〔万〕烦者，扰扰而烦。躁者，愦躁之躁。合而言之，烦躁皆热也，析而分之，
烦阳也热之轻者，躁阴也热之甚者。《难知集》曰∶火入于肺烦也，火入于肾躁也，疮疹烦躁，须宜忌之。若吐利厥
逆，腹胀喘促而烦躁者，昏不知人，谵妄狂扰而烦躁者，谓之闷乱，皆不治之证。凡痘疮出不快，发不透，靥不
齐有烦躁者，此有二证，如面黄，大便色黑，烦躁喘渴，或如狂，或喜忘，腹胀或痛，此为有瘀血在里也，宜当
归丸（痘便闷）或四顺清凉饮（发热）并加桃仁泥、红花，甚者桃仁承气汤主之（失血）。如便血下
黑粪，而又睡不醒，心为血之主，睡不醒则心之神昏矣，玄参地黄汤（失血）加木通、麦门冬。若无面黄屎黑、如
狂喜忘之证，只大便不通、烦躁腹胀者，此有燥屎也，此却真狂谵妄，以三黄丸、四顺清凉饮（俱发热）、三乙承
气汤、当归丸、胆导法（俱便闷）看病轻重，择而用之，如偏执不可下之说，以致陷伏而死者，医之咎也。〔薛〕
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，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。此证多因脾胃气虚，或服克伐之剂所致，但当调补中气为善。
〔万〕如肺热而烦者，坐卧不安，审于何时，若初发热便烦者，此毒火内郁，人
参白虎汤（发热）加栀子仁主之。若疮发见犹烦者，此毒伏于内，未尽出也，消毒饮（见形）、夺命丹（起发）合而服
之。若疮出尽，又已起发犹烦者，此内热也，牛黄清心丸主之。如肾热而躁者，必曾自利，轻则陈氏木香散（泻
），甚则陈氏异功散（见形）主之。如扬手掷足，欲去衣被者，此热甚于表也，羌活汤主之，泻青丸去大黄、加甘
草。如神识昏迷、反复颠倒者，此热甚于里也，导赤散（心）牛黄清心丸合而治之。吐利不食而烦躁者，正气虚也
，陈氏木香散主之。如昼日烦躁，夜则安静者，此阳盛于昼，至夜则阳气退而安静也，人参白虎汤加栀子仁主之。
如昼日明了，夜则烦躁者，此阳陷入于阴，夜则阴盛，阴阳交争，故烦躁也，四物汤加栀子仁主之。
《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。
黄连解毒汤 治发 ，热甚心烦不得眠。
黄连 黄芩 黄柏 山栀（各等分）
上，每服四钱，水二钟，煎五分，温服。若 毒甚者，加青黛一钱，调入汤内
服之。凡脉弦数，内外热甚谵语者，合小柴胡汤主之。若脉洪数，内外热甚，舌燥烦渴者，合化 汤主之。
牛黄清心丸
黄连（五钱，生） 黄芩 山栀仁（各三钱） 郁金（二钱） 辰砂（一钱半） 牛黄（二分半）
共研细末，腊雪调面糊，丸如黍米大。每服七八丸，灯心汤送下。
人参蝉蜕散 治小便不利，痘疮不发，烦躁作渴，切牙喘满。
人参 蝉蜕 白芍药 木通 赤茯苓 甘草 紫草茸
上，每服三四钱，水煎。
人参竹叶汤 治虚烦不得寐，或兼自汗。
人参 竹叶 甘草（各二钱） 半夏（二钱五分） 小麦 麦门冬（各一钱五分）
上，每服二三钱，姜二片，粳米一撮，水煎服。
〔万全〕烦，是指心中扰攘不安。躁，是指肢体愦乱不宁。合起来说，烦躁都属于热证；分开来看，烦属于阳证，是热邪较轻的表现；躁属于阴证，是热邪严重的表现。《难知集》说：火邪侵入肺脏则出现烦，火邪侵入肾脏则出现躁，痘疮疹出期间的烦躁，必须对此加以禁忌和辨别。如果出现呕吐、腹泻、四肢厥冷逆乱，同时伴有腹部胀满、气喘急促而烦躁的，或者神志昏沉不知人事，胡言乱语、狂乱扰动的而烦躁的，这叫做“闷乱”，都是不治之症。凡是痘疮发出迟缓、透发不透、结痂不齐并伴有烦躁的，这有两种证候：如果面色发黄，大便颜色黑，烦躁气喘口渴，或者像发狂一样，或者喜欢遗忘，腹部胀满或疼痛，这是体内有瘀血，应当用当归丸（治疗痘便闷）或四顺清凉饮（治疗发热）并加入桃仁泥、红花；病情严重的，用桃仁承气汤主治（针对失血或瘀血）。如果便血排出黑色粪便，并且嗜睡叫不醒，心是血液的主宰，嗜睡叫不醒说明心神昏昧了，用玄参地黄汤（针对失血）加入木通、麦门冬。如果没有面色黄、大便黑、像发狂、喜忘这些症状，只是大便不通、烦躁腹胀的，这是有燥屎内结，这确实是真正的狂乱谵妄，根据病情的轻重，选择三黄丸、四顺清凉饮（均治发热）、三乙承气汤、当归丸、胆导法（均治大便闭塞闷痛）来使用；如果固执地坚持不可攻下的说法，导致邪气内陷伏匿而死亡的，是医生的过错。
〔薛己〕李东垣说：火邪侵入心脏则产生烦，侵入肾脏则产生躁，这都是心火在作祟。因为火旺则灼伤肺金，导致肾水亏损，所以心肾同病而表现为躁，适宜用栀子豆豉汤。凡是痘疮发作旺盛的时候，必定要让心火有所引导发散，假如毒瓦斯发出而不彻底，于是产生烦躁，可以用生黑豆煎汤，或者磨生犀角汁饮用也可以。如果是津液不足，虚烦不能入睡的，用《活人书》中的酸枣仁汤。这个证候多因脾胃气虚，或者服用克伐损伤正气的药物所致，只应当调补中气为好。
〔万全〕如果是肺热导致的烦，坐卧不安，要审察发病的时间，如果在刚开始发热时就烦的，这是毒火内郁，用人参白虎汤（治疗发热）加入栀子仁主治。如果痘疮发出显现时仍然烦的，这是毒邪伏于体内，没有完全透发出来，将消毒饮（见形期）、夺命丹（起发期）合起来服用。如果痘疮出尽，又已经起发但仍然烦的，这是内热，用牛黄清心丸主治。如果是肾热导致的躁，必定曾经有过自发性腹泻，轻的用陈氏木香散（治疗泻痢），重的用陈氏异功散（见形期）主治。如果扬手掷足，想要去掉衣被的，这是热邪盛于体表，用羌活汤主治，泻青丸去掉大黄、加入甘草。如果神识昏迷、身体反复翻动颠倒的，这是热邪盛于体内，将导赤散（治心经热）、牛黄清心丸合起来治疗。呕吐、腹泻、不能进食而烦躁的，这是正气虚弱，用陈氏木香散主治。如果白天烦躁，夜间则安静的，这是阳气盛于白天，到了夜晚阳气衰退所以安静，用人参白虎汤加入栀子仁主治。如果白天神志清楚，夜间则烦躁的，这是阳气陷入阴分，夜间阴气盛，阴阳交争，所以烦躁，用四物汤加入栀子仁主治。
《活人书》酸枣仁汤 治疗痘疹，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）
以上药材，用水煎煮，温服。儿童剂量加倍。
栀子豆豉汤
山栀（四个） 豆豉（半两）
以上药材，用水二盏，先煮栀子至一盏水，再加入豆豉煎至七分，去渣温服。如果引起快速吐泻就停止服药。
黄连解毒汤 治疗痘疮，热甚心烦不得眠。
黄连 黄芩 黄柏 山栀（各等分）
以上药材，每次服用四钱，用水二钟，煎至五分，温服。如果痘毒严重的，加入青黛一钱，调入汤内服用。凡是脉象弦数，内外热甚胡言乱语的，合用小柴胡汤主治。如果脉象洪数，内外热甚，舌燥烦渴的，合用化斑汤主治。
牛黄清心丸
黄连（五钱，生） 黄芩 山栀仁（各三钱） 郁金（二钱） 辰砂（一钱半） 牛黄（二分半）
共同研成细末，用腊雪调和面糊，制成如黍米大小的丸药。每次服用七八丸，用灯心草汤送下。
人参蝉蜕散 治疗小便不利，痘疮不发，烦躁作渴，切牙喘满。
人参 蝉蜕 白芍药 木通 赤茯苓 甘草 紫草茸
以上药材，每次服用三四钱，用水煎煮。
人参竹叶汤 治疗虚烦不得寐，或者兼有自汗。
人参 竹叶 甘草（各二钱） 半夏（二钱五分） 小麦 麦门冬（各一钱五分）
以上药材，每次服用二三钱，加生姜两片，粳米一撮，用水煎服。
[Wan] "Fan" (restlessness) refers to a state of mental agitation and disturbance. "Zao" (fidgeting) refers to physical restlessness and irritability. Generally speaking, both Fan and Zao belong to heat syndromes; however, analytically distinguished, Fan is associated with Yang and represents a milder form of heat, whereas Zao is associated with Yin and represents a more severe form of heat. The *Nanzhi Ji* states: When fire enters the Lung, it causes Fan; when fire enters the Kidney, it causes Zao. In cases of smallpox or chickenpox accompanied by Fan and Zao, one must exercise caution and differentiation. If vomiting and diarrhea are accompanied by cold extremities, abdominal distension, panting, and restlessness, or if there is unconsciousness, delirium, mania, and restlessness, this is termed "Menluan" (oppressive confusion), which constitutes an intractable condition. In cases where smallpox lesions erupt slowly, fail to fully emerge, or have uneven scabbing, accompanied by restlessness, there are two specific patterns: If the complexion is yellow, stools are black, and there is restlessness, panting, thirst, manic behavior, or forgetfulness, along with abdominal distension or pain, this indicates blood stasis within. One should use Danggui Wan (for smallpox with bowel obstruction) or Sishun Qingliang Yin (for fever) added with Peach Kernel Paste and Safflower; for severe cases, Tao Ren Chengqi Tang is indicated. If there is bloody stool with black feces, accompanied by lethargy and inability to wake, since the Heart governs blood, lethargy indicates clouding of the Heart spirit; Xuan Shen Dihuang Tang (for blood loss) added with Akebia Stem and Ophiopogon Tuber is used. If there are no signs of yellow complexion, black stools, manic behavior, or forgetfulness, but only constipation, restlessness, and abdominal distension, this indicates dry fecal matter accumulation. This constitutes true mania and delirium; based on severity, one may select Sanhuang Wan, Sishun Qingliang Yin (both for fever), Sanyi Chengqi Tang, Danggui Wan, or Gall Bladder Suppository method (all for bowel obstruction). Adhering rigidly to the theory that purgation is contraindicated, leading to death from pathogen entrapment, is the physician's fault.
[Xue] Li Dongyuan stated: Fire entering the Heart causes Fan, while fire entering the Kidney causes Zao; both are driven by Heart fire. Since excessive fire scorches Lung Metal and depletes Kidney Water, the Heart and Kidney interact to produce Zao; Zhizi Chidui Tang is appropriate. During the peak eruption of smallpox, it is essential to guide the Heart fire outward. If toxins are not fully expelled, resulting in restlessness, decocting raw black soybeans or drinking fresh rhinoceros horn juice may be effective. For insufficiency of body fluids causing empty restlessness and insomnia, Suanzao Ren Tang from the *Huoren Shu* is used. This syndrome often results from Spleen and Stomach Qi deficiency or the use of harsh draining medications; therefore, tonifying Middle Qi is the proper approach.
[Wan] For Fan caused by Lung heat, characterized by restlessness in sitting and lying, one must examine the timing. If Fan occurs at the initial stage of fever, it indicates internal depression of toxic fire; Renshen Baizhu Tang (for fever) added with Gardenia Seed is indicated. If Fan persists when lesions appear, it indicates toxins remaining internally and not fully erupted; Xiaodu Yin (for appearance stage) and Tuoming Dan (for eruption stage) should be taken together. If Fan continues after lesions have fully erupted and risen, it indicates internal heat; Niuhuang Qingxin Wan is indicated. For Zao caused by Kidney heat, which typically follows spontaneous diarrhea, Chen Shi Muxiang San is used for mild cases, and Chen Shi Yigong San (for appearance stage) for severe cases. If the patient throws hands and feet about and desires to remove clothing and bedding, this indicates intense heat on the exterior; Qianghuo Tang is indicated, or Xieqing Wan with Rhubarb removed and Licorice added. If there is mental confusion and tossing and turning, this indicates intense heat in the interior; Daochi San (for Heart) and Niuhuang Qingxin Wan should be combined. For vomiting, diarrhea, anorexia, and restlessness, this indicates deficiency of healthy Qi; Chen Shi Muxiang San is indicated. For restlessness during the day but quietness at night, this indicates excess Yang during the day, retreating at night leading to quietness; Renshen Baizhu Tang added with Gardenia Seed is indicated. For clarity during the day but restlessness at night, this indicates Yang sinking into Yin; at night, Yin is dominant, and the struggle between Yin and Yang causes restlessness; Siwu Tang added with Gardenia Seed is indicated.
Suansao Ren Tang from the *Huoren Shu* treats smallpox/chickenpox with empty restlessness, palpitations, and insomnia.
Suanzaoren (Fried), Gancao (Roasted), Zhimu (Fried), Baifuling, Maidong (Heart removed), Chuanxiong, Jiangjiang (Fried, each 3 fen).
Decoct in water and take warm. Double the dose for older children.
Zhizi Chidui Tang
Shanzhi (4 units), Douchi (0.5 liang).
Add 2 cups of water, first decoct Shanzhi until 1 cup remains, then add Douchi and decoct until 0.7 cup remains. Strain and take warm. Stop taking immediately if rapid vomiting occurs.
Huanglian Jiedu Tang treats smallpox with severe heat, restlessness, and insomnia.
Huanglian, Huangqin, Huangbai, Shanzhi (equal parts).
Take 4 qian per dose, decoct in 2 zhong of water until 0.5 zhong remains. Take warm. For severe toxin heat, add Qingdai (1 qian) and mix into the decoction. For wiry and rapid pulse with severe internal/external heat and delirium, combine with Xiao Chaihu Tang. For flooding and rapid pulse with severe internal/external heat, dry tongue, and thirst, combine with Huaban Tang.
Niuhuang Qingxin Wan
Huanglian (5 qian, raw), Huangqin, Shanzhiren (each 3 qian), Yujin (2 qian), Chensha (1.5 qian), Niuhuang (0.25 qian).
Grind into fine powder, mix with wax snow and wheat paste, form pills the size of millet seeds. Take 7-8 pills per dose, washed down with Dengxin Tang.
Renshen Chantui San treats difficulty in urination, non-erupting smallpox, restlessness with thirst, teeth grinding, and panting/distension.
Renshen, Chantui, Baishao, Mutong, Chifuling, Gancao, Zicaorong.
Take 3-4 qian per dose, decoct in water.
Renshen Zhuye Tang treats empty restlessness with insomnia, or accompanied by spontaneous sweating.
Renshen, Zhuye, Gancao (each 2 qian), Banxia (2.5 qian), Xiaomai, Maidong (each 1.5 qian).
Take 2-3 qian per dose, add 2 slices of ginger and a pinch of Jingmi, decoct in water and take.