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Xu Donggao said: The wife of Vice Director Kuang, in her thirties, suffered from pain in the epigastrium radiating to the chest and hypochondrium, which was milder during the day and worse at night. Her pulse at both cun (inch) and guan (bar) positions was wiry, slippery, and forceful.
Various physicians attributed the condition to stagnation and congealed cold, using diaphoretic and purgative medicines, followed by formulas such as Tieshuan San (Iron Brush Powder) and Simo Yin (Four-Mortar Decoction), all without effect. Subsequently, she could not retain even water, vomiting immediately upon ingestion, and had not eaten for a month; the pain intensified further.
I stated that this was clearly Phlegm Stagnation (Phlegm accumulation obstructing Qi dynamics). However, due to prolonged pain causing severe debility, I dared not employ the emetic method. What should be done?
Occasionally, a physician suggested that Wulingzhi (Trogopterus Dung) and Moyao (Myrrh) were effective when used routinely. Others scoffed, saying, "This medicine has been used too much."
I replied, "Using it again poses no harm; why mock it?"
The physician administered it mixed with wine. Upon reaching her mouth, the patient vomited, expelling approximately two bowls of green phlegm. The pain ceased immediately, and she was able to eat.
This indicates that the phlegm was located above the diaphragm; purgatives could not remove it, and only the emetic method could cure it. As the Classic states: "When there is an existing pathogen, there will be no injury," which refers to this principle.

1. For pain in the epigastrium centered over the heart, caused by either Qi stagnation or cold, recurring frequently upon palpation: Burn Litchi Seed (Lizhi He) until slightly charred. Use one qian (approx. 3-5g) of Litchi Seed plus seven fen (approx. 2-3g) of Muxiang (Aucklandiae Radix), grind them into powder, and take about one qian with clear broth. Several doses can eradicate the root cause; this has proven highly effective through repeated trials.
2. For severe pain in the chest, diaphragm, and epigastrium, where examination reveals pathogenic stagnation, and continuous use of Paqi Yin (Qi-Dispersing Decoction) and other medications fails completely: Use only Ya Zao Jiao (Gleditsia Sinensis Fruit). Roast it gently over fire until the smoke just ceases, then remove it, grind into powder, and administer with distilled liquor, taking approximately seven to eight fen or one qian. The effect is miraculous; this is also a formula I have personally verified.
From *Bingbu Shouji* (Manual Collection of the Ministry of War): Treats chronic heart pain lasting five to ten years, effective immediately. Cook small garlic (Xiao Suan) in strong vinegar until soft, and take in one dose. It will not recur thereafter.
Song of Three Formulas for Treating Spleen Pain:
How to withstand abdominal distension and spleen pain? Besides Sichuan Pepper (Huajiao) and Ginger (Shengjiang), add Clove (Dingxiang). Grind these three ingredients in equal parts into powder, mix with white salt and plain water for administration.
Grind Wu Yao (Linderae Radix) with water to treat spleen pain; each dose must be thick, equivalent to one cup. Add one slice of Chenpi (Citri Reticulatae Pericarpium) and one leaf of Ziye (Perillae Folium), decoct again until concentrated, and drink for miraculous efficacy.
There is a wonderful formula for heart and spleen pain: Chop Gao Liang Jiang (Alpiniae Officinarum Rhizoma) and Binglang (Arecae Semen) in equal amounts. Stir-fry them together, grind into powder, and take with rice water; this is also beneficial.
Dietary Therapy Formula: Treats cold pain in the five zang organs and heart/abdominal pain. Take twenty-one grains of Hu Jiao (Piperis Nigris Fructus), crush them, and take with hot wine.
From *Zhou Hou Bei Ji Fang* (Handbook of Prescriptions for Emergencies): Treats distending pain in both the heart and abdomen, shortness of breath nearing death, or even apparent cessation of breathing. Use three liang (approx. 90-150g) of Guan Gui (Cinnamomi Cortex), chop finely, boil in one sheng and two he (approx. 240ml) of water until reduced to eight he (approx. 160ml), strain, and take in one dose. If Cinnamon is unavailable, Ginger may be used instead.