The spirit is the master of the whole body 神爲一身之主
內經曰, 心者, 君主之官, 神明出焉. ○無名子曰, 天一生水, 在人曰精, 地二生火, 在人曰神. ○回春曰, 心者, 一身之主, 淸淨之府, 外有包絡以羅之. 其中精華之聚萃者, 名之曰神. ○邵子曰, 神統於心, 氣統於腎, 形統於首. 形氣交而神主乎其中, 三才之道也.
The Inner Classic says: the Heart is the office of the sovereign, and the spirit light issues from it. — Master No-Name says: Heaven-one engenders Water, which in a person is called essence; Earth-two engenders Fire, which in a person is called spirit. — The Hoechun says: the Heart is the master of the whole body, a pure and quiet mansion, with the pericardium spread about it without. What gathers there of the finest essence is named the spirit. — Master Shao says: the spirit is governed by the Heart, the Qi by the Kidney, the form by the head. Form and Qi meet, and the spirit presides in the midst of them — this is the way of the three powers.
Clinical note The chapter's founding claim, stated four ways: whatever the spirit is, it has an address. Placing it in the Heart is not a metaphor in this system — it means the spirit can be reached by the same means as any other organ's contents, and that its disorders are physiological. The cosmological line is the one to keep: essence is water descending from Heaven, spirit is fire arising from Earth. Everything in this chapter is about what happens when that fire runs unsupervised.
Naegyeong 內經 · Hoechun 回春 · Soja 邵子
仙曰, 心者, 神明之舍, 中虛不過徑寸, 而神明居焉. 事物之滑, 如理亂棼, 如涉驚浸, 或怵惕, 或懲創, 或喜怒, 或思慮, 一日之間, 一時之頃, 徑寸之地, 炎如火矣. 若嗜慾一萌, 卽不善也. ○故曰, 心靜可以通乎神明, 事未至而先知. 是不出戶知天下, 不窺牖見天道也. 盖心如水之不撓, 久而澄淸, 洞見其底, 是謂靈明.
The immortals say: the Heart is the dwelling of the spirit light — hollow within, no more than an inch across, and there the spirit light resides. The slipperiness of affairs and things is like sorting tangled hemp, like wading into a startling flood: now alarm, now remorse, now joy and anger, now brooding thought — and within a single day, within the space of one hour, that inch of ground blazes like fire. And should craving once sprout there, it is already ill. — Therefore it is said: a quiet Heart can penetrate to the spirit light and know a thing before it arrives; this is knowing the world without going out the door, seeing the way of Heaven without peering through the window. For the Heart is like water unstirred, which given time settles clear, so that one sees straight to its bottom — and this is called numinous clarity.
Clinical note The most quoted image in the chapter, and the most useful one at the bedside: a room an inch wide, and everything that happens in a day passing through it, until it blazes. Then the counter-image — water left unstirred long enough to clear, so that the bottom becomes visible. The chapter is describing what a still mind is for, in the plainest physical terms it has: not virtue, but the condition under which the organ can function.
The immortals (仙)
The five flavors engender the spirit 五味生神
內經曰, 天食人以五氣, 地食人以五味. 五氣入鼻, 藏於心肺, 上使五色修明, 音聲能彰. 五味入口, 藏於腸胃, 味有所藏, 以養五氣, 氣和而生, 津液相成, 神乃自生. ○內經曰, 太上養神, 其次養形. 故養神者, 必知形之肥瘦, 榮衛血氣之盛衰. 血氣者, 人之神, 不可不謹養也. 註云, 神安則壽延, 神去則形㢢, 故不可不謹養也.
The Inner Classic says: Heaven feeds a person with the five Qi, Earth feeds a person with the five flavors. The five Qi enter by the nose and are stored in Heart and Lung, making the five colors bright above and the voice able to sound. The five flavors enter by the mouth and are stored in intestines and stomach; the flavors being stored there nourish the five Qi, the Qi harmonizes and engenders, the fluids form together — and the spirit is engendered of itself. — The Inner Classic says: the highest is to nourish the spirit, the next to nourish the form. Therefore one who would nourish the spirit must know whether the form is stout or thin, and whether construction, defense, Blood, and Qi are exuberant or waning. Blood and Qi are a person's spirit, and cannot but be carefully nourished. The commentary: the spirit at peace, the years are extended; the spirit departed, the form decays.
Clinical note The passage that keeps this chapter from floating off into philosophy. The spirit is not installed in a person; it is produced — out of air and food, by way of the stomach and the fluids, and it arises 'of itself' when those are in order. Hence the instruction that anyone treating the spirit must first examine the body's substance: whether the patient is thin, what the blood and Qi are doing. Blood and Qi *are* the spirit, says the Classic, which is as materialist a sentence as the tradition produces.
Naegyeong 內經
The Heart stores the spirit 心藏神
心藏神. 神有餘則笑不休, 神不足則悲. 註云, 心藏脉, 脉舍神. 心氣虛則悲, 實則笑不休. ○皇甫士安曰, 心虛則悲, 悲則憂, 心實則笑, 笑則喜.
The Heart stores the spirit. The spirit in surplus, one laughs without stopping; the spirit insufficient, one grieves. The commentary: the Heart stores the vessels, and the vessels lodge the spirit. The Heart Qi vacuous, there is grief; replete, there is laughter without stopping. — Huangfu Shi'an says: the Heart vacuous, there is grief, and grief becomes worry; the Heart replete, there is laughter, and laughter becomes joy.
Clinical note Four lines that make mood a quantity. Grief is not a response to circumstance here but a reading of the Heart's fullness — too little spirit and one weeps, too much and one cannot stop laughing. Whatever one thinks of the mechanism, the clinical stance is worth noticing: the chapter treats persistent low mood as a deficiency state with a physical substrate, which is why the formulas that follow for it are, without exception, tonifying.
Naegyeong 內經 · Hwangbo Sian 皇甫士安
The spirit governs the seven affects — damaged, they become illness 神統七情傷則爲病
心藏神, 爲一身君主, 統攝七情, 酬酢萬機. 七情者, 喜怒憂思悲驚恐也. 又魂神意魄志, 以爲神主, 故亦皆名神也. 《內經註》
The Heart stores the spirit and is sovereign of the whole body: it governs and holds the seven affects and answers the ten thousand contingencies. The seven affects are joy, anger, worry, thought, sorrow, fright, and fear. And the ethereal soul, spirit, intent, corporeal soul, and will are governed by the spirit, and so all of them are likewise named spirit.
Clinical note The chapter's organizing sentence, and the one on which Korean medicine's later account of emotional illness rests. Seven affects are named as a system rather than as moral failings, and they are placed under an organ's governance — which means excess in any of them is a medical event with an address. This is the passage that the tradition of hwa-byeong descends from.
Commentary on the Inner Classic 內經註
靈樞曰, 心怵惕思慮則傷神, 神傷則恐懼自失, 破䐃脫肉, 毛悴色夭, 死于冬. ○脾憂愁而不解則傷意, 意傷則悗亂, 四肢不擧, 毛悴色夭, 死于春. ○肝悲哀動中則傷魂, 魂傷則狂忘不精, 不精則不正, 當人陰縮而攣筋, 兩脇骨不擧, 毛悴色夭, 死于秋. ○肺喜樂無極則傷魄, 魄傷則狂, 狂者意不存人, 皮革焦, 毛悴色夭, 死于夏. ○腎盛怒而不止則傷志, 志傷則喜忘其前言, 腰脊不可以俛仰屈伸, 毛悴色夭, 死于季夏.
The Numinous Pivot says: when the Heart is startled and brooding, the spirit is damaged; the spirit damaged, one is fearful and loses oneself, the flesh breaks down and wastes away, the hair withers and the complexion dies — death in winter. — When the Spleen worries and cannot let go, the intent is damaged; the intent damaged, there is muddled confusion, the four limbs will not lift, the hair withers and the complexion dies — death in spring. — When grief and sorrow stir within the Liver, the ethereal soul is damaged; damaged, there is wild forgetting and no clarity, and without clarity no rectitude; the genitals retract, the sinews cramp, the ribs on both sides will not lift, the hair withers and the complexion dies — death in autumn. — When the Lung's joy and delight are without limit, the corporeal soul is damaged; damaged, there is mania, and the manic person does not keep others in mind; the skin scorches, the hair withers and the complexion dies — death in summer. — When the Kidney rages and does not stop, the will is damaged; the will damaged, one readily forgets one's own former words, and the lumbus and spine cannot bend, straighten, or turn; the hair withers and the complexion dies — death in late summer.
Clinical note The core text of emotional pathology in this tradition: five affects, five organs, five ways the body fails, each with its fatal season. What is striking is how physical the consequences are — wasted flesh, limbs that will not lift, cramping sinews, a spine that will not bend, and in every case the same two signs of the whole system failing: withered hair and a dying complexion. The passage insists that sustained emotion is not merely felt but metabolized, and that its damage shows on the outside of the body.
Yeongchu 靈樞
Fright palpitations 驚悸
仲景曰, 心悸者, 火懼水也. 惟腎欺心, 故爲悸. ○心虛而痰鬱, 則耳聞大聲, 目擊異物, 遇險臨危, 觸事喪志, 使人有惕惕之狀, 是爲驚悸. ○丹溪曰, 驚悸者, 有時而作. 血虛者, 宜朱砂安神丸, 有痰者, 宜加味定志丸. ○入門曰, 驚悸, 因思慮過度, 及大驚恐而作. 甚則心跳欲厥, 宜淸心補血湯ㆍ辰砂妙香散. 氣血俱虛, 宜養心湯.
Zhongjing says: heart palpitation is Fire fearing Water. It is only that the Kidney bullies the Heart, and hence the palpitation. — Where the Heart is vacuous and phlegm is constrained, then a loud sound in the ear, a strange thing struck by the eye, meeting danger or standing at the edge of peril, or being touched by an affair and losing one's purpose — any of these leaves a person in a state of startled apprehension, and this is fright palpitations. — Danxi says: fright palpitations come at times and go. For Blood vacuity,
Jusaansin-hwan 朱砂安神丸; where there is phlegm, Gamijeongji-hwan. — The Immun says: fright palpitations arise from thought and worry past measure, or from great fright and fear. At worst the heart leaps and one feels about to faint — Cheongsimbohyeol-tang and Jinsamyohyang-san are appropriate. Where Qi and Blood are both vacuous, Yangsim-tang.
Clinical note A description of panic written without the word: the heart leaping until one feels about to faint, brought on by a loud noise, a sudden sight, or simply an affair that unsettles one's purpose. The tradition's causal account has two arms, and both are still recognizable — an acute fright, or thought and worry carried past measure until the ground gives way. Note that the treatment forks on what the person has rather than what frightened them: thin Blood, or phlegm, or both empty.
Junggyeong 仲景 · Dansim 丹心 · Immun 入門
驚悸, 當補血安神, 宜靜神丹ㆍ寧志元ㆍ養血安神湯ㆍ朱砂膏. 若氣鬱驚悸, 宜交感丹 方見氣部ㆍ加味四七湯. 《諸方》
In fright palpitations one should supplement the Blood and quiet the spirit: Jeongsin-dan, Yeongji-won, Yanghyeolansin-tang, and Jusa-go. If the palpitations come of Qi constraint, Gyogam-dan — formula in the Qi chapter — and Gamisachil-tang are appropriate.
Clinical note The treatment principle in four characters — supplement the Blood, quiet the spirit — with a separate branch for palpitations that come of constraint rather than emptiness. Several formulas on this shelf are built on cinnabar, a mercury sulfide that is restricted in contemporary practice; they are recorded here as text, and the chapter's Blood-supplementing formulas carry the same indication without them.
Various formularies 諸方
Fearful throbbing 怔忡
戴氏曰, 怔忡者, 心中躁動不安, 惕惕然如人將捕者是也. 多因汲汲富貴, 戚戚貧賤, 不遂所願而成也. ○怔忡者, 心中惕惕然動搖而不得安靜, 無時而作者是也. 《正傳》 ○心虛而停水, 則胸中滲漉, 虛氣流動, 水旣上升, 心火惡之, 心不自安, 使人有怏怏之狀, 是爲怔忡. ○怔忡, 因驚悸久而成也.
Master Dai says: fearful throbbing is a restless stirring within the heart that will not settle — apprehensive, as though someone were about to seize you. It arises mostly from anxiously chasing wealth and rank, or grieving over poverty and low station, and not attaining what one wished for. — Fearful throbbing is a trembling stir within the heart that cannot come to rest, arising at no fixed time (Jeongjeon 正傳). — Where the Heart is vacuous and water has halted, there is a seeping in the chest and vacuous Qi moves about; the water having risen, the Heart fire loathes it and the Heart cannot settle itself, leaving a person in a state of discontent — and this is fearful throbbing. — Fearful throbbing comes of fright palpitations grown long-standing.
Clinical note Master Dai's definition is the one to remember: apprehension as though someone were about to seize you, arising from chasing status or grieving over its loss and not getting what one wanted. The chapter names ambition and thwarted circumstance as causes of a cardiac symptom, in the same register the Womb chapter used for bleeding after a reversal of fortune. And the last line supplies the clinical arc — panic that goes untreated long enough becomes this: not episodes any more, but a background state with no fixed time.
Dae-ssi 戴氏 · Jeongjeon 正傳
怔忡, 亦曰怔忪, 與驚悸同看. 宜益榮湯ㆍ茯苓飮子ㆍ安神補心湯ㆍ薑朮湯ㆍ朱雀丸ㆍ四物安神湯ㆍ辰砂寧志丸ㆍ加味寧神丸ㆍ天王補心丹. ○四物安神湯, 治心中無血, 如魚無水, 怔忡跳動. ○心下有水氣怔忪, 宜五苓散 方見傷寒ㆍ芎夏湯 方見痰飮.
Fearful throbbing, also written jeongchung, is to be seen together with fright palpitations. Appropriate are
Igyeong-tang 益榮湯, Bokryeongeum-ja,
Ansinbosim-tang 安神補心湯, Gangchul-tang, Jujak-hwan, Samulansin-tang, Jinsayeongji-hwan, Gamiyeongsin-hwan, and
Cheonwangbosim-dan 天王補心丹. — Samulansin-tang treats there being no Blood within the heart — like a fish without water — with fearful throbbing and leaping. — Where there is water Qi below the heart with throbbing:
Oryeong-san 五苓散 — formula in the Cold Damage chapter — and Gunghha-tang
— formula in the Phlegm-Rheum chapter —.
Clinical note Nine formulas for one complaint, and the indication quoted in the middle is the finest line in the chapter: no Blood within the heart, like a fish without water. That is what the tradition thinks a heart pounding from emptiness feels like from the inside — not racing so much as stranded. The closing entry is the useful counterweight: throbbing with water gathered below the heart is not treated by supplementing at all, but by draining.
Donguibogam · Sin
Forgetfulness 健忘
內經曰, 血幷於下, 氣幷於上, 亂而喜忘. ○丹溪曰, 健忘之證, 精神短少者多, 亦有痰者. ○戴氏曰, 健忘者, 爲事有始無終, 言談不知首尾. 此以爲病之名, 非生成之愚頑不知人事者.
The Inner Classic says: the Blood gathered below and the Qi gathered above, there is disorder and ready forgetting. — Danxi says: in the pattern of forgetfulness, most have essence and spirit run short; some also have phlegm. — Master Dai says: the forgetful person is one who begins affairs and does not finish them, and who in speaking does not know beginning from end. **This is the name of an illness — not a description of someone born dull and ignorant of human affairs.**
Clinical note Master Dai's closing sentence is the reason this section matters. Starting things and not finishing them, losing the thread mid-sentence — he insists these are the signs of a *condition*, explicitly not evidence that someone is stupid. Four hundred years on, that distinction is still the first thing many patients need to hear, and still one of the harder ones for them to believe about themselves.
Naegyeong 內經 · Dansim 丹心 · Dae-ssi 戴氏
健忘者, 陟然而忘其事, 盡心力思量不來也. 主心脾二經. 盖心之官則思, 脾之官亦主思. 此由思慮過多, 心傷則血耗散, 神不守舍, 脾傷則胃氣衰憊, 而慮愈深. 二者皆令人事卒然而忘也. ○治法, 必先養其心血, 理其脾土, 以凝神定智之劑調理之. 亦當以幽閑之處, 安樂之中, 使其絶於憂慮, 遠其六淫七情, 如此則日漸以安矣.
The forgetful person loses hold of a matter all at once, and though they spend the whole of their mind and strength on it, it will not come. It is governed by the two channels of Heart and Spleen — for the office of the Heart is thinking, and the office of the Spleen is likewise thought. It comes of brooding beyond measure: the Heart damaged, the Blood is worn and scattered and the spirit does not keep to its dwelling; the Spleen damaged, the stomach Qi wanes into exhaustion and the brooding grows only deeper. Either of these makes a person forget a matter suddenly. — The method of treatment: one must first nourish the Heart Blood and put the Spleen Earth in order, regulating with preparations that congeal the spirit and settle the wits. And one should also place them in a quiet, secluded spot, in the midst of ease and contentment, so that they are cut off from worry and kept far from the six excesses and seven affects — and so, day by day, they come to peace.
Clinical note Two things here are worth carrying. The first is the vicious circle, stated exactly: overthinking damages the Spleen, and the damaged Spleen makes the brooding deeper. Anyone who has watched their own rumination feed on exhaustion will recognize the loop. The second is that the treatment section names an environment before it names a formula — a quiet place, ease, distance from worry — and treats that as part of the prescription rather than as advice appended to it.
Donguibogam · Sin
怔忡久則健忘, 由心脾血少神虧, 引神歸舍丹主之. 或所稟陰魄不足善忘者, 宜定志丸ㆍ開心散. 如年老善忘者, 宜加減固本丸. 《入門》 ○健忘, 宜服加味茯苓湯ㆍ聰明湯ㆍ歸脾湯ㆍ加減補心湯ㆍ天王補心丹ㆍ降心丹ㆍ壯元丸ㆍ加味壽星元ㆍ朱子讀書丸. 《諸方》 ○孔子大聖枕中方, 服之令人聰明.
Fearful throbbing grown long-standing becomes forgetfulness, by reason of scant Blood and diminished spirit in Heart and Spleen: Insingwisa-dan governs it. Where the endowment of the corporeal soul's Yin is insufficient and one forgets readily:
Jeongji-hwan 定志丸 and
Gaesim-san 開心散. In the aged who forget readily: Gagamgobon-hwan (Immun 入門). — For forgetfulness one should take Gamibokryeong-tang,
Chongmyeong-tang 聰明湯,
Gwibi-tang 歸脾湯, Gagambosim-tang,
Cheonwangbosim-dan 天王補心丹, Gangsim-dan, Jangwon-hwan, Gamisuseong-won, and Jujadokseo-hwan. —
Gongjachimjung-bang 孔子大聖枕中方, taken, makes a person clear of hearing and bright of sight.
Clinical note The first line completes the chapter's arc: panic becomes chronic anxiety, and chronic anxiety long enough becomes forgetfulness. Three sections, one trajectory. The shelf that follows separates the causes rather than the symptoms — one set for the constitutionally timid, another for the aged, another for the depleted — and several of the names give away the world these were written in: the Top Graduate Pill, and Master Zhu's Study Pill.
Immun 入門 · Various formularies 諸方
Mania and withdrawal 癲狂
狂爲痰火實盛, 癲爲心血不足, 多爲求望高遠, 不得志者有之. 癎病, 獨主乎痰因火動之所作也. 治法, 癎宜乎吐, 狂宜乎下, 癲則宜乎安神養血, 兼降痰火. 《正傳》
Mania is phlegm-fire in replete exuberance; withdrawal is Heart Blood insufficiency — and it is often found in those who aimed high and far in their hopes and did not attain what they wished for. Epilepsy alone is governed by phlegm set in motion by fire. As to the methods: for epilepsy, vomiting is appropriate; for mania, purging; for withdrawal, quieting the spirit and nourishing the Blood, together with downing phlegm and fire.
Clinical note Three conditions separated by what the person has too much or too little of, and one clause worth pausing on: withdrawal — the quiet, turned-inward state — is attributed to Heart Blood insufficiency and, often, to *aiming high and not attaining it*. Ambition thwarted appears again, as it does in this text's accounts of anxiety and of abnormal bleeding. And the treatments are as different as the states: mania is drained downward, withdrawal is fed. Confusing them means draining someone who has nothing to spare.
Jeongjeon 正傳
河間曰, 五志過極, 皆爲火也. 盖氣爲陽而主輕微, 諸所動亂勞傷, 皆爲陽化之火, 神狂氣亂而爲病熱者多矣. ○子和曰, 河間治五志, 獨得言外之意. 凡見喜怒悲思恐之證, 皆以平心火爲主. 至於勞者傷於動, 動便屬陽, 驚者駭於心, 心便屬火, 二者亦皆藏於心火.
Hejian says: the five minds carried past their extreme all become fire. For Qi is Yang and governs what is light and subtle; all stirring, disorder, taxation, and damage become the fire of Yang's transformation — the spirit deranged and the Qi in disorder, and illnesses of heat are many. — Zihe says: Hejian, in treating the five minds, alone grasped the meaning beyond the words. In every case where one sees the signs of joy, anger, grief, thought, or fear, calming the Heart fire is the governing method. As for taxation, it is damaged by movement, and movement belongs to Yang; fright startles the Heart, and the Heart belongs to Fire — so these two are likewise stored in the Heart fire.
Clinical note **五志過極, 皆爲火也** — the five minds carried past their extreme all become fire. Eight characters, and they are the theoretical hinge of the whole chapter: sustained emotion of any kind, pleasant or unpleasant, converts into heat. Zihe's gloss makes the clinical consequence explicit — whatever the emotion presenting, calming the Heart fire is where treatment starts. This is the doctrine that Korean medicine later built hwa-byeong (화병) upon: illness from emotion that had nowhere to go, understood not as metaphorical heat but as the literal kind.
Hagan 河間 · Jahwa 子和
Signs in spirit illness that cannot be treated 神病不治證
內經曰, 得神者昌, 失神者亡. 失神者, 謂失精神而昏亂者也. ○靈樞曰, 癲疾, 嘔多沃沫, 氣下泄, 不治. ○癲癎之病, 乍作乍醒者甦, 不食迷痴者死. 《得效》 ○凡癲狂癎之病, 若神脫而目瞪如愚痴者, 不可治. 《正傳》
The Inner Classic says: one who obtains the spirit flourishes; one who loses the spirit dies. To lose the spirit means to lose the essence-spirit and fall into clouded disorder. — The Numinous Pivot says: in withdrawal illness, much retching of frothy spittle with the Qi discharging downward — this is not treated. — In withdrawal and epilepsy, one who now has an episode and now wakes clear will revive; one who does not eat and is lost in stupor dies. — In all illnesses of withdrawal, mania, and epilepsy: if the spirit has deserted and the eyes stare fixedly as though dull-witted, it cannot be treated.
Clinical note A short section in which the chapter states the limits of its own art. The prognostic signs it names — whether the person still surfaces between episodes, whether they still eat, whether the eyes still track — are exactly the observations a clinician would make today in assessing severity, even if the conclusions drawn are of their time. What survives is the honesty: a medical text that lists what it cannot do, and does not pretend otherwise.
Naegyeong 內經 · Yeongchu 靈樞 · Deukhyo 得效 · Jeongjeon 正傳
The heart throbbing and stirring greatly 心澹澹大動
綱目曰, 心澹澹動者, 因痰動也. 謂不怕驚而心自動也. 驚恐亦曰心中澹澹, 謂怕驚而心亦動也. ○靈樞曰, 手厥陰之脉, 是動則心中澹澹大動. 又曰, 膽病者, 心中澹澹, 恐如人將捕. ○內經曰, 太陽司天, 寒淫所勝, 則病心澹澹大動, 是寒傷心主也. ○釋曰, 澹澹, 水搖貌. 此屬飮病, 當用逐水消飮之劑, 二陳湯ㆍ芎夏湯, 皆是也.
The Gangmok says: a heart that throbs and stirs does so because phlegm is stirring — meaning the heart moves of itself, without any fear of being startled. In fright and fear one also speaks of a throbbing within the heart, but there it is fear of a start that makes the heart move. — The Numinous Pivot says: when the hand reverting-Yin vessel is stirred, there is a great throbbing stir within the heart. And: in gallbladder illness, the heart throbs, with fear as though someone were about to seize you. — The Inner Classic says: when greater-Yang governs the heavens and cold excess prevails, the illness is a great throbbing stir of the heart — this is cold damaging the Heart's ruler. — The gloss: *dam-dam* is the appearance of water shaking. This belongs to the rheum illnesses, and one should use preparations that expel water and disperse rheum:
Ijin-tang 二陳湯 and Gunghha-tang are both such.
Clinical note A careful distinction inside a symptom that patients describe identically. Palpitations *with* fear belong to the previous sections and get spirit-settling, blood-building treatment. Palpitations *without* fear — the heart simply moving on its own — are read here as fluid, and the gloss makes the image literal: 澹澹 is the look of water sloshing. Its treatment is therefore the opposite of tonifying: drain the water and disperse the rheum. It's the chapter guarding against its own instinct, which by this point is to supplement everything.
Gangmok 綱目 · Yeongchu 靈樞 · Naegyeong 內經
心忪, 非心忪也. 內經曰, 胃之大絡, 名曰虛里, 貫膈絡肺, 出於左乳下, 其動應衣, 脉宗氣也. 虛而有痰則動, 更須臾發一陣熱者, 是也. 《資生》
What seems a throbbing heart is sometimes not the heart at all. The Inner Classic says: the great network vessel of the stomach is named the Empty Hamlet; it threads the diaphragm, nets the lung, and issues below the left breast, where its stirring answers against the clothing — this is the pulse of the ancestral Qi. Where there is vacuity with phlegm, it stirs; and there is a brief wave of heat that follows — this is the case.
Clinical note The 'Empty Hamlet' below the left breast, whose beating is strong enough to move a person's clothing, is the apex beat — the visible impulse of the heart against the chest wall — described accurately and given its own name. The clinical point is subtle and modern: a patient reporting palpitations may be feeling a normal, forceful apex beat rather than an arrhythmia, particularly when depleted. Naming that possibility is good practice in any century, though today the way to settle the question is an ECG.
Jasaeng 資生
Epilepsy and withdrawal 癲癎
癎者, 卒然暈倒, 咬牙作聲, 吐涎沫, 不省人事, 隨後醒醒. ○癲者, 異常也. 平日能言, 癲則沈黙, 平日不言, 癲則呻吟. 甚則僵仆直視, 心常不樂, 言語無倫, 如醉如痴.
In epilepsy, one collapses suddenly in a faint, the teeth clench and grind audibly, drool and froth are spat out, awareness of persons is lost — and afterward one wakes clear. — Withdrawal is otherness. One who ordinarily speaks falls silent; one who ordinarily is silent moans. At worst the body stiffens and falls, the gaze fixes, the heart is never glad, speech is without order — as though drunk, as though dull.
Clinical note Two conditions separated by their shape in time, and the separation is exactly right. Epilepsy is *episodic*: sudden collapse, clenched teeth, frothing, loss of awareness, and then a return to clarity. Withdrawal is *persistent*: a change in how a person is, described by inversion — the talkative fall silent, the quiet begin to moan. 'Withdrawal is otherness' is as good a one-line description of a psychotic or profoundly depressive change as the classical vocabulary manages, and the observation that families notice it as reversal rather than as any specific symptom is still how these presentations arrive in clinic.
Donguibogam · Sin
癎病, 因驚者宜驚氣元ㆍ抱膽丸, 因怒者宜寧神導痰湯 方見風門ㆍ當歸龍薈丸 方見火門. ○肥人多痰, 瘦人火盛. ○心藏虛損, 氣血不足, 宜滋陰寧神湯ㆍ淸心溫膽湯ㆍ歸神丹. ○婦人宜加味逍遙散ㆍ朱砂膏 方幷見婦人. ○痰火俱盛者, 宜甘遂散吐下之. 《諸方》
In epilepsy: where it arises from fright, Gyeonggi-won and Podam-hwan; where from anger, Yeongsindodam-tang — formula in the Wind chapter — and Danggwiyonghoe-hwan — formula in the Fire chapter —. — Stout people have much phlegm; thin people have exuberant fire. — Where the Heart viscus is vacuously damaged and Qi and Blood are insufficient: Jaeumyeongsin-tang, Cheongsimondam-tang, and Gwisin-dan. — For women, Gamisoyo-san and Jusa-go — both formulas in the Women's chapter —. — Where phlegm and fire are both exuberant, Gamsu-san to vomit and purge it.
Clinical note The sorting principle is the chapter's usual one — not by the seizure but by the person: what set it off, what the body composition suggests, whether the ground beneath is empty. **Note on modern practice:** seizures require neurological evaluation and modern anticonvulsant treatment; epilepsy is not a condition to manage with herbal medicine, and several formulas named in this section are built on mercury-containing minerals and other agents that are not used today. This section is preserved as a record of how the illness was understood and sorted, not as a treatment protocol. Where acupuncture has a role in contemporary practice, it is as adjunctive support alongside neurological care.
Various formularies 諸方
Simple medicinals 單方
紫河車, 卽人胎衣也. 主癲狂ㆍ健忘ㆍ怔忡ㆍ失志, 及恍惚ㆍ驚怖ㆍ心神不守ㆍ多言不定. 大能安心養血定神. 蒸熟入藥, 丸服, 或蒸熟單服之亦佳. 《本草》 ○震肉, 主因驚失心, 作脯食之. 此六畜爲天雷所震, 死肉也. 《本草》
Purple River Cart — that is, the human afterbirth. It governs mania and withdrawal, forgetfulness, fearful throbbing, and loss of purpose, together with abstraction, fright and terror, a Heart spirit that will not keep to its dwelling, and much talking without settling. It is greatly able to quiet the Heart, nourish the Blood, and settle the spirit. Steamed through and put into medicines and taken as pills — or simply steamed through and taken alone, which also serves well. — Thunder-struck flesh: it governs loss of mind from fright; make it into dried meat and eat it. This is the flesh of one of the six domestic animals, struck dead by Heaven's thunder.
Clinical note Two entries at opposite ends of the pharmacy's logic. Placenta is used across East Asian medicine as a deep restorative, and its indication list here is essentially the whole chapter compressed — every state from mania to abstraction to talking without settling. Thunder-struck flesh works by a different principle entirely: sympathetic logic, in which what was undone by a shock is treated with the flesh of something shocked. **Note on modern practice:** human placenta is not used in contemporary practice in the United States for regulatory and safety reasons, and thunder-struck flesh belongs entirely to its era; both are recorded here as text.
Bonchō 本草
人參, 安精神, 定魂魄, 止驚悸, 開心益智, 令人不忘. 人參末 一兩, 猪肪 十分, 酒拌和服百日, 則日誦千言, 肌膚悅澤. 《本草》 ○石菖蒲ㆍ遠志, 開心孔, 治多忘長智. 取菖蒲ㆍ遠志爲細末, 每服一錢, 酒飮任下, 日三, 令人耳目聰明, 從外見裏, 及千里外事. 《千金》 ○遠志, 安魂魄, 益智慧, 治健忘, 令人不迷. 以甘草水浸煮, 去骨取肉爲末, 每二錢, 酒飮任下. ○茯神, 安魂魄, 養精神, 主驚悸, 療善忘. 取爲末, 酒飮任下二錢, 或丸服亦佳, 與遠志同用. 《本草》
Ginseng quiets the essence-spirit, settles the ethereal and corporeal souls, stops fright palpitations, opens the Heart and boosts the wits, and keeps a person from forgetting. Powdered ginseng 1 nyang with ten parts of pork fat, stirred into wine and taken for a hundred days: then one recites a thousand words in a day, and the skin becomes glossy and fair (Bonchō 本草). — Acorus and polygala open the Heart's orifices, treat much forgetting, and lengthen the wits. Powder acorus and polygala finely and take 1 don each time with wine, three times daily: it makes the ears and eyes clear and bright, so that one sees the inside from without, and affairs a thousand li away (Cheongeum 千金). — Polygala quiets the ethereal and corporeal souls, boosts the wisdom, treats forgetfulness, and keeps a person from losing their way. Soak and boil it in licorice water, remove the core and take the flesh, powder it, and take 2 don with wine. — Hostwood poria quiets the souls, nourishes the essence-spirit, governs fright palpitations, and heals ready forgetting. Powder it and take 2 don with wine, or take it as pills, which also serves well; it is used together with polygala.
Clinical note The herbal simples of the chapter, and they are the same four that make up nearly every formula in it — ginseng, acorus, polygala, and hostwood poria. Seeing them listed alone is clarifying: the elaborate pills are these four with weight, phlegm-clearers, or coolers added for particular cases. The Thousand Gold Formulas' claim for the acorus-polygala pair is the chapter's most extravagant — clear enough ears and eyes to see a thousand li away — but the pairing itself outlasted the promise, and remains the standard combination for memory and mental clarity in East Asian practice.
Bonchō 本草 · Cheongeum 千金
朱砂, 養精神, 安魂魄. 久服通神明. 又云, 心熱心虛, 非此不除. 細末水飛, 取一錢, 蜜水調服. ○紫石英, 定驚悸, 安魂魄. 取碎如米豆大, 水一斗煮取二升, 澄淸細細飮之. 卽今之紫水晶也. ○靈砂, 久服通神, 安魂魄, 令人心靈. 楊子度云, 靈砂飼猢猻, 輒會人語, 可見通心神. ○生鐵, 治癲癎發熱狂走, 又治心氣狂甚走呼. 取生鐵置器中, 以水浸之, 經久取飮. 《本草》
Cinnabar nourishes the essence-spirit and quiets the souls; taken long, it opens through to the spirit light. It is also said: where the Heart is hot and the Heart is vacuous, nothing but this will remove it. Powder finely, levigate in water, and take 1 don stirred into honey water. — Amethyst settles fright palpitations and quiets the souls. Break it to the size of rice grains, boil in a doe of water down to two doe, let it settle clear, and sip it little by little. This is what is now called purple crystal. — Numinous cinnabar, taken long, opens through to the spirit, quiets the souls, and makes a person's Heart numinous. Yang Zidu said: numinous cinnabar fed to a monkey, and it came to understand human speech — from which one may see that it opens through to the Heart spirit. — Raw iron treats epilepsy with heat effusion and running about in mania, and the Heart Qi in extreme derangement, running and shouting. Set raw iron in a vessel, steep it in water, and after a long while take the water to drink.
Clinical note **Note on modern practice: none of these are used today.** Cinnabar and numinous cinnabar are mercury compounds — mercury sulfide and a mercury-sulfur amalgam — and are toxic; they are prohibited or tightly restricted in contemporary practice, and this site records them as historical text only. What the entries preserve is the reasoning: a spirit that will not stay put was thought to need weight, and the heaviest, most lustrous substances available were recruited for it. The monkey anecdote shows how far that reasoning could travel. The iron-water entry is the same logic in its cheapest form — steep iron, drink the water, and let the metal's downward weight settle a mind that is running.
Bonchō 本草
Acupuncture and moxibustion 鍼灸法
健忘, 取列缺ㆍ心兪ㆍ神門ㆍ中脘ㆍ三里ㆍ少海, 又灸百會. 《綱目》 ○心澹澹大動, 取大陵ㆍ三里. 《綱目》 ○善恐心惕惕, 取然谷ㆍ內關ㆍ陰陵泉ㆍ俠谿ㆍ行間. 《綱目》 ○失志痴騃, 取神門ㆍ中衝ㆍ鬼眼ㆍ鳩尾ㆍ百會ㆍ後谿ㆍ大鍾. 《綱目》
For forgetfulness: LU7 Yeolgyeol, BL15 Simsu, HT7 Sinmun, CV12 Jungwan, ST36 Samni, and HT3 Sohae — and moxa GV20 Baekhoe (Gangmok 綱目). — For the heart throbbing and stirring greatly: PC7 Daereung and ST36 Samni. — For readily taking fright, the heart apprehensive: KI2 Yeongok, PC6 Naegwan, SP9 Eumneungcheon, GB43 Hyeopgye, and LR2 Haenggan. — For loss of purpose with dullness: HT7 Sinmun, PC9 Jungchung, the Ghost Eyes points, CV15 Gumi, GV20 Baekhoe, BL66 Hugye, and KI4 Daejong.
Clinical note The needle's version of the chapter, and the point selections track its doctrine closely — HT7 Sinmun, the Heart channel's own source point, appears in the prescriptions for forgetfulness and for loss of purpose; PC6 Naegwan, still the most-used point in the world for anxiety and nausea alike, appears for the apprehensive heart. Note that ST36 Samni turns up in two of the four: the chapter never forgets that the spirit is engendered from food.
Gangmok 綱目
癲狂, 取豊隆ㆍ期門ㆍ溫留ㆍ通谷ㆍ築賓ㆍ陽谷ㆍ後谿ㆍ陰谷. 《甲乙》 ○癎病, 取鳩尾ㆍ後谿ㆍ湧泉ㆍ心兪ㆍ陽交ㆍ三里ㆍ大衝ㆍ間使ㆍ上脘. 凡癎病, 必先下之乃可灸, 不然則氣不通, 能殺人. 鍼不拘此. 《綱目》
For mania and withdrawal: ST40 Punglyung, LR14 Gimun, LI7 Onnyu, BL66 Tonggok, KI9 Chukbin, SI5 Yanggok, SI3 Hugye, and KI10 Eumgok (Gabeul 甲乙). — For epilepsy: CV15 Gumi, SI3 Hugye, KI1 Yongcheon, BL15 Simsu, GB35 Yanggyo, ST36 Samni, LR3 Daechung, PC5 Gansa, and CV13 Sanggwan. **In all epilepsy, one must first purge, and only then may moxa be applied — otherwise the Qi does not pass through, and it can kill. Needling is not bound by this.**
Clinical note The chapter closes on a warning, and it is the right note to end on. Moxa in epilepsy without purging first *can kill* — a stated contraindication, in bold terms, from a text that elsewhere recommends moxa freely. Whatever one makes of the mechanism, the instinct is sound and rare: a practitioner writing down not only what to do but the sequence in which doing it becomes dangerous. **Note on modern practice:** seizure disorders require neurological evaluation and anticonvulsant management; acupuncture's role today is adjunctive at most, and this passage is preserved as a record rather than as guidance.
Gabeul 甲乙 · Gangmok 綱目