〔钱〕心，主惊。实则叫哭发热，饮水而搐，虚则困卧，悸动不安。心病，多
叫哭惊悸，手足动摇，发热饮水。视其睡，口中气温，或合面睡，及上窜切牙，皆
心热也，导赤散主之。心气热则心胸亦热，欲言不能，而有就冷之意，故合面卧。
心气实则气上下行涩，若合面卧，则气不得通，故喜仰卧，使气得上下通也，泻心
汤主之。心病见冬，火旺，心胜肾也，当补肾治心，轻者心病退，重者下窜不语，
肾怯虚也。（补肾、地黄丸，治心、泻心汤）〔洁〕心主热，自病或大热，泻心汤
主之。实则烦热，黄连泻心汤主之。虚则惊悸，生犀散主之。肺乘心，微邪，喘而
壮热，泻白散主之。肝乘心，虚邪，风热，煎大羌活汤下大青丸主之。脾乘心，实邪，泄
泻身热，泻黄散主之。肾乘心，贼邪，恐怖恶寒，安神丸主之。〔刘〕凡心脏得
病，必先调其肝肾两脏，肾者心之鬼，肝气通则心气和，肝气滞则心气乏，此心病
先求于肝，清其源也。五脏受病，必先传其所胜，水能胜火，则肾之受邪，必传于
心，故先治其肾，逐其邪也，故当退肾气、益肝气两方。或诊其脉肝肾两脏俱和，
而心自生疾，然后审其心家虚实治之。〔薛〕仰面卧者，因其心胸实热，故喜仰面
而向虚也。合面卧者，因心胸虚热，故喜合卧而就实也。实则调治心肝，虚则调补
脾肺，二者别之，尽其状矣。其切牙等证，多有雷同，不必拘泥。如用泻心、导赤、
等剂，邪气虽去而病仍作，当调补元气，或反甚，急温补元气。其心气冬见，或亥
子时病益甚，或下窜不语者，乃肾水虚而心火甚也，用地黄丸，其乳下婴儿，须母
服之。若叫哭发热，作渴饮水、抽搐有力，仰面而睡者，属心经实热，用泻心汤、
导赤散。若发热饮汤，抽搐乏力，惊窜切牙，合面而睡者，属心经虚热，用补心散。
若喘嗽面赤，壮热饮水，肺乘心也，用泻白散。若摇头札目，身热抽搐，肝乘心也，
用柴胡清肝散。若合目昏睡、泄泻身热，脾乘心也，用泻黄散。若窜视惊悸，切牙
足热，肾乘心也，用安神丸。
〔海〕心苦缓，急食酸以收之，五味子。心欲软，急食咸以软之，芒硝。
以咸补之，泽泻。以甘泻之，人参、黄 、甘草。心虚，以炒盐补之。虚则补其
母，肝乃心之母，以生姜补肝。如无他证，钱氏安神丸，是也。
安神丸（钱氏） 治心虚疳热，神思恍忽。
麦门冬（去心，焙） 马牙硝 白茯苓 干山药 寒水石（研） 甘草（各半两） 朱砂（一
两，研） 龙脑（一字，研）
上，末之，炼蜜为丸，芡实大。每服半丸，沙糖水化下，无时。
八物定志丸 （海藏）补益心神，安定魂魄，治痰，去胸中邪热，理肺肾。
人参（一两半） 菖蒲 远志（去心） 茯神（去心） 茯苓（去皮。各一两） 朱砂（二钱）
白术 麦门冬（去心。各半两） 牛黄（二钱，另研）
上为细末，炼蜜丸，如桐子大。米饮汤、下三十丸，无时。
髓竭不足，加生地黄当归。肺气不足，加天门冬、麦门冬、五味子。心气不
足，加上党参、茯神、菖蒲。脾气不足，加白术、白芍药、益智。肝气不足，
加天麻、川芎。肾气不足，加熟地黄、远志、牡丹皮。胆气不足，加细辛、酸
枣仁、地榆。神昏不足，加朱砂、预知子、茯神。
心实，以甘草泻之，如无他证，重则泻心汤，轻则导赤散。
泻心汤 （钱氏） 泻丁心。
黄连（一两，去须）
上为极细末。每服一字至半钱一钱，临卧，温水调下。海藏云∶易老单方泻心
汤出于此，乃实邪也，实则泻其子。
导赤散（钱氏） 泻丙小肠。
生干地黄 木通 甘草（各等分）
上，同为末。每服三钱，水一盏，入竹叶同煎至五分，食后温服。一本，不用
甘草，用黄芩。
〔薛〕泻心散、导赤散，泻心小肠实火之剂，盖心为脾母，脾为心子，然心既
病，则脾土益虚矣，用者审之。
生犀散（钱氏） 治心经虚热。
生犀（错取末，二钱） 地骨皮（自采，佳） 赤芍药 柴胡根 干葛（锉。各一两）
甘草（炙，半两）
上为粗末。每服一二钱，水一盏，煎至七分，温服，食后。
〔薛〕前方云∶治心经虚热，其所用药，多属泻心、泻肝脾之剂，虚热二字，
恐鲁鱼也，如心经自病而血虚热者，用秘旨安神丸。脾虚夺心之气而热者，用秘
旨补脾汤。肝木不能生心火而虚热者，用地黄丸。
秘旨安神丸 治心血虚而睡中惊悸，或受惊吓而作。
人参 半夏（汤泡） 酸枣仁（炒） 茯神（各一钱） 当归（酒洗） 橘红 赤芍药（炒。
各七分） 五味子（五粒） 甘草（炙，三分）
上为末，姜汁糊、丸芡实大。每服一丸，生姜汤化下。
[Qian Yi] The Heart governs fright. In excess conditions, there is crying and shouting, fever, and convulsions when drinking water; in deficiency conditions, there is lethargy and restlessness with palpitations. Heart disease often presents as crying, shouting, fright, palpitations, trembling of the hands and feet, fever, and a desire to drink water. Observe the patient's sleep: if the breath from the mouth is warm, or if they sleep face down, look upward, or grind their teeth, these are all signs of Heart Heat, treated primarily with Dao Chi San (Cinnabar Decoction). When Heart Qi is hot, the chest and heart feel hot; the patient may wish to speak but cannot, and has an inclination towards coolness, hence sleeping face down. When Heart Qi is in excess, the movement of Qi up and down becomes obstructed; sleeping face down further impedes Qi flow, so the patient prefers supine position to allow free circulation of Qi, treated primarily with Xie Xin Tang (Decoction to Drain the Heart). If Heart disease manifests in winter, it indicates Fire is flourishing and Heart overcomes Kidney (Water); treatment should tonify the Kidney while treating the Heart. In mild cases, Heart disease recedes; in severe cases, symptoms include downward gazing and muteness, indicating Kidney weakness and deficiency. (Tonify Kidney with Dihuang Wan; treat Heart with Xie Xin Tang.)
[Zhang Yuansu] The Heart governs heat. If self-inflicted or severe heat occurs, Xie Xin Tang (Decoction to Drain the Heart) is used. In excess conditions with irritability and heat, Huanglian Xie Xin Tang (Coptis Decoction to Drain the Heart) is used. In deficiency conditions with fright and palpitations, Sheng Xi San (Raw Rhinoceros Horn Powder) is used. If Lung overcomes Heart (minor pathogenic factor), presenting with wheezing and high fever, Bai Fei San (Powder to Drain White/Lung) is used. If Liver overcomes Heart (deficient pathogenic factor), presenting with wind-heat, Da Qiang Huo Tang (Large Notopterygium Decoction) is decocted and taken with Da Qing Wan (Great Indigo Pill). If Spleen overcomes Heart (excess pathogenic factor), presenting with diarrhea and body heat, Xie Huang San (Powder to Drain Yellow/Spleen) is used. If Kidney overcomes Heart (hostile pathogenic factor), presenting with terror and aversion to cold, An Shen Wan (Calming Spirit Pill) is used.
[Liu Wansu] Whenever the Heart suffers disease, the Liver and Kidney must first be regulated. The Kidney is the "ghost" (subjugator) of the Heart; if Liver Qi flows freely, Heart Qi harmonizes; if Liver Qi stagnates, Heart Qi becomes deficient. This implies that for Heart disease, one should first seek the Liver to clear the source. When the Five Zang organs suffer disease, transmission first occurs to what they overcome (Wood overcomes Earth, etc.). Water overcomes Fire; thus, if the Kidney suffers evil, it transmits to the Heart. Therefore, treat the Kidney first to expel the evil, using formulas to retreat Kidney Qi and benefit Liver Qi. Alternatively, if pulse diagnosis shows both Liver and Kidney are harmonious, yet the Heart generates disease spontaneously, then examine the Heart for excess or deficiency before treating.
[Xue Ji] Sleeping on the back indicates excess-heat in the chest and heart, so the patient prefers facing upward to vent heat. Sleeping face down indicates deficiency-heat in the chest and heart, so the patient prefers lying prone to seek pressure/stability. Excess conditions are treated by regulating Heart and Liver; deficiency conditions are treated by tonifying Spleen and Lung. Distinguishing these two allows one to fully understand the manifestations. Symptoms like teeth grinding are often similar across conditions and should not be rigidly adhered to. If Xie Xin Tang or Dao Chi San are used and pathogens are expelled but the disease recurs, Yuan Qi (Original Qi) should be regulated and tonified; if symptoms worsen urgently, Yuan Qi must be warmed and tonified. If Heart Qi manifests in winter, or worsens during Hai/Zi hours (9 PM - 1 AM), or involves downward gazing and muteness, this is due to Kidney Water deficiency and excessive Heart Fire; use Dihuang Wan. For infants under nursing age, the mother should take the medicine. If crying, fever, thirst, strong convulsions, and back-sleeping occur, it belongs to Heart Channel Excess-Heat, treated with Xie Xin Tang and Dao Chi San. If fever, drinking warm liquids, weak convulsions, fright/gazing/teeth-grinding, and face-down sleeping occur, it belongs to Heart Channel Deficiency-Heat, treated with Bu Xin San (Decoction to Tonify the Heart). If wheezing, coughing, red face, high fever, and thirst occur, it is Lung overcoming Heart, treated with Bai Fei San. If head-shaking, eye-blinking, body heat, and convulsions occur, it is Liver overcoming Heart, treated with Chai Hu Qing Gan San (Bupleurum Liver-Clearing Decoction). If eyes closed, drowsiness, diarrhea, and body heat occur, it is Spleen overcoming Heart, treated with Xie Huang San. If upward gazing, fright, palpitations, teeth-grinding, and hot feet occur, it is Kidney overcoming Heart, treated with An Shen Wan.
[Zhang Yuansu/Haizang] The Heart dislikes flaccidity; quickly consume sour flavors to astringe it, such as Wuweizi (Schisandra Berry). The Heart desires softness; quickly consume salty flavors to soften it, such as Mangxiao (Mirabilite). Tonify with salty flavor, such as Zexie (Alisma). Drain with sweet flavor, such as Renshen (Ginseng), Huangqi (Astragalus), and Gancao (Licorice). For Heart deficiency, tonify with roasted salt. Deficiency requires tonifying the Mother; Liver is the Mother of Heart, so use Shengjiang (Fresh Ginger) to tonify Liver. If no other symptoms exist, use Qian Shi An Shen Wan (Qian's Calming Spirit Pill).
An Shen Wan (Qian Shi) Treats Heart deficiency with infantile malnutrition-heat and absent-mindedness.
Mai Dong (Ophiopogon Tuber, heart removed, dried) Machaxiao (Mirabilite) Baifuling (Poria Cocos) Ganshanyao (Dried Yam) Hanshuishi (Calcitum, ground) Gancao (Licorice Root, half tael each) Zhusha (Cinnabar, one tael, ground) Longnao (Borneol, one zi unit, ground)
Grind into powder, mix with refined honey to form pills the size of a Chinese quince seed. Take half a pill dissolved in sugar water at any time.
Ba Wu Ding Zhi Wan (Haizang) Tonifies Heart Spirit, stabilizes Hun and Po, treats phlegm, removes pathogenic heat from the chest, and regulates Lung and Kidney.
Renshen (Ginseng Root, 1.5 taels) Shichangpu (Acorus Rhizome) Yuanzhi (Polygala Root, heart removed) Fushen (Poria with Hostwood, heart removed) Fuling (Poria Cocos, peel removed, one tael each) Zhusha (Cinnabar, 2 qian) Baizhu (Atractylodes Macrocephala Rhizome) Maidong (Ophiopogon Tuber, heart removed, half tael each) Niuhuang (Calculus Bovis, 2 qian, separately ground)
Grind into fine powder, mix with refined honey to form pills the size of a paulownia seed. Take thirty pills with rice soup at any time.
For Marrow exhaustion insufficiency, add Shengdihuang (Rehmannia Root) and Danggui (Angelica Sinensis). For Lung Qi insufficiency, add Tiandong (Asparagus Tuber), Maidong, and Wuweizi. For Heart Qi insufficiency, add Shangdangshen (Codonopsis), Fushen, and Shichangpu. For Spleen Qi insufficiency, add Baizhu, Baishao (White Peony Root), and Yizhi (Alpinia Oxyphylla Fruit). For Liver Qi insufficiency, add Tianma (Gastrodia Rhizome) and Chuanxiong (Ligusticum Rhizome). For Kidney Qi insufficiency, add Shudihuang (Prepared Rehmannia Root), Yuanzhi, and Mudanpi (Tree Peony Bark). For Gallbladder Qi insufficiency, add Xixin (Asarum Root) and Suanzaoren (Ziziphus Seed). For Spirit confusion insufficiency, add Zhusha, Yuzhizi (Actinidia Fruit), and Fushen.
Heart Excess: Drain with Gancao (Licorice). If no other symptoms, heavy cases use Xie Xin Tang, light cases use Dao Chi San.
Xie Xin Tang (Qian Shi) Drains Heart Fire.
Huanglian (Coptis Rhizome, one tael, remove stamens)
Grind into extremely fine powder. Take one zi unit to half a qian or one qian, mixed with warm water before bed. Haizang states: Yi Lao's single-ingredient Xie Xin Tang originates from here, addressing excess pathogens; in excess conditions, drain the Child element.
Dao Chi San (Qian Shi) Drains Small Intestine Fire.
Sheng Dihuang (Rehmannia Root, dried) Mutong (Akebia Stem) Gancao (Licorice Root, equal parts)
Grind together into powder. Take three qian, with one cup of water, boil with Zhu Ye (Bamboo Leaf) until reduced to half a cup, take warm after meals. Another version uses Huangqin (Scutellaria Root) instead of Gancao.
[Xue Ji] Xie Xin San and Dao Chi San are agents to drain excess fire of the Heart and Small Intestine. Since Heart is the Mother of Spleen, and Spleen is the Child of Heart, if Heart is diseased, Spleen Earth becomes increasingly deficient; users must exercise caution.
Sheng Xi San (Qian Shi) Treats Heart Channel Deficiency-Heat.
Shengxi (Raw Rhinoceros Horn, scraped into powder, 2 qian) Digupi (Lycium Bark) Chishaoyao (Red Peony Root) Chaihu Gen (Bupleurum Root) Gange (Kudzu Root, cut, one tael each) Gancao (Licorice Root, roasted, half tael)
Grind into coarse powder. Take one or two qian, with one cup of water, boil until seven-tenths remain, take warm after meals.
[Xue Ji] The previous formula claims to treat Heart Channel Deficiency-Heat, but the herbs used mostly belong to draining Heart, Liver, and Spleen categories. The term "Deficiency-Heat" is likely a textual error (Lu-Yu error). If Heart Channel self-disease causes Blood deficiency-heat, use Mizhi An Shen Wan (Secret Instruction Calming Spirit Pill). If Spleen deficiency steals Heart Qi causing heat, use Mizhi Bu Pi Tang (Secret Instruction Spleen-Tonifying Decoction). If Liver Wood fails to generate Heart Fire causing deficiency-heat, use Dihuang Wan.
Mizhi An Shen Wan Treats Heart Blood deficiency causing fright/palpitations during sleep, or triggered by fright.
Renshen (Ginseng Root) Banxia (Pinellia Tuber, soaked in boiling water) Suanzaoren (Ziziphus Seed, roasted) Fushen (Poria with Hostwood, one qian each) Danggui (Angelica Sinensis Root, wine-washed) Juhong (Citrus Peel, red layer) Chishaoyao (Red Peony Root, roasted, seven fen each) Wuweizi (Schisandra Berry, five berries) Gancao (Licorice Root, roasted, three fen)
Grind into powder, make pills with ginger juice paste the size of a Chinese quince seed. Take one pill dissolved in ginger soup.