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Various hypochondriac pains have different causative factors. If the pain is solely caused by cold qi or due to contusions and sprains, Heqi Yin (Harmonizing Qi Decoction) or Wuyao Shunqi San (Lindera Powder to Smooth Qi) should be used. Alternatively, a strong decoction of scallion white (Congbai) can be administered with Zhike San (Bitter Orange Powder). If there are palpable masses in the left or right hypochondrium accompanied by pain, this indicates accumulation disorders (Jiju); refer to the section on Qi Disorders for details. For hypochondriac pain caused by retained fluid, the pills from *Bencao Fang* are most effective.

There was a case where a patient suffered from hypochondriac pain radiating to the diaphragm. After taking various qi-regulating herbs and self-administering purgatives to unblock the bowels, the pain intensified significantly. It was only after administering warm-hot tonifying agents and Heixi Dan (Black Tin Pill) that the condition resolved. This was pain due to deficiency-cold; excessive draining further depleted the righteous qi. Hypochondriac pain involves the Liver and Gallbladder. In Shaoyang disease (Taiyang disease involving the Shaoyang channel), hypochondriac pain belongs to the Shaoyang channel, and Xiao Chaihu Tang (Minor Bupleurum Decoction) should be combined. If the pain is severe and accompanied by constipation, add Zhishi (Aurantii Fructus) to the formula. For ordinary hypochondriac pain not caused by standard exogenous febrile diseases, but with slight body heat, use the Zhige Decoction from *Bencao Fang*: Zhishi (Aurantii Fructus), Jiegeng (Platycodonis Radix), Xixin (Asari Radix et Rhizoma), Xiong (Chuanxiong Rhizoma), Fangfeng (Saposhnikoviae Radix) each 4 fen, Gegen (Puerariae Lobatae Radix) 1.5 qian, Gancao (Glycyrrhizae Radix et Rhizoma) 1 qian. If it is merely hypochondriac pain without other symptoms, pain on the left indicates pathogenic invasion of the Liver channel, treated with Chuanxiong, Zhishi, and Gancao. Pain on the right indicates the Liver channel pathology transferring to the Lung, treated with Pian Jianghuang (Curcumae Longae Rhizoma), Zhishi, Guizhi (Cinnamomi Ramulus), and Gancao. These two formulas originate from Yan Shi's *Jisheng Xuji*; modifications depend on clinical judgment. Additionally, for phlegm-fluid retention in the Liver and Gallbladder channels or unilateral hypochondriac pain, Yan Shi's Daotan Tang (Great Phlegm-Resolving Decoction) is suitable. If phlegm forms into a mass (Pi), Banliu Wan (Half-Sulfur Pill) may be taken intermittently. Since Zhishi is a key herb for treating hypochondriac pain, it is indispensable in various formulas. Pan Zixian reported a case where Qinglong Tang (Green Dragon Decoction) stopped the pain and also cured coughing; this indicated pain in the right hypochondrium, clearly due to cold qi, making Zhishi Lizhong Tang (Bitter Orange and Poria Decocted with Ginseng and Ginger Decoction) appropriate. Dai Fu'an stated that for various cold pains in the abdomen, modified Zhishi Lizhong Tang can be widely used.

The waist is the residence of the Kidney. All types of lumbago belong to the Kidney, whether caused by cold, dampness, wind, or deficiency. Lumbago due to sprains or overexertion should be treated with Shengliao Wuji San (Unprocessed Five Accumulations Powder) plus five fried Taoren (Persicae Semen).

Lumbago feeling like sawing or stabbing, with black stool and dark yellow or black urine, is caused by blood stasis in the waist region, named Lixue Yaotong (Dripping Blood Lumbago). Treat with Heishen San (Black Divine Powder) mixed with peach kernel wine.

For cold-type lumbago, which alleviates with heat and worsens with cold, use Wuji San with added Wuzhuyu (Evodiae Fructus) half a qian per dose.

For damp-type lumbago, feeling as if sitting in water, since the Kidney governs water, prolonged sitting in damp places or exposure to rain and dew allows dampness to enter the Kidney channel, causing lumbago. Use Shenshi Tang (Dampness-Percolating Decoction); if ineffective, use Shenzhe Tang (Kidney-Clothing Decoction).

For lumbago caused by wind invasion, with pain shifting between left and right, unpredictable location, and radiating to both legs, use Wuji San with added Fangfeng (Saposhnikoviae Radix) half a qian per dose, or add three Quanxie (Scorpio) for better effect. Xiaoxuming Tang (Minor Rescue Life Decoction) and Duhuo Jisheng Tang (Angelica Pubescens and Sangjisheng Decoction) are also selectable options. Swallow Sanxian Dan (Three Immortals Pill) concurrently. Stir-fried Du Zhong (Eucommiae Cortex) processed with ginger juice and powdered, one qian per dose, taken with warm wine on an empty stomach, named Du Zhong Jiu (Eucommia Wine), treats Kidney-deficiency lumbago and wind-cold pathologies.

For women with excessive blood loss or chronic blood deficiency causing lumbago, nourish the blood; see the Women's Section. For Kidney-deficiency lumbago with inability to turn or lie down, lethargy, and weakness, use Da Jianzhong Tang (Major Construct the Middle Decoction) with ten Sichuan pepper grains, swallowed with Yao Shen Wan (Waist-Kidney Pill) and Shengliao Lurong Wan (Unprocessed Deer Antler Pill). Roast Fenhui (Foeniculi Fructus), powder it, slice animal kidneys thinly without cutting through, layer with the powder, wrap in wet paper, and bake until cooked. Chew thoroughly and swallow with wine.

For pain due to sprains or contusions, use Heishen San combined with Fuyuan Tongqi San, taken with wine. If ineffective, malignant blood stasis may be present; first administer Suhexiang Wan (Styrax Pill) with wine, then continue with Wuji San adding Dahuang (Rhei Radix et Rhizoma) half a qian, Sumu (Sappanwood) half a qian, and double the amount of Danggui (Angelicae Sinensis Radix). For pain due to laborious work or heavy lifting, use Heqi Yin or Puxian Zhengqi San.