心者，血脉循环之枢机也。心房一动则周身之脉一动，是以心机亢进，脉象即大而有力，或脉搏更甚数；
心脏麻痹，脉象即细而无力，或脉搏更甚迟。是脉不得其平，大抵由心机亢进与心脏麻痹而来也。于以
知心之病虽多端，实可分心机亢进、心脏麻痹为二大纲。
今试先论心机亢进之病∶有因外感之热炽盛于阳明胃府之
中，上蒸心脏，致心机亢进者，其脉象洪而有力，或脉搏加数。可用大剂白虎汤以清其胃。或更兼肠有燥粪，
大便不通者，酌用大、小承气汤以涤其肠，则热由下泻，心机之亢进者自得其平矣。
有下焦阴分虚损，不能与上焦阳分相维系，其心中之君火恒至浮越妄动，以致心机亢进者，其人常苦
眩晕，或头疼、目胀、耳鸣，其脉象上盛下虚，或摇摇无根，至数加数。宜治以加味左归饮。方用大熟地、大
生地、生怀山药各六钱，甘枸杞、怀牛膝、生龙骨、生牡蛎各五钱，净萸肉三钱，云苓片一钱。此壮水
之源以制浮游之火，心机之亢者自归于和平矣。
有心体之阳素旺，其胃腑又积有实热，复上升以助之，以致心机亢进者，其人脉虽有力，而脉搏不数，
五心恒作灼热。宜治以咸寒之品（《内经》谓热淫于内治以咸寒），若朴硝、太阴玄精石及西药硫苦皆
为对证之药（每服少许日服三次久久自愈）。盖心体属火，味之咸者属水，投以咸寒之品，是以寒胜热水胜火也。
人之元神藏于脑，人之识神发于心。识神者思虑之神也。人常思虑，其心必多热，以人之神明属阳，
思虑多者，其神之阳常常由心发露，遂致心机因热亢进，其人恒多迷惑。其脉多现滑实之象，因其思虑所生
之热恒与痰涎互相胶漆，是以其脉滑而有力也。可用大承气汤（浓朴宜少用），以清热降痰；再加赭石（生
赭石两半轧细同煎）、甘遂（甘遂一钱研细调药汤中服）以助其清热降痰之力。药性虽近猛烈，实能稳
建奇功，而屡试屡效也。
有心机亢进之甚者，其鼓血上行之力甚大，能使脑部之血管至于破裂，《内经》所谓血之与气并走于上
之大厥也，亦即西人所谓脑充血之险证也。推此证之原因，实由肝木之气过升，肺金之气又失于肃降，则
金不制木，肝木之横姿遂上干心脏，以致心机亢进。若更兼冲气上冲，其脉象之弦硬有力更迥异乎寻常矣。当
此证之初露朕兆时，必先脑中作疼，或间觉眩晕，或微觉半身不
利，或肢体有麻木之处。宜思患预防，当治以清肺、镇肝、敛冲之剂，更重用引血下行之药辅之，连服十
余剂或数十剂，其脉象渐变柔和，自无意外之患。向因此证方书无相当之治法，曾拟得建瓴汤一方，屡次用
之皆效。即不能治之于预，其人忽然昏倒，须臾能自苏醒者，大抵脑中血管未甚破裂，急服此汤，皆可保其
性命。连服数剂，其头之疼者可以全愈，即脑中血管不复充血，其从前少有破裂之处亦可自愈，而其肢体之痿
废者亦可徐徐见效。此方原用铁锈水煎药，若刮取铁锈数钱，或多至两许，与药同煎服更佳。
有非心机亢进而有若心机亢进者，怔忡之证是也。心之本体，原长发动以营运血脉，然无病之人初不觉
其动也，惟患怔忡者则时觉心中跳动不安。盖人心中之神明原以心中之气血为凭根据，有时其气血过于虚损，
致神明失其凭根据，虽心机之动照常，原分毫未尝亢进，而神明恒若不任其震撼者。此其脉象多微细，或脉搏
兼数。宜用山萸肉、酸枣仁、怀山药诸药品以保合其气；龙眼肉、熟地黄、柏子仁诸药以滋养其血；更宜用
生龙骨，牡蛎、朱砂（研细送服）诸药以镇安其神明。气分虚甚者可加人参，其血分虚而且热者可加生地黄。
有因心体肿胀，或有瘀滞，其心房之门户变为窄小，血之出入致有激荡之力，而心遂因之觉动者，此似心机
亢进而亦非心机亢进也。其脉恒为涩象，或更兼迟。宜治以拙拟活络效灵丹加生怀山药、龙眼肉各一两，共
煎汤服。或用节菖蒲三两，远志二两，共为细末，每服二钱，红糖冲水送下，日服三次，久当自愈。因菖蒲
善开心窍，远志善化瘀滞（因其含有稀盐酸），且二药并用实善调补心脏，而送以红糖水者，亦所以助其血
脉流通也。
至心脏麻痹之原因，亦有多端，治法亦因之各异。如伤寒温病之白虎汤证，其脉皆洪大有力也，若不
实时投以白虎汤，脉洪大有力之极，又可渐变为细小无力，此乃由心机亢进而转为心脏
麻痹。病候至此，极为危险，宜急投以大剂白虎加人参汤，将方中人参加倍，煎汤一大碗，分数次温饮下，
使药力相继不断，一日连服二剂，庶可挽回。盖外感之热，传入阳明，其热实脉虚者，原宜治以白虎加人参
汤（是以伤寒汗吐下后用白虎汤时皆加人参）。然其脉非由实转虚也。至其脉由实转虚，是其心脏为热所伤而
麻痹，已成坏证，故用白虎加人参汤时宜将人参加倍，助其心脉之跳动，即可愈其心脏之麻痹也。
有心脏本体之阳薄弱，更兼胃中积有寒饮，溢于膈上，凌逼心脏之阳，不能用事，其心脏渐欲麻痹，脉
象异常微细，脉搏异常迟缓者，宜治以拙拟理饮汤，连服十余剂，寒饮消除净尽，心脏之阳自复其初，脉之微
弱迟缓者亦自复其常矣。此证间有心中觉热、或周身发热、或耳鸣欲聋之种种响应象，须兼看理饮汤后
所载治愈诸案，临证诊断，自无差误。
有心脏为传染之毒菌充塞以至于麻痹者，霍乱证之六脉皆闭者是也。治此证者，宜治其心脏之麻痹，更
宜治其心脏之所以麻痹，则兴奋心脏之药，自当与扫除毒菌之药并用，如拙拟之急救回生丹、卫生防疫宝丹
是也。此二方中用樟脑所升之冰片，是兴奋心脏以除其麻痹也。二方中皆有朱砂、薄荷冰，是扫除毒菌以治
心脏之所以麻痹也。是以无论霍乱之因凉因热，投之皆可奏效也（急救回生丹药性微凉，以治因热之霍
乱尤效；卫生防疫宝丹其性温，无论病因凉热用之皆有捷效）。
有心中神明不得宁静，有若失其凭根据，而常惊悸者，此其现象若与心脏麻痹相反，若投以西药麻醉之品，
亦可取效于一时。而究其原因，实亦由心体虚弱所致，惟投以强心之剂，乃为根本之治法。当细审其脉，若
数而兼滑者，当系心血虚而兼热，宜用龙眼肉、熟地黄诸药补其虚，生地黄、玄参诸药泻其热，再用生龙
骨、牡蛎以保合其神明，镇靖其魂魄，其惊悸自除矣。其脉微弱无力者，当系心气虚而莫支，宜用参、术、
诸药以补其气，兼
用生地黄、玄参诸滋阴药以防其因补生热，更用酸枣仁、山萸肉以凝固其神明，收敛其气化，其治法与前条
脉弱怔忡者大略相同。特脉弱怔忡者，心机之发动尤能照常，而此则发动力微，而心之本体又不时颤动，犹
人之力小任重而身颤也，其心脏弱似较怔忡者尤甚矣。
有其惊悸恒发于夜间，每当交睫甫睡之时，其心中即惊悸而醒，此多因心下停有痰饮，心脏属火，痰
饮属水，火畏水迫，故作惊悸也。宜清痰之药与养心之药并用，方用二陈汤加当归、菖蒲、远志，煎汤送服
朱砂细末三分。有热者加玄参数钱，自能安枕稳睡而无惊悸矣。
心脏是血脉循环的枢纽。心房每跳动一次，全身的脉搏随之而动，因此心机亢进（心脏功能过度兴奋）时，脉象表现为大而有力，或者脉搏次数更多；心脏麻痹（心脏功能抑制或衰竭）时，脉象表现为细而无力，或者脉搏次数更少。所以脉象失去平和状态，大抵是由心机亢进与心脏麻痹引起的。由此可知，心脏的疾病虽然多种多样，实际上可以归纳为心机亢进和心脏麻痹两大纲领。
现在先论述心机亢进的病症：有一种是因为外感热邪炽盛于阳明胃腑之中，向上熏蒸心脏，导致心机亢进，其脉象洪大有力，或者脉搏次数增加。可以用大剂量的白虎汤（石膏、知母、甘草、粳米组成的清热方剂）来清泄胃热。如果同时伴有肠道有燥屎，大便不通的情况，酌情使用大承气汤或小承气汤（大黄、芒硝、厚朴、枳实等组成的泻下方剂）来涤荡肠道，那么热邪从下面排出，心机的亢进自然恢复平和。
有一种是因为下焦阴分虚损，不能与上焦阳分相互维系，心中之君火（指心阳/心火）经常浮越妄动，导致心机亢进，这种人常常苦于眩晕，或者头痛、眼睛胀痛、耳鸣，其脉象上部盛而下部虚，或者脉象动摇无根，脉搏次数增加。适宜用加味左归饮治疗。方药用大熟地黄、大生地黄、生怀山药各六钱，甘枸杞、怀牛膝、生龙骨、生牡蛎各五钱，净山茱萸三钱，云茯苓片一钱。这是通过壮水之源（滋补肾阴）来制约浮游之火，心机亢进者自然会归于和平。
有一种是心体之阳气素来旺盛，其胃腑又积有实热，热气上升以助长心阳，导致心机亢进，这种人的脉象虽然有力，但脉搏次数不增加，五个手心（两手心两足心）经常感到灼热。适宜用咸寒性质的药物（《内经》说热邪内盛用咸寒药物治疗），如朴硝、太阴玄精石以及西药硫酸镁都是对症的药物（每次服用少许，每日三次，久了自然痊愈）。因为心体属火，味道咸的药物属水，投用咸寒药物，就是用寒胜热、用水胜火。
人的元神藏于脑，人的识神发于心。识神是指思虑之神。人经常思虑，心脏必然多热，因为人的神明属阳，思虑多的人，其神之阳常常由心显露出来，致使心机因热而亢进，这种人常常多有迷惑。其脉象多呈现滑实之象，因为思虑所产生的热常常与痰涎互相胶结，所以脉象滑而有力。可用大承气汤（厚朴宜少用），以清热降痰；再加赭石（生赭石一两半轧细同煎）、甘遂（甘遂一钱研细调在药汤中服）以助其清热降痰之力。药性虽然接近猛烈，实则能建立奇功，而且屡试屡效。
有心机亢进非常严重的，其鼓动血液上行的力量很大，能使脑部血管破裂，《内经》所说的血与气并走于上的大厥证，也就是西医所说的脑充血险证。推究此证的原因，实在由于肝木之气过升，肺金之气又失于肃降，则金不能制木，肝木横逆之势于是上干犯心脏，导致心机亢进。如果更兼冲气上冲，其脉象弦硬有力就更迥异于寻常了。当此证刚露出征兆时，必定脑中作痛，或者偶尔觉得眩晕，或者微微觉得半身不遂，或者肢体有麻木之处。应当思患预防，适宜用清肺、镇肝、敛冲的药剂治疗，更重用引血下行的药物辅助，连服十余剂或数十剂，脉象逐渐变得柔和，自然没有意外的祸患。过去因为此证医书没有相当的治疗方法，曾拟定建瓴汤一方，屡次使用都有效。即使不能在预兆阶段治愈，其人忽然昏倒，片刻能自行苏醒的，大抵脑中血管未严重破裂，急服此汤，都可以保全性命。连服数剂，头痛的可以完全痊愈，脑中血管不再充血，从前少有破裂的地方也可以自愈，其肢体的痿废也可以慢慢见效。此方原本用铁锈水煎药，如果刮取铁锈几钱，或多至一两许，与药同煎服用更好。
有一种不是心机亢进却像心机亢进的，就是怔忡证。心脏的本体，本来经常发动以营运血脉，然而没病的人起初并不觉得心跳，只有患怔忡的人才时常觉得心中跳动不安。大概人心中的神明原以心中的气血为凭借依据，有时气血过于虚损，致使神明失去凭借依据，虽然心机的跳动照常，原本丝毫未曾亢进，而神明常常好像承受不住其震撼。这其脉象多微细，或者脉搏兼有数象。适宜用山茱萸、酸枣仁、怀山药等药品以保合其气；龙眼肉、熟地黄、柏子仁等药以滋养其血；更适宜用生龙骨、牡蛎、朱砂（研细送服）等药以镇安其神明。气分虚甚的可加人参，血分虚而且有热的可加生地黄。
有因为心体肿胀，或者有瘀滞，其心房之门变为窄小，血液出入导致有激荡之力，而心脏因此觉得跳动的，这看似心机亢进其实也不是心机亢进。其脉象常为涩象，或者更兼迟象。适宜用我拟定的活络效灵丹加生怀山药、龙眼肉各一两，共煎汤服用。或者用节菖蒲三两，远志二两，共为细末，每次服用二钱，红糖冲水送下，每日三次，久了应当自愈。因为菖蒲善于开通心窍，远志善于化瘀滞（因其含有稀盐酸），而且两药并用确实善于调补心脏，而用红糖水送下，也是帮助其血脉流通。
至于心脏麻痹的原因，也有多种，治法也因此各异。比如伤寒温病的白虎汤证，其脉皆洪大有力，如果不及时投用白虎汤，脉洪大有力到了极点，又可以逐渐变为细小无力，这是由心机亢进而转为心脏麻痹。病候到了这一步，极为危险，适宜急投以大剂量白虎加人参汤，将方中的人参加倍，煎成一大碗汤，分几次温饮下去，使药力相继不断，一天连服两剂，才可以挽回。因为外感的热邪传入阳明，其热实而脉虚的，原宜用白虎加人参汤治疗（所以伤寒汗吐下后用白虎汤时都加人参）。然而其脉并非由实转虚。至于其脉由实转虚，是其心脏被热邪所伤而麻痹，已成坏证，所以用白虎加人参汤时宜将人参加倍，助其心脉之跳动，就可以治愈心脏的麻痹。
有心脏本体之阳薄弱，更兼胃中积有寒饮，溢于膈上，凌逼心脏之阳，使其不能用事，其心脏渐渐欲麻痹，脉象异常微细，脉搏异常迟缓的，适宜用我拟定的理饮汤治疗，连服十余剂，寒饮消除净尽，心脏之阳自然恢复如初，脉之微弱迟缓者也自然恢复正常。此证间或有心中觉热、或周身发热、或耳鸣欲聋的各种反应现象，须兼看理饮汤后所载治愈诸案，临证诊断，自然没有差误。
有心脏为传染之毒菌充塞以至于麻痹的，霍乱证之六脉皆闭的就是这类。治疗此证，适宜治其心脏的麻痹，更适宜治其心脏之所以麻痹，那么兴奋心脏的药，自然应当与扫除毒菌的药并用，如我拟定的急救回生丹、卫生防疫宝丹就是这类。这两方中用樟脑升华的冰片，是兴奋心脏以除去其麻痹。两方中都有朱砂、薄荷冰，是扫除毒菌以治心脏之所以麻痹。所以无论霍乱是因凉还是因热，投用皆可奏效（急救回生丹药性微凉，以治因热之霍乱尤其有效；卫生防疫宝丹其性温，无论病因凉热用之皆有捷效）。
有心中神明不得宁静，好像失去凭借依据，而常惊悸的，这种现象若与心脏麻痹相反，若投以西药麻醉品，也可暂时取效。但追究其原因，实在也是由心体虚弱所致，只有投用强心的药剂，才是根本的治疗方法。应当仔细审察其脉，如果数而兼滑的，应当是心血虚而兼热，适宜用龙眼肉、熟地黄等药补其虚，生地黄、玄参等药泻其热，再用生龙骨、牡蛎以保合其神明，镇靖其魂魄，其惊悸自然消除。其脉微弱无力的，应当是心气虚而莫支，适宜用人参、白术等药以补其气，兼用生地黄、玄参等滋阴药以防其因补生热，更用酸枣仁、山茱萸以凝固其神明，收敛其气化，其治法与前条脉弱怔忡者大致相同。只是脉弱怔忡者，心机的发动尤能照常，而此则发动力微弱，而心脏本体又不时颤动，犹如人力小任重而身体颤抖一样，其心脏弱似乎较怔忡者更为严重。
有惊悸恒发于夜间，每当闭上眼睛刚要睡之时，其心中即惊悸而醒，这多因心下停有痰饮，心脏属火，痰饮属水，火畏水迫，故作惊悸。适宜用清痰药与养心药并用，方用二陈汤（半夏、陈皮、茯苓、甘草）加当归、菖蒲、远志，煎汤送服朱砂细末三分。有热者加玄参数钱，自然能安枕稳睡而无惊悸了。
The heart is the pivot of blood circulation. Each time the heart chamber beats, the pulse throughout the body moves accordingly. Therefore, when cardiac function is hyperactive (excessive excitement of cardiac function), the pulse appears large and forceful, or the pulse rate increases; when cardiac function is paralyzed (inhibition or failure of cardiac function), the pulse appears thin and weak, or the pulse rate decreases. Thus, a pulse that loses its equilibrium is generally caused by hyperactive cardiac function or paralyzed cardiac function. From this, we can see that although diseases of the heart are manifold, they can essentially be categorized into two main principles: hyperactive cardiac function and paralyzed cardiac function.
Let us first discuss diseases of hyperactive cardiac function: One type occurs when external pathogenic heat blazes within the Yangming Stomach Fu organ, steaming upwards to the heart, causing hyperactive cardiac function. The pulse is surging and forceful, or the pulse rate increases. A large dose of Baihu Tang (Clear Heat Decoction, composed of Gypsum, Anemarrhena, Licorice, and Rice) can be used to clear stomach heat. If there is also dry feces in the intestines with constipation, Dachengqi Tang (Major Order the Qi Decoction) or Xiaochengqi Tang (Minor Order the Qi Decoction) should be used酌情ly to purge the intestines. Then, as heat is discharged downwards, the hyperactive cardiac function will naturally return to equilibrium.
Another type arises from deficiency in the Yin aspect of the Lower Jiao, which fails to maintain connection with the Yang aspect of the Upper Jiao. The Sovereign Fire (referring to Heart Yang/Fire) within the heart floats and moves recklessly, leading to hyperactive cardiac function. Such individuals often suffer from dizziness, headache, distending pain in the eyes, and tinnitus. Their pulse is abundant at the top and deficient at the bottom, or trembling without root, with an increased pulse rate. Treatment with Jiawei Zuogui Yin (Modified Left Restoring Decoction) is appropriate. The prescription uses large doses of Shu Dihuang (Prepared Rehmannia Root), Sheng Dihuang (Raw Rehmannia Root), and Sheng Huai Shanyao (Fresh Chinese Yam), each 6 qian; Gouqizi (Lycium Fruit), Huainiu (Achyranthes Root), Sheng Longgu (Fossilized Bones), and Sheng Muli (Oyster Shell), each 5 qian; Jing Yurou (Cornus Fruit) 3 qian; and Yunling (Poria) slices 1 qian. This strengthens the source of Water (nourishes Kidney Yin) to control the floating fire, allowing hyperactive cardiac function to return to peace.
In another case, the Heart's Yang is naturally robust, and the Stomach Fu accumulates excess heat. This heat rises to assist the Heart Yang, causing hyperactive cardiac function. The pulse is forceful but not rapid, while the five centers (palms of hands and soles of feet) often feel burning hot. It is appropriate to use salty-cold substances (as stated in the *Neijing*: "For excessive heat inside, treat with salty-cold"). Substances such as Xiaosha (Mirabilite), Taiyin Xuanjingshi (Taiyin Crystal Stone), and Western Epsom Salt (Magnesium Sulfate) are对症 medications (take a small amount each time, three times daily, and it will heal over time). Since the Heart body belongs to Fire, and salty flavors belong to Water, administering salty-cold substances utilizes Cold to overcome Heat and Water to overcome Fire.
The Yuan Shen (Original Spirit) resides in the brain, while the Shi Shen (Acquired Spirit) originates from the heart. The Shi Shen refers to the spirit of thought. Frequent thinking generates heat in the heart because the human spirit belongs to Yang. Excessive thinking causes the Yang of the spirit to constantly manifest from the heart, leading to hyperactive cardiac function due to heat. Such individuals often experience confusion. Their pulse often appears slippery and solid because the heat generated by thinking often adheres to phlegm-fluids, resulting in a slippery yet forceful pulse. Dachengqi Tang (with less Houpo) can be used to clear heat and descend phlegm; add Hematite (Sheng Zheishi, 1.5 liang crushed and decocted together) and Gansui (Gansui 1 qian, finely ground and mixed into the decoction) to enhance the power of clearing heat and descending phlegm. Although the medicinal properties are potent, they achieve remarkable results and have proven effective repeatedly.
In severe cases of hyperactive cardiac function, the force driving blood upward is so strong that it can cause rupture of cerebral blood vessels. This corresponds to the "Great Jue" syndrome described in the *Neijing* ("blood and qi moving together upwards") and is equivalent to the dangerous condition known in Western medicine as cerebral congestion. The cause of this syndrome lies in the excessive rising of Liver Wood Qi and the failure of Lung Metal Qi to descend properly. Consequently, Metal fails to control Wood, and the rampant Liver Qi attacks the Heart, causing hyperactive cardiac function. If accompanied by Chong Qi rushing upward, the pulse becomes wiry, hard, and forceful, significantly different from normal. When early signs appear—such as headache, occasional dizziness, slight hemiplegia, or numbness in limbs—one must take preventive measures. Treatment should involve formulas that clear the Lung, calm the Liver, and restrain the Chong Qi, assisted by heavy doses of herbs that guide blood downward. Taking the formula for ten to dozens of doses will gradually soften the pulse, preventing unexpected disasters. Previously, lacking adequate treatments in medical texts, I formulated Jianling Tang (Building High Terrace Decoction), which has been consistently effective. Even if treatment cannot prevent the onset, if a person suddenly faints but recovers consciousness quickly, indicating minor cerebral vessel rupture, immediate administration of this decoction can save their life. Continued use for several doses can completely cure headaches, resolve cerebral congestion, heal minor ruptures, and slowly improve limb paralysis. Originally, this decoction was prepared using rust water; scraping a few qian to one liang of iron rust to decoct with the herbs is even better.
There are conditions that resemble hyperactive cardiac function but are not, specifically Palpitations (Zhengchong). The heart naturally beats to circulate blood, but healthy people do not perceive this. Only those with palpitations feel constant unease and beating in the chest. The spirit in the heart relies on Qi and Blood. When Qi and Blood are severely deficient, the spirit loses its foundation. Although the heart beats normally without hyperactivity, the spirit feels unable to withstand the vibration. The pulse is typically fine and weak, or rapid. Treatment should preserve Qi using Cornus (Shanzhuyu), Sour Jujube Seed (Suanzaoren), and Chinese Yam (Huai Shanyao); nourish Blood using Longan Aril (Longyanrou), Prepared Rehmannia (Shudihuang), and Biota Seed (Baiziren); and calm the spirit using Fossilized Bones (Longgu), Oyster Shell (Muli), and Cinnabar (Zhusha, taken finely ground). If Qi deficiency is severe, add Ginseng (Renshen); if Blood deficiency involves heat, add Raw Rehmannia (Shengdihuang).
Some cases involve swelling of the heart body or blood stasis, narrowing the atrial openings. The turbulence of blood entering and exiting causes the heart to beat noticeably. This resembles hyperactive cardiac function but is distinct. The pulse is typically choppy (Se) or slow. Treatment with Huoluo Xiaoling Dan (Activate Collaterals and Effect Lingering Pain Decoction) plus Fresh Chinese Yam (Sheng Huai Shanyao) and Longan Aril (Longyanrou), each 1 liang, decocted and taken as soup, is suitable. Alternatively, use 3 liang of Acorus (Jie Changpu) and 2 liang of Polygala (Yuanzhi), ground into powder. Take 2 qian per dose, washed down with brown sugar water, three times daily. Over time, it will self-heal. Acorus opens the orifices of the heart, and Polygala resolves stasis (due to containing dilute hydrochloric acid). Together, they tonify the heart, while brown sugar water aids blood circulation.
Causes of paralyzed cardiac function vary, requiring different treatments. For instance, in Shaoyang/Wenbing patterns indicated by Baihu Tang, the pulse is surging and forceful. If Baihu Tang is not administered promptly, this forceful pulse may gradually become thin and weak, marking a transition from hyperactive to paralyzed cardiac function. This stage is extremely dangerous. Urgent administration of a large dose of Baihu Jia Renshen Tang (Baihu Decoction plus Ginseng) is required, doubling the Ginseng dosage. Decoct into a large bowl and drink warm in divided doses to ensure continuous medicinal effect. Administer two doses per day to reverse the condition. Generally, when external heat transmits to Yangming, presenting with excess heat and deficient pulse, Baihu Jia Renshen Tang is indicated (hence Ginseng is added after sweating, vomiting, or purging in Shanghan). However, here the pulse shifts from excess to deficiency because the heart has been damaged by heat, becoming paralyzed and forming a critical condition. Doubling Ginseng assists heart pulse movement, curing the paralysis.
If the Heart's Yang is inherently weak, compounded by cold fluid accumulation in the Stomach overflowing above the diaphragm and suppressing Heart Yang, the heart gradually approaches paralysis. The pulse is exceptionally fine and slow. Treatment with Liyin Tang (Regulate Fluids Decoction) for over ten doses eliminates cold fluids, restoring Heart Yang and normalizing the pulse. Some cases present with sensations of internal heat, generalized fever, or deafening tinnitus. Refer to the cured cases recorded after Liyin Tang for accurate diagnosis.
Paralysis caused by infectious bacteria filling the heart, such as in Cholera where all six pulses are closed, requires treating both the paralysis and its cause. Cardiac stimulants must be combined with antibacterial agents, such as my formulated Jijiu Huisheng Dan (Emergency Rescue Pill) and Weisheng Fangyi Baodan (Health Epidemic Prevention Treasure Pill). Borneol (sublimated from Camphor) in these pills stimulates the heart to remove paralysis. Cinnabar and Menthol Ice eliminate bacteria causing the paralysis. Thus, they are effective regardless of whether Cholera is caused by cold or heat (Jijiu Huisheng Dan is slightly cool, especially effective for heat-induced Cholera; Weisheng Fangyi Baodan is warm, effective for both cold and heat etiologies).
When the spirit lacks tranquility and feels unsupported, causing frequent fright and palpitations, the presentation opposes cardiac paralysis. Western anesthetics may provide temporary relief, but the root cause is heart weakness. Tonifying the heart is the fundamental treatment. Carefully examine the pulse: if rapid and slippery, it indicates Heart Blood deficiency with heat. Use Longan Aril and Prepared Rehmannia to tonify deficiency, Raw Rehmannia and Scrophularia to clear heat, and Fossilized Bones and Oyster Shell to stabilize the spirit and calm the soul, eliminating palpitations. If the pulse is weak and forceless, it indicates Heart Qi deficiency. Use Ginseng and Atractylodes to tonify Qi, combined with Raw Rehmannia and Scrophularia to prevent heat from tonification, and Sour Jujube Seed and Cornus to consolidate the spirit and regulate Qi transformation. This approach is similar to treating weak-pulse palpitations. However, in weak-pulse palpitations, cardiac movement remains normal, whereas here, the driving force is weak, and the heart body trembles intermittently, like carrying a heavy load with insufficient strength. The heart weakness here is more severe than in palpitations.
Palpitations occurring at night, waking the patient upon falling asleep, are often due to phlegm-fluid retention below the heart. The Heart belongs to Fire, and phlegm-fluids to Water. Fire fears being oppressed by Water, causing palpitations. Combine phlegm-resolving and heart-nourishing herbs. Use Erchen Tang (Two-Aged Decoction) plus Danggui, Changpu, and Yuanzhi, decocted and taken with 3 fen of fine Cinnabar powder. Add Scrophularia for heat. This ensures peaceful sleep without palpitations.