夫心痛者。由风冷邪气乘于心也。其痛发有死者。有不成病者。心为诸脏之主。而藏神。
其
乘。不伤于正经者。亦令心痛。则乍间乍甚。故成病不死。又心为火。与诸阳会合。而手少
阴心经也。若诸阳气虚。少阴之经气逆。谓之阳虚阴厥。亦令心痛。其痛引喉是也。又诸脏
虚受病。气乘于心者。亦令心痛。则心下急痛。谓之脾心痛也。足太阴为脾之经。与胃合。
足阳明为胃之经。气虚逆乘于心而痛。其状。腹胀归于心而痛甚。谓之胃心痛也。肾之经足
少阴是也。与膀胱合。膀胱之经。足太阳是也。此二经俱虚。而气逆乘心而痛者。其状下重。
时苦泄寒中。为肾心痛也。诊其心脉急者。为心痛引背。食不下。寸口脉沉紧。苦心下有寒
时痛。关上脉紧。心下苦痛。左手寸口脉沉。则为阴绝。阴绝者无心脉也。苦心下毒痛也。
夫九种心痛者。一虫心痛。二疰心痛。三风心痛。四悸心痛。五食心痛。六饮心痛。七
冷心
正气
治九种心痛。面色青。心腹妨闷。四肢不和。宜服沉香散方。
沉香(三分) 赤芍药〔三(一)两〕 酸石榴皮(一两) 桔梗(三分去芦头) 槟
榔(一两)
大
上件药。捣粗罗为散。每服四钱。以水一中盏。入葱白七寸。煎至六分。去滓。不计时
候。
治九种心痛。多吐腹胀。宜服桂心散方。
桂心(一两) 当归(半两锉微炒) 食茱萸(半两) 赤芍药(半两) 浓朴(一两
去粗皮涂
炙姜
上件药。捣粗罗为散。每服五钱。以水一大盏。煎至五分。去滓。不计时候。稍热服。
治九种心痛。及冷气攻两胁。胸背疼痛。欲吐。宜服当归散方。
当归(一两锉微炒) 桔梗(一两去芦头) 陈橘皮(一两汤浸去白瓤焙) 赤芍药(半
两)
枳壳
分)
上件药。捣细罗为散。不计时候。煎生姜枣汤。调下二钱。
治九种心痛。腹胁气滞。宜服诃黎勒丸方。
诃黎勒(一两煨用皮) 木香(半两) 桂心(一两) 干姜(半两炮裂锉) 川大黄
(一两锉
碎微
上件药。捣罗为末。酽醋煮面糊和丸。如梧桐子大。不计时候。以温酒下二十丸。
治九种心痛。腹内冷气积聚。宜服沉香丸方。
沉香(半两) 阿魏(半两面裹煨以面熟为度) 麝香(半两细研) 木香(一两) 丁
香(一
两)
上件药。捣罗为末。入麝香同研令匀。煎醋浸蒸饼和丸。如绿豆大。不计时候。以热酒
嚼
治九种心痛。腹胁气胀。不欲饮食。宜服附子丸方。
附子(二两炮裂去皮脐) 干姜(二两炮裂锉) 巴豆(半两去皮心研纸裹压去油) 人
参
(一两
上件药。捣罗为末。入巴豆研令匀。炼蜜和捣三二百杵。丸如梧桐子大。不计时候。以
热酒
治九种心痛。及腹胁气聚。滞不消方。
上取干漆二两。捣碎。炒令烟出。细研如粉。炼蜜和丸。如梧桐子大。不计时候。以热
酒下
治九种心痛妨闷方。
桂心(半两末)
上以酒一大盏。煎至半盏。去滓。稍热服。立效。
又方。
槐树枝(一握新生者细锉)
上以水三大盏。煎取一盏。去滓。稍热分为二服。
心痛这一病症,是由于风冷邪气侵袭心脏所致。其疼痛发作时,有的会导致死亡,有的则不会形成严重疾病。心是五脏的主宰,并且藏纳神志。
如果邪气侵犯,但没有伤及正经(十二经脉),也会引起心痛,表现为疼痛时轻时重,因此虽成病但不会致死。另外,心属火,与诸阳经会合,归属于手少阴心经。如果诸阳之气虚弱,少阴经的气机逆乱,称为阳虚阴厥,也会导致心痛,这种疼痛牵引喉咙就是其表现。此外,其他脏腑虚弱受病,气机上逆乘袭心脏,也会引起心痛,表现为心下急迫疼痛,称为脾心痛。足太阴脾经与胃相表里;足阳明胃经,若气虚逆乱上冲于心而致痛,其症状为腹胀并放射至心前区且疼痛剧烈,称为胃心痛。肾的经络是足少阴经,与膀胱相表里;膀胱的经络是足太阳经。这两条经络都虚弱,气机上逆乘袭心脏而致痛,其症状为下身沉重,时常痛苦于腹泻和腹部寒冷,称为肾心痛。诊察发现心脉紧急的,为心痛牵引背部,饮食难下;寸口脉象沉紧,为心下部有寒,时常疼痛;关上脉象紧,为心下部痛苦疼痛;左手寸口脉象沉,则为阴绝。所谓阴绝,是指没有心脉搏动,患者会感到心下部剧烈毒痛。
所谓的九种心痛,包括:一、虫心痛;二、疰心痛;三、风心痛;四、悸心痛;五、食心痛;六、饮心痛;七、冷心痛;八、去心痛;九、来心痛。(注:原文此处文字错乱,后接“正气 治九种心痛”,根据《太平圣惠方》原意,九种心痛通常指上述九类,或包含蛔心痛等,此处依原文结构处理)。
治疗九种心痛,症见面色青,心腹部胀闷不适,四肢不和顺,适宜服用沉香散方。
药材:沉香(三分)、赤芍药(三两)、酸石榴皮(一两)、桔梗(三分,去芦头)、槟榔(一两)。
制法与用法:将上述药物捣碎过粗罗筛成散剂。每次服用四钱,用水一中盏,加入葱白七寸,煎煮至剩余六分药液,滤去药渣。不分时候温服。
治疗九种心痛,症见多呕吐、腹胀,适宜服用桂心散方。
药材:桂心(一两)、当归(半两,锉碎微炒)、食茱萸(半两)、赤芍药(半两)、浓朴(一两,去粗皮涂炙姜汁)。
制法与用法:将上述药物捣碎过粗罗筛成散剂。每次服用五钱,用水一大盏,煎煮至剩余五分药液,滤去药渣。不分时候稍热服用。
治疗九种心痛,以及冷气攻冲两胁,胸背疼痛,想呕吐,适宜服用当归散方。
药材:当归(一两,锉碎微炒)、桔梗(一两,去芦头)、陈橘皮(一两,汤浸去白瓤焙干)、赤芍药(半两)、枳壳(半两,麸炒微黄去瓤)。
制法与用法:将上述药物捣细过罗筛成散剂。不分时候,用生姜枣汤煎好后,调服二钱散剂。
治疗九种心痛,腹胁气机阻滞,适宜服用诃黎勒丸方。
药材:诃黎勒(一两,煨后用皮)、木香(半两)、桂心(一两)、干姜(半两,炮裂锉碎)、川大黄(一两,锉碎微炒)。
制法与用法:将上述药物捣罗成末,用浓醋煮面糊调和制成丸剂,如梧桐子大小。不分时候,用温酒送服二十丸。
治疗九种心痛,腹内冷气积聚,适宜服用沉香丸方。
药材:沉香(半两)、阿魏(半两,用面包裹煨,以面熟为度)、麝香(半两,细研)、木香(一两)、丁香(一两)。
制法与用法:将上述药物捣罗成末,加入麝香共同研磨均匀,用醋浸泡蒸饼调和制成丸剂,如绿豆大小。不分时候,用热酒嚼服。
治疗九种心痛,腹胁气胀,不想饮食,适宜服用附子丸方。
药材:附子(二两,炮裂去皮脐)、干姜(二两,炮裂锉碎)、巴豆(半两,去皮心研烂纸裹压去油)、人参(一两,去芦头)。
制法与用法:将上述药物捣罗成末,加入巴豆研匀,用炼蜜调和捣击三二百下,制成如梧桐子大小的丸剂。不分时候,用热酒送服。
治疗九种心痛,以及腹胁气聚,停滞不消的方剂。
取干漆二两,捣碎,炒至冒烟,细研如粉。用炼蜜调和制成丸剂,如梧桐子大小。不分时候,用热酒送服。
Heart pain is caused by wind-cold pathogenic factors invading the Heart. Its onset may lead to death in some cases, while in others it does not constitute a severe disease. The Heart is the master of the five Zang organs and houses the Shen (Spirit).
If pathogenic factors invade without damaging the regular meridians (Twelve Primary Meridians), heart pain may still occur, characterized by pain that fluctuates in intensity; thus, although illness ensues, it is not fatal. Furthermore, the Heart belongs to Fire and converges with all Yang meridians, specifically corresponding to the Hand-Shaoyin Heart Meridian. If the Qi of all Yang meridians is deficient, leading to rebellious flow of Qi in the Shaoyin meridian, this is termed Yang Deficiency with Yin Reversal (Yang Xu Yin Jue), which also causes heart pain; such pain radiating to the throat is indicative of this condition. Additionally, when other Zang organs are weakened and diseased, their Qi rebels upward to assault the Heart, causing heart pain characterized by urgent and painful sensation below the heart, known as Spleen Heart Pain (Pi Xin Tong). The Foot-Taiyin Spleen Meridian is interiorly-exteriorly related to the Stomach; the Foot-Yangming Stomach Meridian, if its Qi is deficient and rebels upward to the Heart causing pain, presents with abdominal distension radiating to the cardiac region with severe pain, known as Stomach Heart Pain (Wei Xin Tong). The meridian of the Kidney is the Foot-Shaoyin Meridian, interiorly-exteriorly related to the Bladder; the meridian of the Bladder is the Foot-Taiyang Meridian. When these two meridians are both deficient, and their Qi rebels upward to assault the Heart causing pain, the symptoms include heaviness in the lower body and frequent suffering from diarrhea and coldness in the middle jiao, known as Kidney Heart Pain (Shen Xin Tong). Palpation revealing an urgent Heart pulse indicates heart pain radiating to the back and difficulty in eating; a deep and tight pulse at the Cun Kou position indicates cold in the epigastrium with intermittent pain; a tight pulse at the Guan position indicates painful distress in the epigastrium; a deep pulse at the left Cun Kou position indicates Yin Extinction (Yin Jue). Yin Extinction refers to the absence of the Heart pulse, accompanied by severe toxic pain in the epigastrium.
The so-called Nine Types of Heart Pain include: 1. Worm Heart Pain; 2. Zhu (Infectious/Transmitted) Heart Pain; 3. Wind Heart Pain; 4. Palpitation Heart Pain; 5. Food Heart Pain; 6. Drink (Fluid) Heart Pain; 7. Cold Heart Pain; 8. Departing Heart Pain; 9. Arriving Heart Pain. (Note: The original text contains textual corruption here, followed by "Zheng Qi Treat Nine Types of Heart Pain". Based on the structure of *Taiping Shenghui Fang*, these refer to the nine categories).
To treat the Nine Types of Heart Pain, presenting with a bluish complexion, chest and abdominal oppression, and disharmony in the four limbs, Chenxiang San (Agarwood Powder) is indicated.
Ingredients: Agarwood (Chen Xiang, 3 fen), Red Peony Root (Chi Shaoyao, 3 liang), Acid Pomegranate Peel (Suan Shiliu Pi, 1 liang), Platycodon Root (Jie Geng, 3 fen, remove radicle), Areca Seed (Bing Lang, 1 liang).
Preparation and Administration: Coarsely grind the above ingredients into a powder. Take 4 qian per dose, add 1 zhong of water and 7 cun of scallion white, decoct until 6 fen remains, strain, and take warm at any time.
To treat the Nine Types of Heart Pain, presenting with frequent vomiting and abdominal distension, Guixin San (Cinnamon Heart Powder) is indicated.
Ingredients: Cinnamon Heart (Gui Xin, 1 liang), Angelica Sinensis Root (Dang Gui, 0.5 liang, sliced and lightly stir-fried), Edible Evodia Fruit (Shi Zhuyu, 0.5 liang), Red Peony Root (Chi Shaoyao, 0.5 liang), Magnolia Bark (Nou Pu, 1 liang, remove coarse bark, coat with ginger juice and roast).
Preparation and Administration: Coarsely grind the above ingredients into a powder. Take 5 qian per dose, add 1 da zhong of water, decoct until 5 fen remains, strain, and take warm at any time.
To treat the Nine Types of Heart Pain, along with cold qi attacking the hypochondrium, chest and back pain, and nausea, Danggui San (Angelica Sinensis Powder) is indicated.
Ingredients: Angelica Sinensis Root (Dang Gui, 1 liang, sliced and lightly stir-fried), Platycodon Root (Jie Geng, 1 liang, remove radicle), Aged Tangerine Peel (Chen Ju Pi, 1 liang, soaked in hot water, remove white pith, dry), Red Peony Root (Chi Shaoyao, 0.5 liang), Aurantium Fruit (Zhi Ke, 0.5 liang, stir-fried with bran until slightly yellow, remove core).
Preparation and Administration: Finely grind the above ingredients into a powder. At any time, decoct fresh ginger and jujube in water, mix with 2 qian of the powder, and ingest.
To treat the Nine Types of Heart Pain, with qi stagnation in the abdomen and hypochondrium, Helile Wan (Chebula Pill) is indicated.
Ingredients: Chebula Fruit (He Li Le, 1 liang, roasted, use peel), Costus Root (Mu Xiang, 0.5 liang), Cinnamon Heart (Gui Xin, 1 liang), Dried Ginger (Gan Jiang, 0.5 liang, processed and sliced), Rhubarb (Chuan Da Huang, 1 liang, sliced and lightly stir-fried).
Preparation and Administration: Grind the above ingredients into powder. Mix with thick vinegar and wheat paste to form pills the size of Sophora seeds. Take 20 pills with warm wine at any time.
To treat the Nine Types of Heart Pain, with accumulation of cold qi in the abdomen, Chenxiang Wan (Agarwood Pill) is indicated.
Ingredients: Agarwood (Chen Xiang, 0.5 liang), Asafoetida (A Wei, 0.5 liang, wrapped in dough and roasted until dough is cooked), Realgar/Musk (She Xiang, 0.5 liang, finely ground), Costus Root (Mu Xiang, 1 liang), Clove (Ding Xiang, 1 liang).
Preparation and Administration: Grind the above ingredients into powder. Add musk and grind uniformly. Mix with steamed leaven cake soaked in vinegar to form pills the size of mung beans. Chew and swallow with hot wine at any time.
To treat the Nine Types of Heart Pain, with abdominal and hypochondrial qi distension and loss of appetite, Fuzi Wan (Aconite Pill) is indicated.
Ingredients: Prepared Aconite Root (Fu Zi, 2 liang, processed, skin and umbilicus removed), Dried Ginger (Gan Jiang, 2 liang, processed and sliced), Croton Seed (Ba Dou, 0.5 liang, skin and heart removed, ground between paper to remove oil), Ginseng Root (Ren Shen, 1 liang, radicle removed).
Preparation and Administration: Grind the above ingredients into powder. Mix thoroughly with croton seed. Knead with refined honey for 300-200 strikes to form pills the size of Sophora seeds. Take with hot wine at any time.
For treating the Nine Types of Heart Pain, and qi accumulation in the abdomen and hypochondrium that fails to dissipate:
Take 2 liang of Dry Lacquer (Gan Qi), crush it, stir-fry until smoke appears, and grind finely into powder. Mix with refined honey to form pills the size of Sophora seeds. Take with hot wine at any time.
For treating the Nine Types of Heart Pain with chest and abdominal oppression:
Cinnamon Heart (Gui Xin, 0.5 liang, powdered).
Administration: Decoct in 1 da zhong of wine until 0.5 zhong remains, strain, and take warm. Effect is immediate.
Another prescription:
Locust Tree Branch (Huai Shu Zhi, 1 handful, fresh young branches, finely sliced).
Administration: Decoct in 3 da zhongs of water until 1 zhong remains, strain, divide into two doses, and take warm.