《病源论》云∶膈间有寒,胃管有热,寒热相搏,气逆攻乘心,故心腹痛也。
皇甫谧论云∶或心痛如锥刺。坐当食而不食,当洗而不洗,寒热相交,气结不通,结在
心中,口噤不得息,当绞口捉与热酒,任本性多少。其令酒两得,行气自通,得噫(于基反,
根声也),因以冷水洗淹布巾,着所苦处,温复易之自解。解便速冷食,能多益善。若大恶,
着衣小使温,温便去衣即瘥。于诸痛之中,心痛最为急者,救之若赴汤火,乃可济耳。
《短剧方》云∶治散发心痛,腹胀兼冷,动热相格(古伯反。谷也,止也,阙也,正也)
不消,甘草汤方∶
甘草(一两) 栝蒌(二两) 术(二两) 枳实(二两) 栀子仁(二两)
凡五物,以水七升,煮取二升,分三服。
又云∶单行甘草汤方∶
甘草(四两)
凡一物,以水五升,煮之折半,冷之,顿服尽,当大吐。患心腹痛,服诸药无效者,宜
服此汤。
张仲景方云∶黄芩汤治散发腹内切痛方∶
栀子(二两) 香豉(三升) 黄芩(二两)
凡三物,切,绵裹,以水九升,煮取三升,分三服,以衣覆卧,亦应有汗。
《僧深方》云∶若散发悉口噤心痛,服葱白豉汤方∶
葱白(半斤) 豉(三升) 甘草(二两) 生麦门冬(四两,去心)
凡四物,以水五升,煮取二升,分再服。(一方加茱萸一升。)
《诸病源候论》说:膈间有寒邪,胃脘有热邪,寒热相互搏结,气机上逆攻冲心脏,所以导致心腹痛。
皇甫谧论述说:有的心痛像锥子刺一样。本该进食却不进食,本该洗浴却不洗浴,寒热互相交争,气机郁结不通,结聚在心中,牙关紧闭不能呼吸,应当撬开嘴巴喂服热酒,根据患者体质允许的量来定。让酒力两相调和,行气自然通畅,打出嗝(“噫”音yī,指打嗝的声音),然后用冷水浸湿布巾,敷在疼痛处,变温后再更换,这样就能缓解。缓解后迅速吃冷食,吃得越多越好。如果非常厌恶寒冷,穿衣稍微保暖些,暖和了就脱去衣服,病就好了。在各种疼痛中,心痛是最为急迫的,救治时要像奔赴汤火一样急切,这样才能挽救生命。
《短剧方》说:治疗散发性心痛,腹胀兼有冷感,动热相互格拒(“格”音gé,意为谷、止、阙、正)不消化的情况,甘草汤方:
甘草(一两) 栝蒌(二两) 白术(二两) 枳实(二两) 栀子仁(二两)
共五味药,用水七升,煮取二升,分三次服用。
又说:单味甘草汤方:
甘草(四两)
仅一味药,用水五升,煮至减半,放凉后,一次性服完,应当会剧烈呕吐。患有心腹痛,服用其他药物无效的人,适宜服用此汤。
张仲景方说:黄芩汤治疗散发性腹内剧烈疼痛的方子:
栀子(二两) 香豉(三升) 黄芩(二两)
共三味药,切碎,用绵布包裹,用水九升,煮取三升,分三次服用,盖上被子躺卧,也应该会有汗出。
《僧深方》说:如果是散发性且全部出现牙关紧闭、心痛的症状,服用葱白豉汤方:
葱白(半斤) 豆豉(三升) 甘草(二两) 生麦门冬(四两,去心)
共四味药,用水五升,煮取二升,分两次服用。(另一版本加吴茱萸一升。)
The *Zhubing Yuanhou Lun* (Treatise on the Pathogenesis and Manifestations of All Diseases) states: There is cold pathogen in the diaphragm region, and heat pathogen in the stomach tube (stomach). Cold and heat contend with each other, causing qi to rebel and attack the heart, thus resulting in heart and abdominal pain.
Huangfu Mi discusses: Sometimes heart pain feels like being pierced by an awl. One should eat but does not; one should bathe but does not. Cold and heat intersect, qi becomes knotted and fails to flow freely, knotting in the center of the chest. The jaw is clenched, and breathing is obstructed. One should pry open the mouth and give hot wine, according to the patient's constitution and tolerance. When the effects of the wine harmonize, qi circulation will naturally unblock, leading to belching ("yi", sound of belching). Then, soak a cloth in cold water, apply it to the painful area, replace it when it warms up, and the condition will resolve. After resolution, quickly consume cold food; the more, the better. If there is great aversion to cold, wear slightly warmer clothes; once warm, remove the clothes, and the disease will heal. Among all pains, heart pain is the most urgent. Rescue must be as swift as rushing into boiling water or fire to save the life.
The *Duanju Fang* (Short Formulas) states: To treat disseminated heart pain, abdominal distension accompanied by cold, where movement and heat mutually repel (ge, meaning grain, stop, gap, correct) and digestion fails, use the Licorice Decoction formula:
Gancao (Radix Glycyrrhizae, 1 liang), Gualou (Fructus Trichosanthis, 2 liang), Baizhu (Rhizoma Atractylodis Macrocephalae, 2 liang), Zhishi (Fructus Aurantii Immaturus, 2 liang), Zhizi Ren (Semen Gardeniae, 2 liang).
These five substances are boiled in seven sheng of water until two sheng remain, divided into three doses.
It also states: Single-substance Licorice Decoction formula:
Gancao (Radix Glycyrrhizae, 4 liang).
This single substance is boiled in five sheng of water until reduced by half, cooled, and taken all at once. It should induce severe vomiting. For those suffering from heart and abdominal pain who have found no efficacy with other medicines, this decoction is suitable.
Zhang Zhongjing's formula states: Huangqin Tang (Scutellaria Decoction) for treating disseminated cutting pain inside the abdomen:
Zhizi (Fructus Gardeniae, 2 liang), Xiangchi (Fermented Soybean, 3 sheng), Huangqin (Radix Scutellariae, 2 liang).
These three substances are chopped, wrapped in silk, boiled in nine sheng of water until three sheng remain, divided into three doses. Cover oneself with clothing and lie down; sweating should also occur.
The *Sengshen Fang* (Monk Shen's Formulas) states: If disseminated symptoms include complete jaw clenching and heart pain, administer Congbai Chi Tang (Green Onion White and Fermented Soybean Decoction):
Congbai (Bulbus Allii Fistulosi, half jin), Chi (Fermented Soybean, 3 sheng), Gancao (Radix Glycyrrhizae, 2 liang), Sheng Maimendong (Radix Ophiopogonis, fresh, 4 liang, heart removed).
These four substances are boiled in five sheng of water until two sheng remain, divided into two doses. (Another version adds Zhenyu [Fructus Evodiae, 1 sheng].)