或问惊悸怔忡恐怖之别，曰悸即怔忡也。怔忡者，本无所惊，自心动而不宁。惊者，因外有所触而
卒动。张子和云∶惊者为自不知故也，恐者为自知也。盖惊者闻响即惊，恐者自知，如人将捕之状，
及不能独自坐卧，必须人为伴侣，方不恐惧，或夜必用灯照，无灯烛亦恐惧者是也。《内经》无有称
惊怖者，始于《金匮要略》奔
豚条云有惊怖，继之云惊恐，由是而见，惊怖即惊恐。怖、惧也，恐、亦惧也，于义且同。凡连称其
名以为提纲者，多是一阴一阳对待而言。如喜怒并称者，喜出于心，心居于阳；怒出于肝，肝居于阴。
志意并称者，志是静而不移，意是动而不定，静则阴也，动则阳也。惊恐并称者，惊因触于外事内动
其心，心动则神摇；恐因惑于外事，内歉其志，志歉则精却。是故《内经》谓惊则心无所根据，神无所
归，虑无所定，故气乱矣。恐则精却，却则上焦闭，闭则无气还，无气还则下焦胀，故气不行矣。又
谓尝贵后贱，尝富后贫，悲忧内结，至于脱营失精，病深无气，则洒然而惊，此类皆是病从外事所动
内之心神者也。若夫在身之阴阳盛衰而致惊恐者，惊是火热烁动其心，心动则神乱，神用无方，故惊
之变态亦不一状，随其所之，与五神相应而动，肝脏魂，魂不安则为惊骇，为惊妄。肺脏魄，魄不安
则惊躁。脾脏意，意不专则惊惑。肾脏志，志慊则惊恐，心惕惕然。胃虽无神，然为五脏之海，诸热
归之则发惊狂，若闻木音亦惕然心欲动也。恐者则是热伤其肾，肾伤则精虚，精虚则志不足，志本一
定而不移，故恐亦无他状。《内经》于惊之病邪，有火热二淫，司天在泉胜复之气，有各经热病所致，
有三阳积并，有气并于阳，皆为诸惊等病，
故病机统而言曰，诸病惊骇皆属于火也。于恐病之邪者，有精气并于肾则恐，有血不足则恐，有阴少
阳入，阴阳相搏则恐，有胃气热肾气微弱则恐，肾是动病者恐。然于肝之惊恐互相作者，以其脏气属
阳居阴，纳血脏魂，魂不安则神动，神动则惊。血不足则志歉，志歉则恐。故二者肝脏兼而有之。似
此之类，于火热二淫属感邪之外，余者之惊恐，皆因人气之阴阳所动而内生者也。虽然亦非独火热二
淫而已，于阳明脉急，则亦为惊矣。曰惊恐二病，与内外所因，其治法同乎？异乎？曰惊则安其神，
恐则定其志，治当分阴阳之别，何得而同也。夫易之为卦，乾坤交坎离列，坎离交而后为既济，而人
以五脏应之，心为离火，内阴而外阳，肾为坎水，内阳而外阴，内者是主，外者是用。又主内者五神，
外用者五气。是故心以神为主，阳为用，肾以志为主，阴为用。阳则气也、火也，阴则精也、水也。
及乎水火既济，全在阴精上奉以安其神，阳气下脏以定其志。不然则神摇不安于内，阳气散于外，志
感于中，阴精走于下。既有二脏水火之分，治法安得无少异。所以惊者，必先安其神，然后散乱之气
可敛，气敛则阳道行矣。恐者必先定其志，然后走失之精可固，精固则阴气用矣。于药而有二脏君臣
佐使之殊用，内外所感者，亦少异焉。为外事
惊者，虽子和氏谓惊者平之，平、常也，使病者时时闻之习熟，自然不惊，固是良法，不若使其平心
易气以先之，而后药之也。吾谓内气动其神者，则不可用张氏之法，唯当以药平其阴阳之盛衰，而后
神可安，志可定矣。人之所主者心，心之所养者血，心血一虚，神气失守，失守则舍空，舍空而痰入
客之，此惊悸之所由发也。或耳闻大声，目击异物，遇险临危，触事丧志，心为之忤，使人有惕惕之
状，是则为惊。心虚而停水，则胸中渗漉，虚气流动，水既上乘，心火恶之，心不自安，使人有怏怏
之状，或筑筑然动，是则为悸。惊者与之豁痰定惊之剂。悸者与之逐水消饮之剂。所谓扶虚，调养心
血，和平心气而已。若一切以刚燥从事，或者心火自炎，又有热生风之证。
有人问惊、悸、怔忡、恐怖的区别，回答说：悸就是怔忡。怔忡（心中无故跳动不安），是因为本来没有受到惊吓，心脏自己跳动而不安宁。惊（因外界刺激而突然受吓），是因为外部有所触动而突然心动。张子和说：惊是因为自己不知道原因，恐（恐惧害怕）是因为自己知道原因。大概惊是听到响声就受惊，恐是自己心里明白，像被人追捕的样子，以及不能独自坐卧，必须有人陪伴，才不感到恐惧，或者晚上一定要用灯照着，没有灯火也感到恐惧，就是这样。《内经》中没有称“惊怖”的，始于《金匮要略》奔豚条中说有惊怖，接着又说惊恐，由此看来，惊怖就是惊恐。怖、惧是一样的意思，恐、也是惧的意思，在义理上相同。凡是连称其名作为提纲的，多是一阴一阳相对而言。比如喜怒并称，喜出于心，心居于阳位；怒出于肝，肝居于阴位。志意并称，志是静而不移，意是动而不定，静则属阴，动则属阳。惊恐并称，惊是因为触于外物而在内扰动心神，心动则神摇荡；恐是因为惑于外物而在内亏欠意志，志气亏欠则精气退缩。所以《内经》说惊则心无所依托，神无所归依，思虑无定准，所以气机紊乱了。恐则精气退缩，退缩则上焦闭塞，闭塞则气无法归还，气无法归还则下焦胀满，所以气机不行走了。又说曾经尊贵后来卑贱，曾经富有后来贫穷，悲忧郁结在内，以至于脱营失精，病深而无气，就会洒然而惊，这类都是病从外物所动内在心神的情况。至于因为自身阴阳盛衰而导致惊恐的，惊是火热灼烧扰动其心，心动则神乱，神的作用没有常规，所以惊的变态也不止一种形态，随着其所之，与五神相应而动，肝脏藏魂，魂不安则为惊骇，为惊妄。肺脏藏魄，魄不安则惊躁。脾脏藏意，意不专一则惊惑。肾脏藏志，志气不足则惊恐，心中惕惕然。胃虽然没有神，但是五脏的海，各种热邪归于它则发惊狂，如果听到木音也会惕然心动。恐则是热邪伤了肾，肾伤则精虚，精虚则志不足，志本一定而不移，所以恐也没有其他形态。《内经》对于惊的病邪，有火热二淫，司天在泉胜复之气，有各经热病所致，有三阳积并，有气并于阳，都是各种惊等病，所以病机总括来说，各种病惊骇都属于火。对于恐病的邪气，有精气并于肾则恐，有血不足则恐，有阴少阳入，阴阳相搏则恐，有胃气热肾气微弱则恐，肾是动病者恐。然而在肝的惊恐互相作用的，因为其脏气属阳居阴，纳血藏魂，魂不安则神动，神动则惊。血不足则志歉，志歉则恐。所以二者肝脏兼而有之。像这样的，除了火热二淫属于感邪之外，其余的惊恐，都是因为人气之阴阳所动而内生出来的。虽然也不仅仅是火热二淫而已，如果阳明脉急，也就会惊了。问：惊恐二病，与内外所因，其治法相同吗？不同吗？答：惊则安其神，恐则定其志，治疗应当分阴阳的区别，怎么能相同呢。《易经》的卦象，乾坤交坎离列，坎离交而后为既济，而人以五脏应之，心为离火，内阴而外阳，肾为坎水，内阳而外阴，内者是主，外者是用。又主内的是五神，外用的是五气。所以心以神为主，阳为用，肾以志为主，阴为用。阳则是气、火，阴则是精、水。等到水火既济，全在阴精上奉以安其神，阳气下脏以定其志。不然则神摇不安于内，阳气散于外，志感于中，阴精走于下。既然有二脏水火之分，治法怎么能没有少许差异。所以惊者，必须先安其神，然后散乱之气可收敛，气敛则阳道行矣。恐者必须先定其志，然后走失之精可固摄，精固则阴气用矣。在药物上有二脏君臣佐使之殊用，内外所感的，也有少许差异。因为外物而惊的，虽然张子和说惊者平之，平、常也，使病人时时闻之习熟，自然不惊，固然是好方法，不如使其平心易气以先之，而后用药。我认为内气动其神的，则不可用张氏的方法，只当以药平其阴阳之盛衰，而后神可安，志可定了。人所主宰的是心，心所滋养的是血，心血一虚，神气失守，失守则舍空，舍空而痰入客之，这是惊悸之所以发作的原因。或者耳闻大声，目击异物，遇险临危，触事丧志，心为之忤逆，使人有惕惕的状态，这就是惊。心虚而停水，则胸中渗漉，虚气流动，水既上乘，心火恶之，心不自安，使人有怏怏的状态，或者筑筑然跳动，这就是悸。惊者给他豁痰定惊的药剂。悸者给他逐水消饮的药剂。所谓扶虚，调养心血，和平心气罢了。如果用一切刚燥的药物处理，或者心火自炎，又有热生风的证候。
A question was asked regarding the differences between Jing (Fright), Ji (Palpitation), Zhengchong (Severe Palpitation), and Kongbu (Terror). The answer is: Ji is synonymous with Zhengchong. Zhengchong refers to a condition where, without any external cause of fright, the heart beats restlessly and uneasily on its own. Jing refers to a sudden disturbance of the heart caused by external stimuli. Zhang Zihe stated: "Jing arises from ignorance of the cause, whereas Kong arises from awareness." Generally, Jing is triggered by hearing a loud noise, while Kong involves an internal awareness, resembling the feeling of being hunted. It manifests as an inability to sit or lie down alone, requiring companionship to alleviate fear, or a necessity for light at night; without light, fear persists. The *Neijing* does not use the term "Jingbu," which first appears in the "Ben Tun" chapter of the *Jingui Yaolue*, stating there is "Jingbu," followed by "Jingkong." Thus, Jingbu is equivalent to Jingkong. Bu and Ju are synonyms, and Kong is also a synonym for Ju; their meanings are identical. Terms paired together as outlines often represent a yin-yang opposition. For example, Xi (Joy) and Nu (Anger) are paired: Xi originates from the Heart, which resides in Yang; Nu originates from the Liver, which resides in Yin. Zhi (Will) and Yi (Intent) are paired: Zhi is static and unchanging (Yin), while Yi is dynamic and unstable (Yang). When Jing and Kong are paired, Jing is caused by external triggers disturbing the Heart internally, causing the Spirit (Shen) to fluctuate; Kong is caused by confusion from external factors depleting the Will (Zhi) internally, leading to a retreat of Essence (Jing). Therefore, the *Neijing* states that Jing causes the Heart to have no foundation, the Shen to have no return, and thoughts to be undetermined, resulting in chaotic Qi. Kong causes Essence to retreat; this retreat blocks the Upper Jiao, preventing Qi from returning, leading to distension in the Lower Jiao and stagnation of Qi. Furthermore, it mentions that those who were once noble but became lowly, or wealthy but became poor, may suffer from internal binding of sorrow and worry, leading to Tuoying (depletion of nutritive Qi) and Shijing (loss of essence). In deep disease with deficient Qi, one may experience sudden fright (Salerran Jing); these cases involve diseases moving the internal Shen due to external events. Conversely, when Jing and Kong arise from internal imbalances of Yin and Yang, Jing is caused by Fire-Heat scorching and agitating the Heart, leading to chaotic Shen. Since Shen's functions are variable, the manifestations of Jing vary, corresponding to the Five Spirits. If the Liver's Hun (Ethereal Soul) is unsettled, it leads to Jinghai (frightened startle) and Jingwang (delirious fright). If the Lung's Po (Corporeal Soul) is unsettled, it leads to Jingzao (agitated fright). If the Spleen's Yi (Intellect) is unfocused, it leads to Jinghuo (confused fright). If the Kidney's Zhi (Will) is deficient, it leads to Kongjing, with a palpitations sensation in the Heart. Although the Stomach has no specific Spirit, it is the Sea of the Five Zang organs; if Heat accumulates there, it can cause Jingkuang (frightful mania), and even hearing wooden sounds may cause the Heart to tremble. Kong, however, is caused by Heat injuring the Kidney; Kidney injury leads to Essence deficiency, which results in Will insufficiency. Since the Will is inherently stable and unmoving, Kong presents with few other symptoms. Regarding the pathogens of Jing in the *Neijing*, they include Fire and Heat pathogenic factors, climatic influences of Si Tian and Zai Quan, heat diseases of various meridians, accumulation of Yang Qi, and Qi merging into Yang, all categorized under Jing disorders. Thus, the *Bingji* summarizes that all frightful disorders belong to Fire. Regarding pathogens of Kong, they include Essence and Qi merging into the Kidney, Blood deficiency, Yin deficiency with Yang invasion, Yin-Yang conflict, Stomach Heat with weak Kidney Qi, and Kidney meridian movement disorders. However, the Liver is involved in both Jing and Kong because its Qi belongs to Yang yet resides in Yin, housing Blood and Hun. Unsettled Hun moves the Shen, causing Jing; Blood deficiency depletes the Zhi, causing Kong. Thus, the Liver encompasses both. Aside from external contraction of Fire and Heat, most internal Jing and Kong arise from disturbances in the body's Yin and Yang. However, it is not limited to Fire and Heat; urgency in the Yangming Meridian can also cause Jing. A question was posed: Are the treatments for Jing and Kong, based on internal and external causes, the same or different? The answer is: Treatment for Jing aims to calm the Shen, while treatment for Kong aims to stabilize the Zhi; thus, therapies must distinguish between Yin and Yang and cannot be identical. In the *I Ching*, Qian and Kun interact, Kan and Li are arranged; only after Kan and Li interact does one achieve "Ji Ji" (After Completion). Humans correspond to the Five Zang organs: the Heart is Li Fire, Yin inside and Yang outside; the Kidney is Kan Water, Yang inside and Yin outside. The interior represents the Master (Zhu), and the exterior represents the Function (Yong). The interior masters the Five Spirits, while the exterior utilizes the Five Qi. Therefore, the Heart governs Shen with Yang as its function, and the Kidney governs Zhi with Yin as its function. Yang corresponds to Qi and Fire; Yin corresponds to Essence and Water. Achieving "Water and Fire Ji Ji" requires Yin Essence to ascend to calm the Shen, and Yang Qi to descend to stabilize the Zhi. Otherwise, Shen fluctuates internally, Yang dissipates externally, Zhi is disturbed internally, and Yin Essence descends improperly. Given the distinction between the two Zang organs' Water and Fire, treatments must differ slightly. For Jing, one must first calm the Shen so that scattered Qi can converge; once Qi converges, the Yang pathway functions. For Kong, one must first stabilize the Zhi so that lost Essence can be secured; once Essence is secured, the Yin function operates. Medicinal prescriptions must differentiate the Sovereign, Minister, Assistant, and Envoy roles for these two Zang organs, and treatments for internal versus external causes will also vary slightly. For Jing caused by external factors, although Zhang Zihe advocated "Ping" (calming/accustoming) by exposing patients repeatedly to the frightening stimulus until they become accustomed, a better approach is to first calm the mind and regulate Qi before administering medicine. For Jing caused by internal agitation of the Shen, Zhang's method is unsuitable; instead, medicine should balance Yin-Yang excess and deficiency to calm the Shen and stabilize the Zhi. The human body is governed by the Heart, which nourishes Blood. When Heart Blood is deficient, Shen and Qi lose their residence; an empty residence allows Phlegm to invade, causing Ji and Jing. Alternatively, hearing loud noises, seeing strange objects, facing danger, or losing resolve due to events can cause the Heart to be disrupted, leading to a trembling state, which is defined as Jing. If Heart deficiency leads to water retention, fluid trickles in the chest, and floating Qi moves; as water ascends, Heart Fire repels it, causing Heart insecurity and a heavy or pounding sensation, which is defined as Ji. For Jing, administer formulas to resolve Phlegm and calm fright. For Ji, administer formulas to drain water and eliminate fluid retention. This constitutes supporting deficiency, nourishing Heart Blood, and harmonizing Heart Qi. Using only acrid-warm-dry herbs may ignite Heart Fire further, leading to Wind generated by Heat.