仲景云∶火入于肺则烦，入于肾则躁。夫心者，君火也。火王则金燔，水亏而火独存，故肺
肾合而为躁也。活人云∶但烦热者，虚烦也。诸虚烦热，与伤寒相似，但不恶寒，鼻不塞，
故知非伤寒也。头不痛，脉不紧，故知非里寒也。不可发汗攻下，当与竹叶汤，兼呕者与橘
皮汤。又心虚则先烦而后渴，翕翕发热，其脉浮紧而大是也。盖烦者，心中烦扰为内热，故
属阳；躁者，肢体躁动，或裸身欲入井中，为外热，故属阴。外热者无根之火也，是以为虚
。在小儿当辨，其 煎不安是烦； 不定是躁。 煎者，心经有热，精神恍惚，烦满生惊
； 者，心经有风，烦躁惊搐也。热甚者，黄连解毒汤，轻者导赤散。风热者，至宝丹。
脉数而实，便闷有热者，神芎丸，此皆实热之治法也。若烦而头痛短气，口干咽燥不渴者虚
也，用四君加芎、归。因药攻伐而作渴者，用竹茹汤。烦而不得眠者，酸枣仁汤。心神颠倒
，烦热欲吐者，朱砂安神丸。面戴阳，目内赤，六脉洪大，按之全无者，血虚发躁，用当归
补血汤。若躁而裸体欲入井中，脉沉细或浮大，按之如无者，此皆阴盛发躁也，宜用参
附汤，有回生之功。
治验
一小儿烦躁惊悸，热渴饮冷，额间色赤，此心经实热所致，先用泻心汤一服稍缓，又用柴胡
栀子散而愈。
一小儿痢后发热烦躁，用四君、当归、升麻、柴胡顿安，又用补中益气汤而愈。又伤食作泻
，前症复
一小儿溃疡，烦躁惊搐撮空，用六味丸料煎服，以滋肾肝，用五味异功散，以补脾肺渐愈，
又用八珍汤而痊。
一小儿患 疹，服发汗之药，烦躁作渴，先用当归补血汤，及东垣圣愈汤，诸症渐安。又用
八珍汤加麦门冬、五味子而愈。
一小儿痢后烦躁作渴，面赤脉大，按之如无，此血脱烦躁也，先用当归补血汤，又用加味异
功散加升麻、当归而安。又伤食作泻不已，复烦躁，用异功散为主，佐以八珍汤而安。
一小儿患瘰 ，服下毒之药，发热烦躁，口渴作呕，此元气复伤，用八珍汤倍加参、 、归
、术，治之渐安，又用四君、当归、升麻而安。
清热解毒丸 治五脏积热，毒瓦斯上攻，胸臆烦闷，咽喉肿痛，赤眼壅肿，头面发热，唇口干
燥，两颊生疮，精神恍惚，心忪闷乱，坐卧不宁，及伤暑毒，面赤身热，心烦躁而渴，饮食
不下。
寒水石 石膏（各八两） 青黛（四两）
上研末，入青黛和匀蒸饼七个，水调为丸如芡实大，每服一丸，食后新汲水化下，或细嚼生
姜汤下。如中诸毒，并宜服之。及惊风潮热，痰涎壅塞，心胸烦躁，颊赤多渴，坐卧不稳，每
服半粒，量大小加减。
橘皮汤
橘皮（一两半） 甘草（炙，半两） 人参（二钱五分） 竹茹（半两）
上每服五钱，姜水煎，食前服。
东垣圣愈汤 治诸疮出血多，而烦躁不得眠。
熟地黄 生地黄 川芎 人参（各五分） 当归身 黄 （各一钱）
上水煎服。
泻心汤 治心经实热，口舌生疮，烦躁发渴。
宣黄连 犀角（各等分）
上水煎服。
黄连解毒汤（方见诸痢）
竹茹汤（方见呕吐乳）
酸枣仁汤（方见惊痫）
朱砂安神丸（方见诸疳）
神芎丸
至宝丹（二方见惊风）
导赤散（方见心脏）
异功散
四君子汤（二方见内钓）
张仲景说：火邪侵入肺脏则出现烦，侵入肾脏则出现躁。心是君火（主宰生命活动的阳气）。当火气旺盛时，会灼伤肺金；肾水亏虚而火独存，所以肺和肾共同作用导致躁动。《活人书》说：只有烦热症状的，属于虚烦。各种虚证引起的烦热，与伤寒相似，但不怕冷，鼻子不堵塞，所以知道不是伤寒。头部不痛，脉象不紧，所以知道不是里寒。不可以使用发汗或攻下的方法治疗，应当给予竹叶汤，如果兼有呕吐的，配合橘皮汤。另外，心气虚弱则会先感到烦乱而后口渴，伴有轻微发热，脉象浮紧而大。大概来说，烦，是指心中烦扰不安，属于内热，所以归属于阳；躁，是指肢体躁动不安，或者脱光衣服想要跳进井中，属于外热，所以归属于阴。外热是无根之火，因此属于虚证。在小儿身上应当加以辨别，坐立不安是烦；动作不定是躁。煎煎不安，是心经有热，精神恍惚，烦闷并易受惊；躁动不定，是心经有风，烦躁且惊厥抽搐。热势严重的，用黄连解毒汤；轻症的，用导赤散。风热证的，用至宝丹。脉象数而有力，大便不畅且有热的，用神芎丸，这些都是实热证的治疗方法。如果烦乱且头痛、气短，口干咽燥但不想喝水的，属于虚证，用四君子汤加川芎、当归。因为药物攻伐过度而导致口渴的，用竹茹汤。烦乱且无法入睡的，用酸枣仁汤。心神错乱，烦热想吐的，用朱砂安神丸。面色泛红如戴阳，眼睛内部发红，六脉洪大但重按完全无力的，是血虚导致的躁动，用当归补血汤。如果躁动且脱衣欲入井中，脉象沉细或浮大但重按如无的，这都是阴盛格阳导致的躁动，适宜用参附汤，有起死回生之功。
治验案例：
一个小孩烦躁惊悸，发热口渴喜冷饮，额头颜色发红，这是心经实热所致，先用泻心汤服用一次稍见缓解，又用柴胡栀子散而痊愈。
一个小孩痢疾后发热烦躁，用四君子汤、当归、升麻、柴胡顿然安定，又用补中益气汤而痊愈。又有因伤食导致腹泻，前症复发……
一个小孩患有溃疡，烦躁惊搐且撮空理线，用六味丸料煎服以滋补肾肝，用五味异功散以补益脾肺逐渐好转，又用八珍汤而痊愈。
一个小孩患麻疹，服用发汗药后，烦躁作渴，先用当归补血汤，及东垣圣愈汤，诸症逐渐安定。又用八珍汤加麦门冬、五味子而痊愈。
一个小孩痢疾后烦躁作渴，面赤脉大，重按如无，这是血脱导致的烦躁，先用当归补血汤，又用加味异功散加升麻、当归而安定。又有因伤食导致腹泻不止，再次烦躁，用异功散为主，佐以八珍汤而安定。
一个小孩患瘰疬，服用下毒之药，发热烦躁，口渴作呕，这是元气再次受伤，用八珍汤倍加人参、白术、当归、白术，治疗逐渐安定，又用四君子汤、当归、升麻而安定。
清热解毒丸 治疗五脏积热，毒瓦斯上攻，胸膈烦闷，咽喉肿痛，眼睛红肿，头面部发热，嘴唇口干干燥，两颊生疮，精神恍惚，心慌闷乱，坐卧不宁，以及中暑毒，面赤身热，心烦烦躁而渴，饮食不下。
寒水石 石膏（各八两） 青黛（四两）
以上研成粉末，加入青黛混合均匀，用七个蒸饼，用水调制成如芡实大小的丸剂，每次服用一丸，饭后用新汲水化开服用，或者细嚼后用生姜汤送服。如果中了各种毒，都适宜服用。以及惊风潮热，痰涎壅塞，心胸烦躁，脸颊红多渴，坐卧不稳，每次服用半粒，根据年龄大小加减剂量。
橘皮汤
橘皮（一两半） 甘草（炙，半两） 人参（二钱五分） 竹茹（半两）
以上每次服用五钱，用姜水煎煮，饭前服用。
东垣圣愈汤 治疗各种疮疡出血多，而烦躁不得眠。
熟地黄 生地黄 川芎 人参（各五分） 当归身 黄芪（各一钱）
以上用水煎服。
泻心汤 治疗心经实热，口舌生疮，烦躁发渴。
宣黄连 犀角（各等分）
以上用水煎服。
黄连解毒汤（方见诸痢）
竹茹汤（方见呕吐乳）
酸枣仁汤（方见惊痫）
朱砂安神丸（方见诸疳）
神芎丸
至宝丹（二方见惊风）
导赤散（方见心脏）
异功散
四君子汤（二方见内钓）
Zhang Zhongjing stated: When fire pathogen enters the Lung, it causes Fan (restlessness); when it enters the Kidney, it causes Zao (agitation). The Heart is the Minister Fire (Yang qi governing vital activities). When Fire is excessive, it scorches Metal; when Kidney Water is deficient and Fire remains alone, the Lung and Kidney combine to cause Zao. The *Huoren* book states: Cases with only heat-related Fan belong to Xu Fan (deficiency restlessness). Various deficiency-induced Fan and heat resemble Shanghan (cold damage), but without aversion to cold or nasal congestion, thus it is known not to be Shanghan. With no headache and a non-tight pulse, it is known not to be interior cold. Sweating or purging methods should not be used; instead, Zhuye Tang (Bamboo Leaf Decoction) should be given. If accompanied by vomiting, Jupi Tang (Tangerine Peel Decoction) should be combined. Furthermore, Heart Qi deficiency leads to Fan first followed by thirst, accompanied by slight fever and a pulse that is floating, tight, and large. Generally speaking, Fan refers to mental restlessness due to internal heat, thus belonging to Yang; Zao refers to physical agitation, such as stripping naked and wanting to enter a well, due to external heat, thus belonging to Yin. External heat is rootless fire, hence it is a deficiency syndrome. In children, differentiation is necessary: sitting and standing uneasily is Fan; restless movement is Zao. "Jianjian" (uneasy burning sensation) indicates Heat in the Heart Channel, with absent-mindedness, fullness of Fan, and susceptibility to fright; Zao indicates Wind in the Heart Channel, causing irritability and convulsions. For severe heat, Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) is used; for mild cases, Daochi San (Guide Out Red Powder) is used. For Wind-Heat, Zhibao Dan (Precious Treasure Pill) is used. For a rapid and forceful pulse, constipation with heat, Shenxiong Wan (Divine Celery Pill) is used; these are all treatments for Excess-Heat syndromes. If Fan is accompanied by headache, shortness of breath, dry mouth and throat without desire to drink, it is a deficiency syndrome, treated with Sijunzi Tang (Four Gentlemen Decoction) plus Chuanxiong Danggui (Angelica Sinensis). Thirst caused by over-aggressive medication is treated with Zhuru Tang (Bamboo Sheath Decoction). Insomnia due to Fan is treated with Suanzaoren Tang (Sour Jujube Seed Decoction). Mental confusion, heat, and urge to vomit are treated with Zhusha Anshen Wan (Cinnabar Calming Spirit Pill). Facial flushing resembling Daiyang (floating Yang), redness inside the eyes, and a洪大 (surging-large) pulse that vanishes upon deep pressure indicate Zao caused by Blood deficiency, treated with Danggui Buxue Tang (Angelica Tonifying Blood Decoction). If Zao involves stripping naked and wanting to enter a well, with a deep-thin or floating-large pulse that feels empty upon pressure, this is Zao caused by Yin excess repelling Yang, treated with Shenfu Tang (Ginseng and Aconite Decoction), which has life-restoring efficacy.
Clinical Cases:
A child presented with irritability, palpitations, fever, thirst preferring cold drinks, and redness on the forehead. This was caused by Excess-Heat in the Heart Channel. Xie Xin Tang (Drain the Heart Decoction) was administered once for slight relief, followed by Chaihu Zhizi San (Bupleurum and Gardenia Powder) for cure.
A child presented with fever and irritability after dysentery. Si Jun Zi Tang, Danggui, Shengma, and Chaihu were administered for immediate stabilization, followed by Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) for cure. Another case involved diarrhea due to food stagnation where previous symptoms recurred...
A child with ulcers presented with irritability, convulsions, and picking at empty air. Liuwei Wan (Six-Ingredient Pill) decoction was used to nourish the Kidney and Liver; Wuyi Yigong San (Five-Agent Extraordinary Skill Powder) was used to tonify the Spleen and Lung, leading to gradual improvement, followed by Bazhen Tang (Eight Treasures Decoction) for recovery.
A child with measles developed irritability and thirst after taking diaphoretic herbs. Danggui Buxue Tang and Dongyuan Shengyu Tang (Dongyuan's Holy Salvation Decoction) were used for gradual stabilization, followed by Bazhen Tang plus Maidong and Wuweizi for cure.
A child presented with irritability and thirst after dysentery, with a red face and large pulse that vanished upon pressure. This was irritability due to blood loss. Danggui Buxue Tang was used first, followed by Jia Wei Yigong San (Modified Extraordinary Skill Powder) with Shengma and Danggui for stabilization. Subsequent diarrhea due to food stagnation led to recurrent irritability; Yigong San was used as the main formula with Bazhen Tang as an adjunct for stabilization.
A child with scrofula took toxic purgatives, resulting in fever, irritability, thirst, and vomiting. This indicated further injury to Yuan Qi (Original Qi). Bazhen Tang with increased Renshen, Baizhu, Danggui, and Baizhu was used for gradual stabilization, followed by Sijunzi Tang, Danggui, and Shengma for stabilization.
Qingre Jiedu Wan (Clear Heat and Resolve Toxicity Pill) treats accumulated heat in the five Zang organs, toxic vapors attacking upward, chest oppression, sore throat, red and swollen eyes, heat in the head and face, dry lips and mouth, sores on cheeks, absent-mindedness, palpitations, restlessness, and discomfort in sitting or lying down. It also treats summerheat toxicity, red face, body heat, irritability, thirst, and inability to eat.
Hanshui Shi (Metastone), Shigao (Gypsum Fibrosum) (each 8 liang), Qingdai (Indigo Naturalis) (4 liang).
Grind into powder, mix evenly with Qingdai, use seven steamed dough cakes, mix with water to form pills the size of Euryale seeds. Take one pill per dose, dissolve in fresh cool water after meals, or chew finely and swallow with Ginger Decoction. Suitable for various poisonings. Also for wind-stroke tidal fever, phlegm obstruction, chest irritability, red cheeks, excessive thirst, and restlessness. Take half a pill per dose, adjusting according to age and size.
Jupi Tang (Tangerine Peel Decoction)
Jupi (Citri Reticulatae Pericarpium) (1.5 liang), Gancao (Licorice Root, honey-fried) (0.5 liang), Renshen (Ginseng Radix et Rhizoma) (2.5 qian), Zhuru (Bambooae Medulla) (0.5 liang).
Take 5 qian per dose, decoct with ginger water, take before meals.
Dongyuan Shengyu Tang (Dongyuan's Holy Salvation Decoction) treats profuse bleeding from various sores causing irritability and insomnia.
Shudihuang (Rehmanniae Radix Praeparata), Shengdihuang (Rehmanniae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Renshen (Ginseng Radix et Rhizoma) (each 5 fen), Dangguishen (Angelicae Sinensis Radix), Huangqi (Astragali Radix) (each 1 qian).
Decoct in water and take.
Xie Xin Tang (Drain the Heart Decoction) treats Excess-Heat in the Heart Channel, mouth and tongue sores, irritability, and thirst.
Xuanhuanglian (Scutellariae Radix), Xijiao (Rhinocerotis Cornu) (equal parts).
Decoct in water and take.
Huanglian Jiedu Tang (See under Dysentery)
Zhuru Tang (See under Vomiting in Infants)
Suanzaoren Tang (See under Epilepsy)
Zhusha Anshen Wan (See under Malnutrition Syndromes)
Shenxiong Wan
Zhibao Dan (Two formulas see under Convulsions)
Daochi San (See under Heart Diseases)
Yigong San
Sijunzi Tang (Two formulas see under Internal Hookworm/Colic)