人身有九藏，心藏神、肝藏魂，二经皆主于血，血亏则神魂失宁而生惊悸也。经曰∶东方青
色，入通于肝，其病发惊骇。又曰∶二阳一阴，发病主惊骇。惊者，心卒动而恐怖也；悸者
，心跳动而怔忡也。二者因心虚血少，故健忘之症随之，用四物、安神之类。丹溪谓亦有属
痰者，宜用温胆汤加辰砂、远志之类。若思虑便动，虚也，用养心汤。时作时止，痰也，用
茯苓丸。触事易惊，心胆虚怯也，用温胆汤。卧惊多魇，血不归源也，用真珠母丸。梦寐不
宁，肝魂失守也，用定志丸。恐畏不能独处，胆气虚冷也，用茯神汤。睡卧烦躁，胆气实热也
，用酸枣仁丸。眩晕惊悸，风痰内作也，用本事辰砂远志丸。思虑郁结，脾虚气滞，用归脾
汤。前症虽曰属心与肝，而血之所统，实主于脾，脾之志曰思，思虑多则血耗损而不能滋养于
肝，心者脾使之也，思虑内动，未尝有不役其心者。夫心为君火之藏，十二官之主也。夫君
之德不怒而威，无为而治，故宜镇之以静谧，戒之以妄动，动则相火翕合，煽烁阴精，精血
既亏，则火空独发，是以惊悸怔忡之所由生，五志之火，心所不能制者矣。故治脾者不可不
知养心，养心者不可不知镇静而寡欲。然人孰无思也，思之正，则无妄动之欲矣。朱子曰∶
必使道心常为一身之主，而人心每听命焉。此善养于心者也。
治验
一女子素血虚惊悸，出嫁后更怔忡晡热，月经过期，用八珍汤加远志、山药、酸枣仁，三十
余剂渐愈，佐以归脾汤痊愈。后因劳怒，适经行不止，前症复作，先用加味逍遥散，热退经
止；又用养心汤而痊。
一小儿十五岁，彻夜用功记诵，去后少寐，仍不戒劳，患怔忡发热不止，用归脾汤为主，佐
以八珍汤，诸症渐愈。后复作，服归脾、定志二药即愈。
一小儿十五岁，因用心太过，少寐惊悸，怔忡恶寒，先用补中益气汤、茯苓、酸枣仁、远志
，恶寒渐止；又用加味归脾汤，惊悸稍安；又用养心汤而愈。
一小儿惊悸，睡卧不安，发热饮冷。用治要茯苓散而愈。又因劳役恚怒，发热吐痰自汗，用
温胆汤二剂而安，又用归脾汤、宁志丸而愈。
一小儿十三岁，善思多忧，体倦发热，心怀畏惧，必多人相伴乃止，用茯神汤，佐以归脾汤
，两月余渐愈。毕姻后，前症复作，加寒热头晕，先用前二汤而惊悸愈，后用十全大补汤、
补中益气汤，诸症渐愈。后因科举入场劳役，朝寒暮热，自服前二汤各三十余剂，不应，时
仲秋，脉虚大，按之微细，面白腹痛，亦用前方，倍加肉桂、干姜，四剂亦不应，遂以八味丸料煎服
四剂，稍缓；又四剂渐愈，乃用八味丸、十全大补汤而安。
一女子十五岁，性沉静，被盗所恐，遂惊悸，腹胁胀痛，寒热往来，不食无寐，善思恐惧，
用酸枣仁丸、归脾汤、加味逍遥散而寻愈。出嫁后，因丧子兼大劳，惊悸无寐，吐痰发热，
饮食少思，胸腹膨胀，服化痰药日吐痰四五碗，时考续至京，请治，余谓脾肺虚寒，不能摄
涎化食而为痰也。用六君、干姜六剂，痰益甚，手足并冷，用前药，每加附子一钱，仍不应
，乃用人参一两，附子二钱，四剂始稍缓，又二剂，仍用六君加姜、附各五分，数剂后，易
桂治之而愈。
温胆汤 治心胆虚怯，触事易惊，或梦寐不祥，遂致心惊胆摄，气郁生涎，涎与气搏，变生
诸症，或短气悸乏，或复自汗，胆虚不能制脾，则脾之水饮作矣。
半夏（汤洗） 竹茹 枳实（麸炒，各二两） 橘皮（二两，去白） 甘草（炙，一两） 白茯苓（一两半）
上每服四钱，水一盏半，姜五片，枣一枚，煎七分，食前服。
宁志丸 治心虚多惊，若有痰，宜吐之。
人参 白茯苓 茯神 柏子仁 琥珀 当归 酸枣仁（温酒浸半日去壳） 远志（炒。各半两） 乳
香朱砂 石菖蒲（各三钱）
上为末，蜜丸桐子大。每服三十丸，食后枣汤下。
茯神散 治五脏气血虚弱，惊悸怔忡，宜用此安神定志。
茯神（去木） 人参 龙齿（另研） 远志（去心） 桂心 防风 独活 酸枣仁 细辛 白术（炒，各三
钱） 干姜（炮，三两）
上为末，每服四五钱，水煎服，蜜丸亦可。
治要茯苓补心汤 治心气不足，喜悲愁怒，衄血面黄，五心烦热，或咽喉间痛，舌本作强。
（方见喑）
茯神汤 治胆气虚冷，头痛目眩，心神恐畏，不能独处，胸中烦闷。
茯神（去木） 酸枣仁（炒） 黄 （炒） 栀子仁（炒） 白芍药（炒） 五味子（杵，炒 桂心） 熟地（自
制） 人
上每服五钱，姜水煎。
酸枣仁丸 治胆气实热，不得睡卧，神志不安，惊悸怔忡。
茯神（去木） 酸枣仁（炒） 远志（去心） 柏子仁（炒） 防风（各一两） 枳壳（麸炒） 生地黄（杵膏。
各半两）
上为末，蜜丸梧子大。每服七八十丸，滚汤下。
定志丸 治心神虚怯，所患同前，或语言鬼怪，喜笑惊悸。
人参 茯苓（各一两五钱） 菖蒲 远志（去心。各一两）
上为末，蜜丸，如前服。
治要茯苓散 治心经实热，口干烦渴，眠卧不得，心神恍惚。
茯神 麦门冬（各一两半） 通草 升麻（各一两二钱半） 紫菀 桂心（各七钱五分） 知母（一两） 大
枣（十二枚） 淡竹茹（五钱） 赤石脂（一两七钱五分）
上每服一两，水煎服。
朱雀丸 治心病，怔忡不止。
白茯苓（二两） 沉香（半两）
上为末，蜜丸小豆大。每服三十丸，人参煎汤下。
世传密陀僧散 治惊气入心络不能语者，昔有人为野狼及犬蛇所惊，皆以此而安。
密陀僧（研极细末如粉）
上茶清调一钱七分。
丹溪朱砂丸 治劳役心跳。
朱砂 当归身 白芍药 侧柏叶（各三钱） 川芎 陈皮 甘草 黄连（炒，各一钱半）
上用猪心血为丸，粟米大，每服百丸，龙眼汤下。
本事辰砂远志丸 消风化痰，镇心安神。
人参 石菖蒲（去毛） 远志（去心） 茯神（各一两） 川芎 山药 白附子 麦门冬 细辛 铁粉
辰砂（各五钱）
上为末，用生姜汁，入水糊丸绿豆大，以朱砂为衣。每服一二十丸，临睡生姜汤下。
归脾汤
六君子汤
加味逍遥散（三方见内钓）
补中益气汤（方见虚羸）
真珠母丸（方见不寐）
十全大补汤
八珍汤（二方见自汗）
养心汤（方见惊痫）
The human body has nine zang organs. The Heart stores the Shen (Spirit), and the Liver stores the Hun (Ethereal Soul). Both meridians are primarily responsible for Blood. When Blood is deficient, the Shen and Hun lose their tranquility, resulting in Jing Ji (Palpitations and Fright). The Classics state: "The color of the East is Green, which communicates internally with the Liver; its diseases manifest as fright and terror." It also states: "When Er Yang (Yang Ming) and Yi Yin (Jue Yin) are involved, the disease primarily manifests as fright and terror." Jing refers to the sudden palpitation of the Heart accompanied by fear; Ji refers to the palpitation of the Heart accompanied by Zheng Tong (restlessness and insecurity). These two conditions arise from Heart deficiency and Blood insufficiency, so symptoms of forgetfulness follow. Treatment involves Si Wu Tang (Four Substance Decoction) and herbs that calm the Spirit. Danxi stated that some cases belong to Phlegm, suitable for treating with Wen Dan Tang (Warm Gallbladder Decoction) added with Chen Sha (Cinnabar) and Yuan Zhi (Polygala Root). If triggered by overthinking, it is a deficiency pattern, treated with Yang Xin Tang (Nourish Heart Decoction). If intermittent, it is a Phlegm pattern, treated with Fu Ling Wan (Poria Pill). If easily frightened by external events, it is due to Heart and Gallbladder deficiency and timidity, treated with Wen Dan Tang. If prone to fright and nightmares during sleep, it is due to Blood not returning to its source, treated with Zhen Zhu Mu Wan (Pearl Shell Pill). If restless in dreams, it is due to the Hun of the Liver losing its residence, treated with Ding Zhi Wan (Stabilize Will Pill). If fearful and unable to be alone, it is due to Cold deficiency of Gallbladder Qi, treated with Fu Shen Tang (Poria Decoction). If irritable during sleep, it is due to Excess Heat in the Gallbladder, treated with Suan Zao Ren Wan (Ziziphus Seed Pill). If dizzy, frightened, and having palpitations, it is due internal Wind-Phlegm, treated with Ben Shi Chen Sha Yuan Zhi Wan (Essential Skills Cinnabar Polygala Pill). If thoughts are depressed and constrained, with Spleen deficiency and Qi stagnation, treat with Gui Pi Tang (Restore the Spleen Decoction). Although these symptoms are said to belong to the Heart and Liver, the regulation of Blood is actually governed by the Spleen. The emotion of the Spleen is Si (Overthinking). Excessive thinking consumes Blood, preventing it from nourishing the Liver. The Heart is directed by the Spleen; when thoughts move internally, they invariably affect the Heart. The Heart is the organ of Ministerial Fire and the master of the twelve officials. The virtue of the Sovereign is authority without anger and governance through non-action. Therefore, it should be stabilized by tranquility and warned against reckless movement. Movement causes Ministerial Fire to combine and flare up, scorching Yin Essence. Once Essence and Blood are depleted, Fire flares up vacuously, which is the origin of Jing Ji and Zheng Tong. The Fire of the Five Emotions cannot be controlled by the Heart. Thus, those who treat the Spleen must know how to nourish the Heart; those who nourish the Heart must know tranquility and reducing desires. However, who does not have thoughts? Righteous thoughts eliminate reckless desires. Zhu Xi said: "One must ensure that Dao Xin (The Way Mind) is always the master of the body, while Ren Xin (Human Mind) obeys its commands." This is the method of good cultivation of the mind.
Clinical Cases
A woman with chronic Blood deficiency and palpitations developed more severe Zheng Tong and afternoon fever after marriage, with delayed menstruation. She was treated with Ba Zhen Tang (Eight Treasure Decoction) added with Yuan Zhi, Shan Yao, and Suan Zao Ren. After more than thirty doses, she gradually improved, and was fully cured with the assistance of Gui Pi Tang. Later, due to labor and anger, with continuous menstrual bleeding, her previous symptoms recurred. She was first treated with Jia Wei Xiao Yao San (Modified Free Wanderer Powder), which stopped the fever and menstruation; then treated with Yang Xin Tang for complete recovery.
A fifteen-year-old boy studied hard all night, leading to insomnia. Despite continuing his labor, he suffered from incessant Zheng Tong and fever. He was treated primarily with Gui Pi Tang, assisted by Ba Zhen Tang, and his symptoms gradually resolved. When the condition recurred, he recovered after taking Gui Pi Tang and Ding Zhi Wan.
A fifteen-year-old boy suffered from insufficient sleep, fright, palpitations, Zheng Tong, and aversion to cold due to excessive mental exertion. He was first treated with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), Fu Ling, Suan Zao Ren, and Yuan Zhi, which stopped the aversion to cold. Then, Jia Wei Gui Pi Tang calmed the fright and palpitations slightly, and finally, Yang Xin Tang cured him.
A child with fright and palpitations had restless sleep, fever, and a desire for cold drinks. He was cured with Zhi Yao Fu Ling San (Essential Skills Poria Powder). Later, due to labor and anger, he had fever, expectoration, and spontaneous sweating. He was settled with two doses of Wen Dan Tang, and then cured with Gui Pi Tang and Ning Zhi Wan.
A thirteen-year-old boy was prone to worry and anxiety, with fatigue, fever, and fear, requiring company to feel safe. He was treated with Fu Shen Tang, assisted by Gui Pi Tang, and gradually improved over two months. After marriage, his symptoms recurred with chills, fever, and dizziness. He was first treated with the aforementioned two decoctions, curing the palpitations. Then, Shi Quan Da Bu Tang (Ten Great Tonifying Decoction) and Bu Zhong Yi Qi Tang were used, gradually resolving other symptoms. Later, due to labor during imperial examinations, he experienced morning chills and evening fevers. He self-medicated with the previous two decoctions for over thirty doses each, with no effect. In mid-autumn, his pulse was empty and large but fine upon pressure; his face was pale, and he had abdominal pain. The previous formula was used again, with doubled Rou Gui (Cinnamon Bark) and Gan Jiang (Dried Ginger), but four doses were ineffective. Subsequently, Ba Wei Wan (Eight-Ingredient Pill) material was decocted and taken for four doses, providing slight relief; another four doses led to gradual improvement. Finally, Ba Wei Wan and Shi Quan Da Bu Tang brought stability.
A fifteen-year-old girl, quiet in nature, was frightened by thieves, leading to palpitations, distending pain in the abdomen and hypochondrium, alternating chills and fever, anorexia, and insomnia. She was prone to overthinking and fear. She was treated with Suan Zao Ren Wan, Gui Pi Tang, and Jia Wei Xiao Yao San, recovering gradually. After marriage, due to the loss of a child and heavy labor, she suffered from palpitations, insomnia, expectoration, fever, poor appetite, and abdominal distension. Taking phlegm-resolving herbs caused her to vomit four to five bowls of phlegm daily. When exams required her to go to the capital, I treated her. I diagnosed Spleen and Lung deficiency-cold, unable to control saliva and transform food into phlegm. She was treated with Liu Jun Zi Tang (Six Gentlemen Decoction) and Gan Jiang for six doses, but the phlegm increased, and her hands and feet became cold. Using the previous medicine with added Fu Zi (Aconite Root) one qian per dose was still ineffective. Then, using one liang of Ren Shen (Ginseng Root) and two qian of Fu Zi, she showed slight relief after four doses. After two more doses, Liu Jun Zi Tang with five fen of Jiang (Ginger) and Fu Zi was used. After several doses, switching to Gui Zhi (Cinnamon Twig) treatment cured her.
Wen Dan Tang treats Heart and Gallbladder deficiency-timidity, where one is easily frightened by events, or has ominous dreams, leading to heart fright and gallbladder timidity. Qi stagnation generates Xian (Saliva/Phlegm), which struggles with Qi, generating various symptoms such as shortness of breath, palpitations, fatigue, or spontaneous sweating. Gallbladder deficiency fails to control the Spleen, causing Spleen water-dampness to arise.
Ban Xia (washed in hot water), Zhu Ru, Zhi Shi (bran-fried, 2 liang each), Ju Pi (2 liang, white pith removed), Gan Cao (roasted, 1 liang), Bai Fu Ling (1.5 liang).
Take 4 qian per dose, add 1.5 cups of water, 5 slices of ginger, and 1 jujube. Decoct to 0.7 cup, take before meals.
Ning Zhi Wan treats Heart deficiency with frequent fright. If there is phlegm, induce vomiting.
Ren Shen, Bai Fu Ling, Fu Shen, Bai Zi Ren, Hu Po, Dang Gui, Suan Zao Ren (soaked in warm wine for half a day, shell removed), Yuan Zhi (fried, 0.5 liang each), Ru Xiang, Zhu Sha, Shi Chang Pu (3 qian each).
Grind into powder, make pills with honey the size of paulownia seeds. Take 30 pills after meals with jujube tea.
Fu Shen San treats deficiency of Qi and Blood in the five zang organs, causing fright, palpitations, and Zheng Tong. Use this to calm the spirit and stabilize the will.
Fu Shen (remove wood), Ren Shen, Long Chi (separately ground), Yuan Zhi (remove heart), Gui Xin, Fang Feng, Du Huo, Suan Zao Ren, Xi Xin, Bai Zhu (fried, 3 qian each), Gan Jiang (roasted, 3 liang).
Grind into powder. Take 4-5 qian, decoct in water. Honey pills are also acceptable.
Zhi Yao Fu Ling Bu Xin Tang treats Heart Qi deficiency, predisposition to sadness and anger, epistaxis, yellow complexion, heat in the five centers, or pain in the throat, and stiffness of the tongue. (Formula see Aphasia)
Fu Shen Tang treats Cold deficiency of Gallbladder Qi, headache, dizziness, heart fright, inability to be alone, and chest oppression.
Fu Shen (remove wood), Suan Zao Ren (fried), Huang Qi (fried), Zhi Zi Ren (fried), Bai Shao Yao (fried), Wu Wei Zi (pounded, fried), Gui Xin, Shu Di (homemade), Ren Shen.
Take 5 qian per dose, decoct in ginger water.
Suan Zao Ren Wan treats Excess Heat of the Gallbladder, insomnia, restlessness, fright, palpitations, and Zheng Tong.
Fu Shen (remove wood), Suan Zao Ren (fried), Yuan Zhi (remove heart), Bai Zi Ren (fried), Fang Feng (1 liang each), Zhi Ke (bran-fried), Sheng Di Huang (pounded into paste, 0.5 liang each).
Grind into powder, make honey pills the size of walnut seeds. Take 70-80 pills with boiling water.
Ding Zhi Wan treats Heart and Spirit deficiency-timidity, same symptoms as above, or speaking like ghosts, laughing, and fright.
Ren Shen, Fu Ling (1.5 liang each), Chang Pu, Yuan Zhi (remove heart, 1 liang each).
Grind into powder, make honey pills, take as described above.
Zhi Yao Fu Ling San treats Excess Heat of the Heart Meridian, dry mouth, irritability, thirst, inability to sleep, and mental confusion.
Fu Shen, Mai Men Dong (1.5 liang each), Tong Cao, Sheng Ma (1.25 liang each), Zi Wan, Gui Xin (0.75 liang each), Zhi Mu (1 liang), Da Zao (12 pieces), Dan Zhu Ru (0.5 liang), Chi Shi Zhi (1.75 liang).
Take 1 liang per dose, decoct in water.
Zhu Que Wan treats Heart disease with incessant Zheng Tong.
Bai Fu Ling (2 liang), Chen Xiang (0.5 liang).
Grind into powder, make honey pills the size of adzuki beans. Take 30 pills with Ginseng decoction.
Shi Chuan Mi Tuo Seng San treats fright qi entering the Heart collaterals causing aphasia. Previously, people frightened by wild wolves, dogs, or snakes were calmed by this.
Mi Tuo Seng (ground to fine powder).
Mix 1.7 qian with clear tea.
Danxi Zhu Sha Wan treats palpitations due to labor.
Zhu Sha, Dang Gui Shen, Bai Shao Yao, Ce Bai Ye (3 qian each), Chuan Xiong, Chen Pi, Gan Cao, Huang Lian (fried, 1.5 qian each).
Make pills with pig heart blood, size of millet grains. Take 100 pills with longan fruit decoction.
Ben Shi Chen Sha Yuan Zhi Wan dispels Wind and resolves Phlegm, stabilizes the Heart and calms the Spirit.
Ren Shen, Shi Chang Pu (remove hairs), Yuan Zhi (remove heart), Fu Shen (1 liang each), Chuan Xiong, Shan Yao, Bai Fu Zi, Mai Men Dong, Xi Xin, Tie Fen, Chen Sha (5 qian each).
Grind into powder, use fresh ginger juice and water paste to make pills the size of mung beans, coat with Zhu Sha. Take 10-20 pills with ginger decoction before sleep.
Gui Pi Tang
Liu Jun Zi Tang
Jia Wei Xiao Yao San (See Internal Hook)
Bu Zhong Yi Qi Tang (See Emaciation)
Zhen Zhu Mu Wan (See Insomnia)
Shi Quan Da Bu Tang
Ba Zhen Tang (See Spontaneous Sweating)
Yang Xin Tang (See Fright Epilepsy)