大意
健忘由精神短少。神志不交。亦有天禀不足者。亦有属痰者。（汇补）
内因
忧思过度。损伤心胞。以致神舍不宁。遇事多忘。又思伤脾。神不归脾。亦令转盼遗忘。若求望高远。所愿不
遂。悉属心神耗散。
外候
健忘者。陡然而忘其事也。为事有始无终。言谈不知首尾。
健忘因心肾不交
心不下交于肾。浊火乱其神明。肾不上交于心。精气伏而不用。火居上则搏而为痰。水居下则因而生躁。
故补肾而使之时上。养心而使之时下。则神气清明。志意合治矣。（必读）
治法
当养心血。调脾土。佐以宁神定志之品。
用药
大抵思虑过度。病在心脾者。归脾汤。挟痰。加竹沥、姜汁。精神短少者。人参养荣汤。痰迷心窍者。导痰汤送
寿星丸。心肾不交。神志不宁者。朱雀丸。禀赋不足。神志虚扰者。大圣枕中方。
【附惊恐】
惊因触于外事。内动其心。心动则神摇。恐因内歉其志。志歉则精却。故经云。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。闭则气不还。气不还则下焦胀。故气不行矣。治之之法。惊则安
其神。恐则定其志。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。阳气下藏以定其志。（汇补）
健忘选方
归脾汤 治思虑过度。劳伤心脾。健忘怔忡。
人参 茯苓 黄 枣仁 白术 当归 远志 木香 炙甘草 龙眼肉 宁志膏 人参 枣仁（各一两） 辰砂（五
钱） 乳香（二钱半）
蜜丸。弹子大。薄荷汤下一丸。
人参养荣汤 治精神衰倦短少。（方见中风）
导痰汤（方见似中风）
寿星丸 治痰迷心窍健忘。
南星（一斤掘坑深二尺炭五斤坑内烧红扫净酒浇南星下坑急盖密一宿焙） 琥珀（四两另研） 朱砂（一两水飞
一半为衣）
猪心血三个。姜汁打糊为丸。每服三钱。人参汤下。
朱雀丸 治心肾不交。
沉香（一两） 茯苓（四两）
蜜丸豆大。每服三十丸。参汤下。
柏子养心丹
柏子仁（去壳炒二两） 枸杞（三两） 麦冬 茯神（各一两） 熟地 甘草（五钱）
玄参（二两） 当归（五钱） 石菖蒲（五钱）
蜜丸。临卧服。
大圣枕中方
龟甲 龙骨 远志 菖蒲（各等分）
为末。酒服方寸匕。日三服。令人大聪大明。
定志丸 治恍惚多忘。
还志 人参（各一两） 菖蒲（二两） 茯神（三两）
蜜丸。辰砂为衣。如梧子大。每服三十丸。米汤下。
天王补心丹（方见中风）
二丹丸 治健忘。开心志。
丹参 天冬 熟地（各半两） 茯神 甘草 麦冬（各一两） 远志 菖蒲 朱砂（为衣各五钱） 蜜丸。
【大意】
健忘症是由于精神气血亏少，导致心神与肾志不能相互交通所致。也有的是因为先天禀赋不足引起的，还有的属于痰浊阻滞。（出自《证治汇补》）
【内因】
忧思过度，损伤心包络，致使心神居所不安宁，遇到事情容易遗忘。另外，思虑伤脾，神气不能归附于脾，也会导致转眼即忘。如果追求过高的目标，愿望未能实现，这些都归属于心神耗散。
【外候（临床表现）】
健忘的表现是突然忘记某件事。做事有头无尾，说话不知首尾连贯。
【健忘因心肾不交】
心火不能下行交于肾水，浊火扰乱神明；肾水不能上行交于心火，精气潜伏而不能发挥作用。火居上焦则煎熬津液凝结成痰，水居下焦则因虚而生躁动。因此，补肾使肾气适时上升，养心使心气适时下降，那么神气就会清明，意志就能协调统一。（出自《景岳全书·必读》）
【治法】
应当滋养心血，调理脾土，辅以具有宁心安神、定志作用的药物。
【用药】
大抵而言，因思虑过度导致病在心脾的，使用归脾汤；兼夹痰浊的，加竹沥、姜汁。精神气血短少的，用人参养荣汤。痰迷心窍的，用导痰汤送服寿星丸。心肾不交、神志不宁的，用朱雀丸。禀赋不足、神志虚浮扰动的，用大圣枕中方。
【附：惊恐致忘】
惊是因为受到外部事物的刺激，内在扰动心神。心动则神志摇荡。恐是因为内心志向歉疚或恐惧。志意怯弱则精气退却。所以医经说：惊则心无所依，神无所归，虑无所定，因此气机紊乱。恐则精气退却，退却则上焦闭塞，闭塞则气机不能返还，气机不还则下焦胀满，因此气机不能运行。治疗的方法：对于惊，要安定其神；对于恐，要坚定其志。心以神为主宰，以阳为功用；肾以志为主宰，以阴为功用。阳即是气，即是火；阴即是精，即是水。等到水火既济，全赖阴精上奉以安定神志，阳气下藏以坚定意志。（出自《证治汇补》）
【健忘选方】
归脾汤：治疗思虑过度，劳伤心脾，导致的健忘、怔忡。
组成：人参、茯苓、黄芪、酸枣仁、白术、当归、远志、木香、炙甘草、龙眼肉。
宁志膏：人参、酸枣仁（各一两），辰砂（五钱），乳香（二钱半）。
制法：蜂蜜炼蜜为丸，如弹子大小。薄荷汤送服一丸。
人参养荣汤：治疗精神衰败疲倦、气血短少。（方剂见“中风”章节）
寿星丸：治疗痰迷心窍导致的健忘。
组成：天南星（一斤，挖坑深二尺，用炭五斤在坑内烧红后扫净，浇酒放入南星，迅速盖密，过夜后焙干）、琥珀（四两，另研细末）、朱砂（一两，水飞，一半用于包衣）。
制法：用三个猪心血，加姜汁打糊为丸。每服三钱，人参汤送下。
朱雀丸：治疗心肾不交。
组成：沉香（一两），茯苓（四两）。
制法：蜂蜜炼蜜为丸，如豆大。每服三十丸，人参汤送下。
柏子养心丹
组成：柏子仁（去壳炒，二两），枸杞（三两），麦冬，茯神（各一两），熟地黄，甘草（五钱），玄参（二两），当归（五钱），石菖蒲（五钱）。
制法：蜂蜜炼蜜为丸。临睡前服用。
大圣枕中方
组成：龟甲、龙骨、远志、石菖蒲（各等分）。
制法：研为细末。酒送服一方寸匕，每日三次。使人聪明耳聪目明。
定志丸：治疗神志恍惚、多忘。
组成：远志、人参（各一两），石菖蒲（二两），茯神（三两）。
制法：蜂蜜炼蜜为丸，辰砂为衣，如梧桐子大。每服三十丸，米汤送下。
二丹丸：治疗健忘，开心益智。
组成：丹参，天冬，熟地黄（各半两），茯神，甘草，麦冬（各一两），远志，石菖蒲，朱砂（为衣，各五钱）。
制法：蜂蜜炼蜜为丸。
[General Principle]
Forgetfulness arises from a deficiency of Shen (Spirit) and Qi/Blood, leading to a failure of communication between Shen and Zhi (Will). It may also be caused by congenital insufficiency or the presence of Phlegm turbidity. (From *Zhengzhi Huibu*)
[Internal Causes]
Excessive worry and overthinking damage the Pericardium, causing the dwelling of the Heart Spirit to become unsettled, resulting in frequent forgetting when dealing with matters. Furthermore, overthinking injures the Spleen; if the Spirit does not return to the Spleen, it leads to immediate forgetfulness. If one pursues lofty goals but fails to achieve them, these conditions all belong to the dissipation of the Heart Spirit.
[External Manifestations]
Forgetfulness is characterized by suddenly forgetting an event. It manifests as starting tasks without finishing them, and speaking without coherence regarding the beginning and end.
[Forgetfulness due to Non-interaction of Heart and Kidney]
When Heart Fire fails to descend to interact with the Kidney, turbid fire disturbs the Mingde (Bright Virtue/Spirit). When Kidney Water fails to ascend to interact with the Heart, Essence remains latent and unutilized. Fire residing above condenses fluids into Phlegm; Water residing below generates restlessness due to deficiency. Therefore, tonifying the Kidney allows its Qi to rise at the appropriate time, while nourishing the Heart allows its Qi to descend at the appropriate time. This results in clarity of Spirit and Qi, and harmonious regulation of Will. (From *Jingyue Quanshu: Bixu*)
[Therapeutic Methods]
One should nourish Heart Blood, regulate the Spleen Earth, and supplement with herbs that calm the Spirit and stabilize the Will.
[Medication]
Generally, for cases where overthinking causes disease in the Heart and Spleen, use Guipi Tang (Restore the Spleen Decoction); if accompanied by Phlegm, add Zhuli (Bamboo Sap) and Jiangzhi (Ginger Juice). For those with deficiency of Spirit and Qi, use Renshen Yangrong Tang (Ginseng Nourishing the Vigor Decoction). For Phlegm confusing the Heart Orifices, use Daotan Tang (Great Phlegm-Resolving Decoction) administered with Shouxing Wan (Longevity Star Pill). For non-interaction of Heart and Kidney with unsettled Spirit and Will, use Zhuque Wan (Vermilion Bird Pill). For congenital insufficiency with deficient and disturbed Spirit and Will, use Dasheng Zhenzhong Fang (Great Sage Pillow Middle Formula).
[Appendix: Forgetfulness due to Fright and Fear]
Fright arises from external stimuli disturbing the internal Heart. When the Heart moves, the Spirit becomes agitated. Fear arises from internal deficiency of the Will. When the Will is deficient, Essence retreats. Thus, the Classics state: Fright causes the Heart to have no foundation, the Spirit to have no return, and thoughts to lack stability, thereby causing Qi chaos. Fear causes Essence to retreat; retreat leads to closure of the Upper Jiao (Upper Burner); closure prevents Qi from returning; inability of Qi to return leads to distension in the Lower Jiao (Lower Burner), thus preventing Qi movement. The treatment method: For fright, calm the Spirit; for fear, stabilize the Will. The Heart governs the Spirit, using Yang as its function; the Kidney governs the Will, using Yin as its function. Yang is Qi and Fire; Yin is Essence and Water. Achieving Ji Ji (Water and Fire Mutual Completion/Interaction) relies on Yin Essence ascending to calm the Spirit and Yang Qi descending to stabilize the Will. (From *Zhengzhi Huibu*)
[Selected Formulas for Forgetfulness]
Guipi Tang (Restore the Spleen Decoction): Treats forgetfulness and palpitations caused by overthinking damaging the Heart and Spleen.
Ingredients: Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Huangqi (Astragali Radix), Zaoren (Ziziphi Spinosae Semen), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), Yuanzhi (Polygalae Radix), Muxiang (Aucklandiae Radix), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma), Longyanrou (Longan Aril).
Alternative: Ningzhi Gao (Calming Spirit Paste): Renshen (Ginseng Radix et Rhizoma), Zaoren (Ziziphi Spinosae Semen) (each 1 liang), Chen Sha (Cinnabar) (5 qian), Xuxiang (Olibanum) (2.5 qian).
Preparation and Administration: Honey-pilled, size of a bullet. Take one pill with Bohe Tang (Mint Decoction).
Renshen Yangrong Tang (Ginseng Nourishing the Vigor Decoction): Treats mental exhaustion, fatigue, and deficiency of Spirit and Qi. (Formula see Stroke chapter)
Daotan Tang (Great Phlegm-Resolving Decoction): (Formula see Pseudo-Stroke chapter)
Shouxing Wan (Longevity Star Pill): Treats forgetfulness due to Phlegm confusing the Heart Orifices.
Ingredients: Nanxing (Arisaematis Rhizoma Preparatum) (1 jin: dig a pit 2 chi deep, burn 5 jin charcoal inside until red, sweep clean, pour wine, place Nanxing in pit, cover tightly overnight, then dry-roast), Hupo (Succinum) (4 liang, separately ground), Zhusha (Cinnabar) (1 liang, water-triturated, half used for coating).
Preparation and Administration: Use three pig heart bloods, mixed with Ginger Juice to form pills. Take 3 qian per dose, administered with Renshen Tang (Ginseng Decoction).
Zhuque Wan (Vermilion Bird Pill): Treats non-interaction of Heart and Kidney.
Ingredients: Chenxiang (Aquilariae Lignum Resinatum) (1 liang), Fuling (Poria) (4 liang).
Preparation and Administration: Honey-pilled, size of beans. Take 30 pills per dose, administered with Ginseng Decoction.
Baizi Yangxin Dan (Seed-of-Cypress Nourishing the Heart Pill)
Ingredients: Baiziren (Platycladi Semen) (dehusked, stir-fried, 2 liang), Gouqi (Lycii Fructus) (3 liang), Maidong (Ophiopogonis Radix), Fushen (Poria with Hostwood) (each 1 liang), Shudi (Rehmanniae Radix Preparata), Gancao (Glycyrrhizae Radix et Rhizoma) (5 qian), Xuanshen (Scrophulariae Radix) (2 liang), Danggui (Angelicae Sinensis Radix) (5 qian), Shichangpu (Acori Tatarinowii Rhizoma) (5 qian).
Preparation and Administration: Honey-pilled. Take before retiring.
Dasheng Zhenzhong Fang (Great Sage Pillow Middle Formula)
Ingredients: Guijia (Testudinis Carapax et Plastrum), Longgu (Fossilia Ossis Mastodi), Yuanzhi (Polygalae Radix), Changpu (Acori Tatarinowii Rhizoma) (equal parts).
Preparation and Administration: Grind into powder. Take with wine, one fangcun bi (approx. 5-10 grams) per dose, three times daily. Promotes acute hearing and clear vision.
Dingzhi Wan (Stabilizing Will Pill): Treats trance-like states and excessive forgetfulness.
Ingredients: Yuanzhi (Polygalae Radix), Renshen (Ginseng Radix et Rhizoma) (each 1 liang), Changpu (Acori Tatarinowii Rhizoma) (2 liang), Fushen (Poria with Hostwood) (3 liang).
Preparation and Administration: Honey-pilled, coated with Chen Sha (Cinnabar), size of wutong seeds. Take 30 pills per dose, administered with Rice Decoction.
Tianwang Buxin Dan (Emperor of Heaven's Tonifying the Heart Pill): (Formula see Stroke chapter)
Er Dan Wan (Two Dan Pills): Treats forgetfulness, opens the mind and benefits intelligence.
Ingredients: Danshen (Salviae Miltiorrhizae Radix et Rhizoma), Tiandong (Asparagi Radix), Shudi (Rehmanniae Radix Preparata) (each banliang), Fushen (Poria with Hostwood), Gancao (Glycyrrhizae Radix et Rhizoma), Maidong (Ophiopogonis Radix) (each 1 liang), Yuanzhi (Polygalae Radix), Changpu (Acori Tatarinowii Rhizoma), Zhusha (Cinnabar) (for coating, each 5 qian).
Preparation and Administration: Honey-pilled.