生软石膏（五钱） 骨碎补（六钱，去毛，蜜水拌，晒干，微火焙） 青盐（六钱）
槐花（五钱，晒燥） 寒水石（五钱） 没石子（五钱，油煮火烘） 共为细末，每日擦牙固齿最佳。
真心痛者，手足青至节，旦发夕死，夕发旦死，寒邪伤其君主也。盖心为君
主，义不受邪，受邪则本经自
病，必死不治。今之治例，皆言胞络受邪，在腑不在脏，在络不
在经，而非真心痛也，以其在心之部位而名，或心之脉络，或手心主之脉络，或胃
脘，或胸膈，或食伤，或寒伤，或气逆，或痰饮，或死血，或虫或郁火，皆致痛也。盖
胃属湿土，列处中焦，为水谷之海，五脏六腑，十二经脉，皆受气于此，壮者邪不能
干，弱者着而为病。其冲和之气，变至偏寒偏热，因之水停食积，皆与真气相搏而痛，
惟肝木之相乘者为尤甚，肾气上逆者次之。胃病者，腹 胀，胃脘当心而痛，上支两胁。
咽膈不通，盖胃脘逼近于心，移其邪而易得攻害也。
《脉经》曰∶有忧愁思虑伤心而痛者，其人劳倦，即头面赤而下重，心中痛彻背，
其脉弦，此心脏伤所致也。盖心主血而统性情，因于怵惕思虑，伤神涸血，于是清阳不
升，浊阴不降，以致食饮风冷热悸虫疰之九种，乘虚侵凌也。
虫痛者，发作懊 ，肿聚往来，上下行痛，痛有休作，心腹中热善渴，涎出而色乍
青乍白乍赤，呕吐清水者蛔也。
大虚心痛者，宜补之。如大实心痛者，当食受恼，卒然发痛，大便或秘，久而心胸
高起，按之至痛，不能饮食，宜利之。
寒厥心痛者，手足逆而遍身冷汗，便溺清白，大便通利不渴，气微力弱，急以术附
汤温之。寒厥暴痛，非久病也。朝发暮死，急当救之，是知久病无寒，暴病非热也。
夫心痛有九种，曰饮、曰食、曰风、曰冷、曰热、曰悸、曰虫、曰疰、曰去来痛
者，除风热冷属外所因，余皆不内外因。更妇人恶血入心脾经，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，以意推度施治。
心膈之痛，须分新久。若明知身受寒气，口食寒物而病，于初得之时，当有温
散，或温利之。其病得之稍久，则成郁矣。郁则蒸热生火。若再欲温散温利，宁无助火
添病耶！故古方多以山栀为君，加热药为响导，而开郁行气，则邪易伏，病易退。然向
安之后，若纵恣口味，病必复作。
大概皆以诸痛属实，痛无补法，痛随利减，为不易之法，不知形实病实，便闭不通
者，乃为相宜。若形虚脉弱。食少便泄者，岂容混治？须知痛而胀闭者多实，不胀不闭
者多虚；拒按者为实。可按者为虚∶痛不移者为血，痛无定者为气∶喜寒者多实，受热
者多虚；饱则甚者多实，饿则甚者多虚∶脉实气粗者多实，脉虚气少者多虚；新病年壮
者多实，久病年衰者多虚∶补而不效者多实，攻而愈剧者多虚。痛在经者脉多弦大，
痛在脏者脉多沉微，表虚而痛者，阳不足也，非温经不可，里虚而痛者，阴不足也，
非养荣不可。上虚而脾伤也，非补中不可。下虚而脾肾败也。非温补命门不可。若泥痛
无补法，为害不浅。
食积与痰饮作痛者，胃气亦藉所养，故卒不便虚，日数虽多，不食无损。若痛止便
吃物，痛必复作，须三五服药后，以渐将息可也。痛甚者，脉必伏，用温药附子之类，
不可用参术，盖诸痛不可补气，一胃中有热而作痛者，非山栀子不可，须佐以姜汁，多
用台芎开之。一有因平日喜食热物，以致死血留于胃口作痛者，必日轻夜重，甚则用桃
仁承气汤下之。轻则用韭汁消其血，桔梗开提其气。虫痛者，面上白斑，唇红，时吐清
水，痛定便能食，时作时止，有块往来，上下行者是也，治以苦楝根、锡灰之类。然上
半月虫头向上易治，下半月虫头向下难治。凡服药先以肉汁及糖蜜食下，引虫头向上，
然后用药打出。脉坚实不大便者，下之。心痛，用山栀子并劫药止之。若又复发，可用
玄明粉一服立止。左手脉数热多，脉涩者，有死血。右手脉紧实痰积，弦大必是久病。
有脾痛，大小便不通者，此是痰隔中焦，气聚下焦。心痛者，脉必伏，以心主脉，不胜
其痛，故伏也。不可因其脉伏神乱，疑为心虚，而用地黄白术补之。盖邪得温则散，泥
则不散，温散之后，可用阴阳平补。中宫气不清则痛，有挟痰与火，或日久成积，古方
用陈皮、香附、甘草为君，因所挟而兼用，一加海粉，火加栀子，积加醋蓬术，死血加
干漆。胃中若有清痰留饮，腹中漉漉有声，及手足寒痛，或腰膝脊胁抽痛，恶心烦闷，
时吐黄水，甚则摇之作水声，用小胃丹，或控涎丹，彻去病根而止。丹溪曰，草豆蔻一
味，性温能散滞气，利膈上痰。若果因寒而痛者，用之如鼓应桴。若湿郁结痰成痛，服
之多效，若因热郁而痛者，理固不可，但以凉药来之。如炒芩连枝子之类，其效犹捷。
东垣草豆蔻丸，治寒厥心痛，大获奇效。若久热郁热己甚者，诸香燥药断不可用也。
生软石膏（五钱） 骨碎补（六钱，去除毛刺，用蜜水拌匀，晒干，以微火焙干） 青盐（六钱）
槐花（五钱，晒至干燥） 寒水石（五钱） 没石子（五钱，用油煮后火烘） 以上药材共同研磨成细末，每天用来擦牙，是巩固牙齿的最佳方法。
真心痛（心脏本体受邪引起的剧烈心痛），手足发青直到关节，早晨发病晚上死亡，晚上发病早晨死亡，这是寒邪伤害了心这个君主之官。因为心为君主，按理说不应受邪气侵犯，一旦受邪则是本经自病，必然死亡无法医治。现在的治疗案例，都说胞络（心包络）受邪，病在腑不在脏，在络脉不在经脉，这就不是真正的真心痛。因为疼痛部位在心，或者涉及心的脉络，或者手心主（心包）的脉络，或者胃脘部，或者胸膈部，或者是饮食损伤，或者是寒邪侵袭，或者是气机逆乱，或者是痰饮停滞，或者是瘀血阻滞，或者是虫积，或者是郁火，都会导致疼痛。胃属于湿土，位于中焦，是水谷汇聚的海港，五脏六腑、十二经脉的气血都由此获得滋养，身体强壮的人邪气不能干扰，身体虚弱的人邪气停留而致病。胃气的冲和状态，如果变成偏寒或偏热，因此导致水液停聚、食物积滞，这些都与真气相互搏结而产生疼痛，其中肝木乘克脾胃的情况最为严重，肾气上逆的情况次之。胃病表现为腹部胀满，胃脘部当心口处疼痛，向上支撑两胁，咽喉膈部不通畅，这是因为胃脘逼近心脏，邪气转移容易攻害心脏。
《脉经》说：有因忧愁思虑伤心而疼痛的，其人劳累疲倦，就会头面发红且下肢沉重，心中疼痛放射到背部，脉象弦，这是心脏受伤所致。因为心主血脉并统管性情，由于惊恐思虑，损伤神志、耗竭血液，于是清阳之气不升，浊阴之气不降，以致于食饮、风、冷、热、悸、虫、疰这九种病因，趁虚侵入凌犯。
虫痛（寄生虫引起的疼痛），发作时心中烦闷懊恼，肿块聚散无常，上下移动疼痛，疼痛时有休止，心腹中发热且口渴，流涎且面色乍青乍白乍红，呕吐清水的是蛔虫。
大虚的心痛，应当用补法。如果是大实的心痛，多因饮食受到恼怒刺激，突然发作疼痛，大便或秘结，时间久了心胸高起，按压则剧痛，不能进食，应当用通利法。
寒厥心痛（寒邪导致的厥逆性心痛），手足逆冷且遍身出冷汗，大小便清长，大便通畅且不口渴，气息微弱体力衰弱，急需使用术附汤来温补。寒厥暴痛，不是久病。早晨发病晚上死亡，必须紧急救治，由此可知久病没有纯寒证，暴病没有纯热证。
心痛有九种，分别是饮、食、风、冷、热、悸、虫、疰、去来痛（游走性疼痛）。除了风、热、冷属于外因，其余都属于不内外因。另外妇女恶血进入心脾经，发作疼痛，比各种疼痛更严重。还有卒中客忤、鬼击尸疰等，使人出现心痛，也属于不内外因，需凭意推度施治。
心膈部位的疼痛，必须区分新病和久病。如果明确知道是因为感受寒气、食用寒物而患病，在初得病时，应当用温散法，或者温利法。如果病得之稍久，就会形成郁结。郁结则会蒸热生火。如果再想用温散温利的方法，岂不是帮助火势增加病情吗！所以古方多以山栀为君药，加热药作为向导，从而开郁行气，这样邪气容易伏藏，疾病容易消退。然而病愈之后，如果放纵口味，疾病必定复发。
大概都认为各种疼痛属于实证，疼痛没有补法，疼痛随着通利而减轻，这是不可改变的方法，却不知道形体壮实、病势属实、便秘不通者，才适合这种方法。如果形体虚弱、脉象微弱、食少便泄者，怎么可以混同治疗？须知疼痛伴有胀闭的多为实证，不胀不闭的多为虚证；拒按的为实证，可按的为虚证；疼痛位置固定的为血瘀，疼痛位置不定的为气滞；喜寒的多为实证，受热（喜暖）的多为虚证；饱食后加重多为实证，饥饿时加重多为虚证；脉实气粗的多为实证，脉虚气少的多为虚证；新病年轻力壮的多为实证，久病年老体衰的多为虚证；补益无效的多为实证，攻下后加剧的多为虚证。疼痛在经脉的多见脉弦大，疼痛在脏腑的多见脉沉微，表虚而痛的是阳气不足，不用温经法不行；里虚而痛的是阴血不足，不用养荣法不行；上虚而脾伤的是中气不足，不用补中益气法不行；下虚而脾肾败坏的是命门火衰，不用温补命门法不行。如果拘泥于“痛无补法”，危害不浅。
食积与痰饮引起的疼痛，胃气也依赖所养之物，所以即使突然不便虚，日子虽多，不吃东西也不受损。如果疼痛停止就吃东西，疼痛必定复发，需要服用三五剂药后，逐渐调养才可以。疼痛剧烈的，脉象必伏，用温药如附子之类，不可用人参、白术，因为各种疼痛不可补气。一者胃中有热而作痛，非山栀子不可，须佐以姜汁，多用台芎（川芎的一种）开散。一者因平日喜食热物，导致死血留于胃口作痛，必然日轻夜重，严重时用桃仁承气汤攻下。轻症用韭汁消散瘀血，桔梗开提气机。虫痛者，面部有白斑，嘴唇红，时常吐清水，疼痛停止后能进食，时作时止，有块状物往来上下移动的就是，治疗用苦楝根、锡灰之类。然而上半月虫头向上易治，下半月虫头向下难治。凡服药前先以肉汤及糖蜜送服，引导虫头向上，然后用药打出。脉坚实不大便的，攻下它。心痛，用山栀子并劫药（强力止痛药）止住。如果又复发，可用玄明粉一服立即止住。左手脉数热多，脉涩的，有死血。右手脉紧实痰积，弦大必然是久病。有脾痛，大小便不通的，这是痰隔阻中焦，气聚在下焦。心痛者，脉必伏，因为心主脉，不胜其痛，所以脉伏。不可因其脉伏神乱，怀疑为心虚，而用地黄、白术补益。因为邪气得温则散，拘泥于温法则不散，温散之后，可用阴阳平补。中宫气不清则痛，有挟痰与火，或日久成积，古方用陈皮、香附、甘草为君药，根据所挟兼用，一加海粉（海浮石），火加栀子，积加醋蓬术，死血加干漆。胃中若有清痰留饮，腹中漉漉有声，以及手足寒痛，或腰膝脊胁抽痛，恶心烦闷，时常吐黄水，严重时摇动腹部有水声，用小胃丹，或控涎丹，彻底去除病根而止。丹溪说，草豆蔻一味，性温能散滞气，利膈上痰。如果果真是因寒而痛，用它像鼓槌敲鼓一样迅速见效。如果是湿郁结痰成痛，服用多有效，如果是因热郁而痛，道理上固然不可用，但可以用凉药来治疗。如炒黄芩、黄连、栀子之类，效果依然快捷。东垣的草豆蔻丸，治疗寒厥心痛，大获奇效。如果是久热郁热已经严重的，各种香燥药绝对不可用。
Raw Soft Gypsum (Sheng Ruanshi Gao, 5 qian) [Gypsum Fibrosum], Dried Stem and Root of Drynaria (Gusuibu, 6 qian, remove hairs, mix with honey water, dry in sun, bake over low fire), Green Salt (Qingyan, 6 qian), Sophora Flower (Huaihua, 5 qian, dry until crisp), Cold Water Stone (Hanshuishi, 5 qian), Myrobalan Nut (Meishizi, 5 qian, boil in oil then roast over fire). Grind all together into fine powder. Rubbing teeth with this daily is best for strengthening teeth.
Zhenxintong (True Heart Pain, severe cardiac pain caused by pathogenic factors directly affecting the Heart organ): The hands and feet turn cyanotic up to the joints; if it occurs in the morning, death follows in the evening; if it occurs in the evening, death follows in the morning. This is because cold evil damages the "Monarch" (the Heart). Since the Heart is the Monarch, it theoretically should not be invaded by pathogens. If invaded, it is a disease of its own meridian, which is invariably fatal and untreatable. Current treatment examples often state that the Pericardium Collateral (Baoluo) is affected, implying the disease is in the Fu organs rather than Zang organs, or in the collaterals rather than the main meridians; thus, it is not true Zhenxintong. Because the pain is located in the region of the Heart, or involves the Heart's vessels, or the vessels of the Hand-Jueyin (Pericardium), or the epigastrium, or the chest and diaphragm, whether due to dietary injury, cold invasion, qi rebellion, phlegm-fluid retention, static blood, parasites, or stagnant fire, all can cause pain. The Stomach belongs to damp earth, situated in the Middle Jiao, serving as the sea of water and grain. The Qi of the five Zang and six Fu organs, and the twelve main meridians, all derive nourishment from here. Those who are robust cannot have their Qi disturbed by pathogens; those who are weak allow pathogens to lodge and cause disease. When the harmonious Qi of the Stomach becomes biased towards cold or heat, leading to fluid retention and food stagnation, these contend with True Qi causing pain. Among these, Liver Wood overacting on the Spleen/Stomach is the most severe, followed by rebellious Kidney Qi. Stomach disease manifests as abdominal distension, pain in the epigastrium centered at the heart area, radiating upward to support both hypochondria, and obstruction in the throat and diaphragm. This is because the epigastrium is close to the Heart, allowing pathogenic factors to shift and easily harm the Heart.
The *Mai Jing* states: There are cases where worry and overthinking damage the Heart causing pain. The person is fatigued, their head and face become red while the lower body feels heavy, the heart pain penetrates to the back, and the pulse is wiry. This is caused by Heart injury. Since the Heart governs blood and regulates emotions, fright and overthinking damage the Shen (Spirit) and deplete blood. Consequently, clear Yang fails to ascend, and turbid Yin fails to descend, allowing nine types of pathogens—dietary, wind, cold, heat, palpitations, parasites, infectious miasma—to invade due to deficiency.
Parasitic pain (Chongtong): During attacks, there is mental restlessness and discomfort. Swellings gather and disperse, moving up and down causing pain. The pain comes and goes. There is heat in the heart and abdomen with excessive thirst, salivation, and complexion changing suddenly between green, white, and red. Vomiting clear water indicates roundworms (Ascaris).
For severe deficiency-type heart pain, tonification is appropriate. For severe excess-type heart pain, often triggered by dietary indiscretion combined with anger, sudden pain occurs. The stool may be constipated. After a long time, the chest and heart area protrude, and pressing causes severe pain with inability to eat. Purging/draining methods are appropriate.
Cold-Jue type heart pain: The limbs are cold in a reverse manner, the whole body sweats cold sweat, urination and defecation are clear and copious, bowel movements are free without thirst, breath is faint and strength is weak. Urgently use Shu Fu Tang (Aconite and Atractylodes Decoction) to warm. Cold-Jue sudden pain is not a chronic condition. Morning onset leads to evening death; urgent rescue is required. Thus, we know chronic diseases do not present with pure cold, and acute diseases do not present with pure heat.
There are nine types of heart pain: Fluid, Food, Wind, Cold, Heat, Palpitation, Parasite, Infectious Miasma, and Migratory Pain. Except for Wind, Heat, and Cold which belong to external causes, the others belong to non-internal/non-external causes. Additionally, in women, evil blood entering the Heart and Spleen meridians causes pain more severe than other pains. Also, sudden attack by guest evils, ghost strikes, or corpse miasmas causing heart pain also belong to non-internal/non-external causes; treatment should be guided by deduction and reasoning.
Pain in the Heart and Diaphragm must be distinguished by newness or duration. If it is known to be caused by exposure to cold air or ingestion of cold foods, during the initial stage, warming and dispersing methods, or warming and draining methods, should be used. If the disease persists for some time, it forms stagnation (Yu). Stagnation generates heat and fire. If one continues to use warming and dispersing methods, would it not aid the fire and worsen the illness? Therefore, ancient formulas often use Gardenia Fruit (Zhizi) as the sovereign herb, adding heating herbs as guides to open stagnation and move Qi, so that pathogens are easily subdued and the illness recedes. However, after recovery, if one indulges in taste preferences, the illness will surely recur.
Generally, it is believed that all pains belong to excess patterns, there is no tonification method for pain, and pain decreases with purgation/drainage; this is considered an unchangeable rule. However, one must not realize that this is only suitable when the physique is solid, the pathology is excess, and there is constipation/obstruction. If the physique is deficient, the pulse is weak, appetite is poor, and there is loose stool, how can mixed treatment be tolerated? One must know that pain accompanied by distension and obstruction is mostly excess; pain without distension or obstruction is mostly deficiency; pain that refuses pressure is excess; pain that accepts pressure is deficiency; fixed pain is Blood stasis; wandering pain is Qi stagnation; preference for cold indicates excess; preference for warmth indicates deficiency; worsening after eating indicates excess; worsening on an empty stomach indicates deficiency; solid pulse and coarse breath indicate excess; deficient pulse and faint breath indicate deficiency; acute illness in young and strong people indicates excess; chronic illness in elderly and frail people indicates deficiency. Ineffectiveness of tonification suggests excess; aggravation after purgation suggests deficiency. Pain in the meridians often presents with wiry-large pulses; pain in the Zang organs often presents with deep-micro pulses. Exterior deficiency with pain indicates insufficient Yang, requiring warming of the meridians. Interior deficiency with pain indicates insufficient Yin, requiring nourishment of Ying (Nutritive) Qi. Upper deficiency with Spleen injury requires tonification of the Middle Jiao. Lower deficiency with Spleen and Kidney failure requires warming and tonifying the Gate of Vitality (Mingmen). Adhering rigidly to "no tonification for pain" causes significant harm.
When pain is caused by food stagnation and phlegm-fluid, the Stomach Qi relies on nourishment, so even if sudden deficiency does not occur, and despite many days passing, not eating does not cause damage. If food is eaten as soon as pain stops, the pain will surely recur. It is necessary to take three to five doses of medicine before gradually recuperating through diet. For severe pain, the pulse is likely hidden (Fu); use warming herbs like Aconite. Do not use Ginseng or Atractylodes, as various pains should not be treated by tonifying Qi.
One type: Pain caused by heat in the Stomach requires Gardenia Fruit (Zhizi), assisted by Ginger Juice, and using Tai Xiong (Sichuan Lovage Rhizome) to open and disperse.
Another type: Pain caused by habitual consumption of hot foods leading to static blood remaining in the stomach opening, characterized by lighter pain during the day and heavier at night. Severe cases require Peach Kernel and Rheum Decoction (Taoren Chengqi Tang) to purge. Mild cases use Leek Juice to dissipate blood and Platycodon Root (Jiegeng) to lift Qi.
Parasitic pain: White spots on the face, red lips, frequent vomiting of clear water, ability to eat when pain subsides, intermittent occurrence, presence of moving masses up and down. Treatment uses roots of Melia Toosendan (Kuilgen) and Tin Ash. However, parasites with heads pointing up in the first half of the lunar month are easier to treat; those with heads pointing down in the second half are difficult. Before administering medicine, feed meat broth and honey/sugar to guide the parasite's head upward, then administer medication to expel it. If the pulse is firm and large with constipation, purge it. For heart pain, use Gardenia Fruit and "robber medicines" (strong analgesics/astringents) to stop it. If it recurs, a dose of Mirabilite (Xuanmingfen) can stop it immediately. A rapid pulse on the left hand indicates much heat; a choppy pulse indicates static blood. A tight-firm pulse on the right hand indicates phlegm accumulation; a wiry-large pulse indicates chronic illness.
Spleen pain with obstruction of urination and defecation indicates phlegm blocking the Middle Jiao and Qi gathering in the Lower Jiao. In heart pain, the pulse is necessarily hidden because the Heart governs the vessels and cannot withstand the severity of the pain, hence the hidden pulse. Do not mistake the hidden pulse and mental confusion for Heart deficiency and use Rehmannia Root (Dihuang) and Atractylodes Macrocephala Rhizome (Baizhu) for tonification. Pathogens disperse when warmed; adhering to warming alone prevents dispersion. After warming and dispersing, Yin-Yang balanced tonification can be used. If the Central Palace (Middle Jiao) Qi is unclear, pain occurs, potentially involving phlegm and fire, or accumulation formed over time. Ancient formulas use Tangerine Peel (Chenpi), Cyperus Rhizome (Xiangfu), and Licorice Root (Gancao) as sovereign herbs, adding based on accompanying factors: add Sea Sponge (Haifen) for phlegm, Gardenia (Zhizi) for fire, Vinegar-processed Curcuma (Cu Pengzhu) for accumulation, and Dry Lacquer (Ganqi) for static blood. If there is clear phlegm and retained fluids in the Stomach, with gurgling sounds in the abdomen, cold pain in hands and feet, or cramping pain in waist, knees, spine, and hypochondria, nausea, vexation, frequent vomiting of yellow water, and even audible water sloshing upon shaking the abdomen, use Xiao Wei Dan or Kong Yan Dan to thoroughly eliminate the root of the disease.
Danxi stated: Galanga Seed (Caodoukou) alone has a warm nature capable of dispersing stagnant Qi and benefiting phlegm above the diaphragm. If the pain is indeed due to cold, it works as swiftly as a drumstick striking a drum. If pain is caused by damp-stagnation forming phlegm, it is effective. If pain is caused by heat-stagnation, it is theoretically inappropriate, but cool herbs can be used instead, such as fried Scutellaria Root (Huangqin), Phellodendron Bark (Huanglian), and Gardenia Fruit (Zhizi), which still yield quick results. Dongyuan's Caodoukou Wan treats Cold-Jue heart pain with remarkable efficacy. However, for prolonged heat or severe stagnant heat, all aromatic-drying herbs must absolutely not be used.