（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 Spirit Insecurity Due to Blood Loss)
Women suffering from blood wind palpitations (Xue Feng Jing Ji) are affected because wind pathogen invades the Heart. The Heart stores the Shen (Spirit) and is the master of all viscera; if Qi and Blood are harmonious, the Shen remains stable.
If there is deficiency and damage, the Shen becomes weak, allowing wind pathogen to invade due to the deficiency, causing fright and restless palpitations. If palpitations persist, it transforms into dizziness, confusion, worry, and fear. (Pai Feng Tang may also be used.)
[Xue] Master Danxi stated: For palpitations due to Blood deficiency, use Zhu Sha An Shen Wan. For phlegm confusing the Heart orifice, use Ding Zhi Wan. Palpitations with a sense of fullness and unrest (Zheng Chong) belong to Fire or Phlegm; those triggered by overthinking belong to Deficiency; those that come and go are due to Fire agitation. For instance, if the cause is fright leading to palpitations, the Shen leaves its residence, and Phlegm enters in its place. Generally, the Heart governs the person, and the Heart nourishes Blood. Once Heart Blood is deficient, the Shen and Qi cannot remain secure; this is how palpitations arise. Treatment should focus on nourishing Heart Blood and harmonizing Heart Qi.
A woman surnamed Jin attended a banquet in midsummer. Because her seating order was improper, she felt ashamed and became ill, speaking incoherently, with wiry and rapid pulses in both hands. I said, "You need to tonify the Spleen, guide out Phlegm, and clear Heat." She did not believe me and consulted several shamans who sprayed water and chanted spells, resulting in her death. Someone asked, "If there was no pathogenic factor, why did treating it as such lead to death?" I replied, "Attending a banquet in midsummer, she was externally subjected to steaming heat, and spicy food caused internal stagnation and Heat. Moreover, she had accumulated Phlegm previously. Added to shame and depression, the Phlegm increased further. Frightened by the shaman's ruler, her Shen was further disturbed, making Qi and Blood restless. Sprayed with ritual water, her skin pores closed, preventing sweat excretion. Internal burning consumed Yin, leaving Yang unable to stand alone. How could she not die? Therefore, Master Hua Borun stated: If Gallbladder Qi is deficient and cold, use Fu Shen Tang. If Gallbladder Qi is excess and hot, use Suan Zao Ren Wan. If Heart Qi is deficient and hot, use Ding Zhi Gao or Fu Ling Bu Xin Tang. If Heart Qi is excess and hot, use Zhu Sha An Shen Wan or Fu Shen San."
The wife of a scholar named Guiyunqiao had menstruation arrive early, followed suddenly by profuse bleeding, fainting, fever, and insomnia. Some said it was reckless bleeding due to Blood Heat and administered cold herbs, which worsened the condition. Others suspected fetal injury and administered hemostatics, with no effect. I said, "This is due to Spleen Qi deficiency failing to control Blood. The method should be to tonify the Spleen, and the bleeding will stop naturally." I used Bu Zhong Yi Qi Tang (for miscellaneous diseases due to fatigue) with Pao Jiang (Roasted Ginger). After a few doses, it was effective. However, she still had little sleep at night and suffered from palpitations. Taking Ba Wu Tang yielded no effect. I said, "The condition is complex," and prescribed Gui Pi Tang (for miscellaneous diseases involving forgetfulness) with Pao Jiang to tonify Heart and Spleen, resulting in recovery.
Another woman experienced heart palpitations and Zheng Chong upon exertion, with alternating chills and fever. Using Gui Pi Tang as the main formula, assisted by Ba Zhen Tang, her symptoms gradually improved. Later, using Jia Wei Xiao Yao San and Ning Zhi Wan brought peace. Upon recurrence, taking Gui Pi Tang and Ding Zhi Wan cured her.
A woman suffered from palpitations, Zheng Chong, afternoon fever, delayed menstruation, poor appetite, and lack of desire to eat. Using Ba Zhen Tang with Yuan Zhi, Shan Yao, and Suan Zao Ren, she improved after more than thirty doses, and was fully cured with Gui Pi Tang as an adjunct. Later, due to fatigue causing fever, poor diet, and body fatigue, she took Bu Zhong Yi Qi Tang. Then, due to anger during menstruation, bleeding continued, and previous symptoms recurred. First, Jia Wei Xiao Yao San stopped the heat and bleeding, then Yang Xin Tang cured her.
Another woman had palpitations, Zheng Chong, insomnia, spontaneous sweating, night sweats, poor taste in food, lethargy, and propensity to lie down. She was cured with Gui Pi Tang. Over a year later, due to emotional depression, she suffered from the previous symptoms plus epistaxis and hematochezia. Still using the previous decoction, she recovered.
Fu Shen San treats women's blood wind, severe deficiency of the five viscera, and palpitations. It calms the spirit and stabilizes the will.
Fu Shen (wood removed), Ren Shen (rhizome removed), Long Chi (ground separately), Du Huo (rhizome removed), Suan Zao Ren (each 1 liang, slightly stir-fried); Fang Feng (rhizome removed), Yuan Zhi (heart removed), Gui Xin, Xi Xin (sprouts removed), Bai Zhu (rhizome removed, each 7 qian 5 fen); Zhi Gan Cao, Pao Gan Jiang (each 0.5 liang).
Crush the ingredients. Take 5 qian per dose, boil with 1.5 zhong zhan of water until reduced to 1 da zhan. Strain and take warm, at any time.
Long Chi Wan treats women's blood wind attacking upwards, causing mental confusion, palpitations, and restless sleep.
Long Chi (ground separately), Fu Shen (wood removed, each 1 liang); Zhu Sha (ground, water-washed), Ren Shen (rhizome removed), Dang Gui (rhizome removed), Tian Ma (each 7 qian 5 fen); Bing Lang, Fang Feng (rhizome removed), Sheng Gan Di Huang, Xi Jiao Xie (each 0.5 liang); Yuan Zhi (heart removed), Chi Jian (each 2 qian 5 fen); She Xiang (1 qian, ground separately).
Grind into fine powder, mix with refined honey, pound 300-500 times, form pills like wutong seeds. Take 30 pills per dose, washed down with Bo He Tang, at any time.
Zhu Ben Hu Po San treats women's blood wind palpitations.
Hu Po (ground), Mo Yao (ground), Mu Xiang, Dang Gui, Shao Yao, Bai Zhi, Qiang Huo, Gan Di Huang, Yan Hu Suo, Chuan Xiong (each 0.5 liang); Tu Gua Gen, Mu Dan Pi (heart removed), Bai Zhu, Gui Xin (each 1 liang).
Grind into powder. Take 1 qian per dose, boil with 1 zhan of water until reduced to 0.7, add 0.1 part wine, boil briefly, and take hot. Severe cases show effect after several doses.
Fu Ling Bu Xin Tang treats insufficient Heart Qi, prone to sadness and anger, epistaxis, yellow complexion, heat in the five hearts, or sore throat and stiff tongue base.
Fu Ling (4 liang), Gui Xin, Zhi Gan Cao, Mai Men Dong (heart removed, each 3 liang); Zi Shi Ying ( ), Ren Shen (each 1 liang); Da Zao (20 pieces), Chi Xiao Dou (24 grains).
Boil with 7 sheng of water until reduced to 2.5 sheng. Divide into three doses.
Fu Shen Tang treats deficient-cold Gallbladder Qi, headache, vertigo, fearfulness of the Heart Spirit, inability to stay alone, and chest oppression.
Fu Shen (wood removed), Chao Suan Zao Ren, Chao Huang Qi, Chao Bai Zi Ren, Chao Bai Shao Yao, Chu Chao Wu Wei Zi (each 1 liang); Gui Xin, Zi Shu Di Huang (homemade), Ren Shen, Chao Gan Cao (each 0.5 liang).
Take 5 qian per dose, decoct with ginger water.
Suan Zao Ren Wan treats excess-heat Gallbladder Qi, inability to sleep, unsettled mind, palpitations, and Zheng Chong.
Fu Shen (wood removed), Chao Suan Zao Ren, Yuan Zhi (heart removed), Chao Bai Zi Ren, Fang Feng (each 1 liang); Fu Chao Zhi Ke, Chu Gao Sheng Di Huang (each 0.5 liang); Qing Zhu Ru (2 qian 5 fen).
Grind into powder, mix with refined honey to form pills like wutong seeds. Take 70-80 pills per dose, washed down with plain boiled water.
Ding Zhi Wan treats deficient-cowardly Heart Spirit, unsettled mind, or bizarre speech, laughter, and palpitations.
Ren Shen, Fu Ling (each 1 liang 5 qian); Shi Pu, Yuan Zhi (heart removed, each 1 liang).
Grind into powder, form honey pills, take as before.
Yang Xin Tang treats deficient Heart Blood, restless palpitations and Zheng Chong, or night sweats, insomnia, fever, and irritability.
Chao Huang Qi, Bai Fu Ling, Fu Shen (wood removed), Ban Xia Qu, Jiu Ban Dang Gui, Chuan Xiong (each 0.5 liang); Qu Pi La Gui, Bai Zi Ren, Chao Suan Zao Ren, Chu Chao Wu Wei Zi, Ren Shen (each 3 qian); Zhi Gan Cao (4 qian).
Take 3-5 qian per dose, decoct with ginger and jujube water.
Zhu Sha An Shen Wan treats Heart channel Blood deficiency, dizziness, and Heart Spirit palpitations.
Fei Guo Zhu Sha (5 qian), Jiu Xi Huang Lian (6 qian), Zhi Gan Cao (5 fen), Sheng Di Huang, Dang Gui (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 Gui Pi Tang to tonify.
Zhi Yao Fu Ling San treats Heart channel excess heat, dry mouth with vexatious thirst, restless sleep, or mental confusion.
Qu Xin Fu Ling, Qu Xin Mai Men Dong (each 1 liang 5 qian); Tong Cao, Sheng Ma (each 1 liang 2 qian 5 fen); Da Zao (12 pieces); Zi Wan, Gui Xin (each 7 qian 5 fen); Zhi Mu (1 liang), Chi Shi Zhi (1 liang 7 qian 5 fen), Dan Zhu Ru (5 qian).
Take 1 liang per dose, decoct with water.
[Heart Spirit Insecurity Due to Blood Loss]
[Xue] For the above symptoms, if due to Spleen-Liver stagnant heat, use Jia Wei Xiao Yao San. If Spleen-Liver stagnation, use Jia Wei Gui Pi Tang. If Spleen-Stomach weakness with Qi and Blood deficiency, use Ba Zhen Tang or Shi Quan Da Bu Tang. If Spleen-Lung weakness with Qi and Blood deficiency, use Bu Zhong Yi Qi Tang or Liu Jun Zi Tang. If Phlegm-Qi stagnation, use Liu Jun Zi, Jie Geng, and Bei Mu. If ineffective, examine if it is Qi deficiency; simply tonify Spleen and Stomach. If still ineffective, use Du Shen Tang. If there are aversion to cold and fever, it belongs to Qi and Blood dual deficiency. Internal heat or afternoon tidal fever belongs to Blood deficiency. Thirst with red face indicates Blood loss with irritability. All are suitable for sweet and bitter agents to tonify Yang Qi and generate Yin Blood. The Classic states: "In Blood loss, tonify Qi." Using cold-cooling agents to descend Fire would be a mistake. Still, treat according to the specific cause.
Ning Zhi Gao treats women who, due to excessive blood loss, have insecure Heart Spirit, abnormal speech, and inability to sleep.
Yan Sha (ground), Chao Suan Zao Ren, Ren Shen, Bai Fu Shen (wood removed), Hu Po (each 1 fen, ground); Di Ru Xiang (1 qian, ground).
Grind into powder, mix evenly. Take 1 qian per dose, mix with thick decoction of Deng Xin Cao and jujube soup, take on an empty stomach. (One prescription excludes Fu Shen and Hu Po; form honey pills like bullet size, dissolve one pill in Bo He Tang.)
Fu Ling Bu Xin Tang: For women, abundant Blood and declining Qi is the norm. The Heart governs Blood, and the Liver stores Blood. Now, with declining Blood and flourishing Qi, 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 leading to dryness, failing to nourish collaterals, thus causing irregular menstruation. This formula specifically tonifies Heart Yuan deficiency, suppresses Lung Qi attack, harmonizes Ying and Wei, and nourishes blood vessels, so the disease naturally resolves.
Remove Mu Xiang from Shen Su Yin, mix equally with Si Wu Tang, decoct with ginger and jujube. Take 4 qian per dose, warm before meals. Shen Su Yin (formula seen under Fever). Si Wu Tang (formula seen under General Treatments).
Miao Xiang San treats insufficient Heart Qi, mental confusion, deficiency vexation with little sleep, night sweats, etc.
Chao Gan Cao (5 qian), Qu Xin Yuan Zhi, Jiang Zhi Shan Yao, Fu Ling, Fu Shen (wood removed), Huang Qi (each 1 liang); Ren Shen, Jie Geng (each 5 qian); Chen Sha (ground separately, 3 qian), She Xiang (ground separately, 2 qian), Mu Xiang (2 qian 5 fen).
Grind into fine powder. Take 2 qian per dose, mixed with warm wine.
Ban Xia Tang treats Gallbladder organ excess heat, mental confusion, alternating chills and fever, diarrhea, night sweats with aversion to wind, or frequent sighing.
Ban Xia (1 qian 5 fen), Huang Qin, Qu Gu Yuan Zhi (each 1 qian), Sheng Di Huang (2 qian), Shu Mi (1 he), Suan Zao Ren (small amount, 3 qian), Suo Sha Ren (1 qian 5 fen).
Prepare as one dose, decoct with running water.
Du Shen Tang treats weak Yuan Qi, aversion to cold and fever. Or thirst, irritability, phlegm wheezing, and shortness of breath. Or Qi deficiency stroke, muteness, and jaw clenching. Or surging phlegm-saliva, cold limbs. Or difficult labor, postpartile unconsciousness, or急促 breathing.
Use good quality Ren Shen 2 liang or 3-4 liang, add 5 qian Pao Jiang, decoct with water and take slowly. Since Ren Shen is cold in nature, Jiang assists it. If ineffective, urgently add Fu Zi.