经曰∶寒气客于背俞之脉则血脉泣，脉泣则血虚，血虚则痛。其俞注于心，故相引而痛。按
之则热气至，热气至则痛止矣。若背胀而痛，捶打稍愈者，乃痰滞气凝，故捶散而行之少愈。背
痛连腰脊者，皆属太阳经之风寒也。脉有促而急者，有弦紧者，左候左，右候右。肩背痛，治当
散风泻火行气（左属血与风，右属气与痰）。
主方 羌活 独活（各一钱） 本 防风 甘草（各五分） 川芎 荆芥（各三分）
姜一片 葱一茎 水煎服。火加酒连；虚加人参。
苍术复煎散 风湿合作，脑后痛，恶寒。颈项、肩脊、筋骨强痛，腿膝酸痛。
苍术 羌活（各一钱） 白术 泽泻 升麻 柴胡 本 黄柏 红花（各五分）
另煎苍术汁二钟，煎众药，再煎如前。
乌药顺气散 治肩背痛（方见中风）。
凡周身、腿膝、臂膊等处痛甚者，用绵絮包暖，以火烘令极热，微汗出痛可止。或以姜葱汤
淋洗；或用姜葱熨法（法见伤寒）内以乳香研细，充热酒服尤佳。
（附∶膻中痛）
经曰∶真心痛者，寒邪伤其君主。手足甲青至节，甚则旦发夕死。厥心痛者，乃寒邪客于心
胞络也。盖诸心痛证，皆少阴、厥阴之气上冲也。有热厥心痛者，身热足寒，痛甚则烦躁而吐，
额上汗出，脉浮洪大。有火实心痛者，因气而食，卒然发痛，大便燥秘，小便短赤，久则注闷，
心胸高起，口渴思冷冻饮料，按之愈痛，时作时止，不能饮食，多属久病，急宜下之，服宁痛汤。有
寒厥心痛者，手足厥逆，身冷汗出，便溺清长，大便利而不渴，气微力弱，急宜温之，服术附汤（
方见寒门）。凡寒痛者，绵绵无增减，喜手按，近温暖，饮热姜汤则痛少安，多属新感。有恚怒
忧郁，饮食劳役；或生冷浓味，不能消散，结而为积，遇食还发，名积心痛。及其脏寒吐蛔，亦
致心痛。谓九种者，曰∶饮、食、风、冷、热、悸、虫、
注，曰去来痛是也。世之心痛，皆胃脘痛。胃受病不营运，虽多日不食，亦不死。痛初止便食，
必复痛甚，脉短而数，痛甚则伏。沉细而迟者生，浮大弦长者死。病患喜热汤暖气，宜热药；如
口渴喜冷冻饮料，宜凉药。
主方 苍术 陈皮 香附 抚芎 玄胡索 五灵脂（各一钱） 甘草（五分） 草蔻（十
粒，研细）水煎服。
伤肉食加山楂；面食，神曲；谷味，麦芽，水果，草果。有块加三棱、蓬术。如吃热姜汤、
炒盐熨痛减加良姜、干姜（炮）、官桂、藿香、木香、砂仁。
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。必以大便通利方止。经曰∶痛随利
减，胀以利宽。
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。未通去木香、甘草，倍大黄，以大便通为度。实人或再加黄芩、赤芍药、金铃子
、没药、草果、荔枝核（烧焦）滑石之类。煎成入芒硝一钱。
枳实大黄汤 治大痛，大便不通，口渴等证。
枳实 大黄 槟榔 浓朴（各二钱） 木香（另研，五分）水煎温服。
加味七气汤 治七情或风湿致痛。
半夏（制，一钱五分） 肉桂 玄胡（各一钱二分） 人参 乳香（各五分） 甘草（三
分） 加姜一片，枣一枚，水煎服。
落盏汤 治急心痛。
陈皮 香附 良姜 吴茱萸 石菖蒲（各一钱）煎成，先以香油五点入盏内，调匀服。
却痛散 治冷痛。
川乌（炮，二钱） 肉桂 石菖蒲 当归 木香 胡椒（各钱半） 灵脂 蒲黄（各一钱）
水煎，入盐、醋少许服。
行血定痛丸 治素喜食热物，死血留于胃痛。
玄胡（两半） 滑石 红花 官桂 红曲（各五钱） 桃仁（三十粒）
上为末，蒸饼糊丸绿豆大，每服四十丸，姜汤下。
白术半夏丸 治气血、痰热心痛。
白术（五钱） 半夏 砂仁 白芍 当归（各三钱） 桃仁 黄连 神曲（炒） 陈皮（各
二钱） 吴茱萸（钱半） 僵蚕 甘草（各一钱）
上为末，蒸饼糊和丸绿豆大，每服五十丸，姜汤下。
术附汤 寒痛，客忤、尸注，苏合香丸（二方并见中寒）。
简便方 （治心痛） 栀子（炒黑） 干姜（炒焦） 等分为末，水法丸绿豆大，白汤下
。
又方（治火痛） 栀子（炒焦） 煎服；或为末，姜汤调粥糊丸，白汤下。（加草蔻亦可）。
又方（治热痛）栀子、川芎煎服。或栀子合二陈汤加苍术服。凡服栀子药愈后复发者，仍用
栀子不效，另入玄明粉一钱，或芒硝服。
又 热痛，大便不通，服三花神佑丸（方见痰门）。
又方（治冷痛）良姜、官桂各一钱为末，汤下。
又 玄胡索、胡椒各一钱为末，温酒下。
又方（治妇人血刺痛） 玄胡索为末，每服二钱，酒汤任下。或桃仁去皮尖，研如泥，饭丸
服。
又方（治虫痛） 面上白斑唇红，痛后能食，上半月头向上易治。先用肉汁或蜜引虫头向上
，服取虫丸、安虫散（方见虫门）。
又 楝树根皮煎服，加乌梅、川椒尤好。
又 白熟艾一碗，水三碗煎服，有虫吐出。
诸心痛∶玄胡索（一两，） 炙草（二钱）水煎分三服。或明矾、石榴皮末各五分，白汤下。
又 灶心土末一钱（冷痛酒下。热痛水调）。
又 东引桃枝，酒煎服。
又 槟榔二钱、陈皮一两为末，每二钱蜜汤送下。
又 桃仁七枚，研水调服。
又 嫩槐枝，水煎服。
又 萱草根一寸，醋磨服。
又 枯矾，蜜调服。
又 久痛，小蒜醋煮顿服。
The classics state: When cold qi invades the meridians of the back shu points, the blood vessels become stagnant. Stagnation of the blood vessels leads to blood deficiency, and blood deficiency causes pain. The shu points connect to the heart, thus causing mutual traction and pain. Pressing the area brings heat to the site; once heat arrives, the pain stops. If the back is distended and painful, and beating it provides slight relief, this is due to phlegm stagnation and qi condensation, so beating disperses the qi and provides slight relief. Back pain radiating to the waist and spine belongs to wind-cold of the Taiyang meridian. The pulse may be rapid and urgent, or wiry and tight. The left pulse diagnoses the left side, and the right pulse diagnoses the right side. For shoulder and back pain, treatment should involve dispelling wind, draining fire, and moving qi (the left side relates to blood and wind, the right side relates to qi and phlegm).
Main Formula: Qianghuo (Notopterygii Rhizoma et Radix) and Duhuo (Angelicae Pubescentis Radix) (1 qian each), Gaoben (Ligustici Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (5 fen each), Chuanxiong (Ligustici Chuanxiong Rhizoma), Jingjie (Schizonepetae Spica) (3 fen each), one slice of Shengjiang (Zingiberis Rhizoma Recens), one stem of Congbai (Allii Fistulosi Bulbus). Decoct in water and take orally. For fire patterns, add Jiuhuanglian (Coptidis Rhizoma fried with wine); for deficiency patterns, add Renshen (Ginseng Radix).
Cangzhu Fujian San (Atractylodis Macrocephalae Decoction): Indicated for posterior head pain and aversion to cold caused by the combination of wind-dampness. Symptoms include stiffness and pain in the neck, shoulders, spine, sinews, and bones, as well as soreness and pain in the legs and knees.
Ingredients: Cangzhu (Atractylodis Macrocephalae Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix) (1 qian each); Baizhu (Atractylodis Macrocephalae Rhizoma), Zexie (Alismatis Rhizoma), Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Gaoben (Ligustici Rhizoma et Radix), Huangbo (Phellodendri Cortex), Honghua (Carthami Flos) (5 fen each).
Usage: Decoct Cangzhu separately to obtain two zhong of liquid. Use this liquid to decoct the other herbs, then decoct again as previously described.
Wuyao Shunqi San (Litseae Fructus Decoction): Treats shoulder and back pain (see Stroke chapter for formula).
For severe pain anywhere in the body, including legs, knees, and arms, wrap the area with cotton wadding to keep warm, apply intense heat from a fire source until slightly sweating occurs, which can stop the pain. Alternatively, wash with Jiangcong Tang (Ginger and Scallion Decoction); or use the Jiangcong ironing method (see Cold Damage chapter) combined with taking finely ground Rushxiang (Frankincense) mixed with hot wine for better efficacy.
(Attachment: Pain in the Danzhong region)
The classics state: Zhenxintong (True Heart Pain) occurs when cold evil injures the Heart Monarch. Symptoms include cyanosis of the fingernails and toenails extending to the joints; if severe, death may occur from morning to evening. Jue Xintong (Jue Heart Pain) occurs when cold evil lodges in the Pericardium collateral. Generally, all heart pain syndromes are caused by the upward rushing of Qi from the Shaoyin and Jueyin meridians. In Rejue Xintong (Heat-Jue Heart Pain), the body is hot but the feet are cold; severe pain causes irritability and vomiting, sweating on the forehead, and a floating, large, and forceful pulse. In Huoshi Xintong (Fire-Excess Heart Pain), sudden pain arises from Qi stagnation and food retention; there is dry constipation and scanty dark urine. Over time, chest oppression occurs, the chest rises, thirst for cold drinks is present, pressing worsens the pain, pain comes and goes, and eating is impossible. This often belongs to chronic illness and requires purging; administer Ningtong Tang (Calming Pain Decoction). In Hanjue Xintong (Cold-Jue Heart Pain), there is cold extremities, cold sweat, clear and profuse urination and defecation, free bowel movements without thirst, weak breath and energy. This urgently requires warming; administer Zhufu Tang (Aconite and Atractylodes Decoction) (see Cold Door chapter). Cold pain is continuous without fluctuation, relieved by pressure and warmth, and slightly eased by drinking hot ginger tea; this usually indicates a recent cold invasion. Anger, depression, dietary overwork, or inability to digest raw/cold and rich foods can lead to accumulation, causing pain upon eating, known as Ji Xintong (Accumulation Heart Pain). Cold viscera causing vomiting of roundworms also causes heart pain. The nine types of heart pain refer to Yin (Fluid), Shi (Food), Feng (Wind), Leng (Cold), Re (Heat), Ji (Palpitation), Chong (Parasite), Zhu (Infection/Transmission), and Laiqu Tong (Coming-and-Going Pain). Modern "heart pain" is mostly actually Weiwantong (Epigastric Pain). When the stomach is diseased and fails to transport, death does not occur even after days of fasting. Eating immediately after pain subsides will cause severe recurrence; the pulse becomes short and rapid, or deep and hidden during severe pain. A deep, thin, and slow pulse indicates survival; a floating, large, wiry, and long pulse indicates death. Patients preferring hot soup and belching should use hot medicines; those with thirst preferring cold drinks should use cool medicines.
Main Formula: Cangzhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Xiangfu (Cyperi Rhizoma), Fuxiong (Ligustici Chuanxiong Rhizoma), Yuanhusuo (Corydalis Rhizoma), Wulingzhi (Trogopterori Faeces) (1 qian each), Gancao (Glycyrrhizae Radix et Rhizoma) (5 fen), Cao Kou (Amomi Fructus Rotundus) (10 grains, finely ground). Decoct in water and take orally.
For meat injury, add Shanzha (Crataegi Fructus); for flour injury, add Shenqu (Massa Medicata Fermentata); for grain injury, add Maiya (Hordei Fructus Germinatus); for fruit injury, add Caoguo (Tsaoko Fructus). For masses, add Sanleng (Sparganii Rhizoma) and Pengze (Curcumae Rhizoma). If pain is reduced by hot ginger tea or fried salt ironing, add Liangjiang (Alpiniae Officinarum Rhizoma), Ganjiang (Zingiberis Rhizoma, processed), Guangui (Cinnamomi Cortex), Huoxiang (Pogostemonis Herba), Muxiang (Aucklandiae Radix), Sharen (Amomi Fructus).
Qinghuo Ningtong Tang (Clearing Fire Calming Pain Decoction): Treats unbearable epigastric/cardiac pain, thirst, constipation, sudden severe pain or temporary cessation, sensation of blockage rising in the chest/diaphragm, and worsening pain upon pressure. This is caused by fire generated from anger and depression, common in women. Pain must cease only after bowel movement. The classics state: Pain decreases with benefit (bowel movement), distension widens with benefit.
Ingredients: Zhizi (Gardeniae Fructus, fried with ginger, 3 qian), Huanglian (Coptidis Rhizoma, fried with Evodia juice), Zhishi (Aurantii Fructus), Houpo (Magnoliae Officinalis Cortex), Binglang (Arecae Semen) (2 qian each), Wulingzhi (Trogopterori Faeces), Pengze (Curcumae Rhizoma), Yuanhusuo (Corydalis Rhizoma), Dahuang (Rhei Radix et Rhizoma) (1 qian each), Muxiang (Aucklandiae Radix, separately ground, 5 fen), Gancao (Glycyrrhizae Radix et Rhizoma) (3 fen).
Usage: Decoct in water. If not unblocked, remove Muxiang and Gancao, double Dahuang, and continue until stool is passed. For robust individuals, add Huangqin (Scutellariae Radix), Chishao (Paeoniae Radix Rubra), Jinlingzi (Meliae Fructus), Moyao (Myrrha), Caoguo (Tsaoko Fructus), Lizhihe (Litchi Seed, charred), Huashi (Talcum), etc. Add Mangxiao (Natrii Sulfas, 1 qian) after decoction.
Zhishi Dahuang Tang (Immature Bitter Orange and Rhubarb Decoction): Treats severe pain, constipation, and thirst.
Ingredients: Zhishi (Aurantii Fructus), Dahuang (Rhei Radix et Rhizoma), Binglang (Arecae Semen), Houpo (Magnoliae Officinalis Cortex) (2 qian each), Muxiang (Aucklandiae Radix, separately ground, 5 fen).
Usage: Decoct in water and take warm.
Jiawei Qiqi Tang (Modified Seven Qi Decoction): Treats pain caused by seven emotions or wind-dampness.
Ingredients: Banxia (Pinelliae Rhizoma, processed, 1.5 qian), Rougui (Cinnamomi Cortex), Xuanhu (Corydalis Rhizoma) (1.2 qian each), Renshen (Ginseng Radix), Rushxiang (Frankincense) (5 fen each), Gancao (Glycyrrhizae Radix et Rhizoma) (3 fen). Add one slice of Shengjiang (Zingiberis Rhizoma Recens) and one date (Jujubae Fructus). Decoct in water and take orally.
Luozhan Tang (Falling Cup Decoction): Treats acute heart pain.
Ingredients: Chenpi (Citri Reticulatae Pericarpium), Xiangfu (Cyperi Rhizoma), Liangjiang (Alpiniae Officinarum Rhizoma), Wuzhuyu (Evodiae Fructus), Shichangpu (Acori Tatarinowii Rhizoma) (1 qian each). After decoction, add five drops of sesame oil to a cup, mix well, and take.
quetong San (Pain-Relieving Powder): Treats cold pain.
Ingredients: Chuanwu (Aconiti Radix, processed, 2 qian), Rougui (Cinnamomi Cortex), Shichangpu (Acori Tatarinowii Rhizoma), Danggui (Angelicae Sinensis Radix), Muxiang (Aucklandiae Radix), Hujiao (Piperis Longi Fructus) (1.5 qian each), Lingzhi (Trogopterori Faeces), Puhuang (Typhae Pollen) (1 qian each).
Usage: Decoct in water, add a little salt and vinegar, and take.
Xingxue Dingtong Wan (Blood-Moving Pain-Calming Pill): Treats gastric pain caused by stasis from habitual consumption of hot foods.
Ingredients: Xuanhu (Corydalis Rhizoma, 1.5 liang), Huashi (Talcum), Honghua (Carthami Flos), Guangui (Cinnamomi Cortex), Hongqu (Red Yeast Rice) (5 qian each), Taoren (Persicae Semen) (30 grains).
Usage: Grind into powder, make pills with steamed cake paste, size of mung beans. Take 40 pills per dose with ginger tea.
Baizhu Banxia Wan (Atractylodes and Pinellia Pill): Treats heart pain due to Qi/blood and phlegm-fire.
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma, 5 qian), Banxia (Pinelliae Rhizoma), Sharen (Amomi Fructus), Baishao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix) (3 qian each), Taoren (Persicae Semen), Huanglian (Coptidis Rhizoma), Shenqu (Massa Medicata Fermentata, fried), Chenpi (Citri Reticulatae Pericarpium) (2 qian each), Wuzhuyu (Evodiae Fructus, 1.5 qian), Jiangcan (Bombyx Batryticatus), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian each).
Usage: Grind into powder, make pills with steamed cake paste, size of mung beans. Take 50 pills per dose with ginger tea.
Zhufu Tang (Aconite and Atractylodes Decoction): Treats cold pain, Ke Wu (External Evil Invasion), Shi Zhu (Corpse Transmission). (See Zhonghan chapter for formulas). Suhe Xiang Wan (Styrax Pill).
Simple Formula (for Heart Pain): Zhizi (Gardeniae Fructus, charred black), Ganjiang (Zingiberis Rhizoma, charred), equal parts ground to powder. Make pills with water, size of mung beans. Take with plain water.
Another Formula (for Fire Pain): Zhizi (Gardeniae Frizta, charred), decoct and take; or grind to powder, mix with ginger tea and rice paste to make pills, take with plain water. (Caoguo may be added).
Another Formula (for Heat Pain): Zhizi (Gardeniae Fructus) and Chuanxiong (Ligustici Chuanxiong Rhizoma) decocted and taken. Or Zhizi combined with Erchen Tang (Two-Cured Decoction) plus Cangzhu. If recurrence occurs after Zhizi treatment fails, add Xuánmíngfěn (Mirabilite) 1 qian or Mangxiao (Natrii Sulfas).
Also: For heat pain with constipation, take Sanhua Shenyao Wan (Three-Flower Divine Protection Pill) (see Phlegm Door chapter).
Another Formula (for Cold Pain): Liangjiang (Alpiniae Officinarum Rhizoma) and Guangui (Cinnamomi Cortex) 1 qian each, ground to powder, take with water.
Also: Yuanhusuo (Corydalis Rhizoma) and Hujiao (Piperis Longi Fructus) 1 qian each, ground to powder, take with warm wine.
Another Formula (for Women's Blood-Stabbing Pain): Yuanhusuo (Corydalis Rhizoma) ground to powder, 2 qian per dose, take with wine/water at will. Or Taoren (Persicae Semen) peeled and ground to paste, made into rice pills.
Another Formula (for Parasite Pain): White spots on face, red lips, ability to eat after pain, easier to treat in the first half of the lunar month when the worm head faces up. First use meat broth or honey to guide the worm head up, then take Quchong Wan (Expel Parasite Pill) or Anchong San (Settle Parasite Powder) (see Parasite Door chapter).
Also: Decoct root bark of Linden tree (Lianshu Genpi), adding Wumei (Mume Fructus) and Chuanjiao (Szechwan Pepper) is better.
Also: Boil one bowl of Bai Shu Ai (White Matured Mugwort Herb) with three bowls of water; parasites will be vomited out.
Various Heart Pains: Yuanhusuo (Corydalis Rhizoma, 1 liang), Zhi Cao (Prepared Licorice, 2 qian). Decoct in water, divide into three doses. Or Mingfan (Alumen) and Shiliupi (Pomegranate Peel) powder, 5 fen each, take with plain water.
Also: Zaoxintu Mo (Calcined Hearth Earth Powder) 1 qian (take with wine for cold pain, with water for heat pain).
Also: East-facing Peach Branch (Dongyin Taozhi), decoct in wine.
Also: Binglang (Arecae Semen) 2 qian, Chenpi (Citri Reticulatae Pericarpium) 1 liang, ground to powder, take 2 qian with honey water.
Also: Taoren (Persicae Semen) 7 grains, ground and taken with water.
Also: Nen Huai Zhi (Young Locust Branch), decoct in water.
Also: Xuanshen Gen (Veratrum Root) 1 cun, ground with vinegar.
Also: Kufan (Calcined Alum), mixed with honey.
Also: For chronic pain, boil Xiao Suan (Small Allium) in vinegar and take in one dose.