论曰内经谓诊得心脉而急,病名心疝,少腹当有形也,心为牡脏,小肠为之使,故曰少
腹当有形也,夫脏病必传于腑,今心不受邪,病传于腑,故小肠受之,为疝而痛,少腹当有
形也,世之医者,以疝为寒湿之疾,不知心气之厥,亦能为疝,心疝者、当兼心气以治之。
治心疝心痛闷绝,木香散方
木香(炮) 陈橘皮(汤浸去白炒各一两) 高良姜 干姜(炮) 诃黎勒皮 赤芍药 枳
壳
(去瓤麸焙) 赤茯苓(去黑皮各半两) 草豆蔻(去皮) 芎 牵牛子(炒各三分)
上一十一味,捣罗为散,每服二钱匕,水一盏,煎至七分,温服不拘时。
治心疝,心痛,虚冷烦闷,当归汤方
当归(切炒) 干姜(炮) 赤芍药 黄 蜀椒(去目并闭口炒出汗) 半夏(为末
姜汁作
浓朴(去粗
上一十二味, 咀如麻豆,每服三钱匕,水一盏,煎至七分,去滓温服不拘时。
治心疝,心痛如锥所刺,牡丹丸方
牡丹皮 桂(去粗皮) 芍药 乌头(炮裂去皮脐) 细辛(去苗叶) 甘草(炙锉) 木
香
上九味,捣罗为末,炼蜜丸如梧桐子大,每服二十丸,温酒下,不拘时。
治心疝,心痛不可忍,木香散方
木香 羌活(去芦头) 槟榔(生锉) 牡丹皮 当归(切炒) 桂(去粗皮) 青橘
皮(汤浸
上八味,捣罗为散,每服二钱匕,沸汤或温酒调下,不拘时。
治心疝,心胁痛,及绕脐痛,芍药丸方
芍药 桔梗(去芦头炒) 细辛(去苗叶) 蜀椒(去目并闭口炒出汗) 桂(去粗皮)
干姜
上七味,捣罗为末,炼蜜丸如梧桐子大,每服二十丸,温酒或米饮下,不拘时。
治心疝心痛,肢体虚冷,蓬莪术煮散方
蓬莪术(煨) 槟榔(生锉) 附子(炮裂去皮脐) 甘草(炙锉) 桂(去粗皮各一
两) 胡椒
上八味,捣罗为散,每服二钱匕,水一盏,煎至七分,温服不拘时。
治痼冷在内,阴气交攻,心痛如刺,橘皮益智汤方
青橘皮(汤浸去白焙) 益智(去皮) 乌头(炮裂去皮脐) 威灵仙(去土各一两)
上四味,锉如麻豆,每服三钱匕,水一盏,生姜三片,盐少许,煎至六分,去滓食前
温服,日三。
治阴冷交攻,心疝疼痛,紫桂丸方
桂(去粗皮半两) 当归(焙三分) 吴茱萸(汤浸焙炒一两
上三味为细末,醋煮面糊,丸如梧桐子大,每服二十丸,炒生姜盐酒下,米饮亦得,日
三。
治心疝,冷痛不可忍,三温散方
附子(炮裂去皮脐) 蓬莪术(煨锉各一两) 胡椒(半两)
上三味为细散,每服一钱匕,热酒调下,不拘时,妇人醋汤下。
论述说:《内经》中提到,诊察到心脉紧急,病名叫做心疝,小腹部应当出现有形之症。心属于阳脏(牡脏),小肠是它的表里配合脏腑(使),所以说小腹部应当出现有形之症。凡是脏的病必然传变于腑,现在心本身未受邪气侵袭,但病邪传变到了腑,所以由小肠承受病邪,形成疝痛,小腹部应当出现有形之症。世间的医生,认为疝是寒湿引起的疾病,不知道心气逆乱,也能导致疝证。治疗心疝时,应当兼顾调理心气。
治疗心疝、心痛、胸闷昏厥的木香散方:
木香(炮制)、陈皮(汤浸后去白皮炒制,各一两)、高良姜、干姜(炮制)、诃黎勒皮、赤芍药、枳壳(去瓤麸炒)、赤茯苓(去黑皮,各半两)、草豆蔻(去皮)、川芎、牵牛子(炒制,各三分)。
以上十一味药,捣碎过筛成散剂,每次服用二钱匕,用水一盏,煎至七分,不拘时候温服。
治疗心疝、心痛、虚冷烦闷的当归汤方:
当归(切后炒制)、干姜(炮制)、赤芍药、黄芪、蜀椒(去目及闭口者,炒至出汗)、半夏(为末,用姜汁制作)、浓朴(去粗皮)。
以上十二味药,切碎如麻豆大小,每次服用三钱匕,用水一盏,煎至七分,去渣滓,不拘时候温服。
治疗心疝、心痛如针刺感的牡丹丸方:
牡丹皮、桂枝(去粗皮)、芍药、乌头(炮裂后去皮脐)、细辛(去苗叶)、甘草(炙后锉碎)、木香。
以上九味药,捣碎过筛成末,用炼蜜制成梧桐子大小的丸剂,每次服用二十丸,用温酒送下,不拘时候。
治疗心疝、心痛难以忍受的木香散方:
木香、羌活(去芦头)、槟榔(生锉)、牡丹皮、当归(切后炒制)、桂枝(去粗皮)、青橘皮(汤浸)。
以上八味药,捣碎过筛成散剂,每次服用二钱匕,用沸水或温酒调服,不拘时候。
治疗心疝、心胁痛以及绕脐痛的芍药丸方:
芍药、桔梗(去芦头炒制)、细辛(去苗叶)、蜀椒(去目及闭口者,炒至出汗)、桂枝(去粗皮)、干姜。
以上七味药,捣碎过筛成末,用炼蜜制成梧桐子大小的丸剂,每次服用二十丸,用温酒或米饮送下,不拘时候。
治疗心疝心痛、肢体虚冷的蓬莪术煮散方:
蓬莪术(煨制)、槟榔(生锉)、附子(炮裂后去皮脐)、甘草(炙后锉碎)、桂枝(去粗皮,各一两)、胡椒。
以上八味药,捣碎过筛成散剂,每次服用二钱匕,用水一盏,煎至七分,不拘时候温服。
治疗久冷在内、阴气交攻、心痛如刺的橘皮益智汤方:
青橘皮(汤浸去白皮焙干)、益智仁(去皮)、乌头(炮裂后去皮脐)、威灵仙(去土,各一两)。
以上四味药,切碎如麻豆大小,每次服用三钱匕,用水一盏,生姜三片,少许盐,煎至六分,去渣滓,饭前温服,每日三次。
治疗阴冷交攻、心疝疼痛的紫桂丸方:
桂枝(去粗皮,半两)、当归(焙干,三分)、吴茱萸(汤浸焙炒,一两)。
以上三味药研为细末,用醋煮面糊,制成梧桐子大小的丸剂,每次服用二十丸,用炒生姜、盐、酒送下,米饮也可以,每日三次。
治疗心疝、冷痛难以忍受的三温散方:
附子(炮裂后去皮脐)、蓬莪术(煨后锉碎,各一两)、胡椒(半两)。
以上三味药制成细散,每次服用一钱匕,用热酒调服,不拘时候,妇人用醋汤送下。
Commentary states: The *Neijing* (Inner Canon) mentions that if the heart pulse is found to be tight and urgent, the disease is named Heart Shan (Heart Hernia), and there should be palpable masses in the lower abdomen. The Heart is a Yang organ (Muzang), and the Small Intestine is its interior-exterior paired organ (Shi); therefore, it is said that there should be palpable masses in the lower abdomen. Diseases of the Zang organs inevitably transmit to the Fu organs. Now, although the Heart itself has not received pathogenic factors, the disease transmits to the Fu organs; thus, the Small Intestine bears the pathogen, resulting in Shan pain, and palpable masses appear in the lower abdomen. Physicians of the world generally consider Shan to be a disease caused by cold-dampness, unaware that rebellious Qi of the Heart can also cause Shan syndrome. When treating Heart Shan, one must simultaneously regulate the Qi of the Heart.
Mu Xiang San Formula for Treating Heart Shan, Heart Pain, Chest Tightness, and Fainting:
Mu Xiang (Caulis Aucklandiae, processed by stir-frying with bran), Chen Pi (Pericarpium Citri Reticulatae, soaked in water, white pith removed, stir-fried, 1 liang each), Gao Liang Jiang (Rhizoma Alpiniae Officinarum), Gan Jiang (Radix Zingiberis Preparata, processed by stir-frying), He Li Le Pi (Pericarpium Terminaliae Chebulae), Chi Shao Yao (Radix Paeoniae Rubra), Zhi Qiao (Fructus Aurantii, albedo removed, stir-fried with bran), Chi Fu Ling (Poria, black skin removed, 0.5 liang each), Cao Dou Kou (Semen Cardamomi Rotundae, peel removed), Xiong Qiong (Radix Chuanxiong), Qian Niu Zi (Semen Pharbitidis, stir-fried, 3 fen each).
The above eleven ingredients are crushed, sifted into powder. Take 2 qian bi per dose, add 1 zhan of water, decoct until 0.7 zhan remains, take warm at any time.
Dang Gui Tang Formula for Treating Heart Shan, Heart Pain, Deficiency-Cold, and Restlessness:
Dang Gui (Radix Angelicae Sinensis, sliced and stir-fried), Gan Jiang (Radix Zingiberis Preparata, processed by stir-frying), Chi Shao Yao (Radix Paeoniae Rubra), Huang Qi (Radix Astragali Membranacei), Shu Jiao (Fructus Schisandrae Chinensis or Piperis Longi? Context suggests Sichuan Pepper, Fructus Zanthoxyli, remove eyes and closed mouths, stir-fried until oil appears), Ban Xia (Rhizoma Pinelliae Preparata, made into powder, mixed with ginger juice), Hou Po (Cortex Magnoliae Officinalis, rough bark removed).
The above twelve ingredients are cut into pieces like hemp seeds. Take 3 qian bi per dose, add 1 zhan of water, decoct until 0.7 zhan remains, strain and take warm at any time.
Mu Dan Wan Pill for Treating Heart Shan and Heart Pain Like Needle Stabbing:
Mu Dan Pi (Cortex Moutan Radicis), Gui Zhi (Ramulus Cinnamomi, rough bark removed), Shao Yao (Radix Paeoniae Lactiflorae or Rubra), Wu Tou (Radix Aconiti Lateralis Preparata, processed by stir-frying until cracked, peel and umbilicus removed), Xi Xin (Herba Asari), Gan Cao (Radix Glycyrrhizae Preparata, roasted and chopped), Mu Xiang (Caulis Aucklandiae).
The above nine ingredients are crushed, sifted into powder. Mix with refined honey to make pills the size of paulownia seeds. Take 20 pills per dose with warm wine at any time.
Mu Xiang San Formula for Treating Heart Shan and Unbearable Heart Pain:
Mu Xiang (Caulis Aucklandiae), Qiang Huo (Rhizoma et Radix Notopterygii, rhizome head removed), Bing Lang (Semen Arecae, raw and chopped), Mu Dan Pi (Cortex Moutan Radicis), Dang Gui (Radix Angelicae Sinensis, sliced and stir-fried), Gui Zhi (Ramulus Cinnamomi, rough bark removed), Qing Ju Pi (Pericarpium Citri Reticulatae Viride, soaked in water).
The above eight ingredients are crushed, sifted into powder. Take 2 qian bi per dose, mix with boiling water or warm wine to swallow at any time.
Shao Yao Wan Pill for Treating Heart Shan, Heart and Hypochondriac Pain, and Periumbilical Pain:
Shao Yao (Radix Paeoniae Lactiflorae or Rubra), Jie Geng (Radix Platycodonis, rhizome head removed and stir-fried), Xi Xin (Herba Asari, herbaceous part and leaves removed), Shu Jiao (Fructus Zanthoxyli, remove eyes and closed mouths, stir-fried until oil appears), Gui Zhi (Ramulus Cinnamomi, rough bark removed), Gan Jiang (Radix Zingiberis Preparata).
The above seven ingredients are crushed, sifted into powder. Mix with refined honey to make pills the size of paulownia seeds. Take 20 pills per dose with warm wine or rice drink at any time.
Peng E Zhu Decoction Powder for Treating Heart Shan Heart Pain and Cold Limbs Due to Deficiency:
Peng E Zhu (Rhizoma Curcumae, baked), Bing Lang (Semen Arecae, raw and chopped), Fu Zi (Radix Aconiti Lateralis Preparata, processed by stir-frying until cracked, peel and umbilicus removed), Gan Cao (Radix Glycyrrhizae Preparata, roasted and chopped), Gui Zhi (Ramulus Cinnamomi, rough bark removed, 1 liang each), Hu Jiao (Fructus Piperis Nigris).
The above eight ingredients are crushed, sifted into powder. Take 2 qian bi per dose, add 1 zhan of water, decoct until 0.7 zhan remains, take warm at any time.
Ju Pi Yi Zhi Tang Formula for Treating Persistent Cold Inside, Interacting Yin Qi, and Heart Pain Like Stabbing:
Qing Ju Pi (Pericarpium Citri Reticulatae Viride, soaked in water, white pith removed and baked), Yi Zhi Ren (Fructus Alpiniae Oxyphyllae, peel removed), Wu Tou (Radix Aconiti Lateralis Preparata, processed by stir-frying until cracked, peel and umbilicus removed), Wei Ling Xian (Radix Clematidis, soil removed, 1 liang each).
The above four ingredients are cut into pieces like hemp seeds. Take 3 qian bi per dose, add 1 zhan of water, 3 slices of fresh ginger, and a little salt. Decoct until 0.6 zhan remains, strain and take warm before meals, three times daily.
Zi Gui Wan Pill for Treating Interacting Yin Cold and Heart Shan Pain:
Gui Zhi (Ramulus Cinnamomi, rough bark removed, 0.5 liang), Dang Gui (Radix Angelicae Sinensis, baked, 3 fen), Wu Zhu Yu (Fructus Evodiae Routeae, soaked in water, baked and stir-fried, 1 liang).
The above three ingredients are ground into fine powder. Make paste with vinegar and flour dough, form pills the size of paulownia seeds. Take 20 pills per dose with stir-fried fresh ginger, salt, and wine; rice drink is also acceptable, three times daily.
San Wen San Powder for Treating Heart Shan and Unbearable Cold Pain:
Fu Zi (Radix Aconiti Lateralis Preparata, processed by stir-frying until cracked, peel and umbilicus removed), Peng E Zhu (Rhizoma Curcumae, baked and chopped, 1 liang each), Hu Jiao (Fructus Piperis Nigris, 0.5 liang).
The above three ingredients are made into fine powder. Take 1 qian bi per dose, mix with hot wine to swallow at any time. For women, mix with vinegar water.