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There are cases where a person, after encountering certain events or speaking excessively, develops irritability (Fan Xin). They often feel a sense of disturbance, confusion, and discomfort (Zao La) in the chest. This is caused by an imbalance of Yin and Yang, specifically where Fire is excessive and Water is insufficient. Some argue that heart heat causes Fire to move and generate irritation, while gallbladder cold leads to blood deficiency and aversion/annoyance. However, one must not realize that deficiency irritation (Xu Fan) essentially stems from heart heat, and the gallbladder is not actually cold. The gallbladder prefers warmth and abhors cold; when people say "gallbladder cold leads to timidity," it precisely indicates that the gallbladder cannot be cold. If the gallbladder were cold and timid, how could it dare to invade the fiery heart? Thus, it is evident that deficiency irritation is due to the heat of heart fire, not the cold of gallbladder wood. In ancient times, Wen Dan Tang (Warm the Gallbladder Decoction) was used to treat deficiency irritation, but if irritation worsens after taking it, it is precisely because of the misdiagnosis of gallbladder cold. The treatment method should involve supplementing the heart while using herbs that clear heart heat. The formula is named Jie Fan Yi Xin Tang (Relieve Irritation and Benefit Heart Decoction).

Ren Shen (Ginseng Radix et Rhizoma, 2 qian), Huang Lian (Coptidis Rhizoma, 1 qian), Sheng Zao Ren (Raw Semen Ziziphi Spinosae, 3 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 qian), Fu Shen (Poria with Hostwood, 3 qian), Dang Gui (Angelicae Sinensis Radix, 3 qian), Xuan Shen (Scrophulariae Radix, 5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.3 qian), Zhi Ke (Aurantii Fructus Immaturus, 0.5 qian), Tian Hua Fen (Trichosanthis Radix, 2 qian).

Decoct in water and take orally. After one dose, irritation ceases; after two doses, irritation is eliminated.

This formula consists entirely of herbs that enter the Heart channel. Herbs that resolve phlegm are added to those that clear fire because where there is fire, there is inevitably phlegm. Once phlegm and fire dissipate, irritation naturally resolves. Moreover, there are herbs that tonify the heart, working synergistically!

For this syndrome, Xuan Dong Tang (Xuan Dong Decoction) is also very effective.

Xuan Shen (Scrophulariae Radix), Mai Dong (Ophiopogonis Tuber: each 2 liang).

Decoct in water and take orally. After one dose, the mind becomes peaceful; after two doses, full recovery occurs.

There are cases where elderly patients suffer from deficiency irritation and insomnia (Bu Mei), along with constipation. They often feel a surge of hot qi rising directly from below the umbilicus to the heart, causing dizziness, confusion, and a feeling of impending death. People assume this is fire qi rushing to attack the heart, but who would know it is actually a severe depletion of Kidney Water? The fluid in the heart is essentially the essence within the Kidneys. Heart Fire fears the control of Kidney Water, which is a false control; Heart Fire welcomes the generation by Kidney Water, which is true generation. When the Heart receives interaction from the Kidney, the Heart lives; when the Heart loses communication with the Kidney, the Heart dies. Deficiency irritation is merely the gradual approach to a dying Heart. Since the Kidney connects upward to the Heart, why does qi from below the umbilicus rush upward causing heart irritation? It is unknown that the interaction between the Kidney and Heart involves Kidney Water interacting with the Heart, not Kidney Fire interacting with the Heart. When Kidney Water interacts with the Heart, it forms the state of Ji Ji (Water and Fire in Balance), leading to peace; when Kidney Fire interacts with the Heart, it forms the state of Wei Ji (Water and Fire out of Balance), leading to obstruction. Therefore, Ji Ji results in a peaceful heart, while Wei Ji results in an irritated heart. In the elderly, isolated Yang without Water causes hot qi to rush upward, which is Kidney Fire attacking the Heart. The excess of Fire is actually due to the insufficiency of Water. The treatment method is to greatly tonify the Water in the Kidney, so that Water is sufficient to control Fire, preventing Fire from rushing upward and stopping irritation naturally. The formula used is Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Pill Decoction) with modifications.

Shu Di (Prepared Rehmanniae Radix, 1 liang), Shan Zhu Yu (Corni Fructus, 5 qian), Shan Yao (Dioscoreae Rhizoma, 4 qian), Fu Ling (Poria, 3 qian), Dan Pi (Moutan Cortex, 5 qian), Ze Xie (Alismatis Rhizoma, 2 qian), Bai Shao (Radix Paoniae Alba, 5 qian), Mai Dong (Ophiopogonis Tuber, 5 qian), Chao Zao Ren (Stir-fried Semen Ziziphi Spinosae, 5 qian), Bei Wu Wei Zi (Schisandrae Fructus, 1 qian), Chai Hu (Bupleuri Radix, 0.5 qian), Gan Ju (Chrysanthemi Flos, 3 qian).

Decoct in water and take orally. After two doses, irritation recedes; after four doses, bowel movements become unobstructed; after twenty doses, it does not recur.

Liu Wei Wan Tang serves to nourish the depletion of Kidney Water. Mai Dong and Wu Wei Zi nourish its source of transformation; Bai Shao and Chai Hu level the Liver. When the Liver is balanced, Ministerial Fire has no support and does not incite the fire of the Pericardium. Furthermore, aided by the restraining effects of Zao Ren and Gan Ju, the Qi of the Heart naturally relaxes. With the communication of Kidney Water, there is the joy of moistening without the bitterness of dryness. How could there still be movement of deficiency irritation!

For this syndrome, Ji Xin Dan (Heart-Nourishing Pill) is also effective.

Shu Di (2 liang), Mai Dong, Xuan Shen, Sheng Zao Ren (each 5 qian), Dan Pi, Di Gu Pi (Cortex Lycii), Bai Zi Ren (Biota Orientalis Seed), Tu Si Zi (Cuscutae Semen), Ba Ji Tian (Morindae Officinalis Radix, each 3 qian).

Decoct in water and take orally. After ten doses, full recovery is achieved.