烦为烦扰之烦躁为愤躁之躁俗谓焦躁是也合而言之烦躁为热也析而分之烦阳也为热之轻躁阴也为热之甚先烦而渐
至躁者谓之烦躁先躁而后复烦者谓之躁烦有不烦而躁者此为阴盛格阳也（虽大躁欲于泥水中卧但饮水不得入口者是也活
人用霹雳散）又有邪气在表而躁烦者（太阳中风脉浮而紧不汗出而烦躁大青龙汤是也）有邪气在里而烦躁者（病患不大
便六七日绕脐痛烦躁发作有时此有躁屎是也）有因火劫而烦躁者（太阳病以火熏之不得汗其人必躁太阳病二三日反躁火
熨其背令大汗出火热入胃躁烦者是也）有阳虚而烦躁者（阳微发汗躁不得眠与下之后复发汗昼日烦躁不得眠夜而安静不
呕不渴无表证脉沉微身无大热者干姜附子汤及发汗若下之病仍不去烦躁者茯苓四逆汤是也）有阴盛而烦躁者（少阳病吐
利手足厥冷烦躁欲死者吴茱萸汤是也）此皆证之常也又有诸不治证详附于后不可不知
太阳 中风（汗）脉浮紧发热恶寒身痛无汗烦躁者大青龙汤发汗不彻太阳证不罢其人面赤躁烦不知痛处更发汗则愈
（详短气）太阳病（和）大发汗后胃中干烦躁不得眠欲饮者少与之若脉浮小便不利微热消渴者五苓散因下之心下痞与泻
心汤痞不解渴而口躁烦小便不利者五苓散
得病（下）二三日脉弱无太阳柴胡证烦躁心下硬至四五日虽能食以小承气汤少少与微和之令小安至六日与承气汤一
升若不大便六七日小便少者虽不能食但初次硬后必溏未定成硬攻之必溏须小便利屎定硬乃可攻之宜大承气汤（王注云无
太阳证为无表证也无柴胡证为无半表半里证也）烦躁不大便绕脐痛发作有时者有燥屎也下之后（温）复发汗昼日烦躁不
得安眠夜而安静不呕不渴无表证脉沉微身无大热者干姜附子汤（不呕不喝里无热也身无大热表无热也而脉又沉微故宜温
此当与栀子豉汤证参看盖下后烦不得眠一也而药有寒热不同故尔）
干姜附子汤方
干姜（一两） 附子（一枚去皮破八片生用）上二味以水三升煮取一升去滓顿服（内经曰寒淫所胜平以辛热虚寒太
甚是以辛热剂胜之也）
海 服姜附汤有二法一法当热服手少阴心也水包火热服以接心火身表寒盛外火少也寒从外生热从内消譬如冻死
寒
在外也一法当寒服作少阴肾也寒邪入水冷服以类肾水身表微热内水多也热从外生寒从内消譬如饮冷寒在内也
发汗若下之病仍不解烦躁者茯苓四逆汤主之（成 发汗若下病宜解也若病仍不解则发汗外虚阳气下之内虚阴气阴阳
俱虚邪独不解故生烦躁与茯苓四逆汤以复阴阳之气）
茯苓四逆汤方（四逆汤以补阳加茯苓人参以益阴）
茯苓（六两） 甘草（炙二两） 干姜（一两半） 人参（一两） 附子（一枚生用去皮破八片）上五味以水五升
煮取三升去滓温服七合日三服
烦躁心下硬若未曾下者即前条无太阳柴胡证以小承气少少微和之也若已曾下心下硬痛短气烦躁者大陷胸也若结胸
证悉具烦躁者死也（方论见结胸）
火逆下之因烧针烦躁者桂枝甘草龙骨牡蛎汤主之
桂枝甘草龙骨牡蛎汤方
桂枝（去粗皮一两） 甘草（炙） 牡蛎（熬） 龙骨（各二两）上为末以水五升煮取二升半去滓服温八合日三（辛
甘发散桂枝甘草之辛甘以发散经中火邪涩可去脱龙骨牡蛎之涩以收敛浮越之正气）
太阳病以火熏之不得汗其人必躁到不解必清血名为火邪（成 此火邪迫血而血下行者也太阳病用火熏之不得汗则热
无从出阴虚被火必发躁也六日传经尽至七日再到太阳经则热气当解若不解热气迫血下行必清血清厕也按到与倒通反也
到不解者犹云反不解而加甚也本文称太阳病则不可便注为传经尽也止言太阳病则不传他经可知矣况于上下文别无承接
照应之词上文言二日及十余日下文言一二日三四日亦是论日数不言传经到也成氏解到字不彻）太阳病火熨其背大汗出火
热入胃胃中水竭躁烦必发谵语十余日振栗下利者欲解也（论见谵语）
活人云大抵阴气少阳气胜则热而烦故太阳经伤风多烦而躁也
阳明 病患不大便五六日绕脐痛烦躁发作有时者此有躁屎也宜承气汤大抵得病二三日脉弱无大柴胡证烦躁心下热
小便利心下硬以小承气汤少少微和之然有病已瘥面赤微烦必大便硬当问其小便日几行若小便少津液当还入胃不须攻也
少阳 伤寒六七日无大热其人躁烦者此为阳去入阴也
少阴 病吐利手足厥冷烦躁欲死者吴茱萸汤（方见吐）少阴病吐利烦躁四逆者死少阴病四逆恶寒身蜷脉不至不烦而
躁者死少阴病脉微沉细但欲卧汗出不烦自欲吐至五六日自利复烦躁不得卧寐者死
厥阴 伤寒热少厥微指头寒默默不欲食烦躁数日小便利色白者热除也欲得食其病为愈若厥而呕胸胁烦满者必便血
伤寒脉微而厥至七八日肤冷其人躁无暂安者为脏结死蛔厥虽厥而烦吐蛔已则静非若脏厥躁无暂安时也伤寒六七日脉微
手足厥冷烦躁灸厥阴厥不还者死伤寒发热下利厥逆躁不得卧者死伤寒得病无热但狂者烦躁不安者五苓散服之二钱新汲
水一升许则以指探喉去之随手愈
成 所谓烦躁者谓先烦渐至躁也所谓躁烦者谓先发躁而迤逦复烦者也从烦至躁为热未有不渐烦而躁者也先躁后
烦
谓怫怫然更作躁闷此为阴盛隔阳也虽大躁欲于泥水中卧但饮水不得入口是也此气欲脱而争譬如灯将灭而暴明矣盖内热
曰烦谓心中郁烦也外热曰躁谓气外热躁也内热为有根之火故但烦不躁及先烦后躁者皆可治外热为无根之火故但躁不烦
及先躁后烦者皆不可治也
附
活 病患身冷脉沉细疾烦躁而不饮水者阴盛隔阳也宜服霹雳散须臾躁止得睡汗出即瘥火焰散丹砂丸并主之
霹雳散 火焰散（二方并见阴毒） 丹砂丸（方见活人书）
海 已寒丸 此丸不僭上阳生于下治阴证服四逆辈胸中发躁而渴者或数日大便秘小便涩亦服此丸上不躁大小
便自利
肉桂（去粗皮） 茯苓（各五钱） 良姜 乌头（炮各七钱） 附子（炮） 干姜（炮） 芍药 茴香（炒各一两）
上为细末糊为丸如梧桐子大温酒空心下五七十丸八九十丸亦得酒醋为糊俱可
本 破阴丹 治阴中伏阳烦躁六脉沉伏（方论见阴毒）
顷年乡人李信道得疾六脉沉伏不见深按至骨则若有力头疼身温烦躁指末皆冷胸中满恶心更两医矣皆不识止用调气
药予诊之曰此阴中伏阳也仲景法中无此证世人患此者多若用热药以助之则为阴所隔绝不能导引真阳反生客气用冷药则
所伏真火愈见消烁非其治也须用破散阴气导达真火之药使水升火降然后得汗而解矣乃授此药二百粒作一服冷盐汤下不
时烦躁狂热手足躁扰其家大惊予曰俗所谓换阳也须臾稍定略睡身已中汗自昏达旦方止身凉而病除矣
戴 烦躁阴阳经皆有之阳明经胃有燥屎故烦此当下之太阳经已得汗而烦者五苓散少阳亦或有烦宜小柴胡汤阴烦
少
阴为多由阳气传入阴经阴得阳而烦自利而渴烦不眠者辰砂五苓散若非是阳气传阴阴气犯阴经吐利手足厥冷而烦经云阳
虚阴乘之故烦又云阴盛发躁欲坐井中吴茱萸汤甚者四逆汤加葱白二茎外有虚烦一证乃是病愈后阴阳未复时发热烦竹叶
石膏汤痰多睡不宁者温胆汤呕者橘皮汤
烦，是指内心的烦扰；躁，是指肢体的愤急躁动，通俗地说就是焦躁不安。合而言之，烦躁属于热证。若分开来看，烦属阳，是轻度的热邪；躁属阴，是重度的热邪。先出现烦，逐渐发展到躁的，称为“烦躁”；先出现躁，后来又出现烦的，称为“躁烦”。还有一种情况是不烦而只躁，这是阴寒内盛、格拒阳气于外所致（表现为虽然极度躁动想卧在泥水中，但水却无法入口，此时可用霹雳散治疗）。
又有邪气在表而出现躁烦的（如太阳中风证，脉象浮紧，发热恶寒，身体疼痛，无汗且烦躁，适用大青龙汤发汗）；有邪气在里而出现烦躁的（如患者多日不大便，六七天期间绕脐疼痛，烦躁发作有定时，这是有燥屎内结）；有因误用火法劫汗而导致烦躁的（如太阳病用火熏法，不得汗出，其人必然躁动；或太阳病二三天后反而躁动，用火熨背令大汗出，火热之邪入胃导致躁烦）；有因阳虚而导致烦躁的（如脉微而发汗，躁动不得安眠；或攻下后又发汗，白天烦躁不得眠，夜间安静，不呕不渴，无表证，脉沉微，身无大热者，适用干姜附子汤；或者发汗、攻下后病仍不去，出现烦躁者，适用茯苓四逆汤）；有因阴盛而导致烦躁的（如少阳病吐利，手足厥冷，烦躁欲死，适用吴茱萸汤）。以上这些都是常见的证候。另有各种不治之证，详见附录，不可不知。
太阳中风证，脉浮紧，发热恶寒，身痛无汗，烦躁者，用大青龙汤发汗。若发汗不彻底，太阳证未罢，其人面赤，躁烦，不知痛处所在，再适当发汗即可痊愈（详情见短气条）。太阳病，大发汗后，胃中干燥，烦躁不得眠，想喝水的，少量给予饮水以滋润胃气。若脉浮，小便不利，微热，消渴者，用五苓散。因误下导致心下痞，服用泻心汤后痞满不解，口渴且口舌干燥烦躁，小便不利者，也用五苓散。
得病二三日，脉弱，无太阳表和少阳柴胡证，烦躁，心下硬，至四五日虽能进食，用小承气汤少量频服，微微调和肠胃，使其稍安。至六日，给承气汤一升。若六七天不大便，小便少的，虽然不能进食，但只要初次大便硬，后面必定溏薄，未确定完全成硬块前，不可攻下，否则必致溏泄。必须待小便利，大便确定变硬后，才可攻下，宜用大承气汤。（王肯堂注：无太阳证即无表证；无柴胡证即无半表半里证。）烦躁，不大便，绕脐痛，发作有定时的，是有燥屎。攻下之后，又复发汗，白天烦躁不得安眠，夜间安静，不呕不渴，无表证，脉沉微，身无大热者，用干姜附子汤。（不呕不渴说明里无热；身无大热说明表无热；脉沉微故宜温补。此证应与栀子豉汤证参看，因为都是下后烦不得眠，但药物寒热不同。）
干姜附子汤方：
干姜一两，附子一枚（去皮，破成八片，生用）。以上两味药，用水三升，煮取一升，去渣，一次顿服。（《内经》说：寒淫所胜，用辛热之品平之。虚寒太甚，所以用辛热剂来战胜它。）
海藏认为服姜附汤有两种方法：一种方法是当热服，对应手少阴心经。水克火，热服可以接续心火。如果体表寒盛，外火不足，寒从外生，热从内消，譬如冻死，寒气在外。另一种方法是当冷服，对应足少阴肾经。寒邪入里，水冷，冷服可以类比肾水。如果体表微热，内水多，热从外生，寒从内消，譬如饮冷，寒气在内。
发汗或攻下后，病仍不解，出现烦躁者，用茯苓四逆汤主治。（成无己注：发汗和攻下后病应当解除，若病仍不解，则是发汗导致外虚阳气，攻下导致内虚阴气，阴阳俱虚，邪气独留不解，故生烦躁。与茯苓四逆汤以恢复阴阳之气。）
茯苓四逆汤方（四逆汤用来补阳，加茯苓、人参用来益阴）：
茯苓六两，甘草（炙）二两，干姜一两半，人参一两，附子一枚（生用，去皮，破成八片）。以上五味药，用水五升，煮取三升，去渣，温服七合，每日三次。
烦躁，心下硬，如果未曾攻下的，就是前条所述无太阳、柴胡证，用小承气汤少量微微调和。如果已经攻下，心下硬痛，短气烦躁者，是大陷胸汤证。如果结胸证的征象都具备，却出现烦躁者，预后不良，主死。（方论见结胸篇）
火逆证，又误下，因烧针导致烦躁者，用桂枝甘草龙骨牡蛎汤主治。
桂枝甘草龙骨牡蛎汤方：
桂枝（去粗皮）一两，甘草（炙），牡蛎（熬），龙骨（各二两）。以上四味药研为末，用水五升，煮取二升半，去渣，温服八合，每日三次。（辛甘发散，桂枝、甘草的辛甘之性以发散经络中的火邪；涩可固脱，龙骨、牡蛎的涩性以收敛浮越的正气。）
太阳病用火熏法，不得汗出，其人必然躁动。到病程第六七日不解，必然出现便血，这称为火邪。（成无己注：这是火邪迫血下行。太阳病用火熏，不得汗，则热无从出，阴虚被火灼必发躁。六日传经尽，至七日再到太阳经，热气当解。若不解，热气迫血下行，必然便血，清厕即排便。按：“到”与“倒”通假，反也。“到不解”犹言“反不解而加甚”。本文称太阳病，则不可直接注为传经尽，只言太阳病则不传他经可知。况且上下文别无承接照应之词，上文言二日及十余日，下文言一二日三四日，亦是论日数，不言传经到。成氏解释“到”字不够透彻。）太阳病用火熨其背，大汗出，火热入胃，胃中津液枯竭，躁烦必然发谵语。十余日后，振栗下利的，是欲解之兆（论述见谵语篇）。
李杲（活人）说：大抵阴气少，阳气胜则热而烦，所以太阳经伤风多烦而躁。
阳明病：患者不大便五六日，绕脐痛，烦躁发作有定时的，这是有燥屎，宜用承气汤。大抵得病二三日，脉弱，无大柴胡证，烦躁，心下热，小便利，心下硬，用小承气汤少量微微调和。然而有病已愈，面赤微烦，必然大便硬，应当问其小便一天几次。若小便少，津液当还入胃中，不须攻下。
少阴病：病见吐利，手足厥冷，烦躁欲死的，用吴茱萸汤（方见吐利篇）。少阴病吐利，烦躁，四肢厥逆的，主死。少阴病四肢厥冷，恶寒，身体蜷缩，脉不至，不烦而躁的，主死。少阴病脉微沉细，只想睡觉，汗出不烦，自己想吐，至五六日自利，复烦躁不得卧寐的，主死。
厥阴病：伤寒热少厥微，指头寒，默默不欲食，烦躁数日，小便利，尿色白的，是热除，想吃饭，病将愈。若厥逆而呕，胸胁烦满的，必然便血。
伤寒脉微而厥，至七八日，皮肤冷，其人躁动无片刻安宁的，为脏结，主死。蛔厥虽然也有厥逆和烦，但吐蛔虫后即安静，不像脏厥那样躁动无片刻安宁。伤寒六七日，脉微，手足厥冷，烦躁，灸厥阴经穴位后厥逆不还的，主死。伤寒发热，下利，厥逆，躁不得卧的，主死。伤寒得病，无热但狂，烦躁不安的，用五苓散二钱，新汲水一升许，以手指探喉催吐，随手而愈。
成无己说：所谓烦躁，是先烦渐至躁；所谓躁烦，是先发躁而渐渐复烦。从烦至躁，为热邪未退，无不先烦而后躁的。先躁后烦，谓怫怫然更作躁闷，此为阴盛格阳。虽然极度躁动想卧在泥水中，但饮水不得入口。这是气欲脱而争，譬如灯将灭而突然暴明。内热曰烦，谓心中郁烦；外热曰躁，谓气外热躁。内热为有根之火，故但烦不躁，及先烦后躁者皆可治；外热为无根之火，故但躁不烦，及先躁后烦者皆不可治。
附录：
李杲（活人）云：病患身冷，脉沉细疾，烦躁而不饮水的，是阴盛格阳，宜服霹雳散，须臾躁止得睡，汗出即愈。火焰散、丹砂丸并主之。（霹雳散、火焰散并见阴毒篇；丹砂丸方见活人书。）
张元素（海藏）：已寒丸。此丸不僭上，阳生于下，治阴证。服四逆辈药后胸中发躁而渴者，或数日大便秘、小便涩，亦服此丸，上不躁，大小便自利。
配方：肉桂（去粗皮）、茯苓（各五钱），良姜、乌头（炮，各七钱），附子（炮）、干姜（炮）、芍药、茴香（炒，各一两）。以上为细末，糊为丸，如梧桐子大。温酒空心服五七十丸，八九十丸亦可。酒醋为糊均可。
王好古（本）：破阴丹。治阴中伏阳，烦躁，六脉沉伏（方论见阴毒篇）。
近年乡人李信道患病，六脉沉伏不见，深按至骨则若有力，头疼身温，烦躁，指末皆冷，胸中满，恶心，经过两位医生诊治都不识，只用调气药。我诊察后说：这是阴中伏阳。仲景法中无此证，世人患此者多。若用热药以助之，则为阴所隔绝，不能导引真阳，反生客气；用冷药则所伏真火愈见消烁，非其治也。须用破散阴气、导达真火之药，使水升火降，然后得汗而解。于是授以此药二百粒作一服，冷盐汤送下。不久烦躁狂热，手足躁扰，其家大惊。我说：俗所谓换阳也。须臾稍定，略睡，身已中汗，自昏达旦方止，身凉而病除矣。
戴元礼（戴）：烦躁在阴阳经皆有之。阳明经胃有燥屎故烦，此当下之；太阳经已得汗而烦者，用五苓散；少阳亦或有烦，宜小柴胡汤。阴烦多见于少阴，由阳气传入阴经，阴得阳而烦，自利而渴，烦不眠者，用辰砂五苓散。若非是阳气传阴，而是阴气犯阴经，吐利，手足厥冷而烦，《经》云：阳虚阴乘之故烦。又云：阴盛发躁，欲坐井中，用吴茱萸汤。甚者用四逆汤加葱白二茎。此外有虚烦一证，乃是病愈后阴阳未复时发热烦，用竹叶石膏汤。痰多睡不宁者，用温胆汤。呕者，用橘皮汤。
Fan (restlessness) refers to inner mental agitation; Zao (agitation) refers to physical restlessness and irritability, colloquially known as anxiety. Together, Fan-Zao constitutes a Heat syndrome. Analyzed separately, Fan belongs to Yang and represents mild Heat; Zao belongs to Yin and represents severe Heat. When Fan appears first and gradually develops into Zao, it is called "Fan-Zao"; when Zao appears first and later returns to Fan, it is called "Zao-Fan". There is also a condition where there is Zao but no Fan, which indicates Yin excess repelling Yang outward (manifesting as extreme restlessness with a desire to lie in mud or water, yet unable to drink water; in such cases, Pili San may be used).
Furthermore, there are cases of Zao-Fan due to pathogenic factors in the Exterior (e.g., Taiyang Wind-stroke with floating-tight pulse, fever, aversion to cold, body pain, anhidrosis, and restlessness, treated by Da Qing Long Tang to induce sweating); cases of Fan-Zao due to pathogenic factors in the Interior (e.g., patient has not had a bowel movement for 6-7 days, periumbilical pain, periodic episodes of restlessness, indicating dry feces accumulation); cases caused by erroneous fire therapy (e.g., Taiyang disease treated with moxibustion/fire without sweating leading to restlessness; or Taiyang disease on day 2-3 becoming restless, back steaming causing profuse sweating, allowing fire heat to enter the Stomach causing restlessness); cases due to Yang deficiency (e.g., faint pulse after sweating, restlessness and insomnia; or post-purging and re-sweating, daytime restlessness with nighttime quietness, no vomiting/thirst, no exterior signs, deep-faint pulse, no significant body heat, treated by Gan Jiang Fu Zi Tang; or persistent restlessness after sweating/purging, treated by Fu Ling Si Ni Tang); and cases due to Yin excess (e.g., Shaoyang disease with vomiting/diarrhea, cold limbs, severe restlessness, treated by Wu Zhu Yu Tang). These are common syndromes. Other untreatable conditions are detailed in the appendix and must be known.
Taiyang Wind-stroke: Floating-tight pulse, fever, aversion to cold, body pain, anhidrosis, and restlessness indicate Da Qing Long Tang to induce sweating. If sweating is incomplete and Taiyang syndrome persists, with facial redness, restlessness, and unknown pain locations, appropriate further sweating will resolve it (see Shortness of Breath). Taiyang disease: After excessive sweating, stomach dryness causes restlessness and insomnia with thirst; give small amounts of water. If floating pulse, dysuria, slight fever, and polydipsia occur, use Wu Ling San. Post-purging epigastric fullness unrelieved by Xie Xin Tang, accompanied by thirst, dry mouth/restlessness, and dysuria, also uses Wu Ling San.
Two to three days after onset: Weak pulse, no Taiyang or Shao Yang (Chai Hu) signs, restlessness, epigastric hardness. By day 4-5, if able to eat, give Xiao Cheng Qi Tang sparingly to harmonize slightly. By day 6, give one sheng of Cheng Qi Tang. If no bowel movement for 6-7 days with scanty urine, even if unable to eat, if initial stool was hard but subsequent stool is loose, do not purge prematurely lest diarrhea ensue. Wait for clear urine and confirmed hard stool before purging with Da Cheng Qi Tang. (Wang Kentang notes: No Taiyang sign means no exterior syndrome; no Chai Hu sign means no half-exterior/half-interior syndrome.) Restlessness, constipation, periumbilical pain, periodic episodes indicate dry feces. Post-purging and re-sweating, daytime restlessness/insomnia with nighttime quietness, no vomiting/thirst, no exterior signs, deep-faint pulse, no significant body heat, indicates Gan Jiang Fu Zi Tang. (No vomiting/thirst implies interior heat absence; no significant body heat implies exterior heat absence; deep-faint pulse warrants warming. Compare with Zhi Zi Chi Tang syndrome as both involve post-purging restlessness/insomnia, but drug properties differ in hot/cold nature.)
Gan Jiang Fu Zi Tang Formula:
Gan Jiang (1 liang), Fu Zi (1 piece, peeled, broken into 8 pieces, raw). Boil two ingredients in 3 sheng water to obtain 1 sheng, remove dregs, take once. (Nei Jing states: For excess cold, use pungent-hot agents to level it. For severe deficiency-cold, pungent-hot agents overcome it.)
Hai Zang suggests two methods for taking Gan Jiang Fu Zi Tang:
1. Take hot: Corresponds to Hand-Shaoyin Heart channel. Water controls Fire; hot intake connects to Heart Fire. If exterior cold is strong and internal fire weak, cold generates externally and heat dissipates internally, like freezing death where cold is external.
2. Take cold: Corresponds to Foot-Shaoyin Kidney channel. Cold pathogen enters interior; cold water intake mimics Kidney Water. If exterior has slight heat and interior water is abundant, heat generates externally and cold dissipates internally, like drinking cold liquids where cold is internal.
If disease persists after sweating or purging with restlessness, treat with Fu Ling Si Ni Tang. (Cheng Wuji notes: Sweating/purging should resolve disease; persistence implies exterior Yang deficiency from sweating and interior Yin deficiency from purging, leading to dual deficiency and lingering pathogen causing restlessness. Fu Ling Si Ni Tang restores Yin-Yang.)
Fu Ling Si Ni Tang Formula (Si Ni Tonifies Yang; adds Fu Ling/Ren Shen to Nourish Yin):
Fu Ling (6 liang), Gan Cao (roasted, 2 liang), Gan Jiang (1.5 liang), Ren Shen (1 liang), Fu Zi (1 piece, raw, peeled, broken into 8 pieces). Boil five ingredients in 5 sheng water to obtain 3 sheng, remove dregs, take 0.7 sheng warm, three times daily.
Restlessness with epigastric hardness: If not previously purged, refer to previous section (no Taiyang/Chai Hu signs, use Xiao Cheng Qi Tang sparingly). If already purged with epigastric hardness/pain, shortness of breath, and restlessness, this is Da Xian Xiong Tang syndrome. If all Jie Xiong (Chest Binding) signs are present with restlessness, prognosis is fatal (see Jie Xiong section).
Fire reversal with purging and burning needle causing restlessness: Treat with Gui Zhi Gan Cao Long Gu Mu Li Tang.
Gui Zhi Gan Cao Long Gu Mu Li Tang Formula:
Gui Zhi (bark removed, 1 liang), Gan Cao (roasted), Mu Li (calcined), Long Gu (each 2 liang). Powder form. Boil in 5 sheng water to obtain 2.5 sheng, remove dregs, take 0.8 sheng warm, three times daily. (Pungent-sweet disperses; Gui Zhi/Gan Cao disperse fire pathogen in channels. Astringency prevents collapse; Long Gu/Mu Li consolidate floating righteous Qi.)
Taiyang disease with fire smoking causing no sweat leads to restlessness. By day 6-7 unresolved, blood in stool occurs, termed Fire Pathogen. (Cheng Wuji notes: Fire pathogen forces blood downward. Taiyang fire smoking without sweat traps heat, damaging Yin and causing restlessness. Day 6 completes transmission cycle; Day 7 returns to Taiyang, heat should resolve. If not, heat forces blood downward causing hematochezia. 'Dao' implies reversal/worsening. Text specifies Taiyang disease, implying no transmission to other meridians. Context discusses days, not transmission stages. Cheng's interpretation of 'Dao' is insufficient.) Taiyang disease with back steaming causing profuse sweat allows fire heat to enter Stomach, depleting fluids, causing restlessness and delirium. After 10+ days, chills and diarrhea indicate resolution (see Delirium section).
Li Gao states: Generally, deficient Yin and excess Yang cause Heat and Fan. Thus, Taiyang Wind-stroke often presents with Fan and Zao.
Yangming Disease: Constipation for 5-6 days, periumbilical pain, periodic restlessness indicates dry feces; use Cheng Qi Tang. Generally, day 2-3 with weak pulse, no Da Chai Hu signs, restlessness, epigastric heat, clear urine, epigastric hardness: use Xiao Cheng Qi Tang sparingly. However, if disease resolves with facial redness and slight restlessness, stool is likely hard. Ask about urination frequency. If urine is scant, fluids return to Stomach; do not purge.
Shaoyang Disease: Taiyang cold for 6-7 days, no high fever, but restlessness indicates Yang pathogen entering Yin meridians.
Shao Yin Disease: Vomiting/diarrhea, cold limbs, severe restlessness: Wu Zhu Yu Tang (see Vomiting). Vomiting/diarrhea, restlessness, limb coldness: Fatal. Limb coldness, aversion to cold, curled posture, absent pulse, no Fan but Zao: Fatal. Pulse faint/deep-thin, desire to sleep, sweating, no Fan, desire to vomit; by day 5-6 spontaneous diarrhea with recurrent restlessness/insomnia: Fatal.
Jue Yin Disease: Mild heat, slight cold extremities, cold fingertips, silent anorexia, restlessness for several days, clear urine color indicates heat elimination; desire to eat indicates recovery. If cold extremities with vomiting, chest/hypochondriac fullness, likely hematochezia.
Taiyang cold with faint pulse and cold extremities, persisting 7-8 days with cold skin and constant restlessness: Zang Jie (Organ Binding), fatal. Hui Jie (Roundworm Cold) has cold/extremity restlessness but calms after vomiting roundworms, unlike Zang Jie constant restlessness. Taiyang cold 6-7 days, faint pulse, cold limbs, restlessness; if Moxibustion at Jue Yin fails to restore warmth: Fatal. Fever, diarrhea, cold extremities, restlessness/insomnia: Fatal. Onset without fever but mania/restlessness: Use Wu Ling San (2 qian) with fresh water, induce vomiting for immediate cure.
Cheng Wuji explains: Fan-Zao is gradual progression from Fan to Zao; Zao-Fan is recurrence of Fan after initial Zao. Progression from Fan to Zao indicates lingering Heat. Initial Zao followed by Fan indicates Yang repelled by Yin excess (desire to lie in mud/water but inability to drink). This is Qi attempting to escape, like a dying lamp flaring brightly. Internal Heat is Fan (mental depression); External Heat is Zao (physical agitation). Internal Heat is rooted fire (treatable if only Fan or Fan then Zao); External Heat is rootless fire (untreatable if only Zao or Zao then Fan).
Appendix:
Li Gao: Body cold, deep-thin-rapid pulse, restlessness without thirst indicates Yin excess repelling Yang. Use Pili San; restlessness stops, sleep follows, sweating cures. Huo Yan San and Dan Sha Wan also applicable (see Yin Du section).
Zhang Yuansu (Hai Zang): Yi Han Wan. Non-dispersive, Yang generated below, treats Yin syndromes. For restlessness/thirst after Si Ni decoctions, or constipation/dysuria after several days, use this pill to prevent upper restlessness and regulate bowels/bladder.
Ingredients: Rou Gui (5 qian), Fu Ling (5 qian), Liang Jiang (7 qian), Wu Tou (processed, 7 qian), Fu Zi (processed), Gan Jiang (processed), Bai Shao (1 liang), Hui Xiang (stir-fried, 1 liang). Powdered, paste pills (walnut size). Take 50-90 pills with warm wine on empty stomach. Vinegar paste also acceptable.
Wang Haogu (Ben): Po Yin Dan. Treats hidden Yang within Yin, restlessness, deep-hidden six pulses (see Yin Du section).
Case: Li Xin Dao suffered deep-hidden pulses, headache, warm body, restlessness, cold fingers, chest fullness, nausea. Two physicians failed, using Qi-regulating herbs. Diagnosis: Hidden Yang within Yin. Not in Shang Han Lun. Hot herbs would be blocked by Yin, failing to guide True Yang; cold herbs would extinguish hidden True Fire. Must use herbs to break Yin and guide True Fire, raising Water and lowering Fire to induce sweat. Prescribed 200 pills taken cold salt water. Soon became manic/restless/four limbs agitated. Family alarmed. Explained as "changing Yang." Patient slept, sweated from dusk till dawn, cooled down, and recovered.
Dai Yuanli: Fan-Zao occurs in both Yin and Yang meridians. Yangming Stomach dry feces cause Fan, requiring purging; Taiyang post-sweat Fan uses Wu Ling San; Shaoyang Fan uses Xiao Chai Hu Tang. Yin Fan mostly in Shao Yin, from Yang entering Yin, causing Fan with diarrhea/thirst/insomnia, treated by Chen Sha Wu Ling San. If Yin pathogen attacks Yin meridian with vomiting/diarrhea/cold limbs/Fan, per Classic: Yang deficiency with Yin invasion causes Fan; Yin excess causing Zao (desire to sit in well) uses Wu Zhu Yu Tang. Severe cases use Si Ni Tang plus Cong Bai (scallion white). Additionally, Xu Fan (Deficiency Fan) occurs post-recovery during Yin-Yang non-restoration with fever/Fan, treated by Zhu Ye Shi Gao Tang. Phlegm causing restless sleep uses Wen Dan Tang. Vomiting uses Ju Pi Tang.