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There are cases where a person is startled by sounds, with their heart pounding (Palpitations), which subsides only after half a day. People often attribute this to phlegm in the Heart. However, treating it with expectorant herbs proves ineffective. Over time, even without hearing sounds, the person becomes easily startled and develops palpitations (Palpitations), feeling as if someone is constantly coming to catch them. This indicates that Startle (Jing) and Palpitations (Ji) occur together. Although both are symptoms of Heart Qi deficiency, Startle and Palpitations are distinct. Generally, Startle is milder than Palpitations, while Palpitations are more severe. Startle arises from external factors disturbing the Heart Spirit, whereas Palpitations arise internally disturbing the Heart Spirit. Since Zhengchong (Trembling Palpitations, a severe form of palpitations) is the gradual onset of Ji, one must understand the severity of Startle and Palpitations: when encountering Zhengchong, one should prevent the development of Startle; when experiencing Startle, one should prevent the progression to Palpitations. However, despite the difference in severity, the underlying nature is deficiency in both cases. The formula used is Anding Tang (Stability Decoction): Huangqi (Astragali Radix, 1 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 5 qian), Danggui (Angelicae Sinensis Radix, 5 qian), Sheng Zaoren (Ziziphi Spinosomi Semen, raw, 5 qian), Yuanzhi (Polygalae Radix, 3 qian), Fushen (Poria with Hostwood, 5 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian), Shudi (Rehmanniae Radix Praeparata, adequate amount). Decoct in water and take orally. After one dose, Startle and Palpitations lessen; after two more doses, they lessen further; after ten doses, full recovery is achieved.

When the Hun Soul and Shen Spirit are unsettled, Startle arises; when they are insecure, Palpitations begin. Both result from Blood deficiency in the Heart and Liver organs. When Blood is deficient, the Shen has no place to reside, and the Hun has no master. Now, using blood-nourishing agents to greatly tonify the Heart and Liver ensures that these organs have sufficient Blood to nourish each other, preventing the Shen and Hun from causing Startle or Palpitations! If such medicines produce rapid effects but the patient soon returns to Startle and Palpitations, this is due to severe deficiency of the Heart and Liver. In this case, change the decoction into pills. The formula is Zhenshen Dan (Spirit-Calming Pill): Renshen (Ginseng Radix, 4 liang), Danggui (Angelicae Sinensis Radix, 3 liang), Baizhu (Atractylodis Macrocephalae Rhizoma, 5 liang), Sheng Zaoren (Ziziphi Spinosomi Semen, raw, 3 liang), Yuanzhi (Polygalae Radix, 2 liang), Shengdi (Rehmanniae Radix, raw, 3 liang), Shudi (Rehmanniae Radix Praeparata, 8 liang), Baijiezi (Brassicae Semina, 1 liang), Fuling (Poria, 3 liang), Baiziren (Platycladi Semen, 1 liang), Longgu (Fossilized Bones, 1 liang, processed with vinegar), Huqing (Tiger Eyes, 1 pair), Chenpi (Citri Reticulatae Pericarpium, 3 qian), Maidong (Ophiopogonis Radix, 3 liang). Grind all ingredients into fine powder and form pills with honey. Take orally daily with warm boiled water, 5 qian morning and evening. One course of treatment yields full recovery.

This formula is more miraculous and effective than the previous one. The use of Dragon and Tiger in the formula holds profound meaning. Dragon can calm Startle, and Tiger can stop Palpitations. Added to formulas that tonify the Heart and Kidney, they facilitate communication between the Heart and Kidney, thereby naturally stabilizing the Shen and Hun.

This condition can also be effectively treated with Zhenxin Dan (Heart-Calming Pill):
Renshen (Ginseng Radix, 1 liang), Baishao (Paeoniae Radix Alba, 1 liang), Dansha (Cinnabaris, 1 qian), Tielluo (Iron Filings, 1 qian), Tianhuafen (Trichosanthis Radix, 1 qian), Shanyao (Dioscoreae Rhizoma, 5 qian), Yuanzhi (Polygalae Radix, 2 qian), Sheng Zaoren (Ziziphi Spinosomi Semen, raw, 5 qian), Fuling (Poria, 3 qian).
Decoct in water and take orally. Full recovery is achieved after ten doses.

Some patients experience Startle first followed by Palpitations, while others experience Palpitations first followed by Startle. They seem different, but in essence, there is no difference; it is merely a matter of severity. Startle may occur temporarily rather than constantly; Palpitations may develop imperceptibly rather than obviously. This seems to distinguish between constant/temporary and obvious/subtle. However, temporary Startle is milder than constant Startle, and obvious Palpitations are heavier than subtle Palpitations. I have formulated a single prescription to treat both Startle and Palpitations together, named Liangjing Tang (Two-Stillness Decoction):
Renshen (Ginseng Radix, 1 liang), Sheng Zaoren (Ziziphi Spinosomi Semen, raw, 2 liang), Changpu (Acori Tatarinowii Rhizoma, 1 qian), Baijiezi (Brassicae Semina, 3 qian), Dansha (Cinnabaris, 3 qian), Bajitian (Morindae Officinalis Radix, 1 liang).
Decoct in water and take orally. After four consecutive doses, those who were startled will no longer be startled, and those with Palpitations will no longer have Palpitations.

This formula uses a large amount of Sheng Zaoren to calm the Heart, and Renshen and Bajitian to connect the Heart and Kidney. When the Heart and Kidney interact, Heart Qi communicates with the Kidney, allowing for peaceful sleep at night; Kidney Qi communicates with the Heart, allowing for peace during the day. When the Heart and Kidney interact, bringing peace day and night, this is the way to maintain long-term health.

This condition can also be treated concurrently with Zhenxin Dan (Heart-Calming Pill).