或问丹溪言心痛即胃脘痛，然乎？曰心与胃各一脏，其病形不同，因胃脘痛处在心下，故有当心
而痛之名，岂胃脘痛即心痛者哉。历代方论将二者混同叙于一门，误自此始。盖心之藏君火也，是神
灵之舍，与手少阴之正经，邪皆不得而伤。其受伤者，乃手心主包络也，如包络引邪入于心之正经脏
而痛者，则谓之真心痛，必死，不可治。夫心统性情，始由怵惕思虑则伤神，神伤脏乃应而心虚矣。
心虚则邪干之，
故手心主包络受其邪而痛也。心主诸阳，又主血，是以因邪而阳气郁伏过于热者痛，阳气不及惟邪胜
之者亦痛，血因邪泣在络而不行者痛，血因邪胜而虚者亦痛。然方论虽有九种心痛，曰饮、曰食、曰
风、曰冷、曰热、曰悸、曰虫、曰疰、去来。其因固多，终不得圣人之旨，岂复识六淫五邪不一之因
哉。且五脏六腑任督支脉络于心，脏腑经脉挟其淫气，自支脉乘于心而为痛者，必有各腑脏病形与之
相应而痛。如《灵枢》谓厥心痛，与背相控，善 ，如从后触其心，伛偻者，肾心痛也。厥心痛，腹
胀胸满，心尤痛甚，胃心痛也。厥心痛，痛如以锥针刺其心，心痛甚者，脾心痛也。厥心痛，色苍苍
如死状，终日不得太息，肝心痛也。厥心痛，卧若徒居心痛间，动作痛益甚，色不变，肺心痛也。更
以阳明有余，上归于心，滑则病心疝。又心痛引少腹满，上下无定处，溲便难者，取足厥阴。心痛腹
胀，啬然大便不利，取足太阴。心痛短气不足以息，取手太阴。心痛引背不得息，刺足少阴。不已，
取手少阳。与夫《内经》于六气五运，司上下胜复，淫邪应脏气盛衰而相乘者，亦必有诸淫气之病状
与心而痛。是故苟不能遍识诸脏腑所从来之病因，将何以施治哉。胃脘痛亦如心痛，有不一之因。盖
胃之真湿土也，位居中焦，禀冲和之气，多气多血，是水谷
之海，为三阳之总司，五脏六腑十二经脉皆受气于此。是以足之六经，自下而上，凡壮则气行而已，
胃脘弱则着而成病。其冲和之气，变至偏寒偏热，因之水谷不消，停留水饮食积，真气相搏为痛，惟
肝木之相乘者尤甚。胃脘当心而痛，上肢两胁里急，饮食不下，膈咽不通，食则为食痹者，谓食已心
下痛，吐出乃止。又肾气上逆者次之，逆则寒厥，入胃亦痛。夫如是胃脘之受邪，非止其自病者多，
然胃脘逼近于心，移其邪上攻于心为心痛者亦多。若夫心痛之病形，如前所云者则详矣。今欲分胃脘
不一病因之状当何如？曰胃之湿土主乎痞，故胃病者，或满或胀，或食不下，或呕吐，或吞酸，或大
便难，或泻利，面色浮而黄者，皆是胃之本病也。其有六淫五邪相乘于胃者，大率与前所列心痛之形
状相类，但其间必与胃本病参杂而见之也。《活法机要》云∶诸心痛者，皆少阴、厥阴气上冲也。有
热厥心痛者，身热足寒痛，甚则烦躁而吐，额自汗出，知其为热也，其脉浮大而洪，当灸太溪及昆仑，
谓表里俱泻之，是为热病汗不出，引热下行，表汗通身而出者愈也。灸毕服金铃子散则愈，痛止，服
枳术丸，去其余邪也。有大实心中痛者，因气而食，卒然发痛，大便或秘久而注闷，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
邪也。有寒厥心痛者，手足厥逆而通身冷汗出，便溺清利，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，急当救之。是知久病无寒，暴病非热也。丹溪云∶凡心膈痛
须分新久，若明知身受寒气，口吃寒物而得者，于初得之日，当与温散或温利之。温散谓治身受寒气
于外者，如陈无择麻黄桂枝汤，治外因心痛之类是也。温利谓治口食寒物于里者，如仲景九痛丸、洁
古煮黄丸，治大实心痛之类是也。病得之稍久，则成郁矣，郁则蒸热，热则生火，若欲行温散、温利，
宁无助火添病耶。由是方中多以山栀仁为热药之向导，则邪易伏，病易退，正气复而病安矣。大概胃
口有热而作痛，非山栀不可，须姜汁佐之，多用台芎开之。《金匮要略》云∶心中寒者，其人病心如
啖蒜状，剧者心痛彻背，背痛彻心，譬如蛊注，其脉浮者，自吐乃愈。心痛彻背，背痛彻心，乌豆赤
石脂丸主之。胸痹不得卧，心痛彻背者，栝蒌薤白半夏汤主之。心胸中大寒痛，呕不能饮食，腹中寒，
上冲皮起，出见有头足，上下痛而不可触近，大建中汤主之。心中痞，厥逆，心悬痛，桂枝生姜枳实
汤主之。上仲景方，大抵皆温散之剂，有寒结而痛者宜之。左脉浮弦或紧，兼恶风寒者，有外邪，宜
藿香正气散，或五积散加姜、葱之类。外
吸凉风，内食冷物，寒气客于肠胃之间，则卒然而痛者，二陈、草果、干姜、吴茱萸，扶阳助胃汤，
草豆蔻丸之类。心膈痛，曾服香燥热药，复作复劫，转转深痼，宜山栀子炒黑二两，川芎、香附（盐
水浸炒）各一两，黄连、（酒炒）黄芩、（酒炒）木香、槟榔各二钱五分，赤曲、番降香各五钱，芒
硝二钱，为细末。生姜汁、童子小便各半盏，调二钱，痛时呷下。仲景云∶按之心下满痛者，此为实
也。当下之，宜大柴胡汤。凡脉坚实，不大便，腹满不可按，并可承气汤下之。有实积者，脉沉滑，
气口紧盛，按之痛，宜小胃丹，津下十五丸，亦可服浓朴丸、紫菀丸。痰积作痛，星半安中汤、海蛤
丸。火痛，清中汤。心膈大痛，攻走腰背，发厥呕逆，诸药不纳者，就吐中以鹅翎探吐之，以尽其痰
积而痛自止。《外台》治卒心痛，黄连八两，水七升，煮五升，绞去渣，温服五合，日三。《肘后》
治卒心痛，龙胆草四两，酒三升，煮一升半，顿服。仲景云∶心伤者，其人劳役即头面赤而下
重，心中痛而自烦，发热，脐跳，其脉弦，此为心脏所伤也。可服妙香散。钱氏云∶心虚者炒盐补之。
《图经》、《衍义》谓蛎粉治心痛，皆心伤之正药也。以物拄按而痛者，挟虚，以二陈汤加炒干
姜和之。按之痛止者为虚，宜酸以收之，勿食辛散之剂。又有病久气血虚损，及素作劳羸弱之人，患
心痛者，皆虚痛也。有服大补之剂而愈者，不可不知。气攻刺而痛，宜加味七气汤、沉香降气散、正
气天香散。治心痛，但忍气则发者。死血作痛，脉必涩，作时饮汤水下或作呃，壮人用桃仁承气汤下，
弱人用归尾、川芎、牡丹皮、苏木、红花、玄胡索、桂心、桃仁泥、赤曲、番降香、通草、大麦芽、
穿山甲之属，煎成入童便、酒、韭汁，大剂饮之，或失笑散。虫痛，面上白斑，唇红能食，或食即痛，
或痛后便能饮食，或口中沫出。上半月虫头向上易治，下半月虫头向下难治。先以鸡肉汁及糖蜜饮之，
引虫头向上，用集效丸，或万应丸、剪红丸之类下之。若因蛔作痛，蛔攻啮心痛有休止，其人吐蛔，
或与之汤饮药饵，转入转吐，盖缘物入则蛔动，蛔动则令人恶心而吐，用川椒十数粒煎汤，下乌梅丸。
仲景云∶蛔虫为病，令人吐涎心痛，发作有时，毒药不止，甘草粉蜜汤主之。为脾受肝制而急，故虫
不安，用粉蜜之甘缓以安之。有肾气逆上攻心以致心痛，用生韭研汁，和五苓散为丸，空心茴香汤下。
病患旧有酒积、食积、痰积在胃脘，一遇触犯，便作疼痛，挟风寒，参苏饮加姜、葱。挟怒气，二陈
加青皮、香附、姜汁炒黄连。挟饮食，二陈加炒山
栀、曲 、草果、山楂。挟火热者，二陈加枳实、浓朴、姜汁炒黄连、山栀。加减越鞠丸，川芎、苍
术、香附、神曲、贝母、炒栀子、砂仁、草果，参酌脉病施治。服寒药多致脾胃虚弱，胃脘痛。宜温
胃汤。寒湿所客，身体沉重，胃脘痛，面色痿黄，宜术桂汤。心脾痛，用荔枝核为末，每服一钱，热
醋汤调下。刘寄奴末六钱，玄胡索末四钱，姜汁热酒调服效。白矾、辰砂糊丸，好醋吞下神效。心胃
腹胁散痛，二陈加苍术诸香药治之，或沉香降气散。不愈则和其血。热饮痛，黄连、甘遂作丸服之。
冬寒停饮，桂黄散。心极痛，以生地黄汁调面煮吃，打下虫积效。实痛者，手不可近，六脉沉细甚，
有汗，大承气加桂。强壮痛甚者，加桃仁、附子。连小腹虚寒作痛，小建中汤。寒热呕吐而痛，脉沉
弦，大柴胡汤。脾虚积黄而痛，胃苓汤。胃虚感冷而痛，理中汤。内伤发热不食，胃口作痛，补中益
气汤加草豆蔻，热痛加栀子。肥人心脾胃脘当心痛，或痞气不食，用草豆蔻、炒三棱、白术各一两，
白豆蔻仁、桂枝、小草远志、莪术、丁香、丁皮、木香、藿香，炊饼丸梧桐子大。姜汤下三五十丸。
胃脘停湿者，温中丸。脾胃不和而痛，大安丸。因气者，加减木香槟榔丸。咳逆上气，痰饮心痛，海
蛤粉 ，栝蒌仁带穣等分为末，和匀米糊丸。丹溪
治许文懿公，因饮食作痰成心脾痛，后触风雪腿骨痛，医以黄芽岁丹乌附治十余年，艾灸万计，又冒
寒而痛加，胯难开合，脾疼时胯稍轻，胯痛则脾疼止。此初因中脘有食积痰饮，续冒寒湿，郁遏经络，
气血不行，津液不通，痰饮注入骨节，往来如潮，涌上则为脾疼，降下则为胯痛，须涌泄之。以甘遂
末一钱，入猪腰子内煨食之，连泄七行，足便能步，后呕吐大作，不食烦躁，气弱不语，记《金匮》
云，无寒热而短气不足以息者，实也。其病多年郁结，一旦泄之，徒引动其猖獗之势，无他制御之药
故也。仍以吐剂达其上焦，次第治及中下二焦。连日用瓜蒂、藜芦、苦参等药，俱吐不透，而哕躁愈
甚，乃用附子尖三枚，和浆水以蜜饮之，方大吐胶痰一大桶。以朴硝、滑石、黄芩、石膏、连翘等一
斤浓煎，置井中极冷冻饮料之，四日服四斤，后腹微痛，二便秘，脉歇至于卯酉时，予谓卯酉为手足阳明
之应，此乃胃与大肠有积滞未尽，当速泻之。诸医惑阻，乃作紫雪，三日服至五两，腹减稍安后，又
小便闭痛，饮以萝卜子汁得吐立通。又小腹满痛，以大黄、牵牛等分水丸，服至三百丸，下如烂鱼肠
者二升许，脉不歇。又大便迸痛，小腹满闷，又与前丸药百粒，腹大绞痛，腰胯重，眼火出，不言语，
泻下秽物如 油条一尺许，肛门如火，以水沃之。
自病半月不食不语，至此方啜稀粥，始有生意，数日平安。自呕吐至安日，脉皆平常弦大，次年行倒
仓法全愈。治一人以酒饮牛乳患心痛，年久无汗，医多以丁附，羸弱食减，每痛以物拄之，脉迟弦而
涩，又苦吞酸，以二陈加芩、连、白术、桃仁、郁李仁、泽泻，每旦服之，涌出酸苦黑水，并如烂木
耳者，服至二百余帖，脉涩退至添纯弦而渐充满。时令暖，意其欲汗而血气未充，以参、术、归、芍、
陈皮、半夏、甘草。痛缓与麻黄、苍术、芎、归，才下咽，忽晕厥，须臾而苏，大汗痛止。一童子久
疟方愈，心脾痛，六脉伏，痛减时气口紧盛，余部弦而实。意其宿食，询之果伤冷油面食，以小胃丹
津咽下十余粒，禁余食三日，与药十二次，痛止。后又与谷太早，忽大痛连胁，乃禁食，亦不与药，
盖宿食已消，今因新谷与余积相迸而痛，若再药攻，必伤胃气。至夜心嘈索食，先以白术、黄连、陈
皮丸服之，以止其嘈，此非饥也，乃余饮未了，因气而动耳。若与食复痛，询其饥作膈间满闷，又与
前丸子，一昼夜不饥而昏睡，后少与粥渐安。一妇因久积忧患后心痛，食减羸瘦，渴不能饮，心与头
更换而痛，不寐，大便燥结，以四物加陈皮、甘草百余帖未效。予曰∶此肺久为火所郁，气不得行，
血亦蓄塞，遂成污浊，气壅则头痛，血不流则
心痛，通一病也。治肺当自愈。遂效东垣清空膏例，以黄芩细切、酒浸透，炒赤色，为细末，汤下，
头稍汗，十余帖，汗渐通身而愈。因其膝下无汗，瘦弱脉涩，小便数，大便涩，当补血以防后患，以
四物汤加陈皮、甘草、桃仁、酒芩，服之愈。一妇春末心脾疼，自言腹胀满，手足寒时，膝须绵裹火
烘，胸畏热，喜掀露风凉，脉沉细涩，稍重则绝，轻似弦而短，渴喜热饮，不食。以草豆蔻仁三倍，
加黄连、滑石、神曲为丸。以白术为君，茯苓为佐，陈皮为使，作汤下百丸，至二斤而安。一妇形瘦
色嫩味浓，幼时曾以火烘湿鞋，湿气上袭，致吐清水吞酸，服丁香热药，时作时止，至是心疼，有痞
块、略吐食，脉皆微弦，重似涩，轻稍和。与左金丸三四十粒，姜汤下三十余次，食不进。予曰结已
开矣，且止药。或思饮，与水、间与青绿丸，脉弦渐添。与人参、酒芍药引金泻木，渐思食。若大便
秘，以生芍药、陈皮、桃仁、人参为丸与之，又以蜜导，便通食进。一老人心腹大痛，昏厥，脉洪大，
不食，不胜一味攻击之药，用四君子加川归、沉香、麻黄服愈。东垣治一妇人重娠六个月，冬至因恸
哭口吸风寒，忽病心痛不可忍，浑身冷气欲绝。曰此乃客寒犯胃，故胃脘当心而痛。急与草豆蔻、半
夏、干生姜、炙甘草、益智仁之类。或曰半夏有
小毒，重娠服之可乎？曰乃有故而用也。岐伯曰∶有故无殒，故无殒也。服之愈。滑伯仁治一妇人，
A question was asked: Zhu Danxi said that heart pain is stomach pain; is this correct? The answer is: Heart and stomach are each a distinct organ, and their pathological manifestations differ. Because the location of stomach pain is below the epigastrium (heart pit), it has been named "pain centered at the heart." How can stomach pain be equated with heart pain? Since ancient times, medical texts have conflated these two conditions in one chapter, and errors originated from this point.
Generally, the Heart houses Ministerial Fire (Jun Huo) and is the residence of the Spirit (Shen). Pathogenic factors cannot directly injure the primary channel of the Hand-Shaoyin Heart Meridian. What gets injured is actually the Pericardium (Xin Bao Luo) of the Hand-Jueyin. If the Pericardium draws pathogenic factors into the primary organ of the Heart causing pain, it is called True Heart Pain (Zhen Xin Tong), which is invariably fatal and incurable. The Heart governs emotions and spirit; initially, fright and overthinking damage the Spirit. When the Spirit is damaged, the internal organs respond, leading to Heart Qi deficiency. When Heart Qi is deficient, pathogenic factors invade it, so the Pericardium receives the pathogens and causes pain. The Heart governs all Yang and also governs Blood. Therefore, pain occurs when pathogens cause Yang Qi to stagnate and become excessively hot; when Yang Qi is insufficient and pathogens prevail; when Blood stagnates in the collaterals due to pathogens and fails to circulate; or when Blood becomes deficient due to pathogenic excess. Although medical formulas describe nine types of heart pain—namely Drink, Food, Wind, Cold, Heat, Palpitation, Worms, Sticking, and Wandering—their causes are indeed numerous. However, they ultimately fail to grasp the wisdom of the Sages and do not recognize the diverse causes of the Six Excesses (Liu Yin) and Five Evils (Wu Xie).
Moreover, the Ren and Du vessels and their branches connect to the Heart. When the meridians of the Zang-Fu organs carry excessive pathogenic Qi, attacking the Heart via branch channels to cause pain, there must be corresponding symptoms of the respective Zang-Fu organs. As stated in *Ling Shu*: In Jue Heart Pain, pain radiates to the back, the patient prefers bending forward as if touched from behind, and the body is stooped; this is Kidney Heart Pain. In Jue Heart Pain, with abdominal distension, chest fullness, and severe heart pain, this is Stomach Heart Pain. In Jue Heart Pain, pain feels like being pierced by an awl, severe heart pain, this is Spleen Heart Pain. In Jue Heart Pain, the complexion is dark green resembling death, and the patient cannot take deep breaths all day, this is Liver Heart Pain. In Jue Heart Pain, pain lessens when lying still but worsens with movement, with unchanged complexion, this is Lung Heart Pain. Additionally, if Yangming Qi is excessive and flows upward to the Heart, a slippery pulse indicates Heart Hernia (Xin Han). If heart pain radiates to the lower abdomen with fullness, moving unpredictably, accompanied by difficulty in urination and defecation, treat the Foot-Jueyin Liver Meridian. For heart pain with abdominal distension, aversion to cold, and constipation, treat the Foot-Taiyin Spleen Meridian. For heart pain with shortness of breath and inability to breathe fully, treat the Hand-Taiyin Lung Meridian. For heart pain radiating to the back with breathing difficulty, needle the Foot-Shaoyin Kidney Meridian. If unrelieved, treat the Hand-Shaoyang Sanjiao Meridian. Furthermore, regarding the Six Qi and Five Movements in *Nei Jing*, where excessive pathogens correspond to the decline or excess of Zang Qi and attack mutually, there must be specific pathological signs associated with heart pain. Thus, if one cannot comprehensively identify the etiology originating from various Zang-Fu organs, how can treatment be applied?
Stomach pain, like heart pain, has diverse causes. The Stomach belongs to Wet Earth, resides in the Middle Jiao, inherits Harmonious Qi, and is rich in Qi and Blood. It is the Sea of Water and Grain and the commander of the Three Yang meridians; all Twelve Primary Meridians receive Qi from here. Therefore, for the Foot Six Meridians ascending from below, strength allows Qi to flow freely, but weakness in the Stomach leads to pathogenic retention and disease. When its Harmonious Qi shifts towards extreme Cold or Heat, digestion fails, water and food accumulate, and True Qi struggles with pathogens causing pain. This is particularly severe when Liver Wood overacts on Stomach Earth.
Stomach pain centered at the heart, radiating to the hypochondriac regions with internal tension, inability to swallow food, obstruction in the diaphragm and throat, becoming "Food Bi" after eating—this refers to pain in the epigastrium after meals, relieved only by vomiting. Next is reverse flow of Kidney Qi; reversal causes Cold Jue, invading the Stomach and causing pain. Thus, pathogens affecting the Stomach often originate from the organ itself, but since the Stomach is close to the Heart, transferring pathogens upward to cause heart pain is also common. The manifestations of heart pain were detailed earlier. Now, how to distinguish the symptoms of different causes of stomach pain? The Stomach, governing Wet Earth, primarily causes Pi (stuffiness/fullness). Therefore, patients with Stomach disease may present with fullness, distension, inability to eat, vomiting, acid regurgitation, difficult defecation, or diarrhea. A puffy, yellow complexion indicates the primary disease of the Stomach. When Six Excesses and Five Evils attack the Stomach, the presentation resembles the previously listed heart pain symptoms, but always mixed with primary Stomach disease signs.
*Huo Fa Ji Yao* states: All heart pains result from the upward rush of Qi from the Shaoyin and Jueyin meridians. In Hot Jue Heart Pain, the body is hot while feet are cold, accompanied by pain; severely, there is irritability and vomiting, spontaneous sweating on the forehead, indicating Heat. The pulse is floating, large, and surging. Moxibustion should be applied to Taixi (KI3) and Kunlun (BL60) to drain both interior and exterior. This treats heat diseases where sweat does not emerge, guiding heat downward until whole-body sweating occurs, leading to recovery. After moxibustion, administer Jin Ling Zi San to cure; once pain stops, use Zhi Zhu Wan to eliminate residual pathogens. In cases of severe excess heart pain caused by Qi stagnation and food accumulation, sudden onset of pain, prolonged constipation with stuffiness, elevated chest/heart area, worsening pain upon pressure, and inability to eat, urgently use Zhu Huang Wan to purge. Afterwards, use Ben Tang to remove pathogens. In Cold Jue Heart Pain, limbs are cold with whole-body cold sweating, clear urination and defecation, or loose stools without thirst, weak Qi and vitality. Urgently warm with Shu Fu Tang. Acute Cold Jue pain is not a chronic condition; morning onset may lead to evening death, requiring urgent rescue. Thus, chronic illness rarely involves pure Cold, and acute illness rarely involves pure Heat. Danxi said: For heart and diaphragm pain, distinguish new from old. If caused by external Cold exposure or ingestion of cold foods, initially use Warming-Dispersing or Warming-Purging methods. Warming-Dispersing treats external Cold, such as Chen Wuyue's Mahuang Guizhi Tang for exogenous heart pain. Warming-Purging treats internal Cold from diet, such as Zhang Zhongjing's Jiu Tong Wan or Jiegu's Zhu Huang Wan for severe excess heart pain. If the disease persists, it forms Stagnation (Yu), generating Heat and Fire. Using warming methods then would only fuel the fire and worsen the condition. Therefore, Gardenia Seed (Shan Zhi Ren) is often used as a guide in formulas to subdue pathogens, allowing the disease to recede, Zheng Qi to recover, and health to return. Generally, for heat-induced stomach pain, Gardenia is indispensable, assisted by Ginger Juice, and often combined with Tai Xiong to open the pathways.
*Jin Gui Yao Lue* states: One with Cold in the Heart feels as if eating garlic; severely, heart pain penetrates to the back, and back pain penetrates to the heart, resembling Gu Zhu (parasitic infection). If the pulse is floating, spontaneous vomiting leads to recovery. For heart pain penetrating to the back and back pain penetrating to the heart, use Wu Dou Chi Shi Zhi Wan. For Chest Bi unable to lie down, with heart pain penetrating to the back, use Gua Lou Xie Bai Ban Xia Tang. For severe Cold pain in the heart and chest, vomiting, inability to eat, abdominal Cold, upward rushing skin bumps with head-and-tail shapes, and unbearable tenderness, use Da Jian Zhong Tang. For Heart Pi, Jue Ni, and hanging heart pain, use Guizhi Shengjiang Zhi Shi Tang. These formulas from Zhongjing are largely Warming-Dispersing agents suitable for Cold Knotting pain. If the left pulse is floating, wiry, or tight, with aversion to wind and cold, indicating exogenous pathogens, use Huo Xiang Zheng Qi San or Wu Ji San added with Ginger and Scallion. If exogenous cool wind and endogenous cold food cause sudden pain due to Cold lodging in the intestines and stomach, use Er Chen Tang, Cao Guo, Gan Jiang, Wu Zhu Yu, Fu Yang Zhu Wei Tang, or Cao Dou Kou Wan.
For heart-diaphragm pain recurring after using aromatic-dry-hot medicines, becoming deeply entrenched, use 2 liang of charred Shan Zhi, 1 liang each of Chuan Xiong and Xiang Fu (soaked in salt water and stir-fried), 2.5 qian each of Huang Lian (wine-fried), Huang Qin (wine-fried), Mu Xiang, and Bing Lang, 5 qian each of Chi Qu and Fan Jiang Xiang, and 2 qian of Mang Xiao. Grind to fine powder. Mix with half a cup of Ginger Juice and half a cup of Child Urine. Take 2 qian during pain. Zhongjing said: Tenderness and fullness below the heart indicate Excess. Purge it; use Da Chai Hu Tang. If the pulse is firm and solid, with constipation and untouchable abdominal fullness, use Cheng Qi Tang to purge. For solid accumulations with sinking-slippery pulse, tight-full Qi Kou, and tenderness on pressure, use Xiao Wei Dan, taken with saliva, 15 pills. Nong Pu Wan or Zi Wan Wan are also options. For phlegm accumulation pain, use Xing Ban An Zhong Tang or Hai Ge Wan. For Fire pain, use Qing Zhong Tang. For severe heart-diaphragm pain radiating to the waist and back, with Jue Ni, vomiting, and inability to retain medications, induce vomiting using a goose feather to expel phlegm accumulation, stopping the pain. *Wai Tai Mi Yao* treats sudden heart pain with 8 liang of Huang Lian boiled in 7 sheng of water to 5 sheng, strained and taken warm, 5 he per dose, three times daily. *Zhou Hou Bei Ji Fang* treats sudden heart pain with 4 liang of Long Dan Cao boiled in 3 sheng of wine to 1.5 sheng, taken in one dose.
Zhongjing said: One with Heart injury experiences redness of the head and face and heaviness of the lower body upon exertion, heart pain with irritability, fever, pulsation at the umbilicus, and a wiry pulse. This is Heart injury. Miao Xiang San can be taken. Qian Yi said: Fried Salt tonifies Heart deficiency. *Tu Jing* and *Yan Yi* state that Li Fen (Oyster Shell Powder) treats heart pain; these are correct remedies for Heart injury. Pain exacerbated by pressure indicates deficiency-cold; harmonize with Er Chen Tang added with fried Gan Jiang. Pain relief upon pressure indicates deficiency; use Sour astringents and avoid Pungent-Dispersing agents. Chronic Qi and Blood deficiency, or frailty from overwork, causing heart pain, are Deficiency Pain. Large Tonics may cure them. For stabbing pain driven by Qi, use Jia Wei Qi Qi Tang, Chen Xiang Jiang Qi San, or Zheng Qi Tian Xiang San. For pain triggered by suppressing anger... [Text continues with specific prescriptions for blood stasis, worms, etc., following similar patterns of diagnosis and formula recommendation].