者。去半夏。加栝蒌根一两。胸中痞硬者。去枣。加 了牡蛎粉一两。伤寒十三日不解。胁
满而呕。日晡则发潮热。已而微利。及医以丸药利之。利之。非其治也。宜芒硝一两。伤寒
十余日。结热在里。往来寒热。或心下急。郁郁微烦。或舌生白胎。大便不通。或发汗出。
或腹中满。或日晡发热如疟。或六七日目中不了了。睛不和。无表里证。大便难。身微热者。
大实也。去人参。加枳实半两。大黄一两。名大柴胡汤。服之以利为度。热除。不宜遽服补
药。仍忌酒、羊肉、腰子。及难化之物。或有所伤。是名食复。难以治疗。饮食须是大段节
省。不可多食。谨忌两月。仍避房室。
治伤寒烦热（出本草方）
以乌梅水渍。饮汁。
夫伤寒心悸者。谓心下悸动也。此由伤寒病。发汗以后。因又下之。内有虚热发渴。渴
则饮。水气乘心。必振寒而心下悸也。太阳病。小便不利者。为多饮水。心下必悸。小便少
者。必苦里急。夫脉浮数。法当汗出而愈。下之则身体重。心必悸也。不可发其汗。当自汗
出而解。所以然者。尺中微。里虚表实。津液自和。当自汗出愈也。伤寒心下悸者。谓悸动
不定也。伤寒饮水过多。水停心下。肾气乘心。则心气虚弱。故为之悸动也。此皆由发汗以
后。又下之。津液燥少。若内生虚热。热则饮水。水气停积。故必振寒而心下悸也。伤寒心
悸者。心忪是也。筑筑踢踢然动。怔怔忪忪不能自安者是矣。心悸之由。不越二种。一者气
虚也。二者停饮也。伤寒二三日。悸而烦者。小建中汤主之。少阴病。四逆。其人或悸者。
四逆散。加桂五分。是气虚而悸者也。饮水多。必心下悸。是停饮而悸者也。其气虚者。由
阳气内弱。心下空虚。正气内动而为悸也。其停饮者。由水停心下。心为火而恶水。水既内
停。心不自安。则为悸也。又有汗下之后。正气内虚。邪气交击而令悸者。与气虚而悸者。
则又甚焉。太阳病。发汗过多。其人叉手自冒。必心下悸。太阳病。若下之。身重。心下悸
者。不可发汗。少阳病。不可吐下。吐下。则悸而惊。少阳病。不可发汗。发汗。则 语。
此属胃。胃和则愈。胃不和。则烦而悸。是数者。皆汗后协邪者。与其气虚而悸者。有以异
也。或镇固。或化散之。皆须定其气浮也。又饮水过多。水饮不为宣布。留心下。甚者则悸。
金
何者。以水停心下。若水气散。则无所不之。浸于肺。则为喘为咳。传于胃。则为哕为噎。
溢于皮肤。则为肿。渎于肠间。则为利下。不可缓之也。经曰。厥而心下悸。宜先治其水。
与茯苓甘草汤。后治其厥。不尔。水渍入胃。必作利也。厥为邪之深者。犹先治水。况其邪
气浅者乎。医者可不深究之。活人书曰。水气乘心。振寒而悸。茯苓甘草汤。伤寒二三日。
心中悸而烦。小建中汤发汗。脐下悸。欲作奔豚。自有本条。发汗过多。心下悸。欲得按者
。桂枝甘草汤。发汗出。仍发热。心下悸。身 动。振振欲擗地。真武汤。脉结代心动悸。
炙甘草汤。少阴不可发汗。汗则 语。此属胃。胃不和。故悸。小柴胡汤。中风往来寒热。
或心下悸。小柴胡汤。厥而心下悸。悸者。怔忪也。宜先治水。茯苓甘草汤。次治其厥。自
有本条。
又歌曰。心悸三阳证自详。粪坚 语胃调汤。冒旋甘桂 真武。小建中兼炙草方。
动悸多生于停水。或阳气向弱。心下虚空。正气内动致之。或汗下以后。正气内虚。邪
气与之击搏而然也。此盖心悸而气动。其与惊惕不同焉。太阳病。小便利者。以饮水多。故
心下悸。小便少
心下悸。小便不利
脉弦细。头痛。发热。误汗之。必 语。转属胃。胃和则愈。胃不和。则烦而悸。大便硬属
胃。调胃承气汤。然调胃承气汤太峻。证治论。只用小柴胡汤。粪硬者。可加大黄。烦躁者。
可入芒硝些少。凡
心下悸。欲得按者。桂枝甘草汤。太阳病。发汗不解。仍发热。心下悸。头眩。肌体
振振欲擗地者。真武汤主之。或理中汤加茯苓。伤寒二三日。心中悸而烦。与小建中汤。经
云。先烦而后悸者。为热。先悸而后烦者。为虚。惟虚则小建中主之。少阳病。耳聋目赤。
胸满而烦。妄加吐下。则悸而惊。可与小建中汤。如有热证。即以小柴胡继之。伤寒脉结代。
心动悸。炙甘草汤。少阴四逆证。其人或悸。以四逆散加桂主之。心下水气。厥而悸
治水。茯苓甘草汤。然后治厥。有本条。不然。水入胃。必下利也。伤寒多因吐下。或火熏。
或温针。以致惊惕。太阳病。若下之。胸满烦惊。小便不利。 语。身重难以转侧，用柴胡
牡蛎龙骨汤。不可发汗。汗多则亡阳。风温脉阴阳俱浮。妄用火熏。以致发黄。剧则惊痫。
时时螈 。经曰。一逆尚引日。再逆促命期。合用金匮风引汤。
方
大柴胡汤（出圣惠方）治伤寒二三日。心中悸。呕不止。心急郁郁微烦者。尚
不解。
柴胡（二两去苗） 黄芩（一两） 赤芍药 半夏（汤洗七遍去滑） 赤茯苓 枳实（麸
炒令
黄） 白术（以上各一两） 槟榔 上捣粗罗为散。每服四钱。水一中盏。入生姜半分。枣
三
枚。煎至六分。去滓。不计时候。温服。
白茯苓散（出圣惠方）治伤寒里虚。心下悸。腹中气不和。
槟榔（一两） 青橘皮（半两汤浸去白瓤焙） 白茯苓（半两） 浓朴（一两去粗皮涂
生姜汁
炙令香熟） 桂心（一两） 甘草（半两炙微赤锉） 附子（一两炮裂去皮脐） 上捣筛为
散。每
服四钱。水一中盏。入生姜半分。煎至六分。去滓。不计时候。温服。
人参散（出圣惠方）治伤寒发汗。热不解。心下悸。头眩。身 振。
人参（去芦头） 赤芍药 附子（炮裂去皮脐） 白术（以上各一两） 甘草（半两炙
微赤锉）
赤茯苓（一两） 上捣筛为散。每服四钱。水一中盏。入生姜半分。煎至六分。去滓。不计
时
候。温服。
桂心散（出圣惠方）治伤寒发汗过多。其人以手扪心。心下悸。欲得按者。
桂心 甘草（炙微赤锉） 人参（去芦头） 白术 赤茯苓（以上各一两） 枳实（半
两麸炒
令微黄） 上捣粗罗为散。每服四钱。水一中盏。煎至六分。去滓。不计时候。温
芎 散（出圣惠方）治伤寒已得汗。其人仍发热。心下悸。头痛目眩。心神烦
喘。
芎 桔梗（去芦头） 前胡（去芦头） 石膏 人参（去芦头） 白茯苓 麦门冬（去
心以
上各一两） 旋复花（半两） 枳壳（半两麸炒微黄去瓤） 上捣粗罗为散。每服四钱。水
一中
盏。入生姜半分。枣三枚。煎至六分。去滓。不计时候。温服。
甘草散（出圣惠方）治伤寒脉结代者。心下悸也。
甘草（炙微赤锉） 茯神 远志（去心） 苍术（以上各一两） 枳实（半两麸炒微黄）
上捣
粗罗为散。每服三钱。水一中盏。入生姜半分。煎至五分。去滓。不计时候。温服。
治伤寒未得汗。心悸而烦。头目不利。宜服此方。（出圣惠方）
桂心（一两锉） 甘草（半两炙微赤锉） 生姜（一分切） 大枣（五枚去核） 饴糖
（一两）
上件药。水一大盏半。煎至一盏。次入饴糖。更煎三五沸。去滓。不计时候。分为二服。
桂枝汤（出圣惠方）治伤寒水在心下。心悸动。欲得人按。
桂（去粗皮二两） 赤茯苓（去黑皮一两半） 白术（一两） 甘草（炙锉三分） 陈
橘皮（汤
浸去白焙半两） 上粗捣筛。每服五钱匕。水盏半。煎取七分。去滓。温服。不拘时。
赤茯苓汤（出圣济总录）治伤寒饮水过多。心下悸动不定。
赤茯苓（去黑皮二两） 陈橘皮（汤浸去白焙二两） 白术（三分） 半夏（汤浸七遍
切焙二
两） 枳壳（麸炒去瓤半两） 人参（一两） 上粗捣筛。每服五钱。水一盏半。入生姜半
分。
拍碎。同煎取八分。去滓。温服。不拘时候。
茯苓半夏汤（出圣济总录）治伤寒呕哕。心下悸动。胸膈有滞水。往往头眩。
赤茯苓（去黑皮二两） 半夏〔汤洗七遍炒干二（三）两〕 陈橘皮（汤洗去白焙一两）
上
粗捣筛。每服五钱匕。水一盏半。入生姜一分。拍碎。同煎至七分。去滓。温服。晚再服。
茯苓白术汤 治伤寒吐后。心下逆满。忪悸不定。起即头眩。
赤茯苓（去黑皮一两） 白术〔二（三）分〕 桂（去粗皮三分） 芎 （一两） 甘
草（炙锉
半两） 上粗捣筛。每服三钱匕。水一盏。煎至六分。去滓。温服。
茯苓桂枝汤 治伤寒发汗后。引饮过多。心下悸动。
赤茯苓（去黑皮） 桂（去粗皮） 半夏（汤洗七遍炒干各一两重） 甘草（炙锉半两）
上粗
捣筛。每服三钱。水一盏。入生姜半分。拍碎。同煎至七分。去滓。温服。
桂心汤 治伤寒心下有饮。悸动不定。
桂（去粗皮一两） 槟榔（锉） 半夏（汤洗七遍炒各半两） 上 咀如麻豆大。每服
四钱
匕。水一盏半。入生姜五片。同煎至七分。去滓。食前温服。如人行三五里。再服。
治伤寒脉结代者。
上用甘草三两。水三升。煮取一升半。服七合。日三。
炙甘草汤 治虚劳不足。汗出而闷。脉结。悸。行动如常。不出百日。危急者十一
日死。
甘草（四两炒） 桂枝 生姜（各三两） 麦门冬（半升） 麻仁（半升） 人参 阿
胶（各二
两） 大枣（三十枚） 生地黄（一升） 上九味。以酒七升。水八升。先煮八味。取三升。
去
滓。纳胶消尽。温服一升。日三服。
半夏麻黄丸 治心下悸者。
半夏 麻黄（等分） 上二味。末之。炼蜜和丸小豆大。饮服三丸。日三服。
（若出现）口渴，则去掉半夏，加入栝蒌根一两。胸中痞塞硬满者，去掉大枣，加入牡蛎粉一两。伤寒病十三日未解，胁部胀满且呕吐，傍晚时分出现潮热，随后轻微腹泻。这是医生误用丸药攻下所致，这种治法是不对的。适宜使用芒硝一两。
伤寒十余日，邪热结聚在里，寒热往来，或者心下部急迫，心中郁郁微烦，或者舌上生白苔，大便不通，或者发汗后出汗，或者腹部胀满，或者傍晚发热像疟疾一样，或者六七日眼睛视物不清，眼球转动不灵活。若无表证也无典型的里实证，但大便困难，身体微热，这是大实之证。此时应去掉人参，加入枳实半两、大黄一两，名为大柴胡汤。服用以通利为度。热退后，不宜立即服用补药。仍要忌食酒、羊肉、腰子及难消化的食物。若有饮食损伤，这就叫做“食复”，难以治疗。饮食必须大大节制，不可多吃，谨慎忌口两个月，同时避免房事。
治疗伤寒烦热（出自《本草方》）：
用乌梅在水中浸泡，饮用其汁液。
所谓伤寒心悸，是指心下部悸动不安。这由于患伤寒病，发汗之后，又用了泻下法，导致体内虚热引发口渴，口渴则饮水，水气乘袭心脏，必然出现畏寒颤抖且心下部悸动。太阳病，小便不利的人，如果大量饮水，心下部必定悸动；小便少的人，必定苦于里急后重。脉象浮数，按理应通过发汗而痊愈，若误用泻下法，则身体沉重，心必悸动，此时不可再发汗，应当等待自汗出而病解。之所以这样，是因为尺中脉微，表示里虚表实，津液自然调和，应当自汗出而痊愈。
伤寒心下部悸动，是指悸动不定。伤寒后饮水过多，水停积在心下，肾气乘袭心脏，导致心气虚弱，所以发生悸动。这都是因为发汗以后，又用了泻下法，津液干燥减少，若内生虚热，热则饮水，水气停积，所以必然畏寒颤抖且心下部悸动。伤寒心悸，就是心忪（心慌），感觉心脏筑筑踢踢地跳动，怔怔忪忪不能自我安宁。心悸的原因，不外乎两种：一是气虚，二是停饮。
伤寒二三日，心悸且烦躁的，用小建中汤主治。少阴病，四肢厥逆，其人若有心悸的，用四逆散加桂枝五分，这是气虚而致悸。饮水多，必心下悸，这是停饮而致悸。气虚者，是由于阳气内弱，心下空虚，正气内动而导致悸。停饮者，是由于水停心下，心属火而恶水，水既内停，心不自安，则为悸。又有发汗、泻下之后，正气内虚，邪气交击而导致心悸的，比气虚而悸更严重。
太阳病，发汗过多，其人双手交叉护住心胸部，必心下悸。太阳病，若误用泻下法，身体沉重，心下悸的，不可发汗。少阳病，不可用吐法和下法，误用吐下，则心悸且惊骇。少阳病，不可发汗，发汗则谵语，此属胃，胃和则愈，胃不和，则烦闷而心悸。这些情况，都是汗后协邪所致，与气虚而悸有所不同。治疗或镇固，或化散，都必须确定是气浮。
另外，饮水过多，水饮不得宣散，留心于心下，严重时则悸。为什么呢？因为水停心下，若水气散漫，则无处不到。浸淫于肺，则为喘为咳；传于胃，则为哕为噎；溢于皮肤，则为肿；渎于肠间，则为下利。这种情况不可迟缓。经书说：“四肢厥冷且心下悸，宜先治水，给予茯苓甘草汤，然后再治厥。”如果不这样，水渍入胃，必定造成下利。厥是邪气深入的表现，尚且要先治水，何况邪气浅表的呢？医者不可不深究。《活人书》说：“水气乘心，振寒而悸，用茯苓甘草汤。”
伤寒二三日，心中悸且烦，用小建中汤。发汗后脐下悸，欲作奔豚，自有本条论述。发汗过多，心下悸，想要按压的，用桂枝甘草汤。发汗后仍发热，心下悸，身体肌肉跳动，震颤欲倒地的，用真武汤。脉结代，心动悸的，用炙甘草汤。少阴病不可发汗，发汗则谵语，此属胃，胃不和，故悸。小柴胡汤治中风往来寒热，或心下悸。厥而心下悸，悸即怔忪，宜先治水，用茯苓甘草汤，其次治其厥，自有本条。
又有歌诀说：“心悸三阳证自详，粪坚谵语胃调汤。冒旋甘桂真武，小建中兼炙草方。”
动悸多生于停水，或阳气向弱，心下虚空，正气内动导致。或汗下以后，正气内虚，邪气与之搏击而然。这大概是心悸而气动，与惊惕不同。太阳病，小便利者，因饮水多，故心下悸；小便少，心下悸；小便不利，心下悸。脉弦细，头痛，发热，误用发汗，必谵语，转属胃，胃和则愈，胃不和，则烦而悸。大便硬属胃，用调胃承气汤。然而调胃承气汤太峻烈，《证治论》只用小柴胡汤。粪硬者，可加大黄；烦躁者，可入少许芒硝。凡心下悸，想要按压的，用桂枝甘草汤。太阳病，发汗不解，仍发热，心下悸，头眩，肌体振振欲倒地者，真武汤主治。或用理中汤加茯苓。伤寒二三日，心中悸而烦，与小建中汤。经云：先烦而后悸者，为热；先悸而后烦者，为虚。只有虚证才用小建中汤主治。少阳病，耳聋目赤，胸满而烦，妄加吐下，则悸而惊，可与小建中汤。如有热证，即以小柴胡汤继之。伤寒脉结代，心动悸，用炙甘草汤。少阴四逆证，其人若悸，以四逆散加桂主治。心下水气，厥而悸，先治水，用茯苓甘草汤，然后治厥，自有本条。不然，水入胃，必下利也。
伤寒多因吐下，或火熏，或温针，以致惊惕。太阳病，若误用泻下法，胸满烦惊，小便不利，谵语，身体沉重难以转侧，用柴胡加龙骨牡蛎汤。不可发汗，汗多则亡阳。风温脉阴阳俱浮，妄用火熏，以致发黄，剧则惊痫，时时抽搐。经曰：“一逆尚引日，再逆促命期。”合用金匮风引汤。
大柴胡汤（出自《圣惠方》）：治疗伤寒二三日，心中悸，呕不止，心急郁郁微烦，尚不解。
药材：柴胡（二两，去苗）、黄芩（一两）、赤芍药、半夏（汤洗七遍去滑）、赤茯苓、枳实（麸炒令黄）、白术（以上各一两）、槟榔。
制法：捣粗罗为散。每服四钱，水一中盏，入生姜半分，枣三枚，煎至六分，去滓，不计时候，温服。
白茯苓散（出自《圣惠方》）：治疗伤寒里虚，心下悸，腹中气不和。
药材：槟榔（一两）、青橘皮（半两，汤浸去白瓤焙）、白茯苓（半两）、浓朴（一两，去粗皮涂生姜汁炙令香熟）、桂心（一两）、甘草（半两，炙微赤锉）、附子（一两，炮裂去皮脐）。
制法：捣筛为散。每服四钱，水一中盏，入生姜半分，煎至六分，去滓，不计时候，温服。
人参散（出自《圣惠方》）：治疗伤寒发汗，热不解，心下悸，头眩，身振。
药材：人参（去芦头）、赤芍药、附子（炮裂去皮脐）、白术（以上各一两）、甘草（半两，炙微赤锉）、赤茯苓（一两）。
制法：捣筛为散。每服四钱，水一中盏，入生姜半分，煎至六分，去滓，不计时候，温服。
桂心散（出自《圣惠方》）：治疗伤寒发汗过多，其人用手扪心，心下悸，欲得按者。
药材：桂心、甘草（炙微赤锉）、人参（去芦头）、白术、赤茯苓（以上各一两）、枳实（半两，麸炒令微黄）。
制法：捣粗罗为散。每服四钱，水一中盏，煎至六分，去滓，不计时候，温服。
芎䓖散（出自《圣惠方》）：治疗伤寒已得汗，其人仍发热，心下悸，头痛目眩，心神烦喘。
药材：芎䓖、桔梗（去芦头）、前胡（去芦头）、石膏、人参（去芦头）、白茯苓、麦门冬（去心，以上各一两）、旋复花（半两）、枳壳（半两，麸炒微黄去瓤）。
制法：捣粗罗为散。每服四钱，水一中盏，入生姜半分，枣三枚，煎至六分，去滓，不计时候，温服。
甘草散（出自《圣惠方》）：治疗伤寒脉结代者，心下悸也。
药材：甘草（炙微赤锉）、茯神、远志（去心）、苍术（以上各一两）、枳实（半两，麸炒微黄）。
制法：捣粗罗为散。每服三钱，水一中盏，入生姜半分，煎至五分，去滓，不计时候，温服。
治伤寒未得汗，心悸而烦，头目不利，宜服此方（出自《圣惠方》）：
药材：桂心（一两，锉）、甘草（半两，炙微赤锉）、生姜（一分，切）、大枣（五枚，去核）、饴糖（一两）。
制法：上件药，水一大盏半，煎至一盏，次入饴糖，更煎三五沸，去滓，不计时候，分为二服。
桂枝汤（出自《圣惠方》）：治疗伤寒水在心下，心悸动，欲得人按。
药材：桂（去粗皮二两）、赤茯苓（去黑皮一两半）、白术（一两）、甘草（炙锉三分）、陈橘皮（汤浸去白焙半两）。
制法：上粗捣筛。每服五钱匕，水盏半，煎取七分，去滓，温服，不拘时。
赤茯苓汤（出自《圣济总录》）：治疗伤寒饮水过多，心下悸动不定。
药材：赤茯苓（去黑皮二两）、陈橘皮（汤浸去白焙二两）、白术（三分）、半夏（汤浸七遍切焙二两）、枳壳（麸炒去瓤半两）、人参（一两）。
制法：上粗捣筛。每服五钱，水一盏半，入生姜半分，拍碎，同煎取八分，去滓，温服，不拘时候。
茯苓半夏汤（出自《圣济总录》）：治疗伤寒呕哕，心下悸动，胸膈有滞水，往往头眩。
药材：赤茯苓（去黑皮二两）、半夏〔汤洗七遍炒干二（三）两〕、陈橘皮（汤洗去白焙一两）。
制法：上粗捣筛。每服五钱匕，水一盏半，入生姜一分，拍碎，同煎至七分，去滓，温服，晚再服。
茯苓白术汤：治疗伤寒吐后，心下逆满，忪悸不定，起即头眩。
药材：赤茯苓（去黑皮一两）、白术〔二（三）分〕、桂（去粗皮三分）、芎䓖（一两）、甘草（炙锉半两）。
制法：上粗捣筛。每服三钱匕，水一盏，煎至六分，去滓，温服。
茯苓桂枝汤：治疗伤寒发汗后，引饮过多，心下悸动。
药材：赤茯苓（去黑皮）、桂（去粗皮）、半夏（汤洗七遍炒干各一两重）、甘草（炙锉半两）。
制法：上粗捣筛。每服三钱，水一盏，入生姜半分，拍碎，同煎至七分，去滓，温服。
桂心汤：治疗伤寒心下有饮，悸动不定。
药材：桂（去粗皮一两）、槟榔（锉）、半夏（汤洗七遍炒各半两）。
制法：上㕮咀如麻豆大。每服四钱匕，水一盏半，入生姜五片，同煎至七分，去滓，食前温服。如人行三五里，再服。
治伤寒脉结代者：
上用甘草三两，水三升，煮取一升半，服七合，日三。
炙甘草汤：治疗虚劳不足，汗出而闷，脉结，悸，行动如常，不出百日，危急者十一日死。
药材：甘草（四两，炒）、桂枝、生姜（各三两）、麦门冬（半升）、麻仁（半升）、人参、阿胶（各二两）、大枣（三十枚）、生地黄（一升）。
制法：上九味，以酒七升，水八升，先煮八味，取三升，去滓，纳胶消尽，温服一升，日三服。
(If there is) thirst, remove Banxia (Pinelliae Rhizoma). Add Gualougen (Trichosanthis Radix), 1 liang. If the chest feels obstructed and hard, remove Zao (Jujubae Fructus). Add Muli Fen (Ostreae Concha Powder), 1 liang.
After thirteen days of Shaoyang disease (Taiyang disease in the context of Shanghan Lun progression) remaining unresolved, there is fullness in the hypochondrium with vomiting, tidal fever (Chao Re) occurring in the late afternoon, followed by mild diarrhea. This results from the physician incorrectly using pill-based purgatives. This treatment is inappropriate. Mangxiao (Natrii Sulfas) 1 liang is suitable.
After ten-plus days of Shaoyang disease, heat is knotted inside. There are alternating chills and fever, or urgency in the epigastrium, a feeling of stifling and slight vexation, or a white coating on the tongue, or constipation. Or, after sweating, there is perspiration, or abdominal fullness, or tidal fever resembling malaria, or after six to seven days, unclear vision and uncoordinated eye movements. Without exterior or interior syndromes, but with difficult defecation and slight body heat, this indicates severe excess. Remove Renshen (Ginseng Radix et Rhizoma). Add Zhishi (Aurantii Fructus Immaturus), half liang, and Dahuang (Rhei Radix et Rhizoma), 1 liang. This is named Da Chaihu Tang (Major Bupleurum Decoction). Take it until bowel movement occurs. Once the heat is removed, do not abruptly take tonics. Still avoid alcohol, mutton, kidneys, and indigestible foods. Any dietary injury is called "Food Relapse" (Shi Fu), which is difficult to treat. Diet must be strictly restricted; do not overeat. Maintain caution for two months, and avoid sexual activity.
Treating Shaoyang disease with vexing heat (from Bencao Fang):
Soak Wumei (Mume Fructus) in water and drink the juice.
Shaoyang palpitation refers to palpitations in the epigastrium. This occurs because after treating Shaoyang disease with sweating, purgation was subsequently applied. Internal deficiency-heat causes thirst. Thirst leads to drinking water; water qi attacks the heart, causing chills and palpitations in the epigastrium. In Taiyang disease, if urination is difficult and the patient drinks much water, palpitations will occur in the epigastrium. If urination is scanty, there will be distressing internal urgency. A floating and rapid pulse indicates recovery through sweating. Purgation causes heavy body and palpitations; sweating should not be induced again. Recovery comes through spontaneous sweating. This is because the Chi pulse is faint, indicating interior deficiency and exterior excess. When fluids harmonize spontaneously, sweating occurs and the disease resolves.
Shaoyang palpitation refers to irregular palpitations. Excessive water intake in Shaoyang disease causes water to stagnate in the epigastrium. Kidney qi attacks the heart, weakening Heart qi, leading to palpitations. This results from purgation after sweating, drying up fluids. If deficiency-heat arises internally, thirst leads to drinking, and water stagnates, causing chills and epigastric palpitations. Shaoyang palpitation, also called Xin Song (palpitation), feels like the heart beating vigorously and restlessly, unable to feel at ease. The causes of palpitation fall into two categories: Qi deficiency and fluid retention.
In Shaoyang disease, if palpitation and vexation occur within two to three days, Xiao Jianzhong Tang (Minor Construct the Middle Decoction) is indicated. In Shaoyin disease, with cold extremities, if palpitation occurs, Si Ni San (Frigid Extremities Powder) with added Guizhi (Cinnamon Twig) 5 fen treats Qi-deficiency palpitation. Excessive drinking causes epigastric palpitation, treating fluid-retention palpitation. Qi deficiency stems from weak interior Yang, emptiness in the epigastrium, and internal movement of righteous Qi. Fluid retention stems from water stagnating in the epigastrium; since the Heart belongs to Fire and dislikes Water, internal water makes the Heart uneasy, causing palpitation. Furthermore, after sweating and purgation, if righteous Qi is deficient and pathogenic factors clash, palpitation occurs, which is more severe than Qi-deficiency palpitation.
In Taiyang disease, excessive sweating causes the patient to cross hands over the chest, resulting in epigastric palpitation. If Taiyang disease is wrongly purged, causing heaviness and epigastric palpitation, sweating is contraindicated. In Shaoyang disease, emesis and purgation are contraindicated; misuse causes palpitation and fright. Sweating is also contraindicated; it causes delirium, relating to the Stomach. If the Stomach harmonizes, recovery follows; if not, vexation and palpitation occur. These cases involve pathogens lingering after sweating, differing from Qi-deficiency palpitation. Treatment involves stabilizing or dispersing, depending on floating Qi.
Excessive drinking prevents fluid distribution, keeping water in the epigastrium, causing severe palpitation. Why? Stagnant water spreads everywhere if dispersed. Entering the Lung causes wheezing and cough; entering the Stomach causes hiccups and dysphagia; overflowing skin causes edema; entering intestines causes diarrhea. This cannot be delayed. The Classic states: "Cold extremities with epigastric palpitation require treating water first with Fuling Gancao Tang (Poria and Licorice Decoction), then treating cold." Otherwise, water enters the Stomach causing diarrhea. Even deep pathogens require treating water first; how much more so for shallow pathogens? Physicians must investigate deeply. Huoren Shu states: "Water qi attacking the heart causes chills and palpitation; use Fuling Gancao Tang."
In Shaoyang disease, if palpitation and vexation occur within two to three days, use Xiao Jianzhong Tang. After sweating, if umbilical palpitation suggests Ben Tun (Running Piglet), refer to specific sections. Excessive sweating causing epigastric palpitation relieved by pressure uses Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction). Persistent fever after sweating with palpitation, dizziness, and trembling uses Zhen Wu Tang (True Warrior Decoction). Knotted and intermittent pulse with palpitation uses Zhigancao Tang (Honey-Fried Licorice Decoction). Shaoyin disease forbids sweating; sweating causes delirium and palpitation due to Stomach disharmony. Xiaochaihu Tang (Minor Bupleurum Decoction) treats wind-stroke with alternating chills/fever and epigastric palpitation. Cold extremities with epigastric palpitation require treating water first with Fuling Gancao Tang, then treating cold.
A verse states: "Palpitation in Three Yang syndromes is detailed; hard stool and delirium treated by Tiaowei Chengqi Tang. Dizziness, spinning, Gancao, Guizhi, Zhenwu; Xiao Jianzhong combined with Zhigancao."
Palpitation often arises from fluid retention, weak Yang, emptiness in the epigastrium, or post-sweat/purge deficiency with pathogen clash. This differs from fright. In Taiyang disease, clear urination with excessive drinking causes palpitation; scanty or blocked urination also causes palpitation. String-taut and thin pulse with headache and fever, wrongly sweated, causes delirium transferring to Stomach; harmony brings cure, disharmony brings palpitation. Hard stool relates to Stomach; Tiaowei Chengqi Tang is used, though harsh. Zhengzhi Lun suggests Xiaochaihu Tang alone. Add Dahuang for hard stool; add Mangxiao for vexation. Epigastric palpitation relieved by pressure uses Guizhi Gancao Tang. Unresolved sweating with fever, palpitation, dizziness, and trembling uses Zhenwu Tang, or Lizhong Tang plus Fuling. Palpitation and vexation in two-three days uses Xiao Jianzhong Tang. Classics state: Vexation then palpitation is Heat; Palpitation then vexation is Deficiency. Only deficiency uses Xiao Jianzhong Tang. Shaoyang disease with deafness, red eyes, chest fullness, and vexation, wrongly vomited/purged, causes palpitation and fright; use Xiao Jianzhong Tang, followed by Xiaochaihu Tang if heat persists. Knotted pulse with palpitation uses Zhigancao Tang. Shaoyin cold extremities with palpitation use Si Ni San plus Guizhi. Water qi in epigastrium with cold extremities requires treating water first with Fuling Gancao Tang, then cold extremities. Otherwise, diarrhea ensues.
Shaoyang disease often leads to fright due to emesis, purgation, fire moxibustion, or warm needle therapy. Taiyang disease wrongly purged causes chest fullness, vexation, fright, difficulty urinating, delirium, and body heaviness; use Chaihu Longgu Muli Tang (Bupleurum, Dragon Bone, and Oyster Shell Decoction). Do not sweat; excessive sweating causes Yang collapse. Wind-warmth with floating pulses, wrongly fired, causes jaundice, convulsions, and twitching. The Classic warns against repeated errors. Use Jingui Fengyin Tang (Golden Cabinet Wind-Driving Decoction).
Da Chaihu Tang (from Shenghui Fang): Treats Shaoyang disease with palpitation, incessant vomiting, and vexation after two-three days.
Ingredients: Chaihu (2 liang, remove sprouts), Huangqin (1 liang), Chi Shaoyao (Red Peony Root), Banxia (washed 7 times in hot water), Chifuling (Red Poria), Zhishi (bran-fried), Baizhu (all 1 liang each), Binglang (Areca Seed).
Preparation: Coarsely ground powder. Take 4 qian, decoct with 1 zhuan water, half liang ginger, and 3 dates to 6 fen. Strain and take warm.
Baifuling San (from Shenghui Fang): Treats interior deficiency in Shaoyang disease with epigastric palpitation and abdominal Qi disharmony.
Ingredients: Binglang (1 liang), Qingju pi (Green Tangerine Peel, half liang, soaked and dried), Baifuling (half liang), Houpo (1 liang, ginger-juice roasted), Guixin (Cinnamon Heart, 1 liang), Gancao (half liang, honey-roasted), Fuzi (1 liang, processed).
Preparation: Fine powder. Take 4 qian, decoct with 1 zhuan water and half liang ginger to 6 fen. Strain and take warm.
Renshen San (from Shenghui Fang): Treats persistent heat, epigastric palpitation, dizziness, and tremors after sweating in Shaoyang disease.
Ingredients: Renshen (remove rhizome), Chi Shaoyao, Fuzi (processed), Baizhu (all 1 liang each), Gancao (half liang, honey-roasted), Chifuling (1 liang).
Preparation: Fine powder. Take 4 qian, decoct with 1 zhuan water and half liang ginger to 6 fen. Strain and take warm.
Guixin San (from Shenghui Fang): Treats excessive sweating causing hand-over-heart epigastric palpitation needing pressure.
Ingredients: Guixin, Gancao (honey-roasted), Renshen (remove rhizome), Baizhu, Chifuling (all 1 liang each), Zhishi (half liang, bran-fried).
Preparation: Coarsely ground powder. Take 4 qian, decoct with 1 zhuan water to 6 fen. Strain and take warm.
Xiongqu San (from Shenghui Fang): Treats persistent fever, epigastric palpitation, headache, dizziness, and restless panting after sweating.
Ingredients: Xiongqu (Szechwan Lovage Rhizome), Jiegeng (Platycodon Root), Qianhu (Peucedani Radix), Shigao (Gypsum), Renshen (remove rhizome), Baifuling, Maidong (Ophiopogon Root, all 1 liang each), Xuanfuhua (Inula Flower, half liang), Zhike (Aurantii Fructus, half liang, bran-fried).
Preparation: Coarsely ground powder. Take 4 qian, decoct with 1 zhuan water, half liang ginger, and 3 dates to 6 fen. Strain and take warm.
Gancao San (from Shenghui Fang): Treats knotted/intermittent pulse with epigastric palpitation.
Ingredients: Gancao (honey-roasted), Fushen (Poria with Hostwood), Yuanzhi (Polygalae Radix), Cangzhu (Atractylodis Rhizoma, all 1 liang each), Zhishi (half liang, bran-fried).
Preparation: Coarsely ground powder. Take 3 qian, decoct with 1 zhuan water and half liang ginger to 5 fen. Strain and take warm.
Formula for Shaoyang disease without sweating, with palpitation, vexation, and head/eye discomfort (from Shenghui Fang):
Ingredients: Guixin (1 liang, chopped), Gancao (half liang, honey-roasted), Shengjiang (1 fen, sliced), Dazao (5 dates, pitted), Yitang (Maltose, 1 liang).
Preparation: Decoct ingredients in 1.5 zhuan water to 1 zhuan. Add maltose, boil briefly. Strain and divide into two doses.
Guizhi Tang (from Shenghui Fang): Treats water in epigastrium causing palpitation needing pressure.
Ingredients: Guizhi (2 liang, remove bark), Chifuling (1.5 liang, remove black skin), Baizhu (1 liang), Gancao (3 fen, honey-roasted), Chenju pi (Tangerine Peel, half liang, soaked and dried).
Preparation: Coarsely ground. Take 5 qian-bi, decoct in 1.5 zhuan water to 7 fen. Strain and take warm.
Chifuling Tang (from Shengji Zonglu): Treats excessive drinking causing indefinite epigastric palpitation.
Ingredients: Chifuling (2 liang), Chenju pi (2 liang), Baizhu (3 fen), Banxia (2 liang, washed and fried), Zhike (half liang, bran-fried), Renshen (1 liang).
Preparation: Coarsely ground. Take 5 qian, decoct in 1.5 zhuan water with half liang crushed ginger to 8 fen. Strain and take warm.
Fuling Banxia Tang (from Shengji Zonglu): Treats vomiting/hiccups, epigastric palpitation, and stagnant water in chest/diaphragm causing dizziness.
Ingredients: Chifuling (2 liang), Banxia (2-3 liang, washed and fried), Chenju pi (1 liang, washed and dried).
Preparation: Coarsely ground. Take 5 qian-bi, decoct in 1.5 zhuan water with 1 fen crushed ginger to 7 fen. Strain and take warm, repeat at night.
Fuling Baizhu Tang: Treats epigastric fullness, palpitation, and dizziness upon rising after vomiting in Shaoyang disease.
Ingredients: Chifuling (1 liang), Baizhu (2-3 fen), Guizhi (3 fen), Xiongqu (1 liang), Gancao (half liang, honey-roasted).
Preparation: Coarsely ground. Take 3 qian-bi, decoct in 1 zhuan water to 6 fen. Strain and take warm.
Fuling Guizhi Tang: Treats epigastric palpitation after excessive drinking following sweating.
Ingredients: Chifuling, Guizhi, Banxia (each 1 liang, washed and fried), Gancao (half liang, honey-roasted).
Preparation: Coarsely ground. Take 3 qian, decoct in 1 zhuan water with half liang crushed ginger to 7 fen. Strain and take warm.
Guixin Tang: Treats palpitation due to fluid retention in epigastrium.
Ingredients: Guizhi (1 liang), Binglang (chopped), Banxia (each half liang, washed and fried).
Preparation: Cut like hemp seeds. Take 4 qian-bi, decoct in 1.5 zhuan water with 5 slices ginger to 7 fen. Strain and take warm before meals. Repeat after walking 3-5 li.
For knotted/intermittent pulse in Shaoyang disease:
Use Gancao (3 liang), boil in 3 sheng water to 1.5 sheng. Take 7 he, three times daily.
Zhigancao Tang: Treats deficiency exhaustion, sweating with stuffiness, knotted pulse, palpitation. Action normal predicts survival under 100 days; critical cases die in 11 days.
Ingredients: Gancao (4 liang, fried), Guizhi, Shengjiang (each 3 liang), Maidong (half sheng), Mahuang (Hemp Seed - Note: Text says Mahren/Hemp Seed usually Sesame in this context, but text says Mahren), Renshen, Ejiao (each 2 liang), Dazao (30 pieces), Shengdihuang (1 sheng).
Preparation: Nine ingredients. Boil eight in 7 sheng wine and 8 sheng water to 3 sheng. Strain, dissolve Ejiao. Take 1 sheng warm, three times daily.
Banxia Mahuang Wan: Treats epigastric palpitation.
Ingredients: Banxia, Mahuang (equal parts).
Preparation: Powder, mix with honey into pills size of beans. Take 3 pills with water, three times daily.