〔钱〕心，主惊。实则叫哭发热，饮水而搐，虚则困卧，悸动不安。心病，多
叫哭惊悸，手足动摇，发热饮水。视其睡，口中气温，或合面睡，及上窜切牙，皆
心热也，导赤散主之。心气热则心胸亦热，欲言不能，而有就冷之意，故合面卧。
心气实则气上下行涩，若合面卧，则气不得通，故喜仰卧，使气得上下通也，泻心
汤主之。心病见冬，火旺，心胜肾也，当补肾治心，轻者心病退，重者下窜不语，
肾怯虚也。（补肾、地黄丸，治心、泻心汤）〔洁〕心主热，自病或大热，泻心汤
主之。实则烦热，黄连泻心汤主之。虚则惊悸，生犀散主之。肺乘心，微邪，喘而
壮热，泻白散主之。肝乘心，虚邪，风热，煎大羌活汤下大青丸主之。脾乘心，实邪，泄
泻身热，泻黄散主之。肾乘心，贼邪，恐怖恶寒，安神丸主之。〔刘〕凡心脏得
病，必先调其肝肾两脏，肾者心之鬼，肝气通则心气和，肝气滞则心气乏，此心病
先求于肝，清其源也。五脏受病，必先传其所胜，水能胜火，则肾之受邪，必传于
心，故先治其肾，逐其邪也，故当退肾气、益肝气两方。或诊其脉肝肾两脏俱和，
而心自生疾，然后审其心家虚实治之。〔薛〕仰面卧者，因其心胸实热，故喜仰面
而向虚也。合面卧者，因心胸虚热，故喜合卧而就实也。实则调治心肝，虚则调补
脾肺，二者别之，尽其状矣。其切牙等证，多有雷同，不必拘泥。如用泻心、导赤、
等剂，邪气虽去而病仍作，当调补元气，或反甚，急温补元气。其心气冬见，或亥
子时病益甚，或下窜不语者，乃肾水虚而心火甚也，用地黄丸，其乳下婴儿，须母
服之。若叫哭发热，作渴饮水、抽搐有力，仰面而睡者，属心经实热，用泻心汤、
导赤散。若发热饮汤，抽搐乏力，惊窜切牙，合面而睡者，属心经虚热，用补心散。
若喘嗽面赤，壮热饮水，肺乘心也，用泻白散。若摇头札目，身热抽搐，肝乘心也，
用柴胡清肝散。若合目昏睡、泄泻身热，脾乘心也，用泻黄散。若窜视惊悸，切牙
足热，肾乘心也，用安神丸。
〔海〕心苦缓，急食酸以收之，五味子。心欲软，急食咸以软之，芒硝。
以咸补之，泽泻。以甘泻之，人参、黄 、甘草。心虚，以炒盐补之。虚则补其
母，肝乃心之母，以生姜补肝。如无他证，钱氏安神丸，是也。
安神丸（钱氏） 治心虚疳热，神思恍忽。
麦门冬（去心，焙） 马牙硝 白茯苓 干山药 寒水石（研） 甘草（各半两） 朱砂（一
两，研） 龙脑（一字，研）
上，末之，炼蜜为丸，芡实大。每服半丸，沙糖水化下，无时。
八物定志丸 （海藏）补益心神，安定魂魄，治痰，去胸中邪热，理肺肾。
人参（一两半） 菖蒲 远志（去心） 茯神（去心） 茯苓（去皮。各一两） 朱砂（二钱）
白术 麦门冬（去心。各半两） 牛黄（二钱，另研）
上为细末，炼蜜丸，如桐子大。米饮汤、下三十丸，无时。
髓竭不足，加生地黄当归。肺气不足，加天门冬、麦门冬、五味子。心气不
足，加上党参、茯神、菖蒲。脾气不足，加白术、白芍药、益智。肝气不足，
加天麻、川芎。肾气不足，加熟地黄、远志、牡丹皮。胆气不足，加细辛、酸
枣仁、地榆。神昏不足，加朱砂、预知子、茯神。
心实，以甘草泻之，如无他证，重则泻心汤，轻则导赤散。
泻心汤 （钱氏） 泻丁心。
黄连（一两，去须）
上为极细末。每服一字至半钱一钱，临卧，温水调下。海藏云∶易老单方泻心
汤出于此，乃实邪也，实则泻其子。
导赤散（钱氏） 泻丙小肠。
生干地黄 木通 甘草（各等分）
上，同为末。每服三钱，水一盏，入竹叶同煎至五分，食后温服。一本，不用
甘草，用黄芩。
〔薛〕泻心散、导赤散，泻心小肠实火之剂，盖心为脾母，脾为心子，然心既
病，则脾土益虚矣，用者审之。
生犀散（钱氏） 治心经虚热。
生犀（错取末，二钱） 地骨皮（自采，佳） 赤芍药 柴胡根 干葛（锉。各一两）
甘草（炙，半两）
上为粗末。每服一二钱，水一盏，煎至七分，温服，食后。
〔薛〕前方云∶治心经虚热，其所用药，多属泻心、泻肝脾之剂，虚热二字，
恐鲁鱼也，如心经自病而血虚热者，用秘旨安神丸。脾虚夺心之气而热者，用秘
旨补脾汤。肝木不能生心火而虚热者，用地黄丸。
秘旨安神丸 治心血虚而睡中惊悸，或受惊吓而作。
人参 半夏（汤泡） 酸枣仁（炒） 茯神（各一钱） 当归（酒洗） 橘红 赤芍药（炒。
各七分） 五味子（五粒） 甘草（炙，三分）
上为末，姜汁糊、丸芡实大。每服一丸，生姜汤化下。
【钱乙】心，主司惊悸。实证表现为哭闹、发热，饮水时出现抽搐；虚证表现为疲倦嗜睡，心悸不安。心病，多表现为哭闹、惊悸，手足动摇，发热且想喝水。观察其睡眠状态，若口中气息温热，或俯卧而睡，以及上窜眼球、磨牙，都是心热的表现，用导赤散主治。心气热则心胸也热，想说话却说不出来，且有寻求凉爽的意愿，所以喜欢俯卧。心气实则气机上下运行涩滞，如果俯卧，气机更加不通畅，所以喜欢仰卧，以使气机能上下通畅，用泻心汤主治。心病在冬季显现，是因为火旺，心胜肾（水），应当补肾兼治心，轻症心病自愈，重症则会出现下窜眼球、不能言语，这是肾气怯弱虚损。（补肾用地黄丸，治心用泻心汤）
【张元素】心主热，自病或大热，用泻心汤主治。实证烦热，用黄连泻心汤主治。虚证惊悸，用生犀散主治。肺乘心（微邪），喘促且壮热，用泻白散主治。肝乘心（虚邪），风热，用煎大羌活汤送服大青丸主治。脾乘心（实邪），泄泻身热，用泻黄散主治。肾乘心（贼邪），恐怖恶寒，用安神丸主治。
【刘完素】凡心脏得病，必须先调理肝肾两脏。肾是心的“鬼”（即克我者之相关脏腑，此处指母子相生关系中的间接影响，或指肾为心之阴液之源，原文语境强调肝肾对心的制约与滋养关系，刘氏认为肝气通则心气和，肝气滞则心气乏，故心病先求于肝，以清其源）。五脏受病，必先传其所胜（相克关系），水能胜火，则肾之受邪，必传于心，所以先治其肾，驱逐其邪，因此应当使用退肾气、益肝气的方剂。或者诊察脉象，若肝肾两脏脉象调和，而心自行生病，然后审察心的虚实进行治疗。
【薛己】仰面而卧，是因为心胸实热，所以喜欢仰面向空（虚处）。俯卧而卧，是因为心胸虚热，所以喜欢俯卧就实（实处）。实证调理心肝，虚证调补脾肺，二者加以区别，就能穷尽病症的状貌。那些切牙等症状，多有雷同，不必拘泥。如果使用泻心汤、导赤散等药剂，邪气虽去但病仍发作，应当调补元气；如果反而加重，急需温补元气。其心气在冬季显现，或在亥子时病情加重，或出现下窜眼球、不能言语的，是肾水虚而心火盛，用地黄丸治疗；对于吃奶的婴儿，必须让母亲服用。如果哭闹发热，口渴饮水，抽搐有力，仰面而睡的，属于心经实热，用泻心汤、导赤散。如果发热饮汤，抽搐乏力，惊窜磨牙，俯卧而睡的，属于心经虚热，用补心散。如果喘嗽面赤，壮热饮水，是肺乘心，用泻白散。如果摇头眨眼，身热抽搐，是肝乘心，用柴胡清肝散。如果闭目昏睡、泄泻身热，是脾乘心，用泻黄散。如果窜视惊悸，磨牙足热，是肾乘心，用安神丸。
【张元素（海藏）】心苦缓，急食酸味以收敛之，如五味子。心欲软，急食咸味以软化之，如芒硝。以咸味补之，如泽泻。以甘味泻之，如人参、黄芪、甘草。心虚，用炒盐补之。虚则补其母，肝乃心之母，用生姜补肝。如果没有其他症状，用钱氏安神丸即可。
安神丸（钱氏） 治疗心虚疳热，神思恍惚。
麦门冬（去心，焙干） 马牙硝 白茯苓 干山药 寒水石（研碎） 甘草（各半两） 朱砂（一两，研碎） 龙脑（一字，研碎）
以上药物研为细末，炼蜜为丸，大小如芡实。每次服用半丸，沙糖水化开服用，不限时间。
八物定志丸 （海藏） 补益心神，安定魂魄，治疗痰证，去除胸中邪热，调理肺肾。
人参（一两半） 菖蒲 远志（去心） 茯神（去心） 茯苓（去皮。各一两） 朱砂（二钱） 白术 麦门冬（去心。各半两） 牛黄（二钱，另研）
以上研为细末，炼蜜为丸，如梧桐子大。米汤送服三十丸，不限时间。
髓竭不足，加生地黄、当归。肺气不足，加天门冬、麦门冬、五味子。心气不足，加上党参、茯神、菖蒲。脾气不足，加白术、白芍药、益智仁。肝气不足，加天麻、川芎。肾气不足，加熟地黄、远志、牡丹皮。胆气不足，加细辛、酸枣仁、地榆。神昏不足，加朱砂、预知子、茯神。
心实，用甘草泻之，如果没有其他症状，重证用泻心汤，轻证用导赤散。
泻心汤 （钱氏） 泻心火。
黄连（一两，去须）
以上研为极细末。每次服用一字至半钱或一钱，临睡前，温水调服。海藏说：易老单方泻心汤出于此，乃是实邪，实则泻其子。
导赤散（钱氏） 泻小肠火。
生干地黄 木通 甘草（各等分）
以上同为细末。每次服用三钱，水一盏，加入竹叶同煎至五分，饭后温服。另一版本，不用甘草，改用黄芩。
【薛己】泻心散、导赤散，是泻心与小肠实火的药剂。因为心为脾之母，脾为心之子，然而心既病，则脾土更加虚弱了，使用者需审慎。
生犀散（钱氏） 治疗心经虚热。
生犀（锉取末，二钱） 地骨皮（自采为佳） 赤芍药 柴胡根 干葛（锉碎。各一两） 甘草（炙，半两）
以上为粗末。每次服用一二钱，水一盏，煎至七分，饭后温服。
【薛己】前方说：治疗心经虚热，但其所用药物，多属于泻心、泻肝脾的药剂，“虚热”二字，恐怕是文字讹误（鲁鱼亥豕之误）。如心经自病而血虚热者，用秘旨安神丸。脾虚夺心之气而热者，用秘旨补脾汤。肝木不能生心火而虚热者，用地黄丸。
秘旨安神丸 治疗心血虚而睡中惊悸，或受惊吓而发作。
人参 半夏（汤泡） 酸枣仁（炒） 茯神（各一钱） 当归（酒洗） 橘红 赤芍药（炒。各七分） 五味子（五粒） 甘草（炙，三分）
以上研为末，姜汁糊丸，大小如芡实。每次服用一丸，生姜汤化开服用。
[Qian Yi] The Heart governs fright. In excess conditions, there is crying and shouting with fever, and convulsions when drinking water; in deficiency conditions, there is fatigue and drowsiness, palpitations, and restlessness. Heart disease often presents as crying, shouting, fright, and palpitations, shaking of the hands and feet, fever, and a desire to drink water. Observe the patient's sleep: if the breath from the mouth is warm, or if they sleep face down, or if their eyes roll upward and teeth are ground, these are all signs of Heart Heat, treated primarily with Dao Chi San (Cinchona Decoction). When Heart Qi is hot, the chest and heart feel hot; the patient wishes to speak but cannot, and has an inclination towards coldness, thus preferring to sleep face down. When Heart Qi is in excess, the movement of Qi up and down becomes obstructed. If sleeping face down, Qi flow is further impeded; therefore, the patient prefers supine position to allow Qi to circulate freely up and down, treated primarily with Xie Xin Tang (Drain the Heart Decoction). If Heart disease manifests in winter, it indicates Fire is flourishing and Heart overcomes Kidney (Water). One should tonify the Kidney and treat the Heart. In mild cases, the Heart condition recedes; in severe cases, the eyes may roll downward and speech may be lost, indicating Kidney weakness and deficiency. (Tonify Kidney with Dihuang Wan [Rehmannia Pill]; treat Heart with Xie Xin Tang.)
[Zhang Yuansu] The Heart governs heat. Self-originated disease or high fever is treated primarily with Xie Xin Tang (Drain the Heart Decoction). Excess conditions with irritability and heat are treated with Huanglian Xie Xin Tang (Coptis Drain the Heart Decoction). Deficiency conditions with fright and palpitations are treated with Sheng Xi San (Raw Rhinoceros Horn Powder). Lung overcoming Heart (minor pathogenic factor) presents with wheezing and high fever, treated with Xie Bai San (Drain White Powder). Liver overcoming Heart (deficient pathogenic factor) presents with wind-heat, treated with Jian Da Qiang Huo Tang (Decoction of Large Notopterygium) administered with Da Qing Wan (Large Indigo Pill). Spleen overcoming Heart (excess pathogenic factor) presents with diarrhea and body heat, treated with Xie Huang San (Drain Yellow Powder). Kidney overcoming Heart (hostile pathogenic factor) presents with terror and aversion to cold, treated with An Shen Wan (Calming the Spirit Pill).
[Liu Wansu] Whenever the Heart suffers disease, one must first regulate the Liver and Kidney. The Kidney is the "ghost" (subjugator/related element) of the Heart. When Liver Qi flows smoothly, Heart Qi harmonizes; when Liver Qi stagnates, Heart Qi becomes deficient. Thus, for Heart disease, seek the Liver first to clear the source. When the Five Zang organs suffer disease, transmission first occurs to the organ it overcomes (controls). Water overcomes Fire; thus, if the Kidney suffers evil, it transmits to the Heart. Therefore, treat the Kidney first to expel the evil. Hence, formulas that reduce Kidney Qi and benefit Liver Qi should be used. Alternatively, if pulse diagnosis shows both Liver and Kidney harmonious, yet the Heart generates disease independently, then examine the Heart's excess or deficiency and treat accordingly.
[Xue Ji] Sleeping on the back indicates excess-heat in the chest and heart, hence the preference for lying supine facing the void. Sleeping face down indicates deficiency-heat in the chest and heart, hence the preference for prone position seeking solidity. For excess conditions, regulate the Heart and Liver; for deficiency conditions, tonify the Spleen and Lungs. Distinguishing these two exhausts the manifestations. Symptoms such as grinding teeth have many similarities and should not be rigidly adhered to. If using Xie Xin Tang or Dao Chi San, and although the pathogenic factor is removed the disease recurs, one should regulate and tonify Yuan Qi (Original Qi); if symptoms worsen, urgently warm and tonify Yuan Qi. If Heart Qi manifests in winter, or worsens during Hai-Zi hours (9 PM - 1 AM), or presents with downward eye deviation and muteness, this is due to Kidney Water deficiency and excessive Heart Fire, treated with Dihuang Wan (Rehmannia Pill); for nursing infants, the mother should take the medicine. If crying, shouting, fever, thirst with drinking, and forceful convulsions occur with supine sleeping, this belongs to Heart Channel excess-heat, treated with Xie Xin Tang and Dao Chi San. If fever with drinking warm fluids, weak convulsions, fright with eye deviation and tooth grinding occur with prone sleeping, this belongs to Heart Channel deficiency-heat, treated with Bu Xin San (Tonify Heart Powder). If wheezing, coughing, red face, high fever with drinking indicate Lung overcoming Heart, treated with Xie Bai San. If head shaking, blinking, body heat, and convulsions indicate Liver overcoming Heart, treated with Chaihu Qinggan San (Bupleurum Clearing Liver Powder). If closed eyes, drowsiness, diarrhea, and body heat indicate Spleen overcoming Heart, treated with Xie Huang San. If wandering gaze, fright, palpitations, tooth grinding, and hot feet indicate Kidney overcoming Heart, treated with An Shen Wan.
[Zhang Yuansu/Haizang] The Heart suffers from flaccidity; urgently consume sour flavors to astringe it, such as Wuweizi (Schisandra Berry). The Heart desires softness; urgently consume salty flavors to soften it, such as Mangxiao (Mirabilite). Tonify with salty flavor, such as Zexie (Alisma). Drain with sweet flavor, such as Renshen (Ginseng), Huangqi (Astragalus), and Gancao (Licorice). For Heart deficiency, use roasted salt to tonify. Deficiency requires tonifying the Mother; the Liver is the Mother of the Heart, so use Shengjiang (Fresh Ginger) to tonify the Liver. If there are no other symptoms, Qian Shi's An Shen Wan is appropriate.
An Shen Wan (Qian Shi) Treats Heart deficiency with infantile malnutrition heat and absent-mindedness.
Mendong (Ophiopogon Tuber, remove heart, baked) Mayaxiao (Mirabilite) Baifuling (Poria) Gansanyao (Dried Yam) Hanshuishi (Calcitum, crushed) Gancao (Licorice Root, each half tael) Zhusha (Cinnabar, one tael, crushed) Longnao (Borneol, one character, crushed)
Grind into powder, mix with refined honey to make pills the size of Euryale Seed. Take half a pill at a time, dissolved in sugar water, at any time.
Bayu Dingzhi Wan (Haizang) Tonifies Heart Spirit, stabilizes Hun and Po, treats phlegm, removes pathogenic heat from the chest, and regulates Lung and Kidney.
Renshen (Ginseng, one tael and half) Shichangpu (Acorus) Yuanzhi (Polygala Root, remove heart) Fushen (Poria with Hostwood, remove heart) Fuling (Poria, remove skin, each one tael) Zhusha (Cinnabar, two qian) Baizhu (Atractylodes) Mendong (Ophiopogon Tuber, remove heart, each half tael) Niuhuang (Calculus Bovis, two qian, separately crushed)
Grind into fine powder, mix with refined honey to make pills the size of Sesame Seeds. Take thirty pills with rice soup, at any time.
For Marrow exhaustion and insufficiency, add Shengdihuang (Rehmannia Root) and Danggui (Angelica Sinensis). For Lung Qi insufficiency, add Tiandong (Asparagus Tuber), Mendong, and Wuweizi. For Heart Qi insufficiency, add Shangdangshen (Codonopsis), Fushen, and Shichangpu. For Spleen Qi insufficiency, add Baizhu, Baishao (White Peony Root), and Yizhi (Alpinia Oxyphylla). For Liver Qi insufficiency, add Tianma (Gastrodia Rhizome) and Chuanxiong (Ligusticum Rhizome). For Kidney Qi insufficiency, add Shudihuang (Prepared Rehmannia Root), Yuanzhi, and Mudanpi (Tree Peony Bark). For Gallbladder Qi insufficiency, add Xixin (Asarum), Suanzaoren (Ziziphus Seed), and Diyü (Sanguisorba Root). For Spirit confusion and insufficiency, add Zhusha, Yuzhizi (Actinidia Fruit), and Fushen.
Heart excess is drained with Gancao (Licorice). If there are no other symptoms, severe cases use Xie Xin Tang, mild cases use Dao Chi San.
Xie Xin Tang (Qian Shi) Drains Heart Fire.
Huanglian (Coptis Rhizome, one tael, remove stamens)
Grind into extremely fine powder. Take one character to half a qian or one qian at a time, before bed, mixed with warm water. Haizang says: Yi Lao's single-herb Xie Xin Tang originates from here; it addresses excess pathogenic factors. Excess is drained by its child element.
Dao Chi San (Qian Shi) Drains Small Intestine Fire.
Sheng Gan Dihuang (Dried Rehmannia Root) Mutong (Akebia Stem) Gancao (Licorice Root, equal parts)
Grind together into powder. Take three qian at a time, with one cup of water, boil with Zhu Ye (Bamboo Leaf) until reduced to half a cup, take warm after meals. Another version uses Huangqin (Scutellaria Root) instead of Gancao.
[Xue Ji] Xie Xin San and Dao Chi San are agents that drain excess fire of the Heart and Small Intestine. Since the Heart is the Mother of the Spleen, and the Spleen is the Child of the Heart, once the Heart is diseased, the Spleen Earth becomes increasingly deficient. Users should exercise caution.
Sheng Xi San (Qian Shi) Treats Heart Channel deficiency-heat.
Shengxi (Raw Rhinoceros Horn, scraped into powder, two qian) Digupi (Dogwood Root Bark, freshly collected is best) Chishaoyao (Red Peony Root) Chaihu Gen (Bupleurum Root) Gange (Kudzu Root, sliced, each one tael) Gancao (Licorice Root, processed, half tael)
Grind into coarse powder. Take one or two qian at a time, with one cup of water, boil until seven-tenths remain, take warm after meals.
[Xue Ji] The previous formula states: "Treats Heart Channel deficiency-heat." However, the herbs used mostly belong to agents that drain the Heart, Liver, and Spleen. The term "deficiency-heat" is likely a textual error (confusion of characters). If Heart Channel self-disease causes blood-deficiency heat, use Mizhi An Shen Wan (Secret Instruction Calming Spirit Pill). If Spleen deficiency steals Qi from the Heart causing heat, use Mizhi Bupi Tang (Secret Instruction Tonify Spleen Decoction). If Liver Wood fails to generate Heart Fire causing deficiency-heat, use Dihuang Wan.
Mizhi An Shen Wan Treats Heart Blood deficiency causing fright and palpitations during sleep, or triggered by fright.
Renshen (Ginseng) Banxia (Pinellia Tuber, soaked in boiling water) Suanzaoren (Ziziphus Seed, stir-fried) Fushen (Poria with Hostwood, each one qian) Danggui (Angelica Sinensis, washed with wine) Juhong (Citrus Peel, red layer, stir-fried, each seven fen) Wuweizi (Schisandra Berry, five berries) Gancao (Licorice Root, processed, three fen)
Grind into powder, make pills with ginger juice paste the size of Euryale Seed. Take one pill at a time, dissolved in ginger soup.