烦者。心不安也。心为火脏。化生血液。转赖血液以养其火。故心字篆文。即是倒火。火降则心宁也。失血家
亡血过多。心火失其滋养。故多发烦。火太甚者。舌上黑苔。夜不能寐。黄连阿胶汤主之。心中懊 者。以火
不得宣。故郁而不乐也。宜栀子豉汤。加连翘桔梗大力生地远志黄连草梢治之。若火不甚。而血太虚者。
心中了戾不得。是为虚烦。归脾汤加朱砂麦冬炒栀子治之。逍遥散加龙骨枣仁亦治之。仲景酸枣仁汤。
尤为治烦要药。若烦而兼躁。手足妄动。此为虚中夹实。内有燥屎。必见二便不调。发热口渴。脉数有力等
证。在伤寒为承气证。在失血家。须兼顾其虚。宜玉烛散。或用玉女煎加元明粉。烦躁之极。循衣摸床。小便
利者。阴尚未尽。犹可救一二。小便不利。死不治矣。此与阴躁不同。阴躁不烦而但躁。且必现阴寒可据之
证。须细辨之。
又有产后血虚。心烦短气者。虽同是心烦。然产血下行。气多虚脱。其血之虚。皆由于气虚。故心烦而必兼
短气。宜归脾汤。当归补血汤。养荣汤等。以补气者生血。而心烦自愈。至吐血家。则其气上逆。多是气实血
虚。证见心烦。尤血不养心之甚者也。若再补其气。则气益甚。而血益虚。心愈不得其安矣。治宜补血清火。
朱砂安神丸治之。须参看卧寐怔忡惊悸门。
烦，是指心神不安。心属于火脏，负责化生血液，同时依赖血液来滋养其内的火气。因此，“心”字的篆书字形，就是倒置的“火”字，火势下降则心神安宁。
对于失血患者，由于亡血过多，心火失去滋养，所以容易多发烦闷。如果火气过盛，会出现舌上黑苔、夜间无法入睡的症状，主治方剂为黄连阿胶汤（Coptis and Duck Egg Yolk Decoction）。
心中感到懊恼郁结的，是因为火气不得宣散，导致郁滞而不快乐，适宜用栀子豉汤（Gardenia and Fermented Soybean Decoction），并加入连翘、桔梗、牛大力、生地、远志、黄连、甘草梢进行治疗。
如果火气不严重，但血液过于亏虚，心中感觉怪异不适却无法言说，这称为“虚烦”，可用归脾汤（Guipi Tang）加入朱砂、麦冬、炒栀子治疗；逍遥散（Xiaoyao Powder）加入龙骨、酸枣仁也可以治疗。张仲景的酸枣仁汤（Suanzaoren Decoction），更是治疗烦闷的重要方药。
如果烦闷兼有躁动，手足妄动，这是虚证中夹杂实证，体内有燥屎，必然出现大小便不调、发热口渴、脉象数而有力等症状。在伤寒病中属于承气汤证，但在失血患者身上，必须兼顾其虚损，适宜用玉烛散（Yuzhu San），或者使用玉女煎（Yunü Jian）加入元明粉。
烦躁到了极点，出现循衣摸床（手指无意识地抓摸衣被或床沿）的症状，如果小便通利，说明阴气尚未完全耗尽，还有一线生机可以救治；如果小便不利，则是死症，无法治疗。这与“阴躁”不同。阴躁表现为只有躁动而没有烦闷，且必然伴有阴寒确凿的证据，需要仔细辨别。
又有产后因血虚导致心烦、短气的情况，虽然同样是心烦，但生产时血液下行，气机多呈虚脱状态，其血的虚弱，皆源于气的虚弱，所以心烦必然兼有短气，适宜用归脾汤、当归补血汤（Danggui Buxue Tang）、养荣汤（Yangrong Tang）等，通过补气以生血，心烦自然痊愈。
至于吐血患者，其气机上逆，多是气实血虚，症状见心烦，这是血不能养心的严重表现。如果再补其气，则气更盛而血更虚，心更加不得安宁。治疗应当补血清火，用朱砂安神丸（Zhusha Anshen Wan）治疗。须参考《卧寐怔忡惊悸门》相关内容。
Fan (restlessness) refers to the unease of the Heart spirit. The Heart is a Fire organ, responsible for transforming and generating blood, and it relies on blood to nourish its internal fire. Therefore, the seal script character for "Heart" resembles an inverted "Fire"; when the fire descends, the Heart becomes tranquil.
In patients who have lost blood, excessive hemorrhage deprives the Heart fire of nourishment, leading to frequent restlessness. If the fire is excessively severe, black coating appears on the tongue, and insomnia occurs at night. This is primarily treated with Huanglian Ejiao Tang (Coptis Rhizome and Duck Egg Yolk Decoction).
A feeling of inner vexation and depression (Ao Nao) arises because the fire cannot be dispersed, resulting in stagnation and unhappiness. This is suitable for treatment with Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction), added with Qiaojiao (Forsythiae Fructus), Jiegeng (Platycodonis Radix), Dali (Millettiae Speciosae Caulis), Shengdi (Rehmanniae Radix), Yuanzhi (Polygalae Radix), Huanglian (Coptidis Rhizoma), and Cao Shao (Glycyrrhizae Radix et Rhizoma Praeparatum cum Melle).
If the fire is not severe but the blood deficiency is significant, causing a strange discomfort in the heart that is indescribable, this is termed "Xu Fan" (deficiency-type restlessness). It can be treated with Guipi Tang (Restore the Spleen Decoction) added with Zhusha (Cinnabar), Maidong (Ophiopogonis Radix), and Chao Zhizi (Stir-fried Gardeniae Fructus). Xiaoyao San (Free and Easy Wanderer Powder) added with Longgu (Fossilia Ossis Mastodi) and Zaoren (Ziziphi Spinosae Semen) is also effective. Zhang Zhongjing's Suanzaoren Tang (Sour Jujube Seed Decoction) is particularly an important formula for treating restlessness.
If restlessness is accompanied by agitation, with wild movements of the hands and feet, this indicates a condition where deficiency is complicated by excess, specifically dry stool retained internally. Symptoms must include irregular bowel movements and urination, fever, thirst, and a rapid, forceful pulse. In the context of Shanghan (Cold Damage), this corresponds to Chengqi syndrome; however, in patients who have lost blood, one must simultaneously address the deficiency. Yuzhu San (Jade Candle Powder) is suitable, or Yunü Jian (Middle-aged Woman Decoction) added with Yuanmingfen (Mirabilite).
When irritability reaches an extreme, manifesting as picking at clothes and bedrails (Xun Yi Mo Chuang), if urination is free, it indicates that Yin has not yet been completely exhausted, and there is still a chance for rescue. If urination is difficult, the prognosis is fatal. This differs from "Yin Zao" (Yin-type agitation). Yin Zao presents with agitation without restlessness and must be accompanied by definitive signs of Yin-cold; careful differentiation is required.
Furthermore, postpartum blood deficiency can cause restlessness and shortness of breath. Although this is also restlessness, during childbirth, blood flows downward, often leading to Qi depletion. The blood deficiency here stems from Qi deficiency; thus, restlessness is accompanied by shortness of breath. Suitable treatments include Guipi Tang, Danggui Buxue Tang (Angelica Sinensis Decoction for Tonifying Blood), and Yangrong Tang (Nourish the Vigor Decoction), which tonify Qi to generate blood, thereby resolving the restlessness naturally.
Regarding patients with hematemesis (vomiting blood), their Qi tends to rebel upward, typically presenting as Qi excess and Blood deficiency. The symptom of restlessness here is a severe manifestation of blood failing to nourish the Heart. If Qi is further supplemented, Qi will become more excessive and Blood more deficient, causing the Heart greater unrest. The treatment should focus on tonifying blood and clearing fire, using Zhusha Anshen Wan (Cinnabar Calm the Spirit Pill). Refer also to the section on Sleep Disorders, Palpitations, and Fright.