（附∶怔忡）
经曰∶阳气与阴气相搏，水火相恶，故惕然惊也。夫人之所主者心，心之所主者血。心血一
亏，神气不守，此惊悸之肇端也。惊者，谓实有见闻；悸者，恍如见闻，虚之甚也。血不足则神
不守，神不守则惊恐、悸怖、恍惚，众证作焉。肝脉急数，主惊；心脉涩数，虚热。治宜镇心神
，安魂魄，清痰制火，养血疏肝。
怔忡之证，无时而作，忽然虚火上浮，烦闷昏眩，心中惕惕动摇，不能主持，少顷复安，治
亦大同小异。
主方 当归 人参 黄连 远志 炙草 茯神 石菖蒲（炒。各一钱） 加竹叶、龙眼、
灯心煎成，调朱砂（飞一钱，临睡服。）
心虚加柏子仁，麦冬；有汗，黄 、枣仁；痰加半夏、胆星、橘红，痰多，在膈上稀涎散吐
之，膈下滚痰丸利之。养血，生血、芍药；宁心，龙齿、金银箔（或金银入药前）造命丹（效，
见幼科急惊）。
养心汤 治心虚血少，惊悸不宁。
当归 川芎 茯神 远志（各一钱） 人参 黄 半夏曲（三分） 茯苓 柏子仁 枣仁（
各五分） 官桂 甘草（三分） 五味子（九粒）
加莲肉七个，枣一枚，水煎服。
宁志丸 治惊悸，定心神。安神丸宜服（方见不寐）。
人参 茯苓 茯神 柏子仁 枣仁（酒浸，去壳） 远志（肉） 当归 琥珀（另研） 石
菖蒲（各五钱） 乳香 朱砂（研。各二钱）
上为细末，入珀、乳、砂，匀，蜜丸绿豆大。每服二钱，临睡枣汤下。
温胆汤 心胆虚祛，怔忡惊悸。
二陈加竹茹、枳实、远志、姜、枣。
简便方 金银煎汤或朱砂水飞服。因惊，九窍出血，水 面止。
(Attachment: Palpitation with constant anxiety, Zhenchong)
The Classics state: When Yang Qi and Yin Qi contend with each other, and Water and Fire repel one another, thus causing a startled and fearful state. The human body is governed by the Heart (Xin), which governs Blood (Xue). Once Heart Blood is deficient, the Spirit (Shen) fails to remain anchored; this is the beginning of Jingji (startle palpitations). "Jing" refers to being startled by actual sights or sounds heard; "Ji" refers to hallucinations of seeing or hearing things when nothing is present, indicating severe deficiency. When Blood is insufficient, the Spirit cannot anchor; when the Spirit does not anchor, symptoms such as fright, palpitations with fear, and mental confusion arise, manifesting various syndromes. A rapid and tense Liver pulse indicates Fright; a choppy and rapid Heart pulse indicates Deficient Heat. Treatment should focus on settling the Heart Spirit, calming the Hun and Po, clearing Phlegm, controlling Fire, nourishing Blood, and soothing the Liver.
The syndrome of Zhenchong occurs without fixed timing. Sudden floating of Deficient Fire causes irritability, dizziness, and a trembling sensation in the chest where one feels unable to maintain composure, followed by recovery after a short while. The treatment is largely similar with minor differences.
Main Formula: Danggui (Angelicae Sinensis Radix), Renshen (Ginseng Radix), Huanglian (Coptidis Rhizoma), Yuanzhi (Polygalae Radix), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma), Fushen (Poria with Hostwood), Shichangpu (Acori Tatarinowii Rhizoma) (stir-fried, 1 qian each). Add Zhuyez (Bambusae Folium), Longyanrou (Longan Aril), Dengxincao (Junci Medulla). Decoct and mix with Zhusha (Cinnabar, water-ground, 1 qian). Take before sleep.
If Heart deficiency is present, add Baiziren (Platycladi Semen) and Maidong (Ophiopogonis Radix); if sweating occurs, add Huangqi (Astragali Radix) and Zaoren (Ziziphi Spinosae Semen); if Phlegm is present, add Banxia (Pinelliae Rhizoma), Danningxing (Arisaematis Cum Bile), and Juhong (Citri Reticulatae Pericarpium Rubrum). If Phlegm is excessive above the diaphragm, induce vomiting with Xixiansan (Thin Saliva Powder); if below the diaphragm, purge with Guntanwan (Rolling Phlegm Pill). To nourish and generate Blood, add Shaoyao (Paeoniae Radix Alba); to calm the Heart, use Longchi (Fossilia Ossis Mastodi) and Yinjinpao (Lamina Aurea). Alternatively, use Zaomingdan (Life-creating Pill) prepared with Gold and Silver (efficacy noted in Pediatric Acute Startle Wind).
Yangxin Tang (Nourish Heart Decoction): Treats Heart deficiency and Blood insufficiency causing restless palpitations.
Formula: Danggui (Angelicae Sinensis Radix), Chuanxiong (Chuanxiong Rhizoma), Fushen (Poria with Hostwood), Yuanzhi (Polygalae Radix) (each 1 qian); Renshen (Ginseng Radix), Huangqi (Astragali Radix), Banxiaqu (Pinelliae Fermentatum) (3 fen); Fuling (Poria), Baiziren (Platycladi Semen), Zaoren (Ziziphi Spinosae Semen) (each 5 fen); Guangui (Cinnamomi Cortex), Gancao (Glycyrrhizae Radix et Rhizoma) (3 fen); Wuweizi (Schisandrae Fructus) (9 berries).
Add Lianrou (Nelumbinis Semen) seven pieces and Zao (Jujubae Fructus) one piece. Decoct in water and take orally.
Ningzhi Wan (Calming Spirit Pill): Treats startle palpitations and stabilizes the Heart Spirit. Anshen Wan (Sedate Spirit Pill) may also be taken (formula see Insomnia chapter).
Formula: Renshen (Ginseng Radix), Fuling (Poria), Fushen (Poria with Hostwood), Baiziren (Platycladi Semen), Zaoren (Ziziphi Spinosae Semen) (soaked in wine, husked), Yuanzhi (Polygalae Radix flesh), Danggui (Angelicae Sinensis Radix), Hupo (Electrum) (separately ground), Shichangpu (Acori Tatarinowii Rhizoma) (each 5 qian); Xuxiang (Boswelliae Resina), Zhusha (Cinnabar) (ground, each 2 qian).
Grind all into fine powder. Mix in Hupo, Xuxiang, and Zhusha evenly. Form pills with honey, size of mung beans. Take 2 qian per dose, swallow with Jujube decoction before sleep.
Wendan Tang (Warm Gallbladder Decoction): Treats Zhenchong and Jingji due to Heart and Gallbladder deficiency.
Formula: Erchen Tang (Two-Cured Decoction) plus Zhuru (Bambusae Caulis in Taeniam), Zhishi (Aurantii Fructus Immaturus), Yuanzhi (Polygalae Radix), Shengjiang (Zingiberis Rhizoma Recens), Zao (Jujubae Fructus).
Simple Prescription: Decoct Gold and Silver for drinking, or take water-ground Cinnabar. For nine orifices bleeding due to fright, washing the face with water stops the bleeding.