【感冒胁痛之症】并无时行传染，因自冒风寒，先见恶寒发热，胁痛耳聋，呕而口苦
，此伤寒少阳经胁痛症也。若寒热已除，后乃胁痛干呕，此表解里未和，邪热痰饮之症，二者皆非天
灾流行，乃人自感冒之症也。
【感冒胁痛之因】起居不慎，感冒外邪，或初感即中少阳，或传变而入少阳，则邪居
半表半里，而成胁痛之症也。
【感冒胁痛之脉】脉来多弦，弦紧宜汗，弦细宜和，弦数为热，弦促为结。
【感冒胁痛之治】风邪在表，柴胡羌活汤；热邪在半表半里，小柴胡汤；热邪在里，
小柴胡加山栀、青皮、枳壳；表已散，里气不和作痛，审知是燥痰结饮，轻则栝蒌仁汤，重则十
枣汤；若肝胆郁火，成痰，家秘胆星汤主之。
柴胡羌活汤
柴胡 羌活 防风 枳壳 桔梗 青皮 苏梗
小柴胡汤
柴胡 黄芩 广皮 甘草 山栀 青皮 桔梗 枳壳
栝蒌汤
栝蒌仁 枳壳 青皮 苏梗 桔梗
十枣汤
芫花 甘遂 大戟
上三味，以水先煮肥枣三十枚，取枣汁入药末一钱调服。瘦弱人五六分，得利即止。
家秘胆星汤 治胆火成痰，胁肋作痛。
陈胆星 柴胡 黄芩 广皮 甘草 青黛 海石
（痰饮、郁火、死血、肝肾虚）
【内伤胁痛之症】并无外感之邪，或左或右，胁肋作痛，或左右皆痛，或左右攻冲，
或时痛时止，或常痛不休，此内伤胁痛也。
【内伤胁痛之因】或痰饮悬饮，凝结两胁；或死血停滞胁肋；或恼怒郁结，肝火攻冲
；或肾水不足，龙雷之火上冲；或肾阳不足，虚阳上浮；皆成胁肋之痛矣。
【内伤胁痛之脉】右关滑数，胃家痰实。右寸沉弦，肺家悬饮。两关芤涩，乃是死血
。左关数大，肝胆火冲。尺脉沉数，肾水不足。尺脉浮大，虚阳上越。
【内伤胁痛之治】痰饮聚于中脘，攻注两胁者，导痰汤加竹沥；悬饮凝结，咳逆胁痛,
十枣汤；死血作痛，红花桃仁汤；恼怒伤肝，肝经郁火者，柴胡清肝饮、栀连柴胡汤；肝血不
足，肝气不调，家秘补肝汤；肝肾真阴不足，龙雷之火上冲，家秘肝肾丸；若肝肾真阳不足
，无根之火，失守上炎，八味丸治之。
导痰汤
南星 橘红 白茯苓 半夏 甘草 枳壳
热者，冲竹沥一钟；寒者，加白芥子。
十枣汤 见前篇。
红花桃仁汤
大黄 枳壳 浓朴 桃仁 红花 赤芍药 当归尾
柴胡清肝饮
柴胡 黄芩 山栀 白芍药 青皮 枳壳
栀连柴胡汤
柴胡 黄芩 广皮 甘草 山栀 川黄连
家秘补肝汤
当归 白芍药 生地 川芎 青皮 香附 木通 苏梗 钩藤
家秘肝肾丸 治肝肾真阴不足，龙雷之火上炎，当滋阴降火。
天门冬 生地 当归 白芍药 黄柏 知母
八味肾气丸 治肝肾真阳不足。无根之火，失守上炎，法当引火归源。
即六味地黄丸加肉桂、附子。
桢用前二方，皆治龙雷之火，夫龙火主肾，雷火主肝，然当分肝肾之真阴虚、真阳虚；
若真阴虚者，真水涸而火自旺，即干之上九，亢龙有悔之象，宜用家秘肝肾丸，敛而降之；
若真阳虚者，真火不足，无根之火，失守上浮，即坤之上六，龙战于野之象，宜用《金匮》
八味丸以摄伏之；一阴一阳，寒热天壤。堂儿问曰，临症何以分别？余曰∶真阴虚则火旺，
原症脉象，俱是火候，如便闭、喘咳、骨蒸，六脉沉数，皆真阴虚也；若真阳虚则火虚，原
症脉象，俱是虚候，如大便泄、小便清，六脉空大，皆真阳虚也。
[Symptoms of Hypochondriac Pain due to Cold Damage] There is no contagiousness of seasonal epidemics. It occurs because of direct exposure to wind-cold, initially presenting with aversion to cold and fever, hypochondriac pain, deafness, vomiting, and a bitter taste in the mouth. This is the syndrome of hypochondriac pain due to Shaoyang channel involvement in Shanghan (Cold Damage). If the aversion to cold and fever have subsided, followed by hypochondriac pain and dry retching, this indicates that the exterior has been resolved but the interior is not yet harmonized, representing a syndrome of pathogenic heat and phlegm-fluid retention. Neither of these two conditions is a natural disaster or epidemic; rather, they are illnesses caused by the body's own contraction of external pathogens.
[Etiology of Hypochondriac Pain due to Cold Damage] Inconvenient living habits lead to contraction of external pathogens. Either the pathogen directly invades the Shaoyang channel upon initial infection, or it transmits into the Shaoyang channel from other channels. Consequently, the pathogen resides between the exterior and interior, resulting in the syndrome of hypochondriac pain.
[Pulse of Hypochondriac Pain due to Cold Damage] The pulse is predominantly Xian (String-taut). A Xian-Jin (String-taut and Tight) pulse indicates suitability for sweating therapy; a Xian-Xi (String-taut and Fine) pulse indicates suitability for harmonizing therapy; a Xian-Shu (String-taut and Rapid) pulse indicates heat; a Xian-Cu (String-taut and Hasty) pulse indicates stagnation.
[Treatment of Hypochondriac Pain due to Cold Damage] When wind-pathogen is at the exterior, use Chaihu Qianghuo Tang (Bupleurum and Notopterygium Decoction); when heat-pathogen is between the exterior and interior, use Xiao Chaihu Tang (Minor Bupleurum Decoction); when heat-pathogen is in the interior, use Xiao Chaihu Tang plus Zhizi (Gardeniae Fructus), Qingpi (Aurantii Fructus Pericarpium Rubrum), and Zhike (Aurantii Fructus Immaturus). If the exterior is dispersed but interior Qi disharmony causes pain, and it is confirmed as dry-phlegm condensing into fluid retention, use Gualou Ren Tang (Trichosanthis Semen Decoction) for mild cases, and Shizao Tang (Ten Jujube Decoction) for severe cases. If there is liver-gallbladder stagnant fire generating phlegm, use Ji Mi Danxing Tang (Secretly Preserved Arisaema with Bile Decoction).
Chaihu Qianghuo Tang
Chaihu (Bupleuri Radix), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Zhike (Aurantii Fructus Immaturus), Jiegeng (Platycodonis Radix), Qingpi (Aurantii Fructus Pericarpium Rubrum), Sugeng (Perillae Caulis).
Xiao Chaihu Tang
Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Guangpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Zhizi (Gardeniae Fructus), Qingpi (Aurantii Fructus Pericarpium Rubrum), Jiegeng (Platycodonis Radix), Zhike (Aurantii Fructus Immaturus).
Gualou Tang
Gualou Ren (Trichosanthis Semen), Zhike (Aurantii Fructus Immaturus), Qingpi (Aurantii Fructus Pericarpium Rubrum), Sugeng (Perillae Caulis), Jiegeng (Platycodonis Radix).
Shizao Tang
Yuanhua (Kadsurae Flos), Gansui (Euphorbiae Kansui Radix), Daji (Euphorbiae Pekinensis Radix).
Take the above three herbs. First decoct thirty large jujubes (Ziziphi Jujubae Fructus) in water to obtain jujube juice. Mix one qian of the herbal powder into the juice for administration. For emaciated persons, administer five or six fen. Stop medication once bowel movement occurs.
Ji Mi Danxing Tang (Secretly Preserved Arisaema with Bile Decoction) Treats hypochondriac pain caused by gallbladder fire generating phlegm.
Chen Danxing (Arisaematis Cum Bile Rhizoma), Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Guangpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Qingdai (Indigo Naturalis), Haishi (Arcae Concha).
(Involved syndromes: Phlegm-fluid retention, Stagnant fire, Dead blood, Liver-Kidney deficiency)
[Symptoms of Internal Injury Hypochondriac Pain] There is no external pathogenic factor. Pain may occur on the left or right side of the hypochondrium, or on both sides simultaneously, or alternating between left and right with attacking sensations. Pain may be intermittent or continuous without relief. This constitutes internal injury hypochondriac pain.
[Etiology of Internal Injury Hypochondriac Pain] It may be caused by phlegm-fluid or xuan-yin (suspended fluid) condensing in both hypochondria; or by dead blood (stasis) stagnating in the hypochondrium; or by anger causing qi stagnation and liver-fire attacking upward; or by insufficiency of kidney-water leading to Long-Lei fire (dragon-thunder fire) rushing upward; or by insufficiency of kidney-yang causing floating deficient yang. All these result in hypochondriac pain.
[Pulse of Internal Injury Hypochondriac Pain] A Hua-Shu (Slippery-Rapid) pulse at the Right Guan position indicates phlegm-excess in the stomach. A Chen-Xian (Deep-String-taut) pulse at the Right Cun position indicates suspended fluid in the lungs. A Kou-Se (Hollow-Rough) pulse at both Guan positions indicates dead blood (blood stasis). A Shu-Da (Rapid-Big) pulse at the Left Guan position indicates liver-gallbladder fire rushing upward. A Chen-Shu (Deep-Rapid) pulse at the Chi position indicates insufficiency of kidney-water. A Fu-Da (Floating-Big) pulse at the Chi position indicates floating deficient yang.
[Treatment of Internal Injury Hypochondriac Pain] For phlegm-fluid accumulating in Zhongwan (Middle Jiao) and attacking both hypochondria, use Daotan Tang (Great Phlegm Resolving Decoction) plus Zhuli (Bambusa Textilis Cataphylla Juice). For condensed suspended fluid causing cough, counterflow qi, and hypochondriac pain, use Shizao Tang (Ten Jujube Decoction). For pain caused by dead blood (stasis), use Hongtao Tao Ren Tang (Safflower and Peach Kernel Decoction). For liver damage due to anger with stagnant fire in the liver meridian, use Chaihu Qinggan Yin (Bupleurum Liver-Clearing Infusion) or Zhilian Chaihu Tang (Gardenia and Coptis Bupleurum Decoction). For liver-blood insufficiency and disharmonious liver-qi, use Ji Mi Bugan Tang (Secretly Preserved Liver-Nourishing Decoction). For insufficiency of true yin of liver and kidney with Long-Lei fire rushing upward, use Ji Mi Lishen Wan (Secretly Preserved Liver-Kidney Pill). For insufficiency of true yang of liver and kidney with rootless fire losing control and flaming upward, use Ba Wei Wan (Eight-Ingredient Pill).
Daotan Tang
Nanxing (Arisaematis Rhizoma), Juhong (Citri Reticulatae Pericarpium), Baifuling (Poria cum Risus), Banxia (Pinelliae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Zhike (Aurantii Fructus Immaturus).
For heat patterns, add one zhong of Zhuli (Bambusa Textilis Cataphylla Juice); for cold patterns, add Baijiezi (Sinapis Semen).
Shizao Tang See previous section.
Hongtao Tao Ren Tang
Dahuang (Rhei Radix et Rhizoma), Zhike (Aurantii Fructus Immaturus), Nongpo (Moutan Cortex / Magnoliae Officinalis Cortex - *Note: Context suggests Houpo/Magnolia Bark usually, but text says Nongpo which might be a typo for Houpo or specific preparation*, here translated as Magnoliae Cortex based on standard formula context though literal is 'thick bark'), Taoren (Persicae Semen), Honghua (Carthami Flos), Chishao (Paeoniae Radix Rubra), Dangguiwei (Angelicae Sinensis Radix caudex).
Chaihu Qinggan Yin
Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus), Baishao (Paeoniae Radix Alba), Qingpi (Aurantii Fructus Pericarpium Rubrum), Zhike (Aurantii Fructus Immaturus).
Zhilian Chaihu Tang
Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Guangpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Zhizi (Gardeniae Fructus), Chuanlianhuan (Coptidis Rhizoma).
Ji Mi Bugan Tang
Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Shengdi (Rehmanniae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Qingpi (Aurantii Fructus Pericarpium Rubrum), Xiangfu (Cyperi Rhizoma), Mutong (Akebiae Caulis), Sugeng (Perillae Caulis), Gouteng (Uncariae Ramulus cum Uncis).
Ji Mi Lishen Wan (Secretly Preserved Liver-Kidney Pill) Treats insufficiency of true yin of liver and kidney with Long-Lei fire flaming upward. The method should be to nourish yin and descend fire.
Tianmendong (Asparagi Radix), Shengdi (Rehmanniae Radix), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Huangbai (Phellodendri Cortex), Zimu (Anemarrhenae Rhizoma).
Ba Wei Shenqi Wan (Eight-Ingredient Kidney-Qi Pill) Treats insufficiency of true yang of liver and kidney. For rootless fire losing control and flaming upward, the method should be to guide fire back to its source.
This is Liu Wei Dihuang Wan (Six-Ingredient Rehmannia Pill) plus Rougui (Cinnamomi Cortex) and Fuzi (Aconiti Lateralis Radix Praeparata).
Zhen (the author) used the former two formulas to treat Long-Lei fire. Dragon fire governs the kidney, and thunder fire governs the liver. However, one must distinguish between true yin deficiency and true yang deficiency of the liver and kidney. If it is true yin deficiency, true water is exhausted and fire naturally flares up, resembling the image of "Exalted Dragon has cause to repent" from the upper nine line of the Qian hexagon. One should use Ji Mi Lishen Wan to gather and descend the fire. If it is true yang deficiency, true fire is insufficient, and rootless fire loses control and floats upward, resembling the image of "Dragon fights in the wild" from the upper six line of the Kun hexagon. One should use Ba Wei Wan from the *Jingui Yaolue* to subdue it. Yin and Yang differ as much as heaven and earth in their cold and hot nature. A student asked: How to distinguish them clinically? I replied: True yin deficiency leads to hyperactive fire; the original symptoms and pulse all show heat signs, such as constipation, wheezing/cough, bone-steaming tidal fever, and deep-rapid pulses in all six positions, indicating true yin deficiency. If true yang deficiency leads to deficient fire, the original symptoms and pulse all show deficiency signs, such as diarrhea and clear urine, and empty-big pulses in all six positions, indicating true yang deficiency.