寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

The Chest

Hyung

한글 흉  ·  Pinyin Xiong

The ominous place — why a heart pain is almost never the heart, nine kinds and six, the hand laid on the belly to tell vacuity from repletion, and the difference between a fullness and a bind

胸

The graph 胸 carries 凶, ominous, and the Immun says that is the point: breath and food both pass here, and when either goes wrong the evil qi gathers in the chest. The chapter's first real work is to take the heart out of heart pain. The true heart pain kills the same day and cannot be treated; everything else called heart pain is the stomach duct, which lies just behind the breastbone and which the classics themselves placed 當心, right at the heart. From there the chapter sorts: nine kinds by cause, six more by which viscus is behind them, and then the tests that actually decide treatment. Does heat ease it or make it worse. Does pressing lightly hurt and pressing hard relieve, or the reverse. Does it stop when the patient eats, or start. Danxi's warning runs under all of it — a cold pain that has lasted turns to depression, depression to steaming heat, and heat to fire, so that warming an old pain feeds it; and the chapter's own rule that in pain of any kind the qi is not to be supplemented, because a qi made stronger without being freed only hurts more. The second half separates two things that look alike: 痞, a fullness that does not hurt, and 結胸, a bind that hurts and cannot be touched. It ends with the plainest advice in the book — a man may go days without eating and come to no harm, but let him eat the moment the pain stops and it returns.

1.1 The Names Chest and Diaphragm Have Their Sense 胸膈之名有義

1.1.1
Source원문

夫人之胸者, 呼吸之所經, 飮食之所過. 一或失節, 則疾病邪氣交至於胸中, 乃有凶之兆, 故謂之胸也. 《入式》

Translation영역
A person's chest is where the breath passes and where food and drink go by. Let either once lose its measure and disease and evil qi come together into the chest — which is an ominous sign, and so it is called 胸.
Clinical note임상 주석
The graph 胸 is read as carrying 凶, ominous. It is a folk etymology, but it states the chapter's premise: this is the one place where the two indispensable traffics of the body cross.

Ipsik 入式

1.1.2
Source원문

膈膜在心肺之下, 與背脊胸腹周回相着, 如幕不漏. 盖膈者隔也, 遮隔濁氣, 不使上熏於心肺, 故謂之膈也. 《入門》

Translation영역
The diaphragm membrane lies below the heart and lung, attached all round to the spine, chest and abdomen like a curtain with no gap. 膈 means to partition: it screens off the turbid qi and does not let it steam up into the heart and lung, and so it is called 膈.

Immun 入門

1.2 The Measurements of the Chest 胸膈度數

1.2.1
Source원문

胸圍四尺五寸. 缺盆以下至𩩲骬長九寸. 《靈樞》 咽以下膈以上通謂之胸. 《入門》

Translation영역
The chest is four cheok five chon round. From the supraclavicular fossa down to the xiphoid is nine chon. From below the gullet to above the diaphragm is called the chest.

Yeongchu 靈樞 · Immun 入門

1.3 The Parts of the Chest 胸膈部位

1.3.1
Source원문

膈者心肺之分野也. 《綱目》 胸腹者藏府之郭也; 膻中者心主之宮城也. 《靈樞》

Translation영역
The diaphragm is the boundary of the heart and lung. The chest and abdomen are the outer wall of the viscera and bowels; Danjung is the palace city of the heart governor.

Gangmok 綱目 · Yeongchu 靈樞

1.3.2
Source원문

咽之下胃脘也, 貫膈與肺系相幷, 在肺系之後, 其上卽咽門也. 胃脘之下卽胃之上口也, 謂之賁門, 其膈膜相貼之間亦漫脂相包也. 《入門》

Translation영역
Below the gullet is the stomach duct, which threads the diaphragm and runs beside the lung's connection, lying behind it, with the gullet's gate above it. Below the stomach duct is the stomach's upper mouth, called the cardia; and where it lies against the diaphragm membrane it is wrapped about with spreading fat.
Clinical note임상 주석
賁門 — the cardia, which this passage places correctly: the oesophagus threading the diaphragm just behind the heart and opening into the stomach. It is the anatomical basis for 1.6's whole argument.

Immun 入門

1.3.3
Source원문

胃脘一作管貫膈與心肺相通, 膈膜相綴也. 《入門》

Translation영역
The stomach duct — also written 管 — threads the diaphragm and communicates with the heart and lung, the diaphragmatic membrane being stitched to it.
Clinical note임상 주석
This passage had been dropped. The transcription sets it as the fourth ○-item of the section, between the cardia passage above and the pericardium passage below, and it carries its own 《入門》 mark — the section's three 入門 marks were standing at two. Its interlinear ≪一作管≫ is the book noting that 脘 is written 管 elsewhere, and is set as a 細註 here.

Immun 入門

1.3.4
Source원문

心包絡在心下橫膈膜之上, 竪斜膈膜之下, 與橫膜相粘. 黃脂漫包者心也; 漫脂之外細筋膜如絲, 與心肺相連, 此包絡也. 《入門》

Translation영역
The pericardiac network lies below the heart above the transverse diaphragm membrane and beneath the slanting membrane, sticking to the transverse one. What the yellow fat wraps about is the heart; outside that fat is a fine sinewy membrane like silk, joined to the heart and lung, and this is the pericardiac network.

Immun 入門

1.4 The Channels of the Viscera and Bowels All Thread the Diaphragm 藏府經脉皆貫膈

1.4.1
Source원문

手太陰之脉上膈屬肺. 手陽明之脉下膈屬大腸. 足陽明之脉下膈屬胃絡脾. 足太陰之脉上膈挾咽, 其支者別上膈注心中. 手少陰之脉下膈絡小腸. 手太陽之脉下膈屬小腸. 足少陰之脉上貫肝膈. 手厥陰之脉下膈歷絡三焦. 手少陽之脉下膈偏屬三焦. 足少陽之脉貫膈絡肝屬膽. 足厥陰之脉上貫膈布脇肋. 已上十一經皆貫膈, 惟足太陽循下于背, 故不貫膈. 《銅人》

Translation영역
The hand greater yin's channel rises through the diaphragm and belongs to the lung. The hand yang brightness's descends through it and belongs to the large intestine. The foot yang brightness's descends through it, belongs to the stomach and networks with the spleen. The foot greater yin's rises through it beside the gullet, and its branch separately rises through it and pours into the heart. The hand lesser yin's descends through it and networks with the small intestine. The hand greater yang's descends through it and belongs to the small intestine. The foot lesser yin's rises and threads the liver and diaphragm. The hand reverting yin's descends through it and networks all the three burners. The hand lesser yang's descends through it and belongs throughout to the three burners. The foot lesser yang's threads it, networks with the liver and belongs to the gallbladder. The foot reverting yin's rises and threads it, spreading in the flanks and ribs. These eleven channels all thread the diaphragm; only the foot greater yang runs down the back, and so does not.
Clinical note임상 주석
Eleven of the twelve channels pass through the diaphragm and only the bladder channel does not. It is the chapter's argument for why a disorder anywhere can present here.

Dongin 銅人

1.5 The Pulse 脉法

1.5.1
Source원문

脉陽微陰弦, 則胸痺而痛. 陽微故知在上焦, 陰弦故知胸痺心痛. 《仲景》 胸痺痛, 寸口脉沈而遲, 關上小緊而數. 《仲景》

Translation영역
Where the pulse is faint in the yang and wiry in the yin, there is chest impediment with pain. It is faint in the yang, and so one knows it is in the upper burner; it is wiry in the yin, and so one knows it is chest impediment with heart pain. In chest impediment with pain, the pulse at the inch opening is sunken and slow, and at the bar slightly tight and rapid.
Clinical note임상 주석
陽微陰弦 — faint at the distal position, wiry at the proximal. Zhongjing reads the combination topographically: the faintness places the disease above and the wiriness names it as impediment rather than as a stomach pain.

Junggyeong 仲景

1.5.2
Source원문

心腹痛宜見沈細, 不宜見浮大. 《得效》 心腹痛, 脉宜沈細, 忌浮大弦長. 《醫鑑》 心腹痛脉沈細宜, 浮大弦長命必殂. 《脉訣》

Translation영역
In pain of the heart and abdomen the pulse should be seen sunken and fine, and should not be seen floating and large. In pain of the heart and abdomen the pulse should be sunken and fine; floating, large, wiry or long is to be avoided. In pain of the heart and abdomen a sunken fine pulse is right; floating, large, wiry and long, and the life is certainly lost.
Clinical note임상 주석
The same rule from three sources in three strengths — should be, is to be avoided, and the life is lost — which is how the Bogam builds emphasis. A sunken fine pulse in severe chest pain means the pain is holding the pulse down; a full bounding one means something else is driving it.

Deukhyo 得效 · Uigam 醫鑑 · Maekgyeol 脉訣

1.5.3
Source원문

沈弦細動皆是痛證: 心痛在寸, 腹痛在關, 下部在尺, 脉象顯然. 《脉訣》

Translation영역
Sunken, wiry, fine and stirring are all pulses of pain: heart pain at the inch, abdominal pain at the bar, and the lower part at the cubit — the pulse image is plain.

Maekgyeol 脉訣

1.5.4
Source원문

胸痞脉滑爲有痰結, 弦伏亦痞, 澁則氣劣. 《脉訣》

Translation영역
In glomus of the chest a slippery pulse means phlegm has bound; wiry and hidden is also glomus; and rough means the qi is failing.

Maekgyeol 脉訣

1.5.5
Source원문

心痛, 左手脉數熱多也, 脉澁有死血也; 右手脉緊實是痰積也, 脉大必是久病也. 兩手脉堅實不大便, 可下之. 痛甚者脉必伏. 《丹心》

Translation영역
In heart pain, a rapid pulse in the left hand means much heat and a rough one means dead blood; a tight replete pulse in the right hand is a phlegm accumulation, and a large one is certainly a long illness. Where the pulses of both hands are hard and replete and the stool will not pass, it may be precipitated. Where the pain is severe the pulse is certain to go hidden.
Clinical note임상 주석
痛甚者脉必伏 — where the pain is severe the pulse goes hidden. 1.12 turns this into a rule against supplementing: a pulse driven under by pain looks like a vacuity pulse and is not.

Dansim 丹心

1.5.6
Source원문

痞病右關脉多弦, 弦而遲者必心下堅. 《正傳》

Translation영역
In glomus disease the pulse at the right bar is mostly wiry, and where it is wiry and slow there is certainly hardness below the heart.

Jeongjeon 正傳

1.5.7
Source원문

心脉微急爲痛, 微大爲心痺引背痛, 短而數或濇者心痛. 《正傳》

Translation영역
A heart pulse slightly urgent means pain; slightly large means heart impediment with pain drawing into the back; short and rapid, or rough, is heart pain.

Jeongjeon 正傳

1.6 Heart Pain and Stomach-Duct Pain Have Different Causes 心痛與胃脘痛病因不同

1.6.1
Source원문

心之包絡與胃口相應, 往往脾痛連心. 或陽虛陰厥, 亦令心下急痛. 《直指》

Translation영역
The heart's enveloping network answers to the mouth of the stomach, so that again and again a spleen pain reaches the heart. Or where the yang is vacuous and the yin reverting, that too makes an urgent pain below the heart.
Clinical note임상 주석
The section's opening proposition, and the reason it exists: pain felt at the heart usually is not the heart. The pericardial network and the cardia answer to each other, so the two cannot be told apart by where they hurt — which is the problem the four passages that follow set out to solve.

Jikji 直指

1.6.2
Source원문

眞心痛卽死不治. 其久心痛者, 是心之支別絡爲風邪冷熱所乘, 痛故成疹, 不死, 發作有時, 經久不得差也. 《得效》

Translation영역
True heart pain kills at once and is not treated. A long-standing heart pain is a branch network of the heart overcome by wind evil, cold or heat, and the pain makes a complaint of it; it does not kill, it breaks out at its own times, and it goes long without mending.

Deukhyo 得效

1.6.3
Source원문

胃之上口名曰賁門. 賁門與心相連, 故經所謂胃脘當心而痛. 今俗呼爲心痛者誤也. 夫九種心痛, 詳其所由, 皆在胃脘而實不在於心也. 《正傳》

Translation영역
The stomach's upper mouth is named the cardia, and the cardia is joined to the heart; hence the classic's phrase, the stomach duct painful right at the heart. What people now call heart pain is a mistake: examine the cause of the nine kinds of heart pain and they are all in the stomach duct and truly not in the heart.
Clinical note임상 주석
今俗呼爲心痛者誤也 — what people call heart pain is a mistake. The chapter says so plainly, and the reasoning is anatomical: the cardia sits just behind the heart, so a pain there is felt where the heart is. Everything after this section is about the stomach.

Jeongjeon 正傳

1.6.4
Source원문

胃脘當心而痛, 脾藏連心而痛, 局方皆云心痛. 盖心痛少而脾胃痛居多. 心痛因傷思慮, 脾胃痛因傷飮食或痰飮故也. 《入門》

Translation영역
The stomach duct painful right at the heart, and the spleen viscus painful and drawing at the heart — the Gukbang calls both heart pain. But heart pain is rare and spleen and stomach pain common: heart pain comes of damage by brooding, and spleen and stomach pain of damage by food and drink, or of phlegm rheum.

Immun 入門

1.6.5
Source원문

心病者, 胸中痛. 《內經》

Translation영역
In disease of the heart there is pain in the chest.

Naegyeong 內經

1.6.6
Source원문

諸經心痛引背, 多屬風冷; 諸府心痛難以俯仰, 嘔瀉, 多屬熱. 《入門》

Translation영역
Where a channel heart pain draws into the back it mostly belongs to wind cold; where a bowel heart pain makes it hard to bend forward or back, with vomiting and diarrhoea, it mostly belongs to heat.

Immun 入門

1.7 Heart Pain Has Nine Kinds 心痛有九種

1.7.1
Source원문

一曰蟲, 二曰疰, 三曰風, 四曰悸, 五曰食, 六曰飮, 七曰冷, 八曰熱, 九曰去來. 下通用手拈散ㆍ九痛元ㆍ通靈散ㆍ拈痛元ㆍ神聖代鍼散方見前陰.

Translation영역
The first is worm, the second corpse infixation, the third wind, the fourth palpitation, the fifth food, the sixth drink, the seventh cold, the eighth heat, the ninth coming and going. Below, for general use: Pinch of the Hand Powder, Nine Pains Pill, Penetrating Spirit Powder, Pinch the Pain Pill, and Divine Sage Needle-Substitute Powder formula in the Genitals chapter.

Donguibogam · Hyung

1.7.1 Worm Heart Pain 蟲心痛

1.7.1.1
Source원문

胃脘痛, 痛定便能食, 時作時止者, 是蟲痛也. 《丹心》 心痛吐水者蟲痛, 不吐水冷心痛. 《綱目》

Translation영역
Where the stomach duct pains and, the pain once settled, one can eat at once, and it comes and goes by turns, it is worm pain. Where heart pain brings up water it is worm pain; where it does not, it is cold heart pain.
Clinical note임상 주석
痛定便能食 — once the pain settles the patient can eat straight away. The chapter uses appetite between attacks as a sign throughout; here it marks a pain that leaves nothing behind it.

Dansim 丹心 · Gangmok 綱目

1.7.1.2
Source원문

蟲痛之證, 心腹痛上下攻刺, 嘔噦涎沫, 或吐淸水, 面色靑黃, 宜化蟲丸ㆍ化蟲散ㆍ妙應丸三方幷見蟲門. 蟲痛, 二陳湯方見痰飮加苦楝根煎服. 《醫鑑》 蟲痛小兒多有之, 當與蟲部參考治之.

Translation영역
In worm pain the heart and abdomen pain and stab upward and downward, with retching of frothy drool or vomiting of clear water and a green-yellow complexion: Transform Worms Pill, Transform Worms Powder and Wondrous Response Pill all three in the Worms chapter. For worm pain, Two Matured Ingredients Decoction formula in the Phlegm chapter with chinaberry root bark added and decocted. Worm pain is commonest in children, and the Worms chapter should be consulted in treating it.

Uigam 醫鑑 · Donguibogam · Hyung

1.7.2 Corpse Infixation Heart Pain 疰心痛

1.7.2.1
Source원문

卒感惡忤, 尸疰, 神昏卒倒, 口噤不省, 宜蘇合香元方見氣門ㆍ備急丸方見救急. 與中惡同治. 《入門》

Translation영역
Where one is suddenly struck by a malign qi, with corpse infixation, the spirit clouded, a sudden fall, the jaw clenched and no awareness: Storax Pill formula in the Qi chapter and Prepare for Urgency Pill formula in the Emergencies chapter. It is treated the same as malignity strike.

Immun 入門

1.7.3 Wind Heart Pain 風心痛

1.7.3.1
Source원문

因傷風冷, 或肝邪乘心, 兩脇引痛, 宜麻黃桂枝湯或分心氣飮方見氣門. 《入門》

Translation영역
Where wind cold has done damage, or a liver evil overcomes the heart and the pain draws at both flanks: Ephedra and Cinnamon Twig Decoction, or Divide the Heart Qi Drink formula in the Qi chapter.

Immun 入門

1.7.4 Palpitation Heart Pain 悸心痛

1.7.4.1
Source원문

因七情怔忡驚悸, 以致心痛, 宜四七湯方見氣門ㆍ加味四七湯方見神門ㆍ七氣湯ㆍ正氣天香湯方並見氣門. 《入門》

Translation영역
Where fearful throbbing and fright palpitation from the seven affects bring on heart pain, Four-Seven Decoction formula in the Qi chapter, Supplemented Four-Seven Decoction formula in the Spirit chapter, Seven Qi Decoction and Rectify the Qi Heavenly Fragrance Decoction both formulas in the Qi chapter are appropriate.
Clinical note임상 주석
因七情怔忡驚悸 — the palpitation of 神門 5.9 and 5.10 brought forward as a cause of chest pain. All four formulas are qi-moving rather than pain-relieving, which is the chapter's reading of this kind: the pain is secondary to the affect.

Immun 入門

1.7.4.2
Source원문

心傷者, 勞役則頭面赤而下重, 心中痛而自煩發熱, 臍上跳, 其脉弦, 宜辰砂妙香散方見神門. 《入門》

Translation영역
Where the heart is damaged, on exertion the head and face go red and there is heaviness below, with pain in the heart, spontaneous vexation and heat effusion, a throbbing above the navel, and a wiry pulse: Cinnabar Wondrous Fragrance Powder formula in the Spirit chapter is appropriate.
Clinical note임상 주석
臍上跳 — a throbbing felt above the navel, which with exertional flushing, chest pain and a wiry pulse is the one set of signs in the section that would now send a patient for cardiac assessment. **辰砂妙香散 is a cinnabar preparation and is not to be prepared.**

Immun 入門

1.7.5 Food Heart Pain 食心痛

1.7.5.1
Source원문

因食生冷, 或食物過多, 以致心痛, 宜香蘇散方見寒門ㆍ平胃散方見五藏ㆍ香砂養胃湯方見內傷. 《入門》

Translation영역
Where raw and cold things have been eaten, or too much food taken, and so heart pain follows: Cyperus and Perilla Powder formula in the Cold Damage chapter, Calm the Stomach Powder formula in the Five Viscera chapter and Costus and Amomum Nourish the Stomach Decoction formula in the Internal Damage chapter.

Immun 入門

1.7.6 Rheum Heart Pain 飮心痛

1.7.6.1
Source원문

傷水飮, 聚痰涎, 心痛如刺, 宜芎夏湯方見痰飮ㆍ五苓散方見寒門. 水飮流注胸脇痛, 三花神祐丸方見下門. 《入門》

Translation영역
Where water drunk has done damage and phlegm drool gathers and the heart pain is like a stabbing: Chuanxiong and Pinellia Decoction formula in the Phlegm chapter and Five Ingredients Poria Powder formula in the Cold Damage chapter. Where water rheum pours into the chest and flank with pain, Three Flowers Divine Protection Pill formula in the Purgation chapter.

Immun 入門

1.7.7 Cold Heart Pain 冷心痛

1.7.7.1
Source원문

寒氣客於背兪之脉則血脉澁, 血脉澁則血虛, 血虛則痛. 其兪注於心, 故相引而痛. 《內經》

Translation영역
Where cold qi lodges in the vessels of the back transport points the blood vessels are rough; rough, the blood is vacuous; vacuous, there is pain. Those transport points pour into the heart, and so they draw on each other and there is pain.

Naegyeong 內經

1.7.7.2
Source원문

形寒飮冷, 當風取凉, 或腎邪乘心, 痛則心懸若飢, 泄利下重, 宜五積散. 《入門》 寒冷心痛宜扶陽助胃湯ㆍ桂枝四七湯ㆍ鷄舌香散ㆍ神效散ㆍ卻痛散ㆍ草豆蔲丸ㆍ溫胃湯ㆍ抽刀散ㆍ二薑丸.

Translation영역
Where the body is chilled and cold things drunk, or one takes the cool in a draught, or a kidney evil overcomes the heart, the pain makes the heart feel suspended as though with hunger, with diarrhoea and heaviness below: Five Accumulations Powder. For cold heart pain: Support the Yang and Aid the Stomach Decoction, Cinnamon Twig Four Sevens Decoction, Clove Powder, Divinely Effective Powder, Half Pain Powder, Tsaoko Pill, Warm the Stomach Decoction, Drawn Knife Powder and Two Gingers Pill.
Clinical note임상 주석
心懸若飢 — the heart feels suspended, as though with hunger. The sinking, hollow sensation of an empty stomach, which the chapter distinguishes from pain proper.

Immun 入門 · Donguibogam · Hyung

1.7.8 Heat Heart Pain 熱心痛

1.7.8.1
Source원문

積熱攻心, 暑毒入心, 面目赤黃, 身熱煩躁, 掌中熱, 大便堅, 宜連附六一湯ㆍ金鈴子散ㆍ莎芎散ㆍ梔薑飮. 甚者大承氣湯方見寒門下之. 《入門》

Translation영역
Where accumulated heat attacks the heart, or summerheat toxin enters it, with the face and eyes red-yellow, the body hot and vexed and restless, the palms hot and the stool hard: Coptis and Aconite Six to One Decoction, Toosendan Powder, Cyperus and Chuanxiong Powder and Gardenia and Ginger Drink. In a severe case, Major Order the Qi Decoction formula in the Cold Damage chapter to purge it.

Immun 入門

1.7.8.2
Source원문

實熱心痛, 小柴胡湯方見寒門去人參ㆍ甘草, 加枳殼ㆍ梔子仁ㆍ赤芍藥 各一錢, 水煎服. 《醫鑑》

Translation영역
For repletion heat heart pain, Minor Bupleurum Decoction formula in the Cold Damage chapter with the ginseng and licorice removed and bitter orange, gardenia kernel and red peony 1 don each added, decocted in water and taken.

Uigam 醫鑑

1.7.9 Coming and Going Pain 去來痛

1.7.9.1
Source원문

心痛或作或止, 久而不愈也. 心包絡爲風邪冷熱所乘, 痛故成疹不死, 發作有時, 經久不得差. 神仙九氣湯方見氣門呑下九痛元方見上, 一服卽止. 《得效》

Translation영역
A heart pain that breaks out and stops by turns and goes long without healing. The pericardiac network is overcome by wind evil, cold or heat, and the pain makes a complaint of it but does not kill; it breaks out at its own times and goes long without mending. Divine Immortal Nine Qi Decoction formula in the Qi chapter used to swallow Nine Pains Pill formula above, and one dose stops it.

Deukhyo 得效

1.7.9.2
Source원문

心胃久痛, 宜用莎芎散方見上ㆍ妙應丸方見蟲門ㆍ丁香脾積元方見內傷.

Translation영역
For long-standing heart and stomach pain, Cyperus and Chuanxiong Powder formula above, Wondrous Response Pill formula in the Worms chapter and Clove Spleen Accumulation Pill formula in the Internal Damage chapter should be used.
Clinical note임상 주석
The last entry of the section and the one that names the chronic case. 久痛 — pain of long standing — is sent to three formulas of three different kinds: a qi-moving powder for the stagnation, a worm formula on the chance that the pain is parasitic, and an accumulation-breaking pill for retained food. The chapter does not choose between them, which is itself the point: a pain that has gone on for years was not thought to have one cause.

Donguibogam · Hyung

1.8 Heart Pain Also Has Six 心痛亦有六

1.8.1
Source원문

心痛亦有六: 一曰脾心痛, 二曰胃心痛, 三曰腎心痛, 四曰積心痛, 五曰厥心痛, 六曰眞心痛. 《類聚》

Translation영역
Heart pain also has six kinds: first spleen heart pain, second stomach heart pain, third kidney heart pain, fourth accumulation heart pain, fifth reversal heart pain, sixth true heart pain.
Clinical note임상 주석
亦 — also, as against the nine of 1.7, and the Bogam prints both lists without choosing. The nine are sorted by what causes the pain (worms, wind, food, rheum, cold, heat); these six by which viscus it is referred to, with 眞心痛 at the end as the one that kills.

Yuchwi 類聚

1.8.1 Spleen Heart Pain 脾心痛

1.8.1.1
Source원문

脾心痛者, 心下急痛也. 心痛甚而至於脇下如刀劙之痛者, 已連及於脾藏矣, 古方名爲脾痛者是也. 《正傳》 如以錐鍼刺其心, 心痛甚者, 脾心痛也. 《靈樞》

Translation영역
Spleen heart pain is an urgent pain below the heart. Where the heart pain is severe and reaches below the flank with a pain as though cut with a knife, it has already drawn in the spleen viscus, and this is what the old formularies named spleen pain. Where it is as though an awl or a needle were piercing the heart and the heart pain is severe, it is spleen heart pain.

Jeongjeon 正傳 · Yeongchu 靈樞

1.8.1.2
Source원문

宜用訶子散ㆍ手拈散方見上ㆍ復元通氣散方見氣門.

Translation영역
Chebula Powder, Pinch of the Hand Powder formula above and Restore the Origin and Free the Qi Powder formula in the Qi chapter are appropriate.

Donguibogam · Hyung

1.8.2 Stomach Heart Pain 胃心痛

1.8.2.1
Source원문

胃心痛者, 腹脹而心痛, 胃脘當心而痛. 內經曰, 木鬱之發, 民病胃脘當心而痛, 上支兩脇, 嗝咽不通. 又厥陰之勝, 胃脘當心而痛. 《綱目》

Translation영역
Stomach heart pain is the abdomen distended with heart pain, the stomach duct painful right at the heart. The Neijing says: when the wood's depression breaks out, the people suffer the stomach duct painful right at the heart, propping up both flanks, with hiccup and the throat not passing. It also says: where the reverting yin prevails, the stomach duct pains right at the heart.

Gangmok 綱目

1.8.2.2
Source원문

盖木氣被鬱, 發則太過, 故民病有土敗木賊之候也. 夫胃爲脾之府, 陽先於陰, 故藏未病而府先病也. 《正傳》

Translation영역
The wood qi having been depressed, when it breaks out it is excessive, and so the people's disease shows the sign of the earth defeated and the wood plundering. The stomach is the spleen's bowel, and yang comes before yin, so the viscus is not yet diseased while the bowel falls ill first.
Clinical note임상 주석
土敗木賊 — the earth defeated and the wood plundering it. The five-phase name for what the chapter elsewhere calls anger lodging in the stomach, and 1.9's case is the same mechanism in a single patient.

Jeongjeon 正傳

1.8.2.3
Source원문

宜用草豆蔲丸方見上ㆍ加味枳朮丸ㆍ淸熱解鬱湯ㆍ淸鬱散.

Translation영역
Tsaoko Pill formula above, Supplemented Bitter Orange and Atractylodes Pill, Clear Heat and Resolve Depression Decoction and Clear Depression Powder are appropriate.

Donguibogam · Hyung

1.8.3 Kidney Heart Pain 腎心痛

1.8.3.1
Source원문

心痛與背相控, 善瘈, 如從後觸其心, 傴僂者, 腎心痛也. 《靈樞》 下重而苦泄寒中, 名腎心痛. 《類聚》

Translation영역
Where the heart pain and the back draw on each other, with ready spasm, as though something touched the heart from behind, and the patient is bent over, it is kidney heart pain. Where there is heaviness below with distressing diarrhoea and cold in the centre, it is named kidney heart pain.
Clinical note임상 주석
如從後觸其心, 傴僂 — as though touched from behind, and the patient doubled over. A pain felt to come from the back that forces the patient to bend forward, which is how posterior abdominal pain actually presents.

Yeongchu 靈樞 · Yuchwi 類聚

1.8.3.2
Source원문

腎傳之心, 病筋脉相引, 心下急痛, 病名曰瘈. 《內經》 腎之積名曰奔豚, 自臍下上衝心痛最甚, 五苓散方見寒門去白朮倍肉桂服之. 《入門》

Translation영역
Where the kidney passes it on to the heart, the sinews and vessels draw on each other and there is urgent pain below the heart, and the disease is named spasm. The kidney's accumulation is named running piglet: it surges up from below the navel and the heart pain is at its worst — Five Ingredients Poria Powder formula in the Cold Damage chapter with the white atractylodes removed and the cinnamon doubled.

Naegyeong 內經 · Immun 入門

1.8.3.3
Source원문

宜用神保元ㆍ烏沈湯方幷見氣門ㆍ蟠葱散方見前陰ㆍ神聖復氣湯.

Translation영역
Divine Protection Pill and Lindera and Aloeswood Decoction both in the Qi chapter, Coiled Scallion Powder formula in the Genitals chapter and Divine Sage Restore the Qi Decoction are appropriate.

Donguibogam · Hyung

1.8.4 Accumulation Heart Pain 積心痛

1.8.4.1
Source원문

飮食積聚, 遇食還發, 名曰積心痛. 《類聚》

Translation영역
Where food and drink accumulate and gather, and it breaks out again whenever one eats, it is named accumulation heart pain.

Yuchwi 類聚

1.8.4.2
Source원문

凡人飮食後忽然暈倒, 口噤不言, 目不識人, 四肢不擧, 多因飮食過度, 氣道窒塞, 或着氣惱而然. 急用薑鹽湯多灌探吐之, 後服平胃散方見內傷ㆍ六君子湯方見痰飮.

Translation영역
Where a person after eating suddenly falls in a faint, the jaw clenched and speechless, the eyes not knowing anyone and the four limbs not lifting, it is mostly from eating and drinking beyond measure so that the qi passages are stopped and blocked, or from vexation of the qi besides. Quickly pour in plenty of ginger and salt water and probe to make them vomit; afterwards give Calm the Stomach Powder formula in the Internal Damage chapter and Six Gentlemen Decoction formula in the Phlegm chapter.
Clinical note임상 주석
A collapse immediately after a heavy meal with the jaw clenched and no response. Whatever lies behind it, emptying the stomach before anything else is the chapter's instinct, and 1.14 gives the same measure.

Donguibogam · Hyung

1.8.4.3
Source원문

食積心痛宜用行氣香蘇散ㆍ煮黃丸方見下ㆍ草豆蔲丸方見上ㆍ加味枳朮丸方見上.

Translation영역
For food accumulation heart pain: Move the Qi Cyperus and Perilla Powder, Boiled Yellow Pill formula below, Tsaoko Pill formula above and Supplemented Bitter Orange and Atractylodes Pill formula above.

Donguibogam · Hyung

1.8.5 Reversal Heart Pain 厥心痛

1.8.5.1
Source원문

厥心痛者, 因內外邪犯心之包絡, 或他藏之邪犯心之支脉. 謂之厥者, 諸痛皆少陰厥陰氣逆上衝, 又痛極則發厥也. 《入門》 厥心痛者, 他藏病干之而痛也; 邪在心則亦心痛. 《綱目》

Translation영역
Reversal heart pain is where an evil from within or without offends the pericardiac network, or an evil of another viscus offends a branch channel of the heart. It is called reversal because in all these pains the lesser yin and reverting yin qi counterflow and surge upward, and because at the height of the pain reversal breaks out. Reversal heart pain is another viscus's disease intruding on it and making pain; and where the evil is in the heart itself there is heart pain too.

Immun 入門 · Gangmok 綱目

1.8.5.2
Source원문

寒厥心痛者, 手足厥逆而通身冷汗出, 尿淸不渴, 氣微力弱, 急以朮附湯方見寒門溫之. 熱厥心痛者, 身熱足冷, 痛甚煩躁, 其脉洪大, 可與金鈴子散方見上. 《保命》

Translation영역
In cold reversal heart pain the hands and feet are cold in reversal, cold sweat comes out over the whole body, the urine is clear and there is no thirst, the qi is faint and the strength weak: quickly warm it with Atractylodes and Aconite Decoction formula in the Cold Damage chapter. In heat reversal heart pain the body is hot and the feet cold, the pain severe with vexed restlessness and the pulse surging and large: Toosendan Powder formula above may be given.
Clinical note임상 주석
身熱足冷 — the body hot and the feet cold, against cold limbs with cold sweat in the other kind. Two states that both end in cold extremities, told apart by whether the trunk is hot and whether the patient is thirsty.

Bomyeongjip 保命

1.8.5.3
Source원문

乍間乍甚, 成疹久不死, 名曰厥心痛. 《類聚》

Translation영역
Now easing, now severe, settling into a lasting complaint that does not kill — this is named reversal heart pain.
Clinical note임상 주석
This passage had been dropped. The transcription sets it as the fourth and last ○-item of the section, with its own 《類聚》 mark, and the next section opens with the same construction — 名曰眞心痛《類聚》 — so the pair is the Yuchwi's own way of separating the two: the pain that recurs for years without killing, against the pain that kills within the day. Losing it took the section's contrast with 眞心痛 away with it.

Yuchwi 類聚

1.8.6 True Heart Pain 眞心痛

1.8.6.1
Source원문

心痛手足靑至節, 名曰眞心痛. 《類聚》

Translation영역
Heart pain with the hands and feet gone blue as far as the joints is named true heart pain.

Yuchwi 類聚

1.8.6.2
Source원문

眞心痛者, 手足靑至節, 心痛甚, 朝發夕死, 夕發朝死. 《靈樞》

Translation영역
In true heart pain the hands and feet are blue as far as the joints and the heart pain is severe: breaking out in the morning, death by evening; breaking out in the evening, death by morning.
Clinical note임상 주석
手足靑至節 with severe chest pain and death within the day: central cyanosis to the joints is peripheral shutdown, and the whole picture is a massive myocardial infarction with cardiogenic shock. The Lingshu's prognosis was accurate for its time and is the one sentence in the chapter that modern medicine has overturned outright.

Yeongchu 靈樞

1.8.6.3
Source원문

眞心痛者, 大寒觸犯心君, 或汚血衝心, 手足靑過節者, 朝發夕死, 夕發朝死. 《正傳》

Translation영역
In true heart pain, great cold has struck at the heart sovereign, or foul blood has assailed the heart; where the hands and feet are blue past the joints, breaking out in the morning means death by evening, and in the evening, death by morning.
Clinical note임상 주석
汚血衝心 — foul blood assailing the heart. Of the causes the chapter offers for the fatal pain this is the nearest to the truth: something in the blood reaching the heart. 大寒觸犯 records the other half of the observation, that these attacks cluster in cold weather.

Jeongjeon 正傳

1.8.6.4
Source원문

心爲諸藏之主, 不可傷, 傷之而痛者爲眞心痛. 手足靑至節, 朝發夕死, 夕發朝死, 不假復治. 《得效》

Translation영역
The heart is sovereign of all the viscera and must not be damaged; where it is damaged and there is pain, that is true heart pain. The hands and feet are blue as far as the joints, and breaking out in the morning means death by evening, in the evening death by morning — there is no further treating of it.

Deukhyo 得效

1.8.6.5
Source원문

眞心痛者, 因內外邪犯心君, 一日卽死, 無治法. 《入門》

Translation영역
True heart pain comes of evil within or without striking at the heart sovereign: death follows within the day, and there is no method of treatment.
Clinical note임상 주석
無治法 — no method of treatment. Five sources in a row, each stating the same prognosis and none offering a formula, which is unique in the chapter: everywhere else the Bogam has something to prescribe. The section exists to tell the physician to recognise it and not to promise anything.

Immun 入門

1.9 Heart and Abdomen Painful Together 心腹幷痛

1.9.1
Source원문

心腹幷痛宜二炒香良散ㆍ二胡散ㆍ厚朴湯ㆍ桂靈散ㆍ鷄舌香散方見上ㆍ蟠葱散方見前陰ㆍ五積散方見寒門ㆍ備急丸方見救急ㆍ蘇合香元方見氣門.

Translation영역
Where the heart and abdomen are painful together: Twice-Fried Cyperus and Galangal Powder, Two Hu Powder, Magnolia Bark Decoction, Cinnamon and Flying-Squirrel Powder, Clove Powder formula above, Coiled Scallion Powder formula in the Genitals chapter, Five Accumulations Powder formula in the Cold Damage chapter, Prepare for Urgency Pill formula in the Emergencies chapter and Storax Pill formula in the Qi chapter.

Donguibogam · Hyung

1.10 The Seven Affects Make Heart Pain; Food Accumulation, Phlegm-Rheum and Static Blood All Make Stomach-Duct Pain 七情作心痛食積痰飮瘀血皆作胃脘痛

1.10.1
Source원문

七情作心痛, 食積ㆍ痰飮ㆍ瘀血, 皆作胃脘痛.

Translation영역
The seven affects make heart pain; food accumulation, phlegm-rheum and static blood all make stomach-duct pain.
Clinical note임상 주석
A division heading that does two jobs at once: it closes the heart-pain sequence by naming its affect-born form, and opens the stomach-duct sequence by naming the three material causes. The distinction the chapter has been circling — pain at the heart against pain at the stomach duct — is finally stated as a distinction of cause rather than of place.

Donguibogam · Hyung

1.10.1 Heart Pain from the Seven Affects 七情心痛

1.10.1.1
Source원문

七情者, 喜怒憂思悲驚恐. 盖喜則氣散, 怒則氣上, 憂則氣沈, 思則氣結, 悲則氣消, 驚則氣亂, 恐則氣下. 六情皆令心氣鬱結, 所以作痛; 惟喜則氣散, 所以散六情之鬱, 能止痛也.

Translation영역
The seven affects are joy, anger, anxiety, thought, grief, fright and fear. Joy scatters the qi, anger raises it, anxiety sinks it, thought binds it, grief consumes it, fright throws it into confusion, fear sends it down. Six of them make the heart qi depressed and bound, and so make pain; only joy scatters the qi, and so it can scatter the depression of the other six and stop the pain.

Donguibogam · Hyung

1.10.1.2
Source원문

息城司侯聞父死于賊, 乃大悲哭, 哭罷便覺心痛, 日增不已, 月餘成塊狀如覆盃, 大痛不堪, 百藥無效. 戴人至, 學巫者雜以狂言以謔病者, 至是大笑不忍, 回面向壁, 數日心中結硬皆散. 戴人曰, 憂則氣結, 喜則氣散, 又云喜勝悲, 內經自有此法. 《入門》

Translation영역
The magistrate of Xicheng heard that his father had been killed by bandits and wept in great grief; when the weeping was done he felt a pain in the heart, which grew daily without stopping, and in a month more had become a lump like an upturned cup, with pain past bearing, and a hundred medicines had no effect. Zhang Zihe came, took up the manner of a shaman and mixed in wild talk to make sport with the patient, until he laughed so that he could not stop himself and turned his face to the wall; in a few days the hard knot in his heart had all dispersed. Zhang Zihe said: anxiety binds the qi and joy scatters it, and it is also said that joy overcomes grief — the Neijing has this method of its own.
Clinical note임상 주석
A physician playing the fool deliberately until the patient laughs. The reasoning is the five-phase overcoming sequence applied to the emotions, and it is the Bogam's clearest case of a treatment that is entirely psychological.

Immun 入門

1.10.2 Stomach-Duct Pain from Food Accumulation 食積胃脘痛

1.10.2.1
Source원문

飮食過多, 以致積滯成胃脘痛, 先用吐法, 次用香蘇散方見寒門入生薑ㆍ葱白ㆍ烏梅煎服. 《得效》 或平胃散方見內傷加神麴ㆍ麥芽ㆍ山査肉. 《入門》 宜用加味二陳湯方見痰飮ㆍ加味枳朮丸方見上.

Translation영역
Where too much has been eaten and drunk so that it lodges and makes stomach-duct pain, first use the ejection method, then Cyperus and Perilla Powder formula in the Cold Damage chapter with fresh ginger, scallion white and mume added and decocted; or Calm the Stomach Powder formula in the Internal Damage chapter with medicated leaven, barley sprout and hawthorn fruit. Supplemented Two Matured Ingredients Decoction formula in the Phlegm chapter and Supplemented Bitter Orange and Atractylodes Pill formula above are appropriate.

Deukhyo 得效 · Immun 入門 · Donguibogam · Hyung

1.10.3 Stomach-Duct Pain from Phlegm Rheum 痰飮胃脘痛

1.10.3.1
Source원문

胃中若有流飮淸痰作痛, 腹中漉漉有聲, 及手足寒痛, 或腰膝背脇抽掣作痛, 宜用小胃丹ㆍ控涎丹方幷見痰飮ㆍ三花神祐丸方見下門ㆍ芎夏湯方見痰飮ㆍ加味二陳湯方見內傷ㆍ加味枳朮丸方見上.

Translation영역
Where there is flowing rheum and clear phlegm in the stomach making pain, with a gurgling sound in the belly, and the hands and feet cold and painful, or a drawing pain in the waist, knees, back and flanks: Minor Stomach Pill and Control Drool Elixir both formulas in the Phlegm chapter, Three Flowers Divine Protection Pill formula in the Purging chapter, Chuanxiong and Pinellia Decoction formula in the Phlegm chapter, Supplemented Two Matured Ingredients Decoction formula in the Internal Damage chapter and Supplemented Bitter Orange and Atractylodes Pill formula above.

Donguibogam · Hyung

1.10.3.2
Source원문

一方治痰飮胃脘痛. 白螺螄殼(火煆)ㆍ南星(炮)ㆍ滑石ㆍ梔子(炒)ㆍ便香附子ㆍ蒼朮 各一兩, 枳殼ㆍ靑皮ㆍ木香ㆍ半夏ㆍ縮砂 各五錢. 右爲末, 薑汁浸蒸餠和丸菉豆大, 每五七十丸, 薑湯下. 春加川芎, 夏黃連, 冬吳茱萸. 《丹心》 一名白螺殼丸. 《入門》

Translation영역
Another formula treats stomach-duct pain from phlegm rheum. White river-snail shell (calcined), arisaema (blast-fried), talc, gardenia (stir-fried), urine-processed cyperus and atractylodes lancea 1 nyang each; bitter orange, green tangerine peel, costus, pinellia and amomum 5 don each. Powder them, bind with steamed bread soaked in ginger juice into pills the size of a mung bean, and take fifty to seventy with ginger decoction. In spring add chuanxiong, in summer coptis, in winter evodia. It is named White Snail Shell Pill.
Clinical note임상 주석
A medicinal added by season — chuanxiong in spring, coptis in summer, evodia in winter. The calcined snail shell is calcium carbonate and the formula is an antacid with additions, which is why it answers an acid pain.

Dansim 丹心

1.10.4 Stomach-Duct Pain from Static Blood 瘀血胃脘痛

1.10.4.1
Source원문

心痛脉澁者有死血也. 又云, 作時飮湯水下作呃者, 有死血. 桃仁承氣湯方見寒門下之. 《丹心》

Translation영역
Where in heart pain the pulse is rough there is dead blood. It is also said: where at the time of the attack drinking hot water makes it hiccup as it goes down, there is dead blood. Peach Kernel Order the Qi Decoction formula in the Cold Damage chapter purges it.

Dansim 丹心

1.10.4.2
Source원문

如平日喜食熱物, 以致死血留於胃口作痛者, 桃仁承氣湯下之; 輕者韭汁ㆍ桔梗開之. 《丹心》

Translation영역
Where one has habitually liked hot foods so that dead blood stays at the stomach's mouth and makes pain, Peach Kernel Order the Qi Decoction purges it; in a lighter case, leek juice and platycodon open it.
Clinical note임상 주석
喜食熱物 — a habit of eating things hot. Danxi names it as the cause of a fixed, stabbing pain at the cardia, and habitually very hot food is a recognized risk for oesophageal injury.

Dansim 丹心

1.10.4.3
Source원문

飮湯水嚥下作𩚚, 乃素食熱物, 血死胃脘, 桃仁承氣湯下之. 《入門》

Translation영역
Where swallowing hot water or soup brings on hiccup, it is from habitually eating hot food, with dead blood in the stomach cavity; Peach Kernel Order the Qi Decoction is used to purge it.
Clinical note임상 주석
作𩚚, hiccup on swallowing, is the sign the three passages of this section share — the Dansim's 作呃 above and this 作𩚚 are the same reading. A hot drink provoking hiccup points the diagnosis at the cardia rather than at the heart.

Immun 入門

1.10.4.4
Source원문

婦人瘀血入心, 脾痛甚者, 五積散方見寒門加三稜ㆍ蓬朮ㆍ桃仁ㆍ紅花. 《入門》 宜用失笑散方見婦人ㆍ神仙沈麝元方見氣門ㆍ玄胡索丸ㆍ勝金散.

Translation영역
Where in a woman static blood enters the heart and the spleen pain is severe, Five Accumulations Powder formula in the Cold Damage chapter with sparganium, zedoary, peach kernel and safflower added. Sudden Smile Powder formula in the Women chapter, Divine Immortal Aloeswood and Musk Pill formula in the Qi chapter, Corydalis Pill and Victorious Gold Powder are appropriate.

Immun 入門 · Donguibogam · Hyung

1.11 Heart and Stomach Pain Should Be Divided into Vacuity and Repletion 心胃痛當分虛實

1.11.1
Source원문

按之痛止者爲虛, 二陳湯方見痰飮加炒乾薑和之. 《丹心》 虛痛宜歸脾湯方見神門ㆍ加味小建中湯ㆍ參朮散.

Translation영역
Where pressing stops the pain it is vacuity: Two Matured Ingredients Decoction formula in the Phlegm chapter with fried dried ginger added to harmonize it. For vacuity pain: Restore the Spleen Decoction formula in the Spirit chapter, Supplemented Minor Construct the Middle Decoction and Ginseng and Atractylodes Powder.

Dansim 丹心 · Donguibogam · Hyung

1.11.2
Source원문

按之痛反甚者爲實, 宜大柴胡湯方見寒門下之. 《仲景》 實痛宜梔萸丸ㆍ煮黃丸.

Translation영역
Where pressing makes the pain worse it is repletion: Major Bupleurum Decoction formula in the Cold Damage chapter to purge it. For repletion pain: Gardenia and Evodia Pill and Boiled Yellow Pill.
Clinical note임상 주석
按之痛止者爲虛, 按之痛反甚者爲實 — pressure relieving means vacuity, pressure worsening means repletion. The chapter's single most useful rule, and it needs nothing but a hand. Pain relieved by pressure and worsened by it do still separate different causes.

Junggyeong 仲景 · Donguibogam · Hyung

1.12 The Method of Treating Heart and Stomach Pain 心胃痛治法

1.12.1
Source원문

凡心胃痛須分新久. 若明知身受寒氣, 口喫寒物而得者, 於初得之時當與溫散, 或溫利之. 溫散謂麻黃桂枝湯ㆍ桂枝四七湯方見上, 溫利謂九痛元ㆍ煮黃丸方並見上. 得之稍久則成鬱, 鬱久則蒸熱, 熱久必生火. 若行溫散溫利, 寧不助火添病耶. 由是方中多以山梔爲熱藥之向導, 則邪易伏, 病易退, 正氣復而病安矣. 《丹心》

Translation영역
In any heart or stomach pain the new must be told from the old. Where one plainly knows the body took in cold qi or the mouth ate cold things, at the first getting of it warm dispersing or warm freeing should be given — warm dispersing means Ephedra and Cinnamon Twig Decoction and Cinnamon Twig Four Sevens Decoction formula above, warm freeing means Nine Pains Pill and Boiled Yellow Pill both formulas above. But once it has lasted a while it becomes depression; depression lasting steams into heat; and heat lasting must engender fire. If one then warms and disperses or warms and frees, how should it not help the fire and add to the disease? For this reason most formulas use gardenia as the guide for the hot medicines, so that the evil is easily subdued, the disease easily retreats, the upright qi recovers and the patient is well.
Clinical note임상 주석
The chapter's central warning, and it undercuts half of its own formulas: a cold pain that has lasted is no longer cold, and warming it feeds what it has become. Gardenia is Danxi's answer — a cold medicinal carried in among hot ones.

Dansim 丹心

1.12.2
Source원문

寒冷自外而入, 初則是寒, 鬱久則變熱, 始終俱是熱也. 宜分寒ㆍ熱ㆍ血ㆍ蟲四條: 寒則溫之, 熱則淸之, 血則散之, 蟲則殺之, 庶乎不惑也. 《丹心》

Translation영역
Cold comes in from without: at first it is cold, but depressed and lasting it turns to heat, and from first to last it is all heat. It should be divided under four heads — cold, heat, blood and worm: cold is warmed, heat is cleared, blood is dispersed, worm is killed — and then one may not be confused.

Dansim 丹心

1.13 In Pain of Any Kind, Qi-Supplementing Medicines Must Not Be Used 諸痛不可用補氣藥

1.13.1
Source원문

痛甚則脉必伏, 多用溫藥附子之類, 不可用參朮. 盖諸痛不可補氣故也. 《丹心》 諸痛不可用補氣藥, 氣旺不通而痛愈甚矣. 《醫鑑》

Translation영역
Where the pain is severe the pulse will be hidden; warm medicines of the aconite kind are much used, and ginseng and atractylodes must not be. For in pain of any kind the qi is not to be supplemented. Qi-supplementing medicines must not be used in any pain: the qi made exuberant without being freed, the pain is worse than before.
Clinical note임상 주석
氣旺不通而痛愈甚 — the qi made strong while still blocked, and the pain grows worse. A short section with a plain mechanical reason behind it, and it explains why so many formulas here are made of movers rather than tonics.

Dansim 丹心 · Uigam 醫鑑

1.14 Overpowering Medicines for Heart and Stomach Pain 心胃痛劫藥

1.14.1
Source원문

止痛劫藥, 用倉卒散ㆍ連附六一湯方見上ㆍ抽刀散方見上ㆍ愈痛散ㆍ梔薑飮方見上ㆍ神靈丹ㆍ治心頭疼方.

Translation영역
For overpowering medicines that stop pain: Sudden Emergency Powder, Coptis and Aconite Six to One Decoction formula above, Drawn Knife Powder formula above, Heal the Pain Powder, Gardenia and Ginger Drink formula above, Divine Spirit Elixir and the Formula for Pain at the Heart.

Donguibogam · Hyung

1.14.2
Source원문

心痛用山梔幷劫藥止之, 又復發, 前藥必不效, 可加玄明粉 一錢卽止. 《丹心》

Translation영역
Where heart pain has been stopped with gardenia and an overpowering medicine and breaks out again, the former medicine will surely not answer; adding 1 don of mirabilite powder stops it.

Dansim 丹心

1.14.3
Source원문

歌曰, 三箇烏梅三箇棗, 七箇杏仁一處搗, 麝香一粒用酒煎, 永不心疼直到老. 烏梅 三箇, 大棗 三箇(俱去核), 杏仁(泡去皮尖), 麝香如小豆一粒. 右共擣爲泥, 黃酒一鍾同煎兩沸, 溫服. 正疼時服之, 婦人尤神效, 當時卽止. 《必用》

Translation영역
The verse says: three mume and three jujubes, seven apricot kernels pounded together, one grain of musk decocted in wine — and never a heart pain again, right into old age. Mume 3, jujube 3 (both stoned), apricot kernel (scalded and the skin and tip removed), and musk the size of a small bean. Pound the above together to a mash, decoct with one cup of yellow wine to two boils, and take warm. Taken at the height of the pain; in women it is marvellously effective, stopping it on the spot. — Piryongbang 必用 (Donguibogam · Hyung)

Piryongbang 必用

1.15 Heart and Stomach Pain Should Be Ejected 心胃痛宜吐

1.15.1
Source원문

凡心痛皆痰粘, 通用二陳湯方見痰飮隨證加減. 《入門》 凡痛攻走腰背, 發厥嘔吐, 諸藥不效, 二陳湯加蒼朮ㆍ川芎ㆍ梔子煎服, 探吐積痰椀許乃愈. 《入門》

Translation영역
In any heart pain there is sticky phlegm, and Two Matured Ingredients Decoction formula in the Phlegm chapter is used generally with additions and subtractions to suit the pattern. Where the pain attacks and runs into waist and back with reversal and vomiting and no medicine answers, Two Matured Ingredients Decoction with atractylodes lancea, chuanxiong and gardenia added, decocted and taken, and a bowlful of accumulated phlegm brought up by probing, and it heals.

Immun 入門

1.15.2
Source원문

多飮鹽湯, 以鵝翎探吐痰積, 痛卽止. 《醫鑑》 飮食過傷, 心胸痛甚不省人事, 多飮薑鹽湯探吐之, 卽止痛. 《雜著》

Translation영역
Drink plenty of salt water and probe with a goose quill to bring up the accumulated phlegm, and the pain stops at once. Where food and drink have done great damage and the pain of the chest is so severe that the patient knows no one, let them drink plenty of ginger and salt water and probe to make them vomit, and the pain stops.
Clinical note임상 주석
Salt water and a feather at the back of the throat, for a patient overcome by what they have eaten. Emptying the stomach is not unreasonable in acute gastric distension, and it is the chapter's first measure where nothing can be swallowed.

Uigam 醫鑑 · Japjeo 雜著

1.15.3
Source원문

食積痰心胃痛甚, 以瓜蔕散方見吐門吐之. 又蘿葍子五合(油炒擂碎), 和漿水濾汁, 入油與蜜各少許, 旋旋溫服吐之. 《丹心》

Translation영역
Where food accumulation and phlegm make the pain of the heart and stomach severe, Melon Stalk Powder formula in the Ejection chapter is used to eject it. Or radish seed 5 hop (fried in oil and ground fine), mixed with fermented millet water and the juice strained off, with a little oil and honey put in, taken warm little by little to eject.

Dansim 丹心

1.16 Heart and Stomach Pain Should Be Purged 心胃痛宜下

1.16.1
Source원문

心脾痛大小便不通者, 此是痰隔中焦, 氣聚下焦也. 《丹心》 心痛脉堅實不大便者下之, 宜大柴胡湯方見寒門. 胃脘有濕而痛, 小胃丹方見痰飮下之. 《丹心》

Translation영역
Where in heart and spleen pain neither stool nor urine passes, phlegm is partitioning the middle burner and qi is gathered in the lower. Where in heart pain the pulse is hard and replete and the stool will not pass, precipitate: Major Bupleurum Decoction formula in the Cold Damage chapter is appropriate. Where there is damp at the stomach duct with pain, precipitate with Minor Stomach Elixir formula in the Phlegm-Rheum chapter.

Dansim 丹心

1.16.2
Source원문

通則不痛, 不通則痛. 又云諸實爲痛, 痛隨利減. 凡心胃痛甚, 須用下藥利之, 是爲捷法. 《東垣》

Translation영역
Where there is free passage there is no pain; where there is no free passage there is pain. It is also said: all repletion makes pain, and the pain lessens as the bowel is freed. In any severe pain of the heart or stomach, a precipitating medicine must be used to free it, and this is the quick way.
Clinical note임상 주석
通則不痛, 不通則痛 — the most quoted line in the chapter, and the one that licenses purging a patient in severe chest pain. 痛隨利減, the pain lessening as the bowel opens, is true of a pain that is in fact obstructive; the danger of the rule is that 1.8.6's fatal pain is not.

Dongwon 東垣

1.16.3
Source원문

大凡心腹痛嘔吐大便不通者, 欲利其大便, 諸藥皆吐, 惟蘇感元薑汁泡湯呑下最妙. 麝香蘇合元方見氣門ㆍ四分感應元方見大便六分, 硏和作丸菉豆大, 下二三十丸. 《直指》

Translation영역
Where in pain of the heart and abdomen there is vomiting and the stool will not pass, and one would open the bowel but every medicine is vomited back, only Perilla and Response Pill swallowed with hot water steeped with ginger juice answers best. Musk Liquidambar Pill formula in the Qi chapter four parts and Response Pill formula in the Stool chapter six parts, ground together and made into pills the size of a mung bean, twenty or thirty taken down.
Clinical note임상 주석
諸藥皆吐 — every medicine is vomited back, which is the problem the item is written for: an obstructed patient who cannot keep anything down. The answer is a small hard pill rather than a draught, taken with ginger to settle the stomach.

Jikji 直指

1.16.4
Source원문

宜用九痛元ㆍ煮黃丸方並見上ㆍ神保元方見氣門.

Translation영역
Nine Pains Pill, Boiled Yellow Pill both formulas above and Divine Protection Pill formula in the Qi chapter are appropriate.

Donguibogam · Hyung

1.17 What Is Forbidden in Eating and Drinking 飮食禁忌

1.17.1
Source원문

心痛雖日數多不喫飯不死; 若痛止便喫物, 卽還痛. 必須三五服藥方可喫物. 《丹心》 凡心痛數日不食無妨; 痛止恣食卽復發. 《入門》

Translation영역
In heart pain, though many days go by without eating, one does not die; but let the pain stop and food be eaten at once, and the pain returns. Three or five doses of the medicine must be taken before anything is eaten. In any heart pain, going some days without food does no harm; but eating freely as soon as the pain stops brings it straight back.
Clinical note임상 주석
數日不食無妨 — some days without food do no harm. The plainest piece of advice in the chapter, and still correct: resting an inflamed stomach is most of the treatment, and eating at the first relief is what brings the pain back.

Dansim 丹心 · Immun 入門

1.17.2
Source원문

病安之後, 若縱恣口味, 病必復作, 勿歸咎於醫也. 《丹心》

Translation영역
After the illness has settled, if one indulges the appetite the disease will surely break out again — and let no blame be laid on the physician.

Dansim 丹心

1.18 Pigeon Chest 龜胸

1.18.1
Source원문

詳見小兒門.

Translation영역
Treated in detail in the Children chapter.

Donguibogam · Hyung

1.19 Glomus of the Chest 胸痞

1.19.1
Source원문

胸滿而不痛者爲痞, 滿而痛者爲結胸. 痞悶比之結胸爲輕, 始末用藥俱同, 但有輕重之殊耳. 《入門》

Translation영역
Where the chest is full and does not pain it is glomus; full and painful, it is chest bind. The oppression of glomus is lighter than chest bind, and the medicines used from first to last are the same, only differing in weight.

Immun 入門

1.19.2
Source원문

痞者, 心下滿而不痛是也. 太陰濕土主壅塞, 乃土來心下而爲痞也. 傷寒下之早亦爲痞, 乃寒傷榮血, 心主血, 邪入於本, 故爲心下痞. 仲景瀉心湯數方皆用黃連瀉心下之土邪, 其效如響應桴. 《東垣》

Translation영역
Glomus is fullness below the heart without pain. The greater yin's damp earth governs congestion and blockage, and it is the earth coming below the heart and making glomus. Purging too early in cold damage also makes glomus: the cold damages the construction blood, and the heart governs blood, so the evil enters its root and makes glomus below the heart. Zhongjing's several Drain the Heart Decoctions all use coptis to drain the earth evil below the heart, and their effect is as a drum answers the stick.

Dongwon 東垣

1.19.3
Source원문

酒積雜病下之過, 亦作痞. 盖胸中之氣因虛而下陷于心之分野, 故致心下痞. 宜升胃氣, 以血藥兼之. 若全用氣藥導之, 則氣愈下降, 必變爲中滿鼓脹矣. 《東垣》

Translation영역
Where a wine accumulation or a miscellaneous disease has been purged too far, that also makes a glomus. For the qi of the chest, being vacuous, falls down into the heart's own territory, and so a glomus forms below the heart. The stomach qi should be raised, with blood medicines used alongside. If qi medicines alone are used to guide it, the qi descends further still, and it will surely turn into central fullness and drum distension.
Clinical note임상 주석
A glomus made by treatment rather than by disease, and the warning that follows is the useful part: the obvious move — qi-moving drugs for a feeling of fullness — drives the qi further down and ends in distension. Raise instead, and add blood medicines.

Dongwon 東垣

1.19.4
Source원문

痞滿與脹滿不同. 脹滿內脹而外亦形; 痞則內覺痞悶而外無脹急之形也. 盖由陰伏陽蓄, 氣血不運而成, 位于心下之中, 塡滿痞塞, 皆土邪之所爲耳. 《丹心》

Translation영역
Glomus fullness is not the same as distension fullness: in distension there is swelling within and a shape to be seen without; in glomus one feels the oppression within and there is no shape of urgent distension without. It comes of yin lying hidden and yang stored up with the qi and blood not moving, and settles in the middle below the heart, filling and blocking — all of it the work of the earth evil.
Clinical note임상 주석
內覺痞悶而外無脹急之形 — oppression felt within with nothing to be seen without. The distinction between a subjective fullness and a visibly distended abdomen, and it is a real one at the bedside.

Dansim 丹心

1.19.5
Source원문

內經曰, 太陰所至爲積飮痞隔. ○痞者否也, 如易所謂天地不交之否, 內柔外剛, 萬物不通之義也. 物不可以終否, 故痞久則成脹滿而莫能療焉. 《正傳》

Translation영역
痞 is the hexagram Pi: as the Book of Changes says, the standstill where heaven and earth do not intercourse, soft within and hard without, the sense that the ten thousand things do not pass. Nothing can stand still for ever, and so glomus long continued becomes distension fullness, which cannot be cured.

Jeongjeon 正傳

1.19.6
Source원문

痞者, 胸膈飽悶而不舒暢也. 《醫鑑》

Translation영역
A glomus is the chest and diaphragm full and oppressed and not freely at ease.

Uigam 醫鑑

1.19.7
Source원문

寒痞枳實理中元, 熱痞加減陷胸湯, 痰痞柴梗半夏湯, 痞痛瓜蔞實丸, 久痞黃連消痞丸, 食已心下痞平補枳朮丸, 虛痞枳實消痞丸, 飮食不消痞橘皮枳朮丸方見內傷, 或二陳湯方見痰飮加山査ㆍ神麴ㆍ麥芽, 陰伏陽蓄爲痞香砂養胃湯ㆍ加味枳朮丸方見上. 通用桔梗枳殼湯ㆍ解鬱和中湯.

Translation영역
For cold glomus, Bitter Orange Regulate the Centre Pill; heat glomus, Modified Sink into the Chest Decoction; phlegm glomus, Bupleurum, Platycodon and Pinellia Decoction; glomus with pain, Trichosanthes Fruit Pill; long-standing glomus, Coptis Disperse Glomus Pill; glomus below the heart after eating, Even Supplementation Bitter Orange and Atractylodes Pill; vacuity glomus, Bitter Orange Disperse Glomus Pill; glomus from food undigested, Tangerine Peel, Bitter Orange and Atractylodes Pill formula in the Internal Damage chapter, or Two Matured Ingredients Decoction formula in the Phlegm chapter with hawthorn fruit, medicated leaven and barley sprout added; glomus from yin hidden and yang stored, Costus and Amomum Nourish the Stomach Decoction and Supplemented Bitter Orange and Atractylodes Pill formula above. For general use, Platycodon and Bitter Orange Decoction and Resolve Depression and Harmonize the Centre Decoction.

Donguibogam · Hyung

1.20 Glomus Has Cold and Heat 痞有寒熱

1.20.1
Source원문

寒痞不渴, 脉遲, 宜辛甘散之, 枳實理中丸之類方見上. 熱痞煩渴, 脉數, 宜苦寒泄之, 黃連消痞丸ㆍ加味陷胸湯之類方幷見上. 《綱目》

Translation영역
Cold glomus is without thirst and the pulse slow: it should be dispersed with the acrid and sweet, as with Bitter Orange Regulate the Centre Pill and its kind formula above. Heat glomus has vexing thirst and a rapid pulse: it should be drained with the bitter and cold, as with Coptis Disperse Glomus Pill and Supplemented Sink into the Chest Decoction both above.

Gangmok 綱目

1.21 Glomus Has Vacuity and Repletion 痞有虛實

1.21.1
Source원문

痞有虛實之殊. 實痞大便閉, 厚朴枳實湯方見大便主之; 虛痞大便利, 芍藥陳皮湯主之. 《東垣》 痞有虛有實: 大便易而利者爲虛, 大便難而閉者爲實. 《入門》

Translation영역
Glomus differs as vacuity and repletion. In repletion glomus the stool is blocked, and Magnolia Bark and Bitter Orange Decoction formula in the Stool chapter governs it; in vacuity glomus the stool passes freely, and Peony and Tangerine Peel Decoction governs it. Glomus has its vacuity and its repletion: where the stool passes easily and freely it is vacuity, where it is difficult and blocked it is repletion.
Clinical note임상 주석
The stool decides it. Where 1.10.4 used the hand on the abdomen to sort pain, this sorts fullness by what passes below — and the two tests are the chapter's whole practical apparatus.

Dongwon 東垣 · Immun 入門

1.22 Glomus Should Be Ejected or Purged 痞宜吐下

1.22.1
Source원문

飮食過傷, 心胸痞悶, 兀兀欲吐者, 宜吐之. 《東垣》

Translation영역
Where food and drink have done too much damage and the chest is oppressed with glomus and there is a dull wish to vomit, it should be ejected.

Dongwon 東垣

1.22.2
Source원문

飮食傷脾痞滿, 輕者黃連消痞丸方見上ㆍ橘皮枳朮丸方見內傷; 甚者微下之, 吐之. 下者枳實導滯丸加檳榔ㆍ木香方見內傷ㆍ煮黃丸方見上; 吐者二陳湯方見痰飮ㆍ瓜蔕散方見吐門. 《丹心》

Translation영역
Where food and drink have damaged the spleen with glomus fullness, in a light case Coptis Disperse Glomus Pill formula above and Tangerine Peel, Bitter Orange and Atractylodes Pill formula in the Internal Damage chapter; in a severe case purge it a little, or eject it. For purging, Bitter Orange Abduct Stagnation Pill with areca and costus added formula in the Internal Damage chapter and Boiled Yellow Pill formula above; for ejecting, Two Matured Ingredients Decoction formula in the Phlegm chapter and Melon Pedicel Powder formula in the Ejection chapter.

Dansim 丹心

1.23 The Method of Treating Glomus Patterns 痞證治法

1.23.1
Source원문

心下痞須用枳實ㆍ炒黃連. 如稟實氣實而痞, 宜枳實ㆍ黃連ㆍ靑皮ㆍ陳皮ㆍ枳殼. 如稟弱氣弱飮食不化而痞, 宜白朮ㆍ山査ㆍ神麴ㆍ麥芽ㆍ陳皮. 《丹心》

Translation영역
For glomus below the heart, bitter orange and fried coptis must be used. Where the constitution is solid and the qi replete and there is glomus: bitter orange, coptis, green tangerine peel, tangerine peel and bitter orange peel. Where the constitution is weak and the qi weak and food does not transform and there is glomus: white atractylodes, hawthorn fruit, medicated leaven, barley sprout and tangerine peel.

Dansim 丹心

1.23.2
Source원문

如肥人心下痞, 乃濕痰, 宜蒼朮ㆍ半夏ㆍ縮砂ㆍ茯苓ㆍ滑石. 如瘦人心下痞, 乃鬱熱, 宜枳實ㆍ黃連ㆍ葛根ㆍ升麻. 如感寒食不化心下痞, 宜藿香ㆍ草豆蔲ㆍ縮砂ㆍ吳茱萸. 痞挾血成窠囊, 宜桃仁ㆍ紅花ㆍ香附ㆍ大黃. 《丹心》

Translation영역
Where a stout person has glomus below the heart it is damp phlegm: atractylodes lancea, pinellia, amomum, poria and talc. Where a thin person has it, it is depressed heat: bitter orange, coptis, pueraria and cimicifuga. Where cold has been contracted and food does not transform and there is glomus: agastache, tsaoko, amomum and evodia. Where glomus carries blood with it and makes a nest-sac: peach kernel, safflower, cyperus and rhubarb.
Clinical note임상 주석
Six versions of one complaint, sorted by build and by history rather than by pulse. 窠囊, a nest-sac — Danxi's name for an old pocket of phlegm and blood walled off where it sits, and the one that needs blood medicinals rather than qi ones.

Dansim 丹心

1.23.3
Source원문

王道消補, 不輕吐下. 故古人治痞, 用黃連ㆍ黃芩ㆍ枳實之苦以泄之, 厚朴ㆍ生薑ㆍ半夏之辛以散之, 人參ㆍ白朮之甘溫以補之, 猪苓ㆍ茯苓ㆍ澤瀉之淡以滲之. 大槪與濕同治, 使上下分消其濕可也. 《正傳》

Translation영역
The kingly way disperses and supplements and is not quick to eject or purge. So the ancients in treating glomus used the bitterness of coptis, scutellaria and bitter orange to drain it, the acridity of magnolia bark, fresh ginger and pinellia to disperse it, the sweet warmth of ginseng and white atractylodes to supplement it, and the blandness of polyporus, poria and alisma to percolate it. In the main it is treated as damp is treated, letting the damp be dispersed above and below.
Clinical note임상 주석
王道 — the kingly way, against the forceful methods of ejecting and purging. The Jeongjeon is arguing against the section just before it, and the Bogam prints both without choosing.

Jeongjeon 正傳

1.23.4
Source원문

傷寒本無痞, 應發汗, 醫反下之, 遂成痞. 枳實理中丸方見上最良. 審知是痞, 先用桔梗枳殼湯尤妙, 枳桔能行氣故也. 《活人》 盖痞自血中來, 治痞獨益脾土, 以血藥治之, 其法無以加矣. 《海藏》

Translation영역
In cold damage there is properly no glomus; sweating should have been promoted, and the physician purged instead, and so glomus was made. Bitter Orange Regulate the Centre Pill formula above is best. Once one knows surely that it is glomus, using Platycodon and Bitter Orange Decoction first is better still, for bitter orange and platycodon can move the qi. Glomus comes from the blood, and in treating it, to boost the spleen earth alone and to treat it with blood medicines — to that method nothing can be added.

Hwarin 活人 · Haejang 海藏

1.24 The Method of Warm Plastering for Glomus Qi 𨠭痞氣法

1.24.1
Source원문

蘿葍子 三合, 生薑 二兩, 葱白 七莖, 橘葉 一握, 白麪 半合, 共搗勻炒令溫, 𨠭痞滿之處, 外用絹帛縛之. 候半日許, 胸中煩熱卽解去, 復以熱手揉之. 不拘寒熱虛實幷用之. 無橘葉代椒葉. 《入門》

Translation영역
Radish seed three hop, fresh ginger 2 nyang, seven stalks of scallion white, a handful of tangerine leaves and half a hop of white flour, pounded together evenly and fried warm; plaster it on the place of glomus fullness and bind it over with silk. After about half a day, when the chest feels vexed and hot, take it off and rub the place with a warm hand. It is used alike whether the case is cold or hot, vacuous or replete. If there are no tangerine leaves, use pepper leaves.
Clinical note임상 주석
A warm poultice bound on for half a day, with the endpoint being heat felt inside rather than a set time. The Navel chapter's moxa rule works the same way.

Immun 入門

1.25 The Method of Ironing for Glomus Qi 熨痞氣法

1.25.1
Source원문

治心胸痞, 及一切胸膈寒結ㆍ熱結ㆍ水結ㆍ食結ㆍ痰結ㆍ痞結皆治之. 生薑 一斤, 搗取汁, 以貯, 只取渣炒熱, 帛包熨心胸脇下, 其痛豁然而愈. 若薑冷, 再拌汁炒再熨之. 若熱結不用炒. 《入門》

Translation영역
Treats glomus of the heart and chest, and all binds of the chest and diaphragm — cold bind, heat bind, water bind, food bind, phlegm bind and glomus bind. Take a geun of fresh ginger, pound it for the juice and keep the juice by; take only the dregs, fry them hot, wrap them in cloth and iron the chest and below the flanks with it, and the pain opens out and heals. If the ginger grows cold, mix it again with the juice, fry it and iron again. Where the bind is a heat one, do not fry it.
Clinical note임상 주석
若熱結不用炒 — where the bind is from heat, do not fry it. The same ginger dregs used cold instead of hot, which is a sensible adjustment and rarely made this explicitly.

Immun 入門

1.26 Chest Bind 結胸

1.26.1
Source원문

傷寒病發於陽而反下之, 熱入, 因作結胸; 病發於陰而反下之, 因作痞. 所以成結胸者, 以下之太早故也. 《仲景》

Translation영역
In cold damage, where the disease breaks out in the yang and one purges instead, the heat enters and makes chest bind; where it breaks out in the yin and one purges instead, it makes glomus. What makes a chest bind is purging too early.

Junggyeong 仲景

1.26.2
Source원문

結胸之證, 當心緊痛而煩, 水漿不入, 但能仰而不能俯, 項强如柔痓狀. 《入門》 心下滿而硬痛爲結胸, 滿而不痛爲痞, 半夏瀉心湯方見寒門主之. 《仲景》

Translation영역
In the pattern of chest bind there is a tight pain right at the heart with vexation, neither water nor gruel going in, the patient able to lean back but not forward, and the nape stiff as in soft tetany. Below the heart full and hard and painful is chest bind; full and not painful is glomus, and Pinellia Drain the Heart Decoction formula in the Cold Damage chapter governs it.
Clinical note임상 주석
但能仰而不能俯 — able to lean back but not to bend forward. A posture forced on the patient by the pain, and one of the chapter's few purely observational signs.

Immun 入門 · Junggyeong 仲景

1.26.3
Source원문

有大結胸ㆍ小結胸ㆍ寒實結胸ㆍ熱實結胸ㆍ水結胸ㆍ血結胸ㆍ陰陽毒結胸, 又有支結證. 桔梗枳殼湯治結胸痞氣通用. 《入門》

Translation영역
There are great chest bind, minor chest bind, cold repletion chest bind, heat repletion chest bind, water chest bind, blood chest bind and yin-yang toxin chest bind, and besides these the branch bind pattern. Platycodon and Bitter Orange Decoction is used generally for chest bind and glomus qi alike.

Immun 入門

1.26.1 Great Chest Bind 大結胸

1.26.1.1
Source원문

大結胸者, 不按而痛, 胸連臍腹痛硬, 手不可近, 不大便, 日晡潮熱, 宜大陷胸湯ㆍ大陷胸丸方幷見寒門ㆍ穿結散. 大結胸者, 心下滿而硬痛, 手不可按. 《仲景》

Translation영역
In great chest bind it pains without being pressed, the chest and navel and abdomen are painful and hard together, the hand cannot be brought near, the stool does not pass and there is tidal fever in the late afternoon: Major Sink into the Chest Decoction and Pill both in the Cold Damage chapter and Pierce the Bind Powder. In great chest bind it is full below the heart, hard and painful, and the hand cannot press it.

Junggyeong 仲景

1.26.2 Minor Chest Bind 小結胸

1.26.2.1
Source원문

小結胸者, 按之方痛, 只心下硬, 宜小陷胸湯方見寒門. 小結胸者正在心下, 按之則痛. 《仲景》

Translation영역
In minor chest bind it pains only when pressed, and only below the heart is hard: Minor Sink into the Chest Decoction formula in the Cold Damage chapter. Minor chest bind is right below the heart and pains on pressure.

Junggyeong 仲景

1.26.3 Cold Repletion Chest Bind 寒實結胸

1.26.3.1
Source원문

寒實結胸者, 身不熱, 口不渴, 只心中脹硬而痛, 無熱證, 宜枳實理中丸方見上, 甚者三物白散方見寒門. 《入門》

Translation영역
In cold repletion chest bind the body is not hot and the mouth not thirsty, and only within the chest is distended, hard and painful, with no heat signs: Bitter Orange Regulate the Centre Pill formula above, and in a severe case Three Ingredients White Powder formula in the Cold Damage chapter.

Immun 入門

1.26.4 Heat Repletion Chest Bind 熱實結胸

1.26.4.1
Source원문

熱實結胸者, 心下滿硬, 懊憹煩躁而渴, 宜加味陷胸湯方見上ㆍ柴陷湯. 《入門》

Translation영역
In heat repletion chest bind it is full and hard below the heart, with anguish, vexed restlessness and thirst: Supplemented Sink into the Chest Decoction formula above and Bupleurum Sink into the Chest Decoction.

Immun 入門

1.26.5 Water Chest Bind 水結胸

1.26.5.1
Source원문

傷寒結胸無大熱者, 此爲水結在胸脇, 但頭微汗出. 《仲景》

Translation영역
Where in cold damage chest bind there is no great heat, it is water bound in the chest and flank, and only the head sweats slightly.

Junggyeong 仲景

1.26.5.2
Source원문

傷寒飮水過多, 水停心下, 爲水結胸. 但頭汗出, 身無大熱, 心下滿, 揉之汨汨有聲, 謂之水結胸. 宜赤茯苓湯, 甚者大陷胸湯方見寒門. 《入門》

Translation영역
Where in cold damage too much water has been drunk and the water stops below the heart, it makes a water chest bind. A sweat on the head only, no great heat in the body, fullness below the heart, and a gurgling sound when it is rubbed — this is what is called a water chest bind. Red Poria Decoction is appropriate; in severe cases Major Sink the Chest Decoction formula in the Cold Damage chapter.
Clinical note임상 주석
揉之汨汨有聲 — a gurgling under the hand — is the sign that distinguishes this from the other chest binds in the chapter, and it is a succussion splash: free fluid in a distended stomach. The chapter's reading of it as water that was drunk and did not pass on is close enough to gastric outlet obstruction to be worth noting.

Immun 入門

1.26.5.3
Source원문

凡水結胸脇間, 頭必有汗. 《綱目》

Translation영역
Wherever water is bound between the chest and the flanks, there is certain to be a sweat on the head.

Gangmok 綱目

1.26.5.4
Source원문

一人忽患微熱, 心下滿, 頭有汗, 衆醫以爲濕病, 或以爲食積. 孫兆曰, 水結胸. 用半夏茯苓湯遂差. 衆問其故, 答曰, 頭有汗心下滿, 非濕病, 乃水結胸脇也. 水旣去其病當愈. 若濕氣心下滿, 自當遍身汗; 若食積, 頭豈有汗乎. 故知之. 《綱目》

Translation영역
A man suddenly fell ill with slight heat, fullness below the heart and sweat on the head; the physicians took it for a damp disease or for food accumulation. Sun Zhao said: it is water chest bind. He used Pinellia and Poria Decoction and the man mended. Asked the reason, he answered: sweat on the head with fullness below the heart is not a damp disease but water bound in the chest and flank; the water once gone, the disease must heal. In damp qi with fullness below the heart the whole body would sweat; and in food accumulation, how should the head sweat at all? That is how I knew it.
Clinical note임상 주석
Sweat on the head and nowhere else is the whole of Sun Zhao's reasoning, and he states what would have been true for each alternative. It is the most carefully argued differential in the chapter.

Gangmok 綱目

1.26.5.5
Source원문

水結宜枳朮湯.

Translation영역
For water bind, Bitter Orange and Atractylodes Decoction is appropriate.

Donguibogam · Hyung

1.26.6 Blood Chest Bind 血結胸

1.26.6.1
Source원문

婦人傷寒血結胸, 痛不可忍, 宜服海蛤散ㆍ玄胡索散. 《入門》

Translation영역
Where in a woman's cold damage there is blood chest bind with pain past bearing: Clam Shell Powder and Corydalis Powder should be taken.

Immun 入門

1.26.7 Yin and Yang Toxin Chest Bind 陰陽毒結胸

1.26.7.1
Source원문

傷寒陰陽二毒伏逆變爲結胸, 有自利者, 有不得利者, 依結胸灸臍法以利之. 陽毒內服活龍散, 陰毒內服破結丹. 得泄則陰陽升降, 榮衛流行, 自然大汗而解矣. 若心下已結, 延至五日間斷不可治. 《入門》

Translation영역
Where in cold damage the two toxins, yin and yang, lie and counterflow and turn into chest bind, some have spontaneous diarrhoea and some do not, and the moxa-at-the-navel method for chest bind is used to free it. For yang toxin, Live Dragon Powder is taken inwardly; for yin toxin, Break the Bind Elixir. Once it drains, yin and yang rise and fall, construction and defence flow, and a great sweat comes of itself and resolves it. But where it has already bound below the heart and has dragged on to the fifth day, it is decidedly not to be treated.

Immun 入門

1.26.7.2
Source원문

治陽證結胸, 死無可藥者, 活蚯蚓 十二條擂爛, 蜜半盞, 水半椀, 和灌之. 《得效》 服後穩睡一場, 卽揉心下片時, 再令睡. 有汗卽愈. 《醫鑑》

Translation영역
To treat a yang pattern chest bind where the patient is dying and no medicine serves: twelve live earthworms pounded soft with half a jan of honey and half a bowl of water, poured in. After taking it let them sleep quietly a while, then rub below the heart a short time and let them sleep again; when sweat comes it heals.

Deukhyo 得效 · Uigam 醫鑑

1.26.8 Branch Bind 支結

1.26.8.1
Source원문

傷寒心下妨悶, 不滿不硬者, 謂之支結, 宜桂枝人參湯. 傷寒未經下而胸膈氣塞滿悶者, 非痞亦非結胸也. 柴梗湯ㆍ柴陳湯; 胃虛者半夏瀉心湯方見寒門. 《入門》

Translation영역
Where in cold damage there is obstruction and oppression below the heart but it is neither full nor hard, it is called branch bind: Cinnamon Twig and Ginseng Decoction. Where in cold damage no purge has yet been given and the qi of the chest and diaphragm is stopped, full and oppressed, it is neither glomus nor chest bind: Bupleurum and Platycodon Decoction and Bupleurum and Tangerine Peel Decoction; where the stomach is vacuous, Pinellia Drain the Heart Decoction formula in the Cold Damage chapter.
Clinical note임상 주석
非痞亦非結胸 — neither glomus nor chest bind. A third category for what fits neither, which is an unusually honest piece of classification.

Immun 入門

1.27 The Method of Warm Plastering for Chest Bind 𨠭結胸法

1.27.1
Source원문

用初出殼黃毛鷄子 一隻, 生薑 四兩, 共搗爛炒微溫, 攤在胸前結實之處, 外以絹帛縛之. 候半日許, 覺腹中熱燥, 解去, 更以熱手揉之. 《入門》

Translation영역
Take one newly hatched yellow-downed chick and 4 nyang of fresh ginger, pound them together soft and fry slightly warm; lay it over the hard bound place at the front of the chest and bind it over with silk. After about half a day, when heat and restlessness are felt in the belly, take it off and rub the place with a warm hand.

Immun 入門

1.28 The Method of Ironing for Chest Bind 熨結胸法

1.28.1
Source원문

治陰證結胸手足厥逆. 大葱白 十莖, 生薑 一兩, 搗爛作餠, 灸熱貼臍中, 以熨斗火熨餠上. 待熱氣入內, 覺響卽住, 復用枳實理中丸之類方見上. 《入門》

Translation영역
Treats a yin pattern chest bind with the hands and feet cold in reversal. Ten stalks of large scallion white and 1 nyang of fresh ginger, pounded soft and made into a cake, roasted hot and stuck on the navel, with a charcoal iron held over the cake. Wait until the hot qi enters within, and when a rumbling is felt stop; then use Bitter Orange Regulate the Centre Pill and its kind formula above.
Clinical note임상 주석
覺響卽住 — stop when a rumbling is heard. Bowel sounds returning as the endpoint of an external treatment, which is a sound thing to listen for and a rare one to find written down.

Immun 入門

1.29 Untreatable Signs in Chest Bind 結胸不治證

1.29.1
Source원문

結胸脉浮大者, 不可下, 下之卽死. 《仲景》 結胸證悉具, 煩躁者死. 《仲景》 結胸見陰脉陰證, 及喘急呃逆者, 亦死. 《入門》

Translation영역
Where in chest bind the pulse is floating and large it must not be purged, and purging kills. Where all the signs of chest bind are present and there is vexed restlessness, death. Where chest bind shows a yin pulse and yin signs, and there is panting and hiccup, likewise death.
Clinical note임상 주석
A floating large pulse in a patient who looks as though they need purging is the trap, and Zhongjing states the consequence plainly. The sign is that the strength is at the surface and there is nothing left to purge.

Junggyeong 仲景 · Immun 入門

1.30 Simple Medicinals 單方

1.30.1
Source원문

凡二十八種.

Translation영역
Twenty-eight kinds in all.

Donguibogam · Hyung

1.30.2
Source원문

伏龍肝 治卒心痛. 取爲末, 溫水調服二錢. 若冷, 則酒調服. 《本草》

Translation영역
Oven earth (伏龍肝): Treats sudden heart pain. Powder it and take 2 don stirred into warm water. If the pain is a cold one, take it stirred into wine.

Boncho 本草

1.30.3
Source원문

白礬 治心痛. 取細末一錢, 茶淸調下. 《綱目》 ○又方, 礬末二錢ㆍ醋半盞, 煮化溫服卽止, 去熱涎之功也. 《丹心》

Translation영역
Alum (白礬): Treats heart pain. Take 1 don of the fine powder stirred into clear tea. ○ Another method: powdered alum 2 don and half a jan of vinegar, boiled until dissolved and taken warm, and the pain stops at once; this is its power of removing hot drool.

Gangmok 綱目 · Dansim 丹心

1.30.4
Source원문

百草霜 治心痛. 取細末二錢, 以熱童尿調服, 卽愈. 《丹心》

Translation영역
Stove soot (百草霜): Treats heart pain. Take 2 don of the fine powder stirred into warm child's urine and it is cured at once.

Dansim 丹心

1.30.5
Source원문

鹽 治胃脘痛. 卒急無藥, 以鹽置刀頭燒紅, 淬入水中, 乘熱飮之, 吐痰卽愈. 《正傳》

Translation영역
Salt (鹽): Treats pain of the stomach duct. Where it comes on suddenly and no medicine is at hand: put salt on the head of a knife, heat it red, quench it in water, and drink it while it is still hot; phlegm is vomited up and the pain is cured at once.
Clinical note임상 주석
卒急無藥, it comes on suddenly and no medicine is at hand, is the whole indication — this is the emergency measure for a household with nothing in the cupboard. Hot brine drunk quickly is an emetic, and the chapter holds that a stomach pain from undigested food or phlegm is relieved by emptying it. That is sound where the cause is what it is said to be; where the pain is cardiac, which the chapter's own 眞心痛 section describes, it is not.

Jeongjeon 正傳

1.30.6
Source원문

木香 治九種心痛. 爲末和酒服. ○木香專泄決胸腹間滯塞冷氣, 得橘皮ㆍ肉豆蔲ㆍ生薑相佐, 絶佳. 《本草》

Translation영역
Costus root (木香): Treats the nine kinds of heart pain. Powder it and take it in wine. ○ Costus root is specific for draining and breaking through cold qi stagnant and blocked between the chest and the abdomen; with tangerine peel, nutmeg and fresh ginger as its assistants it is excellent.

Boncho 本草

1.30.7
Source원문

生地黃 治一切心痛, 無問新久. 擣絞取汁, 搜麪作餺飥, 或作冷淘食之, 良久當利出蟲長一尺許, 不復患矣. 後有二人患心痛垂絶, 皆服此得蟲出, 遂愈. 《本草》

Translation영역
Raw rehmannia (生地黃): Treats every kind of heart pain, whether new or long-standing. Pound it, press out the juice, knead it into wheat flour and make noodles, or make a cold noodle dish and eat it; after a good while a worm about a cheok long is passed out and the trouble does not return. Afterwards there were two people with heart pain at the point of death, and both took this and the worm came out and they were cured.
Clinical note임상 주석
The same remedy as in the Worm chapter, and the same case reported from the other side. A worm a cheok long is Ascaris, which reaches about that length, and heart pain at the point of death is the biliary colic of a worm in the common bile duct. The chapter places this among heart pains because that is where the patient feels it.

Boncho 本草

1.30.8
Source원문

乾薑 主卒心痛. 爲末, 米飮調二錢服. 《本草》

Translation영역
Dried ginger (乾薑): Governs sudden heart pain. Powder it and take 2 don stirred into rice water.

Boncho 本草

1.30.9
Source원문

生薑 和半夏煎服, 主心下急痛. ○又生薑汁和杏仁作煎服, 下氣結心胸痞, 神效.

Translation영역
Fresh ginger (生薑): Decocted together with pinellia and taken, it governs urgent pain below the heart. ○ Also, ginger juice boiled down with apricot kernel and taken brings down bound qi and glomus of the heart and chest — miraculously effective.

Donguibogam · Hyung

1.30.10
Source원문

黃連 治卒心痛. 剉水煎服, 日三. ○黃連治心下痞滿必用藥也. 仲景治九種心下痞, 五等瀉心湯皆用之. ○黃連瀉心下土邪, 故治痞最效. 《湯液》

Translation영역
Coptis (黃連): Treats sudden heart pain. Cut it up, decoct in water and take, three times a day. ○ Coptis is the medicine that must be used in treating glomus and fullness below the heart. Junggyeong, treating the nine kinds of glomus below the heart, used it in all five of the Drain the Heart Decoctions. ○ Coptis drains the earth evil below the heart, and so for treating glomus it is the most effective of all.
Clinical note임상 주석
The five 瀉心湯 of the Shanghanlun all contain coptis and all treat 心下痞 — a sensation of blockage below the breastbone without tenderness, which is functional dyspepsia as the tradition saw it. 土邪, the earth evil, names the spleen and stomach by their phase, so what coptis drains is heat in the stomach. It remains the reference drug for an epigastric fullness with heat signs.

Tangaek 湯液

1.30.11
Source원문

瓜蔞實 治胸痞痛不得卧ㆍ心痛徹背. 黃瓜蔞大者一枚ㆍ薤白三兩ㆍ半夏 製 四兩, 幷剉, 白酒七升, 煮取二升, 分再服. 《綱目》 ○治胸痛及痰嗽, 瓜蔞子連皮炒, 細硏, 麪糊和丸梧子大, 米飮呑下五十丸. 《本草》

Translation영역
Trichosanthes fruit (瓜蔞實): Treats glomus and pain in the chest so that one cannot lie down, and heart pain piercing through to the back. One large yellow trichosanthes fruit, Chinese chive bulb 3 nyang, pinellia processed 4 nyang, all cut up, boiled in 7 seung of white wine down to 2 seung and taken in two doses. ○ To treat chest pain and a phlegm cough: trichosanthes seed with the skin on, parched and ground fine, made into pills the size of a paulownia seed with wheat-flour paste, 50 pills swallowed down with rice water.
Clinical note임상 주석
This is 栝樓薤白半夏湯 of the Jingui Yaolüe given as a simple, and the indication the chapter attaches to it — 心痛徹背, pain in the chest piercing through to the back, with the patient unable to lie flat — is the classical description of 胸痺, chest impediment. The modern reading of that picture is angina, and the orthopnoea points at heart failure behind it. Trichosanthes, chive bulb and pinellia will not treat coronary disease, but the syndrome description is one of the most clinically recognizable in the book.

Gangmok 綱目 · Boncho 本草

1.30.12
Source원문

草豆蔲 主心腹冷痛. 草豆蔲仁及梔子炒爲末, 薑汁糊和丸服之, 或單煮服之亦佳. 《丹心》 ○此藥性溫, 能散滯氣. 若胃脘因寒作痛, 用之如鼓應桴. 濕痰作痛, 服之亦效. 但熱痛不可用也. 《正傳》

Translation영역
Katsumada galangal seed (草豆蔲): Governs cold pain in the heart and abdomen. Katsumada galangal kernel and gardenia, parched and powdered, made into pills with ginger-juice paste and taken; or boiled alone and taken, which is also good. ○ This medicine is warm in nature and is able to disperse stagnant qi. Where the stomach duct is painful because of cold, using it is like the drum answering the stick. Where the pain comes from damp phlegm, taking it is also effective. But for a hot pain it must not be used.
Clinical note임상 주석
The caution is the point, and the formula embodies it: galangal seed is warm and the gardenia parched with it is cold, so the pair covers the prescriber who has read the pattern wrong. 如鼓應桴, like the drum answering the stick, is the corpus's phrase for an immediate response, and it is reserved for cases where the indication is exactly met.

Dansim 丹心 · Jeongjeon 正傳

1.30.13
Source원문

陳艾葉 治卒心痛. 取熟艾濃煎服之, 卽差. 《本草》

Translation영역
Aged mugwort leaf (陳艾葉): Treats sudden heart pain. Take the matured mugwort, decoct it strongly and take it; it is cured at once.

Boncho 本草

1.30.14
Source원문

玄胡索 止心痛. 爲末酒調服. 雷公云, 心痛欲死, 速覓玄胡, 卽此也. 《本草》 ○又治血刺心痛, 瓦上炒爲末, 每二錢, 溫酒調下, 卽愈. 《得效》

Translation영역
Corydalis (玄胡索): Stops heart pain. Powder it and take it stirred into wine. Noegong said: when the heart pain is such that one would die of it, seek corydalis quickly — this is that. ○ It also treats a stabbing blood pain in the heart: parched on a tile, powdered, 2 don each time taken stirred into warm wine, and it is cured at once.
Clinical note임상 주석
心痛欲死, 速覓玄胡 — a jingle, and it has lasted because corydalis is the materia medica's best analgesic. Tetrahydropalmatine is a genuine analgesic and sedative with demonstrable action, and corydalis appears for severe pain of every kind through the corpus: here for the chest, in the 婦人 chapter for afterpains, elsewhere for the abdomen. The vinegar or wine processing matters — the alkaloids are poorly water-soluble as free bases and dissolve far better as salts.

Boncho 本草 · Deukhyo 得效

1.30.15
Source원문

白附子 主心痛. 炮爲末, 每二錢, 溫水調服, 卽差. 《本草》

Translation영역
Typhonium rhizome (白附子): Governs heart pain. Blast-roast it and powder it, 2 don each time taken stirred into warm water, and it is cured at once.
Clinical note임상 주석
炮, blast-roasting, is not a refinement here. Raw typhonium is an acrid irritant that blisters the mouth and throat, and the corpus never gives it raw internally. The processed drug is the one dispensed and the raw form is used externally only.

Boncho 本草

1.30.16
Source원문

半夏 消胸痞, 去痰, 又治心下急痛堅痞. 半夏硏爲末, 香油炒熟, 薑汁浸蒸餠和丸, 薑湯下三五十丸. 亦治喘而心痛. 《綱目》

Translation영역
Pinellia (半夏): Disperses glomus of the chest, removes phlegm, and also treats urgent pain below the heart with hard glomus. Pinellia ground to a powder, parched through in sesame oil, made into pills with steamed cake soaked in ginger juice, and 30 to 50 taken down with ginger decoction. It also treats panting with heart pain.
Clinical note임상 주석
Ginger runs through every step — the soaking, the pill base and the vehicle — and it is there for safety, not flavour. Raw pinellia contains needle-shaped calcium oxalate raphides that cause severe mucosal irritation, and ginger processing is the standard way of rendering it usable. Pinellia prepared with ginger is the only form that should be dispensed internally.

Gangmok 綱目

1.30.17
Source원문

牛膽南星 治結胸久不差ㆍ狂言ㆍ大小便不通. 取牛膽南星末二錢, 人參湯調服. 少頃, 更以熱人參湯投之, 便尿下黃黑物, 是效. 《得效》

Translation영역
Ox-bile arisaema (牛膽南星): Treats chest bind that has long gone uncured, with raving speech and stool and urine both blocked. Take ox-bile arisaema powder 2 don and take it stirred into ginseng decoction. After a short while give hot ginseng decoction again, and a yellow-black matter is passed in the stool and urine — that is the effect.

Deukhyo 得效

1.30.18
Source원문

乾漆 治九種心痛及瘀血心痛. 乾漆炒烟盡, 爲末, 醋糊和丸梧子大, 熱酒或醋湯下五七丸. 《本草》

Translation영역
Dried lacquer (乾漆): Treats the nine kinds of heart pain, and heart pain from static blood. Dried lacquer parched until the smoke is gone, powdered, made into pills the size of a paulownia seed with vinegar paste, and five to seven taken down with hot wine or vinegar decoction.

Boncho 本草

1.30.19
Source원문

梔子 胃口熱痛, 非梔子不可. 須以薑汁佐之, 川芎開之. ○心痛, 取大梔子十五枚, 去皮炒, 濃煎湯一小盞, 入薑汁令辣, 加川芎末一錢, 再煎服, 卽效. ○又方, 梔子仁炒爲末, 薑汁糊和丸服之, 亦效. 《丹心》

Translation영역
Gardenia (梔子): For a hot pain at the mouth of the stomach nothing but gardenia will do. Ginger juice must be used to assist it and cnidium to open it. ○ For heart pain: take fifteen large gardenias, peeled and parched, decocted strongly to one small cup; add ginger juice until it bites, add 1 don of cnidium powder, decoct again and take — it takes effect at once. ○ Another method: gardenia kernel parched and powdered, made into pills with ginger-juice paste and taken, which is also effective.
Clinical note임상 주석
非梔子不可 — nothing but gardenia will do — is Dangye on the hot epigastric pain, and the two assistants are as important as the chief. Gardenia alone is cold enough to settle in the stomach and do nothing; the ginger carries it and keeps it from chilling, and the cnidium moves. 令辣, until it bites, is a dosing instruction by taste, which is as precise as anything in the chapter.

Dansim 丹心

1.30.20
Source원문

枳實 治心下痞. 潔古用此去脾經積血, 故能去心下痞; 脾無積血, 則心下不痞矣. ○枳實能去脾間瘀血, 瘀血去而痞自消. ○非枳實不能除痞. 《東垣》 ○胸痞痛, 麩炒爲末, 米飮下二錢, 水煎服亦可. 《本草》

Translation영역
Bitter orange (枳實): Treats glomus below the heart. Jiegu used it to remove blood accumulated in the spleen channel, and so it is able to remove glomus below the heart; where the spleen has no accumulated blood there is no glomus below the heart. ○ Bitter orange is able to remove static blood from within the spleen, and when the static blood goes the glomus disperses of itself. ○ Nothing but bitter orange can remove glomus. ○ For glomus and pain of the chest: bran-parched and powdered, 2 don taken down with rice water; decocted in water and taken will also serve.
Clinical note임상 주석
Set beside the coptis entry above, this is the chapter's argument with itself: coptis is the medicine that must be used for glomus, and so is bitter orange, and each claim is stated absolutely. They are not in fact rivals — coptis drains the heat and bitter orange moves what is stuck — and the two together are the core of 枳實消痞丸.

Dongwon 東垣 · Boncho 本草

1.30.21
Source원문

茶 久心痛不可忍, 茶煎水和醋服之, 甚良. 《本草》

Translation영역
Tea (茶): For a long-standing heart pain beyond bearing, tea decocted in water and taken with vinegar is very good.

Boncho 本草

1.30.22
Source원문

胡椒 止心腹冷痛. 酒煮取汁服之. ○又取四十九粒ㆍ乳香一錢, 爲末, 男用薑湯下, 女用當歸湯下. 《丹心》

Translation영역
Black pepper (胡椒): Stops cold pain in the heart and abdomen. Boil it in wine and take the liquid. ○ Or take forty-nine corns with 1 don of frankincense, powdered; for a man take it down with ginger decoction, for a woman with angelica decoction.
Clinical note임상 주석
The two vehicles divide the sexes by what each is held to need — ginger to warm and move the qi, angelica to nourish and move the blood — and the same split appears wherever the corpus gives one powder to both. The forty-nine corns are seven sevens, a number chosen rather than measured.

Dansim 丹心

1.30.23
Source원문

川椒 治心胸冷痛. 酒煮取汁飮之. ○苦熱食氷雪冷物過多, 積冷心脾疼, 半歲不愈. 川椒三十粒, 浸漿水中經一宿, 漉出, 還以漿水呑下, 其病卽脫, 更不復作. 《得效》

Translation영역
Sichuan pepper (川椒): Treats cold pain of the heart and chest. Boil it in wine and drink the liquid. ○ Where one has suffered from heat and eaten too much ice and snow and cold things, so that cold has accumulated and the heart and spleen ache and will not mend in half a year: thirty Sichuan peppercorns steeped a night in fermented rice water, strained out and swallowed down with that same water, and the illness falls away at once and does not return.

Deukhyo 得效

1.30.24
Source원문

蛤粉 治心氣不可忍. 蛤粉炒, 白湯調服. 《丹心》 ○蛤粉和香附末, 薑汁調服, 治痰心痛甚效. 《丹心》 ○熱心痛, 蛤粉ㆍ百草霜爲末, 茶淸或冷水調下. 《丹心》

Translation영역
Clamshell powder (蛤粉): Treats a heart qi beyond bearing. Clamshell powder parched and taken stirred into plain hot water. ○ Clamshell powder with powdered cyperus, taken stirred into ginger juice, treats a phlegm heart pain and is very effective. ○ For a hot heart pain: clamshell powder and stove soot powdered, taken down stirred into clear tea or cold water.

Dansim 丹心

1.30.25
Source원문

田螺殼 治卒心痛. 田螺爛殼燒爲末, 熱酒調下一錢半, 卽愈. 《綱目》 ○亦治濕痰胃脘痛, 服之立止. 《正傳》

Translation영역
River snail shell (田螺殼): Treats sudden heart pain. The weathered shell of the river snail burnt and powdered, 1½ don taken down stirred into hot wine, and it is cured at once. ○ It also treats a damp-phlegm pain of the stomach duct; taking it stops the pain at once.
Clinical note임상 주석
Burnt shell is calcium oxide and carbonate, and taken in water it neutralizes stomach acid — which is what the four shell-and-mineral entries in this stretch of the section have in common. A pain at the stomach duct relieved within minutes by an alkaline powder is dyspepsia or an ulcer, and this is an antacid.

Gangmok 綱目 · Jeongjeon 正傳

1.30.26
Source원문

鰻鱺魚 治諸蟲心痛多吐涎. 取魚淡灸令熟, 食三五度, 差. 《本草》

Translation영역
Japanese eel (鰻鱺魚): Treats heart pain from worms of every kind, with much drooling. Take the fish, grill it plain until done, and eat it three to five times; it cures.

Boncho 本草

1.30.27
Source원문

烏賊魚墨 婦人崩漏而心痛甚, 名曰殺血心痛. 烏賊墨炒爲末, 醋湯調服. 亦治小産後下血過多心痛. 《入門》

Translation영역
Cuttlefish ink (烏賊魚墨): Where a woman has flooding and spotting and severe heart pain, it is called the killed-blood heart pain. Cuttlefish ink parched and powdered, taken stirred into vinegar decoction. It also treats heart pain after a miscarriage with excessive loss of blood.
Clinical note임상 주석
The same entry appears in the Women chapter, and the condition it names is worth holding onto: chest pain following heavy blood loss, which is demand ischaemia in an acutely anaemic heart. 殺血心痛, the killed-blood heart pain, is a precise name for a real association, and it is one of the places where the tradition's observation outruns its remedy.

Immun 入門

1.30.28
Source원문

蜜 治卒心痛. 蜜與薑汁各一合, 水和頓服, 卽止. 《本草》

Translation영역
Honey (蜜): Treats sudden heart pain. Honey and ginger juice, 1 hop each, mixed with water and taken at one draught, and it stops at once.

Boncho 本草

1.30.29
Source원문

桃仁 止心痛. 取七枚, 去皮尖, 熟硏, 水一合和頓服, 良. 亦治三十年久痛. 《本草》

Translation영역
Peach kernel (桃仁): Stops heart pain. Take seven kernels, remove the skins and tips, grind them thoroughly, mix with 1 hop of water and take at one draught — good. It also treats a pain of thirty years' standing.

Boncho 本草

1.30.30
Source원문

桃奴 治心痛及疰痛. 桃奴爲末, 每二錢, 溫酒下, 空心, 名曰蟠桃酒. 《醫鑑》

Translation영역
Withered peach (桃奴): Treats heart pain and infixation pain. Withered peach powdered, 2 don each time taken down in warm wine on an empty stomach; it is called Bando-ju 蟠桃酒, Flat Peach Wine.
Clinical note임상 주석
桃奴 is the fruit that sets but never ripens and hangs withered on the tree through the winter, and the corpus gives it for 疰, infixation — pain held to be caused by a lodged malign influence. A fruit that will not fall is given for a pain that will not leave. The name 蟠桃 is the peach of immortality in the Queen Mother's garden, which tells you what register the prescription belongs to.

Uigam 醫鑑

1.30.31
Source원문

桃枝 治卒心痛. 取枝一握切, 酒一升, 煎取半升, 頓服, 大效. 《本草》

Translation영역
Peach twig (桃枝): Treats sudden heart pain. Take a handful of twigs, cut up, with 1 seung of wine, decocted down to half a seung and taken at one draught — greatly effective.

Boncho 本草

1.30.32
Source원문

芥子 治心痛. 酒醋硏取汁服之. 《本草》

Translation영역
Brown mustard seed (芥子): Treats heart pain. Grind it with wine and vinegar, take the liquid and drink it.

Boncho 本草

1.30.33
Source원문

脂麻油 治心痛無問冷熱. 生香油一合服之. ○又治蛔心痛, 飮之良. ○一人患腰痛牽心, 發則氣絶. 徐文伯視之曰, 髮瘕也. 以油灌之, 吐一物如蛇, 無目, 懸之滴盡, 惟一髮. 《本草》

Translation영역
Sesame oil (脂麻油): Treats heart pain, whether cold or hot. Take 1 hop of raw sesame oil. ○ It also treats heart pain from roundworm; drinking it is good. ○ A man suffered a lumbar pain that dragged at his heart, and when it came on his qi failed altogether. Xu Wenbo examined him and said, this is a hair conglomeration. Oil was poured into him and he vomited up a thing like a snake, with no eyes; hung up until it had dripped dry, it was nothing but a single hair.
Clinical note임상 주석
髮瘕, the hair conglomeration, is a trichobezoar — a mass of swallowed hair in the stomach — and the description of what came up, a long eyeless snake-like thing that proved to be hair, is accurate. Trichobezoars do cause epigastric pain, obstruction and vomiting, and they occur in people who pull and eat their own hair. Oil would not dissolve one; the case is preserved for the diagnosis, which is correct, rather than the cure.

Boncho 本草

1.30.34
Source원문

葱白 治心腹痛, 又治急心疼牙噤欲死. 老葱白三五根, 擂爲膏, 斡開口, 將膏送入咽喉, 以香油四兩灌下. 但得葱下喉, 其人必甦. 腹中蟲積化爲黃水微利, 卽愈, 永除根. 《綱目》

Translation영역
Scallion white (葱白): Treats pain of the heart and abdomen, and also an urgent heart pain with the teeth clenched and the patient at the point of death. Old scallion white, three to five stalks, pounded to a paste; prise the mouth open, pass the paste down into the throat, and pour 4 nyang of sesame oil after it. Once the scallion goes down the throat the person is bound to revive. The worm accumulation in the belly turns to a yellow water and is passed with a slight purge, and the cure is complete and lasting.
Clinical note임상 주석
牙噤欲死, the teeth clenched and the patient at the point of death, is a patient who has lost consciousness, and prising the mouth open to force paste and four nyang of oil down the throat of someone in that state is how an aspiration happens. The entry's confidence — once the scallion goes down, the person is bound to revive — is the kind of claim that survives because the cases where it failed were not written up.

Gangmok 綱目

1.30.35
Source원문

蒜 血氣心痛, 生蒜擣取汁飮一盞, 卽差. ○久心痛不可忍, 小蒜醋煮頓服, 取飽, 不着鹽, 隨手神效. 《本草》

Translation영역
Garlic (蒜): For a heart pain of blood and qi, pound raw garlic, take 1 jan of the juice and drink it — it is cured at once. ○ For a long-standing heart pain beyond bearing: small garlic boiled in vinegar and taken at one draught, eaten to repletion, with no salt added — effective the moment it is used.

Boncho 本草

1.30.36
Source원문

韭汁 治胸痞ㆍ心中急痛, 或痛徹背上欲死. 擣取汁灌服之, 卽吐胸中惡血而愈. 《本草》 ○食鬱久, 則胃脘有瘀血作痛. 韭汁一盞, 先嚼桃仁十數枚, 以汁送下. 《正傳》 ○韭汁能去胸中惡血滯氣. 《綱目》

Translation영역
Chinese chive juice (韭汁): Treats glomus of the chest and urgent pain within the heart, or pain piercing through to the back so that one is at the point of death. Pound it, take the juice and pour it in, and the malign blood in the chest is vomited up and the patient is cured. ○ Where food has been depressed a long while, the stomach duct has static blood and aches. Chinese chive juice, 1 jan: first chew ten or more peach kernels and send them down with the juice. ○ Chinese chive juice is able to remove malign blood and stagnant qi from the chest.
Clinical note임상 주석
Chive juice with peach kernel for a static-blood stomach pain is the ancestor of a line that runs down to the present: it is the core of 韭汁牛乳飮, which Dangye gave for ye-gyeok, the obstruction of the gullet, and the same pair appears in the Vomiting chapter. 食鬱久 — food depressed a long while — describes a chronic epigastric pain following meals, and the tradition reads the chronicity as blood having settled where qi was stuck.

Boncho 本草 · Jeongjeon 正傳 · Gangmok 綱目

1.30.37
Source원문

雞卵 治心痛. 取一枚打開, 好醋二合和攪, 煖頓服, 卽差. 《本草》

Translation영역
Hen's egg (雞卵): Treats heart pain. Take one, break it open, stir it with 2 hop of good vinegar, warm it and take at one draught, and it is cured at once.

Boncho 本草

1.30.38
Source원문

麝香 主鬼疰心痛. 取大豆許, 溫水硏服之. 《本草》

Translation영역
Musk (麝香): Governs heart pain of ghost infixation. Take about the bulk of a soybean, grind it in warm water and take it.
Clinical note임상 주석
**This is not to be used.** All musk deer species are CITES-listed and trade in the gland is prohibited. 鬼疰, ghost infixation, is a pain attributed to a malign influence that has lodged, and musk is given for it throughout the corpus on the strength of its power to open the orifices and rouse the spirit.

Boncho 本草

1.30.39
Source원문

熊膽 治蟲心痛. 取大豆許, 和水服, 大效. 《本草》

Translation영역
Bear bile (熊膽): Treats heart pain from worms. Take about the bulk of a soybean, take it with water — greatly effective.
Clinical note임상 주석
**This is not to be used.** All bear species are CITES-listed and trade in bile is prohibited; ursodeoxycholic acid is manufactured synthetically and licensed. The section closes where the Worm chapter's does, on the same two prohibited animal products given for the same worm pain — which is a fair measure of how much the two chapters overlap.

Boncho 本草

1.31 Acupuncture and Moxibustion 鍼灸法

1.31.1
Source원문

九種心痛, 取間使ㆍ靈道ㆍ公孫ㆍ太衝ㆍ足三里ㆍ陰陵泉. 《綱目》

Translation영역
For the nine kinds of heart pain, take Gansa (間使, PC5), Yeongdo (靈道, HT4), Gongson (公孫, SP4), Taechung (太衝, LR3), Jok-samni (足三里, ST36) and Eumneungcheon (陰陵泉, SP9).
Clinical note임상 주석
Two points on the heart and pericardium channels, two on the spleen, one on the liver and one on the stomach — the spread matches 1.6's argument that most of what is called heart pain is in fact stomach and spleen pain.

Gangmok 綱目

1.31.2
Source원문

卒心痛, 取然谷ㆍ上脘ㆍ氣海ㆍ湧泉ㆍ間使ㆍ支溝ㆍ足三里ㆍ太敦ㆍ獨陰. 《綱目》

Translation영역
For sudden heart pain, take Yeongok (然谷, KI2), Sangwan (上脘, CV13), Gihae (氣海, CV6), Yongcheon (湧泉, KI1), Gansa (間使, PC5), Jigu (支溝, TE6), Jok-samni (足三里, ST36), Taedon (太敦, LR1) and Dogeum (獨陰).
Clinical note임상 주석
獨陰 is on the sole of the second toe and is not in the modern channel lists; the Bogam's own 鍼灸篇 gives it among the 奇穴. 湧泉 and 然谷 on the kidney channel head the list, which is the acute prescription — points at the far end of the body for a pain at the centre.

Gangmok 綱目

1.31.3
Source원문

胃脘痛, 取足三里. 《靈樞》

Translation영역
For pain at the stomach duct, take Jok-samni (足三里, ST36).

Yeongchu 靈樞

1.31.4
Source원문

病在膺, 必灸刺魂門. 《資生》

Translation영역
Where the disease is in the breast, Honmun (魂門, BL47) must be moxaed or needled.

Jasaeng 資生

1.31.5
Source원문

陰維爲病, 苦心痛, 取內關. 《難經》

Translation영역
Where the yin linking vessel is diseased there is distressing heart pain: take Naegwan (內關, PC6).
Clinical note임상 주석
陰維 is the yin linking vessel, 陰維脉, whose confluence is 內關; the Nanjing's one-line indication is why PC6 remains the first point for chest and epigastric pain.

Nangyeong 難經

1.31.6
Source원문

手心主之病, 實則心痛, 取內關. 《綱目》

Translation영역
In disease of the hand heart governor, repletion brings heart pain: take Naegwan (內關, PC6).

Gangmok 綱目

1.31.7
Source원문

心痛引背, 取京骨ㆍ崑崙, 不已取然谷ㆍ委陽. 《靈樞》

Translation영역
Where heart pain draws into the back, take Gyeonggol (京骨, BL64) and Gollyun (崑崙, BL60); if it does not stop, take Yeongok (然谷, KI2) and Wiyang (委陽, BL39).
Clinical note임상 주석
心痛引背 — pain radiating to the back, and the points are all on the foot greater yang, which is the channel that runs there. Pain from chest to back is the presentation that now raises aortic dissection.

Yeongchu 靈樞

1.31.8
Source원문

心脾痛, 取巨闕ㆍ上脘ㆍ中脘. 《綱目》

Translation영역
For heart and spleen pain, take Geogwol (巨闕, CV14), Sangwan (上脘, CV13) and Jungwan (中脘, CV12).

Gangmok 綱目

1.31.9
Source원문

厥心痛卽腎心痛也, 先取京骨ㆍ崑崙, 不已取然谷ㆍ大都ㆍ太白ㆍ太谿ㆍ行間ㆍ太衝ㆍ魚際ㆍ太淵. 《靈樞》

Translation영역
Reversal heart pain is kidney heart pain: first take Gyeonggol (京骨, BL64) and Gollyun (崑崙, BL60); if it does not stop, take Yeongok (然谷, KI2), Daedo (大都, SP2), Taebaek (太白, SP3), Taegye (太谿, KI3), Haenggan (行間, LR2), Taechung (太衝, LR3), Eoje (魚際, LU10) and Taeyeon (太淵, LU9).

Yeongchu 靈樞

1.31.10
Source원문

蟲心痛, 灸上脘ㆍ中脘ㆍ陰都. 《得效》

Translation영역
For worm heart pain, moxa Sangwan (上脘, CV13), Jungwan (中脘, CV12) and Eumdo (陰都, KI19).

Deukhyo 得效

1.31.11
Source원문

血心痛, 取期門. 《綱目》

Translation영역
For blood heart pain, take Gimun (期門, LR14).

Gangmok 綱目

1.31.12
Source원문

傷寒結胸, 先使人心蔽骨下正痛處左畔揉之, 以毫鍼刺左畔支溝穴, 次刺左間使, 名曰雙關刺, 次刺左行間, 左一壁結胸立效. 右畔依上法刺之, 慢慢呼吸停鍼, 卽時愈. 《綱目》

Translation영역
In chest bind of cold damage, first have someone rub the left side of the place of true pain below the covering bone of the heart; then needle Jigu (支溝, TE6) on the left side with a fine needle, and next Gansa (間使, PC5) on the left — this is called the double-gate needling — and next Haenggan (行間, LR2) on the left, and the chest bind on the left wall answers at once. Needle the right side by the same method, with the breath slow and the needle left in place, and it heals immediately.
Clinical note임상 주석
The one needling technique described step by step in the chapter: rubbing the painful side first, then three points on the same side in sequence, then the other side, with the needles retained and the breathing slowed. 心蔽骨 is the xiphoid process.

Gangmok 綱目

1.31.13
Source원문

心胸痞, 湧泉ㆍ太谿ㆍ中衝ㆍ大陵ㆍ隱白ㆍ太白ㆍ少衝ㆍ神門. 《綱目》

Translation영역
For glomus of the heart and chest: Yongcheon (湧泉, KI1), Taegye (太谿, KI3), Jungchung (中衝, PC9), Daeneung (大陵, PC7), Eunbaek (隱白, SP1), Taebaek (太白, SP3), Sochung (少衝, HT9) and Sinmun (神門, HT7).

Gangmok 綱目

1.31.14
Source원문

結胸身黃, 取湧泉. 《綱目》

Translation영역
For chest bind with the body gone yellow, take Yongcheon (湧泉, KI1).

Gangmok 綱目

1.31.15
Source원문

結胸灸法: 巴豆 十粒(去皮硏細)ㆍ黃連末 一錢. 右以津唾和成餠, 塡臍中, 以艾灸其上, 腹中有聲, 其病去矣. 不拘壯數, 病去爲度. 灸了, 溫湯浸手帕拭之, 恐生瘡. 《綱目》

Translation영역
The moxa method for chest bind: ten croton seeds (husked and ground fine) and 1 don of powdered coptis. Mix with saliva into a cake, pack it into the navel and moxa on top of it; when there is a sound in the belly the disease has gone. The number of cones is not fixed — the measure is the disease going. When the moxa is done, wipe the place with a cloth wrung out in warm water, for fear a sore arises.
Clinical note임상 주석
**巴豆, croton, is a violent purgative and a vesicant, and must not be put on the skin.** The Gangmok's own closing instruction — wipe it off afterwards for fear a sore arises — says the blistering was known. 腹中有聲 as the end point is the bowel moving, which is what the croton does once it is absorbed.

Gangmok 綱目

1.31.16
Source원문

一切心腹胸脇腰背苦痛, 川椒爲細末, 醋和爲餠, 貼痛處, 用熟艾鋪餠上, 發火燒艾, 痛卽止. 《醫鑑》

Translation영역
For any distressing pain of the heart, abdomen, chest, flanks, lumbus or back: grind Sichuan pepper fine, mix with vinegar into a cake, lay it on the painful place, spread cured mugwort on the cake, light it and let the mugwort burn, and the pain stops.
Clinical note임상 주석
Indirect moxibustion over a pepper-and-vinegar plaster, applied wherever the pain is rather than at a named point. The last item in the chapter and the most generally useful of them.

Uigam 醫鑑

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Outer Form, Volume 3, Chest chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.