论曰∶《内经》言风寒湿三气杂至，合而为痹。又曰∶以夏遇此为脉痹。脉痹不已，复
感于邪，内舍于心，是为心痹。其状脉不通，烦则心下鼓，曝上气而喘，嗌干善噫，厥气上
则恐。盖淫气忧思痹聚在心，经所谓诸痹不已，亦益内者如此。
治心痹神思昏塞，四肢不利，胸中烦闷，时复恐悸。茯神汤方。
茯神（去木） 羌活（去芦头） 龙齿 麦门冬（去心，焙） 麻黄（去根节，各一两）
蔓
荆实 人参 薏苡仁 防风（去叉） 远志（去心） 犀角屑（各三分） 赤芍药 甘草（微
炙
各半两）
上一十三味，粗捣筛。每服三钱匕，水一盏，生姜五片，同煎至七分，去滓温服，不计
时候。
治心痹胸中满塞，心中微痛，烦闷不能食。赤茯苓汤方。
赤茯苓（去黑皮） 人参 半夏（汤浸，洗七遍去滑，焙） 柴胡（去苗） 前胡（去
芦头）
桂（去粗皮） 桃仁（汤浸，去皮尖、双仁，炒各三分） 甘草（微炙一分）
上八味，粗捣筛。每服三钱匕，水一盏，生姜五片，枣二枚劈破，同煎至七分，去滓
热服，不计时候。
治心痹邪气乘虚，恍惚不乐，身体强直，面目变色。秦艽汤方。
秦艽（去苗土） 菖蒲 桂（去粗皮） 当归（切，焙） 蔓荆实 人参 附子（炮裂，
去皮
脐） 黄芩（去黑心） 甘草（炙） 远志（去心） 防风（去叉各半两） 龙骨 赤石脂 白
茯苓（
去黑皮） 白芍药 芎 防己各三分
上一十七味，锉如麻豆。每服三钱匕，水一盏，同煎至七分，去滓温服，不计时候。
治心痹忧思恍惚，惕惕然惊畏。紫石英散方。
紫石英（别研细，水飞过一两） 远志（去心） 赤小豆（炒） 附子（炮裂，去皮脐）
桂（
去粗皮） 人参 干姜（炮裂） 防风（去叉） 龙骨（别研） 菖蒲 熟干地黄（焙）各
半两 白
茯苓（去黑皮） 白术 黄 （锉各一两）
上一十四味，除别研外，捣罗为散，同拌匀，再研细。每服食前温酒调下二钱匕。
治心痹精神恍惚，恐畏闷乱，不得睡卧，志气不定，言语错误。犀角散方。
犀角屑 牛黄（别研） 麝香（别研） 羚羊角屑（各一分） 丹砂（别研半两） 防
风天
麻独活（去芦头） 人参 茯神（去木） 沙参（去芦头） 天竺黄（别研） 升麻 龙
齿各一分
麦门冬（去心，焙半两） 白藓皮（一分） 远志（去心一分） 龙脑（别研半分） 甘草
（微炙
一分）
上一十九味，除别研者外，捣罗为散，同研药一处拌匀，再研细。每服三钱匕，煎麦门
冬汤调下，不计时候。
论述说：《内经》提到风、寒、湿三种邪气混杂侵袭，结合而成痹证。又说：如果在夏季遭遇这些邪气，则形成脉痹。脉痹久治不愈，再次感受邪气，邪气内侵并留舍于心，这就称为心痹（心脏受邪所致的痹证）。其症状表现为血脉不通畅，心烦时感觉心下悸动如鼓，突然上逆之气导致气喘，咽喉干燥，容易嗳气，厥逆之气上冲则产生恐惧感。这是因为淫佚之邪因忧思而痹阻积聚于心脏，正如经文所说，各种痹证久治不愈，也会向内深入发展，情况正是如此。
治疗心痹导致的神志昏沉闭塞，四肢活动不利，胸中烦闷，时常惊恐心悸的茯神汤方。
药物组成：茯神（去除木质部分）、羌活（去除芦头）、龙齿、麦门冬（去除心部，焙干）、麻黄（去除根和节，各一两）、蔓荆实、人参、薏苡仁、防风（去除刺状物）、远志（去除心部）、犀角屑（各三分）、赤芍药、甘草（微炙，各半两）。
以上十三味药，粗捣筛碎。每次服用三钱匕，用水一盏，生姜五片，共同煎煮至七分满，去渣滓后温服，不限定具体时间。
治疗心痹导致胸中胀满堵塞，心中轻微疼痛，烦闷不能进食的赤茯苓汤方。
药物组成：赤茯苓（去除黑皮）、人参、半夏（用汤浸泡，清洗七遍以去除滑腻，焙干）、柴胡（去除苗）、前胡（去除芦头）、桂（去除粗皮）、桃仁（用汤浸泡，去除皮尖及双仁，炒制，各三分）、甘草（微炙一分）。
以上八味药，粗捣筛碎。每次服用三钱匕，用水一盏，生姜五片，大枣二枚劈破，共同煎煮至七分满，去渣滓后热服，不限定具体时间。
治疗心痹因邪气乘虚而入，出现神情恍惚不乐，身体强直，面目颜色改变的秦艽汤方。
药物组成：秦艽（去除苗土）、石菖蒲、桂（去除粗皮）、当归（切碎，焙干）、蔓荆实、人参、附子（炮裂，去除皮脐）、黄芩（去除黑心）、甘草（炙）、远志（去除心部）、防风（去除刺状物，各半两）、龙骨、赤石脂、白茯苓（去除黑皮）、白芍药、川芎、防己（各三分）。
以上十七味药，锉碎如麻豆大小。每次服用三钱匕，用水一盏，共同煎煮至七分满，去渣滓后温服，不限定具体时间。
治疗心痹因忧思导致神情恍惚，惊恐畏惧的紫石英散方。
药物组成：紫石英（单独研细，水飞法处理，一两）、远志（去除心部）、赤小豆（炒制）、附子（炮裂，去除皮脐）、桂（去除粗皮）、人参、干姜（炮裂）、防风（去除刺状物）、龙骨（单独研细）、石菖蒲、熟干地黄（焙干，各半两）、白茯苓（去除黑皮）、白术、黄芪（锉碎，各一两）。
以上十四味药，除需单独研细的药物外，捣碎过罗成为散剂，混合均匀，再研磨细。每次在饭前用温酒调服二钱匕。
治疗心痹导致精神恍惚，恐惧畏缩闷乱，无法睡眠躺卧，志气不定，言语错误的犀角散方。
药物组成：犀角屑、牛黄（单独研细）、麝香（单独研细）、羚羊角屑（各一分）、丹砂（单独研细半两）、防风、天麻、独活（去除芦头）、人参、茯神（去除木质部分）、沙参（去除芦头）、天竺黄（单独研细）、升麻、龙齿（各一分）、麦门冬（去除心部，焙干，半两）、白鲜皮（一分）、远志（去除心部，一分）、龙脑（单独研细半分）、甘草（微炙，一分）。
以上十九味药，除需单独研细的药物外，捣碎过罗成为散剂，与其他药物混合拌匀，再研磨细。每次服用三钱匕，用煎好的麦门冬汤调服，不限定具体时间。
Commentary states: The *Neijing* (Inner Canon) mentions that wind, cold, and dampness pathogenic factors mix and invade together, combining to form Bi syndrome (obstruction syndrome). It further states: If one encounters these pathogens in summer, it results in Mai Bi (pulse Bi syndrome). If Mai Bi persists and is not cured, and the body is again exposed to pathogens, the evil qi enters internally and lodges in the heart, which is termed Xin Bi (Heart Bi syndrome). Its manifestations include unsmooth pulse flow; when vexation occurs, there is a sensation of palpitation like drumming below the heart; sudden upward reversal of Qi leads to panting; the throat becomes dry; frequent belching occurs; and when rebellious Qi ascends, fear arises. This is because excessive Qi due to worry and thought becomes obstructed and accumulates in the heart. As the classic text says, various Bi syndromes that persist will also deepen internally, which is exactly the case here.
Fushen Tang (Poria with Hostwood Decoction) treats Heart Bi causing mental confusion and blockage, lack of mobility in the four limbs, chest vexation, and recurrent palpitations with fear.
Ingredients: Fushen (Poria with Hostwood, woody part removed), Qianghuo (Notopterygii Rhizoma et Radix, rhizome head removed), Longchi (Dragon Bone), Maimendong (Ophiopogonis Radix, core removed, baked), Mahuang (Ephedrae Herba, roots and joints removed, each 1 liang), Manjingzi (Viticis Fructus), Renshen (Ginseng Radix), Yiyiren (Coicis Semen), Fangfeng (Saposhnikoviae Radix, spines removed), Yuanzhi (Polygalae Radix, core removed), Xijiaoxie (Rhinocerotis Cornu, shaved, each 3 qian), Chishao Yao (Paeoniae Radix Rubra), Gancao (Glycyrrhizae Radix et Rhizoma, slightly roasted, each 0.5 liang).
The above thirteen ingredients are coarsely crushed and sifted. For each dose, take three qianbi (tea-spoonfuls), add one zhan (unit of volume) of water and five slices of Shengjiang (Fresh Ginger), decoct together until reduced to seven-tenths, remove the dregs, and take warm at any time.
Chifuling Tang (Red Poria Decoction) treats Heart Bi causing fullness and obstruction in the chest, slight pain in the heart region, vexation, and inability to eat.
Ingredients: Chifuling (Red Poria, black skin removed), Renshen (Ginseng Radix), Banxia (Pinelliae Rhizoma, soaked in decoction, washed seven times to remove slipperiness, baked), Chaihu (Bupleuri Radix, sprouts removed), Qianhu (Peucedani Radix, rhizome head removed), Gui (Cinnamomi Cortex, coarse bark removed), Taoren (Persicae Semen, soaked in decoction, skin and tips removed, twin kernels discarded, stir-fried, each 3 qian), Gancao (Glycyrrhizae Radix et Rhizoma, slightly roasted, 1 qian).
The above eight ingredients are coarsely crushed and sifted. For each dose, take three qianbi, add one zhan of water, five slices of Shengjiang (Fresh Ginger), and two Zao (Jujubae Fructus) split open, decoct together until reduced to seven-tenths, remove the dregs, and take hot at any time.
Qinjiao Tang (Gentianae Macrophyllae Radix Decoction) treats Heart Bi where pathogenic factors take advantage of deficiency, leading to absent-mindedness and unhappiness, stiffness and rigidity of the body, and changes in facial color.
Ingredients: Qinjiao (Gentianae Macrophyllae Radix, sprouts and soil removed), Changpu (Acori Tatarinowii Rhizoma), Gui (Cinnamomi Cortex, coarse bark removed), Danggui (Angelicae Sinensis Radix, sliced, baked), Manjingzi (Viticis Fructus), Renshen (Ginseng Radix), Fuzi (Aconiti Lateralis Radix Praeparata, cracked, skin and navel removed), Huangqin (Scutellariae Radix, black center removed), Gancao (Glycyrrhizae Radix et Rhizoma, roasted), Yuanzhi (Polygalae Radix, core removed), Fangfeng (Saposhnikoviae Radix, spines removed, each 0.5 liang), Longgu (Fossil Bones), Chishizhi (Halloysit Rubrum), Baifuling (White Poria, black skin removed), Baishao Yao (Paeoniae Radix Alba), Xiong (Ligustici Chuanxiong Rhizoma), Fangji (Stephaniae Tetrandrae Radix, each 3 qian).
The above seventeen ingredients are cut into pieces the size of hemp seeds. For each dose, take three qianbi, add one zhan of water, decoct together until reduced to seven-tenths, remove the dregs, and take warm at any time.
Zhiyanshi San (Fluorite Powder) treats Heart Bi caused by worry and thought, leading to absent-mindedness and palpitations with fear.
Ingredients: Zhiyanshi (Hematitum, separately ground fine, processed by water flotation, 1 liang), Yuanzhi (Polygalae Radix, core removed), Chixiaodou (Phaseoli Semen Rubrum, stir-fried), Fuzi (Aconiti Lateralis Radix Praeparata, cracked, skin and navel removed), Gui (Cinnamomi Cortex, coarse bark removed), Renshen (Ginseng Radix), Ganjiang (Zingiberis Rhizoma, cracked), Fangfeng (Saposhnikoviae Radix, spines removed), Longgu (Fossil Bones, separately ground), Changpu (Acori Tatarinowii Rhizoma), Shudigan Di Huang (Prepared Rehmanniae Radix, baked, each 0.5 liang), Baifuling (White Poria, black skin removed), Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqi (Astragali Radix, cut, each 1 liang).
The above fourteen ingredients, except those requiring separate grinding, are crushed, sieved into powder, mixed evenly, and ground fine again. Take two qianbi before meals, mixed with warm wine.
Xijiao San (Rhinoceros Horn Powder) treats Heart Bi causing spiritual absent-mindedness, fear and agitation, inability to sleep or lie down, unsettled spirit, and erroneous speech.
Ingredients: Xijiaoxie (Rhinocerotis Cornu, shaved), Niuhuang (Calculus Bovis, separately ground), Shexiang (Moschus, separately ground), Lingyangjiaoxie (Saigae Tataricae Cornu, shaved, each 1 fen), Dansha (Cinnabaris, separately ground, 0.5 liang), Fangfeng (Saposhnikoviae Radix), Tianma (Gastrodiae Rhizoma), Duhuo (Angelicae Pubescentis Radix, rhizome head removed), Renshen (Ginseng Radix), Fushen (Poria with Hostwood, woody part removed), Shashen (Glehniae Radix, rhizome head removed), Tianzhuhuang (Calamus Bambusae, separately ground), Shengma ( Cimicifugae Rhizoma), Longchi (Dragon Bone, each 1 fen), Maimendong (Ophiopogonis Radix, core removed, baked, 0.5 liang), Baixianpi (Dictamni Cortex, 1 fen), Yuanzhi (Polygalae Radix, core removed, 1 fen), Nao (Borneolum Syntheticum, separately ground, half fen), Gancao (Glycyrrhizae Radix et Rhizoma, slightly roasted, 1 fen).
The above nineteen ingredients, except those requiring separate grinding, are crushed, sieved into powder, mixed with other drugs evenly, and ground fine again. Take three qianbi, mixed with decocted Maimendong (Ophiopogonis Radix) soup, at any time.