治头目风眩，邪气鼓作，时或旋运。
天麻 羌活 白芷 本（去苗土） 川芎 芍药 细辛 麻黄（以上各二两） 牛
黄（别
上为细末，炼蜜和丸，如皂角子大，每服一二丸，不拘时研碎薄荷酒下。
《内经》曰∶五脏卒痛，何气使然？曰∶寒气客于背俞之脉，则血脉泣，脉泣则血虚，
血虚则痛，其俞注于心，故相引而痛。按之则热气至，则痛止矣，感于寒则痛久矣。病机要
曰∶诸心痛者，皆少阴厥阴气上冲也。有热厥心痛者，身热足寒，痛甚烦躁而吐，额自汗出
，知为热也，其脉浮大而洪，当灸太溪及昆仑，谓表里俱泻之，是谓热病。汗不出，引热下
利，长汗通身而出者愈也。灸毕，服金铃子散则愈，痛止服枳术丸去其余邪也。有大实心中
痛者，因气而食，卒然发痛，大便或秘，久则注闷，心胸高起，按之愈痛，不能饮食，急可
利之，利后以 本汤去其邪也。有寒厥心痛者，手足逆而通身冷汗出，便溺清利，或大便利
而不渴，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。以是论寒厥热厥，与夫大实心痛，治法已详。又有病久气血虚损，及
素作劳羸弱之人患心痛者，皆虚痛也，故钱氏心虚者，炒盐补之。《图经衍义》中，具蛎
心痛，则蛎粉与盐实得之矣。大意治病必求其本，究其本，究其虚实，正谓紫之夺红，相去
一间耳。而毫厘疑似，实霄壤焉。夫心为五官之主，百骸之所以听命者也。心之正经，果为
风冷邪气所干，果为气血痰水所犯，则其痛掣背胁胀，胸烦咽干，两颊赤黄，手足俱青至节
，朝发而暮殂矣。然心之包络，与胃口相应，往往脾痛连心，或肠虚阴厥，亦令心下疼痛。
或他脏之邪，亦有客乘于心者，是则心之别脉受焉，如所谓九种心痛，一曰虫，二曰疰，三
曰风，四曰悸，五曰食，六曰饮，七曰冷，八曰热，九曰来去者，皆是也。真心果痛，不知
能愈否乎？若手足俱青至节，不治。陈无择论心痛，又分三因，云十二经络。外感六淫，则
其气闭塞，郁于中焦，气与邪气发为疼痛。足厥阴心痛，两胁急引，小腹连阴股相引痛；手
心主痛彻背，心烦掌中热，咽干目黄赤胁满；足太阴心痛，腹胀满，涩涩然，大便不利，膈
闭咽塞；手太阴心痛，短气不得倚息，季胁坚痛，遗失无度，胸满烦心；足少阴心痛，烦剧
面黑，心悬若饥，胸满腰脊痛；背俞诸经心痛，心与背相引，心痛彻背，背痛彻心；诸腑心
痛，难以俯仰，小腹上冲，卒不知人，呕吐泄泻。此皆诸经诸俞诸腑涉邪所致，病属外所因
。若五脏内动，汨以七情，则其气痞结聚于中脘，气与血搏，发为疼痛。肝心痛者，色苍苍
如死状，终日不得太息；真心痛者，旦发夕死，夕发旦死；脾心痛者，如针锥刺其心腹，蕴
蕴然气满；肺心痛者，若从心间起，动作痛益甚，不变色；肾心痛者，与背相引善螈，如物
从后触其心，身偃偻；胃心痛者，腹胀满不下食，食则不消，皆脏气不平，喜怒忧郁所致，
属内因。饮食劳逸，触忤悲类，使脏气不平，痞膈于中，食饮遁注，变乱肠胃，发为疼痛。
或饮啖生冷果实，中寒不能消散，结而为积，遇食还散，名积心痛。及其脏寒生蛔致心痛者
，故有九种之名，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。亦有不由外因，丹溪先生曰∶凡心膈之痛
，须分久新，若知身受寒气，口食寒物而病。初得之时，当用温散，或温利之药；病得稍久
，则成郁矣，郁则蒸热，热久必生火。《原病式》曰∶若欲行温利温散，宁无助火添病耶？
凡治此病，必要先问平日起居何如？假如心痛有因平日喜食热物，以致死血留于胃口作痛者
，用桃仁承气汤下之。《脉经》曰∶厥心痛者，乃寒气客于心胞络也。诸虫痛如心腹痛，懊
发作肿聚，往来上下行，痛有休作，心腹中热，善渴涎出，面色乍青乍白乍赤，呕吐清水
者，蛔咬也，以手紧按而坚持之，无令得移。以针刺之，久持之，虫不动，乃出针也。心痛
之脉，阴弦为痛，微急为痛，微大为心痹引背痛，短数为痛，涩则为痛，浮大弦长者死，沉
细者生。且古人论诸心痛，皆因六淫七情所致，有寒厥热厥，有大实者，有内因，有外因，
有不内外因，以成前证。是以古人立论置方，后之学人，当以诚心切脉，热者凉之，寒者温
之，感受风邪者散之，顺气补血，逐水豁痰，此其要略耳。
治疗头目风眩，邪气鼓动发作，时而出现旋转性眩晕。
天麻、羌活、白芷、藁本（去除苗和泥土）、川芎、芍药、细辛、麻黄（以上各二两）、牛黄（单独处理）
将上述药物研磨成细末，用炼蜜调和制成丸剂，大小如皂角子，每次服用一到二丸，不拘时间，研碎后用薄荷酒送服。
《黄帝内经》说：五脏突然疼痛，是什么气导致的呢？回答说：寒气侵袭于背俞之脉，则血脉凝涩，血脉凝涩则血虚，血虚则痛，其俞穴注于心，所以相互牵引而痛。按压患处则热气到达，疼痛就会停止；感受寒邪则疼痛持久。《病机要》说：各种心痛，都是少阴经和厥阴经的气上冲所致。有热厥心痛者，身体发热而足部寒冷，疼痛剧烈且烦躁呕吐，额头自汗出，可知为热证，其脉象浮大而洪，应当灸太溪穴及昆仑穴，称为表里双泻，这是热病。若不出汗，引导热邪向下通过腹泻排出，全身大汗淋漓则痊愈。灸毕后，服用金铃子散则愈，疼痛停止后服用枳术丸以清除其余邪。有大实心中痛者，因气滞和饮食停滞，突然发作疼痛，大便或秘结，时间久了感到闷窒，心胸高起，按压时疼痛加剧，不能进食，急需通利大便，通便后用藁本汤祛除邪气。有寒厥心痛者，手足逆冷且全身冷汗出，小便清长，或大便通畅而不口渴，气息微弱无力，急需用术附汤温补。寒厥暴痛，不是久病，早晨发病晚上可能死亡，急需救治。由此可知，久病多无寒，暴病多非热。据此论述寒厥、热厥以及大实心痛，治疗方法已详尽。又有因病日久气血虚损，以及平时劳累羸弱之人患心痛者，都属于虚痛，所以钱乙认为心虚者，用炒盐补益。《图经衍义》中记载了蛎粉心痛，则是蛎粉与盐实证所得。大意治病必须求其根本，探究其虚实，正如紫草夺去红色，相差仅一步之遥。但毫厘之间的疑似，实则天壤之别。心是五官的主宰，百骸听从命令的器官。心的正经，如果是被风冷邪气所干犯，或者是被气血痰水所侵犯，那么疼痛会牵引背胁胀满，胸烦咽干，两颊赤黄，手足发青直至关节，早晨发病晚上就会死亡。然而心的包络，与胃口相应，往往脾痛牵连心脏，或者肠虚阴厥，也会导致心下疼痛。或者其他脏腑的邪气，也有客居侵犯心脏的，这就是心的别脉受邪，如所谓的九种心痛，一曰虫心痛，二曰疰心痛，三曰风心痛，四曰悸心痛，五曰食心痛，六曰饮心痛，七曰冷心痛，八曰热心痛，九曰来去心痛，都是这种情况。真心如果真的疼痛，不知道能否治愈吗？如果手足发青至关节，无法治愈。陈无择论述心痛，又分为三因，涉及十二经络。外感六淫，则气机闭塞，郁结于中焦，气与邪气相搏发为疼痛。足厥阴心痛，两胁紧急牵引，小腹连及阴股相互牵引疼痛；手心主痛彻背，心烦掌中热，咽干目黄赤胁满；足太阴心痛，腹胀满，涩涩然，大便不利，膈闭咽塞；手太阴心痛，短气不得倚息，季胁坚痛，遗失无度，胸满烦心；足少阴心痛，烦剧面黑，心悬若饥，胸满腰脊痛；背俞诸经心痛，心与背相引，心痛彻背，背痛彻心；诸腑心痛，难以俯仰，小腹上冲，突然不知人事，呕吐泄泻。这些都是诸经、诸俞、诸腑受邪所致，病属外所因。若五脏内动，扰乱于七情，则气痞结聚于中脘，气与血搏，发为疼痛。肝心痛者，面色苍苍如死状，终日不能深呼吸；真心痛者，早晨发病傍晚死亡，傍晚发病早晨死亡；脾心痛者，像针锥刺其心腹，蕴蕴然气满；肺心痛者，好像从心间发起，活动后疼痛更甚，面色不变；肾心痛者，与背相引善抽搐，像有东西从后面触及其心，身体弯曲；胃心痛者，腹胀满不下食，食则不消，都是脏气不平，喜怒忧郁所致，属内因。饮食劳逸，触犯悲类情绪，使脏气不平，痞隔于中，食饮遁注，变乱肠胃，发为疼痛。或者饮用生冷果实，中寒不能消散，结而为积，遇到食物还散开，名为积心痛。等到脏寒生蛔导致心痛者，所以有九种之名，除去风热冷属于外所因，其余皆不内外因。更有妇人恶血入心，脾经发作，疼痛尤其甚于诸痛。更有卒中客忤，鬼击尸疰，使人之心痛。也有不由外因引起的，丹溪先生说：凡是心膈之痛，必须分久新，如果知道身受寒气，口食寒物而病。初得之时，当用温散，或温利之药；病得稍久，则成郁矣，郁则蒸热，热久必生火。《原病式》说：如果想行温利温散，难道不会助火添病吗？凡治疗此病，必要先问平日起居如何？假如心痛有因平日喜食热物，以致死血留于胃口作痛者，用桃仁承气汤下之。《脉经》说：厥心痛者，乃寒气客于心胞络也。诸虫痛如心腹痛，懊恼发作肿聚，往来上下行，痛有休作，心腹中热，善渴涎出，面色乍青乍白乍赤，呕吐清水者，蛔咬也，以手紧按而坚持之，无令得移。以针刺之，久持之，虫不动，乃出针也。心痛之脉，阴弦为痛，微急为痛，微大为心痹引背痛，短数为痛，涩则为痛，浮大弦长者死，沉细者生。且古人论诸心痛，皆因六淫七情所致，有寒厥热厥，有大实者，有内因，有外因，有不内外因，以成前证。是以古人立论置方，后之学人，当以诚心切脉，热者凉之，寒者温之，感受风邪者散之，顺气补血，逐水豁痰，此其要略耳。
Treats wind vertigo of the head and eyes, where pathogenic factors surge and manifest, occasionally causing rotational dizziness.
Gastrodia Rhizoma (Tianma), Notopterygii Rhizoma et Radix (Qianghuo), Angelicae Dahuricae Radix (Baizhi), Ligustici Rhizoma et Radix (Gaoben) [removed seedlings and soil], Chuanxiong Rhizoma (Chuanxiong), Paeoniae Radix (Shaoyao), Asari Radix et Rhizoma (Xixin), Ephedrae Herba (Mahuang) [each 2 liang], Calculus Bovis (Niuhuang) [processed separately].
Grind the above herbs into a fine powder, mix with refined honey to make pills, sized like soap beans. Take one or two pills each time, at any time, crushed and taken down with mint wine.
The *Neijing* states: "What qi causes sudden pain in the five zang organs?" It is answered: "When cold qi invades the back-shu vessels, blood vessels become stagnant; stagnation leads to blood deficiency; deficiency leads to pain. Since the shu points connect to the heart, they pull on each other causing pain. Pressing the area brings heat, stopping the pain; contracting cold makes the pain last long." The *Bingji Yao* states: "All types of heart pain are caused by the upward rush of Qi from the Shaoyin and Jueyin meridians." In cases of Heat-Jue Heart Pain, the body is hot while the feet are cold, pain is severe with irritability and vomiting, and sweat appears spontaneously on the forehead, indicating a heat syndrome. The pulse is floating, large, and surging. Moxibustion should be applied to Taixi (KI3) and Kunlun (BL60), known as draining both interior and exterior, treating this as a heat disease. If there is no sweating, guide the heat downward through diarrhea; recovery occurs when profuse sweating covers the whole body. After moxibustion, take Jinlingzi San for cure; after pain subsides, take Zhizhu Wan to eliminate residual pathogens. In cases of Excess-Heart Pain due to fullness, caused by Qi stagnation and food retention, pain starts suddenly. Stool may be constipated; over time, it causes stifling sensation, chest distension, worsened by pressure, and inability to eat. Urgently promote bowel movement, then use Gaoben Tang to remove pathogens. In cases of Cold-Jue Heart Pain, hands and feet are inverted/cold with whole-body cold sweating, clear urination, or free stool without thirst, weak breath and strength. Urgently warm with Shufu Tang. Sudden Cold-Jue pain is not a chronic illness; morning onset may lead to evening death, requiring urgent rescue. Thus, chronic illnesses rarely involve cold, and acute illnesses rarely involve heat. Based on this, treatments for Cold-Jue, Heat-Jue, and Excess-Heart Pain are detailed. For those suffering heart pain due to long-term Qi and Blood deficiency, or those who are naturally weak from labor, these are Deficiency Heart Pains. Therefore, Qian Yi suggested using fried salt to tonify Heart Deficiency. The *Tujing Yanyi* records Li Shell Heart Pain, resulting from Li Powder and Salt excess syndromes. The general principle is that treating disease requires seeking its root, investigating deficiency and excess. This is like Zicao removing redness, differing by only a step. However, slight similarities can differ vastly. The Heart is the master of the five senses, commanding all limbs. If the Heart's main channels are invaded by Wind-Cold pathogens, or attacked by Qi, Blood, Phlegm, or Water, pain pulls to the back and flanks with distension, chest irritability, dry throat, reddish-yellow cheeks, and blue hands/feet up to joints, leading to death from morning to evening. However, the Pericardium corresponds to the stomach opening; often Spleen pain connects to the Heart, or Intestine deficiency with Yin-Jue causes lower heart pain. Pathogens from other organs may also invade the Heart via its collateral vessels, such as the Nine Types of Heart Pain: 1. Worm, 2. Pestilence, 3. Wind, 4. Palpitation, 5. Food, 6. Drink, 7. Cold, 8. Heat, 9. Wandering. All are included. If true Heart pain occurs, can it be cured? If hands and feet turn blue to joints, it is untreatable. Chen Wuze discusses Heart Pain, dividing it into Three Causes involving twelve meridians. External contraction of Six Evils blocks Qi, stagnating in the Middle Jiao, causing pain with pathogens. Jueyin Heart Pain involves tight hypochondrium pulling to lower abdomen and groin; Shaoyin Heart Pain involves back pain pulling to heart, pain piercing back; Taiyin Heart Pain involves abdominal distension, difficulty defecating, throat blockage; Taiyang Heart Pain involves shortness of breath, rigid costal margin, loss of control, chest fullness; Shaoyang Heart Pain involves severe irritability, black face, hunger-like heart sensation, chest/waist/back pain; Back-Shu Meridian Heart Pain involves mutual pulling between heart and back, pain piercing through; Fu Organ Heart Pain involves difficulty bending, upper abdomen rushing up, unconsciousness, vomiting/diarrhea. These are external causes affecting meridians, shu points, and fu organs. Internal movement of Five Zang disturbed by Seven Emotions causes Qi stagnation in Zhongwan, fighting with Blood to cause pain. Liver Heart Pain shows pale/deadly complexion, inability to sigh deeply; True Heart Pain causes death within half a day; Spleen Heart Pain feels like needle刺 in heart/abdomen with Qi fullness; Lung Heart Pain starts from heart center, worsens with movement, color unchanged; Kidney Heart Pain pulls to back, spasms, feeling touched from behind, body bent; Stomach Heart Pain involves abdominal distension, anorexia, indigestion. All result from unequal Zang Qi due to anger/joy/sorrow, belonging to Internal Causes. Diet and fatigue, emotional shocks, cause Qi imbalance, blocking middle, disrupting intestines/stomach, causing pain. Eating raw/cold fruits causes Cold accumulation, forming masses, dispersing with food, named Accumulation Heart Pain. When Cold generates roundworms causing Heart Pain, hence the Nine Types. Excluding Wind/Heat/Cold as External Causes, the rest are Neither-Internal-Nor-External Causes. Furthermore, women's evil blood entering the Heart or Spleen meridian attacks cause severe pain. Sudden invasion by ghosts or尸疰 also causes Heart Pain. Danxi said: Heart/chest pain must distinguish new vs old. If caused by cold exposure or diet, use warming/dispersing agents initially. Long-standing disease becomes stagnation, generating heat/fire. Using warming agents then would aid fire. Always ask about daily habits first. If pain is due to liking hot foods causing Blood stasis in stomach opening, use Tao Ren Cheng Qi Tang to purge. The *Mai Jing* states: Jue Heart Pain is Cold invading Pericardium. Worm pain resembles abdominal pain, swelling moving up/down, intermittent pain, internal heat, thirst, salivation, changing complexion, vomiting clear fluid indicates roundworm biting. Hold firmly, do not let move. Acupuncture: hold needle until worm stops moving, then withdraw. Pulse diagnostics for Heart Pain: Yin-wiry indicates pain, slightly rapid indicates pain, slightly large indicates Heart Bi pulling back pain, short-rapid indicates pain, choppy indicates pain. Floating-large-wiry-long indicates death; sinking-fine indicates survival. Ancient theories attribute Heart Pain to Six Evils and Seven Emotions, including Cold/Heat Jue, Excess, Internal/External/Neither-Internal-Nor-External Causes. Thus, ancient formulas were established. Later students should sincerely palpate pulses: cool heat, warm cold, disperse Wind, regulate Qi, tonify Blood, drain Water, resolve Phlegm. This is the essence.