背为阳，胸为阴。背痛胀，阴中之阳虚，宜补，用 、参、甘草、桂、附之类；胸痛胀
而连
之。胃口作痛，手不可近者，实也，用石膏不拘多少，火 醋淬，研末，热汤服二、三匙；
手按少愈者，虚也，炮姜之类温之。死血痛者，五灵脂一钱，乌药四分，乳香、没药各一钱
，共为细末，温酒调服。死血痛而胀，胀而痛，绵绵无休息者，五灵脂二钱，蒲黄、乳香、
胃脘痛，时呕吐清水，吐过即痛止，名虫痛。用隔年葱汁一杯，香油一杯，和匀服，虫即
化为
食积痛不喜食，多呕，用酒曲湿纸包煨为末。每服三钱，积食能从大便下。
火痛如刀割，手不可按，四物汤加沉香、栀子。热气乘心作痛，石菖蒲一两，前胡、赤
茯苓各五钱，蜜一盏，生地汁一盏，丸如弹子大。每服一丸，食后，紫苏汤下。
寒痛胸前如冰冷，喜热手熨，用良姜一钱，乌药三钱，水煎服；或为末，烧酒调服。或
芎归汤内加炮姜、肉桂，虚加人参，胀加紫苏。
胃脘痛，桔梗、甘草各三钱，川芎一钱，水煎，调五灵脂、雄黄各五钱，治死血痛更效
飞丝入胸，痛甚，汤水不下，雄黄为末，竹叶汤下。
心胸痛，五灵脂、蒲黄等分末，醋汤调服二钱；或延胡、五灵脂、草果、没药等分为末
，酒服三钱；或延胡、乳香、没药各二钱为末，酒调服。
妇人胃脘痛，火郁宜发之。紫苏、栀子各三钱，延胡二钱，沉香、甘草各一钱，为末，
酒调
胃脘作痛不己，乌药五钱，人参、炙甘草各二钱，共末，生姜、微盐搽之，俟水出，即
蘸药含化。乃累试累效之神方也。
胃口痛引背，早微热，午作痛，血中气滞也。人参、肉桂、香附、陈皮各五分，当归一
钱，乌药一分，紫苏三分。
调理方不一而足，大要在血，得温则行，炮姜、肉桂、当归等药，温中行血活血，间用
炒黑
中间或有死血痛、虫痛、食积痛者，见证施治，而脾胃必须顾之，方无他变。
诸痛不可用白术、黄 ，虚痛人参无碍，必不得已而用之，必须斟酌。盖诸痛不宜补气
故也。惟吐泻者白术必用之。
验案
一人右边近心口作痛，少时曾有人当背一拳，血凝气滞也。五灵脂、蒲黄各五钱，乳香
、没药各二钱，归身一两，肉桂三钱，共末，淡白酒调服二钱。
一妇年四十余，有孕，因怒郁，遂吐黑血水数碗，胃口痛如刀割，且多痰诞，饮食至痛
处隔住不下，或吐血，或吐苋菜水，胃脘时开时闭。此怒则气逆，郁则气结，痰凝血滞于胸也。
治之不得法，必成血膈，宜行血开郁顺气。用归身一钱，川芎七分，栀子五分，乌药三分，
背部属阳，胸部属阴。若背痛且伴有胀感，是阴中之阳气虚弱所致，适宜采用补法，使用人参、甘草、桂枝、附子之类的药物；胸痛且胀满并牵连至背部（原文此处有缺字，结合语境指牵连背部或胁肋）。
胃口处疼痛，手不能触碰的，属于实证，使用石膏不拘多少量，用醋淬炼后研成细末，用热汤送服二至三匙；用手按压后疼痛稍减的，属于虚证，用炮姜之类的药物温中散寒。
瘀血引起的疼痛，用五灵脂一钱，乌药四分，乳香、没药各一钱，共同研成细末，用温酒调服。
瘀血疼痛且伴有胀感，胀而痛，绵绵不断无休止的，用五灵脂二钱，蒲黄、乳香……（原文此处中断，推测为继续配伍），胃脘痛，时常呕吐清水，吐完后疼痛即止，称为虫痛。使用隔年的葱汁一杯，香油一杯，混合均匀服用，虫子即可化为水状排出。
食积引起的疼痛表现为不喜欢进食，经常呕吐，使用酒曲用湿纸包裹煨烤后研成细末。每次服用三钱，积滞的食物能随大便排出。
火邪引起的疼痛如刀割一般，手不能按压，用四物汤加入沉香、栀子。热气侵袭心胸引起疼痛，用石菖蒲一两，前胡、赤茯苓各五钱，蜂蜜一盏，生地黄汁一盏，制成如弹子大小的丸剂。每次服用一丸，饭后用紫苏汤送服。
寒邪引起的疼痛胸前感觉像冰冷一样，喜欢用热手熨烫，用良姜一钱，乌药三钱，加水煎服；或者研成细末，用烧酒调服。或者在芎归汤中加入炮姜、肉桂，气虚加人参，胀满加紫苏。
胃脘痛，用桔梗、甘草各三钱，川芎一钱，加水煎煮，调入五灵脂、雄黄各五钱，治疗瘀血疼痛效果更好。
飞丝进入胸部，疼痛剧烈，汤水无法下咽，将雄黄研成细末，用竹叶汤送服。
心胸疼痛，用五灵脂、蒲黄等份研末，用醋汤调服二钱；或者用延胡索、五灵脂、草果、没药等份研末，用酒送服三钱；或者用延胡索、乳香、没药各二钱研末，用酒调服。
妇女胃脘痛，若是火郁证应当发散。用紫苏、栀子各三钱，延胡索二钱，沉香、甘草各一钱，研成细末，用酒调服。
胃脘持续作痛不止，用乌药五钱，人参、炙甘草各二钱，共同研成细末，用生姜、微量盐搽擦患处，待出水后，蘸取药粉含化。这是多次尝试都有效的神方。
胃口疼痛牵引至背部，早晨轻微发热，中午发作疼痛，这是血分中气机阻滞所致。用人参、肉桂、香附、陈皮各五分，当归一钱，乌药一分，紫苏三分。
调理的方剂不一而足，大要在调理血液，血液得温则运行通畅，使用炮姜、肉桂、当归等药物，温中行气活血，间或用炒黑……（原文此处中断）
中间或有瘀血痛、虫痛、食积痛的情况，根据见证施治，但必须顾护脾胃，才不会发生其他变证。
各种疼痛不可使用白术、黄芪，虚证疼痛用人参无碍，如果不得已必须使用白术、黄芪，必须仔细斟酌。因为各种疼痛不宜补气的原因。只有出现呕吐腹泻时，白术是必须使用的。
验案：
一人右边靠近心口处作痛，不久之前曾有人从背后打了一拳，这是血凝气滞所致。用五灵脂、蒲黄各五钱，乳香、没药各二钱，当归身一两，肉桂三钱，共同研成细末，用淡白酒调服二钱。
一位四十多岁的妇人，怀孕，因愤怒抑郁，于是吐出黑血水数碗，胃口疼痛如刀割，且多痰涎，饮食到疼痛处被阻隔无法下行，有时吐血，有时吐苋菜水样的液体，胃脘时而开通时而闭塞。这是怒则气逆，郁则气结，痰凝血滞于胸所致。
The back belongs to Yang, and the chest belongs to Yin. If there is pain and distension in the back, it indicates deficiency of Yang Qi within Yin; supplementation is appropriate, using herbs such as Renshen (Ginseng Radix), Gancao (Licorice Root), Guizhi (Cinnamon Twig), and Fuzi (Aconite Lateralis Preparata). If there is pain and distension in the chest extending to [the back/ribs], [text missing].
Pain at the stomach opening (epigastrium) that cannot be touched by hand indicates an Excess pattern; use Shigao (Gypsum Fibrosum) in any amount, quenched with vinegar, ground into powder, and taken with hot water, two or three spoonfuls. If pressing with hand relieves the pain significantly, it indicates a Deficiency pattern; warm it with Paojiang (Prepared Zingiberis Rhizoma).
For pain caused by dead blood (stasis), use Wulingzhi (Trogopteri Dung) one qian, Wuyao (Linderae Radix) four fen, Xuxiang (Frankincense) and Moyao (Myrrh) each one qian, ground into fine powder, and taken with warm wine.
For pain due to stasis accompanied by distension, where distension and pain are continuous without rest, use Wulingzhi two qian, Puhuang (Lygodii Spora), Xuxiang... [text interrupted]; epigastric pain with frequent vomiting of clear fluid, where pain stops after vomiting, is called "Worm Pain". Use one cup of juice from green onions stored for over a year, mixed with one cup of sesame oil, taken uniformly, causing worms to dissolve into liquid.
Pain due to food stagnation presents as aversion to food and frequent vomiting; use Jiuku (Medicated Leaven) wrapped in wet paper and roasted into powder. Take three qian per dose; the stagnant food will pass through the large intestine.
Fire-heat pain feels like knife-cutting and cannot be pressed; use Siwu Tang (Four Substances Decoction) added with Chenxiang (Aquilaria Wood) and Zhizi (Gardeniae Fructus). When heat qi attacks the heart/chest causing pain, use Shichangpu (Acori Tatarinowii Rhizoma) one liang, Qianhu (Peucedani Radix) and Chifuling (Poria Cocos with Red Coir) each five qian, honey one zhan, and Shengdijihuang (Rehmanniae Radix Juice) one zhan, made into pills the size of a bullet. Take one pill after meals, washed down with Zisu Tang (Perilla Leaf Decoction).
Cold pain feels like ice in the chest, preferring warmth from hands; use Liangjiang (Alpiniae Officinarum Rhizoma) one qian, Wuyao three qian, decocted in water; or ground into powder and taken with burning wine. Alternatively, add Paojiang and Rougui (Cinnamon Bark) to Xionggui Tang (Xiongu Decoction); add Renshen for deficiency, add Zisu (Perilla Leaf) for distension.
For epigastric pain, use Jiegeng (Platycodonis Radix) and Gancao each three qian, Chuanxiong (Ligustici Chuanxiong Rhizoma) one qian, decocted in water, mixed with Wulingzhi and Xionghuang (Realgar) each five qian; this is more effective for treating stasis pain.
If flying silk enters the chest causing severe pain and inability to swallow liquids/solids, grind Xionghuang into powder and take with Zhuye (Bamboo Leaf) decoction.
For heart/chest pain, mix equal parts of Wulingzhi and Puhuang into powder, taken with vinegar-water, two qian; or mix Yanhusuo (Corydalis Rhizoma), Wulingzhi, Caoguo (Tsaoko Fructus), and Moyao in equal parts into powder, taken with wine, three qian; or mix Yanhusuo, Xuxiang, and Moyao each two qian into powder, taken with wine.
For women's epigastric pain due to Fire Stagnation, disperse it. Use Zisu, Zhizi each three qian, Yanhusuo two qian, Chenxiang, Gancao each one qian, ground into powder, taken with wine.
For persistent epigastric pain, use Wuyao five qian, Renshen, Zhigancao (Honey-fried Licorice Root) each two qian, ground into powder. Rub with fresh ginger and a little salt on the affected area; when moisture appears, dip the medicine and hold in mouth to dissolve. This is a miraculous formula proven effective repeatedly.
Pain at the stomach opening radiating to the back, slight fever in the morning, pain onset at noon, indicates Qi stagnation in Blood. Use Renshen, Rougui, Xiangfu (Cyperi Rhizoma), Chenpi (Citrus Reticulatae Pericarpium) each five fen, Danggui (Angelicae Sinensis Radix) one qian, Wuyao one fen, Zisu three fen.
Regulatory formulas vary, but the key lies in regulating Blood; Blood moves when warmed. Herbs like Paojiang, Rougui, Danggui warm the middle and move/nourish blood. Occasionally use stir-fried black... [text interrupted].
Among these, there may be cases of stasis pain, worm pain, or food stagnation pain; treat according to manifestations while protecting the Spleen and Stomach to prevent other complications.
All pains should not use Baizhu (Atractylodis Macrocephalae Rhizoma) or Huangqi (Astragali Radix). For deficiency pain, Renshen is acceptable. If Baizhu/Huangqi must be used out of necessity, careful consideration is required. This is because all pains generally do not suit Qi-tonifying methods. Only in cases of vomiting and diarrhea is Baizhu essential.
Case Record:
A person had pain near the right side of the heart. Shortly before, someone punched him on the back. This is Blood coagulation and Qi stagnation. Use Wulingzhi, Puhuang each five qian, Xuxiang, Moyao each two qian, Danggui Shen (Danggui Root) one liang, Rougui three qian, ground into powder, taken with light white wine, two qian.
A woman over forty years old, pregnant, became angry and depressed, subsequently vomiting several bowls of dark bloody fluid. Epigastric pain felt like knife-cutting, with much phlegm-saliva. Food was blocked at the painful site and could not go down. Sometimes vomiting blood, sometimes vomit resembling amaranth water. The epigastrium alternated between open and closed states. This is due to anger causing Qi rebellion, depression causing Qi knotting, and phlegm-blood stasis in the chest.
If treated improperly, it will become Blood Ge (Blood Obstruction). Treatment should invigorate blood, resolve depression, and regulate Qi. Use Danggui Shen one qian, Chuanxiong seven fen, Zhizi five fen, Wuyao three fen,