人有久患心疼，时重时轻，大约饥则痛重，饱则痛轻，人以为寒气中心也，谁知是虫伤
胃脘乎。盖心君宁静，客寒客热之气，皆不能到，倘寒气犯心，立刻死矣，安能久痛乎。凡
痛久不愈者，皆邪犯心包与胃口耳。但邪犯胃与心包，暂痛而不常痛也，断无饥重而饱轻者
。若虫蚀则觅食头上行，而无食以充其饥，则其身上撺，口啮胃脘之皮，则若心痛，而实非
心痛也。不杀虫而但止其痛，痛何能止乎。方用化虫定痛丹∶
生地（二两） 水煎汁二碗，入白薇二钱，煎汁一碗，淘饭食之，非吐物如虾蟆，必泻虫如
守宫也。
大凡胃中湿热，人多生虫。饮食倍于寻常，皆易有虫，以此方投之，皆能取效，不止治
心痛之虫也。盖生地杀虫于有形，而白薇杀虫于无形，合而用之，化虫最神。虫死而心痛自
除，非生地、白薇之能定痛也。
此症用草根粥亦效。
楝树根（一两）
煎汤二碗，入甘草一钱，再煮粥一碗。顿食之，即止痛。
人有一时心痛，倏痛倏已，一日而十数遍者，饮食无碍，昼夜不安，人以为此虫也，而
不知不然。夫虫痛必非一日而成，岂有无端而一时心痛者乎。或曰此火也。夫火则终日痛，
而必非时痛时止者。然则为何痛乎?非火、非虫，乃气虚而微感寒湿之邪，邪冲心包而作痛
，邪不冲心包而即不痛，即古人所云去来痛也。痛无补法，而独去来痛，必须用补，不补虚
而痛不能止。然徒用补药，而不加入祛寒祛痰之味，亦不能定痛也
。方用去来汤∶
人参（三钱） 茯苓（三钱） 苍术（三钱） 白术（五钱） 甘草（二钱） 川乌（二钱） 半夏（一钱）
水煎服。一剂而痛即止，再剂而痛不再发。
方中用二术为君主，最有佳意。盖痛虽由于气虚，毕竟湿气之侵心包也。二术去湿而又
健脾胃之气，故用之以佐人参、茯苓补气以利湿，则湿去而气更旺也。气既旺矣，而川乌得
直入心包，以祛逐其寒邪；半夏得行于中脘，而消其败浊之痰；甘草和缓，调停于邪正之间
，以奏功于眉睫矣。
此症用苍乌参苓散亦甚效。
人参 草乌（各一钱） 茯苓 苍术（各三钱） 巴戟天（一两）
水煎服。一剂即止痛。
人有心痛之极，苦不欲生，彻夜呼号，涕泗滂沱者，人以为火邪作祟也。然致此火邪之
犯心者，何故乎?盖因肝气之郁而不舒，木遂生火以犯心矣。夫肝木生心火者也，而何以反
致克心，盖心属火，而火不可极，火极反致焚心，往往有自焚而死者。故心火太旺，火正为
心之所恶，而又得肝木之助火，则心不能受，必呼号求救于四邻，自然涕泪交垂矣。且肝
木之火又系郁火，正火顺而郁火逆，犹非心之所喜，故入心而心不受。然火势太旺，又不能
遏抑，偏欲直入于心宫，而心包又掩护重重，未易焚烧，但肝木之郁火，乃木中之火，龙雷
之火也，每从下而上冲，霹雳之威，震开天门，火光所至，焚林烧木，天地且为之动荡，何
能止遏哉。此肝火之冲心，所以直受其害也。治法必须泻肝木之火，更须解木气之郁，而少
佐以安心之剂，则心痛自止也。方用救痛安心汤∶
白芍（一两） 炒栀子（三钱） 甘草（一钱） 柴胡（二钱） 贯仲（二钱） 乳香（一钱） 没药（
一钱） 苍术
水煎服。一剂而痛定，再剂而全愈矣。
白芍、柴胡，最解肝气之郁；栀子、贯仲，最泻肝火之暴；乳香、没药，最止脏腑之痛
，而甘草、苍术和中消湿，辅佐得宜，故一剂而奏功也。
此症用栀香饮亦妙。
炒栀子 荆芥（各三钱） 茯苓（五钱） 甘草 乳香末 丹砂末 木香末（各一钱）
水煎调服。一剂即止痛。
人有真正心痛，法在不救，然用药得宜，亦未尝不可生也。其症心痛不在胃脘之间，亦
不在两胁之处，恰在心窝之中，如虫内咬，如蛇内钻，不特用饭不能，即饮水亦不可入，手
足冰冷，面目青红者是也。夫真心痛，原有两症，一寒邪犯心，一火邪犯心也。寒犯心者，
乃直中阴经之病，猝不及防，一时感之，立刻身死。死后必有手足尽紫黑者，甚则遍身俱青
，多非药食能救，以至急而不遑救也。倘家存药饵，用人参一、二两，附子三钱，急煎救之
，可以望生，否则必死。若火犯心者，其势虽急而犹缓，可以远觅药饵，故不可不传方法，
以救人也。余言前症，正火邪犯心也，但同是心疼，何以辨其一为寒而一为热?盖寒邪舌必
滑，而热邪舌必燥耳。倘辨其为火热之心痛，即用救真汤投之
炒栀子（三钱） 炙甘草（一钱） 白芍（一两） 广木香末（二钱） 石菖蒲（一钱）
水煎服。一剂而痛止矣，不必更用二剂。但痛止后必须忍饥一日，断不再发。
或曰∶既是真心痛，宜用黄连以直治心火，何以不治心而治肝耶?不知肝为心之母，泻
肝木之气，则肝不助火而心气自平，泻肝木正善于泻心火也。倘直泻其心，则心必受伤，虽
暂取效于一时，而脾胃不能仰给于心火，则生气遏抑，必至中脘虚寒，又变成他症矣。此黄
连之所以不用，而反用栀子也。
人有患心疼之病，百药治之不效，得寒则痛，得热亦痛，盖此症非心痛，乃胃痛也。寒
热俱能作痛，盖寒与热不并立，寒热同乘于心胃之间，寒欲凌热，而热不肯相让；热欲欺寒
，而寒不肯相安，两相攻战，势均力敌。治心则胃气受伤，治胃则心气受损，所以治寒治热
，而两无一效也。治法宜两治之以解纷，而心痛自愈。方用双治汤∶
附子（一钱） 黄连（一钱） 白芍（五钱） 甘草（一钱）
水煎服。一剂而痛立愈。
用黄连以清心火，用附子以祛胃寒，用白芍、甘草为君，使两家有和解之好。盖芍药、
甘草最能入肝平木，肝气既平，自然不去克胃，而又去生心，调和于心胃之间，实有至理
，非漫然而用之者也。
此症亦可用苍乌暖心丹∶
白术（一两） 白芍（二钱） 茯苓（五钱） 苍术（三钱） 川乌（一钱） 肉桂 甘草（各五分）
水煎服。下喉即止痛。
人有心痛不能忍，气息奄奄，服姜汤而少安，手按之而能忍，目轻夜重，痛阵至时，几
不欲生，人以为此寒痛也。用热药少止，片时而仍痛，其故何与?寒有不同也。凡人心君宁
静，由于肾气之通心也。肾气不交于心，而寒邪中之，心遂不安而痛矣。倘徒祛其寒而不补
其肾，则肾虚而火不能下热于肾中，即肾虚，而水不能上交于心内。此治心必须治肾，而补
肾中之火以救心，犹必须补肾中之水以救肾也。方用补水救火汤∶
熟地（一两） 山茱萸（三钱） 巴戟天（五钱） 山药（三钱） 白术（五钱） 肉桂（一钱） 北五味（五分）
水煎服。一剂而痛可止，二剂而痛全愈，十剂而痛不再发。
此方视之，绝非治心痛之药，而用之治心肾不交之心痛，实有奇功。盖肾中水火不交，
而肾邪直犯于心矣。吾补其肾中之水火，水得真火以相生，火得真水以相养，肾中之阴阳既
济，则心肾之阴阳又安得有冰炭之乖乎。故不必引其上下之相交，而肾气自通于心，心气自
降于肾，一如夫妇之好合矣，邪亦乌能间之，况原无寒邪哉。
此症用交济汤亦佳。
白术 苍术（各五钱） 肉桂 破故纸 菟丝子（各三钱） 广木香 甘草（各一钱） 熟地（一两）
水煎服。
A person suffering from long-standing heart pain experiences fluctuations in severity, with pain intensifying when hungry and alleviating after meals. People attribute this to cold pathogen invading the Heart, but little do they know it is actually parasites damaging the stomach region (Wei). The Heart Emperor (Heart) is tranquil; external cold or heat pathogens cannot reach it. If cold truly invaded the Heart, death would be instantaneous, making prolonged pain impossible. Any pain that persists for a long time indicates that pathogens have invaded the Pericardium (Xin Bao) and the Stomach opening. However, invasion of the Stomach and Pericardium causes only temporary, not frequent, pain, and certainly not pain that worsens with hunger and improves with fullness. If parasites are eroding tissues, they seek food and move upward; lacking food to satiate them, they crawl around and gnaw at the mucosa of the stomach region, presenting as heart pain, though it is not true heart pain. Without eliminating the parasites, merely stopping the pain will not work. Use Huachong Dingtong Dan (Parrot-Expelling Pain-Calming Decoction):
Shengdi Radix Rehmanniae Preparata (2 liang), decocted in water to yield two bowls of juice. Add Baiwei Radix Cynanchi Atrati (2 qian), decoct again to yield one bowl of juice. Mix with rice porridge. One will either vomit creatures resembling toads or excrete worms resembling geckos.
Generally, damp-heat in the stomach predisposes individuals to parasitic infestation. Those whose dietary intake exceeds normal levels are prone to such issues. This formula is effective for these cases, not just for parasitic heart pain. Shengdi eliminates parasites in the tangible realm, while Baiwei eliminates them in the intangible realm. Used together, their efficacy in dissolving parasites is miraculous. Once the parasites die, the heart pain naturally ceases; this is not because Shengdi and Baiwei directly stop pain, but because they eliminate the cause.
For this condition, Lian Shu Gen Zhou (Melia Root Porridge) is also effective.
Lian Shu Gen Cortex Meliae Toosendan (1 liang), decocted in water to yield two bowls of soup. Add Gancao Radix Glycyrrhizae (1 qian), and cook into one bowl of porridge. Consume in one sitting; pain stops immediately.
Some experience sudden heart pain that appears and disappears rapidly, occurring more than ten times a day. Their diet is unaffected, yet they suffer restlessness day and night. People suspect parasitic pain, but this is incorrect. Parasitic pain does not develop overnight; how could there be unprovoked, sudden heart pain? Some suggest it is Fire Pathogen. Fire-induced pain is constant, not intermittent. So why the pain? It is neither Fire nor parasites. It is Qi deficiency combined with slight invasion of Cold-Damp pathogens. When the pathogen assaults the Pericardium, pain occurs; when it does not, there is no pain. This is what ancients called "Qu Lai Tong" (Intermittent Pain). Generally, tonification is contraindicated for pain, but for this specific intermittent type, tonification is essential. Without tonifying deficiency, pain cannot cease. However, using tonics alone without adding herbs to dispel Cold and resolve Phlegm will not stop the pain. Use Qulai Tang (Intermittent Pain Decoction):
Renshen Radix Ginseng (3 qian), Fuling Poria (3 qian), Cangzhu Rhizoma Atractylodis Lanceae (3 qian), Baizhu Rhizoma Atractylodis Macrocephalae (5 qian), Gancao Radix Glycyrrhizae (2 qian), Chuanwu Radix Aconiti Kusnezoffii (2 qian), Banxia Rhizoma Pinelliae Preparatum (1 qian). Decoct in water and take orally. Pain stops after one dose and does not recur after a second dose.
The use of Er Zhu (Cangzhu and Baizhu) as sovereign herbs is highly significant. Although pain stems from Qi deficiency, it is ultimately caused by Dampness invading the Pericardium. Er Zhu dispels Dampness and strengthens Spleen and Stomach Qi. Thus, they assist Renshen and Fuling in tonifying Qi to promote Dampness resolution. As Dampness clears, Qi becomes robust. With robust Qi, Chuanwu can penetrate directly into the Pericardium to expel Cold pathogens; Banxia circulates through the Middle Jiao to dissipate turbid Phlegm; Gancao, being mild and harmonizing, mediates between the pathogenic and righteous factors, achieving rapid results.
For this condition, Cangwu Shenling San (Cangzhu, Aconite, Ginseng, and Poria Powder) is also very effective.
Renshen Radix Ginseng, Caowu Radix Aconiti Preparata (each 1 qian), Fuling Poria, Cangzhu Rhizoma Atractylodis Lanceae (each 3 qian), Bajitian Radix Morindae Officinalis (1 liang). Decoct in water and take orally. Pain stops after one dose.
Some suffer extreme heart pain, so agonizing they wish for death, wailing all night with tears flowing profusely. People attribute this to Fire Pathogen wreaking havoc. But why does Fire invade the Heart? It is due to Liver Qi stagnation and frustration, causing Wood to generate Fire which then attacks the Heart. Wood normally generates Fire, so why does it counteract the Heart? The Heart belongs to Fire, but Fire must not reach its extreme; excessive Fire burns the Heart itself, sometimes leading to death by self-combustion. Therefore, if Heart Fire is too vigorous, it becomes abhorrent to the Heart. Assisted by Liver Wood, the Heart cannot bear it, crying out for help, resulting in tears and snot. Moreover, Liver Fire is stagnant fire. While regular Fire flows smoothly, stagnant Fire rebels, which the Heart dislikes. Thus, entering the Heart, it is rejected. Yet, the Fire is too strong to suppress and insists on entering the Heart Palace. The Pericardium provides layered protection, making it hard to burn. However, Liver stagnant fire is fire within Wood, akin to Dragon-Thunder Fire. It often rushes upward from below. Its power resembles thunderbolts, shaking the heavens. Wherever the light reaches, forests burn, and heaven and earth tremble. How can it be restrained? This is why Liver Fire rushing to the Heart causes direct harm. Treatment must drain Liver Wood Fire and resolve Wood Qi stagnation, supplemented slightly by Heart-calming agents, to stop the pain. Use Jiutong Anxin Tang (Pain-Saving Heart-Calming Decoction):
Baishao Radix Paeoniae Alba (1 liang), Chao Zhizi Fructus Gardeniae Praeparatus (3 qian), Gancao Radix Glycyrrhizae (1 qian), Chaihu Radix Bupleuri (2 qian), Guanzhong Herba Dryopteridis Crassirhizomatis (2 qian), Ruxiang Resina Olibani (1 qian), Moyao Resina Myrrhae (1 qian), Cangzhu Rhizoma Atractylodis Lanceae. Decoct in water and take orally. Pain stabilizes after one dose and resolves completely after two doses.
Baishao and Chaihu best resolve Liver Qi stagnation; Zhizi and Guanzhong best purge violent Liver Fire; Ruxiang and Moyao best stop visceral pain; Gancao and Cangzhu harmonize the middle and dissipate Dampness. With proper assistance, efficacy is achieved in one dose.
For this condition, Zhixiang Yin (Gardenia and Costus Drink) is also excellent.
Chao Zhizi Fructus Gardeniae Praeparatus, Jingjie Herba Schizonepetae (each 3 qian), Fuling Poria (5 qian), Gancao Radix Glycyrrhizae, Ruxiang powder, Zhusha powder, Muxiang Radix Aucklandiae (each 1 qian). Decoct in water and administer with the powder. Pain stops after one dose.
True Zhenxin Tong (True Heart Pain) is generally considered incurable, but with appropriate medication, survival is possible. The symptom involves pain precisely in the epigastric pit, not in the stomach region or hypochondrium. It feels like insects biting inside or snakes drilling within. Not only eating is impossible, but even drinking water is intolerable. Hands and feet are cold, and the face shows alternating blue and red hues. True Heart Pain has two types: one caused by Cold Pathogen invading the Heart, and the other by Fire Pathogen. Cold invading the Heart is a direct attack on the Yin meridians. It strikes suddenly, causing immediate death upon infection. Post-mortem, hands and feet turn entirely purple-black, or the whole body turns green. Medication and food usually cannot save such cases due to the urgency. If medicine is available, use 1-2 liang of Renshen Radix Ginseng and 3 qian of Fuzi Radix Aconiti Lateralis Preparata, decoct urgently, and there is hope for life; otherwise, death is certain. If Fire invades the Heart, the progression is urgent but slower, allowing time to seek medicine. Thus, methods must be transmitted to save lives. The previous case described was Fire Pathogen invading the Heart. How to distinguish Cold from Heat in heart pain? Cold presents with a slippery tongue coating, while Heat presents with a dry tongue coating. If identified as Fire-Heat Heart Pain, use Jiuzhen Tang (Save True Decoction):
Chao Zhizi Fructus Gardeniae Praeparatus (3 qian), Zhi Gancao Radix Glycyrrhizae Honey-Fried (1 qian), Baishao Radix Paeoniae Alba (1 liang), Guangmuxiang Radix Aucklandiae Powder (2 qian), Shichangpu Rhizoma Acori Tatarinowii (1 qian). Decoct in water and take orally. Pain stops after one dose; a second dose is unnecessary. After pain cessation, one must fast for one day to prevent recurrence.
One might ask: Since it is True Heart Pain, why not use Huanglian Rhizoma Coptidis to directly clear Heart Fire, instead of treating the Liver? The Liver is the Mother of the Heart. Draining Liver Wood Qi prevents it from assisting Fire, thereby calming Heart Qi. Draining Liver Wood is effectively draining Heart Fire. Directly draining Heart Fire injures the Heart. Although temporary relief may occur, the Spleen and Stomach lose reliance on Heart Fire for warmth, leading to suppression of vital energy, Middle Jiao deficiency-cold, and subsequent complications. This is why Huanglian is avoided and Zhizi is used instead.
Some suffer from heart pain unresponsive to hundreds of medicines. Pain occurs with both cold exposure and heat application. This is likely not heart pain, but stomach pain. Both Cold and Heat can cause pain. Cold and Heat do not coexist peacefully; they simultaneously assault the area between the Heart and Stomach. Cold tries to dominate Heat, but Heat refuses to yield; Heat tries to bully Cold, but Cold refuses to submit. They war against each other with equal strength. Treating the Heart injures Stomach Qi; treating the Stomach injures Heart Qi. Hence, treating Cold or Heat alone yields no effect. The method should address both to resolve the conflict, healing the pain spontaneously. Use Shuangzhi Tang (Double-Treatment Decoction):
Fuzi Radix Aconiti Lateralis Preparata (1 qian), Huanglian Rhizoma Coptidis (1 qian), Baishao Radix Paeoniae Alba (5 qian), Gancao Radix Glycyrrhizae (1 qian). Decoct in water and take orally. Pain heals immediately after one dose.
Huanglian clears Heart Fire; Fuzi dispels Stomach Cold. Baishao and Gancao act as sovereigns to foster reconciliation between the two organs. Shaoyao and Gancao enter the Liver to pacify Wood. Once Liver Qi is pacified, it stops attacking the Stomach and instead nourishes the Heart, harmonizing the Heart-Stomach relationship. This rationale is sound, not arbitrary.
For this condition, Cangwu Nu Xin Dan (Cangzhu, Aconite, and Warming Heart Pill) is also usable.
Baizhu Rhizoma Atractylodis Macrocephalae (1 liang), Baishao Radix Paeoniae Alba (2 qian), Fuling Poria (5 qian), Cangzhu Rhizoma Atractylodis Lanceae (3 qian), Chuanwu Radix Aconiti Kusnezoffii (1 qian), Rougui Cortex Cinnamomi, Gancao Radix Glycyrrhizae (each 5 fen). Decoct in water and take orally. Pain stops upon swallowing.
Some suffer unbearable heart pain, with faint breathing. Ginger soup brings slight relief, and pressure on the abdomen makes it tolerable. Symptoms are lighter during the day and heavier at night. During pain episodes, they feel like dying. People assume it is Cold Pain. Hot herbs provide brief relief, but pain returns shortly after. Why? Cold pathogens vary. The Heart remains tranquil due to Kidney Qi connecting to it. If Kidney Qi fails to connect, Cold Pathogen invades, causing Heart unrest and pain. Merely dispelling Cold without tonifying the Kidney leaves Kidney deficiency. Then Mingmen Fire cannot warm the Kidneys, and Kidney Water cannot ascend to nourish the Heart. Therefore, treating the Heart requires treating the Kidney. Tonifying Kidney Fire saves the Heart, just as tonifying Kidney Water saves the Kidney. Use Bushui Jiuhuo Tang (Water-Nourishing Fire-Saving Decoction):
Shudi Radix Rehmanniae Preparata (1 liang), Shanzhuyu Fructus Corni Officinalis (3 qian), Bajitian Radix Morindae Officinalis (5 qian), Shanyao Rhizoma Dioscoreae Oppositae (3 qian), Baizhu Rhizoma Atractylodis Macrocephalae (5 qian), Rougui Cortex Cinnamomi (1 qian), Bei Wuweizi Fructus Schisandrae Chinensis (5 fen). Decoct in water and take orally. Pain stops after one dose, resolves completely after two doses, and does not recur after ten doses.
This prescription does not appear to treat heart pain, but applied to Heart-Kidney non-interaction heart pain, it yields miraculous results. When Kidney Water and Fire fail to interact, Kidney pathogens directly invade the Heart. By tonifying Kidney Water and Fire, Water is generated by True Fire, and Fire is nourished by True Water. With Kidney Yin and Yang harmonized, how can Heart and Kidney Yin and Yang remain incompatible like ice and charcoal? Thus, there is no need to forcibly guide upper and lower interaction; Kidney Qi naturally connects to the Heart, and Heart Qi descends to the Kidney, like a harmonious union. Pathogens cannot interfere, especially since no original Cold Pathogen exists.
For this condition, Jiaoji Tang (Mutual-Balance Decoction) is also good.
Baizhu Rhizoma Atractylodis Macrocephalae, Cangzhu Rhizoma Atractylodis Lanceae (each 5 qian), Rougui Cortex Cinnamomi, Pogostemonis Herba (Guozhi), Cuscutae Semen (Tusizi) (each 3 qian), Guangmuxiang Radix Aucklandiae, Gancao Radix Glycyrrhizae (each 1 qian), Shudi Radix Rehmanniae Preparata (1 liang). Decoct in water and take orally.