A woman suffered from epigastric pain, unable to swallow even a spoonful of water, accompanied by alternating chills and fever (Huare Wanglai). Some physicians treated it as a Fire syndrome, using bitter-cold herbs such as Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhizi (Gardeniae Fructus), and Huangbai (Phellodendri Cortex). Others treated it as a Cold syndrome, using acrid-hot herbs such as Jiang (Zingiberis Rhizoma), Rougui (Cinnamomi Cortex), and Zhuyu (Evodiae Fructus). After more than a month of辗转 treatment, her body became emaciated and weak, with wiry and rapid pulses in all six positions, nearing death. I said, "This is Liver pain, not epigastric pain." The disease originated from stagnation transforming into fire, injuring Yin blood, leading to the withering and drying of the Liver and Kidneys, causing pain due to dryness forcing movement. The physicians further injured the stomach by administering bitter-cold and acrid-hot agents; how could she recover? I urgently prescribed Zishen Shenggan Yin (Nourish Kidney and Generate Liver Decoction) for her. She consumed three large doses within one day and night. At wu gu (5-7 AM), she fell into a deep sleep. The next day, the pain subsided, and she felt hungry. Subsequently, Jiawei Guipi Tang (Modified Tonify the Spleen Decoction) was used with added Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus). After more than ten doses, she recovered.
The syndrome of Liver pain actually supplements the treatments for epigastric pain that were previously unaddressed by Mr. Siming. I often follow his principles to treat patients with insufficient blood in the Liver meridian: for those with insufficient blood and dryness, Shugan Yishen Tang (Soothe Liver and Benefit Kidney Decoction) is used with added Danggui (Angelicae Sinensis Radix); or Zuogui Yin (Left Restoring Drink) with added Chaihu (Bupleuri Radix) and Baishao (Paeoniae Radix Alba); or Zishen Shenggan Yin; or Zishen Qinggan Yin (Nourish Kidney and Clear Liver Decoction). Formulas are selected according to symptoms, yielding immediate results without exception. If one seeks the cause from factors such as Phlegm-Fire, Cold, or Food Stagnation, the approach is far off. Moreover, if internal factors like Phlegm-Fire, Cold, or Food Stagnation exist, they must manifest externally, allowing one to...