〔怔忡症〕由心包血虚，心火下迫，震动君主神明，或思虑劳神，或郁怒动火，致头晕汗出，不寐便
浊等因，宜养心血调心气，降火安神为主。如心火炽甚，安神丸。心血虚热，四物安神汤。心神浮越，酌用清
镇汤。水衰火旺，心动不安，天王补心丹。由汗下后气虚，益营煎。营卫俱衰，脉来结代，心惕不安，养心
汤。心动而卧不安，枣仁汤。思虑烦劳，心动不寐，养营汤。忧思郁结，怔忡不已，归脾汤。心虚怔忡自汗，
养营汤去木香，加浮小麦煎汤。气郁不宣，怔忡不定，加味四七汤加姜汁、竹沥。痰火怔忡时作时止，参胡
温胆汤、金箔镇心丸。水停心下，水气乘心为悸，茯苓甘草汤、半夏茯苓汤。心为火而畏水，水气乘之，故跳
动不安为悸。脐下悸动，为肾气上凌。五苓散加辰砂。肾气凌心，尺脉必弦紧。因痰饮而悸，导痰汤加参、
桂。通治怔忡恍惚健忘，降火安神，加味安神丸。
〔卑 症〕与怔忡类，其症胸中痞塞，不能饮食，心常有歉，爱居暗室，见人则惊避无地，病至数年，
不得以癫症治之。人参养营汤。
〔惊症〕《内经》以惊属肝胃，虽风木震动，胃土受克之理，良由心主先虚，乍有所触而心骇神乱也。
故曰∶惊则心无所根据，神无所归，虑无所定。丹溪云∶惊则神出于舍，舍空液聚，痰涎着于包络之间，神不得
归。控涎丹加辰砂、远志。多致目晴不转，不能言，短气自汗，卧不安，或眠多异梦，随即惊觉。温胆汤加
枣仁。卧多惊魇，口中有声，温胆汤下远志丸。若卧则魂梦飞扬，惊悸多魇，通夕不寐，乃肝虚风袭入之。
先用独活汤数服，后用珍珠母丸。至因大惊而病者，寸脉必动如豆粒，而无头尾，急宜镇定。黄连安神丸。
惊则气乱，郁而生火生痰，痰与气搏，变生诸症，温胆汤加枣仁、莲子，金银器煎。或镇心丹、琥珀养心丹、
远志丸。胆虚善惊，人参、肉桂、熟地、枣仁、五味子、杞子、柏子仁。肝胆俱虚，百药不效，宜补肾，酒
化鹿角胶五钱。心气虚，神不定而惊，妙香散。心血虚，神易扰而惊，朱砂安神丸。气血俱虚，恍惚烦躁而惊，
养心汤。思虑过度，清心补血汤。痰扰心包，加味定志丸。被物所惊，心跳不安，蕊珠丸。惊悸多属血虚与痰，
瘦人多是血虚，肥人多是痰饮。时时心跳，亦是血虚，或阴火上冲所致。惊症有二，有因病而惊者，当察客邪，
而兼治其标。有因惊而病者，宜安养心神，滋培肝胆，专扶元气为主。
〔恐症〕《内经》兼心肾胃肝胆包络诸经。经曰∶足少阴之脉病善恐。又曰∶恐惧而不解则伤精。又曰∶
恐则气下。又曰∶精气并于肾则恐，肝藏血，血不足则恐。又曰∶胃为恐。注云∶胃热则肾水微，故恐。又曰∶
心怵惕思虑则伤神，神伤则恐惧自失。胆病者惊惕，恐人将捕之。肝病如人将捕之。心包络动，心澹澹大动。
又曰∶恐则精却。而恐为肾志，属水本脏，因旁及他经，故治法亦别焉。恐由于肾伤者，补精髓。人参散去
桂心，加牛膝、远志。由于肝胆虚者，养阴血。酸枣仁汤去 、莲，加山萸、丹皮、白芍。由于心包络者，
镇其神。定志丸去术，加龙齿、琥珀、犀角、金银箔。治在阳明胃者，壮其气。四君子汤倍茯苓。其思虑劳
心而善恐者，一味鹿角胶酒化，多服效。因肾中阳虚而善恐者，八味丸。
[Palpitations (Zhengchong)] Caused by deficiency of blood in the Pericardium, with Heart Fire pressing downward and disturbing the Spirit of the Sovereign (Heart); or due to excessive mental labor and overthinking, or due to depression and anger stirring up Fire, leading to symptoms such as dizziness, sweating, insomnia, and turbid urine. Treatment should primarily focus on nourishing Heart Blood, regulating Heart Qi, descending Fire, and calming the Spirit. If Heart Fire is blazing, use Anshen Wan (Calming the Spirit Pill). If Heart Blood is deficient with heat, use Siwu Anshen Tang (Four Substances Calming the Spirit Decoction). If the Spirit floats and is unsettled, use Qingzhen Tang (Clearing and Settling Decoction) as appropriate. If Kidney Water is depleted and Heart Fire is hyperactive, causing palpitations and unrest, use Tianwang Buxin Dan (Emperor of Heaven's Heart-Nourishing Pill). If Qi is deficient after sweating or purgation, use Yying Jian (Nourishing Ying Decoction). If both Ying and Wei are depleted, with a knotted and intermittent pulse, and heart palpitations with fear, use Yangxin Tang (Nourishing Heart Decoction). If palpitations occur with sleeplessness, use Zaoren Tang (Sour Jujube Seed Decoction). If mental worry and fatigue cause palpitations and insomnia, use Yangying Tang (Nourishing Ying Decoction). If sorrow and worry lead to stagnation and incessant palpitations, use Guipi Tang (Restore the Spleen Decoction). For Heart deficiency causing palpitations with spontaneous sweating, use Yangying Tang without Xiangru (Costus Root), adding Xiaomai (Triticum aestivum L.) decocted in water. If Qi stagnation fails to disperse, causing unstable palpitations, use Jiawei Siqi Tang (Modified Four Seven Decoction) with Jiangzhi (Zingiberis Rhizoma Recens Juice) and Zhuli (Bambusa Textilis Var. Multiplex Sap). For Phlegm-Fire causing intermittent palpitations, use Canhu Wendan Tang (Ginseng and Bupleurum Phlegm-Resolving Decoction) or Jinbo Zhenxin Wan (Gold Leaf Calming the Spirit Pill). If fluid retention under the Heart causes palpitations due to Fluid Qi attacking the Heart, use Fuling Gancao Tang (Poria and Licorice Decoction) or Banxia Fuling Tang (Pinellia and Poria Decoction). The Heart belongs to Fire and fears Water; when Fluid Qi attacks, it causes restless beating known as Ji (Palpitation/Flutter). Palpitations below the umbilicus indicate Kidney Qi attacking upward. Use Wuling San (Five-Ingredient Powder with Poria) added with Chen Sha (Cinnabar). When Kidney Qi attacks the Heart, the Chi (Cun Cun) pulse must be wiry and tight. For palpitations caused by Phlegm-Fluids, use Daotan Tang (Expelling Phlegm Decoction) added with Renshen (Ginseng) and Guizhi (Cinnamon Twig). To treat palpitations, confusion, and forgetfulness generally, focusing on descending Fire and calming the Spirit, use Jiawei Anshen Wan (Modified Calming the Spirit Pill).
[Bi Syndrome] Similar to Palpitations, its symptoms include chest fullness and obstruction, inability to eat, a constant feeling of inadequacy in the heart, preference for staying in dark rooms, and extreme fear and avoidance upon seeing people. The disease lasts for years and should not be treated as Dian Syndrome (Manic-Depressive Psychosis). Use Renshen Yangying Tang (Ginseng Nourishing Ying Decoction).
[Jing Syndrome (Fright)] The Neijing attributes Jing to the Liver and Stomach. Although it involves the logic of Wind-Wood shaking and Earth-of-Stomach being overcome, the root cause is prior deficiency of the Heart Master, leading to sudden fright and chaotic Spirit upon external stimulation. Thus it is said: "Fright leaves the Heart without support, the Spirit without refuge, and thoughts without stability." Danxi stated: "Fright causes the Spirit to leave its residence; the residence becomes empty, fluids gather, and Phlegm-Saliva attaches between the Pericardium channels, preventing the Spirit from returning." Use Kongyan Dan (Draining Phlegm Pill) added with Chen Sha (Cinnabar) and Yuanzhi (Polygalae Radix). This often leads to fixed eyes, inability to speak, shortness of breath, spontaneous sweating, restlessness in sleep, or vivid dreams followed by sudden awakening. Use Wendan Tang (Phlegm-Resolving Decoction) added with Zaoren (Sour Jujube Seed). For frequent nightmares during sleep and sounds from the mouth, administer Wendan Tang with Yuanzhi Wan (Polygala Pill). If the soul flies in dreams during sleep, with frequent palpitations and nightmares, and all-night insomnia, this is due to Liver deficiency allowing Wind invasion. First, use Duhuo Tang (Angelica Pubescens Decoction) for several doses, then use Zhenzhumu Wan (Pearl Shell Pill). For cases caused by severe fright, the Cun (Cun Cun) pulse will be active like a bean grain, without head or tail, requiring urgent sedation. Use Huanglian Anshen Wan (Coptis Calming the Spirit Pill). Fright causes Qi chaos, leading to Fire and Phlegm generation through stagnation; Phlegm and Qi contend, generating various symptoms. Use Wendan Tang added with Zaoren (Sour Jujube Seed) and Lianzi (Nelumbinis Semen), decocted with Silver vessels. Alternatively, use Zhenxin Dan (Calming the Spirit Pill), Hupo Yangxin Dan (Amber Nourishing Heart Pill), or Yuanzhi Wan (Polygala Pill). For Gallbladder deficiency causing easy fright, use Renshen (Ginseng), Rougui (Cinnamon Bark), Shudi (Rehmanniae Radix Preparata), Zaoren (Sour Jujube Seed), Wuweizi (Schisandrae Fructus), Qizi (Lycii Fructus), and Baiziren (Platycladi Semen). For combined Liver and Gallbladder deficiency unresponsive to other medicines, tonify the Kidneys using Lu Jiao Jiao (Deer Antler Glue) five qian dissolved in wine. For Heart Qi deficiency causing unsettled Spirit and fright, use Miao Xiang San (Miraculous Fragrance Powder). For Heart Blood deficiency causing easily disturbed Spirit and fright, use Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill). For combined Qi and Blood deficiency causing confusion, irritability, and fright, use Yangxin Tang (Nourishing Heart Decoction). For excessive overthinking, use Qingxin Buxue Tang (Clearing Heart Nourishing Blood Decoction). For Phlegm disturbing the Pericardium, use Jiawei Dingzhi Wan (Modified Stabilizing Will Pill). For fright caused by objects, with restless heartbeat, use Ruizhu Wan (Rose Pearl Pill). Palpitations and fright mostly belong to Blood deficiency and Phlegm; thin individuals mostly have Blood deficiency, while fat individuals mostly have Phlegm-Fluids. Frequent heartbeat is also due to Blood deficiency or rising Yin Fire. There are two types of Jing Syndrome: one where fright arises from illness, which requires investigating pathogenic factors and treating the branch simultaneously; the other where illness arises from fright, which requires calming and nourishing the Heart Spirit, nourishing and moistening the Liver and Gallbladder, and primarily supporting Yuan Qi.
[Kong Syndrome (Fear)] The Neijing involves the Heart, Kidney, Stomach, Liver, Gallbladder, and Pericardium meridians. The classic states: "Diseases of the Foot-Shaoyin meridian predispose to fear." It also states: "Unresolved fear injures Essence." And: "Fear causes Qi to sink." And: "When Essence and Qi congregate in the Kidney, there is fear." The Liver stores Blood; if Blood is insufficient, there is fear. It also states: "The Stomach is related to fear." Commentary notes: "Stomach Heat makes Kidney Water weak, hence fear." And: "If the Heart is startled and worried, it injures the Spirit; if the Spirit is injured, fear and loss of self-control occur." Diseases of the Gallbladder involve startle and fear, fearing capture. Liver diseases feel like being pursued. Movement of the Pericardium causes violent palpitations. It also states: "Fear causes Essence to retreat." Fear is the will of the Kidney, belonging to Water and its own organ, but affecting other meridians, so treatment methods vary. For fear due to Kidney injury, tonify Essence and Marrow. Use Renshen San (Ginseng Powder) removing Guixin (Cinnamon Heart), adding Niuxi (Achyranthis Bidentatae Radix) and Yuanzhi (Polygalae Radix). For fear due to Liver and Gallbladder deficiency, nourish Yin and Blood. Use Suanzaoren Tang (Sour Jujube Seed Decoction) removing Shaoyao (Peony Root) and Lianrou (Lotus Plumule), adding Shanzhuyu (Corni Fructus), Danpi (Moutan Cortex), and Baishao (White Peony Root). For fear involving the Pericardium, settle the Spirit. Use Dingzhi Wan (Stabilizing Will Pill) removing Baizhu (Atractylodis Macrocephalae Rhizoma), adding Longchi (Fossilized Bones), Hupo (Amber), Xijiao (Rhinocerotis Cornu - note: substitute with Buffalo Horn in modern practice), and Yinjinbo (Gold and Silver Foil). For treatment focusing on the Yangming Stomach, strengthen Qi. Use Sijunzi Tang (Four Gentlemen Decoction) with doubled Fuling (Poria). For those who fear due to mental worry and Heart labor, Lu Jiao Jiao (Deer Antler Glue) dissolved in wine, taken frequently, is effective. For fear due to Kidney Yang deficiency, use Bawei Wan (Eight-Ingredient Pill).