【因】 痰饮随气上，伏留于阳经，遇火则动。去血过多，亦使眩晕，头眩亦然
，兼挟气虚。
【证】 外因者，风在三阳经，头重项强有汗。寒则掣痛，暑则热闷，湿则重着
，皆令吐逆晕倒。
内因者，因七情致脏气不行，郁而生涎，结为饮，随气上厥，伏留阳经，呕吐，眉目疼
痛，眼不得开。
因房劳、饥饱去血过多者，眼花屋倒，起则晕倒。
【治】 散风行湿汤 治痰火晕眩。二陈汤、苍术、黄芩、羌活。
瓜蒂散 治晕眩痰厥。
芎归汤 治血虚眩晕。
参术汤 治挟气虚头痛，补气降火为主。
人参 白术 黄芩 黄连
【脉】 阳微阴弦，胸痹而痛，责在极虚。短而数，心痛心烦。心腹痛不得息，
脉细小迟者
生，坚大实者死。若腹痛脉反浮大而长者死。趺阳脉滑而紧。滑者，谷气强胃气实；紧者，
阴气胜，故痛。病腹痛而喘，脉滑而利，数而紧者，实也。心痛有热厥、寒厥、大实。
【因】 劳役太甚，饮食失节，中气不足；或寒邪乘虚而入客之，或久不散郁而
生热，或素有热，虚热相搏，结于胃脘而痛。或有实积痰饮，或气与食相郁不散，停结胃口
而痛。
【证治】 胃病者，腹 胀，胃脘当心而痛，上支两胁，膈咽不通，食饮不下。
脾病者，食则呕吐，腹胀喜噫，胃脘痛，心下急。
热厥心痛，身热足痛，四肢寒，甚则烦躁而吐，额自汗，脉洪，可汗。刺太 、昆仑。
寒厥心痛，手足逆，通身冷汗，便利溺清，不渴，气脉微弱，可温。
大实心痛，卒然而发，大便或秘，久而注闷，心胸高起，按之痛，不能饮食，可下。
肾心痛，与背相接， 如从后绞触其心，偃偻，刺束骨、合骨、昆仑。胃心痛，腹胀胸
满，刺大都、太白。脾心痛，如锥刺，刺然谷、太 。肝心痛，状如死，终日不得休息，取
行间、太冲。肺心痛，卧若徒居，心痛间动作益盛，刺鱼际、太渊。
厥心痛，乃寒邪客于心包络也，宜以良姜、菖蒲，大辛热之药。
盖诸心痛，皆少阴厥气上冲也。刺之，宜通气、行气，无所凝停也。
腹痛
【因】 有客寒阻之不行，有热内生郁而不散，有死血、食积、湿痰结滞，妨碍
升降，故痛。盖痛当分其部分，从其高下而治之。
【证治】 中脘痛，太阴也，理中、草豆蔻主之。
小腹痛，厥阴也，正阳、回阳，四逆汤主之。
杂证而痛，苦楝汤、酒煮当归丸、丁香楝实丸等主之。
腹中不和而痛者，以甘草芍药汤主之。
伤寒误下传太阴经，腹满而痛，桂枝芍药主之。痛甚，桂枝大黄汤主之。夏月肌热恶热
，脉洪实而痛，黄芩芍药主之。诸虫痛者，如腹痛肿聚，往来无有休息，涎出，呕吐清水。
痰积腹痛隐隐然，得热汤、辛物则暂止，宜导痰解郁气，温散之。中气虚亦痛，或饥而痛是
也，理中汤主之。胸痹，皆痰水宿饮，停留不散，宜栝蒌、枳实、香附、芎、苍术、温散之
。
外有似类而痛异名。心痛，有心中寒，有心热，有心虚，有脾积，有宿食留饮，有胸痞
。腹痛，有香港脚。胸痛，有积实。小腹痛，有肝脾，有胞痛，有筋虚，有疝，有肠痈。
金铃子散 治热厥心痛，或作或止，久不愈。
金铃子 玄胡（各一两）
热加黄连，疝气加荔枝核。酒下三钱。
煮雄丸 治大实心痛、 癖，如神。
雄黄（一两，另研） 巴豆（五钱，生用去油，烂研，却入雄黄末） 白面（二两）
上再研匀，水丸梧桐子大。每服时，先煎浆水令沸，下药二十四粒，煮三十沸，捞入冷
浆水，沉水冷，一时下一丸。二十四时也，加至微利为度，用浸药水下。
术附汤 治寒厥心暴痛，脉微气弱。
附子（一两，炮去皮脐） 白术（四两） 甘草（二两，炙）
姜、枣煎服。
术香散 治心脾卒痛不忍。
木香 蓬术（各一两） 干漆（一钱，炒烟尽） 醋汤下一钱。
燥饭丸 治饮水吞酸作痛。墙上蚬壳丸。
秘丹 治心痛久则成郁，郁久必生火。
川芎 栀子（炒） 苍术 香附 石碱 干姜（炒）
反治之法。
有人饱过患此，以火毒治，遂以黄连六钱、甘草一两，一服而安矣。
有心痛十八年，因酒、牛乳，痛时以一物拄之，脉三至，弦弱而涩，吞酸，七月内以二
陈汤、术、芩、连、桃、郁李仁、泽泻。
秘丹 治死血留于胃口作痛。承气汤、栀子、韭汁、桔梗（能开血气）、麻黄（重
者，须此发之。）
虫痛方 治面上白斑，唇红，能食者是。苦楝根、锡灰。
胃脘当心痛，有垢积者，斑蝥、乌梅肉。丸如绿豆大，泔下一丸。皂树上蕈，泡汤，有
肥珠起，饮之，微泄见效。未已又服，无不验。
草豆蔻丸 治脾胃伤损客寒，一切虚证，心腹大痛。
理中建中汤 治寒腹痛。
调胃承气加木香槟榔汤 治热腹痛。
大承气加方 治有人雨后得凉，腹痛甚。问之，于夏月投渊取鱼，脉沉弦而细实
，重按则如循刀上。本方加桂两帖，又加桂、桃仁两帖，又加附两二帖，下黑血。
二陈芎苍丸 治清痰腹痛，脉滑者是。
二陈汤 台芎 苍术 香附 白芷 姜汁
[Etiology] Phlegm-fluids ascend with the Qi, lingering in the Yang meridians; they are triggered by Fire. Excessive blood loss also causes dizziness and vertigo, often accompanied by Qi deficiency.
[Symptoms] Due to external factors, Wind affects the Three Yang meridians, presenting with heavy head, stiff neck, and sweating. Cold causes pulling pain, Summerheat causes heat and stifling sensation, Dampness causes heaviness and stagnation; all these lead to vomiting, nausea, and fainting.
Due to internal factors, the Seven Emotions cause dysfunction of Zang-Fu Qi, leading to stagnation and generation of saliva/phlegm, which condenses into fluids. These ascend with Qi, lingering in the Yang meridians, causing vomiting, pain in the eyebrows and eyes, and inability to open the eyes.
Those suffering from excessive sexual activity, irregular diet, or excessive blood loss experience blurred vision, visual hallucinations (such as houses tilting), and fainting upon standing.
[Treatment] San Feng Xing Shi Tang (Dispel Wind and Remove Dampness Decoction) treats dizziness and vertigo caused by Phlegm-Fire. It uses Er Chen Tang (Two-Cured Decoction), Cang Zhu (Atractylodis Rhizoma), Huang Qin (Scutellariae Radix), and Qiang Huo (Notopterygii Rhizoma et Radix).
Gua Di San (Melon Stamen Powder) treats dizziness and vertigo due to Phlegm-Jue.
Xiong Gui Tang (Ligusticum and Angelica Decoction) treats dizziness due to Blood deficiency.
Shen Zhu Tang (Ginseng and Atractylodes Decoction) treats headache accompanied by Qi deficiency, focusing on tonifying Qi and descending Fire. Ingredients: Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma).
[Pulse] "Yang pulse is fine, Yin pulse is string-like" indicates Chest Bi (Obstruction Syndrome) with pain, attributed to extreme deficiency. A short and rapid pulse indicates Heart pain and restlessness. For Heart-Abdominal pain with dyspnea, a fine, small, and slow pulse indicates survival, while a firm, large, and excess pulse indicates death. If abdominal pain presents with a floating, large, and long pulse, it is a death sign. The Dubai pulse being slippery and tight: Slippery indicates strong Grain Qi and solid Stomach Qi; Tight indicates excess Yin Qi, hence pain. Abdominal pain with wheezing, slippery pulse, and loose stools, combined with rapid and tight pulses, indicates an Excess pattern. Heart pain includes Hot Jue, Cold Jue, and Great Excess patterns.
[Etiology] Overexertion and irregular diet lead to insufficient Middle Qi. Alternatively, Cold pathogens invade due to deficiency, or long-term stagnation generates Heat. Pre-existing Heat combined with Deficiency Heat binds in the Epigastrium causing pain. There may also be Excess accumulation of Phlegm-fluids, or Qi and Food stagnating in the Stomach opening causing pain.
[Symptoms and Treatment] Stomach disease presents with abdominal distension, epigastric pain radiating to both hypochondria, obstruction of the diaphragm and throat, and inability to swallow food and drink.
Spleen disease presents with vomiting after eating, abdominal distension, preference for belching, epigastric pain, and fullness/tightness in the lower chest/epigastrium.
Hot Jue Heart pain: Body fever, foot pain, cold limbs, severe cases involve irritability and vomiting, spontaneous sweating on the forehead, and a洪 (Surging) pulse. Treat with sweating method. Acupuncture: Tai Xi (KI3), Kun Lun (BL60).
Cold Jue Heart pain: Cold extremities, whole-body cold sweat, clear urine and stool, no thirst, weak Qi and pulse. Treat with warming method.
Great Excess Heart pain: Sudden onset, constipation, prolonged stuffiness, bulging chest/heart area, pain on pressure, inability to eat. Treat with purgative method.
Kidney Heart pain: Pain connects to the back, feeling like something twisting the heart from behind, body bent over. Acupuncture: Shu Gu (BL65), He Gu (LI4), Kun Lun (BL60).
Stomach Heart pain: Abdominal distension and chest fullness. Acupuncture: Da Du (SP13), Tai Bai (SP3).
Spleen Heart pain: Pain like needle insertion. Acupuncture: Ran Gu (KI2), Tai Xi (KI3).
Liver Heart pain: Severe condition resembling death, restlessness all day. Acupoints: Xing Jian (LR2), Tai Chong (LR3).
Lung Heart pain: Discomfort when lying down, pain worsens with movement after resting. Acupuncture: Yu Ji (LU10), Tai Yuan (LU9).
Jue Heart pain: Caused by Cold pathogen lodging in the Pericardium Meridian. Use Liang Jiang (Zingiberis Rhizoma) and Chang Pu (Acori Tatarinowii Rhizoma), herbs that are greatly pungent and hot.
Generally, all Heart pains are due to Jue Qi of the Shaoyin Meridian rushing upward. Acupuncture should promote Qi circulation and movement, preventing stagnation.
Abdominal Pain
[Etiology] External Cold blocking Qi flow, Internal Heat stagnating, Dead Blood, Food Stagnation, and Damp-Phlegm obstruction hinder Qi ascending and descending, causing pain. Pain treatment must distinguish the location and treat according to its height/depth.
[Symptoms and Treatment] Zhong Wan (Middle Epigastrium) pain belongs to Taiyin. Treat with Li Zhong Tang (Regulate the Middle Decoction) and Cao Dou Kou (Cardamomi Fructus).
Xiao Zhong (Lower Abdomen) pain belongs to Jueyin. Treat with Zheng Yang San, Hui Yang San, or Si Ni Tang (Frigid Extremities Decoction).
Miscellaneous pain conditions: Treat with Ku Lian Tang, Jiu Zhu Dang Gui Wan (Wine-Boiled Angelica Pill), Ding Xiang Lian Shi Wan (Clove and Chinaberry Pill).
Abdominal disharmony with pain: Treat with Gan Cao Shao Yao Tang (Licorice and Peony Decoction).
Shang Han (Cold Damage) mismanaged with purgatives transmitting to Taiyin, causing abdominal fullness and pain: Treat with Gui Zhi Shao Yao Tang (Cinnamon Twig and Peony Decoction). Severe pain: Gui Zhi Da Huang Tang (Cinnamon Twig and Rheum Decoction). Summer heat with skin fever, aversion to heat, surging/excess pulse and pain: Huang Qin Shao Yao Tang (Scutellaria and Peony Decoction). Parasitic pain: Abdominal mass moving up and down without rest, salivation, vomiting clear fluid.
Phlegm accumulation abdominal pain: Dull pain, temporarily relieved by hot soup or spicy foods. Guide phlegm, resolve stagnation, and warm-disperse. Middle Qi deficiency pain (e.g., hunger pain): Treat with Li Zhong Tang. Chest Bi due to retained Phlegm-Fluids: Use Gua Lou (Trichosanthis Fructus), Zhi Shi (Aurantii Fructus), Xiang Fu (Cyperi Rhizoma), Xiong (Ligustici Rhizoma), Cang Zhu (Atractylodis Rhizoma), warm-disperse.
Similar appearances but different names: Heart pain includes Cold in Heart, Heart Heat, Heart Deficiency, Spleen Accumulation, Retained Food/Fluids, Chest Pi. Abdominal pain includes Hong Kong Foot (Beriberi). Chest pain includes Accumulated Mass. Lower abdominal pain includes Liver/Spleen issues, Bao (Uterus) pain, Sinew Deficiency, Hernia, Intestinal Abscess.
Jin Ling Zi San (Chukia Powder) treats Hot Jue Heart pain, intermittent and chronic. Ingredients: Jin Ling Zi (Meliae Semen), Yan Hu Suo (Corydalis Rhizoma) (each 1 liang). Add Huang Lian for Heat, Li Zhi He (Litchi Seed) for Hernia. Take 3 qian with wine.
Zhu Xiong Wan (Boiled Realgar Pill) treats Great Excess Heart pain and Pi masses. Ingredients: Xiong Huang (Realgar) (1 liang, separately ground), Ba Dou (Crotonis Fructus) (5 qian, raw, oil removed, pounded, mixed with Realgar powder), Bai Mian (White Flour) (2 liang). Grind uniformly, make pills the size of Sophora seeds. Boil Jiang Shui (fermented grain water), add 24 pills, boil 30 times, remove into cold Jiang Shui. Swallow one pill when cold. Start with 24 pills, increase until mild diarrhea occurs, wash down with infused medicine water.
Shu Fu Tang (Atractylodes and Aconite Decoction) treats sudden Cold Jue Heart pain with weak pulse and Qi. Ingredients: Fu Zi (Aconiti Lateralis Radix Praeparata) (1 liang, prepared, peeled), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (4 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma) (2 liang, honey-fried). Decoct with Ginger and Jujube.
Shu Xiang San (Atractylodes and Costus Powder) treats unbearable sudden Heart-Spleen pain. Ingredients: Mu Xiang (Aucklandiae Radix), Peng Zhu (Curcumae Rhizoma) (each 1 liang), Gan Xi (Drynariae Rhizoma / Asafoetida? Context suggests Drynaria or similar resinous herb, usually Gan Xi refers to Drynaria here or similar, but text says 'stir-fry until smoke gone') (1 qian, stir-fried until smoke ceases). Take 1 qian with Vinegar decoction.
Zao Fan Wan (Dried Rice Pill) treats pain from drinking water and acid regurgitation. Wall Clam Shell Pill.
Mi Dan (Secret Pill) treats chronic Heart pain leading to stagnation and subsequent Fire generation. Ingredients: Chuan Xiong (Ligustici Chuanxiong Rhizoma), Zhi Zi (Gardeniae Fructus, fried), Cang Zhu (Atractylodis Rhizoma), Xiang Fu (Cyperi Rhizoma), Shi Jian (Alkali Stone), Gan Jiang (Zingiberis Rhizoma, fried). This is a Contrary Treatment method.
Case: Someone suffered this after overeating, treated with Fire toxin, then cured with one dose of Huang Lian (6 qian) and Gan Cao (1 liang).
Case: 18-year Heart pain due to alcohol and cow's milk, pressing on something during pain, pulse 3 beats per respiration, string-taut, weak, and choppy, acid regurgitation. Treated in July with Er Chen Tang, Bai Zhu, Huang Qin, Huang Lian, Tao Ren, Yu Li Ren, Ze Xie.
Mi Dan (Secret Pill) treats Dead Blood stagnating in the stomach causing pain. Cheng Qi Tang, Zhi Zi, Jiu Zhi (Leek Juice), Jie Geng (Platycodonis Radix - opens Blood/Qi), Ma Huang (Ephedrae Herba - for severe cases to disperse).
Parasite Pain Formula: White spots on face, red lips, good appetite indicate parasite pain. Ingredients: Ku Lian Gen (Meliae Cortex), Xi Hui (Tin Ash).
Epigastric pain with filth accumulation: Ban Mao (Mylabris), Wu Mei (Mume Fructus). Make pills size of mung beans, take one with rice water. Mushroom from Soap Tree, soak in water, if fatty pearls rise, drink it; mild diarrhea indicates efficacy. Repeat if necessary.
Cao Dou Kou Wan (Cardamom Pill) treats Spleen-Stomach damage from external Cold, all deficiency syndromes, severe Heart-Abdominal pain.
Li Zhong Jian Zhong Tang (Regulate Middle and Establish Middle Decoction) treats Cold Abdominal Pain.
Tiao Wei Cheng Qi Jia Mu Xiang Bing Lang Tang (Regulate Stomach Cheng Qi Plus Costus and Areca Nut Decoction) treats Heat Abdominal Pain.
Da Cheng Qi Jia Fang (Major Cheng Qi Modified Formula) treats severe abdominal pain after cooling off in rain. History: Fishing in summer deep waters. Pulse: Deep, string-taut, fine, and solid; feels like touching a knife edge on heavy pressure. Added Gui Zhi (Cinnamon Twig) for two doses, then added Gui Zhi and Tao Ren (Persicae Semen) for two doses, then added Fu Zi (Prepared Aconite Root) for two doses. Passed black blood.
Er Chen Xiong Cang Wan (Two-Cured, Ligusticum, and Atractylodes Pill) treats Clear Phlegm Abdominal Pain with slippery pulse. Ingredients: Er Chen Tang, Tai Xiong (Ligusticum), Cang Zhu, Xiang Fu, Bai Zhi (Angelicae Dahuricae Radix), Jiang Zhi (Ginger Juice).