（即胃脘痛。）
心痛，虽日数多，不吃饮食，不死。若痛方止便吃还痛，必须三五服药后，方可吃物。
大凡心膈之痛，须分新久。若明知身受寒气，口食寒物而病，于初得之时，当以温散或温利之药。若曰
病得之稍久，则成郁矣。郁则蒸热，热则久必生火，原病式中备言之矣。若欲行温散，宁无助火添病耶。由
是古方中多以山栀为热药之向导，则邪伏而病易退，正易复而病易安。虽然，病安之后，若纵恣口味，不改前
非，病复作时，必难治之也。
山栀炒，去皮，每十五个浓煎汤一呷，入生姜汁令辣，再煎小沸服。或入芎一钱尤妙。山栀大者用七
个或九个。大概胃口有热而作痛，非山栀子不可。佐以姜汁，或半夏、橘红各五，黄芩三，甘草一。用二陈汤
加苍、芎，倍加炒栀。痛甚者，加炒干姜从之反治之法。心痛轻者，散之。麻黄、桂枝。重者，加石碱、川芎、
苍术、栀子必炒去皮用，作丸服之。
凡治病必须先问平日起居如何。假如心痛有因平日喜食热物，以致血流于胃口作痛，用桃仁承气汤下之，
切记！轻者用韭汁、桔梗，能开提气，血药中兼用之。
以物拄按痛则止者，挟虚也，以二陈汤加炒干姜和之。
有虫痛者，面上白斑、唇红、能食，属虫。治苦楝根、锡灰之类。脉坚实不大便者，下之。
痛甚者，脉必伏。多用温药，不用参术，可用附子。
诸痛不可用补气药。
客寒犯胃，草豆蔻丸用之。热亦可用，止用一二服。
草豆蔻（一钱四分，裹烧热去皮） 吴茱萸（汤泡，洗去梗焙干） 益智仁 白僵蚕 橘皮 人参 黄
（以上各八分） 生甘草 归身 炙甘草 桂皮（各六分） 曲末 姜黄（各四分） 桃仁（七个，去皮） 半
夏（一钱，洗） 麦 （一钱半，炒黄） 泽泻（一钱，小便多减半用之） 柴胡（四分） 详膈下痛多为用之。
上一十八味，除桃仁另研如泥外，余极细末，同桃仁研匀，用汤泡，蒸饼为丸，如桐子大。每服三十
丸，食远，用热白汤送下。旋斟酌多少用之。
又方∶用黄荆子炒焦为末，米饮调服。亦治白带。
又方∶脾痛用海蛤粉，佐以香附末。用川芎、山栀、生姜煎辣汤，调服为佳。
又方∶单用牡粉，酒调下一二钱。气实不可用。
（即胃脘痛。）
心痛，虽然病程较长，即使不进食，也不会死亡。但如果疼痛刚停止就立即进食，疼痛会复发，必须服用三五剂药后，才可以进食。
大凡心膈部位的疼痛，必须区分新病和久病。如果明确知道是因为感受寒气、食用寒凉食物而发病，在初得病时，应当使用温散或温利的药物。如果说病情已经持续了一段时间，就会形成郁滞。郁滞则会产生蒸热，热久了必然生火，《原病式》中对此已有详细论述。如果想要使用温散法，难道不是帮助火势、加重病情吗？因此古方中多以山栀作为热药的向导，这样邪气潜伏而疾病容易消退，正气容易恢复而疾病容易安宁。虽然如此，病愈之后，如果放纵口腹之欲，不改正以前的错误，疾病再次发作时，就一定难以治疗了。
山栀炒制，去皮，每十五个浓煎成汤一呷（一口），加入生姜汁使其变辣，再煎至小沸后服用。或者加入川芎一钱尤其好。大的山栀用七个或九个。大概胃口有热而作痛，非山栀子不可。佐以姜汁，或者半夏、橘红各五钱，黄芩三钱，甘草一钱。使用二陈汤加苍术、川芎，加倍加入炒山栀。疼痛严重的，加入炒干姜，这是从治的反治法。心痛轻微的，用发散法。麻黄、桂枝。疼痛严重的，加入石碱、川芎、苍术、栀子（必须炒制去皮使用），制成丸药服用。
凡是治病必须先询问患者平时的起居情况。假如心痛是因为平时喜欢吃热物，导致血流到胃口处而作痛，用桃仁承气汤攻下它，切记！轻的用韭汁、桔梗，能开提气机，在血药中兼用。
用物体按压疼痛就停止的，是挟带虚证，用二陈汤加炒干姜调和。
有虫痛的患者，脸上有白斑、嘴唇红、能吃，属于虫痛。治疗用苦楝根、锡灰之类。脉象坚实且不大便的，用攻下法。
疼痛剧烈的，脉象必然伏匿。多用温药，不用人参、白术，可以用附子。
各种疼痛都不可用补气药。
客寒犯胃，用草豆蔻丸治疗。热证也可以用，只服用一两剂。
草豆蔻（一钱四分，包裹烧热后去皮） 吴茱萸（汤泡，洗去梗焙干） 益智仁 白僵蚕 橘皮 人参 黄芩（以上各八分） 生甘草 当归身 炙甘草 桂皮（各六分） 神曲末 姜黄（各四分） 桃仁（七个，去皮） 半夏（一钱，洗） 麦冬（一钱半，炒黄） 泽泻（一钱，小便多者减半使用） 柴胡（四分） 详细适用于膈下疼痛。
上一十八味药，除了桃仁单独研成泥状外，其余研成极细粉末，与桃仁研匀，用汤浸泡，蒸饼为丸，如梧桐子大。每次服用三十丸，饭后较远的时间，用热白开水送下。随时斟酌用量多少使用。
又一方：用黄荆子炒焦为末，米饮调服。也治疗白带。
又一方：脾痛用海蛤粉，佐以香附末。用川芎、山栀、生姜煎成辣汤，调服为佳。
又一方：单用牡蛎粉，酒调下一二钱。气实者不可用。
(That is, epigastric pain.)
Heartache (Xintong), although the course of the disease may be long and even if food intake is refused, it will not lead to death. However, if food is consumed immediately after the pain subsides, the pain will recur; one must take three to five doses of medicine before resuming food intake.
Generally speaking, pain in the heart and diaphragm region must be distinguished as either new or chronic. If it is known that the disease was caused by exposure to cold pathogens or consumption of cold foods, at the initial stage, warming and dispersing or warming and purgative herbs should be used. If the disease has persisted for a while, it will form stagnation (Yu). Stagnation generates steaming heat; prolonged heat inevitably generates fire, as detailed in *Yuan Bing Shi* (Original Treatise on Diseases). If one were to use warming and dispersing methods in this context, would it not assist the fire and aggravate the illness? Therefore, in ancient prescriptions, Gardenia (Zhizi) is often used as a guide for heat-clearing herbs, so that latent pathogenic factors are expelled, diseases recede easily, healthy qi recovers easily, and the patient becomes comfortable. Nevertheless, after recovery, if one indulges in dietary preferences and does not correct previous habits, when the disease recurs, it will be difficult to treat.
Gardenia (Zhizi) is stir-fried, skin removed. For every fifteen fruits, decoct strongly with water to obtain one sip of liquid, add ginger juice until spicy, boil briefly, and administer. Alternatively, adding Chuanxiong (Chuanxiong Rhizome) 1 qian is especially effective. For large Gardenia fruits, use seven or nine. Generally, for stomach heat causing pain, only Gardenia is suitable. It can be assisted with ginger juice, or Pinellia (Banxia) and Tangerine Peel (Juhong) each 5 qian, Scutellaria (Huangqin) 3 qian, and Licorice (Gancao) 1 qian. Use Erchen Tang (Two-Cured Decoction) added with Atractylodes (Cangzhu) and Chuanxiong, with doubled stir-fried Gardenia. For severe pain, add stir-fried Dried Ginger (Ganjiang); this follows the principle of contrary treatment (Fan Zhi). For mild heartache, use dispersing methods: Ephedra (Mahuang) and Cinnamon Twig (Guizhi). For severe cases, add Alkaline Earth (Shijian), Chuanxiong, Atractylodes, and Gardenia (must be stir-fried and skin removed), processed into pills for administration.
In treating any disease, one must first inquire about the patient's daily routine. For instance, if heartache is caused by a habit of consuming hot foods, leading to blood flow stagnation in the stomach area causing pain, use Tao Ren Cheng Qi Tang (Peach Kernel and Magnolia Bark Decoction) to purge it. Remember this! For mild cases, use Leek Juice (Jiu Zhi) and Platycodon (Jiegeng), which can raise and open qi; they can be used concurrently with blood-invigorating herbs.
If pressing the painful area with an object stops the pain, it indicates accompanying deficiency; use Erchen Tang (Two-Cured Decoction) added with stir-fried Dried Ginger to harmonize.
For parasitic pain, characterized by white spots on the face, red lips, and good appetite, it belongs to parasites. Treat with roots of Melia (Kulian Gen) and Tin Ash (Xi Hui). If the pulse is firm and there is constipation, use purgative methods.
For severe pain, the pulse will likely be deep and hidden (Fu). Use more warming herbs; avoid Ginseng (Renshen) and Atractylodes (Baizhu); Aconite (Fuzi) can be used.
Various pains should not be treated with qi-tonifying herbs.
For invading cold affecting the stomach, Caodoukou Wan (Grass Cardamom Pill) is used. It can also be used for heat patterns, but only for one or two doses.
Grass Cardamom (Caodoukou) (1 qian 4 fen, wrapped and heated, then peeled) Evodia (Wuzhuyu) (soaked in boiling water, washed, stems removed, dried over fire) Alpinia Oxyphylla (Yizhiren) White Silkworm (Bai Jiangcan) Tangerine Peel (Chenpi) Ginseng (Renshen) Scutellaria (Huangqin) (each 8 fen) Raw Licorice (Sheng Gancao) Angelica Sinensis Root (Guishen) Honey-fried Licorice (Zhi Gancao) Cinnamon Bark (Guipi) (each 6 fen) Fermented Wheat Qu (Qumao) Turmeric (Jianghuang) (each 4 fen) Peach Kernel (Taoren) (7 grains, peeled) Pinellia (Banxia) (1 qian, washed) Ophiopogon (Maimen) (1 qian 5 fen, stir-fried until yellow) Alisma (Zexie) (1 qian, reduce dose by half if urination is excessive) Bupleurum (Chaihu) (4 fen) Detailed application: frequently used for pain below the diaphragm.
The above eighteen ingredients, except for Peach Kernel which is separately ground into a paste, are all ground into fine powder, mixed uniformly with the peach kernel paste. Soak in water, steam, and process into pills the size of paulownia seeds. Take thirty pills per dose, far from meals, swallowed with hot plain water. Adjust dosage according to circumstances.
Another prescription: Stir-fry Vitex Fruit (Huangjingzi) until charred, grind into powder, mix with rice drink, and take orally. Also treats leukorrhea.
Another prescription: For spleen pain, use Arca Shell Powder (Haige Fen), assisted with Cyperus (Xiangfu) powder. Decoct Ligusticum (Chuanxiong), Gardenia (Zhizi), and Fresh Ginger (Shengjiang) to make a spicy soup, mix with powder, and take orally; this is preferred.
Another prescription: Use only Oyster Shell Powder (Muli Fen), taken with wine, 1-2 qian per dose. Contraindicated for excess qi patterns.