脏腑恐有四∶一曰肾。经云∶在脏为肾,在志为恐。又云∶精气并于肾则恐是也。二曰肝胆。经
云∶肝脏血,血不足则恐。戴人曰∶胆者敢也,惊怕则胆伤矣。盖肝胆实则怒而勇敢,肝胆虚则善恐
而不敢也。三曰胃。经云∶胃为恐是也。四曰心。经云∶心怵惕思虑则伤神,神伤则恐惧自失
者是也。运气善恐,皆属肝木虚。经云∶木不及曰委和,委和之纪,其病摇动注恐是也。针灸
善恐有三∶其一取肾。经云∶肾足少阴之脉,是动病,气不足,则善恐,心惕惕如人将捕之。虚则补
之,寒则留之是也。其二取肝。经云∶肝虚则目KT KT ,KT 无所见,耳无所闻,善恐,如人将捕
之,取其经,厥阴与少阳是也。其三取胆。经云∶胆病者,善太息,口苦呕宿汁,心下澹澹,恐人将
捕之,取阳陵泉。又云∶善呕,呕有苦,善太息,心中 ,恐人将捕之,邪在胆,逆在胃,
胆液泄则口苦,胃气逆则呕苦,故曰呕
胆。取三里,以下胃气逆,则刺少阳血络以闭胆逆,却调其虚实,以去其邪是也。丹溪
治周本心,年六十,形气俱实,因大恐,正月间染病,心不自安,如人将捕之状,夜卧亦不安,两耳
后亦见火光炎上,食饮虽进而不知味,口干而不欲食,以人参、白术、当归身为君,陈皮为佐,
加盐炒黄柏,炙玄参各少许煎服自愈,月余而安。经云∶恐伤肾,此用盐炒黄柏、炙玄参,引参、归
等药入补肾足少阴络也。《本事方》人参散、茯神散、补胆防风汤,皆治胆虚之剂。
恐惧这一病症在脏腑中有四种情况:第一种与肾有关。医经说:“在五脏中对应肾,在五志中对应恐。”又说:“精气汇聚于肾则产生恐惧。”第二种与肝胆有关。医经说:“肝脏藏血,血液不足则会产生恐惧。”戴人(张从正)说:“胆代表勇气,受到惊吓害怕会损伤胆气。”大概肝胆实证表现为愤怒和勇敢,肝胆虚证则容易恐惧且不敢行动。第三种与胃有关。医经说:“胃的功能异常会导致恐惧。”第四种与心有关。医经说:“心神受到惊惧思虑的干扰会受损,神受损则会出现恐惧且自我控制能力丧失的情况。”五运六气学说中认为容易恐惧多属于肝木虚弱。医经说:“木气不及称为‘委和’,在委和之年,其疾病表现为摇动不安和恐惧。”
针灸治疗容易恐惧有三种取穴方法:第一是取肾经穴位。医经说:“足少阴肾经发生病变时,若经气不足,就会容易恐惧,心中惊恐不安,好像有人要抓捕自己一样。对于虚证应当用补法,寒证应当留针久一点。”第二是取肝经穴位。医经说:“肝虚会导致视力模糊看不清,耳朵听不见声音,容易恐惧,好像有人要抓捕自己一样,此时应取肝经及与其相表里的厥阴经和少阳经的穴位。”第三是取胆经穴位。医经说:“胆病患者,喜欢长叹气,口苦呕吐隔夜汁液,心下悸动不安,恐惧别人要抓捕自己,应取阳陵泉穴。”又说:“经常呕吐,呕吐物带苦味,喜欢长叹气,心中烦闷,恐惧别人要抓捕自己,这是邪气在胆,逆乱之气在胃,胆液外泄导致口苦,胃气上逆导致呕吐苦水,所以称为‘呕胆’。应取足三里穴以通降胃气上逆,再针刺少阳经的血络以遏制胆气上逆,随后调理虚实以祛除邪气。”
朱丹溪治疗周本心的案例:患者六十岁,形体和正气都充实,因遭受极大惊恐,在正月间染病,内心不安宁,像被人追捕一样的状态,夜间睡眠也不安稳,两耳后方也见到火光向上燃烧,饮食虽然能进但尝不出味道,口干但不想进食。朱丹溪用人参、白术、当归身作为主药,陈皮作为辅药,加入盐炒黄柏、炙玄参各少许煎服,病愈自愈,一个多月后身体安宁。医经说:“恐惧损伤肾”,这里使用盐炒黄柏、炙玄参,是为了引导人参、当归等药物进入补肾足的少阴络脉。《本事方》中记载的人参散、茯神散、补胆防风汤,都是治疗胆虚证的方剂。
There are four visceral origins for the symptom of fear (Kong): First, the Kidney. The Classics state: "In the Zang organs it corresponds to the Kidney, and in the emotions it corresponds to Fear." It also states: "When Essence and Qi congregate in the Kidney, fear arises." Second, the Liver and Gallbladder. The Classics state: "The Liver stores Blood; when Blood is insufficient, fear arises." Dai Ren (Zhang Congzheng) said: "The Gallbladder represents courage; being startled or afraid injures the Gallbladder." Generally, excess in the Liver and Gallbladder manifests as anger and bravery, while deficiency manifests as propensity to fear and timidity. Third, the Stomach. The Classics state: "Stomach dysfunction leads to fear." Fourth, the Heart. The Classics state: "If the Spirit (Shen) is injured by fright, terror, and overthinking, the Spirit becomes damaged, leading to fear and loss of self-control." In the theory of Five Movements and Six Qi, a propensity to fear is generally attributed to the deficiency of Liver Wood. The Classics state: "When Wood is deficient, it is called 'Wei He' (Lax Harmony). In the era of Wei He, diseases manifest as tremors and fear."
There are three acupuncture approaches for treating a propensity to fear: First, select points on the Kidney meridian. The Classics state: "When the Foot Shaoyin Kidney Meridian is disturbed, if Qi is insufficient, one tends to fear, feeling terrified as if someone were about to capture them. For deficiency, apply tonification; for cold, retain the needle." Second, select points on the Liver meridian. The Classics state: "Liver deficiency causes blurred vision and inability to see clearly, deafness, a propensity to fear, and feeling as if someone were about to capture them. Select points from the Liver meridian, along with its interior-exterior paired Jueyin and Shaoyang meridians." Third, select points on the Gallbladder meridian. The Classics state: "Patients with Gallbladder disease often sigh deeply, have a bitter taste in the mouth, vomit old bile fluids, experience palpitations in the epigastrium, and fear others capturing them. Select Yanglingquan (GB34)." It further states: "Frequent vomiting with a bitter taste, deep sighing, mental restlessness, and fear of being captured indicate pathogenic factors in the Gallbladder and rebellious Qi in the Stomach. Leakage of Gallbladder fluid causes bitterness; rebellious Stomach Qi causes vomiting of bitter fluid, hence termed 'Vomiting from the Gallbladder.' Select Zusanli (ST36) to descend rebellious Stomach Qi, then puncture blood collaterals of the Shaoyang meridian to arrest Gallbladder rebellion, subsequently regulating deficiency and excess to eliminate pathogens."
Case study by Zhu Danxi: Zhou Benxin, aged sixty, presented with robust constitution and vigorous Qi. Due to severe fright, he fell ill in January, experiencing inner insecurity, feeling as if pursued, restless sleep, and visual phenomena of firelight rising behind both ears. Although he could eat and drink, he lost his sense of taste, felt dry-mouthed, and had no appetite. Zhu Danxi prescribed Ginseng Radix (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), and Angelica Sinensis Radix (Danggui Shen) as sovereign drugs, Tangerine Peel (Chenpi) as minister drug, plus salt-fried Phellodendri Cortex (Huangbai) and prepared Scrophulariae Radix (Xuanshen) in small amounts, decocted and administered orally. The patient recovered spontaneously and stabilized within a month. The Classics state: "Fear injures the Kidney." Here, salt-fried Huangbai and prepared Xuanshen were used to guide Renshen and Danggui into the Foot Shaoyin collateral to tonify the Kidney. *Formulas from the Handful of Gold* (*Ben Shi Fang*), including Ginseng Powder (Renshen San), Poria and Spirit Calming Powder (Fushen San), and Gallbladder-Tonifying Wind-Expelling Decoction (Budang Fangfeng Tang), are all formulas for treating Gallbladder deficiency.