胁为肝胆之区。故胁痛。昔人多从肝治。推其致痛之因，亦各不同。有因忿怒气郁，有因肝胆火
盛，有因痰饮流注。有因瘀血停留，有因闪挫跌扑，有因食压肝气，治亦有异。其阴虚火旺，而胁肋作痛
者，宜从虚劳门治之。仲淳云∶胸胁痛属肝血虚，肝气实而上逆所致。治宜养血和肝，〔生地、归、
芍、甘草、续断。〕除热下气〔羚角、苏子、郁金、降香。〕古云∶肝无补法。此论肝气则不可亢，而肝
血仍当自养也。
加味逍遥散〔见虚劳。〕治郁怒伤肝，胸膈胁肋肚腹等处作痛，〔肝气喜条达。若因忿怒气郁
冲上，则胸胃痛、奔下则少腹痛，横行则胁肋胀痛。〕加减用之。
宜加木香、香附、〔开郁快气。〕枳壳、〔治气结刺痛。〕青皮。〔疏肝胆滞气。〕如
肺金气盛，而制肝木太过，而胁痛者，宜泻白散〔抑金。〕合逍遥散〔扶木。〕加减治之。
此方辛散酸收，甘缓养血，而兼宁心扶脾之剂，乃肝经之要药也。
龙胆泻肝汤 治肝胆实火，或胸膈胁肋刺痛，〔以肝脉上贯膈中，布胁肋也。〕或两拗阴囊肿
痛，〔肝脉循股内侧，入毛中，过阴器也。〕或头目胀痛，〔肝脉连目系，上出额至巅，〕或少腹作
痛，〔肝脉抵少腹也。〕或下部生疮，〔如下疳、便毒、囊痈、悬痈、妇人阴肿、阴疮、阴中突出如
挺。〕或乍寒发热，或大便燥结，或大便赤涩等症。
龙胆草〔专泻肝胆之火。〕黄芩 山栀〔君以胆草，同入肝胆。〕生地 白芍〔以凉
肝血。〕甘草〔以缓火势。〕木通 泽泻 车前，〔以泄火邪。〕或加羚羊角〔咸寒入肝，
除热下气。〕黄连〔吴茱萸汁炒。〕寒热加柴胡，便秘加大黄。
左金丸〔亦可小剂作汤。〕治肝经实火，胁肋作痛，一切肝火之症。〔外用大黄、朴硝捣贴
痛处。〕
黄连〔泻心火，使肺金清肃，得行令于左，而肝平。猪胆汁炒，径入肝胆。六两。〕吴
茱萸〔独入厥阴有功，引连
入肝泻火。此从治之义。汤泡三次，炒一两。入汤剂，但浸汁拌炒。〕可加羚羊角。〔能治胸
胁痛满。〕
二陈汤〔见中风。〕
四苓散〔见湿。〕痰饮流注，胁下支满而痛，〔甚至有形肿
色赤，坚硬不移。〕或咳或呕者，合二方加减用之。
宜加枳壳 青皮 竹沥 白芥子〔痰在胁下，非白芥子不能达。如有热者，少加寒凉药中为
引导。〕黄连。〔吴茱萸浸炒。〕如人强壮实，脉滑有力痛甚者，〔去甘草。〕量加甘遂〔驱逐胸
胃痰饮之峻药，半分至一分，须同大枣数枚用。〕
犀角地黄汤〔见伤寒。〕失笑散〔见胃脘痛，〕均治瘀血停留，胁肋作痛，及闪挫瘀凝胁
痛，随宜采用。
保和汤〔见泄泻。〕治饮食填塞太阴，肝气被压，莫能舒泄，横行胁肋作痛，主此加减。
宜加香砂 香附 青皮 黄连〔吴茱萸浸炒。〕
此七方或泻火，或驱痰，或祛瘀，或消食，皆宗肝无补法之良治也。然肝为藏血之海，若失血则空
虚，是仍宜补之，慎勿胶执。
The hypochondriac region is the area of the Liver and Gallbladder. Therefore, for hypochondriac pain, ancient practitioners often treated it from the perspective of the Liver. Investigating the causes of pain, they varied. Some were due to anger causing Qi stagnation, some due to excess Fire in the Liver and Gallbladder, some due to Phlegm-Fluids flowing and accumulating, some due to Stasis of Blood remaining, some due to sprains, falls, or blows, and some due to food compressing the Liver Qi; thus, treatments also differed. For those with Yin deficiency and hyperactive Fire causing hypochondriac pain, treatment should follow the category of Deficiency Consumption (Xu Lao). Zhong Chun stated: Chest and hypochondriac pain is caused by Liver Blood deficiency and excess Liver Qi rebelling upward. Treatment should nourish Blood and harmonize the Liver, [Formula: Sheng Di Huang, Dang Gui, Bai Shao, Gan Cao, Xu Duan.] to clear Heat and direct Qi downward [Formula: Ling Yang Jiao, Su Zi, Yu Jin, Jiang Xiang]. The ancients said: "The Liver has no tonification method." This refers to the fact that Liver Qi must not be hyperactive, but Liver Blood should still be self-nourished.
Jia Wei Xiao Yao San [See Deficiency Consumption] treats pain in the chest, diaphragm, hypochondrium, ribs, abdomen, etc., caused by depression and anger injuring the Liver, [The Liver Qi likes to flow freely and smoothly. If anger and Qi stagnation rush upward, it causes chest and stomach pain; if it rushes downward, it causes lower abdominal pain; if it moves horizontally, it causes distending pain in the hypochondrium and ribs.] Use with modifications according to circumstances.
It is appropriate to add Mu Xiang and Xiang Fu, [to open depression and move Qi.] Zhi Ke, [to treat stabbing pain from Qi knotting.] Qing Pi. [to disperse stagnant Qi in the Liver and Gallbladder.] If Lung Metal Qi is excessive, overly restraining Liver Wood and causing hypochondriac pain, use Xie Bai San [to suppress Metal.] combined with Xiao Yao San [to support Wood.] with modifications.
This formula (Xiao Yao San) is pungent to disperse and sour to astringe, sweet to slow and nourish Blood, and also calms the Heart and supports the Spleen; it is an essential medicine for the Liver Meridian.
Long Dan Xie Gan Tang treats excess Fire in the Liver and Gallbladder, or stabbing pain in the chest, diaphragm, hypochondrium, and ribs, [because the Liver Meridian passes through the diaphragm and spreads over the hypochondrium.] or swelling and pain in the scrotum and testicles, [the Liver Meridian runs along the medial aspect of the thigh, enters the pubic hair region, and passes through the genitalia.] or distending pain in the head and eyes, [the Liver Meridian connects to the eye system, goes up to the forehead and vertex,] or pain in the lower abdomen, [the Liver Meridian reaches the lower abdomen.] or sores in the lower body, [such as chancre, inguinal bubo, scrotal abscess, perineal abscess, female vulvar swelling, vulvar sores, prolapse of the vagina resembling a protruding object.] or alternating chills and fever, or dry and hard stools, or red and scanty urination, and other symptoms.
Long Dan Cao [specializes in draining Fire from the Liver and Gallbladder.] Huang Qin and Shan Zhi [with Dan Cao as the sovereign herb, entering both Liver and Gallbladder meridians.] Sheng Di and Bai Shao [to cool Liver Blood.] Gan Cao [to moderate the Fire pathogen.] Mu Tong, Ze Xie, Che Qian, [to drain Fire pathogens.] Alternatively, add Ling Yang Jiao [salty and cold, enters the Liver, clears Heat and directs Qi downward.] Huang Lian [stir-fried with Wu Zhu Yu juice.] If there are alternating chills and fever, add Chai Hu; if constipation, add Da Huang.
Zuo Jin Wan [can also be used in small doses as a decoction.] treats excess Fire in the Liver Meridian, hypochondriac pain, and all conditions of Liver Fire. [Externally, apply Da Huang and Po Xiao pounded together to the painful area.]
Huang Lian [drains Heart Fire, making Lung Metal clear and肃 (solemn/clear), allowing it to exercise its function on the left, thereby calming the Liver. Stir-fried with pig bile, directly entering the Liver and Gallbladder meridians. Dosage: 6 liang.] Wu Zhu Yu [has merit specifically in the Jueyin meridian, guiding Huang Lian into the Liver to drain Fire. This follows the principle of contrary treatment. Soaked in decoction three times, stir-fried for 1 liang. When used in decoctions, only soak and extract juice for stir-frying.] Ling Yang Jiao can be added. [Can treat chest and hypochondriac fullness and pain.]
Er Chen Tang [See Stroke.]
Si Ling San [See Dampness.] For Phlegm-Fluids flowing and accumulating, causing distension and fullness with pain under the hypochondrium, [even forming tangible masses that are red, hard, and immobile.] or coughing or vomiting, combine these two formulas and use with modifications.
It is appropriate to add Zhi Ke, Qing Pi, Zhu Li, and Bai Jie Zi [Phlegm in the hypochondrium cannot reach without Bai Jie Zi. If there is heat, add a small amount of cold herbs as guides.] Huang Lian. [Steeped and stir-fried with Wu Zhu Yu.] If the person is strong and excess-type, with a slippery and forceful pulse and severe pain, [remove Gan Cao.] add Gan Sui appropriately [a harsh drug to expel Phlegm-Fluids from the chest and stomach, dosage 0.5 fen to 1 fen, must be used with several dates.]
Xi Jiao Di Huang Tang [See Cold Damage.] Shi Xiao San [See Epigastric Pain,] both treat Stasis of Blood remaining causing hypochondriac pain, and hypochondriac pain from stasis coagulation after sprains/blows, select according to suitability.
Bao He Tang [See Diarrhea.] treats food blocking the Taiyin Spleen, suppressing Liver Qi so it cannot diffuse and vent, causing horizontal pain in the hypochondrium; this formula is the main choice for modification.
It is appropriate to add Xiang Sha, Xiang Fu, Qing Pi, and Huang Lian [steeped and stir-fried with Wu Zhu Yu.]
These seven formulas either drain Fire, expel Phlegm, remove Stasis, or digest Food; all adhere to the good treatment principle of "The Liver has no tonification method." However, the Liver is the sea of storing Blood; if blood loss occurs, it becomes empty, and in such cases, tonification is still appropriate. Do not be rigidly dogmatic.