论曰体虚之人。寒气客之。气结在胸。郁而不散。故为胸痹。其证心下坚满痞急。甚者、
痛抢心如刺。手不得犯。治之稍缓。便致危殆。不可忽也。
治胸痹。心下坚痞。枳实汤方
枳实（麸炒四枚） 桂（去粗皮一两） 浓朴（去粗皮生姜汁炙四两） 栝蒌实（去皮
焙一枚）
上四味。粗捣筛。每服五钱匕。水一盏半。薤白五寸切。煎至八分。去滓温服。空心日
午临卧各一。
治心胸气急刺痛。不可俯仰。气促咳唾不下食。陈橘汤方
陈橘皮（汤浸去白焙） 芍药 当归（切焙各半两） 木香（一分） 桔梗（炒三分）
上五味。粗捣筛。每服五钱匕。水一盏半。生姜五片。煎至八分。去滓温服。
治胸痹。心下气坚。 刺不可俯仰。气促咳唾引痛不能食。枳实桔梗汤方
枳实（麸炒七枚） 陈橘皮（汤浸去白炒） 桔梗（炒各半两） 甘草（炙一分）
上四味。粗捣筛。每服五钱匕。水一盏半。生姜一枣大拍破。薤白五寸切。煎至八分。
去滓温服。
治胸痹缓急。薏苡散方
薏苡仁（七百五十粒） 附子（大者五枚炮裂去皮脐）
上二味。捣罗为散。每服半钱匕。温酒调下。空心日午临卧各一服。未瘥稍增之。
治胸中隐然而痛。桂姜丸方
桂（去粗皮） 干姜（炮） 乌头（炮裂去皮脐各一分） 人参（三两） 细辛（去苗
叶） 山茱萸 贝母（去
上七味。捣罗为末。炼蜜丸如小豆大。每服二十丸。温酒下。稍加之。粥饮亦得。
治寒气客在胸中。郁而不散。坚满痞急。病名胸痹。四温散方
附子（炮裂去皮脐） 蓬莪术（煨锉各一两） 胡椒 枳实（麸炒各半两）
上四味捣罗为散。每服三钱匕。热酒调下。
治胸痹。心下坚痞。五味丸方
桂（去粗皮） 诃黎勒皮 槟榔（锉各一两） 附子（炮裂去皮脐） 干姜（炮各三分）
上五味。捣罗为末。炼蜜丸如梧桐子大。每服二十丸。温酒或姜汤下。
治胸痹。心下坚痞。豆蔻汤方
白豆蔻（去皮） 桂去（粗皮） 木香 人参（各半两） 陈曲 京三棱（煨锉各一两）
陈橘皮（汤浸去
上一十味。粗捣筛。每服三钱匕。水一盏。生姜三片。盐少许。煎至七分。去滓食前温
服。
治寒气结为胸痹。心下坚痞。木香丸方
木香 青橘皮（汤浸去白焙） 陈橘皮（汤浸去白焙） 羌活（去芦头） 半夏（汤洗
七遍各半两） 槟榔（锉） 桔梗（去芦头） 枳实（麸炒黄色秤） 浓朴（去粗皮姜制秤）
白术 甘草（各半两炙黄锉）
上一十一味。捣罗为细末。炼蜜为丸。如梧桐子大。每服生姜汤下三十丸。日三。
Discourse states: In individuals with deficient constitution, cold pathogenic qi invades the body. The qi becomes knotted in the chest, stagnating and failing to disperse, thus forming Chest Bi (Chest Obstruction). The manifestations include hardness, fullness, stuffiness, and tension/pain in the epigastrium. In severe cases, the pain strikes the heart like a needle prick, making it intolerable to touch. If treatment is delayed even slightly, it may lead to critical danger; therefore, it must not be neglected.
For treating Chest Bi with hardness and stuffiness in the epigastrium, Zhi Shi Tang (Immature Bitter Orange Decoction):
Zhi Shi (Immature Bitter Orange, stir-bran fried, four pieces) Guizhi (Cinnamon Twig, bark removed, one tael) Houpo (Magnolia Bark, bark removed, processed with ginger juice, four taels) Gualou Shi (Trichosanthes Fruit, peel removed, baked, one piece)
The above four herbs are coarsely crushed and sieved. Each dose consists of five qianbi (approx. 5-10g depending on era/measure), boiled with one dan and a half of water, along with five cun of cut Xiebai (Allium Macrostemon Rhizome), until reduced to eight-tenths volume. Strain and take warm. Administer on an empty stomach, at noon, and before bed.
For treating urgent Qi distress and stabbing pain in the chest and heart, inability to bend or extend, shortness of breath, coughing with expectoration, and inability to eat, Chen Ju Tang (Aged Tangerine Peel Decoction):
Chenpi (Aged Tangerine Peel, soaked in water, white pith removed, baked) Shaoyao (Peony Root) Danggui (Angelica Sinensis, cut and baked, each half tael) Muxiang (Costus Root, one fen) Jiegeng (Platycodon Root, stir-fried, three fen)
The above five herbs are coarsely crushed and sieved. Each dose consists of five qianbi, boiled with one dan and a half of water and five slices of Shengjiang (Fresh Ginger), until reduced to eight-tenths volume. Strain and take warm.
For treating Chest Bi with Qi knotting and hardness in the epigastrium, stabbing pain preventing bending/extending, shortness of breath, coughing with expectoration causing pulling pain, and inability to eat, Zhi Shi Jie Geng Tang (Immature Bitter Orange and Platycodon Decoction):
Zhi Shi (Immature Bitter Orange, stir-bran fried, seven pieces) Chenpi (Aged Tangerine Peel, soaked in water, white pith removed, stir-fried) Jiegeng (Platycodon Root, stir-fried, each half tael) Gancao (Licorice Root, honey-fried, one fen)
The above four herbs are coarsely crushed and sieved. Each dose consists of five qianbi, boiled with one dan and a half of water, a date-sized piece of broken Shengjiang (Fresh Ginger), and five cun of cut Xiebai (Allium Macrostemon Rhizome), until reduced to eight-tenths volume. Strain and take warm.
For treating intermittent or acute Chest Bi, Yiyi San (Coix Seed Powder):
Yiyiren (Coix Seed, 750 grains) Fuzi (Prepared Aconite Root, large ones, five pieces, roasted/cracked, peel and umbilical scar removed)
The above two herbs are crushed and sifted into a powder. Each dose is half a qianbi, taken with warm wine. Administer on an empty stomach, at noon, and before bed. If symptoms do not resolve, the dose may be slightly increased.
For treating dull pain in the chest, Gui Jiang Wan (Cinnamon and Dried Ginger Pill):
Guizhi (Cinnamon Twig, bark removed) Ganjiang (Dried Ginger, roasted) Wutou (Prepared Aconite Root, roasted/cracked, peel and umbilical scar removed, each one fen) Renshen (Ginseng Root, three taels) Xixin (Asarum Root, roots and leaves removed) Shanzhuyu (Cornus Fruit) Beimu (Fritillaria Bulb, heart removed)
The above seven herbs are crushed and sifted into fine powder, mixed with refined honey to form pills the size of small beans. Each dose is twenty pills, taken with warm wine; the dose may be slightly increased. Taking with gruel drink is also acceptable.
For treating cold pathogenic qi lodging in the chest, stagnating without dispersing, causing hardness, fullness, stuffiness, and tension, diagnosed as Chest Bi, Si Wen San (Four Warmth Powder):
Fuzi (Prepared Aconite Root, roasted/cracked, peel and umbilical scar removed) Peng Ezhu (Curcuma Zedoaria Rhizome, baked and crushed, one tael) Hujiao (Black Pepper) Zhi Shi (Immature Bitter Orange, stir-bran fried, each half tael)
The above four herbs are crushed and sifted into a powder. Each dose is three qianbi, taken with hot wine.
For treating Chest Bi with hardness and stuffiness in the epigastrium, Wu Wei Wan (Five Ingredient Pill):
Guizhi (Cinnamon Twig, bark removed) Helile Pi (Pericarpio Chebulae) Binglang (Areca Seed, crushed, each one tael) Fuzi (Prepared Aconite Root, roasted/cracked, peel and umbilical scar removed) Ganjiang (Dried Ginger, roasted, each three fen)
The above five herbs are crushed and sifted into fine powder, mixed with refined honey to form pills the size of Sophora seeds. Each dose is twenty pills, taken with warm wine or ginger decoction.
For treating Chest Bi with hardness and stuffiness in the epigastrium, Doukou Tang (Cardamom Decoction):
Baidoukou (White Cardamom Seed, peel removed) Guizhi (Cinnamon Twig, bark removed) Muxiang (Costus Root) Renshen (Ginseng Root, each half tael) Shenqu (Medicated Leaven) Jingsanleng (Burret Curcuma Rhizome, baked and crushed, each one tael) Chenpi (Aged Tangerine Peel, soaked in water, white pith removed...)
The above ten herbs are coarsely crushed and sieved. Each dose is three qianbi, boiled with one cup of water, three slices of Shengjiang (Fresh Ginger), and a little salt, until reduced to seven-tenths volume. Strain and take warm before meals.
For treating cold pathogenic qi congealing to form Chest Bi with hardness and stuffiness in the epigastrium, Muxiang Wan (Costus Root Pill):
Muxiang (Costus Root) Qingju Pi (Green Tangerine Peel, soaked in water, white pith removed, baked) Chenpi (Aged Tangerine Peel, soaked in water, white pith removed, baked) Qianghuo (Notopterygium Rhizome, rhizome head removed) Banxia (Pinellia Tuber, washed in water seven times, each half tael) Binglang (Areca Seed, crushed) Jiegeng (Platycodon Root, rhizome head removed) Zhi Shi (Immature Bitter Orange, stir-bran fried to yellow, weighed) Houpo (Magnolia Bark, bark removed, ginger-processed, weighed) Baizhu (Atractylodes Rhizome) Gancao (Licorice Root, each half tael, honey-fried, yellow, crushed)
The above eleven herbs are crushed and sifted into fine powder, mixed with refined honey to form pills the size of Sophora seeds. Each dose is thirty pills, taken with ginger decoction, three times daily.