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Body pain is a syndrome present in all six channels (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin). It may involve exterior or interior patterns, cold or heat patterns, wind or dampness pathogens. For instance, body pain caused by impaired circulation of Ying blood (nutritive blood) due to Taiyang Cold Damage should be treated with sweating methods. If, after sweating, the pulse becomes deep and slow accompanied by body pain, warming methods should be applied.

Zhong Hui stated: For body pain, Baihu Tang (White Tiger Decoction) resolves it; for body pain caused by interior cold and exterior heat, one must first rescue the interior cold before attacking the exterior pathogen. When cold is in the three Yin channels, the pulse is deep and body pain occurs like being blown by wind; when cold is in the three Yang channels, there is vexatious pain in the limbs and joints. How can one use Sini Tang (Frigid Extremities Decoction) or Chaihu Tang (Bupleurum Decoction) without careful examination? Taiyang body pain is merely stiffness and tension; dampness-induced body pain makes the body heavy and unable to turn; Yin Du (Yin Toxin) body pain feels as heavy as if beaten by a staff, which serves to distinguish them.

Taiyang Disease: Fever, aversion to cold, and body pain belong to Taiyang disease, treatable with Mahuang Tang (Ephedra Decoction) or Da Qinglong Tang (Great Blue Green Dragon Decoction) (see formula discussion under Taiyang Disease Fever, same below). If accompanied by a sensation of support and knotting in the epigastrium, Chaihu Jia Guizhi Tang (Bupleurum plus Cinnamon Twig Decoction) is used. If accompanied by diarrhea with undigested food and abdominal distension, first warm the interior with Sini Tang, then release the exterior with Guizhi Tang. If the cunian pulse (radial pulse at the chi position) is slow, indicating blood deficiency and insufficient Ying Qi, *Ren Shu* suggests first nourishing blood with Huangqi Jianzhong Tang (Astragalus Building the Middle Decoction), and only after the chi pulse recovers, using Chaihu Tang etc. to harmonize.

Huangqi Jianzhong Tang Formula: Huangqi (Astragali Radix), Guizhi (Cinnamomi Ramulus) (each 1.5 qian), Baishao Yao (Paeoniae Radix Alba) (3 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian). The above four herbs are decocted with 1 zhong half water, 5 slices of Shengjiang (Zingiberis Rhizoma Recens), and 2 dates (Jujubae Fructus), until reduced to 0.8 volume. Strain, add 1 large spoon of thick malt sugar (Chixi), and simmer again before taking. Do not use malt sugar if there is pre-existing mild diarrhea or vomiting.

Commentary: Heat predominates over cold, chi pulse is slow, indicating insufficiency of Ying blood; use Huangqi Jianzhong Tang. Using Huangqi for blood insufficiency works because Huangqi is sweet-tasting; combined with Gancao, it greatly generates blood. This is a subtle method of Zhang Zhongjing. Generally, "grain and soil produce sweetness"; sweet flavor tonifies the Stomach, which is the sea of Qi and Blood, from which they arise. As stated in *Neijing*: "Without Yang, Yin cannot be generated." Using sweet flavor to tonify the Stomach and generate blood is profound. Today's practitioners only know that Renshen (Ginseng Radix) and Huangqi are Qi-tonifying herbs, thus limiting their application.

After sweating, if body pain persists with a deep and slow pulse, Guizhi Ji Shaoyao Shengjiang Renshen Xinjia Tang (Cinnamon Twig plus Peony, Fresh Ginger, and Ginseng New Augmented Decoction) is indicated.

Guizhi Ji Shaoyao Shengjiang Renshen Xinjia Tang Formula: Guizhi (Cinnamomi Ramulus), Renshen (Panacis Ginseng Radix) (each 1.5 liang), Shaoyao (Paeoniae Radix), Shengjiang (Zingiberis Rhizoma Recens) (each 2 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (1 liang), Dazao (Jujubae Fructus) (6 pieces). Crush the herbs, take 5 qian per dose, decoct with water, and take warm.

Cheng Wuji commented: Body pain after sweating indicates incomplete resolution of pathogens; deep and slow pulse indicates insufficiency of Ying blood. The classic states: "Deep pulse means weak Ying Qi." And: "Slow pulse means insufficient Ying blood." Due to blood scarcity, Guizhi Tang is used to resolve remaining pathogens, while adding Shaoyao, Shengjiang, and Renshen to replenish deficient blood.

Zhang Yuansu commented: Some say the classic states that excess exterior pathogens cause floating and tight pulses and body pain, requiring sweating. Since body pain stems from unresolved exterior pathogens, why add Renshen, Shaoyao, and Shengjiang to nourish blood? I reply: Excess exterior pathogens cause body pain; blood deficiency also causes body pain. Floating and tight pulses indicate pathogen excess; deep and faint pulses indicate blood deficiency. Excess is resolved by reducing; deficiency is cured by tonifying. Whenever Zhongjing mentions post-sweating conditions where there is no exterior pattern, no interior heat, and only body pain remains, if the pulse is slightly floating and full, it means exterior pathogens remain unresolved. Here, the deep and slow pulse indicates blood deficiency, hence the addition of Renshen, Shengjiang, and Shaoyao to nourish blood.

Warm Disease: Fever, headache, but paradoxically deep pulse. If not improving and body pain persists, rescue the interior with Sini Tang (see Warm Disease discussion). After 8-9 days of Cold Damage, if Wind-Dampness combats each other causing severe body pain and inability to turn independently, without vomiting or thirst, and with a floating, empty, and choppy pulse, Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction) is indicated. (Cheng Wuji commented: In Cold Damage or Wind Strike cases, by day 7-8, pathogens often move inward, so body pain is usually absent. Persistent severe body pain and inability to turn indicate Wind-Dampness combat. Vexation is due to Wind; inability to turn is due to Dampness. Classics state: Wind leads to floating emptiness. Pulse classics state: Choppy pulse indicates Cold-Dampness. No vomiting/thirst means no interior pathogens. Floating, empty, choppy pulse with bone pain confirms Wind-Dampness in the channels. Guizhi Fuzi Tang disperses Wind-Dampness in the exterior.)

Guizhi Fuzi Tang Formula: Guizhi (Cinnamomi Ramulus, remove bark, 4 liang), Fuzi (Aconiti Lateralis Radix Praeparata, 3 pieces, prepared, peeled, broken into 8 pieces), Shengjiang (Zingiberis Rhizoma Recens, 3 liang, sliced), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 2 liang), Dazao (Jujubae Fructus, 12 pieces, split). Decoct the five herbs in 6 sheng water to obtain 2 sheng. Strain and divide into three warm doses. (Cheng Wuji commented: Wind in the exterior is dispersed by the acrid-sweet nature of Guizhi and Gancao; Dampness in the channels is driven out by the acrid-hot nature of Fuzi. Ginger and dates, acrid-sweet, circulate Ying and Wei, unblock fluids, and harmonize the exterior.) If the patient has hard stool and free urination, remove Guizhi and add Baizhu Tang (Atractylodes Macrocephala Decoction). (Cheng Wuji commented: Guizhi induces sweating and depletes fluids; free urination and hard stool indicate fluid insufficiency. Remove Guizhi, add Baizhu.) If Wind-Dampness combats causing vexatious joint pain, pulling pain, inability to flex/extend, severe pain upon touch, sweating, shortness of breath, difficult urination, aversion to wind, reluctance to remove clothing, or slight edema, Gancao Fuzi Tang (Licorice and Aconite Decoction) is indicated.

Gancao Fuzi Tang Formula: Gancao (Glycyrrhizae Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 1 liang), Guizhi (Cinnamomi Ramulus, 2 liang), Fuzi (Aconiti Lateralis Radix Praeparata, 1 piece, prepared). Crush, make four doses, decoct with water, and take warm. (*Ren Shu* notes: Add Fangfeng (Saposhnikoviae Radix) 1 liang for edema; add Baifuling (Poria) 1.5 liang for palpitations and difficult urination.)

Yangming Disease: Desire to eat, yet urine is obstructed, stool is normal, bone pain, feeling of heat, sudden onset of mania, followed by continuous sweating leading to resolution. This indicates Water failing to overcome Grain Qi, combining with sweat; if the pulse is tight, recovery occurs (use Guizhi Tang).

Taiyin Wind Strike: Vexatious pain in the four limbs; if the radial pulse is faint and the cunian pulse is choppy yet long, recovery is imminent.

Shaoyin Disease: Body pain, cold hands and feet, joint pain, deep pulse; use Fuzi Tang (Aconite Decoction). If Shaoyin disease lasts 4-5 days, with abdominal pain, difficult urination, heavy/painful limbs, and spontaneous diarrhea, indicating Water Qi retention, use Zhenwu Tang (True Warrior Decoction).

Jueyin Disease: Profuse sweating, fever persists, internal cramping, limb pain, diarrhea, cold extremities, and aversion to cold; use Sini Tang (Frigid Extremities Decoction).

Body pain with diarrhea (see Diarrhea section). Body pain with vomiting and diarrhea constitutes Huoluan (Colic and Vomiting Disorder) (see Vomiting/Diarrhea section). Body pain with cold hands and feet, deep pulse, and desire to sleep; use Fuzi Tang (see Desire to Sleep section). Profuse sweating, persistent fever, internal cramping, spontaneous diarrhea, aversion to cold; use Sini Tang (see Diarrhea section). Summerheat stroke in summer with empty pulse and thirst; use Baihu Jia Renshen Tang (White Tiger plus Ginseng Decoction) (see Summerheat section). Body pain as if beaten, blue-green complexion, sore throat indicates Yin Du (Yin Toxin); use Shengma Biejia Tang minus Xionghuang and Shujiao (Marsh Mallow and Turtle Shell Decoction excluding Realgar and Sichuan Pepper) (see Yin Toxin section).

Li Dongyuan commented: For Wind-Dampness combat causing whole-body pain, use Buzhong Yiqi Tang (Middle-Boosting Qi-Rescuing Decoction) plus Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Shengma (Cimicifugae Rhizoma), Ben Cao (Ligustici Chuanxiong Rhizoma), and Cangzhu (Atractylodis Rhizoma). Do not continue服用 once the illness passes, as wind-dispelling herbs damage Healthy Qi and exacerbate the condition.

Wang Haici commented: Shenzhu Tang treats Wind-Dampness with aversion to cold, tight pulse, and anhidrosis; Baizhu Tang treats Wind-Dampness with aversion to wind, slow pulse, and diaphoresis (both see Fever in Cold Damage section).

The above two Zhu Tang formulas treat Wind-Dampness and should be modified according to symptoms; details are found in the Spasm section and following discussions of Baizhu Tang and Shenzhu Tang.

*Renshu*: Xingren Tang (Apricot Seed Decoction) treats Wind-Dampness body pain, aversion to wind, and slight edema.

Xingren Tang Formula: Guizhi (Cinnamomi Ramulus, 2 liang), Mahuang (Ephedrae Herba, removed nodes, boiled dry), Shaoyao (Paeoniae Radix), Tianmendong (Asparagi Radix, removed heart) (each 1 liang), Shengjiang (Zingiberis Rhizoma Recens, 1.5 liang), Xingren (Armeniacae Semen Amarum, 25 pieces, peeled, tip removed, stir-fried). Crush, take 5 qian per dose, decoct with water, and take warm.

Li Dongyuan: Mahuang Fujian Tang (Ephedra Re-decoction) treats sweating in dark rooms, lethargy, fatigue in limbs, wandering pain, caused by latent fire in the Lower Jiao unable to extend, floating restless heat, sweating, and whole-body pain due to Wind-Dampness combat. Use Mahuang to induce gradual sweating; even pathogens in channels require sweating. Especially in late spring, with slow and deep pulses, sweating is particularly appropriate to expel Wind-Dampness, raise Yang Qi, relieve fatigue, and promote vigorous Qi and Blood generation.

Mahuang Fujian Tang Formula: Mahuang (Ephedrae Herba, removed nodes, boil in 5 bowls water until boiling, remove foam/dregs, re-boil to 3 bowls, then add other herbs), Huangqi (Astragali Radix), Baizhu (Atractylodis Rhizoma), Renshen (Panacis Ginseng Radix), Chaihu Gen (Bupleuri Radix), Fangfeng (Saposhnikoviae Radix), Sheng Dihuang (Rehmanniae Radix Recens) (each 5 fen), Qianghuo (Notopterygii Rhizoma et Radix), Huangbai (Phellodendri Cortex) (each 1 qian), Gancao (Glycyrrhizae Radix et Rhizoma), Xingren (Armeniacae Semen Amarum, 3 pieces, peeled, tip removed). Crush, make one dose, add to Mahuang decoction, boil to 1 bowl, take before bed, do not take on a full stomach.

Danggui Niantong Tang (Angelica Pain-Relieving Decoction) treats body pain due to Damp-Heat (see Miscellaneous Diseases Body Pain section).