寸口脉动而弱。动为惊。弱为悸。心中惊悸。脉必大结。饮食之悸。沉伏动滑。夫惊悸
即动悸也。动之为病。惕然而惊。悸之为病。心下怯怯。如恐人捕。皆心虚胆怯之所致也。
又曰。惊者。恐怖之谓。悸者。怔忡之谓。怔忡、惊悸、健忘三症。名异而病同。又云。惊
悸者。蓦然而跳跃惊动。如有欲厥之状。有时而厥者是也。属血虚。时觉心跳者。亦是血虚
盖人之所主者心。心之养者血。心血虚。神气不守。此惊悸之肇端也。
一人闻声即惊。医者令病患坐于堂下。使两人挟之。医自堂上。以小凳木槌
手击。而口云。吾击凳。亦常事耳。尔何必惊且击且言。患者视之久。而惊遂定。此深
得乎治之法也。
一论惊悸怔忡。健忘不寐。属心血虚者。
补心汤 主方。
当归(一钱二分) 川芎(七分) 白芍(炒一钱) 生地黄(一钱二分) 白术(去芦一钱)
远志
(去心八分) 白茯神(一钱二分) 酸枣仁(炒八分) 麦门冬(去心一钱) 黄连(姜汁炒
一钱) 元参(五钱) 甘草(炙三钱)
上锉一剂。水煎。温服。一方。加柏子仁。
一论血虚心神不安。惊悸怔忡不寐并治。
安神镇惊丸
当归(酒洗一钱) 贝母(去心一两) 川芎(七钱) 生地黄(酒洗一两半) 麦门冬(去心)
酸
枣仁(炒) 白芍(酒炒一两) 远志(去心七钱) 陈皮(去白一两) 白茯神(去皮木七钱)
黄连(姜汁炒五钱) 甘草(三钱) 朱砂(研末水飞为衣一两)
上为末。炼蜜为丸。如绿豆大。每服五十丸。食远。枣汤送下。
一论七情六欲。相感而心虚。夜多梦寐。睡卧不宁。恍惚惊怖痰痴。属心气虚者。
益气安神汤
当归(一钱二分) 黄连(姜汁炒) 生地黄 麦门冬(去心) 酸枣仁(炒) 远志(去心各
一
钱) 白茯苓(去皮心一钱二分) 人参 黄 (蜜炒) 胆星(各一钱) 淡竹叶(一钱)
甘草(六分)
上锉一剂。姜一片。枣一枚。水煎服。
一论小儿大人被惊。神不守舍。痰迷心窍。恍惚健忘。诸痫痴风心风诸症。
安神醒心丸
南星末(五两) 川连末(一两五钱先以姜汁拌浸半日入南星末调和匀成饼于饭甑内蒸半
日
)人参末(一两五钱) 制远志末(一两五钱) 飞过辰砂(研七钱五分) 琥珀(七钱五分)
酸枣仁(炒研末一两)
上用雄猪心血三个。入竹沥。打面糊为丸。如梧桐子大。金箔为衣。每服五十丸。食远
白汤送下。小者二三十丸。
一论异梦多惊有二法。一于髻中。戴粗大灵砂一囊。一于枕中。置真麝香一囊。皆能杜
绝异梦。而疗夜魇。
一论夜梦。阴盛梦大水恐惧。阳盛梦大火燔灼。阴阳俱盛梦相杀。上盛梦飞。下盛梦堕
饱
梦与人食。饥梦取人食。心实梦燔灼。心虚梦救火阳物坚。肝虚梦细草芒芒。肝实梦伏树
下不敢起。脾虚梦饮食不足。脾实梦筑墙盖屋。肺虚梦白物斩血籍。肺实梦兵刃血战。肾虚
梦舟船溺水。肾实梦伏水中。若有所畏。
寸口脉象跳动而虚弱。脉动主惊证,脉弱主悸证。心中出现惊悸症状时,脉象必然呈现大而结滞之象。因饮食不当引起的悸证,脉象多呈沉伏、动滑之态。所谓惊悸,也就是动悸。由“动”引发的病症,表现为惊恐不安;由“悸”引发的病症,表现为心下部怯懦恐惧,好像被人追捕一样。这些都是因为心气虚弱、胆气不足所导致的。
又说:惊,是指恐怖的感觉;悸,是指怔忡(心跳剧烈)的感觉。怔忡、惊悸、健忘这三种症状,名称不同但病因相同。又有说法称:惊悸,是指突然之间跳跃惊动,好像要昏厥的样子,有时确实会发生昏厥,这属于血虚。时常感觉心跳的,也是血虚所致。大概是因为人主宰精神的是心,滋养心的物质是血。心血虚弱,神气就不能安居其位,这是惊悸发生的开端。
曾有一人听到声音就受惊。医生让病人坐在堂下,让两个人夹住他,医生自己在堂上,用小凳子和木槌敲击,并说道:“我敲凳子,也是平常事罢了,你何必惊慌呢?”一边敲击一边说话。患者注视久了,惊吓便安定下来。这深得治疗此病的方法精髓。
论述惊悸、怔忡、健忘、失眠,属于心血虚证的,用补心汤作为主方。
当归(一钱二分)、川芎(七分)、白芍(炒制一钱)、生地黄(一钱二分)、白术(去芦头一钱)、远志(去心八分)、白茯神(一钱二分)、酸枣仁(炒制八分)、麦门冬(去心一钱)、黄连(姜汁炒一钱)、元参(五钱)、甘草(炙制三钱)。
以上药材锉碎为一剂,用水煎煮,温服。另一配方,加入柏子仁。
论述因血虚导致心神不安,惊悸、怔忡、失眠同时治疗的,用安神镇惊丸。
当归(酒洗一钱)、贝母(去心一两)、川芎(七钱)、生地黄(酒洗一两半)、麦门冬(去心)、酸枣仁(炒制)、白芍(酒炒一两)、远志(去心七钱)、陈皮(去白一两)、白茯神(去皮木七钱)、黄连(姜汁炒五钱)、甘草(三钱)、朱砂(研成细末,水飞法处理作为包衣一两)。
以上药物研成粉末,用炼蜜制成丸药,大小如绿豆。每次服用五十丸,在饭后服用,用枣汤送服。
论述因七情六欲相互感应而导致心虚,夜间多梦,睡卧不宁,神情恍惚,惊恐恐怖,痰迷心窍痴呆,属于心气虚证的,用益气安神汤。
当归(一钱二分)、黄连(姜汁炒)、生地黄、麦门冬(去心)、酸枣仁(炒制)、远志(去心各一钱)、白茯苓(去皮心一钱二分)、人参、黄芪(蜜炒)、胆南星(各一钱)、淡竹叶(一钱)、甘草(六分)。
以上药材锉碎为一剂,加生姜一片、大枣一枚,用水煎煮后服用。
论述小儿和大人受到惊吓,神志不守舍,痰迷心窍,神情恍惚,健忘,各种癫痫、痴风、心风等症状,用安神醒心丸。
天南星末(五两)、黄连末(一两五钱,先用姜汁拌浸半天,再纳入天南星末调和均匀做成饼,放在饭甑内蒸半天)、人参末(一两五钱)、制远志末(一两五钱)、飞过辰砂(研细七钱五分)、琥珀(七钱五分)、酸枣仁(炒制研末一两)。
以上用药材雄猪的三个心血,加入竹沥,打面糊为丸,大小如梧桐子。用金箔作为包衣。每次服用五十丸,在饭后用白开水送服。年幼者服用二三十丸。
论述因奇异梦境和多惊有两种方法:一种是在发髻中佩戴装有粗大灵砂的香囊;一种是在枕头中放置装有真麝香的香囊。都能杜绝奇异梦境,并治疗夜魇(梦中惊叫或窒息感)。
论述夜间做梦:阴气盛则梦见大水恐惧;阳气盛则梦见大火焚烧;阴阳俱盛则梦见互相杀戮。上部气盛则梦见飞翔;下部气盛则梦见坠落。吃饱了梦见给别人食物;饿了梦见向别人索取食物。心实证梦见火烧灼;心虚证梦见救火且阳物坚硬。肝虚证梦见细草茫茫;肝实证梦见趴在树下不敢起来。脾虚证梦见饮食不足;脾实证梦见筑墙盖屋。肺虚证梦见白色物体斩出血迹;肺实证梦见兵器血战。肾虚证梦见舟船溺水;肾实证梦见趴在水中,好像有所畏惧。
The pulse at the Cun Kou (radial artery) is moving and weak. "Moving" indicates Jing (startle), while "weak" indicates Ji (palpitation). When there is Jing-Ji (startle and palpitation) in the heart, the pulse must appear large and knotted. For palpitations caused by dietary factors, the pulse is typically deep, hidden, moving, or slippery. Jing-Ji is essentially the same as Dong-Ji (moving and palpitation). The disease caused by "Dong" manifests as sudden fright and alarm; the disease caused by "Ji" manifests as timidity and fear in the epigastrium, as if being chased by someone. Both are caused by Heart Qi deficiency and Gallbladder Qi deficiency.
Furthermore, "Jing" refers to terror, and "Ji" refers to Zheng-Chong (violent palpitations). Zheng-Chong, Jing-Ji, and Jian-Wang (forgetfulness) are three symptoms with different names but identical pathology. It is also said that Jing-Ji involves a sudden jumping and agitation, resembling a state of impending syncope, sometimes actually resulting in syncope; this belongs to Blood deficiency. Frequent sensations of heartbeat are also due to Blood deficiency. Generally, the Heart governs the Spirit (Shen), and Blood nourishes the Heart. When Heart Blood is deficient, the Shen cannot remain in its abode, which marks the beginning of Jing-Ji.
In one case, a person was startled by sounds. The physician instructed the patient to sit below the hall and have two assistants hold him. The physician stood above the hall, struck a small wooden stool with a mallet, and said, "I am striking the stool, which is a common occurrence. Why are you so alarmed?" While striking, he spoke continuously. After the patient watched for a long time, his startle subsided. This method deeply grasps the essence of treatment.
Regarding Jing-Ji, Zheng-Chong, forgetfulness, and insomnia caused by Heart Blood deficiency:
Bu Xin Tang (Heart-Nourishing Decoction) is the principal formula.
Dang Gui (Angelicae Sinensis Radix, 1.2 qian), Chuan Xiong (Ligusticum Chuanxiong Rhizoma, 0.7 qian), Bai Shao (Paeoniae Radix Alba, stir-fried 1 qian), Sheng Di Huang (Rehmanniae Radix Recens, 1.2 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, de-gelled 1 qian), Yuan Zhi (Polygalae Radix, de-core 0.8 fen), Bai Fu Shen (Poria with Hostwood, 1.2 qian), Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried 0.8 fen), Mai Men Dong (Ophiopogonis Radix, de-core 1 qian), Huang Lian (Coptidis Rhizoma, stir-fried with ginger juice 1 qian), Yuan Shen (Scrophulariae Radix, 5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-roasted 3 qian).
Crush these ingredients into one dose, decoct with water, and take warm. Another variation adds Bai Zi Ren (Biota Seed).
Regarding simultaneous treatment of Jing-Ji, Zheng-Chong, and insomnia due to Blood deficiency causing restless Shen:
An Shen Zhen Jing Wan (Spirit-Calming and Startle-Subduing Pill).
Dang Gui (Angelicae Sinensis Radix, wine-washed 1 qian), Bei Mu (Fritillariae Cirrhosae Bulbus, de-core 1 liang), Chuan Xiong (Ligusticum Chuanxiong Rhizoma, 7 qian), Sheng Di Huang (Rehmanniae Radix Recens, wine-washed 1.5 liang), Mai Men Dong (Ophiopogonis Radix, de-core), Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried), Bai Shao (Paeoniae Radix Alba, wine-stir-fried 1 liang), Yuan Zhi (Polygalae Radix, de-core 7 qian), Chen Pi (Citri Reticulatae Pericarpium, de-white 1 liang), Bai Fu Shen (Poria with Hostwood, de-bark and wood 7 qian), Huang Lian (Coptidis Rhizoma, stir-fried with ginger juice 5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 qian), Zhu Sha (Cinnabaris, ground fine and washed with water for coating, 1 liang).
Grind these into powder, mix with refined honey to form pills the size of mung beans. Take 50 pills per dose after meals, delivered with Jujube Decoction.
Regarding Heart Qi deficiency caused by mutual induction of the Seven Emotions and Six Desires, leading to frequent dreams at night, restlessness during sleep, mental confusion, fright, terror, and phlegm confusing the Heart orifice manifesting as dementia:
Yi Qi An Shen Tang (Qi-Replenishing and Spirit-Calming Decoction).
Dang Gui (Angelicae Sinensis Radix, 1.2 qian), Huang Lian (Coptidis Rhizoma, stir-fried with ginger juice), Sheng Di Huang (Rehmanniae Radix Recens), Mai Men Dong (Ophiopogonis Radix, de-core), Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried), Yuan Zhi (Polygalae Radix, de-core, each 1 qian), Bai Fu Ling (Poria, de-bark and core 1.2 qian), Ren Shen (Ginseng Radix et Rhizoma), Huang Qi (Astragali Membranacei Radix, honey-roasted), Dan Xing (Arisaematis Cum Bile Rhizoma, each 1 qian), Dan Zhu Ye (Lophatheri Herba, 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.6 fen).
Crush these ingredients into one dose, add one slice of fresh ginger and one jujube, decoct with water, and take.
Regarding startle in children and adults where the Shen does not reside in its house, phlegm confuses the Heart orifice, leading to mental confusion, forgetfulness, and various conditions such as epilepsy, dementia wind, and Heart wind:
An Shen Xing Xin Wan (Spirit-Calming and Heart-Awakening Pill).
Nan Xing Mo (Arisaematis Rhizoma powder, 5 liang), Chuan Lian Mo (Coptidis Rhizoma powder, 1.5 liang; first soaked in ginger juice for half a day, then mixed with Nan Xing Mo to form cakes, steamed in a rice steamer for half a day), Ren Shen Mo (Ginseng Radix et Rhizoma powder, 1.5 liang), Zhi Yuan Zhi Mo (Processed Polygalae Radix powder, 1.5 liang), Fei Guo Chen Sha (Washed Cinnabaris, ground fine 0.75 liang), Hu Po (Amber, 0.75 liang), Suan Zao Ren Mo (Stir-fried and ground Ziziphi Spinosae Semen powder, 1 liang).
Use the blood from the heart of three male pigs, add Bamboo Sap (Zhu Li), mix with wheat paste to form pills the size of Chinese parasol tree seeds. Coat with Gold Leaf (Jin Bo). Take 50 pills per dose after meals, delivered with plain boiled water. Children take 20-30 pills.
Regarding strange dreams and frequent startles, there are two methods: one is to wear a pouch containing coarse Ling Sha (refined cinnabar) in the hair bun; the other is to place a pouch containing real She Xiang (Musk) in the pillow. Both can prevent strange dreams and treat Ye Yan (night terrors/sleep paralysis).
Regarding dreams at night: If Yin is excessive, one dreams of large waters and fear; if Yang is excessive, one dreams of fire burning; if both Yin and Yang are excessive, one dreams of killing each other. If Upper Jiao Qi is excessive, one dreams of flying; if Lower Jiao Qi is excessive, one dreams of falling. If full, one dreams of feeding others; if hungry, one dreams of taking food from others. If Heart Excess, one dreams of burning; if Heart Deficiency, one dreams of putting out fires and experiencing rigid genitalia. If Liver Deficiency, one dreams of sparse grass; if Liver Excess, one dreams of hiding under trees afraid to rise. If Spleen Deficiency, one dreams of insufficient food/drink; if Spleen Excess, one dreams of building walls and houses. If Lung Deficiency, one dreams of white objects cutting and bleeding; if Lung Excess, one dreams of weapons and bloody battles. If Kidney Deficiency, one dreams of boats sinking and drowning; if Kidney Excess, one dreams of lying in water, feeling fearful.