多饮数溲曰热中多食数溲曰消中多喜曰 多怒曰狂热中消中皆富贵人也(内经)
心藏神心者身之主也其正经为风邪所乘名真心痛旦发夕死夕发旦死心有包络脉是心之别
脉为
风冷所乘亦令心痛然乍轻乍盛不至于死又手少阴心之经其气逆谓之阳虚阴厥亦令心痛其痛引
喉是也其心下急痛名脾心痛腹胀而心痛名胃心痛下重而苦泄寒中为肾心痛又有九种心痛一虫
二疰三风四悸五食六饮七冷八热九支从来此皆邪气乘于手少阴之络邪气搏于正气邪正相击故
令心痛诊其心脉急者为痛引背食不下寸口脉沉紧苦心下寒时痛关上脉紧心下苦痛左手寸脉沉
则为阴阳绝者无心脉也苦心下毒痛(鸡峰方)
有人患腹痛其状不一有风痛热痛有冷痛有冷积痛有气积痛有虫痛有妇人经脉行而先腹痛
有
小儿疮疹出而先腹痛者满腹虚服暖药无效者此风痛也宜服官局胃风汤火 草丸如附子乌头之
类
大便秘结小便赤而喜冷冻饮料食者此热痛也后生宜四顺饮老人宜服大麻仁丸皆局方有块起而腹
痛
者皆积也冷积则面无色瘦瘁脉沉伏宜于暖药中用巴豆如官局积气丸之类气积多噫气宜服嘉禾
散调气散五鬲宽中散如茴香丁香木香沉香之类食积则多噫酸口出清水恶心宜服京三棱蓬莪
术
干漆之类亦须兼巴豆至于腹中有块起急以手按之便不见五更心嘈牙关轿硬恶心而清水出及梦
中啮齿者此谓之虫痛宜服官局化虫丸如使君子之类又有室女妇人月经行先腹痛此特与诸痛不
同只可服四物汤小儿身热足冷耳及尻骨冷及眼涩者皆疮疹候必先腹痛盖疹子先自肠胃中出然
后发于外宜服葛根升麻汤及绵煎散之类舒王解痛字云宜通而塞则为痛此极有理凡痛须通利脏
腑乃能随其冷热而须用巴豆大黄牵牛此最要法(医余)
多饮且小便频数称为热中;多食且小便频数称为消中;易喜笑者称为多喜;易发怒者称为狂热。热中和消中这两种病证,多见于富贵之人。(出自《内经》)
心藏神,心是身体的主宰。其正经(手少阴心经)若被风邪侵袭,称为真心痛,早晨发病傍晚死亡,傍晚发病早晨死亡。心有包络脉,这是心的别脉,若被风冷之邪侵袭,也会引起心痛,但疼痛时轻时重,不至于致死。另外,手少阴心经的气机逆乱,称为阳虚阴厥,也会引起心痛,这种疼痛牵引喉咙。心下急迫疼痛的,称为脾心痛;腹胀且伴有心痛的,称为胃心痛;下腹坠胀且伴有腹泻、腹部寒冷的,称为肾心痛。此外还有九种心痛:一为虫心痛,二为疰心痛,三为风心痛,四为悸心痛,五为食心痛,六为饮心痛,七为冷心痛,八为热心痛,九为支心痛。这些心痛皆因邪气乘袭手少阴心经的络脉所致。邪气与正气搏结,正邪相击,故而引发心痛。诊察心脉,脉象急迫的,疼痛牵引背部,饮食难下;寸口脉沉紧的,心中苦寒,时常疼痛;关上脉紧的,心下痛苦;左手寸脉沉的,则是阴阳绝断,无心脉的表现,心中苦受毒痛。(出自《鸡峰方》)
有人患腹痛,症状不一。有风痛、热痛、冷痛、冷积痛、气积痛、虫痛。妇女经期先出现腹痛;小儿出疮疹前先出现腹痛。若满腹疼痛,服用温热药物无效,此为风痛,适宜服用官局胃风汤或火草丸等如附子、乌头之类的药物。大便秘结,小便赤黄,喜欢冷饮冷食的,此为热痛,年轻后生适宜服用四顺饮,老年人适宜服用大麻仁丸,这些都在局方中有记载。腹部有肿块起且伴腹痛的,都是积滞所致。冷积则面色无华,身体消瘦憔悴,脉象沉伏,适宜在温热药中加入巴豆,如官局积气丸之类。气积则多打嗝,适宜服用嘉禾散、调气散、五鬲宽中散等,如茴香、丁香、木香、沉香之类的药物。食积则多打酸嗝,口中流出清水,恶心,适宜服用京三棱、蓬莪术、干漆之类的药物,但也须兼用巴豆。至于腹中有肿块突起,用手按压即刻消失的,以及五更时分心中嘈杂、牙关僵硬、恶心流清水及梦中磨牙的,这称为虫痛,适宜服用官局化虫丸,如使君子之类的药物。又有室女或妇人月经来潮前先腹痛,这与各种疼痛不同,只可服用四物汤。小儿身热足冷,耳朵及尾骨寒冷,眼睛干涩的,都是疮疹的征候,必定先出现腹痛,因为疹子先从肠胃中生发,然后发于体表,适宜服用葛根升麻汤及绵煎散之类。舒王解释“痛”字说:“宜通而塞则为痛”,这非常有道理。凡是疼痛,必须通利脏腑,然后根据寒热情况,必要时使用巴豆、大黄、牵牛子,这是最重要的法则。(出自《医余》)
Excessive drinking with frequent urination is called *Re Zhong* (Heat Middle); excessive eating with frequent urination is called *Xiao Zhong* (Consumption Middle); excessive joy is called *Duo Xi*; excessive anger is called *Kuang Re*. Both *Re Zhong* and *Xiao Zhong* are diseases prevalent among the wealthy and noble. (From *Nei Jing*)
The Heart stores the Spirit (*Shen*); the Heart is the master of the body. If its regular meridian (Hand-Shaoyin Heart Meridian) is invaded by Wind Evil, it is called *Zhen Xin Tong* (True Heartache), where onset in the morning leads to death in the evening, and onset in the evening leads to death in the morning. The Pericardium Meridian is an extra-meridian branch of the Heart; if invaded by Wind-Cold Evil, it also causes heartache, but the pain fluctuates in intensity and does not lead to death. Furthermore, when the Qi of the Hand-Shaoyin Heart Meridian rebels, it is called *Yang Xu Yin Jue* (Yang Deficiency and Yin Collapse), which also causes heartache, characterized by pain radiating to the throat. Urgent pain below the heart is called *Pi Xin Tong* (Spleen Heartache); abdominal distension accompanied by heartache is called *Wei Xin Tong* (Stomach Heartache); lower abdominal heaviness accompanied by diarrhea and coldness in the middle jiao is called *Shen Xin Tong* (Kidney Heartache). Additionally, there are nine types of heartache: 1. Insect (*Chong*), 2. Pestilence (*Zhu*), 3. Wind (*Feng*), 4. Palpitation (*Ji*), 5. Food (*Shi*), 6. Drink/Fluid (*Yin*), 7. Cold (*Leng*), 8. Heat (*Re*), 9. Branch (*Zhi*). All these heartaches result from Evil Qi invading the collaterals of the Hand-Shaoyin Heart Meridian. When Evil Qi contends with Healthy Qi, the struggle between Evil and Healthy Qi causes heartache. Diagnosis reveals that an urgent heart pulse indicates pain radiating to the back and inability to eat; a deep and tight pulse at the Cun Kou position indicates bitter cold in the heart and frequent pain; a tight pulse at the Guan position indicates severe pain below the heart; a deep pulse at the left Cun position indicates the severance of Yin and Yang, absence of heart pulse, and bitter toxic pain in the heart. (From *Ji Feng Fang*)
A person suffers from abdominal pain with varied manifestations. There are Wind Pain, Heat Pain, Cold Pain, Cold Accumulation Pain, Qi Accumulation Pain, and Insect Pain. Women may experience abdominal pain prior to menstruation; children may experience abdominal pain prior to the eruption of chickenpox/rash. If the entire abdomen hurts and warm herbs are ineffective, this is Wind Pain, suitable for treating with Official Bureau *Wei Feng Tang* (Stomach Wind Decoction) or *Huo Cao Wan* (Fire Grass Pill), such as those containing *Fuzi* (Prepared Aconite Root) or *Wutou* (Aconite Root). Constipation, red urine, and a preference for cold drinks and food indicate Heat Pain. Young people should take *Si Shun Yin* (Four Smooths Decoction), while the elderly should take *Da Ma Ren Wan* (Cannabis Seed Pill), both recorded in the Official Formularies. Abdominal masses accompanied by pain indicate Accumulations. Cold accumulation presents with pallor, emaciation, and a deep, hidden pulse; it is suitable to add *Badou* (Croton Seed) to warm herbs, such as in the Official Bureau *Ji Qi Wan* (Qi Accumulation Pill). Qi accumulation involves frequent belching; it is suitable to take *Jia He San*, *Tiao Qi San*, or *Wu Ge Kuan Zhong San*, using herbs like *Huixiang* (Fennel Fruit), *Dingxiang* (Clove), *Muxiang* (Costus Root), or *Chenxiang* (Agarwood). Food accumulation involves sour belching, clear water in the mouth, and nausea; it is suitable to take *Jingsanleng* (Burreed Tuber), *Peng'e zhu* (Turmeric Tuber), or *Ganqi* (Resin of Toxicodendron vernicifluum), but must also include *Badou*. If there is a mass in the abdomen that disappears upon pressing, along with mid-night gastric discomfort, stiff jaw, nausea with clear fluid, and teeth grinding during sleep, this is Insect Pain, suitable for taking the Official Bureau *Hua Chong Wan* (Insect Dissolving Pill), such as *Shijunzi* (Quince Seed). For virgins or women experiencing abdominal pain before menstruation, this differs from other pains and requires only *Si Wu Tang* (Four Substances Decoction). Children with feverish body, cold feet, cold ears and coccyx, and dry eyes exhibit signs of rash eruption; they must first have abdominal pain because the rash emerges from the intestines and stomach before appearing on the exterior. They should take *Gegen Shengma Tang* (Pueraria and Cimicifuga Decoction) or *Mian Jian San* (Cotton Decoction Powder). Prince Shu explained the character "Tong" (Pain): "If what should be unobstructed becomes obstructed, it is pain." This is highly reasonable. For any pain, one must unblock and regulate the Zang-Fu organs, and then use *Badou* (Croton Seed), *Dahuang* (Rhubarb Root), or *Qianniu* (Morning Glory Seed) according to the cold or heat condition. This is the most crucial method. (From *Yi Yu*)