癫属阴，狂属阳，癫多喜而狂多怒，脉虚者可治，实则死。大率多因痰结于心
间，治当镇心神、开痰结。亦有中邪而成此疾者，则以治邪法治之，《原病式》所论尤精。
盖为世所谓重阴者癫，重阳者狂是也，大概是热。癫者，神不守舍，狂言如有所见，经年不愈，
心
邪所
则耳鸣，用天门冬去心，日干作末，酒服方寸匕。癫证，春治之，入夏自安，宜助心气之
药。阳虚阴实则癫，阴虚阳实则狂。狂病宜大吐下则除之。
入方
治癫风。
麻仁（四升）
上以水六升，猛火煮至二升，去滓，煎取七合。旦，空心服。或发或不发，或多言语，
勿怪之，但人摩手足须定，凡进三剂，愈。
又方 治狂邪发无时，披头大叫，欲杀人，不避水火。
苦参（不以多少）
上为末，蜜丸如梧子大。每服十五丸，煎薄荷汤下。
惊悸者血虚，惊悸有时，以朱砂安神丸。痰迷心膈者，痰药皆可，定志丸加琥
、郁金。怔忡者血虚，怔忡无时，血少者多，有思虑便动，属虚。时作时止者，痰因火动
瘦人多因是血少，肥人属痰，寻常者多是痰。真觉心跳者是血少，四物、朱砂安神之类。假
如病因惊而得，惊则神出其舍，舍空则痰生也。
戴云∶怔忡者，心中不安，惕惕然如人将捕者是也。
〔附录〕惊悸，人之所主者心，心之所养者血，心血一虚，神气不守，此惊悸之所肇端也
曰惊、曰悸，其可无辨乎？惊者，恐怖之谓；悸者，怔忡之谓。心虚而郁痰，则耳闻大声，
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
漉，虚气流动，水既上乘，心火恶之，心不自安，使人有怏怏之状，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，不过调养心血，和平心气而已。
入方
治劳役心跳大虚证。
朱砂 归身 白芍 侧柏叶（炒，五钱） 川芎 陈皮 甘草（各二钱） 黄连（炒,一钱半）
上为末，猪心血丸服。
附方
养心汤 治心虚血少，惊悸不宁。
黄 （炙） 白茯苓 茯神 半夏曲 当归 川芎（各半两） 远志（去心，姜汁炒） 辣桂
柏子仁 酸枣仁（炒） 五味 人参（二钱半） 甘草（炙,四钱）
上每服三钱，水煎姜三片，枣一个，食前服。治停水怔忡，加槟榔、赤茯苓。
宁志丸 治心虚血虚，多惊。若有痰惊，宜吐之。
人参 白茯苓 茯神 柏子仁 琥珀 当归 酸枣（温酒浸半日，去壳，隔纸炒） 远志
（各半两，炒） 乳香 朱砂 石菖蒲（二钱半）
上为末，炼蜜丸如梧子大。服三十丸，食后煎枣汤吞下。
朱雀丸 治心病怔忡不止。
白茯神（二两） 沉香（五钱）
上为末，炼蜜丸小豆大。服三十丸，人参汤下。
加味四七汤 治心气郁滞，豁痰散惊。
半夏（二两半） 白茯苓 浓朴（各一两半） 茯神 紫苏（各一两） 远志（炒） 甘草（炙,半两）
上每服四钱，生姜五片，石菖蒲一寸，枣一个，水煎服。
朱砂安神丸
朱砂（五钱水飞过，另研） 黄连（酒洗，六钱） 甘草（炙，二钱半） 生地黄（一钱半） 当归（二
上四味为末，蒸饼丸如黍米大，朱砂为衣。服二十丸或五十丸，津下。
定志丸 见健忘类。
癫证属于阴，狂证属于阳；癫证患者多表现为喜悦（或喜静），狂证患者多表现为愤怒（或躁动）。脉象虚弱的可以治愈，脉象实大的则预后不良。这类疾病大多是因为痰浊结聚在心胸之间，治疗应当镇安心神、开通痰结。也有因中受邪气而引发此病的，则用治邪的方法来处理，《原病式》中的论述尤为精辟。这大概就是世人所说的“重阴者癫，重阳者狂”，大体上都是热证所致。癫证是神志不守舍，胡言乱语好像看到了什么，经久不愈，如果伴有耳鸣，可用天门冬去掉心部，晒干研成粉末，用酒送服方寸匕。对于癫证，如果在春季治疗，到了夏天自然就会安宁，适宜使用补益心气的药物。阳虚阴实则发为癫证，阴虚阳实则发为狂证。狂病适宜用催吐和泻下的方法才能去除病根。
下面列出治疗癫风的方剂：
麻仁（四升）
以上药材用水六升，猛火煮至二升，滤去药渣，再煎取七合。早晨空腹服用。服药后或者发作或者不发作，或者多言语，不要感到奇怪，只需让人按住患者的手足使其安定，总共服用三剂，即可痊愈。
另一个方子：治疗狂邪随时发作，披头散发大声叫喊，想要杀人，不避水火。
苦参（用量不限）
将上述药材研成粉末，用蜂蜜制成梧桐子大小的丸药。每次服用十五丸，用薄荷煎汤送下。
惊悸是由于血虚引起的，惊悸时有时无的，用朱砂安神丸。痰浊迷蒙心膈的，各种化痰药都可以，可用定志丸加琥珀、郁金。怔忡也是由于血虚，怔忡无时不在，血少的情况较多，有思虑时就发作，属于虚证。时作时止的，是痰因火动引起的。瘦人多因血少，肥人属痰，寻常的惊悸多是痰湿引起。真正感觉心跳剧烈的，是血少所致，可用四物汤、朱砂安神丸之类。假如病因惊吓而得，惊则神气外越离开其居所，居所空虚则痰生。
戴元礼说：怔忡，就是心中不安，警惕害怕好像有人要抓捕自己一样。
〔附录〕惊悸，人的主宰是心，心所滋养的是血，心血一旦虚弱，神气就不能固守，这是惊悸产生的开端。称为惊、称为悸，难道没有区别吗？惊，是指恐怖的意思；悸，是指怔忡的意思。心虚而有郁滞之痰，则听到巨大的声音，看到奇异的事物，遇到危险临近危难，接触事物丧失意志，心受到逆乱，使人产生警惕害怕的状态，这就是惊；心虚而有停水，则胸中漉漉作响，虚气流动，水既上乘于心，心火厌恶它，心不能自安，使人产生怏怏不乐的状态，这就是悸。对于惊，给予豁痰定惊的药剂；对于悸，给予逐水消饮的药剂。所谓扶正补虚，不过是调养心血，平和心气罢了。
下面列出治疗劳役导致的心跳大虚证的方剂：
朱砂 当归身 白芍 侧柏叶（炒，五钱） 川芎 陈皮 甘草（各二钱） 黄连（炒，一钱半）
将上述药材研成粉末，用猪心血泛丸服用。
附方：
养心汤：治疗心虚血少，惊悸不宁。
黄芪（炙） 白茯苓 茯神 半夏曲 当归 川芎（各半两） 远志（去心，姜汁炒） 肉桂 柏子仁 酸枣仁（炒） 五味子 人参（二钱半） 甘草（炙，四钱）
以上每服三钱，加水煎煮，放入生姜三片，大枣一个，饭前服用。治疗停水引起的怔忡，加槟榔、赤茯苓。
宁志丸：治疗心虚血虚，容易受惊。如果有痰惊，适宜用吐法。
人参 白茯苓 茯神 柏子仁 琥珀 当归 酸枣（温酒浸泡半天，去壳，隔纸炒） 远志（各半两，炒） 乳香 朱砂 石菖蒲（二钱半）
将上述药材研成粉末，炼蜜制成梧桐子大小的丸药。每次服用三十丸，饭后用煎好的枣汤吞服。
朱雀丸：治疗心病怔忡不止。
白茯神（二两） 沉香（五钱）
将上述药材研成粉末，炼蜜制成小豆大小的丸药。每次服用三十丸，用人参汤送下。
加味四七汤：治疗心气郁滞，豁痰散惊。
半夏（二两半） 白茯苓 厚朴（各一两半） 茯神 紫苏（各一两） 远志（炒） 甘草（炙，半两）
以上每服四钱，加生姜五片，石菖蒲一寸，大枣一个，水煎服。
朱砂安神丸：
朱砂（五钱，水飞，另研） 黄连（酒洗，六钱） 甘草（炙，二钱半） 生地黄（一钱半） 当归（二钱）
将上述四味药研成粉末，用蒸饼糊制成黍米大小的丸药，以朱砂为衣。每次服用二十丸或五十丸，津液送下。
定志丸：见健忘类。
Dian (Manic-Depressive Psychosis) belongs to Yin, while Kuang (Mania) belongs to Yang. Dian is characterized by excessive joy (or preference for quietness), whereas Kuang is characterized by excessive anger (or agitation). A deficient pulse indicates a treatable condition, while an excess pulse suggests a fatal prognosis. Generally, these conditions are caused by phlegm knotting in the chest and heart region; treatment should focus on calming the Shen (Spirit) and resolving phlegm knots. Some cases arise from invasion by pathogenic factors, which should be treated according to methods for expelling pathogens; the discussion in *Yuan Bing Shi* (Treatise on the Original Causes of Diseases) is particularly refined. This corresponds to what the world calls "excess Yin leads to Dian, excess Yang leads to Kuang," which is generally due to heat. Dian involves the Shen failing to reside in its proper place, resulting in delirious speech as if seeing things, persisting for years without cure. If accompanied by tinnitus, use Tian Men Dong (Asparagi Radix), removing the heart, drying it, grinding it into powder, and taking one fangcun bi (a measure roughly equivalent to a tablespoon) with wine. For Dian syndrome, if treated in spring, it will naturally settle by summer; herbs that tonify Heart Qi are appropriate. Deficiency of Yang with Excess of Yin leads to Dian; Deficiency of Yin with Excess of Yang leads to Kuang. Kuang disease is best cured by inducing vomiting and purging.
The following formula treats Dian Feng (Wind-induced Mania):
Hemp Seed (Semen Cannabis, Mahu Ren) - 4 sheng
Take six sheng of water, boil vigorously until reduced to two sheng, strain the dregs, and further decoct to obtain seven he. Take in the morning on an empty stomach. Whether the patient attacks or not, or speaks excessively, do not be alarmed; simply have someone hold the patient's hands and feet to keep them calm. After three doses, the patient will recover.
Another formula: Treats Kuang Xie (Maniacal Deviation) occurring at any time, with disheveled hair, loud screaming, desire to kill, and disregard for fire and water.
Sophora Root (Radix Sophorae Flavescentis, Kushen) - as needed
Grind into powder, make pills the size of sophora seeds with honey. Take fifteen pills each time, washed down with mint decoction.
Jing Ji (Palpitations due to Fright) is caused by Blood deficiency. For palpitations that occur intermittently, use Zhu Sha An Shen Wan (Cinnabar Pill for Calming the Spirit). For Phlegm misting the Heart and Diaphragm, various phlegm-resolving herbs can be used; add Hu Po (Amber) and Yu Jin (Curcuma Longa Rhizome) to Ding Zhi Wan (Pill for Stabilizing the Spirit). Zheng Chong (Constant Palpitations/Anxiety) is also due to Blood deficiency. Constant palpitations are more common in those with low blood volume; they occur when thinking, belonging to deficiency syndromes. Intermittent palpitations are caused by Phlegm stirred by Fire. Thin individuals often suffer from this due to low Blood, while fat individuals are associated with Phlegm; ordinary palpitations are mostly due to Phlegm. True sensation of violent heartbeat is due to low Blood; use Si Wu Tang (Four Substances Decoction) or Zhu Sha An Shen Wan. If the cause is fright, fright causes the Shen to leave its residence; emptiness in the residence generates Phlegm.
Dai Yuanli stated: Zheng Chong refers to inner unease, feeling fearful and apprehensive as if someone were about to capture you.
[Appendix] The master of humans is the Heart, and what nourishes the Heart is Blood. Once Heart Blood becomes deficient, the Shen (Spirit) cannot remain secure; this is the origin of Jing Ji (Palpitations due to Fright). Are there distinctions between Jing (Fright) and Ji (Palpitations)? Jing refers to terror; Ji refers to Zheng Chong (constant palpitations). When the Heart is deficient and contains stagnant Phlegm, hearing loud noises, seeing strange objects, encountering danger, or facing crises causes the will to falter, disturbing the Heart and creating a state of apprehension; this is Jing. When the Heart is deficient and retains Water, fluid sounds are heard in the chest; moving deficient Qi allows Water to ascend, which the Heart Fire dislikes, causing the Heart to feel insecure and creating a state of dissatisfaction; this is Ji. For Jing, administer formulas that resolve Phlegm and calm fright; for Ji, administer formulas that drain Water and eliminate retained fluids.所谓的扶虚 (Supporting deficiency) merely involves nourishing Heart Blood and harmonizing Heart Qi.
The following formula treats severe deficiency and palpitations due to overwork:
Cinnabar (Zhu Sha)
Angelica Sinensis Root (Dang Gui Shen)
White Peony Root (Bai Shao)
Biota Tops (Ce Bai Ye) - stir-fried, 5 qian
Ligusticum Chuanxiong Rhizome (Chuan Xiong)
Tangerine Peel (Chen Pi)
Licorice Root (Gan Cao) - 2 qian each
Coptis Rhizome (Huang Lian) - stir-fried, 1.5 qian
Grind into powder, make pills using pig Heart Blood.
Attached Formulas:
Yang Xin Tang (Decoction for Nourishing the Heart): Treats Heart deficiency and low Blood, causing restless palpitations.
Astragalus Root (Huang Qi) - roasted
Poria (Bai Fu Ling)
Poria with Hostwood (Fu Shen)
Fermented Wheat Leaven (Ban Xia Qu)
Angelica Sinensis Root (Dang Gui)
Ligusticum Chuanxiong Rhizome (Chuan Xiong) - half liang each
Polygala Root (Yuan Zhi) - remove heart, stir-fried with ginger juice
Cinnamon Twig (La Gui)
Biota Seeds (Bai Zi Ren)
Ziziphus Seed (Suan Zao Ren) - stir-fried
Schisandra Fruit (Wu Wei Zi)
Codonopsis Root (Ren Shen) - 2.5 qian
Licorice Root (Gan Cao) - roasted, 4 qian
Take three qian per dose, decoct with water, add three slices of ginger and one jujube, take before meals. For Zheng Chong due to retained water, add Areca Seed (Bing Lang) and Red Poria (Chi Fu Ling).
Ning Zhi Wan (Pill for Calming the Mind): Treats Heart and Blood deficiency with frequent fright. If there is Phlegm-Fright, vomiting is appropriate.
Codonopsis Root (Ren Shen)
Poria (Bai Fu Ling)
Poria with Hostwood (Fu Shen)
Biota Seeds (Bai Zi Ren)
Amber (Hu Po)
Angelica Sinensis Root (Dang Gui)
Ziziphus Seed (Suan Zao) - soaked in warm wine for half a day, shell removed, stir-fried between papers
Polygala Root (Yuan Zhi) - half liang each, stir-fried
Frankincense (Ru Xiang)
Cinnabar (Zhu Sha)
Acorus Rhizome (Shi Chang Pu) - 2.5 qian
Grind into powder, make pills the size of sophora seeds with refined honey. Take thirty pills, swallowed with jujube decoction after meals.
Zhu Que Wan (Vermilion Bird Pill): Treats persistent Zheng Chong due to Heart disease.
Poria with Hostwood (Bai Fu Shen) - 2 liang
Agarwood (Chen Xiang) - 5 qian
Grind into powder, make pills the size of soybeans with refined honey. Take thirty pills, washed down with Codonopsis decoction.
Jia Wei Si Qi Tang (Modified Four Seven Decoction): Treats stagnation of Heart Qi, resolving Phlegm and dispersing fright.
Pinellia Tuber (Ban Xia) - 2.5 liang
Poria (Bai Fu Ling)
Magnolia Bark (Hou Po) - 1.5 liang each
Poria with Hostwood (Fu Shen)
Perilla Leaf (Zi Su) - 1 liang each
Polygala Root (Yuan Zhi) - stir-fried
Licorice Root (Gan Cao) - roasted, half liang
Take four qian per dose, decoct with five slices of ginger, one inch of Acorus Rhizome, and one jujube in water.
Zhu Sha An Shen Wan (Cinnabar Pill for Calming the Spirit):
Cinnabar (Zhu Sha) - 5 qian, water-triturated, ground separately
Coptis Rhizome (Huang Lian) - 6 qian, washed with wine
Licorice Root (Gan Cao) - roasted, 2.5 qian
Rehmannia Root (Sheng Di Huang) - 1.5 qian
Angelica Sinensis Root (Dang Gui) - 2 qian
Grind the four ingredients into powder, make pills the size of millet grains using steamed bread paste, coat with Cinnabar. Take twenty or fifty pills, swallowed with saliva.
Ding Zhi Wan (Pill for Stabilizing the Spirit): See the section on Forgetfulness.