田（十三） 脉细数。闻雷被惊。心下漾漾作痛。（惊伤）逍遥散去柴胡加钩藤丹皮。
宋 脉左涩伏。心下痛甚。舌白不能食谷。下咽阻膈。痛极昏厥。此皆积劳损阳。前者曾下瘀血。
延绵经月不止。此为难治。（劳伤血滞）
生鹿角 当归须 姜汁 官桂 桃仁 炒半夏
谭（三五） 心痛引背。口涌清涎。肢冷。气塞脘中。此为脾厥心痛。病在络脉。例用辛香。（脾寒厥）
高良姜 片姜黄 生茅术 公丁香柄 草果仁 浓朴
朱 重按痛势稍衰。乃一派苦辛燥。劫伤营络。是急心痛症。若上引泥丸。则大危矣。议用金匮
法。（营络伤急心痛）
人参 桂枝尖 川椒 炙草 白蜜
厥心痛一症。古人辨论者。多且精矣。兹不复赘。但厥心痛与胃脘痛。情状似一。而症实有
别。世人因内经胃脘当心而痛一语。往往混而视之。不知厥心痛。为五脏之气。厥而入心
胞络。而胃实与焉。则心痛与胃痛。不得不各分一门。今先生案中。闻雷被惊者。用逍遥散
去柴胡。加钓藤丹皮治之。以其肝阳上逆。不容升达。为之养血以平调也。积劳损阳者。用
归鹿姜桂桃仁半夏治之。以其劳伤血痹。无徒破气。为之通络以和营也。脾厥心痛者。用
良姜姜黄茅术丁香草果浓朴治之。以其脾寒气厥。病在脉络。为之辛香以开通也。重按
而痛稍衰者。用人参桂枝川椒炙草白蜜治之。以其心营受伤。攻劫难施。为之辛甘以化
阳也。方案虽未全备。然其审病之因。制方之巧。无不一一破的。果能举一反三。其义宁有
尽乎。（龚商年）
徐评 心痛胃痛确是二病。然心痛绝少。而胃痛极多。亦有因胃痛而及心痛者。故此二症。古
人不分两项。医者细心求之。自能辨其轻重也。
田某（十三岁）。脉象细数。因听到雷声受惊，心下部位荡漾作痛。（此为惊恐损伤心神）选用逍遥散去柴胡，加钩藤、丹皮。
宋某。左侧脉象涩而伏匿。心下疼痛剧烈。舌苔白腻，无法进食谷物。食物下咽时感觉阻塞膈部。疼痛极度严重时出现昏厥。这都是因为长期劳累损伤阳气所致。此前曾使用攻下法排出瘀血。病情拖延延续一个月不止。这属于难治之症。（此为劳伤导致血行滞涩）
处方：生鹿角、当归须、姜汁、官桂、桃仁、炒半夏。
谭某（三十五岁）。心痛牵引至背部。口中涌出清稀涎沫。四肢发冷。气机堵塞在胃脘中。这是脾厥心痛。病位在络脉。按照惯例使用辛香类药物。（此为脾寒厥逆）
处方：高良姜、片姜黄、生茅术、公丁香柄、草果仁、浓朴。
朱某。重按之后痛势稍微减轻。这是一派苦辛燥烈之药，劫伤了营分络脉。这是急性的心痛症。如果疼痛向上牵引至头部泥丸宫，那就非常危险了。建议采用《金匮要略》中的方法。（此为营络受伤导致的急性心痛）
处方：人参、桂枝尖、川椒、炙甘草、白蜜。
关于厥心痛这一病症，古人辨别论述的很多且精辟。这里不再赘述。但是厥心痛与胃脘痛，情状看似相同，而症状实际上有区别。世人因为《内经》中有“胃脘当心而痛”这句话，往往将二者混为一谈。不知道厥心痛是五脏之气厥逆而入心包络，而胃也参与其中。那么心痛与胃痛，不得不分为两个门类。如今先生医案中，听到雷声受惊的，用逍遥散去柴胡，加钩藤、丹皮治疗，是因为肝阳上逆，不容升达，所以为之养血以平调；积劳损伤阳气的，用归鹿姜桂桃仁半夏治疗，是因为劳伤导致血痹，不能单纯破气，所以为之通络以调和营血；脾厥心痛的，用良姜、姜黄、茅术、丁香、草果、浓朴治疗，是因为脾寒气厥，病在脉络，所以为之用辛香以开通；重按而痛势稍减的，用人参、桂枝、川椒、炙甘草、白蜜治疗，是因为心营受伤，攻伐难以施展，所以为之用辛甘以化生阳气。虽然方案并不完全完备，但其审察病因、制定方剂的巧妙之处，无一不切中要害。如果能举一反三，其中的义理难道会有穷尽吗？（龚商年评）
徐评：心痛和胃痛确实是两种疾病。然而心痛极少见，而胃痛极多见。也有因为胃痛而波及心痛的。所以古人不将这两项分开。医者细心探求，自然能辨别其轻重。
Tian (13 years old). The pulse is fine and rapid. Startled by the sound of thunder, there is a rippling pain in the epigastrium. (Injury from fright) Xiao Yao San (Free and Easy Wanderer Powder) with Chai Hu (Bupleuri Radix) removed, plus Gou Teng (Uncariae Ramulus cum Uncis) and Dan Pi (Moutan Cortex).
Song. The left pulse is choppy and deep-hidden. Severe pain in the epigastrium. White tongue coating, unable to eat grains. Obstruction and difficulty in swallowing. Extreme pain leads to syncope. This is all due to chronic fatigue damaging Yang Qi. Previously, blood stasis was purged via downward-draining methods. The condition has persisted for over a month. This is difficult to treat. (Fatigue injury leading to blood stagnation)
Prescription: Sheng Lu Jiao (Deer Antler without Horn), Dang Gui Xu (Angelicae Sinensis Radix Lateralalis), Jiang Zhi (Zingiberis Rhizoma Expressum), Guan Gui (Cinnamomi Ramulus), Tao Ren (Persicae Semen), Chao Ban Xia (Pinelliae Rhizoma Praeparatum).
Tan (35 years old). Heart pain radiating to the back. Profuse clear saliva in the mouth. Cold limbs. Qi obstruction in the stomach region. This is Spleue Jue Heart Pain. The disease is in the collaterals. According to precedent, acrid-aromatic herbs should be used. (Spleen cold and Jue syndrome)
Prescription: Gao Liang Jiang (Galangal Rhizome), Pian Jiang Huang (Curcumae Longae Rhizoma), Sheng Mao Zhu (Atractylodis Rhizoma), Gong Ding Xiang Bing (Syzygii Arillatus Caulis), Cao Guo Ren (Tsaoko Fructus), Nong Po (Magnoliae Officinalis Cortex).
Zhu. The pain intensity slightly decreases upon heavy pressure. A batch of bitter-acrid drying herbs has injured the Ying (Nutritive) collaterals. This is an acute Heart Pain syndrome. If the pain radiates upward to the Ni Wan (the brain/cranial cavity), it would be extremely critical. It is proposed to use the method from Jin Gui Yao Lue (Essential Prescriptions from the Golden Cabinet). (Ying collateral injury causing acute heart pain)
Prescription: Ren Shen (Ginseng Radix et Rhizoma), Gui Zhi Jian (Cinnamomi Ramulus Apex), Chuan Jiao (Zanthoxyli Pericarpium), Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata), Bai Mi (Honey).
Regarding the syndrome of Jue Heart Pain, ancient physicians' discussions on differentiation are numerous and profound. There is no need to repeat them here. However, although Jue Heart Pain and Stomach-Abdominal Pain present similarly, their symptoms are actually distinct. Because the Nei Jing (Inner Canon) states "Stomach-Abdominal Pain at the center of the chest," people often confuse the two. They do not realize that Jue Heart Pain involves the rebellion of Qi from the five zang organs entering the Pericardium Collateral, while the Stomach is also involved. Therefore, Heart Pain and Stomach Pain must be classified into separate categories. In Mr.'s medical cases mentioned above: for the case of being startled by thunder, Xiao Yao San minus Chai Hu plus Gou Teng and Dan Pi was used because Liver Yang rebelled upwards and could not ascend; thus, nourishing Blood to harmonize and calm was employed. For the case of chronic fatigue damaging Yang, Dang Gui, Lu Jiao, Jiang, Gui, Tao Ren, and Ban Xia were used because fatigue injury caused Blood Bi (obstruction); mere Qi-breaking was insufficient, so unblocking collaterals to harmonize Ying was employed. For Spleen Jue Heart Pain, Gao Liang Jiang, Jiang Huang, Mao Zhu, Ding Xiang, Cao Guo, and Nong Po were used because Spleen cold and Jue syndrome affected the collaterals; thus, acrid-aromatic herbs were used to open and unblock. For the case where pain subsided slightly with heavy pressure, Ren Shen, Gui Zhi, Chuan Jiao, Zhi Cao, and Bai Mi were used because Ying of the Heart was injured, making aggressive attack difficult; thus, acrid-sweet herbs were used to transform and generate Yang. Although the prescriptions are not exhaustive, the precision in diagnosing the etiology and the ingenuity in formulating prescriptions hit the mark every time. If one can apply this principle to other cases, the profundity of these principles is inexhaustible. (Commentary by Gong Shangnian)
Xu's Commentary: Heart Pain and Stomach-Abdominal Pain are indeed two different diseases. However, Heart Pain is rare, while Stomach-Abdominal Pain is very common. There are also cases where Stomach-Abdominal Pain extends to cause Heart Pain. Therefore, ancients did not separate them into two items. Physicians who investigate carefully can naturally distinguish their severity.