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8 Palpitation due to fright
Palpitation due to fright means that the patient has the subjective symptoms of violent heart beat, fright, even loss of autonomy in severe cases. The disease is mostly caused by consumption of qi and blood, cardiac loss of nourishment after recovery from a disease, or concurrent phlegm disturbing the interior.
Syndrome differentiation and treatment
Qi deficiency of the heart and gallbladder
It manifests palpitation, susceptibility to fright, timidness and overcautiousness, short breath, hypodynamia, low voice, poor and dream-disturbed sleep, pale tongue with thin fur and weak pulse. It is advisable to supplement qi and nourish the heart. The prescription used is the modified Fushen Powder (Powder of Poria cure Ligno Hospite). In the case of fright and restlessness due to asthenia of the heart and timidness, add Longchi (Dens Draconis), Hupo ( Succinum ), Cishi ( Magnetitum ) and Zhusha (Cinnabaris); in the case of deficiency of cardiac qi and yin, this prescription is used in combination with Shengmai Powder (Pulsation-Promoting Powder), or select the modified Wuweizi Decoction (Decoction of Fructus Schisandrae); in the case of deficiency of the heart yang and concurrent thoracic oppression, short breath, cold body and limbs, use Guizhi Gancao Longgu Muli Decoction (Decoction of Ramutus Cinnamomi, Radix Glycyrrhizae , Os Draconis and Concha Ostreae ) with additional ingredients.
Deficiency of yin and blood
It manifests palpitation, insomnia, vertigo, amnesia, fatigue, short breath, dysphoria with smothery sensation, night sweat, lustreless complexion, red tongue with a little fur, thready or knotted and intermittent pulse. It is suitable to nourish and tonify yin and blood. The prescription used is the modified Tianwang Buxin Pill (Cardiotonic Pill). In the case of marked heat manifestations like concurrent restlessness, dry throat and mouth and bitter taste, use Zhusha Anshen Bolus (Sedative Bolus); in the case of severe palpitation, knotted and intermittent pulse due to deficiency of qi and blood, use Zhigancao Decoction (Decoction of Radix Glycyrrhizae Praeparata); in the case of concurrent anorexia and tiredness due to deficiency of both the heart and spleen, use Guipi Decoction (Decoction for Invigorating the Spleen and Nourishing the Heart) or the modified Xiao Jianzhong Decoction (Minor Decoction for Strengthening Middle Energizer).
Phlegm disturbing the interior
It manifests palpitation due to fright, vexation, restless nocturnal sleep, profuse sputum, nausea, anorexia, or edema of limbs, white and greasy fur, taut and slippery pulse. It is advisable to resolve phlegm and tranquilize the mind. The prescription used is the modified Shiwei Wendan Decoction (Ten-Ingredient Gallbladder-Heat-Clearing Decoction). In the case of concurrent bitter taste, dry mouth, yellowish and greasy fur, slippery and rapid pulse due to phlegm and heat disturbing the interior, use the modified Huanglian Wendan Decoction (Gallbladder-Heat-Clearing Decoction with Rhizoma Coptidis).
Rehabilitation methods
Regulating emotions and recreation therapy
Most patients have the psychological disturbances of fright and fear which are induced or aggravated by emotional changes. Therefore, it is of vital importance to regulate emotions.
(1) Checking one emotion with another Guide the patient to think about the relevant questions to remove or divert the patient's fear in the light of "checking fear with pensiveness".
(2) Removing suspicion Most patients suspect that they suffer from "heart disease". The doctor may rule out the organic cardiac diseases diagnostically, and remove their nervousness and fear psychologically with the affirmative tone by means of removing their suspicion and the necessary examinations of cardiac special department.
(3) The recreation therapy Guide the patient to have recreational activities. The activities like enjoying the sight of scenery with hills and waters, flower and grass, appreciating music, calligraphy and painting, playing a musical instrument, playing chess and attending a ball can make the patient happy, divert his emotions and achieve mental relaxation.
Physical training
Taking a walk, jogging, setting-up exercises, Wushu (martial arts), five mimic-animal games, Taijiquan, eight-section brocade, etc, are all advisable. But, abstain from sudden excitement or overfatigue so as to avoid increasing the cardiac burden. The amount of exercise is suitable if the heart rate is less than 110 beats per minute, and thoracic tightness, palpitation and short breath are not caused after the training.
Acumox and massage
Acumox: Select Xinshu (BL 15), Juque (CV 14), Shenmen (HT 7), Neiguan (PC 6) and Ximen (PC 4) in acumox. In the case of qi deficiency of the heart and gallbladder, add Qihai (CV 6), Danshu (BL 19) and Pishu (BL 20); in the case of deficiency of yin and blood, add Pishu (BL 20), Geshu (BL 17) and Zusanli (ST 36); in the case of phlegm disturbing the interior, add Chize (LU 5), Danzhong (CV 17) and Fenglong (ST 40). The uniform reinforcing-reducing method is advisable.
Ear acupuncture: Select the points of Xin, Nao, Ershenmen (MA- TF 1) and Xiaochang (MA- SC 2) in ear acupuncture therapy. Each time, select two or three of these points. Puncture the points gently with the twirling-rotating method. Retain the needle for twenty to thirty minute. Or use the pressing method with Wangbuliuxingzi (Semen Vaccariae) applied on these points.
Massage. Health care massage is mainly applied. First, massage the head 'and face. Then, massage the back, waist and limbs with the soft and relaxing manipulation. Meanwhile, better therapeutic effects may be achieved by the combined use of digitally kneading the acupoints like Neiguan (PC 6), Shenmen (HT 7), Tongli (I-IT 5) and Danzhong (CV 17) with the gentle, slow and even digital acupoints-pressing manipulation. Besides, massage the chest and precordial region clockwise or from the upper part to the lower part with the palm.
Dietary therapy
In the case of qi deficiency of the heart and gallbladder, select Cishi Gruel (Gruel of Magnetitum); in the case of deficiency of yin and blood, select Baiziren Gruel (Gruel of Semen Biotae); in the case of phlegm disturbing the interior, select Fuling Yiyiren Gruel (Gruel of Poria and Semen Coicis). The patient may eat hearttonifying food at ordinary times such as Zhuxin (Cor Suis), Dazao ( Fructus Ziziphi Jujubae ) and Lianzi (Semen Nelumbinis). However, do not overeat them. Abstain from smoking, drinking, strong tea, pungent, irritating, fatty and sweat foods. The patient with concurrent edema should be given the low salt diet or salt-free diet.
Nursing in daily life
The living surroundings should be free from various noises and adverse irritations so as to prevent the induced palpitation due to fright.
Syndrome differentiation and treatment
Qi deficiency of the heart and gallbladder
It manifests palpitation, susceptibility to fright, timidness and overcautiousness, short breath, hypodynamia, low voice, poor and dream-disturbed sleep, pale tongue with thin fur and weak pulse. It is advisable to supplement qi and nourish the heart. The prescription used is the modified Fushen Powder (Powder of Poria cure Ligno Hospite). In the case of fright and restlessness due to asthenia of the heart and timidness, add Longchi (Dens Draconis), Hupo ( Succinum ), Cishi ( Magnetitum ) and Zhusha (Cinnabaris); in the case of deficiency of cardiac qi and yin, this prescription is used in combination with Shengmai Powder (Pulsation-Promoting Powder), or select the modified Wuweizi Decoction (Decoction of Fructus Schisandrae); in the case of deficiency of the heart yang and concurrent thoracic oppression, short breath, cold body and limbs, use Guizhi Gancao Longgu Muli Decoction (Decoction of Ramutus Cinnamomi, Radix Glycyrrhizae , Os Draconis and Concha Ostreae ) with additional ingredients.
Deficiency of yin and blood
It manifests palpitation, insomnia, vertigo, amnesia, fatigue, short breath, dysphoria with smothery sensation, night sweat, lustreless complexion, red tongue with a little fur, thready or knotted and intermittent pulse. It is suitable to nourish and tonify yin and blood. The prescription used is the modified Tianwang Buxin Pill (Cardiotonic Pill). In the case of marked heat manifestations like concurrent restlessness, dry throat and mouth and bitter taste, use Zhusha Anshen Bolus (Sedative Bolus); in the case of severe palpitation, knotted and intermittent pulse due to deficiency of qi and blood, use Zhigancao Decoction (Decoction of Radix Glycyrrhizae Praeparata); in the case of concurrent anorexia and tiredness due to deficiency of both the heart and spleen, use Guipi Decoction (Decoction for Invigorating the Spleen and Nourishing the Heart) or the modified Xiao Jianzhong Decoction (Minor Decoction for Strengthening Middle Energizer).
Phlegm disturbing the interior
It manifests palpitation due to fright, vexation, restless nocturnal sleep, profuse sputum, nausea, anorexia, or edema of limbs, white and greasy fur, taut and slippery pulse. It is advisable to resolve phlegm and tranquilize the mind. The prescription used is the modified Shiwei Wendan Decoction (Ten-Ingredient Gallbladder-Heat-Clearing Decoction). In the case of concurrent bitter taste, dry mouth, yellowish and greasy fur, slippery and rapid pulse due to phlegm and heat disturbing the interior, use the modified Huanglian Wendan Decoction (Gallbladder-Heat-Clearing Decoction with Rhizoma Coptidis).
Rehabilitation methods
Regulating emotions and recreation therapy
Most patients have the psychological disturbances of fright and fear which are induced or aggravated by emotional changes. Therefore, it is of vital importance to regulate emotions.
(1) Checking one emotion with another Guide the patient to think about the relevant questions to remove or divert the patient's fear in the light of "checking fear with pensiveness".
(2) Removing suspicion Most patients suspect that they suffer from "heart disease". The doctor may rule out the organic cardiac diseases diagnostically, and remove their nervousness and fear psychologically with the affirmative tone by means of removing their suspicion and the necessary examinations of cardiac special department.
(3) The recreation therapy Guide the patient to have recreational activities. The activities like enjoying the sight of scenery with hills and waters, flower and grass, appreciating music, calligraphy and painting, playing a musical instrument, playing chess and attending a ball can make the patient happy, divert his emotions and achieve mental relaxation.
Physical training
Taking a walk, jogging, setting-up exercises, Wushu (martial arts), five mimic-animal games, Taijiquan, eight-section brocade, etc, are all advisable. But, abstain from sudden excitement or overfatigue so as to avoid increasing the cardiac burden. The amount of exercise is suitable if the heart rate is less than 110 beats per minute, and thoracic tightness, palpitation and short breath are not caused after the training.
Acumox and massage
Acumox: Select Xinshu (BL 15), Juque (CV 14), Shenmen (HT 7), Neiguan (PC 6) and Ximen (PC 4) in acumox. In the case of qi deficiency of the heart and gallbladder, add Qihai (CV 6), Danshu (BL 19) and Pishu (BL 20); in the case of deficiency of yin and blood, add Pishu (BL 20), Geshu (BL 17) and Zusanli (ST 36); in the case of phlegm disturbing the interior, add Chize (LU 5), Danzhong (CV 17) and Fenglong (ST 40). The uniform reinforcing-reducing method is advisable.
Ear acupuncture: Select the points of Xin, Nao, Ershenmen (MA- TF 1) and Xiaochang (MA- SC 2) in ear acupuncture therapy. Each time, select two or three of these points. Puncture the points gently with the twirling-rotating method. Retain the needle for twenty to thirty minute. Or use the pressing method with Wangbuliuxingzi (Semen Vaccariae) applied on these points.
Massage. Health care massage is mainly applied. First, massage the head 'and face. Then, massage the back, waist and limbs with the soft and relaxing manipulation. Meanwhile, better therapeutic effects may be achieved by the combined use of digitally kneading the acupoints like Neiguan (PC 6), Shenmen (HT 7), Tongli (I-IT 5) and Danzhong (CV 17) with the gentle, slow and even digital acupoints-pressing manipulation. Besides, massage the chest and precordial region clockwise or from the upper part to the lower part with the palm.
Dietary therapy
In the case of qi deficiency of the heart and gallbladder, select Cishi Gruel (Gruel of Magnetitum); in the case of deficiency of yin and blood, select Baiziren Gruel (Gruel of Semen Biotae); in the case of phlegm disturbing the interior, select Fuling Yiyiren Gruel (Gruel of Poria and Semen Coicis). The patient may eat hearttonifying food at ordinary times such as Zhuxin (Cor Suis), Dazao ( Fructus Ziziphi Jujubae ) and Lianzi (Semen Nelumbinis). However, do not overeat them. Abstain from smoking, drinking, strong tea, pungent, irritating, fatty and sweat foods. The patient with concurrent edema should be given the low salt diet or salt-free diet.
Nursing in daily life
The living surroundings should be free from various noises and adverse irritations so as to prevent the induced palpitation due to fright.
Comment made on this article doesn't stand for the position of TCMADVISORY.
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