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Zhang Sanxi stated: The *Neijing* (Classic of Internal Medicine) records: "The Heart is the sovereign official, from which spirit and consciousness emerge." Diseases such as palpitations (Zhenchong, persistent palpitation) and fright palpitations (Jingji, sudden palpitation due to fright) may arise because anger injures the Liver, or because fright disrupts Gallbladder Qi. When the mother organ (Liver) is deficient and fails to nourish the son organ (Heart), Heart Blood becomes insufficient. Alternatively, encountering complex matters with endless thinking causes the Heart Sovereign to become unsettled, leading to restless spirit, which gives rise to Zhenchong and Jingji.

Zhenchong refers to a state where the heart spirit is terrified, trembling and unable to remain quiet, occurring at any time. Jingji refers to sudden violent heartbeat with a sensation of impending fainting, occurring intermittently. However, the etiology of these symptoms may also involve retained phlegm and accumulated fluid stagnating in the chest, diaphragm, stomach, and throat; thus, one must not rigidly treat them solely as Heart deficiency. Amnesia (Jianwang) refers to suddenly forgetting events, undertaking tasks without finishing them, and speaking without knowing beginning or end. This results from complex affairs and endless thinking, which deplete spirit and essence. However, excessive thinking injures the Spleen, which can also cause amnesia. Treatment should simultaneously regulate the Heart and Spleen; once the spirit is calm and will is settled, the symptoms will naturally resolve. Generally, Zhenchong, Jingji, and Jianwang, though named differently, all stem from insufficient Heart Blood, weak Spleen Qi, and accumulation of fluids and phlegm. Treatment focuses on nourishing Heart Blood, harmonizing Spleen Qi, calming the spirit, and resolving phlegm. When spirit and Qi are complete and abundant, these three ailments will be prevented.

There is also a type of deficiency-related vexation (Xufan), characterized by internal disturbance and depression. This is largely due to excessive loss of body fluids causing dryness in the five zang organs; or insufficient Ying (Nutritive) Blood with excess Yang and deficient Yin; or exhaustion of Kidney Water allowing Heart Fire to flare upward, generating deficiency heat and vexation, which may progress to restlessness (Zao).

Another type occurs after severe illness when Qi and Blood have not yet recovered. Chen stated: Internal heat is called vexation (Fan); external heat is called restlessness (Zao). Heart heat causes Fan; Kidney heat causes Zao. One should use Bazhen Tang (Eight Treasures Decoction) plus Zhuye (Bamboo Leaf), Zaoren (Sour Jujube Seed), and Maidong (Ophiopogon Root), or Siwu Tang (Four Substances Decoction) plus Renshen (Ginseng) and Fushen (Poria with Hostwood).

Regarding insomnia (Bumei), elderly individuals and those debilitated after illness suffer from insomnia due to declining Yang. Insomnia caused by phlegm in the Gallbladder channel, preventing the spirit from returning to its residence, is another type. For deficiency, use Sijunzi Tang (Four Gentlemen Decoction) plus Zaoren and Huangbo (Phellodendron Bark); for phlegm, use Wendan Tang (Warm the Gallbladder Decoction) plus Tiannanxing (Arisaema Rhizome). It may also result from insufficient Heart Blood, in which case Yying Tang (Nourish Ying Decoction) is suitable.

The *Yuanbing Shi* states: Due to water deficiency and fire prosperity, causing agitation in the chest and heart, it is called Zhenchong. Palpitation (Ji) arises when Heart Qi deviates from normality, transforming into fire pathogen. The Heart is Ministerial Fire (Junhuo), and the Pericardium is Assistant Fire (Xianghuo). Fire belongs to Yang, and Yang is active. Beneath Junhuo, Yin Essence supports it; beneath Xianghuo, Water Qi supports it. When moving under this support, it adheres to the correct way, presenting clarity and brightness, constituting the vital energy. If lacking support, Junhuo becomes excessive and abnormal, transforming into vexation and heat; Xianghuo moves recklessly, creating both heat and movement, manifesting as palpitations. Since the Heart houses spirit, the classics say: "When two essences interact, spirit is formed," and "Qi and Blood constitute human spirit." Thus, Yin-Yang and Qi-Blood in the Heart never separate. Now, losing Yin leads to bias toward Yang; Yang loses its support and scatters, causing spiritual instability and inability to self-regulate. In such cases, one must supplement the deficient Heart Blood within the Heart to calm the spirit. If ineffective, seek the related organ to reduce excess Yang, i.e., strengthen the source of Water to control Solar Fire (nourish Kidney Yin to restrain Heart Fire). Furthermore, Pericardium Fire not only assists the Heart but also circulates through the five zang organs. Therefore, reckless movement of Qi in any zang is due to fire. Phlegm in any zang can combine with Pericardium Fire to induce palpitation. Treatment requires addressing the root of fire in each zang via supplementation or purgation, then regulating the Pericardium according to favorable conditions. If heat from other zangs transfers to the Heart, activating Pericardium Fire, treatment follows similarly. If Heart Qi is deficient and Kidney Water invades upward, stopping in the Heart, one must curb the rebellious Qi, drain the water, and tonify Yang. If Left Kidney True Water is insufficient while Right Kidney Fire rebels upward, combining with Pericardium Fire, one must vigorously tonify Left Kidney Yin to restrain it. If various internal and external pathogens depress the two fires, preventing their release, isolating Ying and Wei, and failing to nourish righteous Qi, treatment primarily targets expelling pathogens and resolving depression. If phlegm-fluids stagnate in the Middle Jiao, obstructing meridians, and depressed fire clashes with phlegm below the heart causing Zhenchong, one must guide out the phlegm; once meridians flow freely, the disease resolves spontaneously.

Zhu Danxi stated: Zhenchong generally belongs to Blood deficiency and phlegm. Movement caused by worry indicates deficiency. Intermittent episodes suggest phlegm stirred by fire; thin individuals are mostly Blood deficient, while obese individuals are mostly affected by phlegm-fluids. Feeling heartbeat immediately after eating indicates low Blood. Heartbeat after overwork indicates deficiency combined with Qi deficiency.

Li Dongyuan stated: A large and empty pulse in all six positions, with a red face and heartbeat, indicates deficient fire flaring upward; tonification is needed to descend it. Heartbeat not caused by fright is called Ji Dong, belonging to phlegm-fire. Wang Yutai stated: Yin and Yang are often discussed in opposition. Joy and anger together: Joy originates from the Heart (Yang); anger from the Liver (Yin). Will (Zhi) and intention (Yi) together: Will is static and unchanging; Yi is dynamic and unstable. Static is Yin; dynamic is Yang. Fright (Jing) and fear (Kong) together: Fright arises from external stimuli agitating the Heart internally, causing spirit to waver; fear arises from confusion regarding external matters, causing the Will to feel inadequate, leading to essence retreat. Thus, the *Neijing* states: "Fright leaves the Heart without foundation, spirit without refuge, thoughts without direction, so Qi becomes chaotic." "Fear causes essence to retreat; retreat blocks the Upper Jiao; blockage prevents Qi return; lack of Qi return causes Lower Jiao distension, so Qi does not move." Also, "Once noble, now base; once rich, now poor; sorrow and grief knot internally, leading to depletion of Ying and loss of Jing, deep disease with no Qi, resulting in shivering fright." These are all cases where external events disturb internal spirit.

If fright and fear arise from Yin-Yang imbalance within the body, fright involves fire-heat agitating the Heart, disturbing spirit unpredictably, manifesting in various forms corresponding to the five spirits. The Liver stores Hun (Ethereal Soul); if Hun is unsettled, there is fright and delusion. The Lungs store Po (Corporeal Soul); if Po is unsettled, there is fearful restlessness. The Spleen stores Yi (Intellect); if Yi is unfocused, there is bewildered fright. The Kidneys store Zhi (Willpower); if Zhi is unsatisfied, there is fear and fright, with the Heart trembling. Although the Stomach has no specific spirit, it is the sea of the five zang organs; when various heats converge, it triggers fright mania. Hearing wooden sounds may also cause the Heart to tremble. Fright calms the spirit and gathers scattered Qi; fear stabilizes the will and secures escaping essence.