属性：伤损胁肋胀痛之证：
[1]如大便通利，喘咳吐痰者，肝火侮肺也，用小柴胡汤加青皮、山栀清
之。
[2]若胸腹胀痛，大便不通，喘咳吐血者，乃瘀血停滞也，当归导滞散通
之。
[3]内经云：「肝藏血，脾统血。」盖肝属木，木胜侮土，其脾气必虚：
<1>宜先清肝养血，则瘀血不致凝滞，
<2>次壮脾胃，则气血充盛。
<3>若行克伐，则虚者益虚，滞者益滞，祸不旋踵矣。
按、方剂：[1]当归导滞散
川大黄一两 当归二钱五分 麝香少许
以上三味，除麝香另研外，为极细末，后入麝香令匀，每服三钱，
热酒一杯调下。
[2]又方
川大黄 当归各二两
上共为细末，每服三钱，不拘时，温酒调服。
[3]小柴胡汤方见瘀血泛注
注：
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属性：[1]伤损之证，胸腹痛闷者，多因跳跃、捶胸，闪挫、举重，劳役恚怒所
致。
[2]其胸腹喜手摸者，肝火伤脾也，用四君子汤加柴胡、山栀。
[3]如畏手摸者，肝经血滞也，用四物汤加柴胡、山栀、桃仁、红花。
[4]若胸胁闷痛，发热晡热，肝经血伤也，用加味逍遥散。
[5]若胸胁闷痛，饮食少思，肝脾气伤也，用四君子汤加芎、归、柴、栀
、丹皮。
[6]若胸腹胀满，饮食少思，肝脾气滞也，用六君子汤加柴胡、芎、归。
[7]若胸腹不利，食少无寐，脾气郁结也，用加味归脾汤。
[8]若痰气不利，脾肺气滞也，用二陈汤加白术、芎、归、山栀、天麻、
钩藤钩。
[9]如因过用风热之药，致肝血受伤，肝火益甚。
[10]或饮糖酒，则肾水益虚，脾火益炽。
[11]若用大黄、芍药内伤阴络，反致下血，少壮者，必成痼疾；老弱者，
多致不起。
按、方剂：[1]加味归脾汤
黑栀一钱 牡丹皮一钱 人参一钱 黄耆(炙)一钱五分 白术(炒)
一钱五分 茯神二钱 枣仁(炒)一钱五分 当归一钱 木香五分
远志(去心)八分 圆肉二钱 甘草(炙)五分
并用姜、枣，水煎服。
[2]二陈汤
陈皮一钱五分 半夏(制)二钱 茯苓二钱 甘草五分
引用姜，水煎服。
[3]六君子汤
即四君子汤加陈皮、半夏各一钱五分。
引用姜、枣，水煎服。
[4]四君子汤 四物汤 加味消遥汤俱见伤损出血
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属性：损伤导致胁肋部胀痛的证候：
[1]如果大便通畅，伴有气喘咳嗽、吐痰的症状，这是肝火侵犯肺脏（肝火侮肺）的表现，使用小柴胡汤加青皮、山栀来清泻肝火。
[2]如果胸腹部胀痛，大便秘结不通，伴有气喘咳嗽、吐血的症状，这是瘀血停滞在体内的表现，使用当归导滞散来通导瘀滞。
[3]《内经》说：“肝藏血，脾统血。”大概因为肝属木，木气过盛会克制土（脾），所以脾气必然虚弱：
<1>应当先清泻肝火并滋养肝血，这样瘀血就不会凝结阻滞，
<2>接着补益脾胃，气血就会充盛。
<3>如果使用攻伐克削的药物，那么虚弱的会更虚弱，停滞的会更严重，灾祸很快就会降临。
按语、方剂：[1]当归导滞散
川大黄一两 当归二钱五分 麝香少许
以上三味药，除了麝香单独研磨外，其余研成极细末，然后加入麝香混合均匀，每次服用三钱，用一杯热酒调服。
[2]另一个方子
川大黄 当归各二两
以上两味药共同研成细末，每次服用三钱，不限时间，用温酒调服。
[3]小柴胡汤方见“瘀血泛注”条下
属性：[1]损伤引起的证候中，出现胸腹痛闷症状的，多是因为跳跃、捶打胸部、闪挫扭伤、举重劳累，以及劳役过度、愤怒所致。
[2]如果胸腹部喜欢被人用手按压的，是肝火损伤了脾脏，使用四君子汤加柴胡、山栀。
[3]如果害怕被人用手按压的，是肝经血液运行滞涩，使用四物汤加柴胡、山栀、桃仁、红花。
[4]如果胸胁部闷痛，下午发热（晡热），是肝经血液受损，使用加味逍遥散。
[5]如果胸胁部闷痛，饮食减少不想进食，是肝脾之气受损，使用四君子汤加川芎、当归、柴胡、山栀、丹皮。
[6]如果胸腹部胀满，饮食减少不想进食，是肝脾之气滞塞，使用六君子汤加柴胡、川芎、当归。
[7]如果胸腹不适，食少失眠，是脾气郁结，使用加味归脾汤。
[8]如果痰气运行不利，是脾肺气机滞涩，使用二陈汤加白术、川芎、当归、山栀、天麻、钩藤钩。
[9]如果是由于过度使用风热性质的药物，导致肝血受伤，肝火更加旺盛。
[10]或者饮用糖和酒，会导致肾水更加亏虚，脾火更加炽盛。
[11]如果使用大黄、芍药治疗内伤阴络出血，反而导致便血，年轻力壮的人，必定形成顽固疾病；年老体弱的人，大多导致死亡。
按语、方剂：[1]加味归脾汤
黑栀一钱 牡丹皮一钱 人参一钱 黄耆(炙)一钱五分 白术(炒)一钱五分 茯神二钱 枣仁(炒)一钱五分 当归一钱 木香五分 远志(去心)八分 圆肉二钱 甘草(炙)五分
并用生姜、大枣，加水煎服。
[2]二陈汤
陈皮一钱五分 半夏(制)二钱 茯苓二钱 甘草五分
引用生姜，加水煎服。
[3]六君子汤
即四君子汤加陈皮、半夏各一钱五分。
引用生姜、大枣，加水煎服。
[4]四君子汤、四物汤、加味逍遥散均见于“伤损出血”条下
Attribute: Syndrome of distending pain in the hypochondrium caused by trauma:
[1] If the stool is unimpeded, accompanied by asthma, coughing, and expectoration, this is a manifestation of Liver Fire invading the Lung (Liver Fire insulting the Lung). Use Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Qing Pi (Green Tangerine Peel) and Shan Zhi (Gardenia Fruit) to clear the heat.
[2] If there is distending pain in the chest and abdomen, constipation, accompanied by asthma, coughing, and hemoptysis, this is due to the stagnation of Blood Stasis. Use Dang Gui Dao Zhi San (Angelica Dahurica Detoxification Powder) to unblock the stagnation.
[3] The *Nei Jing* (Inner Canon) states: "The Liver stores Blood, and the Spleen controls Blood." Generally, because the Liver belongs to Wood, excessive Wood energy overacts on Earth (Spleen), causing the Spleen Qi to be deficient:
<1> One should first clear the Liver fire and nourish Liver Blood, so that Blood Stasis will not coagulate and stagnate;
<2> Subsequently, strengthen the Spleen and Stomach, so that Qi and Blood will become abundant.
<3> If one uses purgative or attacking methods, the deficient will become more deficient, and the stagnant will become more obstructed, bringing disaster swiftly.
Note, Formulas: [1] Dang Gui Dao Zhi San
Chuan Da Huang (Rhei Radix et Rhizoma) 1 liang, Dang Gui (Angelicae Sinensis Radix) 2 qian 5 fen, She Xiang (Moschus) a small amount.
Grind the above three ingredients into an extremely fine powder, except for She Xiang which is ground separately, then mix She Xiang evenly into the powder. Take 3 qian per dose, mixed with one cup of hot wine.
[2] Another Formula
Chuan Da Huang (Rhei Radix et Rhizoma) and Dang Gui (Angelicae Sinensis Radix) each 2 liang.
Grind the above two ingredients into a fine powder. Take 3 qian per dose at any time, mixed with warm wine.
[3] Xiao Chai Hu Tang (Minor Bupleurum Decoction) formula is seen under the entry "Blood Stasis Overflowing".
Attribute: [1] In syndromes caused by trauma, chest and abdominal pain with oppression are often caused by jumping, chest beating, sprains, heavy lifting, labor fatigue, and anger.
[2] If the chest and abdomen feel better when pressed by hand, it is Liver Fire damaging the Spleen. Use Si Jun Zi Tang (Four Gentlemen Decoction) with Chai Hu (Bupleuri Radix) and Shan Zhi (Gardenia Fruit).
[3] If the area dislikes being touched or pressed, it is Blood stagnation in the Liver Meridian. Use Si Wu Tang (Four Substance Decoction) with Chai Hu (Bupleuri Radix), Shan Zhi (Gardenia Fruit), Tao Ren (Persicae Semen), and Hong Hua (Carthami Flos).
[4] If there is oppressive pain in the chest and hypochondrium with afternoon fever (Bhu Re), it is damage to the blood of the Liver Meridian. Use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder).
[5] If there is oppressive pain in the chest and hypochondrium with poor appetite, it is damage to the Qi of the Liver and Spleen. Use Si Jun Zi Tang (Four Gentlemen Decoction) with Xiong (Chuanxiong Rhizome), Gui (Dang Gui), Chai (Chai Hu), Zhi (Shan Zhi), and Dan Pi (Moutan Cortex).
[6] If there is abdominal fullness and poor appetite, it is Qi stagnation in the Liver and Spleen. Use Liu Jun Zi Tang (Six Gentlemen Decoction) with Chai Hu (Bupleuri Radix), Xiong (Chuanxiong Rhizome), and Gui (Dang Gui).
[7) If there is discomfort in the chest and abdomen, poor appetite, and insomnia, it is Spleen Qi depression and knotting. Use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction).
[8] If there is difficulty in the movement of Phlegm and Qi, it is Qi stagnation in the Spleen and Lung. Use Er Chen Tang (Two Aged Things Decoction) with Bai Zhu (Atractylodis Macrocephalae Rhizoma), Xiong (Chuanxiong Rhizome), Gui (Dang Gui), Shan Zhi (Gardenia Fruit), Tian Ma (Gastrodiae Rhizoma), and Gou Teng (Uncariae Ramulus cum Uncis).
[9] If Wind-Heat herbs were overused, causing injury to Liver Blood and exacerbating Liver Fire.
[10] Or if sugar and alcohol were consumed, leading to further deficiency of Kidney Water and hyperactivity of Spleen Fire.
[11] If Da Huang (Rhei Radix et Rhizoma) and Shao Yao (Paeoniae Radix) are used for internal injury to the Yin collaterals, it may instead cause lower bleeding. Young and strong individuals will likely develop chronic diseases; old and weak individuals may die.
Note, Formulas: [1] Jia Wei Gui Pi Tang
Hei Zhi (Gardeniae Fructus) 1 qian, Mu Dan Pi (Moutan Cortex) 1 qian, Ren Shen (Ginseng Radix) 1 qian, Huang Qi (Astragali Radix) roasted 1 qian 5 fen, Bai Zhu (Atractylodis Macrocephalae Rhizoma) fried 1 qian 5 fen, Fu Shen (Poria with Hostwood) 2 qian, Zao Ren (Ziziphi Spinosae Semen) fried 1 qian 5 fen, Dang Gui (Angelicae Sinensis Radix) 1 qian, Mu Xiang (Aucklandiae Radix) 5 fen, Yuan Zhi (Polygalae Radix) dehearted 8 fen, Yuan Rou (Longan Arillus) 2 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) roasted 5 fen.
Decoct with Ginger and Jujube in water.
[2] Er Chen Tang (Two Aged Things Decoction)
Chen Pi (Citri Reticulatae Pericarpium) 1 qian 5 fen, Ban Xia (Pinelliae Tuber) processed 2 qian, Fu Ling (Poria) 2 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) 5 fen.
Decoct with Ginger in water.
[3] Liu Jun Zi Tang (Six Gentlemen Decoction)
This is Si Jun Zi Tang (Four Gentlemen Decoction) plus Chen Pi (Citri Reticulatae Pericarpium) and Ban Xia (Pinelliae Tuber) each 1 qian 5 fen.
Decoct with Ginger and Jujube in water.
[4] Si Jun Zi Tang (Four Gentlemen Decoction), Si Wu Tang (Four Substance Decoction), and Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) are all seen under the entry "Trauma Bleeding".