体痛为一身尽痛。伤寒霍乱。中暑阴毒。湿痹痛痹。皆有体痛。但看兼证。及问因诊脉而别
之。治法分见各门。其流连难已者。于此求之。寒而身痛。痛处常冷。或如湿状。甘草附子汤。
内伤劳倦。兼风湿相搏。一身尽痛。补中益气加
羌、防、 本、苍术。湿热相搏。肩背沉重。疼痛上热。胸膈不利。遍身上下沉重疼痛。当归拈
痛汤。风湿相搏。一身尽痛。阴湿中汗出。懒语。四肢困倦乏力。走注疼痛。乃下焦伏火不得泄。
而躁热常微汗出。而热不解。麻黄复煎汤。身体拘急。皆属虚寒。与寒湿风湿。小续命随证加减。
发寒热而周身作痛。胸胁痞闷不舒。肝血虚而郁火用事也。逍遥散加羌活、桂技。小便不利。加
山栀、丹皮。天暑衣浓。则腠理开汗出。邪留于分肉之间。聚沫则为痛。六和汤加羌活。遍身皆
痛如劳证者。十全大补去白术、熟地。加羌活、附子。下体痛。宜分利小便。五苓、二妙为主。
下体肿痛。脉浮自汗。恶风者。防己黄 汤。温覆微汗之。痛而大便不通者。浓朴七物汤。微利
之。丹溪曰。因湿痰浊血流注为痛。若在下焦。道路深远。非乌、附不能下达。少加引经用之。
若以为主治。非徒无益。而反害之也。善治者。必行气流湿。疏风导滞。滋养新血。升降阴阳。
治有先后。须分肿与不肿可也。肢节肿痛。痛属火。肿属湿。盖为风寒所郁。而发动于经络之中。
湿热流注于肢节之间而无已也。先宜微汗以散之。故羌活、桂枝为肢节痛之要药。身体疼痛及重
者。湿也。五苓散汗之。如风湿相搏。一身尽痛。加羌、防、升、柴、 本、苍术。风能胜湿故
也。痛家不可食浓味与肉。大能助火。若食肉浓味痛愈盛者。并鱼腥面酱酒醋。皆断去之。丹溪
曰。环跳穴痛不已。防生附骨痈。掘地成坑。以火 赤。沃以小便。赤体坐其上。以被围绕下体。
便热蒸腠理开。血气畅则愈。
〔诊〕伤寒六脉俱紧。为太阳表证。身如被杖。脉沉紧。为阴毒。发汗后脉弦迟。身体痛。为
气血不和。一身关节尽痛。而脉沉弦。为中湿。肢体重痛。微肿。汗出恶风。关节不利。不可转
侧。而脉缓。为风湿。遍身疼痛。脉弦小。或豁大。为气血虚损。
Body pain refers to pain felt throughout the entire body. Conditions such as Shanghan (Cold Damage), Huoluan (Stomach Intestine Turmoil), Zhongshu Yindu (Heatstroke with Yin Toxin), and Shibi Tongbi (Damp Bi Pain Syndrome) all present with body pain. However, differentiation must be made by observing accompanying symptoms, inquiring about the etiology, and examining the pulse. Specific treatment methods are detailed in their respective sections; for cases that are lingering and difficult to resolve, one may seek guidance here.
If body pain is caused by Cold, the painful areas are often cold to the touch or feel damp/heavy. Gancao Fuzi Tang (Licorice and Aconite Decoction) is indicated.
If internal injury from overwork is complicated by Wind-Dampness attacking each other, causing whole-body pain, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used with added Qianghuo (Notopterygii Rhizoma), Fangfeng (Saposhnikoviae Radix), Gaoben (Ligustici Wallichii Rhizoma), and Cangzhu (Atractylodis Rhizoma).
If Damp-Heat attacks each other, leading to heaviness in the shoulders and back, pain with upper-body heat sensation, chest and diaphragm discomfort, and heavy pain throughout the body, Danggui JianTong Tang (Angelica Joint-Pain Resolving Decoction) is indicated.
If Wind-Dampness attacks each other, causing whole-body pain, sweating due to internal Yin-Dampness, reluctance to speak, fatigue and weakness in the four limbs, and migratory pain, this is due to latent Fire in the Lower Jiao failing to vent, resulting in restlessness, slight sweating, but unresolved heat. Mahuang Fuxian Tang (Ephedra Double-Decoction) is indicated.
If the body feels stiff and cramped, it generally belongs to Deficiency-Cold, related to Cold-Damp or Wind-Damp. Xiaoxuming Tang (Minor Continuation of Life Decoction) should be modified according to the specific syndrome.
If chills and fever occur accompanied by generalized pain, along with fullness and discomfort in the chest and hypochondrium, this indicates Liver Blood Deficiency with constrained Fire acting up. Xiaoyao San (Free and Easy Wanderer Powder) should be used with added Qianghuo (Notopterygii Rhizoma) and Guizhi (Cinnamomi Ramulus). If urination is difficult, add Zhizi (Gardeniae Fructus) and Danpi (Moutan Cortex).
If the weather is hot and clothing is thick, causing pores to open and sweat to flow, pathogenic factors remain between the muscle layers. Accumulation of fluid droplets causes pain. Liuhe Tang (Six Harmonies Decoction) with added Qianghuo (Notopterygii Rhizoma) is indicated.
If whole-body pain resembles exhaustion syndrome, Shiquan Dabu Tang (Ten Complete Tonifying Decoction) should be used, removing Baizhu (Atractylodis Macrocephalae Rhizoma) and Shudi (Rehmanniae Radix Preparata), and adding Qianghuo (Notopterygii Rhizoma) and Fuzi (Aconiti Lateralis Radix Preparata).
For pain in the lower body, it is appropriate to separate and drain via urination. Wuling San (Five-Ingredient Powder with Poria) and Ermiao San (Two Marvels Powder) are primary formulas.
For swelling and pain in the lower body, with a floating pulse, spontaneous sweating, and aversion to wind, Fangji Huangqi Tang (Stephania and Astragalus Decoction) is indicated. Apply warm coverings to induce slight sweating.
If pain is accompanied by constipation, Nongpo Qiwu Tang (Magnolia Bark Seven-Ingredient Decoction) is used to gently promote bowel movement.
Zhu Danxi stated: Pain caused by the flow and injection of Damp-Phlegm and turbid blood, if located in the Lower Jiao where pathways are deep and distant, requires Wutou (Aconiti Radix) and Fuzi (Aconiti Lateralis Radix Preparata) to guide the medicine downward. These should be added in small amounts as guiding herbs. Using them as main therapeutic agents is not only ineffective but harmful. Skilled practitioners must move Qi and resolve Dampness, disperse Wind and guide out stagnation, nourish new Blood, and regulate the ascending and descending of Yin and Yang. Treatment must follow a sequence, distinguishing clearly whether swelling is present or not.
Swelling and pain in joints: Pain belongs to Fire, while swelling belongs to Dampness. This occurs when Wind-Cold is constrained and activated within the meridians, with Damp-Heat flowing into the joints without cessation. Initially, mild sweating should be induced to disperse the pathogen; thus, Qianghuo (Notopterygii Rhizoma) and Guizhi (Cinnamomi Ramulus) are essential herbs for joint pain.
Body pain accompanied by heaviness indicates Dampness. Wuling San (Five-Ingredient Powder with Poria) can be used to induce sweating. In cases of Wind-Dampness attacking each other with whole-body pain, add Qianghuo (Notopterygii Rhizoma), Fangfeng (Saposhnikoviae Radix), Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Gaoben (Ligustici Wallichii Rhizoma), and Cangzhu (Atractylodis Rhizoma), because Wind can overcome Dampness.
Patients suffering from pain should avoid rich flavors and meat, as these greatly assist Fire. If eating meat and rich foods exacerbates pain, along with fishy odors, noodles, sauces, alcohol, and vinegar, all should be strictly avoided.
Zhu Danxi said: Persistent pain at the Huantiao (GB30) acupoint warns of potential development of Aguta Yong (Bone-Attached Abscess). The treatment method involves digging a pit, heating it red with fire, pouring urine onto it, and having the patient sit naked on it, covering the lower body with blankets. The steaming heat opens the pores, allowing Qi and Blood to flow freely, leading to recovery.
[Diagnosis] In Shanghan (Cold Damage), if all six pulses are tight, it indicates a Taiyang exterior syndrome, with body pain severe as if beaten by a club. A sinking and tight pulse indicates Yin Toxin. After sweating therapy, if the pulse becomes wiry and slow with body pain, it indicates disharmony of Qi and Blood. Whole-body joint pain with a sinking and wiry pulse indicates Zhongshi (Middle Dampness). Heavy limb pain, slight swelling, sweating, aversion to wind, joint stiffness preventing turning, and a slow pulse indicate Fengshi (Wind-Dampness). Generalized body pain with wiry-small or large-empty pulses indicates Qi and Blood deficiency.