栝蒌薤白白酒汤 栝蒌薤白半夏汤
栝蒌薤白白酒汤，胸痹胸背痛难当，喘息短气时咳唾，难卧仍加半夏良。
【注】栝蒌薤白白酒汤，即栝蒌实、小根菜，水白酒煎也。
颠倒木金散
胸痛气血热饮痰，颠倒木金血气安，饮热大陷小陷治，顽痰须用控涎丹。
【注】胸痛之证，须分属气、属血、属热饮、属老痰。颠倒木金散，即木香、郁金也。
属气郁痛者，以倍木香君之。属血郁痛者，以倍郁金君之。为末，每服二钱，老酒调下。虚
者，加人参更效。胸中有痰饮热作痛者，轻者小陷胸汤，重者大陷胸汤、丸治之。若吐
唾稠粘痰盛，则用控涎丹。
枳芎散 枳橘散 柴胡疏肝汤 加味逍遥散 左金丸 当归龙荟丸
胁痛左属瘀留血，轻金芎枳草重攻，右属痰气重逐饮，片姜橘枳草医轻，肝实太息
难转侧，肝虚作痛引肩胸，实用疏肝柴芍草，香附枳陈与川芎，肝虚逍遥加芎细，陈皮生
姜缓其中，肝虚左金实龙荟，一条扛起积食攻。
【注】左属瘀血，轻，谓瘀血轻者，宜用
枳芎散。重攻，谓瘀血重者，宜以攻血之剂也。枳芎散，即枳壳、抚芎、郁金、甘草也。
右属痰气。重逐饮，谓以控涎、十枣逐痛之重者也。枳橘散，即枳壳、橘皮、片子姜黄、
甘草，医痛之轻者也。柴胡疏肝散，即柴胡、白芍、甘草、香附、枳壳、陈皮、川芎也，逍
遥散，即白术、茯苓、当归、白芍、柴胡、炙草、薄荷少许，加川芎、细辛、陈皮、生姜
也。左金，即左金丸，吴茱萸、黄连也。肝实火旺者，当归龙荟丸，积食者，以化滞丸。
积饮者，以控涎丹。
Gualou Xiebai Jiuba Tang (Trichosanthes Fruit, Allium Macrostemon, and White Wine Decoction), Gualou Xiebai Banxia Tang (Trichosanthes Fruit, Allium Macrostemon, and Pinellia Decoction)
Gualou Xiebai Jiuba Tang is indicated for Xiongbi (chest bi-syndrome, characterized by chest oppression and pain) presenting with severe, unbearable pain in the chest and back, accompanied by wheezing, shortness of breath, and frequent coughing with expectoration. If the condition is severe enough to prevent lying flat, adding Banxia (Pinelliae Rhizoma) improves efficacy.
[Note] Gualou Xiebai Jiuba Tang consists of Gualou Shi (Trichosanthis Fructus), Xiebai (Allii Macrostemonis Bulbus), decocted with water and white wine.
Diandao Mujin San (Inverted Costus and Curcuma Powder)
For chest pain caused by Qi and Blood stagnation, heat, phlegm-fluid retention, taking Diandao Mujin San can regulate Qi and Blood. For severe heat-fluid retention, Da Xianxiong Tang (Major Trapping-in-the-Chest Decoction) or Xiao Xianxiong Tang (Minor Trapping-in-the-Chest Decoction) should be used respectively; for stubborn old phlegm, Kongyan Dan (Saliva-Draining Pill) is required.
[Note] Chest pain syndromes must be differentiated into those attributable to Qi, Blood, heat-fluid, or old phlegm. Diandao Mujin San consists of Muxiang (Aucklandiae Radix) and Yujin (Curcumae Longae Rhizoma).
For pain due to Qi stagnation, double the dosage of Muxiang as the sovereign herb; for pain due to Blood stagnation, double the dosage of Yujin as the sovereign herb. Grind into powder, take 2 qian per dose, mixed with aged wine. For deficiency patterns, adding Renshen (Ginseng Radix et Rhizoma) enhances efficacy. For chest pain caused by phlegm-fluid and heat in the chest, mild cases are treated with Xiao Xianxiong Tang, while severe cases are treated with Da Xianxiong Tang or pills. If thick, sticky sputum is abundant, Kongyan Dan is used.
Zhixiong San (Zhi Ke and Chuanxiong Powder), Zhiju San (Zhi Ke and Chen Pi Powder), Chaihu Shugan Tang (Bupleurum Liver-Soothing Decoction), Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder), Zuojin Wan (Left Metal Pill), Danggui Longhui Wan (Angelica Sinensis and Gardenia Pill)
Hypochondriac pain on the left side is mostly due to retained blood stasis; mild cases use Zhixiong San (Zhike, Chuanxiong, Gancao), while severe cases require formulas that aggressively purge blood stasis. Hypochondriac pain on the right side is mostly due to phlegm-Qi; severe cases require purging fluid retention, while mild cases are treated with Zhiju San (Pian Jianghuang, Ju pi, Zhike, Gancao). Liver excess manifests as sighing and difficulty turning the body; Liver deficiency manifests as pain radiating to the shoulder and chest. For Liver excess, Chaihu Shugan Tang (Chaihu, Baishao, Gancao, Xiangfu, Zhike, Chenpi, Chuanxiong) is used; for Liver deficiency, Xiaoyao San is modified with Chuanxiong and Xixin, combined with Chenpi and Shengjiang to moderate the Middle Jiao. For Liver deficiency, Zuojin Wan is used; for Liver excess, Danggui Longhui Wan is used; for food stagnation, Huazhi Wan is used to attack the accumulation.
[Note] Left-sided pain is attributed to blood stasis. "Mild" refers to mild blood stasis, suitable for Zhixiong San. "Aggressive purging" refers to severe blood stasis, suitable for blood-purging formulas. Zhixiong San consists of Zhike (Aurantii Fructus), Fuxiong (Chuanxiong Rhizoma), Yujin (Curcumae Longae Rhizoma), and Gancao (Glycyrrhizae Radix et Rhizoma).
Right-sided pain is attributed to phlegm-Qi. "Severe fluid purging" refers to using strong agents like Kongyan Dan or Shizao Tang (Jujube Decoction) to relieve pain by purging fluids. Zhiju San consists of Zhike (Aurantii Fructus), Ju pi (Citri Reticulatae Pericarpium), Pian Jianghuang (Curcumae Longae Rhizoma), and Gancao (Glycyrrhizae Radix et Rhizoma), used for milder pain. Chaihu Shugan San consists of Chaihu (Bupleuri Radix), Baishao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma), Xiangfu (Cyperi Rhizoma), Zhike (Aurantii Fructus), Chenpi (Citri Reticulatae Pericarpium), and Chuanxiong (Chuanxiong Rhizoma). Xiaoyao San consists of Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Chaihu (Bupleuri Radix), Zhi Cao (Prepared Glycyrrhizae Radix et Rhizoma), a small amount of Bohe (Menthae Haplocalycis Herba), plus Chuanxiong (Chuanxiong Rhizoma), Xixin (Asari Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium), and Shengjiang (Zingiberis Rhizoma Recens). Zuojin refers to Zuojin Wan, consisting of Wuzhuyu (Evodiae Fructus) and Huanglian (Coptidis Rhizoma). For Liver excess with fire hyperactivity, Danggui Longhui Wan is used; for food stagnation, Huazhi Wan is used; for fluid retention, Kongyan Dan is used.