怔忡之症本是心气之虚如何分为上下其故实有至理而世人未知也肺脉居于心之上肺气有
养
则清肃之令下行足以制肝木之旺肝木不敢下克脾土脾土得令自能运化以分津液而上输于心而
后心
君安静无为何致有怔忡不定之病耶此所谓上症之源流也因肺金失令则肝木寡畏以克脾土脾土
为肝所制事肝木之不暇又安能上奉于心乎心无脾土之输而肝木又旺自己尊大罔顾心君之子此
心所以摇摇靡定而怔忡之症起矣但怔忡上病何以知之其症必兼咳嗽而饮食能食而不能消者是
也方用安止汤此方合肺脾心肝四脏之药以治之也一剂而少定再剂而更安十剂而怔忡之病可以
全愈矣其下病奈何其症吐痰如清水饮食知味而苦不能多闻人言则惊见天光可畏时时懊 刻刻
烦闷此病乃肾水耗竭不能上输于肝木而肝木自顾不遑又安能上养于心乎心血既耗又安能下通
于肾心肾交困怔忡时生不止痰气之作祟也治用消烦汤此方乃补心肝肾之圣药三经大补则气血
精皆足虽有痰气不清又有白芥子以消其痰于胆膈之中岂尚有怔忡之不定乎自然烦去而心安闷
除而魂静也
安上汤
人参（三钱） 茯神（五钱） 麦冬（五钱） 北五味（一钱） 丹参（二钱） 柏子仁（二钱） 半夏（
一钱） 丹砂（一钱） 菖蒲（二钱） 白术（五钱） 枳壳（三分） 神曲（五分） 白芍（五钱）水煎服
消烦汤
熟地（一两） 山茱萸（五钱） 白芍（五钱） 当归（五钱） 黄 （五钱） 人参（五钱） 牛膝（五
钱）
巴戟天（五钱） 菟丝子（五钱） 枸杞子（五钱） 炒枣仁（五钱） 白芥子（五钱） 山药（五钱）水煎
服
Palpitations (Zhenchong) are essentially caused by a deficiency of Heart Qi. Why are they divided into upper and lower categories? The rationale is profound, yet unknown to the general public. The Lung pulse resides above the Heart. If Lung Qi is sufficient, its descending and purifying function can move downward, thereby restraining the exuberance of Liver Wood. When Liver Wood does not dare to overact upon Spleen Earth below, Spleen Earth can perform its functions normally, transforming fluids and transporting them upward to the Heart. Consequently, the Heart Monarch remains tranquil and at ease, preventing the onset of palpitations characterized by restlessness and fright. This explains the origin and mechanism of the upper-type palpitations.
However, if the Metal of the Lung fails to function properly, Liver Wood, lacking fear, will excessively restrain Spleen Earth. Spleen Earth, being controlled by Liver Wood, is too busy coping with this restraint to send essence upward to nourish the Heart. Without the transport from Spleen Earth, and with Liver Wood in a state of hyperactivity that disregards the protection of the Heart's offspring (Heart Blood), the Heart becomes unstable and unsteady, giving rise to palpitations. How then can one identify this as an upper-type disorder? The symptoms must include coughing, along with the ability to eat but an inability to digest food properly. The prescribed formula is Anzhi Tang (Calm and Stop Decoction). This formula combines herbs targeting the four Zang organs—Lung, Spleen, Heart, and Liver—for treatment. After one dose, symptoms subside slightly; after two doses, peace is further restored; after ten doses, the disease of palpitations can be completely cured.
What about the lower-type disorder? Its symptoms include vomiting phlegm resembling clear water, having taste perception for food but suffering from aversion to hearing people speak, being startled by sounds, fearing daylight, experiencing frequent inner vexation, and constant mental agitation. This condition arises because Kidney Water is exhausted and cannot ascend to nourish Liver Wood. Since Liver Wood cannot even sustain itself, how can it nourish the Heart? With Heart Blood already depleted, how can it descend to communicate with the Kidneys? The mutual distress of the Heart and Kidneys leads to recurrent palpitations, which is not merely due to the disturbance of Phlegm-Qi. The treatment utilizes Xiaofan Tang (Eliminate Vexation Decoction). This formula is a sacred prescription for tonifying the three meridians of the Heart, Liver, and Kidneys. By greatly tonifying these three, Qi, Blood, and Essence become abundant. Even if turbid Phlegm-Qi persists, White Mustard Seed (Baijiezi) in the formula eliminates phlegm within the Gallbladder and Diaphragm, leaving no room for unstable palpitations. Naturally, vexation disappears bringing peace to the Heart, and depression is removed calming the Hun (Ethereal Soul).
Anzhi Tang (Calm and Stop Decoction)
Ren Shen (Ginseng Radix et Rhizoma) [3 qian]
Fushen (Poria with Hostwood) [5 qian]
Maidong (Ophiopogonis Radix) [5 qian]
Bei Wuwei Zi (Schisandrae Chinensis Fructus) [1 qian]
Danshen (Salviae Miltiorrhizae Radix et Rhizoma) [2 qian]
Baizi Ren (Biota Semen) [2 qian]
Banxia (Pinelliae Tuber) [1 qian]
Dansha (Cinnabar) [1 qian]
Changpu (Acori Tatarinowii Rhizoma) [2 qian]
Baizhu (Atractylodis Macrocephalae Rhizoma) [5 qian]
Zhike (Aurantii Fructus Immaturus) [3 fen]
Shenqu (Massa Medicata Fermentata) [5 fen]
Baishao (Paeoniae Radix Alba) [5 qian]
Decoct in water and take orally.
Xiaofan Tang (Eliminate Vexation Decoction)
Shu Dihuang (Rehmanniae Radix Praeparata) [1 liang]
Shanzhuyu (Corni Fructus) [5 qian]
Baishao (Paeoniae Radix Alba) [5 qian]
Danggui (Angelicae Sinensis Radix) [5 qian]
Huangqi (Astragali Radix) [5 qian]
Ren Shen (Ginseng Radix et Rhizoma) [5 qian]
Niuxi (Achyranthis Bidentatae Radix) [5 qian]
Bajitian (Morinda Officinalis Radix) [5 qian]
Tusizi (Cuscutae Semen) [5 qian]
Gouqizi (Lycii Fructus) [5 qian]
Chao Zaoren (Ziziphi Spinosae Semen Preparatum) [5 qian]
Baijiezi (Brassicae Semens) [5 qian]
Shanyao (Dioscoreae Rhizoma) [5 qian]
Decoct in water and take orally.