《活人》云∶虚烦似伤寒非伤寒也。成无己云∶伤寒有虚烦，有心中烦，有胸
中烦。二说不同，考之于书，成无己之言，实出仲景，活人无据，然往往有非因伤寒而虚烦者，今故
两存之。陈无择云∶虚烦身不觉热，头目昏疼，口干嗌燥不渴，清清不寐，皆虚烦也。《保命集》云∶
起卧不安，睡不稳，谓之烦。宜栀子豉汤、竹叶石膏汤。《活人》云∶但独热者，虚烦也。诸虚烦热
与伤寒相似，但不恶寒，身不疼痛，故知非伤寒也，不可发汗。头不痛，脉不紧数，故知非里实也，
不可下。病此者，内外皆不可攻，攻之必遂烦渴，当与竹叶汤。若呕者，与陈皮汤一剂，不愈再与之。
《三因》淡竹茹汤，东垣朱砂安神丸。仲景云∶下利后更烦，按之心下濡者，为虚烦也。栀子豉汤主
之。《素问》，帝曰∶有病身热，汗出烦满，烦满不为汗解，此为何病？岐伯曰∶汗出而身热者，风
也；汗出而烦满不解者，厥也；病名曰风厥。帝曰∶愿卒闻之。岐伯曰∶巨阳主气，故先受邪，少阴
与其为表里，得热则上从之，从之则厥也。帝曰∶治之奈何？岐伯曰∶表里刺之，饮之服汤。（表谓
太阳，里谓少阴，剌以治风汤，以止逆上之肾气，如仲景止逆下气，麦门汤之类。）丹溪治一女子，
年二十余岁，在室素强健，六月间发烦闷，困惫不食，发时欲入井，六脉皆沉细而弱数，两日后微渴，
众以为病暑，治不效，四五日加呕而人瘦，手心极热，喜在阴
处，渐成伏脉，时妄语，乃急制《局方》妙香丸如桐子大，以井水下一丸，半日许大便药已出，病无
退减，遂以麝香水洗药，以针穿三窍，次日以凉水送下，半日许大便下稠痰数升，是夜得睡，困顿伏
枕，旬日而愈。因记《金匮》云，昔肥而今瘦者，痰也。遂作此药治之。温胆汤，治大病后虚烦不得
眠。（审知有饮者用之，无饮者勿用。）《金匮》酸枣汤，治虚劳虚烦不得眠。上九法治热烦，前五
法烦热怔忡，知热在心肺也，故用竹叶、石膏、朱砂镇坠其热，使下行也。第六法烦而下利，知热在
上也，故用栀豉汤吐之。第七法烦而汗出不解，知表里有邪也，故用表里饮汤。第八法脉沉口渴手心
热，知热不在表也，故用妙香丸下之。第九法温胆、酸枣，治不得眠也。凡心虚则烦心，肝肾脾虚亦
烦心。经云∶夏脉者心也，其不及者，令人烦心。又云∶肝虚、肾虚、脾虚，皆令人体重烦冤，是知
烦多生于虚也。大法津液去多，五内枯燥而烦者，八珍汤加竹叶、酸枣仁、麦门冬。荣血不足，阳胜
阴微而烦者，人参、生地黄、麦门冬、地骨皮、白芍药、竹茹之属，或人参养荣汤下朱砂安神丸。肾
水下竭，心火上炎而烦者，竹叶石膏汤下滋肾丸。病后虚烦，有饮温胆汤，无饮远志汤。产、痘、滞
下后虚烦，为血液耗散，心神不守，危矣！宜猛进独参汤。烦
而小便不利，五苓散。心中蕴热而烦，清心莲子饮。烦而呕，不喜食，陈皮汤。
运气烦有五∶一曰热助心实而烦。经云∶少阴司天，热淫所胜，病胸中烦热，嗌干。又云∶少阳
司天，火淫所胜，病烦心，胸中热。又云∶少阳之胜，烦心心痛，治以咸寒是也。二曰心从水制而烦。
经云∶太阳司天，寒气下临，心气上从，寒清时举，火气高明，心热烦是也。三曰金攻肝虚而烦。经
云∶岁金太过，燥气流行，肝木受邪，民病体重烦冤是也。四曰土攻肾虚而烦。经云∶岁土太过，雨
湿流行，肾水受邪，民病体重烦冤。又云∶岁水不及，湿乃大行，民病烦冤足痿是也。五曰木攻脾虚
而烦。经云∶岁木太过，风气流行，脾土受邪，民病体重烦冤。盖肝虚、肾虚，皆令人体重烦冤。故
金太过则肝虚，土太过则肾虚，木太过则脾虚，凡此三太过之岁，则肝、肾、脾受邪而虚，皆病体重
烦冤也。
灸刺烦心有四∶其一取心俞。经云∶心主手厥阴心包络之脉，所生病者，烦心心痛，掌中热，详
盛、虚、寒、热、陷下取之。又云∶气乱于心则烦心密默，俯首静伏，取之手少阴心主之 是也。其
二取肾、膀胱俞。经云∶肾足少阴之脉，所生病者，烦心心痛，痿厥，足下热痛，视盛、虚、热、寒、
陷下取之。又云∶舌纵涎
下，烦 ，取足少阴。又云∶足少阴之别，名曰大钟，当踝后绕跟，别走太阳，其病气逆则烦闷，取
之所别也。又汗出烦满不解，表里取之，巨阳、少阴也。其三取肺俞。经云∶手太阴之脉，所生病者，
烦心胸满，视盛、虚、热、寒、陷下取之。又云∶振寒洒洒，鼓颔，不得汗出，腹胀烦冤，取手太阴
是也。其四取脾俞。经云∶脾足太阴之脉，所生病者，烦心，心下急痛，溏瘕泄，水闭，视盛、虚、
热、寒、陷下取之是也。
【胎前烦】妊娠烦闷，名曰子烦。以四月受少阴君火以养精，六月受少阳相火以养气，若母心惊
胆寒，多有是证。《产宝》云∶是心肺虚热，或痰积于胸。若三月而烦者，但热而已。若痰饮而烦者，
吐涎恶食。内热者，竹叶汤、竹茹汤、益母丸。气滞者，紫苏饮。痰滞者，二陈、白术、黄芩、枳壳。
气郁者，分气饮加川芎。脾胃虚弱者，六君、紫苏、山栀。
【产后烦】《金匮》云∶妇人在草蓐，自发露得风，四肢苦烦热，头痛者，与小柴胡汤；头不痛
但烦者，三物黄芩汤主之。又云∶妇人产中虚，烦乱呕逆，安
中益气，竹皮大丸主之。产后余血不尽，奔心烦闷，生藕汁饮二升，竹沥亦得。产后余血攻心，或下
血不止，心闷，面青冷，气欲绝，羊血一盏顿服，如不定更服。产后血虚气烦，生地黄汁、清酒各一
盏相和，煎一沸，分二服。蒲黄方寸匕，以东流水和服良。产后去血过多，血虚则阴虚，阴虚生内热，
心胸烦满短气，头疼闷乱，晡时辄甚，与大病后虚烦相类，宜《和剂》人参当归散。产后短气欲绝，
心中烦闷，竹叶汤、甘竹汤。产后虚烦不得眠，芍药栀豉汤、酸枣汤。经验方治产后烦躁，禹余粮一
枚，状如酸馅者入地埋一半，四面紧筑，用炭一秤发顶火一斤， 去火三分耗二为度，用湿砂土奄一
宿，方取出，打去外面一重，只使里面，细研，水淘澄五七度，将纸衬干，再研数千遍，用甘草煎汤，
调二钱匕。
《活人书》说：虚烦症状类似伤寒，但并非伤寒。成无己说：伤寒病中有虚烦，有心中烦，有胸中烦。这两种说法不同，考证书籍可知，成无己的观点确实出自张仲景，而《活人书》的说法缺乏依据，然而临床上往往有并非因伤寒引起的虚烦，所以现在将两种观点都保留下来。陈无择说：虚烦患者身体不觉得发热，头目昏沉疼痛，口干咽燥但不想喝水，清醒时无法入睡，这些都是虚烦的表现。《保命集》说：坐卧不安稳，睡不踏实，称为烦。适宜使用栀子豉汤（Gardenia and Fermented Soybean Decoction）、竹叶石膏汤（Bamboo Leaf and Gypsum Decoction）。《活人书》说：只有单独发热的，是虚烦。各种虚烦热证与伤寒相似，只是没有恶寒、身体不疼痛，所以知道不是伤寒，不可使用发汗法。头部不痛，脉象不紧数，所以知道不是里实证，不可使用泻下法。患此病的人，表里都不可攻伐，攻伐必然导致烦躁口渴，应当给予竹叶汤（Bamboo Leaf Decoction）。如果呕吐的，给陈皮汤（Tangerine Peel Decoction）一剂，不好再给。《三因方》中的淡竹茹汤（Light Bamboo Sheath Decoction），李东垣的朱砂安神丸（Cinnabar Calming the Spirit Pill）。张仲景说：腹泻后更加烦躁，按压心下部柔软的，是虚烦。用栀子豉汤主治。《素问》中，黄帝问：有人身体发热，出汗后仍然烦躁胀满，烦躁胀满不因出汗而缓解，这是什么病？岐伯说：出汗且身体发热的，是风邪；出汗后烦躁胀满不缓解的，是厥逆；病名叫做风厥。黄帝说：我想详细听听。岐伯说：太阳经主司体表之气，所以先受邪气，少阴经与太阳经互为表里，受热则向上从属于太阳，从属则发生厥逆。黄帝说：怎么治疗？岐伯说：表里两经同时针刺，并服用汤药。（表指太阳经，里指少阴经，针刺以治疗风邪汤剂，来制止上逆的肾气，如同张仲景治疗气逆降气的麦门冬汤之类。）朱丹溪治疗一名女子，二十多岁，未婚，平时身体强健，六月间发作烦闷，困倦疲惫不想进食，发作时想要跳入井中，六脉皆沉细而弱且数，两天后轻微口渴，众人认为是中暑，治疗无效，四五天后加重呕吐且人消瘦，手心极热，喜欢待在阴凉处，逐渐变成伏脉，时常胡言乱语，于是紧急配制《局方》妙香丸（Wonderful Fragrance Pill）如梧桐子大，用井水送下一丸，约半天大便排出药物，病情无退减，于是用麝香水洗药，用针穿三个孔，第二天用凉水送下，约半天大便排出稠痰数升，当晚得以睡眠，困顿伏在枕头上，十天痊愈。因为记得《金匮要略》说，过去肥胖现在消瘦的，是痰湿所致。于是用此药治疗。温胆汤（Warm Gallbladder Decoction），治疗大病后虚烦不得眠。（确知有饮邪者使用它，无饮邪者勿用。）《金匮要略》酸枣仁汤（Sour Jujube Seed Decoction），治疗虚劳虚烦不得眠。以上九种方法治疗热烦，前五法针对烦热怔忡，知道热在心肺，所以用竹叶、石膏、朱砂镇坠其热，使之下行。第六法烦而下利，知道热在上焦，所以用栀豉汤催吐。第七法烦而汗出不解，知道表里有邪气，所以用表里双解的汤药。第八法脉沉口渴手心热，知道热不在表，所以用妙香丸攻下。第九法温胆汤、酸枣仁汤，治疗不得眠。凡是心虚则心烦，肝肾脾虚也会心烦。经文说：夏脉对应心，其不及者，使人烦心。又说：肝虚、肾虚、脾虚，都让人身体沉重烦冤，由此知道烦多生于虚证。大法津液去失过多，五脏内枯燥而烦的，用八珍汤（Eight-Treasure Decoction）加竹叶、酸枣仁、麦门冬。营血不足，阳胜阴微而烦的，用人参、生地黄、麦门冬、地骨皮、白芍药、竹茹之类，或人参养荣汤（Ginseng Nourishing Prosperity Decoction）送服朱砂安神丸。肾水下竭，心火上炎而烦的，用竹叶石膏汤送服滋肾丸（Kidney-Nourishing Pill）。病后虚烦，有饮邪用温胆汤，无饮邪用远志汤（Polygala Decoction）。产褥期、痘疹、痢疾后虚烦，为血液耗散，心神不守，情况危急！宜猛进独参汤（Single Ginseng Decoction）。烦而小便不利，用五苓散（Five-Ingredient Powder with Poria）。心中蕴热而烦，用清心莲子饮（Clear Heart Lotus Seed Decoction）。烦而呕，不喜欢吃东西，用陈皮汤。
运气致烦有五种：一是热助心实而烦。经文说：少阴司天，热淫所胜，病胸中烦热，咽干。又说：少阳司天，火淫所胜，病烦心，胸中热。又说：少阳之胜，烦心心痛，治以咸寒即是。二是心从水制而烦。经文说：太阳司天，寒气下临，心气上从，寒清时举，火气高明，心热烦即是。三是金攻肝虚而烦。经文说：岁金太过，燥气流行，肝木受邪，民病体重烦冤即是。四是土攻肾虚而烦。经文说：岁土太过，雨湿流行，肾水受邪，民病体重烦冤。又说：岁水不及，湿乃大行，民病烦冤足痿即是。五是木攻脾虚而烦。经文说：岁木太过，风气流行，脾土受邪，民病体重烦冤。盖肝虚、肾虚，都让人身体沉重烦冤。所以金太过则肝虚，土太过则肾虚，木太过则脾虚，凡这三种太过之年，肝、肾、脾受邪而虚，都病体重烦冤。
灸刺治烦心有四种：其一取心俞穴（Xinshu, BL15）。经文说：心包络之脉，所生病者，烦心心痛，掌中热，详审盛、虚、寒、热、陷下取之。又说：气乱于心则烦心密默，俯首静伏，取手少阴心主之经即是。其二取肾俞、膀胱俞。经文说：足少阴之脉，所生病者，烦心心痛，痿厥，足下热痛，视盛、虚、热、寒、陷下取之。又说：舌纵涎下，烦闷，取足少阴经。又说：足少阴之别，名叫大钟穴（Dazhong, KI4），当踝后绕跟，别走太阳，其病气逆则烦闷，取之所别即是。又说汗出烦满不解，表里两经同取，巨阳、少阴经即是。其三取肺俞穴（Feishu, BL13）。经文说：手太阴之脉，所生病者，烦心胸满，视盛、虚、热、寒、陷下取之。又说：振寒洒洒，鼓颔，不得汗出，腹胀烦冤，取手太阴经即是。其四取脾俞穴（Pishu, BL20）。经文说：足太阴之脉，所生病者，烦心，心下急痛，溏瘕泄，水闭，视盛、虚、热、寒、陷下取之即是。
【胎前烦】妊娠期间烦闷，名叫子烦。因为四月受少阴君火以养精，六月受少阳相火以养气，若母亲心惊胆寒，多有此证。《产宝》说：这是心肺虚热，或痰积于胸。若三月而烦的，只是热而已。若痰饮而烦的，吐涎恶食。内热者，用竹叶汤、竹茹汤、益母丸（Motherwort Pill）。气滞者，紫苏饮（Perilla Decoction）。痰滞者，二陈汤（Two-Cured Decoction）、白术、黄芩、枳壳。气郁者，分气饮加川芎。脾胃虚弱者，六君子汤（Six-Gentleman Decoction）、紫苏、山栀。
【产后烦】《金匮要略》说：妇人在产褥期，自发露得风，四肢苦烦热，头痛的，与小柴胡汤（Minor Bupleurum Decoction）；头不痛但烦的，三物黄芩汤（Three-Ingredient Scutellaria Decoction）主治。又说：妇人产中虚，烦乱呕逆，安中益气，竹皮大丸（Bamboo Skin Large Pill）主治。产后余血不尽，奔心烦闷，生藕汁饮二升，竹沥（Bamboo Sap）也可以。产后余血攻心，或下血不止，心闷，面青冷，气欲绝，羊血一盏顿服，如果不定再服。产后血虚气烦，生地黄汁、清酒各一盏相和，煎一沸，分二服。蒲黄（Polygoni Catenati Pollen）方寸匕，以东流水和服良。产后去血过多，血虚则阴虚，阴虚生内热，心胸烦满短气，头疼闷乱，傍晚时加重，与大病后虚烦相类似，宜《和剂局方》人参当归散（Ginseng and Angelica Decoction）。产后短气欲绝，心中烦闷，竹叶汤、甘竹汤。产后虚烦不得眠，芍药栀豉汤（Peony, Gardenia and Fermented Soybean Decoction）、酸枣汤。经验方治产后烦躁，禹余粮（Haematitum）一枚，状如酸馅者入地埋一半，四面紧筑，用炭一秤发顶火一斤，去火三分耗二为度，用湿砂土奄一宿，方取出，打去外面一重，只使里面，细研，水淘澄五七度，将纸衬干，再研数千遍，用甘草煎汤，调二钱匕。
The *Huoren Shu* (Book of Vitality) states: Xu Fan (deficiency vexation) resembles Taiyang disease (disease of the Taiyang channel), but it is not Taiyang disease. Cheng Wuji states: In Taiyang disease, there is Xu Fan (deficiency vexation), Xin Zhong Fan (vexation in the heart region), and Xiong Zhong Fan (vexation in the chest). These two theories differ; upon examination of texts, Cheng Wuji's words indeed originate from Zhang Zhongjing, while the *Huoren Shu* lacks evidence. However, clinically, there are often cases of Xu Fan (deficiency vexation) not caused by Taiyang disease, so both theories are retained here. Chen Wuyue states: Patients with Xu Fan (deficiency vexation) do not feel feverish in the body, but have dizziness and headache, dry mouth and throat without thirst, and remain awake unable to sleep; these are all manifestations of Xu Fan (deficiency vexation). The *Baoming Ji* (Collection for Preserving Life) states: Restlessness in sitting and lying, and unstable sleep, are called Fan (vexation). Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) and Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) are appropriate. The *Huoren Shu* states: Isolated fever indicates Xu Fan (deficiency vexation). Various deficiency-heat vexations resemble Taiyang disease, but lack aversion to cold and body pain, thus indicating it is not Taiyang disease; sweating therapy should not be used. Lack of headache and a pulse that is not tight or rapid indicates it is not an interior excess syndrome; purgative therapy should not be used. For this condition, neither exterior nor interior attacks should be employed; attacking will inevitably lead to vexation and thirst. One should administer Zhu Ye Tang (Bamboo Leaf Decoction). If vomiting occurs, Chen Pi Tang (Tangerine Peel Decoction) one dose should be given; if not improved, give another. Dan Zhu Ru Tang (Light Bamboo Sheath Decoction) from the *Sanyin Fang* (Three Causes Formulae) and Zhu Sha An Shen Wan (Cinnabar Calming the Spirit Pill) by Li Dongyuan are also mentioned. Zhang Zhongjing states: After diarrhea, increased vexation with a soft epigastrium upon palpation indicates Xu Fan (deficiency vexation); Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) governs it. In the *Suwen* (Basic Questions), the Yellow Emperor asks: There is a disease where the body is hot, sweat is present, and vexation/fullness persists, not resolving with sweat. What disease is this? Qibo replies: Body heat with sweat indicates Wind pathogen; vexation/fullness not resolving with sweat indicates Jue (reversal); the disease name is Feng Jue (Wind Reversal). The Yellow Emperor says: I wish to hear more. Qibo says: The Taiyang channel governs Qi and is thus first affected by pathogens; Shaoyin is its interior-exterior pair. When heat enters, it follows upwards, leading to Jue (reversal). The Yellow Emperor asks: How to treat? Qibo says: Needle both exterior and interior channels and administer decoctions. (Exterior refers to Taiyang, interior to Shaoyin; needle with wind-treating decoctions to stop rebellious Kidney Qi, similar to Zhang Zhongjing's Mai Men Dong Tang [Ophiopogon Decoction] for descending rebellious Qi.)
Zhu Danxi treated a woman, over twenty years old, unmarried, usually robust. In June, she developed vexation and oppression, fatigue, and anorexia. During attacks, she desired to jump into a well. Her six pulses were deep, fine, weak, and rapid. Two days later, slight thirst appeared. Others diagnosed Summerheat, but treatment failed. By day four or five, vomiting worsened, emaciation occurred, palms became extremely hot, and she preferred cool places. The pulse gradually became hidden (Fu Mai). She occasionally spoke deliriously. Urgently, he prepared Miao Xiang Wan (Wonderful Fragrance Pill) from the *Jufang*, sized like Sophora seeds, administered with well water. Half a day later, the pill was passed in stool without symptom relief. He then washed the pill with musk-water, pierced three holes with a needle, and administered it with cool water the next day. Half a day later, several liters of thick phlegm were passed in stool. That night, she slept, resting heavily on her pillow, and recovered in ten days. Recalling the *Jingui Yaolue*: "Those who were formerly fat but are now thin have Phlegm." Thus, he treated with this method. Wen Dan Tang (Warm the Gallbladder Decoction) treats Xu Fan (deficiency vexation) and insomnia after severe illness. (Use only if Fluid retention is confirmed; do not use if absent.) Jingui Suan Zao Ren Tang (Sour Jujube Decoction) treats deficiency exhaustion with Xu Fan (deficiency vexation) and insomnia.
The above nine methods treat Heat Vexation. The first five address vexation, heat, and palpitations, indicating Heat in the Heart and Lungs; thus, Zhu Ye (Bamboo Leaf), Shi Gao (Gypsum), and Zhu Sha (Cinnabar) are used to suppress and descend the Heat. The sixth method addresses vexation with diarrhea, indicating Heat in the Upper Jiao; thus, Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is used to induce vomiting. The seventh method addresses vexation with unremitting sweat, indicating Exterior and Interior pathogens; thus, exterior-interior resolving decoctions are used. The eighth method addresses deep pulse, thirst, and hot palms, indicating Heat is not in the Exterior; thus, Miao Xiang Wan (Wonderful Fragrance Pill) is used to purge. The ninth method uses Wen Dan Tang (Warm the Gallbladder Decoction) and Suan Zao Ren Tang (Sour Jujube Decoction) for insomnia. Whenever the Heart is deficient, there is Heart Vexation; Liver, Kidney, and Spleen deficiency also cause Heart Vexation. The Classics state: The Summer pulse corresponds to the Heart; insufficiency causes Heart Vexation. It also states: Liver, Kidney, and Spleen deficiencies cause heaviness and vexation (Zhong Yuan), knowing that vexation mostly arises from deficiency. Generally, excessive loss of Jin Ye (Body Fluids) leads to dryness of the Five Zang organs and vexation; Ba Zhen Tang (Eight Treasures Decoction) plus Zhu Ye (Bamboo Leaf), Suan Zao Ren (Sour Jujube Seed), and Mai Men Dong (Ophiopogon Tuber) is used. Ying Blood (Nutritive Blood) insufficiency with Yang excess and Yin deficiency causing vexation is treated with Ren Shen (Ginseng), Sheng Di Huang (Rehmannia Root), Mai Men Dong (Ophiopogon Tuber), Di Gu Pi (Lycium Bark), Bai Shao Yao (White Peony Root), Zhu Ru (Bamboo Shavings), etc., or Ren Shen Yang Rong Tang (Ginseng Nourishing the Nutritive Decoction) administered with Zhu Sha An Shen Wan (Cinnabar Calming the Spirit Pill). Kidney Water depletion with Heart Fire flaming upward causing vexation is treated with Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) administered with Zi Shui Wan (Nourishing the Kidney Pill). Post-illness Xu Fan (deficiency vexation) with Fluid retention uses Wen Dan Tang (Warm the Gallbladder Decoction); without Fluid retention, Yuan Zhi Tang (Polygala Decoction) is used. Postpartum, post-chickenpox/smallpox, or post-dysentery Xu Fan (deficiency vexation) results from blood consumption and unsettled Spirit; this is critical. One should vigorously administer Du Shen Tang (Single Ginseng Decoction). Vexation with difficult urination uses Wu Ling San (Five-Ling Powder). Internal Heat accumulation causing vexation uses Qing Xin Lian Zi Yin (Clear Heart Lotus Seed Drink). Vexation with vomiting and anorexia uses Chen Pi Tang (Tangerine Peel Decoction).
Yun Qi (Climate Influence) causes five types of Vexation: 1. Heat assisting Heart Excess causing vexation. The Classics state: When Shaoyin governs the year, excessive Heat causes chest vexation and heat, dry throat. Also: When Shaoyang governs, excessive Fire causes Heart vexation and chest heat. Also: Shaoyang victory causes Heart vexation and pain, treated with Salty-Cold herbs. 2. Heart constrained by Water causing vexation. The Classics state: When Taiyang governs, Cold descends, Heart Qi follows upward; cold clarity rises, Fire ascends high, causing Heart Heat and vexation. 3. Metal attacking Liver Deficiency causing vexation. The Classics state: Excessive Metal year, Dryness prevails, Liver Wood is attacked, people suffer heaviness and vexation. 4. Earth attacking Kidney Deficiency causing vexation. The Classics state: Excessive Earth year, Rain/Dampness prevails, Kidney Water is attacked, people suffer heaviness and vexation. Also: Insufficient Water year, Dampness dominates, people suffer vexation and foot atrophy. 5. Wood attacking Spleen Deficiency causing vexation. The Classics state: Excessive Wood year, Wind prevails, Spleen Earth is attacked, people suffer heaviness and vexation. Since Liver and Kidney deficiency cause heaviness and vexation, excessive Metal leads to Liver Deficiency, excessive Earth to Kidney Deficiency, and excessive Wood to Spleen Deficiency. In these three excessive years, Liver, Kidney, and Spleen are attacked and deficient, causing heaviness and vexation.
Moxibustion and Acupuncture treat Heart Vexation in four ways: First, select Xin Shu (Heart Transporter). The Classics state: The Pericardium Channel diseases include Heart vexation, chest pain, and palm heat; select based on Excess, Deficiency, Cold, Heat, or sinking. Also: Qi disorder in the Heart causes vexation and silence, head bowed and still; select Hand Shaoyin (Heart) and Hand Jueyin (Pericardium) channels. Second, select Shen Shu (Kidney Transporter) and Pang Guang Shu (Bladder Transporter). The Classics state: Foot Shaoyin (Kidney) Channel diseases include Heart vexation, chest pain, ataxia, and hot painful feet; select based on Excess, Deficiency, Heat, Cold, or sinking. Also: Tongue deviation with salivation and vexation; select Foot Shaoyin. Also: Foot Shaoyin Luo-connecting vessel, named Da Zhong, located behind the ankle encircling the heel, diverging to Taiyang; rebellious Qi causes chest oppression; select the divergent point. Also: Sweat with vexation/fullness not resolving; select both exterior and interior, i.e., Ju Yang (Taiyang) and Shaoyin. Third, select Fei Shu (Lung Transporter). The Classics state: Hand Taiyin (Lung) Channel diseases include Heart vexation and chest fullness; select based on Excess, Deficiency, Heat, Cold, or sinking. Also: Chills, shivering, jaw quivering, no sweat, abdominal distension and vexation; select Hand Taiyin. Fourth, select Pi Shu (Spleen Transporter). The Classics state: Foot Taiyin (Spleen) Channel diseases include Heart vexation, acute epigastric pain, loose stools, masses, and urinary obstruction; select based on Excess, Deficiency, Heat, Cold, or sinking.
[Prenatal Vexation] Pregnancy vexation is named Zi Fan (Fetal Vexation). In the fourth month, Shaoyin Jun Fire nourishes Essence; in the sixth month, Shaoyang Xiang Fire nourishes Qi. If the mother has Heart fright and Gallbladder timidity, this syndrome often occurs. The *Chanbao* states: This is Heart-Lung Deficiency Heat or Phlegm accumulation in the chest. Vexation in the third month is merely Heat. Vexation due to Phlegm-Fluid involves spitting saliva and food aversion. Internal Heat uses Zhu Ye Tang (Bamboo Leaf Decoction), Zhu Ru Tang (Bamboo Shavings Decoction), Yi Mu Wan (Motherwort Pill). Qi Stagnation uses Zi Su Yin (Perilla Drink). Phlegm Stagnation uses Er Chen Tang (Two-Aged Decoction) plus Bai Zhu (Atractylodes Rhizome), Huang Qin (Scutellaria Root), Zhi Ke (Bitter Orange). Qi Depression uses Fen Qi Yin (Separating Qi Drink) plus Chuan Xiong (Ligusticum Rhizome). Spleen-Stomach Weakness uses Liu Jun Zi Tang (Six Gentlemen Decoction) plus Zi Su (Perilla Leaf), Shan Zhi (Gardenia Fruit).
[Postpartum Vexation] The *Jingui Yaolue* states: Women in confinement, exposed to wind, suffering limb vexation-heat and headache, receive Xiao Chai Hu Tang (Minor Bupleurum Decoction); those with no headache but only vexation, receive San Wu Huang Qin Tang (Three-Ingredient Scutellaria Decoction). Also: Women postpartum with deficiency, vexation, restlessness, vomiting, and reversal, receiving Middle-calming and Qi-nourishing effects, use Zhu Pi Da Wan (Bamboo Peel Large Pill). Postpartum residual blood not cleared, rushing vexation, drink raw lotus root juice two cups, or bamboo sap is acceptable. Postpartum residual blood attacking the Heart, or continuous bleeding, chest oppression, cyanotic cold face, impending Qi collapse, drink one cup of sheep blood at once; if unstable, repeat. Postpartum Blood Deficiency and Qi Vexation: mix raw Rehmannia juice and clear wine, each one cup, boil once, divide into two doses. Pu Huang (Typha Pollen) one square inch measure, taken with flowing eastward water is good. Postpartum excessive blood loss leads to Blood Deficiency and Yin Deficiency, generating internal Heat, chest vexation-fullness, shortness of breath, headache, confusion, worsening at dusk; similar to post-severe illness Xu Fan (deficiency vexation), use *Heji Jufang* Ren Shen Dang Gui San (Ginseng and Angelica Powder). Postpartum shortness of breath nearing collapse, chest vexation, use Zhu Ye Tang (Bamboo Leaf Decoction) or Gan Zhu Tang (Sweet Bamboo Decoction). Postpartum Xu Fan (deficiency vexation) with insomnia uses Shao Yao Zhi Chi Tang (Peony and Gardenia-Soybean Decoction) or Suan Zao Ren Tang (Sour Jujube Decoction). Empirical formula for postpartum irritability: Yu Yu Liang (Halloysitum, one piece resembling sour filling), bury half in the ground, compact soil around it. Burn one picul of charcoal to red heat (one jin top fire), burn until two-thirds are consumed. Cover with wet sandy soil overnight. Remove, discard outer layer, use inner part. Grind finely, wash and clarify five to seven times, dry on paper, grind thousands of times. Mix with Gan Cao (Licorice) decoction, take two qian measures.