Written By Jun Heo(許浚, 1539~1615), Translated by Namil Kim, Wung Seok Cha et al., Published by Ministry of Health & Welfare (Korea)
09 Palpitation 驚悸경계
- ① The Inner Classic (內經) says, “When blood gathers in yin and qi gathers in yang, it becomes fright manic psychosis.”
- ② The Annotation from Inner Classic (內經) say, “Palpitations are throbbings of the heart.”
- ③ The Compendium of Medicine (綱目) says, “Fright is when one’s heart pounds suddenly and feels uncomfortable. Palpitations are when one’s heart pounds and feels afraid.”
- ④ The Treatise on and Formulas for the Three Categories of Pathogenic Factors (三因) says, “Palpitation occurs when one is greatly frightened, and it is also called Simgyeong damseop (frightened heart and fearful gallbladder, 心驚膽懾). Pulses beat large when disease is in the heart meridian or the gallbladder meridian. One should use a Calm Spirit Cinnabar Pill, Calm Heart Elixir, or Augmented Gallbladder-Warming Decoction.”
- ⑤ Zhongjing (仲景) said, “Palpitations are when Fire is afraid of Water. Palpitations occur because the kidney suppresses the heart. There is pounding in the epigastric region if one drinks a lot of water when he is suffering from Cold Damage.”
- ⑥ Danxi (丹溪) said, “Palpitations occur once in a while. One should use a Calm Spirit Cinnabar Pill if blood is deficient and an Augmented Settle the Emotions Pill if phlegm is existent. Most of the time, palpitations are a result of blood deficiency and phlegm. For thin people, it is mostly caused by a blood deficiency, and for fat people, it is mostly caused by phlegm. The occasional pounding of the heart is also the result of a blood deficiency.”
- ⑦ Zhongjing (仲景) said, “When water stays in the epigastric region because one ate little food and drank lots of water, it becomes palpitations if it is serious, and shortness of breath if otherwise.”
- ⑧ The Treatise on and Formulas for the Three Categories of Pathogenic Factors (三因) says, “Palpitations are easy to occur when the five retained fluids accumulate and the abdominal region is blocked. It is common among those who have had phlegm.”
- ⑨ The Introduction to Medicine (入門) says, “Palpitations occur when one thinks too much or is frightened. If it gets serious, one’s heart pounds and he or she feels like fainting. One should use a Clear Heart and Nourish Blood Decoction or Cinnabar, Aucklandia, Musk and Cyperus Powder. If qi and blood are both deficient, one should use a Maintain Heart Decoction. Occasional attacks occur when phlegm moves as a consequence of the movement of Fire. In this case, add Ponciri Fructus Immaturus (枳實), Liriopis Tuber 麥門冬), Bambusae Caulis in Taeniam (竹茹), Coptidis Rhizoma (黃連), Gardeniae Fructus (梔子), Ginseng Radix (人參), Atractylodis Rhizoma Alba (白朮), Angelica Gigantis Radix (當歸), Mume Fructus Praeparatum (烏梅), 3 pieces of Zingiberis Rhizoma Crudus (生薑), and 1 Zizyphi Fructus (大棗) to a Syzygii Flos Relieve Stomach Decoction and decoct, put in 3 spoons of Bambusae Caulis in Liquamen (竹瀝) and 3 spoons of Cinnabaris (朱砂) powder.” [The prescription is shownin the chapter Phlegm].
- ⑩ One should use a Tranquilise Spirit Elixir, Stabilize the Will Formula, Maintain the Blood and Calm Spirit Decoction, or Crimson Cinnabar Paste for palpitations because one should tonify the blood and relieve the spirit. One should use a Sympathy Elixir. [The prescription is shown in the chapter on Qi]. Or an Augmented Four Ingredients for the Seven Emotions Decoction if the palpitations are caused by qi stagnation.
– Calm Spirit Cinnabar Pill 朱砂安神丸 주사안신환
Dongyuan (東垣) said, “When heat is excessive, use Coptidis Rhizoma (黃連) as the sovereign medicine because it is bitter and cold, removing vexation and dampness-heat. Also, use Glycyrrhizae Radix (甘草) and Rehmanniae Radix Crudus (生地黃) as the minister medicines because they are sweet and cold, purge Fire, tonify qi, and nurture yin blood. Angelica Gigantis Radix (當歸)
tonifies a deficiency in blood, and Cinnabaris (朱砂) gathers floating Fire.
Thus, they both relieve the spirit.” Coptidis Rhizoma (黃連) (6 don), Cinnabaris (朱砂) (5 don), Glycyrrhizae Radix (甘草), Rehmanniae Radix (生乾地黃) (cleansed with wine) (3.5 don each), Angelica Gigantis Radix (當歸) (cleansed with wine) (2.5 don). Grind these herbs, knead with steamed rice-cake that had been put into boiling water, and make it into pills the size of Panicis Semen Glutinosa (黍米). Take 20~30 pills at a time with saliva.
– Calm Heart Elixir 鎭心丹 진심단
It cures palpitations caused by a heart deficiency. Cinnabaris (辰砂) [put in wine with Pini Radix Obsitus Poriae (黃松節)] and Fossilia Mastodi Dentis (龍齒) [boiled in vinegar with the bud of Polygalae Radix (遠志)]. Take the Cinnabaris (辰砂), grind it until it becomes the same amounts as Fossilia Mastodi Dentis (龍齒), knead with the blood obtained from the heart of a pig, and make it into pills the size of Euryales Semen (芡實). Put Liriopis Tuber (麥門冬), Phaseoli Radiati Semen (菉豆), Junci Medulla (燈心), and honey in water, boil them until the Phaseoli Radiati Semen (菉豆) is done, and get rid of the remnants. Take
one pill before going to sleep.
– Augmented Gallbladder-Warming Decoction 加味溫膽湯 가미온담탕
- ① It cures the tendency to get easily frightened caused by deficiencies in the heart and the gallbladder. It also cures various symptoms caused by the collision of saliva and qi. Cyperi Rhizoma (香附子) (2.4 don), Citrus Unshius Exocarpium (橘紅) (1.2 don), Pinelliae Tuber (半夏), Ponciri Fructus Immaturus (枳實), Bambusae Caulis in Taeniam (竹茹) (8 pun each), Ginseng Radix (人參), Poria Sclerotium (白茯苓), Bupleuri Radix (柴胡), Liriopis Tuber (麥門冬), Platycodonis Radix (桔梗) (6 pun each), and Glycyrrhizae Radix (甘草) (4 pun). Chop these herbs, make them into 1 package, and boil them with 3 pieces of Zingiberis Rhizoma Crudus (生薑) and 2 Zizyphi Fructus (大棗).
- ② Introduction to Medicine (入門) refers to this as the Ginseng and Bupleurum Decoction to Warm the Gallbladder.
– Augmented Stabilize Will Pill 加味定志丸 가미정지환
It cures palpitations and throbbing caused by phlegm blocking the heart region and the diaphragm. Poria Sclerotium (白茯苓) (3 nyang), Polygalae Radix (遠志), Acori Gramineri Rhizoma (石菖蒲) (2 nyang each), Ginseng Radix (人參) (1 nyang), Succinum (琥珀), and Curcumae Radix (鬱金) (5 don each). Grind these, knead with honey, make it into pills the size of the seed of the royal foxglove tree, and coat them with Cinnabaris (朱砂). Take 30 pills at a time with rice gruel.
– Clear Heart and Nourish Blood Decoction 淸心補血湯 청심보혈탕
- ① It cures exhaustion of the heart, dizziness in the head, weak vision, deficiency in the heart, shortage of breath, palpitations, and vexing heat. These symptoms are caused by thinking too much which in turn leads to overworking of the heart and damage of the spirit. Ginseng Radix (人參) (1.2 don), Angelica Gigantis Radix (當歸), Paeoniae Radix Alba (白芍藥) (parched), Hoelen cum Radix (茯神), Zizyphi Semen (酸棗仁) (parched), Liriopis Tuber (麥門冬) (1 don each), Cnidii Rhizoma (川芎), Rehmanniae Radix Crudus (生地黃), Citrus Unshius Pericarpium (陳皮), Gardeniae Fructus (梔子) (parched), Glycyrrhizae Radix Praeparata (灸甘草) (5 pun each), and 15 berries of Schisandrae Fructus (五味子). Chop these, make them into 1 package, and boil them down in water.
- ② The Medical Mirror of Past and Present referred to it as the Tonify the Blood Decoction, and Essential Formulas (必用方) referred to it as the Angelicae Gigantis Radix Pill.
– Cinnabar, Aucklandia, Musk, and Cyperus Powder 辰砂妙香散 진사묘향산
It cures deficient heart qi causing palpitations and throbbing, craziness, sense of fear, sorrow, and anxiety, inconsistency of feelings, and insufficient sleep caused by deficiency vexation. Dioscoreae Rhizoma (山藥), Poria Sclerotium (白茯苓), Hoelen cum Radix (茯神), Astragali Radix (黃芪), Polygalae Radix (遠志) (put in the juice of Zingiberis Rhizoma Crudus (生薑汁) and then dry) (1 nyang each), Ginseng Radix (人參), Platycodonis Radix (桔梗), Glycyrrhizae Radix (甘草) (5 don each), Cinnabaris (朱砂) (3 don), Aucklandiae Radix (木香) (2.5 don), and Moschus (麝香) (1 don). Grind these finely and put the powder in warm
wine by 2 don. For those who cannot drink wine, put it in water boiled with Nelumbinis Semen (蓮肉).
– Maintain Heart Decoction 養心湯 양심탕
- ① It cures damage in the heart caused by worries, anxieties, and deep thoughts as well as palpitations caused by the weak heart and spirit due to paying too much attention to political affairs and insufficient sleep. Poria Sclerotium (白茯苓), Hoelen cum Radix (茯神), Angelica Gigantis Radix (當歸), Rehmanniae Radix Crudus (生地黃) (1 don each), Astragali Radix (黃芪) (pasted with honey and roasted), Polygalae Radix (遠志) (put into the juice of Zingiberis Rhizoma Crudus (生薑汁) and parched) (8 pun each), Cnidii Rhizoma (川芎), Thujae Semen (柏子仁), Zizyphi Semen (酸棗仁) (parched) (7 pun each), Pinelliae Tube Fermentata (半夏麴) (6 pun), Ginseng Radix (人參) (5 pun), Glycyrrhizae Radix Praeparata (灸甘草), Cinnamomi Cortex Spissus (肉桂) (pungent one) (3 pun each), and 14 berries of Schisandrae Fructus (五味子). Chop these, make them into 1 package, and decoct them with 3 pieces of Zingiberis Rhizoma Crudus (生薑).
- ② For throbbing caused by stagnant water, use Arecae Semen (檳榔) and Poria Sclerotium Rubra (赤茯苓) together.
• Tranquilise Spirit Elixir 靜神丹 정신단
- ① It cures palpitations caused by worries and deep thoughts, and the anxiety itself caused by palpitations. Angelica Gigantis Radix (當歸) (its body washed with wine), Rehmanniae Radix (生乾地黃) (cleansed with wine), Polygalae Radix (遠志) (put into the juice of Zingiberis Rhizoma Crudus (生薑汁) and dried), Hoelen cum Radix (茯神) (5 don each), Acori Gramineri Rhizoma (石菖蒲), Coptidis Rhizoma (黃連) (2.5 don each), Cinnabaris (辰砂) (2 don), Bovis Calculus (牛黃) (1 don), and 15 sheets of Aurum Foil (金箔). Grind these, knead with the blood obtained from the heart of a pig, make it into pills the size of Panicis Semen Glutinosa (黍米), and coat them with Aurum Foil (金箔). Take 50 pills at a time with water decocted with Junci Medulla (燈心).
- ② It was first handed down from the Orthodox Transmission of Medicine (正傳). It is a secret formula of experience.
– Stabilize Will Formula 寧志元 영지원
It cures frequent frightening caused by deficient heart blood. Ginseng Radix (人參), Poria Sclerotium (白茯苓), Hoelen cum Radix (茯神), Thujae Semen (柏子仁), Succinum (琥珀), Angelica Gigantis Radix (當歸), Zizyphi Semen (酸棗仁) (parched), Polygalae Radix (遠志) (put in wine for half a day and then take only its flesh) (5 don each), Olibanum (乳香), Cinnabaris (朱砂), and Acori Gramineri Rhizoma (石菖蒲) (2.5 don each). Grind these, knead with honey, and make it into pills the size of the seed of the royal foxglove tree. Take 30 pills at a time with water decocted with Zizyphi Fructus (大棗).
– Maintain Blood and Calm Spirit Decoction 養血安神湯 양혈안신탕
It cures palpitations. Rehmanniae Radix Crudus (生地黃), Hoelen cum Radix (茯神) (1 don each), Atractylodis Rhizoma Alba (白朮), Zizyphi Semen (酸棗仁) (parched) (7 pun each), Angelica Gigantis Radix (當歸) (body part), Cnidii Rhizoma (川芎), Paeoniae Radix Alba (白芍藥) Citrus Unshius Pericarpium (陳皮), Thujae Semen (柏子仁), Coptidis Rhizoma (黃連) (put in wine and then parched) (5 pun each), and Glycyrrhizae Radix Praeparata (灸甘草) (3 pun). Chop these, make them into 1 package, and decoct with water.
– Crimson Cinnabar Paste 朱砂膏 주사고
It cures unconsciousness caused by a severe fever, which is in turn caused by being frightened. Glycyrrhizae Radix (甘草) (7.5 don), Glauberite (寒水石) (heated), Gypsum Fibrosum (石膏) (heated) (5 don each), Cinnabaris (朱砂), Borax (鵬砂), Niter (焰硝) (2.5 don each), Borneolum (龍腦) (2.5 pun), Aurum Foil (金箔), and Argentum Foil (銀箔) (5 sheets each). Grind these and put the powder in water decocted with Liriopis Tuber (麥門冬) by 2 don.
– Augmented Four Ingredients for the Seven Emotions Decoction 加味四七湯 가미사칠탕
It cures a blockage of heart qi. It opens up the gallbladder and dissipates frightened qi. Pinelliae Tube Preparata (半夏製) (2 don), Poria Sclerotium Rubra (赤茯苓), Magnoliae Cortex (厚朴) (1.2 don each), Hoelen cum Radix (茯神), Perillae Folium (紫蘇葉) (8 pun each), Polygalae Radix (遠志) (put in the juice of Zingiberis Rhizoma Crudus (生薑汁) and then dried), and Glycyrrhizae Radix Praeparata (灸甘草) (5 pun each). Chop these, make them into 1 package, and decoct them with 7 pieces of Zingiberis Rhizoma Crudus (生薑), 2 Zizyphi Fructus (大棗), and 0.5 chon of Acori Gramineri Rhizoma (石菖蒲).
09-1 Treat Fright by Making One Familiar with the Cause 常法治驚 익숙해지게 하여 놀란 것을 치료한다
A lady met a thief one night and was frightened greatly. From then, she fainted and lost consciousness whenever she heard any sound. The doctor thought it was a heart disease, but the treatment had no effect. Zhang Congzheng (張從正) looked and said, “Fright is yang and it enters from the outside. Fear is yin and it comes out from the inside. Fright is when one does not know the object of the fear and fear is when one knows it. The gallbladder makes one brave. When one is frightened or fearful, the gallbladder is damaged.” He then grabbed both of her hands, sat her down in a chair, and said in front of a desk, “Madam, look at this.” And he hit the desk hard with a piece of wood. The lady was very frightened. When after a while he hit it again, her fright became milder. After 4~5 times of repetition, her fright alleviated gradually. Struck with wonder, she asked, “What kind of treatment is this?” Zhang Congzheng (張從正) said, “They say, ‘Relieve the frightened.’ To relieve is to make one feel familiar. When one looks at something familiar, one is not frightened.” After that, the lady was deep in sleep from evening to dawn and could not hear any sound even when one hit on the window during the night. Spirit floats above when one is frightened. Having the lady to look down on the desk when it was being hit was to gather her spirit.
10 Throbbing 怔忡정충
- ① Dai Yuanli (戴元禮) said, “Throbbing is being anxious while the heart pounds or being fearful of someone chasing after oneself. It occurs when one is engrossed in money, worries about one’s poverty, or when one cannot achieve one’s desires.”
- ② The Compendium of Medicine (綱目) says, “Throbbing is being uncomfortable while the heart pounds.”
- ③ When phlegm is stagnated because the heart is deficient, one tends to worry a lot upon hearing a loud sound, looks at a strange object, encounters danger, or is distressed over certain matters. This is palpitation. When the heart is deficient and so water remains, water smears into the chest and deficient qi flows in the chest. One’s mind becomes uncomfortable when water rises because the heart Fire dislikes it. This is throbbing.
- ④ Throbbing is the pounding of the chest as if one is fearful and unstable, and this symptom can occur at any time.
- ⑤ Chronic palpitations become throbbing. When phlegm exists below and Fire up, add Coptidis Rhizoma (黃連), Gardeniae Fructus (梔子), Angelica Gigantis Radix (當歸), and Bulbus Fritillariae Cirrhosae (貝母) to a Ginseng and Bupleurum Decoction to Warm the Gallbladder. If it is caused by qi stagnation, add Bambusae Caulis in Liquamen (竹瀝) and the juice of Zingiberis Rhizoma Crudus (生薑汁) to an Augmented Four Ingredients for the Seven Emotions Decoction or use an Aurum Foil (金箔) Calm Heart Pill (鎭心丸). When phlegm is stagnated, add Hoelen cum Radix (茯神), Arecae Semen (檳榔), Liriopis Tuber (麥門冬), and Aquillariae Lignum (沈香) to a Syzygii Flos Relieve Stomach Decoction. [The prescription is shown in the chapter on Phlegm]. Or use a Cinnabar Nyctalopia Pill.
- ⑥ When throbbing is caused by the existence of water qi in the epigastric region, one should use Five Ingredients with Poria Powder (五苓散) [The prescription is shown in the chapter on Cold]. Or Chuanxiong and Pinellia Decoction (芎夏湯). [The prescription is shown in the chapter on Phlegm]. Symptoms of retained fluid include dizziness and pounding of the heart.
- ⑦ Throbbing (怔忡) is also called throbbing (怔忪); It is the sameas palpitations. One should use an Augment Nutrient Qi Decoction, Poria Pill, Calm Spirit and Tonify Heart Decoction, Zingiberis and Atractylodes Decoctio, Cinnabar Nyctalopia Pill, our Substances Calm Spirit Decoction, Cinnabar Stabilize the Will Pill, Augmented Stabilize Spirit Pill or Celestial King Tonify Heart Elixir. [Three of the prescriptions are shown].
– Augment Nutrient Qi Decoction 益榮湯 익영탕
It cures throbbing and absent-mindedness caused by the exhaustion of heart blood due to deep thinking. Astragali Radix (黃芪), Angelica Gigantis Radix (當歸), Polygalae Folium (小草), Zizyphi Semen (酸棗仁), Thujae Semen (柏子仁), Liriopis Tuber (麥門冬), Hoelen cum Radix (茯神), Paeoniae Radix Alba (白芍藥), Fluoritum (紫石英) (1 nyang each), Aucklandiae Radix (木香), Ginseng Radix (人參), and Glycyrrhizae Radix (甘草) (5 don each). Chop these and put in water by 7 don with 5 pieces of Zingiberis Rhizoma Crudus (生薑) and 2 Zizyphi Fructus (大棗), and decoct.[B231]
– Poria Pill 茯苓飮子 복령음자
It cures throbbing caused by the accumulation of phlegm in the heart and stomach. Pinelliae Tube Preparata (半夏製), Poria Sclerotium Rubra (赤茯苓), Hoelen cum Radix (茯神), Liriopis Tuber (麥門冬), Citrus Unshius Pericarpium (陳皮) (with its white skin peeled off) (1 nyang each), Aquillariae Lignum (沈香) (peeled and ground), Arecae Semen (檳榔), Glycyrrhizae Radix (甘草) (5 don each). Chop these and put them in water by 7 don with 5 pieces of Zingiberis Rhizoma Crudus (生薑), and then decoct.[B090]
– Zingiberis and Atractylodes Decoction 薑朮湯 강출탕
It cures throbbing caused by stagnated phlegm in deficient people. Zingiberis Rhizoma (乾薑) (with its skin peeled off, dried, and not roasted), Atractylodis Rhizoma Alba (白朮), Poria Sclerotium Rubra (赤茯苓), Pinelliae Tube Fermentata (半夏麴) (5 don each), Cinnamomi Cortex (桂皮), and Glycyrrhizae Radix (甘草) (2.5 don each). Chop these and put them in water by 5 don with 3 pieces of Zingiberis Rhizoma Crudus (生薑) and 2 Zizyphi Fructus (大棗).
– Calm Spirit and Tonify Heart Decoction 安神補心湯 안신보심탕
It cures throbbing and palpitations. Angelica Gigantis Radix (當歸), Rehmanniae Radix Crudus (生地黃), Hoelen cum Radix (茯神), Scutellariae Radix (黃芩) (1.2 don each), Liriopis Tuber (麥門冬) (2 don), Paeoniae Radix Alba (白芍藥), Atractylodis Rhizoma Alba (白朮) (1 don each), Polygalae Radix (遠志), Zizyphi Semen (酸棗仁) (parched) (8 pun each), Cnidii Rhizoma (川芎) (7 pun), Scrophulariae Radix (玄參) (5 pun), and Glycyrrhizae Radix (甘草) (3 pun). Chop these and decoct in water.[B162]
– Four Substances Calm Spirit Decoction 四物安神湯 사물안신탕
It cures pounding of the heart that occurs when there is not enough blood in the heart, just as when there is not enough water for a fish. Angelica Gigantis Radix (當歸), Paeoniae Radix Alba (白芍藥), Rehmanniae Radix Crudus (生地黃), Rehmanniae Radix Preparata (熟地黃), Ginseng Radix (人參), Atractylodis Rhizoma Alba (白朮), Hoelen cum Radix (茯神), Zizyphi Semen (酸棗仁) (parched), Coptidis Rhizoma (黃連) (parched), Gardeniae Fructus (梔子) (parched), Liriopis Tuber (麥門冬), Bambusae Caulis in Taeniam (竹茹) (7 pun each), and Cinnabaris (辰砂) (ground separately) (5 pun). Chop these, make them 1 package, decoct
with 2 Zizyphi Fructus (大棗), 1 handful of parched rice, and 1 Mume Fructus Praeparatum (烏梅), and put in Cinnabaris (辰砂) powder.
– Cinnabar Nyctalopia Pill 朱雀丸 주작환
It cures an unstable heart and spirit, restlessness, absent-mindedness, forgetfulness, and hard throbbing of the heart caused by the inability of Fire to descend. Hoelen cum Radix (白茯神) (2 nyang), and Aquillariae Lignum (沈香) (5 don). Grind these, knead with steamed pancakes that had been put into boiled water, make them into pills the size of seed of a royal foxglove tree, and coat them with 5 don of Cinnabaris (朱砂) (levigated). Take 50 pills at a time with water decocted with Ginseng Radix (人參).
