夫虚烦者。心胸烦扰而不宁也。多是体虚。摄养有乖。荣卫不调。使阴阳二气皆有所偏
胜也
或阴虚而阳盛。或阴盛而阳虚。内经曰。阴虚则内热。阳虚则外寒。阳盛则外热。阴盛则
内寒。令人虚烦。多是阴虚生内热所致。虚劳之人。肾水有亏。心火内蒸。其烦必躁。吐泻
之后。津液枯竭。烦而有渴。惟伤寒及大病后。虚烦之症。却无霍乱。临病宜审之。巢氏病
源曰心烦不得寐者。心热也。但虚烦不得寐者。胆冷也。
一论病后虚烦不得眠。及心胆虚怯。触事易惊。短气心悸。或复自汗等症。
温胆汤
半夏（汤泡七钱） 竹茹 枳实（麸炒各三钱） 陈皮（四钱半） 白茯苓（去皮二钱五分）
甘草（炙二钱五分）
上锉。分二剂。姜、枣煎服。一方。加酸枣仁炒、远志去心、五味子、熟地黄、人参各
等分。
一论大病后。表里俱虚。内无津液。烦渴心躁。及诸虚烦热。与伤寒相似。但不恶寒。
身不痛。不可汗下。宜服竹叶石膏汤。（方见伤寒）
不寐有二种。有疾后虚弱。及年高人阳衰不寐者。有痰在胆经。神不守舍。亦令不寐。
虚者用六君子汤。加炒酸枣仁、黄 。痰者用温胆汤。减竹茹一半。加南星、炒酸枣仁。伤
寒不寐者。当求之本门。
一论心胆虚弱。昼夜不眠。百方无效。服此如神。
高枕无忧散
人参（五钱） 软石膏（三钱） 陈皮 半夏（姜炒） 白茯苓（去皮） 枳实（麸炒） 竹茹
麦门冬（去心） 酸枣仁（炒） 甘草（各一钱五分）
上锉一剂。龙眼五个。水煎服。
一论劳心。痰多少睡。心神不定。
养心汤
人参 麦门冬（去心） 黄连（微炒） 白茯苓（去皮） 白茯神（去木） 当归（酒洗） 白
芍（酒炒） 远志（去心） 陈皮 柏子仁 酸枣仁 甘草（等分）
上锉。莲肉五个去心。水煎。温服。
安神复睡汤
当归 川芎 白芍（酒炒） 熟地黄 益智仁 酸枣仁（炒） 远志（甘草水泡去心）
山药 龙眼肉（各等分）
上锉。姜、枣煎服。
一论心气不足。恍惚多忘。或劳心胆冷。夜卧不睡。此药能安神定志
加味定志丸
人参（三两） 白茯神（去皮木二两） 远志（甘草水泡去心） 石菖蒲（各二两） 酸枣仁（
炒二两） 柏子仁（炒去壳二两）
上为细末。炼蜜为丸。如梧桐子大。朱砂、乳香为丸。每服五十丸。临卧。枣汤送下。
附睡法
睡不厌蜷。觉不厌舒。蜷者曲膝蜷腹。以左右肋侧卧。修养家所谓狮子眠是也。如此则
气海深
满。丹田常暖。肾水易生。益人多宏。舒体而卧。则气宣而寡蓄。神散而不潜。故卧惟觉时
可舒体耳。
西山蔡季通引千金方睡诀云。睡则必侧。觉正而伸。早晚以时。先睡心。后睡眼。晦庵
以为此古今未发之妙。
一论胆虚卧不安。心多惊悸。酸枣仁一两。炒令香熟。为末。每服二钱。不拘时服。竹
叶汤送下。
一治心下怔忡。睡倒即大声打鼾睡。醒即不寐。余以羚羊角、乌犀角。各用水磨浓汁。
入前所用养心汤。或复睡汤内。服之立效。盖打鼾睡者。心肺之火也。
一治胆虚常多畏恐。不能独卧。如人捕状。头目不清。
人参 枳壳 五味子 桂心（各三分） 柏子仁（一钱） 甘菊花 白茯苓 枸杞子（各三
分） 山茱萸（五分） 熟地黄（五分）
上为末。每服二钱。温酒调下。
所谓虚烦，是指心胸部位感到烦乱躁扰而不得安宁。这大多是因为身体虚弱，调养不当，导致营卫之气不调和，使得阴阳二气出现偏盛的情况。
或者是阴虚而阳盛，或者是阴盛而阳虚。《内经》说：阴虚则产生内热，阳虚则产生外寒；阳盛则产生外热，阴盛则产生内寒。这些情况都会导致人出现虚烦的症状。大多数虚烦是由阴虚生内热所引起的。患有虚劳病的人，肾水亏损，心火在体内蒸腾，其烦躁必然伴有躁动不安。在呕吐腹泻之后，津液枯竭，会出现烦躁且口渴的症状。只有在伤寒及大病初愈后出现的虚烦症状，才没有霍乱病的表现，临证时应当仔细审察。巢元方在《诸病源候论》中说：心烦导致无法入睡的，是心热所致；但如果是单纯的虚烦导致无法入睡的，则是胆冷所致。
有一篇论述关于大病之后出现虚烦、无法入睡，以及心胆虚怯、遇事容易受惊、呼吸短促、心悸，或者再次出现自汗等症状的治疗。
温胆汤（Calm the Gallbladder Decoction）
半夏（用热水浸泡，七钱） 竹茹 枳实（用麦麸炒制，各三钱） 陈皮（四钱半） 白茯苓（去皮，二钱五分） 甘草（炙烤，二钱五分）
以上药材切碎，分为两剂，加生姜、大枣煎服。另一版本方剂，加入炒酸枣仁、去心的远志、五味子、熟地黄、人参，各等分。
有一篇论述关于大病之后，表里俱虚，体内缺乏津液，出现烦渴、心中躁扰，以及各种虚性烦热的症状，这与伤寒相似，但不怕冷，身体不疼痛，不可使用发汗或攻下的治法，适宜服用竹叶石膏汤。（方剂见伤寒章节）
不寐（失眠）有两种类型。一种是疾病后身体虚弱，以及老年人阳气衰退导致的不寐；另一种是痰浊阻滞胆经，神志不能守舍，也会导致不寐。属于虚证的，使用六君子汤（Six Gentlemen Decoction），加入炒酸枣仁、黄芩。属于痰浊的，使用温胆汤，减少一半的竹茹，加入南星、炒酸枣仁。由伤寒引起的不寐，应当在本门（伤寒章节）中寻求治疗方法。
有一篇论述关于心胆虚弱，昼夜无法入睡，各种方法都无效，服用此方如神效。
高枕无忧散（High Pillow Without Worry Powder）
人参（五钱） 软石膏（三钱） 陈皮 半夏（姜炒） 白茯苓（去皮） 枳实（麸炒） 竹茹 麦门冬（去心） 酸枣仁（炒） 甘草（各一钱五分）
以上药材切碎为一剂，加五个龙眼肉，用水煎服。
养心汤（Nourish the Heart Decoction）
人参 麦门冬（去心） 黄连（微炒） 白茯苓（去皮） 白茯神（去木） 当归（酒洗） 白芍（酒炒） 远志（去心） 陈皮 柏子仁 酸枣仁 甘草（各等分）
以上药材切碎，加五个去心的莲子肉，用水煎煮，温服。
安神复睡汤（Calming Spirit and Restoring Sleep Decoction）
当归 川芎 白芍（酒炒） 熟地黄 益智仁 酸枣仁（炒） 远志（用甘草水泡过，去心） 山药 龙眼肉（各等分）
以上药材切碎，加生姜、大枣煎服。
有一篇论述关于心气不足，精神恍惚，健忘，或者因劳心导致胆冷，夜间卧床无法入睡。此药能安神定志。
加味定志丸（Modified Dingzhi Pill）
人参（三两） 白茯神（去皮木，二两） 远志（用甘草水泡过，去心） 石菖蒲（各二两） 酸枣仁（炒，二两） 柏子仁（炒去壳，二两）
以上药材研为细末，用炼蜜制成丸药，大小如梧桐子。用朱砂、乳香作为衣丸。每次服用五十丸，临睡前，用枣汤送服。
附：睡眠方法
睡觉时不妨蜷缩身体，醒来时不妨舒展身体。蜷缩是指弯曲膝盖、收缩腹部，向左右两侧卧位，这是养生家所说的“狮子眠”。这样能使气海充满，丹田常暖，肾水易于生成，对人有益。舒展身体躺卧，则气机宣通但容易耗散，神志分散而不潜藏。所以只有在醒来时才适合舒展身体。
西山蔡季通引用《千金方》中的睡眠秘诀说：睡觉时必须侧卧，醒来时端正并伸展四肢，早晚按时作息。先让心静下来，再让眼睛闭上。晦庵（朱熹）认为这是古今未曾发掘的奥妙。
有一篇论述关于胆虚导致卧不安稳，心中经常惊悸。取酸枣仁一两，炒至香气溢出，研为粉末。每次服用二钱，不拘时间，用竹叶汤送服。
有一例治疗心下怔忡，睡着后立即大声打鼾，醒来后却无法入睡。我用羚羊角、乌犀角，分别用水磨成浓汁，加入之前所用的养心汤或安神复睡汤中，服用后立刻见效。因为打鼾睡觉，是由于心肺之火所致。
有一例治疗胆虚经常感到畏惧恐惧，不能独自睡觉，如同被人追捕的样子，头目不清爽。
人参 枳壳 五味子 桂心（各三分） 柏子仁（一钱） 甘菊花 白茯苓 枸杞子（各三分） 山茱萸（五分） 熟地黄（五分）
以上药材研为粉末。每次服用二钱，用温酒调服。
The so-called "deficiency vexation" (Xu Fan) refers to a state of mental restlessness and agitation in the chest and heart region. This is mostly caused by physical weakness, improper care, leading to disharmony of Ying and Wei Qi (Defensive and Nutritive Qi), resulting in an excess of either Yin or Yang.
It may be that Yin is deficient while Yang is excessive, or that Yin is excessive while Yang is deficient. The *Neijing* states: "Yin deficiency leads to internal heat; Yang deficiency leads to external cold. Yang excess leads to external heat; Yin excess leads to internal cold." These conditions all cause people to experience deficiency vexation. Most cases of deficiency vexation are caused by Yin deficiency generating internal heat. Patients with consumptive diseases (Xu Lao) have a deficiency of Kidney Water, causing Heart Fire to steam internally; their vexation must be accompanied by restlessness. After vomiting and diarrhea, when body fluids are depleted, one experiences vexation accompanied by thirst. Only in cases of deficiency vexation following Shanghan (Cold Damage) or major illnesses is Huoluan (Cholera-like disease) absent; clinical judgment should be careful. Chao Yuanfang stated in *Zhubing Yuanhou Lun*: "Vexation causing inability to sleep is due to Heart Heat. But pure deficiency vexation causing inability to sleep is due to Gallbladder Cold."
One discussion addresses deficiency vexation and insomnia after major illness, as well as symptoms of Heart and Gallbladder deficiency and timidity, easily startled by events, shortness of breath, palpitations, or recurrent spontaneous sweating.
Calm the Gallbladder Decoction (Wendan Tang)
Pinelliae Rhizoma Preparatum (soaked in hot water, 7 qian) Zhuru (Bambusae Folium) Zhishi (Fructus Aurantii Immaturus, bran-fried, each 3 qian) Chenpi (Pericarpium Citri Reticulatae, 4.5 qian) Baifuling (Poria, peeled, 2.5 qian) Gancao (Licorice Root, honey-fried, 2.5 qian)
Crush the above ingredients, divide into two doses, decoct with Shengjiang (Fresh Ginger) and Dazao (Jujube). Another formula adds Suanzaoren (Semen Ziziphi Spinosae, fried), Yuanzhi (Radix Polygalae, heart removed), Wuweizi (Fructus Schisandrae), Shudihuang (Rehmanniae Radix Praeparata), and Renshen (Ginseng Radix et Rhizoma) in equal parts.
One discussion addresses the condition after major illness where both exterior and interior are deficient, lacking internal body fluids, presenting with vexation, thirst, and mental agitation, along with various deficiency-type vexatious heat. This resembles Shanghan but without aversion to cold or body pain; sweating and purging methods are contraindicated. It is appropriate to take Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). (Formula see Shanghan section)
Insomnia (Bumei) has two types. One type occurs after illness due to weakness, or in elderly people due to declining Yang Qi. The other type is caused by phlegm obstructing the Gallbladder Meridian, preventing the Shen (Spirit) from residing in its house, also leading to insomnia. For deficiency patterns, use Liujunzi Tang (Six Gentlemen Decoction) with added fried Suanzaoren and Huangqin (Scutellariae Radix). For phlegm patterns, use Wendan Tang, reducing Zhuru by half, adding Nanxing (Arisaematis Rhizoma) and fried Suanzaoren. Insomnia caused by Shanghan should be sought within this chapter (Shanghan section).
One discussion addresses Heart and Gallbladder deficiency causing day-and-night insomnia, unresponsive to various methods. Taking this formula yields miraculous results.
High Pillow Without Worry Powder (Gaozhen Wuyou San)
Renshen (5 qian) Ruan Shigao (Soft Gypsum, 3 qian) Chenpi Banxia (Pinelliae Rhizoma, ginger-fried) Baifuling (Poria, peeled) Zhishi (Fructus Aurantii Immaturus, bran-fried) Zhuru Sanyeqia (Ophiopogonis Radix, heart removed) Suanzaoren (Semen Ziziphi Spinosae, fried) Gancao (Licorice Root, each 1.5 qian)
Crush the above ingredients for one dose. Add five Longyanrou (Longan Aril), decoct with water, and take.
One discussion addresses overthinking, excessive phlegm, little sleep, and unsettled Shen.
Nourish the Heart Decoction (Yangxin Tang)
Renshen Sanyeqia (Ophiopogonis Radix, heart removed) Huanglian (Coptidis Rhizoma, lightly fried) Baifuling (Poria, peeled) Baifushen (Poria cum Pino, wood removed) Danggui (Angelicae Sinensis Radix, wine-washed) Baishao (Paeoniae Radix Alba, wine-fried) Yuanzhi (Radix Polygalae, heart removed) Chenpi Baiziren (Platycladi Semen) Suanzaoren Gancao (Licorice Root, equal parts)
Crush the above ingredients. Add five lotus seeds (Lianrou) with hearts removed. Decoct with water and take warm.
Calming Spirit and Restoring Sleep Decoction (Anshen Fushui Tang)
Danggui Chuanxiong (Ligustici Chuanxiong Rhizoma) Baishao (Paeoniae Radix Alba, wine-fried) Shudihuang (Rehmanniae Radix Praeparata) Yizhiren (Alpiniae Oxyphyllae Fructus) Suanzaoren (Semen Ziziphi Spinosae, fried) Yuanzhi (Radix Polygalae, soaked in Licorice water, heart removed) Shanyao (Dioscoreae Rhizoma) Longyanrou (Longan Aril, equal parts)
Crush the above ingredients. Decoct with Shengjiang and Dazao and take.
One discussion addresses insufficient Heart Qi, mental恍惚 (fluctuation/unsteadiness), and forgetfulness, or Gallbladder cold due to overworking the mind, preventing sleep at night. This medicine can calm the spirit and stabilize the will.
Modified Dingzhi Pill (Jiawei Dingzhi Wan)
Renshen (3 liang) Baifushen (Poria cum Pino, peeled and wood removed, 2 liang) Yuanzhi (Radix Polygalae, soaked in Licorice water, heart removed) Shichangpu (Acori Tatarinowii Rhizoma, each 2 liang) Suanzaoren (Semen Ziziphi Spinosae, fried, 2 liang) Baiziren (Platycladi Semen, fried and shelled, 2 liang)
Grind into fine powder. Form pills using refined honey, size of Sophora japonica seeds. Coat with Zhusha (Cinnabar) and Rushiang (Frankincense). Take 50 pills per dose before bed, delivered with Jiantang (Jujube decoction).
Appendix: Sleeping Method
Sleeping does not dislike curling up; waking does not dislike stretching. Curling up means bending the knees and drawing in the abdomen, lying on either side—this is what cultivators call the "Lion's Sleep." This fills the Qihai (Sea of Qi) and keeps the Dantian warm, facilitating the generation of Kidney Water and benefiting the person. Lying stretched out allows Qi to circulate freely but scatters it, causing the Shen to disperse rather than submerge. Therefore, one should only stretch the body upon waking.
Cai Jitong of Xishan quoted the sleeping prescription from *Qianjin Fang*: "When sleeping, one must lie on the side; when awake, lie straight and stretch. Observe morning and evening times. First let the Heart sleep, then let the eyes sleep." Hui'an (Zhu Xi) considered this an unfathomable secret of ancient and modern times.
One discussion addresses Gallbladder deficiency causing restless sleep and frequent palpitations. Take 1 liang of Suanzaoren, fry until fragrant, grind into powder. Take 2 qian per dose, at any time, delivered with Zhuye Tang (Bamboo Leaf Decoction).
One case treated palpitations in the epigastrium, loud snoring immediately upon falling asleep, and insomnia upon waking. I used Lingyangjiao (Saiga Antelope Horn) and Wuxijiao (Black Rhinoceros Horn), ground separately in water to make concentrated juice, added to the previously mentioned Yangxin Tang or Anshen Fushui Tang. Immediate effect was achieved. Snoring during sleep is caused by Fire in the Heart and Lungs.
One case addressed Gallbladder deficiency causing constant fear and dread, inability to sleep alone, feeling like being hunted, with unclear head and eyes.
Renshen Zhike (Aurantii Fructus) Wuweizi (Schisandrae Fructus) Guixin (Cinnamomi Cortex, each 3 fen) Baiziren (Platycladi Semen, 1 qian) Ganjuhua (Chrysanthemi Flos) Baifuling (Poria) Gouqizi (Lycii Fructus, each 3 fen) Shanzhuyu (Corni Fructus, 5 fen) Shudihuang (Rehmanniae Radix Praeparata, 5 fen)
Grind into powder. Take 2 qian per dose, mixed with warm wine.