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The deficiency and excess of hypochondriac pain (Hypochondriac Pain) should be differentiated as follows: Hypochondriac pain is associated with the Liver. Since the Liver meridian resides in a position of extreme Yin, one might assume that such pain always constitutes a Cold syndrome (Yin Syndrome). However, although the Liver organ belongs to Yin, its Qi belongs to Yang. If wind-pathogen invades temporarily, causing pain in both hypochondria, or if phlegm turbidity obstructs the Upper Jiao without pain in the Zhongwan region, forming old phlegm that creates a distressing condition where one desires to vomit but cannot, or desires to defecate but cannot, this is also an extremely painful syndrome. The treatment method should employ herbs that soothe the Liver and disperse wind; Xiaoyao San (Free and Easy Wanderer Powder) is the most excellent formula. Regarding deficiency of Liver Qi, once anger is triggered and damages Liver Blood, it also causes pain in both hypochondria. The symptoms are similar to the aforementioned condition, except for the absence of the desire to vomit without success or difficulty swallowing. Theoretically, Xiaoyao San could also be used to soothe and resolve this. However, although the ingredients of this formula are good, their dosages are relatively light. I now establish a new formula named Pinggan Shunu Yin (Soothe Liver and Calm Anger Decoction), which is highly effective for hypochondriac pain caused by anger. For pain caused by depression/stagnation, one dose often results in immediate relief. The brilliance of this formula lies in using Bai Shao (Radix Paeoniae Alba) up to 1 liang; thus, the Liver Wood is calmed by the sour flavor. Furthermore, it is assisted by Dang Gui (Radix Angelicae Sinensis) to nourish blood and generate Liver essence, along with other complementary herbs. When Liver Qi stagnation is resolved, how can hypochondriac pain persist? If one fails to use this formula and instead uses Xiao Chai Hu Tang (Minor Bupleurum Decoction) or similar formulas, although they can remove phlegm, the process is prolonged and lacks the miraculous speed of this formula.

Pinggan Shunu Yin (Soothe Liver and Calm Anger Decoction)
Chai Hu (Bupleuri Radix, 2 qian), Bai Shao (Radix Paeoniae Alba, 1 liang), Chao Zhi Zi (Gardeniae Fructus, roasted, 3 qian), Dang Gui (Radix Angelicae Sinensis, 1 liang), Bai Jie Zi (Brassicae Semen Album, 3 qian), Che Qian Zi (Plantaginis Semen, 3 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 qian), Zhi Ke (Aurantii Fructus, 1 qian), Dan Pi (Moutan Cortex, 3 qian), Shen Qu (Massa Medicata Fermentata, 1 qian), Mai Ya (Hordei Fructus Germinatus, 2 qian), Shan Zha (Crataegi Fructus, 10 pieces). Decoct in water and take orally.

The differentiation of deficiency and excess in abdominal pain (Abdominal Pain) is as follows: The abdomen resides below the extreme Yin. Since the pain is considered a Yin syndrome, it should theoretically be deficiency rather than excess. Yet, pain varies significantly between deficiency and excess syndromes. How to identify excess abdominal pain? It is characterized by severe tenderness where the patient refuses pressure (abdominal rigidity/tenderness). This occurs when dry stool accumulates in the Large Intestine, and fire forces its way through the organs. In prolonged Taiyang disease (Taiyang Disease), this condition is common. This represents excess pathogenic factors, distinct from deficiency diseases, and requires purgative therapy. Zhang Zhongjing’s Da Chai Hu Tang (Major Bupleurum Decoction) may also be selected, though it is not specifically designed for abdominal pain. I now establish a new formula specifically for abdominal pain, named Dixie Jiutong Tang (Eliminate Pathogen and Relieve Pain Decoction), which proves miraculously effective. Although this formula contains Da Huang (Rhei Radix et Rhizoma) to purge pathogens, it simultaneously includes Dang Gui (Radix Angelicae Sinensis) and Sheng Di Huang (Rehmanniae Radix) to nourish blood and promote circulation. Despite the pushing action of Zhi Shi (Aurantii Fructus Immaturus), this does not hinder the strategy; it exemplifies the brilliant method of combining purgation with tonification. If abdominal pain is accompanied by unresolved exterior cold, add 1 qian of Chai Hu (Bupleuri Radix) to this formula; no other additions are necessary. After one dose, the pathogen dissipates, turbid matter is expelled, the body cools, and pain vanishes. As for deficiency-type abdominal pain, symptoms typically include aversion to cold, aversion to food, preference for warm compresses, and preference for massage. This is due to deficiency-cold lingering in the Lower Jiao. Stool is invariably loose, and urine clear and cold. Inquiry suffices for diagnosis without deep differentiation. The prescribed formula is Quhan Zhitong Tang (Dispel Cold and Stop Pain Decoction). The efficacy of this formula lies in using Bai Zhu (Atractylodis Macrocephalae Rhizoma) as the sovereign herb to benefit the Qi of the waist and umbilical region. When Qi moves, dampness transforms, and cold-warm pathogens cannot linger in the abdomen. Naturally, pathogens exit via urination, and pain is instantly relieved. Using mild and clearing herbs for harmonization would likely fail to achieve such miraculous results.

Dixie Jiutong Tang (Eliminate Pathogen and Relieve Pain Decoction)
Da Huang (Rhei Radix et Rhizoma, 5 qian), Hong Hua (Carthami Flos, 1 qian), Sheng Di Huang (Rehmanniae Radix, 5 qian), Dang Gui (Radix Angelicae Sinensis, 5 qian), Zhi Shi (Aurantii Fructus Immaturus, 1 qian), Hou Po (Magnoliae Officinalis Cortex, 1 qian), Tian Hua Fen (Trichosanthis Radix, 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian). Decoct in water and take orally.

Quhan Zhitong Tang (Dispel Cold and Stop Pain Decoction)
Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 liang), Rou Gui (Cinnamomi Cortex, 2 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian), Wu Zhu Yu (Evodiae Fructus, 0.5 fen), Sha Ren (Amomi Fructus, 3 grains), Huo Xiang (Pogostemonis Herba, 1 qian), Ren Shen (Ginseng Radix, 2 qian), Ban Xia (Pinelliae Rhizoma, 1 qian). Decoct in water and take orally.