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Heart and stomach pain has nine types, among which Zhenxin Tong (True Heart Pain) is incurable. What is currently referred to as "heart pain" actually refers to pain in the Xinbaoluo (Pericardium Meridian) and Weiwuan (Stomach Epigastrium). There are nine types in total, which should be carefully differentiated.

Differentiate Deficiency and Excess, Clarify Severity: Deficiency patterns prefer pressure, pain stops after eating, and the pulse is weak. Excess patterns reject pressure, pain worsens after eating, and the pulse is forceful. Both symptoms have varying degrees of severity.

Pain arises from obstruction; Qi and Blood stagnation causes pain. Unobstructed means no pain because Qi and Blood are harmonious. Gao Shizong stated: "The methods of 'unblocking' vary." Regulating Qi to harmonize Blood, and regulating Blood to harmonize Qi constitutes unblocking. Directing upward-rebellious Qi downward, and dispersing central knotting Qi laterally also constitute unblocking. For deficiency, tonification promotes unblocking; for cold, warming promotes unblocking. All are methods of unblocking. If one insists on using purgation as the only method of unblocking, it would be erroneous.

First is Chong Tong (Worm Pain): Use Wumei Wan (Mume Pill). Worm pain presents with intermittent pain, white spots on the lips and tongue, and worsening pain upon eating. Worm pain transforms according to Jueyin Wind-Wood, so Wumei Wan is appropriate.

Second is Zhu Tong (Infestation/Pathogenic Injection Pain): Use Suhe Wan (Styrax Pill). Onset occurs after entering mountains, ancient temples, or seeing unusual objects. The pulse fluctuates between large and small, and the pulses in both hands feel like two different people. Suhe Wan, ground and administered via gavage, is appropriate.

Third is Qi Tong (Qi Stagnation Pain): Xiangsu Yin (Fragrant Perilla Decoction) is specialized. Pain caused by severe anger and emotional Qi stagnation is treated with Xiangsu Yin, adding 2 qian of Yuanhusuo (Corydalis Rhizome). Qiqi Tang (Seven Qi Decoction) is also excellent. Another prescription uses 1 liang of Baihe (Lily Bulb) and 3 qian of Wuyao (Lindera Root), decocted in water.

Fourth is Xue Tong (Blood Stasis Pain): Start with Shixiao San (Marvelous Powder). Pain caused by blood stasis feels like knife-cutting, may present with masses, the pulse is choppy, and stool is black. Taoren Chengqi Tang (Peach Kernel and Rhubarb Decoction) and Shixiao San are appropriate.

Fifth is Ji Tong (Palpitation Pain): Miaoxiang San (Wonderful Fragrance Powder) resolves it. Ji Tong is essentially deficiency pain. Pain comes and goes, prefers pressure, slightly alleviates after eating, and the pulse is weak. Miaoxiang San or Lizhong Tang (Regulate the Middle Decoction) added with Rougui (Cinnamon Bark) and Muxiang (Aucklandia Root) are indicated.

Sixth is Shi Tong (Food Retention Pain): Pingwei San (Calm the Stomach Powder) decocted. Pain due to food retention presents with belching of rotten smells, acid regurgitation, and a sensation of a band-like pain. Pingwei San added with Shanzha (Hawthorn Fruit) and Guya (Sprouted Millet) is primary. For alcohol injury, add 3 qian of Gegen (Kudzu Root) and 1 qian of Sharen (Amomum Fruit). However, for acute injury, vomiting is the correct method; for chronic retention, purging is the correct method.

Seventh is Yin Tong (Fluid Retention Pain): Erchen Tang (Two Aged Decoction) swallowed. Pain due to retained fluids presents with frequent spitting of clear fluid or sound of water under the hypochondrium. Erchen Tang added with Baizhu (Atractylodes Macrocephala Rhizome) and Zexie (Alisma Rhizome) is primary. In severe cases, Shizao Tang (Ten Jujube Decoction) can be taken temporarily.

Eighth is Leng Tong (Cold Pain): Lizhong Tang is comprehensive. Cold pain presents with cool body, fine pulse, and neutral mouth sensation. Lizhong Tang added with Fuzi (Prepared Aconite Lateral Root) and Rougui (Cinnamon Bark) is primary. If accompanied by vomiting, Wuzhuyu Tang (Evodia Decoction) is primary.

Ninth is Re Tong (Heat Pain): Jinlingzi San (Melia Dispersion) cures. Heat pain presents with fever, rapid pulse, and hot mouth sensation. Jinlingzi (Melia Seed) and Yuanhusuo (Corydalis Rhizome), each 2 liang, ground into powder and taken with yellow wine, 2 qian per dose. It is named Jinlingzi San and is very effective. If heat is severe, use Huanglian (Coptis Rhizome) and Zhizi (Gardenia Fruit) with fresh ginger juice.

Abdominal Pain: Refer to various chapters. Above the umbilicus belongs to Taiyin, at the level of the umbilicus belongs to Shaoyin, below the umbilicus belongs to Jueyin, and the hypochondrium is the junction of Shaoyang and Jueyin. Treatment should be differentiated accordingly. However, the general principle is the same as above.

Jinkui Methods: Can reverse heaven (save lives). The discussions in Jinkui Yaolue (Essential Prescriptions of the Golden Cabinet) are all methods for saving lives from critical conditions.

Discussions on Various Formulas: Must be cherished. The Doctrine of the Mean states: "Attaining one good thing, hold it firmly in heart and never lose it." Abdominal fullness and pain with diarrhea indicate deficiency. Vomiting, diarrhea, and pain indicate Taiyin syndrome, treated with Lizhong Tang. Borborygmus, cutting pain, and vomiting indicate cold, treated with Fuzi Jingmi Tang (Aconite and Rice Decoction). This diagnoses deficiency through diarrhea. Chest fullness and pain with constipation indicate excess. Constipation and pain without fever are treated with Houpo Sanwu Tang (Magnolia Bark Three-Ingredient Decoction) to attack the interior exclusively. Constipation and pain with fever are treated with Houpo Qiyu Tang (Magnolia Bark Seven-Ingredient Decoction) to address both exterior and interior. Constipation, fever, pain radiating to hypochondrium, and tight-stringy pulse are treated with Dahuang Fuzi Tang (Rhubarb and Aconite Decoction) for simultaneous warming and purging. This diagnoses excess through constipation. If pain surrounds the umbilicus, it is named Hanshan (Cold Hernia). Wu Tou Jian (Veratrum Decoction) is too harsh to use rashly; the efficacy of Danggui Shengjiang Yangrou Tang (Angelica, Ginger, and Mutton Decoction) must be studied.

Regarding Xiongbi (Chest Bi): It does not occur by chance. The upper chest is the great void of the human body. Zongqi (Pectoral Qi) accumulates here; it is not accidental.

Xiejiu (Leek Juice and Wine): Marvelous rotation. Gualou Xiebai Jiubai Tang (Trichosanthes, Chinese Leek, and White Wine Decoction), or those added with Banxia (Pinellia Tuber), or Zhishi (Bitter Orange) and Xiebai Guizhi Tang (Chinese Leek and Cinnamon Twig Decoction), all possess marvelous rotational effects.

Deficiency-Cold: Jianzhong Tang fills. Severe cold in the heart and chest, with pain, vomiting, inability to eat, and cold qi rushing upward creating a sensation of head and feet that cannot be touched, is treated with Da Jianzhong Tang (Great Construct the Middle Decoction). The upper and middle jiao are bi-blocked by cold pathogen. Therefore, Renshen (Ginseng Root) and Jiang (Dried Ginger) are used to open Yang in the upper jiao, combined with Yitang (Maltose) to construct Middle Qi. Additionally, the descending nature of Jiao (Sichuan Pepper) is used to direct rebellious Qi downward and restore Yang in the lower jiao. This is the main formula for tonics.