或问惊悸怔忡恐怖之别，曰∶悸即怔忡也。怔忡者，本无惊恐，动而不宁，惊者，因外
有所
触而卒动，子和云∶惊为不自知，恐为自知是也。盖惊者闻响即惊，恐者自知，如人将捕之
状，与夫不能独处，必须伴侣，方不恐惧，或夜无灯烛，亦生恐惧之类。怖与恐，于义相同
，《内经》无有称惊怖者，始于《金匮要略》，有云惊怖，由是而见，为惊恐即惊怖也，大
凡连称其名以为提纲者，多是一阴一阳对待而言，如喜怒并称者。喜出于心，心居于阳，
怒出于肝，肝居于阴，志意并称者，志是静而不移，意是动而不定，静则阴也，动则阳也，
惊恐
并称者，惊因触于外事，内动其心，心动则
神摇，恐因感于外事，内歉其志，志歉则神却。是故《内经》谓惊则心无所根据，神无所
归，虑无所定，故气乱矣。恐则神却，却则上焦闭，闭则气还，还则下焦胀，故气不行矣。
又谓尝贵后贱，尝富后贫，恐忧内结，至于脱营失精，病深无气，则洒然而惊，此类皆是病
从外致，而动内之心神者也。若夫在身之阴阳盛衰而致惊恐者，惊是火热铄动其心，心动则
神乱，神动无力，故惊之变态亦不一状，随其所之，与五神相应而动。肝藏魂，魂不安，则
为惊骇，为惊妄。肺藏魄，魄不安，则惊躁。脾藏意，意不专则惊惑。肾藏志，志歉而惊恐
，心惕惕然。胃虽无神，然为五脏之海，诸热归之，则发惊狂，若闻木音，亦惕然心欲动也
。恐者，则是热伤其肾，肾伤则精虚，精虚则志不足，志本一定而不移，故恐亦无他状。《
内经》于惊之病邪者，有火热，热淫司天在泉，胜复之气，有各经热病所致，有三阳积并，
有气并于阳，皆为惊疾。故病机统而言曰∶诸病惊骇，皆属于火也。于恐之病邪者，有精
并于肾则恐；有血不足则恐；有阴少阳入，阴阳相搏则恐；有胃气热，肾气微弱则恐；有肾
是动，病气不足则恐。然于肝之惊恐，互相作者，以其脏属阳居阴。纳血藏魂，魂不安则神
动，神动则惊，血不足则志歉，志歉则恐，皆因人之阴阳所动而内生者也。为治之法，惊则
安其神，恐则定其志。神属阳，阳则气也，火也，志属阴，阴则精也，水也，水火既济，全
在阴精上奉以安其神，阳气下藏以定其志，神安则散乱之气可敛，气敛，气敛则阳道行矣。
志定然后走失之精可固，精固则阴气用矣。若为外事惊者，子和谓惊者平之。平、常也，使
病者时时闻之，习熟而不惊，固是良法。余谓不若使其平心易气以先之，而后安其神，定其
志为得也。
有人询问惊、悸、怔忡、恐怖的区别，回答说：悸就是怔忡。怔忡（心中惕惕然跳动不安）的人，原本并没有惊恐的感觉，只是内心动荡而不安宁；惊（因外界突发刺激而受惊吓），是因为在外受到触动而突然心动。张子和说：“惊是当事人自己不知道（指猝不及防），恐是当事人自己知道（指有所预感或自知其害）。”大概来说，惊是听到响声就受惊，恐是自己心里清楚，就像被人追捕时的状态，以及那些不能独自待着、必须有伴侣陪伴才不感到恐惧，或者夜里没有灯烛也会产生恐惧等情况。怖与恐，在义理上是相同的，《黄帝内经》中没有称为“惊怖”的，这一称呼始于《金匮要略》，书中说“惊怖”，由此可以看出，惊恐即等同于惊怖。大凡将两个词连称作为提纲的，多是从一阴一阳相对待的角度而言的，比如喜和怒并称。喜出于心，心居于阳位；怒出于肝，肝居于阴位。志和意并称，志是静止而不移易的，意是变动而不定的，静属于阴，动属于阳。惊和恐并称，惊是因为触动了外在事物，使内心动摇，心动则神气摇荡；恐是因为感应了外在事物，使内心志向亏欠，志气亏欠则神气退缩。因此《黄帝内经》说：惊则心无所依托，神无所归依，思虑无定准，所以气机紊乱了。恐则神气退缩，退缩则上焦闭塞，闭塞则气机返还，返还则下焦胀满，所以气机运行不畅了。又说：曾经尊贵后来卑贱，曾经富有后来贫穷，导致忧恐郁结于内，以至于脱营（营血耗损）失精，病情深重而无气，此时就会洒然而惊，这类情况都是病从外致，而动摇了内在的心神。如果是由于身体内部的阴阳盛衰而导致惊恐的，惊是火热灼烧扰动其心，心动则神乱，神动无力，所以惊的表现形态也不一致，随着病邪所至之处，与五神相应而动。肝藏魂，魂不安宁，则表现为惊骇、惊妄。肺藏魄，魄不安宁，则表现为惊躁。脾藏意，意不专一则表现为惊惑。肾藏志，志气亏欠而惊恐，心中惕惕然。胃虽然没有神志主宰，但它是五脏的海，各种热邪归于它，则会引发惊狂，如果听到木器敲击的声音，也会惕然心惊想要跳动。恐，则是热邪伤了肾，肾伤则精虚，精虚则志不足，志本来是一定而不移的，所以恐也没有其他形态。《黄帝内经》对于引起惊的病邪，有火热，热淫司天在泉，胜复之气，有各经热病所致，有三阳经积热并合，有气并于阳，这些都是惊疾的原因。所以病机十九条概括说：各种引起惊骇的病，都归属于火。对于引起恐的病邪，有精气并于肾则恐；有血不足则恐；有阴少阳入，阴阳相搏则恐；有胃气热，肾气微弱则恐；有肾经病变，病气不足则恐。然而在肝脏的惊恐，互相作用的，因为其脏属阳居阴位。肝纳血藏魂，魂不安宁则神动，神动则惊；血不足则志歉，志歉则恐，这都是因为人的阴阳被触动而内生出来的。治疗的方法，惊则要安神，恐则要定志。神属于阳，阳即是气，即是火；志属于阴，阴即是精，即是水。水火既济，关键在于阴精上奉以安其神，阳气下藏以定其志。神安则散乱的气可以收敛，气收敛，阳气之道就能运行了。志定然后走失的精可以固摄，精固摄则阴气得以发挥作用。如果是因外在事物而惊的，张子和说对惊要用“平”法。“平”就是平常，让病人经常听到这种声音，习以为常而不感到惊恐，这确实是好方法。我认为不如先让他平心易气，然后再安神、定志更为得当。
A question was asked regarding the distinctions among Jing (Fright), Ji (Palpitation), Zhengchong (Severe Palpitation), and Kongbu (Fear/Terror). The response was: Ji is synonymous with Zhengchong. Zhengchong refers to a state where there is no initial feeling of fright or fear, but rather an internal restlessness and agitation. Jing refers to being suddenly startled due to external stimuli. Zhang Zihe stated: "Jing occurs when one is unaware (sudden/unexpected), whereas Kong occurs when one is aware." Generally speaking, Jing is triggered by hearing a loud noise, while Kong arises from a conscious awareness, resembling the feeling of being hunted, or the inability to stay alone without companionship to avoid fear, or feeling fearful in the dark without light. Bu (Terror) and Kong are semantically identical. The *Huangdi Neijing* does not use the term "Jingbu," which first appears in the *Jingui Yaolue*. It states "Jingbu," indicating that Jing and Kong are equivalent to Jingbu. Typically, terms paired together as headings represent a yin-yang duality. For instance, Xi (Joy) and Nu (Anger) are paired. Joy originates from the Heart, which resides in Yang; Anger originates from the Liver, which resides in Yin. Zhi (Willpower) and Yi (Intent) are paired. Zhi is static and unchanging, representing Yin; Yi is dynamic and unstable, representing Yang. Jing and Kong are paired. Jing is caused by external triggers disturbing the heart internally; when the Heart moves, the Shen (Spirit) becomes unsettled. Kong is caused by external influences depleting the Zhi internally; when the Zhi is deficient, the Shen retreats. Therefore, the *Huangdi Neijing* states: "Jing causes the Heart to have no foundation, the Shen to have no refuge, and thoughts to lack certainty, resulting in chaotic Qi." "Kong causes the Shen to retreat; retreat leads to the closure of the Upper Jiao; closure causes Qi to return; returning Qi causes distension in the Lower Jiao, thus impeding Qi movement." It also states: "Those who were once noble but became lowly, or once wealthy but became poor, may suffer from internal knotting of fear and worry, leading to Tuoying (depletion of Ying blood) and loss of Jing (Essence). When the disease is deep and Qi is exhausted, they may suddenly become frightened." These cases illustrate diseases originating externally that disturb the internal Heart-Shen. If Jing and Kong arise from internal imbalances of Yin and Yang, Jing is caused by Fire-Heat scorching and agitating the Heart; Heart agitation leads to Shen disorder. Since Shen movement lacks strength, the manifestations of Jing vary according to its location and interaction with the Five Spirits. The Liver stores Hun (Ethereal Soul); if Hun is unsettled, it results in Jinghai (fright/terror) and jingwang (delirious fright). The Lungs store Po (Corporeal Soul); if Po is unsettled, it results in jingzao (agitated fright). The Spleen stores Yi (Intellect); if Yi is not focused, it results in jinghuo (confused fright). The Kidneys store Zhi (Willpower); if Zhi is deficient, it leads to fear and palpitations. The Stomach, though lacking spirit, is the Sea of the Five Zang organs; when various Heat pathogens converge here, it can cause Jingkuang (frightful mania). Hearing wooden sounds may also cause palpitations. Kong, however, is caused by Heat damaging the Kidneys; Kidney damage leads to Jing deficiency, which leads to Zhi insufficiency. Since Zhi is inherently stable and unchanging, Kong presents without other varied symptoms. Regarding the pathogenic factors for Jing in the *Neijing*, they include Fire-Heat, climatic factors like Re-Yin Si Tian/Zai Quan (excessive Heat governing Heaven/Earth), winning and repelling Qi, heat diseases of specific meridians, accumulation of San Yang (Three Yang meridians), and Qi merging into Yang. Thus, the Pathogenesis chapter summarizes: "All diseases involving fright and terror belong to Fire." Regarding pathogenic factors for Kong, they include Jing merging into the Kidneys causing Kong; Blood deficiency causing Kong; insufficient Yin and invading Yang with Yin-Yang conflict causing Kong; Stomach Heat combined with weak Kidney Qi causing Kong; and Kidney meridian pathology with deficient Qi causing Kong. In the case of the Liver, Jing and Kong interact because the Liver belongs to Yang yet resides in Yin. It stores Blood and Hun; if Hun is unsettled, Shen moves, causing Jing; if Blood is deficient, Zhi is depleted, causing Kong. These are endogenous conditions arising from disturbances in human Yin and Yang. The treatment principle is: for Jing, calm the Shen; for Kong, stabilize the Zhi. Shen belongs to Yang, which is Qi and Fire; Zhi belongs to Yin, which is Jing and Water. The mutual interaction of Water and Fire depends on Yin-Jing ascending to calm the Shen and Yang-Qi descending to stabilize the Zhi. When the Shen is calm, scattered Qi can be gathered; when Qi is gathered, the Yang pathway functions. When the Zhi is stabilized, lost Jing can be secured; when Jing is secured, Yin Qi functions properly. For Jing caused by external events, Zhang Zihe advocated the method of "Ping" (Leveling/Desensitization). "Ping" means making it ordinary; exposing the patient repeatedly to the stimulus until they become accustomed and no longer frightened is indeed a good method. However, I believe it is better to first help them calm their mind and regulate their Qi, followed by calming the Shen and stabilizing the Zhi, which is more appropriate.