《准绳》云∶悸即怔忡。今历观病状,则二证少有分别。悸则心中微动,如恐如
惊。怔忡则心胸振筑,莫知其来;忽尔宁寂,莫知其去。甚则头目眩晕,神气若浮,
盖悸之重者也。大抵因痰积饮停,气冲火击所致。(宜导痰汤、温胆汤、茯苓甘草汤、姜术汤之类。)
亦有中气虚而忡悸者。(宜补中益气汤、四君子汤、六君子汤、小建中汤、黄 建中汤之类。)亦有
心经气血不足,火不定,神不安而忡悸者。(宜四物汤、朱雀丸、当归补血汤、经验定心丹之类。)
有心液过耗,汗多亡阳,脉代而忡悸者。(宜炙甘草汤。)
导痰汤(见第四十一)
温胆汤(见第二十)
茯苓甘草汤 治心下停水忪悸。
白茯苓(去皮) 桂枝(各三钱) 生姜(半两) 甘草(二钱)
水二钟,煎一钟,不拘时服。
姜术汤 治停饮怔忡。
白姜(生) 白术 茯苓 半夏曲(各一钱) 辣桂 甘草(各五分)
水一钟,姜三片,红枣一枚,煎六分,不拘时服。
补中益气汤(见第二十九)
四君子汤(见第十六)
六君子汤(见第十六)
小建中汤(见第六十九)
黄 建中汤(见第三十三)
四物汤(见第二十一)
朱雀丸(见第五十一)
当归补血汤(见第十六)
经验定心丹(楫自制)
茯神(去皮木,一两) 远志(酒浸软去心,五钱) 人参(去芦,八钱) 沉香(黑
重沉水者,三钱,不见火) 龙
骨( ,七钱) 怀生地(洗去土,一两半) 当归身(酒洗,一两) 白芍药(酒炒,八钱) 丹参(
去芦,一两) 桂枝(去骨,三钱) 甘草(炙,二钱) 荷蕊(出水而未开者焙干,一个)
为极细末,炼蜜为丸,如绿豆大,用上好水飞过,朱砂为衣。每服二钱,食远
白汤下。午后勿服。此方验过多人矣。
炙甘草汤(见第三十三)
《准绳》说:悸就是怔忡。如今遍观病症表现,这两个证候很少有区别。悸表现为心中微微跳动,好像恐惧、好像受惊。怔忡则心胸剧烈震动,不知道它何时开始;忽然间安静下来,也不知道它何时停止。严重的会出现头目眩晕,神气浮越,这是悸的严重阶段。大抵是因为痰饮积聚停留,气机上冲、火热冲击所致。(适宜使用导痰汤、温胆汤、茯苓甘草汤、姜术汤这类方剂。)也有因为中气虚弱而导致怔忡心悸的。(适宜使用补中益气汤、四君子汤、六君子汤、小建中汤、黄芪建中汤这类方剂。)也有因为心经气血不足,虚火浮动,神志不安而导致怔忡心悸的。(适宜使用四物汤、朱雀丸、当归补血汤、经验定心丹这类方剂。)有心液过度耗损,汗出过多导致亡阳,脉象出现代脉而引发怔忡心悸的。(适宜使用炙甘草汤。)
导痰汤(见第四十一卷)
温胆汤(见第二十卷)
茯苓甘草汤 治疗心下停水引起的怔忡心悸。
白茯苓(去皮) 桂枝(各三钱) 生姜(半两) 甘草(二钱)
用水二钟,煎至一钟,不限时间服用。
姜术汤 治疗停饮引起的怔忡。
干姜(生用) 白术 茯苓 半夏曲(各一钱) 肉桂 甘草(各五分)
用水一钟,加生姜三片,红枣一枚,煎至六分,不限时间服用。
补中益气汤(见第二十九卷)
四君子汤(见第十六卷)
六君子汤(见第十六卷)
小建中汤(见第六十九卷)
黄芪建中汤(见第三十三卷)
四物汤(见第二十一卷)
朱雀丸(见第五十一卷)
当归补血汤(见第十六卷)
经验定心丹(潘楫自制)
茯神(去皮木,一两) 远志(酒浸软后去心,五钱) 人参(去芦头,八钱) 沉香(黑重沉水的,三钱,不经过火炒) 龙骨(煅,七钱) 怀生地(洗去泥土,一两半) 当归身(酒洗,一两) 白芍药(酒炒,八钱) 丹参(去芦头,一两) 桂枝(去骨皮,三钱) 甘草(蜜炙,二钱) 荷蕊(出水未开的荷花花蕊焙干,一个)
研成极细粉末,用炼蜜制成丸药,大小如绿豆,用上好水飞过的朱砂作为包衣。每次服用二钱,饭后用白开水送服。午后不要服用。此方已经验证过很多人了。
炙甘草汤(见第三十三卷)
According to *Zhunsheng* (Standard Guidelines): "Palpitation (Ji) is the same as severe palpitation (Zhongchong)." Upon reviewing clinical manifestations in modern practice, there is little distinction between these two syndromes. Ji (palpitation) presents as a slight trembling sensation in the heart region, resembling fear or fright. Zhongchong (severe palpitation) involves violent throbbing and pounding in the chest and heart area, with no clear indication of its onset; it suddenly subsides into silence, with no clear indication of its cessation. In severe cases, dizziness and vertigo of the head and eyes occur, and the Shen spirit appears floating; this represents the severe stage of Ji. Generally, these conditions are caused by the accumulation and retention of Phlegm-Fluids (Tan-Yin), where Qi rushes upward and Fire strikes internally. (Formulas such as Daotan Tang [Expel Phlegm Decoction], Wendan Tang [Warm the Gallbladder Decoction], Fuling Gancao Tang [Poria and Licorice Decoction], and Jiangzhu Tang [Ginger and Atractylodes Decoction] are appropriate.) There are also cases of Zhongchong and Ji caused by deficiency of Middle Qi. (Formulas such as Buzhong Yiqi Tang [Tonify the Middle and Augment the Qi Decoction], Sijunzi Tang [Four Gentlemen Decoction], Liujunzi Tang [Six Gentlemen Decoction], Xiaojianzhong Tang [Minor Construct the Middle Decoction], and Huangqi Jianzhong Tang [Astragalus Construct the Middle Decoction] are appropriate.) There are also cases caused by insufficiency of Qi and Blood in the Heart Meridian, where deficient Fire floats restlessly and the Shen spirit is unsettled. (Formulas such as Siwu Tang [Four Substances Decoction], Zhuque Wan [Vermilion Bird Pill], Danggui Buxue Tang [Angelica Tonify the Blood Decoction], and Jingyan Dingxin Dan [Experience-Based Heart-Calming Elixir] are appropriate.) There are cases where Heart Fluids are excessively depleted, excessive sweating leads to Yang collapse, and the pulse presents as intermittent (Dai Mai), resulting in Zhongchong and Ji. (Zhi Gancao Tang [Honey-Fried Licorice Decoction] is appropriate.)
Daotan Tang (See Volume 41)
Wendan Tang (See Volume 20)
Fuling Gancao Tang: Treats palpitations caused by water retention below the heart.
Bai Fuling (Poria cocos, peeled) 3 qian, Guizhi (Cinnamomi Ramulus, 3 qian), Shengjiang (Fresh Zingiberis Rhizoma, half liang), Gancao (Glycyrrhizae Radix et Rhizoma, 2 qian).
Decoct with 2 zhong of water until 1 zhong remains. Take at any time.
Jiangzhu Tang: Treats severe palpitations caused by retained fluids.
Sheng Baijiang (Raw Zingiberis Rhizoma, 1 qian), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 qian), Fuling (Poria cocos, 1 qian), Banxiaqu (Fermented Pinelliae Rhizoma, 1 qian), Lagui (Cinnamomi Cortex, 5 fen), Gancao (Glycyrrhizae Radix et Rhizoma, 5 fen).
Decoct with 1 zhong of water, add 3 slices of fresh ginger and 1 red date, reduce to 6 fen. Take at any time.
Buzhong Yiqi Tang (See Volume 29)
Sijunzi Tang (See Volume 16)
Liujunzi Tang (See Volume 16)
Xiaojianzhong Tang (See Volume 69)
Huangqi Jianzhong Tang (See Volume 33)
Siwu Tang (See Volume 21)
Zhuque Wan (See Volume 51)
Danggui Buxue Tang (See Volume 16)
Jingyan Dingxin Dan (Self-formulated by Pan Ji)
Fushen (Poria cocos with hostwood, peeled of wood, 1 liang), Yuanzhi (Polygalae Radix, soaked in wine until soft, heart removed, 5 qian), Renshen (Ginseng Radix, radix removed, 8 qian), Chenxiang (Aquilariae Lignum Resinatum, black and heavy enough to sink in water, 3 qian, not roasted), Longgu (Fossilized mammal bones, calcined, 7 qian), Huai Shengdi (Rehmanniae Radix Preparata, washed clean, 1.5 liang), Dangguishen (Angelicae Sinensis Radix, body part only, wine-washed, 1 liang), Baishaoyao (Paeoniae Radix Alba, wine-fried, 8 qian), Danshen (Salviae Miltiorrhizae Radix et Rhizoma, radix removed, 1 liang), Guizhi (Cinnamomi Ramulus, bark removed, 3 qian), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 2 qian), Heruil (Lotus flower bud before opening, dried by roasting, 1 piece).
Grind into an extremely fine powder. Form pills using refined honey, size of mung beans. Coat with Zhusha (Cinnabaris, purified with water). Take 2 qian per dose, swallow with plain warm water after meals. Do not take in the afternoon. This formula has been verified on many people.
Zhi Gancao Tang (See Volume 33)