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[Da] Heartache in women caused by blood and qi disharmony results from deficiency of the zang-fu organs, irregular flow of blood and qi, and invasion of wind-cold pathogenic factors into the heart. Upon onset of pain, some cases may be fatal, while others are not. If the condition progresses to a syndrome stage, since the Heart is the master of the five zang organs and governs the Shen (Spirit), its primary meridian (Hand-Shaoyin Heart Meridian) must not be injured. Injury leading to pain is termed "Zhen Xin Tong" (True Heart Pain); if it occurs in the morning, death follows by evening; if it occurs in the evening, death follows by morning. If pain arises because the branch collaterals of the Heart are invaded by wind-cold, the pain will fluctuate in intensity, resulting in a general syndrome.

[Xue] For the aforementioned conditions: if caused by cold pathogens, apply warming and dispersing methods; if due to food stagnation, apply digestion-promoting methods; if due to reckless movement of Liver Fire, apply acrid-neutral methods; if due to Spleen Qi stagnation, apply harmonizing methods. These can still be used in conjunction with the formulas for the six syndromes mentioned later. A woman suffered from chronic heartache, poor appetite, and vomiting immediately after taking medicine. I diagnosed this as Spleen Earth deficiency and prescribed only Baid Zhu (Atractylodis Rhizoma). It was stir-fried with yellow loess, then the loess removed. Each dose was one liang, decocted in thick rice wash water, taken slowly in small amounts. After several days, she could drink large quantities naturally. After consuming over three jin, she recovered. The wife of the eldest son of Chen Luxue, a scholar of Shangshe, was constitutionally weak. She suffered from scabies postpartum for over a year without healing. During a month-long mourning period, she frequently felt dizzy and nearly fainted. One day, after contracting an external pathogen, she suddenly developed swelling and severe pain in the Heart and Spleen regions, intolerable to touch, accompanied by incessant vomiting and faint, thin pulses in all six positions. Observing her robust physique, some mistakenly believed that tonifying Qi was contraindicated for various pains, and treated her with Qing Pi (Tangerine Peel), Mu Xiang (Costus Root), Wu Wei Zi (Schisandra Berry), and Wu Zhu Yu (Evodia Fruit), which cured her. Subsequently, she contracted malaria and suffered a miscarriage. Further treatment with Qi-regulating and Blood-invigorating drugs expelled the disease but further depleted her Yuan Qi. Subsequent administration of Ginseng tonics was ineffective; her pulses were thread-like and nearly imperceptible. I was summoned to diagnose her and stated: Although her physique appears robust, her pulse indicates extreme deficiency. The use of Qi-regulating agents damaged her True Qi. I administered two doses of Ren Shen (Ginseng), [missing character, likely Huang Qi], Dang Gui (Angelica Sinensis), Bai Zhu (Atractylodis Rhizoma), Fu Zi (Aconiti Lateralis Radix Praeparata), Gan Jiang (Zingiberis Rhizoma), and Gui Zhi (Cinnamomi Ramulus), interspersed with Ba Wei Wan (Eight-Ingredient Pill). Within five days, her sleep and appetite improved, and her pulses fully recovered. Had these medicines been administered at the onset of Heart-Spleen pain, the malaria would not have occurred.

[Da] Wu Yao San (Lindera Powder): Treats heartache in women caused by attacking blood and qi, with irregular onset and cessation.
Wu Yao (Linderae Radix), E Zhu (Curcumae Rhizoma), Gui Xin (Cinnamomi Cortex), Dang Gui (Angelicae Sinensis Radix, stir-fried), Tao Ren (Persicae Semen), Qing Pi (Citri Reticulatae Pericarpium Viride), Mu Xiang (Aucklandiae Radix) (equal parts).
Grind into powder. Take two qian per dose, mixed with hot wine.

A Wei Wan (Asafoetida Pill): Treats heartache in women caused by attacking blood and qi, and all types of accumulated cold qi.
Dang Gui (Angelicae Sinensis Radix), Gui Xin (Cinnamomi Cortex), Qing Pi (Citri Reticulatae Pericarpium Viride), Fu Zi (Aconiti Lateralis Radix Praeparata, processed), A Wei (Asafoetida, baked in flour until flour is cooked), Bai Zhu (Atractylodis Rhizoma), Chuan Xiong (Ligustici Chuanxiong Rhizoma) (each 1 liang).
Wu Zhu Yu (Evodiae Fructus, processed), Mu Xiang (Aucklandiae Radix), Gan Jiang (Zingiberis Rhizoma) (each 3 fen).
Bing Lang (Arecae Semen), Rou Dou Kou (Myristicae Semen, baked), Yan Hu Suo (Corydalis Rhizoma), E Zhu (Curcumae Rhizoma) (each 1 liang).
Zhu Sha (Cinnabaris, finely ground, 0.5 liang).
Grind all into powder. First, boil one sheng of vinegar with A Wei until it forms a paste. Mix with the powder and pound 300 times. Form pills the size of paulownia seeds. Take 20 pills before meals with hot wine.

Ji She Xiang San (Amomum Cardamomum Powder): Treats nine types of heartache in men and women, and all types of cold qi.
Liang Jiang (Alpiniae Officinarum Rhizoma, finely chopped, stir-fried in sesame oil), Gui Xin (Cinnamomi Cortex), Chi Shao Yao (Paeoniae Radix Rubra) (equal parts).
Grind into fine powder. Take two qian per dose with one cup of water, add three slices of salt-pickled papaya, decoct to 70%, and take warm. Taking with salt water is also acceptable. For pain due to blood and qi hernia masses, mix with ripe vinegar water. Avoid raw and cold foods.

Ying Tong San (Pain-Relieving Powder): Treats unbearable Heart-Spleen pain; particularly effective for Heart-Spleen pain in women caused by Spleen blood and qi issues. Same formula as above, except without Gui Xin. Decoct with vinegar or take with vinegar water.

In early spring of the Yichou year, my second daughter, aged fifteen, had not yet begun menstruation. On the first day, she experienced stabbing heartache and incessant vomiting of fluids. Her pulse was deep, slow, wiry, and fine. Su He Xiang Wan (Styrax Pill), Shen Bao Wan (Divine Preservation Pill), Chen Xiang Wan (Aquilaria Pill), Li Zhong Wan (Regulate the Middle Pill), He Zi San (Chebula Powder), and Qi Qi Tang (Seven-Qi Decoction) were all ineffective. I reasoned that this condition was either due to parasites or fluid retention, and only Jiu Tong Wan (Nine-Pain Pill) from the *Ju Fang* could cure it. I prepared and gave her one or two pills, and she was cured immediately.

Chen Shi Er Shen Wan (Chen's Two-God Pill): Treats disharmony of blood and qi in women, unceasing pain, irregular uterine bleeding, and irregular menstruation.
Zhen Pu Huang (Polygoni Typhonii Pollen, stir-fried), Bi Bo (Piperis Longi Fructus, salt-stir-fried).
Grind into fine powder, mix with refined honey, and form pills the size of paulownia seeds. Take 30 pills on an empty stomach with warm wine. If unable to drink alcohol, swallow with rice gruel. Cessation occurs after two doses.

Chen Rihua Chou Dao San (Chen Rihua's Knife-Withdrawing Powder): Treats diseases such as blood-wind and blood-qi in women. Hou Kai, Military Commissioner of Wuxing, stated: I saw a Daoist priest use this prescription to treat illnesses with repeated success, so I presented it. It is truly miraculous.
Wu Ling Zhi (Trogopterori Faeces, stir-fried, 1 liang), E Zhu (Curcumae Rhizoma), Gui Xin (Cinnamomi Cortex), Yun Tai Zi (Brassicae Pekinensis Seed, stir-fried, each 0.5 liang).
Grind into powder. Take two large qian per dose with half a cup of wine and half a cup of water, decoct to 80%, and take hot when symptoms arise.

Shi Xiao San (Smile-Laughing Powder) (see Postpartum Heartache), He Zi San (Chebula Powder) (see Cholera) are also excellent.

*Ling Yuan Fang* treats sudden blood-qi heartache in women. Use only raw Wu Ling Zhi (Trogopterori Faeces) ground into fine powder. Take one qian per dose with one cup of wine, boil until bubbling, and take hot.

Si Qi Tang (Four-Seven Decoction) from the *Ju Fang* added with Liang Jiang (Alpiniae Officinarum Rhizoma), along with Chen Xiang Jiang Qi Tang (Aquilaria Qi-Descending Decoction) and Fen Xin Qi Yin (Separate-Heart-Qi Drink), are all good remedies for heartache. (All three formulas are found in the Miscellaneous Diseases of Qi section.)