（附血虚胁胀、血瘀胁胀。）
陈侍御坠马，腿痛作呕，服下药一剂，胸腹胀痛，按之即止，惟倦怠少气。诊其脉，细而涩，曰∶
非瘀血也，乃痛伤气血，复因药损脾气而然耳。投养脾胃生气血之药而愈。
李进士季夏伤手，出血不止，发热作渴，两胁作胀，按之即止，此血虚也。用八珍加软柴胡、花
粉治之而愈。更用养气血之药调理而痊。
孙文垣治桂亭兄，壮年原有湿热痰积。年逾艾，偶坠轿，跌伤背胁，外敷内攻而愈。越十五年，
左胁痛，手不可近，左脉弦数，坚劲搏指，小腹亦痛。知为旧瘀及痰积作祟，以青皮、赤芍、黄连、
当归尾各一钱，桃仁钱半，大黄二钱，滑石三钱，临服调元明粉一钱。服下吐痰碗余，大便仅行一次，
左胯及腿膝皆痛，卧不安，
小腹痛甚，此瘀血欲行未能也。再与前方加减，便三次，皆沉香色稠粘瘀物，腹痛除，胯痛仍在。再
与加减，便行四次，所下紫黑如筋膜者甚伙，诸症悉减。因食鸡汤、牛肉，腹痛复重，此余积未尽，
欲再下之，恐年高不任。曰∶药力已到，积已动，行而后补，庶无反顾之忧。仍以前药去大黄，调元
明粉，下二次，瘀物如前之半，诸痛俱平。用人参、白芍、甘草、陈皮、山楂、桂心、当归、半夏，
调理半月而愈。
一男子跌仆，皮肤不破，两胁作胀，发热口干，自汗，类风症，令先饮童便一瓯，烦渴顿止。随
进复元活血汤，倍用柴胡、青皮，一剂胀痛悉愈，再剂而安。发明经云∶夫从高坠下，恶血流于内，
不分十二经络，圣人俱作风中肝经，留于胁下，以中风疗之。血者，皆肝之所主，恶血必归于肝，不
问何经之伤，必留于胁下，盖肝主血故也。甚痛则必有自汗，但人汗出，皆为风症。诸痛皆属于肝木，
况败血凝滞，从其所属入于肝也。从高坠下，逆其所行之血气，非肝而何？以破血行经药治之。
一男子坠马，两胁作痛，以复元活血汤，二剂顿止。更以小柴胡加当归、桃仁，二剂而安。
(Attached: Hypochondriac distension due to Blood deficiency, hypochondriac distension due to Blood stasis.)
Chen Shiyu fell from a horse, suffering from leg pain and vomiting. After taking one dose of purgative medicine, he experienced chest and abdominal distension and pain, which subsided upon pressure, but remained fatigued and short of breath. Upon palpating his pulse, it was fine (Xi) and choppy (Se). He said: "This is not Blood stasis, but rather Qi and Blood damaged by severe pain, compounded by Spleen Qi damage caused by the medication." He was treated with herbs that nourish the Spleen and Stomach to generate Qi and Blood, and recovered.
Li Jinshi injured his hand in midsummer, with bleeding that would not stop, accompanied by fever, thirst, and distension in both hypochondria, which subsided upon pressure. This indicates Blood deficiency. He was treated with Bazhen Tang (Eight Treasures Decoction) supplemented with Ruan Chaihu (Bupleuri Radix mollis) and Huafen (Trichosanthis Radix), and recovered. Subsequently, he was regulated with herbs that nourish Qi and Blood until fully healed.
Sun Wenyuan treated the elder brother of Guiting, who, in his prime, originally had accumulation of damp-heat and phlegm. Over fifty years old, he accidentally fell from a sedan chair, injuring his back and hypochondria, which healed through external application and internal administration of herbs. Fifteen years later, he suffered from left-sided hypochondriac pain, intolerable to touch. The left pulse was wiry (Xian) and rapid (Shu), firm and strong against the finger, accompanied by lower abdominal pain. It was determined to be caused by old Blood stasis and phlegm accumulation. A prescription of Qingpi (Aurantii Fructus Pericarpium), Chi Shao (Paeoniae Radix Rubra), Huanglian (Coptidis Rhizoma), Danggui Wei (Angelicae Sinensis Radix caudex) each at 1 qian, Taoren (Persicae Semen) at 1.5 qian, Dahuang (Rhei Radix et Rhizoma) at 2 qian, and Huashi (Talcum) at 3 qian was given. Before ingestion, 1 qian of Yuanmingfen (Natrii Sulfas) was mixed in. After taking the medicine, over a bowl of phlegm was vomited, and only one bowel movement occurred. Pain persisted in the left hip, legs, and knees, with restlessness in bed and severe lower abdominal pain. This indicated that Blood stasis was attempting to move but failed. The previous formula was modified and administered again. After three bowel movements consisting of dark-chestnut-colored, thick, sticky bloody matter, the abdominal pain ceased, though hip pain remained. Further modifications led to four bowel movements, expelling large amounts of purple-black, membrane-like material, significantly reducing all symptoms. However, after consuming chicken soup and beef, abdominal pain recurred severely, indicating residual accumulation. Although further purging was desired, it was feared that his advanced age could not tolerate it. It was stated: "The medicinal force has reached its target, and the accumulation has been stirred. Purge first, then tonify, to avoid future worries." The same formula was used minus Dahuang, with Yuanmingfen added. Two more bowel movements expelled half the amount of bloody matter as before, and all pains subsided. Ren Shen (Ginseng Radix), Bai Shao (Paeoniae Radix Alba), Gan Cao (Glycyrrhizae Radix et Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Shan Zha (Crataegi Fructus), Gui Xin (Cinnamomi Ramulus), Dang Gui (Angelicae Sinensis Radix), and Ban Xia (Pinelliae Rhizoma) were used to regulate the condition for half a month until recovery.
A man fell, with intact skin, experiencing hypochondriac distension, fever, dry mouth, and spontaneous sweating, resembling wind syndrome. He was instructed to first drink a cup of Tongbian (Child's Urine), which immediately relieved irritability and thirst. Then, Fuyuan Huoxue Tang (Restore Vitality and Invigorate Blood Decoction) was administered, with increased doses of Chaihu (Bupleuri Radix) and Qingpi (Aurantii Fructus Pericarpium). One dose resolved all distension and pain, and a second dose brought peace. An explanation cites the Classic: "Falling from heights causes evil blood to flow internally, regardless of the twelve meridians. The Sages consider this as Liver Meridian affected by Wind, remaining in the hypochondrium, and treat it as wind stroke." Blood is governed by the Liver; evil blood inevitably returns to the Liver. Regardless of which meridian is injured, the blood remains in the hypochondrium because the Liver governs Blood. Severe pain necessarily involves spontaneous sweating; however, sweating is often attributed to wind syndromes. All pains belong to Liver Wood. Moreover, congealed bad blood follows its affinity and enters the Liver. Falling from heights disrupts the normal flow of Qi and Blood; thus, it affects the Liver. Therefore, it is treated with herbs that break Blood and unblock meridians.
Another man fell from a horse, suffering from bilateral hypochondriac pain. Fuyuan Huoxue Tang (Restore Vitality and Invigorate Blood Decoction) stopped the pain within two doses. Xiao Chaihu Tang (Minor Bupleurum Decoction) supplemented with Dang Gui (Angelicae Sinensis Radix) and Taoren (Persicae Semen) brought relief after two doses.