青娥丸（马伏所秘传） 治诸虚百病。大补之圣药也。素患腰痛者殊效。
仙茅（酒浸洗勿犯铁器四两） 白茯神（去皮四两） 破故纸（四两酒浸一日） 怀生地黄（
酒浸
砂锅内蒸黑四两） 甘枸杞子（四两） 小茴香（盐酒炒二两） 黄精（酒蒸四两） 川杜仲（
去皮
姜炒四两） 天门冬（去心四两） 菟丝子（酒炒捣饼四两） 当归（酒洗四两） 肉苁蓉（酒
洗去
鳞三两） 怀熟地黄（酒洗四两） 巴戟（盐水泡去心四两） 青盐（四两水洗去泥打碎炒）
牛
膝（去芦酒洗四两） 参（二两） 锁阳（三两） 鹿茸（一两炙） 川萆 （四两童便浸七
日流水洗净去臭气） 核桃肉（去壳一百五十个捣成泥）
上为细末。好酒打糊为丸。如梧子大。每服百丸。空心。好酒盐汤送下。忌三白。
一治一切腰痛如神。（宋东园传）黑丑半生半炒为细末。水和丸如梧子大。硫黄末为衣。
每服五十丸。空心。盐水汤下。
脉双弦者。肝气有余。两胁作痛。
夫胁痛者。厥阴肝经为病也。其症自两胁下。痛引小腹。亦当视内外所感之邪而治之。
若因
暴怒伤触。悲哀气结。饮食过度。冷热失调。颠仆伤形。或痰积流注于胁。与血相搏。皆能
为痛。此内因也。若伤寒少阳。耳聋胁痛。风寒所袭而为胁痛者。此外因也。治之当以散结
顺气。化痰和血为主。平其肝。导其滞。则无不愈矣。
一论左胁下痛。肝积属血。或因怒气所伤。或颠仆闪挫所致。而为痛也。
疏肝散 主方。
黄连（吴茱萸煎炒二钱） 柴胡 当归（酒洗各一钱五分） 青皮（去穣） 桃仁（研如泥）
枳壳（麸炒各一钱） 川芎 白芍（酒炒各七分） 红花（五分）
上锉一剂。水煎。食远服。
一论右胁痛者。肝邪入肺也。
推气散
片姜黄 枳壳（麸炒各一钱） 桂心（少许） 甘草（炙五分）
上锉一剂。生姜三片。水煎。食远服。一方。加广陈皮一钱五分。半夏姜炒一钱。
一论左右胁俱痛。肝火盛而木气实也。
柴胡归芎汤
柴胡 川芎 白芍 青皮（去穣） 枳壳（麸炒各一钱五分） 甘草 香附子 当归
龙胆草 木香 砂仁
上锉一剂。姜一片。水煎。温服。
一论因内有湿热。两胁痛甚。伐肝木之气。泻肝火之要药也。
当归龙荟丸
当归 龙胆草 山栀子 黄连 大黄（酒浸纸裹煨） 芦荟 青黛（各五钱） 木香（三
钱五分） 麝香（另研五分） 加柴胡五钱。青皮去穣醋炒一两。
上为细末。神曲打糊为丸。如梧桐子大。每服二十丸。姜汤送下。
一论劳伤身热胁痛者。脉必虚也。补中益气汤。（方见内伤）根据本方加川芎、白芍、青皮
、木香、砂仁、小茴香、枳壳。去白术、升麻。
一论左胁下有块。作痛不移者。是死血也。活血汤。（方见腹痛）根据本方加青皮。去白芍
一论男子房劳兼怒。风府胀闷。两胁胀痛。此色欲损肾。怒气伤肝。六味地黄丸料加柴
胡、当归。一剂而安。（方见补益）
一妇人口苦胁胀。此肝火也。用小柴胡汤加黄连、栀子。稍愈。更以四君子汤加当归、
白芍、柴胡。调理脾胃而瘥。
Qing'e Wan (Secretly transmitted by Ma Fu): Treats various deficiencies and hundred diseases; it is a holy medicine for great tonification. It is particularly effective for those who have long suffered from lower back pain.
Ingredients:
Xianmao (Rhizoma Curculiginis, 4 liang, soaked in wine and washed, avoid iron vessels), Baifushen (Poria with Hostwood, 4 liang, peeled), Poguzhi (Fructus Psoraleae, 4 liang, soaked in wine for one day), Huaishengdihuang (Radix Rehmanniae Preparata, 4 liang, soaked in wine and steamed in a clay pot until black), Gangaogouqi (Fructus Lycii, 4 liang), Xiaohuixiang (Fructus Foeniculi, 2 liang, stir-fried with salt and wine), Huangjing (Rhizoma Polygonati, 4 liang, steamed with wine), Chuanduzhong (Cortex Eucommiae, 4 liang, peeled and stir-fried with ginger juice), Tianmendong (Radix Asparagi, 4 liang, heart removed), Tiansizi (Semen Cuscutae, 4 liang, stir-fried with wine and pounded into cakes), Danggui (Radix Angelicae Sinensis, 4 liang, washed with wine), Roubancongrou (Herba Cistanche, 3 liang, washed with wine to remove scales), Huaishudihuang (Radix Rehmanniae Praeparata, 4 liang, washed with wine), Bajitian (Radix Morinda Officinalis, 4 liang, soaked in salt water and heart removed), Qingyan (Halitum, 4 liang, washed with water to remove mud, crushed and stir-fried), Niuxi (Radix Achyranthis Bidentatae, 4 liang, radicle removed and washed with wine), Shen (Radix Ginseng, 2 liang), Suoyang (Herba Cynomorii, 3 liang), Lurong (Cornu Cervi Pantotrichum, 1 liang, roasted), Chuanbixie (Rhizoma Dioscoreae Hypoglaucae, 4 liang, soaked in child's urine for seven days, washed with running water to remove odor), Hetaorou (Semen Juglandis, 150 kernels, shelled and pounded into paste).
Preparation and Administration: Grind the above ingredients into fine powder. Use good wine to make a paste and form pills the size of wutong seeds. Take 100 pills per dose, on an empty stomach, delivered with good wine or salted water. Avoid "three whites" (salt, garlic, leeks).
Another prescription for treating all kinds of lower back pain with miraculous effect (Transmitted by Song Dongyuan): Heiqiu (Fructus Pharbitidis, half raw and half stir-fried) ground into fine powder, formed into pills with water the size of wutong seeds, coated with sulfur powder. Take 50 pills per dose, on an empty stomach, delivered with salted water.
When the pulse is double-string-like (Shuangxian), there is an excess of Liver Qi, causing pain in both hypochondriac regions.
Hypochondriac pain is a disease of the Jueyin Liver Meridian. The symptoms involve pain starting from the bilateral hypochondriac regions and radiating to the lower abdomen. Treatment should be based on the external or internal pathogenic factors involved. If caused by violent anger injuring the body, sorrow leading to Qi stagnation, excessive diet, imbalance of cold and heat, falls injuring the form, or phlegm accumulation flowing into the hypochondriac region and battling with blood, these are internal causes. If caused by Shaoyang syndrome of Cold Damage resulting in deafness and hypochondriac pain, or wind-cold invasion, these are external causes. Treatment should focus on resolving nodules, regulating Qi, transforming phlegm, and harmonizing blood, calming the Liver, and guiding out stagnation, ensuring recovery.
Regarding pain in the left hypochondrium: Left-sided hypochondriac pain belongs to Liver accumulation and involves blood. It may be caused by injury from anger or by falls and sprains.
Main Formula: Shugan San (Liver-Soothing Powder).
Ingredients: Huanglian (Coptidis Rhizoma, 2 qian, stir-fried with Evodia decoction), Chaihu (Bupleuri Radix), Danggui (Angelicae Sinensis Radix, 1.5 qian each, washed with wine), Qingpi (Citri Reticulatae Pericarpium Viride, rind removed), Taoren (Persicae Semen, pounded into paste), Zhike (Aurantii Fructus, bran-stir-fried, 1 qian each), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba, 0.7 qian each, stir-fried with wine), Honghua (Carthami Flos, 0.5 qian).
Preparation and Administration: Cut the herbs into pieces for one dose. Decoct in water and take well after meals.
Regarding right hypochondriac pain: Right-sided hypochondriac pain indicates Liver pathogen entering the Lung.
Main Formula: Tuiqi San (Qi-Pushing Powder).
Ingredients: Pianjianghuang (Curcumae Longae Rhizoma), Zhike (Aurantii Fructus, bran-stir-fried, 1 qian each), Guixin (Cinnamomi Cortex, a small amount), Gancao (Glycyrrhizae Radix et Rhizoma, honey-roasted, 0.5 qian).
Preparation and Administration: Cut the herbs into pieces for one dose. Add three slices of fresh ginger, decoct in water, and take well after meals. Another variation adds Guangchenpi (Citri Reticulatae Pericarpium, 1.5 qian) and Banxia (Pinelliae Rhizoma, ginger-processed, 1 qian).
Regarding pain in both left and right hypochondria: This indicates excessive Liver Fire and solid Wood Qi.
Main Formula: Chaihu Guixiong Tang (Bupleurum and Ligusticum Decoction).
Ingredients: Chaihu (Bupleuri Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Qingpi (Citri Reticulatae Pericarpium Viride, rind removed), Zhike (Aurantii Fructus, bran-stir-fried, 1.5 qian each), Gancao (Glycyrrhizae Radix et Rhizoma), Xiangfu (Cyperi Rhizoma), Danggui (Angelicae Sinensis Radix), Longdancao (Gentianae Radix), Muxiang (Aucklandiae Radix), Sharen (Amomi Fructus).
Preparation and Administration: Cut the herbs into pieces for one dose. Add one slice of ginger, decoct in water, and take warm.
Regarding severe pain in both hypochondria due to internal damp-heat: This formula is a key herb for subduing Liver Wood Qi and draining Liver Fire.
Main Formula: Danggui Longhui Wan (Angelica and Gentian Pill).
Ingredients: Danggui (Angelicae Sinensis Radix), Longdancao (Gentianae Radix), Shanzhizi (Gardeniae Fructus), Huanglian (Coptidis Rhizoma), Dahuang (Rhei Radix et Rhizoma, soaked in wine and wrapped in paper and baked), Lvhua (Aloe), Qingdai (Indigo Naturalis, 5 qian each), Muxiang (Aucklandiae Radix, 3.5 qian), Shexiang (Moschus, separately ground, 0.5 qian). Add Chaihu (Bupleuri Radix, 5 qian) and Qingpi (Citri Reticulatae Pericarpium Viride, vinegar-stir-fried, rind removed, 1 liang).
Preparation and Administration: Grind into fine powder. Use Shenqu (Massa Medicata Fermentata) paste to form pills the size of wutong seeds. Take 20 pills per dose, delivered with ginger tea.
Regarding fatigue injury causing fever and hypochondriac pain: The pulse must be deficient. Use Buzhong Yiqi Tang (see Internal Injury chapter). Modify this formula by adding Chuanxiong, Baishao, Qingpi, Muxiang, Sharen, Xiaohuixiang, and Zhike; remove Baizhu and Shengma.
Regarding a mass under the left hypochondrium with fixed, unchanging pain: This is dead blood (stasis). Use Huoxue Tang (see Abdominal Pain chapter). Modify this formula by adding Qingpi and removing Baishao.
Regarding men suffering from sexual exhaustion combined with anger, causing distension and stuffiness at Fengfu point and distending pain in both hypochondria: This is kidney damage from lust and liver injury from anger. Use Liuwei Dihuang Wan formula modified with Chaihu and Danggui. One dose brings peace (see Tonification chapter).
Regarding a woman with bitter taste in the mouth and hypochondriac distension: This is Liver Fire. Initially use Xiao Chaihu Tang modified with Huanglian and Zhizi. After slight improvement, switch to Sijunzi Tang modified with Danggui, Baishao, and Chaihu to regulate the Spleen and Stomach until recovery.