秦子曰∶胃脘痛，在胸之下，脐之上，两肋中间；但心胞络痛，同在心下脐上，极难分
别。大抵痛而能饮食者，心胞络痛也。痛而不能饮食者，胃脘痛也。二经之痛，俗名心头痛
，此症内伤者多，外感者间或有之。今列外感二条，内伤七条，即古名九种心疼也。
（风寒、暑热）
【外感胃脘痛之症】向无此症，偶值时令暴寒，心下闷痛，恶寒厥冷，二便清利，口
吐冷沫，此寒邪入胃，凝结痰饮食积，卒然暴痛之症也。若时令暴热，心下忽绞痛，手足虽冷，
头额多汗，身虽恶寒，口燥舌干，大便虽泻，溺色黄赤，此湿热所伤之症也。
【外感胃脘痛之因】其人中气向寒，偶触时令之寒，则寒凝胃口而痛。若内有积热
，外遇湿热，两热蒸酿，则热壅胃口，亦成胃痛之症。
【外感胃脘痛之脉】或见浮紧，寒邪在表。或见沉弦，寒邪入里。或见浮数，表有热
邪。或见沉数，里有热结。
【外感胃脘痛之治】宜分寒热二条。寒痛者，先用五积散，兼散外寒；后用温胃汤，
以温内寒。热痛者，先用神术平胃散，以清外热，后用清中汤，以清里热。言寒则风亦在焉，言
热则暑湿燥火皆在焉。
五积散
白茯苓 陈皮 半夏 甘草 川芎 白芷 枳壳 浓朴 苍术 麻黄 干姜 肉桂 桔
温胃汤
浓朴 砂仁 甘草 陈皮 干姜 白豆蔻 黄 人参 姜黄 益智仁
神术平胃散
苍术 防风 甘草 石膏 知母 浓朴 广皮
清中汤
黄连 山栀 草豆蔻 半夏 陈皮 白茯苓 甘草
Qin Zi said: Stomach epigastrium pain is located below the chest, above the umbilicus, and between the two hypochondria. However, pericardium collateral pain also occurs below the heart and above the umbilicus, making it extremely difficult to distinguish. Generally speaking, if there is pain but the patient can eat, it is pericardium collateral pain; if there is pain and the patient cannot eat, it is stomach epigastrium pain. The pain of these two meridians is commonly known as "heart-headache." This condition is mostly caused by internal injury, with external contraction occurring occasionally. Here, two types of external contraction and seven types of internal injury are listed, which correspond to the ancient name for nine types of heart pain.
(Wind-Cold, Summer-Heat/Heat)
[Symptoms of External Contraction Stomach Epigastrium Pain] Previously, this condition was not recognized. Occasionally, due to sudden cold weather, one may experience stifling pain in the epigastrium, aversion to cold, cold extremities, clear and profuse urination and defecation, and vomiting of cold saliva. This is a condition where Cold Evil invades the Stomach, congealing Phlegm-Fluids and Food Retention, causing sudden severe pain. If, on the other hand, sudden heat occurs due to the season, one may experience sudden stabbing pain in the epigastrium. Although the hands and feet are cold, there is much sweating on the forehead. Although the body feels an aversion to cold, the mouth is dry and the tongue is parched. Although there is diarrhea, the urine is yellow and red. This is a condition injured by Damp-Heat.
[Etiology of External Contraction Stomach Epigastrium Pain] If a person's Middle Qi has always been deficient and cold, and they accidentally encounter seasonal Cold, then Cold stagnates at the Stomach opening, causing pain. If there is accumulated Heat inside and Damp-Heat outside, the two heats steam and brew each other, causing Heat to obstruct the Stomach opening, thereby forming a Stomach pain condition.
[Pulse of External Contraction Stomach Epigastrium Pain] A Floating-Tight pulse may be seen, indicating Cold Evil in the Exterior. A Deep-Wiry pulse may be seen, indicating Cold Evil entering the Interior. A Floating-Rapid pulse may be seen, indicating Heat Evil in the Exterior. A Deep-Rapid pulse may be seen, indicating Heat accumulation in the Interior.
[Treatment of External Contraction Stomach Epigastrium Pain] Treatment should be divided into Cold and Heat categories. For Cold pain, first use Wuji San (Five Accumulations Decoction) to disperse external Cold; subsequently use Wenwei Tang (Stomach-Warming Decoction) to warm internal Cold. For Heat pain, first use Shenzhu Pingwei San (Shen-Zhu Spleen-Ping Decoction) to clear external Heat; subsequently use Qingzhong Tang (Middle-Clearing Decoction) to clear internal Heat. When mentioning Cold, Wind is also included; when mentioning Heat, Summer-Heat, Dampness, Dryness, and Fire are all included.
Wuji San (Five Accumulations Decoction)
Poria Cocos (Fuling, 茯苓), Tangerine Peel (Chenpi, 陈皮), Pinellia Tuber (Banxia, 半夏), Licorice Root (Gancao, 甘草), Ligusticum Rhizome (Chuanxiong, 川芎), Angelica Dahurica Root (Baizhi, 白芷), Bitter Orange (Zhike, 枳壳), Magnolia Bark (Houpo, 厚朴), Atractylodes Macrocephala Rhizome (Cangzhu, 苍术), Ephedra Stem (Mahuang, 麻黄), Ginger Rhizome (Ganjiang, 干姜), Cinnamon Twig (Rougui, 肉桂), Platycodon Root (Jiegeng, 桔梗).
Wenwei Tang (Stomach-Warming Decoction)
Magnolia Bark (Houpo, 厚朴), Amomum Fruit (Sharen, 砂仁), Licorice Root (Gancao, 甘草), Tangerine Peel (Chenpi, 陈皮), Ginger Rhizome (Ganjiang, 干姜), Cardamom Seed (Baidoukou, 白豆蔻), Astragalus Root (Huangqi, 黄芪), Ginseng Root (Renshen, 人参), Turmeric Rhizome (Jianghuang, 姜黄), Alpinia Oxyphylla Fruit (Yizhiren, 益智仁).
Shenzhu Pingwei San (Shen-Zhu Spleen-Ping Decoction)
Atractylodes Macrocephala Rhizome (Cangzhu, 苍术), Saposhnikovia Root (Fangfeng, 防风), Licorice Root (Gancao, 甘草), Gypsum Fibrosum (Shigao, 石膏), Anemarrhena Rhizome (Zhimu, 知母), Magnolia Bark (Houpo, 厚朴), Tangerine Peel (Guangpi, 广皮).
Qingzhong Tang (Middle-Clearing Decoction)
Coptis Rhizome (Huanglian, 黄连), Gardenia Fruit (Shanzhi, 山栀), Areca Seed (Caodoukou, 草豆蔻), Pinellia Tuber (Banxia, 半夏), Tangerine Peel (Chenpi, 陈皮), Poria Cocos (Fuling, 茯苓), Licorice Root (Gancao, 甘草).