《病源》胸胁痛者，由胆与肝及肾之支脉虚，为寒气所乘故也。足少阳，胆之经也，其
支脉从目锐 ，贯目下行，至胸循胁里。足厥阴，肝之经也，其支脉起足大指聚毛上，循入
腹，贯膈布胁肋。足少阴，肾之经也，其支脉起肺，出络心，注胸中。此三经之支脉，并循
行胸胁，邪气乘于胸胁，故伤其经脉，邪气之与正气交击，故令胸胁相引而急痛也。诊其寸
口脉弦而滑，弦则为痛，滑则为实，痛则为急，实则为跃，弦滑相搏，则胸胁抢息痛也。
又卒苦烦满，又胸胁痛欲死候，此由手少阳之络脉虚，为风邪所乘故也。手少阳之脉，
起小指次指之端，上循入缺盆。布膻中，散络心包，风邪在其经，邪气迫于心络，心气不得
宣畅，故烦满。乍上攻于胸或下引于胁，故烦满而又胸胁痛也。若经久邪气留连，搏于脏则
成积，搏于腑则成聚也。（并出第十六卷中）
《广济》疗气结筑心，胸胁闷痛，不能吃食。诃黎勒散方。
诃黎勒（四颗炮，去核） 人参（二分）
上二味，捣筛为散，以牛乳二升，煮三四沸，顿服之。分为二服亦得，如人行三二里进
一服。无所忌。
又疗胸胁不利，腹中胀，气急妨闷。半夏汤方。
半夏（一升洗） 生姜（一斤） 桂心（六两） 槟榔（二两末）
上四味，细切，以水八升，煮取二升四合，绞去滓，分温五服，服别相去如人行六七里
进一服，快利为度。忌羊肉、饧、生葱、油腻。《短剧》有吴茱萸三十颗，无槟榔，余并同
又疗胸胁妨闷，胃中客气，大便苦难。大黄丸方。
大黄（十二分） 浓朴（四分炙） 枳实（四分炙） 芒硝（八分） 杏仁（六分去皮、
尖）
葶苈子（四分熬）
上六味，捣筛，蜜和丸。空腹以饮服如梧子十丸，日二服，稍稍加，以大便微调为度。
忌生冷、油腻、粘食。（出第二卷中）
《千金》疗冷气胁下往来，胸膈痛引胁背闷。当归汤方。
当归 芍药 吴茱萸 桂心 人参 大黄 甘草（各二两） 茯苓 枳实（各一两） 干
姜
（三两）
上十味，细切，以水八升，煮取二升半，一服八合，日三服。治尸注亦佳。忌海藻、菘
菜、生葱、酢物等。（出第十六卷中）
According to the *Zhu Bing Yuan Hou Lun* (Treatise on the Pathogenesis and Manifestations of All Diseases), chest and hypochondriac pain is caused by the deficiency of the branch meridians of the Gallbladder, Liver, and Kidney, which are invaded by cold pathogenic factors. The Foot-Shaoyang Gallbladder Meridian is the meridian of the Gallbladder; its branch originates from the outer canthus, passes through the eye, descends, and runs along the interior of the chest and hypochondrium. The Foot-Jueyin Liver Meridian is the meridian of the Liver; its branch originates from the hair-covered area at the tip of the great toe, ascends into the abdomen, pierces the diaphragm, and spreads over the hypochondrium. The Foot-Shaoyin Kidney Meridian is the meridian of the Kidney; its branch originates in the Lung, emerges to connect with the Heart, and pours into the chest. The branches of these three meridians all circulate through the chest and hypochondrium. When pathogenic factors invade the chest and hypochondrium due to deficiency, they damage these meridians. The interaction between pathogenic factors and healthy Qi causes the chest and hypochondrium to pull against each other, resulting in acute pain. Palpation of the Cun Kou pulse reveals a wiry (Xian) and slippery (Hua) quality. A wiry pulse indicates pain, while a slippery pulse indicates excess. Pain manifests as tension, and excess manifests as vigorous pulsation. When wiry and slippery pulses interact, it results in chest and hypochondriac pain accompanied by labored breathing.
Additionally, sudden severe irritability and fullness, as well as excruciating chest and hypochondriac pain bordering on death, are caused by the deficiency of the collaterals of the Hand-Shaoyang Sanjiao Meridian, which are invaded by wind pathogenic factors. The Qi of the Hand-Shaoyang Meridian originates at the ends of the little finger and the index finger, ascends along the neck to the Clavicular Fossa (Quepen). It distributes at the Shanzhong (Conception Vessel 17), scatters and connects with the Pericardium. Wind pathogens residing in this meridian force their way into the heart collaterals, preventing the free flow of Heart Qi, thus causing irritability and fullness. The pathogenic factors may attack upward to the chest or downward to the hypochondrium, resulting in both irritability/fullness and chest-hypochondriac pain. If the disease persists for a long time and pathogenic factors linger, clashing with Zang organs leads to the formation of "Ji" (masses), while clashing with Fu organs leads to the formation of "Ju" (accumulations). (All content cited from Volume 16 of the *Zhu Bing Yuan Hou Lun*)
The *Guangji Fang* treats Qi stagnation blocking the chest and heart, causing chest and hypochondriac stuffiness and pain, and inability to eat. Heheli San Powder:
Heheli (4 pieces, processed, pitted) Renshen (2 fen)
Grind the above two ingredients into powder. Boil in 2 sheng of cow's milk for three to four boils, then take in one dose. Alternatively, divide into two doses, administering one dose every interval equivalent to walking two or three li. No dietary restrictions apply.
It also treats chest and hypochondriac Qi obstruction, abdominal distension, rapid breathing, and stifling sensation. Banxia Decoction:
Banxia (1 sheng, washed) Shengjiang (1 jin) Guixin (6 liang) Binglang (2 liang, powdered)
Finely cut the above four ingredients. Boil in 8 sheng of water until reduced to 2.4 sheng. Strain out the dregs. Divide into five warm doses. Administer one dose every interval equivalent to walking six or seven li. Stop when bowel movements become smooth. Avoid mutton, maltose, raw green onions, and greasy foods. (The *Duanju Fang* includes 30 Wuzhuyu but no Binglang; the rest are identical.)
It also treats chest and hypochondriac stifling discomfort, rebellious Qi in the stomach, and difficult dry stools. Dahuang Wan Pills:
Dahuang (12 fen) Houpo (4 fen, stir-fried) Zhishi (4 fen, stir-fried) Mangxiao (8 fen) Xingren (6 fen, skin and tips removed) Tinglizi (4 fen, roasted)
Grind the above six ingredients into powder. Mix with honey to form pills. Take ten pills (size of wutong seeds) with warm water on an empty stomach, twice daily. Gradually increase the dosage until bowel movements are mildly regulated. Avoid raw/cold foods, greasy foods, and sticky foods. (Cited from Volume 2 of the *Guangji Fang*)
The *Qianjin Fang* treats cold Qi moving back and forth under the hypochondrium, causing chest-diaphragm pain radiating to the hypochondrium and back, accompanied by stifling sensation. Danggui Decoction:
Danggui Shaoyao Wuzhuyu Guixin Renshen Dahuang Gancao (each 2 liang) Fuling Zhishi (each 1 liang) Ganjiang (3 liang)
Finely cut the above ten ingredients. Boil in 8 sheng of water until reduced to 2.5 sheng. Take 0.8 sheng per dose, three times daily. This formula is also effective for treating Shizhu (corpse transmission/parasitic disease). Avoid seaweed, Chinese cabbage, raw green onions, and vinegar products. (Cited from Volume 16 of the *Qianjin Fang*)