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Pain of the skin belongs to excess syndrome of the Heart. The Classics state: "The summer pulse corresponds to the Heart. If the summer pulse is excessive, it causes disease characterized by fever, painful skin, and spreading sores (Jinyin)."

According to the theory of Six Qi (Yunqi), pain of the skin caused by climatic abnormalities all belongs to fire pathogen injuring the Lung. The Classics state: "When Shaoyin (Ministerial Fire) is in the lower position (Zaiquan), if heat is excessively prevalent, it causes diseases with alternating chills and fever and painful skin." It also states: "When Shaoyin governs the upper position (Sitian), if fire is excessively prevalent, heat rises and causes painful skin." Furthermore: "If there is a recurrence of Shaoyin qi, cough and painful skin occur; treatment should employ various cold-natured herbs."

For acupuncture treatment of painful skin, points from the Lung meridian are selected. The Classics state: "When pathogenic factors are in the Lung, they cause painful skin, alternating chills and fever, upward rushing of qi leading to asthma, sweating, cough that pulls on the shoulder and back. Treatment involves selecting points lateral to the third thoracic vertebra on the chest and back. Press firmly with the hand until the patient feels relief, then puncture. Alternatively, select Quepen (LU 1) to disperse the pathogen."

[From *Jia Yi Jing*]: Body edema, painful skin, intolerance to clothing contact, limb weakness and itching, progressing to numbness over time; treated by Pingyi (BL 43).

"Skin Suoze" refers to what Zhang Zhongjing called "skin like fish scales" (Jiacuo), meaning the skin is rough and dry rather than smooth and moist.

[Zhang Zhongjing]: In cases of five types of consumptive disorders leading to extreme debility and emaciation, abdominal fullness, and inability to eat, caused by injury from diet, sorrow, drinking, sexual activity, hunger, labor, and damage to the meridians, Ying (Nutrient) and Wei (Defensive) qi, with dry blood retained internally, the manifestations include skin like fish scales and darkened eyes around the orbits. The treatment method is to gently replenish the center and tonify deficiency, primarily using Dahuang Mengchong Wan (Rhubarb and Ground Beetle Pill). (Formula see under "Consumptive Disorders".)

Diseases of the Three Yang meridians manifest with chills and fever; if transmitted, they develop into Suoze. (Full text see under "Diagnosis of Disease Transmission". Suo means exhaustion. Wang Bing notes: Essence and blood are dried up, thus the qi of moisture and luster of the skin is completely exhausted.)

[Zhang Zhongjing]: Cough accompanied by slight fever, vexation and fullness, and rough, scaly skin in the chest region indicates Lung Abscess (Fei Yong). Treated primarily with Weijing Tang (Reed Shoot Decoction). (Formula see under "Lung Abscess Section".)

Regarding Yunqi, skin Suoze belongs to dryness pathogen injuring Gallbladder qi. The Classics state: "When Yangming (Dryness Metal) is in the lower position, if dryness is excessively prevalent, it causes the body to lack oiliness and luster; treatment employs bitter-cold herbs."

For acupuncture treatment of skin Suoze, points from the Foot-Shaoyang (Gallbladder) meridian are selected. The Classics state: "When the Foot-Shaoyang meridian undergoes change, it causes the body to lack oiliness and luster; treatment depends on observing whether the pulse is excess or deficient, hot or cold, or sunken, and selecting points accordingly."

If the skin of the chi area (inner forearm) is rough like the scales of a dead fish, it indicates water-fluid retention. (Full text see under "Diagnostic Methods".)