懊 者，烦心、热燥、闷乱不宁也，甚者似中巴豆、草乌头之类毒药之状也。
栀子汤 治懊 、烦心、反复颠倒、不得眠者；
燥热怫郁于内，而气不能宣通也。经曰∶血气者，人之神，由荣卫血气营运，则神在乎其
中也。然神行于表则荣卫流注于经，谓之行阳，令人寤，犹天之日出为昼也。神行于里，则五脏相生
而顺传，谓之行阴，令人寐。故神识外无所用而惑，神迷于内，则复为梦也，犹日入于夜。其夫燥
金主涩，而湿土主滑，夫燥湿之体，必先因之于彼气而后为其兼化也，犹先大凉而物后燥，及风胜，
湿热耗其液而成燥体，及热太甚，则万物湿润而出液者也。由是表热无燥者，气血营运通利，而成
癫狂走呼而力大者也。燥热病于外者，气血壅滞，则痿弱而无力也。故病内热而无燥者，津液润泽，
气血滑利，则昏冒多睡也。如洗心散寒药，言治多睡是也。故小儿昼精健，夜安
寝，由血液不衰也。夫燥病于内者，气血涩滞，则懊 烦心不得眠也。夫伤寒之燥热者，因于大
发吐下，或呕吐泻痢，自汗过多，或阳热太甚，损阴耗液，亡液则血衰而成燥热也。或炙熨、炙烙，
或误服热剂，或误因银粉、巴豆燥热大毒丸药下之，反损阴亡液，血衰则燥热太甚，多为此误。经
曰∶目得血而能视，耳得血而能听，手指得血而能操，掌得血而能握，足得血而能步，脏得血而能
液，腑得血而能气。然则一身之至贵者莫过于血，故阳热虽甚而血液不衰，则荣卫通利而为病微。
血液既衰以伐，燥热怫郁则甚也。且如酒热方甚，而血液未衰，则气血宣通而和畅；因其酒热损
阴亡液，以致血衰而酒渐以散之，燥热怫郁而烦渴，病于酒也。而再饮后得平者，气液宣行而燥
热怫郁后得散也。或不受，复者，酒毒已甚，燥热不能散也。亦犹世俗妄意以分阳毒微于阴毒者，是
谓内外燥热太甚，而血液不衰，则气血营运之太甚，而为病者，犹泰极失常，以为阳毒也。以血液
衰竭，燥热太甚，蓄之于内，则阳气不能营运于表，故遍身青冷、厥逆，病危极将死者，妄谓寒极
阴毒也，因以中外急救其阳，而反招暴祸。倘或病热尚微，而误中《素问》言辛热开发强劫之效，
因以妄矜己能，以谓阴毒必死之证，救之以活，致使世俗愈感而惟恨救之不及，误人多矣。殊不知，
但以退热、润燥、散结，则气
液宣行而愈也。故经曰∶肾苦燥，急食辛以温之。开腠理，致津液，通气脉也。然气通和即津液
宣行也（故经曰∶气和而生津液相盛而神自生）。
或胸满结滞，或头微汗出，剧烦者，栀子汤主之。或少气者，加甘草一钱，或加呕者，及初
误以丸药下之者，加生姜半两。凡懊 虚烦者，皆用凉膈散甚佳，及宜汤濯手足，使心胸结热宣散而已。
栀子浓朴汤 治心烦、腹满、坐卧不安。
懊（心中烦乱不安）的症状，表现为心烦、燥热、胸闷扰乱且不得安宁，严重的情况类似于中了巴豆、草乌头等毒药后的状态。
栀子汤用于治疗懊（心中烦乱不安）、心烦、翻来覆去无法安卧、不能入睡的情况；这是因为燥热郁结在体内，导致气机不能宣通。经典论述说：血和气，是人的精神所在，由于营卫气血的运行，精神就存在于其中。然而，当神行于体表时，营卫之气流注于经脉，这称为“行阳”，使人清醒，就像太阳出来是白天一样。当神行于体内时，五脏相生并顺次传变，这称为“行阴”，使人入睡。所以，如果神识在外没有用处而感到困惑，神迷于内，就会做梦，就像太阳落入黑夜。燥金主涩，湿土主滑，燥和湿的体质，一定是先受到其他气候的影响而后才形成兼夹的变化，就像先大凉然后物体变干，以及风胜、湿热耗伤津液而成为燥体，如果热太甚，万物湿润并渗出津液。因此，表热而没有燥象的，气血运行通畅，会表现为癫狂呼喊且力气大。燥热病在体外的，气血壅滞，就会痿弱无力。所以病在内热而没有燥象的，津液润泽，气血滑利，就会昏沉嗜睡。比如洗心散中的寒药，说的就是治疗多睡症。所以小儿白天精神健旺，夜晚安静睡眠，是因为血液没有衰败。燥病在体内的，气血涩滞，就会出现懊（心中烦乱不安）、心烦、不能入睡。伤寒的燥热证，是因为大发汗、攻下，或者呕吐泻痢，自汗过多，或者阳热太甚，损伤阴液耗伤津液，亡失津液则血液衰少而成燥热。或者是艾灸、熨烫、烙法，或者误服热性药剂，或者误用银粉、巴豆等燥热大毒的丸药攻下，反而损伤阴液亡失津液，血液衰少则燥热太甚，多是犯这样的错误。经典说：眼睛得到血就能视物，耳朵得到血就能听声，手指得到血就能拿取东西，手掌得到血就能握持，脚得到血就能行走，脏得到血就能产生津液，腑得到血就能化生气。既然这样，全身最宝贵的莫过于血，所以即使阳热很盛而血液没有衰败，营卫通畅，病情就轻微。血液既然衰败被削弱，燥热郁结就会严重。就像酒热正盛，而血液没有衰败，气血宣通而和畅；因为酒热损伤阴液亡失津液，导致血衰而酒热逐渐消散，燥热郁结而烦渴，这是酒病。如果再饮酒后得以平复，是气液宣行而燥热郁结后得以消散。如果不能受纳，反复出现，是酒毒已甚，燥热不能消散。也如同世俗错误地认为分阴阳毒中阳毒较轻于阴毒，这是指内外燥热太甚，而血液没有衰败，气血运行过甚，作为疾病，就像泰极失常，认为是阳毒。如果血液衰竭，燥热太甚，蓄积在体内，阳气就不能运行于体表，所以遍身青冷、四肢厥逆，病情危重即将死亡的，错误地认为是寒极阴毒，因而内外急救其阳气，反而招致暴祸。倘若病热尚轻微，而误信《素问》中辛热开发强劫的功效，于是狂妄自负，认为阴毒是必死之证，却救活了，致使世俗更加信服而只恨救得不够及时，误导人很多了。殊不知，只要退热、润燥、散结，气液宣行就能痊愈。所以经典说：肾苦燥，急食辛味以温之。开腠理，致津液，通气脉。气通和即津液宣行（所以经典说：气和而生津液相盛而神自生）。
如果有胸满结滞，或者头部微汗出，剧烈烦躁的，用栀子汤主治。如果少气的，加甘草一钱，或者加上呕吐的，以及起初误用丸药攻下的，加生姜半两。凡是懊（心中烦乱不安）属于虚烦的，都用凉膈散效果很好，并且适宜用汤水浸泡手足，使心胸结热宣散而已。
Ao (mental restlessness and discomfort) refers to symptoms of vexation, dryness-heat, chest oppression, mental disturbance, and inability to remain calm. In severe cases, it resembles the condition caused by poisoning with drugs such as Crotonis Fructus (Badou, 巴豆) or Aconiti Kusnezoffii Radix (Caowutou, 草乌头).
Zhizi Tang (Gardenia Decoction) is used to treat Ao (mental restlessness and discomfort), vexation, tossing and turning, and insomnia; this occurs because dryness-heat is constrained within, preventing the free flow of Qi. The Classics state: "Blood and Qi are the spirit of man." Because Ying and Wei, Blood and Qi circulate, the Spirit resides within them. When the Spirit moves outward, Ying and Wei flow into the meridians, which is called "moving in Yang," causing wakefulness, just as the sun rising brings day. When the Spirit moves inward, the Five Zang organs generate each other in a smooth sequence, which is called "moving in Yin," causing sleep. Thus, if the Spirit has no external function and becomes confused, or if the Spirit is lost within, dreams occur, just as night follows sunset. Dry Metal governs astringency, while Damp Earth governs slipperiness. The constitutions of Dryness and Dampness must first be influenced by other climatic factors before forming combined transformations. For example, after extreme cold, things become dry; when Wind prevails, and Damp-Heat consumes body fluids, a dry constitution forms. If Heat is excessive, all things become moist and exude fluids. Therefore, in exterior Heat without Dryness, the circulation of Blood and Qi is unobstructed, leading to manic behavior, shouting, and great strength. In exterior Dryness-Heat, Blood and Qi are congested, leading to flaccidity and weakness. In interior Heat without Dryness, body fluids are moist, and Blood and Qi are slippery, leading to drowsiness and excessive sleep. For instance, the cold herbs in Xixin San (Heart-Washing Powder) treat excessive sleep. Children are vigorous during the day and sleep peacefully at night because their Blood is not depleted. When Dryness affects the interior, Blood and Qi become stagnant and sluggish, resulting in Ao (mental restlessness and discomfort), vexation, and insomnia. The Dryness-Heat of Shanghan (Cold Damage) arises from excessive sweating or purging, vomiting and diarrhea, profuse spontaneous sweating, or excessive Yang Heat damaging Yin and consuming fluids. Loss of fluids leads to Blood deficiency and Dryness-Heat. It may also result from moxibustion, hot compresses, cauterization, or mistakenly taking hot formulas, or erroneously using pills containing Mercury(II) Sulfide (Yinfen, 银粉) or Crotonis Fructus (Badou, 巴豆)—drugs that are extremely drying, hot, and toxic—to purge, thereby further damaging Yin and depleting fluids. Blood deficiency then causes extreme Dryness-Heat. Such errors are common. The Classics say: "The eyes see when they receive Blood; the ears hear when they receive Blood; fingers grasp when they receive Blood; palms hold when they receive Blood; feet walk when they receive Blood; Zang organs produce fluids when they receive Blood; Fu organs generate Qi when they receive Blood." Therefore, nothing in the body is more precious than Blood. Even if Yang Heat is severe, if Blood is not depleted, Ying and Wei flow freely, and the disease is mild. However, if Blood is depleted and weakened, constrained Dryness-Heat becomes severe. Consider alcohol heat: if Blood is not yet depleted, Qi and Blood flow smoothly and harmoniously. But if alcohol heat damages Yin and depletes fluids, leading to Blood deficiency, the alcohol heat dissipates gradually, causing constrained Dryness-Heat, vexation, and thirst—this is an alcohol-induced disease. Drinking again may bring relief because Qi and Body Fluids circulate, dispersing the constrained Dryness-Heat. If one cannot tolerate it and symptoms recur, the alcohol toxicity is severe, and Dryness-Heat cannot disperse. This is similar to the popular misconception that Yang Toxin is milder than Yin Toxin. This view assumes that extreme internal and external Dryness-Heat exists while Blood remains robust, causing excessive circulation of Qi and Blood, resembling a state of excess Yang (Yang Toxin). Conversely, if Blood is exhausted and Dryness-Heat is extreme, accumulating internally, Yang Qi cannot circulate to the exterior. The body becomes cold and blue, limbs are cold and inverted, the condition is critical and near death, yet this is mistakenly diagnosed as extreme Cold Yin Toxin. Treating this with urgent warming and tonifying of Yang internally and externally can cause sudden disaster. If the heat is mild but one mistakenly believes in the strong opening effects of acrid-hot remedies mentioned in the Suwen (Plain Questions), claiming personal skill in saving patients deemed doomed by Yin Toxin, the public will admire this and regret insufficient rescue efforts, misleading many. One should simply clear Heat, moisten Dryness, and resolve stagnation; once Qi and Body Fluids circulate freely, recovery occurs. Thus, the Classics state: "The Kidney suffers from Dryness; urgently consume Acrid flavors to warm it." This opens the interstices (Couli, 腠理), promotes Body Fluids, and unblocks Qi channels. When Qi flows harmoniously, Body Fluids circulate freely (as the Classics say: "When Qi is harmonious, Body Fluids are abundant, and the Spirit naturally arises").
If there is chest fullness and stagnation, slight sweating on the head, and severe vexation, Zhizi Tang (Gardenia Decoction) is the primary treatment. If there is shortness of breath, add 1 qian of Glycyrrhizae Radix et Rhizoma (Gancao, 甘草). If vomiting is present, or if the patient was initially incorrectly treated with pill-based purgatives, add 0.5 liang of Zingiberis Rhizoma Recens (Shengjiang, 生姜). For all cases of Ao (mental restlessness and discomfort) due to deficient vexation, Liangge San (Cooling the Diaphragm Powder) is very effective. Additionally, soaking the hands and feet in warm water helps disperse the constrained heat in the chest and heart.
Zhizi Nongpu Tang (Gardenia and Magnolia Bark Decoction) treats vexation, abdominal fullness, and restlessness in sitting or lying down.