（即怔忡。）
悸者，心筑筑惕惕然，动而不安也。（俗名心跳。）一由血虚，血虚则不能养心，心
气常动，幸无火热相乘，故不至于惊而但悸也。若血不虚而动者，则为心火盛，（亦
有肾火上冲者。）火主动也，幸血不虚，故但动而不惊。此惊与悸之别也。一由于停饮，
水停心下，心火为水所逼，不能下达而上浮，故动而不安也。（必有气喘之证。）肾水
上泛凌心，义亦如之，而治有异。（饮食所停之水宜疏导，肾阴上泛之水宜益火。）
但思虑即动者，
属血虚。时作时止者，痰因火动。有失志之人，由所求不遂，或过误自咎，恨叹不
已，独语书空，则心不息不安，时常劳动而怔忡作矣。温胆汤（见惊）去竹茹，加人参、
柏子仁各一钱，下定志丸，仍佐以酒调辰砂妙香散。（见心痛。）有痞塞不思饮食，心中
常有所歉，爱处暗地，或倚门后，见人则惊避，似失志状，心常跳动，此为卑
之病，以气血两不足也，人参养荣汤。（见虚损。）饮食少者，嘉禾散（见疟）加当归、
黄各一钱。
恐者，心有所怯也，盖心气虚使然。而属之肾者，恐则气下，故属肾也。经曰
精气并于肾（气本观上，今因虚而下，与精血并居肾部。）则恐是也。又属之肝胆者，
以肝胆之气
旺则上升，虚则下降，今恐而气下，是肝胆之气不足也。故勇者谓之胆壮，怯者谓
之胆小。张子和曰∶惊者不自知，因外有所触而卒动；恐者自知，不能独坐安卧，
必须人为伴侣。惊由血虚，恐因气怯，此大概也。恐亦有由血虚者，热伤肾阴，水
涸血虚，复为火所扰。则志昏惑而不定。（肾藏志，志者心之定向也。肾属水，
水清故鉴物分明，明
则不惑，慧生定也。火扰之则浊，浊则昏暗，又火为荧惑，故昏惑也。）不定则不静故恐，恐亦心之动
也。故孟子言不动心，以无惧为训。惊恐常相因，恐则惊矣，惊则恐矣。惊则安其
神，恐则定其志。心之神下交，则肾有所主而志定，即坎中之一阳也。肾之精上奉，
则心有所滋而神安，即离中之一阴也。丹溪治周本心病恐，如人将捕之，夜卧不安，
口干，饮食不知味，以参、术、当归为君，陈皮为佐，盐炒黄柏、炙玄参各少许，
煎服，月余而安。经云恐伤肾，（恐则精却而走失，盖肾精方欲化气而上，因恐则退却而下，
则精伤矣。
精伤则肾气亦虚，而阴痿、骨酸等证皆作矣。）故用柏、玄引之入肾以补之。人参散、茯神
散、补胆防风汤，皆治胆虚。
悸，是指心中筑筑跳动、惕惕不安的感觉，心跳动而不得安宁。（俗称心跳。）一种情况是由于血虚，血虚则不能滋养心脏，导致心气经常浮动；幸好没有火热之邪乘虚侵袭，所以不至于惊恐，仅仅表现为悸。如果血液不虚却出现跳动的情况，则是由于心火旺盛，（也有肾火上冲的情况。）火性主动，幸好血液不虚，所以只是跳动而不惊恐。这就是惊与悸的区别。另一种情况是由于水饮停聚，水停在心下，心火被水邪逼迫，不能下行而上浮，所以跳动不安。（必然伴有气喘的症状。）肾水上泛凌犯心脏，道理也是类似的，但治疗方法不同。（饮食停滞的水饮宜用疏导法，肾阴上泛的水饮宜用益火法。）如果是思虑过度就引发跳动的，属于血虚。时好时坏的，是痰因火动引起的。有失意之人，因为所求不遂，或者因过错而自责，恨叹不已，独自说话对着空气比划，导致心神不息不安，时常劳累而发作怔忡。可用温胆汤（见惊证章节）去掉竹茹，加入人参、柏子仁各一钱，配合下定志丸，再辅以酒调服辰砂妙香散。（见心痛章节。）如果有痞塞感不想吃东西，心中常觉得歉疚，喜欢躲在暗处，或倚靠在门后，见到人就惊恐躲避，神情似失志状态，心中常跳动，这是卑慄病，由气血两虚引起，用人参养荣汤。（见虚损章节。）饮食减少的，用嘉禾散（见疟疾章节）加当归、黄芪各一钱。
恐，是内心有所怯惧的表现，大概是因为心气虚所致。而归属于肾的，是因为“恐则气下”，所以归属于肾。《内经》说：“精气并于肾”（气本应上升，现在因虚而下陷，与精血并居于肾部），说的就是这种情况。又归属于肝胆的，是因为肝胆之气旺则上升，虚则下降，现在恐惧导致气机下陷，说明肝胆之气不足。所以说勇敢的人叫胆壮，怯懦的人叫胆小。张子和说：“惊是自己不知道原因，因为外界有所触动而突然受惊；恐是自己知道原因，不能独自坐卧，必须有人陪伴。”惊多由血虚引起，恐多因气怯引起，这是一般规律。恐也有由血虚引起的，热邪损伤肾阴，导致水涸血虚，再加上火邪扰乱，就会导致神志昏惑不定。（肾藏志，志是心的定向作用。肾属水，水清故能照物分明，明则不迷惑，智慧产生定力。火扰乱它则变浊，浊则昏暗，又火为荧惑，所以昏惑。）神志不定则不宁静，所以生恐，恐也是心的动荡表现。所以孟子说“不动心”，以无惧作为准则。惊恐常常相互关联，恐会导致惊，惊也会导致恐。惊则安其神，恐则定其志。心之神向下交于肾，则肾有所主而志定，这就是坎卦中的一阳。肾之精向上奉养于心，则心有所滋而神安，这就是离卦中的一阴。朱丹溪治疗周本的心病，表现为恐惧如被人追捕，夜间睡眠不安，口干，饮食不知味道，以人参、白术、当归为君药，陈皮为佐药，盐炒黄柏、炙玄参各少许，煎服，一个月后病情安定。经文说“恐伤肾”，（恐惧则精气退却流失，盖肾精正欲化气上行，因恐惧而退却下行，则精受伤了。精伤则肾气也虚，于是阳痿、骨酸等症状都出现了。）所以用黄柏、玄参引导药力入肾以补益之。人参散、茯神散、补胆防风汤，都是治疗胆虚的方剂。
(Zhengchong, i.e., palpitations.)
Ji (palpitations) refers to the sensation of the heart beating vigorously and fearfully, with movement and unrest. (Commonly known as heartbeat.) One cause is Blood deficiency; when Blood is deficient, it cannot nourish the Heart, causing Heart Qi to move frequently. Fortunately, if there is no Fire pathogen taking advantage of this deficiency, it will not lead to fright but only to palpitations. If the movement occurs despite adequate Blood, it is due to excessive Heart Fire, (or in some cases, Kidney Fire rushing upward.) Since Fire has a nature of movement, and assuming Blood is not deficient, there is movement without fright. This distinguishes Jing (fright) from Ji (palpitations). Another cause is the retention of fluid-dampness; when water stagnates below the Heart, the Heart Fire is forced by the water to fail in descending and instead floats upward, causing movement and unrest. (This must be accompanied by symptoms of asthma or panting.) When Kidney Water overflows and assaults the Heart, the principle is similar, but the treatment differs. (Water retained due to dietary stagnation should be guided out, while water from overflowing Kidney Yin requires tonifying Fire.) When mental worry triggers movement, it belongs to Blood deficiency. When symptoms come and go intermittently, it is phlegm stirred by Fire. In individuals who have suffered frustration, where desires are unfulfilled, or who blame themselves for past errors, sighing and lamenting endlessly, speaking alone to empty air, the Heart mind remains restless and uneasy, leading to frequent labor and the onset of Zhengchong (severe palpitations). Use Wendan Tang (see Fright), remove Zhuru (Bamboo Shavings), add Renshen (Ginseng Root) and Baiziren (Biota Seed) each at 1 qian, combined with Xiadazhi Wan, assisted by Chensha Miaoxiang San taken with wine mixed. (See Heartache.) For those with chest fullness, loss of appetite, a constant sense of guilt, preference for dark places, leaning behind doors, and fleeing in fright upon seeing people, resembling a state of lost will, with frequent heart palpitations, this is Beili disease, caused by dual deficiency of Qi and Blood; use Renshen Yangrong Tang. (See Deficiency Damage.) For those with reduced food intake, use Jiahe San (see Malaria) added with Danggui (Angelica Sinensis Root) and Huangqi (Astragalus Root) each at 1 qian.
Kong (fear) is a state of timidity within the Heart, generally resulting from Heart Qi deficiency. It is associated with the Kidney because "fear causes Qi to sink," thus linking it to the Kidney. The Classics state: "Essence and Qi congregate in the Kidney" (Qi originally ascends, but now sinks due to deficiency, residing with essence and blood in the Kidney region); this refers to Kong. It is also associated with the Liver and Gallbladder because when Liver and Gallbladder Qi is robust, it ascends; when deficient, it descends. Now, fear causes Qi to descend, indicating insufficiency of Liver and Gallbladder Qi. Thus, the brave are said to have strong Gallbladder, while the timid have weak Gallbladder. Zhang Zihe stated: "Fright arises unknowingly, triggered suddenly by external stimuli; Fear is self-aware, preventing one from sitting or lying down alone, requiring companionship." Fright is largely due to Blood deficiency, while fear is due to Qi timidity; this is the general rule. However, fear can also stem from Blood deficiency. Heat damages Kidney Yin, leading to dried fluids and Blood deficiency, further disturbed by Fire. This causes confusion and instability of the Will. (The Kidney stores the Will; the Will is the directional focus of the Heart. The Kidney belongs to Water; clear water reflects objects distinctly, clarity leads to no confusion, wisdom generates stability. Fire disturbs it, making it turbid; turbidity leads to dimness. Fire is also misleading, hence confusion.) Instability leads to restlessness, thus generating fear; fear is also a movement of the Heart. Therefore, Mencius spoke of "not moving the Heart," using fearlessness as the guideline. Fright and fear often follow each other; fear leads to fright, and fright leads to fear. Fright calms the Spirit, while fear stabilizes the Will. When the Spirit of the Heart descends to interact with the Kidney, the Kidney has its master and the Will is stabilized; this is the single Yang line in the Kan trigram. When the Essence of the Kidney ascends to nourish the Heart, the Heart receives nourishment and the Spirit is calm; this is the single Yin line in the Li trigram. Danxi treated Zhou Ben’s Heart disease, characterized by fear as if being hunted, insomnia, dry mouth, and loss of taste in food. He used Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome), and Danggui (Angelica Sinensis Root) as sovereign herbs, Chenpi (Tangerine Peel) as minister herbs, and salt-fried Huangbai (Phellodendron Bark) and Zhi Xuanshen (Scrophularia Root) in small amounts, decocted and taken orally. After more than a month, the patient was stabilized. The Classics say "Fear injures the Kidney" (Fear causes essence to retreat and leak; just as Kidney essence intends to transform into Qi and ascend, fear causes it to retreat downward, injuring the essence. Injury to essence leads to deficiency of Kidney Qi, resulting in impotence, bone soreness, etc.). Therefore, Huangbai (Phellodendron Bark) and Xuanshen (Scrophularia Root) are used to guide the medicine into the Kidney for tonification. Renshen San, Fushen San, and Budang Fangfeng Tang are all formulas treating Gallbladder deficiency.