论
《内经》曰∶心者，君主之官，神明出焉。夫怔忡惊悸之候，或因怒气伤肝，或因惊气入胆，母能令子虚，因而心
血为之不足，又或遇事繁冗，思想无穷，则心君亦为之不宁，故神明不安而怔忡惊悸之证作矣。夫所谓怔忡者，心中惕
惕然动摇而不得安静，无时而作者是也。惊悸者，蓦然而跳跃惊动而有欲厥之状，有时而作者是也。若夫二证之因，亦
有清痰积饮，留结于心胞胃口而为之者，又不可固执以为心虚而治。医者自宜以脉证参究其的而药之，毋认非以为是也，
慎之慎之！
脉法
寸口脉动而弱，动为惊，弱为悸。趺阳脉微而浮。（浮为胃气虚微，则不能食，此恐惧之脉，忧迫所致也。）寸口脉
紧，趺阳脉浮，胃气则虚，是以悸。肝脉动暴，有所惊骇。
方法
丹溪曰∶属血虚有痰。有虑便动，属虚。时作时止者，痰因火动。瘦人多是血少，肥人只是痰多。时觉心跳者，亦
是血虚。怔忡无时，悚悸有时而作。
大法，四物汤、安神丸之类，有痰者用痰药。
惊悸者属血虚，用朱砂安神丸最好。或有痰迷心窍者，宜用治痰药。
一方 治劳役大虚心跳。
朱砂（另研，水飞） 白芍药 当归身（酒浸） 侧柏叶（各三钱） 川芎 甘草 陈皮（各一钱） 炒黄连（一
钱五分）
上为细末，猪心血为丸，如黍米大，每服五、六十丸，津唾咽下，或少用白汤一口送下，食后临卧服。
（以上丹溪方法凡四条）
惊悸养血汤（局方） 治肥人因痰火而心惕然跳动惊起。
黄 茯神 半夏曲 川芎（各五分） 远志（去心，甘草水浸） 桂心 柏子仁 酸枣仁（炒） 五味子 人参
（各二分半） 甘草（四分）
上细切，作一服，生姜三片，大枣一枚，水一盏，煎至七分服。如停水，加茯神、槟榔各三分同煎。
安神丸（东垣）
黄连（一钱五分，酒洗） 朱砂（一钱，另研，水飞） 生地黄（酒洗） 当归身（酒洗） 甘草（炙，各五分）
上为细末，汤浸蒸饼为丸，如黍米大，每服十五丸，食后津唾咽下。一方，朱砂安神丸，无地黄、当归，用生甘草。
温胆汤（活人） 治心胆怯，怔忡易惊。
半夏（汤炮七次，去皮） 竹茹 枳实（各二钱） 生姜（四钱） 陈皮（三钱） 甘草（一钱）
上细切，作一服，水二盏，煎至一盏，去渣食后温服。
定志丸 治心气不足，恍惚多忘，及怔忡惊悸等证。
人参 白茯苓（各三钱） 远志（去心） 石菖蒲（各二两）
上为细末，炼蜜为丸，如梧桐子大，朱砂为衣，每服五十丸，食后白汤下。
朱雀丸（河间） 治怔忡惊悸等证。
茯神（二两） 沉香（五钱） 朱砂（五钱，另研，为衣）
上为细末，蒸饼为丸，如梧桐子大，每服五十丸，人参汤下。
八物定志丸（东垣） 平补心气，安神镇惊，除膈间痰热等证。
远志（去心） 石菖蒲 麦门冬（去心） 茯神（去皮） 白茯苓（各一两） 白术（五钱） 人参（一两五钱） 牛
黄（二钱，另研）
上炼蜜为丸，如梧桐子大，朱砂为衣，每服二十丸，白汤送下。
归脾汤 治思虑过度，劳伤心脾，健忘怔忡。
白术 茯神 黄 （蜜炙） 龙眼肉 酸枣仁（炒，各一钱） 人参 木香（各五分） 甘草（炙，二分半）
上细切，作一服，水二盏，加生姜三片，大枣一枚，煎至一盏，去渣温服。
（祖传方）
治忧愁思虑伤心，令人惕然心跳动，惊悸不安之证。
川归（酒洗用身） 生地黄（酒洗） 远志（去心） 茯神（各五钱） 石菖蒲（九节） 黄连（各二钱五分） 牛
黄（一钱，另研） 辰砂（二钱，另研） 金箔（十五片）
上以前六味研细，入牛黄、辰砂二味末子，猪心血丸如黍米大，金箔为衣，每服五十丸，煎灯心汤送下。
论
《黄帝内经》说：心，是君主之官，人的精神意识（神明）由此产生。所谓怔忡、惊悸的证候，有的因为怒气损伤肝脏，有的因为受惊之气侵入胆腑，母脏（肝）虚弱不能滋养子脏（心），从而导致心血不足；又或者因为事务繁杂冗多，思虑无穷无尽，致使心主也不得安宁，所以精神意识不安定，怔忡和惊悸的病症就发作了。所谓怔忡，是指心中惕惕然动摇而不能安静，没有特定时间发作的情况。惊悸，是指突然受到惊吓而心跳加速、惊动不安，甚至有昏厥的样子，是有特定时间发作的情况。至于这两种证候的病因，也有因为清痰和积饮，停留结聚在心包和胃脘部位而导致的，这又不可以固执地认为都是心虚而进行治疗。医生应当自行通过脉象和症状相互参究，确定确切的病机然后用药，不要将非此认为是此，务必谨慎！
脉法
寸口脉搏动且弱，脉“动”主惊，脉“弱”主悸。趺阳脉微而浮。（浮脉表示胃气虚弱微弱，则不能进食，这是恐惧的脉象，由忧愁逼迫所致。）寸口脉紧，趺阳脉浮，胃气则虚，因此出现心悸。肝脉动而急暴，是因为受到了惊恐骇怕。
方法
朱丹溪说：属于血虚有痰。有忧虑就发作的，属于虚证。时作时止的，是痰因火动引起的。瘦人多是血少，肥人只是痰多。时常觉得心跳的，也是血虚。怔忡是没有固定时间发作，惊悸是有特定时间发作。
惊悸属于血虚，用朱砂安神丸最好。如果有痰迷心窍的，适宜用治痰药。
一方 治疗劳役过度导致的大虚心跳。
朱砂（单独研磨，水飞法处理） 白芍药 当归身（酒浸） 侧柏叶（各三钱） 川芎 甘草 陈皮（各一钱） 炒黄连（一钱五分）
以上药物研为细末，用猪心血制成丸药，大小如黍米，每次服用五六十丸，用唾液咽下，或者少量用白开水送服，饭后临睡前服用。
（以上是丹溪的方法共四条）
惊悸养血汤（出自《太平惠民和剂局方》） 治疗肥胖之人因痰火导致心中惕惕跳动受惊而起。
黄芩 茯神 半夏曲 川芎（各五分） 远志（去心，用甘草水浸泡） 桂心 柏子仁 酸枣仁（炒） 五味子 人参（各二分半） 甘草（四分）
以上切碎，作为一服药的量，加生姜三片，大枣一枚，水一盏，煎至七分，服用。如果有停水（水饮内停），加茯神、槟榔各三分同煎。
黄连（一钱五分，酒洗） 朱砂（一钱，单独研磨，水飞法处理） 生地黄（酒洗） 当归身（酒洗） 甘草（炙，各五分）
以上研为细末，用热水浸泡蒸饼制成丸药，大小如黍米，每次服用十五丸，饭后用唾液咽下。另一方，朱砂安神丸，没有地黄、当归，使用生甘草。
半夏（汤泡七次，去皮） 竹茹 枳实（各二钱） 生姜（四钱） 陈皮（三钱） 甘草（一钱）
以上切碎，作为一服药的量，水二盏，煎至一盏，去渣滓，饭后温服。
以上研为细末，炼蜜制成丸药，大小如梧桐子大，朱砂为衣，每次服用五十丸，饭后用白开水送下。
茯神（二两） 沉香（五钱） 朱砂（五钱，单独研磨，作为衣料）
以上研为细末，蒸饼制成丸药，大小如梧桐子大，每次服用五十丸，用人参汤送下。
八物定志丸（李东垣方） 平补心气，安神镇惊，清除膈间痰热等证。
远志（去心） 石菖蒲 麦门冬（去心） 茯神（去皮） 白茯苓（各一两） 白术（五钱） 人参（一两五钱） 牛黄（二钱，单独研磨）
以上炼蜜制成丸药，大小如梧桐子大，朱砂为衣，每次服用二十丸，用白开水送下。
白术 茯神 黄芪（蜜炙） 龙眼肉 酸枣仁（炒，各一钱） 人参 木香（各五分） 甘草（炙，二分半）
以上切碎，作为一服药的量，水二盏，加生姜三片，大枣一枚，煎至一盏，去渣滓温服。
（祖传方）
川当归（酒洗，用归身） 生地黄（酒洗） 远志（去心） 茯神（各五钱） 石菖蒲（九节者） 黄连（各二钱五分） 牛黄（一钱，单独研磨） 辰砂（二钱，单独研磨） 金箔（十五片）
Treatise
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The Heart is the Sovereign Official, from which Shen Ming (Spiritual Consciousness) emerges. The syndromes of Zheng Tong (Palpitations with a sense of unrest) and Jing Ji (Fright palpitations) may arise because anger injures the Liver, or because fright Qi enters the Gallbladder. Since the Mother organ (Liver) fails to nourish the Child organ (Heart), Heart Blood becomes deficient. Alternatively, due to complex and tedious affairs, endless rumination causes the Heart Sovereign to become unsettled. Thus, Shen Ming loses its peace, and the syndromes of Zheng Tong and Jing Ji manifest. Zheng Tong refers to a state where the heart feels terrified and trembling, unable to remain quiet, occurring without fixed timing. Jing Ji refers to a sudden startle, with heart palpitations and a sensation of impending syncope, occurring at specific times. Regarding the etiology of these two syndromes, it is also possible that clear phlegm and accumulated fluid stagnate and knot in the Pericardium and Stomach region, causing the condition. One must not rigidly assume this is solely Heart deficiency and treat accordingly. Physicians should carefully investigate the exact pathology by correlating pulse findings with symptoms before prescribing medication, avoiding misidentification. Exercise utmost caution!
Pulse Diagnosis
At the Cun Kou (Radial artery) position, if the pulse is moving and weak, "Dong" (Moving) indicates Fright, and "Ruo" (Weak) indicates Palpitations. At the Fu Yang (Dorsalis pedis artery) position, if the pulse is faint and floating: Floating indicates that Stomach Qi is weak and deficient, leading to an inability to eat; this is the pulse of fear, caused by anxiety and pressure. If the Cun Kou pulse is tight and the Fu Yang pulse is floating, Stomach Qi is deficient, resulting in palpitations. If the Liver pulse is moving and violent, it indicates shock and terror.
Methods
Zhu Danxi stated: These conditions belong to Blood deficiency with Phlegm. Symptoms triggered by worry indicate deficiency. Intermittent onset and cessation indicate Phlegm stirred by Fire. Thin individuals mostly suffer from Blood deficiency, while obese individuals mostly have excessive Phlegm. Frequent sensations of heart beating also indicate Blood deficiency. Zheng Tong occurs without fixed timing, whereas Jing Ji occurs at specific times.
The general principle is to use formulas such as Si Wu Tang (Four Substances Decoction) or An Shen Wan (Calming the Spirit Pill). For cases with Phlegm, use Phlegm-resolving medications.
Jing Ji belongs to Blood deficiency; Zhu Sha An Shen Wan (Cinnabar Calming the Spirit Pill) is best. If there is Phlegm confusing the Heart orifices, Phlegm-resolving medications are appropriate.
Prescription 1: Treats heart palpitations due to severe deficiency from overwork.
Zhu Sha (Cinnabar, ground separately, processed by water flotation) Bai Shao Yao (White Peony Root) Dang Gui Shen (Angelica Sinensis Root Body, soaked in wine) Ce Bai Ye (Biota Tops) [each 3 qian] Chuan Xiong (Ligusticum Rhizome) Gan Cao (Licorice Root) Chen Pi (Aged Tangerine Peel) [each 1 qian] Chao Huang Lian (Stir-fried Coptis Rhizome) [1.5 qian]
Grind all ingredients into fine powder. Form pills using pig heart blood, sized like millet seeds. Take 50-60 pills per dose, swallowing with saliva, or a small amount of warm water. Administer after meals and before bed.
(Above are four methods from Danxi)
Jing Ji Yang Xue Tang (Palpitation Nourishing Blood Decoction, from *Ju Fang*): Treats obese individuals whose hearts tremble and jump in fright due to Phlegm-Fire.
Huang Qin (Scutellaria Root) Fu Shen (Poria with Hostwood) Ban Xia Qu (Pinellia Fermented Paste) Chuan Xiong [each 0.5 fen] Yuan Zhi (Polygala Root, core removed, soaked in Licorice water) Gui Xin (Cinnamon Twig Center) Bai Zi Ren (Biota Seed) Suan Zao Ren (Ziziphus Seed, stir-fried) Wu Wei Zi (Schisandra Berry) Ren Shen (Ginseng Root) [each 0.25 fen] Gan Cao (Licorice Root) [0.4 fen]
Cut finely. Prepare as one dose. Add three slices of fresh ginger and one jujube. Decoct with one cup of water until reduced to 0.7 cups. If there is fluid retention, add Fu Shen and Bing Lang (Areca Seed) 0.3 fen each and decoct together.
An Shen Wan (Calming the Spirit Pill, from Dongyuan):
Huang Lian (Coptis Rhizome, 1.5 qian, washed in wine) Zhu Sha (Cinnabar, 1 qian, ground separately, processed by water flotation) Sheng Di Huang (Rehmannia Root, washed in wine) Dang Gui Shen (Angelica Sinensis Root Body, washed in wine) Gan Cao (Licorice Root, honey-fried) [each 0.5 fen]
Grind into fine powder. Mix with steamed bread dough soaked in hot water to form pills, sized like millet seeds. Take 15 pills per dose, swallowing with saliva after meals. Another variation, Zhu Sha An Shen Wan, omits Di Huang and Dang Gui, using raw Gan Cao instead.
Wen Dan Tang (Warm the Gallbladder Decoction, from *Huoren*): Treats heart gallbladder timidity, Zheng Tong, and susceptibility to fright.
Ban Xia (Pinellia Tuber, boiled seven times, skin removed) Zhu Ru (Bamboo Shavings) Zhi Shi (Immature Bitter Orange) [each 2 qian] Sheng Jiang (Fresh Ginger) [4 qian] Chen Pi (Aged Tangerine Peel) [3 qian] Gan Cao (Licorice Root) [1 qian]
Cut finely. Prepare as one dose. Decoct with two cups of water until reduced to one cup. Strain and take warm after meals.
Ding Zhi Wan (Stabilize Will Pill): Treats Heart Qi deficiency, mental confusion, forgetfulness, and syndromes of Zheng Tong and Jing Ji.
Ren Shen (Ginseng Root) Bai Fu Ling (Poria) [each 3 qian] Yuan Zhi (Polygala Root, core removed) Shi Chang Pu (Acorus Rhizome) [each 2 liang]
Grind into fine powder. Form pills with refined honey, sized like photinia seeds. Coat with Zhu Sha (Cinnabar). Take 50 pills per dose with warm water after meals.
Zhu Que Wan (Vermilion Bird Pill, from Hejian): Treats syndromes of Zheng Tong and Jing Ji.
Fu Shen (Poria with Hostwood) [2 liang] Chen Xiang (Aquilaria Wood) [5 qian] Zhu Sha (Cinnabar, 5 qian, ground separately, used for coating)
Grind into fine powder. Form pills with steamed bread dough, sized like photinia seeds. Take 50 pills per dose with Ren Shen (Ginseng) decoction.
Ba Wu Ding Zhi Wan (Eight-Ingredient Stabilize Will Pill, from Dongyuan): Gently tonifies Heart Qi, calms the spirit and settles fright, clears Phlegm-Heat from the diaphragm.
Yuan Zhi (Polygala Root, core removed) Shi Chang Pu (Acorus Rhizome) Mai Men Dong (Ophiopogon Tuber, core removed) Fu Shen (Poria with Hostwood, skin removed) Bai Fu Ling (Poria) [each 1 liang] Bai Zhu (Atractylodes Rhizome) [5 qian] Ren Shen (Ginseng Root) [1.5 liang] Niu Huang (Calculus Bovis) [2 qian, ground separately]
Form pills with refined honey, sized like photinia seeds. Coat with Zhu Sha (Cinnabar). Take 20 pills per dose with warm water.
Gui Pi Tang (Restore the Spleen Decoction): Treats excessive rumination injuring Heart and Spleen, forgetfulness, and Zheng Tong.
Bai Zhu (Atractylodes Rhizome) Fu Shen (Poria with Hostwood) Huang Qi (Astragalus Root, honey-fried) Long Yan Rou (Longan Aril) Suan Zao Ren (Ziziphus Seed, stir-fried) [each 1 qian] Ren Shen (Ginseng Root) Mu Xiang (Costus Root) [each 0.5 fen] Gan Cao (Licorice Root, honey-fried) [0.25 fen]
Cut finely. Prepare as one dose. Add three slices of fresh ginger and one jujube to two cups of water. Decoct until reduced to one cup. Strain and take warm.
(Ancestral Prescription)
Treats syndromes where sorrow and rumination injure the Heart, causing terrifying heart palpitations and restless Jing Ji.
Chuan Gui (Sichuan Angelica Root Body, washed in wine) Sheng Di Huang (Rehmannia Root, washed in wine) Yuan Zhi (Polygala Root, core removed) Fu Shen (Poria with Hostwood) [each 5 qian] Shi Chang Pu (Acorus Rhizome, nine-jointed) Huang Lian (Coptis Rhizome) [each 2.5 qian] Niu Huang (Calculus Bovis) [1 qian, ground separately] Chen Sha (Cinnabar) [2 qian, ground separately] Jin Bo (Gold Leaf) [15 pieces]
Grind the first six ingredients finely. Mix in the powders of Niu Huang and Chen Sha. Form pills using pig heart blood, sized like millet seeds. Coat with Jin Bo (Gold Leaf). Take 50 pills per dose with Deng Xin Tang (Juncus Decoction).