人有久患心疼，时重时轻，大约饥则痛重，饱则痛轻，人以为寒气中心也，谁知是虫伤
胃脘乎。盖心君宁静，客寒客热之气，皆不能到，倘寒气犯心，立刻死矣，安能久痛乎。凡
痛久不愈者，皆邪犯心包与胃口耳。但邪犯胃与心包，暂痛而不常痛也，断无饥重而饱轻者
。若虫蚀则觅食头上行，而无食以充其饥，则其身上撺，口啮胃脘之皮，则若心痛，而实非
心痛也。不杀虫而但止其痛，痛何能止乎。方用化虫定痛丹∶
生地（二两） 水煎汁二碗，入白薇二钱，煎汁一碗，淘饭食之，非吐物如虾蟆，必泻虫如
守宫也。
大凡胃中湿热，人多生虫。饮食倍于寻常，皆易有虫，以此方投之，皆能取效，不止治
心痛之虫也。盖生地杀虫于有形，而白薇杀虫于无形，合而用之，化虫最神。虫死而心痛自
除，非生地、白薇之能定痛也。
此症用草根粥亦效。
楝树根（一两）
煎汤二碗，入甘草一钱，再煮粥一碗。顿食之，即止痛。
人有一时心痛，倏痛倏已，一日而十数遍者，饮食无碍，昼夜不安，人以为此虫也，而
不知不然。夫虫痛必非一日而成，岂有无端而一时心痛者乎。或曰此火也。夫火则终日痛，
而必非时痛时止者。然则为何痛乎?非火、非虫，乃气虚而微感寒湿之邪，邪冲心包而作痛
，邪不冲心包而即不痛，即古人所云去来痛也。痛无补法，而独去来痛，必须用补，不补虚
而痛不能止。然徒用补药，而不加入祛寒祛痰之味，亦不能定痛也
。方用去来汤∶
人参（三钱） 茯苓（三钱） 苍术（三钱） 白术（五钱） 甘草（二钱） 川乌（二钱） 半夏（一钱）
水煎服。一剂而痛即止，再剂而痛不再发。
方中用二术为君主，最有佳意。盖痛虽由于气虚，毕竟湿气之侵心包也。二术去湿而又
健脾胃之气，故用之以佐人参、茯苓补气以利湿，则湿去而气更旺也。气既旺矣，而川乌得
直入心包，以祛逐其寒邪；半夏得行于中脘，而消其败浊之痰；甘草和缓，调停于邪正之间
，以奏功于眉睫矣。
此症用苍乌参苓散亦甚效。
人参 草乌（各一钱） 茯苓 苍术（各三钱） 巴戟天（一两）
水煎服。一剂即止痛。
人有心痛之极，苦不欲生，彻夜呼号，涕泗滂沱者，人以为火邪作祟也。然致此火邪之
犯心者，何故乎?盖因肝气之郁而不舒，木遂生火以犯心矣。夫肝木生心火者也，而何以反
致克心，盖心属火，而火不可极，火极反致焚心，往往有自焚而死者。故心火太旺，火正为
心之所恶，而又得肝木之助火，则心不能受，必呼号求救于四邻，自然涕泪交垂矣。且肝
木之火又系郁火，正火顺而郁火逆，犹非心之所喜，故入心而心不受。然火势太旺，又不能
遏抑，偏欲直入于心宫，而心包又掩护重重，未易焚烧，但肝木之郁火，乃木中之火，龙雷
之火也，每从下而上冲，霹雳之威，震开天门，火光所至，焚林烧木，天地且为之动荡，何
能止遏哉。此肝火之冲心，所以直受其害也。治法必须泻肝木之火，更须解木气之郁，而少
佐以安心之剂，则心痛自止也。方用救痛安心汤∶
白芍（一两） 炒栀子（三钱） 甘草（一钱） 柴胡（二钱） 贯仲（二钱） 乳香（一钱） 没药（
一钱） 苍术
水煎服。一剂而痛定，再剂而全愈矣。
白芍、柴胡，最解肝气之郁；栀子、贯仲，最泻肝火之暴；乳香、没药，最止脏腑之痛
，而甘草、苍术和中消湿，辅佐得宜，故一剂而奏功也。
此症用栀香饮亦妙。
炒栀子 荆芥（各三钱） 茯苓（五钱） 甘草 乳香末 丹砂末 木香末（各一钱）
水煎调服。一剂即止痛。
人有真正心痛，法在不救，然用药得宜，亦未尝不可生也。其症心痛不在胃脘之间，亦
不在两胁之处，恰在心窝之中，如虫内咬，如蛇内钻，不特用饭不能，即饮水亦不可入，手
足冰冷，面目青红者是也。夫真心痛，原有两症，一寒邪犯心，一火邪犯心也。寒犯心者，
乃直中阴经之病，猝不及防，一时感之，立刻身死。死后必有手足尽紫黑者，甚则遍身俱青
，多非药食能救，以至急而不遑救也。倘家存药饵，用人参一、二两，附子三钱，急煎救之
，可以望生，否则必死。若火犯心者，其势虽急而犹缓，可以远觅药饵，故不可不传方法，
以救人也。余言前症，正火邪犯心也，但同是心疼，何以辨其一为寒而一为热?盖寒邪舌必
滑，而热邪舌必燥耳。倘辨其为火热之心痛，即用救真汤投之
炒栀子（三钱） 炙甘草（一钱） 白芍（一两） 广木香末（二钱） 石菖蒲（一钱）
水煎服。一剂而痛止矣，不必更用二剂。但痛止后必须忍饥一日，断不再发。
或曰∶既是真心痛，宜用黄连以直治心火，何以不治心而治肝耶?不知肝为心之母，泻
肝木之气，则肝不助火而心气自平，泻肝木正善于泻心火也。倘直泻其心，则心必受伤，虽
暂取效于一时，而脾胃不能仰给于心火，则生气遏抑，必至中脘虚寒，又变成他症矣。此黄
连之所以不用，而反用栀子也。
人有患心疼之病，百药治之不效，得寒则痛，得热亦痛，盖此症非心痛，乃胃痛也。寒
热俱能作痛，盖寒与热不并立，寒热同乘于心胃之间，寒欲凌热，而热不肯相让；热欲欺寒
，而寒不肯相安，两相攻战，势均力敌。治心则胃气受伤，治胃则心气受损，所以治寒治热
，而两无一效也。治法宜两治之以解纷，而心痛自愈。方用双治汤∶
附子（一钱） 黄连（一钱） 白芍（五钱） 甘草（一钱）
水煎服。一剂而痛立愈。
用黄连以清心火，用附子以祛胃寒，用白芍、甘草为君，使两家有和解之好。盖芍药、
甘草最能入肝平木，肝气既平，自然不去克胃，而又去生心，调和于心胃之间，实有至理
，非漫然而用之者也。
此症亦可用苍乌暖心丹∶
白术（一两） 白芍（二钱） 茯苓（五钱） 苍术（三钱） 川乌（一钱） 肉桂 甘草（各五分）
水煎服。下喉即止痛。
人有心痛不能忍，气息奄奄，服姜汤而少安，手按之而能忍，目轻夜重，痛阵至时，几
不欲生，人以为此寒痛也。用热药少止，片时而仍痛，其故何与?寒有不同也。凡人心君宁
静，由于肾气之通心也。肾气不交于心，而寒邪中之，心遂不安而痛矣。倘徒祛其寒而不补
其肾，则肾虚而火不能下热于肾中，即肾虚，而水不能上交于心内。此治心必须治肾，而补
肾中之火以救心，犹必须补肾中之水以救肾也。方用补水救火汤∶
熟地（一两） 山茱萸（三钱） 巴戟天（五钱） 山药（三钱） 白术（五钱） 肉桂（一钱） 北五味（五分）
水煎服。一剂而痛可止，二剂而痛全愈，十剂而痛不再发。
此方视之，绝非治心痛之药，而用之治心肾不交之心痛，实有奇功。盖肾中水火不交，
而肾邪直犯于心矣。吾补其肾中之水火，水得真火以相生，火得真水以相养，肾中之阴阳既
济，则心肾之阴阳又安得有冰炭之乖乎。故不必引其上下之相交，而肾气自通于心，心气自
降于肾，一如夫妇之好合矣，邪亦乌能间之，况原无寒邪哉。
此症用交济汤亦佳。
白术 苍术（各五钱） 肉桂 破故纸 菟丝子（各三钱） 广木香 甘草（各一钱） 熟地（一两）
水煎服。
有一位长期患有心痛病的人，疼痛时轻时重，大致在饥饿时疼痛加重，饱食后疼痛减轻。人们认为是寒气侵袭心脏，却不知这是寄生虫损伤了胃脘。心主神明，本性宁静，外来的寒热邪气都无法到达心脏；如果寒气真的侵犯心脏，人立刻就会死亡，怎么可能长期疼痛呢？凡是疼痛长久不愈的，都是邪气侵犯了心包和胃口。但是，邪气侵犯胃与心包，只会暂时疼痛而不会经常疼痛，绝不会有饥饿时加重、饱食后减轻的情况。如果是寄生虫侵蚀，它们会寻找食物向上爬行，如果没有食物充饥，就会在身上窜动，啃咬胃脘的黏膜，这就表现为心痛，但实际上并不是真正的心脏疼痛。如果不杀虫而只是止痛，疼痛怎么能停止呢？方用化虫定痛丹：
生地（二两），水煎取汁两碗，加入白薇二钱，再煎取汁一碗，淘米煮饭食用。如果不是吐出像蛤蟆一样的东西，一定会排出像壁虎一样的虫子。
大凡胃中有湿热，人就容易生虫。饮食量超过常人，都容易有虫，用这个方子治疗，都能取得效果，不仅限于治疗引起心痛的虫。因为生地能在有形层面杀虫，而白薇能在无形层面杀虫，两者合用，化杀虫子的功效最神奇。虫子死了，心痛自然消除，这并不是生地和白薇直接能止痛，而是通过杀虫实现的。
这种病症用楝树根粥也有效。
楝树根（一两），煎汤两碗，加入甘草一钱，再煮成一碗粥。一次性服下，疼痛立即停止。
有人突然感到心痛，疼痛突然发生又突然消失，一天发作十几次，饮食没有妨碍，但昼夜不安宁。人们以为是虫痛，却不知道不是这样。虫痛必然不是一天形成的，怎么会有无缘无故突然心痛的呢？有人说这是火邪。火邪导致的疼痛是整天都痛，而不是时痛时止。那么为什么会痛呢？既不是火，也不是虫，而是气虚且轻微感受了寒湿之邪，邪气冲犯心包就作痛，邪气不冲犯心包就不痛，这就是古人所说的“去来痛”（阵发性疼痛）。通常说疼痛不能用补法，唯独这种去来痛，必须用补法，不补虚则疼痛不能停止。然而，如果单纯使用补药，而不加入祛寒祛痰的药物，也不能止痛。方用去来汤：
人参（三钱）、茯苓（三钱）、苍术（三钱）、白术（五钱）、甘草（二钱）、川乌（二钱）、半夏（一钱），水煎服。一剂药后疼痛即止，再服一剂疼痛不再复发。
方中重用二术（苍术、白术）为君药，最有深意。因为疼痛虽然由于气虚，但终究是湿气侵扰心包所致。二术既能祛湿又能健脾胃之气，所以用它来辅助人参、茯苓补气以利湿，湿气去除则气更旺盛。气既然旺盛了，川乌就能直入心包，祛除寒邪；半夏运行于中脘，消除败浊之痰；甘草性味缓和，调和在邪正之间，从而迅速奏效。
这种病症用苍乌参苓散也非常有效。
人参、草乌（各一钱）、茯苓、苍术（各三钱）、巴戟天（一两），水煎服。一剂即可止痛。
有人心痛极其剧烈，痛苦得不想活，整夜呼号，泪流满面。人们以为是火邪作祟。然而导致火邪侵犯心脏的原因是什么呢？这是因为肝气郁结不舒，木气生火进而侵犯心脏。肝木本应生心火，为什么反而克制心脏呢？因为心属火，而火不可过极，火极反致焚烧心脏，往往有自焚而死的人。所以心火太旺，火正是心脏所厌恶的，再加上肝木助长火势，心脏就不能承受，必然呼号求救于四周，自然涕泪交加。而且肝木之火属于郁火，正火顺行而郁火逆行，这也不是心脏所喜欢的，所以进入心脏而心脏不接受。然而火势太旺，又不能遏制，偏偏想直入心宫，而心包层层掩护，不易被焚烧。但肝木的郁火，乃是木中之火，即龙雷之火，常常从下向上冲逆，其威力如霹雳，震开天门，火光所到之处，焚林烧木，天地为之动荡，怎么能遏制得住呢？这就是肝火冲犯心脏，心脏直接受害的原因。治疗方法必须泻肝木之火，更要疏解木气的郁结，并稍加安心之剂，心痛自然停止。方用救痛安心汤：
白芍（一两）、炒栀子（三钱）、甘草（一钱）、柴胡（二钱）、贯仲（二钱）、乳香（一钱）、没药（一钱）、苍术，水煎服。一剂疼痛安定，再剂完全痊愈。
白芍、柴胡最能疏解肝气之郁；栀子、贯仲最能泻除肝火之暴烈；乳香、没药最能止脏腑之痛；甘草、苍术和中消湿，辅佐得当，所以一剂就见效。
这种病症用栀香饮也很妙。
炒栀子、荆芥（各三钱）、茯苓（五钱）、甘草、乳香末、丹砂末、木香末（各一钱），水煎调服。一剂即止痛。
人有真正的真心痛，原则上是不治之症，但如果用药得当，也未尝不可以求生。其症状是心痛不在胃脘之间，也不在两胁之处，恰好在心窝之中，感觉像虫子在内咬，像蛇在内钻，不仅不能吃晚饭，连喝水也无法入口，手足冰冷，面目青红交错的就是这种病。真心痛原本有两种证型，一是寒邪犯心，二是火邪犯心。寒邪犯心，是直接中伤阴经的病，猝不及防，一时感邪，立刻身亡。死后必定手足全部紫黑，甚至全身发青，大多非药物食物能救，因为病情急迫来不及救治。如果家中存有药物，用人参一两至二两，附子三钱，急煎服用抢救，还可以希望存活，否则必死。如果是火邪犯心，其势虽然急迫但相对缓慢，可以远求药物，所以不可不传授方法以救人。我前面说的症状，正是火邪犯心。但是同样是心疼，如何辨别一个是寒证一个是热证呢？因为寒邪致病舌苔必滑润，而热邪致病舌苔必干燥。如果辨明是火热之心痛，就用救真汤投服：
炒栀子（三钱）、炙甘草（一钱）、白芍（一两）、广木香末（二钱）、石菖蒲（一钱），水煎服。一剂疼痛停止，不必再服第二剂。但疼痛停止后必须忍耐饥饿一天，断不会再发。
有人说：既然是真心痛，应该用黄连来直接清心火，为什么不治心而治肝呢？不知道肝是心的母脏，泻肝木之气，则肝不助火而心气自然平静，泻肝木正是善于泻心火的方法。如果直接泻心火，则心脏必受损伤，虽然暂时取效，但脾胃不能依赖心火来温煦，则生气被遏制，必然导致中脘虚寒，又变成其他病症了。这就是不用黄连而反用栀子的原因。
有人患心痛病，百药治疗无效，遇冷则痛，遇热也痛。大概此症不是心痛，而是胃痛。寒热都能引起疼痛，因为寒与热不能并存，寒热同时乘袭于心胃之间，寒欲凌驾于热之上，而热不肯相让；热欲欺凌寒，而寒不肯相安，两者相互攻战，势均力敌。治心则胃气受伤，治胃则心气受损，所以治寒治热，都没有效果。治疗方法宜双管齐下以解纷乱，则心痛自愈。方用双治汤：
附子（一钱）、黄连（一钱）、白芍（五钱）、甘草（一钱），水煎服。一剂疼痛立即痊愈。
用黄连清心火，用附子祛胃寒，用白芍、甘草为君药，使心胃两家有和解之好。因为芍药、甘草最能入肝平抑肝木，肝气既已平和，自然不去克制胃，而又去生养心，调和于心胃之间，实有至理，并非随意使用。
这种病症也可以用苍乌暖心丹：
白术（一两）、白芍（二钱）、茯苓（五钱）、苍术（三钱）、川乌（一钱）、肉桂、甘草（各五分），水煎服。下喉即止痛。
有人心痛不能忍受，气息微弱，喝姜汤后稍微安宁，用手按压疼痛处能忍受，白天轻晚上重，疼痛发作时，几乎不想活。人们认为这是寒痛。用热药稍微缓解，片刻后又疼痛，这是什么原因呢？寒邪也有不同。凡人心神宁静，是由于肾气通达心脏。肾气不交于心，寒邪侵入其中，心便不安而痛。如果只祛除寒邪而不补肾，则肾虚而命门之火不能下温于肾中，即肾虚，肾水不能上交于心内。因此治心必须治肾，补肾中的命门之火以救心，同时也必须补肾中的肾水以救肾。方用补水救火汤：
熟地（一两）、山茱萸（三钱）、巴戟天（五钱）、山药（三钱）、白术（五钱）、肉桂（一钱）、北五味子（五分），水煎服。一剂疼痛可止，二剂疼痛全愈，十剂疼痛不再复发。
此方看起来，绝不是治心痛的药，但用来治疗心肾不交引起的心痛，确有奇功。因为肾中水火不交，肾邪直犯心脏。我们补益肾中的水火，水得到真火而生生不息，火得到真水而滋养，肾中的阴阳既已济和，那么心肾的阴阳又怎会有冰炭不相容的乖违呢？所以不必刻意引导上下相交，而肾气自然通达心脏，心气自然下降于肾，就像夫妇和好一样，邪气怎能从中干扰呢？况且原本就没有寒邪存在。
这种病症用交济汤也很好。
A person suffering from long-standing heart pain experiences fluctuations in severity, with pain intensifying when hungry and alleviating after meals. People attribute this to cold pathogen invading the Heart, but little do they know it is actually parasites damaging the stomach region (Wei). The Heart Emperor (Heart) is tranquil; external cold or heat pathogens cannot reach it. If cold truly invaded the Heart, death would be instantaneous, making prolonged pain impossible. Any pain that persists for a long time indicates that pathogens have invaded the Pericardium (Xin Bao) and the Stomach opening. However, invasion of the Stomach and Pericardium causes only temporary, not frequent, pain, and certainly not pain that worsens with hunger and improves with fullness. If parasites are eroding tissues, they seek food and move upward; lacking food to satiate them, they crawl around and gnaw at the mucosa of the stomach region, presenting as heart pain, though it is not true heart pain. Without eliminating the parasites, merely stopping the pain will not work. Use Huachong Dingtong Dan (Parrot-Expelling Pain-Calming Decoction):
Shengdi Radix Rehmanniae Preparata (2 liang), decocted in water to yield two bowls of juice. Add Baiwei Radix Cynanchi Atrati (2 qian), decoct again to yield one bowl of juice. Mix with rice porridge. One will either vomit creatures resembling toads or excrete worms resembling geckos.
Generally, damp-heat in the stomach predisposes individuals to parasitic infestation. Those whose dietary intake exceeds normal levels are prone to such issues. This formula is effective for these cases, not just for parasitic heart pain. Shengdi eliminates parasites in the tangible realm, while Baiwei eliminates them in the intangible realm. Used together, their efficacy in dissolving parasites is miraculous. Once the parasites die, the heart pain naturally ceases; this is not because Shengdi and Baiwei directly stop pain, but because they eliminate the cause.
For this condition, Lian Shu Gen Zhou (Melia Root Porridge) is also effective.
Lian Shu Gen Cortex Meliae Toosendan (1 liang), decocted in water to yield two bowls of soup. Add Gancao Radix Glycyrrhizae (1 qian), and cook into one bowl of porridge. Consume in one sitting; pain stops immediately.
Some experience sudden heart pain that appears and disappears rapidly, occurring more than ten times a day. Their diet is unaffected, yet they suffer restlessness day and night. People suspect parasitic pain, but this is incorrect. Parasitic pain does not develop overnight; how could there be unprovoked, sudden heart pain? Some suggest it is Fire Pathogen. Fire-induced pain is constant, not intermittent. So why the pain? It is neither Fire nor parasites. It is Qi deficiency combined with slight invasion of Cold-Damp pathogens. When the pathogen assaults the Pericardium, pain occurs; when it does not, there is no pain. This is what ancients called "Qu Lai Tong" (Intermittent Pain). Generally, tonification is contraindicated for pain, but for this specific intermittent type, tonification is essential. Without tonifying deficiency, pain cannot cease. However, using tonics alone without adding herbs to dispel Cold and resolve Phlegm will not stop the pain. Use Qulai Tang (Intermittent Pain Decoction):
Renshen Radix Ginseng (3 qian), Fuling Poria (3 qian), Cangzhu Rhizoma Atractylodis Lanceae (3 qian), Baizhu Rhizoma Atractylodis Macrocephalae (5 qian), Gancao Radix Glycyrrhizae (2 qian), Chuanwu Radix Aconiti Kusnezoffii (2 qian), Banxia Rhizoma Pinelliae Preparatum (1 qian). Decoct in water and take orally. Pain stops after one dose and does not recur after a second dose.
The use of Er Zhu (Cangzhu and Baizhu) as sovereign herbs is highly significant. Although pain stems from Qi deficiency, it is ultimately caused by Dampness invading the Pericardium. Er Zhu dispels Dampness and strengthens Spleen and Stomach Qi. Thus, they assist Renshen and Fuling in tonifying Qi to promote Dampness resolution. As Dampness clears, Qi becomes robust. With robust Qi, Chuanwu can penetrate directly into the Pericardium to expel Cold pathogens; Banxia circulates through the Middle Jiao to dissipate turbid Phlegm; Gancao, being mild and harmonizing, mediates between the pathogenic and righteous factors, achieving rapid results.
For this condition, Cangwu Shenling San (Cangzhu, Aconite, Ginseng, and Poria Powder) is also very effective.
Renshen Radix Ginseng, Caowu Radix Aconiti Preparata (each 1 qian), Fuling Poria, Cangzhu Rhizoma Atractylodis Lanceae (each 3 qian), Bajitian Radix Morindae Officinalis (1 liang). Decoct in water and take orally. Pain stops after one dose.
Some suffer extreme heart pain, so agonizing they wish for death, wailing all night with tears flowing profusely. People attribute this to Fire Pathogen wreaking havoc. But why does Fire invade the Heart? It is due to Liver Qi stagnation and frustration, causing Wood to generate Fire which then attacks the Heart. Wood normally generates Fire, so why does it counteract the Heart? The Heart belongs to Fire, but Fire must not reach its extreme; excessive Fire burns the Heart itself, sometimes leading to death by self-combustion. Therefore, if Heart Fire is too vigorous, it becomes abhorrent to the Heart. Assisted by Liver Wood, the Heart cannot bear it, crying out for help, resulting in tears and snot. Moreover, Liver Fire is stagnant fire. While regular Fire flows smoothly, stagnant Fire rebels, which the Heart dislikes. Thus, entering the Heart, it is rejected. Yet, the Fire is too strong to suppress and insists on entering the Heart Palace. The Pericardium provides layered protection, making it hard to burn. However, Liver stagnant fire is fire within Wood, akin to Dragon-Thunder Fire. It often rushes upward from below. Its power resembles thunderbolts, shaking the heavens. Wherever the light reaches, forests burn, and heaven and earth tremble. How can it be restrained? This is why Liver Fire rushing to the Heart causes direct harm. Treatment must drain Liver Wood Fire and resolve Wood Qi stagnation, supplemented slightly by Heart-calming agents, to stop the pain. Use Jiutong Anxin Tang (Pain-Saving Heart-Calming Decoction):
Baishao Radix Paeoniae Alba (1 liang), Chao Zhizi Fructus Gardeniae Praeparatus (3 qian), Gancao Radix Glycyrrhizae (1 qian), Chaihu Radix Bupleuri (2 qian), Guanzhong Herba Dryopteridis Crassirhizomatis (2 qian), Ruxiang Resina Olibani (1 qian), Moyao Resina Myrrhae (1 qian), Cangzhu Rhizoma Atractylodis Lanceae. Decoct in water and take orally. Pain stabilizes after one dose and resolves completely after two doses.
Baishao and Chaihu best resolve Liver Qi stagnation; Zhizi and Guanzhong best purge violent Liver Fire; Ruxiang and Moyao best stop visceral pain; Gancao and Cangzhu harmonize the middle and dissipate Dampness. With proper assistance, efficacy is achieved in one dose.
For this condition, Zhixiang Yin (Gardenia and Costus Drink) is also excellent.
Chao Zhizi Fructus Gardeniae Praeparatus, Jingjie Herba Schizonepetae (each 3 qian), Fuling Poria (5 qian), Gancao Radix Glycyrrhizae, Ruxiang powder, Zhusha powder, Muxiang Radix Aucklandiae (each 1 qian). Decoct in water and administer with the powder. Pain stops after one dose.
True Zhenxin Tong (True Heart Pain) is generally considered incurable, but with appropriate medication, survival is possible. The symptom involves pain precisely in the epigastric pit, not in the stomach region or hypochondrium. It feels like insects biting inside or snakes drilling within. Not only eating is impossible, but even drinking water is intolerable. Hands and feet are cold, and the face shows alternating blue and red hues. True Heart Pain has two types: one caused by Cold Pathogen invading the Heart, and the other by Fire Pathogen. Cold invading the Heart is a direct attack on the Yin meridians. It strikes suddenly, causing immediate death upon infection. Post-mortem, hands and feet turn entirely purple-black, or the whole body turns green. Medication and food usually cannot save such cases due to the urgency. If medicine is available, use 1-2 liang of Renshen Radix Ginseng and 3 qian of Fuzi Radix Aconiti Lateralis Preparata, decoct urgently, and there is hope for life; otherwise, death is certain. If Fire invades the Heart, the progression is urgent but slower, allowing time to seek medicine. Thus, methods must be transmitted to save lives. The previous case described was Fire Pathogen invading the Heart. How to distinguish Cold from Heat in heart pain? Cold presents with a slippery tongue coating, while Heat presents with a dry tongue coating. If identified as Fire-Heat Heart Pain, use Jiuzhen Tang (Save True Decoction):
Chao Zhizi Fructus Gardeniae Praeparatus (3 qian), Zhi Gancao Radix Glycyrrhizae Honey-Fried (1 qian), Baishao Radix Paeoniae Alba (1 liang), Guangmuxiang Radix Aucklandiae Powder (2 qian), Shichangpu Rhizoma Acori Tatarinowii (1 qian). Decoct in water and take orally. Pain stops after one dose; a second dose is unnecessary. After pain cessation, one must fast for one day to prevent recurrence.
One might ask: Since it is True Heart Pain, why not use Huanglian Rhizoma Coptidis to directly clear Heart Fire, instead of treating the Liver? The Liver is the Mother of the Heart. Draining Liver Wood Qi prevents it from assisting Fire, thereby calming Heart Qi. Draining Liver Wood is effectively draining Heart Fire. Directly draining Heart Fire injures the Heart. Although temporary relief may occur, the Spleen and Stomach lose reliance on Heart Fire for warmth, leading to suppression of vital energy, Middle Jiao deficiency-cold, and subsequent complications. This is why Huanglian is avoided and Zhizi is used instead.
Some suffer from heart pain unresponsive to hundreds of medicines. Pain occurs with both cold exposure and heat application. This is likely not heart pain, but stomach pain. Both Cold and Heat can cause pain. Cold and Heat do not coexist peacefully; they simultaneously assault the area between the Heart and Stomach. Cold tries to dominate Heat, but Heat refuses to yield; Heat tries to bully Cold, but Cold refuses to submit. They war against each other with equal strength. Treating the Heart injures Stomach Qi; treating the Stomach injures Heart Qi. Hence, treating Cold or Heat alone yields no effect. The method should address both to resolve the conflict, healing the pain spontaneously. Use Shuangzhi Tang (Double-Treatment Decoction):
Fuzi Radix Aconiti Lateralis Preparata (1 qian), Huanglian Rhizoma Coptidis (1 qian), Baishao Radix Paeoniae Alba (5 qian), Gancao Radix Glycyrrhizae (1 qian). Decoct in water and take orally. Pain heals immediately after one dose.
Huanglian clears Heart Fire; Fuzi dispels Stomach Cold. Baishao and Gancao act as sovereigns to foster reconciliation between the two organs. Shaoyao and Gancao enter the Liver to pacify Wood. Once Liver Qi is pacified, it stops attacking the Stomach and instead nourishes the Heart, harmonizing the Heart-Stomach relationship. This rationale is sound, not arbitrary.
For this condition, Cangwu Nu Xin Dan (Cangzhu, Aconite, and Warming Heart Pill) is also usable.
Baizhu Rhizoma Atractylodis Macrocephalae (1 liang), Baishao Radix Paeoniae Alba (2 qian), Fuling Poria (5 qian), Cangzhu Rhizoma Atractylodis Lanceae (3 qian), Chuanwu Radix Aconiti Kusnezoffii (1 qian), Rougui Cortex Cinnamomi, Gancao Radix Glycyrrhizae (each 5 fen). Decoct in water and take orally. Pain stops upon swallowing.
Some suffer unbearable heart pain, with faint breathing. Ginger soup brings slight relief, and pressure on the abdomen makes it tolerable. Symptoms are lighter during the day and heavier at night. During pain episodes, they feel like dying. People assume it is Cold Pain. Hot herbs provide brief relief, but pain returns shortly after. Why? Cold pathogens vary. The Heart remains tranquil due to Kidney Qi connecting to it. If Kidney Qi fails to connect, Cold Pathogen invades, causing Heart unrest and pain. Merely dispelling Cold without tonifying the Kidney leaves Kidney deficiency. Then Mingmen Fire cannot warm the Kidneys, and Kidney Water cannot ascend to nourish the Heart. Therefore, treating the Heart requires treating the Kidney. Tonifying Kidney Fire saves the Heart, just as tonifying Kidney Water saves the Kidney. Use Bushui Jiuhuo Tang (Water-Nourishing Fire-Saving Decoction):
Shudi Radix Rehmanniae Preparata (1 liang), Shanzhuyu Fructus Corni Officinalis (3 qian), Bajitian Radix Morindae Officinalis (5 qian), Shanyao Rhizoma Dioscoreae Oppositae (3 qian), Baizhu Rhizoma Atractylodis Macrocephalae (5 qian), Rougui Cortex Cinnamomi (1 qian), Bei Wuweizi Fructus Schisandrae Chinensis (5 fen). Decoct in water and take orally. Pain stops after one dose, resolves completely after two doses, and does not recur after ten doses.
This prescription does not appear to treat heart pain, but applied to Heart-Kidney non-interaction heart pain, it yields miraculous results. When Kidney Water and Fire fail to interact, Kidney pathogens directly invade the Heart. By tonifying Kidney Water and Fire, Water is generated by True Fire, and Fire is nourished by True Water. With Kidney Yin and Yang harmonized, how can Heart and Kidney Yin and Yang remain incompatible like ice and charcoal? Thus, there is no need to forcibly guide upper and lower interaction; Kidney Qi naturally connects to the Heart, and Heart Qi descends to the Kidney, like a harmonious union. Pathogens cannot interfere, especially since no original Cold Pathogen exists.
For this condition, Jiaoji Tang (Mutual-Balance Decoction) is also good.
Baizhu Rhizoma Atractylodis Macrocephalae, Cangzhu Rhizoma Atractylodis Lanceae (each 5 qian), Rougui Cortex Cinnamomi, Pogostemonis Herba (Guozhi), Cuscutae Semen (Tusizi) (each 3 qian), Guangmuxiang Radix Aucklandiae, Gancao Radix Glycyrrhizae (each 1 qian), Shudi Radix Rehmanniae Preparata (1 liang). Decoct in water and take orally.