怔忡之病,心胸筑筑振动,惶惶惕惕,无时得宁者是也。然古无是名,其在《内经》,
则曰∶胃之大络,名曰虚里,出于左乳下,其动应衣,宗气泄也。在越人、仲景,则有动气
在上下左右之辨,云∶诸动气皆不可汗下也。凡此者,即皆怔忡之类。此证惟阴虚劳损之人
乃有之,盖阴虚于下,则宗气无根,而气不归源,所以在上则浮撼于胸臆,在下则振动于脐
旁,虚微者动亦微,虚甚者动亦甚。凡患此者,速宜节欲节劳,切戒酒色;凡治此者,速宜
养气养精,滋培根本。若或误认为痰火而妄施清利,则速其危矣。外,伤寒门论下条附有动
气辨,宜能证之。
惊有二证,有因病而惊者,有因惊而病者。如东方色青,入通于肝,其病发惊骇,及伤
寒阳明证闻木音则惕然而惊之类,此则或因岁火之盛,或因岁木之衰,或因风热之相搏,或
因金木之相制,是当察客邪以兼治其标。若因惊而病者,如惊则气乱,而心无所倚,神无所
归,虑无所定之类,此必于闻见夺气而得之,是宜安养心神,滋培肝胆,当以专扶元气为主
治。此固二者之辨,然总之主气强者不易惊,而易惊者必肝胆之不足者也。故虽有客邪,亦
当知先本后标之义。又如惊则气乱,恐则气下,惊恐虽若同类,而不知恐之伤人,尤甚于惊
。何也?盖惊出于暂,而暂者即可复;恐积于渐,而渐者不可解,甚至心怯而神伤,精却则
阴痿,日消月缩,不亡不已,此非大勇大断者,必不能拔去其病根,徒资药力,不易及也。
予尝治暴惊者,十愈其八九;治恐惧者,十不得其一二。
The disease of *Zhengchong* (palpitations with a sense of impending doom) is characterized by a throbbing and trembling sensation in the chest and heart region, accompanied by fearfulness and apprehension, with no time for peace. However, this name did not exist in ancient times. In the *Neijing* (Classic of Internal Canon), it is stated: "The great collateral of the Stomach is named Xuli (Empty Well), emerging from below the left breast; its movement can be seen through the clothing, indicating the leakage of Zongqi (Gathering Qi)." In the works of Yue Ren (Bian Que) and Zhang Zhongjing, there is a distinction regarding the location of moving qi (abdominal pulsations or palpitations) above, below, to the left, or to the right, stating: "All types of moving qi should not be treated with sweating or purging methods." All these cases belong to the category of *Zhengchong*. This condition occurs only in individuals with Yin deficiency and consumptive damage. Generally, because of Yin deficiency in the lower part, Zongqi (Gathering Qi) loses its root, and Qi fails to return to its source. Therefore, above, it floats and shakes within the chest and diaphragm; below, it vibrates beside the umbilicus. When deficiency is slight, the movement is slight; when deficiency is severe, the movement is severe. Those suffering from this should quickly restrain sexual desire and labor, and strictly avoid alcohol and lust. Those treating this should quickly nourish Qi and Essence, and tonify the root. If mistakenly identified as Phlegm-Fire and wrongly treated with clearing and draining methods, it will accelerate the danger. Additionally, the section on "Moving Qi" in the *Shanghan Lun* (Treatise on Cold Damage) chapter provides further verification.
There are two types of *Jing* (Fright/Startle): one where fright arises due to illness, and one where illness arises due to fright. For example, the color Green corresponds to the East and communicates internally with the Liver; its disease manifests as fright and terror, such as in Yangming syndrome of cold damage where hearing the sound of wood causes sudden alarm. These cases may be due to excessive Fire in the year, deficient Wood in the year, conflict between Wind-Heat, or restriction between Metal and Wood. In such cases, one should examine the pathogenic factors and treat the branch symptoms concurrently. If the illness arises from fright, such as "fright causes Qi chaos, the Heart has no support, the Spirit has no residence, and thoughts have no stability," this is necessarily caused by the loss of Qi due to shocking sights or sounds. The treatment should focus on calming and nourishing the Heart Spirit, and tonifying the Liver and Gallbladder, primarily by supporting Yuanqi (Original Qi). This distinguishes the two, but generally, those with strong Zhengqi (Upright Qi) are not easily frightened, while those easily frightened must have insufficiency in the Liver and Gallbladder. Therefore, even if external pathogens exist, one must understand the principle of treating the root before the branch. Furthermore, "fright causes Qi chaos, fear causes Qi sinking." Although fright and fear seem similar, fear harms the body more severely than fright. Why? Because fright is sudden, and sudden Qi chaos can recover quickly; fear accumulates gradually, and gradual accumulation is difficult to resolve, potentially leading to a timid Heart and damaged Spirit, retreat of Essence causing impotence, daily wasting and monthly shrinking, continuing until death. Without great courage and decisiveness, the root of the disease cannot be eradicated; relying solely on medicinal power is unlikely to succeed. I have treated patients with sudden fright, curing eight or nine out of ten; but among those treated for fear, fewer than one or two out of ten were cured.