肝藏于内。外应乎胁。胁之所在。肝之所在也。所藏者血。所属者怒气。扑跌斗殴。内
伤乎
。藏于肝部。则虽无瘀血。而亦痛矣。然何以辨其为血与气耶。盖瘀血作痛者。痛而不膨按
之亦痛。不按亦痛。其痛无时而息也。怒气作痛者。痛而且膨。得嗳则缓。已而复痛。其痛
有时而息也。此非血与气之辨乎。然有左胁痛右胁痛。左胁痛甚者。必是肝火盛。木气实。
右胁痛甚者。必是痰流注。并食积。两胁走痛者。必痰饮也。又有季胁作痛者何也。盖季胁
两肋稍之处。肝之下胆之位也。痛甚而下连小腹者。亦是死血。痛不甚而止于一处者痰也。
治此病者。审其所伤而治之。亦无不中矣。
脉沉气。涩血。滑痰数热。两胁疼痛。脉必双弦。弦满者顺洪大者逆。
疏肝散瘀汤 治瘀血凝结两胁刺痛。
当归 红花 苏木 青皮 柴胡（各一钱） 山楂（二钱） 白芍 乌药 桂枝 甘草（各
八分） 水煎热服。
抑肝定痛饮 治怒气伤肝胁痛。
广木香 橘红 青皮 柴胡 白芍 当归（各一钱五分） 官桂（六分） 沉香 枳壳（各
一钱） 水煎热服。
龙荟丸 治肝火盛肋胁作痛。
当归 龙胆草 山栀仁（炒黑） 黄芩（酒炒） 黄连（各一两） 大黄（酒蒸） 芦荟 青黛
（各五钱） 广木香（三钱） 麝香（五分）
上为末。神曲三两。打糊为丸。每服二钱。姜汤送下。
和肝饮 治胁下杠梗起一条作疼。
当归 白芍 三棱 青皮（各一钱五分） 大茴香 木香 枳壳 柴胡 砂仁（各八分）
水煎不拘时服。
调肝饮 治季胁痛连小腹。
当归 川芎 乌药 玄胡索 青皮（各一钱五分） 柴胡 槟榔 广木香 桃仁（去皮尖
各一钱） 水煎热服。
舒肝汤 治痰凝聚结。两胁胀痛。夜不能卧。
白芥子 柴胡 青皮（各二钱） 橘核 乌药（各一钱五分） 澹竹沥（一钟） 龙胆草（
一钱） 生姜五片煎服。
肝脏位于体内，外部对应胁肋部位。胁肋所在的位置，就是肝脏所在的地方。肝所藏的是血液，肝所主的情志是愤怒。遭受扑打、跌倒或斗殴等外力损伤，会内伤于气机，郁结在肝部。即使没有形成瘀血，也会产生疼痛。然而，如何辨别疼痛是由瘀血引起还是由气滞引起呢？一般来说，瘀血引起的疼痛，特点是疼痛且局部胀满，按压时疼痛加剧，不按压时也疼痛，这种疼痛没有间歇的时候。怒气（气滞）引起的疼痛，特点是疼痛且伴有胀满感，通过打嗝排气后症状会缓解，但过后又会再次疼痛，这种疼痛是有间歇性的。这难道不是血与气的区别吗？
此外，还有左胁痛和右胁痛的区别。左胁痛剧烈的，必然是肝火旺盛，木气实盛；右胁痛剧烈的，必然是痰湿流注，并伴有食积。两胁之间游走性疼痛的，必然是痰饮所致。又有季胁（侧腹部肋骨下端）疼痛是怎么回事呢？季胁位于两肋稍下方的位置，是肝脏下方、胆腑所在的部位。如果疼痛剧烈且向下牵连小腹的，也是死血（瘀血）；如果疼痛不剧烈且固定在一处的，则是痰湿。治疗这类疾病，审察其受伤的原因（病因）并进行针对性治疗，就没有不奏效的。
脉象方面：脉沉主气滞，脉涩主血瘀，脉滑主痰，脉数主热。两胁疼痛，脉象必定呈现双弦脉。脉象弦而有力为顺证，脉象洪大则为逆证。
疏肝散瘀汤：治疗瘀血凝结导致的两胁刺痛。
药材：当归、红花、苏木、青皮、柴胡（各一钱），山楂（二钱），白芍、乌药、桂枝、甘草（各八分）。用水煎煮，热服。
抑肝定痛饮：治疗因怒气伤肝导致的胁痛。
药材：广木香、橘红、青皮、柴胡、白芍、当归（各一钱五分），官桂（六分），沉香、枳壳（各一钱）。用水煎煮，热服。
龙荟丸：治疗肝火旺盛导致的肋胁疼痛。
药材：当归、龙胆草、山栀仁（炒黑）、黄芩（酒炒）、黄连（各一两），大黄（酒蒸）、芦荟、青黛（各五钱），广木香（三钱），麝香（五分）。
以上药物研成细末，用神曲三两打糊作为粘合剂制成丸药。每次服用二钱，用姜汤送服。
和肝饮：治疗胁下梗硬隆起一条状物并伴有疼痛。
药材：当归、白芍、三棱、青皮（各一钱五分），大茴香、木香、枳壳、柴胡、砂仁（各八分）。用水煎煮，不拘时间服用。
调肝饮：治疗季胁疼痛牵连至小腹。
药材：当归、川芎、乌药、玄胡索、青皮（各一钱五分），柴胡、槟榔、广木香、桃仁（去皮尖，各一钱）。用水煎煮，热服。
舒肝汤：治疗痰湿凝聚结聚，导致两胁胀痛，夜间无法入睡。
药材：白芥子、柴胡、青皮（各二钱），橘核、乌药（各一钱五分），澹竹沥（一钟），龙胆草（一钱），生姜五片。用水煎煮服用。
The Liver is stored internally and externally corresponds to the hypochondriac region. The location of the hypochondrium is the location of the Liver. What the Liver stores is Blood, and what it governs in terms of emotion is Anger (Nu Qi). External trauma such as beating, falling, or fighting causes internal injury to Qi, which stagnates in the Liver region. Even without the formation of Blood stasis, pain will occur. However, how can one distinguish whether the pain is caused by Blood stasis or Qi stagnation? Generally speaking, pain caused by Blood stasis is characterized by pain accompanied by distension; pressing on the area exacerbates the pain, and even without pressing, there is pain. This type of pain has no respite. Pain caused by Anger (Qi stagnation) is characterized by pain and distension; relief is obtained after belching, but the pain returns later. This type of pain has intermittent periods. Is this not the distinction between Blood and Qi?
Furthermore, there are differences between left-sided and right-sided hypochondriac pain. Severe pain on the left side indicates excessive Liver Fire and excess Wood Qi. Severe pain on the right side indicates the flow and deposition of Phlegm-Dampness, accompanied by Food Stagnation. Wandering pain across both hypochondria indicates the presence of Fluid Retention (Tan Yin). What about pain in the costal margin (Ji Xie)? The costal margin is located slightly below the lower ribs, corresponding to the position below the Liver and within the Gallbladder. If the pain is severe and radiates downward to the lower abdomen, it is also due to Dead Blood (severe Blood stasis). If the pain is mild and fixed in one location, it is due to Phlegm. To treat this disease, one must examine the cause of the injury and treat accordingly; there will be no failure in efficacy.
Regarding pulse diagnosis: a Deep (Chen) pulse indicates Qi stagnation; a Choppy (Se) pulse indicates Blood stasis; a Slippery (Hua) pulse indicates Phlegm; a Rapid (Shu) pulse indicates Heat. For pain in both hypochondria, the pulse must be Double Wiry (Shuang Xian). A Wiry and full pulse is a favorable sign (Shun); a Full and Large pulse is an unfavorable sign (Ni).
Shugan Sanyu Tang (Liver-Soothing and Blood-Dispersing Decoction): Treats stabbing pain in both hypochondria caused by coagulation of Blood stasis.
Ingredients: Dang Gui (Radix Angelicae Sinensis), Hong Hua (Flos Carthami), Su Mu (Lignum Sappan), Qing Pi (Pericarpium Citri Reticulatae Viride), Chai Hu (Radix Bupleuri) (each 1 qian); Shan Zha (Fructus Crataegi) (2 qian); Bai Shao (Radix Paeoniae Alba), Wu Yao (Radix Linderae), Gui Zhi (Ramulus Cinnamomi), Gan Cao (Radix Glycyrrhizae) (each 8 fen). Decoct with water and take hot.
Yigan Dingyin Yin (Liver-Calmating and Pain-Relieving Drink): Treats hypochondriac pain caused by Anger injuring the Liver.
Ingredients: Guang Mu Xiang (Radix Aucklandiae), Ju Hong (Exocarpium Citri Reticulatae Rubrum), Qing Pi, Chai Hu, Bai Shao, Dang Gui (each 1.5 qian); Guan Gui (Cortex Cinnamomi Cassiae) (6 fen); Chen Xiang (Aquilaria Lignum), Zhi Ke (Fructus Aurantii) (each 1 qian). Decoct with water and take hot.
Longhui Wan (Dragon Ash Pill): Treats hypochondriac pain caused by excessive Liver Fire.
Ingredients: Dang Gui, Long Dan Cao (Radix Gentianae), Shan Zhi Ren (Semen Gossypii Herbacei - stir-fried until black), Huang Qin (Radix Scutellariae - wine-fried), Huang Lian (Rhizoma Coptidis) (each 1 liang); Da Huang (Radix et Rhizoma Rhei - steamed with wine), Lu Hui (Aloe), Qing Dai (Indigo Naturalis) (each 5 qian); Guang Mu Xiang (3 qian); She Xiang (Moschus) (5 fen).
Grind the above ingredients into powder. Use San Qu (Massa Medicata Fermentata) 3 liang, made into paste as a binder to form pills. Take 2 qian per dose, washed down with Ginger Decoction.
He Gan Yin (Liver-Harmonizing Drink): Treats hardness and swelling forming a strip under the hypochondrium accompanied by pain.
Ingredients: Dang Gui, Bai Shao, San Leng (Rhizoma Sparganii), Qing Pi (each 1.5 qian); Da Hui Xiang (Fructus Foeniculi), Mu Xiang (Radix Aucklandiae), Zhi Ke, Chai Hu, Sha Ren (Fructus Amomi Rotundus) (each 8 fen). Decoct with water and take at any time.
Tiao Gan Yin (Liver-Regulating Drink): Treats pain in the costal margin radiating to the lower abdomen.
Ingredients: Dang Gui, Chuan Xiong (Rhizoma Chuanxiong), Wu Yao, Yuan Hu Suo (Rhizoma Corydalis), Qing Pi (each 1.5 qian); Chai Hu, Bing Lang (Areca Semen), Guang Mu Xiang, Tao Ren (Semen Persicae, peeled and removed of pits) (each 1 qian). Decoct with water and take hot.
Shugan Tang (Liver-Soothing Decoction): Treats condensation and accumulation of Phlegm causing distending pain in both hypochondria, preventing sleep at night.
Ingredients: Bai Jie Zi (Semen Mustardae), Chai Hu, Qing Pi (each 2 qian); Ju He (Fructus Citri Reticulatae), Wu Yao (each 1.5 qian); Dan Zhu Li (Nodus Bambusae in Taedia) (1 zhong); Long Dan Cao (1 qian); Sheng Jiang (Rhizoma Zingiberis Recens) (5 slices). Decoct with water and take.