夫伤寒虚烦者。心中郁郁而烦也。有胸烦。有心中烦。有虚烦。诸如此者。皆热也。若
止云烦者。表热也。及其邪热传里。故有胸中烦。心中烦。虚烦之别。三者。要在观其热所
从来。审其虚实。而治为不同也。如不经发汗吐下而烦者。则是传经之热。不作膈实者。但
多和解而已。故经曰。心烦喜呕。或胸中烦而不呕者。小柴胡汤主之。少阴病。二三日。心
中烦。不得卧者。黄连阿胶汤主之。少阴病。胸满心烦者。猪肤汤主之。是皆和解而彻热者
也。若因吐下发汗后。而烦者。则是内陷之烦。但多涌吐而已。下后虚烦。不得眠。若剧者。
必反复颠倒。心中懊 者。栀子豉汤主之。若少气者。栀子甘草豉汤主之。若呕者。栀子生
姜豉汤主之。心烦腹满。卧起不安者。栀子浓朴汤主之。丸药大下后。身热不去。微烦者。
栀子干姜汤主之。是皆取其吐。而涌其热者也。虚烦之状。心中温温然欲吐。愦愦然无奈欲
其不呕。扰扰乱乱。是名烦也。非吐则不能已。经曰。若下后更烦。心下濡者。为虚烦也。
栀子豉汤主之。脉作结。心下满而烦。饥不能食。病在胸中。瓜蒂散主之。二者证均烦也。
药均是吐也。而又轻重之不同。吐下发汗后。邪气乘虚而入。烦者。则谓之为虚烦。与栀子
豉汤。则是吐剂之轻者。不因吐下发汗后。邪气结胸中。则为膈实。与瓜蒂散。则是吐剂之
重者。又阳明病。不吐不下。心烦者。则是烦之实者也。与调胃承气汤下之。伤寒二三日。
心中悸。心烦者。则是烦也。虚也。与小建中汤补之。烦。为热也。悸而烦。复为虚者。以
悸为虚。悸甚而烦。故为虚也。少阳之邪入府者。烦而悸。则为热也。大抵先烦而悸者。是
为热也。先悸而烦者。是为虚也。内经曰。治病必先求其本。诚哉是言也。又云。伤寒病后
躁烦者。有虚烦。有谷烦。阳气偏多。谓之虚烦。病瘥后。食谷太早。心虚不胜谷气。胃内
蒸热。谓之谷烦。若阴阳和调。则虚烦自已。损其谷食。则谷烦者瘥。
活人书云。不恶寒。身不痛。头不疼。脉不紧。但烦热者。此多虚烦热证也。烦热与伤
寒相似。然不恶寒。身不疼痛。故知非伤寒也。不可发汗。头不疼。脉不紧数。故知非里实
也。不可下。如此者。内外皆不可攻。攻之。必遂损竭多死者也。此虚烦。但当与竹叶汤。
苦呕者。与橘皮汤一剂。不愈。再与之。孙真人云。此法数用。甚有效。伤寒虚之。宜服。
王叔和云。有热不可大攻之。热去则寒起。并宜服竹叶汤。
方
竹叶汤 治虚烦。状似伤寒。但身不疼痛。不恶寒。或得汗。亡津液。躁热未解。
内外皆不
竹叶（半把） 石膏（碎四两） 半夏（汤洗去滑切焙三分） 人参（半两） 麦门冬
（去心二
两） 甘草（炙半两） 上锉如麻豆大。每服五钱匕。以水一盏半。入粳米一百余粒。生姜
半
分。拍碎。同煎取八分。去滓。温服。并解暑毒。阴证伤寒未解人。勿服。若表里俱虚。不
利。发热。去石膏。加附子煎。名既济汤。济生除石膏、粳米。加茯苓、小麦。治伤寒霍乱
吐泻后。心虚烦闷。
栀子豉汤（出圣济总录）治伤寒发汗后。虚烦不得眠。剧者必反复颠倒。心中
懊 。宜服栀子豉汤。又伤寒发汗。若下之。而烦热。胸中窒痛。亦宜服栀子豉汤。又
伤寒下利后。更烦。按之心下濡者。虚烦也。亦宜服之。发汗。若下之。而烦热。胸中
窒者。栀子豉汤主之。
栀子（十四枚去皮） 豉（四合） 上锉如麻豆大。每服三钱匕。水一盏。煎至六分。
去滓。
温服。得快吐。止后服。
乌梅汤（同前）治伤寒大病瘥后。体虚烦满。
乌梅（取肉） 山栀子仁 甘草（炙） 葛根（各半两） 上粗捣筛。每服五钱匕。水
一盏。
入豉二七粒。同煎至半盏。去滓。早晚食后。温服。
麦门冬饮（同前）治伤寒汗后虚烦。心神不宁。
麦门冬（去心焙） 柴胡（去苗） 防风（去叉） 半夏（汤洗滑姜汁制） 赤茯苓（去
黑皮）
犀角（镑各半两） 上粗捣筛。每服五钱匕。水一盏半。入生姜五片。煎至八分。去滓。温
服。
人参汤（出同前）治伤寒后虚烦。心胸满闷。腹胀微喘。
人参 白茯苓（去黑皮） 杏仁（去皮尖双仁细研各半两） 上除杏仁外。锉如麻豆大。
每
服三钱匕。水一盏半。入粳米百余粒。同煎。米熟去滓。温服。空心。
麦门冬汤（出同前）治伤寒后不解。或寒或热。四肢瘦弱。饮食不能。胸中烦
满虚躁。
麦门冬（去心焙） 赤茯苓（去黑皮） 人参 白术（各一两） 桂（去粗皮半两） 陈
橘皮
（去白炒一两） 甘草（炙半两） 地骨皮 黄 （锉各一两） 上粗捣筛。每服五钱匕。
水一盏
半。煎至八分。去滓。温服。日再。
浓朴饮（出同前）治伤寒发汗后。气虚心烦。腹满痰逆。不思饮食。
浓朴（二两去粗皮姜汁制） 甘草（炙） 半夏（姜汁制） 人参 陈橘皮（去白焙各
二两）
上粗捣筛。每服五钱匕。水一盏半。生姜五片。同煎至七分。去滓。空心服。
薏苡仁汤（出同前）治伤寒汗后烦满。多睡。小便赤色。
薏苡仁 酸枣仁 防风（去叉） 人参 甘菊花 地骨皮 紫苏子 甘草（炙） 白茯
苓
（去黑皮各一两） 上粗捣筛。每服三钱匕。水一盏。入荆芥、薄荷、生姜各少许。同煎七
分。
去
人参饮（出同前）治伤寒汗后烦满。气虚。心神不宁。
人参 赤茯苓（去黑皮） 陈橘皮（去白焙） 白术（锉炒各一两） 上粗捣筛。每服
五钱
匕。水一盏。生姜三片。煎至七分。去滓。温服。日三。
麦门冬茯苓饮（出同前）治伤寒后烦满。心神恍惚。不得眠卧。
麦门冬（去心焙） 赤茯苓（去黑皮） 知母（焙） 芎 酸枣仁（微焙） 陈橘皮
（去白焙）
槟榔（锉） 甘草（炙各一两） 上粗捣筛。每服五钱匕。水一盏半。入生姜五片。煎至一
盏。
去滓。温服。日三。
柴胡汤（出圣济总录）治伤寒后。虚劳烦热。惊悸不得眠睡。
柴胡（去苗半两） 酸枣仁（微炒二两） 远志（去心一分） 当归 防风（去叉） 甘
草（炙
锉） 茯神（去木） 猪苓（去黑皮） 黄 （锉） 人参 生干地黄 芎 （各半两） 麦
门冬（去
心焙半两） 上粗捣筛。每服三钱匕。水一大盏。生姜三片。煎至七分。去滓。温服。空心。
日三服。
人参汤（出同前）治伤寒后。虚劳不得眠。烦闷。四肢乏力。
人参（一两） 酸枣仁（微炒三两） 当归（切焙） 芎 （锉） 桂（去粗皮） 甘
草（炙锉）
柴胡（去苗） 白茯苓（去黑皮） 石膏（碎各一两） 上粗捣筛。每服五钱匕。水一盏半。
生姜
三片。煎至一盏。去滓。食前服。
六神汤（出同前）治伤寒虚烦不安。
人参 白茯苓（去黑皮） 防风（去叉） 百合 黄 （锉） 干山芋（各一两） 上
粗捣筛。
每服三钱匕。水一盏。煎至七分。去滓。温服。不拘时候。
酸枣仁汤（出同前）治伤寒后。虚烦不得眠卧。头目昏眩。
酸枣仁（炒三两） 麦门冬（去心焙二两） 地骨皮（锉一两） 上粗捣筛。每服三钱
匕。水
一盏。生姜三片。同煎至七分。去滓。温服。不拘时候。
茯神散（出同前）治伤寒后虚烦。心腹不快。
茯神（去木） 柴胡（去苗） 陈橘皮（去白焙） 甘草（炙各一两） 上粗捣筛。每
服五钱。
水一盏半。煎取八分。去滓。温服。不拘时候。
黄连一物汤 治伤寒不解。恐服药大多。大小便不利。虚烦不安。
黄连（一两锉碎生姜数片入酒少许微炒） 上作一服。水一碗。煎七分。去滓。徐饮。
冷
热皆不可服。一物黄连泻心汤。易老。随证加减。列于后。
烦者加栀子。躁者加香豉。呕者加半夏。满者去甘草。腹痛加芍药。脉迟者加附子。大
便硬。加酒浸大黄。
用干姜、附子。先煎。令热不僭也。后另煎黄连。与黄连姜附同用。少阴渴逆者。失下
也。阴消将尽。阳逆上行。使阴不纳也。或舌弯。言语不正。反昏冒。与咽喉痛者。少阴也。
速下之。宜大承气汤。若阳极脉微将尽者。不宜下。宜泻心汤。凉膈。去硝。清肺亦可。饮
水多。心下痞。渴逆。无别恶候者。五苓散主之。
地仙散 治大病后。烦热不安。及一切虚劳病烦热。宜服之。
地骨皮（去木二两） 防风（去叉一两） 甘草（炙半两） 上 咀。每服四钱。水一
盏。姜
五片。煎八分。不拘时。温服。
枳实柴胡汤（出济生方）治虚烦昏闷。呕逆恶心。往来寒热。胸膈闷肢节痛。
日晚所发潮热
枳实（半两麸炒令紫色去瓤） 柴胡（去苗二两） 黄芩（一两半） 人参（半两） 甘
草（炙
一两半） 上杵为粗末。每服四钱。水一盏半。生姜三片。枣一枚。同煎至七分。去滓。温
服。日三。不拘时候。
大橘皮汤（出活人书）治动气在下。不可发汗。汗发则无津。心中大烦。骨节
疼痛。目运恶
甘草（炙半两） 人参（一分） 竹茹（半升） 橘皮（一两半去白） 上锉麻豆大。
每服五
钱。生姜四片。枣子一枚。水二盏。煎取一盏。去滓。分二服。
【背景信息】
书名：普济方 作者：朱梓 朝代：明·永乐四年 章节：伤寒虚烦附论 类别：方剂
【正文翻译】
所谓伤寒虚烦，是指心中郁结不舒而感到烦闷。其中有胸中烦、心中烦、虚烦之分。诸如此类的症状，本质上都是热邪所致。如果仅仅说是“烦”，那是表热；等到邪热传入体内，因此才有胸中烦、心中烦、虚烦的区别。这三者的关键，在于观察热邪的来源，审察其虚实性质，治疗方法因而不同。例如，未经过发汗、催吐或泻下治疗而出现的烦，属于传经之热，并未形成膈实（胸膈间痰食阻滞的实证），只需多用和解法即可。所以医经说：“心烦且喜呕，或者胸中烦而不呕的，用小柴胡汤主治。”少阴病，发病两三天，心中烦，无法入睡的，用黄连阿胶汤主治。少阴病，胸满心烦的，用猪肤汤主治。这些都是通过和解的方法来透达热邪。如果是因催吐、发汗或泻下之后出现的烦，则是邪气内陷引起的烦，多用涌吐法治疗。泻下后出现虚烦，无法入睡，严重的必定翻来覆去，心中懊恼郁闷，用栀子豉汤主治。如果兼有气短的，用栀子甘草豉汤主治。如果兼有呕吐的，用栀子生姜豉汤主治。心烦伴腹部胀满，坐卧不安的，用栀子厚朴汤主治。服用丸药猛烈泻下后，身热不退，轻微烦闷的，用栀子干姜汤主治。这些方剂都是取其涌吐作用，以涌出热邪。
虚烦的症状表现是：心中温温然想要呕吐，昏沉无奈想吐又吐不出来，心神扰乱，这就叫做“烦”。如果不使用吐法就不能痊愈。医经说：“如果泻下后更加烦闷，心下部按之柔软的，称为虚烦，用栀子豉汤主治。”脉象出现结代，心下部胀满且烦，饥饿却不能吃，病位在胸中，用瓜蒂散主治。这两种情况证候都有烦，用药都是吐法，但又有轻重之分。在吐下发汗之后，邪气乘虚而入导致烦的，称之为虚烦，给予栀子豉汤，这是吐剂中较轻的；不因吐下发汗后，邪气结聚胸中，则形成膈实，给予瓜蒂散，这是吐剂中较重的。另外，阳明病，没有经过催吐或泻下，出现心烦的，这是烦的实证，用调胃承气汤攻下。伤寒发病两三天，心中悸动、心烦的，这是烦与虚并存，用小建中汤补益。烦，属于热；悸动且烦，又属于虚，因为悸动本身属虚，悸动严重而导致烦，所以归为虚证。少阳邪气入腑，烦且悸，属于热证。大体而言，先烦后悸的，属于热；先悸后烦的，属于虚。《内经》说：治病必须先探求根本。这话确实正确。又说：伤寒病后出现躁烦的，有虚烦和谷烦之分。阳气偏盛，称为虚烦；病愈后，进食过早，心虚不能耐受谷气，胃中蒸腾发热，称为谷烦。如果阴阳调和，虚烦自然痊愈；减少谷物饮食，谷烦就会痊愈。
《活人书》说：不恶寒，身体不痛，头不疼，脉不紧，只是烦热的，这多是虚烦热证。烦热与伤寒相似，然而不恶寒、身体不疼痛，所以知道不是伤寒，不可发汗；头不疼、脉不紧数，所以知道不是里实证，不可攻下。像这样的情况，内外都不可攻伐，攻伐必然导致损耗枯竭，多致死亡。这种虚烦，只应当给予竹叶汤。苦于呕吐的，给予橘皮汤一剂，若不愈，再给一剂。孙思邈说：这种方法多次使用，非常有效。伤寒体虚者适宜服用。王叔和说：有热不可猛烈攻伐，热去则寒起，都适宜服用竹叶汤。
方剂：
竹叶汤：治疗虚烦，症状类似伤寒，但身体不疼痛，不恶寒，或者已经出汗，津液耗伤，燥热未解。
药材：竹叶（半把）、石膏（打碎四两）、半夏（热水洗去滑腻，切片，烘焙三分）、人参（半两）、麦门冬（去心二两）、甘草（炙半两）。以上锉如麻豆大小。每次服用五钱匕，用水一盏半，加入粳米一百多粒，生姜半分，拍碎，同煎至八分，去渣，温服。并能解除暑毒。阴证伤寒未解者，勿服。若表里俱虚，小便不利，发热，去掉石膏，加附子煎煮，名为既济汤。济生方去掉石膏、粳米，加茯苓、小麦，治疗伤寒霍乱吐泻后，心虚烦闷。
栀子豉汤（出自《圣济总录》）：治疗伤寒发汗后，虚烦不得眠，严重的必定翻来覆去，心中懊恼。宜服栀子豉汤。又治伤寒发汗或泻下后，烦热，胸中窒塞疼痛，也宜服栀子豉汤。又治伤寒下利后，更烦，按之心下部柔软的，是虚烦，也宜服之。发汗或泻下后，烦热，胸中窒塞的，用栀子豉汤主治。
药材：栀子（十四枚，去皮）、豉（四合）。以上锉如麻豆大小。每次服用三钱匕，水一盏，煎至六分，去渣，温服。得快吐即停服。
乌梅汤（同上）：治疗伤寒大病痊愈后，体虚烦满。
药材：乌梅（取肉）、山栀子仁、甘草（炙）、葛根（各半两）。以上粗捣筛。每次服用五钱匕，水一盏，加入豉二十粒，同煎至半盏，去渣，早晚饭后温服。
麦门冬饮（同上）：治疗伤寒汗后虚烦，心神不宁。
药材：麦门冬（去心焙）、柴胡（去苗）、防风（去叉）、半夏（热水洗去滑，姜汁制）、赤茯苓（去黑皮）、犀角（镑片，各半两）。以上粗捣筛。每次服用五钱匕，水一盏半，加入生姜五片，煎至八分，去渣，温服。
人参汤（出自同上）：治疗伤寒后虚烦，心胸满闷，腹胀微喘。
药材：人参、白茯苓（去黑皮）、杏仁（去皮尖双仁细研，各半两）。除杏仁外，锉如麻豆大小。每次服用三钱匕，水一盏半，加入粳米百余粒，同煎，米熟去渣，温服，空腹服用。
麦门冬汤（出自同上）：治疗伤寒后不解，或寒或热，四肢瘦弱，饮食难进，胸中烦满虚躁。
药材：麦门冬（去心焙）、赤茯苓（去黑皮）、人参、白术（各一两）、桂（去粗皮半两）、陈橘皮（去白炒一两）、甘草（炙半两）、地骨皮、黄芪（锉，各一两）。以上粗捣筛。每次服用五钱匕，水一盏半，煎至八分，去渣，温服，每日两次。
浓朴饮（出自同上）：治疗伤寒发汗后，气虚心烦，腹满痰逆，不思饮食。
药材：浓朴（二两，去粗皮，姜汁制）、甘草（炙）、半夏（姜汁制）、人参、陈橘皮（去白焙，各二两）。以上粗捣筛。每次服用五钱匕，水一盏半，生姜五片，同煎至七分，去渣，空腹服。
薏苡仁汤（出自同上）：治疗伤寒汗后烦满，多睡，小便赤色。
药材：薏苡仁、酸枣仁、防风（去叉）、人参、甘菊花、地骨皮、紫苏子、甘草（炙）、白茯苓（去黑皮，各一两）。以上粗捣筛。每次服用三钱匕，水一盏，加入荆芥、薄荷、生姜各少许，同煎七分，去渣。
人参饮（出自同上）：治疗伤寒汗后烦满，气虚，心神不宁。
药材：人参、赤茯苓（去黑皮）、陈橘皮（去白焙）、白术（锉炒，各一两）。以上粗捣筛。每次服用五钱匕，水一盏，生姜三片，煎至七分，去渣，温服，每日三次。
麦门冬茯苓饮（出自同上）：治疗伤寒后烦满，心神恍惚，不得眠卧。
药材：麦门冬（去心焙）、赤茯苓（去黑皮）、知母（焙）、川芎、酸枣仁（微焙）、陈橘皮（去白焙）、槟榔（锉）、甘草（炙，各一两）。以上粗捣筛。每次服用五钱匕，水一盏半，加入生姜五片，煎至一盏，去渣，温服，每日三次。
柴胡汤（出自《圣济总录》）：治疗伤寒后，虚劳烦热，惊悸不得眠睡。
药材：柴胡（去苗半两）、酸枣仁（微炒二两）、远志（去心一分）、当归、防风（去叉）、甘草（炙锉）、茯神（去木）、猪苓（去黑皮）、黄芪（锉）、人参、生干地黄、川芎（各半两）、麦门冬（去心焙半两）。以上粗捣筛。每次服用三钱匕，水一大盏，生姜三片，煎至七分，去渣，温服，空腹，每日三次。
人参汤（出自同上）：治疗伤寒后，虚劳不得眠，烦闷，四肢乏力。
药材：人参（一两）、酸枣仁（微炒三两）、当归（切焙）、川芎（锉）、桂（去粗皮）、甘草（炙锉）、柴胡（去苗）、白茯苓（去黑皮）、石膏（碎，各一两）。以上粗捣筛。每次服用五钱匕，水一盏半，生姜三片，煎至一盏，去渣，饭前服。
六神汤（出自同上）：治疗伤寒虚烦不安。
药材：人参、白茯苓（去黑皮）、防风（去叉）、百合、黄芪（锉）、干山药（各一两）。以上粗捣筛。每次服用三钱匕，水一盏，煎至七分，去渣，温服，不拘时候。
酸枣仁汤（出自同上）：治疗伤寒后，虚烦不得眠卧，头目昏眩。
药材：酸枣仁（炒三两）、麦门冬（去心焙二两）、地骨皮（锉一两）。以上粗捣筛。每次服用三钱匕，水一盏，生姜三片，同煎至七分，去渣，温服，不拘时候。
茯神散（出自同上）：治疗伤寒后虚烦，心腹不快。
药材：茯神（去木）、柴胡（去苗）、陈橘皮（去白焙）、甘草（炙，各一两）。以上粗捣筛。每次服用五钱，水一盏半，煎取八分，去渣，温服，不拘时候。
黄连一物汤：治疗伤寒不解，恐服药太多，大小便不利，虚烦不安。
药材：黄连（一两，锉碎，入生姜数片，酒少许，微炒）。以上作一服，水一碗，煎七分，去渣，慢慢饮用。冷热皆不可服。一方黄连泻心汤，易老随证加减，列于后：
烦者加栀子，躁者加香豉，呕者加半夏，满者去甘草，腹痛加芍药，脉迟者加附子，大便硬，加酒浸大黄。
用干姜、附子，先煎，令其热力不僭越。后另煎黄连，与黄连姜附同用。少阴渴逆者，是失下所致。阴消将尽，阳逆上行，使阴不纳。或舌卷缩，言语不正，反而昏冒，与咽喉痛者，属少阴病。速下之，宜大承气汤。若阳极脉微将尽者，不宜下，宜泻心汤。凉膈散去芒硝，清肺亦可。饮水多，心下痞，渴逆，无其他恶候者，五苓散主治。
地仙散：治疗大病后，烦热不安，及一切虚劳病烦热，宜服之。
药材：地骨皮（去木二两）、防风（去叉一两）、甘草（炙半两）。以上切碎。每次服用四钱，水一盏，姜五片，煎八分，不拘时，温服。
枳实柴胡汤（出自《济生方》）：治疗虚烦昏闷，呕逆恶心，往来寒热，胸膈闷肢节痛，日晚所发潮热。
药材：枳实（半两，麸炒令紫色，去瓤）、柴胡（去苗二两）、黄芩（一两半）、人参（半两）、甘草（炙一两半）。以上杵为粗末。每次服用四钱，水一盏半，生姜三片，枣一枚，同煎至七分，去渣，温服，每日三次，不拘时候。
大橘皮汤（出自《活人书》）：治疗动气在下，不可发汗，汗发则无津，心中大烦，骨节疼痛，目运恶风。
药材：甘草（炙半两）、人参（一分）、竹茹（半升）、橘皮（一两半，去白）。以上锉麻豆大。每次服用五钱，生姜四片，枣子一枚，水二盏，煎取一盏，去渣，分二服。
[Background Information]
Book: Puji Fang (Universal Relief Formulas)
Author: Zhu Zi
Dynasty: Ming Dynasty, Yongle 4th Year
Chapter: Supplementary Discussion on Deficiency-Fan in Cold Damage
Category: Formulas
[English Translation]
The so-called "deficiency-fan" (deficiency-related irritability/restlessness) in cold damage refers to a state of mental郁结 (depression/stagnation) and irritability within the heart. There are distinctions among irritability in the chest (chest-fan), irritability in the heart (heart-fan), and deficiency-fan. All such symptoms are essentially caused by heat pathogens. If one simply speaks of "fan," it indicates exterior heat; when the pathogenic heat transmits inward, distinctions arise between chest-fan, heart-fan, and deficiency-fan. The key to these three lies in observing the origin of the heat and examining its deficiency or excess nature, leading to different treatment methods. For instance, if fan occurs without prior sweating, vomiting, or purging, it is heat transmitted through the meridians that has not formed diaphragm-solidity (a solid pattern of phlegm-food stagnation in the chest/diaphragm). Such cases require mainly harmonizing methods. Thus, the classics state: "For heart-fan with frequent vomiting, or chest-fan without vomiting, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is indicated." In Shaoyin disease, if after two or three days there is heart-fan and inability to sleep, Huanglian Ejiao Tang (Coptis and Donkey-Hide Gelatin Decoction) is indicated. In Shaoyin disease, if there is chest fullness and heart-fan, Zhufu Tang (Pig Skin Decoction) is indicated. These all utilize harmonizing methods to resolve heat.
If fan arises after vomiting, sweating, or purging, it is due to the internal entrapment of pathogens, and often requires emetic methods. After purging, if deficiency-fan occurs with insomnia, and in severe cases, restlessness and tossing about with inner vexation (ao-nao), Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) is indicated. If accompanied by shortness of breath, Zhizi Gancao Chi Tang (Gardenia, Licorice, and Fermented Soybean Decoction) is indicated. If accompanied by vomiting, Zhizi Shengjiang Chi Tang (Gardenia, Ginger, and Fermented Soybean Decoction) is indicated. For heart-fan with abdominal fullness and restlessness day and night, Zhizi Houpo Tang (Gardenia and Magnolia Bark Decoction) is indicated. After harsh purgation with pill medicines, if body heat persists with mild fan, Zhizi Ganjiang Tang (Gardenia and Dried Ginger Decoction) is indicated. These formulas utilize emetic properties to expel heat upward.
The manifestation of deficiency-fan includes a warm sensation in the heart with an urge to vomit, a sense of dizziness and helplessness where one wants to vomit but cannot, and chaotic mental disturbance; this is called "fan." Without using emesis, it cannot be cured. The classics state: "If after purging the vexation worsens and the epigastrium is soft upon pressure, it is called deficiency-fan, treated with Zhizi Chi Tang." If the pulse shows knotted irregularities, with epigastric fullness and fan, hunger but inability to eat, and the pathology is in the chest, Gouti San (Melon Trichosanthes Powder) is indicated. Both conditions present with fan and use emetic drugs, yet differ in severity. Fan arising from pathogenic invasion due to deficiency after vomiting/sweating/purging is termed deficiency-fan; giving Zhizi Chi Tang represents a mild emetic. Fan arising from pathogenic knotting in the chest without prior vomiting/sweating/purging forms diaphragm-solidity; giving Gouti San represents a heavy emetic. Furthermore, in Yangming disease, if fan occurs without vomiting or purging, it is an excess type of fan, treated with Xiaochengqi Tang (Major Order the Golden Dragon Decoction - note: text says Tiaowei Chengqi Tang/Regulate the Stomach Major Purge Decoction) to purge downward. In cold damage, if after two or three days there is palpitations and fan, this involves both fan and deficiency; Xiaojianzhong Tang (Minor Construct the Middle Decoction) is used to tonify. Fan belongs to heat; palpitations with fan belong to deficiency because palpitations themselves indicate deficiency, and severe palpitations leading to fan thus classify as deficiency. When Shaoyang pathogens enter the fu organs, fan with palpitations indicates heat. Generally, fan preceding palpitations indicates heat; palpitations preceding fan indicate deficiency. The *Neijing* states: "In treating disease, one must first seek the root." This is truly correct. It also states: "After cold damage, restlessness and fan may be deficiency-fan or grain-fan. Excess yang is called deficiency-fan; after recovery, eating too early causes the heart's deficiency to fail to handle the grain qi, steaming heat in the stomach, called grain-fan." If yin and yang are harmonious, deficiency-fan resolves naturally; reducing grain intake cures grain-fan.
The *Liuren Shu* states: "If there is no aversion to cold, no body pain, no headache, no tight pulse, only fan-heat, this is mostly a deficiency-fan heat pattern." Fan-heat resembles cold damage, but the absence of aversion to cold and body pain indicates it is not cold damage, so sweating is contraindicated; the absence of headache and tight-numerous pulse indicates it is not interior excess, so purging is contraindicated. In such cases, neither interior nor exterior should be attacked; attacking will surely lead to depletion and death. For this deficiency-fan, only Zhuye Tang (Bamboo Leaf Decoction) should be given. For bitter vomiting, Jupi Tang (Tangerine Peel Decoction) one dose is given; if not resolved, another dose is given. Sun Simiao said: "This method has been used many times with great effect. It is suitable for those with cold damage and deficiency." Wang Shuhe said: "When there is heat, do not attack heavily; once heat leaves, cold arises. Zhuye Tang is suitable for both."
Formulas:
Zhuye Tang (Bamboo Leaf Decoction): Treats deficiency-fan resembling cold damage, but without body pain, aversion to cold, or with sweating already occurring, fluid exhaustion, and unresolved燥热 (dry-heat).
Ingredients: Zhuye (Bamboo Leaves, half a handful), Shigao (Gypsum Fibrosum, crushed, 4 liang), Banxia (Pinelliae Rhizoma, washed in hot water to remove slipperiness, sliced, dried, 3 qian), Renshen (Ginseng Radix et Rhizoma, 0.5 liang), Maimendong (Ophiopogonis Radix, heart removed, 2 liang), Gancao (Licorice Root, honey-fried, 0.5 liang). Crush these into pieces the size of hemp seeds. Take 5 qian-bi per dose. Add 1.5 cups of water, over 100 grains of Jingmi (Rice), 0.5 fen of Shengjiang (Fresh Ginger, smashed), and decoct together until 0.8 cup remains. Strain and take warm. It also resolves summer-heat toxicity. Do not use in Yin-pattern cold damage that is not resolved. If exterior and interior are both deficient, with difficulty urinating and fever, remove Shigao and add Fuzi (Aconiti Lateralis Radix Praeparata) to decoct; this is named Jiji Tang (Ji-Sheng Formula removes Shigao and Jingmi, adds Fuling (Poria) and Xiaomai (Tritici Fructus), treating post-cholera vomiting/diarrhea with heart-deficiency and vexation).
Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) (from *Shengji Zonglu*): Treats post-sweating cold damage causing deficiency-fan and insomnia; severe cases involve restlessness and inner vexation. Also treats post-sweating or post-purging cold damage with fan-heat and chest obstruction/pain. Also treats post-diarrhea cold damage with worsening fan and soft epigastrium (deficiency-fan).
Ingredients: Zhizi (Gardeniae Fructus, 14 pods, skin removed), Chi (Fermented Soybeans, 4 he). Crush into hemp-seed sized pieces. Take 3 qian-bi per dose. Add 1 cup of water, decoct until 0.6 cup remains. Strain and take warm. Stop administration after inducing rapid vomiting.
Wumei Tang (Dark Plum Decoction) (Same source): Treats post-major illness cold damage recovery with body-deficiency and vexation/fullness.
Ingredients: Wumei (Dark Plum Fruit flesh), Shanzhizi Ren (Gardeniae Semen), Gancao (Licorice Root, fried), Gegen (Puerariae Radix, each 0.5 liang). Coarsely grind and sieve. Take 5 qian-bi per dose. Add 1 cup of water, 27 grains of Chi, decoct until half a cup remains. Strain and take warm after morning and evening meals.
Maimendong Yin (Ophiopogon Drink) (Same source): Treats post-sweating cold damage deficiency-fan with restless mind.
Ingredients: Maimendong (Ophiopogonis Radix, heart removed, dried), Chaihu (Bupleuri Radix, stem removed), Fangfeng (Saposhnikoviae Radix, fork removed), Banxia (Pinelliae Rhizoma, washed, ginger juice processed), Chifuling (Red Poria, black skin removed), Xijiao (Rhinocerotis Cornu, shaved, each 0.5 liang). Coarsely grind and sieve. Take 5 qian-bi per dose. Add 1.5 cups of water, 5 slices of Shengjiang, decoct until 0.8 cup remains. Strain and take warm.
Renshen Tang (Ginseng Decoction) (From same source): Treats post-cold damage deficiency-fan with chest/heart fullness, abdominal distension, and slight panting.
Ingredients: Renshen (Ginseng Radix et Rhizoma), Baifuling (White Poria, black skin removed), Xingren (Prunus Armeniacae Semen, skin/kernel removed, double-kernel, finely ground, each 0.5 liang). Except for Xingren, crush to hemp-seed size. Take 3 qian-bi per dose. Add 1.5 cups of water, over 100 grains of Jingmi, decoct until rice is cooked. Strain and take warm on an empty stomach.
Maimendong Tang (Ophiopogon Decoction) (From same source): Treats unresolved post-cold damage with alternating chills/fever, emaciated limbs, poor appetite, chest vexation/fullness, and deficiency-restlessness.
Ingredients: Maimendong (Ophiopogonis Radix, heart removed, dried), Chifuling (Red Poria, black skin removed), Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma, each 1 liang), Gui (Cinnamomi Ramulus, coarse bark removed, 0.5 liang), Chenjupi (Aged Tangerine Peel, white part removed, stir-fried, 1 liang), Gancao (Licorice Root, honey-fried, 0.5 liang), Digupi (Lycii Cortex, 1 liang), Huangqi (Astragali Radix, cut, 1 liang). Coarsely grind and sieve. Take 5 qian-bi per dose. Add 1.5 cups of water, decoct until 0.8 cup remains. Strain and take warm, twice daily.
Houpo Yin (Magnolia Bark Drink) (From same source): Treats post-sweating cold damage with qi-deficiency fan, abdominal fullness, phlegm-reversal, and loss of appetite.
Ingredients: Houpo (Magnoliae Officinalis Cortex, 2 liang, coarse bark removed, ginger juice processed), Gancao (Licorice Root, honey-fried), Banxia (Pinelliae Rhizoma, ginger juice processed), Renshen (Ginseng Radix et Rhizoma), Chenjupi (Aged Tangerine Peel, white part removed, dried, each 2 liang). Coarsely grind and sieve. Take 5 qian-bi per dose. Add 1.5 cups of water, 5 slices of Shengjiang, decoct until 0.7 cup remains. Strain and take on an empty stomach.
Yiyiren Tang (Coix Seed Decoction) (From same source): Treats post-sweating cold damage fan/fullness, excessive sleepiness, and red urine.
Ingredients: Yiyiren (Coicis Semen), Suanzaoren (Ziziphi Spinosae Semen), Fangfeng (Saposhnikoviae Radix, fork removed), Renshen (Ginseng Radix et Rhizoma), Ganjuhua (Chrysanthemi Flos), Digupi (Lycii Cortex), Zisuzi (Perillae Fructus), Gancao (Licorice Root, honey-fried), Baifuling (White Poria, black skin removed, each 1 liang). Coarsely grind and sieve. Take 3 qian-bi per dose. Add 1 cup of water, small amounts of Jingjie (Schizonepetae Herba), Bohe (Menthae Haplocalycis Herba), and Shengjiang, decoct until 0.7 cup remains. Strain.
Renshen Yin (Ginseng Drink) (From same source): Treats post-sweating cold damage fan/fullness, qi-deficiency, and restless mind.
Ingredients: Renshen (Ginseng Radix et Rhizoma), Chifuling (Red Poria, black skin removed), Chenjupi (Aged Tangerine Peel, white part removed, dried), Baizhu (Atractylodis Macrocephalae Rhizoma, cut and stir-fried, each 1 liang). Coarsely grind and sieve. Take 5 qian-bi per dose. Add 1 cup of water, 3 slices of Shengjiang, decoct until 0.7 cup remains. Strain and take warm, three times daily.
Maimendong Fuling Yin (Ophiopogon and Poria Drink) (From same source): Treats post-cold damage fan/fullness, mental trance, and insomnia.
Ingredients: Maimendong (Ophiopogonis Radix, heart removed, dried), Chifuling (Red Poria, black skin removed), Zhimu (Anemarrhenae Rhizoma, dried), Xiong (Ligustici Chuanxiong Rhizoma), Suanzaoren (Ziziphi Spinosae Semen, slightly dried), Chenjupi (Aged Tangerine Peel, white part removed, dried), Binglang (Arecae Semen, cut), Gancao (Licorice Root, honey-fried, each 1 liang). Coarsely grind and sieve. Take 5 qian-bi per dose. Add 1.5 cups of water, 5 slices of Shengjiang, decoct until 1 cup remains. Strain and take warm, three times daily.
Chaihu Tang (Bupleurum Decoction) (From *Shengji Zonglu*): Treats post-cold damage deficiency-fatigue with fan-heat, palpitations, and insomnia.
Ingredients: Chaihu (Bupleuri Radix, stem removed, 0.5 liang), Suanzaoren (Ziziphi Spinosae Semen, slightly stir-fried, 2 liang), Yuanzhi (Polygalae Radix, heart removed, 1 qian), Danggui (Angelicae Sinensis Radix), Fangfeng (Saposhnikoviae Radix, fork removed), Gancao (Licorice Root, honey-fried and cut), Fushen (Poria with Hostwood, wood removed), Zhuling (Polypori Umbellatus), Huangqi (Astragali Radix, cut), Renshen (Ginseng Radix et Rhizoma), Sheng Dihuang (Rehmanniae Radix Recens), Xiong (Ligustici Chuanxiong Rhizoma, each 0.5 liang), Maimendong (Ophiopogonis Radix, heart removed, dried, 0.5 liang). Coarsely grind and sieve. Take 3 qian-bi per dose. Add 1 large cup of water, 3 slices of Shengjiang, decoct until 0.7 cup remains. Strain and take warm on an empty stomach, three times daily.
Renshen Tang (Ginseng Decoction) (From same source): Treats post-cold damage deficiency-fatigue with insomnia, vexation, and limb weakness.
Ingredients: Renshen (Ginseng Radix et Rhizoma, 1 liang), Suanzaoren (Ziziphi Spinosae Semen, slightly stir-fried, 3 liang), Danggui (Angelicae Sinensis Radix, cut and dried), Xiong (Ligustici Chuanxiong Rhizoma, cut), Gui (Cinnamomi Ramulus, coarse bark removed), Gancao (Licorice Root, honey-fried and cut), Chaihu (Bupleuri Radix, stem removed), Baifuling (White Poria, black skin removed), Shigao (Gypsum Fibrosum, crushed, each 1 liang). Coarsely grind and sieve. Take 5 qian-bi per dose. Add 1.5 cups of water, 3 slices of Shengjiang, decoct until 1 cup remains. Strain and take before meals.
Liushen Tang (Six Gods Decoction) (From same source): Treats cold damage deficiency-fan with uneasiness.
Ingredients: Renshen (Ginseng Radix et Rhizoma), Baifuling (White Poria, black skin removed), Fangfeng (Saposhnikoviae Radix, fork removed), Baihe (Lilii Bulbus), Huangqi (Astragali Radix, cut), Ganshanyao (Dioscoreae Rhizoma Dryum, each 1 liang). Coarsely grind and sieve. Take 3 qian-bi per dose. Add 1 cup of water, decoct until 0.7 cup remains. Strain and take warm at any time.
Suanzaoren Tang (Ziziphus Seed Decoction) (From same source): Treats post-cold damage deficiency-fan with insomnia, dizziness, and vertigo.
Ingredients: Suanzaoren (Ziziphi Spinosae Semen, stir-fried, 3 liang), Maimendong (Ophiopogonis Radix, heart removed, dried, 2 liang), Digupi (Lycii Cortex, cut, 1 liang). Coarsely grind and sieve. Take 3 qian-bi per dose. Add 1 cup of water, 3 slices of Shengjiang, decoct until 0.7 cup remains. Strain and take warm at any time.
Fushen San (Poria with Hostwood Powder) (From same source): Treats post-cold damage deficiency-fan with cardiac/abdominal discomfort.
Ingredients: Fushen (Poria with Hostwood, wood removed), Chaihu (Bupleuri Radix, stem removed), Chenjupi (Aged Tangerine Peel, white part removed, dried), Gancao (Licorice Root, honey-fried, each 1 liang). Coarsely grind and sieve. Take 5 qian per dose. Add 1.5 cups of water, decoct until 0.8 cup remains. Strain and take warm at any time.
Huanglian Yi Wu Tang (Single Ingredient Coptis Decoction): Treats unresolved cold damage, fearing excessive medication, difficulty urinating/defecating, and deficiency-fan uneasiness.
Ingredients: Huanglian (Coptidis Rhizoma, 1 liang, cut, with several slices of Shengjiang and a little wine, slightly stir-fried). Prepare as one dose. Add 1 bowl of water, decoct until 0.7 remains. Strain and drink slowly. Do not take hot or cold. Another formula, Huanglian Xiexin Tang (Coptis Drain the Epigastrium Decoction) by Yi Lao, modifies according to syndrome:
Add Zhizi (Gardeniae Fructus) for fan; add Chixiang (Fermented Soybeans) for agitation; add Banxia (Pinelliae Rhizoma) for vomiting; remove Gancao (Licorice Root) for fullness; add Shaoyao (Paeoniae Radix Alba/Rubra) for abdominal pain; add Fuzi (Aconiti Lateralis Radix Praeparata) for slow pulse; add Jiuhuangda Huang (Rhizoma Rhei prepared with wine) for hard stool.
Use Ganjiang (Zingiberis Rhizoma) and Fuzi first, decoct until heat is moderated. Then decoct Huanglian separately and combine with the ginger/aconite decoction. For Shaoyin thirst/reversal due to missed purging, with yin fading and yang reversing upward preventing yin reception, or tongue curling, speech impairment, confusion, or sore throat, this is Shaoyin disease. Purge rapidly with Dachengqi Tang (Major Order the Golden Dragon Decoction). If yang is extreme, pulse is faint and near exhaustion, do not purge; use Xiexin Tang (Drain the Epigastrium Decoction). Liangge San (Cool the Diaphragm Powder) without Mangxiao (Natrii Sulfas) or Qingfei (Clear Lung) methods are also acceptable. For excessive drinking, epigastric痞 (stuffiness), thirst/reversal, without other bad signs, Wuling San (Five-Ingredient Powder with Poria) is indicated.
Dixian San (Earth Immortal Powder): Treats post-major illness fan-heat uneasiness and all deficiency-fatigue fan-heat.
Ingredients: Digupi (Lycii Cortex, wood removed, 2 liang), Fangfeng (Saposhnikoviae Radix, fork removed, 1 liang), Gancao (Licorice Root, honey-fried, 0.5 liang). Chop coarsely. Take 4 qian per dose. Add 1 cup of water, 5 slices of Jiang, decoct until 0.8 cup remains. Take warm at any time.
Zhishi Chaihu Tang (Immature Bitter Orange and Bupleurum Decoction) (From *Jisheng Fang*): Treats deficiency-fan with dizziness/stuffiness, nausea/vomiting, alternating chills/fever, chest/diaphragm stuffiness, limb/joint pain, and tidal fever in the evening.
Ingredients: Zhishi (Aurantii Fructus Immaturus, 0.5 liang, bran-fried to purple, placenta removed), Chaihu (Bupleuri Radix, stem removed, 2 liang), Huangqin (Scutellariae Radix, 1.5 liang), Renshen (Ginseng Radix et Rhizoma, 0.5 liang), Gancao (Licorice Root, honey-fried, 1.5 liang). Pound into coarse powder. Take 4 qian per dose. Add 1.5 cups of water, 3 slices of Shengjiang, 1 Jujube, decoct until 0.7 cup remains. Strain and take warm, three times daily, at any time.
Da Jupi Tang (Large Tangerine Peel Decoction) (From *Liuren Shu*): Treats moving Qi in the lower jiao, where sweating is contraindicated; if sweated, fluids are exhausted, causing severe heart-fan, bone/joint pain, dizzy eyes, and aversion to wind.
Ingredients: Gancao (Licorice Root, honey-fried, 0.5 liang), Renshen (Ginseng Radix et Rhizoma, 1 qian), Zhuru (Bambusae Caulis in Taeniam, 0.5 sheng), Jupi (Tangerine Peel, 1.5 liang, white part removed). Cut to hemp-seed size. Take 5 qian per dose. Add 4 slices of Shengjiang, 1 Jujube, 2 cups of water, decoct until 1 cup remains. Strain and divide into two doses.