头目痛,脉反短涩者死。
脑痛,脉弦大者死。
卒视无所见者死。
风气与阳明入胃循脉而上,至目内 ,泣泄名风成寒中,宜辛温之。不得外
泄,目黄名风成热中而郁也,宜辛凉发之。
因痰饮随气上,伏留于阳经,遇火则动,或七情郁而生涎,亦同呕吐,眉目
疼痛,目不欲开。
因血虚眩晕,眼花屋转,起则晕倒。
因外感,风在三阳经,头重项强,有汗。
因虚则掣痛;暑则热闷;湿则重着,皆令吐逆晕倒。
散风行湿汤 治痰火眩晕。
二陈汤 黄芩 苍术 活石
瓜蒂散 治痰厥眩晕,吐之。
芎归汤 治血虚眩晕。
参苓汤 治气虚挟火。
人参 白术 黄芩 黄连
脉细小迟者生;坚大实者死。
腹痛,反浮大而长者死。
腹痛而喘,滑利数而紧者死。
滑而紧者痛,阳微阴弦者虚,短数心痛。
由中气虚,寒邪乘虚客之,治宜温之、散之。
或久不散郁而生热,宜开郁治热。或素有热,虚热相搏,结郁胃脘而痛。或
有食积痰饮,或气而食相郁,停结胃口作痛。
热厥心痛 身热足冷,痛甚则烦躁而吐,额汗,脉洪,宜刺太溪、昆仑。
寒厥心痛 手足逆,冷汗,不渴,便利,溺清,脉微,乃寒客心包络也,宜
温之,良姜、菖蒲辛热也。
大实心痛 卒然发痛,便秘久而注闷,心胸高起,按之痛,不能饮食,可下之。
胃病者 腹胀胸满,胃脘当心而痛,上支两胁膈咽不通,饮食不下,刺大都、大白。
脾病者 腹胀,食则吐呕,善噫,胃脘痛也,心下急痛如锥刺,刺太溪。
又中胃痛 太阴也。理中、建中、草豆蔻丸等主之。
胃心痛 痛与背相接,善恐如从后触其心偃偻,刺束骨、合谷、昆仑。
脾心痛 状若死,终日不得休息,取行间、太冲。
肺心痛 卧若起居动作益痛甚,刺鱼际、太渊。
草豆蔻丸 治脾胃虚损、客寒,及一切虚证心腹大痛。
草豆蔻(面煨去皮四两) 吴茱萸(八钱) 益智仁(二钱) 陈皮(八钱) 青皮(三分)
泽泻(三分)
人参(八分) 甘草(炙三分生六分) 麦 (一钱) 黄 (八分) 姜黄(四分) 川归
(八分) 柴胡(四分) 桃仁(去皮) 姜蚕(六分) 半夏(一钱) 神曲(一钱半)
金铃子散 治热厥心痛,或作或止,久不愈。
金铃子 玄胡(各一钱) 热加黄连,散气加荔枝核酒下三钱。
术附汤 治寒厥心痛,脉微虚弱暴痛。
白术(四两) 附子(一两) 甘草(二两)
治心痛久成郁
川芎 栀子 苍术 香附(以上四味俱开郁) 石咸 干姜(炒灰治) 火毒加黄连 甘草
有因酒、牛乳,心痛十八年,时以一物拄之,脉三至弦弱而涩,吞酸,用二
陈汤 白术 黄芩 黄连 泽泻 桃仁 郁李仁
痰水停饮留结不散名胸痹
栝蒌 枳实 香附 苍术 台芎
死血留于胃口作痛
承气汤 栀子 韭汁 桔梗(能开提气血) 麻黄(重者须此发之)
木香散 治心脾卒痛。
木香 蓬术(一两) 干漆(炒烟尽二钱)
上醋汤下一钱。
煮雄黄 治大实心痛、 癖,如神。
雄黄(一两另研) 巴豆(五分研入雄黄末) 白面(三两再研匀)
上水丸梧桐子大,每服时先煎井水令沸,下药二十四、五丸,煮二十沸,
捞入冷浆水浸冰冷,一时一丸,一日二十四时,加至微利为度,用前浸水下。
治吞酸作痛,饮水为病也,可燥之。
干蚬壳丸 苍术半夏丸
胃脘当心痛,有垢积者
斑蝥 乌梅肉 丸如豆大,泔下一丸。
皂树上蕈 汤泡肥珠起,饮之泄效。
头部和眼部疼痛,如果脉象反而表现为短而涩的,是死证。
脑部疼痛,如果脉象弦而大的,是死证。
突然失明、看不见东西的,是死证。
风邪与阳明经之气进入胃中,沿着经脉上行至目内眦,泪液流出,这称为“风成寒中”,适宜用辛温性质的药物来治疗。如果风邪不能向外发散,导致眼睛发黄,这称为“风成热中”且伴有郁结,适宜用辛凉性质的药物来发散治疗。
因为痰饮随着气机上逆,潜伏停留在阳经,遇到火邪则发作;或者因七情郁结而生出涎沫,也会引起呕吐、眉目疼痛、眼睛不想睁开。
因为血虚导致的眩晕,眼花、感觉房屋旋转,站起来时会晕倒。
因为外感病邪,风邪在三阳经,表现为头重、项部僵硬,有汗出。
因为虚损引起的掣痛;暑邪引起闷热;湿邪引起沉重感,这些都会导致呕吐、逆气和晕倒。
散风行湿汤:治疗痰火引起的眩晕。
二陈汤 加黄芩、苍术、活石(注:原文为活石,疑为滑石之误或特定矿物药):瓜蒂散:治疗痰厥引起的眩晕,采用催吐法。
芎归汤:治疗血虚引起的眩晕。
参苓汤:治疗气虚兼有火邪。
人参、白术、黄芩、黄连。
脉象细小迟缓的,预后良好(生);脉象坚大实硬的,是死证。
腹痛,如果脉象反而浮大而长的,是死证。
腹痛且伴有气喘,脉象滑利数而紧的,是死证。
脉滑而紧表示疼痛;脉阳微阴弦表示虚证;脉短数表示心痛。
这是由于中气虚弱,寒邪乘虚侵入所致,治疗适宜用温补和发散的方法。
或者久郁不散而生热,适宜疏通郁结并治疗热邪。或者素来有热,虚热相互搏结,郁结在胃脘部位而疼痛。或者有食积、痰饮,或者气滞与食积相互郁结,停滞在胃口处而作痛。
热厥心痛:身体发热、足部发冷,疼痛剧烈时烦躁并呕吐,额头出汗,脉象洪大,适宜针刺太溪穴、昆仑穴。
寒厥心痛:手足逆冷,出冷汗,不口渴,大小便正常,小便清长,脉象微弱,这是寒邪客居于心包络所致,适宜温补,良姜、菖蒲性味辛热。
大实心痛:突然发作疼痛,便秘日久且腹部胀闷,心胸部位高起,按压时疼痛,不能进食,可以采用攻下法。
胃病:腹胀胸满,胃脘当心处疼痛,向上支撑两胁及膈咽部不通畅,饮食难以下咽,适宜针刺大都穴、大白穴。
脾病:腹胀,进食后呕吐,容易嗳气,胃脘疼痛,心下急痛如锥刺般,适宜针刺太溪穴。
又中胃痛:属于太阴病。理中汤、建中汤、草豆蔻丸等为主治方剂。
胃心痛:疼痛牵连背部,容易恐惧,感觉像有人从背后触动心脏而弯腰曲背,适宜针刺束骨穴、合谷穴、昆仑穴。
脾心痛:症状严重如同濒死,整天无法休息,适宜取行间穴、太冲穴。
肺心痛:躺卧或起居活动时疼痛加重,适宜针刺鱼际穴、太渊穴。
草豆蔻丸:治疗脾胃虚损、外感寒邪,以及一切虚证引起的心腹大痛。
草豆蔻(面粉煨熟去皮四两)、吴茱萸(八钱)、益智仁(二钱)、陈皮(八钱)、青皮(三分)、泽泻(三分)、人参(八分)、甘草(炙三分,生用六分)、麦冬(一钱)、黄芪(八分)、姜黄(四分)、川当归(八分)、柴胡(四分)、桃仁(去皮)、僵蚕(六分)、半夏(一钱)、神曲(一钱半)。
金铃子散:治疗热厥心痛,疼痛时作时止,久治不愈。
金铃子、玄胡索(各一钱),热邪重加黄连,气滞加荔枝核,酒送服三钱。
术附汤:治疗寒厥心痛,脉象微弱虚弱且突发剧痛。
白术(四两)、附子(一两)、甘草(二两)。
治疗心痛日久形成郁结:
川芎、栀子、苍术、香附(以上四味均能开郁)、石膏(原文石咸疑为石膏或寒水石之误)、干姜(炒炭治疗火毒,若加黄连)。
有因饮酒、喝牛乳,心痛十八年,时常需用物体顶住胸口缓解,脉象三至一息,弦弱而涩,吞酸,使用二陈汤 加白术、黄芩、黄连、泽泻、桃仁、郁李仁。
痰水停饮留结不散,称为胸痹。
栝蒌、枳实、香附、苍术、台芎(川芎的一种)。
死血(瘀血)停留在胃口处引起疼痛:
承气汤、栀子、韭菜汁、桔梗(能升提气血)、麻黄(重症必须用此药发散)。
木香散:治疗心脾卒然疼痛。
木香、蓬术(莪术,一两)、干漆(炒至烟尽,二钱)。
上药醋汤送服一钱。
煮雄黄:治疗大实心痛、癖块,效果神奇。
雄黄(一两,另研细末)、巴豆(五分,研入雄黄末中)、白面(三两,再研匀)。
上药用水泛丸,如梧桐子大小。每次服用时,先煎沸井水,放入药丸二十四、五粒,煮二十沸,捞出放入冷浆水中浸至冰冷,每隔一时辰服一丸,一日二十四时辰,逐渐增加剂量,以轻微腹泻为度,用之前浸泡的水送服。
治疗吞酸作痛,饮水致病,可以用燥湿法治疗。
干蚬壳丸、苍术半夏丸。
胃脘当心处疼痛,有污垢积聚者:
斑蝥、乌梅肉,制成如豆大小的丸剂,米泔水送服一丸。
皂树上的蕈类,用汤泡后肥大珠状物出现,饮用后泄下见效。
Head and eye pain, if the pulse is unexpectedly short and choppy (Duan Se), indicates a fatal condition.
Brain pain, if the pulse is wiry and large (Xian Da), indicates a fatal condition.
Sudden blindness, inability to see, indicates a fatal condition.
Wind pathogen combined with Yangming channel qi enters the stomach, travels upward along the channels to the inner canthus of the eye, causing lacrimation; this is named "Wind transforming into Cold Center" (Feng Cheng Han Zhong), suitable for treatment with acrid-warm herbs. If wind pathogen cannot diffuse outward, resulting in yellowing of the eyes, this is named "Wind transforming into Heat Center" (Feng Cheng Re Zhong) with stagnation, suitable for treatment with acrid-cool herbs to induce dispersion.
Due to phlegm-fluids ascending with Qi, lodging in the Yang channels, moving upon encountering Fire; or due to emotional stagnation generating saliva/phlegm, also causing vomiting, pain in eyebrows and eyes, and reluctance to open the eyes.
Due to Blood deficiency causing dizziness, visual blurring, sensation of rotating houses, fainting upon standing.
Due to external contraction, Wind in the Three Yang channels, presenting with heavy head, stiff neck, and sweating.
Due to deficiency causing pulling pain; Summerheat causing stifling heat; Dampness causing heaviness; all these lead to vomiting, regurgitation, and fainting.
San Feng Xing Shi Tang (Dispel Wind and Expel Dampness Decoction): Treats dizziness caused by Phlegm-Fire.
Er Chen Tang (Two-Cured Decoction) + Huang Qin (Scutellariae Radix), Cang Zhu (Atractylodis Rhizoma); Huo Shi (likely Hua Shi/Gypsum Fibrosum): Gua Di San (Melon Stalk Powder): Treats dizziness caused by Phlegm-Jue, using emesis therapy.
Xiong Gui Tang (Ligusticum and Angelica Decoction): Treats dizziness caused by Blood deficiency.
Shen Ling Tang (Ginseng and Poria Decoction): Treats Qi deficiency with accompanying Fire.
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma).
Pulse fine, small, and slow indicates survival; pulse firm, large, and excess indicates death.
Abdominal pain, if the pulse is unexpectedly floating, large, and long, indicates death.
Abdominal pain with panting, pulse slippery, rapid, and tight indicates death.
Slippery and tight pulse indicates pain; Superficially weak and Deeply wiry pulse indicates deficiency; Short and rapid pulse indicates Heart pain.
This arises from Middle Qi deficiency, allowing Cold pathogen to invade vacuity; treatment should involve warming and dispersing.
Or prolonged stagnation generates Heat, requiring opening stagnation and treating Heat. Or pre-existing Heat combines with Deficiency-Heat, knotting in the epigastrium causing pain. Or there is food retention or phlegm-fluids, or Qi stagnation combined with food retention, stopping at the stomach gate causing pain.
Re Jue Heart Pain (Heat-Jue Heart Pain): Body heat with cold feet, severe pain causing irritability and vomiting, sweating on the forehead, Hong (Surging) pulse; suitable for needling Tai Xi (KI3) and Kun Lun (BL60).
Han Jue Heart Pain (Cold-Jue Heart Pain): Cold extremities, cold sweat, no thirst, normal bowel/bladder function, clear urine, Wei (Weak) pulse; this is Cold lodging in the Pericardium; suitable for warming, using Liang Jiang (Alpiniae Officinarum Rhizoma) and Chang Pu (Acori Tatarinowii Rhizoma) which are acrid-hot.
Da Shi Heart Pain (Great Excess Heart Pain): Sudden onset of pain, constipation for many days with abdominal fullness/stifling, protrusion in the chest/heart area, pain upon pressure, inability to eat; purgative method can be used.
Stomach Disease: Abdominal distension and chest fullness, pain in the epigastrium at the heart's location, radiating to both hypochondria and blocking the diaphragm/throat, inability to swallow food; suitable for needling Da Du (SP13) and Da Bai (ST44 - *Note: Da Bai is typically ST44, text says Da Bai but context implies ST points*).
Spleen Disease: Abdominal distension, vomiting after eating, frequent belching, epigastric pain, urgent pain below the heart like needle pricking; suitable for needling Tai Xi (KI3).
Also Zhong Wei Tong (Middle Stomach Pain): Belongs to Tai Yin. Zhi Li Zhong Tang (Regulate the Middle Decoction), Jian Zhong Tang (Establish the Middle Decoction), Cao Dou Kou Wan (Cardamom Pill) etc. are primary treatments.
Wei Xin Tong (Stomach Heart Pain): Pain connecting to the back, fearfulness as if touched from behind causing stooping; suitable for needling Shu Gu (BL65), He Gu (LI4), Kun Lun (BL60).
Pi Xin Tong (Spleen Heart Pain): Condition resembles death, no rest all day; select Hang Jian (LR2), Tai Chong (LR3).
Fei Xin Tong (Lung Heart Pain): Pain worsens when lying down or during movement/activity; suitable for needling Yu Ji (LU10), Tai Yuan (LU9).
Cao Dou Kou Wan (Cardamom Pill): Treats Spleen/Stomach deficiency damage, exogenous Cold, and all deficiency-type severe heart/abdominal pain.
Ingredients: Cao Dou Kou (Cardamomi Fructus, flour-roasted, peeled, 4 liang), Wu Zhu Yu (Evodiae Fructus, 8 qian), Yi Zhi Ren (Alpiniae Oxyphyllae Fructus, 2 qian), Chen Pi (Citri Reticulatae Pericarpium, 8 qian), Qing Pi (Citri Reticulatae Pericarpium Viride, 3 fen), Ze Xie (Alismatis Rhizoma, 3 fen), Ren Shen (Ginseng Radix, 8 fen), Gan Cao (Licorice Root, roasted 3 fen/raw 6 fen), Mai Dong (Ophiopogonis Tuber, 1 qian), Huang Qi (Astragali Radix, 8 fen), Jiang Huang (Curcumae Longae Rhizoma, 4 fen), Chuan Gui (Angelicae Sinensis Radix, 8 fen), Chai Hu (Bupleuri Radix, 4 fen), Tao Ren (Persicae Semen, peeled), Jiang Can (Bombyx Batryticatus, 6 fen), Ban Xia (Pinelliae Tuber, 1 qian), Shen Qu (Massa Medicata Fermentata, 1.5 qian).
Jin Ling Zi San (Melia Seed Powder): Treats Re Jue Heart Pain, pain coming and going, chronic and unhealed.
Jin Ling Zi (Meliae Fructus), Yan Hu Suo (Corydalis Rhizoma) (each 1 qian); add Huang Lian (Coptidis Rhizoma) for Heat, add Li Zhi He (Litchi Seed) for Qi stagnation, taken with wine, 3 qian.
Zhu Fu Tang (Atractylodes and Aconite Decoction): Treats Han Jue Heart Pain, Wei (Weak) pulse, sudden severe pain.
Bai Zhu (Atractylodis Macrocephalae Rhizoma, 4 liang), Fu Zi (Aconiti Lateralis Radix Praeparata, 1 liang), Gan Cao (Licorice Root, 2 liang).
Treating Heart Pain becoming chronic stagnation:
Chuan Xiong (Ligustici Chuanxiong Rhizoma), Zhi Zi (Gardeniae Fructus), Cang Zhu (Atractylodis Rhizoma), Xiang Fu (Cyperi Rhizoma) (these four all open stagnation); Shi Gao (Gypsum Fibrosum - *text says Shi Xian, likely typo*), Gan Jiang (Zingiberis Rhizoma, charred to treat fire toxin, add Huang Lian if needed).
Case: Due to alcohol and cow's milk, heart pain for 18 years, often needing an object to press against the chest, pulse 3 beats per respiration, Xian (Wiry) Ruo (Weak) Se (Choppy), acid regurgitation; use Er Chen Tang + Bai Zhu, Huang Qin, Huang Lian, Ze Xie, Tao Ren, Yu Li Ren.
Phlegm-water retention and fluid accumulation not dispersing is named Xiong Bi (Chest Bi).
Gua Lou (Trichosanthis Fructus), Zhi Shi (Aurantii Fructus Immaturus), Xiang Fu (Cyperi Rhizoma), Cang Zhu (Atractylodis Rhizoma), Tai Xiong (Ligustici Chuanxiong Rhizoma).
Si Xue (Dead Blood/Stasis) lodging at the stomach gate causing pain:
Cheng Qi Tang (Order the Qi Decoction), Zhi Zi (Gardeniae Fructus), Jiu Zhi (Leek Juice), Jie Geng (Platycodonis Radix - *can lift Qi and Blood*), Ma Huang (Ephedrae Herba - *heavy cases require this for dispersion*).
Mu Xiang San (Costus Root Powder): Treats sudden Heart/Spleen pain.
Mu Xiang (Aucklandiae Radix), Peng Zhu (Curcumae Zedoariae Rhizoma, 1 liang), Gan Xi (Drynariae Rhizoma? No, Gan Xi usually refers to Drynaria or specific resin, here likely Drynariae Rhizoma or similar, text says Gan Xi fried until smoke gone, 2 qian).
Take 1 qian with vinegar soup.
Zhu Xiong Huang (Boiled Realgar): Treats Da Shi Heart Pain and Pi Masses, effective as a spirit.
Xiong Huang (Realgar, 1 liang, separately ground), Ba Dou (Crotonis Fructus, 5 fen, ground into Xiong Huang powder), Bai Mian (White Flour, 3 liang, mixed well).
Make pills with water, size of Sophora seeds. Each dose: boil well water, add 24-25 pills, boil 20 times, remove and soak in cold grain water until ice-cold. Take one pill every two hours (one shichen), 24 times a day, increase dosage until slight diarrhea occurs, then stop. Use the soaked water to swallow.
Treat acid regurgitation and pain caused by drinking water; use drying methods.
Gan Xian Ke Wan (Dried Clam Shell Pill), Cang Zhu Ban Xia Wan (Atractylodes and Pinellia Pill).
Epigastric pain at the heart's location with filth accumulation:
Ban Mao (Mylabris), Wu Mei Rou (Mume Fructus Flesh), make pills bean-sized, take one pill with rice wash water.
Zao Shu Shang Zhun (Mushroom on Soap Tree): Soak in hot water until it swells and forms pearl-like beads; drink it, leads to evacuation and efficacy.