency cause heaviness and vexation, excessive Metal leads to Liver Deficiency, excessive Earth to Kidney Deficiency, and excessive Wood to Spleen Deficiency. In these three excessive years, Liver, Kidney, and Spleen are attacked and deficient, causing heaviness and vexation.

Moxibustion and Acupuncture treat Heart Vexation in four ways: First, select Xin Shu (Heart Transporter). The Classics state: The Pericardium Channel diseases include Heart vexation, chest pain, and palm heat; select based on Excess, Deficiency, Cold, Heat, or sinking. Also: Qi disorder in the Heart causes vexation and silence, head bowed and still; select Hand Shaoyin (Heart) and Hand Jueyin (Pericardium) channels. Second, select Shen Shu (Kidney Transporter) and Pang Guang Shu (Bladder Transporter). The Classics state: Foot Shaoyin (Kidney) Channel diseases include Heart vexation, chest pain, ataxia, and hot painful feet; select based on Excess, Deficiency, Heat, Cold, or sinking. Also: Tongue deviation with salivation and vexation; select Foot Shaoyin. Also: Foot Shaoyin Luo-connecting vessel, named Da Zhong, located behind the ankle encircling the heel, diverging to Taiyang; rebellious Qi causes chest oppression; select the divergent point. Also: Sweat with vexation/fullness not resolving; select both exterior and interior, i.e., Ju Yang (Taiyang) and Shaoyin. Third, select Fei Shu (Lung Transporter). The Classics state: Hand Taiyin (Lung) Channel diseases include Heart vexation and chest fullness; select based on Excess, Deficiency, Heat, Cold, or sinking. Also: Chills, shivering, jaw quivering, no sweat, abdominal distension and vexation; select Hand Taiyin. Fourth, select Pi Shu (Spleen Transporter). The Classics state: Foot Taiyin (Spleen) Channel diseases include Heart vexation, acute epigastric pain, loose stools, masses, and urinary obstruction; select based on Excess, Deficiency, Heat, Cold, or sinking.

[Prenatal Vexation] Pregnancy vexation is named Zi Fan (Fetal Vexation). In the fourth month, Shaoyin Jun Fire nourishes Essence; in the sixth month, Shaoyang Xiang Fire nourishes Qi. If the mother has Heart fright and Gallbladder timidity, this syndrome often occurs. The *Chanbao* states: This is Heart-Lung Deficiency Heat or Phlegm accumulation in the chest. Vexation in the third month is merely Heat. Vexation due to Phlegm-Fluid involves spitting saliva and food aversion. Internal Heat uses Zhu Ye Tang (Bamboo Leaf Decoction), Zhu Ru Tang (Bamboo Shavings Decoction), Yi Mu Wan (Motherwort Pill). Qi Stagnation uses Zi Su Yin (Perilla Drink). Phlegm Stagnation uses Er Chen Tang (Two-Aged Decoction) plus Bai Zhu (Atractylodes Rhizome), Huang Qin (Scutellaria Root), Zhi Ke (Bitter Orange). Qi Depression uses Fen Qi Yin (Separating Qi Drink) plus Chuan Xiong (Ligusticum Rhizome). Spleen-Stomach Weakness uses Liu Jun Zi Tang (Six Gentlemen Decoction) plus Zi Su (Perilla Leaf), Shan Zhi (Gardenia Fruit).

[Postpartum Vexation] The *Jingui Yaolue* states: Women in confinement, exposed to wind, suffering limb vexation-heat and headache, receive Xiao Chai Hu Tang (Minor Bupleurum Decoction); those with no headache but only vexation, receive San Wu Huang Qin Tang (Three-Ingredient Scutellaria Decoction). Also: Women postpartum with deficiency, vexation, restlessness, vomiting, and reversal, receiving Middle-calming and Qi-nourishing effects, use Zhu Pi Da Wan (Bamboo Peel Large Pill). Postpartum residual blood not cleared, rushing vexation, drink raw lotus root juice two cups, or bamboo sap is acceptable. Postpartum residual blood attacking the Heart, or continuous bleeding, chest oppression, cyanotic cold face, impending Qi collapse, drink one cup of sheep blood at once; if unstable, repeat. Postpartum Blood Deficiency and Qi Vexation: mix raw Rehmannia juice and clear wine, each one cup, boil once, divide into two doses. Pu Huang (Typha Pollen) one square inch measure, taken with flowing eastward water is good. Postpartum excessive blood loss leads to Blood Deficiency and Yin Deficiency, generating internal Heat, chest vexation-fullness, shortness of breath, headache, confusion, worsening at dusk; similar to post-severe illness Xu Fan (deficiency vexation), use *Heji Jufang* Ren Shen Dang Gui San (Ginseng and Angelica Powder). Postpartum shortness of breath nearing collapse, chest vexation, use Zhu Ye Tang (Bamboo Leaf Decoction) or Gan Zhu Tang (Sweet Bamboo Decoction). Postpartum Xu Fan (deficiency vexation) with insomnia uses Shao Yao Zhi Chi Tang (Peony and Gardenia-Soybean Decoction) or Suan Zao Ren Tang (Sour Jujube Decoction). Empirical formula for postpartum irritability: Yu Yu Liang (Halloysitum, one piece resembling sour filling), bury half in the ground, compact soil around it. Burn one picul of charcoal to red heat (one jin top fire), burn until two-thirds are consumed. Cover with wet sandy soil overnight. Remove, discard outer layer, use inner part. Grind finely, wash and clarify five to seven times, dry on paper, grind thousands of times. Mix with Gan Cao (Licorice) decoction, take two qian measures.