温、发散。因宿食者，忌升、补敛、苦寒，宜消导兼降气。因瘀血者，忌补气、酸敛，宜辛温、苦温以行血。
因血虚者，按之则痛止，忌破气，复忌补气、燥热、辛温。因恼怒者，虚弱人忌破气，壮实人忌补气，总忌酸
敛，宜降气、辛温。因痰饮者，忌宜俱见痰饮证下。（《本草经疏》）（按∶胃脘痛禁辛热，《正传》有说，见上。）
近人患心胃痛者甚多，十人之中必有二三，皆系痰饮留于心下，久成饮囊，发作轻重疏数虽各不同，而
病因一辙，治法以涤饮降气为主。（《轨范》）
补法可否 诸痛不可补气。（《丹溪》）
治诸痛不可用补气，气旺不通而痛愈甚，故云通则不痛，痛则不通也。（《医鉴》）（互见《
腹痛》及《身体痛》中，宜参。）
凡胃脘痛，始用攻击涤荡疏散之剂，愈而复作，再三用之，随止随作，或渐甚而脉浮大者，此为虚候，当量
其邪正虚实多寡。正气虚多，则多用养正之药，而少佐以除邪。或正气不甚虚，当攻养平半用之可也。又有
纯用养正之药，脾气不得营运（按∶不字疑），而郁痛遂止。（《医统》）
家叔祖（讳守礼）初为太学生，家素封，体气有余，参、术分毫不能用。后因业中微，两手脉时一歇至，
或八九至一
歇，或二三十至一歇。再后选任平阳，即不歇至矣。比还家，歇至如初。年七十余，忽患胸胀 满之病。因
其素性不喜补，他医概以消导药治之，胀满不除。予诊其脉，平素虽歇至，然甚强实。今病脉弱，且高年又
必无大有余之理。遂用人参，黄 ，如补中益气之类，倍升麻，服下即瘳。喜曰∶吾年已老，未闻补药能消胀
者，此何以故？予曰∶叔祖年高，年高则气弱，膻中之气所以不能行。且服克伐药过多，气益弱矣。今补则
气旺，再用升提药提其清气，清气升则浊气自降。所胀者浊气耳，浊气既降，岂有不消之理哉。（《星海》）
逐饮诸方 主簿李述之母，患胸中痞急，不得喘息，按之则痛，脉数且涩。兆曰∶胸痹也。因与仲景
三物小陷胸汤，一剂知，二剂愈。（《鸡峰》）
治胸痹短气方。
KT （一枚） 陈橘皮（一两） 半夏（一两） 枳实（二两）
上件药捣筛为散，每服五钱，以水一大盏，入生姜半分，薤白五茎，煎至五分去滓，不计时候稍热服。
（《圣惠》）
治胸痹短气，心中烦闷，宜服此方。
杏仁 赤茯苓 槟榔 青橘皮（各一两） 甘草（半两）
上件药捣筛为散，每服三钱，以水一中盏，入生姜半分。煎至六分去滓，不计时候温服。（《圣惠》）
治胸痹壅闷闭塞短气方。
赤茯苓（一两） 甘草（半两） 陈橘皮（三分） 杏仁（三分）
上件药捣筛为散，每服五钱，以水一大盏，入生姜半分，煎至五分去滓，不计时候稍热服。（同上）
桔梗枳壳汤，治热气痞满，胸膈两胁按之则痛。
枳壳（去穣） 桔梗（去芦五钱） 半夏（汤洗） 黄芩 栝蒌仁 黄连（去须各三钱）
上锉散，生姜、麦门冬去心煎服，利黄涎沫即安。（《得
效》）《医林集要》名加味陷胸汤。一法，只用小陷胸汤加桔梗、枳壳。（宜参《伤寒·结胸》。）
朱氏，苦寒辛通。
川连 土栝蒌皮 白芥子 茯苓 炒半夏 姜汁 橘红 竹茹（《临证指南》）
滚痰丸，一切男子妇人，大小虚实，久患心疼，下连小腹，面黄羸瘦，痛阵日发，必呕绿水黑汁冷涎，
乃至气绝，心下温暖者，并量大小，多至七八十丸，事属不虞之际，至于百丸，即便回生。如未至颠危者，虚弱
疑似之间，只服三五十丸，立见生意，然后续续进之，以瘥为度。兼服生津化痰理中理气药，以全其功。
（《养生主论》）
温凉并用方法 卜晋公如夫人，产后胸中作痛，痛甚则迫切不能支，至欲求死。医药杂投，略无一
效，延至五月，病转危急，求治于余。为诊其脉，两手弦涩少神，察其候，不能转侧，不得言语。余曰∶胸中
者，阳气所治之位。今为阴邪所入，阴与阳搏，所以作痛。前医破气不应，转而和血，又转而温补，又转而镇
逆。不知阴阳适当相结，补之则无益，攻之则愈结。若镇坠之，益足以抑遏生阳而阻滞邪气。惟交通一法，足
尽开阳入阴、通上彻下之妙，然后阴归于下，阳治于上，太虚之府，旷然廓然，何胸痛之有哉。时定一方，
用人参三钱，肉桂一钱，合仲景黄连汤，一剂痛减二三，三剂宿疾顿释。继进加桂理中汤数剂，神旺如初。
（印机草）
饥而心痛者，名曰饥疝。龙胆、附子、黄连分等捣筛，服一钱匕，日三度服之。（《肘后》）
《肘后》桂心散，疗卒心痛方。
桂心 当归（各一两） 栀子（十四枚）
上三味捣为散，酒服方寸匕，日三五服。亦主久心痛发作有时节者。（《外台》）
治胸痹切痛，栀子汤。
栀子（二两） 附子（一两炮）
上每服三钱，水一大盏，薤白三寸，同煎至五分，温服。泗州有人病岁余，百方不效，服此二服顿愈。
（《苏沈》）（按∶此方为散，名仓卒散，录在《寒疝》中。）
治急心痛，并男子小肠气。
高良姜（半两） 山栀子（半两） 蔚金（半两）（《神效名方》）（按∶此方缺修制并服法，当考。）
大凡心膈之痛，须分新久。若明知身受寒气、口吃寒物而得病者，于初得之时，当与温散或温利之药。若
曰病得之稍久则成郁，久郁则蒸热，热久必生火，《原病式》中备言之矣。若欲行温散温利，宁无助火添病
耶。古方中多以山栀子为热药之向导，则邪易伏，病易退，正易复而病安。然病安之后，若纵恣口腹，不改
前非，病复作时，反咎医之失，良可叹哉。一方用山栀子炒去皮，每服十五枚，浓煎汤一呷，
入生姜汁令辣，再煎小沸（按∶《医约》名仓卒散），又入川芎一钱尤妙。山栀子大者，或七枚，或九枚，
须炒黑。大概胃口有热而作痛者，非山栀子不可，须佐以姜汁，多用台芎开之。病发者，或用二陈汤加川芎、
苍术，倍加炒栀子。痛甚者，加炒干姜从之，反治之法也。（《丹溪》）（按∶《简明医彀》栀子炒黑，
干姜炒焦，等分丸用，即本此意。）
丹溪云∶凡痛必用温散，意以痛者必是滞而不行之故，纯寒不能行邪滞也。是以用寒凉亦用热
剂为引导，用温药亦用凉剂为引导。一方，用栀子、附子二味，加盐少许，以治腹
痛不可屈伸，厥冷之症也。（《粹言》）
治气实心痛者。
山栀子（炒焦六钱） 香附（一钱） 吴茱萸（一钱）
上为末，蒸饼丸如花椒大，以生地黄酒洗净，同生姜汤煎，送下二十丸。（《丹溪》）（《入门》名茱萸丸。）
黄连六一汤，治多食煎炒或烧饼热面等物，致热郁胃口而痛者甚效。
黄连（六钱） 甘草（炙一钱）
上细切作一服，水一大盏，煎至七分，去渣温服。（《正传》引丹溪）
连附六一汤，治胃脘痛甚，诸药不效者，寒因热用方也。
黄连（六钱） 附子（炮去皮脐一钱）
上细切作一服，加生姜二片，大枣一枚，水一盏半，煎至一盏，去渣稍热服。（同上引丹溪）《辨证录》
胃痛，寒热同乘于心胃之间，用双治汤，附子、黄连、甘草各一钱，白芍五钱，水煎服。
莎芎散，治曾服香燥热药，以致病根深固者，宜用。
香附 川芎（各一两） 黄连 山栀（各五钱） 木香 干生姜（各三钱） 槟榔 酒黄芩 芒硝（各二钱）
为末，每二钱，用姜汁滚白汤调，痛时呷下。（《入门》）（按∶此方配合之意，本于《明医杂着》，
其说录在《腹痛》中，宜参。）
清中蠲痛汤，痛久脉数有火。
炒黑栀子 炒黑姜 川芎 黄连（姜汁炒） 橘红 制香附 苍术 神曲
白水煎服。（《六要》）
清中诸方 清中汤，治火痛。
黄连 山栀（炒各二钱） 陈皮 茯苓（各一钱半） 半夏（一钱姜汤
泡七次） 草豆仁（七分捶碎） 甘草（炙四分）
水二钟，姜三片，煎八分，食前服。（《统旨》）
清膈散，治心胃刺痛，憎寒壮热，口干烦躁不卧，时痛时止。
柴胡（二钱） 黄芩（半钱） 黄连 枳实 枝子（酒炒） 竹茹 赤芍（各一钱） 甘草（三分）
上锉，姜一片，水煎服。痛甚，加姜汁三匙。（《回春》）
清火宁痛汤，治心胃痛甚，不可忍者。口渴思饮，大便不通，忽大痛，或暂止，胸膈间如有块筑塞升上，
手按愈痛，此因怒气郁闷成火致痛，妇人多患之，必以大便通利为止。
栀子（姜炒三钱） 黄连（吴萸汁炒） 枳实 浓朴 槟榔（各二钱） 五灵脂 蓬术 玄胡索 大黄
（各一钱） 木香（另研五分） 甘草（三分）
上水煎服。（《简明医彀》）
一妇人素有心脾痛疾，痛时四肢厥冷，每用辛香桂附之类云云。召余诊视，见脉数有力，知其服香燥药
太过，先与单栀子仁汤一服，继用黄连解毒汤而安。（《医约》）
通判丈人胃脘作痛，诸治不应，垂死。予以熊胆如大豆许，和水服之，顿效如神。（《石山》）
温中诸方 《录验方》治人心痛，懊 闷，筑筑引两乳立，或如刺，困极，桂汤方。
桂心（半两） 茱萸（二升） 芍药（三两） 当归（二两） 生姜（半斤）
凡五物切，以水一斗二升，煮取四升，服一升，日三夜一有验。无生姜，用干姜五两代。（《医心》）
张文仲，蜀椒丸，疗胸中气满，心痛引背方。
蜀椒（一升出汗） 半夏（一升洗） 附子（一两炮）
上三味捣筛，蜜和为丸，如梧子大，一服五丸，日三。（《外台》）
生姜枳实汤，若痛而但腹胀，心痛甚者，此由胃邪干心，其脉微缓，谓之胃心痛，宜此。（《鸡峰》）
（即桂枝生姜枳实汤。）
新定桂苓汤，肾逆胃痛。
桂（一钱） 茯苓（三钱） 人参（一钱） 甘草（五钱） 芍药（一钱） 生姜（五分）
上作一服，水煎，空心服。（《金匮翼》）
两浙江淮都漕运使崔君长男云卿，年二十有五，体本丰肥，奉养膏粱，时有热证。友人劝食寒凉物，及
服寒凉药。于至元庚辰秋，病疟久不除。医以砒霜等药治之，新汲水送下，禁食热物。疟病不除，反添吐泻，
脾胃复伤，中气愈虚，腹痛肠鸣，时复胃脘当心而痛，不任其苦。屡易医药，未尝有效。至冬还家，百般治疗
而不瘥。延至四月间，因劳役烦恼过度，前证大作。请予治之，具说其由。诊得脉弦细而微，
手足稍冷，面色青黄而不泽，情思不乐，恶人烦冗，饮食减少，微饱则心下痞闷，呕吐酸水，发作疼痛，冷
汗时出，气促闷乱不安，须人额相抵而坐，少时易之。予思《内经》云∶中气不足，溲便为之变，肠为之苦
鸣。下气不足，则为痿厥心 。又曰∶寒气客于肠胃之间，则卒然而痛，得炅则已。炅者热也，
非甘辛大热之剂则不能愈，遂制一方，名之曰扶阳助胃汤方。
干姜（炮一钱半） 拣参 草豆蔻仁 甘草（炙） 官桂 白芍药（各一钱） 陈皮 白术 吴茱
萸（各五分） 黑附子（炮去皮二钱） 益智仁（五分，一方一钱。）
上 咀，都作一服，水三盏，生姜三片，枣子二个，煎至一盏，去渣温服食前。三服大势
皆去，痛减过半。至秋先
灸中脘三七壮，以助胃气，次灸气海百余壮，生发元气，滋荣百脉。（《宝鉴》）
盏落汤，治急心疼。
陈皮 香附子 良姜 吴茱萸 石菖蒲（各等分）
上 咀，用水一碗，煎至七分，先用碗一个，用香油三、五点在内，小盏盖之，将药淋下热服。（《众妙方》）
治暴心痛不可忍者。
良姜（一两实者只骰子大） 巴豆（二钱去壳）
上二味，同炒令黄色，去巴豆，只取良姜一味碾细，热酒或汤调下二钱。（《是斋》）（《济生续
》名却痛散。）
神砂一粒丹，治一切厥心痛、小肠膀胱痛不可止者。
附子（一两炮） 郁金 橘红 等附子停用
共为末，醋面糊为丸，如酸枣大，以朱砂为衣，每服一丸，男子酒下，妇人醋汤下。（《宣明》）
救急心气疼，《海上方》急救男子妇人心疼，禁了牙关欲死者，可急救之。
隔年老葱白。
上将老葱白三、五根，去皮须叶，擂为膏，将病患口斡开，用银铜匙将葱膏送入咽喉中，用香油四两灌
送葱膏，油不可少用，但得葱膏下喉中，其人即苏。少时将腹中所停虫
等物，化为黄水，微利为佳，除根永不再发，累曾救得人效。（《瑞竹》）
降气诸方（兼行血方） 治胸满，短气噎塞，通气汤方。
半夏（八两） 生姜（六两） 橘皮（三两） 吴茱萸（四十枚）
上四味 咀，以水八升，煮取三升，分三服。一方，用桂二两，无橘皮。（《千金》）
治心痛不可忍者。
木香 蓬术（各一两） 干漆（一分炒）
上为末，每服一钱，热醋汤调下，入口立止。（《中藏》）
治胸痹，麝香散方。
麝香（研一两） 牛黄（研半两） 犀角（镑一分）
上三味捣研为散，每服二钱匕，温酒调下，空心日午临卧各一。（《圣济》）
治心痛不可忍，姜黄散方。
Warming and dispersing methods. For cases caused by retained food, ascending, tonifying/astringent, and bitter-cold herbs are contraindicated; resolving food stagnation combined with descending qi is appropriate. For cases caused by blood stasis, qi-tonifying and sour-astringent herbs are contraindicated; acrid-warm and bitter-warm herbs should be used to promote blood circulation.
For cases caused by blood deficiency, pain ceases upon pressure; qi-breaking herbs are contraindicated, as are qi-tonifying, drying-hot, and acrid-warm herbs. For cases caused by anger, weak individuals should avoid qi-breaking herbs, while robust individuals should avoid qi-tonifying herbs; overall, sour-astringent herbs are contraindicated; descending qi and acrid-warm herbs are appropriate. For cases caused by phlegm-fluids, the contraindications and indications are detailed under the chapter on Phlegm-Fluids syndromes. (*Bencao Jing Shu*) (Note: Acrid-hot herbs are prohibited for epigastric pain, as stated in *Zheng Chuan*, see above.)
In recent times, many people suffer from heart and stomach pain; among ten people, two or three are affected. All are due to phlegm-fluids lingering in the chest below, forming a fluid sac over time. Although the severity and frequency of attacks vary, the etiology is consistent, and the treatment method focuses on eliminating phlegm-fluids and descending qi. (*Gui Fan*)
Regarding the applicability of tonification methods: Various pains should not be treated with qi-tonifying methods. (*Danxi*)
Treating various pains with qi-tonifying herbs is inadvisable; if qi becomes abundant but obstructed, pain will worsen. Hence it is said that "patency leads to no pain, pain indicates obstruction." (*Yi Jian*) (See also *Abdominal Pain* and *Body Pain* chapters for reference.)
For all epigastric pain, initially use attacking, purging, and dispersing agents. If the disease recurs after healing, repeated use leads to immediate recurrence or gradual worsening with a floating-large pulse, indicating a deficiency syndrome. One must assess the balance between pathogenic factors and healthy qi. If healthy qi is significantly deficient, use more herbs to nourish healthy qi with a small amount to eliminate pathogens. If healthy qi is not severely deficient, use half attacking and half tonifying. There are also cases where purely using herbs to nourish healthy qi allows the Spleen Qi to circulate (Note: "not" may be an interpolation), thereby stopping stagnation pain. (*Yi Tong*)
My great-uncle (named Shouli) was initially a Grand Student, from a wealthy family, with excess body qi, unable to tolerate even a trace of Ren Shen (Ginseng Root) or Bai Zhu (Atractylodis Rhizoma). Later, as his family fortune declined, his pulses showed intermittent pauses, sometimes pausing after eight or nine beats, or after twenty to thirty beats. Later, when appointed to Pingyang, the pauses ceased. Upon returning home, the pauses returned. In his seventies, he suddenly developed chest distension and fullness. As he disliked tonics, other doctors treated him solely with digestive-resolving drugs, but the distension persisted. I palpated his pulse; although he usually had pauses, the pulse was strong and solid. Now, with illness, the pulse is weak, and given his advanced age, it is unlikely he has significant excess. Thus, I used Ren Shen (Ginseng Root) and Huang Qi (Astragali Radix), similar to Bu Zhong Yi Qi Tang, doubling the dose of Sheng Ma (Cimicifugae Rhizoma). He recovered immediately. He rejoiced, saying, "I am old; I never heard that tonics could resolve distension. Why is this?" I replied, "Your Great-Uncle is advanced in age; aging leads to weak qi, so the Qi of Dan Zhong (Pericardium/Chest) cannot move. Moreover, excessive use of draining drugs further weakened his qi. Now, tonifying makes qi abundant; using lifting herbs raises clear qi. When clear qi rises, turbid qi naturally descends. The distension is due to turbid qi; once descended, how can it not dissipate?" (*Xing Hai*)
Various formulas for eliminating phlegm-fluids: The mother of Li Shu, Registrar, suffered from chest oppression and urgency, inability to breathe, pain upon pressure, and a rapid, choppy pulse. Zhao said, "This is Xiong Bi (Chest Bi)." He prescribed Zhang Zhongjing's San Wu Xiao Xian Xiong Tang (Three-Ingredient Minor Trapped-in-the-Chest Decoction). It showed effect after one dose and cured after two doses. (*Ji Feng*)
Formula for treating Xiong Bi (Chest Bi) with shortness of breath.
Gua Lou (Trichosanthis Fructus) (one piece) Chen Pi (Citri Reticulatae Pericarpium) (one liang) Ban Xia (Pinelliae Rhizoma) (one liang) Zhi Shi (Aurantii Fructus Immaturus) (two liang)
Crush and sieve the above ingredients into powder. Take five qian per dose, with one large cup of water, add half a fen of Sheng Jiang (Zingiberis Rhizoma Recens) and five stalks of Xie Bai (Allii Macrostemonis Bulbus). Decoct until reduced to half a cup, remove dregs, and take slightly warm at any time. (*Sheng Hui*)
Formula for treating Xiong Bi (Chest Bi) with shortness of breath and mental restlessness.
Xing Ren (Armeniacae Semen Amarum) Chi Fu Ling (Poria cum Ligno) Bing Lang (Arecae Semen) Qing Ju Pi (Citri Reticulatae Pericarpium Viride) (each one liang) Gan Cao (Glycyrrhizae Radix et Rhizoma) (half liang)
Crush and sieve the above ingredients into powder. Take three qian per dose, with one medium cup of water, add half a fen of Sheng Jiang (Zingiberis Rhizoma Recens). Decoct until reduced to six-tenths, remove dregs, and take warm at any time. (*Sheng Hui*)
Formula for treating Xiong Bi (Chest Bi) with congestion, oppression, blockage, and shortness of breath.
Chi Fu Ling (Poria cum Ligno) (one liang) Gan Cao (Glycyrrhizae Radix et Rhizoma) (half liang) Chen Pi (Citri Reticulatae Pericarpium) (three fen) Xing Ren (Armeniacae Semen Amarum) (three fen)
Crush and sieve the above ingredients into powder. Take five qian per dose, with one large cup of water, add half a fen of Sheng Jiang (Zingiberis Rhizoma Recens). Decoct until reduced to half a cup, remove dregs, and take slightly warm at any time. (Same source)
Jie Geng Zhi Ke Tang (Platycodon and Aurantium Decoction), treating heat-induced oppression and fullness, pain upon pressure in the chest, diaphragm, and hypochondrium.
Zhi Ke (Aurantii Fructus) (pith removed) Jie Geng (Platycodonis Radix) (radicle removed, five qian) Ban Xia (Pinelliae Rhizoma) (washed in decoction) Huang Qin (Scutellariae Radix) Gua Lou Ren (Trichosanthis Semen) Huang Lian (Coptidis Rhizoma) (fibers removed, each three qian)
Cut into pieces, decoct with Sheng Jiang (Zingiberis Rhizoma Recens) and Mai Dong (Ophiopogonis Radix) (heart removed). Relief occurs when yellow saliva and foam are discharged. (*De Xiao*) Named Jia Wei Xian Xiong Tang (Modified Trapped-in-the-Chest Decoction) in *Yi Lin Ji Yao*. Another method uses only Xiao Xian Xiong Tang (Minor Trapped-in-the-Chest Decoction) plus Jie Geng (Platycodonis Radix) and Zhi Ke (Aurantii Fructus). (Refer to *Shang Han · Jie Xiong* chapter.)
Zhu Shi, using bitter-cold and acrid-unblocking methods.
Chuan Lian (Coptidis Rhizoma) Tu Gua Lou Pi (Trichosanthis Pericarpium) Bai Jie Zi (Sinapis Semen) Fu Ling (Poria) Chao Ban Xia (Pinelliae Rhizoma, stir-fried) Jiang Zhi (Zingiberis Rhizoma Recens Juice) Ju Hong (Citri Reticulatae Pericarpium Rubrum) Zhu Ru (Bambusae Caulis in Taenia) (*Lin Zheng Zhi Nan*)
Gun Tan Wan (Rolling Phlegm Pill), for all men and women, young and old, excess and deficiency, suffering from long-term heart pain radiating to the lower abdomen, sallow complexion, emaciation, daily paroxysmal pain, vomiting green water, black juice, and cold saliva, even to the point of qi cessation and warmth in the epigastrium. Dosage varies from seventy to eighty pills in emergencies, up to one hundred pills for revival. For non-critical cases, suspected weakness, take thirty to fifty pills to restore vitality, then continue until cured. Concurrently administer herbs to generate fluids, resolve phlegm, regulate middle jiao, and move qi to complete the efficacy. (*Yang Sheng Zhu Lun*)
Methods combining warming and cooling: The secondary wife of Bo Jin Gong suffered from postpartum chest pain, severe enough to cause desperation. Various medicines failed. After five months, the condition became critical. I palpated her pulse: string-taut and choppy with little spirit. Observing her symptoms, she could not turn or speak. I said, "The chest is the domain of Yang Qi. Now Yin pathogens have entered, clashing with Yang, causing pain. Previous doctors tried breaking qi, then harmonizing blood, then warming/tonifying, then suppressing rebellion. They did not understand that Yin and Yang were appropriately bound; tonifying helps nothing, attacking worsens binding. Suppressing herbs further inhibit generating Yang and obstruct pathogens. Only the method of communicating Yin and Yang can open Yang entering Yin and connect upper to lower. Then Yin returns below, Yang governs above, the vast cavity becomes spacious, and chest pain disappears." I prescribed Ren Shen (Ginseng Root) three qian, Rou Gui (Cinnamomi Cortex) one qian, combined with Zhang Zhongjing's Huang Lian Tang (Coptis Decoction). Pain decreased by two or three parts after one dose; chronic illness resolved after three doses. Subsequently administered Jia Gui Li Zhong Tang (Added Cinnamon Regulate Middle Decoction) for several doses; spirit recovered fully. (*Yin Ji Cao*)
Heart pain upon hunger is called Ji Shan (Hunger Hernia). Long Dan (Gentianae Radix), Fu Zi (Aconiti Lateralis Radix Praeparata), and Huang Lian (Coptidis Rhizoma) in equal parts, crushed and sieved. Take one qian bi per dose, three times daily. (*Zhou Hou*)
*Zhou Hou* Gui Xin San (Cinnamon Heart Powder), treating sudden heart pain.
Gui Xin (Cinnamomi Cortex) Dang Gui (Angelicae Sinensis Radix) (each one liang) Zhi Zi (Gardeniae Fructus) (fourteen pieces)
Crush the above three ingredients into powder. Take one cun bi with wine, three to five times daily. Also treats periodic long-term heart pain. (*Wai Tai*)
Zhi Zi Tang (Gardenia Decoction) for treating cutting pain in Xiong Bi (Chest Bi).
Zhi Zi (Gardeniae Fructus) (two liang) Fu Zi (Aconiti Lateralis Radix Praeparata) (one liang, processed)
Take three qian per dose, with one large cup of water and three cun of Xie Bai (Allii Macrostemonis Bulbus). Decoct together until reduced to half a cup, take warm. A person in Sizhou suffered for over a year without success from other prescriptions; two doses of this cured him instantly. (*Su Shen*) (Note: This formula is a powder named Cang Cu San (Sudden Emergency Powder), recorded in *Han Shan* chapter.)
Treating urgent heart pain and male Small Intestine Qi.
Gao Liang Jiang (Alpiniae Officinarum Rhizoma) (half liang) Shan Zhi Zi (Gardeniae Fructus) (half liang) Wei Jin (Half liang) (*Shen Xiao Ming Fang*) (Note: Processing and administration methods are missing; verification needed.)
Generally, heart and diaphragm pain must be distinguished by newness or duration. If the disease is known to result from external cold or consuming cold substances, initially use warming-dispersing or warming-promoting drugs. However, if the disease persists, it becomes stagnation; long stagnation steams heat; long heat generates fire, as detailed in *Yuan Bing Shi*. Attempting warming-dispersing or warming-promoting methods would only aid fire and worsen the disease. Ancient formulas often use Shan Zhi Zi (Gardeniae Fructus) as a guide for heat drugs, allowing pathogens to subside, disease to retreat, and healthy qi to recover. After recovery, if one indulges in diet without change, relapse may occur, leading to blaming the doctor, which is lamentable. One formula uses Shan Zhi Zi (Gardeniae Fructus) stir-fried to remove skin, fifteen pieces per dose, decocted strongly in one sip, add Sheng Jiang Zhi (Zingiberis Rhizoma Recens Juice) to make spicy, boil slightly again (Named Cang Cu San in *Yi Yue*), adding Chuan Xiong (Ligustici Chuanxiong Rhizoma) one qian is excellent. Large Shan Zhi Zi (Gardeniae Fructus), seven or nine pieces, must be charred. Generally, for stomach heat pain, Shan Zhi Zi (Gardeniae Fructus) is indispensable, assisted by Jiang Zhi (Zingiberis Rhizoma Recens Juice), and Chuan Xiong (Ligustici Chuanxiong Rhizoma) to open. During attacks, use Er Chen Tang (Two-Aged Decoction) plus Chuan Xiong (Ligustici Chuanxiong Rhizoma) and Cang Zhu (Atractylodis Rhizoma), doubling Chao Zhi Zi (Gardeniae Fructus, stir-fried). For severe pain, add Chao Gan Jiang (Zingiberis Rhizoma, stir-fried), following reverse treatment principles. (*Danxi*) (Note: *Jian Ming Yi Gou* chars Shan Zhi Zi (Gardeniae Fructus) and Gan Jiang (Zingiberis Rhizoma Secatus), equal parts as pills, based on this idea.)
Danxi said: "All pain requires warming and dispersing," implying pain is due to stagnation and lack of movement; pure cold cannot move pathogenic stagnation. Therefore, when using cold-cooling herbs, use hot agents as guides; when using warm herbs, use cooling agents as guides. One formula uses Zhi Zi (Gardeniae Fructus) and Fu Zi (Aconiti Lateralis Radix Praeparata) with a little salt to treat abdominal pain preventing flexion/extension and cold limbs. (*Cui Yan*)
Treating Qi-excess heart pain.
Shan Zhi Zi (Gardeniae Fructus) (charred six qian) Xiang Fu (Cyperi Rhizoma) (one qian) Wu Zhu Yu (Evodiae Fructus) (one qian)
Make into powder, form pills like Sichuan pepper size using steamed dough. Wash with Sheng Di Huang Jiu (Rehmanniae Radix Wine), decoct with Sheng Jiang (Zingiberis Rhizoma Recens) soup, swallow twenty pills. (*Danxi*) (Named Zhu Yu Wan in *Ru Men*.)
Huang Lian Liu Yi Tang (Coptis Six-to-One Decoction), highly effective for pain caused by heat stagnation in the stomach opening due to excessive consumption of fried, roasted, or hot noodles/biscuits.
Huang Lian (Coptidis Rhizoma) (six qian) Gan Cao (Glycyrrhizae Radix et Rhizoma) (roasted one qian)
Cut finely for one dose, decoct in one large cup of water until reduced to seven-tenths, remove dregs, take warm. (*Zheng Chuan* citing Danxi)
Lian Fu Liu Yi Tang (Coptis and Aconite Six-to-One Decoction), for severe epigastric pain unresponsive to other drugs, a method of treating cold with heat.
Huang Lian (Coptidis Rhizoma) (six qian) Fu Zi (Aconiti Lateralis Radix Praeparata) (processed, peeled, navel removed, one qian)
Cut finely for one dose, add two slices of Sheng Jiang (Zingiberis Rhizoma Recens) and one Da Zao (Jujubae Fructus). Decoct in one and a half cups of water until reduced to one cup, remove dregs, take slightly warm. (Same source citing Danxi) *Bian Zheng Lu* states for Stomach Pain where cold and heat simultaneously invade between Heart and Stomach, use Shuang Zhi Tang (Double Treatment Decoction): Fu Zi (Aconiti Lateralis Radix Praeparata), Huang Lian (Coptidis Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma) each one qian, Bai Shao (Paeoniae Radix Alba) five qian, decoct in water.
Sha Xiong San (Saussurea and Ligusticum Powder), suitable for cases where fragrant-dry-hot drugs were previously taken, leading to deep-rooted pathology.
Xiang Fu (Cyperi Rhizoma) Chuan Xiong (Ligustici Chuanxiong Rhizoma) (each one liang) Huang Lian (Coptidis Rhizoma) Shan Zhi Zi (Gardeniae Fructus) (each five qian) Mu Xiang (Aucklandiae Radix) Gan Sheng Jiang (Zingiberis Rhizoma Recens, dried) (each three qian) Bing Lang (Arecae Semen) Jiu Huang Qin (Scutellariae Radix, wine-processed) Mang Xiao (Natrii Sulfas) (each two qian)
Make into powder. Take two qian, mix with Jiang Zhi (Zingiberis Rhizoma Recens Juice) and boiling white water, sip during pain. (*Ru Men*) (Note: The combination logic originates from *Ming Yi Za Zhu*, recorded in *Abdominal Pain* chapter, refer there.)
Qing Zhong Juan Tong Tang (Clear Middle Eliminate Pain Decoction), for long-standing pain with rapid pulse indicating fire.
Chao Hei Zhi Zi (Gardeniae Fructus, charred black) Chao Hei Jiang (Zingiberis Rhizoma, charred black) Chuan Xiong (Ligustici Chuanxiong Rhizoma) Huang Lian (Coptidis Rhizoma, Jiang Zhi stir-fried) Ju Hong (Citri Reticulatae Pericarpium Rubrum) Zhi Xiang Fu (Cyperi Rhizoma, processed) Cang Zhu (Atractylodis Rhizoma) Shen Qu (Massae Medicatae Fermentatae)
Decoct in plain water. (*Liu Yao*)
Various Clear-Middle Formulas: Qing Zhong Tang (Clear Middle Decoction), treating Fire Pain.
Huang Lian (Coptidis Rhizoma) Shan Zhi Zi (Gardeniae Fructus) (stir-fried, each two qian) Chen Pi (Citri Reticulatae Pericarpium) Fu Ling (Poria) (each one and a half qian) Ban Xia (Pinelliae Rhizoma) (one qian, soaked seven times in Jiang Tang) Cao Dou Ren (Amomi Fructus Rotundus) (seven fen, crushed) Gan Cao (Glycyrrhizae Radix et Rhizoma) (roasted four fen)
Decoct two zhong of water with three slices of Sheng Jiang (Zingiberis Rhizoma Recens) until reduced to eight-tenths, take before meals. (*Tong Zhi*)
Qing Ge San (Clear Diaphragm Powder), treating stabbing Heart-Stomach pain, aversion to cold with high fever, dry mouth, irritability, insomnia, intermittent pain.
Chai Hu (Bupleuri Radix) (two qian) Huang Qin (Scutellariae Radix) (half qian) Huang Lian (Coptidis Rhizoma) Zhi Shi (Aurantii Fructus Immaturus) Zhi Zi (Gardeniae Fructus) (wine-stir-fried) Zhu Ru (Bambusae Caulis in Taenia) Chi Shao (Paeoniae Radix Rubra) (each one qian) Gan Cao (Glycyrrhizae Radix et Rhizoma) (three fen)
Cut into pieces, decoct with one slice of Sheng Jiang (Zingiberis Rhizoma Recens) in water. For severe pain, add three spoons of Jiang Zhi (Zingiberis Rhizoma Recens Juice). (*Hui Chun*)
Qing Huo Ning Tong Tang (Clear Fire Calm Pain Decoction), for unbearable Heart-Stomach pain. Thirsty for drinking, constipation, sudden severe pain or temporary relief, sensation of blockage rising in chest/diaphragm, worse upon pressure. Caused by anger/stagnation transforming into fire, common in women. Must wait for bowel movement to relieve.
Zhi Zi (Gardeniae Fructus) (Jiang stir-fried three qian) Huang Lian (Coptidis Rhizoma) (Wu Zhu Yu juice stir-fried) Zhi Shi (Aurantii Fructus Immaturus) Hou Po (Magnoliae Officinalis Cortex) Bing Lang (Arecae Semen) (each two qian) Wu Ling Zhi (Trogopterori Faeces) Peng Ze (Curcumae Rhizoma) Yuan Hu Suo (Corydalis Rhizoma) Da Huang (Rhei Radix et Rhizoma) (each one qian) Mu Xiang (Aucklandiae Radix) (separately ground, five fen) Gan Cao (Glycyrrhizae Radix et Rhizoma) (three fen)
Decoct in water. (*Jian Ming Yi Gou*)
A woman with chronic Heart-Spleen pain, cold limbs during attacks, previously using acrid-aromatic Gui Fu (Cinnamon and Aconite) types. I examined her pulse: rapid and forceful, knowing she took too many acrid-dry drugs. First gave single Zhi Zi Ren (Gardeniae Semen) Tang (Decoction), then Huang Lian Jie Du Tang (Coptis Detoxification Decoction), resulting in peace. (*Yi Yue*)
The father-in-law of the Tong Pan (Assistant Magistrate) suffered epigastric pain, unresponsive to treatments, near death. I gave him Xiong Dan (Ursi Bile) the size of a soybean mixed with water; effect was miraculous. (*Shi Shan*)
Various Warming-Middle Formulas: *Lu Yan Fang* treats Heart Pain, vexation/oppression, throbbing pulling to both breasts, stabbing pain, extreme fatigue, Gui Tang (Cinnamon Decoction).
Gui Xin (Cinnamomi Cortex) (half liang) Zhu Yu (Evodiae Fructus) (two sheng) Shao Yao (Paeoniae Radix) (three liang) Dang Gui (Angelicae Sinensis Radix) (two liang) Sheng Jiang (Zingiberis Rhizoma Recens) (half jin)
Cut the five items, decoct in twelve dou of water until four sheng remain. Take one sheng, three times daily and once at night. Effective. Without Sheng Jiang (Zingiberis Rhizoma Recens), use five liang of Gan Jiang (Zingiberis Rhizoma Secatus). (*Yi Xin*)
Zhang Wen Zhong's Shu Jiao Wan (Sichuan Pepper Pill), treating chest Qi fullness and heart pain radiating to back.
Shu Jiao (Zanthoxyli Pericarpium) (one sheng, sweating out moisture) Ban Xia (Pinelliae Rhizoma) (one sheng, washed) Fu Zi (Aconiti Lateralis Radix Praeparata) (one liang, processed)
Crush and sieve the three items, mix with honey to form pills like wu zi (Chinese parasol tree seeds). Take five pills per dose, three times daily. (*Wai Tai*)
Sheng Jiang Zhi Shi Tang (Fresh Ginger and Aurantium Decoction), for pain with abdominal distension and severe heart pain, caused by Stomach pathogen interfering with Heart, pulse slightly slow, called Wei Xin Tong (Stomach Heart Pain). Use this. (*Ji Feng*) (i.e., Gui Zhi Sheng Jiang Zhi Shi Tang (Cinnamon Twig, Fresh Ginger, and Aurantium Decoction)).
Newly Defined Gui Ling Tang (Cinnamon and Poria Decoction), for Kidney Reversal Stomach Pain.
Gui (Cinnamomi Ramulus) (one qian) Fu Ling (Poria) (three qian) Ren Shen (Ginseng Root) (one qian) Gan Cao (Glycyrrhizae Radix et Rhizoma) (five qian) Shao Yao (Paeoniae Radix) (one qian) Sheng Jiang (Zingiberis Rhizoma Recens) (five fen)
Make one dose, decoct in water, take on empty stomach. (*Jin Kui Yi*)
Cui Yunqing, eldest son of Cui Jun, Commissioner of Transport for Zhejiang and Jianghuai, aged twenty-five, originally obese, fed rich foods, occasionally had heat signs. Friends advised cold foods and medicines. In autumn of Gengchen year of Zhiyuan, malaria persisted. Doctors treated with Pi Shuang (Arsenic) etc., delivered with fresh well water, forbade hot food. Malaria persisted, added vomiting/diarrhea, spleen/stomach injured again, middle qi more deficient, abdominal pain, borborygmus, occasional epigastric pain opposite heart, unbearable suffering. Many medicine changes ineffective. Returned home in winter, myriad treatments failed. By April, due to overwork and worry, previous symptoms flared. Asked me to treat, explained history. Pulse string-taut, fine, and faint; hands/feet slightly cold; complexion green-yellow lacking luster; depressed mood, avoiding people/noise, reduced appetite, slight fullness causes epigastric oppression, vomiting acid water, paroxysmal pain, cold sweat, shortness of breath/confusion/anxiety, needing someone to sit forehead-to-forehead, changing positions frequently. I recalled *Nei Jing*: "Middle qi insufficient, urination/defecation change, intestines suffer borborygmus. Lower qi insufficient, leads to flaccidity/cold limbs and heart [distress]. Also: 'Cold qi lodging between stomach/intestines causes sudden pain, relieved by heat.' Heat means warmth; only sweet-acrid large-hot agents can cure." Thus I formulated a prescription named Fu Yang Zhu Wei Tang (Support Yang Assist Stomach Decoction).
Gan Jiang (Zingiberis Rhizoma Secatus, processed) (one and a half qian) Jian Shen (Ginseng Root, selected) Cao Dou Kou Ren (Amomi Fructus Rotundus Kernel) Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted) Guan Gui (Cinnamomi Ramulus) Bai Shao Yao (Paeoniae Radix Alba) (each one qian) Chen Pi (Citri Reticulatae Pericarpium) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Wu Zhu Yu (Evodiae Fructus) (each five fen) Hei Fu Zi (Aconiti Lateralis Radix Praeparata, processed, peeled) (two qian) Yi Zhi Ren (Alpiniae Oxyphyllae Fructus) (five fen, another version one qian)
Cut into pieces, make one dose, decoct in three zhan of water with three slices of Sheng Jiang (Zingiberis Rhizoma Recens) and two dates until one zhan remains, remove dregs, take warm before meals. After three doses, major symptoms gone, pain reduced by half. In autumn, first moxa Zhong Wan (CV12) thirty-seven moxibustions to assist Stomach Qi, then moxa Qi Hai (CV6) over one hundred moxibustions to generate primal qi and nourish all vessels. (*Bao Jian*)
Zhan Luo Tang (Cup-Falling Decoction), treating urgent heart pain.
Chen Pi (Citri Reticulatae Pericarpium) Xiang Fu Zi (Cyperi Rhizoma) Liang Jiang (Alpiniae Officinarum Rhizoma) Wu Zhu Yu (Evodiae Fructus) Shi Chang Pu (Acori Tatarinowii Rhizoma) (equal parts)
Cut into pieces, decoct one bowl of water until seven-tenths remain. Take one bowl, add three to five drops of Xi You (Sesame Oil) inside, cover with a small cup, pour medicine down and take hot. (*Zhong Miao Fang*)
Treating sudden unbearable heart pain.
Liang Jiang (Alpiniae Officinarum Rhizoma) (one liang, solid dice-sized) Ba Dou (Crotonis Fructus) (two qian, shell removed)
Stir-fry the two items until yellow, remove Ba Dou (Crotonis Fructus), grind only Liang Jiang (Alpiniae Officinarum Rhizoma) finely. Take two qian mixed with hot wine or water. (*Shi Zhai*) (Named Que Tong San (Eliminate Pain Powder) in *Ji Sheng Xu*.)
Shen Sha Yi Li Dan (Cinnabar One-Pill Elixir), treating all Jue Heart Pain, Small Intestine/Bladder pain unceasing.
Fu Zi (Aconiti Lateralis Radix Praeparata) (one liang, processed) Yu Jin (Curcumae Radix) Ju Hong (Citri Reticulatae Pericarpium Rubrum) Equal to Fu Zi (Aconiti Lateralis Radix Praeparata) stop using [Note: Text implies balancing amounts]
Grind into powder, make pills with vinegar-dough paste like Suan Zao (Ziziphi Spinosae Semen) size, coat with Zhu Sha (Cinnabaris). Take one pill per dose, men with wine, women with vinegar-water decoction. (*Xuan Ming*)
Emergency Rescue for Heart Qi Pain: *Hai Shang Fang* emergency rescue for men/women with heart pain, jaw locked, near death.
Old Scallion White (from previous year).
Take three to five roots of old scallion white, peel skin/roots/leaves, pound into paste. Open patient's mouth, use silver/copper spoon to push paste into throat, pour four liang of Xi You (Sesame Oil) to wash down the paste. Do not use less oil. Once paste enters throat, patient revives. Soon, worms/stagnation in abdomen transform into yellow water, slight diarrhea is best. Roots eliminated, never recurs. Has saved many lives. (*Rui Zhu*)
Various Descending-Qi Formulas (also moving Blood): Treating chest fullness, shortness of breath, choking, Tong Qi Tang (Qi-Opening Decoction).
Ban Xia (Pinelliae Rhizoma) (eight liang) Sheng Jiang (Zingiberis Rhizoma Recens) (six liang) Ju Pi (Citri Reticulatae Pericarpium) (three liang) Wu Zhu Yu (Evodiae Fructus) (forty pieces)
Cut the four items, decoct in eight sheng of water until three sheng remain, divide into three doses. Another version uses Gui (Cinnamomi Ramulus) two liang, no Ju Pi (Citri Reticulatae Pericarpium). (*Qian Jin*)
Treating unbearable heart pain.
Mu Xiang (Aucklandiae Radix) Peng Ze (Curcumae Rhizoma) (each one liang) Gan Qi (Drynariae Rhizoma? Note: Likely Gan Qi (Drynariae Rhizoma) or similar, text says Gan Qi (炒) - likely Gan Qi (Drynariae Rhizoma) or specific herb, context suggests resinous/hard substance, possibly Gan Qi (Drynariae Rhizoma) or Gan Qi (Resin). Given "stir-fried", likely Gan Qi (Drynariae Rhizoma) or similar. Actually, "Gan Qi" here likely refers to Gan Qi (Drynariae Rhizoma) or potentially a typo for something else, but standard translation keeps name. Wait, "Gan Qi" (干漆) is Dried Lacquer Resin. Yes, Gan Qi (Dried Lacquer Resin).) (one fen, stir-fried)
Make into powder. Take one qian per dose, mix with hot vinegar-water, stops immediately upon entry. (*Zhong Zang*)
Treating Xiong Bi (Chest Bi), She Xiang San (Musk Powder).
She Xiang (Moschi Feratum) (ground, one liang) Niu Huang (Bovis Calculus) (ground, half liang) Xi Jiao (Rhino Horn) (shaved, one fen)
Crush and grind the three items into powder. Take two qian bi per dose, mix with warm wine, take on empty stomach, noon, and bedtime. (*Sheng Ji*)
Treating unbearable heart pain, Jiang Huang San (Turmeric Powder).