散，治左胁下痛，肝积属血，于本方去香附、甘草，加黄连、当归、桃仁、红花。
柴胡泻肝汤，郁怒伤肝，左胁痛。
柴胡（一钱二分） 甘草（五分） 青皮 芍药（各一钱） 黄连（炒）
山栀（炒） 龙胆草（各八分） 川归（一钱二分）
水煎服。（《赤水》）
平肝流气饮，治胁痛，及小腹，至绕脐，并疝气内外疼者。
当归（一钱） 白芍（八分） 川芎（六分） 橘皮（盐汤洗一钱） 茯苓（一钱） 半夏 青皮（醋炒
各六分） 黄连（炒八分） 柴胡（七分） 香附（童便浸炒八分） 浓朴（姜汁炒七分） 枝子（盐水炒八
分） 吴茱萸（煮三次去水炒四分） 甘草（炙去皮四分）
上剂，姜三片，水煎，空心热服。（《回春》）
治胁痛，和肝饮，用鳖甲、柴胡、当归、川芎、半夏、白芍药、枳壳各二钱，水煎服。（《汇言》）
和肝饮，治胁下扛梗起一条作疼。
当归 白芍 三棱 青皮（各一钱五分） 大茴香 木香
枳壳 柴胡 砂仁（各八分）
水煎，不拘时服。（《玉案》）
调肝饮，治胁痛，痛连小腹。
当归 川芎 乌药 玄胡索 青皮（各一钱五分） 柴胡 槟榔 广木香 桃仁（去皮尖各一钱）
水煎，热服。（同上）
驱痰诸方 控涎丹，治一身气痛，及胁走痛。痰挟死血，加桃仁泥。凡胁有痰流注，二陈加南星、川
芎、苍术。实者，控涎丹下之。（《丹溪》）两胁走痛因于痰者，控涎丹佳。以痰在胁下，非白芥子不
能除也。（《六要》）
方东 两胁痛，上壅至胸，发热，饮食不进。脉左手沉而弦数，乃积气也。右手滑，痰饮也。关脉濡弱，
脾气不充也。据症或触于□，故痛之暴耳。治当先去积热，消痰气，然后用补。栝蒌仁六钱，枳壳、姜连、
半夏各一钱半，白芥子一钱，牡蛎二钱，炙甘草五分，柴胡一钱五分，二帖诸症尽去。
饮食进矣。然恐其复发也，与当归龙荟丸使行之，以刈其根，服下果行二次。（《赤水》）
栝蒌枳实汤，治痰结胁下痛（方见《痰涎》），根据本方加白芥子、青皮、茴香，去桔梗、片
芩。发热，加柴胡。（《回春》）
如右胁下有块，痞塞不通，名曰痰癖，宜。
南星（二两用白矾一两半同煮干） 软石膏（ 二两） 枳实（麸炒二两） 桔梗（二两） 黄芩（
二两） 青礞石（一钱半生腐）
上锉，生姜三片，水煎服。（《慈航》）
行血诸方 金氏子年四十余，因骑马跌扑，次年左胁胀痛。医与小柴胡汤加草龙胆、青皮等药，
不效，来求治。诊其脉，左手寸尺皆弦数而涩，关脉芤而急数，右三部惟数而
虚。予曰∶明是死血证。用抵当丸，一剂下黑血二升许，后以四物汤加减调理而安。（《正传》）
复元活血汤，治从高坠下，恶血留于胁下，及疼痛不可忍。
柴胡（半两） 栝蒌根 当归（各三钱） 红花 甘草 穿山甲（炮各二钱） 大
黄（酒浸一两） 桃仁（酒浸去皮尖研如泥五十个）
上件除桃仁外，锉如麻豆大，每服一两，水一盏半，酒
半盏，同煎至七分去滓，大温服之食前，以利为度。得利痛减，不尽服。（《医学发明》）
当归须散，闪坠瘀血，流在腰胁，疼痛不能转侧。（原更有加独活等文。）
当归须（一钱五分） 红花（八分） 桃仁（七分） 甘草（炙五分） 赤芍药 乌药 香
附子 苏木（各一钱） 官桂（六分）
酒水煎，空心服。（《原病集》）
退热和血汤，瘦人胁下痛，寒热，多怒者，必有瘀血。
桃仁 红花 大黄（酒洗） 山栀（各五分） 当归须 柴胡（各
一钱） 赤芍药 川芎 青皮（各七分）
食前服。（同上）
钱君 家藏，治两胁痛，有血瘀气滞者，用姜黄、柴胡、红花、芦荟、白芥子各等分。（《汇言》）
余治吾儒病痰火者，多见胁痛。由作文写字，多以左胸伏桌，倦后尽力倚靠，暂不见伤，久则胁痛，
乃胸前死血作梗也。于主方中加红花一钱，其效如神。再于熟药内，掺入童便、韭汁少许，搅匀
温服更效。（《痰火点雪》）
芍药散，治妇人胁痛。
白芍药 玄胡索（炒） 肉桂（各一两） 香附子（二两醋一升盐半两同煎干）
上为细末，每服二钱，不拘时，白汤调服。（《奇效》）
乌金 砂饼子，治男子妇人左胁下痛。
干漆（三两炒取一两） 砂 没药 乳香（各一分）
上为细末，和作饼子，以梧桐子大为剂子，每服一饼子，热汤下。（《鸡峰》）
利气诸方 木通散，治胁肋苦痛偏效，并心下胁肋并小腹牵引痛者皆主之。
木通（去皮头） 青皮（去白） 川楝子（去皮核，各一两。以上三味，用
巴豆半两炒黄，去巴豆不用。） 萝卜子（炒一两） 舶上茴香（二两炒） 莪术 木香 滑石（各半两）
上为细末，煎葱白酒调三钱。一服愈者，不过再服。（《妇人良方》）
三脘散，治中焦虚痞，两胁气痛，面目手足浮肿，大便秘结。戊午秋，在京城，有一妇人中焦虚痞，
腹胁胀痛，大便秘涩，六脉虚弱，更数医服药无效，仆投此药，不终剂而愈。（同上）
推气散，治右胁疼痛，胀满不食。
枳壳（去穣炒） 桂心（去粗皮不见火） 片子姜黄（洗各半两） 甘草（炙三钱）
上为细末，每服二钱，姜枣煎汤调服，调热酒服亦可，不拘时候。（《济生续》）（按∶此本《
本事》治因惊伤肝，胁骨里疼痛不已，桂枝散，今加姜黄、甘草。）
加减七气汤，凡妇人两胁痛，小腹疼，至胸背，乃气不顺也。
人参（三钱） 桂（三钱） 半夏（四钱） 甘草（二钱） 沉香（二钱） 玄
胡索（二钱） 乌药（五钱） 香附子（二钱）
上姜煎，不拘时候。（《仙传济阴方》）
香橘汤，治七情所伤，中脘不快，腹胁胀满。
香附子（炒） 橘红 半夏（姜制各三钱） 甘草（炙一钱）
上作一服，水二钟，生姜五片，红枣二枚，煎至一钟，食远服。（《奇效》）
四磨汤，治男子妇人，胁痛不可忍。（《医林集要》）
木香调气散，治气怒伤于肝胁，大痛难忍。（《订补指掌》）
温利温散诸方 治冷气胁下往来，冲胸膈痛，引胁背闷，当归汤方。
当归 吴茱萸 桂心 人参 甘草 芍药 大黄（各二两） 茯苓 枳实（各一两） 干姜（三两）
上十味 咀，以水七升，煮取二升半，分三服，日三。（《千金》）《外台》张文仲，当归大黄汤，疗
冷气牵引腰背肋下腹内痛，于本方去茯苓、枳实。《叶氏》趁痛汤，治气滞不散，攻刺肠肋 痛，及
走疰气痛，于本方去枳实，加枳壳、附子、生姜，水煎。
神保丸（出《灵苑》）。
木香（一分） 胡椒（一分） 巴豆（十枚去皮心研） 干蝎（一枚）（按∶馆本作十枚。）
上汤释蒸饼丸，麻子大，朱砂为衣，每服三丸。心膈痛，柿蒂汤下，或灯心同柿蒂汤下。腹痛，柿蒂、煨
姜煎汤下。血痛，炒姜、醋、小便下（按∶馆本无小便字）。肾气胁下痛，茴香酒下云云。予三十年前客
金陵，医者王琪传此方。琪云∶诸气，惟膀胱气胁下痛最难治，独此方辄能去之。熙宁中，予病项
筋痛，诸医咸以为风，治之数月不瘥，乃流入背膂，久之又注右胁，挛痛甚苦。忆琪语，方向已编入《灵
苑》，取读之，有此一验，乃合服之，一投而瘥。后尝再发，又一投而瘥。（《苏沉》）
（按∶《医史·抱一翁传》有一男子病胁病，投神保丸，下黑溲痛止，治验。当参。）《杨氏》麝香丸，
于本方加麝香（详见《寒疝》）。
红丸子，两胁引乳作痛，沉香汤下。（《易简》）（方见《积聚》中。）
京卿胡慕东（名欣），少腹作痛，连于两胁，服疏肝之
剂，一月以来，日甚一日。余诊之，左关尺俱沉迟，治以理中汤加吴茱萸，一剂知，十剂起矣。（《必读》）
建脾散，治脾痞胁痛。（《示儿仙方》）（即建中汤加缩砂。按∶《仙方》更并进莞花莪术丸，其方用莞
花、半夏、南星、莪术，共醋入苦竹油内煨用，载在《观聚方》中。）
滋补诸方 补肝散（滑氏），治肝肾二经气血亏损，胁胀作痛，或胁胀头眩，寒热发热，或身痛经不调。
山茱萸肉 当归 五味子（炒杵） 山药 黄 （炒） 川芎 木瓜（各半两） 熟地黄（
自制） 白术（炒各一钱） 独活 酸枣仁（炒各四钱）
上为末，每服五钱，水煎服。（《准绳》）肝体阴而用阳，此以甘酸补肝体，以辛味补肝用。加独
活者，假风药以张其气也。（《金匮翼》）
补肝汤（滑氏），肝气不足，两胁下满，筋急，不得太
息，四肢厥冷，发抢心腹痛，目不明了，爪甲枯，口面青，宜。
山茱萸 甘草 桂心（各半两） 桃仁 细辛 柏子仁 茯苓 防风（各三两） 大枣（二十四枚）
上 咀，以水九升，煮五升，去渣分三服。（《准绳》）
一人胁疼，每日至晚发热，乃阴虚也。用小柴胡汤合四
物汤，加龙胆、青皮、甘葛。阴虚甚，加黄柏、知母。（《丹
溪》）
一男子房劳兼怒，风府胀闷，两胁胀痛。薛作色欲损肾，怒气伤肝，用六
味地黄丸料，加柴胡、当归，一剂而愈。（《类按》）
Decoction powder, used to treat pain under the left hypochondrium. Liver accumulation belongs to blood lesions; remove Cyperi Rhizoma (Xiangfu) and Glycyrrhizae Radix et Rhizoma (Gancao) from this formula, and add Coptidis Rhizoma (Huanglian), Angelicae Sinensis Radix (Danggui), Persicae Semen (Taoren), and Safflower (Honghua).
Chaihu Xiegan Tang (Bupleurum Decoction to Drain the Liver), used for left-sided hypochondriac pain caused by depression and anger injuring the Liver.
Bupleuri Radix (Chaihu) (1 qian 2 fen), Glycyrrhizae Radix et Rhizoma (Gancao) (5 fen), Citri Reticulatae Pericarpium (Qingpi), Paeoniae Radix (Shaoyao) (each 1 qian), Coptidis Rhizoma (Huanglian) (stir-fried), Gardeniae Fructus (Shanzhi) (stir-fried), Gentianae Radix (Longdancao) (each 8 fen), Angelicae Sinensis Radix (Chuan Gui) (1 qian 2 fen).
Decoct in water and take orally. (From *Chishui Xuanshu*)
Pinggan Liuqi Yin (Liver-Calming and Qi-Flowing Decoction), treats hypochondriac pain, as well as lower abdominal pain radiating around the umbilicus, and internal/external pain associated with hernia.
Angelicae Sinensis Radix (Danggui) (1 qian), Paeoniae Albae Radix (Baishao) (8 fen), Chuanxiong Rhizome (Chuanxiong) (6 fen), Citri Reticulatae Pericarpium (Jupi) washed with salt water (1 qian), Poria (Fuling) (1 qian), Pinelliae Tuber (Banxia), Citri Reticulatae Pericarpium (Qingpi) stir-fried with vinegar (each 6 fen), Coptidis Rhizoma (Huanglian) stir-fried (8 fen), Bupleuri Radix (Chaihu) (7 fen), Cyperi Rhizoma (Xiangfu) soaked in child's urine and stir-fried (8 fen), Magnoliae Officinalis Cortex (Nongpo) stir-fried with ginger juice (7 fen), Gardeniae Fructus (Zhizi) stir-fried with salt water (8 fen), Evodiae Fructus (Wuzhuyu) boiled three times, water discarded, then stir-fried (4 fen), Glycyrrhizae Radix et Rhizoma (Gancao) roasted and peeled (4 fen).
Take the above ingredients with three slices of fresh ginger, decoct in water, and drink hot on an empty stomach. (From *Yixue Runchun*)
He Gan Yin (Liver-Harmonizing Decoction) for treating hypochondriac pain, using Turtle Carapace and Plastron (Biejia), Bupleuri Radix (Chaihu), Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizome (Chuanxiong), Pinelliae Tuber (Banxia), Paeoniae Radix (Baishao), Aurantii Fructus (Zhiqiao) each 2 qian, decoct in water and take orally. (From *Yixue Huibian*)
He Gan Yin (Liver-Harmonizing Decoction), treats a feeling of distension and obstruction under the hypochondrium forming a painful band.
Angelicae Sinensis Radix (Danggui), Paeoniae Albae Radix (Baishao), Sparganii Rhizoma (Sanleng), Citri Reticulatae Pericarpium (Qingpi) (each 1 qian 5 fen), Foeniculi Fructus (Dahuixiang), Aquilariae Lignum Resinatum (Muxiang), Aurantii Fructus (Zhiqiao), Bupleuri Radix (Chaihu), Amomi Fructus (Sharen) (each 8 fen).
Decoct in water and take at any time. (From *Xue Yi An Yu*)
Tiao Gan Yin (Liver-Regulating Decoction), treats hypochondriac pain radiating to the lower abdomen.
Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizome (Chuanxiong), Linderae Radix (Wuyao), Corydalis Rhizoma (Yanhusuo), Citri Reticulatae Pericarpium (Qingpi) (each 1 qian 5 fen), Bupleuri Radix (Chaihu), Arecae Semen (Binglang), Aquilariae Lignum Resinatum (Guangmuxiang), Persicae Semen (Taoren) peeled and removed of pits (each 1 qian).
Decoct in water and take hot. (Same source)
Formulas for Treating Phlegm
Kengyan Dan (Control Saliva Pill), treats generalized qi pain and migrating pain in the hypochondrium. If phlegm is combined with dead blood, add Persicae Paste. For phlegm flowing and accumulating in the hypochondrium, use Erchen Tang plus Arisaematis Rhizoma (Nanxing), Chuanxiong Rhizome (Chuanxiong), and Atractylodis Rhizoma (Cangzhu). For excess patterns, purge with Kengyan Dan. (From *Danxi Xinfa*) For migrating pain in both hypochondria due to phlegm, Kengyan Dan is excellent. Because phlegm resides in the hypochondrium, only white mustard seed can eliminate it. (From *Jingyue Quanshu Liuyao*)
Case of Fang Dong: Pain in both hypochondria, obstructing upwards to the chest, fever, loss of appetite. The pulse is deep, wiry, and rapid on the left hand, indicating accumulated qi. It is slippery on the right hand, indicating phlegm-fluid retention. The guan pulse is soggy and weak, indicating insufficient Spleen qi. Based on symptoms, pain may have been triggered by contact, hence its sudden onset. Treatment should first clear accumulated heat and resolve phlegm-qi, then apply tonification. Trichosanthis Semen (Gualouren) 6 qian, Aurantii Fructus (Zhiqiao), Ginger-processed Coptidis Rhizoma (Jianglian), Pinelliae Tuber (Banxia) each 1.5 qian, Sinapis Alti Semen (Baijiezi) 1 qian, Ostreae Concha (Muli) 2 qian, Roasted Glycyrrhizae Radix et Rhizoma (Zhigancao) 5 fen, Bupleuri Radix (Chaihu) 1.5 qian. After two doses, all symptoms disappeared.
Appetite returned. However, fearing recurrence, administer Danggui Longhui Wan to promote movement and eradicate the root cause. The patient indeed had two bowel movements after taking it. (From *Chishui Xuanshu*)
Gualou Zhishi Tang (Trichosanthes and Immature Bitter Orange Decoction), treats pain in the hypochondrium due to phlegm knotting (formula seen in *Tanxian* chapter). Modify this base formula by adding Sinapis Alti Semen (Baijiezi), Citri Reticulatae Pericarpium (Qingpi), and Foeniculi Fructus (Huixiang), removing Platycodonis Radix (Jiegeng) and Scutellariae Radix (Pianqin). Add Bupleuri Radix (Chaihu) if there is fever. (From *Yixue Runchun*)
If there is a mass in the right hypochondrium causing stuffiness and obstruction, it is called Tanpi (Phlegm Pi Syndrome). Use this formula.
Arisaematis Rhizoma (Nanxing) (2 liang boiled dry with 1.5 liang of Alum), Gypsum Fibrosum (Ruan Shigao) (2 liang), Immature Bitter Orange (Zhishi) bran-fried (2 liang), Platycodonis Radix (Jiegeng) (2 liang), Scutellariae Radix (Huangqin) (2 liang), Calamine Qingmengshi (Qingmengshi) raw and calcined (1.5 qian).
Cut into pieces, add three slices of fresh ginger, decoct in water and take orally. (From *Cihang*)
Formulas for Promoting Blood Circulation
The son of Mr. Jin, over forty years old, fell while horseback riding. The following year, he suffered distending pain in the left hypochondrium. Physicians prescribed Xiaochaihu Tang plus Longdan Cao and Qingpi, etc., without effect. He sought treatment. His pulse was wiry, rapid, and choppy at the cun and chi positions on the left hand, and hollow, urgent, and rapid at the guan position. On the right hand, all three positions were merely rapid and deficient. I said: This is clearly a Dead Blood syndrome. Use Didang Wan. One dose produced about two sheng of black blood. Afterwards, he recovered with modifications of Siwu Tang. (From *Shenzhai Yishu Zhengzhuan*)
Fuyuan Huoxue Tang (Restore Vitality and Invigorate Blood Decoction), treats severe pain in the hypochondrium caused by evil blood remaining there after falling from a height.
Bupleuri Radix (Chaihu) (0.5 liang), Trichosanthis Radix (Gualougen), Angelicae Sinensis Radix (Danggui) (each 3 qian), Safflower (Honghua), Glycyrrhizae Radix et Rhizoma (Gancao), Pangolin Scales (Chuanshanjia) fried (each 2 qian), Rheum Palmatum Radix et Rhizoma (Dahuang) soaked in wine (1 liang), Persicae Semen (Taoren) soaked in wine, peeled, pits removed, ground into paste (50 seeds).
Except for Persicae Semen, cut the other ingredients to the size of hemp seeds. Take 1 liang per dose, decoct with 1.5 cups of water and 0.5 cup of wine until reduced to 0.7 cup. Strain and take warm before meals. Stop when bowel movement occurs. If pain decreases after bowel movement, do not finish the dose. (From *Yixue Faxing*)
Dangguixu San (Angelica Rootlet Powder), treats pain in the waist and hypochondrium unable to turn due to bruising/falling and blood stasis. (Original text adds Du Huo, etc.)
Angelicae Sinensis Radix (Dangguixu) (1.5 qian), Safflower (Honghua) (8 fen), Persicae Semen (Taoren) (7 fen), Roasted Glycyrrhizae Radix et Rhizoma (Zhigancao) (5 fen), Paeoniae Rubra Radix (Chishaoyao), Linderae Radix (Wuyao), Cyperi Rhizoma (Xiangfuzi), Paoniae Radix (Sumu) (each 1 qian), Cinnamomi Ramulus (Guangui) (6 fen).
Decoct with wine and water, take on an empty stomach. (From *Yuanbing Ji*)
Retreat Heat and Harmonize Blood Decoction (Tuire He Xue Tang), for thin individuals with hypochondriac pain, alternating chills and fever, and irritability, indicating blood stasis.
Persicae Semen (Taoren), Safflower (Honghua), Rheum Palmatum Radix et Rhizoma (Dahuang) washed with wine, Gardeniae Fructus (Shanzhi) (each 5 fen), Angelicae Sinensis Radix (Dangguixu), Bupleuri Radix (Chaihu) (each 1 qian), Paeoniae Rubra Radix (Chishaoyao), Chuanxiong Rhizome (Chuanxiong), Citri Reticulatae Pericarpium (Qingpi) (each 7 fen).
Take before meals. (Same source)
Mr. Qian's family secret formula, for hypochondriac pain with blood stasis and qi stagnation, uses Curcumae Longae Rhizoma (Jianghuang), Bupleuri Radix (Chaihu), Safflower (Honghua), Aloe (Luhui), and Sinapis Alti Semen (Baijiezi) in equal parts. (From *Yixue Huibian*)
In my treatment of Confucian scholars suffering from Phlegm-Fire, hypochondriac pain is common. Due to writing or composing, they often lean their left chest on the desk, and after fatigue, lean heavily against support. Initially no injury is felt, but over time hypochondriac pain develops, caused by dead blood blocking the anterior chest. Adding 1 qian of Safflower (Honghua) to the main formula yields miraculous results. Additionally, mixing a small amount of child's urine and Chinese chive juice into prepared medicine and taking it warm enhances efficacy. (From *Tanhuo Dianxue*)
Shaoyao San (Peony Powder), treats hypochondriac pain in women.
Paeoniae Radix (Baishaoyao), Corydalis Rhizoma (Yanhusuo) stir-fried, Cinnamon Twig (Rougui) (each 1 liang), Cyperi Rhizoma (Xiangfuzi) (2 liang boiled dry with 1 sheng of vinegar and 0.5 liang of salt).
Grind into fine powder. Take 2 qian per dose at any time, mixed with plain water. (From *Qixiao Liangfang*)
Wujin Sha Bingzi (Black Gold Sand Cake), treats left-sided hypochondriac pain in men and women.
Dry Lacquer (Ganqi) (3 liang stir-fried to yield 1 liang), Realgar (Shama), Myrrha (Moyao), Olibanum (Ruxiang) (each 1 fen).
Grind into fine powder, mix into cakes the size of Sophora japonica seeds. Take one cake per dose with hot water. (From *Jifeng Puji Fang*)
Formulas for Promoting Qi Movement
Mutong San (Akebia Decoction Powder), highly effective for bitter pain in the hypochondrium and ribs, and also indicated for pulling pain from the epigastrium/hypochondrium to the lower abdomen.
Akebiae Caulis (Mutong) peeled at ends, Citri Reticulatae Pericarpium (Qingpi) peeled, Toosendan Fructus (Chuanlianzi) peeled and pitted (each 1 liang. These three are stir-fried with 0.5 liang of Crotonis Fructus (Badou) until yellow, then Badou is discarded.), Brassicae Semen (Luobozǐ) stir-fried (1 liang), Foeniculi Fructus (Bo Shang Huixiang) stir-fried (2 liang), Curcumae Zedoariae Rhizoma (Ezhu), Aquilariae Lignum Resinatum (Muxiang), Talcum (Huashi) (each 0.5 liang).
Grind into powder. Mix 3 qian with decoction of green onion and white wine. If cured after one dose, no more than two doses are needed. (From *Funu Daquan Liangfang*)
Sanwan San (Three Palaces Powder), treats deficiency-type fullness in the middle jiao, qi pain in both hypochondria, edema of face/eyes/hands/feet, and constipation. In autumn of Wuwu year, in the capital, a woman suffered from middle jiao deficiency-fullness, abdominal/hypochondriac distending pain, constipation, and weak pulses throughout. After several physicians failed to cure her, I administered this medicine, and she was cured before finishing the dose. (Same source)
Tuiqi San (Pushing Qi Powder), treats right-sided hypochondriac pain, distension, and anorexia.
Aurantii Fructus (Zhiqiao) peeled and stir-fried, Cinnamon Bark (Guixin) bark removed without burning, Curcumae Longae Rhizoma (Pian Jiang Huang) washed (each 0.5 liang), Roasted Glycyrrhizae Radix et Rhizoma (Zhigancao) (3 qian).
Grind into powder. Take 2 qian per dose, mixed with decoction of ginger and jujube, or hot wine. Take at any time. (From *Jisheng Xu Fang*) (Note: This originates from *Ben Shi Fang* treating persistent rib pain due to fright injuring the Liver, Guizhi San; now added Jiang Huang and Gancao.)
Modified Seven Qi Decoction (Jiajian Qiqi Tang), for women with pain in both hypochondria and lower abdomen radiating to the chest/back, caused by qi maladjustment.
Codonopsis Radix (Ren Shen) (3 qian), Cinnamon Twig (Gui) (3 qian), Pinelliae Tuber (Banxia) (4 qian), Glycyrrhizae Radix et Rhizoma (Gancao) (2 qian), Aquilariae Lignum Resinatum (Chenxiang) (2 qian), Corydalis Rhizoma (Yanhusuo) (2 qian), Linderae Radix (Wuyao) (5 qian), Cyperi Rhizoma (Xiangfuzi) (2 qian).
Decoct with ginger, take at any time. (From *Xianchuan Jiyin Fang*)
Xiangju Tang (Cyperi and Tangerine Peel Decoction), treats discomfort in the epigastrium and abdominal/hypochondriac distension due to emotional injury.
Cyperi Rhizoma (Xiangfuzi) stir-fried, Citri Reticulatae Pericarpium (Juhong), Pinelliae Tuber (Banxia) ginger-processed (each 3 qian), Roasted Glycyrrhizae Radix et Rhizoma (Zhigancao) (1 qian).
Take as one dose, decoct with 2 zhong of water, five slices of fresh ginger, and two jujubes until reduced to one zhong. Take long after meals. (From *Qixiao Liangfang*)
Simotu Tang (Four Knocks Decoction), treats unbearable hypochondriac pain in men and women. (From *Yilin Jiyao*)
Muxiang Tiaoqi San (Aquilaria Regulating Qi Powder), treats severe hypochondriac pain due to anger injuring the Liver. (From *Dingbu Zhizhang*)
Formulas for Warming, Purging, and Dispersing Cold
Danggui Tang Formula for treating cold qi moving under the hypochondrium, rushing to the chest/diaphragm causing pain, and pulling pain in the hypochondrium/back causing oppression.
Angelicae Sinensis Radix, Evodiae Fructus (Wuzhuyu), Cinnamon Twig (Guixin), Codonopsis Radix (Renshen), Glycyrrhizae Radix et Rhizoma (Gancao), Paeoniae Radix (Shaoyao), Rheum Palmatum Radix et Rhizoma (Dahuang) (each 2 liang), Poria (Fuling), Immature Bitter Orange (Zhishi) (each 1 liang), Zingiberis Rhizoma Recens (Ganjiang) (3 liang).
Chop the ten ingredients. Decoct in 7 sheng of water to obtain 2.5 sheng. Divide into three doses, taken three times daily. (From *Qianjin Fang*) Zhang Wenzhong's Danggui Dahuang Tang in *Waitai Mi Yao* treats cold qi pulling pain in the waist, back, ribs, and abdomen; remove Fuling and Zhishi from this formula. Ye Shi's Chen Tong Tang treats stagnant qi piercing intestinal/rib pain and wandering zhu qi pain; remove Zhishi from this formula, add Zhike, Fuzi, and Shengjiang, decoct in water.
Shenbao Wan (Divine Preservation Pill) (from *Lingyuan Fang*).
Aquilariae Lignum Resinatum (Muxiang) (1 fen), Piperis Longi Fructus (Hujiao) (1 fen), Crotonis Fructus (Badou) peeled and heart removed, ground (10 seeds), Dry Scorpion (Ganxie) (1 scorpion) (Note: Manuscript edition has 10 seeds).
Soak in soup, mix with steamed dough to make pills the size of sesame seeds, coat with Cinnabar. Take 3 pills per dose. For chest/diaphragm pain, take with Diospyros Leaf Decoction (Shidi Tang) or with Centipede Grass (Dengxincao) and Shidi Tang. For abdominal pain, take with Shidi and baked ginger decoction. For blood pain, take with stir-fried ginger, vinegar, and urine (Note: Manuscript edition omits urine). For Kidney qi hypochondriac pain, take with Fennel wine. Thirty years ago, while staying in Jinling, physician Wang Qi transmitted this formula. Qi said: Among all qi disorders, bladder qi hypochondriac pain is hardest to treat, but this formula removes it. During the Xining era, I suffered from neck tendon pain. All physicians attributed it to wind. Months of treatment failed, and the pain flowed into the back spine, and later to the right hypochondrium, causing severe spasmodic pain. Remembering Qi's words, I found this formula compiled in *Lingyuan*, took it, and was cured after one dose. It recurred later, and one dose cured it again. (From *Su Shen Liang Fang*)
(Note: *History of Medicine · Biography of Baoyi Weng* records a man with hypochondriac disease treated with Shenbao Wan, passing black urine and stopping pain. Refer to this.) Yang Shi's Shexiang Wan adds Moschus (She Xiang) to this formula (see *Han Shan* chapter).
Hong Wan Zi (Red Pill), for hypochondriac pain radiating to the breast, take with Agarwood Decoction. (From *Yijian Fang*) (Formula seen in *Jiju* chapter).
Marquis Hu Mudong (name Xin) suffered from lower abdominal pain connecting to both hypochondria. After taking Liver-soothing agents for a month, symptoms worsened daily. I diagnosed his left guan and chi pulses as deep and slow. Treated with Lizhong Tang plus Evodiae Fructus (Wuzhuyu). Improved after one dose, recovered after ten doses. (From *Yixue Bidu*)
Jianpi San (Spleen-Building Powder), treats Spleen pi syndrome with hypochondriac pain. (From *Shi'er Xianfang*) (This is Jianzhong Tang plus Amomi Fructus (Suasha). Note: *Xianfang* also includes Guan Hua Ezhu Wan, using Guan Hua, Banxia, Nanxing, Ezhu, simmered in vinegar and bitter bamboo oil, recorded in *Guan Ju Fang*.)
Tonifying Formulas
Bugan San (Slippery Man's Liver-Tonifying Powder), treats qi and blood deficiency in the Liver and Kidney meridians, causing hypochondriac distension/pain, or distension with dizziness, alternating chills/fever, or body/menstrual irregularities.
Corni Fructus (Shanzhuyu Rou), Angelicae Sinensis Radix (Danggui), Schisandrae Fructus (Wuweizi) stir-fried and pounded, Dioscoreae Rhizoma (Shanyao), Astragali Radix (Huangqi) stir-fried, Chuanxiong Rhizome (Chuanxiong), Chaenomelis Fructus (Mu Gua) (each 0.5 liang), Prepared Rehmanniae Radix (Shudihuang) homemade, Atractylodis Macrocephalae Rhizoma (Baizhu) stir-fried (each 1 qian), Actaea Rhizoma (Duohuo), Ziziphi Spinosae Semen (Suanzaoren) stir-fried (each 4 qian).
Grind into powder. Take 5 qian per dose, decoct in water. (From *Yixue Zhunseng Liuyao*) The Liver body is Yin, its function is Yang. This formula tonifies the Liver body with sweet/sour flavors and the Liver function with pungent flavors. Duohuo is added to borrow wind herbs to expand its qi. (From *Jinkui Yi*)
Bugan Tang (Slippery Man's Liver-Tonifying Decoction), for Liver qi deficiency causing fullness under both hypochondria, tendon tension, inability to sigh deeply, cold extremities, palpitations/abdominal pain, blurred vision, withered nails, and blue complexion around mouth/face.
Corni Fructus, Glycyrrhizae Radix et Rhizoma (Gancao), Cinnamon Twig (Guixin) (each 0.5 liang), Persicae Semen (Taoren), Asari Radix et Rhizoma (Xixin), Biota Seed (Baizi Ren), Poria (Fuling), Saposhnikoviae Radix (Fangfeng) (each 3 liang), Jujubae Fructus (Dazao) (24 fruits).
Chop ingredients. Decoct in 9 sheng of water to obtain 5 sheng. Strain and divide into three doses. (From *Yixue Zhunseng Liuyao*)
One case: Hypochondriac pain with evening fever indicates Yin deficiency. Use Xiaochaihu Tang combined with Siwu Tang, plus Gentianae Radix (Longdan), Citri Reticulatae Pericarpium (Qingpi), and Puerariae Radix (Gange). If Yin deficiency is severe, add Phellodendri Cortex (Huangbai) and Anemarrhenae Rhizoma (Zhimu). (From *Danxi Xinfa*)
One case: A man suffered from wind-fu distension/oppression and bilateral hypochondriac distending pain due to sexual exhaustion and anger. Xue Ji diagnosed kidney damage from lust and Liver injury from anger. Prescribed Liuwei Dihuang Wan material plus Bupleuri Radix (Chaihu) and Angelicae Sinensis Radix (Danggui). Cured after one dose. (From *Xue Yi An Lei'an*)