一位妇女患有胃脘痛，连一勺水都喝不下，伴有寒热往来（忽冷忽热）。有的医生从火证治疗，使用黄芩、黄连、栀子、黄柏等苦寒药物；有的医生从寒证治疗，使用干姜、肉桂、吴茱萸等辛热药物。辗转治疗一个多月，患者身体消瘦虚弱，六脉弦数，几乎危及生命。我说：“这是肝痛，不是胃脘痛。”这个病起因于郁结化火，导致阴血受损，肝肾枯竭干燥，燥邪逼迫而引发疼痛。医生又投以苦寒和辛热的药剂，进一步重伤了胃脘，怎么能痊愈呢？急忙给予滋肾生肝饮给她服用，一昼夜服完三大剂。五更时分熟睡，第二天疼痛停止并感到饥饿。再用加味归脾汤加入麦冬、五味子，服用十余剂后痊愈。
肝痛这一病症，四明先生实际上补充了胃脘痛诸种治法所未涉及的内容。我每次遵循他的意旨，用来治疗肝经血少的患者：如果是血少且干燥的，用疏肝益肾汤加入当归；或者使用左归饮加入柴胡、白芍；或者使用滋肾生肝饮；或者使用滋肾清肝饮。根据症状选择方剂，没有不立即见效的。如果从痰火、寒邪、食积等原因去寻求病因，就相差太远了。况且痰火、寒邪、食积等原因，如果在体内存在，必然会在外部显现出来，从而依据其……
A woman suffered from epigastric pain, unable to swallow even a spoonful of water, accompanied by alternating chills and fever (Huare Wanglai). Some physicians treated it as a Fire syndrome, using bitter-cold herbs such as Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhizi (Gardeniae Fructus), and Huangbai (Phellodendri Cortex). Others treated it as a Cold syndrome, using acrid-hot herbs such as Jiang (Zingiberis Rhizoma), Rougui (Cinnamomi Cortex), and Zhuyu (Evodiae Fructus). After more than a month of辗转 treatment, her body became emaciated and weak, with wiry and rapid pulses in all six positions, nearing death. I said, "This is Liver pain, not epigastric pain." The disease originated from stagnation transforming into fire, injuring Yin blood, leading to the withering and drying of the Liver and Kidneys, causing pain due to dryness forcing movement. The physicians further injured the stomach by administering bitter-cold and acrid-hot agents; how could she recover? I urgently prescribed Zishen Shenggan Yin (Nourish Kidney and Generate Liver Decoction) for her. She consumed three large doses within one day and night. At wu gu (5-7 AM), she fell into a deep sleep. The next day, the pain subsided, and she felt hungry. Subsequently, Jiawei Guipi Tang (Modified Tonify the Spleen Decoction) was used with added Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus). After more than ten doses, she recovered.
The syndrome of Liver pain actually supplements the treatments for epigastric pain that were previously unaddressed by Mr. Siming. I often follow his principles to treat patients with insufficient blood in the Liver meridian: for those with insufficient blood and dryness, Shugan Yishen Tang (Soothe Liver and Benefit Kidney Decoction) is used with added Danggui (Angelicae Sinensis Radix); or Zuogui Yin (Left Restoring Drink) with added Chaihu (Bupleuri Radix) and Baishao (Paeoniae Radix Alba); or Zishen Shenggan Yin; or Zishen Qinggan Yin (Nourish Kidney and Clear Liver Decoction). Formulas are selected according to symptoms, yielding immediate results without exception. If one seeks the cause from factors such as Phlegm-Fire, Cold, or Food Stagnation, the approach is far off. Moreover, if internal factors like Phlegm-Fire, Cold, or Food Stagnation exist, they must manifest externally, allowing one to...