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When epidemic febrile disease (Shi Yi) begins with wrist pain, it is a disorder of the extremities caused by wind pathogen invading the limbs. In the initial stage, exterior-releasing methods should be used; after sweating or purging, qi-nourishing and blood-supplementing methods should be applied, treating it similarly to shoulder and arm pain.

Pains in the neck, back, waist, knees, shins, feet, shoulders, and arms have been listed previously, thus covering the condition of generalized body soreness. Here, generalized bone and joint soreness is listed again because: pain localized in one area indicates that the pathogen has a specific focus; pain distributed throughout the body indicates that the pathogen is dispersed. For focused pathogens, stagnation must be unblocked; for dispersed pathogens, binding must be released. Therefore, the primary principle for treating generalized soreness is to disperse the exterior. There is also a distinction between "sourness" (suan) and "pain" (tong): sourness is mild and superficial; pain is severe and deep. There is also a distinction between "soreness-pain" and "spasm/contracture": those with soreness-pain move normally, while those with contracture have difficulty flexing and extending; soreness-pain involves Ying and Wei (nutritive and defensive qi), whereas contracture involves sinews and vessels. Combining soreness-pain and contracture, there are differences in upper/lower, shallow/deep, and anterior/posterior locations: conditions above the midpoint of the body are minor disorders (wei ji), which are superficial and easy to resolve; conditions below the midpoint are fundamental diseases, which are deep and difficult to eliminate. Regarding soreness-pain and contracture in the upper and lower body, there is a difference between those who have not undergone sweating/purging and those who have: those who have not undergone sweating/purging have excess pathogenic factors and require dispersing and attacking methods; those who have undergone sweating/purging have deficient healthy qi and require regulating and tonifying methods. Understanding these principles allows for appropriate treatment based on symptoms, whether the soreness is generalized or localized. Exterior-releasing formulas include: Renshen Baidu San (Ginseng Decoction to Overcome Toxins), Jiwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction), Liushen Tongjie San (Six-Efficacy Unblocking Powder), and Da Qianghuo Tang (Major Notopterygium Decoction).

In the initial stage of epidemic febrile disease, fever accompanied by heavy sensation of the body indicates dampness exceeding heat, treated primarily with Cangzhu (Atractylodis Rhizoma). After transmission occurs from day two or three to day four or five, if sweating leads to higher fever and heavy sensation of the body, it indicates heat obstructing the meridians, treated primarily with Baihu Tang (White Tiger Decoction). If the pathogen transmits to the interior, with no heat on the exterior but dry tongue, constipation, abdominal pain with refusal to press, and heavy sensation of the body, it indicates internal accumulation preventing qi from reaching the exterior, treated primarily with the Three Chengqi Formulas (San Chengqi). After repeated sweating and purging, if exterior heat has subsided, the body is so heavy it cannot move, the pulse is deficient, scattered, and rootless, the tongue lacks coating, and urination and defecation occur naturally, this indicates exhaustion of both Yin and Yang and depletion of the meridians. Treatment should be determined by assessing which aspect of Yin or Yang is predominant. Predominant Yin exhaustion often presents with dryness syndromes, treated primarily with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) combined with Siwu Tang (Four-Substance Decoction); predominant Yang exhaustion often presents with Spleen-Stomach syndromes, treated primarily with Liujunzi Tang (Six-Gentleman Decoction) combined with Shengmai San (Generate the Pulse Powder); if both Yin and Yang are exhausted, Shengmai San is combined with Liuwei Dihuang Wan as the primary treatment.