胁痛，肝火盛，木气实，有死血，有痰流注，肝急。木气实，用苍术、川芎、
皮、当归之类；痛甚者，肝火盛，以当归龙荟丸，姜汁下，是泻火之要药；死血，用桃仁
红花、川芎；痰流注，以二陈汤加南星、苍术、川芎；肝苦急，急食辛以散之，用抚芎、
苍术。血病，入血药中行血。治咳嗽胁痛，以二陈汤加南星、香附、青皮、青黛，入姜汁。
胁痛有瘀血，行气药中加桃仁不去尖，并香附之类。有火盛者，当伐肝木。
左金丸治肝火，有气郁而胸胁痛者，看其脉沉涩，当作郁治。痛而不得伸舒者蜜丸，龙荟
快。胁下有食积一条扛起，用吴茱萸、炒黄连。控涎丹，一身气痛，及胁痛，痰挟死血，
桃仁泥，丸服。右胁痛，用推气散，出严氏方；左胁痛，用前药为君加柴胡或小柴胡，亦
入方
小龙荟丸
当归 草龙胆（酒洗） 山栀（炒） 黄连（炒） 川芎（各半两） 大黄（煨，半两） 芦荟（三钱）
木香（一钱）
一方有黄芩、柴胡各半两，无大黄、木香。一方有甘草、柴胡、青皮，无当归、栀子。
上为末，入麝香少许，粥糊丸如绿豆大。每服五十丸，姜汤下。仍以琥珀膏贴痛处。龙
荟丸，亦治有积，因饮食大饱，劳力行房胁痛。
当归龙荟丸 治内有湿热，两胁痛。先以琥珀膏贴痛处，却以生姜汁吞此丸。痛甚者，
草龙胆 当归 大栀子 黄连 黄芩（各一两） 大黄 芦荟（各半两） 木香（一钱半） 黄柏（一
两） 麝香（半钱）
上十味为末，面糊丸。一方，加柴胡、川芎各半两。又方，加青黛半两。蜜丸，治胁痛
；曲丸，降肝火。
抑青丸 泻肝火。
黄连（半斤）
上为末，蒸饼糊丸服。
〔附录〕胁下痛，发寒热，小柴胡汤。肥白人因气虚而发寒热，胁下痛者，补虚用参、
，退热用柴胡、黄芩，调气止痛用青木香、青皮。瘦人胁下痛，发寒热，多怒者，必有瘀血，
宜桃仁、当归、红花、柴胡、青皮、大黄、栀子、草龙胆。
附方
推气散 治右胁疼痛，胀满不食。
枳壳 桂心 片子姜黄（各半两，一本作僵蚕） 甘草（炙，一钱半）
上为末。每服二钱，姜枣汤调下，酒亦可。
枳芎散 治左胁痛刺不可忍者。
枳实（炒） 川芎（各半两） 粉草（炙，一钱半）
上为末。每服二钱，姜枣汤下，酒亦可。
十枣汤 治胁痛，甚效，病患气实可用，虚人不可用。
甘遂 芫花（慢火□紫色） 大戟（各等分）
上为末，水一大盏，枣十枚，切开，煮取汁半盏，调半钱，人实更加一钱。量虚实加减
控涎丹 见痛风类。
小柴胡汤 见疟类。
琥珀汤 见积聚类。
Hypochondriac pain, if caused by excessive Liver Fire, excess Wood Qi, stagnant blood, phlegm flowing and depositing, or Liver urgency. For excess Wood Qi, use Rhizoma Atractylodis Macrocephalae (Cangzhu), Rhizoma Chuanxiong (Chuanxiong), Pericarpium Citri Reticulatae (Chenpi), Radix Angelicae Sinensis (Danggui); for severe pain due to excessive Liver Fire, administer Danggui Longhui Wan (Angelica Sinensis and Picrorhiza Pill) taken with ginger juice, which is a key herb for purging fire; for stagnant blood, use Semen Persicae (Taoren), Flos Carthami Tinctorii (Honghua), Rhizoma Chuanxiong (Chuanxiong); for phlegm flowing and depositing, use Erchen Tang (Two-Cured Decoction) added with Rhizoma Pinelliae Preparatum (Nanxing), Rhizoma Atractylodis Macrocephalae (Cangzhu), Rhizoma Chuanxiong (Chuanxiong); when the Liver suffers from urgency, urgently consume pungent substances to disperse it, using Fuxiong (a type of Chuanxiong), Rhizoma Atractylodis Macrocephalae (Cangzhu). For blood diseases, incorporate blood-invigorating herbs into blood-activating formulas. To treat cough with hypochondriac pain, use Erchen Tang (Two-Cured Decoction) added with Rhizoma Pinelliae Preparatum (Nanxing), Rhizoma Cyperi (Xiangfu), Exocarpium Citri Grandis (Qingpi), Indigo Naturalis (Qingdai), adding ginger juice. For hypochondriac pain with blood stasis, add unpitted Semen Persicae (Taoren) and Rhizoma Cyperi (Xiangfu) among qi-moving herbs. For those with excessive fire, one should purge the Liver Wood.
Zuojin Wan (Left Metal Pill) treats Liver Fire. For cases with Qi stagnation causing chest and hypochondriac pain, if the pulse is deep and choppy, treat as stagnation. For pain accompanied by inability to stretch comfortably, Longhui Wan (Picrorhiza Pill) in honeyed pill form acts quickly. For a band-like accumulation of food retention under the hypochondrium, use Fructus Evodiae Officinalis (Wuzhuyu), stir-fried Radix Coptidis Chinensis (Huanglian). Kongxian Dan (Control Phlegm Elixir) treats generalized Qi pain and hypochondriac pain; if phlegm clings to stagnant blood, prepare pills with Semen Persicae paste for oral administration. For right-sided hypochondriac pain, use Tuiqi San (Pushing Qi Powder) from Yan Shi's formula; for left-sided hypochondriac pain, use the aforementioned drugs as the sovereign, adding Radix Bupleuri (Chaihu) or Xiaochaihu Tang (Minor Bupleurum Decoction), also included in the formula Xiaolonghui Wan (Little Dragon Gallbladder Pill).
Xiaolonghui Wan Composition: Radix Angelicae Sinensis (Danggui), Radix Scutellariae Barbatae (Caolongdan, wine-washed), Fructus Gardeniae Jasminoidis (Shanzhi, stir-fried), Radix Coptidis Chinensis (Huanglian, stir-fried), Rhizoma Chuanxiong (Chuanxiong) (each 1.5 liang), Radix et Rhizoma Rhei Palmati (Dahuang, baked, 1.5 liang), Aloe (Luhui) (1 qian), Radix Aucklandiae (Muxiang) (0.1 qian). Another prescription contains Radix Scutellariae Baicalensis (Huangqin) and Radix Bupleuri (Chaihu) each 1.5 liang, without Dahuang and Muxiang. Yet another contains Radix Glycyrrhizae Uralensis (Gancao), Radix Bupleuri (Chaihu), Exocarpium Citri Grandis (Qingpi), without Danggui and Shanzhi. Grind the above into powder, add a small amount of Moschus (Shexiang), make pills with rice porridge paste the size of mung beans. Take 50 pills each time, washed down with ginger soup. Still apply Hupo Gao (Amber Plaster) to the painful area. Longhui Wan also treats hypochondriac pain caused by overeating followed by labor and sexual intercourse.
Danggui Longhui Wan: Treats damp-heat inside causing bilateral hypochondriac pain. First apply Hupo Gao (Amber Plaster) to the painful area, then swallow this pill with fresh ginger juice. For severe pain, use Radix Scutellariae Barbatae (Caolongdan), Radix Angelicae Sinensis (Danggui), Magnolia Flower (Dazishizi - note: text says Da Zhizi, likely Fructus Gardeniae), Radix Coptidis Chinensis (Huanglian), Radix Scutellariae Baicalensis (Huangqin) (each 1 liang), Radix et Rhizoma Rhei Palmati (Dahuang), Aloe (Luhui) (each 0.5 liang), Radix Aucklandiae (Muxiang) (1.5 qian), Cortex Phellodendri Amurensis (Huangbai) (1 liang), Moschus (Shexiang) (0.5 qian). Grind these ten ingredients into powder, make pills with wheat flour paste. Another prescription adds Radix Bupleuri (Chaihu) and Rhizoma Chuanxiong (Chuanxiong) each 0.5 liang. Yet another adds Indigo Naturalis (Qingdai) 0.5 liang. Honeyed pills treat hypochondriac pain; Qu pills (fermented pill base) reduce Liver Fire.
Yiqing Wan (Suppress Blue Pill): Purges Liver Fire. Composition: Radix Coptidis Chinensis (Huanglian) (8 liang). Grind into powder, make pills with steamed cake paste for oral administration.
[Appendix] Pain under the hypochondrium with alternating chills and fever, use Xiaochaihu Tang (Minor Bupleurum Decoction). For obese individuals with Qi deficiency causing chills, fever, and hypochondriac pain, tonify deficiency with Ginseng Radix et Rhizoma (Renshen)... [text missing], clear heat with Radix Bupleuri (Chaihu), Radix Scutellariae Baicalensis (Huangqin), regulate Qi and relieve pain with Radix Aucklandiae (Qingmuxiang), Exocarpium Citri Grandis (Qingpi). For thin individuals with hypochondriac pain, chills, fever, and irritability, there must be blood stasis; use Semen Persicae (Taoren), Radix Angelicae Sinensis (Danggui), Flos Carthami Tinctorii (Honghua), Radix Bupleuri (Chaihu), Exocarpium Citri Grandis (Qingpi), Radix et Rhizoma Rhei Palmati (Dahuang), Fructus Gardeniae Jasminoidis (Zhizi), Radix Scutellariae Barbatae (Caolongdan).
Attached Formulas:
Tuiqi San (Pushing Qi Powder): Treats right hypochondriac pain, distension, and anorexia. Composition: Fructus Aurantii (Zhike), Cortex Cinnamomi (Guixin), Rhizoma Curcumae Longae (Pianzi Jianghuang) (each 1.5 liang, one version uses Bombyx Batryticatus/Jiangcan), Radix Glycyrrhizae Uralensis (Gancao, roasted) (1.5 qian). Grind into powder. Take 2 qian each time, mixed with ginger and jujube decoction, wine is also acceptable.
Zhixiong San (Aurantium and Chuanxiong Powder): Treats unbearable stabbing pain in the left hypochondrium. Composition: Fructus Aurantii Immaturus (Zhishi, stir-fried), Rhizoma Chuanxiong (Chuanxiong) (each 1.5 liang), Radix Glycyrrhizae Uralensis (Fencao, roasted) (1.5 qian). Grind into powder. Take 2 qian each time, washed down with ginger and jujube decoction, wine is also acceptable.
Shizao Tang (Ten Jujube Decoction): Treats hypochondriac pain, very effective; usable for patients with excess Qi, not for deficient persons. Composition: Radix Kansui (Gansui), Flos Genkwa (Yanhua, slow-fire roasted until purple), Radix Euphorbiae Lathyris (Daji) (equal parts). Grind into powder. Use one large cup of water, ten jujubes cut open, boil to obtain half a cup of juice, mix with 0.5 qian of powder; for robust individuals, increase by 1 qian. Adjust dosage according to deficiency or excess.
Kongxian Dan: See Gout category.
Xiaochaihu Tang: See Malaria category.
Hupo Tang: See Accumulation category.