（即胃脘痛）
脉∶心痛微急，痛甚伏入，阳微阴弦，或短又数；紧实便难；滑实痰积；心痹引背，脉微而大，寸沉而迟，
关紧数锐。
心痛初起者，胃中有寒也。
姜桂汤 治初起胃脘寒痛。
干姜 良姜 官桂（各七分） 藿香 苍术（米泔制） 浓朴（姜汁炒） 陈皮 甘草（炙） 木香
茴香（酒炒） 枳壳（麸炒） 砂仁 香附（炒。各等分）
上锉一剂，姜三片，水煎，磨木香服。痛甚加乳香；手足厥冷，脉沉伏加附子，去良姜。
心痛稍久者，胃中有郁热也。
清热解郁汤
栀子（炒黑，二钱） 枳壳（麸炒） 西芎 黄连（炒） 香附（炒。各一钱） 陈皮 干姜
（炒黑。各五分） 苍术（米泔浸，七分） 甘草（三分）
上锉一剂，生姜三片，水煎热服。服后戒饮食半日。渣再煎服。
清膈散 治心胃刺痛，憎寒壮热，口干烦躁不卧，时痛时止。
柴胡（二钱） 黄芩（一钱半） 黄连 枳实 栀子（酒炒） 竹茹 赤芍（各一钱） 甘草（三分）
上锉一剂，生姜一片，水煎服。痛甚加姜汁三匙。
心痛大便实者，宜利，则痛随利减也。
枳实大黄汤 治大便结实不通，胃中痛者。（方见腹痛。）
利气丸（方见诸气。）
心痛原素喜食热物者，死血留于胃口也。
活血汤 治热伤胃口，死血作痛。（方见腹痛症。）
韭菜丸 治胸膈背后死血积滞疼痛，或吐血后，或劳后饮酒，怒气过多，俱胸背作痛。
当归 川芎 人参 牡丹皮 桃仁 大黄 黄芩 姜黄 三棱 莪术 桔梗 枳壳 半夏 防风 羌活
（各等分，俱要生用）
上用韭菜根共一处，酒浸晒干又浸。如此三五次，共为末，水丸，绿豆大。每服三五十丸或百丸，茶清下。
心膈大痛，攻走腰背，厥冷呕吐者，是痰涎在心膈也。以先用鹅管探吐，痰涎出后用。
枳缩二陈汤 治痰涎在心膈上，攻走腰背，呕哕大痛。
枳实（麸炒） 砂仁 半夏（姜汁制） 陈皮 香附（各二钱） 木香 草豆蔻 干姜（炒，各五分）
浓朴（姜汁炒） 茴香（酒炒） 玄胡索（各八分） 甘草（三分）
上锉一剂，姜三片，水煎，入竹沥磨木香同服。
心痛胃口有虫作痛者，时痛时止，面白唇红是也。
椒梅汤（方见腹痛证。）
治虫咬心痛
凤眼草（即椿树枯用子） 乳香（各等分）
上为末，面糊丸，如樱桃大。每服一丸，黄酒送下。
苦楝汤 治虫咬心痛。用苦楝根皮，煎汤服之。
灸心痛神法 两手肘后陷处酸痛是穴。先用香油半钟，重汤煮温服，即用艾入水粉揉烂为炷。每处灸
五壮，其痛立止。
补遗秘方
九气汤 治膈气、风气、寒气、忧气、惊气、喜气、怒气、山岚瘴气、积聚痞气，心腹刺痛，不能饮
食，时止时发，攻则欲死，并治，神效。
香附米 郁金 甘草
上锉生姜三片煎服。
红白散 治心疼神效。
官粉（二钱） 红碱（一钱半）
上二味为极细末，用极辣葱捣汁和一处，烧酒调下立
止。
神效散 治心痛作酸；又治水停心下，作声如雷；又治口眼 斜，不省人事。用胆矾一分为末，温黄
酒调下，以吐痰尽为度。
桃灵丹 治心腹痛疼及阴症，或绞肠痧等症。
玄胡索（一两） 桃仁（去皮，五钱另研） 五灵脂（五钱） 乳香（五钱） 没药（七钱）
上各为细末，醋糊为丸。每服二三十丸。心疼，淡醋汤下；腹痛，干姜汤下，或用黄酒下。
三仙丹 治心疼至危，将此即起。
白信（煨） 巴豆（去皮油） 黄蜡（各等分）
上共为末，熔黄蜡为丸，如黍米大。每服三丸，烧酒下。忌醋。
芎术姜栀二陈汤 治素有痰火，胃脘急痛不可忍者，食不能消。
川芎（一钱） 干姜（炮，一钱） 苍术（米泔制，一钱） 栀子（炒，一钱） 陈皮
（去白，二钱二分） 半夏（姜汁炒，一钱） 茯苓（去皮，一钱） 甘草（五分）
上锉一剂，生姜五片，水煎。正痛时温服痛止，待半日方可饮食。
沉香化滞定痛丸 专治胃脘痛、胸中满闷、停痰积块、滞气壅塞，不拘远年，心胃痛，服之即效，屡
屡有验。
沉香（三钱） 没药（五钱） 大黄（五钱，炒） 瓦珑子（一个，火 红，醋一日） 莪术（三钱）
玄胡索（二钱，酒炒） 乳香（二钱）
上为细末，醋糊为丸，如绿豆大。每服九丸，壮实者十一丸，白滚水送下。行二次，米汤补之即安。
心疼、肚腹痛、小肠气积块冷气等症，属虚寒者宜服。
当归 川芎 陈皮 茯苓 砂仁 官桂 玄胡索（各一钱）
丁香（五分） 三棱（一钱半） 莪术（二钱） 槟榔（二钱） 甘草（五分）
上锉一剂，水煎温服，神效。忌房劳。
破积散 治心气痛、食积肚腹痛、饮热积块痛，症属实热者宜服。
香附米（四两，酷浸煮干） 栀子仁（炒黑，二两） 三棱 莪术 郁金 枳壳 黄连 大黄（各一两）
上共为细末，水丸如梧桐子大。每服三二十丸，淡姜汤送下。
进士中寰何公夫人，患经行胃口作痛，憎寒发热。一医以四物汤加官桂、香附服之，即吐血而痛愈甚。余
见六脉洪数，乃郁火也。以山栀二两，姜汁炒黑色，一服立愈。
一教谕年五十一岁，因酒食过饱，胃脘作痛。每食后，其气自两肩下及胸，次至胃口，痛不可忍。令人将
手重按痛处，超时忽响动一声痛遂止。如此八年，肌瘦如柴。余诊六脉微数，气口稍大有力。以神 丸一服下
之，其痛如失。后以参苓白术散调理撤消。
(Pain in the heart is synonymous with epigastric pain.)
Pulse: The pulse of heart pain is slightly rapid and tense; when the pain is severe, the pulse may become hidden. If the yang pulse is weak and the yin pulse is taut (like a bowstring), or if the pulse is short and rapid; a tight and solid pulse indicates difficulty in defecation; a slippery and solid pulse indicates phlegm accumulation; in heart bi syndrome with pain radiating to the back, the pulse is weak and large, the cun position is deep and slow, and the guan position is tight, rapid, and sharp.
When heart pain first begins, it is caused by cold in the stomach.
Jiang Gui Tang (Ginger and Cinnamon Decoction): Treats initial epigastric pain due to cold.
Ingredients: Gan Jiang (Dried Ginger), Liang Jiang (Galangal), Guan Gui (Cinnamon Twig) (each 0.7 fen); Huo Xiang (Patchouli), Cang Zhu (Atractylodes Rhizome processed with rice water); Nong Po (Magnolia Bark stir-fried with ginger juice); Chen Pi (Tangerine Peel); Gan Cao (Licorice Root roasted); Mu Xiang (Aucklandia Root); Hui Xiang (Fennel Seed wine-fried); Zhi Qiao (Bitter Orange peel stir-fried with bran); Sha Ren (Amomum Fruit); Xiang Fu (Cyperus Rhizome stir-fried). All ingredients are in equal proportions.
Usage: Coarsely crush one dose. Add three slices of fresh ginger, decoct in water, and administer with Mu Xiang juice ground from the herb. For severe pain, add Ru Xiang (Frankincense). For cold extremities and a hidden pulse, add Fu Zi (Aconite Root) and remove Liang Jiang.
When heart pain persists for a while, it is caused by stagnant heat in the stomach.
Qing Re Jie Yu Tang (Clear Heat and Resolve Stagnation Decoction)
Ingredients: Zhi Zi (Gardenia Fruit stir-fried until black, 2 qian); Zhi Qiao (Bitter Orange peel stir-fried with bran); Xi Xiong (Ligusticum Chuanxiong); Huang Lian (Coptis Rhizome stir-fried); Xiang Fu (Cyperus Rhizome stir-fried) (each 1 qian); Chen Pi (Tangerine Peel); Gan Jiang (Dried Ginger stir-fried until black) (each 0.5 fen); Cang Zhu (Atractylodes Rhizome soaked in rice water, 0.7 fen); Gan Cao (Licorice Root, 0.3 fen).
Usage: Coarsely crush one dose. Add three slices of fresh ginger, decoct in water, and take hot. Avoid food and drink for half a day after administration. Decoct the dregs again for a second dose.
Qing Ge San (Clear Diaphragm Powder): Treats stabbing pain in the heart and stomach, aversion to cold with high fever, dry mouth, irritability, inability to lie down, and intermittent pain.
Ingredients: Chai Hu (Bupleurum Root, 2 qian); Huang Qin (Scutellaria Root, 1.5 qian); Huang Lian (Coptis Rhizome); Zhi Shi (Immature Bitter Orange); Zhi Zi (Gardenia Fruit wine-fried); Zhu Ru (Bamboo Shavings); Chi Shao (Red Peony Root) (each 1 qian); Gan Cao (Licorice Root, 0.3 fen).
Usage: Coarsely crush one dose. Add one slice of fresh ginger, decoct in water, and take. For severe pain, add three spoons of ginger juice.
For heart pain accompanied by constipation, purgation is appropriate, as the pain will subside with bowel movement.
Zhi Shi Da Huang Tang (Immature Bitter Orange and Rhubarb Decoction): Treats epigastric pain due to hard, unpassable stool. (Formula see Abdominal Pain section.)
Li Qi Wan (Regulate Qi Pill): (Formula see Various Qi Disorders section.)
If heart pain originates from a preference for hot foods, it is caused by blood stasis remaining at the stomach opening.
Huo Xue Tang (Invigorate Blood Decoction): Treats pain caused by blood stasis resulting from heat damaging the stomach opening. (Formula see Abdominal Pain Syndrome section.)
Jiu Cai Wan (Leek Pill): Treats pain from blood stasis accumulation in the chest, diaphragm, and back, or pain in the chest and back following hematemesis, post-exertion alcohol consumption, or excessive anger.
Ingredients: Dang Gui (Angelica Sinensis Root), Chuan Xiong (Ligusticum Chuanxiong Rhizome), Ren Shen (Ginseng Root), Mu Dan Pi (Moutan Cortex), Tao Ren (Peach Kernel), Da Huang (Rhubarb Root), Huang Qin (Scutellaria Root), Jiang Huang (Turmeric Rhizome), San Leng (Sparganium Rhizome), E Zhu (Curcuma Rhizome), Jie Geng (Platycodon Root), Zhi Qiao (Bitter Orange peel), Ban Xia (Pinellia Tuber), Fang Feng (Saposhnikovia Root), Qiang Huo (Notopterygium Rhizome). All in equal proportions, all must be used raw.
Usage: Combine the above herbs with leek roots. Soak in wine, dry, soak again. Repeat this process three to five times. Grind into fine powder, make pills with water, size of mung beans. Take 30-50 or 100 pills per dose, washed down with tea liquor.
Severe pain in the heart and diaphragm radiating to the waist and back, accompanied by cold extremities and vomiting, indicates phlegm-fluid retention in the heart and diaphragm. First, induce vomiting using a goose quill probe. After the phlegm-fluid is expelled, administer medication.
Zhi Suo Er Chen Tang (Immature Bitter Orange and Two-Chen Decoction): Treats phlegm-fluid retention in the upper heart and diaphragm, radiating to the waist and back, with violent pain, vomiting, and hiccups.
Ingredients: Zhi Shi (Immature Bitter Orange stir-fried with bran); Sha Ren (Amomum Fruit); Ban Xia (Pinellia Tuber processed with ginger juice); Chen Pi (Tangerine Peel); Xiang Fu (Cyperus Rhizome) (each 2 qian); Mu Xiang (Aucklandia Root); Cao Dou Kou (Black Cardamom); Gan Jiang (Dried Ginger stir-fried) (each 0.5 fen); Nong Po (Magnolia Bark stir-fried with ginger juice); Hui Xiang (Fennel Seed wine-fried); Yan Hu Suo (Corydalis Rhizome) (each 0.8 fen); Gan Cao (Licorice Root, 0.3 fen).
Usage: Coarsely crush one dose. Add three slices of fresh ginger, decoct in water. Add Zhu Li (Bamboo Sap) and Mu Xiang juice ground from the herb, then take together.
Heart pain caused by parasites in the stomach opening presents as intermittent pain, pale complexion, and red lips.
Jiao Mei Tang (Pepper and Plum Decoction): (Formula see Abdominal Pain Syndrome section.)
Treatment for Parasitic Heart Pain:
Ingredients: Feng Yan Cao (Toona Seeds, i.e., seeds from old Toona trees); Ru Xiang (Frankincense) (equal proportions).
Usage: Grind into powder, make pills with wheat paste, size of cherries. Take one pill per dose, washed down with yellow wine.
Kou Lian Tang (Evodia Tree Bark Decoction): Treats parasitic heart pain. Use bark of Evodia root, decoct in water, and take.
Moxibustion Divine Method for Heart Pain: The acupoint is located in the depression behind both elbows; tenderness upon pressure confirms the point. First, consume half a cup of sesame oil warmed in a double boiler. Then, mix moxa wool with water powder, knead until soft, and form moxa cones. Moxa-burn five cones at each site; the pain will stop immediately.
Supplementary Secret Prescriptions
Jiu Qi Tang (Nine Qi Decoction): Treats diaphragmatic qi, wind qi, cold qi, sorrow qi, fright qi, joy qi, anger qi, mountain miasma qi, accumulation and stagnation qi, stabbing pain in the heart and abdomen, inability to eat, intermittent attacks, excruciating pain during attacks, and more. It is highly effective.
Ingredients: Xiang Fu Mi (Cyperus Rhizome kernels), Yu Jin (Turmeric Tuber), Gan Cao (Licorice Root).
Usage: Coarsely crush, add three slices of fresh ginger, decoct, and take.
Hong Bai San (Red and White Powder): Highly effective for heart pain.
Ingredients: Guan Fen (Lead White, 2 qian); Hong Jian (Red Alkali, 1.5 qian).
Usage: Grind both ingredients into an extremely fine powder. Mix with juice extracted from very spicy scallions pounded together. Take mixed with strong liquor; pain stops immediately.
Shen Xiao San (Divine Effect Powder): Treats heart pain with sourness; also treats fluid retention under the heart causing roaring sounds; also treats facial paralysis and unconsciousness. Use Dan Fan (Chalcanthite), one fen, ground into powder. Take mixed with warm yellow liquor until phlegm is fully vomited out.
Tao Ling Dan (Peach Spirit Pill): Treats heart and abdominal pain, yin syndromes, or intestinal colic (Jiao Chang Sha).
Ingredients: Yan Hu Suo (Corydalis Rhizome, 1 liang); Tao Ren (Peach Kernel, skin removed, 5 qian, separately ground); Wu Ling Zhi (Trogopterus Dung, 5 qian); Ru Xiang (Frankincense, 5 qian); Mo Yao (Myrrh, 7 qian).
Usage: Grind each into fine powder. Make pills with vinegar paste. Take 20-30 pills per dose. For heart pain, wash down with light vinegar soup; for abdominal pain, wash down with Dried Ginger Soup or yellow wine.
San Xian Dan (Three Immortals Pill): Treats critical heart pain; takes effect immediately.
Ingredients: Bai Xin (White Arsenic, baked); Ba Dou (Croton Seed, skin and oil removed); Huang La (Yellow Beeswax) (equal proportions).
Usage: Grind into powder. Melt beeswax to make pills, size of millet grains. Take three pills per dose, washed down with strong liquor. Avoid vinegar.
Xiong Shu Jiang Zhi Er Chen Tang (Ligusticum, Atractylodes, Ginger, Gardenia, and Two-Chen Decoction): Treats chronic phlegm-fire causing unbearable acute epigastric pain and indigestion.
Ingredients: Chuan Xiong (Ligusticum Chuanxiong Rhizome, 1 qian); Gan Jiang (Dried Ginger, processed, 1 qian); Cang Zhu (Atractylodes Rhizome processed with rice water, 1 qian); Zhi Zi (Gardenia Fruit stir-fried, 1 qian); Chen Pi (Tangerine Peel, pith removed, 2.2 qian); Ban Xia (Pinellia Tuber stir-fried with ginger juice, 1 qian); Fu Ling (Poria, skin removed, 1 qian); Gan Cao (Licorice Root, 0.5 fen).
Usage: Coarsely crush one dose. Add five slices of fresh ginger, decoct in water. Take warm during active pain. Wait half a day before eating after pain subsides.
Chen Xiang Hua Zhi Ding Tong Wan (Agarwood Stagnation-Resolving and Pain-Calming Pill): Specifically treats epigastric pain, chest fullness, retained phlegm and masses, and qi stagnation obstruction. Effective regardless of duration for heart and stomach pain.
Ingredients: Chen Xiang (Aquilaria Wood, 3 qian); Mo Yao (Myrrh, 5 qian); Da Huang (Rhubarb Root stir-fried, 5 qian); Wa Long Zi (Tile Fragment, one, fired red and soaked in vinegar for one day); E Zhu (Curcuma Rhizome, 3 qian); Yan Hu Suo (Corydalis Rhizome wine-fried, 2 qian); Ru Xiang (Frankincense, 2 qian).
Usage: Grind into fine powder. Make pills with vinegar paste, size of mung beans. Take nine pills per dose, eleven for robust individuals, washed down with plain boiled water. After two bowel movements, replenish with rice soup to restore comfort.
Indication: Suitable for heart pain, abdominal pain, small intestine qi masses, and cold qi syndromes belonging to deficiency-cold.
Another Formula:
Ingredients: Dang Gui (Angelica Sinensis Root), Chuan Xiong (Ligusticum Chuanxiong Rhizome), Chen Pi (Tangerine Peel), Fu Ling (Poria), Sha Ren (Amomum Fruit), Guan Gui (Cinnamon Twig), Yan Hu Suo (Corydalis Rhizome) (each 1 qian); Ding Xiang (Clove, 0.5 fen); San Leng (Sparganium Rhizome, 1.5 qian); E Zhu (Curcuma Rhizome, 2 qian); Bing Lang (Areca Seed, 2 qian); Gan Cao (Licorice Root, 0.5 fen).
Usage: Coarsely crush one dose, decoct in water, take warm. Highly effective. Avoid sexual activity.
Po Ji San (Break Accumulation Powder): Treats heart qi pain, food-stagnation abdominal pain, and pain from heat-retention masses. Suitable for excess-heat syndromes.
Ingredients: Xiang Fu Mi (Cyperus Rhizome kernels, 4 liang, soaked in vinegar and boiled dry); Zhi Zi Ren (Gardenia Fruit kernel, stir-fried until black, 2 liang); San Leng (Sparganium Rhizome); E Zhu (Curcuma Rhizome); Yu Jin (Turmeric Tuber); Zhi Qiao (Bitter Orange peel); Huang Lian (Coptis Rhizome); Da Huang (Rhubarb Root) (each 1 liang).
Usage: Grind into fine powder. Make water pills, size of paulownia seeds. Take 20-30 pills per dose, washed down with light ginger soup.
Madam He, wife of Jinshi Zhonghuan He Gong, suffered from epigastric pain during menstruation, accompanied by aversion to cold and fever. A physician prescribed Si Wu Tang (Four Substances Decoction) plus Guan Gui (Cinnamon Twig) and Xiang Fu (Cyperus Rhizome). She subsequently vomited blood and her pain worsened. I examined her six pulses, which were flooding and rapid, indicating stagnant fire. I prescribed Zhi Zi (Gardenia Fruit) 2 liang, stir-fried with ginger juice until black. One dose resulted in immediate recovery.
A Tutor, aged fifty-one, suffered from epigastric pain due to overeating and drinking. After every meal, qi would descend from both shoulders to the chest, then to the stomach opening, causing unbearable pain. Pressing heavily on the painful area with hands would cause a sudden sound after some time, relieving the pain. This persisted for eight years, leaving him emaciated. I examined his six pulses, which were slightly rapid, with the Qi Kou (Radial Artery at the wrist) slightly large and forceful. I administered Shen Wan (Divine Pill) once, and the pain vanished. Later, he was regulated and recovered using Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder).