滑伯仁治一人。病怔忡善忘。口淡舌燥。多汗。四肢疲软。发热。小便白而浊。众医以
内伤不足。拟进茸、附等药。未决。脉之虚大而数。曰。是由思虑过度。厥阴之火为害耳。
夫君火以明。相火以位。相火代君火行事者也。相火一扰。能为百病。百端之起。皆由心生
越人云。忧愁思虑则伤心。其人平生志大心高。所谋不遂。抑郁积久。致内伤也。服补中
益气汤、朱砂安神丸。空心进小坎离丸。月余而安。
一人因事恐怖。心常惕惕。如畏人捕之状。诊其脉。豁豁然虚大而浮。体热多汗。曰。
凡病得之从高坠下。惊仆击搏。恶血留滞。皆从中风论。终归厥阴。此海藏之说也。盖厥阴
多血。其化风木故也。有形当从血论。无形当从风论。今疾是走无形也。从风家治之。兼化
痰散结。佐以铁粉朱砂丸。愈。
吴茭山治一妇气盛血少。火旺痰多。因事忤意。得怔忡之患。心惕惕然而惊。时发时止
清晨至晚。如此无度。每服镇心金石之药。愈不安。吴诊其脉左弦而大。知血少火旺。右
浮滑不匀。气盛痰多也。遂也温胆汤入海粉、苏子。数服而安。次以安神丸。常服全愈。
高果哉治钱塞庵相国怔忡不寐。诊得心脉独虚。肝脉独旺。因述上年驿路还乡。寇盗充
斥。风声鹤唳。日夜惊惧而致。高用生地、麦冬、枣仁、元参各五钱。人参三钱。龙眼肉十
五枚。服数剂。又用夏枯草、羚羊角、远志、茯神、甘草、人参。大效。仍以天王补心丹。
常服全愈。
震按怔忡本非重病。而居官者多患之。因劳心太过。或兼惊忧所致。治法不外养血安神
补元镇怯。然亦难效。莫若抛弃一切。淡然漠然。病自肯去。老子曰。内观其心。心无其
心。广成子曰。毋劳尔形。毋摇尔精。毋使尔思虑营营。岂惟却病。并可长生。
Hua Borén treated a patient suffering from palpitations (Zhen Tong, characterized by restless anxiety and heart palpitations) and forgetfulness. The patient had a bland taste in the mouth, dry tongue, excessive sweating, flaccidity of the four limbs, fever, and urine that was white and turbid. Other physicians attributed this to deficiency due to internal injury and proposed administering warming tonics such as Deer Antler Velvet (Rong) and Prepared Aconite Root (Fu Zi). Before a decision was made, Hua Borén examined the pulse, finding it deficient, large, and rapid. He stated: "This is caused by excessive rumination, leading to harm from the Ministerial Fire of the Jueyin channel." The Sovereign Fire (Jun Huo) manifests as clarity, while the Ministerial Fire (Xiang Huo) maintains its proper position; the Ministerial Fire acts on behalf of the Sovereign Fire. Once the Ministerial Fire is disturbed, it can cause myriad diseases. The origins of all ailments stem from the mind's loss of control. Yue Ren (Bian Que) said: "Worry and rumination damage the Heart." This individual has always had high ambitions and a proud spirit, but his plans have not been realized. Long-term depression led to internal injury. He was prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill). Xiaokanli Wan (Small Kan-Li Pill) was taken on an empty stomach. After more than a month, the condition stabilized.
Another person, terrified by a certain incident, felt constant apprehension, as if fearing capture by others. His pulse was hollow, deficient, large, and floating. His body was hot with excessive sweating. Hua Borén said: "Any disease resulting from falling from heights, being startled and falling, or being struck and beaten, causing stagnant evil blood, should be discussed under the category of Wind Stroke (Zhong Feng), ultimately returning to the Jueyin channel. This is the theory of Haicang (Zhang Yuansu)." Generally, the Jueyin channel contains abundant blood and transforms into Wind-Wood. Pathogens with form should be treated from the perspective of Blood; pathogen without form should be treated from the perspective of Wind. This illness involves wandering without form, so it is treated according to Wind patterns, combined with resolving phlegm and dissipating nodules, assisted by Tie Fen Zhusha Wan (Iron Powder and Cinnabar Pill). The patient recovered.
Wu Jiaoshan treated a woman with excess Qi and deficient Blood, accompanied by hyperactive Fire and profuse Phlegm. Due to dissatisfaction with circumstances, she developed palpitations. Her heart felt constantly startled and frightened, with episodes occurring intermittently from morning until night, without restraint. Each time she took mineral-based sedatives to calm the Heart, her condition worsened. Wu Jiaoshan diagnosed her pulse: left side wiry and large, indicating deficient Blood and hyperactive Fire; right side floating, slippery, and irregular, indicating excess Qi and profuse Phlegm. He therefore used Wendan Tang (Warm the Gallbladder Decoction) added with Hai Fen (Sea Powder) and Su Zi (Perilla Seed). After several doses, the condition stabilized. Subsequently, Anshen Wan (Calming the Spirit Pill) was administered for long-term use, resulting in complete recovery.
Gao Guozai treated Qian Sai'an, a Grand Secretary, for palpitations and insomnia. Examination revealed a solitary deficiency in the Heart pulse and hyperactivity in the Liver pulse. The patient recounted that during his return home via the postal route last year, bandits were rampant, and the sound of wind and cranes induced fear. Day and night, he lived in terror, which caused this ailment. Gao Guozai prescribed Sheng Di Huang (Rehmanniae Radix), Mai Dong (Ophiopogonis Radix), Suan Zao Ren (Ziziphi Spinosae Semen), Yuan Shen (Scrophulariae Radix), each 5 qian, Renshen (Ginseng Radix et Rhizoma) 3 qian, and Long Yan Rou (Longan Aril) 15 pieces. After several doses, he prescribed Xia Ku Cao (Prunellae Spica), Ling Yang Jiao (Antelope Horn), Yuan Zhi (Polygalae Radix), Fu Shen (Poria with Hostwood), Gan Cao (Licorice Radix et Rhizoma), and Renshen (Ginseng Radix et Rhizoma). The effect was remarkable. Finally, Tianwang Buxin Dan (Emperor of Heaven's Special Pill to Tonify the Heart) was taken regularly for complete recovery.
Yu Zhen commented: Palpitations are not inherently severe illnesses, yet officials often suffer from them. This is due to excessive mental labor or concomitant fright and worry. Treatment methods generally involve nourishing Blood, calming the Spirit, tonifying Original Qi, and settling timidity. However, efficacy is difficult to achieve. It is better to abandon all worldly concerns and remain indifferent; the illness will naturally depart. Laozi said: "Look inward at your heart; let there be no heart in your heart." Guangchengzi said: "Do not exhaust your form, do not agitate your essence, do not let your thoughts run rampant." This not only cures disease but also promotes longevity.