论曰肝胀之状，千金谓胁下满而痛引少腹，盖足厥阴之经，起于大指。抵少腹，侠胃上
贯膈布胁肋。脉经曰∶肝病者，必两胁下痛引少腹是也。夫肝受邪，则令气血不通。故令胁
下胀满，引少腹而痛也。
治肝受邪气，两胁下痛，牵连少腹，胸胁胀满。桂苓汤方
桂（去粗皮） 赤茯苓（去黑皮） 柏子仁 细辛（去苗叶） 防风（去叉各三分） 鳖
甲（醋炙去裙 二两） 桔梗（炒） 枳壳（去瓤麸炒） 白术（各半两） 犀角（屑三分）
独活（去芦头半两） 甘草（炙锉三
上一十二味。粗捣筛，每服三钱匕，水一盏，入枣三枚劈破，同煎至七分，去滓温服，
不计时。
治肝气受寒，胁下胀满，痛引少腹。附子茯苓汤方
附子（炮裂去皮脐七枚） 赤茯苓（去黑皮三两） 槟榔（二十四枚） 母姜（五两） 陈
橘皮（汤浸去白焙） 桂（去粗皮各三两） 桔梗（炒） 白术（各四两） 吴茱萸（汤浸
焙干一两）
上九味。锉如麻豆，每服三钱匕，水一盏，煎至七分，去滓温服，空心食前，日三服。
治肝受风邪，面多青黄，两胁胀满，引少腹痛，浑身疼痛，口淡无味，饮食减少。沉香
煎丸方
沉香（锉一两） 附子（炮裂去皮脐） 白附子（炮） 巴戟天（去心） 砂（研各
半两） 补骨脂（炒一两） 肉苁蓉（酒浸切焙半两同上六味为末以酒二升熬成膏次入下项
药） 干蝎（去土炒一分） 木香（半两） 青橘皮（汤浸去白焙三分） 防风（去叉） 当
归（切焙各半两） 桂（去粗皮一分） 香子（炒三分） 牛膝（酒浸切焙半两） 楝实
（只取肉三分微炒过）
上一十六味。除前膏外，捣罗为末，入前膏拌和，仍再入臼内，捣令匀，如未相着，更
入蜜少许，和丸如梧桐子大。每服二十丸，空心温酒下。
治邪气客于肝经，攻胀两胁，时引少腹痛，四肢厥逆。三辅散方
赤茯苓（去黑皮七两） 赤芍药（三两） 菖蒲（去须） 蜀漆 桂（去粗皮各二两） 丹
砂（别研） 紫石
上九味。除别研外，捣罗为散，再一处拌匀，每服一钱匕，渐加至二钱，早晚食前，用
温酒调下。
治肝脏邪气，两胁胀满，筋脉拘急，痛连少腹。茱萸汤方
山茱萸 当归（切焙） 五味子 山芋 黄 （锉焙） 芎 （各半两） 生干地黄（焙）
白术（各一分） 独活（去芦头） 酸枣仁（微炒各二钱） 木瓜（去皮子焙半两）
上一十一味。粗捣筛，每服五钱匕，以水一盏半，枣二枚，同煎至八分，去滓温服，空
心食前，日二服。
治肝脏风寒，面色青黄，两胁胀痛，牵连少腹，筋脉不利，背 拘急。覆盆子丸方
覆盆子 五味子 附子（炮裂去皮脐） 酸枣仁（微炒） 白术（各一两） 熟干地黄
（焙半两）
上六味。捣罗为末，炼蜜和丸，如梧桐子大。每服三十丸，空心食前温酒下，米饮亦得
Discussion states: The manifestation of Liver Distension (Gan Zhang), as described in the *Qianjin Fang* (Thousand Gold Formulas), involves fullness and pain in the hypochondrium radiating to the lower abdomen. This is because the Foot Jueyin Liver Meridian (Zu Jueyin Gan Jing) originates from the big toe, reaches the lower abdomen, flanks the stomach, pierces through the diaphragm, and spreads over the costal region. The *Mai Jing* (Pulse Classic) states: "In liver diseases, there must be pain in both hypochondria radiating to the lower abdomen." This is precisely such a case. When the Liver is invaded by pathogenic factors, it causes stagnation of Qi and Blood. Consequently, this leads to distension and fullness in the hypochondrium with pain radiating to the lower abdomen.
**Guiling Tang (Cinnamon Twig and Poria Decoction)** for treating the Liver invaded by pathogenic factors, presenting with pain in both hypochondria radiating to the lower abdomen and distension/fullness in the chest and hypochondrium:
Gui Zhi (Ramulus Cinnamomi, remove coarse bark) 3 fen, Chi Fu Ling (Poria cum Radix Pini, remove black skin) 3 fen, Baizi Ren (Semen Platycladi) 3 fen, Xi Xin (Herba Asari, remove seedlings and leaves) 3 fen, Fang Feng (Radix Saposhnikoviae, remove forks) 3 fen, Bie Jia (Carapax et Plastrum Testudinis, vinegar-fried, remove skirt) 2 liang, Jie Geng (Radix Platycodonis, stir-baked), Zhi Ke (Fructus Aurantii, remove pulp and bran-fried), Bai Zhu (Rhizoma Atractylodis Macrocephalae) each 0.5 liang, Xi Jiao (Cornu Rhinocerotis, shaved) 3 fen, Du Huo (Radix Angelicae Pubescentis, remove rhizome head) 0.5 liang, Gan Cao (Radix Glycyrrhizae, honey-fried and chopped) 3 fen.
The above twelve ingredients are coarsely crushed and sieved. Each dose consists of 3 qianbi (approx. 9-15g depending on era/measure), boiled with one sheng (approx. 200ml) of water and three cracked dates until reduced to 70%. Strain and take warm, at any time.
**Fuzi Fuling Tang (Aconite and Poria Decoction)** for treating Liver Qi affected by Cold, presenting with distension/fullness in the hypochondrium and pain radiating to the lower abdomen:
Fu Zi (Radix Aconiti Lateralis Preparata, roasted, split, remove skin and umbilicus) 7 pieces, Chi Fu Ling (Poria cum Radix Pini, remove black skin) 3 liang, Bing Lang (Arecae Semen) 24 pieces, Sheng Jiang (Rhizoma Zingiberis Recens) 5 liang, Chen Pi (Pericarpium Citri Reticulatae, soaked in hot water, remove white pith, dried), Gui Zhi (Ramulus Cinnamomi, remove coarse bark) each 3 liang, Jie Geng (Radix Platycodonis, stir-baked), Bai Zhu (Rhizoma Atractylodis Macrocephalae) each 4 liang, Wu Zhu Yu (Fructus Evodiae, soaked in hot water, dried) 1 liang.
The above nine ingredients are chopped like hemp seeds. Each dose consists of 3 qianbi, boiled with one sheng of water until reduced to 70%. Strain and take warm, on an empty stomach and before meals, three times daily.
**Chenxiang Jian Wan (Agarwood Paste Pills)** for treating the Liver invaded by Wind pathogen, presenting with a complexion often greenish-yellow, distension/fullness in both hypochondria radiating to lower abdominal pain, generalized body pain, insipid taste in mouth, and decreased appetite:
Chen Xiang (Lignum Aquilariae Resinatum, chopped) 1 liang, Fu Zi (Radix Aconiti Lateralis Preparata, roasted, split, remove skin and umbilicus), Bai Fu Zi (Rhizoma Typhonii, roasted), Ba Ji Tian (Radix Morindae Officinalis, remove heart), Sha (Realgar, ground) each 0.5 liang, Buguzhi (Fructus Psoraleae, fried) 1 liang, Rou Cong Rong (Herba Cistanche, soaked in wine, sliced, dried) 0.5 liang. The above six ingredients are ground into powder, boiled with two sheng of wine to form a paste. Then add the following: Quan Xie (Scorpio, cleaned, fried) 1 fen, Mu Xiang (Radix Aucklandoniae) 0.5 liang, Qing Ju Pi (Pericarpium Citri Reticulatae Viride, soaked in hot water, remove white pith, dried) 3 fen, Fang Feng (Radix Saposhnikoviae, remove forks), Dang Gui (Radix Angelicae Sinensis, sliced, dried) each 0.5 liang, Gui Zhi (Ramulus Cinnamomi, remove coarse bark) 1 fen, Xiang Zi (Semen Lepidii, fried) 3 fen, Niu Xi (Radix Achyranthis Bidentatae, soaked in wine, sliced, dried) 0.5 liang, Lian Shi (Fructus Meliae Toosendan, only the flesh, lightly fried) 3 fen.
The above sixteen ingredients, excluding the paste, are ground into powder, mixed with the paste, and pounded again in a mortar until uniform. If not adhering well, add a little honey. Form pills the size of Sophora seeds. Each dose is 20 pills, taken on an empty stomach with warm wine.
**Sanfu San (Three Assistants Powder)** for treating pathogenic factors lodging in the Liver Meridian, causing attacking distension in both hypochondria, occasional radiating lower abdominal pain, and cold extremities:
Chi Fu Ling (Poria cum Radix Pini, remove black skin) 7 liang, Chi Shao Yao (Radix Paeoniae Rubra) 3 liang, Chang Pu (Rhizoma Acori Tatarinowii, remove roots), Shu Qi (Radix Codonopsis? Note: Historically distinct, likely specific herb), Gui Zhi (Ramulus Cinnamomi, remove coarse bark) each 2 liang, Dan Sha (Cinnabar, separately ground), Zi Shi (Mineral Cupritum).
The above nine ingredients, except those separately ground, are crushed into powder, mixed thoroughly. Each dose is 1 qianbi, gradually increased to 2 qianbi, taken morning and evening before meals, mixed with warm wine.
**Zhuyu Tang (Evodia Decoction)** for treating pathogenic factors in the Liver, presenting with distension/fullness in both hypochondria, tendon vessel spasm, and pain connecting to the lower abdomen:
Shan Zhu Yu (Fructus Corni), Dang Gui (Radix Angelicae Sinensis, sliced, dried), Wu Wei Zi (Fructus Schisandrae), Shan Yu (Dioscoreae Rhizoma), Huang Qi (Radix Astragali, chopped, dried), Xiong Qiong (Rhizoma Chuanxiong) each 0.5 liang, Sheng Gan Di Huang (Radix Rehmanniae Preparata, dried), Bai Zhu (Rhizoma Atractylodis Macrocephalae) each 1 fen, Du Huo (Radix Angelicae Pubescentis, remove rhizome head), Suan Zao Ren (Semen Ziziphi Spinosae, lightly fried) each 2 qian, Mu Gua (Fructus Chaenomelis, peel and seeds removed, dried) 0.5 liang.
The above eleven ingredients are coarsely crushed and sieved. Each dose is 5 qianbi, boiled with one and a half sheng of water and two dates until reduced to 80%. Strain and take warm, on an empty stomach and before meals, twice daily.
**Fupenzi Wan (Rubus Fruit Pills)** for treating Wind-Cold in the Liver, presenting with greenish-yellow complexion, distending pain in both hypochondria radiating to the lower abdomen, impaired tendon vessels, and stiffness/spasm in the back:
Fu Pen Zi (Fructus Rubi) 1 liang, Wu Wei Zi (Fructus Schisandrae) 1 liang, Fu Zi (Radix Aconiti Lateralis Preparata, roasted, split, remove skin and umbilicus) 1 liang, Suan Zao Ren (Semen Ziziphi Spinosae, lightly fried) 1 liang, Bai Zhu (Rhizoma Atractylodis Macrocephalae) 1 liang, Shu Gan Di Huang (Radix Rehmanniae Preparata, dried) 0.5 liang.
The above six ingredients are ground into powder, mixed with refined honey to form pills the size of Sophora seeds. Each dose is 30 pills, taken on an empty stomach and before meals with warm wine; rice drink is also acceptable.