王叔权旧患心脾痛，发则痛不可忍，急用瓦片置炭火中，烧令通红，取出投米醋中洒出，以纸二三重裹之，
置于痛处，稍止，冷即再易。耆旧所传也。后阅《千金》一有云∶凡心腹冷痛，熬盐一升熨，或熬蚕砂烧砖石
蒸熨，取其温里暖中，或蒸土亦大佳，始知予家所用，盖出《千金方》也。他日心疼甚，急灸中脘数壮，觉小
腹两边有冷气自下而上，至灸处即散，此灸之功也。《本事方》载王思和论心忪，非心忪也。胃之大络，名曰虚
里，络胸膈及两乳间。虚而有痰，则动更甚，须臾发一阵，是其症也。审若是，又灸虚里矣，但不若中脘为要
穴云。
《左传》巫臣以夏姬之故怨子反，曰∶余必使汝疲于奔命以死。于是子反一岁七奔命，遂遇心疾而卒，则又
因用心而成疾矣。平居当养其心，使之和平，疾自不作。其次则当服镇心丹之类，以补养之可也。若疾将作而
针灸，抑亦可以为次矣。（《资生经》。）
一妇人患胸中痞急，不得喘息，按之则痛，脉数且涩，此胸痹也。因与小陷胸汤，二剂而愈。
一人年二十三岁，膈有一点相引痛，吸气皮觉急，此有污血也。滑石一两，桃仁五钱，黄连五钱，枳壳一
两，甘草炙二钱，为末，每一钱半，以萝卜自然汁煎熟饮之，一日五六服即愈。
缪仲淳治高存之夫人，患心口痛，一日忽大发，胸中有一物上升冲心，三妇人用力捺之不下，叫号欲绝。
存之曾预求救，缪立此方，是日急煎服之，冲上者立堕下，腹中作痛不升矣。再服，腹中痛亦消。二日后，以
病起洗浴，又忽作呕，头痛如劈。存之曰∶此即前症也，煎前药服之立安。白芍酒炒三钱，炙草五分，吴茱萸
汤泡三次、八分，茯苓二钱，延胡索醋煮一钱，苏子炒研一钱五分，橘红盐水泡一钱二分。复加半夏姜汁炒一
钱，旋复花一钱，木通七分，竹茹一钱。（《广笔记》。）
李季虬曰∶予妇今春忽患心痛连下腹，如有物上下撞，痛不可忍。急以手重按之，痛稍定，按者稍松，即
叫号。仲淳曰∶此必血虚也。脉之，果然。急投以白芍五钱，炙草七分，橘红三钱，炒盐五分，二剂稍定已。
又以牛黄苏合丸，疏其滞，嗳气数次痛徐解。子问故？仲淳曰∶白芍、甘草，治血虚之圣药也。因久郁气逆，
故减甘草之半，仲景甲己化土之论详矣。诸医不解尔，炒盐者何？曰∶心虚以炒盐补之，即水火既济之意也。
予惧俗师概以食积痰火，疗心腹之痛，故疏其详如左。（同上。）
二案均是治肝之法，前案兼涤饮，此案养肝，兼以降逆，非纯补虚也。
昔年予过曲河，适王宇泰夫人，病心口痛甚，日夜不眠，手摸之如火。予问用何药？曰∶以大剂参、归补
之稍定，今尚未除也。（ 按∶心胃痛惟阴维虚损一症，可用参、归、其余多是停痰积饮，与肝火犯胃之症。
此案叙症既未详悉，又不云脉象如何，殊属含混。）曰∶得无有火或气乎？宇泰曰∶下陈皮及凉药少许，即胀闷欲
死。非主人精医，未有不误者。予又存此公案，以告世之不识虚实，而轻执方者。（同上。）
刘云密治一女子，值暑月夜间甚凉，患心痛，从右肋下起，至心前岐骨陷处并两乳下俱痛，复连背痛，腰
及两膊俱骨缝胀疼。惟右肋并心疼独甚，时作恶心且呕。疑夜眠受凉，寒邪郁遏，气不流畅所致，用散寒行气
药不效。又疑寒滞中有郁火，加散郁之品，亦不效。服加味煮黄丸乃顿愈。姜黄三钱半，雄黄三分，乳香三分
去油，净巴豆霜八分，其为细末，醋糊为丸如黍米大。虚者七丸，实者十一丸，姜汤送下。经云∶邪气甚则
实。此妇体素虚弱，而受寒邪甚则为实。惟此辛热之剂，可以导之。前所用药，虽亦散而不能及病也。其用姜
黄、乳香，亦有深意，盖寒伤血故耳。此时珍所谓配合得宜，则罔不奏功。
金铃子散∶川楝子去核一两，延胡索一两，为末，每服三钱，温酒调服。水煎服亦可。王晋三曰∶此方一
泄气分之热，一行血分之滞。《雷公炮炙论》曰∶心痛欲死，速觅延胡。洁古复以金铃治热厥心痛，经言诸痛
皆属于心，而热厥属于肝逆，金铃子非但泄肝，功专导去小肠膀胱之热，引心包相火下行。延胡和一身上下诸
痛，方虽小，制配合宜，却有应手取愈之功，勿以淡而忽之。
肝胃久痛，诸药不效，或腹有 瘕，此方皆验，名梅花丸。孕妇慎用。绿萼梅蕊三两，滑石七两，丹皮四
两，制香附二两，甘松、蓬莪术各五钱，茯苓三钱五分，人参、嫩黄 、砂仁、益智各三钱，远志肉二钱五分，
山药、木香各一钱五分，桔梗一钱，甘草七分。凡十六味，共研细末，炼白蜜十二两，捣丸如龙眼大，白蜡封
固。每服一丸，开水调下。此方传自维扬沈月枝封翁。幕于姑苏时，患心腹久痛，诸药罔效，得此而愈。遂配
合施送，服者多愈。但用药甚奇，其分两之多寡亦难测识。
雪羹大荸荠四个，海 漂去锻石矾性一两，水二钟，煎八分。王晋三曰∶羹，食物之味调和也；雪，喻其
淡而无奇，有清凉内浸之妙。荸荠味甘，海 味咸，性皆寒而滑利。凡肝经热厥，少腹攻冲作痛，诸药不效者，
用以泄热止痛，捷如影响。
王叔权过去患有心脏和脾脏部位的疼痛，发作时疼痛难以忍受。紧急时用瓦片放在炭火中烧至通红，取出投入米醋中淬火发出声响，再用两三层纸包裹，敷在疼痛部位，稍作缓解后，变冷就再次更换。这是老年人世代相传的方法。后来阅读《千金方》中有记载：凡是心腹部冷痛，可以炒盐一升进行熨烫，或者炒蚕砂、烧砖石蒸热后熨烫，取其温暖内脏、温补中焦的作用，或者用蒸热的土熨烫也非常好，这才知道我家所用的方法，大概出自《千金方》。另有一天心痛得很厉害，急忙在中脘穴灸了几壮，感觉小腹两边有冷气从下往上冲，到了灸治的部位就消散了，这就是艾灸的功效。《本事方》记载王思和论述的心悸（心中慌乱不安），并不是真正的心悸。胃的大络脉，名叫虚里，联络胸膈及两侧乳房之间。如果这里空虚且有痰饮，搏动会更加剧烈，一会儿发作一阵，就是这种症状。如果确实是这种情况，也可以灸虚里穴，但不如中脘穴重要。
《左传》记载巫臣因为夏姬的缘故怨恨子反，说：“我一定要让你疲于奔命而死。”于是子反一年中七次奔波救急，最终因患心疾而去世，这又是由于过度用心而导致疾病。平时应当养护心神，使心境平和，疾病自然不发生。其次则应当服用镇心丹之类的药物来补养即可。如果疾病将要发作再采用针灸治疗，也可以作为次要手段。（出自《资生经》。）
有一位妇女患有胸部痞塞紧迫，不能喘息，按压则疼痛，脉搏快且涩，这是胸痹病。因此给予小陷胸汤，服用两剂后痊愈。
一位二十三岁的男子，膈部有一点牵引性疼痛，吸气时皮肤感觉紧绷，这是体内有瘀血。用滑石一两，桃仁五钱，黄连五钱，枳壳一两，炙甘草二钱，研为细末，每次取一钱半，用萝卜自然汁煎熟服用，一天服用五六次即痊愈。
缪仲淳治疗高存之的夫人，患有心口疼痛，一天突然大发，胸中有一股气上升冲击心脏，三个妇人用力按压也按不下去，她叫喊哀号几乎断气。高存之前曾预先求救，缪仲淳立即开出此方，当天紧急煎服后，上冲的气立刻降下，腹痛不再上升。再服用一次，腹中的疼痛也消除了。两天后，因为病愈洗澡，又忽然呕吐，头痛如刀劈。高存之说：“这就是之前的病症，煎服前药立刻安宁。”白芍酒炒三钱，炙甘草五分，吴茱萸汤泡三次八分，茯苓二钱，延胡索醋煮一钱，苏子炒研一钱五分，橘红盐水泡一钱二分。再加半夏姜汁炒一钱，旋覆花一钱，木通七分，竹茹一钱。（出自《广笔记》。）
李季虬说：我的妻子今年春天突然患心痛连及下腹，好像有东西上下撞击，疼痛难忍。急忙用手重按，疼痛稍定，手稍微松开，就叫喊哀号。缪仲淳说：“这一定是血虚。”诊脉，果然如此。急忙投以白芍五钱，炙甘草七分，橘红三钱，炒盐五分，服用两剂后稍定已止。又用牛黄苏合丸，疏通其滞气，打嗝几次后疼痛慢慢解除。儿子询问原因？缪仲淳说：“白芍、甘草，是治疗血虚的圣药。因为长期郁结气逆，所以减少一半甘草的量，张仲景关于甲己化土的论述很详细了。各位医生不理解，为什么要用炒盐？我说：心虚用炒盐来补益，就是水火既济的意思。我担心庸医一概将心腹疼痛归结为食积痰火，所以详细说明如下。（同上。）”
这两个案例都是治疗肝脏的方法，前案兼有涤除痰饮，此案滋养肝脏，兼以降逆，并非单纯的补虚。
往年我经过曲河，恰逢王宇泰的夫人，患心口疼痛非常严重，日夜不眠，手摸上去像火一样烫。我问用什么药？回答说：“用大剂量人参、当归补益后稍定，现在尚未除根。”（按语：心胃痛只有阴维脉虚损这一症，可以用参、归，其余多是停痰积饮，以及肝火犯胃的症状。此案叙述症状既不详细，又不说明脉象如何，确实含糊不清。）问：“莫非有火或者有气吗？”王宇泰说：“吃了一点陈皮和凉药，就胀闷得想死。如果不是主人精通医术，没有人不误治的。”我又保存这个案例，以此告诫世间那些不识虚实而轻率执方的人。（同上。）
刘云密治疗一名女子，正值暑月夜间天气很凉，患心痛，从右肋下发起，到心前歧骨陷处及两乳下都痛，又牵连背痛，腰部和两臂骨头缝都胀痛。只有右肋和心痛特别严重，时常恶心且呕吐。怀疑夜间睡眠受凉，寒邪郁遏，气机不畅所致，用散寒行气的药无效。又怀疑寒滞中有郁火，加入散郁的药物，也无效。服用加味煮黄丸才顿时痊愈。姜黄三钱半，雄黄三分，乳香三分去油，净巴豆霜八分，研为细末，醋糊做成如黍米大的丸药。体虚者七丸，体实者十一丸，姜汤送下。经文说：“邪气盛则为实。”这位妇女体质素来虚弱，但受寒邪很重表现为实证。只有这种辛热的药剂，可以引导排出。前面用的药，虽然也能散寒但不能到达病所。使用姜黄、乳香，也有深意，因为寒伤血分缘故。此时珍所说的配合得当，就没有不奏效的。
金铃子散：川楝子去核一两，延胡索一两，研为细末，每次服用三钱，温酒调服。水煎服也可以。王晋三说：此方一方面泄气分之热，一方面行血分之滞。《雷公炮炙论》说：“心痛欲死，速觅延胡。”洁古先生又用金铃子治疗热厥心痛，经文说诸痛皆属于心，而热厥属于肝气上逆，金铃子不仅泄肝，功效专门引导去除小肠膀胱的热，引心包相火下行。延胡索调和一身上下各种疼痛，方子虽小，制作配合适宜，却有应手而愈的功效，不要因为药味平淡而忽视它。
肝胃久痛，各种药无效，或者腹部有癥瘕，此方都有效，名叫梅花丸。孕妇慎用。绿萼梅蕊三两，滑石七两，丹皮四两，制香附二两，甘松、蓬莪术各五钱，茯苓三钱五分，人参、嫩黄芪、砂仁、益智各三钱，远志肉二钱五分，山药、木香各一钱五分，桔梗一钱，甘草七分。共十六味，一起研成细末，炼白蜜十二两，捣成如龙眼大的丸药，用白蜡封固。每次服用一丸，开水调下。此方传自维扬沈月枝老先生。他在苏州幕僚任上时，患心腹久痛，各种药无效，得到此方而痊愈。于是配制施送，服用者多痊愈。但用药很奇特，其分量之多寡也难以推测识别。
雪羹：大荸荠四个，海螵蛸漂去锻石矾性一两，水两钟，煎至八分。王晋三说：羹，是食物口味的调和；雪，比喻其清淡而无奇，有清凉内浸的妙处。荸荠味甘，海螵蛸味咸，性质都寒而滑利。凡是肝经热厥，少腹攻冲作痛，各种药无效的，用来泄热止痛，快捷得像影子跟随物体一样。
Wang Shuquan previously suffered from pain in the heart and spleen regions. Upon onset, the pain was unbearable. Urgently, a tile was placed in charcoal fire until red-hot, then removed and quenched in rice vinegar, producing steam. It was wrapped in two or three layers of paper and applied to the painful area. Once relief was slight, it was replaced when cold. This was a method passed down by elders. Later, reading *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold), it stated: "For any cold pain in the heart and abdomen, roast one sheng of salt for moxibustion/ironing, or roast mulberry silkworm feces, burn bricks/stones, steam and iron them, taking advantage of warming the interior and middle jiao; or steaming earth is also very good." Only then did I realize that the method used by my family likely originated from *Qianjin Fang*. Another day, the heart pain was severe. Urgently, several moxa cones were burned at Zhongwan (CV12). I felt cold qi rising from both sides of the lower abdomen upwards. Upon reaching the moxibustion site, it dissipated. This was the efficacy of moxibustion. *Ben Shi Fang* (Prescriptions of Capability) records Wang Sihe's discussion on Xin Song (palpitations with anxiety), which is not true palpitations. The great collateral of the Stomach is named Xuli (ST15), connecting the chest/diaphragm and between the two breasts. If this area is deficient and has phlegm-fluids, the pulsation becomes more severe, erupting in bursts every moment; this is its symptom. If indeed so, one could also moxa Xuli, but it is not as crucial as Zhongwan.
The *Zuo Zhuan* records that Wuxin harbored resentment against Zifan due to Xia Ji, saying, "I will surely make you die from exhaustion running back and forth." Thus, Zifan ran on urgent missions seven times in one year, eventually dying of a heart disease. This illustrates illness caused by excessive mental exertion. In daily life, one should nourish the Heart Spirit, keeping it peaceful, so diseases naturally do not arise. Secondly, one should take medicines like Zhenxin Dan (Calming the Heart Pill) to tonify and nourish. If illness is about to occur, acupuncture and moxibustion can be used as secondary measures. (From *Zisheng Jing*.)
A woman suffered from chest fullness and tightness, inability to breathe, and pain upon pressure. Her pulse was rapid and choppy. This was Chest Bi (Obstruction Syndrome). Therefore, Xiao Xianxiong Tang (Minor Inverted Chest Decoction) was administered, and she recovered after two doses.
A twenty-three-year-old man had a pulling pain in the diaphragm, with skin tension upon inhalation. This indicated stagnant blood. One tael of Huashi (Talcum), five qian of Taoren (Peach Kernel), five qian of Huanglian (Coptis Rhizome), one tael of Zhiqiao (Bitter Orange Fruit), and two qian of Zhi Gancao (Honey-fried Licorice Root) were ground into powder. Each dose of 1.5 qian was decocted in natural radish juice and drunk. Five to six doses per day led to recovery.
Miao Zhongchun treated the wife of Gao Cunzhi, who suffered from heart-mouth pain. Suddenly, a severe attack occurred where a sensation rose from the chest striking the heart. Three women pressed down forcefully but could not suppress it; she cried out nearly fainting. Gao had previously sought help. Miao immediately prescribed this formula, which was urgently decocted and taken that day. The rising sensation immediately dropped, and abdominal pain ceased rising. After another dose, abdominal pain also vanished. Two days later, bathing due to feeling better, she suddenly vomited and suffered splitting headache. Gao said, "This is the previous syndrome. Decoct and take the previous medicine for immediate peace." Bai Shao (White Peony Root) wine-fried 3 qian, Zhi Gancao (Honey-fried Licorice Root) 5 fen, Wuzhuyu (Evodia Fruit) soaked in water three times 8 fen, Fuling (Poria) 2 qian, Yanhusuo (Corydalis Rhizome) vinegar-boiled 1 qian, Suzi (Perilla Seed) fried and crushed 1.5 qian, Juhong (Aged Tangerine Peel) salt-water soaked 1.2 qian. Added Banxia (Pinellia Tuber) ginger-juice fried 1 qian, Xuanfuhua (Inula Flower) 1 qian, Mutong (Akebia Stem) 7 fen, Zhuru (Bamboo Shavings) 1 qian. (From *Guang Biji*.)
Li Jiqiu said: My wife suddenly suffered heart pain radiating to the lower abdomen, as if something was colliding up and down, unbearable pain. Urgently pressing heavily with hands slightly relieved it; loosening caused crying out. Zhongchun said, "This must be Blood deficiency." Pulse diagnosis confirmed it. Urgently administered Baishao (White Peony Root) 5 qian, Zhi Gancao (Honey-fried Licorice Root) 7 fen, Juhong (Aged Tangerine Peel) 3 qian, Chao Yan (Fried Salt) 5 fen. Two doses brought slight relief. Then Niuhuang Suhé Wan (Bezoar and Storax Pill) was used to unblock stagnation. After several belches, pain slowly resolved. Son asked why? Zhongchun said: Baishao and Gancao are holy medicines for treating Blood deficiency. Due to long-term depression and rebellious Qi, half the Gancao was reduced. Zhang Zhongjing's theory on Jia-Ji transforming Earth is detailed. Other doctors do not understand. Why Fried Salt? I say: For Heart deficiency, Fried Salt tonifies it, embodying the concept of Water and Fire having achieved balance. I fear vulgar physicians generally attribute heart/abdominal pain to food retention or phlegm-fire, so I detail it below. (Same source.)
Both cases treat the Liver. The former case clears fluids; this case nourishes the Liver and descends rebellious Qi, not purely tonifying deficiency.
In past years, passing Quhe, I met Mrs. Wang Yutai suffering severe heart-mouth pain, sleepless day and night, hot to touch. I asked what medicine was used. She replied: Large doses of Renshen (Ginseng) and Danggui (Angelica Sinensis) provided slight relief, but not cured. (Commentary: For heart/abdominal pain, only Yin Wei vessel deficiency allows Renshen/Danggui; most others are retained phlegm/fluids or Liver Fire invading Stomach. This case description is vague, lacking pulse details.) I asked: "Is there Fire or Qi?" Yutai said: "Taking some Chenpi (Tangerine Peel) and cooling medicines caused fatal bloating. If the master were not a skilled physician, no one would avoid error." I preserved this case to warn those who ignore deficiency/excess and rigidly apply formulas. (Same source.)
Liu Yunmi treated a young woman. During cool summer nights, she suffered heart pain starting from the right hypochondrium, extending to the xiphoid process, under both breasts, radiating to the back, with bone-gap swelling/pain in waist and arms. Right hypochondrium and heart pain were most severe, accompanied by nausea and vomiting. Suspecting cold invasion during sleep causing Qi stagnation, cold-dispersing and Qi-moving herbs failed. Suspecting郁火 (depressed fire) within cold stagnation, adding dispersing herbs also failed. Jiawei Zhuhuang Wan (Modified Boiled Yellow Pill) brought instant cure. Jianghuang (Turmeric Rhizome) 3.5 qian, Xionghuang (Realgar) 3 fen, Ruxiang (Olibanum) 3 fen (oil removed), Jing Badou Shuang (Pure Croton Seed Frost) 8 fen. Ground fine, formed into pills the size of millet seeds with vinegar paste. Deficient patients: 7 pills; Excess patients: 11 pills. Taken with Ginger Decoction. Classic says: "Excess pathogenic factors constitute Excess syndrome." This woman was constitutionally weak but suffered heavy cold, manifesting as excess. Only this acrid-hot agent could guide it out. Previous herbs dispersed but did not reach the disease. Using Jianghuang and Ruxiang has deep meaning, as cold injures Blood. As Shizhen said, proper combination ensures efficacy.
Jinlingzi San (Golden Bell Powder): Chuannanzi (Szechwan Chinaberry Fruit) pitted 1 tael, Yanhusuo (Corydalis Rhizome) 1 tael. Ground fine. Take 3 qian each time, mixed with warm wine. Decoction is also acceptable. Wang Jinshan said: This formula drains Heat from the Qi level and moves Stasis from the Blood level. *Leigong Paozhi Lun* states: "Heart pain wanting death, quickly seek Yanhusuo." Jiegū added Jinlingzi for Reversal Cold Heart Pain. Classics state all pains belong to the Heart, while Reversal Cold belongs to Liver rebellion. Jinlingzi not only drains Liver, but specifically guides Heat from Small Intestine and Bladder downward, leading Pericardium Ministerial Fire down. Yanhusuo harmonizes pains throughout the body. Though small, its preparation is apt, achieving quick cures. Do not neglect it for being mild.
Chronic Liver/Stomach pain unresponsive to other herbs, or abdominal masses (Jia/Zhen), this formula is effective, named Meihua Wan (Plum Blossom Pill). Pregnant women use with caution. Lü'emeirui (Green Plum Bud) 3 liang, Huashi (Talcum) 7 liang, Danpi (Moutan Bark) 4 liang, Zhi Xiangfu (Cyperi Rhizoma processed) 2 liang, Gansong (Nardostachys Root) and Peng'e Zhu (Curcuma Zedoaria Rhizome) 5 qian each, Fuling (Poria) 3.5 qian, Renshen (Ginseng), Neng Huangqi (Young Astragalus Root), Sharen (Amomum Fruit), Yizhi (Alpinia Oxyphylla Fruit) 3 qian each, Yuanzhi Rou (Polygala Root flesh) 2.5 qian, Shanyao (Dioscorea Rhizome), Muxiang (Aucklandia Root) 1.5 qian each, Jiegeng (Platycodon Root) 1 qian, Gancao (Licorice Root) 7 fen. Sixteen ingredients, ground fine, refined white honey 12 liang, pounded into pills the size of dragon eyes, sealed with white wax. Take one pill each time, mixed with boiling water. This formula was transmitted from Shen Yuezhizhi, an elder from Weiyang. When he served as a幕僚 (staff officer) in Suzhou, he suffered chronic heart/abdominal pain unresponsive to drugs, cured by this. He prepared and distributed it; many recovered. The medication is peculiar, and dosages are hard to fathom.
Xue Geng (Snow Broth): Four large Biboli (Water Chestnut), one tael of Haijie (Cuttlefish Bone)漂 washed to remove calcareous properties. Two zhong of water, decoct to eight fen. Wang Jinshan said: Geng refers to harmonizing food flavors; Xue metaphorically implies blandness without peculiarity, possessing subtle internal cooling penetration. Biboli is sweet; Haijie is salty. Both are cold and slippery. For Liver channel Reversal Cold, lower abdomen attacking pain unresponsive to other herbs, using this drains Heat and stops pain, swift as shadow following form.