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The back belongs to Yang, and the chest belongs to Yin. If there is pain and distension in the back, it indicates deficiency of Yang Qi within Yin; supplementation is appropriate, using herbs such as Renshen (Ginseng Radix), Gancao (Licorice Root), Guizhi (Cinnamon Twig), and Fuzi (Aconite Lateralis Preparata). If there is pain and distension in the chest extending to [the back/ribs], [text missing].

Pain at the stomach opening (epigastrium) that cannot be touched by hand indicates an Excess pattern; use Shigao (Gypsum Fibrosum) in any amount, quenched with vinegar, ground into powder, and taken with hot water, two or three spoonfuls. If pressing with hand relieves the pain significantly, it indicates a Deficiency pattern; warm it with Paojiang (Prepared Zingiberis Rhizoma).

For pain caused by dead blood (stasis), use Wulingzhi (Trogopteri Dung) one qian, Wuyao (Linderae Radix) four fen, Xuxiang (Frankincense) and Moyao (Myrrh) each one qian, ground into fine powder, and taken with warm wine.

For pain due to stasis accompanied by distension, where distension and pain are continuous without rest, use Wulingzhi two qian, Puhuang (Lygodii Spora), Xuxiang... [text interrupted]; epigastric pain with frequent vomiting of clear fluid, where pain stops after vomiting, is called "Worm Pain". Use one cup of juice from green onions stored for over a year, mixed with one cup of sesame oil, taken uniformly, causing worms to dissolve into liquid.

Pain due to food stagnation presents as aversion to food and frequent vomiting; use Jiuku (Medicated Leaven) wrapped in wet paper and roasted into powder. Take three qian per dose; the stagnant food will pass through the large intestine.

Fire-heat pain feels like knife-cutting and cannot be pressed; use Siwu Tang (Four Substances Decoction) added with Chenxiang (Aquilaria Wood) and Zhizi (Gardeniae Fructus). When heat qi attacks the heart/chest causing pain, use Shichangpu (Acori Tatarinowii Rhizoma) one liang, Qianhu (Peucedani Radix) and Chifuling (Poria Cocos with Red Coir) each five qian, honey one zhan, and Shengdijihuang (Rehmanniae Radix Juice) one zhan, made into pills the size of a bullet. Take one pill after meals, washed down with Zisu Tang (Perilla Leaf Decoction).

Cold pain feels like ice in the chest, preferring warmth from hands; use Liangjiang (Alpiniae Officinarum Rhizoma) one qian, Wuyao three qian, decocted in water; or ground into powder and taken with burning wine. Alternatively, add Paojiang and Rougui (Cinnamon Bark) to Xionggui Tang (Xiongu Decoction); add Renshen for deficiency, add Zisu (Perilla Leaf) for distension.

For epigastric pain, use Jiegeng (Platycodonis Radix) and Gancao each three qian, Chuanxiong (Ligustici Chuanxiong Rhizoma) one qian, decocted in water, mixed with Wulingzhi and Xionghuang (Realgar) each five qian; this is more effective for treating stasis pain.

If flying silk enters the chest causing severe pain and inability to swallow liquids/solids, grind Xionghuang into powder and take with Zhuye (Bamboo Leaf) decoction.

For heart/chest pain, mix equal parts of Wulingzhi and Puhuang into powder, taken with vinegar-water, two qian; or mix Yanhusuo (Corydalis Rhizoma), Wulingzhi, Caoguo (Tsaoko Fructus), and Moyao in equal parts into powder, taken with wine, three qian; or mix Yanhusuo, Xuxiang, and Moyao each two qian into powder, taken with wine.

For women's epigastric pain due to Fire Stagnation, disperse it. Use Zisu, Zhizi each three qian, Yanhusuo two qian, Chenxiang, Gancao each one qian, ground into powder, taken with wine.

For persistent epigastric pain, use Wuyao five qian, Renshen, Zhigancao (Honey-fried Licorice Root) each two qian, ground into powder. Rub with fresh ginger and a little salt on the affected area; when moisture appears, dip the medicine and hold in mouth to dissolve. This is a miraculous formula proven effective repeatedly.

Pain at the stomach opening radiating to the back, slight fever in the morning, pain onset at noon, indicates Qi stagnation in Blood. Use Renshen, Rougui, Xiangfu (Cyperi Rhizoma), Chenpi (Citrus Reticulatae Pericarpium) each five fen, Danggui (Angelicae Sinensis Radix) one qian, Wuyao one fen, Zisu three fen.

Regulatory formulas vary, but the key lies in regulating Blood; Blood moves when warmed. Herbs like Paojiang, Rougui, Danggui warm the middle and move/nourish blood. Occasionally use stir-fried black... [text interrupted].

Among these, there may be cases of stasis pain, worm pain, or food stagnation pain; treat according to manifestations while protecting the Spleen and Stomach to prevent other complications.

All pains should not use Baizhu (Atractylodis Macrocephalae Rhizoma) or Huangqi (Astragali Radix). For deficiency pain, Renshen is acceptable. If Baizhu/Huangqi must be used out of necessity, careful consideration is required. This is because all pains generally do not suit Qi-tonifying methods. Only in cases of vomiting and diarrhea is Baizhu essential.

Case Record:
A person had pain near the right side of the heart. Shortly before, someone punched him on the back. This is Blood coagulation and Qi stagnation. Use Wulingzhi, Puhuang each five qian, Xuxiang, Moyao each two qian, Danggui Shen (Danggui Root) one liang, Rougui three qian, ground into powder, taken with light white wine, two qian.

A woman over forty years old, pregnant, became angry and depressed, subsequently vomiting several bowls of dark bloody fluid. Epigastric pain felt like knife-cutting, with much phlegm-saliva. Food was blocked at the painful site and could not go down. Sometimes vomiting blood, sometimes vomit resembling amaranth water. The epigastrium alternated between open and closed states. This is due to anger causing Qi rebellion, depression causing Qi knotting, and phlegm-blood stasis in the chest.

If treated improperly, it will become Blood Ge (Blood Obstruction). Treatment should invigorate blood, resolve depression, and regulate Qi. Use Danggui Shen one qian, Chuanxiong seven fen, Zhizi five fen, Wuyao three fen,