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Palpitations caused by Cold Damage (Shanghan) refer to a sensation of palpitation in the epigastrium. This condition arises from contracting Cold Damage, followed first by sweating therapy and subsequently by mistaken purgation. Internal deficiency-heat leads to thirst; upon drinking water, there is inevitably discomfort and urgency in the interior. If the pulse is surging and rapid, recovery should normally occur through sweating. However, after mistaken purgation, the body feels heavy, and the heart must palpitate. Sweating therapy is contraindicated at this stage; one should wait for spontaneous sweating to resolve the condition.

For Cold Damage lasting two to three days, characterized by palpitations in the heart region, incessant vomiting, mental anxiety, depression, and slight irritability, indicating that the pathogen has not yet resolved, Da Chai Hu Tang (Major Bupleurum Decoction) may be administered.
Chai Hu (Bupleuri Radix, 2 liang, remove seedlings), Huang Qin (Scutellariae Radix, 1 liang), Chi Shao Yao (Paeoniae Radix Rubra), Ban Xia (Pinelliae Rhizoma, washed seven times in boiling water to remove slipperiness), Zhi Shi (Immature Bitter Orange Fruit, stir-fried with bran until yellow), Bing Lang (Arecae Semen), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chi Fu Ling (Poria with Red Hostwood, each 1 liang).
Crush the above ingredients into a coarse powder. Take 4 qian per dose, add 1 zhong of water, half a fen of fresh ginger, and three jujubes. Decoct until reduced to 60%. Strain and take warm, regardless of time.

For Cold Damage with interior deficiency, palpitations in the epigastrium, and disharmony of qi in the abdomen, Bai Fu Ling San (White Poria Powder) is suitable.
Bing Lang (Arecae Semen, 1 liang), Qing Ju Pi (Green Tangerine Peel, 0.5 liang, soaked in water, white pith removed, dried), Gui Xin (Cinnamomi Cortex), Hou Po (Magnoliae Officinalis Cortex, 1 liang, coarse bark removed, brushed with fresh ginger juice, roasted until fragrant), Bai Fu Ling (Poria, 0.5 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.5 liang, roasted until slightly red and crushed), Fu Zi (Aconiti Lateralis Radix Praeparata, 1 liang, roasted, cracked, skin and umbilicus removed).
Sift the above ingredients into a fine powder. Take 4 qian per dose, add 1 zhong of water and half a fen of fresh ginger. Decoct until reduced to 60%. Strain and take warm, regardless of time.

For Cold Damage where heat persists after sweating, accompanied by palpitations in the epigastrium, dizziness, and body tremors, Ren Shen San (Ginseng Powder) is suitable.
Ren Shen (Panacis Ginseng Radix, remove rhizome), Chi Shao Yao (Paeoniae Radix Rubra), Fu Zi (Aconiti Lateralis Radix Praeparata, roasted, cracked, skin and umbilicus removed), Bai Zhu (Atractylodis Macrocephalae Rhizoma, each 1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.5 liang, roasted until slightly red and crushed), Chi Fu Ling (Poria with Red Hostwood, 1 liang).
Sift the above ingredients into a fine powder. Take 4 qian per dose, add 1 zhong of water and half a fen of fresh ginger. Decoct until reduced to 60%. Strain and take warm, regardless of time.

For Cold Damage resulting from excessive sweating, where the patient presses their hand over the heart due to palpitations in the epigastrium and desires pressure, Gui Xin San (Cinnamon Heart Powder) is suitable.
Gui Xin (Cinnamomi Cortex), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted until slightly red and crushed), Ren Shen (Panacis Ginseng Radix, remove rhizome), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chi Fu Ling (Poria with Red Hostwood, each 1 liang), Zhi Shi (Immature Bitter Orange Fruit, 0.5 liang, stir-fried with bran until slightly yellow).
Crush the above ingredients into a coarse powder. Take 4 qian per dose, add 1 zhong of water. Decoct until reduced to 60%. Strain and take warm, regardless of time.

For Cold Damage where sweating has occurred but fever persists, accompanied by palpitations in the epigastrium, headache, dizziness, mental restlessness, and panting, Xiong Qun San (Ligusticum and Ligusticum Powder) is suitable.
Xiong Qun (Ligustici Chuanxiong Rhizoma), Jie Geng (Platycodonis Radix, remove rhizome), Qian Hu (Peucedani Radix, remove rhizome), Shi Gao (Gypsum Fibrosum), Ren Shen (Panacis Ginseng Radix, remove rhizome), Bai Fu Ling (Poria), Mai Men Dong (Ophiopogonis Tuber, remove heart, each 1 liang), Xuan Fu Hua (Inulae Flos, 0.5 liang), Zhi Ke (Aurantii Fructus Immaturus, 0.5 liang, stir-fried until slightly yellow, pith removed).
Sift the above ingredients into a fine powder. Take 4 qian per dose, add 1 zhong of water, half a fen of fresh ginger, and three jujubes. Decoct until reduced to 60%. Strain and take warm, regardless of time.

For Cold Damage presenting with knotted or intermittent pulses, indicating palpitations in the epigastrium, Gan Cao San (Licorice Powder) is suitable.
Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted until slightly red and crushed), Fu Shen (Poria with Pine Root), Yuan Zhi (Polygalae Radix, remove heart), Cang Zhu (Atractylodis Rhizoma, each 1 liang), Zhi Shi (Immature Bitter Orange Fruit, 0.5 liang, stir-fried until slightly yellow).
Crush the above ingredients into a coarse powder. Take 3 qian per dose, add 1 zhong of water and half a fen of fresh ginger. Decoct until reduced to 50%. Strain and take warm, regardless of time.

For Cold Damage without sweating, accompanied by palpitations, irritability, and clouded vision/head, this formula is suitable.
Gui Xin (Cinnamon Heart, 1 liang, crushed), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.5 liang, roasted until slightly red and crushed), Sheng Jiang (Zingiberis Rhizoma Recens, 1 fen, sliced), Da Zao (Jujubae Fructus, five pieces, pits removed), Yi Tang (Maltose, 1 liang).
Add 1.5 zhong of water to the ingredients and decoct until reduced to 1 zhong. Then add Yi Tang and boil for three to five boils. Strain and divide into two doses, taking them regardless of time.