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If excessive sweating leads to the patient crossing their hands over the heart area, experiencing palpitations (palpitation), and desiring pressure relief, treat with Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction) (see entry for "Palpitation").

The distinction between Jing (Startle/Fright) and Ji (Palpitation) is clarified in miscellaneous diseases. In Shanghan (Cold Damage) disease, there are cases mentioning only Jing and cases mentioning only Ji; their mechanisms must not be confused, so they are separated into two categories. The only case where both Jing and Ji are mentioned together is in Shaoyang (Lesser Yang) syndrome presenting with deafness, red eyes, chest fullness, and irritability; emesis or purgation must not be used here. If emesis or purgation is mistakenly applied, it results in palpitation and startle.

Fuling Wan (Poria Pill): Treats post-Shanghan conditions or those caused by mental exertion and fatigue, resulting in emaciated limbs, Songxin (heart flustered/palpitations), Jingji (startle and palpitations), and shortness of breath.
Ingredients: Fushen (Poria with Hostwood), Maidong (Ophiopogon Tuber, core removed), Shudi (Rehmannia Root, prepared) (each 1 liang); Mudanpi (Moutan Cortex), Renshen (Ginseng Root), Huangqi (Astragalus Root) (each 7 qian); Guizhi (Cinnamon Twig), Zhigancao (Licorice Root, honey-fried), Niuxi (Achyranthes Root), Zexie (Alisma Rhizome) (each 0.5 liang).
Preparation and Administration: Grind all ingredients into a fine powder. Mix with refined honey and pound/beaten 300-500 times. Form pills the size of Sophora seeds. Take 20 pills before meals with warm wine.

Xijiao Tang (Rhinoceros Horn Decoction): Treats residual heat lingering in the Heart after Shanghan, causing Zhengchong (severe palpitations/anxiety), Jingji (startle and palpitations), and insomnia.
Ingredients: Xijiao xie (Rhinoceros Horn shavings, half liang, sliced); Yinchenhao (Artemisia Capillaris Herba) (7.5 qian); Fuling (Poria) (2 liang); Shaoyao (Peony Root) (2 liang); Shengdihuang (Rehmannia Root, fresh, baked) (2 liang); Maidong (Ophiopogon Tuber, core removed) (1.5 liang); Shanzhi (Gardenia Fruit) (half liang).
Preparation and Administration: Cut herbs into small pieces (Ju). Take 5 qian per dose. Add one cup of water, 2 slices of Shengjiang (Fresh Ginger), and 30 Zhu Ye (Bamboo Leaves). Decoct until reduced to 70%. Take after meals.

Maidong Fuling Yinzi (Ophiopogon and Poria Drink): Treats post-Shanghan conditions characterized by vague spirit (Shen) and inability to lie down/sleep.
Ingredients: Maidong (Ophiopogon Tuber, core removed); Chifuling (Red Poria, peel removed); Zhi mu (Anemarrhena Rhizome, baked); Xiong (Ligusticum Rhizome); Zhigancao (Licorice Root, honey-fried); Suanzaoren (Ziziphus Seed, lightly fried); Chenpi (Citrus Reticulata Peel, white part removed, fried); Binglang (Areca Seed) (each 1 liang).
Preparation and Administration: Cut herbs into small pieces (Ju). Take 5 qian per dose. Add 1.5 cups of water and 5 slices of Shengjiang (Fresh Ginger). Decoct and take warm. Three times daily.

"Jing Huai Bing" (Disease complicated by Startle) is caused by mistaken purgation, fire therapy counter-flow, or warm needle application. Zhang Zhongjing's method is simply to regulate according to the counter-flow.

In Shanghan lasting eight or nine days, if purgation is applied leading to chest fullness, irritability, startle, difficulty urinating, delirious speech, and whole-body heaviness making turning difficult, the primary formula is Chaihu Jia Longgu Muli Tang (Bupleurum plus Dragon Bone and Oyster Shell Decoction). (Cheng Wuji notes: At eight or nine days of Shanghan, pathogenic qi has transformed into heat and transmitted to the Yang meridians. Mistaken purgation damages the interior while heat remains. Chest fullness and irritability indicate Yang-heat lodging in the chest. Startle occurs because the Heart dislikes heat and the Spirit does not remain secure. Difficulty urinating indicates interior deficiency and impaired fluid transport. Delirium indicates Stomach heat. Whole-body heaviness and inability to turn indicate Yang qi moving inward and failing to nourish the exterior. This formula uses Chaihu Tang to resolve chest fullness and irritability; adds Longgu (Dragon Bone), Muli (Oyster Shell), and Qiandan (Lead Monoxide) to gather the Spirit and calm startle; adds Fuling (Poria) to move fluids and promote urination; adds Dahuang (Rhubarb Root) to purge Stomach heat and stop delirium; adds Guizhi (Cinnamon Twig) to circulate Yang qi and resolve body heaviness and mixed pathogens. Thus, all symptoms are resolved.)

Chaihu Jia Longgu Muli Tang Formula:
Banxia (Pinellia Tuber, washed in hot water, 2 he); Chaihu (Bupleurum Root, 4 liang); Dahuang (Rhubarb Root, 2 liang); Renshen (Ginseng Root); Guizhi (Cinnamon Twig, coarse bark removed); Fuling (Poria); Longgu (Dragon Bone); Qiandan (Lead Monoxide); Muli (Oyster Shell, calcined); Shengjiang (Fresh Ginger) (each 1.5 liang); Dazao (Jujube, 6 pieces).
Preparation and Administration: These eleven ingredients are boiled in 8 sheng of water to obtain 4 sheng. Add chopped Dahuang (Rhubarb Root), boil for one or two more boils, strain, and take 1 sheng warm.

In Shanghan with a floating pulse, if a physician uses fire methods to force sweating, leading to loss of Yang qi, inevitable symptoms include Jingkuang (startle and mania/restlessness) and inability to sit or lie still. The primary formula is Guizhi Qu Shaoyao Jia Shuqi Longgu Muli Jiuni Tang (Cinnamon Twig Decoction minus Peony plus Kochia Herb, Dragon Bone, and Oyster Shell to Rescue Counterflow). (Cheng Wuji notes: A floating pulse in Shanghan indicates pathogenic qi in the exterior. Using fire methods to force sweating causes excessive perspiration, leading to loss of Yang. Sweat is the fluid of the Heart; loss of Yang implies Heart qi deficiency. The Heart dislikes heat; internal forcing by fire pathogen causes the Spirit to float outward, resulting in startle, mania, restlessness, and inability to sit or lie still. Use Guizhi Tang to resolve remaining exterior pathogen. Remove Shaoyao (Peony Root) because it benefits Yin, which is unsuitable for this condition of Yang/Yin loss. For the counter-flow of fire pathogen, add Shuqi (Kochia Herb) for its acrid nature to disperse. For the collapse of Yang qi, add the astringent properties of Longgu (Dragon Bone) and Muli (Oyster Shell) to consolidate. Materia Medica states: Astringents can treat collapse. Longgu and Muli belong to this category.)

Guizhi Qu Shaoyao Jia Shuqi Longgu Muli Jiuni Tang Formula:
Guizhi (Cinnamon Twig, coarse bark removed); Shengjiang (Fresh Ginger, sliced); Shuqi (Kochia Herb, washed to remove fishy smell) (each 3 liang); Muli (Oyster Shell, calcined, 5 liang); Longgu (Dragon Bone, 4 liang); Zhigancao (Licorice Root, honey-fried, 2 liang); Dazao (Jujube, 12 pieces, split).
Preparation and Administration: Grind into powder. Boil in 12 sheng of water. First decoct Shuqi (Kochia Herb) until reduced by 2 sheng, then add other herbs. Decoct to obtain 3 sheng, strain, and take 1 sheng warm.

In Taiyang Shanghan (Greater Yang Cold Damage), applying warm needles will inevitably cause Jing (Startle). (The Heart belongs to Fire, and Fire enters the Heart first. The Heart governs Blood and houses the Spirit. Blood is like water; Spirit is like a fish. When two Yangs scorch each other, the water boils, causing the fish [Spirit] to jump in fright and become unsettled.) In Fengwen (Wind-Warmth), with a floating pulse, spontaneous sweating, body heaviness, and somnolence, if fire therapy is applied, mild cases result in jaundice, while severe cases resemble convulsions of Jingxian (startle epilepsy) (See discussion on Wind-Warmth).

Wu states: Generally, after Shanghan has been treated with sweating, vomiting, or purgation, extremely deficient patients may develop Jingji (startle and palpitations) due to unresolved concerns. They should be treated with formulas that nourish Blood, calm the Spirit, and anchor the Heart, such as Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill).