（失血心神不安）
妇人血风惊悸者，是风乘于心故也。心藏神为诸脏之主，若血气调和，则心神安定。
若虚损则心神虚弱，致风邪乘虚袭之，故惊而悸动不定也。其惊悸不止，则变惚恍而忧
惧也。（排风汤亦可用。）
〔薛〕丹溪先生云∶惊悸者，血虚用朱砂安神丸。痰迷心窍用定志丸。怔忡者属火
属痰，思虑便动者属虚，时作时止者火动也。假如病因惊而到惊，则神出其舍，痰乘而入
矣。盖人之所主者心，心之所养者血，心血一虚，神气不守，此惊悸之所由生也。治当
调养心血，和平心气而已。金氏妇暑月赴筵，因坐次失序，自愧成病，言语失伦，两脉弦
数。予曰∶当补脾导痰清热。不信，以数巫者喷水咒之而死。或谓病既无邪，以邪治之，
何至于死？予曰∶暑月赴筵，外受蒸热，辛辣适口，内伤郁热，而况旧有积痰，加之愧
闷，其痰愈盛。又惊以法尺，益惊其神而气血不宁，喷以法水，闭其肌肤而汗不得泄，内
燔则阴既销而阳不能独立，不死何待？故滑伯仁先生云∶若胆气虚寒，用茯神汤。胆气
实热，用酸枣仁丸。心气虚热，用定志膏、茯苓补心汤。心气实热，用朱砂安神丸、茯神
散。文学归云桥内人，月事不及期，忽崩血昏愦，发热不寐，或谓血热妄行，投以寒
剂益甚。或谓胎成受伤，投以止血，亦不效。余曰∶此脾气虚弱无以统摄故耳，法当补脾
而血自止，用补中益气汤（杂病伤劳倦。）加炮姜，不数剂而验。惟终夜少寐惊悸，别服八物汤
不效。余曰∶杂矣，乃与归脾汤（杂病健忘，）加炮姜以补心脾，遂如初。 一妇人劳则心跳
怔忡，寒热往来，用归脾汤为主，佐以八珍汤，诸证渐愈，又用加味逍遥散、宁志丸而
安。后复作，服归脾、定志二药即愈。一妇人患惊悸怔忡，日晡发热，月经过期，饮
食少思，用八珍汤加远志、山药、酸枣仁，三十余剂渐愈，佐以归脾汤全愈。后因劳发热，
食少体倦，用补中益气汤。又因怒，适月经，去血不止，前证复作，先以加味逍遥散热退
经止，又用养心汤治之而痊。一妇人惊悸怔忡无寐，自汗盗汗，饮食不甘，怠惰嗜卧，
用归脾汤而愈。至年余怀抱郁结，患前证兼衄血、便血，仍用前汤而愈。
茯神散 治妇人血风，五脏大虚，惊悸。安神定志。
茯神（去木） 人参（去芦） 龙齿（另研） 独活（去芦） 酸枣仁（各一两，微炒）
防风（去芦） 远志（去心） 桂心 细辛（去苗） 白术（去芦，各七钱半）
甘草（炙） 干姜（炮，各半两）
上 咀，每服五钱，水一中盏半，煎至一大盏，去滓温服，不拘时候。
龙齿丸 治妇人血风上攻，心神恍惚惊悸，眠卧不安。
龙齿（另研） 茯神（去木，各一两） 朱砂（研，水飞） 人参（去芦） 当归（去芦）
天麻（各七钱半） 槟榔 防风（去芦） 生干地黄 犀角屑（各半两）
远志（去心） 赤箭（各二钱半） 麝香（一钱，另研）
上为细末，炼蜜和捣三五百下，丸如梧桐子大。每服三十丸，薄荷汤送下，不拘
时。
朱贲琥珀散 治妇人血风惊悸。
琥珀（研） 没药（研） 木香 当归 芍药 白芷 羌活 干地黄 延胡索 川芎（各半两）
土瓜根 牡丹皮（去心） 白术 桂心（各一两）
上为末，每服一钱，水一盏，煎至七分，加酒一分，再煎少时，热服。重者数服效。
茯苓补心汤 治心气不足，善悲愁怒，衄血面黄，五心烦热，或咽喉痛，舌本作强。
茯苓（四两） 桂心 甘草（炒） 麦门冬（去心，各三两） 紫石英（ ） 人参（各一两）
大枣（二十枚） 赤小豆（二十四粒）
上用水七升，煎二升半，分三服。
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） 柏子仁（炒） 白芍药（炒） 五味子（杵炒，各一两）
桂心 熟地黄（自制） 人参 甘草（炒，各半两）
上每五钱，姜水煎服。
酸枣仁丸 治胆气实热，不得睡卧，神思不安，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） 青竹茹（二钱五分）
上为末，炼蜜丸梧桐子大。每服七八十丸，白汤下。
定志丸 治心神虚怯，神思不安，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。
养心汤 治心血虚，惊悸怔忡不宁，或盗汗无寐，发热烦躁。
黄 （炒） 白茯苓 茯神（去木） 半夏曲 当归（酒拌） 川芎（各半两）
辣桂（去皮） 柏子仁 酸枣仁（炒） 五味子（杵炒） 人参（各三钱） 甘草（炙，四钱）
上每服三五钱，姜、枣水煎服。
朱砂安神丸 治心经血虚，头晕，心神惊悸等证。
朱砂（飞过，五钱） 黄连（酒洗，六钱） 甘草（炙，五分） 生地黄 当归（各一钱五分）
上为末，饭糊为丸。每服十五丸，如一二服不应，当服归脾汤补之。
治要茯苓散 治心经实热，口干烦渴，眠卧不安，或心神恍惚。
茯神 麦门冬（各一两半，去心） 通草 升麻（各一两二钱半） 大枣（十二枚）
紫菀 桂心（各七钱半） 知母（一两） 赤石脂（一两七钱半） 淡竹茹（五钱）
上每服一两，水煎。
〔失血心神不安〕
〔薛〕前证若脾肝郁热，用加味逍遥散。脾肝郁结，用加味归脾汤，脾胃虚弱，气血
不足，用八珍汤、十全大补汤。脾肺虚弱，气血不足，用补中益气汤、六君子汤。痰气郁
滞，用六君、桔梗、贝母。如不应，审系气虚，但补脾胃，如不应，用独参汤。如恶寒
发热，属气血俱虚。内热晡热，属血虚。作渴面赤，是血脱烦躁。皆宜甘苦之剂，以补
阳气而生阴血。经云∶血脱补气。若用寒凉之剂以降火，则误矣。仍审所属之因治之。
宁志膏 治妇人因失血过多，心神不安，言语失常，不得睡卧。
辰砂（研） 酸枣仁（炒） 人参 白茯神（去木） 琥珀（各一分，研）
滴乳香（一钱，研）
上为末，和停，每服一钱，浓煎灯心、枣汤，空心调下。（一方无茯神、琥珀，
蜜丸如弹子大，薄荷汤化下一丸。）
茯苓补心汤 妇人以血旺气衰为本。心主血，肝藏血，今血衰而气盛者，由心气虚
耗，不能主血，又不能制乎肺金，使肺金得以乘乎肝木。肝之亏损则血不能藏，渐致枯
涸，不荣经络，故月事不调矣。此方专补心元之虚，抑其肺气之乘，调和荣卫，滋养血
脉，其疾自然平复矣。
即参苏饮内除木香，与四物汤对分匀和，以姜枣煎，每服四钱，食前温服。参苏饮
（方见发热。） 四物汤（方见通治）
妙香散 治心气不足，精神恍惚，虚烦少睡，盗汗等证。
甘草（炒，五钱） 远志（去心，炒） 山药（姜汁炙） 茯苓 茯神（去木） 黄 （各一两）
人参 桔梗（各五钱） 辰砂（另研，三钱） 麝香（另研，二钱） 木香（二钱五分）
上为细末，每服二钱，温酒调下。
半夏汤 治胆腑实热，精神恍惚，寒热泄泻，或寝汗憎风，善太息。
半夏（一钱五分） 黄芩 远志（去骨，各一钱） 生地黄（二钱） 秫米（一合）
酸枣仁（少，三钱） 缩砂仁（一钱五分）
上作一剂，长流水煎服。
独参汤 治元气虚弱，恶寒发热。或作渴烦躁，痰喘气促。或气虚卒中，不语口噤。
或痰涎上涌，手足逆冷。或难产、产后不省，喘急。
用好人参二两或三四两，加炮姜五钱，水煎徐徐服。盖人参性寒，故以姜佐之，如不
应，急加附子。
(Heart-Mind Disturbance Due to Blood Loss)
Women suffering from blood-wind palpitations (Jingji, palpitations and fright) are affected because wind pathogen invades the Heart. The Heart stores the Mind (Shen) and is the master of all viscera; if Qi and Blood are harmonious, the Heart-Mind remains stable. If deficiency and damage occur, the Heart-Mind becomes weak, allowing wind pathogen to invade due to deficiency, resulting in fright and unstable palpitations. If palpitations persist, it transforms into trance-like states with worry and fear. (Paifeng Tang may also be used.)
[Xue Ji] Mr. Danxi stated: For palpitations due to Blood deficiency, use Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill). For phlegm confusing the Heart orifices, use Dingzhi Wan (Stabilizing the Spirit Pill). Palpitations with a sense of fullness in the chest (Zhongchong) belong to Fire or Phlegm; those triggered by overthinking belong to deficiency; those that come and go belong to Fire agitation. For instance, if the cause is fright leading to palpitations, the Spirit leaves its residence, and Phlegm enters to take advantage. The human body is governed by the Heart, and the Heart is nourished by Blood. Once Heart Blood becomes deficient, the Spirit and Qi cannot remain secure, which is how palpitations arise. Treatment should focus on nourishing Heart Blood and harmonizing Heart Qi. Lady Jin attended a banquet in summer. Because her seating order was improper, she became ashamed and fell ill, speaking incoherently, with wiry and rapid pulses in both hands. I said: "Spleen should be tonified, Phlegm guided out, and Heat cleared." She did not believe me and died after several shamans sprayed water and chanted spells. Someone asked: "If there was no pathogenic factor, why did treating it as such lead to death?" I said: "Attending a banquet in summer, she was externally subjected to steaming heat, and spicy food caused internal stagnation-Heat. Moreover, she had old accumulated Phlegm, which increased due to shame and depression. Further fright from the ruler agitated her Spirit and disturbed Qi and Blood. Spraying water closed the skin pores, preventing sweat excretion. Internal blazing consumed Yin, leaving Yang unable to stand alone. How could she not die?" Thus, Mr. Hua Borén said: If Gallbladder Qi is deficient and cold, use Fushen Tang (Poria Decoction). If Gallbladder Qi is excess and hot, use Suanzaoren Wan (Ziziphus Seed Pill). If Heart Qi is deficient and hot, use Dingzhi Gao (Stabilizing Spirit Paste) or Fuling Buxin Tang (Poria Nourishing the Heart Decoction). If Heart Qi is excess and hot, use Zhusha Anshen Wan or Fushen San (Poria Powder). The wife of Scholar Gui Yunqiao had menstruation arriving early, suddenly suffered metrorrhagia with fainting, fever, and insomnia. Some said it was Blood-heat causing reckless bleeding and prescribed cold herbs, worsening the condition. Others said it was fetal injury and prescribed hemostatics, also ineffective. I said: "This is due to Spleen Qi deficiency failing to control Blood. The method should be to tonify the Spleen so Blood stops naturally." I used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) [for miscellaneous diseases involving fatigue] with Paojiang (Prepared Ginger). After a few doses, it was effective. However, she still had little sleep and palpitations at night. Taking Babu Tang (Eight Substances Decoction) was ineffective. I said: "The case is complex," and prescribed Guipi Tang (Restore the Spleen Decoction) [for miscellaneous diseases involving forgetfulness] with Paojiang to tonify Heart and Spleen, restoring her health. A woman who experienced heart palpitations and Zhongchong upon exertion, with alternating chills and fever, was treated primarily with Guipi Tang, assisted by Bazhen Tang (Eight Treasures Decoction), gradually recovering. Later, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Ningzhi Wan (Calming the Spirit Pill) brought peace. Upon recurrence, taking Guipi and Dingzhi pills cured her. Another woman suffered from Jingji, Zhongchong, evening fever, delayed menstruation, poor appetite, and lack of desire for food. She took Bazhen Tang with Yuanzhi (Polygala Root), Shanyao (Dioscorea Rhizome), and Suanzaoren (Ziziphus Seed) for over thirty doses, gradually improving, and was fully cured with Guipi Tang assistance. Later, exertion caused fever, poor diet, and fatigue, treated with Buzhong Yiqi Tang. Anger coincided with menstruation, causing continuous bleeding and recurrence of previous symptoms. First, Jiawei Xiaoyao San stopped the heat and bleeding, then Yangxin Tang (Nourish the Heart Decoction) cured her. A woman with Jingji, Zhongchong, insomnia, spontaneous sweating, and night sweats, unpalatable food, lethargy, and drowsiness, was cured with Guipi Tang. Over a year later, emotional depression led to recurrence with epistaxis and hematochezia, still cured with the same decoction.
Fushen San treats women's blood-wind, great deficiency of the five Zang organs, and palpitations. It calms the Spirit and stabilizes the will.
Fushen (wood removed), Renshen (radicle removed), Longchi (ground separately), Duhuo (radicle removed), Suanzaoren (each 1 liang, slightly fried), Fangfeng (radicle removed), Yuanzhi (heart removed), Guixin, Xixin (sprouts removed), Baizhu (radicle removed, each 7 qian 5 fen), Gancao (roasted), Ganjiang (prepared, each half liang).
Chop coarsely. Take 5 qian per dose, boil with 1.5 zhong zhan of water until reduced to 1 da zhan, remove dregs, and take warm at any time.
Longchi Wan treats women's blood-wind attacking upward, causing trance-like states, palpitations, and restless sleep.
Longchi (ground separately), Fushen (wood removed, each 1 liang), Zhusha (ground, water-suspended), Renshen (radicle removed), Danggui (radicle removed), Tianma (each 7 qian 5 fen), Binglang, Fangfeng (radicle removed), Shenggan Dihuang, Xijiaoxie (each half liang), Yuanzhi (heart removed), Chijian (each 2 qian 5 fen), Shexiang (1 qian, ground separately).
Grind into fine powder, mix with refined honey, pound 300-500 times, form pills like paulownia seeds. Take 30 pills per dose, washed down with mint tea, at any time.
Zhuben Hupo San treats women's blood-wind palpitations.
Hupo (ground), Moyao (ground), Muxiang, Danggui, Shaoyao, Baizhi, Qianghuo, Gan Dihuang, Yanhusuo, Chuanxiong (each half liang), Tugua Gen, Mudanpi (heart removed), Baizhu, Guixin (each 1 liang).
Grind into powder. Take 1 qian per dose, boil with 1 zhan of water until reduced to 70%, add 10% wine, boil briefly, and take hot. Severe cases respond after several doses.
Fuling Buxin Tang treats insufficient Heart Qi, prone to sadness and anger, epistaxis, sallow complexion, heat in the five palms and chest, or sore throat and stiff tongue base.
Fuling (4 liang), Guixin, Gancao (roasted), Maidong (heart removed, each 3 liang), Zi Shiyun, Renshen (each 1 liang), Dazao (20 pieces), Chi Xiaodou (24 grains).
Boil with 7 sheng of water until reduced to 2.5 sheng, divide into three doses.
Fushen Tang treats deficient-cold Gallbladder Qi, headache and vertigo, fearful Heart-Mind, inability to stay alone, and chest oppression.
Fushen (wood removed), Suanzaoren (fried), Huangqi (fried), Baiziren (fried), Baishaoyao (fried), Wuweizi (pounded and fried, each 1 liang), Guixin, Shudihuang (homemade), Renshen, Gancao (roasted, each half liang).
Take 5 qian per dose, decoct with ginger water.
Suanzaoren Wan treats excess-heat Gallbladder Qi, inability to sleep, unsettled mind, palpitations, and Zhongchong.
Fushen (wood removed), Suanzaoren (fried), Yuanzhi (heart removed), Baiziren (fried), Fangfeng (each 1 liang), Zhike (bran-fried), Shengdihuang (pounded into paste, each half liang), Qingzhuru (2 qian 5 fen).
Grind into powder, mix with refined honey to form paulownia seed-sized pills. Take 70-80 pills per dose, washed down with plain boiled water.
Dingzhi Wan treats deficient-cowardly Heart-Mind, unsettled mind, or speaking nonsense, laughing, and palpitations.
Renshen, Fuling (each 1 liang 5 qian), Shichangpu, Yuanzhi (heart removed, each 1 liang).
Grind into powder, make honey pills as previously directed.
Yangxin Tang treats deficient Heart Blood, restless palpitations and Zhongchong, or night sweats and insomnia, fever, and irritability.
Huangqi (fried), Bai Fuling, Fushen (wood removed), Banxiaqu, Danggui (wine-soaked), Chuanxiong (each half liang), Lagui (bark removed), Baiziren, Suanzaoren (fried), Wuweizi (pounded and fried), Renshen (each 3 qian), Gancao (roasted, 4 qian).
Take 3-5 qian per dose, decoct with ginger and jujube water.
Zhusha Anshen Wan treats Heart channel Blood deficiency, dizziness, and Heart-Mind palpitations.
Zhusha (washed through, 5 qian), Huanglian (wine-rinsed, 6 qian), Gancao (roasted, 5 fen), Shengdihuang, Danggui (each 1 qian 5 fen).
Grind into powder, bind with rice paste to form pills. Take 15 pills per dose. If ineffective after one or two doses, take Guipi Tang to tonify.
Zhiyao Fuling San treats excess-heat in the Heart channel, dry mouth and thirst, restless sleep, or trance-like Heart-Mind.
Fushen, Maidong (heart removed, each 1 liang 5 qian), Tongcao, Shengma (each 1 liang 2 qian 5 fen), Dazao (12 pieces), Ziwan, Guixin (each 7 qian 5 fen), Zhimu (1 liang), Chishizhi (1 liang 7 qian 5 fen), Danzhuru (5 qian).
Take 1 liang per dose, decoct with water.
[Heart-Mind Disturbance Due to Blood Loss]
[Xue Ji] For the aforementioned syndromes, if there is Liver-Spleen stagnation-heat, use Jiawei Xiaoyao San. If Liver-Spleen stagnation, use Jiawei Guipi Tang. If Spleen-Stomach weakness with Qi and Blood deficiency, use Bazhen Tang or Shiquan Dabu Tang. If Lung-Spleen weakness with Qi and Blood deficiency, use Buzhong Yiqi Tang or Liujunzi Tang. If Phlegm-Qi stagnation, use Liujunzi, Jiegeng, and Beimu. If ineffective, examine if it is Qi deficiency; only tonify Spleen and Stomach. If still ineffective, use Dushen Tang. If aversion to cold and fever, it belongs to dual deficiency of Qi and Blood. Internal heat and afternoon fever belong to Blood deficiency. Thirst and red face indicate Blood loss with irritability. All are suitable for sweet-bitter agents to tonify Yang Qi and generate Yin Blood. The Classics state: "In Blood loss, tonify Qi." Using cold-cooling agents to descend Fire would be a mistake. Still, examine the specific cause and treat accordingly.
Ningzhi Gao treats women who, due to excessive blood loss, have an unsettled Heart-Mind, abnormal speech, and inability to sleep.
Chensha (ground), Suanzaoren (fried), Renshen, Bai Fushen (wood removed), Hupo (each 1 fen, ground), Dilixiang (1 qian, ground).
Grind into powder, mix evenly. Take 1 qian per dose, mix with thick decoction of Centella/Juncus and jujube water, take on an empty stomach. (Another prescription excludes Fushen and Hupo, makes honey pills like bullet size, dissolve one pill in mint tea.)
Fuling Buxin Tang: In women, abundant Blood and deficient Qi is the norm. The Heart governs Blood, and the Liver stores Blood. Now, if Blood is deficient but Qi is excessive, it is due to Heart Qi deficiency and consumption, failing to govern Blood and failing to control Lung Metal, allowing Lung Metal to attack Liver Wood. Liver deficiency means Blood cannot be stored, gradually becoming dry and failing to nourish collaterals, thus menstrual irregularity occurs. This formula specifically tonifies Heart Yuan deficiency, suppresses Lung Qi attack, harmonizes Ying and Wei, and nourishes blood vessels, allowing the disease to resolve naturally.
It is Shen Su Yin excluding Muxiang, mixed equally with Siwu Tang, decocted with ginger and jujube. Take 4 qian per dose, warm before meals. Shen Su Yin (formula see Fever). Siwu Tang (formula see General Treatment).
Miaoxin San treats insufficient Heart Qi, trance-like spirit, empty irritability and little sleep, night sweats, etc.
Gancao (roasted, 5 qian), Yuanzhi (heart removed, fried), Shanyao (fried with ginger juice), Fuling, Fushen (wood removed), Huangqi (each 1 liang), Renshen, Jiegeng (each 5 qian), Chensha (ground separately, 3 qian), Shexiang (ground separately, 2 qian), Muxiang (2 qian 5 fen).
Grind into fine powder. Take 2 qian per dose, mix with warm wine.
Banxia Tang treats excess-heat in the Gallbladder fu, trance-like spirit, alternating chills and fever with diarrhea, or night sweats and aversion to wind, frequent sighing.
Banxia (1 qian 5 fen), Huangqin, Yuanzhi (bone removed, each 1 qian), Shengdihuang (2 qian), Shumi (1 he), Suanzaoren (small amount, 3 qian), Suosharen (1 qian 5 fen).
Make one dose, decoct with long-flowing water.
Dushen Tang treats weak Yuan Qi, aversion to cold and fever. Or thirst and irritability, phlegm-panting and shortness of breath. Or Qi deficiency stroke, muteness and jaw clenching. Or surging saliva and fluids, cold limbs. Or difficult labor, postpartum unconsciousness, panting urgency.
Use good quality Renshen 2 liang or 3-4 liang, add Paojiang 5 qian, decoct with water and take slowly. Since Renshen is cold in nature, Jiang assists it. If ineffective, urgently add Fuzi.