某氏 左胁痛，卧必偏右，咳则气急，痰带血丝，症由五志怫抑，损伤营络。仿《内经》肝苦急，急食甘
以缓之。潞参、茯苓、甜杏仁、白芍、杞子、枣仁、川贝母（俱炒）、桑皮（蜜炙）、金橘皮、炙草、红枣，
煎服效。
沈氏 气攻肋胁左右，上入乳际，痛引胸背，子夜特甚。思人身气血，于子丑时注肝胆，（子时注胆，
丑时注肝）。今肝阳上升，诸气皆逆，势必营卫失度，瘀浊不降，呕逆便艰，有自来矣，用微苦微
辛以泄降。杏仁、当归须、青皮（醋炒）、延胡、郁金、枳壳（炒）、栝蒌、广木香（汁冲），二服随定。
堂弟 右胁久痛，牵引背膊，呼吸不利，咳则痛甚，坐必体伛，食入稍安，右脉浮弦。此操劳所伤，损动
肺络，当春木旺，痛难遽止。夫诸气 郁，皆属于肺。然痛久则入络，姑用苦辛宣通。老韭根、当归须、郁金、
杏仁、川贝母、陈皮、佛手柑，二服痛减。按其胁仍觉痞硬，仿咸以软坚。用旋复花、牡蛎粉、白芍、金橘皮、
延胡、当归、降香，二服，转用甘缓理虚，以参、苓、归、芍、陈、贝、甘草，痛缓。其亲戚一医以为肝肾阴
虚，用熟地滋腻，竟成单胀矣。
郭 去秋肋痛痰血，见症于肝，不足于肾，入春医用通摄奇经，未效。改用桂心、蒺藜等药平肝，不知
肝为刚脏，药忌刚燥，痛宜益加矣。延至夏初，木火相乘，体羸食减，日晡寒热，咳嗽气促，口干舌腻，坐则
胁背牵引刺痛，脉来弦数无神。症由情志不遂，肝胆寄居之相火，上侮肺金，以至痰红气急，日就羸怯，此以
水涵木之法，急宜进商也。阿胶、麦冬、白芍、贝母（各二钱）、五味子（五分）、石斛、黑豆皮（各三钱）、
丹皮（钱半），二服寒热止，嗽痛减，食加餐矣。又令晨服燕窝汤，晚服生脉散，症有起色。
韩 右胁有块，梗起攻胸，气痹食少，宵胀引背。此肝强胃弱，升降失和，泄肝通胃可效。浓朴、枳壳、
杏仁、蒌仁、青皮、旋复花、降香末、木瓜，三服而平。
Patient of the Mou family Left hypochondriac pain, lying on the right side when sleeping, shortness of breath upon coughing, sputum with blood streaks. The syndrome arises from the depression of the Five Emotions (Joy, Anger, Worry, Thought, Fear), damaging the Ying (Nutritive) collaterals. Following the principle in *Huangdi Neijing* (Yellow Emperor's Inner Canon): "When the Liver suffers from tension, urgently use sweet flavors to relieve it." Prescription: Radix Codonopsis (Lushen), Poria (Fuling), Sweet Almond Seed (Tian Xingren), Radix Paeoniae Alba (Baishao), Fructus Lycii (Qizi), Semen Ziziphi Spinosae (Zaoren), Fritillariae Cirrhosae Bulbus (Chuan Beimu, all stir-fried), Cortex Mori Radicis (Sangpi, honey-fried), Pericarpium Citri Reticulatae Viride (Jinju Pi), Glycyrrhizae Radix et Rhizoma Preparatum (Zhigancao), Jujubae Fructus (Hongzao). Decocted and taken orally; effective.
Patient of the Shen family Qi attacking the left and right hypochondrium, ascending to the breast margin, pain radiating to the chest and back, especially severe at Zi hour (11 PM - 1 AM). Considering human Qi and Blood flow into the Liver and Gallbladder channels during Zi and Chou hours (Zi hour flows into Gallbladder, Chou hour into Liver). Now Liver Yang ascends, all Qi rebels, inevitably leading to disharmony of Ying and Wei (Defensive and Nutritive Qi), failure of turbid stasis to descend, thus vomiting/rebellious Qi and difficult defecation naturally follow. Use slightly bitter and slightly acrid herbs to drain and descend. Prescription: Almond Seed (Xingren), Radix Angelicae Sinensis Caulis (Danggui Xu), Exocarpium Citri Reticulatae Viride (Qingpi, vinegar-fried), Rhizoma Corydalis (Yanhu), Turmeric Tuber (Yujin), Fructus Aurantii (Zhike, stir-fried), Trichosanthis Fructus (Gualou), Aucklandiae Radix (Guangmuxiang, juice mixed). Two doses led to immediate stabilization.
Younger brother of the hall Right hypochondrium long-standing pain, radiating to the back and arms, difficulty breathing, pain worsens with coughing, must sit hunched over, slightly relieved after eating, right pulse is floating and wiry. This is injury due to overwork, damaging Lung collaterals. In spring when Wood Qi is prosperous, pain is hard to stop abruptly. All Qi stagnation belongs to the Lung. However, long-standing pain enters the collaterals. Temporarily use bitter and acrid methods to ventilate and unblock. Old Leek Root (Laojiugen), Radix Angelicae Sinensis Caulis (Danggui Xu), Turmeric Tuber (Yujin), Almond Seed (Xingren), Fritillariae Cirrhosae Bulbus (Chuan Beimu), Pericarpium Citri Reticulatae (Chenpi), Bergamia Fructus (Foshougan). Two doses reduced pain. Palpation of the hypochondrium still felt distended and hard. Following the method of salty flavor to soften hardness. Prescription: Inulae Flos (Xuanjinhua), Ostreae Concha (Muli Fen), Radix Paeoniae Alba (Baishao), Pericarpium Citri Reticulatae Viride (Jinju Pi), Rhizoma Corydalis (Yanhu), Radix Angelicae Sinensis (Danggui), Dalbergiae Odoriferae Lignum (Xiang), two doses. Then switched to sweet and緩 (soothing) method to treat deficiency, using Ginseng Radix (Shen), Poria (Ling), Radix Angelicae Sinensis (Gui), Radix Paeoniae Alba (Shao), Pericarpium Citri Reticulatae (Chen), Fritillariae Cirrhosae Bulbus (Bei), Glycyrrhizae Radix et Rhizoma (Gancao), pain alleviated. A relative who was a physician considered it Kidney and Liver Yin deficiency, used Rehmanniae Radix Preparata (Shudi) which is cloying/greasy, resulting in single abdominal distension (Abdominal Distension disease/Guzhang).
Patient Guo Last autumn, hypochondriac pain with blood in sputum, symptoms manifested in Liver, insufficiency in Kidney. In spring, physicians used methods to regulate the Extraordinary Vessels without effect. Switched to Cinnamon Twig Heart (Guixin), Tribulus Fructus (Jili) etc. to calm Liver, not knowing Liver is a rigid organ, drugs should avoid being rigid and dry, pain would likely increase. Dragged until early summer, Wood and Fire multiplying each other, body emaciated, appetite decreased, afternoon/evening alternating chills and fever, coughing and shortness of breath, dry mouth, greasy tongue coating, sitting causes pulling stabbing pain in hypochondrium and back, pulse is wiry, rapid, and spiritless. Syndrome caused by unfulfilled emotions, Ministerial Fire residing in Liver and Gallbladder insulting Metal of Lung, leading to bloody sputum, shortness of breath, becoming increasingly weak day by day. At this point, the method of Water nourishing Wood (Nourishing Water to Subdue Wood) is urgent. Prescription: Donkey-hide Gelatin (Ejiao), Ophiopogonis Radix (Maidong), Radix Paeoniae Alba (Baishao), Fritillariae Thunbergii Bulbus (Beimu, 2 qian each), Schisandrae Fructus (Wuweizi, 0.5 fen), Dendrobii Caulis (Shihu), Black Soybean Skin (Heidoupi, 3 qian each), Moutan Cortex (Danpi, 1.5 qian). Two doses stopped chills/fever, reduced cough/pain, increased food intake. Also instructed to swallow Bird's Nest Soup in the morning, Shengmai San (Generate Pulse Powder) at night, condition showed improvement.
Patient Han Mass in right hypochondrium, protruding and attacking chest, Qi obstruction, poor appetite, nighttime bloating radiating to back. This is strong Liver and weak Stomach, loss of harmony in ascending and descending functions. Draining Liver and unblocking Stomach can be effective. Prescription: Magnoliae Officinalis Cortex (N Houpo), Fructus Aurantii (Zhike), Almond Seed (Xingren), Trichosanthis Semen (Lou Ren), Exocarpium Citri Reticulatae Viride (Qingpi), Inulae Flos (Xuanjinhua), Dalbergiae Odoriferae Lignum Powder (Xiangmo), Chaenomelis Fructus (Mu Gua). Three doses brought peace.