【歌】惊悸心中常惕惕，如人将捕时惊惑。延缠不已渐怔忡，寤寐神魂多恍惚。精神短少或多痰，健忘之
病因而得。皆缘大恐与大惊，触事丧志心神失。
【论】夫人之所主者心，心之所养者血。心血一虚，神气失守，神去则舍空，舍空则郁而停痰，痰居心位，
此惊悸之所以肇端也。或耳闻大声，目击异物，遇险临危，触事丧志，则心为之忤，使人有惕惕之状，始则为
惊悸。久而心虚停饮，水气乘心，胸中渗漉，虚气流动，水既上乘，心火畏之，心不自安，故怏怏然而怔忡也。
日久不已，精神短少，心气空虚，神不清而生痰，痰迷心窍，则遇事多忘；亦因思虑过度，病在心脾，故令转
盼遗忘，名曰健忘。三者虽有浅深之殊，皆心脾之病，其所由来者一也。而治之之法，必审其脉之虚实，病之
浅深，元气之盛衰，则虚实邪正之情自了然矣。
【脉】惊悸怔忡，寸动而弱。寸紧关浮，悸病乃作。饮食痰火，伏动滑搏。浮微弦濡，忧惊过却。健忘
神亏，心虚浮薄。
惊悸
血虚惊悸者，四物汤加贝母、橘红、黄连、山栀，（方见血证。）安神丸。气血两虚者，益荣汤、（方
俱见女科。）天王补心丹。
天王补心丹
人参（四两） 玄参（二两） 杜仲（炒，去丝，四两） 天门冬（三两） 麦门冬（三两） 远志（四
两） 熟地黄（六两） 百部（三两） 桔梗（三两） 牡丹皮（四两） 柏子仁（四两） 五味子（四两） 甘草
（二两） 茯神（四两） 茯苓（四两） 石菖蒲（四两） 酸枣仁（四两）
末之，蜜丸，每下三钱。
怔忡
心血虚少，惕惕然恍惚怔忡，益荣汤。（方见女科。）痰火盛，心下怔忡者，温胆汤加炒黄连、山栀、
当归、贝母。（温胆汤即二陈汤加炒枳壳一钱、竹茹一钱，二陈方见痰证。）水气承心而作怔忡，朱雀丸。心
气郁滞，痰气结于心下而作怔忡，四七汤加竹沥、姜汁。（方见气证。）
朱雀丸
治水气怔忡。
白茯苓（一两） 沉香（半两）
末之，蜜丸桐子大，每服三十丸，人参汤送下。
健忘
思虑伤脾，作事忘前失后者，归脾汤。心气不定，恍惚多忘者，定志丸。年老神衰，遇事多忘，二丹丸。
痰多郁滞于心脾而善忘者，四七汤加竹沥、姜汁、胆星、栝蒌。（方见气证。）
归脾汤
治怔忡、健忘。
白术（一两） 茯神（一两） 黄 （一两） 圆眼肉（一两） 枣仁（炒，一两） 人参（半两） 木香
（半两） 甘草（二钱半，炙）
每服锉四钱，姜三片，枣一枚，水煎服。
定志丸
治恍惚多忘。
远志（一两） 人参（一两） 蒲黄（二两） 白茯苓（三两）
末之，蜜丸梧子大，辰砂为衣，每服三十丸，米汤下。
二丹丸
治健忘，开心志。
丹参（半两） 天门冬（半两） 熟地黄（二两） 麦门冬（一两） 白茯苓（一两） 人参（半两） 远志
（半两） 朱砂（半两） 石菖蒲（半两）
末之，炼蜜丸如桐子大，每五十丸至百丸，圆眼汤送下。
【歌诀】惊悸发作时，心中常常感到惊恐不安，就像有人要抓捕自己一样惊慌失措。如果病情拖延缠绵不愈，逐渐发展为怔忡，无论醒着还是睡着，神魂都显得恍惚不定。这是由于精神亏少或者体内有多余的痰浊，从而导致了健忘这一病症。这些情况都是由于遭受了极大的恐惧和惊吓，遇到事情丧失志气，导致心神失守所致。
【论述】人体所主宰的是心，心所滋养的是血。一旦心血虚弱，神气就会失去依附；神气离去则心舍空虚，心舍空虚则气机郁滞而停聚成痰，痰浊居于心的位置，这就是惊悸产生的根源。或者是听到巨大的声响，看到奇异的事物，遭遇危险面临危机，遇到事情丧失志气，那么心就会受到逆乱冲击，使人产生惊恐不安的状态，起初表现为惊悸。时间久了，心脏虚弱且体内停聚水饮，水气侵犯心脏，胸中漉漉作响，虚气流动，水邪既已上乘于心，心火畏惧水邪，心脏不能安宁，所以郁郁不乐而表现为怔忡。日子久了不停止，精神日益减少，心气空虚，神志不清而生出痰浊，痰迷心窍，那么遇到事情就容易遗忘；也是因为思虑过度，病变涉及心和脾，所以转眼之间就忘记事情，这叫做健忘。这三种病证虽然有浅深程度的不同，但都属于心和脾的疾病，其产生的原因是一致的。而治疗的方法，必须审察脉象的虚实、病情的浅深、元气的盛衰，那么虚实邪正的情况自然就会清楚明了。
【脉诊】惊悸和怔忡，寸口脉动而弱。如果寸脉紧、关脉浮，惊悸之病就会发作。如果是饮食停滞、痰火内伏，脉象表现为滑搏有力。如果脉象浮微弦濡，说明是由于忧虑和惊吓过度所致。健忘是因为神气亏损，心气虚弱导致脉象浮薄。
惊悸
因血虚引起的惊悸，使用四物汤加贝母、橘红、黄连、山栀（方剂见血证章节），配合安神丸。气血两虚者，使用益荣汤（方剂俱见女科章节）、天王补心丹。
天王补心丹
人参（四两） 玄参（二两） 杜仲（炒，去丝，四两） 天门冬（三两） 麦门冬（三两） 远志（四两） 熟地黄（六两） 百部（三两） 桔梗（三两） 牡丹皮（四两） 柏子仁（四两） 五味子（四两） 甘草（二两） 茯神（四两） 茯苓（四两） 石菖蒲（四两） 酸枣仁（四两）
研为细末，用蜂蜜制成丸药，每次服用三钱。
怔忡
心血虚少，心中惕惕然恍惚怔忡，使用益荣汤（方剂见女科章节）。痰火旺盛，心下感到怔忡的，使用温胆汤加炒黄连、山栀、当归、贝母。（温胆汤即二陈汤加炒枳壳一钱、竹茹一钱，二陈方见痰证章节）。水气侵犯心脏而引发怔忡的，使用朱雀丸。心气郁滞，痰气结聚于心下而引发怔忡的，使用四七汤加竹沥、姜汁（方剂见气证章节）。
朱雀丸
治疗水气引起的怔忡。
白茯苓（一两） 沉香（半两）
研为细末，用蜂蜜制成梧桐子大小的丸药，每次服用三十丸，用人参汤送服。
健忘
思虑损伤脾气，做事前事不忘后事忘的，使用归脾汤。心气不定，恍惚多忘的，使用定志丸。年老神气衰弱，遇事多忘的，使用二丹丸。痰多郁滞于心脾而善于遗忘的，使用四七汤加竹沥、姜汁、胆星、栝蒌（方剂见气证章节）。
归脾汤
治疗怔忡、健忘。
白术（一两） 茯神（一两） 黄芪（一两） 圆眼肉（一两） 枣仁（炒，一两） 人参（半两） 木香（半两） 甘草（二钱半，炙）
每次取药锉碎四钱，加生姜三片，大枣一枚，用水煎服。
定志丸
治疗恍惚多忘。
远志（一两） 人参（一两） 蒲黄（二两） 白茯苓（三两）
研为细末，用蜂蜜制成梧桐子大小的丸药，朱砂为衣，每次服用三十丸，用米汤送服。
二丹丸
治疗健忘，开心志。
丹参（半两） 天门冬（半两） 熟地黄（二两） 麦门冬（一两） 白茯苓（一两） 人参（半两） 远志（半两） 朱砂（半两） 石菖蒲（半两）
研为细末，炼蜜制成梧桐子大小的丸药，每次五十丸至一百丸，用桂圆汤送服。
[Verse] In cases of Jingji (Palpitations due to fright) and Zhengchong (Persistent palpitations), the heart often feels terrified, as if someone is about to capture them, causing panic and confusion. If the condition lingers without cessation, it gradually develops into Zhengchong, where the spirit and soul remain恍惚 (trance-like/unstable) whether awake or asleep. This arises from a deficiency of spirit and essence or from excessive phlegm, leading to the disease of Jianwang (Amnesia). All these stem from great fear and sudden fright; encountering events causes one to lose their will, resulting in the loss of Shen (Spirit) control.
[Discussion] The organ that governs the human body is the Heart, and what nourishes the Heart is Blood. Once Heart Blood becomes deficient, the Shen (Spirit) loses its residence. When the Shen departs, the Heart residence becomes empty; emptiness leads to Qi stagnation and the retention of Phlegm. When Phlegm occupies the position of the Heart, this marks the beginning of Jingji (Palpitations due to fright). Alternatively, hearing loud noises, seeing strange objects, encountering danger, or facing crises can cause one to lose their resolve, disrupting the Heart and inducing a state of terror, initially manifesting as Jingji (Palpitations due to fright). Over time, Heart deficiency leads to fluid retention; Water Qi invades the Heart, causing a sloshing sensation in the chest. As deficient Qi moves and Water rises to overwhelm the Heart, the Heart Fire fears the Water, causing the Heart to feel insecure, thus resulting in YuYu (depressed mood) and Zhengchong (Persistent palpitations). If prolonged, Spirit and Essence become depleted, Heart Qi becomes empty, and unclear Shen generates Phlegm. When Phlegm confuses the Heart orifices, one easily forgets upon encountering events. This also occurs due to excessive overthinking, affecting the Heart and Spleen, causing one to forget things instantly, known as Jianwang (Amnesia). Although these three conditions differ in depth and severity, they are all diseases of the Heart and Spleen, sharing a common origin. The treatment method must carefully examine the deficiency or excess of the pulse, the superficiality or profundity of the disease, and the strength or weakness of Yuan Qi (Primal Qi), so that the nature of deficiency, excess, pathogenic factors, and healthy Qi will become clear.
[Pulse Diagnosis] In Jingji (Palpitations due to fright) and Zhengchong (Persistent palpitations), the Cun (Inch) pulse is moving but weak. If the Cun pulse is tight and the Guan (Carpal) pulse is floating, the disease of Ji (Palpitations) arises. Due to food retention, Phlegm, and Fire, the pulse may be Fu Dong Hua Bo (Surging, Sliding, and Forceful). If the pulse is Floating, Micro, Wiry, and Soft, it indicates excessive worry and fright. Jianwang (Amnesia) results from Spirit deficiency, with a Heart-deficient, Floating, and Thin pulse.
Jingji (Palpitations due to fright)
For Jingji (Palpitations due to fright) caused by Blood deficiency, use Siwu Tang (Four Substances Decoction) added with Bei Mu (Fritillaria Bulb), Ju Hong (Tangerine Peel), Huang Lian (Coptis Rhizome), and Shan Zhi (Gardenia Fruit) (Formula see Blood Syndromes chapter), along with Anshen Wan (Calming the Spirit Pill). For dual deficiency of Qi and Blood, use Yirong Tang (Nourishing Prosperity Decoction) (Formula see Gynecology chapter) and Tianwang Buxin Dan (Emperor of Heaven's Special Pill to Tonify the Heart).
Tianwang Buxin Dan (Emperor of Heaven's Special Pill to Tonify the Heart)
Renshen (Ginseng Radix et Rhizoma) (4 liang), Xuanshen (Scrophulariae Radix) (2 liang), Duzhong (Eucommiae Cortex) (stir-fried, silk removed, 4 liang), Tiantaomen Dong (Asparagi Radix) (3 liang), Maimendong (Ophiopogonis Radix) (3 liang), Yuanzhi (Polygalae Radix) (4 liang), Shudihuang (Rehmanniae Radix Preparata) (6 liang), Baibu (Stemonae Radix) (3 liang), Jiegeng (Platycodonis Radix) (3 liang), Mudanpi (Moutan Cortex) (4 liang), Baiziren (Biota Seed) (4 liang), Wuweizi (Schisandrae Fructus) (4 liang), Gancao (Licorice Root) (2 liang), Fushen (Poria with Hostwood) (4 liang), Fuling (Poria) (4 liang), Shichangpu (Acori Tatarinowii Rhizoma) (4 liang), Suanzaoren (Ziziphi Spinosae Semen) (4 liang).
Grind into fine powder, make pills with honey, each pill weighing 3 qian.
Zhengchong (Persistent palpitations)
When Heart Blood is deficient and scant, causing a terrified, trance-like Zhengchong (Persistent palpitations), use Yirong Tang (Nourishing Prosperity Decoction) (Formula see Gynecology chapter). When Phlegm-Fire is abundant and there is Zhengchong (Persistent palpitations) below the heart, use Wendan Tang (Warm the Gallbladder Decoction) added with stir-fried Huang Lian (Coptis Rhizome), Shan Zhi (Gardenia Fruit), Danggui (Angelicae Sinensis Radix), and Bei Mu (Fritillaria Bulb). (Wendan Tang is Erchen Tang (Two Aged Ingredients Decoction) added with 1 qian stir-fried Zhike (Aurantii Fructus) and 1 qian Zhuru (Bambusae Caulis in Taenia)). For Zhengchong (Persistent palpitations) caused by Water Qi overwhelming the Heart, use Zhuque Wan (Vermilion Bird Pill). For Zhengchong (Persistent palpitations) caused by Heart Qi stagnation and Phlegm-Qi knotting below the heart, use Siqi Tang (Seven Emotions Decoction) added with Zhuli (Bambusae Succus) and Jiangzhi (Zingiberis Rhizoma Juice) (Formula see Qi Syndromes chapter).
Zhuque Wan (Vermilion Bird Pill)
Treats Zhengchong (Persistent palpitations) caused by Water Qi.
Baifuling (Poria) (1 liang), Chenxiang (Aquilariae Lignum Resinatum) (0.5 liang).
Grind into fine powder, make pills the size of mulberry seeds with honey, take 30 pills per dose, washed down with Renshen Tang (Ginseng Decoction).
Jianwang (Amnesia)
When overthinking injures the Spleen, causing forgetfulness of past actions, use Guipi Tang (Restore the Spleen Decoction). When Heart Qi is unstable, causing trance and frequent forgetting, use Dingzhi Wan (Stabilize the Spirit Pill). When elderly people suffer from Spirit decline and frequent forgetting upon events, use Erdan Wan (Two Dan Pills). When excessive Phlegm stagnates in the Heart and Spleen leading to easy forgetting, use Siqi Tang (Seven Emotions Decoction) added with Zhuli (Bambusae Succus), Jiangzhi (Zingiberis Rhizoma Juice), Dansheng (Arisaematis Cum Bile) and Gualou (Trichosanthis Fructus) (Formula see Qi Syndromes chapter).
Guipi Tang (Restore the Spleen Decoction)
Treats Zhengchong (Persistent palpitations) and Jianwang (Amnesia).
Baizhu (Atractylodis Macrocephalae Rhizoma) (1 liang), Fushen (Poria with Hostwood) (1 liang), Huangqi (Astragali Radix) (1 liang), Yuanyanrou (Longan Aril) (1 liang), Zaoren (Ziziphi Spinosae Semen) (stir-fried, 1 liang), Renshen (Ginseng Radix et Rhizoma) (0.5 liang), Muxiang (Aucklandiae Radix) (0.5 liang), Gancao (Licorice Root) (2.5 qian, honey-fried).
Each dose: chop 4 qian of herbs, add 3 slices of fresh ginger and 1 jujube, decoct in water and drink.
Dingzhi Wan (Stabilize the Spirit Pill)
Treats trance and frequent forgetting.
Yuanzhi (Polygalae Radix) (1 liang), Renshen (Ginseng Radix et Rhizoma) (1 liang), Puhuang (Typhae Pollen) (2 liang), Baifuling (Poria) (3 liang).
Grind into fine powder, make pills the size of mulberry seeds with honey, coat with Zhusha (Cinnabar), take 30 pills per dose, washed down with rice soup.
Erdan Wan (Two Dan Pills)
Treats Jianwang (Amnesia), opens the mind and spirit.
Danshen (Salviae Miltiorrhizae Radix et Rhizoma) (0.5 liang), Tiantaomen Dong (Asparagi Radix) (0.5 liang), Shudihuang (Rehmanniae Radix Preparata) (2 liang), Maimendong (Ophiopogonis Radix) (1 liang), Baifuling (Poria) (1 liang), Renshen (Ginseng Radix et Rhizoma) (0.5 liang), Yuanzhi (Polygalae Radix) (0.5 liang), Zhusha (Cinnabar) (0.5 liang), Shichangpu (Acori Tatarinowii Rhizoma) (0.5 liang).
Grind into fine powder, make pills the size of mulberry seeds with refined honey, take 50 to 100 pills per dose, washed down with Longan soup.