胁痛，肝火盛，木气实，有死血，有痰流注，肝急。木气实，用苍术、川芎、
皮、当归之类；痛甚者，肝火盛，以当归龙荟丸，姜汁下，是泻火之要药；死血，用桃仁
红花、川芎；痰流注，以二陈汤加南星、苍术、川芎；肝苦急，急食辛以散之，用抚芎、
苍术。血病，入血药中行血。治咳嗽胁痛，以二陈汤加南星、香附、青皮、青黛，入姜汁。
胁痛有瘀血，行气药中加桃仁不去尖，并香附之类。有火盛者，当伐肝木。
左金丸治肝火，有气郁而胸胁痛者，看其脉沉涩，当作郁治。痛而不得伸舒者蜜丸，龙荟
快。胁下有食积一条扛起，用吴茱萸、炒黄连。控涎丹，一身气痛，及胁痛，痰挟死血，
桃仁泥，丸服。右胁痛，用推气散，出严氏方；左胁痛，用前药为君加柴胡或小柴胡，亦
入方
小龙荟丸
当归 草龙胆（酒洗） 山栀（炒） 黄连（炒） 川芎（各半两） 大黄（煨，半两） 芦荟（三钱）
木香（一钱）
一方有黄芩、柴胡各半两，无大黄、木香。一方有甘草、柴胡、青皮，无当归、栀子。
上为末，入麝香少许，粥糊丸如绿豆大。每服五十丸，姜汤下。仍以琥珀膏贴痛处。龙
荟丸，亦治有积，因饮食大饱，劳力行房胁痛。
当归龙荟丸 治内有湿热，两胁痛。先以琥珀膏贴痛处，却以生姜汁吞此丸。痛甚者，
草龙胆 当归 大栀子 黄连 黄芩（各一两） 大黄 芦荟（各半两） 木香（一钱半） 黄柏（一
两） 麝香（半钱）
上十味为末，面糊丸。一方，加柴胡、川芎各半两。又方，加青黛半两。蜜丸，治胁痛
；曲丸，降肝火。
抑青丸 泻肝火。
黄连（半斤）
上为末，蒸饼糊丸服。
〔附录〕胁下痛，发寒热，小柴胡汤。肥白人因气虚而发寒热，胁下痛者，补虚用参、
，退热用柴胡、黄芩，调气止痛用青木香、青皮。瘦人胁下痛，发寒热，多怒者，必有瘀血，
宜桃仁、当归、红花、柴胡、青皮、大黄、栀子、草龙胆。
附方
推气散 治右胁疼痛，胀满不食。
枳壳 桂心 片子姜黄（各半两，一本作僵蚕） 甘草（炙，一钱半）
上为末。每服二钱，姜枣汤调下，酒亦可。
枳芎散 治左胁痛刺不可忍者。
枳实（炒） 川芎（各半两） 粉草（炙，一钱半）
上为末。每服二钱，姜枣汤下，酒亦可。
十枣汤 治胁痛，甚效，病患气实可用，虚人不可用。
甘遂 芫花（慢火□紫色） 大戟（各等分）
上为末，水一大盏，枣十枚，切开，煮取汁半盏，调半钱，人实更加一钱。量虚实加减
控涎丹 见痛风类。
小柴胡汤 见疟类。
琥珀汤 见积聚类。
胁痛，若因肝火旺盛、木气实盛，或有瘀血停滞，或痰湿流注，以及肝气急迫所致。对于木气实盛者，使用苍术、川芎、陈皮、当归等药物；疼痛剧烈者，属肝火旺盛，服用当归龙荟丸，以姜汁送服，这是泻火的要药；若有瘀血，使用桃仁、红花、川芎；若是痰湿流注，用二陈汤加天南星、苍术、川芎；肝苦于急迫，应紧急食用辛味药物以疏散之，使用抚芎（川芎的一种）、苍术。血分病变，需在活血药中配合行血药物。治疗咳嗽伴胁痛，用二陈汤加天南星、香附、青皮、青黛，加入姜汁。胁痛伴有瘀血者，在行气药中加入不去尖的桃仁及香附等。有火旺者，应当清伐肝木。
左金丸治疗肝火。若有气机郁结导致胸胁疼痛，诊察脉象沉涩，当作郁证治疗。疼痛且身体不得舒展者，用蜜丸形式的龙荟丸效果较快。胁下有食积形成条索状隆起者，使用吴茱萸、炒黄连。控涎丹治疗全身气痛及胁痛，若为痰挟瘀血，可用桃仁泥制丸服用。右胁痛，使用推气散，出自《严氏济生方》；左胁痛，以前述药物为主药，加柴胡或小柴胡汤，也收录在方剂小龙荟丸中。
小龙荟丸组成：当归、草龙胆（酒洗）、山栀（炒）、黄连（炒）、川芎（各半两）、大黄（煨，半两）、芦荟（三钱）、木香（一钱）。另一配方含有黄芩、柴胡各半两，无大黄、木香。再一方含有甘草、柴胡、青皮，无当归、栀子。以上药物研为细末，加入少许麝香，用米粥糊制成如绿豆大小的丸剂。每次服用五十丸，姜汤送服。同时仍用琥珀膏贴敷疼痛部位。龙荟丸也治疗因饮食过饱、劳累后行房事导致的胁痛。
当归龙荟丸：治疗体内湿热引起的两胁疼痛。先用琥珀膏贴敷疼痛处，然后用生姜汁吞服此丸。疼痛剧烈者，可用草龙胆、当归、大栀子、黄连、黄芩（各一两）、大黄、芦荟（各半两）、木香（一钱半）、黄柏（一两）、麝香（半钱）。以上十味药研为细末，用面糊制丸。另一配方，加柴胡、川芎各半两。又一方，加青黛半两。蜜丸，治疗胁痛；曲丸，降肝火。
抑青丸：泻肝火。组成：黄连（半斤）。以上研为细末，用蒸饼糊制丸服用。
〔附录〕胁下疼痛，伴有寒热往来，用小柴胡汤。肥胖之人因气虚而发寒热、胁下痛者，补虚用人参、[此处原文缺字，通常指白术或黄芪]，退热用柴胡、黄芩，调气止痛用青木香、青皮。瘦人胁下痛，发寒热，易怒者，必有瘀血，宜用桃仁、当归、红花、柴胡、青皮、大黄、栀子、草龙胆。
附方：
推气散：治疗右胁疼痛，胀满不食。组成：枳壳、桂心、片子姜黄（各半两，一本作僵蚕）、甘草（炙，一钱半）。以上研为细末。每次服用二钱，姜枣汤调下，酒亦可。
枳芎散：治疗左胁刺痛不可忍受。组成：枳实（炒）、川芎（各半两）、粉草（炙，一钱半）。以上研为细末。每次服用二钱，姜枣汤下，酒亦可。
十枣汤：治疗胁痛，效果显著，患者气实者可用，虚人不可用。组成：甘遂、芫花（慢火煨至紫色）、大戟（各等分）。以上研为细末，用水一大盏，大枣十枚，切开，煮取汁半盏，调服半钱，体质壮实者可增加一钱。根据虚实加减用量。
小柴胡汤：见疟类。
Hypochondriac pain, if caused by excessive Liver Fire, excess Wood Qi, stagnant blood, phlegm flowing and depositing, or Liver urgency. For excess Wood Qi, use Rhizoma Atractylodis Macrocephalae (Cangzhu), Rhizoma Chuanxiong (Chuanxiong), Pericarpium Citri Reticulatae (Chenpi), Radix Angelicae Sinensis (Danggui); for severe pain due to excessive Liver Fire, administer Danggui Longhui Wan (Angelica Sinensis and Picrorhiza Pill) taken with ginger juice, which is a key herb for purging fire; for stagnant blood, use Semen Persicae (Taoren), Flos Carthami Tinctorii (Honghua), Rhizoma Chuanxiong (Chuanxiong); for phlegm flowing and depositing, use Erchen Tang (Two-Cured Decoction) added with Rhizoma Pinelliae Preparatum (Nanxing), Rhizoma Atractylodis Macrocephalae (Cangzhu), Rhizoma Chuanxiong (Chuanxiong); when the Liver suffers from urgency, urgently consume pungent substances to disperse it, using Fuxiong (a type of Chuanxiong), Rhizoma Atractylodis Macrocephalae (Cangzhu). For blood diseases, incorporate blood-invigorating herbs into blood-activating formulas. To treat cough with hypochondriac pain, use Erchen Tang (Two-Cured Decoction) added with Rhizoma Pinelliae Preparatum (Nanxing), Rhizoma Cyperi (Xiangfu), Exocarpium Citri Grandis (Qingpi), Indigo Naturalis (Qingdai), adding ginger juice. For hypochondriac pain with blood stasis, add unpitted Semen Persicae (Taoren) and Rhizoma Cyperi (Xiangfu) among qi-moving herbs. For those with excessive fire, one should purge the Liver Wood.
Zuojin Wan (Left Metal Pill) treats Liver Fire. For cases with Qi stagnation causing chest and hypochondriac pain, if the pulse is deep and choppy, treat as stagnation. For pain accompanied by inability to stretch comfortably, Longhui Wan (Picrorhiza Pill) in honeyed pill form acts quickly. For a band-like accumulation of food retention under the hypochondrium, use Fructus Evodiae Officinalis (Wuzhuyu), stir-fried Radix Coptidis Chinensis (Huanglian). Kongxian Dan (Control Phlegm Elixir) treats generalized Qi pain and hypochondriac pain; if phlegm clings to stagnant blood, prepare pills with Semen Persicae paste for oral administration. For right-sided hypochondriac pain, use Tuiqi San (Pushing Qi Powder) from Yan Shi's formula; for left-sided hypochondriac pain, use the aforementioned drugs as the sovereign, adding Radix Bupleuri (Chaihu) or Xiaochaihu Tang (Minor Bupleurum Decoction), also included in the formula Xiaolonghui Wan (Little Dragon Gallbladder Pill).
Xiaolonghui Wan Composition: Radix Angelicae Sinensis (Danggui), Radix Scutellariae Barbatae (Caolongdan, wine-washed), Fructus Gardeniae Jasminoidis (Shanzhi, stir-fried), Radix Coptidis Chinensis (Huanglian, stir-fried), Rhizoma Chuanxiong (Chuanxiong) (each 1.5 liang), Radix et Rhizoma Rhei Palmati (Dahuang, baked, 1.5 liang), Aloe (Luhui) (1 qian), Radix Aucklandiae (Muxiang) (0.1 qian). Another prescription contains Radix Scutellariae Baicalensis (Huangqin) and Radix Bupleuri (Chaihu) each 1.5 liang, without Dahuang and Muxiang. Yet another contains Radix Glycyrrhizae Uralensis (Gancao), Radix Bupleuri (Chaihu), Exocarpium Citri Grandis (Qingpi), without Danggui and Shanzhi. Grind the above into powder, add a small amount of Moschus (Shexiang), make pills with rice porridge paste the size of mung beans. Take 50 pills each time, washed down with ginger soup. Still apply Hupo Gao (Amber Plaster) to the painful area. Longhui Wan also treats hypochondriac pain caused by overeating followed by labor and sexual intercourse.
Danggui Longhui Wan: Treats damp-heat inside causing bilateral hypochondriac pain. First apply Hupo Gao (Amber Plaster) to the painful area, then swallow this pill with fresh ginger juice. For severe pain, use Radix Scutellariae Barbatae (Caolongdan), Radix Angelicae Sinensis (Danggui), Magnolia Flower (Dazishizi - note: text says Da Zhizi, likely Fructus Gardeniae), Radix Coptidis Chinensis (Huanglian), Radix Scutellariae Baicalensis (Huangqin) (each 1 liang), Radix et Rhizoma Rhei Palmati (Dahuang), Aloe (Luhui) (each 0.5 liang), Radix Aucklandiae (Muxiang) (1.5 qian), Cortex Phellodendri Amurensis (Huangbai) (1 liang), Moschus (Shexiang) (0.5 qian). Grind these ten ingredients into powder, make pills with wheat flour paste. Another prescription adds Radix Bupleuri (Chaihu) and Rhizoma Chuanxiong (Chuanxiong) each 0.5 liang. Yet another adds Indigo Naturalis (Qingdai) 0.5 liang. Honeyed pills treat hypochondriac pain; Qu pills (fermented pill base) reduce Liver Fire.
Yiqing Wan (Suppress Blue Pill): Purges Liver Fire. Composition: Radix Coptidis Chinensis (Huanglian) (8 liang). Grind into powder, make pills with steamed cake paste for oral administration.
[Appendix] Pain under the hypochondrium with alternating chills and fever, use Xiaochaihu Tang (Minor Bupleurum Decoction). For obese individuals with Qi deficiency causing chills, fever, and hypochondriac pain, tonify deficiency with Ginseng Radix et Rhizoma (Renshen)... [text missing], clear heat with Radix Bupleuri (Chaihu), Radix Scutellariae Baicalensis (Huangqin), regulate Qi and relieve pain with Radix Aucklandiae (Qingmuxiang), Exocarpium Citri Grandis (Qingpi). For thin individuals with hypochondriac pain, chills, fever, and irritability, there must be blood stasis; use Semen Persicae (Taoren), Radix Angelicae Sinensis (Danggui), Flos Carthami Tinctorii (Honghua), Radix Bupleuri (Chaihu), Exocarpium Citri Grandis (Qingpi), Radix et Rhizoma Rhei Palmati (Dahuang), Fructus Gardeniae Jasminoidis (Zhizi), Radix Scutellariae Barbatae (Caolongdan).
Attached Formulas:
Tuiqi San (Pushing Qi Powder): Treats right hypochondriac pain, distension, and anorexia. Composition: Fructus Aurantii (Zhike), Cortex Cinnamomi (Guixin), Rhizoma Curcumae Longae (Pianzi Jianghuang) (each 1.5 liang, one version uses Bombyx Batryticatus/Jiangcan), Radix Glycyrrhizae Uralensis (Gancao, roasted) (1.5 qian). Grind into powder. Take 2 qian each time, mixed with ginger and jujube decoction, wine is also acceptable.
Zhixiong San (Aurantium and Chuanxiong Powder): Treats unbearable stabbing pain in the left hypochondrium. Composition: Fructus Aurantii Immaturus (Zhishi, stir-fried), Rhizoma Chuanxiong (Chuanxiong) (each 1.5 liang), Radix Glycyrrhizae Uralensis (Fencao, roasted) (1.5 qian). Grind into powder. Take 2 qian each time, washed down with ginger and jujube decoction, wine is also acceptable.
Shizao Tang (Ten Jujube Decoction): Treats hypochondriac pain, very effective; usable for patients with excess Qi, not for deficient persons. Composition: Radix Kansui (Gansui), Flos Genkwa (Yanhua, slow-fire roasted until purple), Radix Euphorbiae Lathyris (Daji) (equal parts). Grind into powder. Use one large cup of water, ten jujubes cut open, boil to obtain half a cup of juice, mix with 0.5 qian of powder; for robust individuals, increase by 1 qian. Adjust dosage according to deficiency or excess.
Kongxian Dan: See Gout category.
Xiaochaihu Tang: See Malaria category.
Hupo Tang: See Accumulation category.