心腹疼痛者，土湿而木贼之也。土湿而胃胆上逆，则痛在心胸，土湿而肝脾下陷，则痛在少腹。
若中气颓败，木邪内侵，则不上不下，痛在当脐，更为剧也。上痛者热多而风少，下痛者风多而热少
，而究其根源，总属湿寒所致。如痛在心胸，热多者以柴胡牡蛎汤主之。如痛在少腹，寒多者以姜苓桂
枝汤主之。如因食积而疼，宜温下者，以大黄附子汤主之，或以浓
朴七物汤主之。如因水积而疼者，以五苓汤主之，或以十枣汤主之。如因血积而疼者，
以桂枝茯苓丸主之，或以下瘀血汤主之。如因痰积而疼者，以姜苓半夏汤主之。如因虫积
而疼者，以乌梅丸主之。如无宿物，专属寒湿者，以大建中汤附子粳米汤主之。
柴胡牡蛎汤
柴胡（三钱） 牡蛎（一钱粉） 甘草（二钱） 栝蒌（三钱） 半夏（三钱）
芍药（三钱） 生姜（三钱） 水煎大半杯，温服。如胸痹疼，仍宜用金匮方治之。
姜苓桂枝汤
桂枝（三钱） 芍药（三钱） 甘草（二钱） 茯苓（三钱） 当归（三钱） 生姜（三钱）
半夏（三钱） 杏仁（三钱） 砂仁（二钱） 水煎大半杯，温服。如寒甚，加附子。
大黄附子汤
大黄（三钱） 附子（三钱） 细辛（二钱） 水煎大半杯，温服。
浓朴七物汤
浓朴（四钱） 大黄（二钱） 枳实（一钱半） 桂枝（一钱半） 甘草（一钱半）
生姜（二钱半） 大枣（二枚） 水煎大半杯，温服。呕者加半夏，寒者再加生姜。
五苓汤 十枣汤（方均见痰饮）
桂枝茯苓丸
桂枝 茯苓 丹皮 桃仁（去皮尖） 芍药（各等分） 陈皮（三钱）
上为细末，炼蜜为丸，如兔屎大，每日食前服一丸，不瘥，加至三丸。
下瘀血汤
大黄（三两） 桃仁（二十个） 虫（二十枚去足翅） 上为细末，炼蜜和为四丸，
以酒一杯，煮一丸，取八分，顿服之。
姜苓半夏汤（方见痰饮） 乌梅丸（方见蛔虫）
大建中汤
蜀椒（二钱炒去汗） 干姜（四钱） 人参（二钱） 水二杯，煎一杯，去滓，
入胶饴四钱，煎取八分，温服，如一炊顷，可食热粥半碗。
附子粳米汤
附子（二钱制） 半夏（四钱） 甘草（一钱炙） 粳米（五钱布包）
大枣（二枚） 生姜（三钱） 水煎大半杯，温服，日夜作三服。
Pain in the heart and abdomen is caused by dampness of the Earth element (Spleen/Stomach) leading to the encroachment of the Wood element (Liver/Gallbladder). If dampness of the Earth causes the Stomach Qi and Gallbladder Qi to rebel upward, pain occurs in the chest and heart region; if dampness causes Liver Qi and Spleen Qi to sink downward, pain occurs in the lower abdomen.
If the Middle Jiao (Middle Burner/Spleen-Stomach) Qi collapses and fails, and Wood pathogenic factors invade internally, the Qi mechanism neither ascends nor descends, resulting in pain at the umbilicus, which is even more severe. Generally, pain in the upper part indicates more Heat and less Wind, while pain in the lower part indicates more Wind and less Heat. However, investigating the root cause, it always belongs to pathology induced by Damp-Cold.
For instance, if pain is in the chest/heart region with predominant Heat, Chaihu Muli Tang (Bupleurum and Oyster Shell Decoction) is the primary formula. If pain is in the lower abdomen with predominant Cold, Jiangling Guizhi Tang (Ginger, Poria, Cinnamon Twig, and Atractylodes Decoction) is the primary formula. If pain is due to food stagnation and requires warm purgation, Dahuang Fuzi Tang (Rhubarb and Aconite Decoction) or Nongpu Qiwu Tang (Magnolia Bark Seven-Ingredient Decoction) are used. If pain is due to fluid retention, Wuling Tang (Five-Ingredient Powder with Poria) or Shizao Tang (Ten Jujube Decoction) are used. If pain is due to blood stasis, Guizhi Fuling Wan (Cinnamon Twig and Poria Pill) or Xiayuxue Tang (Decoction for Draining Stagnant Blood) are used. If pain is due to phlegm accumulation, Jiangling Banxia Tang (Ginger, Poria, and Pinellia Decoction) is used. If pain is due to parasitic accumulation, Wumei Wan (Mume Pill) is used. If there are no accumulated pathogens (such as food, fluid, blood, or phlegm) and the condition is exclusively due to Cold-Dampness, Dajianzhong Tang (Major Construct the Middle Decoction) and Fuzi Jingmi Tang (Aconite and Rice Decoction) are used.
[Chaihu Muli Tang]
Ingredients: Chai Hu (Bupleuri Radix, 3 qian), Mu Li (Ostreae Concha, 1 qian, powdered), Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 qian), Gua Lou (Trichosanthis Fructus, 3 qian), Ban Xia (Pinelliae Rhizoma, 3 qian), Shao Yao (Paeoniae Radix Alba, 3 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 3 qian).
Usage: Decoct in water until half a cup remains, take warm. If chest bi (obstruction) pain occurs, formulas from Jin Gui Yao Lue (Essential Prescriptions of the Golden Cabinet) should still be used.
[Jiangling Guizhi Tang]
Ingredients: Gui Zhi (Cinnamomi Ramulus, 3 qian), Shao Yao (Paeoniae Radix Alba, 3 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 qian), Fu Ling (Poria, 3 qian), Dang Gui (Angelicae Sinensis Radix, 3 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 3 qian), Ban Xia (Pinelliae Rhizoma, 3 qian), Xing Ren (Armeniacae Semen Amarum, 3 qian), Sha Ren (Amomi Fructus Rotundus, 2 qian).
Usage: Decoct in water until half a cup remains, take warm. If cold is severe, add Fu Zi (Aconiti Lateralis Radix Praeparata).
[Dahuang Fuzi Tang]
Ingredients: Da Huang (Rhei Radix et Rhizoma, 3 qian), Fu Zi (Aconiti Lateralis Radix Praeparata, 3 qian), Xi Xin (Asari Radix et Rhizoma, 2 qian).
Usage: Decoct in water until half a cup remains, take warm.
[Nongpu Qiwu Tang]
Ingredients: Nong Pu (Magnoliae Officinalis Cortex, 4 qian), Da Huang (Rhei Radix et Rhizoma, 2 qian), Zhi Shi (Aurantii Fructus Immaturus, 1.5 qian), Gui Zhi (Cinnamomi Ramulus, 1.5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1.5 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 2.5 qian), Da Zao (Jujubae Fructus, 2 pieces).
Usage: Decoct in water until half a cup remains, take warm. Add Ban Xia if vomiting occurs; add extra Sheng Jiang if cold is present.
[Wuling Tang] [Shizao Tang]
(See the section on "Tan Yin" [Phlegm-Fluids] for formulas.)
[Guizhi Fuling Wan]
Ingredients: Gui Zhi (Cinnamomi Ramulus), Fu Ling (Poria), Dan Pi (Moutan Cortex), Tao Ren (Persicae Semen), Shao Yao (Paeoniae Radix Alba) (all equal parts), Chen Pi (Citri Reticulatae Pericarpium, 3 qian).
Usage: Grind into fine powder, mix with refined honey to form pills the size of rabbit feces. Take one pill before meals daily. If not cured, increase to three pills per dose.
[Xiayuxue Tang]
Ingredients: Da Huang (Rhei Radix et Rhizoma, 3 liang), Tao Ren (Persicae Semen, 20 kernels), E Chong (Eupolyphaga seu Steleophaga, 20 pieces, feet and wings removed).
Usage: Grind into fine powder, mix with refined honey to form four pills. Boil one pill in one cup of wine, reduce to eight-tenths of the volume, and take in one dose.
[Jiangling Banxia Tang] [Wumei Wan]
(See the sections on "Tan Yin" [Phlegm-Fluids] and "Hui Chong" [Roundworms] for formulas.)
[Dajianzhong Tang]
Ingredients: Shu Jiao (Zanthoxyli Pericarpium, 2 qian, stir-fried to remove moisture/sweat), Gan Jiang (Zingiberis Rhizoma, 4 qian), Ren Shen (Ginseng Radix, 2 qian).
Usage: Add two cups of water, decoct to one cup, strain, add Jiao Yi (Maltose, 4 qian), decoct again to eight-tenths, take warm. About the time of one meal preparation, drink half a bowl of hot porridge.
[Fuzi Jingmi Tang]
Ingredients: Fu Zi (Aconiti Lateralis Radix Praeparata, 2 qian, processed), Ban Xia (Pinelliae Rhizoma, 4 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian, honey-fried), Jing Mi (Oryza Sativa Var. Glutinosa, 5 qian, wrapped in cloth), Da Zao (Jujubae Fructus, 2 pieces), Sheng Jiang (Zingiberis Rhizoma Recens, 3 qian).
Usage: Decoct in water until half a cup remains, take warm. Divide into three doses throughout day and night.