1. Acupuncture Treatment of Diseases Cardiology 2: Palpitation 心悸

2. Definition: 1.Refers to the subjective feeling of an uncertain heartbeat and nervousness that is even uncontrollable. 2.May be seen in many diseases and often accompanied by insomnia, amnesia, vertigo and tinnitus. 3.In western medicine may be presented in functional diseases like CAD, RHD, Hypertensive heart disease, arrhythmias, anemia, hypokalemia and cardiac neurosis.

3. Causes and Pathogenesis : Related to: i.Weak constitution - Resulting in failure of nourishing the heart. ii.Long term chronic diseases iii.Emotional disturbances iv.Exertion v.Invasion of external evils qi after perspiration vi.Disturbance of the heart spirit by evils -Resulting in an abnormal heart beat which is manifested as palpitation.

4. Clinical Manifestations: Chief symptoms: i.Subjective feeling of an uncertain heart beat accompanied by terror and fright and restlessness.

5. Clinical Manifestations: A.Heart gall bladder deficiency type i.Dreaminess. ii.Lassitude. iii.Insomnia. iv.Fear induced. v.Light coloured tongue. vi.Thin coating. vii.Wiry, thready pulse.

6. Clinical Manifestations: B.Heart spleen deficiency type i.Dizziness. ii.Blurred vision. iii.Poor appetite. iv.Lassitude. v.Pale complexion. vi.Insomnia. vii.Profuse dreaminess. viii.Pale tongue. ix.Thin white coting. x.Thready, weak pulse.

7. Clinical Manifestations: C. Effulgent fire due to yin deficiency type i.Restlessness. ii.Insomnia, iii.Dizziness. iv.Blurred vision v.Tinnitus. vi.Soreness of the loin.. vii.Dry mouth. viii.Red tongue. ix.Thin white coating x.Thready, rapid pulse.

8. Clinical Manifestations: D.Obstruction of heart vessels type i.Oppression in the chest. ii.Paroxysmal pain in the heart. iii.Irritability. iv.SOB. v.Lassitude. vi.Dark purple tongue with possible ecchymosis. vii.Thready, irregular pulse.

9. Clinical Manifestations: E.Water Qi intimidating the heart type i.Oppression in the chest. ii.Inability to lie supine. iii.Profuse frothy sputum. iv.Coldness in the body and limbs. v.Pale tongue. vi.White slippery coating vii.Slippery, racing pulse.

10. Principle of Treatment : 1.Regulate heart Qi. 2.Conduct Qi and Blood. 3.Subside palpitation. 4.Tranquilize and calm the frightened spirit. Principle channels: 1.HT channel. 2.PC channel. 3.Conception Vessel. 4.BL channel

11. Principle acupoints: 1.PC 4 Ximen 郗门. 2.PC 6 Neiguan 内关. 3.HT7 Shenmen 神门. 4.BL 15 Xinshu 心俞. 5.CV14 Juque 巨阙.

12. Prescription explanation (Principle acupoint): 1.HT 7 Shenmen 神门 and PC 6 Neiguan 内关： Shu-Stream and Yuan-Source acupoint of the HT channel and PC channel, chosen to calm the heart and tranquilize the mind. 2.PC 4 Ximen 郗门： Xi-Cleft acupoint of the PC channel where the qi of the channel flows the deepest, chosen to conduct qi and blood. 3.BL 15 Xishu 心俞， CV14 Juque 巨阙. Back-Shu acupoint of the heart and Front-Mu acupoint of the heart, chosen to tranquilize the mind and tonify heart qi.

13. Principle of treatment A. Heart gall bladder deficiency type Calm the heart spirit and tonify the function of the gall bladder. Principle acupoints: as stated Supplementary acupoints: 1.BL 19 Danshu 胆俞. 2.HT5 Tongli 通里. 3.PC 7 Daling 大陵.

14. Principle of treatment B. Heart spleen deficiency type Calm the heart spirit and tonify the function of the spleen. Principle acupoints: as stated Supplementary acupoints: 1.BL 20 Pishu 脾俞. 2.ST36 Zusanli 足三里.

15. Principle of treatment C.Effulgent fire due to yin deficiency type Calm the mind, nourish yin. Principle acupoints: as stated Supplementary acupoints: 1.BL 23 Shenshu 肾俞. 2.KI 3 Taixi 太溪. 3.PC 8 Laogong 劳宫. 4.TE 3 Zhongzhu 中渚.

16. Principle of treatment D.Obstruction of heart vessels type Calm the mind and disperse obstruction. Principle acupoints: as stated Supplementary acupoints: 1.CV 17 Danzhong 檀中. 2.BL17 Geshu 膈俞．

17. Principle of treatment E.Water Qi intimidating the heart type Calm the mind tonify constitution and disperse dampness. Principle acupoints: as stated Supplementary acupoints: 1.CV 8 Shenque 神阙. 2.CV6 Qihai 气海. 3.CV 9 Shuifen 水分.

18. TCM medical advises: 1.Should avoid strong emotional stimulation or stress. 2.Good diet habit avoiding raw, cold and greasy, spicy and fried food. 3.Enough rest. 4.Reduce sexual activity. 5.Keep warm. 6.Suitable exercise.