(附怔忡 惊悸 健忘 附颠狂 附邪祟)
心痛者。非真心痛也。乃心胞络与胃脘痛也。然果何以知之。盖心胞络护捧其心。脉络
相系位居心之四旁。火载痰而上升。碍其所居。胞络为痰相轧。故脂膜紧急而作痛。遂误认以为
心痛也。胃脘近心。位居心下。而络于脾。饮食过多。不能克化。伤乎胃脘。病根常在。略
伤饮食。即闷闷作痛。亦误认以为心痛也。大抵痛而有痰。常觉恶心。呕去痰即宽者。即为
之心胞络痛也。痛而作饱。时时嗳气。直至饥而缓者即谓之胃脘痛也。又有痛时得饮热汤酒
而稍缓者。乃寒气客于心脾之间也。又有心头作痛。其痛应于背心者。乃忧郁悲思积而成病
也。又有心头急痛。唇白毛竖口吐黄水者。乃虫之为害也。又有心头结疼。逆气上腾。如虫
搅扰。自觉胸中唧唧作声者。非虫也。乃死血随气而动也。又有一月一发。或一月两发。或
二三月一发。其发也。疼极闷死。搔爬无措。涎水一涌而即苏者。乃寒积于心脾之间。安
堵不动。一为恼怒劳倦所伤。则寒痰乘势涌起。泛溢胃口。迷塞心窍
故闷疼而欲死。涎水一涌而出。则胃口渐宽心窍
渐通。而复苏也。凡此皆可施
治。惟平素原无心痛之疾。卒然大痛无声。面青气冷。切牙噤齿。手足如冰冷者。乃真心痛
也。盖寒邪直犯君火。旦发则暮死。暮发则旦死。不救之症也。
心痛,并非真正的“真心痛”,而是心包络与胃脘部位的疼痛。那么究竟如何辨别呢?因为心包络护卫并环绕着心脏,脉络相连,位置位于心脏的四周。当火邪挟带痰浊向上冲逆,阻碍了心包络的正常居所,痰浊挤压心包络,导致脂膜紧张拘急而引发疼痛,于是被误认为是心痛。
胃脘部位靠近心脏,位于心脏下方,且经络连接于脾脏。如果饮食过量,脾胃无法运化消化,就会损伤胃脘。这种病的病根往往存在,只要稍微饮食不当,就会感到闷痛,这也常被误认为是心痛。
大抵而言,疼痛伴有痰湿,常感觉恶心,吐出痰液后疼痛缓解的,这就是心包络痛。疼痛时感觉饱胀,经常打嗝,直到饥饿时疼痛才缓解的,这就称为胃脘痛。
又有在疼痛时饮用热汤或饮酒后稍能缓解的,这是寒气客居于心脾之间所致。
又有心头作痛,疼痛放射至背部的,这是由于忧郁悲思积聚而成病。
又有心头急痛,嘴唇发白、毫毛竖起、口吐黄水的,这是虫类为害所致。
又有心头结聚疼痛,气逆上冲,如同虫类搅扰,自觉胸中发出唧唧声响的,这不是虫患,而是瘀血随气机运行而动所致。
还有一种情况,每月发作一次,或两次,或两三个月发作一次。发作时疼痛剧烈,令人窒息欲死,抓挠无措,一旦涌出涎水便立即苏醒的,这是寒邪积聚在心脾之间,平时安堵不动,一旦因恼怒或劳倦所伤,寒痰便乘势涌起,泛溢胃口,迷塞心窍,所以胸闷疼痛欲死。待涎水涌出,胃口逐渐宽舒,心窍逐渐通畅,人便复苏过来。
以上这些情况都可以进行治疗。唯独平素没有心痛疾病的人,突然发生剧烈疼痛且无声响,面色青紫,气息寒冷,咬牙紧闭牙齿,手足冰冷如冰的,这才是真正的“真心痛”。这是因为寒邪直接侵犯君火(心阳),早晨发病则傍晚死亡,傍晚发病则早晨死亡,属于无法救治的危症。
(Attached: Palpitations [Zhengchong], Startled Palpitations [Jingji], Forgetfulness [Jianwang]; Attached: Mania [Diankuang], Evil Influence [Xiesui])
Heart pain is not true "Zhenxin Tong" (True Heart Pain), but rather pain in the Pericardium Collateral [Xinbaoluo] and the epigastrium. How, then, can one distinguish them? The Pericardium Collateral protects and surrounds the heart, with meridians connected, located on the four sides of the heart. When Fire carries Phlegm upward, obstructing its dwelling place, the Phlegm compresses the Pericardium Collateral, causing the fatty membrane to become tense and painful, leading to a misdiagnosis as heart pain.
The epigastrium is close to the heart, located below it, and its collaterals connect to the Spleen. If food intake is excessive and cannot be transformed and digested, the epigastrium is injured. The root of this disease often persists; slight dietary indiscretion leads to stifling pain, which is also frequently mistaken for heart pain.
Generally, if pain is accompanied by Phlegm, with frequent nausea, and relief occurs after vomiting up Phlegm, it is identified as Pericardium Collateral pain. If pain presents with a sensation of fullness, frequent belching, and relief only when hungry, it is termed Epigastric pain.
If pain is slightly relieved by drinking hot soup or wine, it indicates Cold pathogen lodging between the Heart and Spleen.
If there is pain in the heart region radiating to the back, it results from accumulated depression and sorrowful thoughts.
If there is urgent pain in the heart region, with white lips, erect hair, and vomiting of yellow fluid, it is caused by parasitic worms.
If there is knotted pain in the heart region, with rebellious Qi ascending, feeling like worms disturbing, and hearing squirming sounds in the chest, it is not due to worms, but rather stagnant Blood moving with Qi.
In another scenario, occurring once or twice a month, or every two to three months, the attack involves extreme pain causing suffocation and despair, with no recourse but scratching. Upon the sudden gush of saliva/phlegm, the patient revives. This is due to Cold accumulation between the Heart and Spleen, which remains static normally. However, injury from anger or fatigue causes Cold-Phlegm to surge, overflowing the stomach opening and blocking the Heart orifice, resulting in stifling pain and near-death state. Once the saliva/phlegm is expelled, the stomach opening widens, the Heart orifice clears, and revival occurs.
All these conditions are treatable. However, if a person who previously had no history of heart pain suddenly experiences severe pain without sound, cyanotic complexion, cold breath, clenched teeth, and ice-cold hands and feet, this is True Heart Pain [Zhenxin Tong]. This occurs because Cold pathogen directly attacks the Ministerial Fire (Heart Yang). Onset in the morning leads to death by evening; onset in the evening leads to death by morning. It is an incurable condition.