秦子曰∶胁痛者，左右两肋痛也。胁之下尽处名季胁。若痛在胁之上，名腋痛。痛在季
胁之后，名腰痛；二者皆非胁痛也。夫腋痛者，肺症也。腰痛者，肾与膀胱症也。凡胁痛多
火，皆肝胆症也。上胁痛属肝，下胁痛属胆，或有肺气怫郁，金邪乘木，亦令胁痛，名肺胁
痛，最利害，金乘木为贼邪，故重。
（运气感冒）
【运气胁痛之症】病起于仓卒，暴发寒热，胁肋刺痛，沿门相似，或在一边，或在
两边
疫症，俗名刺肋伤寒，又名痧胀是也。
【运气胁痛之因】少阳司政，相火用事；少阴司政，君火用事；阳明司政，燥火用事
；其年胜复之气太过，则相火甚于本位，而肝胆自病；君火太过，则子病累母，肝胆亦病；燥火
用事，金病克木，肝胆亦病；三火炽甚，木火通明，肝胆之气怫郁，则两胁暴痛之症作矣。
【运气胁痛之脉】多见弦数。浮数居表，沉数主里。脉减痛缓则生，沉伏厥冷则死。
散，对泻心汤；阳明司政，干葛石膏汤主之。凡胁痛，外用针刺委中、三里二穴出血；若痛甚，
指甲黑者，即刺十指尖出血为妙，越地所谓放痧是也。若咳嗽痰声，无论左右，即为肺邪胁
痛，宜泻青各半汤，并刺少商穴。
柴胡汤
柴胡 黄芩 广皮 甘草 青皮 山栀 枳壳 木通
加苏梗。
独活败毒散
独活 木通 柴胡 黄芩 桔梗 枳壳 甘草 钩藤 广皮
加苏梗。
泻心汤
黄连 甘草 灯心
干葛石膏汤
干葛 柴胡 黄芩 石膏 枳壳 广皮 甘草 木通
加苏梗。
泻青各半汤
龙胆草 黄芩 山栀 桑白皮 地骨皮 甘草
加青黛一钱冲服。
Qin Zi said: Hepatic region pain refers to pain in the lateral aspects of both ribs. The lower extremity of the ribs is named Jixie (Hypochondriac Region). If the pain is located above the hepatic region, it is named Yitong (Axillary Pain); if the pain is located behind the Jixie, it is named Yaotong (Lumbar Pain); neither of these belongs to hepatic region pain. Axillary pain is a syndrome of the Lung. Lumbar pain is a syndrome of the Kidney and Bladder. Generally, hepatic region pain is mostly due to Fire pathogen and belongs to Liver and Gallbladder syndromes. Upper hepatic region pain belongs to the Liver; lower hepatic region pain belongs to the Gallbladder. Alternatively, due to Qi stagnation of the Lung, Metal pathogen overcoming Wood, hepatic region pain may also occur, named Fei Xietong (Lung Hepatic Region Pain), which is the most severe. Metal overcoming Wood constitutes a "Thief Evil" (excessive controlling relationship), hence the condition is heavy.
(Fate and Climate Cold Damage)
[Symptoms of Fate and Climate Hepatic Region Pain] The disease arises suddenly, rapidly manifesting with alternating chills and fever, stabbing pain in the hepatic and rib regions, spreading door-to-door similarly, sometimes on one side, sometimes on both sides. This epidemic disease is commonly known as "Stabbing Rib Cold Damage," also named Shazhang (Sha Distension).
[Etiology of Fate and Climate Hepatic Region Pain] When Shaoyang governs the climate, Ministerial Fire is active; when Shaoyin governs the climate, Sovereign Fire is active; when Yangming governs the climate, Dryness-Fire is active. If the winning and reversing Qi of that year is excessive, Ministerial Fire becomes excessively strong in its proper position, causing self-disease of the Liver and Gallbladder; if Sovereign Fire is excessive, the child disease affects the mother, causing disease in the Liver and Gallbladder; if Dryness-Fire is active, Metal disease overcomes Wood, causing disease in the Liver and Gallbladder; with the three Fires blazing intensely, Wood and Fire illuminate each other, causing Qi stagnation in the Liver and Gallbladder, thus resulting in the sudden onset of severe bilateral hepatic region pain.
[Pulse of Fate and Climate Hepatic Region Pain] Mostly presents as Xianshu (Wiry-Rapid) pulse. Fushu (Floating-Rapid) indicates exterior syndrome; Chenshu (Deep-Rapid) indicates interior syndrome. If the pulse weakens and pain alleviates, there is survival; if the pulse is deep and hidden with cold extremities, there is death. For San (Scattered) pulse, use Xiexin Tang (Drain the Heart Decoction); for Yangming governing climate, use Gange Shigao Tang (Pueraria and Gypsum Decoction) as the main treatment. For all hepatic region pain, externally prick Weizhong (BL40) and Zusanli (ST36) acupoints to bleed; if the pain is severe and fingernails turn black, pricking the tips of the ten fingers to bleed is excellent; this is what the Yue region calls Fangsha (Releasing Sha). If there is coughing with phlegm sounds, regardless of left or right hepatic pain, it is hepatic region pain caused by Lung pathogen, suitable for using Xieqing Banban Tang (Drain Green Half-Half Decoction), and prick Shaoshang (LU11) acupoint.
Chaihu Tang (Bupleurum Decoction)
Ingredients: Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Guang Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma), Qing Pi (Citri Reticulatae Pericarpium Viride), Shan Zhi (Gardeniae Fructus), Zhi Qiao (Aurantii Fructus Immaturus), Mu Tong (Akebiae Caulis).
Add Su Geng (Perillae Caulis).
Duhuo Baidu San (Angelica Pubescens Detoxification Powder)
Ingredients: Duhuo (Angelicae Pubescentis Radix), Mu Tong (Akebiae Caulis), Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Jie Geng (Platycodonis Radix), Zhi Qiao (Aurantii Fructus Immaturus), Gan Cao (Glycyrrhizae Radix et Rhizoma), Gou Teng (Uncariae Ramulus cum Uncis), Guang Pi (Citri Reticulatae Pericarpium).
Add Su Geng (Perillae Caulis).
Xiexin Tang (Drain the Heart Decoction)
Ingredients: Huang Lian (Coptidis Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Deng Xin (Junci Medullia).
Gange Shigao Tang (Pueraria and Gypsum Decoction)
Ingredients: Gan Ge (Puerariae Lobatae Radix), Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Shi Gao (Gypsum Fibrosum), Zhi Qiao (Aurantii Fructus Immaturus), Guang Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma), Mu Tong (Akebiae Caulis).
Add Su Geng (Perillae Caulis).
Xieqing Banban Tang (Drain Green Half-Half Decoction)
Ingredients: Long Dan Cao (Gentianae Radix), Huang Qin (Scutellariae Radix), Shan Zhi (Gardeniae Fructus), Sang Bai Pi (Mori Cortex), Di Gu Pi (Lycii Cortex), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Add Qing Dai (Indigo Naturalis) 1 qian mixed and taken orally.