论曰。诸心痛者。皆少阴厥气上冲也。有热厥心痛者。身热足寒。痛甚则烦躁而吐。额自汗出。知为热也。
其脉洪大。当灸太溪及昆仑。谓表里俱泻之。是谓热病汗不出。引热下行。表汗通身而出者。愈也。灸毕服金
铃子散。痛止服枳术丸。去其余邪也。有大实心中痛者。因食受时气。卒然发痛。大便或秘。久而滞闷。心胸
高起。按之愈痛。不能饮食。急以煮黄丸利之。利后以 本汤去其余邪。有寒厥心痛者。手足逆而通身冷汗出。
便利溺清。或大便利而不渴。气微力弱。急以术附汤温之。寒厥暴痛。非久病也。朝发暮死。当急救之。是知
久痛无寒。而暴痛非热。
治热厥心痛。或发或止。久不愈者。当用金铃子散。
金铃子 玄胡（各一两）
上为细末。每服三钱。酒调下。
大实心痛。煮黄丸。
雄黄（一两研） 巴豆（五钱去皮生用研细入雄黄末）
上再研二味。白面二两同和。再研匀。滴水丸如桐子大。每服时。先煎浆水令沸。下药二十四丸。煮一二十
沸。涝入冷浆水沉冷。一时服二丸。一日二十四丸，加至微利为度。用浸药水送下。此治胁下 癖痛如神。
治大实心痛。大便已利。宜 本汤。彻其毒也。
本（半两） 苍术（一两）
上为粗末。每服一两。水二盏。煎至一盏。温服清。
治寒厥暴痛。脉微气弱。宜术附汤。
附子（一两炮去皮脐细切一两） 白术（四两） 甘草（二两炙）
上为粗末。入附子令匀。每服三钱。水一大盏半。入生姜五
片。枣一枚劈破。同煎至一盏。去滓温服食前。
此药又治风湿相搏。身重疼烦。不能转侧。不呕不渴。大便坚硬。小便自利。及风虚头目眩重者。不知食
味。暖肌补中。助阳气。止自汗。
治男子妇人心经中热。搐如痫病状。宜服妙香丸。
风痫者。煎羌活为引。下妙香丸。血痫当归汤引下。
刺心痛诸穴于后。
真心痛。手足青至节。痛甚。旦发夕死。夕发旦死。
心痛腹胀。啬啬然。大便不利。取足太阴。
心痛引腰脊欲呕。取刺足少阴。
心痛引小腹满。上下无常处。便溺难。刺足厥阴。
心痛短气。刺手太阴。
心痛。当九穴刺之立已。不已上下求之。得之则已。
按经三法
心痛与背相接。善恐。如从后触其心。伛偻者。肾心痛也。先刺京骨昆仑。不已刺合谷。
心痛腹胀胸满。心尤痛者。胃心痛也。刺大都太白二穴。
心痛如锥刺。乃脾心痛也。刺然谷太溪。
心痛苍然如死状。终日不得休息。乃肝心痛。取行间太冲。
心痛卧若徒居。心痛间动作益痛甚者。其色不变。此肺心痛也。刺鱼际太渊。宣通气行。无所凝滞。则病
愈也。
太溪穴足少阴肾经土也。为 。在足内踝后跟骨上脉动陷中。可灸三壮或五七壮。此泻热厥心痛。
昆仑足太阳膀胱经火也。在足外踝后跟骨上陷中。可灸三壮。或五七壮。亦可泻热厥心痛。
It is stated that all types of heart pain are caused by the counterflow qi of the Shaoyin (Lesser Yin) channel rushing upward. Among them, there is Heart Pain due to Heat-Jue (Cold extremities with internal heat), characterized by a hot body and cold feet. When the pain is severe, it causes irritability and vomiting, with spontaneous sweating on the forehead, indicating a heat syndrome. The pulse is flooding and large. One should moxa Taixi (KI3) and Kunlun (BL60) points, which constitutes draining both the interior and exterior. This applies to heat diseases where sweat does not occur; by guiding the heat downward, allowing sweat to emerge from the whole body, the patient recovers. After moxibustion, administer Jinlingzi San (Corydalis and Melia Pills). Once the pain stops, take Zhizhu Wan (Immature Bitter Orange and Atractylodes Macrocephala Pills) to eliminate residual pathogenic factors. There is also Great Excess Heart Pain, caused by food stagnation combined with seasonal pathogens, suddenly erupting in pain. The stool may be constipated, leading to prolonged stagnation and fullness, with the chest and epigastrium protruding, pain worsening upon pressure, and inability to eat. Urgently use Zhu Huang Wan (Boiled Yellow Pill) to promote purgation. After purgation, use Cangzhu Tang (Atractylodes Decoction) to clear residual pathogens. There is Heart Pain due to Cold-Jue (Cold extremities with internal cold), characterized by inverted coldness of the hands and feet, profuse cold sweating over the whole body, clear urine and loose stools, or free bowel movements without thirst, with faint qi and weak strength. Urgently use Shu Fu Tang (Atractylodes and Prepared Aconite Decoction) to warm the body. Sudden pain due to Cold-Jue is not a chronic disease; onset in the morning leads to death by evening, requiring emergency rescue. Thus, it is known that chronic pain rarely involves cold, while sudden pain is rarely due to heat.
For treating Heart Pain due to Heat-Jue, if attacks come and go and persist for a long time without healing, Jinlingzi San should be used.
Jinlingzi (Fructus Meliae Toosendan) and Xuanhu (Rhizoma Corydalidis) (each 1 liang).
Grind into fine powder. Take 3 qian each time, mixed with wine.
For Great Excess Heart Pain, use Zhu Huang Wan.
Xionghuang (Realgar) (1 liang, ground); Badou (Fructus Crotonis Tiglii) (5 qian, peeled, raw, ground finely and mixed with Realgar powder).
Grind these two ingredients again until uniform. Mix with 2 liang of white flour, grind evenly, add water drop by drop to make pills the size of paulownia seeds. When taking the medicine, first boil Jiangshui (fermented rice water) until boiling, add 24 pills, boil for 10-20 times, remove and sink in cold Jiangshui to cool. Take 2 pills at one time. Daily dose is 24 pills, increase until slight diarrhea is achieved. Administer with the water in which the pills were soaked. This treats pain from hypochondriac masses effectively.
For Great Excess Heart Pain after bowel movement has been promoted, Cangzhu Tang (Atractylodes Decoction) is suitable to clear the toxicity.
Cangzhu (Rhizoma Atractylodis Lancae) (half liang); Baizhu (Rhizoma Atractylodis Macrocephalae) (1 liang).
Grind into coarse powder. Take 1 liang each time, add 2 zhan of water, decoct to 1 zhan, take the clear liquid warm.
For sudden pain due to Cold-Jue with faint pulse and weak qi, Shu Fu Tang (Atractylodes and Prepared Aconite Decoction) is suitable.
Fuzi (Radix Aconiti Lateralis Preparata) (1 liang, processed, peeled, navel removed, cut finely); Baizhu (Rhizoma Atractylodis Macrocephalae) (4 liang); Gancao (Radix Glycyrrhizae Preparata) (2 liang, honey-fried).
Grind into coarse powder, mix Fuzi evenly. Take 3 qian each time, add 1.5 zhan of water, 5 slices of fresh ginger, and 1 jujube split open. Decoct to 1 zhan, strain, and take warm before meals.
This medicine also treats wind-dampness intermingling, causing heavy and painful body, inability to turn, no vomiting or thirst, hard stool, free urination, as well as dizziness and heaviness of head and eyes due to wind-deficiency, loss of taste, warming muscles, tonifying the middle, assisting yang qi, and stopping spontaneous sweating.
For men and women with heat in the Heart channel, convulsions resembling epilepsy, Miaoxiang Wan (Wonderful Incense Pills) is suitable.
For Wind-Epilepsy, use Qianghuo Decoction as a guide to administer Miaoxiang Wan. For Blood-Epilepsy, use Danggui Tang (Angelica Decoction) as a guide.
Acupuncture points for treating heart pain are listed below:
True Heart Pain: Hands and feet turn blue up to the joints, severe pain, death if onset in morning occurs in evening, death if onset in evening occurs in morning.
Heart pain with abdominal distension, aversion to cold, and difficulty in defecation: Select points from the Foot-Taiyin Spleen Channel.
Heart pain radiating to the lower back and spine, desire to vomit: Puncture points from the Foot-Shaoyin Kidney Channel.
Heart pain radiating to the lower abdomen with fullness, moving up and down without fixed location, difficulty in urination and defecation: Puncture points from the Foot-Jueyin Liver Channel.
Heart pain with shortness of breath: Puncture points from the Hand-Taiyin Lung Channel.
For heart pain, puncture nine specific points for immediate relief. If not relieved, search above and below; once the correct point is found, the condition resolves.
According to the meridians, three methods are described:
Heart pain connecting to the back, fearfulness, sensation of being touched from behind, stooping posture: Kidney Heart Pain. First puncture Jinggu (BL64) and Kunlun (BL60). If not relieved, puncture Hegu (LI4).
Heart pain with abdominal distension, chest fullness, especially severe heart pain: Stomach Heart Pain. Puncture Dadu (SP2) and Taibai (SP3).
Heart pain like a needle prick: Spleen Heart Pain. Puncture Rangu (KI2) and Taixi (KI3).
Heart pain with pale complexion resembling death, unable to rest all day: Liver Heart Pain. Select Xingjian (LR2) and Taichong (LR3).
Heart pain relieved when lying still but worsened by movement, unchanged complexion: Lung Heart Pain. Puncture Yuji (LU10) and Taiyuan (LU9). Promote qi circulation so there is no stagnation, then the disease heals.
Taixi (KI3) belongs to the Earth point of the Foot-Shaoyin Kidney Channel, specifically the Shu-Stream point. Located in the depression anterior to the medial malleolus, where the posterior tibial artery pulses. Moxa 3 zhuang or 5-7 zhuang. This point drains Heart Pain due to Heat-Jue.
Kunlun (BL60) belongs to the Fire point of the Foot-Taiyang Bladder Channel. Located in the depression between the lateral malleolus and the Achilles tendon. Moxa 3 zhuang or 5-7 zhuang. This point can also drain Heart Pain due to Heat-Jue.