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Realgar, Borneolum Syntheticum (Bofan), and Areca Seed (Betel Nut) are used in equal proportions.
They are ground together into a powder and formed into pills the size of millet seeds using rice paste. Each dose is 0.5 fen (approx. 1.875g or 3g depending on historical standard, here kept as 'fen'), taken long after meals.
Intermittent dry pain in the abdomen indicates worm pain; this formula treats it.
"Dry pain" refers to pain without vomiting or diarrhea. "Intermittent" means symptoms occur when eating light food and feeling hungry, but do not occur when eating rich/flavorful food and feeling full. The *Fusu Jing* states:
If worms are abundant, emetic, purgative, or vermifuge agents may be added, adjusted according to the patient's deficiency or excess condition.

Emperor Huizong of Song frequently consumed ice, which led to abdominal pain. The imperial physicians' prescribed medicines were ineffective. He then summoned Yang Jilao from Sizhou for pulse diagnosis. Yang Jilao said, "The Lizhong Wan (Regulate the Middle Pill) should be the primary treatment." The Emperor replied, "I have taken it many times with no effect." Yang Jilao said, "The vehicles (solvents/excipients) used in previous decoctions were different. Your Majesty's illness resulted from consuming ice. Now, I use ice to decoct the medicine. This follows the principle of treating like with like. If not for Yang Jilao's superior skill, who could have devised this?"

Preface: The hypochondriac region is the area of the Liver and Gallbladder. The Liver is the extreme Yin organ, and the Gallbladder has no separate orifice. Anger causes Qi to have no outlet to vent, and stagnation causes Fire to have no path to escape. Therefore, pathological manifestations are often numerous. Here, three famous formulas are examined to show their general principles.

Coptis Rhizome (Coptidis Rhizoma) (Single ingredient, soaked overnight in Evodia Decoction [Wuzhuyu Tang], dried, and ground into powder for pill formation)
Pain in the left hypochondrium is treated by this formula.
The Liver corresponds to Wood in the East. Standing facing South, the left side is East; thus, the left hypochondrium is the location of the Liver. Pain occurs because Wood Qi is excessive. For Wood to become excessive, Metal must regulate it. Coptis Rhizome clears Heart Fire, so that Metal is unafraid and naturally sufficient to subdue Liver Wood; hence it is called "Yiqing" (Suppressing Green). This follows the ancient principle of "draining the son when the mother is excess," treating it with its conquering element (Metal conquers Wood; note: original text mentions "water conquers," which contradicts standard Wu Xing theory regarding Metal/Wood, but translates literally as treating with what water conquers, likely a textual error in source or specific theoretical nuance, translated faithfully).

Bupleuri Radix (Chaihu), Scutellariae Radix (Huangqin), Ginseng Radix et Rhizoma (Renshen), Glycyrrhizae Radix et Rhizoma (Gancao), Pinelliae Tuber (Banxia), Zingiberis Rhizoma Recens (Shengjiang), and Jujubae Fructus (Dazao)
Pain in both hypochondria is treated by this formula.
Shaoyang Gallbladder Meridian runs through both hypochondria; therefore, pain in both sides is attributed to Shaoyang. In this formula, Chaihu is acrid and warm. Acridity is the flavor of Metal, thus sufficient to subdue Wood; warmth is the Qi of Spring, thus sufficient to enter the Shaoyang channel. Huangqin assists by draining excess heat. Banxia assists by breaking stagnation. Ginseng and Gancao are essential because one fears Liver disease transmitting to the Spleen, so the Earth is first fortified. Shengjiang and Dazao are used to harmonize Ying and Wei, preventing stagnation of meridian Qi.