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Pain in the heart region has long been said to lack a "true" disease; however, it is unknown that pain in the heart does indeed have a true pathology, distinguished only by Yin and Yang. Generally speaking, pain invading the Heart due to Yang disorders is mostly incurable, while pain invading the Heart due to Yin disorders is mostly difficult to treat.

Yang disorders refer to Fire pathogenic factors. When Fire invades the Heart, although the *Shanzhong* (Chest Center/Pericardium area) acts as a barrier preventing the Fire from directly assaulting the Heart, clearing the Fire in the Stomach will calm the Heart. Why is this? Because pathogenic Fire and Heart Fire are of the same category; when Fire combines with Fire, although their manifestations differ, their hot nature is identical. There is originally no suspicion of mutual overcoming; thus, when the pathogenic Fire recedes, the Ministerial Fire naturally subsides, avoiding the disaster of self-incineration.

In contrast, Yin disorders involve Cold pathogenic factors. Cold invades the Heart directly; despite the barrier of the *Shanzhong*, the Cold Qi rushes upward, striking straight at the Imperial Residence (the Heart). The "Prime Minister" (other organs or meridians) cannot withstand the sharp edge and flees first to other places, leaving the "Heavenly King" (Heart) forced to abandon its palace. This is because Water overcomes Fire; the Cold Water can extinguish Heart Fire instantly, making it more severe than Yang disorders. Therefore, if onset occurs in the morning, death follows by evening; if onset occurs in the evening, death follows by morning. If medical treatment is delayed even slightly, rescue is often impossible. How much more so if the medication is inappropriate? It is no wonder such sudden death occurs. Observers see the rapid demise and assume it is "true" heart pain, but it is not truly heart pain. If treated appropriately, could it not be saved? Therefore, how can one fail to distinguish between Yin and Yang in heart pain?

If it is a Yang disorder, the pain persists through the night and day, accompanied by crying out. The eyes must be red, and the mouth dry with a desire to drink cold water, which provides slight relief. Eating aggravates the pain, and pressure on the abdomen worsens it significantly. Sweating is inevitable on the body, with symptoms heavier during the day and lighter at night. This is caused by pathogenic Fire disturbing the Stomach and rushing up to the *Shanzhong*. Using *Xiehuo Shendan* (Fire-Draining Divine Elixir), the pain ceases immediately upon ingestion. The brilliance of this formula lies in the heavy use of Gardenia (*Zhi Zi*) to directly suppress depressed Fire; Atractylodes (*Cang Zhu*) and Poria (*Fu Ling*) remove Dampness; once Dampness is gone, Heat is not generated, and Fire power naturally declines. Additionally, Houttuynia (*Guan Zhong*) removes turbidity, Frankincense (*Ruxiang*) and Costus Root (*Muxiang*) stop pain. A large dose of Licorice (*Gan Cao*) prevents Gardenia from being too cold, achieving proper modulation. Immature Bitter Orange (*Zhi Ke*) digests food stagnation; once food is cleared, Fire descends with the food. Furthermore, fearing that excessive pathogenic Fire might reject the medicine due to its ascending nature, blackened dried ginger (*Chao Hei Gan Jiang*) is used to remove excessive heat and guide Gardenia downward, providing leading action. Since the medicinal properties are harmonious, efficacy is immediate. Thus, pain stops as soon as the medicine enters the throat.

If it is a Yin disorder, it results from contracting Cold. Symptoms include initial pain in the lower abdomen spreading to the heart, vomiting clear fluid, vomiting tea when given, cyanosis of hands and feet, testicular retraction, and opisthotonos. This is Yin-Cold Qi invading the Heart, arriving very rapidly. If half a jin of fresh ginger is crushed, stir-fried until hot, and applied to the heart and abdomen, the Cold pathogen will decrease slightly. Drinking three liang of crushed fresh ginger can also restore vitality. However, this is merely a temporary emergency method, not a perpetual remedy for saving people. One should use *Quhan Dingtong Tang* (Cold-Expelling Pain-Stopping Decoction) for rescue, which is miraculous. Delay is not an option; prompt administration leads to survival, otherwise rescue is difficult. The brilliance of this formula lies in the massive use of Atractylodes Macrocephala (*Bai Zhu*), which enters deeply into the waist and navel area. Why? Because Cold invasion originally enters through the navel. If the source is not urgently blocked, the pathogen will rush fearlessly to the Pericardium collaterals, unable to be resisted against the rampant aggression. Therefore, Bai Zhu is used to cut off the pathogen. However, without a large dose, the force is weak, and the Cold pathogen would not recoil. Hence, a large dose is necessary for efficacy. Yet, relying solely on abundant Bai Zhu without hot herbs like Aconite (*Fuzi*) and Cinnamon Bark (*Rou Gui*) is like having an army without a general capable of breaking lines; the troops will not advance, and the enemy will not fear. Thus, Fuzi and Rou Gui are essential. However, using only Fuzi and Rou Gui for attack without dispersing the Cold pathogen's cohesion makes the "enemy" united and hard to disperse. Therefore, Fu Ling is used to guide the Cold downward. Additionally, fearing the Heart Monarch is too cold and lacks internal warmth—like a palace besieged by bandits where loyal generals exist but lack guiding troops, resulting in no internal support despite external reinforcements—a trusted minister is needed to communicate inside and outside. Thus, Acorus (*Chang Pu*) is used to guide Cinnamon and Aconite into the Heart to guard the Monarch. I hope people strictly follow my formulas to treat true heart pain, achieving success effortlessly. If the condition lightens slightly, reducing the dosage of the previous two formulas is acceptable.

*Xiehuo Shendan* (Fire-Draining Divine Elixir): Gardenia Fruit (*Zhi Zi*, 5 qian), White Peony Root (*Bai Shao*, 3 qian), Liquidambar Resin (*Ruxiang*, 1 qian), Aucklandia Root (*Guang Muxiang*, 1 qian), Houttuynia Rhizome (*Guan Zhong*, 3 qian), Licorice Root (*Gan Cao*, 3 qian), Immature Bitter Orange (*Zhi Ke*, 1 qian), Blackened Dried Ginger (*Chao Hei Gan Jiang*, 1 qian), Poria (*Fu Ling*, 5 qian), Brown Atractylodes Rhizome (*Cang Zhu*, 3 qian). Decoct in water and take orally.

*Quhan Dingtong Tang* (Cold-Expelling Pain-Stopping Decoction): Prepared Aconite Root (*Fuzi*, 3 qian), Atractylodes Macrocephala Rhizome (*Bai Zhu*, 3 liang), Cinnamon Bark (*Rou Gui*, 3 qian), Ginseng Root (*Renshen*, 3 qian), Acorus Tatarinowii Rhizome (*Chang Pu*, 1 qian), Poria (*Fu Ling*, 5 qian). Decoct in water and take orally.