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(Zhengchong, i.e., palpitations.)

Ji (palpitations) refers to the sensation of the heart beating vigorously and fearfully, with movement and unrest. (Commonly known as heartbeat.) One cause is Blood deficiency; when Blood is deficient, it cannot nourish the Heart, causing Heart Qi to move frequently. Fortunately, if there is no Fire pathogen taking advantage of this deficiency, it will not lead to fright but only to palpitations. If the movement occurs despite adequate Blood, it is due to excessive Heart Fire, (or in some cases, Kidney Fire rushing upward.) Since Fire has a nature of movement, and assuming Blood is not deficient, there is movement without fright. This distinguishes Jing (fright) from Ji (palpitations). Another cause is the retention of fluid-dampness; when water stagnates below the Heart, the Heart Fire is forced by the water to fail in descending and instead floats upward, causing movement and unrest. (This must be accompanied by symptoms of asthma or panting.) When Kidney Water overflows and assaults the Heart, the principle is similar, but the treatment differs. (Water retained due to dietary stagnation should be guided out, while water from overflowing Kidney Yin requires tonifying Fire.) When mental worry triggers movement, it belongs to Blood deficiency. When symptoms come and go intermittently, it is phlegm stirred by Fire. In individuals who have suffered frustration, where desires are unfulfilled, or who blame themselves for past errors, sighing and lamenting endlessly, speaking alone to empty air, the Heart mind remains restless and uneasy, leading to frequent labor and the onset of Zhengchong (severe palpitations). Use Wendan Tang (see Fright), remove Zhuru (Bamboo Shavings), add Renshen (Ginseng Root) and Baiziren (Biota Seed) each at 1 qian, combined with Xiadazhi Wan, assisted by Chensha Miaoxiang San taken with wine mixed. (See Heartache.) For those with chest fullness, loss of appetite, a constant sense of guilt, preference for dark places, leaning behind doors, and fleeing in fright upon seeing people, resembling a state of lost will, with frequent heart palpitations, this is Beili disease, caused by dual deficiency of Qi and Blood; use Renshen Yangrong Tang. (See Deficiency Damage.) For those with reduced food intake, use Jiahe San (see Malaria) added with Danggui (Angelica Sinensis Root) and Huangqi (Astragalus Root) each at 1 qian.

Kong (fear) is a state of timidity within the Heart, generally resulting from Heart Qi deficiency. It is associated with the Kidney because "fear causes Qi to sink," thus linking it to the Kidney. The Classics state: "Essence and Qi congregate in the Kidney" (Qi originally ascends, but now sinks due to deficiency, residing with essence and blood in the Kidney region); this refers to Kong. It is also associated with the Liver and Gallbladder because when Liver and Gallbladder Qi is robust, it ascends; when deficient, it descends. Now, fear causes Qi to descend, indicating insufficiency of Liver and Gallbladder Qi. Thus, the brave are said to have strong Gallbladder, while the timid have weak Gallbladder. Zhang Zihe stated: "Fright arises unknowingly, triggered suddenly by external stimuli; Fear is self-aware, preventing one from sitting or lying down alone, requiring companionship." Fright is largely due to Blood deficiency, while fear is due to Qi timidity; this is the general rule. However, fear can also stem from Blood deficiency. Heat damages Kidney Yin, leading to dried fluids and Blood deficiency, further disturbed by Fire. This causes confusion and instability of the Will. (The Kidney stores the Will; the Will is the directional focus of the Heart. The Kidney belongs to Water; clear water reflects objects distinctly, clarity leads to no confusion, wisdom generates stability. Fire disturbs it, making it turbid; turbidity leads to dimness. Fire is also misleading, hence confusion.) Instability leads to restlessness, thus generating fear; fear is also a movement of the Heart. Therefore, Mencius spoke of "not moving the Heart," using fearlessness as the guideline. Fright and fear often follow each other; fear leads to fright, and fright leads to fear. Fright calms the Spirit, while fear stabilizes the Will. When the Spirit of the Heart descends to interact with the Kidney, the Kidney has its master and the Will is stabilized; this is the single Yang line in the Kan trigram. When the Essence of the Kidney ascends to nourish the Heart, the Heart receives nourishment and the Spirit is calm; this is the single Yin line in the Li trigram. Danxi treated Zhou Ben’s Heart disease, characterized by fear as if being hunted, insomnia, dry mouth, and loss of taste in food. He used Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome), and Danggui (Angelica Sinensis Root) as sovereign herbs, Chenpi (Tangerine Peel) as minister herbs, and salt-fried Huangbai (Phellodendron Bark) and Zhi Xuanshen (Scrophularia Root) in small amounts, decocted and taken orally. After more than a month, the patient was stabilized. The Classics say "Fear injures the Kidney" (Fear causes essence to retreat and leak; just as Kidney essence intends to transform into Qi and ascend, fear causes it to retreat downward, injuring the essence. Injury to essence leads to deficiency of Kidney Qi, resulting in impotence, bone soreness, etc.). Therefore, Huangbai (Phellodendron Bark) and Xuanshen (Scrophularia Root) are used to guide the medicine into the Kidney for tonification. Renshen San, Fushen San, and Budang Fangfeng Tang are all formulas treating Gallbladder deficiency.