足厥阴心痛，两胁急，引小腹连阴股相引痛。手心主心痛，彻背，心烦，掌中热，咽干
，目黄赤，胁满。足太阴心痛，腹胀满，涩涩然大便不利，膈闭咽塞。手太阴心痛，短气不
足以息，季胁空痛，遗失无度，胸满烦心。足少阴心痛，烦剧面黑，心悬若饥，胸满，腰脊
痛。背输诸经心痛，心与背相引，心痛彻背，背痛彻心。诸腑心痛，难以俯仰，小腹上冲，
卒不知人，呕吐泄泻，此皆诸经、诸俞、诸腑涉邪所致病，属外所因。
肝心痛者，色苍苍如死灰状，终日不得太息。真心痛者，手足青至节，旦发夕死，夕发
旦死。脾心痛者，如针锥刺其心腹，蕴蕴然气满。肺心痛者，若从心间起，动作痛益甚，色
不变。肾心痛者，与背相引，善螈，如物从后触其心，身伛偻。胃心痛者，腹胀满，不下食
，食则不消。皆脏气不平，喜怒忧郁所致，属内所因。
久积心腹痛者，以饮啖生冷果实，中寒不能消散，结而为积，甚则数日不能食，便出干
血，吐利不定，皆由积物客于肠胃之间，遇食还发，名积心痛。及其脏寒生蛔致心痛者，心
腹中痛，发作肿聚，往来上下，痛有休止，腹热涎出，病属不内外因。方证中所谓九种心痛
，曰饮，曰食，曰风，曰冷，曰热，曰悸，曰虫，曰注，曰去来痛者，除风热冷属外所因，
余皆属不内外。更有妇人恶血入心脾经，发作疼痛，尤甚于诸痛。更有卒中客忤，鬼击尸疰
，使人心痛，亦属不内外因。
足厥阴经所致的心痛，表现为两胁拘急，疼痛牵引至小腹并连及阴股部位相互牵引作痛。手厥阴心包经所致的心痛，疼痛放射至背部，伴有心烦、手掌发热、咽喉干燥、眼睛发黄且红赤、胁肋部胀满。足太阴脾经所致的心痛，表现为腹部胀满，大便涩滞不通利，膈部闭塞、咽喉堵塞感。手太阴肺经所致的心痛，表现为气短不足以呼吸，季胁（侧胸下部）空痛，大小便失禁无度，胸部胀满、心烦。足少阴肾经所致的心痛，烦躁剧烈、面色发黑，心中空虚感如同饥饿，胸部胀满，腰脊疼痛。背俞穴所属各经脉所致的心痛，心脏与背部相互牵引，心痛放射至背部，背痛放射至心脏。诸腑所致的心痛，难以俯身和仰身，小腹胀气上冲，突然昏不知人，伴有呕吐、泄泻，这些都属于各经、各俞穴、各腑受邪气侵袭所致的疾病，归属于外所因。
肝心痛者，面色青苍苍白如死灰之状，整天无法深长叹息。真心痛者，手足青紫直至关节，早晨发病傍晚死亡，傍晚发病早晨死亡。脾心痛者，疼痛如同针锥刺入心腹，气机郁结胀满。肺心痛者，疼痛似乎从心间发起，活动时疼痛加剧，但面色不变。肾心痛者，疼痛与背部相互牵引，容易抽搐，感觉像有物体从背后触碰心脏，身体弯曲佝偻。胃心痛者，腹部胀满，不能进食，进食后食物不消化。这些都是由于脏气不平衡，由喜怒忧郁等情志因素导致，归属于内所因。
长期积聚的心腹痛，是因为饮食生冷果实，中焦受寒不能消散，凝结而成积块，严重时数日不能进食，排出干血，呕吐泄泻不定，这都是因为积滞之物客居于肠胃之间，遇到食物就发作，称为积心痛。至于因脏腑虚寒生蛔虫而导致的心痛，表现为心腹疼痛，发作时肿块聚散无常，上下移动，疼痛有休止时间，腹部发热、口吐涎水，这种病属于不内外因。方证中所说的九种心痛，即饮、食、风、冷、热、悸、虫、注、去来痛，其中风、热、冷属于外所因，其余都属于不内外因。更有妇女恶血侵入心脾二经，发作时疼痛，比各种疼痛都严重。还有突然中受客忤之气、鬼击或尸疰邪气，使人发生心痛，也属于不内外因。
Heartache due to the Foot Jueyin (Liver) channel presents with tension in both hypochondria, with pain radiating to the lower abdomen and connecting to the inner thigh, causing mutual pulling pain. Heartache due to the Hand Jueyin (Pericardium) channel involves pain penetrating through to the back, accompanied by vexation, heat in the palms, dryness of the throat, yellowing and reddening of the eyes, and fullness in the hypochondria. Heartache due to the Foot Taiyin (Spleen) channel manifests as abdominal fullness, astringent difficulty in defecation, obstruction at the diaphragm, and a sensation of blockage in the throat. Heartache due to the Hand Taiyin (Lung) channel is characterized by shortness of breath insufficient for respiration, empty pain in the lateral costal margin, uncontrolled loss of urine and feces, chest fullness, and vexation. Heartache due to the Foot Shaoyin (Kidney) channel presents with severe vexation, black complexion, a sensation of hunger-like emptiness in the heart, chest fullness, and pain in the waist and spine. Heartache involving the Back-Shu points of various channels features mutual traction between the heart and the back, where heartache penetrates to the back and backache penetrates to the heart. Heartache arising from the Fu organs makes it difficult to bend or extend the body, with upward rushing of Qi in the lower abdomen, sudden loss of consciousness, vomiting, and diarrhea; these are all diseases caused by pathogenic factors affecting various channels, Shu points, and Fu organs, belonging to External Causes.
Liver heartache is characterized by a pale cyan complexion resembling dead ash, with an inability to sigh deeply throughout the day. True heartache presents with cyanosis of the hands and feet extending to the joints; if it occurs in the morning, death ensues in the evening, and if in the evening, death occurs in the morning. Spleen heartache feels like needle-like stabbing in the heart and abdomen, with a feeling of Qi stagnation and fullness. Lung heartache seems to originate from the heart region, worsening with movement, while the complexion remains unchanged. Kidney heartache involves mutual traction with the back, frequent spasms, a sensation as if an object is touching the heart from behind, and a stooped posture. Stomach heartache presents with abdominal fullness, inability to eat, and indigestion after eating. These are all caused by imbalance of Zang Qi due to emotional factors such as anger, joy, and depression, belonging to Internal Causes.
Long-standing accumulated heart and abdominal pain results from consuming cold raw foods and fruits, leading to Cold in the Middle Jiao that fails to dissipate, condensing into an accumulation. In severe cases, one cannot eat for several days, passes dry blood, and experiences irregular vomiting and diarrhea. This is caused by accumulated matter lodging between the stomach and intestines, re-triggered upon eating, known as Accumulation Heartache. When heartache is caused by intestinal roundworms due to visceral Cold, it presents with pain in the heart and abdomen, episodic swelling and gathering moving up and down, intermittent pain, abdominal heat, and salivation; this disease belongs to Neither-Internal-Nor-External Causes. The nine types of heartache mentioned in formulas and syndromes are: Drink, Food, Wind, Cold, Heat, Palpitation, Worm, Transmission, and Migratory Pain. Among these, Wind, Heat, and Cold belong to External Causes, while the rest belong to Neither-Internal-Nor-External Causes. Additionally, in women, evil blood entering the Heart and Spleen channels causes pain that is more severe than other pains. Sudden attacks by Guest Worry (Ke Wu), Ghost Strikes, or Corpse Transfusion pathogens also cause heartache, which similarly belongs to Neither-Internal-Nor-External Causes.