〔大〕夫妇人血气心痛者，由脏腑虚，血气不调，风冷邪气乘于心也。其痛发有死
者，有不死者。成证者，心为诸脏之主，而主于神，其正经不可伤，伤之而痛者，名为
真心痛，朝发夕死，夕发旦死。心之支别络为风冷所乘而痛者，故痛发乍轻乍甚，而成
证者也。
〔薛〕前证若寒邪所伤，温散之。饮食停滞，消导之。肝火妄动，辛平之。脾气郁
结，和解之。仍与后六证方药同用。一妇人久患心痛，饮食少思，诸药到口即吐。予
以为脾土虚弱，用白术一味，同黄土炒，去土，每服一两，以米泔煎浓，徐服少许，数
日后自能大饮。用三斤余而安。上舍陈履学长子室，素怯弱，产后患疥疮，年余不愈，
因执丧旬月，每欲眩仆。一日感气，忽患心脾高肿作疼，手不可按，而呕吐不止，六脉
微细。或见其形实，误认诸痛不可补气，乃用青皮、木香、五味、吴茱萸等药而愈。继
复患疟，且堕胎，又投理气行血之药，病虽去，元气转脱，再投参 补剂不应矣，六脉
如丝欲绝。迎予至诊之，曰∶形虽实而脉虚极，反用理气之剂，损其真气故也。连投参、
、归、术、附子、姜、桂二剂，间用八味丸，五日寝食渐甘，六脉全复。此证若心脾
疼痛时，即服此等药，疟亦不作矣。
〔大〕乌药散 治妇人血气攻心痛，发歇不定。
乌药 莪术 桂心 当归（炒） 桃仁 青皮 木香（各等分）
为末，每服二钱，热酒调下。
阿魏丸 治妇人血气攻心疼痛，及一切积冷气。
当归 桂心 青皮 附子（炮） 阿魏（面裹煨，以面熟为度） 白术 川芎（各一两）
吴茱萸（炮） 木香 干姜（各三分） 槟榔 肉豆蔻（煨） 延胡索 莪术（各一两）
朱砂（细研，半两）
上为末，先以醋一升，煎阿魏成膏，和药末捣三百杵，丸如梧桐子大。每服二十丸，
食前热酒下。
鸡舌香散 治男子妇人九种心痛，一切冷气。
良姜（锉细，麻油炒） 桂心 赤芍药（各等分）
上为细末，每服二钱，水一盏，入盐木瓜三片，同煎七分，温服，盐汤点亦可。血
气疝瘕痛，用熟醋汤调下，忌生冷。
应痛散 治心脾痛不可忍者，妇人脾血气作心脾痛尤效。前方同，只无桂心。用醋
煎、醋汤点亦可。
乙丑年春初，次女年十五，经脉未行，初一日心痛如刺，吐饮不止，脉沉缓弦细，以
苏合香丸、神保丸、沉香丸、理中丸、诃子散、七气汤，皆无效。余思之，此证非虫即
饮作疾，非《局方》九痛丸则不可。遂合与服一二丸，即愈矣。
陈氏二神丸 治妇人血气不和，作痛不止，及下血无时，月水不调。
真蒲黄（炒） 荜茇（盐炒）
上等分为细末，炼蜜丸如梧子大。每服三十丸，空心温酒下。如不能饮，米饮吞下，
两服即止。
陈日华抽刀散 治妇人血风血气等疾。武兴戎司机宜侯恺云∶见一道人，用此方疗
病，不一而足，遂以为献，真是奇妙。
五灵脂（炒，一两） 莪术 桂心 芸苔子（炒，各半两）
上为末，每服二大钱，酒半盏，水半盏，煎至八分，疾作热服。
失笑散（见产后心痛。） 诃子散（见霍乱。）亦妙。
《灵苑方》治妇人卒血气心痛。只用生五灵脂为细末，每服一钱，酒一盏，煎沸热
服。
《局方》四七汤加良姜，又沉香降气汤、分心气饮，皆治心痛良。（三方并见杂病诸气。）
【大】妇女因血气失调所致的心痛，是由于脏腑虚弱，气血运行不调，风冷邪气侵袭心脏所致。这种疼痛发作时，有的会导致死亡，有的则不会。如果病情严重到形成证候，因为心是五脏的主宰，并主宰神志，其正经（手少阴心经）不可受损伤，一旦受损而引发疼痛，称为“真心痛”，早晨发病傍晚死亡，傍晚发病次日清晨死亡。若是心的分支络脉受到风冷邪气侵袭而引发的疼痛，所以疼痛发作时有时减轻、有时加重，从而形成一般的证候。
【薛】上述病症如果是寒邪所伤，应用温散法治疗；如果是饮食停滞，应用消导法治疗；如果是肝火妄动，应用辛平法治疗；如果是脾气郁结，应用和解法治疗。这些方法仍可与后文提到的六种证候的方药配合使用。有一位妇人长期患心痛，食欲不振，服药即吐。我认为这是脾土虚弱所致，只用白术一味药，与黄土同炒，去掉黄土，每次服用一两，用浓米泔水煎煮，慢慢服用少量，数日后自然能大量饮水。累计服用三斤多后痊愈。上舍陈履学的长子之妻，素来怯弱，产后患疥疮，一年多未愈，因守丧一个月，经常感到眩晕欲倒。有一天感受外邪，突然心脾部位高肿疼痛，手不能触碰，且呕吐不止，六脉微细。有人见其形体壮实，误认为各种疼痛不可补气，于是使用青皮、木香、五味子、吴茱萸等药物治疗而痊愈。后来再次患疟疾，且发生堕胎，又投以理气行血的药物，病虽去，但元气更加虚脱，再投人参补剂已无效，六脉如丝线般微弱欲绝。请我去诊治，我说：形体虽然看似壮实，但脉象极度虚弱，反而使用理气药剂，损伤了真气所致。连续投用人参、[此处原文缺字，推测为黄芪或类似补气药]、当归、白术、附子、干姜、肉桂两剂，间服八味丸，五天后睡眠和饮食逐渐好转，六脉完全恢复。此证如果在心脾疼痛时立即服用此类药物，疟疾也不会发作了。
【大】乌药散：治疗妇女血气攻冲引起的心痛，发作间歇不定。
乌药、莪术、桂心、当归（炒）、桃仁、青皮、木香（各等分）。
研为细末，每次服用二钱，用热酒调服。
阿魏丸：治疗妇女血气攻心引起的疼痛，以及一切积冷气。
当归、桂心、青皮、附子（炮制）、阿魏（面粉包裹煨熟，以面熟为度）、白术、川芎（各一两）。
吴茱萸（炮制）、木香、干姜（各三分）。
槟榔、肉豆蔻（煨）、延胡索、莪术（各一两）。
朱砂（细研，半两）。
以上研为细末，先用一升醋，将阿魏煎成膏状，与药末混合捣三百下，制成梧桐子大小的丸剂。每次服用二十丸，饭前用热酒送服。
鸡舌香散：治疗男女九种心痛，以及一切冷气。
良姜（锉细，用麻油炒）、桂心、赤芍药（各等分）。
以上研为细末，每次服用二钱，用水一盏，加入盐渍木瓜三片，同煎至七分，温服，用盐汤点服也可以。如果是血气疝瘕疼痛，用熟醋汤调服，忌食生冷。
应痛散：治疗心脾疼痛剧烈难以忍受者，妇女脾血气引起的心脾痛尤为有效。前方相同，只是没有桂心。用醋煎服或用醋汤点服也可以。
乙丑年春初，次女十五岁，月经尚未初潮，初一那天心痛如针刺，呕吐痰饮不止，脉象沉缓弦细。使用了苏合香丸、神保丸、沉香丸、理中丸、诃子散、七气汤，都无效。我思考后认为，此证不是虫积就是痰饮致病，非《局方》中的九痛丸不可治愈。于是配制给她服用一二丸，立即痊愈。
陈氏二神丸：治疗妇女血气不和，疼痛不止，以及非经期下血，月经不调。
真蒲黄（炒）、荜茇（盐炒）。
以上研为细末，炼蜜制成梧桐子大小的丸剂。每次服用三十丸，空腹用温酒送服。如果不能饮酒，用米汤吞服，服用两次即可停止。
陈日华抽刀散：治疗妇女血风、血气等疾病。武兴戎司机宜侯恺说：见到一位道人用此方治病，屡试不爽，于是将其进献，确实奇妙。
五灵脂（炒，一两）、莪术、桂心、芸苔子（炒，各半两）。
以上研为细末，每次服用两大钱，用酒半盏、水半盏，煎至八分，疾病发作时热服。
[Da] Heartache in women caused by blood and qi disharmony results from deficiency of the zang-fu organs, irregular flow of blood and qi, and invasion of wind-cold pathogenic factors into the heart. Upon onset of pain, some cases may be fatal, while others are not. If the condition progresses to a syndrome stage, since the Heart is the master of the five zang organs and governs the Shen (Spirit), its primary meridian (Hand-Shaoyin Heart Meridian) must not be injured. Injury leading to pain is termed "Zhen Xin Tong" (True Heart Pain); if it occurs in the morning, death follows by evening; if it occurs in the evening, death follows by morning. If pain arises because the branch collaterals of the Heart are invaded by wind-cold, the pain will fluctuate in intensity, resulting in a general syndrome.
[Xue] For the aforementioned conditions: if caused by cold pathogens, apply warming and dispersing methods; if due to food stagnation, apply digestion-promoting methods; if due to reckless movement of Liver Fire, apply acrid-neutral methods; if due to Spleen Qi stagnation, apply harmonizing methods. These can still be used in conjunction with the formulas for the six syndromes mentioned later. A woman suffered from chronic heartache, poor appetite, and vomiting immediately after taking medicine. I diagnosed this as Spleen Earth deficiency and prescribed only Baid Zhu (Atractylodis Rhizoma). It was stir-fried with yellow loess, then the loess removed. Each dose was one liang, decocted in thick rice wash water, taken slowly in small amounts. After several days, she could drink large quantities naturally. After consuming over three jin, she recovered. The wife of the eldest son of Chen Luxue, a scholar of Shangshe, was constitutionally weak. She suffered from scabies postpartum for over a year without healing. During a month-long mourning period, she frequently felt dizzy and nearly fainted. One day, after contracting an external pathogen, she suddenly developed swelling and severe pain in the Heart and Spleen regions, intolerable to touch, accompanied by incessant vomiting and faint, thin pulses in all six positions. Observing her robust physique, some mistakenly believed that tonifying Qi was contraindicated for various pains, and treated her with Qing Pi (Tangerine Peel), Mu Xiang (Costus Root), Wu Wei Zi (Schisandra Berry), and Wu Zhu Yu (Evodia Fruit), which cured her. Subsequently, she contracted malaria and suffered a miscarriage. Further treatment with Qi-regulating and Blood-invigorating drugs expelled the disease but further depleted her Yuan Qi. Subsequent administration of Ginseng tonics was ineffective; her pulses were thread-like and nearly imperceptible. I was summoned to diagnose her and stated: Although her physique appears robust, her pulse indicates extreme deficiency. The use of Qi-regulating agents damaged her True Qi. I administered two doses of Ren Shen (Ginseng), [missing character, likely Huang Qi], Dang Gui (Angelica Sinensis), Bai Zhu (Atractylodis Rhizoma), Fu Zi (Aconiti Lateralis Radix Praeparata), Gan Jiang (Zingiberis Rhizoma), and Gui Zhi (Cinnamomi Ramulus), interspersed with Ba Wei Wan (Eight-Ingredient Pill). Within five days, her sleep and appetite improved, and her pulses fully recovered. Had these medicines been administered at the onset of Heart-Spleen pain, the malaria would not have occurred.
[Da] Wu Yao San (Lindera Powder): Treats heartache in women caused by attacking blood and qi, with irregular onset and cessation.
Wu Yao (Linderae Radix), E Zhu (Curcumae Rhizoma), Gui Xin (Cinnamomi Cortex), Dang Gui (Angelicae Sinensis Radix, stir-fried), Tao Ren (Persicae Semen), Qing Pi (Citri Reticulatae Pericarpium Viride), Mu Xiang (Aucklandiae Radix) (equal parts).
Grind into powder. Take two qian per dose, mixed with hot wine.
A Wei Wan (Asafoetida Pill): Treats heartache in women caused by attacking blood and qi, and all types of accumulated cold qi.
Dang Gui (Angelicae Sinensis Radix), Gui Xin (Cinnamomi Cortex), Qing Pi (Citri Reticulatae Pericarpium Viride), Fu Zi (Aconiti Lateralis Radix Praeparata, processed), A Wei (Asafoetida, baked in flour until flour is cooked), Bai Zhu (Atractylodis Rhizoma), Chuan Xiong (Ligustici Chuanxiong Rhizoma) (each 1 liang).
Wu Zhu Yu (Evodiae Fructus, processed), Mu Xiang (Aucklandiae Radix), Gan Jiang (Zingiberis Rhizoma) (each 3 fen).
Bing Lang (Arecae Semen), Rou Dou Kou (Myristicae Semen, baked), Yan Hu Suo (Corydalis Rhizoma), E Zhu (Curcumae Rhizoma) (each 1 liang).
Zhu Sha (Cinnabaris, finely ground, 0.5 liang).
Grind all into powder. First, boil one sheng of vinegar with A Wei until it forms a paste. Mix with the powder and pound 300 times. Form pills the size of paulownia seeds. Take 20 pills before meals with hot wine.
Ji She Xiang San (Amomum Cardamomum Powder): Treats nine types of heartache in men and women, and all types of cold qi.
Liang Jiang (Alpiniae Officinarum Rhizoma, finely chopped, stir-fried in sesame oil), Gui Xin (Cinnamomi Cortex), Chi Shao Yao (Paeoniae Radix Rubra) (equal parts).
Grind into fine powder. Take two qian per dose with one cup of water, add three slices of salt-pickled papaya, decoct to 70%, and take warm. Taking with salt water is also acceptable. For pain due to blood and qi hernia masses, mix with ripe vinegar water. Avoid raw and cold foods.
Ying Tong San (Pain-Relieving Powder): Treats unbearable Heart-Spleen pain; particularly effective for Heart-Spleen pain in women caused by Spleen blood and qi issues. Same formula as above, except without Gui Xin. Decoct with vinegar or take with vinegar water.
In early spring of the Yichou year, my second daughter, aged fifteen, had not yet begun menstruation. On the first day, she experienced stabbing heartache and incessant vomiting of fluids. Her pulse was deep, slow, wiry, and fine. Su He Xiang Wan (Styrax Pill), Shen Bao Wan (Divine Preservation Pill), Chen Xiang Wan (Aquilaria Pill), Li Zhong Wan (Regulate the Middle Pill), He Zi San (Chebula Powder), and Qi Qi Tang (Seven-Qi Decoction) were all ineffective. I reasoned that this condition was either due to parasites or fluid retention, and only Jiu Tong Wan (Nine-Pain Pill) from the *Ju Fang* could cure it. I prepared and gave her one or two pills, and she was cured immediately.
Chen Shi Er Shen Wan (Chen's Two-God Pill): Treats disharmony of blood and qi in women, unceasing pain, irregular uterine bleeding, and irregular menstruation.
Zhen Pu Huang (Polygoni Typhonii Pollen, stir-fried), Bi Bo (Piperis Longi Fructus, salt-stir-fried).
Grind into fine powder, mix with refined honey, and form pills the size of paulownia seeds. Take 30 pills on an empty stomach with warm wine. If unable to drink alcohol, swallow with rice gruel. Cessation occurs after two doses.
Chen Rihua Chou Dao San (Chen Rihua's Knife-Withdrawing Powder): Treats diseases such as blood-wind and blood-qi in women. Hou Kai, Military Commissioner of Wuxing, stated: I saw a Daoist priest use this prescription to treat illnesses with repeated success, so I presented it. It is truly miraculous.
Wu Ling Zhi (Trogopterori Faeces, stir-fried, 1 liang), E Zhu (Curcumae Rhizoma), Gui Xin (Cinnamomi Cortex), Yun Tai Zi (Brassicae Pekinensis Seed, stir-fried, each 0.5 liang).
Grind into powder. Take two large qian per dose with half a cup of wine and half a cup of water, decoct to 80%, and take hot when symptoms arise.
Shi Xiao San (Smile-Laughing Powder) (see Postpartum Heartache), He Zi San (Chebula Powder) (see Cholera) are also excellent.
*Ling Yuan Fang* treats sudden blood-qi heartache in women. Use only raw Wu Ling Zhi (Trogopterori Faeces) ground into fine powder. Take one qian per dose with one cup of wine, boil until bubbling, and take hot.
Si Qi Tang (Four-Seven Decoction) from the *Ju Fang* added with Liang Jiang (Alpiniae Officinarum Rhizoma), along with Chen Xiang Jiang Qi Tang (Aquilaria Qi-Descending Decoction) and Fen Xin Qi Yin (Separate-Heart-Qi Drink), are all good remedies for heartache. (All three formulas are found in the Miscellaneous Diseases of Qi section.)