经曰∶心者，五脏之尊也，号帝王之称也。与小肠通为表里，神之所〔舍〕，又
〔主〕于血，属火，旺于夏，手〔少〕阴（太阳）是其经也。凡夏脉钩，来盛去衰，
故曰钩，反此者病。来盛去亦盛，为太过，病在外；来衰去亦衰，为不足，病在内。太
过，令人〔身〕热而骨痛，口疮而舌焦引水；不及，令人〔躁〕烦，上为咳唾，下为
气泄。其脉如循琅〔 〕，如连珠，曰平；来而啄啄连属，其中微曲，曰病；脉来
前曲后〔倨〕，如〔操〕带钩，曰死。思虑过多〔则怵惕〕，怵惕则伤心，心伤则
神失，神失则恐惧。又真心痛，手足寒而过〔节〕，则旦占夕死。又心有水气，身
肿不〔得〕卧，烦躁。心中风，则吸吸发热，不能行立，饥而不〔能〕食，食则
呕吐。夏心脉〔旺〕，左手〔寸口〕浮大而散，曰平；反此则病。若沉而滑者，
水〔来〕克火，十死不治。长而弦者，木来归子，不治自愈。缓而大者，土来
入火，〔为〕微邪相干，无所害。心病则胸中痛，〔胁〕满〔胀〕，肩背臂膊皆
〔痛〕；虚则多惊悸〔惕惕然〕无眠，胸〔腹及〕腰背引痛，喜悲。心积气久
不去，则苦烦，心中痛。实则笑不休，梦火发；心气盛则梦喜笑〔及〕恐畏。邪气客
于心，则梦烟火，心〔胀〕气短，夜卧不宁，懊 ，气〔逆〕往来，腹中热，喜
水涎出。心病，日中慧，夜半甚，平旦静。又左手脉大，手热腋肿；大甚，胸中满而
烦，澹澹大动，面赤目黄也。心病，先心痛，时刻不止，关〔格〕不通，身重不已，
三日死。心虚甚，则畏〔人〕，〔瞑〕目欲眠，精神不守，魂魄妄行。心脉沉之小而
紧，浮之〔不〕喘，苦心下气坚，食不下，喜咽唾，手热烦满，多忘，太息，此得
之思虑太过也。其脉急甚，螈 ；微急则心中痛，引前后胸背，不下食。缓甚则痛引
背，善泪。小甚则哕，微小则消〔瘅〕。滑甚则为〔渴〕，微滑则心〔疝〕，引脐
腹鸣。涩甚谙不语。又心脉坚搏而长，主舌强不能言；软而散，当慑怯不食也。又
急甚〔则〕心疝，脐下有病形，烦闷少气，大热上煎。又心病狂言，汗出如珠，
身厥冷，其脉当浮而〔大〕，反沉濡而滑，其色当赤，而反黑者，水克火，不治，十
死。又心积，沉之空空，上下往来无常处，病胸满悸，腹中热，面颊赤，咽干，躁烦掌
热，甚则吐血，夏瘥冬甚，宜急疗之，止于旬日也。又赤黑色入口必死也。面目赤色亦
死，赤如〔 〕血亦死。又忧〔恚〕思虑太过，心气内去，其色反和而盛者，不
出十日死。扁鹊云∶心绝一日死，色见凶多，人虽健〔敏〕，号曰行尸，一年之中，
祸必至矣。又其人语声前宽后急，后声不接前声，其声浊恶，其口不正，冒昧善笑，此
风入心也。又心伤则心损，手足不遂，骨节离解，舒缓不自由，利下无休，此病急宜治
之，不过十日而〔亡〕矣。又笑不休，呻而复忧，此水乘火也，阴〔击〕于阳，
阴起阳伏，伏则热，热生狂冒，谵〔乱〕妄言，不可采〔问〕，心已损矣。扁鹊
云∶其人唇口赤色可治，青黑色即死。又心〔疟〕则先烦而后渴，翕翕发热也，其脉
浮紧而大是也。心气实而（大）便不利，腹满身热而重，温温欲吐，吐而不出，喘息
急，不安卧，其脉左寸口与人迎皆实大者是也。心虚则恐悸多惊，忧思不乐，胸腹中苦
痛，言语战栗，恶寒恍惚，面赤目黄，〔喜〕血衄，其脉左寸口虚而微者是也。
此心脏寒热虚实，生死逆顺脉证也。
《主治备要》云∶是动则病嗌干心痛，渴而欲饮，是为臂厥。主心所生病者，目黄，
（心）胁痛， 臂内后廉痛厥，掌中热痛。心苦〔缓〕，以五味子之酸收之。心欲
软，软以芒硝之咸，补以泽泻之咸，泻以人参、甘草、黄 之甘。心虚则以炒盐补之。
虚则补其母，木能生火，肝乃心之母，肝母生心火也。以生姜补肝，如无他证，钱氏安
神丸是也。实则甘草泻之，如无他证，钱氏方中，重则泻心汤，轻则导赤散是也。
《内经》说：心，是五脏中的尊长，享有帝王的称号。它与小肠互为表里，是神志寄居的场所，又主宰血液，五行属火，在夏季旺盛，手少阴经（注：原文括号内“太阳”为衍文或误植，手少阴心经对应手太阳小肠经为表里，此处指心经本身）是其所属经脉。凡是夏季的脉象呈钩状，来势强盛而去势衰弱，所以称为钩脉；与此相反的就是病脉。来势强盛而去势也强盛，属于太过，病邪在体表；来势衰弱而去势也衰弱，属于不足，病邪在体内。太过，使人身体发热且骨痛，口舌生疮且舌干焦渴引水；不及，使人烦躁不安，上部出现咳嗽吐痰，下部出现气泄（如遗尿、失禁等）。其脉象如果像抚摸美玉一样温润，或者像连珠一样圆润流利，称为平脉（正常脉象）；脉来急促连续，其中略有弯曲，称为病脉；脉来前段弯曲后段僵硬，如同拿着带钩的腰带，称为死脉。思虑过多就会引起惊恐不安，惊恐则损伤心脏，心脏受损则神志丧失，神志丧失就会产生恐惧感。另外真心痛，手足寒冷超过关节，那么早晨诊断晚上就会死亡。另外心脏有水气停留，身体浮肿不能平卧，烦躁不安。心中风，则呼吸间感觉发热，不能行走站立，饥饿却不能进食，进食则呕吐。夏季心脉旺盛，左手寸口脉浮大而散，称为平脉；与此相反就是病脉。如果是沉而滑的脉象，是水来克火，十死无救。脉象长而弦的，是木来归子（母病及子或子盗母气之变通说法，此处指相生关系），不治疗也能自愈。脉象缓而大的，是土来入火（火生土，此处指子病犯母或相侮，原文意指土火相生之象但略显异常），为轻微的邪气干扰，没有大害。心脏有病则胸中疼痛，胁肋胀满，肩背手臂都疼痛；虚证则容易受惊心悸，惕惕然无法入睡，胸腹及腰背部牵引作痛，喜欢悲伤哭泣。心积之气长久不去，就会苦于烦闷，心中疼痛。实证则笑个不停，梦见火烧；心气盛则梦见欢喜大笑以及恐惧畏惧。邪气客居于心，则梦见烟火，心脏胀满气短，夜间睡眠不宁，懊恼，气逆往来，腹中发热，喜欢喝水并流出涎沫。心脏有病，中午时清醒，半夜时加重，清晨时安静。另外左手脉大，手部发热腋窝肿胀；脉大特别明显，胸中胀满而烦躁，心跳剧烈跳动，面色红赤眼睛发黄。心脏有病，先心痛，时刻不停止，关格不通，身体沉重不止，三天死亡。心虚严重，则害怕见人，闭眼想睡觉，精神不能守舍，魂魄妄行。心脉重按小而紧，轻取不喘（注：此处“喘”可能指脉象躁动或浮取时的特定状态，结合语境理解为轻取无明显躁动或特定脉形），苦心下气坚，食物不下，喜欢吞咽唾沫，手部发热烦满，多忘事，叹气，这是由思虑过度导致的。脉象急甚，出现抽搐；微急则心中疼痛，牵引前后胸背，不能进食。缓甚则疼痛牵引背部，容易流泪。小甚则呃逆，微小则消瘅（消渴类疾病）。滑甚则为口渴，微滑则心疝，牵引脐腹鸣响。涩甚则谵语不语。另外心脉坚硬搏指且长，主舌强不能说话；柔软而散，应当表现为胆怯不想吃东西。另外急甚则心疝，脐下有病形，烦闷少气，大热上煎。另外心病狂言，汗出如珠，身体厥冷，其脉应当浮大，反而沉濡而滑，其色应当红赤，反而发黑，这是水克火，不治，十死。另外心积，重按空空荡荡，上下往来无常处，病胸满悸动，腹中发热，面颊红赤，咽干，烦躁手掌热，严重时吐血，夏季缓解冬季加重，应该紧急治疗，限制在十日内。另外赤黑色入口必死。面目红赤也死，红如衃血（凝固的血块）也死。另外忧恚思虑太过，心气内去，其色反而调和而盛的，不出十日死亡。扁鹊说：心绝一日死，面色呈现凶兆的多，人虽然健康敏捷，号曰行尸，一年之中，灾祸必定到来。另外其人说话声音前宽后急，后声接不上前声，声音浊恶，口角歪斜，冒昧善笑，这是风邪入心。另外心脏受伤则心损，手足不遂，骨节离解，舒缓不自由，腹泻无休止，此病急宜治疗，不超过十日就会死亡。另外笑个不停，呻吟后又忧愁，这是水乘火（水克火），阴击于阳，阴起阳伏，伏则热，热生狂冒，谵乱妄言，不可采问，心已损矣。扁鹊说：其人唇口红赤可治，青黑色即死。另外心疟则先烦而后渴，翕翕发热，其脉浮紧而大是也。心气实而大便不利，腹满身热而重，温温欲吐，吐而不出，喘息急，不安卧，其脉左寸口与人迎皆实大是也。心虚则恐悸多惊，忧思不乐，胸腹中苦痛，言语战栗，恶寒恍惚，面赤目黄，喜血衄（鼻出血等），其脉左寸口虚而微是也。这是心脏寒热虚实、生死逆顺的脉证。
《主治备要》说：是动则病咽喉干燥心痛，口渴想饮水，这叫臂厥。主心所生病者，目黄，胁痛，臂内后廉痛厥，掌中热痛。心苦缓，用五味子的酸味收敛它。心欲软，用芒硝的咸味使其软，补以泽泻的咸味，泻以人参、甘草、黄芩的甘味。心虚则用炒盐补之。虚则补其母，木能生火，肝乃心之母，肝母生心火也。用生姜补肝，如果没有其他症状，钱氏安神丸即可。实证则用甘草泻之，如果没有其他症状，钱氏方中，重的用泻心汤，轻的用导赤散即可。
The *Classic of Medicine* states: The Heart is the honored elder among the five Zang organs, bearing the title of Emperor. It forms an interior-exterior relationship with the Small Intestine; it is the residence of the Shen (Spirit), governs Blood, belongs to Fire, and is prosperous in Summer. The Hand-Shaoyin (Heart) Meridian is its channel. In Summer, the pulse should be "hook-shaped" (Gou Mai), coming strong and departing weak; hence it is called hook. Deviation from this indicates disease. If it comes strong and departs strong, it is Excess (Tai Guo), indicating disease in the exterior; if it comes weak and departs weak, it is Deficiency (Bu Zu), indicating disease in the interior. Excess causes body heat and bone pain, mouth ulcers, and a scorched tongue leading to thirst for water. Deficiency causes restlessness, upper coughing and expectoration, and lower Qi leakage. A normal pulse feels like touching fine jade or like connected pearls. A pathological pulse comes rapidly and continuously with slight curvature. A fatal pulse comes curved at the front and stiff at the back, like handling a belt hook. Excessive thinking leads to fright and palpitations; fright damages the Heart; Heart damage leads to loss of Shen; loss of Shen leads to fear. Additionally, True Heart Pain presents with cold hands and feet extending beyond the joints, resulting in death by evening if diagnosed in the morning. Water Qi in the Heart causes edema, inability to lie flat, and irritability. Wind striking the Heart causes feeling of heat during breathing, inability to walk or stand, hunger without appetite, and vomiting after eating. In Summer, when the Heart pulse is prosperous, the left Cun Kou pulse should be floating, large, and scattered; deviation indicates disease. A sinking and slippery pulse indicates Water overcoming Fire, which is fatal. A long and wiry pulse indicates Wood returning to the Son (generating relationship), which will heal spontaneously. A slow and large pulse indicates Earth entering Fire, representing minor pathogenic interference with no serious harm. Heart disease causes chest pain, fullness and distension in the hypochondrium, and pain in the shoulders, back, arms, and elbows. Deficiency causes frequent fright and palpitations, insomnia, pulling pain in the chest, abdomen, waist, and back, and a tendency toward sadness. Long-standing Heart Accumulation causes vexation and heart pain. Excess causes incessant laughter and dreams of fire; abundant Heart Qi causes dreams of joy/laughter and fear. Pathogenic factors lodging in the Heart cause dreams of smoke and fire, Heart distension, shortness of breath, restless sleep, regret, rebellious Qi movement, abdominal heat, preference for water, and salivation. Heart disease improves at noon, worsens at midnight, and is calm at dawn. A large left hand pulse with hot hands and swollen axillae indicates pathology; if excessively large, it causes chest fullness, irritability, palpitations, red face, and yellow eyes. Initial Heart pain that is constant, accompanied by Guan-Ge obstruction, persistent heaviness, leads to death in three days. Severe Heart Deficiency causes fear of people, desire to close eyes and sleep, loss of mental control, and wandering Hun and Po. A Heart pulse that is small and tight on deep pressure, but not rapid on superficial pressure, indicates difficult Qi stagnation below the epigastrium, difficulty swallowing food, preference for swallowing saliva, hot and irritable hands, forgetfulness, sighing, caused by excessive thinking. An extremely urgent pulse indicates convulsions; slightly urgent causes heart pain radiating to the chest and back, and inability to eat. Extremely slow causes pain radiating to the back and tearing; very small indicates hiccups; minute indicates Xiao Dan (wasting-thirst). Very slippery indicates thirst; slightly slippery indicates Heart Shan (hernia) with umbilical rumbling. Very choppy indicates muteness. A firm, pounding, and long Heart pulse indicates a stiff tongue and inability to speak; a soft and scattered pulse indicates timidity and anorexia. Extremely urgent indicates Heart Shan with sub-umbilical masses, vexation, shortness of breath, and scalding heat. Manic speech, pearl-like sweat, and cold limbs indicate Heart disease; the pulse should be floating and large, but if sinking, slippery, and the color black instead of red, it indicates Water overcoming Fire, which is fatal. Heart Accumulation feels empty on deep pressure, moves irregularly, causing chest fullness, palpitations, abdominal heat, malar flush, dry throat, irritability, palm heat, and severe hematemesis; it improves in Summer and worsens in Winter, requiring urgent treatment within ten days. Blackish-red color entering the mouth indicates death. Red face and eyes indicate death; red like clotted blood indicates death. Excessive worry and anger deplete Heart Qi; if the complexion appears harmoniously excessive, death occurs within ten days. Bian Que stated: Heart exhaustion leads to death in one day; ominous facial colors indicate impending doom even if the person seems agile ("Walking Corpse"), with disaster inevitable within a year. Speech that starts broad and becomes urgent, disjointed, turbid, with facial distortion and inappropriate laughter, indicates Wind invading the Heart. Heart injury leads to Heart damage, paralysis, joint dislocation, stiffness, chronic diarrhea, and death within ten days if untreated. Incessant laughter followed by groaning and sorrow indicates Water overacting on Fire (Yin attacking Yang), leading to heat, mania, delirium, and irreparable Heart damage. Bian Que stated: Red lips and mouth are treatable; blue-black indicates death. Heart Malaria begins with irritability then thirst, with mild fever, and a floating, tight, large pulse. Heart Qi Excess with constipation, abdominal fullness, heat, heaviness, nausea without vomiting, rapid breathing, and inability to lie down, presents with a solid and large left Cun Kou and Ren Ying pulse. Heart Deficiency causes fear, palpitations, fright, sorrow, chest/abdominal pain, trembling speech, aversion to cold, confusion, red face, yellow eyes, epistaxis, and a deficient, minute left Cun Kou pulse. These are the pulse and symptom patterns of Cold, Heat, Excess, and Deficiency of the Heart, indicating life/death and favorable/unfavorable outcomes.
*Zhu Zhi Bei Yao* states: Disorders of the meridian manifest as dry throat, heart pain, thirst, and desire to drink, known as Bi Jue (Arm Jue). Diseases governed by the Heart include yellow eyes, hypochondriac pain, pain and coldness along the posterior medial aspect of the arm, and heat/pain in the palm. The Heart suffers from Laxity (Huan); Sour flavor of Wuweizi (Schisandrae Fructus) astringes it. The Heart desires Softness; Salty flavor of Mangxiao (Natrii Sulfas) softens it. Tonification uses Xieye (Alismatis Rhizoma) salty flavor; Purging uses Renshen (Ginseng Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), and Huangqin (Scutellariae Radix) sweet flavors. Heart Deficiency is tonified with fried salt. Deficiency is treated by tonifying the Mother; Wood generates Fire, so the Liver is the Mother of the Heart. Shengjiang (Zingiberis Rhizoma) tonifies the Liver; if no other symptoms exist, Qian Shi's Anshen Wan is indicated. Excess is purged with Gancao; if no other symptoms exist, in Qian Shi's formulas, severe cases use Xiexin Tang (Coptis Decoction) and mild cases use Daochi San (Guide Out Red Powder).