TRADITIONAL INTERNAL MEDICINE – DISEASES & FORMULAS
Palpitations and Arrhythmias
Heart Tremors refer to Arrhythmia, irregular Heart beats. Tachycardia means a rapid Heart beat. Palpitations are notable rapid or irregular Heart beats which are felt. Both may come from either excess, deficiency or obstruction. Excess are from Heat or Phlegm; deficient types are from Qi, Yin or Yang deficiency; obstruction is of Qi and Blood stasis. Due to the fact that there is irregularity in the flow of Vital Spirit (Qi), medicines to settle and regulate the Wind are often used.
Causes:
Three primary causes were recognised in the West (from The Practice of Physick, 1663)
1. “Vapor or Wind which troubles the Heart … especially in the Pericardium, are gathered sometimes cold and thick Humors, which send up vapors to the Ventricles of the Heart, which cause PaIpitation. But from more remote parts, vapors and wind are sent to the Ventricles of the Heart; as from the Stomach, Spleen, Mother [Uterus], and other parts of the lower Belly”.
2. “Heat in the Heart, by which the Spirits [Qi] are inflamed”
3. “Defect of Spirits [Qi] which comes by hunger, watching, anger, joy, fear, shame and great Diseases”,
Here it can be seen the “Vapors” are equivalent to the TCM interpretation of Qi stagnation, or erratic Qi movement; Heat in the Heart to Heart Fire; and defect of the Spirits to Heart Qi deficiency
Diagnosis:
1. Vapors or Wind: quickly comes and goes, occurs after little motion, breath is difficult, Tinnitus, sometimes pain in some part which quickly goes.
2. Heart Fire: Great and quick pulse, Fever, heat of the chest, deep and frequent breathing, and desire for cold things.
3. Defects of the Spirits: known by recent events and by Deficiency symptoms
4. From the Stomach: “want of Appetite, loathing, vomiting of base Humors, and gnawing at the Stomach”
5. From the Uterus: “Suppression of the Terms [menstruation], and Hysterical fits, declare that it comes from the Womb”.
Special Herbs & Combinations
1. Indian Spikenard has been widely used for Palpitations and Arrhythmias
i. Indian Spikenard, Arjuna
ii. Indian Spikenard, Arjuna, Boerhaavia, Sida cordifolia (Ayurveda)
iii. Indian Spikenard with Mastic, Aloeswood, Cinnamon (as in Aloeswood Powder for Palpitations)
iv. Indian Spikenard with Aloeswood, Rose, Mastic, Cinnamon, Clove, Nutmeg (as in Troches of Aloeswood)
v. Indian Spikenard with Mastic, Aloeswood, Cinnamon, Clove, Nutmeg, Cardamon, Citron peel, Musk
vi. Indian Spikenard, Isatis Folium Da Qing Ye, Codonopsis Dang Shen, Ginseng, Cinnamon twig (Gui Zhi), Bitter Orange (Zhi Ke), Licorice. This was used in a clinical trial with an effectiveness of 83%. (Chen & Chen)
If there is excess Heat, Bloodletting can be used.
Some commended Cupping with Scarification over the Heart, or over the Heart on the back.
Western Tradition
Simples
Aloeswood
Rose
Basil seed
Emblic Myrobalan
Licorice
Frankincense
Amber
Musk
Sandalwood
Indian Spikenard
Dodder
Yellow Myrobalan
Cinnamon
Saffron
Pearl
Camphor
1. “Walnut is good for Palpitations”. (Rhazes)
2. “Tabasheer is good for palpitations in conjunction with intense heat”. (Rhazes)
3. “Fresh butter from cows’ milk is good forpalpitations of the heart”. (Rhazes)
Cordis Tremori Conferunt
Heart Tremors, Arrhythmias
Irregular Heart rate
Infusion of Rose
Aloeswood Powder for Palpitations
Powder of Gems for Palpitations (Wirtzung)
Powder for Palpitation (Rhazes)
Powder to Strengthen the Heart
Sweet Powder of Musk (Diamoschu Dulce) (Mesue)
Cooling Electuary of Musk (Rhazes)
Aromatic Musk Compound (Aromaticum Moschatum)
Electuary of Gems (Mesue)
Electuary of Gems for the Heart (Rhazes)
Temperate Electuary for the Heart
Comp. Rosemary Powder (Dianthos)
Comp. Cooling Pearl Powder (Diamargariton Frigidum)
Troches of Musk (Gallia Muscata) (Mesue)
Troches of Nutmeg (Rhazes)
Syrup of Apple Simple
Sugar of Borage
Sugar of Bugloss
Vigorous Cakes
Safoof e Jawahar Mohra (Precious Defender Powder)
Aloeswood 8 (A gar bdgyad pa) (Tibetan)
Aloeswood 8 Water Transformer (Ar brgyad chu bsgyur)
Aloeswood 9 (A gar dgu pa) (Tibetan)
Aloeswood 10 (A gar bcu pa) (Tibetan)
Aloeswood 17 (A gar bcu bdun) (Tibetan)
Aloeswood 18 (A gar bcu bdun) (Tibetan)
Aloeswood Clear the Heart 8 Powder (Mongolian)
Blood Medicine 11 (Khrag sman bcu gcig) (Tibetan)
Caraway 8 (Go snyod brgyad pa) (Tibetan)
Life Holding Jewel (Srog ‘dzin nor bu) (Tibetan)
Nutmeg 14 (Dza ti bcu bzhi) (Tibetan)
Prabhakara Vati (Ayurveda)
Undying Aloeswood 8 (Chi med a gar brgyad pa)
Tachycardia
Rapid Heart rate
Powder of Gems for Palpitation (Wirtzung)
Powder to Cool the Heart (Augustana)
Electuary of Gems (Mesue)
Letificans Temperate Electuary
Royal Confection of Kermes (Mesue)
Safoof e Jawahar Mohra (Precious Defender Powder)
Aloeswood 8 (Tibetan)
Aloeswood 8 Water Transformer (Ar brgyad chu bsgyur)
Aloeswood Clear the Heart 8 Powder
Caraway 8 (Go snyod brgyad pa) (Tibetan)
Life Holding Jewel (Srog ‘dzin nor bu) (Tibetan)
Palpitations
Cordial Decoction (Florentini)
Hiera Logadii
Blessed Wine
Aloeswood Powder for Palpitations
Abbots Confect of Rose (Diarrhodon Abbatis) (Nicholas)
Aromatic Clove Powder (Aromaticum Caryophyllatum)
Aromatic Rose Powder (Aromaticum Rosatum)
Powder for Palpitation from Heat
Powder for Palpitation (Rhazes)
Powder of Galangal (Diagalanga) (Mesue)
Powder of Lavender
Powder of Gems for Palpitations (Wirtzung)
Powder to Cool the Heart (Augustana)
Powder to Strengthen the Heart
Powder of Three Sandalwoods (Diatriasantalum)
Galens Powder of Happiness (Letificans)
Cooling Pearl Powder (Diamargariton Frigidum)
Cooling Exhilarating Electuary (Unani)
Letificans Cooling Electuary (Unani)
Sweet Powder of Musk (Diamoschu Dulce)
New Rose Powder
Cooling Electuary of Musk (Rhazes)
Royal Confection of Kermes (Mesue)
Aromatic Musk Compound (Aromaticum Moschatum)
Electuary of Aloeswood (Diaxyloaloes) (Mesue)
Electuary of Aloeswood (Persica)
Electuary of Gems for the Heart (Rhazes)
Electuary of Pearl (Actuarius)
Letificans Temperate Electuary
Troches of Aloeswood
Troches of Musk (Gallia Muscata) (Mesue)
Troches of Myrrh (Rhasis)
Troches of Nutmeg (Rhasis)
Vigorous Cakes
Safoof e Jawahar Mohra (Precious Defender Powder)
Aloeswood 8 (Tibetan)
Aloeswood 9 (A gar dgu pa) (Tibetan)
Aloeswood 10 (A gar bcu pa) (Tibetan)
Aloeswood 17 (A gar bcu bdun)
Aloeswood Clear the Heart 8 Powder
Caraway 8 (Go snyod brgyad pa)
Nutmeg 14 (Dza ti bcu bzhi)
Prabhakara Vati
Undying Aloeswood 8 (Chi med a gar brgyad pa)
To Purge in Palpitations
Indian Electuary Lesser (Mesue)
Electuary of Dates (Diaphoenicum) (Mesue)
Pills of Agaric (Mesue)
Arabian Confect Purging Melancholy (Confec. Hamech)
Electuary of Senna (Diasenna) (Nicholas)
Golden Pills (Nicholas)
Pills of Lapis Lazuli 1 (Mesue)
Pills to Aggregate (Pilulae Aggregative)
To Strengthen after
Royal Confection of Kermes (Mesue)
Abbots Confection of Roses (Diarrhodon Abbatis)
Aromatic Rose Compound (Aromaticum Rosatum)
Electuary of Aloeswood (Diaxyloaloes) (Mesue)
Confection of Hyacinth (Confectio de Hyacintho)
Powder of Happiness (Letificans)
Powder of Cinnamon Compound (Diacinnamonum)
Restorative of Nicholas (Pleres Arconticon) (Nicholas)
Powder of Anise Compound (Dianisum) (Mesue)
Powder of Three Sandalwood (Ditrionsantalum)
TCM Classifications
Palpitations and Arrhythmias
Heart Deficiency
palpitations, restless sleep, insomnia, shortness of breath, dizziness, fatigue, pale complexion, spontaneous sweating, fearful
Gui Zhi Gan Cao Tang
Sheng Mai San
An Shen Ding Zhi Wan
Bao Yuan Tang
Ding Zhi Wan
Huang Lian Wen Dan Tang
Heart Qi and Blood Deficiency
palpitations, insomnia, anxiety, poor concentration, poor memory, poor appetite, pale, heavy or prolonged menstruation, pale tongue
Gui Pi Tang
Zhen Zhu Mu Wan
Zhi Gan Cao Tang
Ren Shen Yang Rong Tang
Heart Yin Deficiency Heat
Palpitations, insomnia, heat of the palms and soles, dry mouth and throat, dizzy, tinnitus, night sweats or spontaneous sweating, forgetful, dry stool
Sheng Mai San
Suan Zao Ren Tang
Tian Wan Bu Xin Wan
Zhen Zhu Mu Wan
Zhu Sha An Shen Wan
Huang Lian E Jiao Tang
Heart and Kidney Deficiency
Loss of Communication between Heart and Kidney
Palpitations, irritability, restless, insomnia, night sweats, red tongue, thready and rapid pulse.
Jiao Tai Wan
Phlegm Obstruction
Palpitations, heavy feeling of the chest, excess mucus, nausea, vomiting, dizziness
Er Chen Tang
Li Zhong Wan
An Shen Ding Zhi Wan
Yang Deficiency
palpitations, shortness of breath, tightness in the chest, fatigue, cold extremities, spontaneous sweating, fearful, pale or dull complexion, pitting edema, frequent urine.
Bao Yuan Tang
Gui Zhi Gan Cao Tang
Gui Zhi Jia Long Gu Mu Li Tang
Zhen Wu Tang
Blood Stasis
Palpitations with sharp chest pain, heaviness or pressure of the chest, cyanosis of the lips, tongue and nail beds, spontaneous sweating, irritability, restlessness, dull tongue color and choppy pulse
Dang Gui Shao Yao San
Xue Fu Zhu Yu Tang
Special Formula
Powder for Palpitation from Heat
Melon seed
Cucumber seed
Gourd seed
Barberry
Armenian Earth Rose
Tabasheer 2 drams ea.
Amber
Aloeswood 1 dram ea.
Borneo Camphor 1/4 dram
Mastic 1/3 dram
Powder and take with water of Apple or Pomegranate. (The Dispensatory of Ibn at Tilmid)
Powder for Palpitation (Rhazes)
Silk cocoons, burnt 5 dirhams
Red Coral, prepared
White Coral, prepared 3 dirhams ea.
Amber 2 dirhams
Pearl, prepared
Tabasheer
Burnt Deer horn
Borage flowers 3 dirhams ea.
Saffron 1 dirham
Red Sandalwood
White Sandalwood 3 dirhams ea.
Reduce all to fine powder. This benefits palpitation and strengthens the Heart. The dose is two dirhams with apple syrup
Cooling Musk Electuary (Rhazes)
Rose
Tabasheer
Coriander
Amber 1 part ea.
Pearl ½ part
Musk 1/6 part
Dissolve Sugar in sour apple juice, boil until like honey; add the above in powder. Strengthens the Heart without heating: Palpitations and Arrhythmia.
Pill for Palpitation
Emerald
Amber ½ dram ea.
Hyacinth (Zircon)
Basil seed 2 scruple ea.
Form pills with Rose water qs. (Renou)
Confection for Palpitations
Cinnamon 2 drams
Mace
Hyacinth (Zircon)
Emerald
Ruby ½ dram ea.
Pearl 1 scruple
Gold & Silver leaf. 10 of each
With Rose water, form into little pills. Used for “Trembling and Panting of the Heart”, as well as for lost strength due to chronic Fever, and was also said to protect from Epidemics including the Plague. (Secrets of Alexis)
Pills for Palpitation
Amber ½ dram
Emerald
Hyacinth 2 scruples ea.
Pearl 1 scruple
Basil seed 1 dram
Camphor ½ scruple
With Citron juice form Pills. Good for Palpitation with weakness. Dose: ½ dram (Platerus)
WATER OF HEARTS
Hogs or Sheep Hearts 3
Cinnamon, Clove 1 dram ea.
Lettuce and Sorrel seed 1 ½ drams
White Wine 2 oz.
Borage, Scabious, and
Rose Waters 1 ½ oz. ea.
Confection of Aikermes 1 dram
Boil them all between Two Dishes, and let him take 2 spoonfuls of the Liquor morning and evening. (The Practice of Physick, 1663)
Wen Xin Keli
Indian Spikenard
Codonopsis Dang Shen
Notoginseng San Qi
Polygonatum Huang Jing,
Amber
This is used for Palpitations and Arrhythmisa. It has been studied for effectiveness.
Research:
1. Heart Palpitation From Traditional and Modern Medicine Perspectives
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