夫胸痹之病，令人心中坚满，痞急痛。肌中苦痹，绞急如刺，不得俯仰。其胸前皮皆痛，
手
塞
夫脉当视太过与不及。阳微阴弦，即胸痹而痛。所以然者，以其人极虚故也。今阳虚知在上
焦，所以胸痹心痛者，以其人脉阴弦故也。平人无寒热，短气不足以息者，实也。又曰，寸
口沉而迟，关上小紧数是也。夫胸痹之病，其脉阳微而阴弦者，阳虚则知在上焦，阴弦故令
胸痹心痛，古方用理中汤，取缓其中气，则可也。然背者胸之府，或筑、或悸、或渴、或腹
痛、或寒，或肠满。其候不一，治当审宜加损也。
方
利隔甘草汤 治胸痹，喘息不通。
人参（去芦） 赤茯苓 前胡（各一两去芦） 甘草（炒微赤） 桂心 干姜（各半两）
诃黎勒皮
分，煎至五分
蜀椒散（出《千金方》）治胸痹达背。
蜀椒 吴茱萸（各一两） 桂心 桔梗（各三两） 乌头（半两） 豉（六铢） 上治
下筛，食后酒
小草丸（出《圣惠方》）疗胸痹心痛，逆气膈中，饮不下。
小草 桂心 蜀椒（炒出汗） 干姜 细辛（各三分） 附子（二分炮） 上捣筛和以
蜜，丸梧桐
理中汤（一名人参汤出《千金方》）治胸痹。
人参 甘草（炙） 白术 干姜（炮各一两半） 上捣筛，每服五钱，水二盏，煎至一
盏，去滓
吐多者，
中痛者
稀粥投
枳实汤 治胸痹。
枳实（去瓤面炒半两） 栝蒌实（一枚并瓤用） 浓朴（去皮姜汁炙三两） 上锉如麻
豆，每服五
麝香散 治胸痹壅闷。
麝香（研） 牛黄（研半两） 犀角（一分） 上为散，每服二钱，温酒调下，空心，
日午、临卧
半夏汤 治胸痹心下坚痞，急痛彻背，短气烦闷，自汗出。
半夏（汤洗七次切焙二两半） 栝蒌实（一枚） 上锉如麻豆，每服五钱，水二盏，入
生姜一分
枳壳汤 治胸痹胁下《秘结方》
枳壳 滑石（各二两） 甘草（一两） 上 咀，每服三钱，用冷臭橘叶七片，同煎温
服，连进
薏苡仁散（出《圣惠方》）疗胸痹遍缓急，及心下坚痞。
薏苡仁（五百枚） 附子十枚大者炮） 甘草（三两炙） 上筛，每服方寸匕，日三。
忌海藻、
麝香丸（出《圣惠方》）治胸痹壅闷。
麝香（一分研） 牛膝（一两去苗） 犀角屑（半两） 上为细末，炼蜜为丸，如梧
桐子大，每
下气汤（出《千金方》）治胸腹皆闭满，上气喘息。
大腹槟榔（二十七枚） 杏仁（四七枚） 上 咀，以童子小便三升，煎取一升半，分
再服，
枳实汤 治胸痹。
枳实（去瓤面炒四枚） 浓朴（去粗皮生姜汁炙三两） 上筛，每服五钱，水二盏，入
薤白一握
栀子汤 治胸痹切痛，此方与仓卒散，煮制不同，故别出。
栀子仁（二两） 附子（炮去皮脐一两） 上 咀，每服三钱，水一盏，薤白三寸，同
煎至五分
陈橘皮散（一名橘皮生姜汤出《圣惠方》）治胸痹胸中 如满，噎塞如
痒，咽喉中涩，唾
陈橘皮（二两汤去白瓤焙） 枳壳（二两麸炒黄去瓤）上为散，每服三钱，水一中盏，
入生姜
栝蒌丸 治胸痹胸中痛彻背，气塞喘急咳嗽，心腹痞闷。
栝蒌（去瓤取子炒香熟留皮与瓤别用） 枳壳（麸炒去瓤各等分） 上为细末，
取栝蒌
槟榔汤（出《千金方》）主破胸背恶气，音声塞闭。
上用极大者四枚，小者八枚， 咀，以小儿尿二升半，煮减一升，去滓分三服频与，五
剂永
枳壳散 治胸痹心下结痞，急痛彻背，短气烦闷，自汗出。
上用枳壳去瓤麸炒微黄，三十枚，捣散食，米饮调下方寸匕，日三夜一，又方加桂等分。
枳实散（《肘后方》）治胸痹气壅满，心膈不利。
上用枳实二两，麸炒微黄为丸，以清饮调下二钱。
薤汁散（出《圣惠方》）治胸痹骨痹不可触者，已瘥更发。
上取薤根五片，净洗去土，捣绞取汁，温服一小盏，立愈，多服之良。
雄黄丸 治胸痹强急疼痛。
栝蒌汤（出《圣惠方》）治胸痹疼痛，痰逆，心膈不利。
枳壳（四个一用枳实） 浓朴 薤白（各一两） 栝蒌（一两） 生姜（半两） 桂枝
（一两有热除
治胸痹、心中急痛，如锥刺，不得俯仰。自汗出，或痛彻背上，不治或至死。可取生韭
或根
治胸痹，心中痛痹坚，留气结胸，胸满胁下逆抢心。
人参 白术 干姜 甘草（各二两） 上四味，以水八升，煮取三升，每服一升日三。
如脐上
者，加
满者，
唐，名
温中汤
导引法\x
《养生方》云∶以右足践地，左足上跷，除胸痹食热呕。
Chest Bi syndrome causes hardness and fullness in the heart region, with a sensation of obstruction and urgent pain. The muscles suffer from bi-occlusion, with twisting pain like stabbing, making it impossible to bend forward or backward. The skin over the chest is painful, and pressure on the hands results in qi stagnation and blockage.
Pulse diagnosis should observe excess (Tai Guo) and deficiency (Bu Ji). A pulse that is Yang微弱 (Wei - faint/weak) and Yin 弦 (Xian - string-taut) indicates Chest Bi with pain. This occurs because the person is extremely deficient. Knowing that Yang deficiency is in the Upper Jiao (Upper Burner), the reason for Chest Bi and heart pain is due to the Yin Xian pulse. In a healthy person without chills or fever, shortness of breath and inability to take a deep breath indicate an Excess condition. It is also said that a Cun Kou (Radial artery at the wrist) pulse that is Chen (Deep) and Chi (Slow), with Guan (Middle) position being Xiao Jin Shu (Small, Tight, and Rapid), are signs of Chest Bi. When the pulse of Chest Bi shows Yang Wei and Yin Xian, Yang deficiency indicates pathology in the Upper Jiao, and Yin Xian causes Chest Bi and heart pain. Ancient formulas use Lizhong Tang (Regulate the Middle Decoction) to soothe the Middle Qi, which is appropriate. However, the back is the mansion of the chest; symptoms may include pulsating sensations, palpitations, thirst, abdominal pain, coldness, or intestinal fullness. Since manifestations vary, treatment must be adjusted according to suitability.
Lige Gancao Tang (Separate Obstruction Licorice Decoction): Treats Chest Bi with wheezing and inability to breathe freely.
Ren Shen (Ginseng Radix et Rhizoma) 1 liang (removed rhizome), Chi Fuling (Red Poria) 1 liang, Qian Hu (Peucedani Radix) 1 liang (removed rhizome), Gan Cao (Licorice Root) stir-fried until slightly red, Gui Xin (Cinnamon Twig Heart) 0.5 liang, Gan Jiang (Dried Ginger) 0.5 liang, He Li Le Pi (Terminalia Chebula Pericarpium) 0.5 liang. Processed into powder, take 3 qian per dose, decoct with 1 zhan of water until 0.5 zhan remains, warm drink.
Shu Jiao San (Sichuan Pepper Powder) (from *Qianjin Fang*): Treats Chest Bi radiating to the back.
Shu Jiao (Sichuan Pepper Fruit) 1 liang, Wu Zhu Yu (Evodia Fruit) 1 liang, Gui Xin (Cinnamon Twig Heart) 3 liang, Jie Geng (Platycodon Root) 3 liang, Wu Tou (Aconite Lateral Root) 0.5 liang, Chi (Fermented Soybean) 6 zhu. Processed into powder, take 2 qian after meals with wine.
Xiao Cao Wan (Herba Siegesbeckiae Pill) (from *Shenghui Fang*): Treats Chest Bi heart pain, rebellious qi blocking the diaphragm, inability to swallow drinks.
Xiao Cao (Herba Siegesbeckiae) 3 fen, Gui Xin (Cinnamon Twig Heart) 3 fen, Shu Jiao (Sichuan Pepper Fruit) stir-fried to release oil 3 fen, Gan Jiang (Dried Ginger) 3 fen, Xi Xin (Asarum Root) 3 fen, Fu Zi (Prepared Aconite Lateral Root) 2 fen. Processed into powder, mixed with honey into pills the size of tung tree seeds, take 10 pills with warm water.
Lizhong Tang (Regulate the Middle Decoction), also known as Renshen Tang (Ginseng Decoction) (from *Qianjin Fang*): Treats Chest Bi.
Ren Shen (Ginseng Radix et Rhizoma) 1.5 liang, Gan Cao (Licorice Root) roasted 1.5 liang, Bai Zhu (Atractylodes Macrocephala Rhizome) 1.5 liang, Gan Jiang (Dried Ginger) prepared 1.5 liang. Processed into powder, take 5 qian per dose, decoct with 2 zhan of water until 1 zhan remains, remove dregs, warm drink. For excessive vomiting, add Sheng Jiang (Fresh Ginger); for heart pain, add Bai Shao (White Peony Root); for diarrhea, reduce Bai Zhu and add Huang Lian (Coptis Rhizome); for thirst, increase Bai Zhu; for abdominal fullness, reduce Bai Zhu and add Fu Zi (Prepared Aconite Lateral Root). Drink thin congee after taking medicine to assist efficacy.
Zhishi Tang (Immature Bitter Orange Decoction): Treats Chest Bi.
Zhi Shi (Immature Bitter Orange Fruit) stir-fried with flour 0.5 liang, Gua Lou Shi (Trichosanthes Fruit) 1 piece (use whole including rind), Hou Po (Magnolia Bark) peeled and stir-fried with ginger juice 3 liang. Cut into hemp seed size, take 5 qian per dose, decoct with 1.5 zhan of water until 1 zhan remains, remove dregs, warm drink.
Shexiang San (Musk Powder): Treats Chest Bi with oppression and stuffiness.
She Xiang (Musk) ground, Niu Huang (Calculus Bovis) ground 0.5 liang, Xi Jiao (Rhinoceros Horn) 1 fen. Processed into powder, take 2 qian mixed with warm wine, taken on an empty stomach, at noon, and before bed.
Banxia Tang (Pinellia Decoction): Treats Chest Bi with hardness and obstruction below the heart, urgent pain radiating to the back, shortness of breath, irritability, and spontaneous sweating.
Ban Xia (Pinellia Tuber) washed seven times in hot water, sliced and dried 2.5 liang, Gua Lou Shi (Trichosanthes Fruit) 1 piece. Cut into hemp seed size, take 5 qian per dose, decoct with 2 zhan of water plus 1 fen of Sheng Jiang (Fresh Ginger) until 1 zhan remains, remove dregs, warm drink.
Zhike Tang (Bitter Orange Decoction): Treats Chest Bi hypochondriac binding (*Mijie Fang*).
Zhike (Bitter Orange Fruit) 2 liang, Hua Shi (Talcum) 2 liang, Gan Cao (Licorice Root) 1 liang. Cut into pieces, take 3 qian per dose, decoct with 7 leaves of cold smelly orange leaf in water, warm drink, continue for several doses.
Yiyi Ren San (Coix Seed Powder) (from *Shenghui Fang*): Treats Chest Bi with generalized flaccidity or spasticity, and hardness/obstruction below the heart.
Yiyi Ren (Coix Seed) 500 pieces, Fu Zi (Prepared Aconite Lateral Root) 10 large pieces (prepared), Gan Cao (Licorice Root) roasted 3 liang. Processed into powder, take 1 fang cun bi per dose, three times daily. Avoid Hai Zao (Sargassum) and Song Cai (Chinese Cabbage).
Shexiang Wan (Musk Pill) (from *Shenghui Fang*): Treats Chest Bi with oppression and stuffiness.
She Xiang (Musk) 1 fen (ground), Niu Xi (Achyranthes Root) 1 liang (removed sprout), Xi Jiao Xie (Rhinoceros Horn Shavings) 0.5 liang. Processed into fine powder, mixed with refined honey into pills the size of tung tree seeds, take 10 pills with warm water.
Xiaqi Tang (Descend Qi Decoction) (from *Qianjin Fang*): Treats fullness and closure in chest and abdomen, rebellious qi and wheezing.
Da Fu Bing Lang (Areca Seed) 27 pieces, Xing Ren (Apricot Seed) 4-7 pieces. Cut into pieces, decoct with 3 sheng of urine from a young boy until 1.5 sheng remains, divide into two doses.
Zhishi Tang (Immature Bitter Orange Decoction): Treats Chest Bi.
Zhi Shi (Immature Bitter Orange Fruit) stir-fried with flour 4 pieces, Hou Po (Magnolia Bark) peeled and stir-fried with ginger juice 3 liang. Processed into powder, take 5 qian per dose, decoct with 2 zhan of water plus one handful of Xie Bai (Allium Macrostemon Bulb) until 1 zhan remains, remove dregs, warm drink.
Zhizi Tang (Gardenia Decoction): Treats Chest Bi with cutting pain. This formula differs in preparation from Cangcu San, hence listed separately.
Zhi Zi Ren (Gardenia Seed) 2 liang, Fu Zi (Prepared Aconite Lateral Root) peeled and umbilicus removed 1 liang. Cut into pieces, take 3 qian per dose, decoct with 1 zhan of water plus 3 cun of Xie Bai (Allium Macrostemon Bulb) until 0.5 zhan remains, remove dregs, warm drink.
Chen Ju Pi San (Aged Tangerine Peel Powder), also known as Ju Pi Sheng Jiang Tang (Tangerine Peel Fresh Ginger Decoction) (from *Shenghui Fang*): Treats Chest Bi with sensation of fullness in chest, choking/blockage like itching, dryness in throat, and difficulty expectorating.
Chen Ju Pi (Aged Tangerine Peel) 2 liang (washed, white pith removed, dried), Zhike (Bitter Orange Fruit) stir-fried with bran until yellow, pith removed 2 liang. Processed into powder, take 3 qian per dose, decoct with 1 zhong zhan of water plus 0.5 fen of Sheng Jiang (Fresh Ginger) until 0.6 zhan remains, remove dregs, warm drink.
Gua Lou Wan (Trichosanthes Pill): Treats Chest Bi with pain radiating from chest to back, qi blockage, wheezing, cough, and epigastric/abdominal obstruction.
Gua Lou (Trichosanthes Fruit) pith and rind separated, seeds stir-fried until fragrant, Zhike (Bitter Orange Fruit) stir-fried with bran, pith removed (equal parts). Processed into fine powder, decoct Gua Lou pith and rind in water, mix with powder to form pills the size of tung tree seeds, take 20 pills with warm water.
Bing Lang Tang (Areca Nut Decoction) (from *Qianjin Fang*): Mainly breaks evil qi in chest and back, clears voice obstruction.
Use 4 very large pieces or 8 small pieces, cut into pieces, decoct with 2.5 sheng of child's urine until reduced by 1 sheng, remove dregs, divide into three frequent doses. Five courses permanently cure.
Zhike San (Bitter Orange Powder): Treats Chest Bi with knotting and obstruction below the heart, urgent pain radiating to back, shortness of breath, irritability, and spontaneous sweating.
Use 30 pieces of Zhike (Bitter Orange Fruit) removed pith and stir-fried with bran until slightly yellow, grind into powder, eat with food, adjust with rice drink 1 fang cun bi, three times day and once night. Another method adds Gui (Cinnamon) in equal parts.
Zhishi San (Immature Bitter Orange Powder) (*Zhouhou Fang*): Treats Chest Bi with qi congestion and fullness, lack of smoothness in heart and diaphragm.
Use 2 liang of Zhi Shi (Immature Bitter Orange Fruit) stir-fried with bran until slightly yellow, form into pills, take 2 qian adjusted with clear drink.
Xie Zhi San (Garlic Juice Powder) (from *Shenghui Fang*): Treats Chest Bi bone bi untouchable, recurring after recovery.
Take 5 slices of Xie Gen (Garlic Root), wash clean to remove soil, crush and squeeze to extract juice, warm drink 1 small zhan, immediate cure, more doses are good.
Xiong Huang Wan (Realgar Pill): Treats Chest Bi with stiffness, urgency, and pain.
Xiong Huang (Realgar) ground, Bei Mu (Fritillaria Bulb) removed center, Gua Lou Gen (Trichosanthes Root) (each 1 liang). Processed into fine powder, mixed with refined honey into pills the size of tung tree seeds, take 10 pills with warm water.
Gua Lou Tang (Trichosanthes Decoction) (from *Shenghui Fang*): Treats Chest Bi pain, phlegm rebellion, lack of smoothness in heart and diaphragm.
Zhike (Bitter Orange Fruit) 4 pieces (can use Zhi Shi), Hou Po (Magnolia Bark), Xie Bai (Allium Macrostemon Bulb) (each 1 liang), Gua Lou (Trichosanthes Fruit) 1 liang, Sheng Jiang (Fresh Ginger) 0.5 liang, Gui Zhi (Cinnamon Twig) 1 liang (remove if heat present). Cut into pieces, decoct with 3 zhan of water until 1 zhan remains, remove dregs, warm drink.
Treat Chest Bi, urgent pain in heart like awl piercing, inability to bend. Spontaneous sweating, or pain radiating to back, untreated may lead to death. Can take raw Jiu (Garlic) or roots, crush and drink juice.
Treat Chest Bi, hard pain obstruction in heart, lingering qi forming Jie Xiong (Knotting Chest), chest fullness, rebellious qi seizing heart from hypochondrium.
Ren Shen (Ginseng Radix et Rhizoma) 2 liang, Bai Zhu (Atractylodes Macrocephala Rhizome) 2 liang, Gan Jiang (Dried Ginger) 2 liang, Gan Cao (Licorice Root) (each 2 liang). These four ingredients, decoct with 8 sheng of water until 3 sheng remains, take 1 sheng three times daily. If there is moving qi above navel, add Gui Xin (Cinnamon Twig Heart); if abdominal fullness, add Hou Po (Magnolia Bark).
Tang, named Wenzhong Tang (Warm Middle Decoction).
Dao Yin Method:
*Yangsheng Fang* states: Place right foot on ground, lift left foot up, to eliminate Chest Bi, food stagnation, heat, and vomiting.