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，故心肾合而为躁也，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。此症多因脾胃气虚，或服克伐之剂所致，但当调补中气为善。
一小儿患此，饮冷不止，或作胀痛，余谓胃火所致，用犀角地黄汤、芹菜汁而顿愈。
一小儿烦躁作渴，饮冷不止，先君谓脾胃热毒，用犀角地黄汤而愈。后复作，喜饮热汤，面目赤色，用当归补血汤
而痊，惟倦怠少食，用白术散而愈。
一小儿贯脓之际，烦躁不宁，肝脾脉数，用圣济犀角地黄汤，一剂稍止，用八珍汤加牡丹皮而止，又二剂浆渐贯，
却用内托散，倍用参、 、归、术而靥。
一小儿痘将贯脓，烦躁面赤，脉数大而虚，此气血虚也，先用参 四圣散，又用当归补血汤而愈。
一小儿出痘烦躁作渴，面赤口干，脉洪而大，按之无力，两尺为甚，此禀肾不足，阴虚而火动也，用大剂地黄丸料
加五味子，煎与恣饮，诸症顿减，乃佐以补中益气汤，二剂痘齐，乃用参 四圣散而靥。
一小儿出痘烦躁，作渴饮汤，面目赤色，脉数无力，两尺为甚，此禀足三阴虚也，用益气汤及地黄丸料加五味子大
剂，始末服而靥。
一男子出痘，烦躁作渴，虚症不能悉举，先君用益气汤、地黄丸料加五味子，各三十余剂，更用人参五斤煎汤代
茶，饮两月余而靥；又用参、 、归、术各数斤，半载始能步履，得元气充实，且慎调摄而痊。
一小儿十五岁，痘将愈而烦躁，脉数而无力，劳则益甚，且无寐，或惊悸，余用归脾、补中二汤渐愈。后因劳仍作，
或用四物、化痰之剂，前症益甚，更发热恶寒头晕而殁。
一小儿痘愈后，烦躁面赤，脉洪大，按之如无，余谓血虚，朝用补中汤，夕用归脾汤将愈。因饮食过多，功课劳心，
吐泻腹痛，头晕恶寒，反服藿香正气散，发热如炙，汗出如雨，手足并冷而殁。
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，即止后服。
当归六黄汤 治血气不足，虚火内动，或烦躁，盗汗不止。
熟地黄 当归 黄 （炒） 黄柏（以下俱炒黑） 黄芩 黄连 生地黄
上每服三五钱，水煎。
八珍汤 治气血俱虚，或用克伐之剂，脾胃虚损，肌肉消瘦，发热恶寒，饮食少思等症。（方见顶陷灰白）
补中益气汤
当归补血汤（二方见寒战切牙）
六味地黄丸（方见痘发热属阴阳）
圣济犀角地黄汤（方见顶陷心烦）
内托散（即托里散，方见痘痈）
七味白术散（方见痘发热属阴阳）
李东垣说：火邪侵入心脏则产生烦乱，侵入肾脏则产生躁动，这都是心火作祟。因为火势旺盛会灼伤肺金、耗竭肾水，所以心和肾共同作用导致烦躁，适宜使用栀子豆豉汤。凡是痘疮正处于盛发阶段时，必须引导心火下行；如果毒气排出未尽，从而产生烦躁，可以用生黑豆煎汤，或者用生犀牛角磨汁饮用也可以。如果是津液不足，因虚热而心烦无法入睡的，使用《活人书》酸枣仁汤。这种病症多因脾胃气虚，或服用攻伐药物所致，只应当调理补益中焦之气为好。
有一个小孩患此症，不停地喝冷饮，有时出现胀痛，我认为这是胃火所致，使用犀角地黄汤和芹菜汁，顿时痊愈。
另一个小孩烦躁且口渴，不停地喝冷饮，我的父亲认为这是脾胃热毒，使用犀角地黄汤而痊愈。后来病情复发，喜欢喝热汤，面色发红，使用当归补血汤而康复，只是感到疲倦、食欲减退，使用七味白术散而痊愈。
还有一个小孩在痘疮化脓阶段，烦躁不安，肝脉和脾脉跳动急促，使用圣济犀角地黄汤，一剂后稍见缓解，接着使用八珍汤加入牡丹皮使症状停止，又服两剂后脓浆逐渐充盈，随后使用内托散，加倍使用人参、黄芪、当归、白术，使痘疮结痂。
又一个小孩痘疮即将化脓，烦躁面红，脉象数大而虚弱，这是气血亏虚，先用参芪四圣散，又用当归补血汤而痊愈。
又一个小孩出痘疮烦躁口渴，面色红赤，口干，脉象洪大但按之无力，两尺脉尤为明显，这是先天肾气不足，阴虚导致虚火妄动，使用大剂量的六味地黄丸药料加入五味子，煎汤让其大量饮用，各种症状立刻减轻，然后辅以补中益气汤，两剂后痘疮出齐，接着使用参芪四圣散使痘疮结痂。
又一个小孩出痘疮烦躁，口渴想喝热汤，面目红赤，脉象数而无力，两尺脉尤为明显，这是足三阴经（肝、脾、肾）亏虚，使用补中益气汤及大剂量的六味地黄丸药料加入五味子，从头到尾服用后痘疮结痂。
一个男子出痘疮，烦躁口渴，虚证表现不一，我的父亲使用补中益气汤、六味地黄丸药料加入五味子，各服用三十多剂，另用人参五斤煎汤代替茶水，饮用两个多月后痘疮结痂；后来又使用人参、黄芪、当归、白术各数斤，半年后才能行走，得到元气充实，并且谨慎调养而痊愈。
一个十五岁的小孩，痘疮将愈却出现烦躁，脉象数而无力，劳累后加重，且失眠，有时惊悸，我使用归脾汤、补中益气汤逐渐治愈。后来因劳累再次发作，有人使用四物汤、化痰药物，前面的症状更加严重，进而发热、恶寒、头晕而死。
一个小孩痘疮痊愈后，烦躁面红，脉象洪大，按之空虚，我认为这是血虚，早晨使用补中益气汤，晚上使用归脾汤，病将愈。但因饮食过多，功课劳心，出现呕吐腹泻、腹痛、头晕恶寒，反而服用藿香正气散，导致发热如火烤，汗出如雨，手脚冰冷而死。
《活人书》酸枣仁汤：治疗痘疹虚烦，惊悸无法入睡。
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）
以上用水煎煮温服，年龄大的儿童剂量加倍。
栀子豆豉汤
山栀（四个） 豆豉（半两）
以上用水二盏，先煮栀子至一盏水，加入豆豉煎至七分，去渣，温服，若引起快速呕吐，即停止后续服用。
当归六黄汤：治疗气血不足，虚火内动，或烦躁，盗汗不止。
熟地黄 当归 黄芪（炒） 黄柏（以下均炒黑） 黄芩 黄连 生地黄
以上每次服用三五钱，用水煎煮。
八珍汤：治疗气血俱虚，或服用攻伐药物后，脾胃虚损，肌肉消瘦，发热恶寒，饮食少思等症状。（方剂见顶陷灰白条下）
当归补血汤（这两个方剂见寒战切牙条下）
Li Dongyuan stated: When fire pathogen enters the Heart, it causes *fan* (restlessness/mental agitation); when it enters the Kidney, it causes *zao* (physical restlessness). Both are driven by Heart Fire. Since excessive fire scorches Lung Metal and depletes Kidney Water, the Heart and Kidney interact to produce restlessness; in such cases, Zhizi Douchi Tang (Gardenia and Fermented Soybean Decoction) is appropriate. During the peak stage of smallpox eruption, one must guide the Heart Fire downward. If toxic factors have not been fully expelled, leading to restlessness, decocting raw black soybeans or drinking juice ground from raw rhinoceros horn is also effective. For cases where fluid deficiency leads to deficiency-heat causing mental agitation and insomnia, Huoren Suanzao Ren Tang (Sour Jujube Seed Decoction from the *Huoren Shu*) should be used. This condition often results from Spleen-Stomach Qi deficiency or the use of purgative/draining agents; therefore, regulating and tonifying Middle-Jiao Qi is the best approach.
A child suffered from this condition, constantly drinking cold liquids, sometimes experiencing distension and pain. I diagnosed this as Stomach Fire and treated him with Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) and celery juice, resulting in immediate recovery.
Another child presented with restlessness and thirst, constantly drinking cold liquids. My father diagnosed this as Heat-Toxin in the Spleen and Stomach and cured him with Xijiao Dihuang Tang. The condition later recurred, with a preference for hot drinks and redness of the face; he was cured using Danggui Buxue Tang (Angelica Sinensis and Astragalus Decoction). He remained fatigued with poor appetite, which was resolved using Qimian Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder).
During the suppuration phase of another child's smallpox, there was restless agitation. The Liver and Spleen pulses were rapid. One dose of Shengji Xijiao Dihuang Tang provided slight relief. Subsequently, Bazhen Tang (Eight-Treasure Decoction) with Mudanpi (Moutan Bark) stopped the symptoms. After two more doses, the pus filled the lesions. Finally, Neituo San (Internal Support Powder) was used, with increased dosages of Renshen (Ginseng), Huangqi (Astragalus), Danggui (Angelica), and Baizhu (Atractylodes), leading to scabbing.
Another child, whose smallpox was about to suppurate, exhibited restlessness, facial redness, and a rapid, large, yet empty pulse. This indicated Qi and Blood deficiency. First, Shenqi Sixiang San (Ginseng and Astragalus Four-Saints Powder) was administered, followed by Danggui Buxue Tang, resulting in recovery.
Another child presenting with smallpox-related restlessness and thirst, red face, dry mouth, and a洪 (surging) but large pulse that felt weak upon pressure, especially at the Chi (Cun) positions, was diagnosed with congenital Kidney insufficiency and Yin deficiency leading to hyperactive fire. Large doses of Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) material added with Wuweizi (Schisandra) were decocted and allowed to drink freely. Symptoms decreased immediately. This was then supplemented with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). After two doses, the eruptions were complete, and Shenqi Sixiang San was used to promote scabbing.
Another child with smallpox-related restlessness, thirst for hot drinks, red face and eyes, and a rapid, weak pulse (especially at the Chi positions) was diagnosed with deficiency of the Three Yin meridians of the Foot (Liver, Spleen, Kidney). Treatment with Buzhong Yiqi Tang and large doses of Liuwei Dihuang Wan material added with Wuweizi from start to finish led to scabbing.
A man suffering from smallpox presented with restlessness and thirst, with various deficiency signs. My father prescribed Buzhong Yiqi Tang and Liuwei Dihuang Wan material added with Wuweizi, each taken for over thirty doses. Additionally, five jin (approx. 2.5 kg) of Renshen was decocted as tea substitute, consumed for over two months until scabbing occurred. Later, several jin each of Renshen, Huangqi, Danggui, and Baizhu were used. It took half a year before he could walk. With sufficient Yuan Qi (Original Qi) restored and careful regulation, he recovered.
A fifteen-year-old child experienced restlessness as smallpox was healing, with a rapid, weak pulse worsening with exertion, insomnia, and occasional palpitations/fright. I gradually improved his condition using Guipi Tang (Restore the Spleen Decoction) and Buzhong Yiqi Tang. However, due to overexertion, the condition recurred. Another practitioner used Siwu Tang (Four-Substance Decoction) and phlegm-resolving agents, exacerbating the previous symptoms. The patient subsequently developed fever, aversion to cold, dizziness, and died.
After smallpox healed, another child presented with restlessness, facial redness, and a洪 (surging) pulse that felt empty upon pressure. I diagnosed this as Blood deficiency. Morning administration of Buzhong Tang and evening administration of Guipi Tang showed promise. However, due to overeating and mental strain from studies, the child developed vomiting, diarrhea, abdominal pain, dizziness, and aversion to cold. Instead, Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi) was administered. This caused high fever like roasting, profuse sweating, and cold extremities, leading to death.
Huoren Suanzao Ren Tang: Treats deficiency-heat restlessness, fright, and insomnia due to rash diseases.
Suanzaoren (Fried Sour Jujube Seed), Gancao (Fried Licorice), Zhi mu (Fried Anemarrhena), Bai Fuling (Poria), Maidong (Ophiopogon, heart removed), Chuanxiong, Jiangtan (Fried Dried Ginger). Each 3 fen.
Decoct in water and take warm. Dosage doubles for older children.
Zhizi Douchi Tang
Shanzhi (4 Gardenia fruits), Douchi (Half liang fermented soybeans).
Add 2 cups of water. First boil Shanzhi until reduced to 1 cup. Add Douchi and boil until reduced to 0.7 cup. Strain and take warm. If rapid vomiting occurs, stop subsequent doses.
Danggui Liuhuang Tang: Treats Qi and Blood insufficiency, internal movement of deficiency-fire, restlessness, and continuous night sweats.
Shudihuang (Prepared Rehmannia), Danggui (Angelica), Huangqi (Fried Astragalus), Huangbai (Phellodendron, fried black below), Huangqin (Scutellaria), Huanglian (Coptis), Shengdihuang (Raw Rehmannia).
Take 3-5 qian per dose, decoct in water.
Bazhen Tang: Treats combined Qi and Blood deficiency, or Spleen-Stomach damage from purgative agents, emaciation, fever with aversion to cold, and poor appetite. (Formula see entry on "Inverted Pustules Grey/White").
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction)
Danggui Buxue Tang (See entry on "Chills and Teeth Grinding" for both formulas)
Liuwei Dihuang Wan (See entry on "Smallpox Fever Belonging to Yin/Yang" for formula)
Shengji Xijiao Dihuang Tang (See entry on "Inverted Pustles with Mental Agitation" for formula)
Neituo San (Also known as Tuoli San, See entry on "Smallpox Carbuncle" for formula)
Qimian Baizhu San (See entry on "Smallpox Fever Belonging to Yin/Yang" for formula)