论曰肝胀之状，千金谓胁下满而痛引少腹，盖足厥阴之经，起于大指。抵少腹，侠胃上
贯膈布胁肋。脉经曰∶肝病者，必两胁下痛引少腹是也。夫肝受邪，则令气血不通。故令胁
下胀满，引少腹而痛也。
治肝受邪气，两胁下痛，牵连少腹，胸胁胀满。桂苓汤方
桂（去粗皮） 赤茯苓（去黑皮） 柏子仁 细辛（去苗叶） 防风（去叉各三分） 鳖
甲（醋炙去裙 二两） 桔梗（炒） 枳壳（去瓤麸炒） 白术（各半两） 犀角（屑三分）
独活（去芦头半两） 甘草（炙锉三
上一十二味。粗捣筛，每服三钱匕，水一盏，入枣三枚劈破，同煎至七分，去滓温服，
不计时。
治肝气受寒，胁下胀满，痛引少腹。附子茯苓汤方
附子（炮裂去皮脐七枚） 赤茯苓（去黑皮三两） 槟榔（二十四枚） 母姜（五两） 陈
橘皮（汤浸去白焙） 桂（去粗皮各三两） 桔梗（炒） 白术（各四两） 吴茱萸（汤浸
焙干一两）
上九味。锉如麻豆，每服三钱匕，水一盏，煎至七分，去滓温服，空心食前，日三服。
治肝受风邪，面多青黄，两胁胀满，引少腹痛，浑身疼痛，口淡无味，饮食减少。沉香
煎丸方
沉香（锉一两） 附子（炮裂去皮脐） 白附子（炮） 巴戟天（去心） 砂（研各
半两） 补骨脂（炒一两） 肉苁蓉（酒浸切焙半两同上六味为末以酒二升熬成膏次入下项
药） 干蝎（去土炒一分） 木香（半两） 青橘皮（汤浸去白焙三分） 防风（去叉） 当
归（切焙各半两） 桂（去粗皮一分） 香子（炒三分） 牛膝（酒浸切焙半两） 楝实
（只取肉三分微炒过）
上一十六味。除前膏外，捣罗为末，入前膏拌和，仍再入臼内，捣令匀，如未相着，更
入蜜少许，和丸如梧桐子大。每服二十丸，空心温酒下。
治邪气客于肝经，攻胀两胁，时引少腹痛，四肢厥逆。三辅散方
赤茯苓（去黑皮七两） 赤芍药（三两） 菖蒲（去须） 蜀漆 桂（去粗皮各二两） 丹
砂（别研） 紫石
上九味。除别研外，捣罗为散，再一处拌匀，每服一钱匕，渐加至二钱，早晚食前，用
温酒调下。
治肝脏邪气，两胁胀满，筋脉拘急，痛连少腹。茱萸汤方
山茱萸 当归（切焙） 五味子 山芋 黄 （锉焙） 芎 （各半两） 生干地黄（焙）
白术（各一分） 独活（去芦头） 酸枣仁（微炒各二钱） 木瓜（去皮子焙半两）
上一十一味。粗捣筛，每服五钱匕，以水一盏半，枣二枚，同煎至八分，去滓温服，空
心食前，日二服。
治肝脏风寒，面色青黄，两胁胀痛，牵连少腹，筋脉不利，背 拘急。覆盆子丸方
覆盆子 五味子 附子（炮裂去皮脐） 酸枣仁（微炒） 白术（各一两） 熟干地黄
（焙半两）
上六味。捣罗为末，炼蜜和丸，如梧桐子大。每服三十丸，空心食前温酒下，米饮亦得
论述说：肝胀的症状，千金方认为胁下胀满且疼痛牵引至小腹，这是因为足厥阴肝经，起始于大脚趾，抵达小腹，夹胃上行，贯穿膈肌，分布于胁肋部。脉经说：肝病的人，必定两胁下疼痛牵引至小腹，正是这种情况。肝脏受到邪气侵袭，就会导致气血不通畅。因此出现胁下胀满，疼痛牵引小腹的症状。
治疗肝脏受邪气，两胁下疼痛，牵连小腹，胸胁胀满的桂苓汤方：
桂枝（去除粗皮）三分，赤茯苓（去除黑皮）三分，柏子仁三分，细辛（去除苗叶）三分，防风（去除叉枝）三分，鳖甲（醋炙后去除裙边）二两，桔梗（炒制），枳壳（去除瓤麸炒），白术各半两，犀角（锉成屑）三分，独活（去除芦头）半两，甘草（炙后锉碎）三分。
以上十二味药，粗捣筛过，每次服用三钱匕，用水一盏，加入三枚劈破的大枣，一同煎煮至七分，去渣温服，不拘时间。
治疗肝气受寒，胁下胀满，疼痛牵引小腹的附子茯苓汤方：
附子（炮裂去皮脐）七枚，赤茯苓（去除黑皮）三两，槟榔二十四枚，生姜五两，陈皮（热水浸泡去除白瓤焙干），桂枝（去除粗皮）各三两，桔梗（炒制），白术各四两，吴茱萸（热水浸泡焙干）一两。
以上九味药，锉碎如麻豆大小，每次服用三钱匕，用水一盏，煎煮至七分，去渣温服，空腹、饭前服用，每日三次。
治疗肝脏受风邪，面色多呈青黄色，两胁胀满，牵引小腹疼痛，浑身疼痛，口淡无味，饮食减少的沉香煎丸方：
沉香（锉碎）一两，附子（炮裂去皮脐），白附子（炮制），巴戟天（去除心），砂（研碎）各半两，补骨脂（炒制）一两，肉苁蓉（酒浸切后焙干）半两。以上六味药为末，用酒二升熬成膏，其次加入以下药物：全蝎（去土炒制）一分，木香半两，青橘皮（热水浸泡去除白瓤焙干）三分，防风（去除叉枝），当归（切后焙干）各半两，桂枝（去除粗皮）一分，香子（炒制）三分，牛膝（酒浸切后焙干）半两，楝实（只取肉微炒过）三分。
以上十六味药，除前面的膏剂外，捣罗成末，加入前面的膏剂拌和，再放入臼中捣匀，如果还不粘合，再加入少许蜂蜜，调和制成梧桐子大小的丸药。每次服用二十丸，空腹时用温酒送下。
治疗邪气客居肝经，攻冲导致两胁胀满，时常牵引小腹疼痛，四肢厥冷的三辅散方：
赤茯苓（去除黑皮）七两，赤芍药三两，石菖蒲（去除须），蜀漆，桂枝（去除粗皮）各二两，丹砂（单独研碎），紫石英。
以上九味药，除单独研碎的之外，其余捣罗成散剂，再在一起拌匀，每次服用一钱匕，逐渐增加至二钱，早晚饭前，用温酒调服。
治疗肝脏邪气，两胁胀满，筋脉拘急，疼痛连及小腹的茱萸汤方：
山茱萸，当归（切后焙干），五味子，山芋，黄芪（锉后焙干），川芎各半两，生干地黄（焙干），白术各一分，独活（去除芦头），酸枣仁（微炒）各二钱，木瓜（去皮去籽焙干）半两。
以上十一味药，粗捣筛过，每次服用五钱匕，用水一盏半，大枣两枚，一同煎煮至八分，去渣温服，空腹、饭前服用，每日两次。
治疗肝脏风寒，面色青黄，两胁胀痛，牵连小腹，筋脉不利，背部拘急的覆盆子丸方：
覆盆子，五味子，附子（炮裂去皮脐），酸枣仁（微炒），白术各一两，熟干地黄（焙干）半两。
以上六味药，捣罗成末，炼蜜调和制成丸药，如梧桐子大小。每次服用三十丸，空腹、饭前用温酒送下，米饮也可以。
Discussion states: The manifestation of Liver Distension (Gan Zhang), as described in the *Qianjin Fang* (Thousand Gold Formulas), involves fullness and pain in the hypochondrium radiating to the lower abdomen. This is because the Foot Jueyin Liver Meridian (Zu Jueyin Gan Jing) originates from the big toe, reaches the lower abdomen, flanks the stomach, pierces through the diaphragm, and spreads over the costal region. The *Mai Jing* (Pulse Classic) states: "In liver diseases, there must be pain in both hypochondria radiating to the lower abdomen." This is precisely such a case. When the Liver is invaded by pathogenic factors, it causes stagnation of Qi and Blood. Consequently, this leads to distension and fullness in the hypochondrium with pain radiating to the lower abdomen.
**Guiling Tang (Cinnamon Twig and Poria Decoction)** for treating the Liver invaded by pathogenic factors, presenting with pain in both hypochondria radiating to the lower abdomen and distension/fullness in the chest and hypochondrium:
Gui Zhi (Ramulus Cinnamomi, remove coarse bark) 3 fen, Chi Fu Ling (Poria cum Radix Pini, remove black skin) 3 fen, Baizi Ren (Semen Platycladi) 3 fen, Xi Xin (Herba Asari, remove seedlings and leaves) 3 fen, Fang Feng (Radix Saposhnikoviae, remove forks) 3 fen, Bie Jia (Carapax et Plastrum Testudinis, vinegar-fried, remove skirt) 2 liang, Jie Geng (Radix Platycodonis, stir-baked), Zhi Ke (Fructus Aurantii, remove pulp and bran-fried), Bai Zhu (Rhizoma Atractylodis Macrocephalae) each 0.5 liang, Xi Jiao (Cornu Rhinocerotis, shaved) 3 fen, Du Huo (Radix Angelicae Pubescentis, remove rhizome head) 0.5 liang, Gan Cao (Radix Glycyrrhizae, honey-fried and chopped) 3 fen.
The above twelve ingredients are coarsely crushed and sieved. Each dose consists of 3 qianbi (approx. 9-15g depending on era/measure), boiled with one sheng (approx. 200ml) of water and three cracked dates until reduced to 70%. Strain and take warm, at any time.
**Fuzi Fuling Tang (Aconite and Poria Decoction)** for treating Liver Qi affected by Cold, presenting with distension/fullness in the hypochondrium and pain radiating to the lower abdomen:
Fu Zi (Radix Aconiti Lateralis Preparata, roasted, split, remove skin and umbilicus) 7 pieces, Chi Fu Ling (Poria cum Radix Pini, remove black skin) 3 liang, Bing Lang (Arecae Semen) 24 pieces, Sheng Jiang (Rhizoma Zingiberis Recens) 5 liang, Chen Pi (Pericarpium Citri Reticulatae, soaked in hot water, remove white pith, dried), Gui Zhi (Ramulus Cinnamomi, remove coarse bark) each 3 liang, Jie Geng (Radix Platycodonis, stir-baked), Bai Zhu (Rhizoma Atractylodis Macrocephalae) each 4 liang, Wu Zhu Yu (Fructus Evodiae, soaked in hot water, dried) 1 liang.
The above nine ingredients are chopped like hemp seeds. Each dose consists of 3 qianbi, boiled with one sheng of water until reduced to 70%. Strain and take warm, on an empty stomach and before meals, three times daily.
**Chenxiang Jian Wan (Agarwood Paste Pills)** for treating the Liver invaded by Wind pathogen, presenting with a complexion often greenish-yellow, distension/fullness in both hypochondria radiating to lower abdominal pain, generalized body pain, insipid taste in mouth, and decreased appetite:
Chen Xiang (Lignum Aquilariae Resinatum, chopped) 1 liang, Fu Zi (Radix Aconiti Lateralis Preparata, roasted, split, remove skin and umbilicus), Bai Fu Zi (Rhizoma Typhonii, roasted), Ba Ji Tian (Radix Morindae Officinalis, remove heart), Sha (Realgar, ground) each 0.5 liang, Buguzhi (Fructus Psoraleae, fried) 1 liang, Rou Cong Rong (Herba Cistanche, soaked in wine, sliced, dried) 0.5 liang. The above six ingredients are ground into powder, boiled with two sheng of wine to form a paste. Then add the following: Quan Xie (Scorpio, cleaned, fried) 1 fen, Mu Xiang (Radix Aucklandoniae) 0.5 liang, Qing Ju Pi (Pericarpium Citri Reticulatae Viride, soaked in hot water, remove white pith, dried) 3 fen, Fang Feng (Radix Saposhnikoviae, remove forks), Dang Gui (Radix Angelicae Sinensis, sliced, dried) each 0.5 liang, Gui Zhi (Ramulus Cinnamomi, remove coarse bark) 1 fen, Xiang Zi (Semen Lepidii, fried) 3 fen, Niu Xi (Radix Achyranthis Bidentatae, soaked in wine, sliced, dried) 0.5 liang, Lian Shi (Fructus Meliae Toosendan, only the flesh, lightly fried) 3 fen.
The above sixteen ingredients, excluding the paste, are ground into powder, mixed with the paste, and pounded again in a mortar until uniform. If not adhering well, add a little honey. Form pills the size of Sophora seeds. Each dose is 20 pills, taken on an empty stomach with warm wine.
**Sanfu San (Three Assistants Powder)** for treating pathogenic factors lodging in the Liver Meridian, causing attacking distension in both hypochondria, occasional radiating lower abdominal pain, and cold extremities:
Chi Fu Ling (Poria cum Radix Pini, remove black skin) 7 liang, Chi Shao Yao (Radix Paeoniae Rubra) 3 liang, Chang Pu (Rhizoma Acori Tatarinowii, remove roots), Shu Qi (Radix Codonopsis? Note: Historically distinct, likely specific herb), Gui Zhi (Ramulus Cinnamomi, remove coarse bark) each 2 liang, Dan Sha (Cinnabar, separately ground), Zi Shi (Mineral Cupritum).
The above nine ingredients, except those separately ground, are crushed into powder, mixed thoroughly. Each dose is 1 qianbi, gradually increased to 2 qianbi, taken morning and evening before meals, mixed with warm wine.
**Zhuyu Tang (Evodia Decoction)** for treating pathogenic factors in the Liver, presenting with distension/fullness in both hypochondria, tendon vessel spasm, and pain connecting to the lower abdomen:
Shan Zhu Yu (Fructus Corni), Dang Gui (Radix Angelicae Sinensis, sliced, dried), Wu Wei Zi (Fructus Schisandrae), Shan Yu (Dioscoreae Rhizoma), Huang Qi (Radix Astragali, chopped, dried), Xiong Qiong (Rhizoma Chuanxiong) each 0.5 liang, Sheng Gan Di Huang (Radix Rehmanniae Preparata, dried), Bai Zhu (Rhizoma Atractylodis Macrocephalae) each 1 fen, Du Huo (Radix Angelicae Pubescentis, remove rhizome head), Suan Zao Ren (Semen Ziziphi Spinosae, lightly fried) each 2 qian, Mu Gua (Fructus Chaenomelis, peel and seeds removed, dried) 0.5 liang.
The above eleven ingredients are coarsely crushed and sieved. Each dose is 5 qianbi, boiled with one and a half sheng of water and two dates until reduced to 80%. Strain and take warm, on an empty stomach and before meals, twice daily.
**Fupenzi Wan (Rubus Fruit Pills)** for treating Wind-Cold in the Liver, presenting with greenish-yellow complexion, distending pain in both hypochondria radiating to the lower abdomen, impaired tendon vessels, and stiffness/spasm in the back:
Fu Pen Zi (Fructus Rubi) 1 liang, Wu Wei Zi (Fructus Schisandrae) 1 liang, Fu Zi (Radix Aconiti Lateralis Preparata, roasted, split, remove skin and umbilicus) 1 liang, Suan Zao Ren (Semen Ziziphi Spinosae, lightly fried) 1 liang, Bai Zhu (Rhizoma Atractylodis Macrocephalae) 1 liang, Shu Gan Di Huang (Radix Rehmanniae Preparata, dried) 0.5 liang.
The above six ingredients are ground into powder, mixed with refined honey to form pills the size of Sophora seeds. Each dose is 30 pills, taken on an empty stomach and before meals with warm wine; rice drink is also acceptable.