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Pain in the body (Shentong) can occur in all six meridians. Pain in the body associated with the Three Yang meridians is caused by exterior pathogenic factors; pain in the body associated with the Three Yin meridians is caused by interior cold.

For pain in the body of the Taiyang meridian, characterized by fever, absence of sweating, cold hands and feet, and a floating-tight pulse, diaphoresis (Fahan, inducing sweating to release the exterior) is indicated. In the northwest during winter, Mahuang Tang (Ephedra Decoction) is used; in the south during the three seasons (spring, summer, autumn), Qianghuo Tang (Notopterygium Decoction) is used. If there is sweating and a floating-slow pulse, Guizhi Tang (Cinnamon Twig Decoction) is used in the northwest during winter, and Jiajian Fangfeng Tang (Modified Saposhnikovia Decoction) is used in the south during the three seasons. If body pain persists after diaphoresis and the pulse remains floating-tight, diaphoresis may be repeated. However, if body pain persists after diaphoresis but the pulse becomes slow (Chi), diaphoresis must absolutely not be repeated; Guizhirenshen Shaoyao Tang (Cinnamon Twig, Ginseng, and White Peony Root Decoction) is indicated. If body pain was absent initially but appears after diaphoresis, this is pain due to Yang collapse from erroneous diaphoresis; Huangqi Jianzhong Tang (Astragalus Decoction for Building the Middle) is used.

If there is fever, yellowing of the face and eyes, generalized body pain, forgetfulness, and a desire to rinse the mouth with water but an inability to swallow it, this is pain due to blood stasis in the Upper Jiao (Upper Burner); Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) with Honghua (Carthamus Flower) and Chishaoyao (Red Peony Root) is used. If the lower abdomen is hard and full, and stool is either obstructed or black, this is pain due to blood stasis in the Lower Jiao (Lower Burner); Taoren Chengqi Tang (Peach Kernel and Da Huang Decoction) is the primary treatment.

In summer and autumn, heatstroke causes excessive sweating, body pain, a paradoxically deficient pulse, and thirst; Renshen Baihu Tang (Ginseng and White Tiger Decoction) is used. When wind affects the Three Yang meridians, causing aversion to wind, fever, vexing pain in the joints, a floating pulse, and no sweating, Qianghuo Fangfeng Tang (Notopterygium and Saposhnikovia Decoction) is indicated. When wind and dampness contend, causing vexing body pain and inability to turn over, without thirst, and with a floating-soft pulse, Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction) is used in the north during winter, and Fangfeng Shenzhu Tang (Saposhnikovia and Atractylodes Macrocephala Decoction) is used in the south during the three seasons. For damp-warmth causing body pain with excessive sweating and thirst and inability to turn over, Shigao Shenzhu Tang (Gypsum and Atractylodes Macrocephala Decoction) is used.

Regarding similar symptoms of body pain and inability to turn over: the previous clause described wind-dampness with no thirst, indicating no damp-heat in the interior, hence the use of Fangfeng Shenzhu Tang for warming and dispersing. The next clause describes damp-warmth with excessive sweating and thirst, indicating heat in the interior, hence the use of Shigao Shenzhu Tang for clearing and draining. Generally, pain from dampness often involves heaviness of the body; pain from wind often involves lightness of the body; pain from heat often involves sweating; pain from cold often presents with bluish discoloration of the body; pain from fluid retention often involves nausea and vomiting; pain from summerheat often involves thirst; deficiency pain is often relieved by pressure; Qi stagnation pain often involves wandering or rushing sensations; wind-fire pain moves unpredictably and comes and goes; wind-cold pain stays fixed and persists long-term, often with cold limbs.

Additionally, cases without fever, with a deep-slow pulse and body pain, are Yin-cold pain of the Three Yin meridians. Severe cases require Sini Tang (Four Reversal Decoction); mild cases require Lizhong Tang (Regulate the Middle Decoction).

Headache and body pain syndromes generally belong to exterior pathogens. Although headache clauses mention phlegm-fluids and fire-rushing, these also involve internal phlegm-fire combined with external exterior pathogens. Body pain, however, is exclusively a Taiyang exterior syndrome. Our family secret method specifically treats it with Qiangdu Tang (Notopterygium and Angelica Dahurica Decoction) plus Su Geng (Perilla Stem) and Mutong (Akebia Stem). In cases of epidemic cold and rain/dampness causing epidemic pathogen body pain, Qianghuo Baidu San (Notopterygium Detoxification Powder) is also used. If accompanied by chest fullness and vomiting, Pingwei Erchen Tang (Stomach-Pacifying and Two-Chen Decoction) is added to disperse stomach dampness and phlegm-fluids, combined with exterior-releasing herbs to induce sweating and resolve externally. If there is body pain, aversion to cold, fever, vomiting, and dysentery with bloody water, the same formula is used to ventilate and disperse warm-toxic exterior pathogens, after which the dysentery heals itself. Erroneous use of cold-cooling herbs suppresses sweating, causing exterior pathogens to sink inward, leading to untreatable conditions.

Taiyang disease, with headache, fever, body ache, lumbar pain, joint pain, aversion to wind, no sweating, and wheezing, is treated primarily with Mahuang Tang (Ephedra Decoction). This describes the exterior syndrome of Cold injuring the Ying (Nutrient) level in Taiyang, thus requiring dispersion of exterior pathogens.

After six or seven days of Shanghan (Cold Damage), with slight fever and aversion to cold, vexing joint pain, slight vomiting, epigastric binding, and unresolved exterior symptoms, Chaihu Tang (Bupleurum Decoction) and Guizhi Tang (Cinnamon Twig Decoction) are used. Since exterior pathogens of Taiyang and Shaoyang remain, these two formulas are combined (see detailed notes under Aversion to Cold).

If a physician erroneously uses purgatives in Shanghan, leading to continuous diarrhea with undigested food and body pain, urgent rescue of the Interior is required. Later, if body pain persists but bowel and bladder functions normalize, urgent rescue of the Exterior is required. To rescue the Interior, Sini Tang (Four Reversal Decoction) is indicated; to rescue the Exterior, Guizhi Tang (Cinnamon Twig Decoction) is indicated. Because erroneous purgation in Shanghan exterior syndrome causes continuous diarrhea, the Interior must be rescued urgently. After medication, if body pain persists due to unresolved exterior pathogens, the Exterior must be rescued urgently.

After eight or nine days of Shanghan, with wind-dampness contending, vexing body pain, inability to turn over, no vomiting or thirst, and a floating-deficient-choppy pulse, Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction) is used. Vexing body pain, inability to turn over, no vomiting or thirst, indicate cold-dampness. A deficient and choppy pulse indicates cold-stagnation. Hence, Guizhi Fuzi Tang is used.

When wind and dampness contend, causing vexing and pulling pain in joints, inability to flex or extend, severe pain upon touch, sweating, shortness of breath, difficult urination, aversion to wind with reluctance to remove clothes, or slight edema, Gancao Fuzi Tang (Licorice and Aconite Decoction) is used. This follows the previous chapter on cold-damp body pain, adding symptoms like severe pain upon touch, sweating, shortness of breath, difficult urination, and aversion to wind, thus requiring Gancao Fuzi Tang to warm the channels and dissipate dampness. Using Fangfeng Shenzhu Tang would be incorrect.

Taiyang Wind Strike, with a floating-tight pulse, fever, aversion to cold, body pain, no sweating, and irritability, is treated primarily with Da Qinglong Tang (Major Green Dragon Decoction). If the pulse is weak and faint with sweating and aversion to wind, it must not be administered. (See detailed notes under Irritability).

Taiyang disease, with a floating-tight pulse, no sweating, fever, body pain, persisting for eight or nine days without resolution, while exterior symptoms remain, requires diaphoresis. After taking medicine, symptoms may slightly improve, but the patient may develop vexing heat and closed eyes; in severe cases, nasal bleeding (Xu) occurs, after which the condition resolves. This happens because Yang Qi is heavy. Mahuang Tang (Ephedra Decoction) is used. (This chapter has been misinterpreted for millennia. "Mahuang Tang Zhu Zhi" should be read under "should induce diaphoresis." See detailed notes under Nasal Bleeding).

Yangming disease, initially desiring food, but with contrary difficulty in urination, normal stool, bone joint pain, a feeling of slight heat, sudden madness, and profuse sweating leading to resolution, indicates that Water cannot overcome Grain Qi. With sweat, they combine, and if the pulse is tight, recovery ensues. This describes Yangming disease where appetite is preserved but urine is difficult, indicating internal water retention. Bone joint pain and slight heat indicate exterior symptoms; sudden madness indicates interior symptoms. This is cold-heat of water and grain. Profuse sweating is required to resolve the internal retained water-grain pathogens together with sweat. Recovery depends on a tight and forceful pulse enabling sweating.

Taiyin Wind Strike, with vexing pain in the four limbs, a superficial-micro and interior-choppy-long pulse, indicates impending recovery. If Taiyin disease presents with a floating pulse, diaphoresis is possible, and Guizhi Tang (Cinnamon Twig Decoction) is indicated. The Three Yin meridians can also have Shanghan or Wind Strike; a Long pulse in Yang syndromes indicates transmission to Yangming, suggesting recovery. If Taiyin disease has a floating pulse, it transmits outward to Taiyang, so diaphoresis is possible using Guizhi Tang.

Shaoyin disease, with body pain, cold hands and feet, joint pain, and a deep pulse, is treated with Fuzi Tang (Aconite Decoction). This is Yin syndrome body pain of the Shaoyin meridian, hence Fuzi Tang is used.

Diarrhea with abdominal fullness and body pain: first warm the Interior, then attack the Exterior. To warm the Interior, Sini Tang (Four Reversal Decoction) is indicated; to attack the Exterior, Guizhi Tang (Cinnamon Twig Decoction) is indicated. This clause belongs to the Jueyin meridian, with interior cold causing diarrhea and exterior pathogens causing body pain. Due to interior Qi deficiency and cold, wind-cold enters causing pain; thus, the Interior is warmed first, then the Exterior is attacked.

Mahuang Tang, Qianghuo Tang, and Guizhi Tang are seen under Aversion to Cold. Modification methods are detailed under Aversion to Cold.

Jiajian Fangfeng Tang (Modified Saposhnikovia Decoction):
Fangfeng (Saposhnikovia Root), Jingjie (Schizonepeta Spike), Qianghuo (Notopterygium Rhizome), Duhuo (Angelica Pubescens Root), Chuanxiong (Ligusticum Chuanxiong Rhizome), Gancao (Licorice Root), Shengjiang (Fresh Ginger), Shaoyao (Peony Root), Dazao (Jujube Fruit).
This family secret formula treats body pain, headache, and wind-dampness of the Taiyang meridian during the three seasons.

Guizhirenshen Shaoyao Tang (Cinnamon Twig, Ginseng, and White Peony Root Decoction):
Guizhi (Cinnamon Twig), Renshen (Ginseng Root), Baishao Yao (White Peony Root), Shengjiang (Fresh Ginger), Gancao (Licorice Root), Dazao (Jujube Fruit).
This formula treats interior Qi deficiency and cold, where body pain persists after diaphoresis with pathogens remaining and a deep-slow pulse, making further diaphoresis contraindicated. Thus, Xiao Jianzhong Tang (Minor Decoction for Building the Middle) plus Renshen is used to support Yuan Qi to expel exterior pathogens.

Huangqi Jianzhong Tang (Astragalus Decoction for Building the Middle):
Baishao Yao (White Peony Root), Gancao (Licorice Root), Guizhi (Cinnamon Twig), Huangqi (Astragalus Root).
This formula treats exterior deficiency body pain due to Yang collapse from erroneous diaphoresis. Previously, interior Qi deficiency prevented pathogen expulsion, causing pain, so Jianzhong Tang plus Renshen was used. Here, exterior Qi deficiency fails to protect the exterior, causing pain, so Jianzhong Tang plus Huangqi is used. One uses Renshen and Guizhi to build merit internally and expel pathogens externally; the other uses Huangqi and Guizhi to strengthen the exterior and secure Wei Yang.

Sini Tang (Four Reversal Decoction):
Fuzi (Prepared Aconite Lateral Root), Ganjiang (Dried Ginger), Guangpi (Tangerine Peel), Gancao (Licorice Root).
For Yin syndrome body pain with cold limbs, this formula warms the Interior. Adding Guangpi harmonizes Yang Qi further.

Lizhong Tang (Regulate the Middle Decoction) is seen under "Rinsing Mouth Without Swallowing".
Yin syndrome body pain is caused by deficiency-cold of Middle Qi. Using Lizhong Tang allows Yang Qi to circulate freely, connecting interior and exterior.

Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction):
Sheng Xijiao (Raw Rhino Horn - *Note: Substitute legally*), Zhizi (Gardenia Fruit), Shengdi (Rehmannia Root), Chishaoyao (Red Peony Root), Dangguiwei (Angelica Sinensis Root Tail), Zelan Ye (Leonurus Leaf), Jingjie (Schizonepeta Spike), Zharon ( Hawthorn Flesh), Mudanpi (Tree Peony Bark), Honghua (Carthamus Flower).
When heat pathogens cannot exit externally, stasis-heat hides and knots in the Blood level, causing fever, yellowing of face and eyes, and generalized body pain. This formula clears Heat in the Upper Jiao and dissipates Blood stasis in the Upper Jiao.

Taoren Chengqi Tang (Peach Kernel and Da Huang Decoction) is seen under Blood Stasis.
Renshen Baihu Tang (Ginseng and White Tiger Decoction) is seen under Tidal Fever.
Qianghuo Fangfeng Tang (Notopterygium and Saposhnikovia Decoction) is seen under Yellowing.
Fangfeng Shenzhu Tang (Saposhnikovia and Atractylodes Macrocephala Decoction) is seen under Headache.

Shigao Shenzhu Tang (Gypsum and Atractylodes Macrocephala Decoction):
Shigao (Gypsum), Shu Cangzhu (Processed Atractylodes Macrocephala Rhizome), Gancao (Licorice Root).
This is a formula for damp-warmth body pain. For upper body pain, add Fangfeng, Jingjie, Baizhi (Angelica Dahurica Root), Chuanxiong; for lower body pain, add Fangji (Stephania Tetrandra Root), Qinjiao (Gentiana Macrophylla Root), Huangbai (Phellodendron Bark).

Da Qinglong Tang (Major Green Dragon Decoction) is seen under Irritability.

Pingwei Fabiao Tang (Stomach-Pacifying Exterior-Releasing Decoction): Family secret for chills, fever, chest fullness, and no sweating.
Qianghuo, Chaihu (Bupleurum Root), Gange (Pueraria Root), Zhi Po (Magnolia Bark and Pinellia), Banxia (Pinellia Tuber), Guangpi.

Lifei Fabiao Tang (Lung-Regulating Exterior-Releasing Decoction): Family secret for chills, fever, wheezing, cough, and no sweating.
Qianghuo, Chaihu, Gange, Zhike (Bitter Orange Fruit), Jiegeng (Platycodon Root), Sangpi (Mulberry Bark).
These two formulas: one treats the Stomach governing muscles; when Stomach Qi is congealed, Stomach Yang cannot distribute to generate sweat and disperse pathogens. The other treats the Lung governing skin and hair; when the Lung is affected by external pathogens, skin and hair close up preventing sweat generation. These two methods are not only for body pain but are excellent keys for dispersing pathogens. For cold feet and lumbar pain, add Duhuo; for night fever, add Shengma (Cimicifuga Rhizome); for little sweat, add Fangfeng.