论曰胁肋痛者，足厥阴经虚、寒气乘之也，足厥阴肝经，其支脉起足大指丛毛上，循阴
股入腹，贯膈布胁肋，寒邪之气乘虚，则伤于经络邪气与正气相搏，故令胁肋痛也。
治胁下偏痛发热脉弦，此寒也，当以温药下寒。大黄附子汤方
大黄（锉碎醋炒香一两半） 附子（炮裂去皮脐三枚） 细辛（去苗叶一两）
上三味，锉如麻豆，每服三钱匕，水一盏半，煎至七分，去滓温服，如人行四五里、再
服。
治胁肋痛腹冷，或食冷物不消，或块聚不转，心肋胀闷刺痛，霍乱，桂心丸方
桂（去粗皮） 诃黎勒（煨去核） 浓朴（去粗皮生姜汁炙各一两）
以上三味，细锉，掘地作坑子，用炭火烧赤，吹去灰，以酽醋一茶盏并药，投于坑子中，
急以瓷碗热盖土培，勿令漏气，待冷即取出焙干入后药。
干姜（炮） 草豆蔻（去皮） 陈橘皮（汤浸去白焙） 木香（各一两） 阿魏（研一
分） 槟榔
上一十一味，取前三味与后八味，同捣罗为末，炼蜜和丸，如小豆大，每服温酒下二十
丸，初服急行三二百步，又服二十丸，掣两脚各二三十下，贴膝便坐，气即散也。
治寒气入客，胸胁引痛。当归汤方
当归（切焙） 枳壳（去瓤麸炒） 赤芍药 槟榔（锉） 木香 桔梗（炒） 附子（炮
裂去皮脐） 白术（各一两） 诃黎勒（煨用皮一两半）
上九味，锉如麻豆，每服三钱匕，以水一盏，入生姜半分切，煎至七分，去滓温服。
不拘时候。
治腹满胁肋痛、不可忍。备急四神丸方
桂（去粗皮） 附子（炮裂去皮脐） 干姜（炮裂各一两） 巴豆（四十粒去心膜麸炒
出油尽）
上四味，捣罗为末，炼蜜和丸，如小豆大，每服三丸，温水下，不动更加二丸，当下恶
物，黄绿水一二升，以温浆水止之，三五日即瘥。
治胁肋 痛，上攻心胸。槟榔丸方
槟榔（锉） 桂（去粗皮） 当归（切焙） 赤芍药 桃仁（汤浸去皮尖双仁麸炒） 诃
黎勒（
上八味，捣罗为末，炼蜜和丸，如梧桐子大，每服二十丸，温酒下，不拘时候。
治胸胁气不利，腹胀急痛。半夏汤方
半夏（一两半汤洗七遍去滑焙） 桂（去粗皮） 槟榔（锉各一两）
上三味，粗捣筛，每服三钱匕，水一盏，入生姜半分拍碎，煎至六分，去滓温服。不拘
时候。
治冷气内攻，胁肋疼痛。不入饮食。荜澄茄汤方
荜澄茄 浓朴（去粗皮生姜汁炙） 桂（去粗皮） 桔梗（炒） 当归（切焙） 赤芍
药赤茯
榔（锉） 白术（各
上一十二味，粗捣筛，每服三钱匕，以水一盏，入生姜半分切，大枣二枚劈破，煎取七
分，去滓稍热服，不拘时候。
治胁胸气妨闷疼痛。茱萸丸方
茱萸（汤浸七遍焙干微炒） 麝香（研各一两） 当归（切焙半两）
上三味，将二味捣罗为末，入麝香同研匀，炼蜜和丸，如小豆大，每服二十丸。热酒下、
不拘时。
论述说：胁肋痛，是由于足厥阴经虚弱，寒气乘虚侵袭所致。足厥阴肝经的支脉，起于足大趾丛毛处，沿大腿内侧进入腹部，穿过膈肌，分布于胁肋部。寒邪之气乘虚而入，损伤经络，邪气与正气相互搏结，从而导致胁肋疼痛。
治疗胁下偏侧疼痛、发热、脉象弦紧，这是寒证，应当用温性药物攻下寒积。大黄附子汤方：
大黄（切碎，醋炒至香，一两半） 附子（炮制裂开，去皮去脐，三枚） 细辛（去苗叶，一两）
以上三味药，锉碎如麻豆大小，每次服用三钱匕，加水一盏半，煎煮至七分，去渣，温服。如果人行走四五里的时间后，再服一次。
治疗胁肋痛伴腹部寒冷，或食用冷物不消化，或有积块聚结不移动，心肋部位胀闷刺痛，霍乱，桂心丸方：
桂（去掉粗皮） 诃黎勒（煨制去核） 浓朴（去掉粗皮，用生姜汁炙，各一两）
以上三味药，细细锉碎，在地上挖一个坑，用炭火烧红坑壁，吹去灰烬，将一茶盏浓醋和药物投入坑中，迅速用热瓷碗盖住，并用土培实，不要漏气，待冷却后取出焙干，再加入以下药物。
干姜（炮制） 草豆蔻（去皮） 陈橘皮（热水浸泡去白瓤焙干） 木香（各一两） 阿魏（研成一分） 槟榔
以上十一味药，取前三味与后八味，一起捣碎过筛成粉末，用炼蜜调和制成丸剂，如小豆大小，每次服用二十丸，用温酒送下。初次服药后急行三四百步，再服二十丸，两脚各踢二三十下，然后贴膝坐下，气机即可消散。
治疗寒气客居体内，牵引胸胁疼痛。当归汤方：
当归（切后焙干） 枳壳（去瓤麸炒） 赤芍药 槟榔（锉碎） 木香 桔梗（炒制） 附子（炮制裂开去皮去脐） 白术（各一两） 诃黎勒（煨制，用皮一两半）
以上九味药，锉碎如麻豆大小，每次服用三钱匕，加水一盏，放入切碎的生姜半分，煎煮至七分，去渣温服。不拘时候。
治疗腹部胀满、胁肋疼痛剧烈难以忍受。备急四神丸方：
桂（去掉粗皮） 附子（炮制裂开去皮去脐） 干姜（炮制裂开，各一两） 巴豆（四十粒，去心膜，麸炒至油尽）
以上四味药，捣碎过筛成粉末，用炼蜜调和制成丸剂，如小豆大小，每次服用三丸，温水送下。若未见效，再加服二丸。当下出恶物，黄绿水一二升，用温浆水止泻，三五天即痊愈。
治疗胁肋疼痛，向上攻冲心胸。槟榔丸方：
槟榔（锉碎） 桂（去掉粗皮） 当归（切后焙干） 赤芍药 桃仁（热水浸泡去皮尖双仁麸炒） 诃黎勒（原文此处中断，推测为后续药材或剂量缺失，按原文保留）
以上八味药，捣碎过筛成粉末，用炼蜜调和制成丸剂，如梧桐子大小，每次服用二十丸，温酒送下，不拘时候。
治疗胸胁气机不利，腹胀急痛。半夏汤方：
半夏（一两半，热水洗七遍去滑腻焙干） 桂（去掉粗皮） 槟榔（锉碎，各一两）
以上三味药，粗捣筛过，每次服用三钱匕，加水一盏，放入拍碎的生姜半分，煎煮至六分，去渣温服。不拘时候。
治疗冷气内攻，胁肋疼痛，无法进食。荜澄茄汤方：
荜澄茄 浓朴（去掉粗皮，用生姜汁炙） 桂（去掉粗皮） 桔梗（炒制） 当归（切后焙干） 赤芍药 赤茯苓（原文“赤茯”后缺字，推测为茯苓类） 槟榔（锉碎） 白术（各...原文此处中断，推测为剂量缺失）
以上十二味药，粗捣筛过，每次服用三钱匕，加水一盏，放入切碎的生姜半分，劈破的大枣二枚，煎取七分，去渣稍热服，不拘时候。
治疗胁胸部气机受阻闷痛。茱萸丸方：
茱萸（热水浸泡七遍，焙干微炒） 麝香（研细，各一两） 当归（切后焙干，半两）
以上三味药，将前两种药捣碎过筛成粉末，加入麝香共同研匀，用炼蜜调和制成丸剂，如小豆大小，每次服用二十丸。热酒送下，不拘时候。
Discussion states: Pain in the hypochondrium and ribs is caused by deficiency of the Foot Jueyin Meridian, allowing Cold Pathogen to invade. The collateral branch of the Foot Jueyin Liver Meridian originates from the pubic hair on the big toe, runs along the medial thigh into the abdomen, pierces the diaphragm, and spreads over the hypochondrium and ribs. When Cold Pathogen invades due to deficiency, it damages the meridians; the pathogenic factor contends with healthy Qi, resulting in pain in the hypochondrium and ribs.
For treating unilateral pain under the hypochondrium accompanied by fever and a Wiry Pulse (Xian Mai), this indicates Cold Syndrome. One should use warm-purgative herbs to purge cold accumulation. Da Huang Fu Zi Tang (Rhubarb and Aconite Decoction) Formula:
Da Huang (Cortex Rhei Preparata, chopped and stir-fried with vinegar until fragrant, 1.5 liang) Fu Zi (Radix Aconiti Lateralis Preparata, roasted until cracked, peel and umbilicus removed, three pieces) Xi Xin (Herba Asari, seedlings and leaves removed, 1 liang).
The above three ingredients are chopped like hemp seeds. Each dose consists of 3 qian bi (approx. 9-10g depending on era measurement), boiled in 1.5 sheng (approx. 300ml) of water until reduced to 0.7 sheng. Strain and take warm. If after walking for four or five li (approx. 2-3 km), symptoms persist, administer another dose.
For treating hypochondriac pain with abdominal coldness, indigestion of cold food, fixed masses that do not move, distending and stabbing pain in the heart and hypochondrium, cholera-like vomiting and diarrhea, Gui Xin Wan (Cinnamon Heart Pill) Formula:
Gui Rou (Cortex Cinnamomi, coarse bark removed) He Li Le (Fructus Chebulae, baked and pitted) Hou Po (Cortex Magnoliae Officinalis, coarse bark removed, stir-fried with ginger juice, each 1 liang).
The above three ingredients are finely chopped. Dig a pit in the ground and heat the walls red with charcoal. Blow away the ash. Pour one tea cup of strong vinegar and the herbs into the pit. Quickly cover with a hot porcelain bowl and seal with earth to prevent gas leakage. Wait until cool, then remove and dry-roast. Add the following herbs:
Gan Jiang (Rhizoma Zingiberis Preparata, roasted) Dou Kou (Fructus Cardamomi Rotundus, peel removed) Chen Pi (Pericarpium Citri Reticulatae, soaked in water, white pith removed, dried) Mu Xiang (Radix Aucklandiae, each 1 liang) A Wei (Resin Ferulae, ground, 1 fen) Bing Lang (Semen Arecae).
Take the first three ingredients and the remaining eight ingredients, pound and sieve into powder. Mix with refined honey to form pills the size of small beans. Take 20 pills each time with warm wine. After the first dose, walk briskly for 300-400 steps. Take another 20 pills, then kick each leg 20-30 times. Sit with knees close together; the qi stagnation will dissipate.
For treating cold pathogen lodging internally, causing radiating pain in the chest and hypochondrium. Dang Gui Tang (Angelica Decoction) Formula:
Dang Gui (Radix Angelicae Sinensis, sliced and dried) Zhi Ke (Fructus Aurantii, pulp removed, stir-fried with bran) Chi Shao Yao (Radix Paeoniae Rubra) Bing Lang (Semen Arecae, chopped) Mu Xiang (Radix Aucklandiae) Jie Geng (Radix Platycodonis, stir-fried) Fu Zi (Radix Aconiti Lateralis Preparata, roasted until cracked, peel and umbilicus removed) Bai Zhu (Rhizoma Atractylodis Macrocephalae, each 1 liang) He Li Le (Fructus Chebulae, baked, using peel, 1.5 liang).
The above nine ingredients are chopped like hemp seeds. Each dose consists of 3 qian bi, boiled in 1 sheng (approx. 200ml) of water with half a qian of sliced fresh ginger. Simmer until reduced to 0.7 sheng. Strain and take warm. No specific timing required.
For treating abdominal fullness and unbearable hypochondriac pain. Bei Ji Si Shen Wan (Emergency Four Spirits Pill) Formula:
Gui Rou (Cortex Cinnamomi, coarse bark removed) Fu Zi (Radix Aconiti Lateralis Preparata, roasted until cracked, peel and umbilicus removed) Gan Jiang (Rhizoma Zingiberis Preparata, roasted until cracked, each 1 liang) Ba Dou (Semen Crotonis, 40 grains, heart membrane removed, stir-fried with bran until oil is exhausted).
The above four ingredients are pounded and sieved into powder. Mix with refined honey to form pills the size of small beans. Take 3 pills each time with warm water. If there is no effect, add 2 more pills. It should induce evacuation of foul matter, such as 1-2 sheng of yellow-green water. Stop diarrhea with warm sour rice water. Recovery occurs within 3-5 days.
For treating hypochondriac pain radiating upward to the heart and chest. Bing Lang Wan (Areca Nut Pill) Formula:
Bing Lang (Semen Arecae, chopped) Gui Rou (Cortex Cinnamomi, coarse bark removed) Dang Gui (Radix Angelicae Sinensis, sliced and dried) Chi Shao Yao (Radix Paeoniae Rubra) Tao Ren (Semen Persicae, soaked in water, peel and pointed end removed, double-kernel, stir-fried with bran) He Li Le (Fructus Chebulae [Text incomplete here]).
The above eight ingredients are pounded and sieved into powder. Mix with refined honey to form pills the size of sophora seeds. Take 20 pills each time with warm wine. No specific timing required.
For treating unfavorable qi in the chest and hypochondrium, abdominal distension and acute pain. Ban Xia Tang (Pinellia Decoction) Formula:
Ban Xia (Rhizoma Pinelliae Preparata, 1.5 liang, washed seven times in hot water to remove slipperiness, dried) Gui Rou (Cortex Cinnamomi, coarse bark removed) Bing Lang (Semen Arecae, chopped, each 1 liang).
The above three ingredients are coarsely crushed and sifted. Each dose consists of 3 qian bi, boiled in 1 sheng of water with half a qian of smashed fresh ginger. Simmer until reduced to 0.6 sheng. Strain and take warm. No specific timing required.
For treating internal attack by cold qi, hypochondriac pain, and inability to eat. Bi Cheng Qie Tang (Long Pepper Decoction) Formula:
Bi Cheng Qie (Fructus Cubebae) Hou Po (Cortex Magnoliae Officinalis, coarse bark removed, stir-fried with ginger juice) Gui Rou (Cortex Cinnamomi, coarse bark removed) Jie Geng (Radix Platycodonis, stir-fried) Dang Gui (Radix Angelicae Sinensis, sliced and dried) Chi Shao Yao (Radix Paeoniae Rubra) Chi Fu Ling (Poria Cocos with Red Cortex [Text truncated]) Bing Lang (Semen Arecae, chopped) Bai Zhu (Rhizoma Atractylodis Macrocephalae [Dosage text truncated]).
The above twelve ingredients are coarsely crushed and sifted. Each dose consists of 3 qian bi, boiled in 1 sheng of water with half a qian of sliced fresh ginger and two split jujubes. Simmer until 0.7 sheng remains. Strain and take slightly warm. No specific timing required.
For treating obstruction and painful distension in the hypochondrium and chest. Zhu Yu Wan (Cornel Pill) Formula:
Shan Zhu Yu (Fructus Corni, soaked in water seven times, dried and lightly stir-fried) She Xiang (Moschus, ground, each 1 liang) Dang Gui (Radix Angelicae Sinensis, sliced and dried, half liang).
The above three ingredients: Pound the first two into powder, mix with ground musk evenly. Combine with refined honey to form pills the size of small beans. Take 20 pills each time with hot wine. No specific timing required.