肝火盛，木气实，有痰流注，有死血。若肝急木气实，用川芎、苍术、青皮，水煎，下龙荟丸。肝火盛，用
生姜汁下当归龙荟丸，此泻火要药也。当归龙荟丸方，蜜丸，治胁痛行痰，曲丸，降肝火，行迟治杂证∶当归 草
龙胆 山栀仁 黄柏 黄芩 黄连（各一两） 大黄 芦荟（各半两） 木香（一钱半） 麝香（五分）。一有柴
胡、青皮各半两；一方有青黛者，又治湿热，两胁痛尤妙，先以琥珀膏贴痛处，又以生姜汁吞此丸，痛甚者，须炒令
热服之；一方入青黛，每服三十丸，姜汤下。又方，小龙会丸∶当归 草龙胆 山栀 黄连 黄芩 柴胡 川芎（
各半两），芦荟（三钱）。死血用桃仁、红花、川芎；痰流注者，用二陈汤加南星、川芎、苍术，
实，用控涎丹下痰；肝苦急（已见《医要》），急食辛以散之，抚芎、苍术；胁痛甚者，用生姜汁下龙荟丸，肝火
盛故也；咳嗽胁痛者（已见《医要》），二陈加南星、香附、青皮、青黛、姜汁。左金丸治肝火∶黄芩（六两） 茱
萸（五钱）。又方推气散，治右胁痛甚不可忍∶片姜黄 炒枳壳 炒桂心（各半两） 炙甘草（三钱） 上末，每服
二钱，酒服下。控涎丹治一身气痛，及胁走痛，痰挟死血加桃仁泥丸。治心胁痛∶干姜（微炒） 芫花（醋炒，各等分）
蜜丸，每服十二丸，大效。气弱人，胁下痛、脉细紧或弦，多从劳役怒气得之，八物汤∶人参、白术、白茯苓、
甘草、当归、熟地黄、川芎、白芍药，加木
香、官桂、青皮。胁痛、大便秘实，脉实者，木香槟榔丸∶木香（五钱） 青皮（二钱） 陈皮（二钱） 枳壳（一
钱） 槟榔（二钱） 川连（二钱） 黄柏（四钱） 大黄（四钱） 香附（一钱） 牵牛头末（八钱） 上
为末，滴水为丸，如桐子大，每服六七十丸，空心姜汤下。湿热腰腿疼痛，两胁搐急，露卧湿地，不能转侧，苍术汤，
（方见腰痛条下）。一人胁下痰气攻痛，以控涎丹下；如面之状，用白芥子下痰，辛以散痛。一人胸右一点刺痛虚
肿，自觉内热攻外，口觉流涎不止，怨成肺痈，贝母、栝蒌、南星去涎，紫苏梗泻肺气，芩、连姜炒、陈皮、茯苓，
导而下行，香附、枳壳宽膈痛，皂角刺解结痛，桔梗浮上，不食加白术，凡吐水饮不用栝蒌，恐泥用苍术之类。一人左
胁应胸气痛∶栝蒌（一两） 贝母（一两） 南星（一两） 当归（五钱） 桃仁（五钱） 川芎（五钱） 柴胡
（五钱） 黄连（炒五钱） 黄芩（炒五钱） 山栀（炒五钱） 香附（五钱炒） 姜黄（五钱炒） 芦荟（三钱）
青皮（三钱） 陈皮（三钱） 青黛（一钱五分） 草龙胆（炒五钱）。心胸腹胁疼痛，二陈汤加人参、白术、
并诸香药治效；有瘀血，当用破血行气药，留尖桃仁、香附之类；火盛当伐肝，肝苦急，宜食辛以散之，或小柴胡汤亦
可治。木走土中，胁痛呕吐乃风邪羁绊于脾胃之间也。用二陈汤加天麻、白芍药、炒曲、枳壳、香附、白术、砂仁。
多怒之人，腹胁时常作痛者，小柴胡加川芎、芍药、青皮之类；痛甚者，就以煎药送下当归龙荟丸，其效甚速。一人脾
疼带胁痛，口微干，问已多年，时尚秋热，以二陈加甘葛、川芎、青皮、木通，煎下龙荟丸。一人元气虚乏，两胁微痛，
补中益气加白芍、龙胆、青皮、枳壳、香附、川芎。一人胁疼，每日至晚发热，乃阴虚也，用小柴胡汤合四物汤，加
龙胆、青皮、甘葛；阴虚甚加黄柏、知母。
肝火旺盛，木气充实，伴有痰湿流注或死血（瘀血）。若因肝气急迫、木气实盛所致，可用川芎、苍术、青皮，水煎后送服龙胆泻肝丸（此处指当归龙荟丸类方，原文语境下多指清肝泻火之剂，但根据下文具体方名，此处应理解为针对肝实火的通用治法描述，结合后文“用生姜汁下当归龙荟丸”，前文“下龙荟丸”亦指此方或同类方，为准确起见，保留原意并依后文明确方剂）；若肝火旺盛，用生姜汁送服当归龙荟丸，这是泻火的要药。
当归龙荟丸的配方：蜜制丸剂。主治胁痛以行痰，曲丸（小丸）以降肝火，治疗迟缓的杂证。药物组成：当归、草龙胆、山栀仁、黄柏、黄芩、黄连（各一两），大黄、芦荟（各半两），木香（一钱半），麝香（五分）。有的方子加柴胡、青皮各半两；有的方子加青黛，又适用于湿热证，治疗两胁疼痛尤为巧妙。先用琥珀膏贴敷疼痛处，再用生姜汁吞服此丸。疼痛剧烈的，必须炒热后服用；另一版本加入青黛，每服三十丸，姜汤送下。
又一方：小龙会丸。药物组成：当归、草龙胆、山栀、黄连、黄芩、柴胡、川芎（各半两），芦荟（三钱）。
若有死血（瘀血），用桃仁、红花、川芎；若是痰湿流注，用二陈汤加天南星、川芎、苍术；若实证，用控涎丹攻下痰饮；肝苦于急迫（已在《医要》中提及），应用辛味食物/药物发散，如抚芎（川芎）、苍术；胁痛严重的，用生姜汁送服龙胆泻肝丸（当归龙荟丸），这是因为肝火旺盛的缘故；咳嗽伴胁痛的（已在《医要》中提及），用二陈汤加天南星、香附、青皮、青黛、姜汁。
又一方：推气散，治疗右胁剧烈疼痛难以忍受：片姜黄、炒枳壳、炒桂心（各半两），炙甘草（三钱）。研为末，每服二钱，酒送下。
控涎丹治疗全身气痛，以及胁肋游走性疼痛，若兼夹死血则加桃仁泥制成丸剂。治疗心胁痛：干姜（微炒）、芫花（醋炒，各等分），蜜制丸，每服十二丸，效果显著。
气虚之人，胁下疼痛，脉象细紧或弦，多因劳役和怒气引起，用八物汤：人参、白术、白茯苓、甘草、当归、熟地黄、川芎、白芍药，加木香、官桂、青皮。
胁痛、大便秘结坚实，脉象实者，用木香槟榔丸：木香（五钱），青皮（二钱），陈皮（二钱），枳壳（一钱），槟榔（二钱），川连（二钱），黄柏（四钱），大黄（四钱），香附（一钱），牵牛头末（八钱）。研为末，滴水为丸，如梧桐子大，每服六七十丸，空腹姜汤送下。
湿热引起的腰腿疼痛，两胁抽搐急迫，因露宿湿地导致，不能转身侧卧，用苍术汤（方见腰痛条下）。
有一人胁下痰气攻冲作痛，用控涎丹攻下；若面色如常（此处原文“如面之状”疑为笔误或特定语境，结合后文“用白芥子下痰”，推测指痰湿在表或浅层，或指面部/体表症状，但依据提取规则仅提取实体，不修正原文逻辑，故译为：若出现某种面部/体表征象，用白芥子化痰，用辛味药散痛）。
有一人右侧胸部一点刺痛且虚肿，自觉内热攻向外，口角流涎不止，担心形成肺痈，用贝母、栝蒌、天南星去痰，紫苏梗泻肺气，黄芩、黄连姜炒，陈皮、茯苓，引导下行，香附、枳壳宽胸膈止痛，皂角刺解结聚之痛，桔梗升浮上行，不进食加白术，凡呕吐清水饮液不用栝蒌，恐怕黏腻，用苍术之类。
有一人左胁及胸部气痛：栝蒌（一两），贝母（一两），天南星（一两），当归（五钱），桃仁（五钱），川芎（五钱），柴胡（五钱），黄连（炒五钱），黄芩（炒五钱），山栀（炒五钱），香附（五钱炒），姜黄（五钱炒），芦荟（三钱），青皮（三钱），陈皮（三钱），青黛（一钱五分），草龙胆（炒五钱）。
心胸腹胁疼痛，用二陈汤加人参、白术，以及各类香药治疗效果良好；若有瘀血，应当用破血行气的药物，保留尖端的桃仁、香附之类；火盛应当伐肝，肝苦于急迫，宜吃辛味以发散之，或小柴胡汤也可治疗。
木气走窜入土中（肝木乘脾土），胁痛呕吐乃风邪羁绊于脾胃之间。用二陈汤加天麻、白芍药、炒神曲、枳壳、香附、白术、砂仁。
易怒之人，腹部胁肋时常作痛的，用小柴胡汤加川芎、芍药、青皮之类；疼痛剧烈的，就用煎好的药汤送下当归龙荟丸，效果非常迅速。
有一人脾疼带胁痛，口微干，询问已多年，当时还是秋热季节，用二陈汤加甘葛（葛根）、川芎、青皮、木通，煎好后送服龙胆泻肝丸（当归龙荟丸）。
When Liver Fire is excessive and Wood Qi is full, with Phlegm flowing and accumulating or Fixed Blood (Blood Stasis) present: If the Liver is tense and Wood Qi is full, use Chuanxiong Rhizome (Chuanxiong), Atractylodis Rhizoma (Cangzhu), and Citri Reticulatae Pericarpium (Qingpi), decocted in water, followed by Longdan Xiegan Wan (Gentian Root Decoction for Draining Fire - *Note: Context implies Danggui Longhui Wan based on subsequent text*). When Liver Fire is excessive, administer Danggui Longhui Wan (Angelica Sinensis and Aloe Pill) with Ginger Juice; this is a crucial herb for draining fire.
Formula for Danggui Longhui Wan (Angelica Sinensis and Aloe Pill): Honey pills. Treats hypochondriac pain to move Phlegm; small pills to descend Liver Fire and treat chronic miscellaneous diseases. Ingredients: Radix Angelicae Sinensis (Danggui), Radix Gentianae Macrophyllae (Caolongdan), Fructus Gardeniae Jasminoidis (Shanzhiren), Cortex Phellodendri Amurensis (Huangbai), Cortex Scutellariae (Huangqin), Rhizoma Coptidis (Huanglian) (each 1 liang); Radix Rheii Palmati (Dahuang), Fructus Aloe (Lvhui) (each 0.5 liang); Radix Aucklandiae (Muxiang) (1.5 qian); Moschus (Shexiang) (0.5 fen). Some versions add Bupleuri Radix (Chaihu) and Citri Reticulatae Pericarpium (Qingpi) each 0.5 liang; some add Indigo Naturalis (Qingdai), which is also suitable for Damp-Heat, especially for bilateral hypochondriac pain. First apply Hupo Gao (Amber Plaster) to the painful area, then swallow these pills with Ginger Juice. For severe pain, it must be taken warm after frying; another version adds Qingdai, take 30 pills per dose with Ginger Soup.
Another formula: Xiaolonghui Wan (Little Dragon Meets Pill). Ingredients: Radix Angelicae Sinensis (Danggui), Radix Gentianae Macrophyllae (Caolongdan), Fructus Gardeniae Jasminoidis (Shanzhi), Rhizoma Coptidis (Huanglian), Cortex Scutellariae (Huangqin), Radix Bupleuri (Chaihu), Rhizoma Chuanxiong (Chuanxiong) (each 0.5 liang); Fructus Aloe (Lvhui) (3 qian).
For Fixed Blood (Blood Stasis), use Persicae Semen (Taoren), Carthami Flos (Honghua), and Rhizoma Chuanxiong (Chuanxiong); for Phlegm flowing and accumulating, use Erchen Tang (Two-Cured Decoction) plus Arisaematis Rhizoma Preparatum (Nanxing), Rhizoma Chuanxiong (Chuanxiong), and Atractylodis Rhizoma (Cangzhu); for Excess patterns, use Kongxian Dan (Control Saliva Pill) to purge Phlegm; when the Liver suffers from tension (as seen in *Yi Yao*), use Pungent substances to disperse them, such as Chuanxiong and Cangzhu; for severe hypochondriac pain, administer Danggui Longhui Wan with Ginger Juice, due to excessive Liver Fire; for cough with hypochondriac pain (as seen in *Yi Yao*), use Erchen Tang plus Nanxing, Cyperi Rhizoma (Xiangfu), Qingpi, Qingdai, and Ginger Juice.
Zuojin Pill (Left Metal Pill) treats Liver Fire: Cortex Scutellariae (Huangqin) (6 liang), Fructus Evodiae (Zhuyu) (5 qian).
Another formula: Tuiqi San (Pushing Qi Powder), treating unbearable severe right-sided hypochondriac pain: Curcumae Longae Rhizoma (Pianjianghuang), Zizyphi Fructus (Chao Zhike), Cinnamomi Cortex (Chao Guixin) (each 0.5 liang), Glycyrrhizae Radix et Rhizoma Praeparata (Zhi Gancao) (3 qian). Grind into powder, take 2 qian per dose with Wine.
Kongxian Dan (Control Saliva Pill) treats general Qi pain and wandering hypochondriac pain; if accompanied by Fixed Blood, add Persicae Semen Paste to make pills. To treat Heart-Hypochondriac pain: Zingiberis Rhizoma (Ganjiang, slightly fried), Genkwa Flos (Yuanhua, vinegar-fried) (equal parts), honey pills, take 12 pills per dose, highly effective.
For those with weak Qi, pain under the hypochondrium, with fine-tight or wiry pulse, often caused by overwork and anger, use Bawu Tang (Eight Substances Decoction): Ginseng Radix et Rhizoma (Renshen), Atractodis Macrocephalae Rhizoma (Baizhu), Poria (Baifuling), Glycyrrhizae Radix et Rhizoma (Gancao), Radix Angelicae Sinensis (Danggui), Rehmanniae Radix Praeparata (Shudihuang), Rhizoma Chuanxiong (Chuanxiong), Paeoniae Radix Alba (Baishao), plus Aucklandiae Radix (Muxiang), Cinnamomi Cortex (Guangui), and Citri Reticulatae Pericarpium (Qingpi).
For hypochondriac pain with hard constipation and an Excess pulse, use Muxiang Binglang Wan (Aucklandia and Areca Nut Pill): Aucklandiae Radix (Muxiang) (5 qian), Citri Reticulatae Pericarpium (Qingpi) (2 qian), Citri Reticulatae Pericarpium (Chenpi) (2 qian), Zizyphi Fructus (Zhike) (1 qian), Arecae Semen (Binglang) (2 qian), Coptidis Rhizoma (Chuanlian) (2 qian), Cortex Phellodendri Amurensis (Huangbai) (4 qian), Radix Rheii Palmati (Dahuang) (4 qian), Cyperi Rhizoma (Xiangfu) (1 qian), Strychni Semen (Qianniu Toumo) (8 qian). Grind into powder, mix with water to form pills like wattle seeds, take 60-70 pills per dose with Ginger Soup on an empty stomach.
For Damp-Heat causing lower back and leg pain, spasmodic tightness of both hypochondria, inability to turn sides due to sleeping exposed to damp ground, use Cangzhu Tang (Atractylodis Rhizoma Decoction) (see Lower Back Pain section).
One case: Phlegm-Qi attacking the hypochondrium causing pain, treated with Kongxian Dan to purge; if facial appearance indicates [specific condition], use Mustard Seed (Baijiezi) to resolve Phlegm and Pungent herbs to disperse pain.
One case: A single stabbing pain point in the right chest with deficiency swelling, feeling internal heat attacking outward, continuous drooling, fearing formation of Lung Abscess (Fei Yong). Use Fritillariae Bulbus (Beimu), Trichosanthis Fructus (Gualou), Arisaematis Rhizoma Preparatum (Nanxing) to remove Phlegm; Perilla Caulis (Zisugeng) to drain Lung Qi; Huangqin and Huanglian stir-fried with Ginger, Chenpi, Fuling to guide downward; Xiangfu and Zhike to widen diaphragm and relieve pain; Gleditsiae Spina (Zaocispina) to resolve knot-like pain; Platycodonis Radix (Jiegeng) to float upwards; add Baizhu if not eating. Do not use Gualou when vomiting water/drinks, lest it be cloying; use Cangzhu instead.
One case: Left hypochondrium and chest Qi pain. Formula: Gualou (1 liang), Beimu (1 liang), Nanxing (1 liang), Danggui (5 qian), Taoren (5 qian), Chuanxiong (5 qian), Chaihu (5 qian), Huanglian stir-fried (5 qian), Huangqin stir-fried (5 qian), Shanzhi stir-fried (5 qian), Xiangfu stir-fried (5 qian), Jianghuang stir-fried (5 qian), Lvhui (3 qian), Qingpi (3 qian), Chenpi (3 qian), Qingdai (1.5 qian), Caolongdan stir-fried (5 qian).
For pain in heart, chest, abdomen, and hypochondrium, Erchen Tang plus Renshen, Baizhu, and various aromatic herbs are effective; if there is Blood Stasis, use blood-breaking and Qi-moving herbs like Taoren (keeping the tip) and Xiangfu; if Fire is excessive, suppress the Liver; since the Liver suffers from tension, eat Pungent things to disperse, or Xiao Chaihu Tang may also work.
Wood moving into Earth (Liver invading Spleen/Stomach), hypochondriac pain and vomiting are due to Wind Pathogen trapped between Spleen and Stomach. Use Erchen Tang plus Tianma, Baishao, Chao Qu, Zhike, Xiangfu, Baizhu, Sharen.
For people prone to anger, with frequent abdominal and hypochondriac pain, use Xiao Chaihu Tang plus Chuanxiong, Shaoyao, Qingpi, etc.; for severe pain, send down Danggui Longhui Wan with the decoction, effect is very rapid.
One case: Spleen pain with hypochondriac pain, slight dry mouth, lasting many years, during autumn heat. Use Erchen Tang plus Gegen, Chuanxiong, Qingpi, Mutong, decocted and taken with Longhui Wan.
One case: Deficient Yuan Qi, slight pain in both hypochondria. Use Buzhong Yiqi Tang plus Baishao, Longdan, Qingpi, Zhike, Xiangfu, Chuanxiong.
One case: Hypochondriac pain, fever every evening, indicating Yin Deficiency. Use Xiao Chaihu Tang combined with Siwu Tang, plus Longdan, Qingpi, Gegen; if Yin Deficiency is severe, add Huangbai and Zhimu.