Hypochondrial pain indicates pain under the rib-cage margin on both sides or one side only
(Figure 15.1(381)).

Hypochondrial pain is always related to a Liver disharmony. The "Spiritual Axis" in chapter 20
says: "When the disease is in the Liver there is hypochondrial pain on both sides."1(382) The
"Simple Questions" in chapter 22 says: "In Liver disease there is bilateral hypochondrial pain
extending to the lower abdomen."2(383)

It is important to note that hypochondrial pain on either side is related to a Liver disharmony
because of the bilateral pathway of the Liver channel.

Aetiology and Pathology

Emotional Strain

Anger, resentment, frustration or hatred can all cause stagnation of Liver-Qi especially when
they are repressed and emotions are not shown. This is the most common cause of hypochondrial
pain.

After a long time, stagnation of Liver-Qi may give rise to stasis of Liver-Blood.

External Damp-Heat

External Damp-Heat may invade the Liver channel and cause hypochondrial pain. This is very
common in tropical countries, but it does occur in temperate countries in summertime.

Diet

Excessive consumption of dairy products and greasy-fried foods may lead to the formation of
Damp-Heat in the Liver channel. Damp-Heat settles in the Liver channel rather than the Stomach