怔忡之症本是心气之虚如何分为上下其故实有至理而世人未知也肺脉居于心之上肺气有
养
则清肃之令下行足以制肝木之旺肝木不敢下克脾土脾土得令自能运化以分津液而上输于心而
后心
君安静无为何致有怔忡不定之病耶此所谓上症之源流也因肺金失令则肝木寡畏以克脾土脾土
为肝所制事肝木之不暇又安能上奉于心乎心无脾土之输而肝木又旺自己尊大罔顾心君之子此
心所以摇摇靡定而怔忡之症起矣但怔忡上病何以知之其症必兼咳嗽而饮食能食而不能消者是
也方用安止汤此方合肺脾心肝四脏之药以治之也一剂而少定再剂而更安十剂而怔忡之病可以
全愈矣其下病奈何其症吐痰如清水饮食知味而苦不能多闻人言则惊见天光可畏时时懊 刻刻
烦闷此病乃肾水耗竭不能上输于肝木而肝木自顾不遑又安能上养于心乎心血既耗又安能下通
于肾心肾交困怔忡时生不止痰气之作祟也治用消烦汤此方乃补心肝肾之圣药三经大补则气血
精皆足虽有痰气不清又有白芥子以消其痰于胆膈之中岂尚有怔忡之不定乎自然烦去而心安闷
除而魂静也
安上汤
人参（三钱） 茯神（五钱） 麦冬（五钱） 北五味（一钱） 丹参（二钱） 柏子仁（二钱） 半夏（
一钱） 丹砂（一钱） 菖蒲（二钱） 白术（五钱） 枳壳（三分） 神曲（五分） 白芍（五钱）水煎服
消烦汤
熟地（一两） 山茱萸（五钱） 白芍（五钱） 当归（五钱） 黄 （五钱） 人参（五钱） 牛膝（五
钱）
巴戟天（五钱） 菟丝子（五钱） 枸杞子（五钱） 炒枣仁（五钱） 白芥子（五钱） 山药（五钱）水煎
服
怔忡这种病症，本质上是心气虚弱所致，为何还要分为上部和下部？这其中的道理确实非常精妙，只是世人尚不了解。肺脉位于心的上方，如果肺气充足，其清肃下降的机能就能下行，从而制约肝木的过旺；肝木不敢向下克制脾土，脾土得以正常行使职能，自然能够运化水湿并输布津液上行至心脏，这样心君（心脏）就能安静无为，怎么会发生心神不定、惊恐不安的怔忡病呢？这就是所谓的上部病症的来源和机理。
如果肺金功能失常，肝木就会因为缺乏畏惧而过度克制脾土；脾土被肝木所制，忙于应付肝木的克制都来不及，又怎能向上输送精气以滋养心脏呢？心脏得不到脾土的输送，而肝木又过于旺盛，只顾自己壮大而不顾护心君之子（心血），因此心脏摇摇欲坠、不能安定，怔忡的病就产生了。但是，如何判断这是上部的病呢？其症状必然兼有咳嗽，且虽然能进食但食物无法消化。治疗方剂用安止汤。此方融合了调理肺、脾、心、肝四脏的药物来治疗。服用一剂后症状稍定，再服一剂则更加安宁，服用十剂后怔忡之病可以完全痊愈。
那么下部的病又是怎样的呢？其症状表现为吐出像清水一样的痰，饮食有味但苦于不能多听人说话，听到声音就受惊，见到天光感到恐惧，时时内心懊恼，刻刻烦闷。这种病是由于肾水耗竭，不能上行滋养肝木，而肝木自身难保，又怎能向上滋养心脏呢？心血既然已经耗损，又怎能向下通达于肾？心肾相互困顿，导致怔忡时常发作，这不仅仅是痰气作祟的结果。治疗使用消烦汤。此方是补益心、肝、肾三经的圣药，三经得到大补，则气血精皆充足；即使有不清的痰气，方中又有白芥子来消除胆膈之间的痰浊，哪里还会有心神不定的怔忡呢？自然是烦躁去除而心安，郁闷消除而神魂宁静。
安止汤
人参（三钱） 茯神（五钱） 麦冬（五钱） 北五味子（一钱） 丹参（二钱） 柏子仁（二钱） 半夏（一钱） 朱砂（一钱） 石菖蒲（二钱） 白术（五钱） 枳壳（三分） 神曲（五分） 白芍（五钱） 用水煎服。
消烦汤
熟地黄（一两） 山茱萸（五钱） 白芍（五钱） 当归（五钱） 黄芪（五钱） 人参（五钱） 牛膝（五钱） 巴戟天（五钱） 菟丝子（五钱） 枸杞子（五钱） 炒酸枣仁（五钱） 白芥子（五钱） 山药（五钱） 用水煎服。
Palpitations (Zhenchong) are essentially caused by a deficiency of Heart Qi. Why are they divided into upper and lower categories? The rationale is profound, yet unknown to the general public. The Lung pulse resides above the Heart. If Lung Qi is sufficient, its descending and purifying function can move downward, thereby restraining the exuberance of Liver Wood. When Liver Wood does not dare to overact upon Spleen Earth below, Spleen Earth can perform its functions normally, transforming fluids and transporting them upward to the Heart. Consequently, the Heart Monarch remains tranquil and at ease, preventing the onset of palpitations characterized by restlessness and fright. This explains the origin and mechanism of the upper-type palpitations.
However, if the Metal of the Lung fails to function properly, Liver Wood, lacking fear, will excessively restrain Spleen Earth. Spleen Earth, being controlled by Liver Wood, is too busy coping with this restraint to send essence upward to nourish the Heart. Without the transport from Spleen Earth, and with Liver Wood in a state of hyperactivity that disregards the protection of the Heart's offspring (Heart Blood), the Heart becomes unstable and unsteady, giving rise to palpitations. How then can one identify this as an upper-type disorder? The symptoms must include coughing, along with the ability to eat but an inability to digest food properly. The prescribed formula is Anzhi Tang (Calm and Stop Decoction). This formula combines herbs targeting the four Zang organs—Lung, Spleen, Heart, and Liver—for treatment. After one dose, symptoms subside slightly; after two doses, peace is further restored; after ten doses, the disease of palpitations can be completely cured.
What about the lower-type disorder? Its symptoms include vomiting phlegm resembling clear water, having taste perception for food but suffering from aversion to hearing people speak, being startled by sounds, fearing daylight, experiencing frequent inner vexation, and constant mental agitation. This condition arises because Kidney Water is exhausted and cannot ascend to nourish Liver Wood. Since Liver Wood cannot even sustain itself, how can it nourish the Heart? With Heart Blood already depleted, how can it descend to communicate with the Kidneys? The mutual distress of the Heart and Kidneys leads to recurrent palpitations, which is not merely due to the disturbance of Phlegm-Qi. The treatment utilizes Xiaofan Tang (Eliminate Vexation Decoction). This formula is a sacred prescription for tonifying the three meridians of the Heart, Liver, and Kidneys. By greatly tonifying these three, Qi, Blood, and Essence become abundant. Even if turbid Phlegm-Qi persists, White Mustard Seed (Baijiezi) in the formula eliminates phlegm within the Gallbladder and Diaphragm, leaving no room for unstable palpitations. Naturally, vexation disappears bringing peace to the Heart, and depression is removed calming the Hun (Ethereal Soul).
Anzhi Tang (Calm and Stop Decoction)
Ren Shen (Ginseng Radix et Rhizoma) [3 qian]
Fushen (Poria with Hostwood) [5 qian]
Maidong (Ophiopogonis Radix) [5 qian]
Bei Wuwei Zi (Schisandrae Chinensis Fructus) [1 qian]
Danshen (Salviae Miltiorrhizae Radix et Rhizoma) [2 qian]
Baizi Ren (Biota Semen) [2 qian]
Banxia (Pinelliae Tuber) [1 qian]
Dansha (Cinnabar) [1 qian]
Changpu (Acori Tatarinowii Rhizoma) [2 qian]
Baizhu (Atractylodis Macrocephalae Rhizoma) [5 qian]
Zhike (Aurantii Fructus Immaturus) [3 fen]
Shenqu (Massa Medicata Fermentata) [5 fen]
Baishao (Paeoniae Radix Alba) [5 qian]
Decoct in water and take orally.
Xiaofan Tang (Eliminate Vexation Decoction)
Shu Dihuang (Rehmanniae Radix Praeparata) [1 liang]
Shanzhuyu (Corni Fructus) [5 qian]
Baishao (Paeoniae Radix Alba) [5 qian]
Danggui (Angelicae Sinensis Radix) [5 qian]
Huangqi (Astragali Radix) [5 qian]
Ren Shen (Ginseng Radix et Rhizoma) [5 qian]
Niuxi (Achyranthis Bidentatae Radix) [5 qian]
Bajitian (Morinda Officinalis Radix) [5 qian]
Tusizi (Cuscutae Semen) [5 qian]
Gouqizi (Lycii Fructus) [5 qian]
Chao Zaoren (Ziziphi Spinosae Semen Preparatum) [5 qian]
Baijiezi (Brassicae Semens) [5 qian]
Shanyao (Dioscoreae Rhizoma) [5 qian]
Decoct in water and take orally.