【内伤胸痛之症】不因外感，胸中隐隐作痛，其痛缓，其来渐，久久不愈，饮食渐少
，此内伤胸痛也。若见咳嗽寒热，吐痰腥秽，则是肺痈之症，而非胸痛也。
【内伤胸痛之因】七情六欲，动其心火，刑及肺金，或怫郁气逆，伤其肺道，则痰凝
气结；或过饮辛热，伤其上焦，则血积于内，而闷闭胸痛矣。
【内伤胸痛之脉】滑大主痰；洪数主火。左寸洪数，心火刑金；左关弦数，肝胆有热
。右寸沉结，气滞上焦；寸脉芤涩，上部蓄血。
【内伤胸痛之治】痰气不清，栝蒌仁汤，加青黛、海石；兼火者，栀连二陈汤；心
火乘
者，红花当归汤加桃仁、牡丹皮，有热，加炒山栀、郁金。
栝蒌仁汤 见前。
栀连二陈汤
山栀 黄连 熟半夏 白茯苓 广皮 甘草
泻心汤
川黄连 甘草
清肺饮
地骨皮 桑白皮 桔梗 知母 黄芩 玄参 薄荷 甘草
热甚，加石膏。
加味柴胡汤
柴胡 黄芩 广皮 甘草 山栀
四七汤
半夏 浓朴 茯苓 紫苏
加姜、枣。
红花当归汤
红花 当归 红曲 赤芍药 牡丹皮 青皮 桃仁 郁金 楂肉 泽兰叶 黑山栀
胸痛上焦气分病，当理肺气，要分肺管、胃管。若胃气有伤，胃脘气逆，亦多胸痛，其
中分别∶若饮食自如，而见气逆咳喘作痛，病不在胃而在于肺，当和肺气；若无喘咳气逆，
而见饮食阻滞，病不在肺而在于胃，当调胃气；若二经皆病，当审其何经先起，如先见喘咳
气逆满作痛，后见妨碍饮食者，此肺病遗祸于胃也，当治其肺，兼治其胃；若先见饮食妨碍
，后见喘咳气逆，此胃病遗祸于肺也，当平其胃，兼治其肺。此从方广肿胀门，辨脾肺相传
法中，化出辨肺胃二经之胸痛。又有语言即痛，饮食不痛者，病在于肺；饮食即痛，语言不
痛者，病在于胃。此从辨喉痛症中，化出辨肺胃之胸痛也。
【内伤胸痛的症状】并非由外感邪气引起，胸中隐隐作痛，疼痛程度较轻，发作逐渐显现，长期不愈，饮食量逐渐减少，这就是内伤胸痛。如果见到咳嗽、寒热交替、吐出腥臭痰液，则是肺痈（肺部化脓性病变）的症状，而不是单纯的胸痛。
【内伤胸痛的病因】七情六欲扰动心火，火克金而损伤肺脏；或者情绪抑郁导致气机逆乱，损伤肺道，致使痰凝气结；或者过量饮用辛辣温热之物，损伤上焦，导致血液瘀积于体内，从而出现胸闷闭塞和胸痛。
【内伤胸痛的脉象】脉滑大主痰饮；脉洪数主火热。左寸脉洪数，表示心火刑克肺金；左关脉弦数，表示肝胆有热。右寸脉沉结，表示气滞于上焦；寸脉芤涩，表示上部有蓄血。
【内伤胸痛的治法】若为痰气不清，使用栝蒌仁汤，加青黛、海浮石；兼有火邪者，使用栀连二陈汤；若心火乘袭肺金者，使用红花当归汤加桃仁、牡丹皮，若有热象，加炒山栀、郁金。
栝蒌仁汤 见前文。
清肺饮
地骨皮 桑白皮 桔梗 知母 黄芩 玄参 薄荷 甘草
热势严重，加石膏。
红花当归汤
红花 当归 红曲 赤芍药 牡丹皮 青皮 桃仁 郁金 楂肉 泽兰叶 黑山栀
胸痛属于上焦气分病，应当调理肺气，关键在于区分肺管和胃管。如果胃气受损，胃脘气逆，也常出现胸痛，其中需要仔细辨别：如果饮食正常，但出现气逆、咳嗽、气喘并伴有疼痛，病位不在胃而在肺，应当调和肺气；如果没有喘咳气逆，但出现饮食阻滞，病位不在肺而在胃，应当调理胃气；如果肺胃两经均患病，应当审查哪一经先发病，如先出现喘咳气逆满闷作痛，后出现妨碍饮食的情况，这是肺病波及胃，应当治疗肺，兼治胃；如先出现饮食妨碍，后出现喘咳气逆，这是胃病波及肺，应当平抑胃气，兼治肺。这是从方广《肿胀门》中辨脾肺相传的方法中，演化出辨别肺胃二经所致胸痛的方法。又有说话时即痛，饮食时不痛的，病在肺；饮食时即痛，说话时不痛的，病在胃。这是从辨别喉痛症状中，演化出辨别肺胃之胸痛的方法。
[Symptoms of Internal Injury Chest Pain] Not caused by external pathogenic factors, there is a dull pain in the chest. The pain is mild, develops gradually, persists for a long time without healing, and food intake gradually decreases. This is internal injury chest pain. If cough, alternating chills and fever, and expectoration of foul-smelling sputum are observed, it is Lung Abscess (Fei Yong), not simple chest pain.
[Etiology of Internal Injury Chest Pain] Seven emotions and six desires stir up Heart Fire, which overacts on Metal to damage the Lungs; or emotional depression causes Qi rebellion, damaging the Lung channels, leading to phlegm condensation and Qi stagnation; or excessive consumption of pungent and hot substances damages the Upper Jiao, causing blood stasis internally, resulting in chest stuffiness, closure, and pain.
[Pulse Signs of Internal Injury Chest Pain] A slippery and large pulse indicates Phlegm; a flooding and rapid pulse indicates Fire. A flooding and rapid pulse at the Left Cun position indicates Heart Fire overacting on Metal; a wiry and rapid pulse at the Left Guan position indicates Heat in the Liver and Gallbladder. A deep and knotted pulse at the Right Cun position indicates Qi stagnation in the Upper Jiao; a hollow and choppy pulse at the Cun positions indicates Blood stasis in the upper body.
[Therapeutic Methods for Internal Injury Chest Pain] For unclear Phlegm and Qi, use Gualou Ren Tang (Trichosanthis Semen Decoction), add Qingdai (Indigo Naturalis) and Haishi (Sponge); if accompanied by Fire, use Zhilian Erchen Tang (Gardenia and Coptis Two-Chen Decoction); if Heart Fire attacks, use Honghua Danggui Tang (Carthamus and Angelica Decoction) with Taoren (Peach Kernel) and Mudanpi (Moutan Cortex); if Heat is present, add Chao Shanzhi (Stir-fried Gardenia Fruit) and Yujin (Curcuma Longa Rhizome).
Gualou Ren Trichosanthis Semen Decoction See previous text.
Zhilian Erchen Tang
Zhizi (Gardenia Fruit) Huanglian (Coptis Rhizome) Shu Banxia (Prepared Pinellia Tuber) Baifuling (White Poria) Guangpi (Citrus Reticulata Peel) Gancao (Licorice Root)
Xiexin Tang (Drain the Epigastrium Decoction)
Chuan Huanglian (Coptis Rhizome) Gancao (Licorice Root)
Qingfei Yin (Clear the Lungs Infusion)
Digupi (Lycium Bark) Sangbaipi (Mulberry Root Bark) Jiegeng (Platycodon Root) Zhimu (Anemarrhena Rhizome) Huangqin (Scutellaria Root) Xuanshen (Scrophularia Root) Bohe (Mint Herb) Gancao (Licorice Root)
If Heat is severe, add Shigao (Gypsum Fibrosum).
Jiawei Chaihu Tang (Modified Bupleurum Decoction)
Chaihu (Bupleurum Root) Huangqin (Scutellaria Root) Guangpi (Citrus Reticulata Peel) Gancao (Licorice Root) Zhizi (Gardenia Fruit)
Siqi Tang (Four-Seven Decoction)
Banxia (Pinellia Tuber) Nongpo (Magnolia Bark) Fuling (Poria) Zisu (Perilla Leaf)
Add Shengjiang (Fresh Ginger) and Zao (Jujube).
Honghua Danggui Tang (Carthamus and Angelica Decoction)
Honghua (Carthamus Flower) Danggui (Angelica Sinensis Radix) Hongqu (Red Yeast Rice) Chishaoyao (Red Peony Root) Mudanpi (Moutan Cortex) Qingpi (Aurantii Fructus Immaturus Peel) Taoren (Peach Kernel) Yujin (Curcuma Longa Rhizome) Zharou (Hawthorn Flesh) Zelan Ye (Eupatorium Leaf) Heishanzhi (Black Gardenia Fruit)
Chest pain in the Upper Jiao Qi level disease should be treated by regulating Lung Qi, distinguishing between the Lung tube and the Stomach tube. If Stomach Qi is damaged and rebellious in the epigastrium, chest pain often occurs; differentiation is required: If diet is normal but Qi rebellion, cough, asthma, and pain occur, the disease is not in the Stomach but in the Lung, so harmonize Lung Qi; If there is no asthma, cough, or Qi rebellion, but dietary obstruction occurs, the disease is not in the Lung but in the Stomach, so regulate Stomach Qi; If both meridians are diseased, examine which meridian was affected first. If asthma, cough, Qi rebellion, fullness, and pain appear first, followed by dietary obstruction, this is Lung disease affecting the Stomach; treat the Lung and concurrently treat the Stomach. If dietary obstruction appears first, followed by asthma, cough, and Qi rebellion, this is Stomach disease affecting the Lung; calm the Stomach and concurrently treat the Lung. This method of differentiating chest pain between the Lung and Stomach meridians is derived from the method of differentiating transmission between the Spleen and Lung in Fang Guang's "Swelling Section." Furthermore, if pain occurs upon speaking but not upon eating, the disease is in the Lung; if pain occurs upon eating but not upon speaking, the disease is in the Stomach. This differentiation of chest pain between the Lung and Stomach is derived from the differentiation of throat pain symptoms.