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(That is, epigastric pain.)
Heartache (Xintong), although the course of the disease may be long and even if food intake is refused, it will not lead to death. However, if food is consumed immediately after the pain subsides, the pain will recur; one must take three to five doses of medicine before resuming food intake.
Generally speaking, pain in the heart and diaphragm region must be distinguished as either new or chronic. If it is known that the disease was caused by exposure to cold pathogens or consumption of cold foods, at the initial stage, warming and dispersing or warming and purgative herbs should be used. If the disease has persisted for a while, it will form stagnation (Yu). Stagnation generates steaming heat; prolonged heat inevitably generates fire, as detailed in *Yuan Bing Shi* (Original Treatise on Diseases). If one were to use warming and dispersing methods in this context, would it not assist the fire and aggravate the illness? Therefore, in ancient prescriptions, Gardenia (Zhizi) is often used as a guide for heat-clearing herbs, so that latent pathogenic factors are expelled, diseases recede easily, healthy qi recovers easily, and the patient becomes comfortable. Nevertheless, after recovery, if one indulges in dietary preferences and does not correct previous habits, when the disease recurs, it will be difficult to treat.
Gardenia (Zhizi) is stir-fried, skin removed. For every fifteen fruits, decoct strongly with water to obtain one sip of liquid, add ginger juice until spicy, boil briefly, and administer. Alternatively, adding Chuanxiong (Chuanxiong Rhizome) 1 qian is especially effective. For large Gardenia fruits, use seven or nine. Generally, for stomach heat causing pain, only Gardenia is suitable. It can be assisted with ginger juice, or Pinellia (Banxia) and Tangerine Peel (Juhong) each 5 qian, Scutellaria (Huangqin) 3 qian, and Licorice (Gancao) 1 qian. Use Erchen Tang (Two-Cured Decoction) added with Atractylodes (Cangzhu) and Chuanxiong, with doubled stir-fried Gardenia. For severe pain, add stir-fried Dried Ginger (Ganjiang); this follows the principle of contrary treatment (Fan Zhi). For mild heartache, use dispersing methods: Ephedra (Mahuang) and Cinnamon Twig (Guizhi). For severe cases, add Alkaline Earth (Shijian), Chuanxiong, Atractylodes, and Gardenia (must be stir-fried and skin removed), processed into pills for administration.
In treating any disease, one must first inquire about the patient's daily routine. For instance, if heartache is caused by a habit of consuming hot foods, leading to blood flow stagnation in the stomach area causing pain, use Tao Ren Cheng Qi Tang (Peach Kernel and Magnolia Bark Decoction) to purge it. Remember this! For mild cases, use Leek Juice (Jiu Zhi) and Platycodon (Jiegeng), which can raise and open qi; they can be used concurrently with blood-invigorating herbs.
If pressing the painful area with an object stops the pain, it indicates accompanying deficiency; use Erchen Tang (Two-Cured Decoction) added with stir-fried Dried Ginger to harmonize.
For parasitic pain, characterized by white spots on the face, red lips, and good appetite, it belongs to parasites. Treat with roots of Melia (Kulian Gen) and Tin Ash (Xi Hui). If the pulse is firm and there is constipation, use purgative methods.
For severe pain, the pulse will likely be deep and hidden (Fu). Use more warming herbs; avoid Ginseng (Renshen) and Atractylodes (Baizhu); Aconite (Fuzi) can be used.
Various pains should not be treated with qi-tonifying herbs.
For invading cold affecting the stomach, Caodoukou Wan (Grass Cardamom Pill) is used. It can also be used for heat patterns, but only for one or two doses.
Grass Cardamom (Caodoukou) (1 qian 4 fen, wrapped and heated, then peeled) Evodia (Wuzhuyu) (soaked in boiling water, washed, stems removed, dried over fire) Alpinia Oxyphylla (Yizhiren) White Silkworm (Bai Jiangcan) Tangerine Peel (Chenpi) Ginseng (Renshen) Scutellaria (Huangqin) (each 8 fen) Raw Licorice (Sheng Gancao) Angelica Sinensis Root (Guishen) Honey-fried Licorice (Zhi Gancao) Cinnamon Bark (Guipi) (each 6 fen) Fermented Wheat Qu (Qumao) Turmeric (Jianghuang) (each 4 fen) Peach Kernel (Taoren) (7 grains, peeled) Pinellia (Banxia) (1 qian, washed) Ophiopogon (Maimen) (1 qian 5 fen, stir-fried until yellow) Alisma (Zexie) (1 qian, reduce dose by half if urination is excessive) Bupleurum (Chaihu) (4 fen) Detailed application: frequently used for pain below the diaphragm.
The above eighteen ingredients, except for Peach Kernel which is separately ground into a paste, are all ground into fine powder, mixed uniformly with the peach kernel paste. Soak in water, steam, and process into pills the size of paulownia seeds. Take thirty pills per dose, far from meals, swallowed with hot plain water. Adjust dosage according to circumstances.
Another prescription: Stir-fry Vitex Fruit (Huangjingzi) until charred, grind into powder, mix with rice drink, and take orally. Also treats leukorrhea.
Another prescription: For spleen pain, use Arca Shell Powder (Haige Fen), assisted with Cyperus (Xiangfu) powder. Decoct Ligusticum (Chuanxiong), Gardenia (Zhizi), and Fresh Ginger (Shengjiang) to make a spicy soup, mix with powder, and take orally; this is preferred.
Another prescription: Use only Oyster Shell Powder (Muli Fen), taken with wine, 1-2 qian per dose. Contraindicated for excess qi patterns.