经云。气乱于心则烦。盖热客于肺则烦。入于肾则躁。大抵心火旺。则水亏金烁。惟火独炽。
故肺肾合而为烦躁也。烦躁俱作。有属热者。有属寒者。先哲治独烦不躁者多属热。惟悸而烦者
为虚寒。治独躁不烦者多属寒。惟火旺脉实者为热。盖烦者胸中烦。为内热也。躁者身体手足躁
扰。或裸体不欲近衣。或欲投井中。为无根之外热。急以附子、理中、四逆、姜附辈热药治之。
若误认为热。投以凉药。则周身之火。得水则升走。顷刻喘汗。外脱而死也。凡表证不得汗。内
外皆热而躁乱不宁。取汗则定。里实热郁。大便不通。无论伤寒杂证。心神不安。脉数实有力者。
下之则定。火客心包。或酒客膏粱。上焦不清。令人烦躁。宜芩、连、山栀等凉药为君。稍用炮
姜为使。甚则凉膈散下之。汗下后热不止而发狂烦躁。面赤咽痛者。此热乘少阴之经也。葶苈苦
酒汤探吐之。
经云。夏脉者。心也。其不及者。令人烦心。肝虚肾虚脾虚。皆令人体重烦冤。是知烦多生
于虚也。大法。津液去多。五内枯燥而烦者。八珍汤加竹叶、枣仁、麦冬。营血不足。阳盛阴微
而烦者。当归补血汤下朱砂安神丸。或生脉散
加归、地、枣仁、竹茹之属。肾水下竭。心火上炎而烦者。大剂生料六味丸。少用肉桂为引导。
肥人虚烦。不眠不饮。温胆汤。大病后有余热。呕吐咳逆。虚烦不安。竹叶石膏汤。五心烦热。
口干唇燥。胸中热闷。千金竹叶汤。虚烦懊 。颠倒不安。栀子豉汤。不应。加犀角、黑参。久
病余热不止。虚烦不安。卧寐不宁。六味丸加枣仁。烦而小便不利。五苓散加辰砂、滑石。烦而
呕。不喜食。金匮橘皮竹茹汤。胎前产后诸烦。见妇人本门。
《黄帝内经》说：“气机紊乱于心则产生烦感。”大概热邪客居肺脏则生烦，侵入肾脏则生躁。大抵心火旺盛，会导致肾水亏虚、肺金被灼，只有火邪独自炽盛，所以肺和肾共同作用而形成了烦躁的症状。
烦躁同时出现，有的属于热证，有的属于寒证。先贤治疗只烦不躁的，大多属于热证；只有心悸且烦的，才属于虚寒证。治疗只躁不烦的，大多属于寒证；只有火旺且脉象实大的，才属于热证。大概“烦”是指胸中烦闷，这是内热的表现；“躁”是指身体手足躁动不安，或者脱衣裸露不想靠近衣物，或者想跳进井里，这是无根的外在假热。应当紧急使用附子、理中汤、四逆汤、姜附类药物等热性药物来治疗。如果误认为是热证，投用凉药，那么周身之火遇到水就会升腾游走，顷刻间导致气喘、出汗，阳气外脱而死。凡是表证无法发汗，内外皆热且躁乱不宁的，通过发汗即可安定；如果是里实热郁结，大便不通，无论是伤寒还是杂病，只要心神不安、脉象数而实有力，通过泻下即可安定。火邪客居心包，或者是嗜酒及膏粱厚味之人，上焦不清爽，令人烦躁，适宜用黄芩、黄连、山栀等凉性药物作为主药，稍加炮姜作为引导药。严重时可用凉膈散泻下。发汗或泻下后热势不止且发狂烦躁、面红咽痛的，这是热邪乘袭少阴经脉。可用葶苈苦酒汤探吐治疗。
《黄帝内经》说：“夏季的脉象对应心脏。”如果脉象不及（虚弱），会让人心烦。肝虚、肾虚、脾虚，都会让人身体沉重、心中烦闷冤屈。由此可知，烦多生于虚证。一般法则：津液耗损过多，五脏内部枯燥而烦的，用八珍汤加竹叶、枣仁、麦冬。营血不足，阳盛阴微而烦的，用当归补血汤送服朱砂安神丸。或者用生脉散加当归、地黄、枣仁、竹茹之类。肾水下竭，心火上炎而烦的，用大剂量生料六味丸，少用肉桂作为引经药。肥胖之人患虚烦，不眠且不渴饮，用温胆汤。大病之后有余热，呕吐咳逆，虚烦不安，用竹叶石膏汤。五心烦热，口干唇燥，胸中热闷，用千金竹叶汤。虚烦懊恼，颠倒不安，用栀子豉汤；若无效，加犀角、黑参。久病余热不止，虚烦不安，卧寐不宁，用六味丸加枣仁。烦且小便不利，用五苓散加辰砂、滑石。烦且呕吐，不喜欢进食，用金匮橘皮竹茹汤。产前产后各种烦症，参见妇人科相关章节。
The *Classic of Difficult Issues* (Huangdi Neijing) states: "When Qi is disordered in the Heart, it generates 'Fan' (restlessness/irritability)." Generally, when heat pathogens lodge in the Lung, 'Fan' arises; when they enter the Kidney, 'Zao' (agitation/restlessness) arises. Broadly speaking, when Heart Fire is hyperactive, it leads to a deficiency of Kidney Water and the scorching of Lung Metal, leaving only Fire blazing alone. Thus, the Lung and Kidney combine to produce both Fan and Zao.
When Fan and Zao occur simultaneously, some cases belong to Heat patterns, while others belong to Cold patterns. Ancient sages treated cases of isolated Fan without Zao as mostly belonging to Heat; only those with palpitations accompanied by Fan belong to Deficiency-Cold patterns. Cases of isolated Zao without Fan are mostly attributed to Cold; only those with hyperactive Fire and a full pulse belong to Heat. Generally, "Fan" refers to chest distress, indicating internal heat. "Zao" refers to physical agitation of the body and limbs, or nakedness with a desire not to be near clothing, or even a desire to jump into a well, representing rootless external false heat. In such cases, hot medicines such as Fuzi (Aconite Lateralis Radix Praeparata), Lizhong Tang (Regulate the Middle Decoction), Sini Tang (Frigid Extremities Decoction), and Jiang-Fu (Ginger and Aconite) preparations should be urgently administered. If mistakenly identified as Heat and cooled medicines are administered, the fire throughout the body will rise and scatter upon contact with water, leading to panting and sweating within moments, resulting in death due to the collapse of Yang Qi from the exterior.
For all cases where exterior syndromes fail to produce sweat, presenting with internal and external heat plus restless agitation, inducing sweat will resolve the condition. For interior excess-heat stagnation with constipation, regardless of whether it is Shanghan (Cold Damage) or miscellaneous diseases, if there is mental unrest and a rapid, full, and forceful pulse, purgation will resolve the condition. When Fire pathogens lodge in the Pericardium, or in individuals accustomed to alcohol and rich/greasy foods, causing turbidity in the Upper Jiao which leads to Fan and Zao, cooling herbs such as Huangqin (Scutellariae Radix), Lianzi (Corydalis Rhizoma), and Zhizi (Gardeniae Fructus) should be used as sovereign drugs, with slightly processed Shengjiang (Zingiberis Rhizoma) used as an attendant guide. In severe cases, Liangge San (Cool the Diaphragm Powder) may be used for purgation. If fever persists after sweating or purging, leading to mania, Fan, Zao, red face, and sore throat, this indicates Heat invading the Shaoyin (Lesser Yin) meridian. Tingli Kujiu Tang (Descurainia Seed and Vinegar Decoction) can be used to induce vomiting via probing.
The *Classic of Difficult Issues* states: "The summer pulse corresponds to the Heart." If the pulse is deficient (not reaching normal strength), it causes heart vexation. Liver deficiency, Kidney deficiency, and Spleen deficiency all cause heavy body weight and inner vexation/oppression. From this, we know that Fan often arises from Deficiency patterns. The general principle is: When fluids are excessively depleted, causing dryness in the five zang organs and resulting in Fan, Bazhen Tang (Eight Treasures Decoction) with Zhuye (Bambusae Folium), Zaoren (Ziziphi Spinosomi Semen), and Maidong (Ophiopogonis Radix) should be used. When Ying (Nutrient) Blood is insufficient, with Yang hyperactivity and Yin weakness causing Fan, Danggui Buxue Tang (Angelica Sinensis and Astragalus Decoction) administered with Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill) is appropriate. Alternatively, Shengmai San (Generate the Pulse Powder) with Danggui (Angelicae Sinensis Radix), Dihu (Rehmanniae Radix), Zaoren (Ziziphi Spinosomi Semen), and Zhuru (Bambusae Caulis in Taenia) may be used. When Kidney Water is exhausted at the bottom and Heart Fire flares upward causing Fan, a large dose of Shengliu Wei Wan (Six Ingredient Pill with Rehmannia) should be used, with a small amount of Rougui (Cinnamomi Cortex) as a guiding agent.
For obese individuals suffering from Deficiency-Vexation, characterized by insomnia and no thirst, Wendan Tang (Warm the Gallbladder Decoction) is indicated. After a major illness, if residual heat remains with vomiting, cough, and reverse flow, causing Deficiency-Vexation and unrest, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is used. For five-palm heat (heat in palms, soles, and chest), dry mouth, dry lips, and chest heat/stuffiness, Qianjin Zhuye Tang (Million Gold Bamboo Leaf Decoction) is prescribed. For Deficiency-Vexation with deep restlessness, tossing and turning, Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) is used; if ineffective, Xijiao (Rhinocerotis Cornu - note: substitute with Buffalo Horn in modern practice) and Heishen (Polygoni Multiflori Preparata) are added. For lingering residual heat from chronic illness causing Deficiency-Vexation, unrest, and sleep disturbance, Liuwei Wan (Six Ingredient Pill) with Zaoren is used. For Fan accompanied by difficult urination, Wuling San (Five-Ingredient Powder with Poria) with Chencha (Cinnabaris) and Huashi (Talcum) is indicated. For Fan accompanied by vomiting and loss of appetite, Jingui Jupi Zhuyu Tang (Golden Cabinet Tangerina Peel and Bamboo Node Decoction) is used. Various types of Fan during pregnancy and postpartum are discussed in the Women's Diseases section.