（心之所主者神也神之所根据者血也心血一虚神气失守则舍空而痰水客之此惊悸之
所由作也惊者惕惕然不宁触事易郁气郁生痰也 悸者筑筑然跳动盖以心虚则停
水水居火位心实畏之故怔忡而不能自安也）
伤寒八九日下之胸满烦惊。小便不利。谵语。一身尽重。（柴胡加龙骨牡蛎汤）火劫汗。
亡
。（炙甘草汤）汗
枝甘草大枣汤）太阳病汗出不解。发热心悸。头眩。身 动。振振欲擗地。（真武汤）少阳耳
聋。目赤。烦满。不可吐下。吐下则悸而惊。（救逆小柴胡去黄芩加茯苓）五六日往来寒热。胸
胁满。嘿嘿不饮食。心烦悸。喜呕微热。或咳。（小柴胡汤）脉弦细。头痛。发热。属少阳。不
可汗。汗则谵语。胃不和。则烦而悸。（调胃承气汤）少阴病。四逆而悸。或小便不利。或腹痛
。泄利。（四逆散）厥而悸者。宜先治水。（茯苓甘草汤）霍乱心悸。（理中丸加茯苓）
按惊与悸虽有分别。总皆心受伤也。因阳气内弱。法当镇固。因水饮停留。法当疏通。
饮之为
溢
况其他乎。
（振者身微动正气虚寒也战者身大动邪正相争也栗者心动邪气胜也振为轻而战
为重战在外而栗在内也）
吐下后。心下满。气上冲。头眩。脉沉紧。发汗则动经。身为振摇。（茯苓桂枝白术甘
草汤）太阳病。汗后仍热。心悸头眩。肉 身振。（真武汤）
按经云。下后复发汗。及亡血家误汗。必为寒振。内外俱虚也。又曰。表气微虚。里气
不守。邪中于阴则栗。乃知振摇之症。大抵属虚。素问曰。寒邪伤人使人毫毛毕直。鼓颔战栗。
此素有邪。当发其汗。仲景云。脉浮而紧。按之反芤此为本虚。当战汗而解。又三部脉。浮
沉迟数同等。必战汗而解。若脉浮数。按之不芤。其人不虚。汗自出而解不发战也。外不战
但内栗者。阴中于邪也。凡伤寒欲解。则战而汗出。此邪不胜正也。若正不胜邪。虽战无汗
。为不可治矣。
（心的主宰是神，神的依托是血。心血一旦虚弱，神气就会失去居所，导致心舍空虚，痰饮之水乘虚而入，这就是惊悸产生的原因。所谓“惊”，是指心中惕惕不安，遇事容易郁结，气机郁滞而生痰；所谓“悸”，是指心脏筑筑跳动，因为心虚则水液停聚，水占据火位（心属火），心对此感到畏惧，所以出现怔忡而不能安宁。）
伤寒病程经过八九日，误用下法后，出现胸中胀满、烦躁惊骇、小便不利、胡言乱语、全身沉重。（适用柴胡加龙骨牡蛎汤）因火疗强行发汗，导致亡失津液。（适用炙甘草汤）发汗后，桂枝甘草大枣汤证未解。太阳病发汗后病不解，出现发热、心悸、头晕、身体肌肉跳动、震颤欲倒仆于地。（适用真武汤）少阳病见耳聋、目赤、烦闷，不可使用吐法和下法，若误用吐下法则会导致心悸和惊骇。（适用救逆小柴胡汤，即去黄芩加茯苓）病程五六日，出现往来寒热、胸胁胀满、神情沉默不欲饮食、心烦心悸、喜欢呕吐、微热或咳嗽。（适用小柴胡汤）脉象弦细，头痛，发热，属于少阳病，不可发汗，发汗则会出现胡言乱语，胃气不和，进而烦躁且心悸。（适用调胃承气汤）少阴病，四肢厥冷且心悸，或小便不利，或腹痛、泄泻。（适用四逆散）四肢厥冷且心悸者，应当先治疗水饮。（适用茯苓甘草汤）霍乱病伴随心悸。（适用理中丸加茯苓）
按：惊与悸虽然有所区别，但总归都是心脏受伤所致。因为阳气内部虚弱，治法应当镇固收敛；因为水饮停留，治法应当疏通化解。水饮为患，其害尚且如此，何况其他情况呢？
（“振”是指身体轻微颤动，原因是正气虚寒；“战”是指身体剧烈抖动，原因是邪气与正气相争；“栗”是指内心恐惧战栗，原因是邪气胜过正气。“振”较轻，“战”较重；“战”表现于外，“栗”表现于内。）
呕吐或攻下之后，心下部胀满，气向上冲逆，头晕，脉象沉紧，若再发汗则会扰动经络，导致身体震颤摇晃。（适用茯苓桂枝白术甘草汤）太阳病发汗后仍然发热，心悸头晕，肌肉瞤动，身体震颤。（适用真武汤）
按：经书云，攻下后又复发汗，以及亡血之人误用发汗，必然导致寒战震颤，这是内外俱虚的表现。又说，表气微弱虚弱，里气不能固守，邪气侵入阴分则出现战栗，由此可知，震颤动摇的症状，大抵都属于虚证。《素问》说：寒邪伤人，使人毫毛竖立，下巴打颤战栗。这是体内素有邪气，应当发汗解除。张仲景说：脉象浮而紧，按之反而中空（芤脉），这是因为本元虚弱，应当通过战汗来解除病邪。又如果寸关尺三部脉象，浮沉迟数程度相当，也必然通过战汗来解除病邪。如果脉象浮数，按之不呈芤脉，患者不虚，汗自出而病解，不会发生战栗。外部不战但内部战栗的，是阴分受了邪气。凡是伤寒病将要解除时，会先战栗然后出汗，这是邪气不胜正气的表现。如果正气不胜邪气，虽然战栗但无汗出，就是不可治愈的了。
(The heart governs the Shen (Spirit), and the blood serves as the foundation for the Shen. When Heart Blood is deficient, the Shen loses its residence, leaving the Heart Palace empty, allowing Phlegm and Fluid retention to invade; this is the origin of Jing Ji (Palpitations with Fright). "Jing" refers to a state of apprehension and unrest, where one becomes easily depressed upon encountering events; Qi stagnation generates Phlegm. "Ji" refers to the palpable pounding sensation in the chest, caused by Heart deficiency leading to Water retention. Since Water occupies the Fire position (the Heart belongs to Fire), the Heart fears it, resulting in Zheng Chong (Severe Palpitations) and an inability to feel at ease.)
In Tai Yang disease (Exterior Syndrome of the Tai Yang channel), after eight or nine days, if purgatives are mistakenly used, symptoms such as chest fullness, irritability, fright, difficulty in urination, delirium, and heaviness of the entire body may occur. (Apply Chai Hu Jia Long Gu Mu Li Tang [Bupleurum Decoction with Dragon Bone and Oyster Shell]) If sweating is forced by fire therapy, leading to the loss of fluids, (apply Zhi Gan Cao Tang [Honey-Fried Licorice Decoction]). In Tai Yang disease, if sweating fails to resolve the condition, accompanied by fever, palpitations, dizziness, muscle twitching, and trembling as if about to fall to the ground, (apply Zhen Wu Tang [True Warrior Decoction]). In Shao Yang disease (Exterior-Interior Syndrome of the Shao Yang channel), presenting with deafness, red eyes, irritability, and fullness, emetics and purgatives must not be used; if mistakenly applied, they will cause palpitations and fright. (Apply Jiu Ni Xiao Chai Hu Tang [Rescue the Perilous Bupleurum Decoction], which is Xiao Chai Hu Tang minus Huang Qin [Scutellaria Root] plus Fu Ling [Poria]) After five or six days, presenting with alternating chills and fever, chest and hypochondriac fullness, silent demeanor with loss of appetite, irritability and palpitations, frequent vomiting, slight fever, or cough, (apply Xiao Chai Hu Tang [Minor Bupleurum Decoction]). With a wiry and fine pulse, headache, and fever, the syndrome belongs to Shao Yang; sweating is contraindicated. If sweating is induced, delirium occurs, Stomach disharmony ensues, leading to irritability and palpitations. (Apply Tiao Wei Cheng Qi Tang [Regulate the Intestines and Direct Downward Decoction]). In Shao Yin disease (Interior Deficiency-Cold Syndrome of the Shao Yin channel), presenting with cold extremities and palpitations, or difficulty in urination, abdominal pain, or diarrhea, (apply Si Ni San [Four Counterflow Powder]). For cold extremities accompanied by palpitations, water retention should be treated first. (Apply Fu Ling Gan Cao Tang [Poria and Licorice Decoction]). In Huo Luan (Vomiting and Diarrhea Syndrome) with palpitations, (apply Li Zhong Wan [Regulate the Middle Pill] plus Fu Ling [Poria]).
Note: Although Jing (Fright) and Ji (Palpitations) are distinct, both ultimately stem from injury to the Heart. Due to internal weakness of Yang Qi, the treatment method should focus on anchoring and consolidating. Due to the retention of Fluids, the treatment method should focus on unblocking and draining. The harm caused by Fluid retention is significant; how much more so for other conditions?
("Zhen" refers to slight trembling of the body, caused by deficiency-cold of the Righteous Qi; "Zhan" refers to severe shaking of the body, caused by the struggle between Pathogenic factors and Righteous Qi; "Li" refers to inner trembling/fear, caused by Pathogenic factors overcoming Righteous Qi. "Zhen" is mild, while "Zhan" is severe; "Zhan" manifests externally, while "Li" manifests internally.)
After vomiting or purging, if there is fullness below the heart, Qi rushing upward, dizziness, and a deep-tight pulse, inducing sweating will disturb the meridians, causing the body to tremble and shake. (Apply Fu Ling Gui Zhi Bai Zhu Gan Cao Tang [Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction]). In Tai Yang disease, if fever persists after sweating, accompanied by palpitations, dizziness, muscle twitching, and body trembling, (apply Zhen Wu Tang [True Warrior Decoction]).
Note: The Classics state that purging followed by repeated sweating, or sweating mistakenly administered to patients who have lost blood, will inevitably lead to cold trembling due to deficiency in both interior and exterior. It is also said that when Exterior Qi is slightly deficient and Interior Qi cannot hold fast, Pathogenic factors invading the Yin aspect cause trembling. Thus, it can be known that symptoms of trembling and shaking largely belong to deficiency. The Su Wen states: "When Cold Pathogens injure the person, it causes all hair follicles to stand erect and the jaw to chatter and tremble." This indicates that since Pathogens are already present within, sweating should be induced to release them. Zhang Zhongjing states: "If the pulse is floating and tight, but feels hollow (Kou) upon pressure, this indicates fundamental deficiency; the disease should resolve through trembling and sweating." Furthermore, if the pulses at the three positions (Cun, Guan, Chi) are equal in floating/sinking, slow/rapid characteristics, the disease will also resolve through trembling and sweating. If the pulse is floating and rapid, but does not feel hollow upon pressure, and the patient is not deficient, the disease will resolve through spontaneous sweating without trembling. If there is no external trembling but only internal trembling, it indicates that the Yin aspect has been invaded by Pathogens. Generally, when Tai Yang disease is about to resolve, trembling precedes sweating, indicating that Pathogenic factors cannot overcome Righteous Qi. If Righteous Qi cannot overcome Pathogenic factors, even if trembling occurs without sweating, the condition is untreatable.