宜浮滑，忌短涩。
景岳曰∶微弱细涩者，阴中之阳虚也；浮大弦芤，按之全虚者，阳中之阴虚也。微弱者顺
而易医，浮空者险而难治。
《圣济总录》曰∶呷嗽者，咳而胸中多痰，结于喉间，与气相系，随其呼吸，呀呷有声
，故名呷嗽。宜调顺肺经，仍加消痰破饮之剂。
次男元犀按∶痰饮咳嗽喘证，俱宜参看。
射干丸(方见前用)
治久呷嗽，喉中作声，发即偃卧不得。
杏仁丸（《圣济》）
治呷嗽有声。
杏仁（去皮尖，炒） 甘草（炙，各一两） 大黄（蒸） 牙硝（熬，各五钱）
共为末，炼蜜丸如桐子大，空心姜汤送下二十丸。
紫菀杏仁煎（《圣济》）
治肺脏气积，呷嗽不止，因肺虚损，致劳疾相侵，或胃冷膈上热者。
紫菀 酥（各二两） 贝母 姜汁（各三两） 大枣（去皮核，半斤） 五味 人参 茯苓 甘草 桔梗 地骨皮
（洗，各一两） 白蜜（一斤） 生地汁（六两）
共末，与蜜生地汁同煎，器盛三五次，成饴煎，仰卧含化一匙，日二服。
有所触而动曰惊，无所触而动曰悸，凡怔忡 惕，皆其类也。高鼓峰曰∶此心血少也
。起于肾水不足，不能上升，以致心火不能下降。大剂归脾汤去木香，加麦冬、五味、枸杞
，吞都气丸，（杨乘六云∶治怔忡大法。无逾此旨。）如怔忡而实，挟包络一种有余之火，兼痰者，
则加生地、川贝母、黄连之类以清之。
胡念斋曰∶虽缘心血不足，然亦有胃络不能上通者，有脾脉不能入心者，有宗气虚而虚
里穴动者，有水气凌心者，有奔豚上乘者，治法不甚相远。惟水气与奔豚，当另法治之。
孙男心典按∶水气凌心，轻则用小半夏加茯苓汤以泄之，重则用茯苓甘草汤安之，再重
则用真武汤镇之。奔豚用桂枝汤加桂主之，或以茯苓桂枝甘草大枣汤主之。
脉象应当浮滑，忌讳短涩。
张景岳说：脉象微弱细涩的，是阴中之阳虚；脉象浮大弦芤，重按完全空虚的，是阳中之阴虚。脉象微弱的属于顺证，容易医治；脉象浮空无根的属于险证，难以治疗。
《圣济总录》说：呷嗽（哮鸣性咳嗽），是指咳嗽且胸中痰多，痰结聚在喉间，与气息相互牵系，随着呼吸运动，发出呀呷的声音，所以叫呷嗽。适宜调理肺经气机，并配合使用消痰破饮的方剂。
次子陈元犀按语：痰饮、咳嗽、喘证，都应当参考此条内容。
射干丸（方剂见前文）
治疗久治不愈的呷嗽，喉中发出声音，发作时身体僵卧不能动弹。
杏仁丸（出自《圣济总录》）
治疗呷嗽伴有声音。
杏仁（去皮尖，炒制） 甘草（炙烤，各一两） 大黄（蒸制） 牙硝（熬制，各五钱）
共同研为细末，用炼蜜制成梧桐子大小的药丸，空腹时用姜汤送服二十丸。
紫菀杏仁煎（出自《圣济总录》）
治疗肺脏气机积滞，呷嗽不止，因肺气虚损，导致劳疾侵袭，或者胃寒膈上有热的情况。
紫菀 酥（各二两） 贝母 姜汁（各三两） 大枣（去皮核，半斤） 五味子 人参 茯苓 甘草 桔梗 地骨皮（洗净，各一两） 白蜜（一斤） 生地黄汁（六两）
共同研为细末，与蜂蜜、生地黄汁一同煎煮，盛放在容器中多次加热浓缩，成为饴糖状的煎膏，仰卧时含化一匙，每日服用两次。
受到外界刺激而心跳不安称为惊，没有受到外界刺激而自觉心中跳动称为悸，凡是怔忡（心慌不安）、惕惧（惊恐害怕），都属于这一类。高鼓峰说：这是心血不足所致。起因于肾水不足，不能上升，导致心火不能下降。使用大剂量的归脾汤去掉木香，加入麦冬、五味子、枸杞子，吞服都气丸。（杨乘六说：治疗怔忡的大法，没有超过这个宗旨的。）如果怔忡表现为实证，兼有包络（心包）一种有余的火邪，兼有痰浊的，则加入生地黄、川贝母、黄连之类来清泻火热。
胡念斋说：虽然源于心血不足，但也有胃络不能上通的情况，有脾脉不能入心的情况，有宗气虚弱导致虚里穴跳动的情况，有水气凌心（水饮之邪上犯于心）的情况，有奔豚（气从少腹上冲心胸）上乘的情况，治疗方法大致相近。只有水气和奔豚，应当另外采用其他方法治疗。
孙子陈心典按语：水气凌心，轻症用小半夏加茯苓汤以泄除水饮，重症用茯苓甘草汤以安定心神，再重的用真武汤以镇摄阳气。奔豚病用桂枝加桂汤为主方，或者用茯苓桂枝甘草大枣汤为主方。
The pulse should be floating and slippery; a short and choppy pulse is contraindicated.
Zhang Jingyue stated: A weak, fine, and choppy pulse indicates deficiency of Yang within Yin; a floating, large, wiry, or hollow pulse that feels completely empty upon deep pressure indicates deficiency of Yin within Yang. A weak pulse is a favorable sign and easy to treat; a floating and empty pulse is dangerous and difficult to treat.
The *Shengji Zonglu* (General Records of the Holy Emergency) states: "Xiao cough" (cough with wheezing sound) refers to coughing accompanied by excessive phlegm in the chest, which accumulates in the throat, binds with the Qi, and produces a whistling or rattling sound during respiration, hence the name Xiao cough. It is appropriate to regulate the Lung meridian and add formulas that resolve phlegm and break up fluid retention.
My second son, Chen Yuanxi, noted: Phlegm-fluid retention, cough, and asthma syndromes should all be consulted together.
*Shegan Wan* (Formula seen previously)
Treats chronic Xiao cough with sounds in the throat, where attacks cause the patient to lie stiffly unable to move.
*Xingren Wan* (from *Shengji Zonglu*)
Treats Xiao cough with audible sounds.
*Xingren* (Almond, peeled and tipped, stir-fried) *Gancao* (Licorice Root, honey-fried, each 1 liang) *Dahuang* (Rhubarb Root and Rhizome, steamed) *Yaxiao* (Natrii Sulfas, boiled, each 5 qian)
Grind into fine powder, mix with refined honey to make pills the size of paulownia seeds. Take 20 pills on an empty stomach with ginger decoction.
*Ziwan Xingren Jian* (from *Shengji Zonglu*)
Treats accumulation of Qi in the Lungs causing incessant Xiao cough, resulting from Lung deficiency allowing consumptive diseases to invade, or cold in the Stomach with heat above the Diaphragm.
*Ziwan* (Asarum Root) *Su* (Butter/Ghee, each 2 liang) *Beimu* (Fritillaria Bulb) *Jiangzhi* (Ginger Juice, each 3 liang) *Dazao* (Jujube Fruit, peeled and pitted, half a jin) *Wuweizi* (Schisandra Berry) *Renshen* (Ginseng Root) *Fuling* (Poria) *Gancao* (Licorice Root) *Jiegeng* (Platycodon Root) *Digupi* (Lycium Bark, washed, each 1 liang) *Baimi* (White Honey, 1 jin) *Shengdiye* (Rehmannia Juice, 6 liang)
Grind into powder, decoct together with honey and Rehmannia juice. Store in vessels and heat repeatedly until it becomes a maltose-like syrup. While lying supine, dissolve one spoonful in the mouth. Take twice daily.
Palpitations triggered by external stimuli are called "Jing" (Fright); spontaneous palpitations without external stimuli are called "Ji" (Palpitation). All cases of Zhengchong (constant anxiety and palpitation) and Ti (fearfulness) belong to this category. Gao Gufeng stated: This is due to insufficient Heart Blood. The origin lies in insufficient Kidney Water failing to ascend, thereby preventing Heart Fire from descending. Use a large dose of *Guipi Tang* (Restore the Spleen Decoction) removing *Muxiang*, adding *Maidong* (Ophiopogon Tuber), *Wuweizi* (Schisandra Berry), and *Gouqi* (Goji Berry), swallowed with *Duqi Wan* (Eight-Ingredient Pill with Cornus). (Yang Chengliu said: This is the general principle for treating Zhengchong, nothing surpasses this guideline.) If Zhengchong presents as excess syndrome, accompanied by an excess fire in the Pericardium and phlegm, then add *Shengdi* (Rehmannia Root), *Chuanbeimu* (Sichuan Fritillaria Bulb), *Huanglian* (Coptis Rhizome), etc., to clear the heat.
Hu Nianzhai stated: Although originating from insufficient Heart Blood, there are also cases where the Stomach collaterals fail to connect upwards, where the Spleen pulse fails to enter the Heart, where Zong Qi (Gathering Qi) is deficient causing movement at the Xuli acupoint, where Water Qi overcomes the Heart, and where Ben Tun (Running Piglet) ascends. The treatment methods are not vastly different. However, Water Qi and Ben Tun require separate treatment approaches.
My grandson, Chen Xindian, noted: For Water Qi overcoming the Heart, mild cases use *Xiao Banxia Jia Fuling Tang* (Minor Pinellia Decoction plus Poria) to drain it; severe cases use *Fuling Gancao Tang* (Poria and Licorice Decoction) to calm it; even more severe cases use *Zhenwu Tang* (True Warrior Decoction) to suppress it. For Ben Tun, use *Guizhi Jia Gu Tang* (Cinnamon Twig Decoction plus Cinnamon) as the main formula, or alternatively use *Fuling Guizhi Gancao Dazao Tang* (Poria, Cinnamon Twig, Licorice, and Jujube Decoction) as the main formula.