人有得怔忡之症者,一遇拂情之事,或听逆耳之言,便觉心气怦怦上冲,有不能自主之
势,似烦而非烦,似晕而非晕,人以为心虚之故也。然而心虚由于肝虚,肝虚则肺金必旺,
以心弱不能制肺也。肺无火 炼,则金必制木,肝不能生金,而心气益困。故补心必须补肝
,而补肝尤宜制肺。然而肺不可制也,肺乃娇脏,用寒凉以制肺,必致伤损脾胃,肺虽制矣
,而脾胃受寒,不能运化水谷,则肝又何所取资,而肾又何能滋益,所以肺不宜制而宜养也
。方用制忡汤治之。
人参(五钱) 白术(五钱) 白芍(一两) 当归(一两) 生枣仁(一两) 北五味(一钱) 麦冬(五钱)
贝母(五分) 竹沥(十匙)
水煎调服。一剂而怔忡少定,二剂更安,十剂全愈。
此方不全去定心,而反去补肝以平木,则火不易动;补肺以养金,则木更能静矣。木气
既静,则肝中生血,自能润心之液,而不助心之焰,怔忡不治而自愈矣。
此症用柏莲汤亦佳。
人参 麦冬 玄参(各五钱) 茯苓 柏子仁 丹皮(各三钱) 丹参(二钱) 半夏 莲子心(各一
钱) 生枣仁(三钱)
水煎服。一剂安,十剂愈。
人有得怔忡之症,日间少轻,至夜则重,欲思一睡熟而不可得者,人以为心虚之极也,
谁知是肾气之乏乎。凡人夜卧则心气必下降于肾宫,惟肾水大耗,一如家贫,客至无力相延
,客见主人之窘迫,自然不可久留,徘徊岐路,实乃 徨耳。治法大补其肾中之精,则
肾气充足矣。方用心肾两交汤∶
熟地(一两) 山茱(八钱) 人参(五钱) 当归(五钱) 炒枣仁(八钱) 白芥子(五钱) 麦冬(五钱) 肉
桂(三分) 黄连(三分)
水煎服。一剂即熟睡,二剂而怔忡定,十剂全愈矣。
此方补肾之中仍益之补心之剂,似乎无专补之功。殊不知肾水既足,而心气若虚,恐有
不相契合之虞。今心肾两有余资,主客分外加欢,相得益彰矣。况益之介绍如黄连、肉桂并
投,则两相赞颂和美,有不赋胶漆之好者乎!
此症用交合汤亦效。
人参(五钱) 熟地(二两) 黄莲(三分) 肉桂(五分)
水煎服。一剂即睡,十剂全安。
人有得怔忡之症,心常怦怦不安,常若有官事未了,人欲来捕之状,人以为心气之虚也
,谁知是胆气之怯乎?夫胆属少阳,心之母也,母虚则子亦虚。惟是胆气虽虚,何便作怔忡
之病?不知脏腑之气,皆取决于胆,胆气一虚,而脏腑之气皆无所遵从,而心尤无主,故怦
怦而不安者,乃似乎怔忡,而实非怔忡也。治法徒补心而不补各脏腑之气,则怔忡之病不能
痊;补各脏腑之气而不补胆之气,内无刚断之风,外有纷纭之扰,又安望心中之宁静乎!故
必补胆之气,而后可以去怯也。方用坚胆汤∶
白术(五钱) 人参(五钱) 茯神(三钱) 白芍(二两) 铁粉(一钱) 丹砂(一钱) 天花粉(三钱) 生
枣
仁(三钱) 竹茹(一钱)
水煎服。一剂而胆壮,二剂而胆更壮,十剂而怦怦者不知其何以去也。
此方肝胆同治之剂,亦心胆共治之剂也。肝与胆为表里,治胆而因治肝者,兄旺而弟自
不衰也;心与胆为子母,补胆而兼补心者,子强而母自不弱也。又有镇定之品以安神,刻削
之味以消痰,更相佐之得宜,即是怔忡,未有不奏功如响者,况非怔忡之真病乎!
此症用龙齿壮胆汤亦效。
人参 竹茹(各三钱) 五味子 远志(各一钱) 生枣仁(一两) 白芍(八钱) 当归(五钱) 龙齿(
醋淬研末,五分)
水煎服。二剂即安。
有一位患有怔忡(心中悸动不安)病症的人,每当遇到令心情不愉快的事情,或听到刺耳逆耳的话时,就会感到心气怦怦向上冲撞,有一种无法自主控制的态势,感觉像是烦躁又不是烦躁,像是头晕又不是头晕。人们认为这是心脏虚弱所致。然而,心脏虚弱是由于肝脏虚弱引起的。肝脏虚弱,则肺金必然偏旺,因为心脏虚弱不能制约肺脏。肺脏没有火来锻炼,则金气必然克制木气;肝脏不能生助肺金,导致心气更加困顿。因此,补益心脏必须同时补益肝脏,而补益肝脏尤其应当制约肺脏。然而,肺脏是不宜直接制约的,肺是娇嫩之脏,如果用寒凉药物去制约肺脏,必定会损伤脾胃。虽然肺被制约了,但脾胃受寒,不能运化水谷精微,那么肝脏又从哪里获取滋养,肾脏又怎能得到滋益呢?所以,对于肺脏不宜制约而宜于调养。治疗方剂使用制忡汤。
人参(五钱) 白术(五钱) 白芍(一两) 当归(一两) 生枣仁(一两) 北五味子(一钱) 麦冬(五钱) 贝母(五分) 竹沥(十匙)
用水煎煮后调服。服用一剂后怔忡症状稍微安定,两剂后更加安稳,十剂后完全痊愈。
这个方子不全在于直接镇定心神,而是反而通过补益肝脏来平抑肝木,这样心火就不易妄动;补益肺脏以养肺金,这样肝木就能更加安静。肝气既然安静,则肝脏中生成的血液,自然能滋润心脏的阴液,而不会助长心脏的火势,怔忡不治而自愈了。
这种病症使用柏莲汤效果也很好。
人参 麦冬 玄参(各五钱) 茯苓 柏子仁 丹皮(各三钱) 丹参(二钱) 半夏 莲子心(各一钱) 生枣仁(三钱)
用水煎服。一剂后症状安宁,十剂后痊愈。
有人患上怔忡病症,白天症状稍轻,到了晚上就加重,想要睡个熟觉却不可得,人们认为是心脏极度虚弱,谁知这其实是肾气匮乏的缘故。大凡人在夜间卧床时,心气必然会下降至肾宫。只有当肾水大量消耗时,就像家境贫寒,客人到来时无力招待,客人见主人窘迫,自然不能久留,徘徊在歧路上,实在是彷徨无措。治疗方法是大补肾中的精气,这样肾气就充足了。方剂用心肾两交汤:
熟地黄(一两) 山茱萸(八钱) 人参(五钱) 当归(五钱) 炒枣仁(八钱) 白芥子(五钱) 麦冬(五钱) 肉桂(三分) 黄连(三分)
用水煎服。一剂后即能熟睡,两剂后怔忡安定,十剂后完全痊愈。
这个方子在补肾的同时仍辅以补心的药物,似乎没有专门补益的功效。殊不知肾水既已充足,如果心气依然虚弱,恐怕会有不相契合的忧虑。如今心肾两者都有充足的资粮,主客之间分外欢欣,相得益彰。况且加入了像黄连、肉桂这样的引经报使药物并投用,则两者相互赞美和谐,难道不会有如胶似漆般的美好结合吗!
这种病症使用交合汤也有效。
人参(五钱) 熟地黄(二两) 黄连(三分) 肉桂(五分)
用水煎服。一剂后即能入睡,十剂后完全安康。
有人患上怔忡病症,心中常常怦怦不安,常常好像有官府的事情未了结,有人要来抓捕自己的样子,人们认为是心气虚弱,谁知这是胆气怯懦呢?胆属于少阳经,是心脏的母亲,母亲虚弱则儿子也虚弱。只是胆气虽然虚弱,为何便做出怔忡的病状呢?不知道脏腑之气,都取决于胆气,胆气一旦虚弱,脏腑之气都无所遵从,而心脏尤其没有主宰,所以怦怦不安,看起来像是怔忡,实际上并非怔忡。治疗方法如果只是单纯补心而不补其他脏腑之气,那么怔忡的病就不能痊愈;补其他脏腑之气而不补胆气,内部缺乏刚断之风,外部又有纷纭的干扰,又怎么指望心中宁静呢!所以必须补益胆气,然后才能去除怯懦。方剂使用坚胆汤:
白术(五钱) 人参(五钱) 茯神(三钱) 白芍(二两) 铁粉(一钱) 丹砂(一钱) 天花粉(三钱) 生枣仁(三钱) 竹茹(一钱)
用水煎服。一剂后胆气壮实,两剂后胆气更加壮实,十剂后怦怦不安的感觉不知为何消失了。
这个方子是肝胆同治的药剂,也是心胆共治的药剂。肝与胆互为表里,治疗胆病而连带治疗肝病,兄长旺盛则弟弟自然不衰;心与胆互为母子,补益胆气而兼补心气,儿子强大则母亲自然不弱。又有镇定的药物来安神,刻削(化痰)的味道来消痰,更相互佐使得当,即使是真正的怔忡,也没有不奏效如响应的,何况这不是怔忡的真病呢!
这种病症使用龙齿壮胆汤也有效。
人参 竹茹(各三钱) 五味子 远志(各一钱) 生枣仁(一两) 白芍(八钱) 当归(五钱) 龙齿(醋淬研末,五分)
用水煎服。两剂后即安宁。
A person suffering from *Zhengchong* (palpitations, anxiety with a sense of impending doom) finds that whenever encountering frustrating matters or hearing unpleasant words, they feel their heart qi surging upward with a pounding sensation, as if beyond their control. It feels like irritability but is not quite irritability, and like dizziness but is not quite dizziness. People attribute this to heart deficiency. However, heart deficiency stems from liver deficiency. When the liver is deficient, lung metal inevitably becomes excessive because the weak heart cannot restrain the lungs. Without fire to refine it, lung metal will constrain liver wood; since the liver cannot generate lung metal, the heart qi becomes further constrained. Therefore, tonifying the heart must involve tonifying the liver, and tonifying the liver particularly requires restraining the lungs. However, the lungs are not suitable for direct restraint; the lungs are a delicate organ, and using cold-cooling herbs to restrain them will inevitably damage the spleen and stomach. Although the lungs may be restrained, the spleen and stomach, chilled, fail to transform and transport food and fluids. Consequently, where does the liver draw its nourishment from, and how can the kidneys receive enrichment? Thus, the lungs should not be restrained but rather nurtured. The treatment formula used is *Zhi Chong Tang* (Palpitation-Restraining Decoction).
Ren Shen (Ginseng Radix et Rhizoma) (5 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (5 qian), Bai Shao (Paeoniae Radix Alba) (1 liang), Dang Gui (Angelicae Sinensis Radix) (1 liang), Sheng Zao Ren (Ziziphi Spinosae Semen) (1 liang), Bei Wu Wei Zi (Schisandrae Chinensis Fructus) (1 qian), Mai Dong (Ophiopogonis Radix) (5 qian), Bei Mu (Fritillariae Cirrhosae Bulbus) (5 fen), Zhu Li (Bambusa Textilis Sap) (10 spoons).
Decoct in water and take orally. After one dose, palpitations subside slightly; after two doses, there is greater peace; after ten doses, full recovery occurs.
This formula does not solely aim to settle the heart spirit directly; instead, it tonifies the liver to calm the liver wood, thereby preventing heart fire from stirring easily; it tonifies the lungs to nourish lung metal, allowing liver wood to remain tranquil. Once the liver qi is tranquil, the blood generated by the liver naturally moistens the heart's yin fluids without exacerbating heart fire. Palpitations heal themselves without specific treatment for the symptom itself.
For this condition, *Bai Lian Tang* (Lotus Seed and Biota Decoction) is also effective.
Ren Shen (Ginseng Radix et Rhizoma), Mai Dong (Ophiopogonis Radix), Xuan Shen (Scrophulariae Radix) (each 5 qian), Fu Ling (Poria) (3 qian), Bai Zi Ren (Biota Seed) (3 qian), Dan Pi (Moutan Cortex) (3 qian), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma) (2 qian), Ban Xia (Pinelliae Tuber) (1 qian), Lian Zi Xin (Nelumbinis Plumula) (1 qian), Sheng Zao Ren (Ziziphi Spinosae Semen) (3 qian).
Decoct in water and take orally. One dose brings relief; ten doses bring cure.
Some individuals suffer from palpitations, with symptoms slightly lighter during the day but heavier at night, desiring deep sleep but unable to achieve it. People assume this is extreme heart deficiency, yet it is actually due to a lack of kidney qi. Generally, when lying down at night, heart qi descends into the kidney palace. Only when kidney water is severely depleted—like a poor household unable to entertain guests when visitors arrive—do the guests (heart qi), seeing the host's (kidney's) distress, naturally find it impossible to stay long, lingering hesitantly on the path, truly feeling lost. The treatment method is to greatly tonify the essence within the kidneys so that kidney qi becomes sufficient. The formula used is *Xin Shen Liang Jiao Tang* (Heart-Kidney Mutual Penetration Decoction):
Shu Di Huang (Rehmanniae Radix Praeparata) (1 liang), Shan Zhu Yu (Corni Fructus) (8 qian), Ren Shen (Ginseng Radix et Rhizoma) (5 qian), Dang Gui (Angelicae Sinensis Radix) (5 qian), Chao Zao Ren (Ziziphi Spinosae Semen, Stir-fried) (8 qian), Bai Jie Zi (Brassicae Semens) (5 qian), Mai Dong (Ophiopogonis Radix) (5 qian), Rou Gui (Cinnamomi Cortex) (3 fen), Huang Lian (Coptidis Rhizoma) (3 fen).
Decoct in water and take orally. One dose leads to sound sleep; two doses stabilize palpitations; ten doses result in complete recovery.
This formula supplements the kidneys while simultaneously benefiting the heart, seemingly lacking dedicated tonification. However, once kidney water is sufficient, if heart qi remains deficient, there is a risk of mismatch. Now, with both heart and kidney having ample resources, the host and guest enjoy mutual delight, enhancing each other's effects. Moreover, with the introduction of agents like Huang Lian (Coptidis Rhizoma) and Rou Gui (Cinnamomi Cortex) working together, they praise and harmonize each other, forming a bond as inseparable as glue and lacquer!
For this condition, *Jiao He Tang* (Union Decoction) is also effective.
Ren Shen (Ginseng Radix et Rhizoma) (5 qian), Shu Di Huang (Rehmanniae Radix Praeparata) (2 liang), Huang Lian (Coptidis Rhizoma) (3 fen), Rou Gui (Cinnamomi Cortex) (5 fen).
Decoct in water and take orally. One dose induces sleep; ten doses ensure total peace.
Some people suffer from palpitations, with their hearts often pounding uneasily, as if they have unfinished official business and someone is coming to arrest them. People attribute this to heart qi deficiency, unaware that it is actually gallbladder qi timidity. The gallblong belongs to Shaoyang and is the mother of the heart; if the mother is deficient, the son is also deficient. But why does gallbladder deficiency lead to palpitations? It is unknown that the qi of all zang-fu organs depends on the gallbladder. Once gallbladder qi is deficient, the qi of all zang-fu organs has no leader, and the heart especially lacks mastery. Thus, the pounding uneasiness appears like palpitations but is essentially not true palpitations. The treatment method: merely tonifying the heart without tonifying the qi of other zang-fu organs will not cure palpitations; tonifying other zang-fu organs without tonifying the gallbladder means lacking internal decisiveness and facing external disturbances, making inner tranquility unattainable. Therefore, one must tonify gallbladder qi to dispel timidity. The formula used is *Jian Dan Tang* (Gallbladder-Strengthening Decoction):
Bai Zhu (Atractylodis Macrocephalae Rhizoma) (5 qian), Ren Shen (Ginseng Radix et Rhizoma) (5 qian), Fu Shen (Poria with Hostwood) (3 qian), Bai Shao (Paeoniae Radix Alba) (2 liang), Tie Fen (Ferrum) (1 qian), Dan Sha (Cinnabar) (1 qian), Tian Hua Fen (Trichosanthis Radix) (3 qian), Sheng Zao Ren (Ziziphi Spinosae Semen) (3 qian), Zhu Ru (Bambusa Textilis Caulis Intercatulus) (1 qian).
Decoct in water and take orally. One dose strengthens the gallbladder; two doses strengthen it further; ten doses make the pounding sensation disappear unknowingly.
This formula treats both liver and gallbladder simultaneously, and also treats both heart and gallbladder. Liver and gallbladder are interior-exterior partners; treating the gallbladder while addressing the liver ensures that if the elder brother (liver) thrives, the younger brother (gallbladder) naturally does not decline. Heart and gallblound are mother-son; tonifying the gallblound while supplementing the heart ensures that if the child (gallblound) is strong, the mother (heart) naturally remains robust. Additionally, calming agents soothe the spirit, and phlegm-resolving agents clear turbidity; when these auxiliaries are properly coordinated, even true palpitations respond effectively like an echo, let alone conditions that are not true palpitations!
For this condition, *Long Chi Zhuang Dan Tang* (Dragon Tooth Gallblound-Strengthening Decoction) is also effective.
Ren Shen (Ginseng Radix et Rhizoma), Zhu Ru (Bambusa Textilis Caulis Intercatulus) (each 3 qian), Wu Wei Zi (Schisandrae Chinensis Fructus), Yuan Zhi (Polygalae Radix) (each 1 qian), Sheng Zao Ren (Ziziphi Spinosae Semen) (1 liang), Bai Shao (Paeoniae Radix Alba) (8 qian), Dang Gui (Angelicae Sinensis Radix) (5 qian), Long Chi (Dent fossilis, processed with vinegar and ground to powder) (5 fen).
Decoct in water and take orally. Two doses bring peace.