心腹痛者，上心、下腹，相引而痛。痛之名虽同，而所痛之部不同，如堪舆移步换形，其中不可不条分
缕晰者也。心为君主而藏神，不可以痛，今云心痛，乃心包之络，不能旁通于脉，则痛也。
心脉之上，则为胸膈，两乳之间，则为膺胸。胸膈痛，乃上焦失职，不能如雾露之溉，则胸痹而痛，薤白、
蒌仁、茜草、贝母、豆蔻之药，可开胸痹以止痛。膺胸痛者，乃肝血内虚，气不充于期门，致冲、任之血，不能
从膺胸而散，则痛，当归、白芍、红花、银花、续断、木通之药，可和气血而止痛。
有中脘作痛，手不可近者。夫手不可近，乃内外不和，外则寒气凝于皮毛，内则垢浊停于中脘。当审其体
之虚实以施治，莫若以灯草火，当痛处爆十余点，则寒结去而内外通，便不痛矣。有中脘之下，当阳明胃土之
间，时痛时止者，乃中土虚而胃气不和，若行气消泄之剂，服之过多，便宜温补。但以手重按之，则痛稍平，此
中土内虚，虚而且寒之明验也。
其乳下两旁胸骨尽处痛者，乃上下阴阳不和，少阳枢转不利也。伤寒病中，每多此痛，当助其枢转，和其
气血，上下通调，则愈矣。
其大腹痛者，乃太阴脾土之部，痛在内而缓，坤土虚寒也；痛兼内外而急，脾络不通也。盖脾之大络，名曰
大包，从经隧而外出于络脉。今脾络滞而不行，则内外皆痛。《太阳篇》云∶伤寒阳脉涩，阴脉弦，法当腹中急
痛，先与小建中汤，不瘥者与小柴胡汤。此先补益于内，而后枢转于外也。
其有脐旁左右痛者，乃冲脉病也。冲脉当脐左右，若为寒气所凝，其冲脉之血不能上行外达，则当脐左右
而痛。当用血分之药，使胞中之血通肌达表，若用气药，无裨也。又有脐下痛者，乃少阴水脏、太阳水腑，不
得阳热之气以施化，致阴寒凝结而痛。少阴水脏虚寒，当用桂、附以温之；太阳膀胱水腑虚寒，亦当用桂、附以
温之。盖太阳、少阴相为表里，互为中见者也。
又小腹两旁谓之少腹。少腹痛者，乃厥阴肝脏之部，又为胞中之血海。盖膀胱之水，主于少阴；而胞中
之血，主于厥阴也。痛者，厥阴肝气不合胞中之血而上行也。肝脏不虚者，当疏通以使之上；肝脏虚者，当补
益以助其上。盖厥阴不从标本，从中见少阳之气，使厥阴上合乎少阳，则不痛矣。
其两旁季胁痛者，肝气虚也。两胁之上痛者，少阳之气不和也。所痛之部，有气血、阴阳之不同，若概以
行气、消导为治，漫云通则不痛。夫通则不通，理也，但通之之法，各有不同。调气以和血，调血以和气，
通也；下逆者使之上行，中结者使之旁达，亦通也；虚者助之使通，寒者温之使通，无非通之之法也。若必
以下泄为通，则妄矣！
心腹痛，是指心窝部与腹部相互牵引而发生的疼痛。虽然都称为“痛”，但疼痛的部位各不相同，就像风水师（堪舆）观察地形时步移景换一样，其中的道理必须条理分明、细致剖析。
心为君主之官，藏神，正常情况下是不应该痛的。现在所说的“心痛”，实际上是心包络的病变。因为心包络不能旁通于经脉，所以发生疼痛。
在心脉之上的部位，是胸膈；在两乳之间的部位，是膺胸。胸膈疼痛，是由于上焦功能失职，不能像雾露滋润万物那样布散精气，从而导致胸痹而痛。此时可用薤白、瓜蒌仁、茜草、贝母、豆蔻等药物，来开通胸痹以止痛。
膺胸疼痛，是由于肝血内部亏虚，气不能充盈于期门穴，导致冲脉和任脉的血气，不能从膺胸部位疏散，从而发生疼痛。此时可用当归、白芍、红花、金银花、续断、木通等药物，调和气血以止痛。
有的患者中脘穴处疼痛，手不敢触碰。这种手不可近的症状，是因为内外不和：外部则是寒气凝结在皮毛，内部则是污浊之物停滞在中脘。应当审察患者体质的虚实来施治，不如用灯芯草点燃，在疼痛处爆灸十余点，这样寒结散去，内外气机通畅，疼痛就会停止。
在中脘之下，正当阳明胃土所在的区域，出现时痛时止的情况，这是由于中土虚弱且胃气不和。如果使用行气消导的药物过多，就应当改为温补之法。如果用手重按疼痛部位，疼痛稍微缓解，这是中土内部虚弱，且兼有虚寒的明确证据。
乳房下方两侧肋骨尽头的疼痛，是由于上下阴阳不和，少阳枢机运转不利所致。在伤寒病中，这种疼痛很常见，应当帮助其枢机运转，调和气血，使上下气机通调，疾病即可痊愈。
大腹部的疼痛，属于太阴脾土的管辖范围。如果疼痛在内部且感觉舒缓，这是坤土（脾）虚弱寒冷；如果疼痛涉及内外且感觉急迫，这是脾络不通畅。脾的大络名为大包，从经络隧道向外出于络脉。现在脾络滞涩而不运行，就会导致内外都疼痛。《伤寒论·太阳篇》说：“伤寒病见阳脉涩、阴脉弦，按照法度应当腹中急痛，先给予小建中汤治疗，如果不愈，再给予小柴胡汤。”这是先在内部补益，然后在外部枢转的治疗方法。
有的患者脐旁左右疼痛，这是冲脉的病变。冲脉经过脐的左右两侧，如果被寒气凝滞，冲脉的血气不能上行外达，就会导致脐旁左右疼痛。此时应当使用入血分的药物，使胞宫中的血液通达肌肤体表，如果使用理气药，则没有益处。
又有脐下疼痛的，这是少阴肾水之脏和太阳膀胱水之腑，得不到阳热之气的气化作用，导致阴寒凝结而疼痛。如果是少阴肾水之脏虚寒，应当用肉桂、附子来温补；如果是太阳膀胱水之腑虚寒，也应当用肉桂、附子来温补。因为太阳与少阴互为表里，互为中见之气。
另外，小腹两侧称为少腹。少腹疼痛，属于厥阴肝脏的区域，也是胞宫的血海。膀胱的水液代谢主要受少阴肾主司；而胞宫的血液主要受厥阴肝主司。疼痛的原因，是厥阴肝气不能与胞宫之血协调而上行。如果肝脏不虚，应当疏通气机使其上行；如果肝脏虚损，应当补益以助其上行。因为厥阴肝经不遵循标本理论，而是从中见少阳之气，只要使厥阴上合于少阳，疼痛就会消除。
身体两侧季胁部位的疼痛，是肝气虚弱所致。两胁上方的疼痛，是少阳之气不和所致。疼痛的部位不同，涉及的气血、阴阳性质也不同。如果一概用行气、消导的方法治疗，盲目地说“通则不痛”，那是错误的。所谓的“通”与“不通”，是有道理的，但是“通”的方法各有不同。调理气机以调和血液，调理血液以和气机，这是通；使逆上的气机上行，使中结的气机向旁扩散，这也是通；虚弱的通过补助使其通畅，寒冷的通过温煦使其通畅，无非都是“通”的方法。如果一定要把泻下通便当作“通”，那就荒谬了！
Heart and abdominal pain refers to pain that radiates between the epigastrium (upper heart area) and the abdomen. Although both are termed "pain," the affected areas differ, much like how a Feng Shui master observes changing landscapes with every step; thus, the underlying principles must be analyzed meticulously and clearly.
The Heart is the Sovereign Ruler and houses the Spirit (Shen); it should not normally experience pain. What is currently referred to as "heart pain" is actually a disorder of the Pericardium Collateral (Xinbao Luo). Because the Pericardium cannot communicate laterally with the meridians, pain ensues.
Above the Heart vessels lies the chest and diaphragm; between the two breasts lies the anterior chest (Yingxiong). Pain in the chest and diaphragm results from the dysfunction of the Upper Jiao, which fails to distribute essence like mist and dew, leading to Chest Bi (Thoracic Obstruction) and pain. Herbs such as Allii Macrostemonis Bulbus (Xiebai), Trichosanthis Fructus (Gualou Ren), Rubiae Radix et Rhizoma (Qiancao), Fritillariae Cirrhosae Bulbus (Beimu), and Cardamomi Fructus Rotundus (Doukou) can open the Chest Bi to relieve pain.
Pain in the anterior chest arises from internal deficiency of Liver Blood, causing Qi to fail to fill the Qimen (LR14) acupoint. This prevents the blood of the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) from dispersing through the anterior chest, resulting in pain. Herbs such as Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Carthami Flos (Honghua), Lonicerae Japonicae Flos (Yinhua), Dipsaci Radix (Xuduan), and Akebiae Caulis (Mutong) can harmonize Qi and Blood to relieve pain.
In cases where the Zhongwan (CV12) area is painful and intolerant to touch, this indicates disharmony between interior and exterior. Externally, cold pathogen condenses in the skin and hair; internally, turbid matter stagnates in the Zhongwan. Treatment must assess the constitution's deficiency or excess. A suitable method is to ignite rush pith (Dengcao) and apply moxa-burning (explosive moxibustion) at the painful site for more than ten spots. This dispels cold congealation, unites the interior and exterior, and stops the pain.
Below Zhongwan, in the region corresponding to the Yangming Stomach Earth, intermittent pain indicates deficiency of the Middle Jiao Earth and disharmony of Stomach Qi. If excessive doses of Qi-moving and purgative agents have been taken, warming and tonifying methods should be employed instead. If heavy pressure alleviates the pain slightly, it confirms internal deficiency of the Middle Jiao Earth accompanied by deficiency-cold.
Pain at the ends of the ribs on both sides below the breasts indicates disharmony of upper and lower Yin and Yang, and impaired pivot function of Shaoyang. This pain frequently occurs in Shanghan (Cold Damage) diseases. Treatment should assist the pivot function, harmonize Qi and Blood, and regulate the upper and lower pathways to achieve recovery.
Pain in the greater abdomen belongs to the Taoyin Spleen Earth domain. If the pain is internal and dull/relaxed, it indicates deficiency-cold of Kun Earth (Spleen). If the pain involves both interior and exterior and is urgent/tight, it indicates obstruction of the Spleen collaterals. The great collateral of the Spleen is named Dabao (SP21), emerging from the meridian channels into the collaterals. When Spleen collaterals are stagnant and non-flowing, pain occurs both internally and externally. The Taiyang Chapter states: "In Cold Damage, if the Yang pulse is choppy and the Yin pulse is wiry, acute abdominal pain is expected according to the law. First administer Xiao Jian Zhong Tang; if ineffective, then administer Xiao Chai Hu Tang." This illustrates first tonifying the interior, then regulating the exterior pivot.
Pain around the umbilicus on either side indicates a disorder of the Chong Mai (Penetrating Vessel). The Chong Mai passes on both sides of the umbilicus. If congealed by cold pathogen, the blood of the Chong Mai cannot ascend or reach the exterior, causing pain around the umbilicus. Blood-invigorating herbs should be used to circulate blood from the Baozhong (Uterus/Energy Center) to the muscles and surface; Qi-regulating herbs would be of no benefit.
Pain below the umbilicus results from the Shaoyin Water Organ (Kidney) and Taiyang Water Bowel (Bladder) failing to receive Yang-heat Qi for transformation, leading to Yin-cold congealation and pain. For Shaoyin Kidney deficiency-cold, use Cinnamon Twig (Guizhi) and Prepared Aconite Root (Fuzi) to warm. For Taiyang Bladder deficiency-cold, also use Guizhi and Fuzi to warm. Taiyang and Shaoyin are exterior-interior pairs and share intermediate manifestations.
The lateral aspects of the lower abdomen are called Shaofu (Lesser Abdomen). Pain here belongs to the Jueyin Liver domain and is also the Sea of Blood of the Baozhong. While bladder water metabolism is governed by Shaoyin, the blood of the Baozhong is governed by Jueyin. Pain occurs when Jueyin Liver Qi fails to coordinate with the Baozhong blood to ascend upward. If the Liver is not deficient, dredge the pathways to facilitate ascent; if the Liver is deficient, tonify to assist ascent. Since Jueyin does not follow the standard root/branch theory but relies on its intermediate manifestation of Shaoyang, harmonizing Jueyin with Shaoyang will resolve the pain.
Pain in the hypochondriac regions on both sides indicates Liver Qi deficiency. Pain above the two flanks indicates disharmony of Shaoyang Qi. The location of pain reflects differences in Qi, Blood, Yin, and Yang. Treating all cases indiscriminately with Qi-moving and digestive methods under the assumption that "free flow prevents pain" is incorrect. The principle of "unblocking" versus "blockage" has logic, but the methods of unblocking vary. Regulating Qi to harmonize Blood, and regulating Blood to harmonize Qi, constitutes unblocking. Directing rebellious Qi upward and dispersing central knots laterally also constitute unblocking. Tonifying deficiency to promote flow and warming cold to promote flow are all methods of unblocking. To insist that only purgation constitutes "unblocking" is absurd!