左 胸痛脉弦，当舒气郁，用葛仙翁颠倒木金散法加减主治。
木香（五分） 旋复花（一钱五分） 炒栝蒌霜（三钱） 陈香橼皮（一钱五分） 橘皮（二钱） 炒枳
谷（一钱） 广郁金（一钱五分） 猩绛（四分） 生香附（二钱） 薤白头（三钱） 青葱管（三茎）
钱（左） 腹痛渐定，目黄略退。胸痛甚而气滞于络隧，以致气血不行。药既应手，再当扩充。
旋复花 当归尾 单桃仁 广郁金 青葱管 五加皮 金铃子 生薏仁 制香附 真猩绛 醋炒青皮
钟（左） 右胁作痛。脉象沉弦。饮悬胁下，脾肺之络在右也。
广郁金 赤白苓 广皮 旋复花 生香附 制半夏 炒苏子 枳壳 真猩绛 青葱管
二诊 胁下之痛，仍然未定。左脉弦大，右关带滑。气湿郁阻不宣。再为宣通。
制半夏 制香附 杭白芍 川萆 川芎 橘皮络 旋复花 真猩绛 广玉金 葱管 醋炒柴胡
阙（左） 烟体痰浊素盛，痰湿下注，发为泻痢，痢止而痰湿不行，升降开合之机，皆为之阻，以致右胁作
痛，痛势甚剧，按之坚硬有形，中脘板滞，不时呃忒，气坠欲便，而登圊又不果行。苔白罩霉，脉形濡细。此
痰湿气三者互聚，脾肺之道路，阻隔不通，以致流行之气，欲升不能，欲降不得，所以痛甚不止矣。气浊
既阻，中阳安能旋运，挟浊上逆，此呃之所由来也。在法当控逐痰涎，使之宣畅。然脉见濡细，正气已虚，
病实正虚，深恐呃甚发厥，而致汗脱。拟疏通痰气，旋运中阳，以希万一。即请明哲商进。
生香附（二钱研） 真猩绛（七分） 公丁香（三分） 橘红（一钱） 橘络（一钱五分） 磨刀豆子（四分冲）
姜汁拌炒竹茹（一钱五分） 炒枳壳（一钱） 旋复花（三钱包） 磨郁金（七分冲） 青葱管（三茎）
改方 服一剂后痛势大减，去郁金。加苏子三钱，炒白芥子一钱，乳没药各二分，黑白丑各三分，六
味研极细末，米饮为丸如绿豆大烘干，开水先服。其内香附旋复花用一钱五分。
（原注） 服后右胁不痛，但便泄不止，改用连理汤出入。师云此乃不治之症。（正蒙附志）
Left-sided chest pain with a wiry pulse indicates qi stagnation; treatment should focus on soothing qi depression, using a modified version of Ge Xianweng's Diandao Mujin San (Reversed Gold and Wood Powder) method.
Muxiang (5 fen) Xuanfuhua (1.5 qian) Chao Gualou Shuang (3 qian) Chen Xiangyuan Pi (1.5 qian) Jupi (2 qian) Chao Zhike (1 qian) Guang Yujin (1.5 qian) Xingjiang (4 fen) Sheng Xiangfu (2 qian) Xie Baitou (3 qian) Qingcong Guan (3 stems)
Left abdominal pain gradually settled, and yellow discoloration of the eyes slightly receded. Severe chest pain with qi stagnation in the collaterals and vessels leads to impaired circulation of qi and blood. Since the medication has been effective, the treatment scope should be expanded.
Xuanfuhua Danggui Wei Dan Taoren Guang Yujin Qingcong Guan Wujia Pi Jinlingzi Sheng Yiren Zhi Xiangfu Zhen Xingjiang Cu Chao Qingpi
Patient Zhong (left), pain in the right hypochondrium. The pulse is deep and wiry. Fluid retention hangs under the hypochondrium because the collaterals of the Spleen and Lung are located on the right side.
Guang Yujin Chi Bai Ling Guang Pi Xuanfuhua Sheng Xiangfu Zhi Banxia Chao Suzi Zhike Zhen Xingjiang Qingcong Guan
Second consultation: Pain under the hypochondrium remains unsettled. The left pulse is wiry and large; the right Guan position carries a slippery quality. Qi and dampness are stagnant and obstructed, failing to diffuse. Treatment continues to promote diffusion and unblocking.
Zhi Banxia Zhi Xiangfu Hang Baishao Chuan Bi Chuanxiong Jupi Luo Xuanfuhua Zhen Xingjiang Guang Yujin Congguan Cu Chao Chaihu
Patient Que (left), due to a smoking habit, phlegm-turbidity has been abundant constitutionally. Phlegm-dampness descends and causes diarrhea and dysentery. After dysentery stops, phlegm-dampness persists, obstructing the mechanisms of ascending/descending and opening/closing. This leads to pain in the right hypochondrium, which is severe; palpation reveals hardness and distinct form. The Zhongwan region feels rigid and stagnant, accompanied by frequent hiccups. There is a sensation of qi sinking and urge to defecate, yet passage does not occur upon attempting. The tongue coating is white with a moldy appearance, and the pulse is soggy and fine. This condition results from the mutual aggregation of phlegm, qi, and dampness, blocking the pathways of the Spleen and Lung. Consequently, circulating qi cannot ascend nor descend, causing unceasing severe pain. With turbid qi obstructed, how can Middle Yang rotate and transform? Carrying turbidity upward reverses, giving rise to hiccups. According to therapeutic principles, one should control and purge phlegm-fluids to restore smooth flow. However, the soggy and fine pulse indicates deficiency of healthy qi; this is a case of excess pathogen with deficient healthy qi. There is deep concern that severe hiccups may lead to syncope and subsequent collapse through sweating. The proposed strategy is to unblock phlegm and qi, and rotate Middle Yang, hoping for a favorable outcome. Please consult wise physicians for further advice.
Sheng Xiangfu (2 qian, crushed) Zhen Xingjiang (7 fen) Gong Dingxiang (3 fen) Juhong (1 qian) Juluo (1.5 qian) Modao Dousi (4 fen, taken with liquid) Jiangzhi Ban Chao Zhuru (1.5 qian) Chao Zhike (1 qian) Xuanfuhua (3 qian, wrapped) Moyujin (7 fen, taken with liquid) Qingcong Guan (3 stems)
Modified prescription: After one dose, pain significantly decreased; remove Yujin. Add Suzi (3 qian), Chao Baijiezi (1 qian), Ruxiang and Moyao (2 fen each), Heibai Chou (3 fen each). Grind these six ingredients into an extremely fine powder, form pills the size of mung beans using rice water, and dry them. Take initially with boiled water. The dosage for Xiangfu and Xuanfuhua within the pill is 1.5 qian each.
(Original note): After taking the medicine, right hypochondriac pain ceased, but diarrhea persisted. Switched to Lianli Tang (Coptis and Poria Decoction) with modifications. The Master stated this is an incurable condition. (Recorded by Zhengmeng)