心属少阴君火，为脏腑之主，精神之舍，邪不能干。干之则伤心而神去，必面目俱黑，
手足青至节，为真心痛，旦发夕死。今之心痛乃胃气当心作痛，治之痛止。若食后痛，治法
须分新久。初起时明知受寒伤冷物，可用温散，如草豆蔻、枳壳、枳实、山栀等，丹溪用麻
桂。若脉坚实用温利药，如备急丸，丹溪用陈气汤。稍久则成郁热，若更用温散，宁无助火
为痛乎，古方多用山栀为主，佐以姜汁。痛无补法，勿用人参、白术。此症不过痰火与食积
耳，若大吐大泻尤妙。痛攻腰背，发厥呕吐，诸药不纳者蛔虫，用鹅翎探出痰碗许而痛止。总
宜消其痰、降其火。新者温散之。
降火消痰本方
枳实 枳壳 山栀 黄连 川芎 陈皮 白桔梗 花粉 香附 姜制半夏
新者去黄连，加麻黄、浓朴，痛甚加元明粉、石膏；火加青黛，痰甚加海石、胆星。喜食
热物，必有死血停胃口，宜桃仁承气汤下之。一方∶
元胡索（一两） 浓朴（五钱） 滑石（五钱） 红花（五钱） 归梢（五钱） 红曲（五钱） 桃仁
（三十粒）
研如泥蒸饼丸，湿流胃脘作痛，宜小胃丹。有虫攻心作痛，论见虫门。寒邪客心胞络作痛，又有痞癖上攻
心作痛，为抱心顺气理中汤。
乌药 香附 苍术 甘草 干姜
或用枳壳、青皮、木香、蓬术、半夏，或枳实亦可，丹溪用草豆蔻。寒热俱宜，治九种心痛∶石菖蒲、赤芍、木通、
五灵脂。
心在五行中属于少阴君火，是脏腑的主宰，也是精神居住的处所，外邪通常不能侵犯。如果邪气侵犯了心脏，就会损伤心神导致神志离散，必然出现面目发黑、手足青紫直至关节的症状，这称为“真心痛”，早晨发作傍晚就会死亡。现在所说的“心痛”，实际上是胃气在心窝部位作痛，经过治疗疼痛可以停止。如果是进食后疼痛，治疗方法必须根据病程的新旧来区分。
初起时，如果明确知道是因为受寒或吃了生冷食物引起的，可以使用温散法，如草豆蔻、枳壳、枳实、山栀等药材，丹溪（朱震亨）使用麻黄汤和桂枝汤。如果脉象坚实有力，则使用温通泻下的药物，如备急丸，丹溪使用陈气汤。如果病程稍久，则会形成郁热，此时如果再使用温散法，岂不是助长火势而加剧疼痛吗？古方多使用山栀作为主药，辅以姜汁。治疗这种疼痛没有补益的方法，不要使用人参、白术。此症不过是痰火与食积罢了，如果能引起大吐大泻，效果尤其好。
如果疼痛放射到腰背部，伴有四肢厥冷、呕吐，且各种药物都无法服下的情况，这是蛔虫所致，可以用鹅毛管探出约一碗的痰涎，疼痛即可停止。总的来说，适宜消除痰浊、降泄火热。新发的病症用温散法。
降火消痰本方：
枳实、枳壳、山栀、黄连、川芎、陈皮、白桔梗、花粉、香附、姜制半夏。
新发病症去掉黄连，加入麻黄、浓朴；疼痛剧烈的加入元明粉、石膏；火热重的加入青黛；痰浊重的加入海浮石、胆南星。如果喜欢食用热物，说明胃口必有死血（瘀血）停滞，适宜用桃仁承气汤攻下。
另一方：
延胡索（一两）、浓朴（五钱）、滑石（五钱）、红花（五钱）、归梢（五钱）、红曲（五钱）、桃仁（三十粒）。
研成泥状，用蒸饼做丸剂。湿气流注于胃脘引起疼痛的，适宜用小胃丹。有虫邪攻心引起疼痛的，论述见虫门章节。寒邪客居于心包络引起疼痛的，又有痞块癖积上攻心脏引起疼痛的，称为抱心顺气理中汤。
乌药、香附、苍术、甘草、干姜。
或者使用枳壳、青皮、木香、蓬术、半夏，枳实也可以，丹溪使用草豆蔻。寒证热证都适宜，用于治疗九种心痛：石菖蒲、赤芍、木通、五灵脂。
The Heart belongs to the Shaoyin (Lesser Yin) Ministerial Fire, serves as the master of the Zang-Fu organs, and is the residence of the Spirit (Shen); thus, pathogenic factors generally cannot invade it. If invaded, the Heart is damaged and the Spirit departs, inevitably resulting in blackening of the face and eyes, and cyanosis of the hands and feet extending to the joints. This is termed "Zhen Xin Tong" (True Heartache), where morning onset leads to death by evening. The "Xin Tong" (Heartache) described today is actually pain arising from Stomach Qi at the epigastrium; upon treatment, the pain ceases. If pain occurs after eating, the treatment method must be differentiated based on whether the condition is new or chronic.
In the initial stage, if it is known to be caused by cold exposure or consumption of cold/raw foods, warming and dispersing methods may be used, such as Caodoukou (Grains of Paradise Seed), Zhike (Aurantii Fructus), Zhishi (Aurantii Fructus Immaturus), and Shanzhi (Gardeniae Fructus). Danxi (Zhu Zhenheng) utilized Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction). If the pulse is firm and solid, warming and purgative medicines should be used, such as Beiji Wan (Emergency Pill), while Danxi used Chenqi Tang (Chenqi Decoction). If the condition persists for a while, it transforms into stagnant heat; using warming and dispersing methods at this stage would only assist the fire and exacerbate the pain. Ancient formulas often use Shanzhi as the principal herb, assisted by Jiangzhi (Ginger Juice). There is no tonifying method for this type of pain; Ren Shen (Ginseng Root) and Baizhu (Atractylodes Rhizome) should not be used. This syndrome is merely due to Phlegm-Fire and Food Retention. Inducing severe vomiting and diarrhea is particularly beneficial.
If the pain radiates to the lower back, accompanied by cold extremities (Jue), vomiting, and inability to retain any medication, this indicates Ascaris (Roundworm). Using a goose feather to probe and extract approximately one bowl of phlegm will stop the pain. Generally, it is appropriate to resolve phlegm and descend fire. For new conditions, use warming and dispersing methods.
Formula for Descending Fire and Resolving Phlegm:
Zhishi (Aurantii Fructus Immaturus), Zhike (Aurantii Fructus), Shanzhi (Gardeniae Fructus), Huanglian (Coptidis Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Bai Jiegeng (Platycodonis Radix), Huafen (Trichosanthis Radix), Xiangfu (Cyperi Rhizoma), Jiang Zhi Banxia (Pinelliae Tuber Prepared with Ginger).
For new conditions, remove Huanglian and add Mahuang (Ephedrae Herba) and Houpo (Magnoliae Officinalis Cortex); for severe pain, add Yuanmingfen (Natrii Sulfas) and Shigao (Gypsum Fibrosum); for excessive fire, add Qingdai (Indigo Naturalis); for severe phlegm, add Haishi (Spongilia) and Danning (Arisaematis Cum Bile). If there is a preference for hot foods, it indicates that dead blood (Blood Stasis) is stagnating in the stomach area; Taoren Chengqi Tang (Peach Kernel and Rhubarb Decoction) should be used to purge it.
Another Formula:
Yanhusuo (Corydalis Rhizoma) (1 liang), Houpo (Magnoliae Officinalis Cortex) (5 qian), Huashi (Talcum) (5 qian), Honghua (Carthami Flos) (5 qian), Gui Shao (Radix Angelicae Sinensis Caudex) (5 qian), Hongqu (Red Yeast Rice) (5 qian), Taoren (Persicae Semen) (30 grains).
Grind into a paste and form pills with steamed wheat dumpling dough. For pain caused by dampness flowing into the epigastrium, Xiaowei Dan (Minor Stomach Pill) is appropriate. For pain caused by worms attacking the heart, see the section on Worms. For pain caused by Cold Evil lodging in the Pericardium Collateral, or pain caused by Pi Xi (Masses and Accumulations) attacking the heart, this is called Baoxin Shunqi Lizhong Tang (Embracing Heart, Regulating Qi, and Warming the Middle Decoction).
Wuyao (Linderae Radix), Xiangfu (Cyperi Rhizoma), Cangzhu (Atractylodis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma).
Alternatively, use Zhike (Aurantii Fructus), Qingpi (Citri Reticulatae Pericarpium Viride), Muxiang (Aucklandiae Radix), Pengzhu (Curcumae Longae Rhizoma), Banxia (Pinelliae Tuber); Zhishi (Aurantii Fructus Immaturus) is also acceptable. Danxi used Caodoukou (Grains of Paradise Seed). This combination is suitable for both Cold and Heat syndromes and treats the Nine Types of Heartache: Shichangpu (Acori Tatarinowii Rhizoma), Chishao (Paeoniae Radix Rubra), Mutong (Akebiae Caulis), Wulingzhi (Trogopterori Faeces).