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Due to external contraction or internal injury, the pain is so severe that death seems imminent. First, use one liang of salt, dissolved in a bowl of boiling water and a bowl of cold water mixed together. Have the patient drink it all; vomiting and diarrhea will occur, stopping the pain. In Yin Sha syndrome, the hands and feet are cold, and red spots appear on the body; these can be cauterized with an oil lamp flame. In Yang Sha syndrome, the limbs are warm; prick the edges of the fingernails on all ten fingers to bleed, then apply warm water (a specific emergency technique). If purple spots appear at the knees and wrists, pricking them to bleed brings relief.

The Classic states: "Liver disease causes pain in both hypochondriac regions radiating to the lower abdomen, accompanied by irritability." What is the reason? The answer is: The Jueyin Liver meridian ascends from the foot, circles the genitalia, reaches the lower abdomen, then pierces through the liver and diaphragm, distributing along the hypochondriac regions. Therefore, pain in the bilateral hypochondriac regions radiates to the lower abdomen. Generally, hypochondriac pain should be treated differently based on the side. The left belongs to the Liver, which governs Blood; pathology arises from blood stasis. The right belongs to the Lung, which governs Qi; pathology arises from Qi stagnation. The Spleen is also associated with the right side; its meridian is prone to dampness excess, causing phlegm-fluids to flow into the right hypochondrium causing pain. Thus, in general terms, the left involves Liver Fire and blood stasis, while the right involves Qi depression and damp-phlegm. However, if the pulse is wiry on both sides, it indicates Liver Fire stirred by emotional depression. Excessive Liver Wood overacts on the Earth (Spleen) it normally controls and insults the Metal (Lung) it cannot control. When Liver Wood invades, the right side also hurts. For those with Qi knotting due to seven emotions, irregular diet, improper temperature regulation, and frequent anger, both hypochondriac regions may hurt. Treatment should primarily focus on soothing Liver Wood. Cases involving damp-phlegm accumulation or trauma require flexible approaches, not rigid adherence to one method. A deep and choppy pulse indicates Qi stagnation; wiry and choppy is favorable, while surging and large is unfavorable.

Main Formula (for bilateral hypochondriac pain): Chai Hu (Bupleuri Radix), Qing Pi (Aurantii Fructus Immaturus), Bai Shao (Paeoniae Radix Alba), Chuan Xiong (Chuanxiong Rhizoma), Zhi Ke (Aurantii Fructus, stir-fried) [each 1.5 qian], Xiang Fu (Cyperi Rhizoma), Dang Gui (Angelicae Sinensis Radix) [each 1 qian], Long Dan Cao (Gentianae Radix), Mu Xiang (Aucklandiae Radix), Sha Ren (Amomi Fructus) [each 0.5 qian]. Add fresh ginger, decoct in water, and take orally.

For shortness of breath, add Sang Bai Pi (Mori Cortex) and Zi Su (Perillae Folium); for distension, add Fu Pi (Arecae Pericarpium), Cao Guo (Tsaoko Fructus), Chen Pi (Citri Reticulatae Pericarpium), and Luo Bo Zi (Raphani Semen). For left-sided pain, add Huang Lian (Coptidis Rhizoma, stir-fried with Wu Zhu Yu), Tao Ren (Persicae Semen) [each 1 qian], Hong Hua (Carthami Flos) [0.5 qian], Xiang Fu, Sha Ren, and Gan Cao (Licorice Root). For right-sided pain, add Chen Pi, Ban Xia (Pinelliae Rhizoma) [each 1 qian], Bing Lang (Areca Seed), Rou Gui (Cinnamomi Cortex) [each 0.5 qian]; remove Bai Shao, Chuan Xiong, Dang Gui, and Long Dan Cao.

Danggui Longhui Wan (Angelica and Gentian Pill): Universally treats hypochondriac pain caused by Qi transforming into Fire, showing miraculous efficacy.
Ingredients: Dang Gui, Long Dan Cao, Zhi Zi Ren (Gardeniae Semen, large ones), Huang Lian, Da Huang (Rhei Radix et Rhizoma, steamed with wine), Lu Hui (Aloe), Qing Dai (Indigo Naturalis) [each 5 qian], Qing Pi, Mu Xiang [2.5 qian], She Xiang (Moschus) [0.5 qian], Chai Hu [0.5 qian].
Grind all into fine powder. Mix in Lu Hui, Qing Dai, and She Xiang. Use Shen Qu (Medicated Leaven) paste to form pills the size of tung seeds. Take 30 pills each time, washed down with hot, strong ginger tea.

Huotan Wan (Phlegm-Expelling Pill): Treats right-sided hypochondriac pain caused by pre-existing phlegm-fluids.
Ingredients: Chen Pi, Bei Mu (Fritillariae Bulbus), Fu Ling (Poria), Gua Lou Ren (Trichosanthis Semen), Zhi Shi (Aurantii Fructus Immaturus), Bai Jie Zi (Sinapis Semen), Ban Xia, Qing Pi, Zhi Zi [each 1 qian], Mu Xiang, Gan Cao [each 0.4 qian]. Add ginger water, decoct, and take.

Zhi Ke Zhu San (Immature Bitter Orange Decoction Powder): Treats hypochondriac pain in both sides caused by grief and worry injuring Liver Qi, leading to tendon and vessel spasm, heaviness and stiffness in the waist and legs, pain in the groin and hypochondrium, and inability to move the limbs.
Ingredients: Fang Feng (Saposhnikoviae Radix), Chuan Xiong, Xi Xin (Asari Radix et Rhizoma), Zhi Ke (stir-fried), Jie Geng (Platycodonis Radix) [each 1 qian], Gan Cao (roasted) [0.5 qian], Ge Gen (Puerariae Lobatae Radix) [0.8 qian].
Cut into pieces. Decoct two cups of water with three slices of ginger until reduced to 0.8 cup. Take warm after meals.

Zuo Jin Wan (Left Metal Pill): Purges Liver Fire and moves dampness, serving as a counter-agent for extreme heat.
Ingredients: Huang Lian [6 qian], Wu Zhu Yu (Evodiae Fructus) [1 qian].
Grind into powder. Soak in broth, steam with leavened bread dough, and form pills the size of mung beans. Take 30 pills each time, washed down with boiling ginger tea.

Mutong San (Akebia Decoction Powder): Treats severe hypochondriac pain in men and women.
Ingredients: Mutong (Akebiae Caulis), Qing Pi, Chuan Li Zi (Toosendan Fructus, flesh 1 liang stir-fried with half a liang of shelled Ba Dou until yellow, discard Ba Dou), Luo Bo Zi (stir-fried), E Zhu (Curcumae Rhizoma), Mu Xiang, Hua Shi (Talcum) [each 0.5 liang].
Grind into fine powder. Take 3 qian each time, mixed with scallion white soup. Alternatively, decoct and take. Recovery usually occurs quickly; severe cases resolve in two doses.

Yixiang San (Rare Fragrance Powder): Treats epigastric and hypochondriac fullness and oppression.
Ingredients: E Zhu, San Leng (Sparganii Rhizoma), Yi Zhi (Alpiniae Oxyphyllae Fructus), Gan Cao [each 1 qian], Qing Pi, Chen Pi [each 0.5 qian], Shi Lian Rou (Nelumbinis Plumula), Hou Po (Magnoliae Officinalis Cortex, processed with ginger) [0.3 qian].
Cut into pieces. Decoct one and a half cups of water with three slices of ginger and two jujubes until reduced to 0.7 cup. Take warm.

Qizhen Wan (Qi-Needle Pill): Treats long-standing wind obstruction causing throbbing chest pain, needle-like stabbing pain in both hypochondriac regions, unbearable pain, deep and hidden pulses in all six positions, and tenderness to touch. This formula has proven miraculously effective and soothes Liver Qi and stops pain with regular use.
Ingredients: Mu Xiang, Bing Lang, Qing Pi, Chen Pi, Da Huang [each 4 liang], Qian Niu (Pharbitidis Semen, half raw half stir-fried, using the finest powder, 0.5 jin).
Grind into fine powder. Form pills with refined honey, sized like tung seeds. Take 30 pills each time, washed down with ginger tea.

If left-sided pain is fixed and unchanging, it is dead blood (blood stasis); use Huoxue Tang (Blood-Invigorating Decoction) (see Abdominal Pain chapter).

If pain persists for a long time due to labor-induced deficiency, use Buzhong Yiqi Tang (Middle-Qi-Reinforcing Decoction) (see Deficiency Damage chapter).

Warming Compress Method: Stir-fry ginger and scallions until hot, wrap in cloth, and compress. Ginger alone, mugwort, leeks, or garlic can also be used for compression.

Moxibustion Method: For sudden hypochondriac pain. Measure horizontally between the nipples with a wax cord. Bend the cord from the nipple laterally towards the painful hypochondrium. Moxa-burn thirty burns at the end of the cord.

External Application Method: Grind mustard seeds with water and apply; or grind Wu Zhu Yu with vinegar and apply.