经义
帝曰∶人之善忘者，何气使然？岐伯曰∶上气不足，下气有余，肠胃实而心肺虚，虚则营卫留于下，久
之，不以时上，故善忘。（《灵枢》）
哲言
人生气禀不同，得气之清，则心之知觉者灵；得气之浊，则心之知觉者昏。心之灵者，无有限量，虽千百
世已往之事，一过目则终身记之而不忘；心之昏者，虽无所伤，而目前之事，亦不能记矣。刘河间谓∶水清明，
火昏浊，故上善若水，下愚若火，此禀质使然。设禀清浊相混者，则不能耐事烦扰，烦扰则失其灵而健忘。盖
血与气，人之神也。《经》曰∶静则神藏，躁则消亡。静乃水之体，躁乃火之用。故性静则心存于中，动则心
忘于外，动不已则忘不已，忘不已则存于中者几希，故语后便忘，不俟终日。所以老人多忘，盖由役役扰扰，
纷纭交错，气血之阴，于斯将竭。求其清明，则曰寡欲，此善治乎火也。苟不以此是务，而日以百忧感其心，
万事劳其形，惟恃刀圭之力，以求旦夕之功，是谓舍本逐末，徇外遗内也，岂根本之论哉！（《推求师意》）
人之记性，皆在脑中。小儿善忘者，脑未满也。老人健忘者，脑渐空也。凡外见一形，必有一形留于脑
中，人每记忆往事，必闭目上瞪而思索之，此即凝神于脑之意也。（《见闻录》）
《内经》之论健忘，俱责之心肾不交。心不下交于肾，浊火乱其神明；肾不上交于心，精气伏而不用。
火居上则因而为痰，水居下则因而生躁，扰扰纭纭，昏而不定。故补肾而使之时上，养心而使之善下，则神气
清明，志意常治矣。（《医宗必读》）
健忘者，为事有始无终，言谈不知首尾。有因精神短少者，有因痰者，有因肾虚伤志者。《经》曰∶肾
盛怒而不止则伤志，喜忘其前言。丹溪曰∶此证皆由忧思过度，所愿不遂，损其心志，以致神舍不清，遇事多
忘，病在心脾。凡思伤脾，故令转盼遗忘，治以归脾汤，调养心脾，神安意定，其证自除。（《冯氏锦囊》）
健忘治法∶心气不足，妄有见闻，心悸恍惚者，《千金》茯神汤。思虑过度，病在心脾者，归脾汤。
挟痰者加姜汁、竹沥。精神短少者，人参养营汤送远志丸。痰迷心窍者，导痰汤。上虚
下热者，天王补心丹。心火不降，肾水不升，神明不定而健忘者，六味丸加五味子、远志。心气不足，恍惚多
忘者，四君子汤去白术，加菖蒲、远志、朱砂，蜜丸服。精神恍惚，少睡盗汗，怔忡健忘者，辰砂妙香散。瘀
积善忘如狂者，代抵当丸。○因病健忘者，精血亏少，或为痰饮瘀血所致，可以药治。若生平健忘，乃心窍大
疏，岂药石所能疗乎？故凡开凿混沌之方，悉行裁汰。（张路玉）
【经文义理】
黄帝问：人之所以容易健忘，是什么气机导致的？岐伯答：上部之气不足，下部之气有余，肠胃充实而心肺虚弱。虚则营卫之气滞留于下，久而久之，不能按时上行，所以容易健忘。（出自《灵枢》）
【哲人言论】
人生来禀受的气有清浊不同，禀受清气多的人，心的知觉就灵敏；禀受浊气多的人，心的知觉就昏昧。心志灵敏的人，记忆没有极限，即使是千百世以前的事，只要看过一次就能终身记住不忘；心志昏昧的人，即使没有受到外伤，眼前发生的事也不能记住。刘河间说：水清澈明亮，火昏暗浑浊，所以上善之人像水一样清明，下愚之人像火一样昏浊，这是由先天禀赋决定的。如果禀赋清浊相混，就不能耐受事务的烦扰，烦扰就会使心神失去灵性而导致健忘。大概血与气是人的神志基础。《内经》说：静则神气内藏，躁则神气消亡。静是水本体状态，躁是火的作用表现。所以性情安静则心神存于体内，性情躁动则心神散失于外，躁动不停则遗忘不止，遗忘不止则存于体内的神气就很少了，所以话说完就忘记，甚至等不到一天结束。因此老人大多健忘，大概是因为终日忙碌纷扰，思绪交错，导致气血中的阴精在此时将要枯竭。想要达到清明境界，就要减少欲望，这是善于调理“火”的方法。如果不致力于此，反而每天让百种忧虑感动内心，让万事劳累形体，只依赖药物的力量，以求片刻的功效，这叫舍本逐末，追求外在而遗弃内在，难道是根本之论吗！（出自《推求师意》）
人的记忆力都在脑中。小儿容易健忘，是因为脑髓尚未充盈。老人健忘，是因为脑髓逐渐空虚。凡是外界看到一个形象，必然有一个形象留在脑中。人们每当回忆往事，必定闭上眼睛向上看并思索，这就是将精神凝聚于脑的意思。（出自《见闻录》）
《内经》论述健忘，都归责于心肾不交。心气不下交于肾，浊火扰乱神明；肾气不上交于心，精气潜伏而不发挥作用。火居上则进而生痰，水居下则因而生躁，纷乱嘈杂，昏沉而不安定。所以补肾使其气时而上行，养心使其气善于下行，那么神气清明，意志就能常保安定了。（出自《医宗必读》）
健忘的表现，是做事有始无终，说话不知首尾。有的因为精神短少，有的因为有痰，有的因为肾虚伤及志意。《内经》说：肾盛怒不止会伤志，喜忘以前的言语。朱丹溪说：这个病证都是由忧思过度，愿望不能实现，损伤心志，导致神舍不清，遇事多忘，病位在心脾。凡是思虑伤脾，所以让人转眼就遗忘，治疗用归脾汤，调养心脾，神安意定，病症自然消除。（出自《冯氏锦囊》）
健忘的治疗方法：心气不足，出现幻觉妄见，心悸恍惚的，用《千金方》的茯神汤。思虑过度，病在心脾的，用归脾汤。兼夹痰邪的加姜汁、竹沥。精神短少的，用人参养营汤送服远志丸。痰迷心窍的，用导痰汤。上虚下热的，用天王补心丹。心火不降，肾水不升，神明不定而健忘的，用六味地黄丸加五味子、远志。心气不足，恍惚多忘的，用四君子汤去掉白术，加石菖蒲、远志、朱砂，蜜丸服用。精神恍惚，睡眠少且盗汗，怔忡健忘的，用辰砂妙香散。瘀血积聚导致健忘如狂的，用代抵当丸。○因病引起的健忘，多是精血亏少，或是痰饮瘀血所致，可以用药物治疗。如果是生平就健忘，那是心窍过于疏漏，难道药物能治愈吗？所以凡是开凿混沌（比喻强行提神醒脑）的方剂，全部予以淘汰。（张路玉）
[Scriptural Principles]
The Yellow Emperor asked: What qi mechanism causes people to be prone to forgetfulness? Qibo replied: The qi in the upper part is insufficient, while the qi in the lower part is excessive. The intestines and stomach are full, while the heart and lungs are deficient. Due to deficiency, Ying (Nutritive) and Wei (Defensive) qi remain stagnant in the lower part. Over time, they fail to ascend at the proper times, thus leading to forgetfulness. (From *Ling Shu*)
[Philosophical Discourses]
Individuals are born with different endowments of qi. Those who receive clear qi have sharp mental perception; those who receive turbid qi have dull mental perception. For those with a sharp mind, memory has no limit; even events from thousands of generations ago can be remembered for life after a single glance. For those with a dull mind, even without physical injury, they cannot remember current events. Liu Wansu stated: Water is clear and bright, while fire is dim and turbid. Hence, the superior person is like water (clear), and the inferior person is like fire (turbid); this is determined by innate constitution. If one's constitution is a mixture of clear and turbid, they cannot tolerate mental disturbance. Disturbance causes the loss of mental clarity, resulting in forgetfulness. Blood and qi constitute the spirit of humans. As the Classics state: "Stillness allows the spirit to reside within; restlessness causes it to dissipate." Stillness is the essence of water; restlessness is the function of fire. Therefore, a calm nature keeps the heart-mind within, while agitation scatters it outward. Continuous agitation leads to continuous forgetting; continuous forgetting depletes the spirit stored within, causing one to forget immediately after speaking, or even before the day ends. Thus, the elderly often suffer from forgetfulness because their daily busyness and chaotic thoughts exhaust the yin aspect of qi and blood. To achieve clarity, one must reduce desires; this is the proper way to regulate "fire." If one does not pursue this but instead allows worries to disturb the heart and affairs to labor the body, relying solely on medicinal power for temporary relief, this is abandoning the root for the branch and pursuing the external while neglecting the internal. Is this a fundamental argument? (From *Tui Qiu Shi Yi*)
Memory resides in the brain. Children are forgetful because their brain marrow is not yet full. The elderly are forgetful because their brain marrow gradually empties. Whenever an external form is seen, a corresponding image remains in the brain. When recalling past events, people close their eyes and look upward while thinking; this is the act of concentrating spirit in the brain. (From *Jian Wen Lu*)
The *Nei Jing* attributes forgetfulness to the failure of communication between the Heart and Kidney. When Heart qi fails to descend to the Kidney, turbid fire disturbs the spirit and mind; when Kidney qi fails to ascend to the Heart, essential essence remains latent and unused. Fire residing above generates phlegm; water residing below generates irritability. This chaos leads to confusion and instability. Therefore, tonifying the Kidney to allow its qi to ascend periodically, and nourishing the Heart to facilitate its descent, results in clear spirit and stable will. (From *Yi Zong Bi Du*)
Forgetfulness manifests as starting tasks without finishing them and speaking without coherence. It may be caused by deficient spirit, phlegm, or Kidney deficiency injuring the Will (Zhi). The Classics state: "Unrestrained anger injures the Will, causing forgetfulness of previous words." Zhu Danxi said: This condition arises from excessive worry and thought, unfulfilled desires, and damage to the Heart and Will, leading to an unclear residence of the spirit and frequent forgetting. The pathology lies in the Heart and Spleen. Since overthinking damages the Spleen, causing immediate forgetting, treatment should use Gui Pi Tang (Spleen-Restoring Decoction) to nourish the Heart and Spleen. With peace of spirit and stability of intent, the condition will resolve. (From *Feng Shi Jin Nang*)
Treatment methods for forgetfulness:
For Heart qi deficiency with hallucinations, palpitations, and trance, use Fushen Tang (Poria Cocos Decoction) from *Qian Jin Fang*.
For excessive worry affecting the Heart and Spleen, use Gui Pi Tang (Spleen-Restoring Decoction).
If complicated by phlegm, add Ginger Juice (Sheng Jiang Zhi) and Bamboo Sap (Zhu Li).
For deficient spirit, administer Ren Shen Yang Ying Tang (Ginseng Nourishing Qi and Blood Decoction) with Yuan Zhi Wan (Polygala Pill).
For phlegm confusing the Heart orifices, use Dao Tan Tang (Phlegm-Expelling Decoction).
For upper deficiency and lower heat, use Tian Wang Bu Xin Dan (Emperor of Heaven's Heart-Nourishing Pill).
For Heart fire failing to descend and Kidney water failing to ascend, causing unstable spirit and forgetfulness, use Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) added with Wu Wei Zi (Schisandra) and Yuan Zhi (Polygala).
For Heart qi deficiency with trance and frequent forgetting, use Si Jun Zi Tang (Four Gentlemen Decoction) minus Bai Zhu (Atractylodes Macrocephala Rhizome), added with Shi Chang Pu (Acorus Tatarinowii Rhizome), Yuan Zhi (Polygala), and Cinnabar (Zhu Sha), formed into honey pills.
For spiritual trance, insomnia, night sweats, palpitations, and forgetfulness, use Chen Sha Miao Xiang San (Cinnabar Wonderful Fragrance Powder).
For forgetfulness resembling mania due to blood stasis accumulation, use Dai Di Dang Wan (Substitute Tingling Pill).
○ Forgetfulness caused by disease, resulting from deficient essence and blood or phlegm-fluids and blood stasis, can be treated with medicine. However, lifelong forgetfulness indicates excessively open Heart orifices; can medicine cure this? Therefore, all formulas claiming to "open chaos" (forcefully awaken the mind) should be discarded. (Zhang Luyu)