夫太阳、少阴、厥阴皆有身痛。当以外证与脉别之。太阳证表未解。脉浮紧。法当身体
痛。宜麻黄汤以汗之。
（脉浮紧当身体疼痛。宜以汗解。假令尺脉迟者。不可发汗。何以知其然。荣气不出。
血少故也。尺脉迟者。先以小建中汤以养之。脉浮者。麻黄汤主之。）
太阳中湿。一身尽痛。发热身黄。小便不利。病患中湿。因而伤风。风湿相搏。一身痛
肿。是名风湿。当于风湿中求之。
（麻黄加术汤主之。）
若脉沉。自利而身体痛者。阴证也。急当救里。宜四逆汤。附子汤。真武汤之类以温之。
（大抵大便利而身体疼者。当救里。大便如常而体疼者。急当救表。此不可不知也。）
或身重背强。腹中绞痛。咽喉不利。身如被杖者。当作阴毒治之。又问。发汗后身疼痛。
脉沉而迟。当用何药。仲景有桂枝芍药生姜人参新加汤。盖为此证也。小建中汤。兼治汗后
身疼。脉沉而迟者。若霍乱吐泻止。而身疼痛不休者。少与桂枝汤即愈。金匮要略云。疮家
虽身体痛。不可发汗。汗出则 。又问身痒者何也。脉浮而迟。迟为无阳。不能作汗。其身
必痒。太阳病。七八日。脉微而恶寒。以阴阳俱虚。不可更发汗更下更吐也。
（小柴胡汤主之。若重反发汗。则气虚。必两耳聋无闻。可芍药甘草附子汤。素有热人。
可黄 建中汤。）
面赤有热者。未欲解也。以其不能得小汗出。身必当痒。宜桂枝麻黄各半汤。
歌曰。胁痛多属少阳家。燥粪阳明并小柴。里水痞坚须十枣。阴胁引痛脏中乖。
胁肋痛满者。邪气在半表半里之间也。邪方传里。即将为实。气郁不行。法当和解。若
夫里水痛坚。非下之不可也。少阳病。胁痛。耳聋。寒热。干呕。或胁下坚满。并用小柴胡
汤和解之。
阳明病之解。传入少阳。胁下坚满。干呕。小柴胡汤。又阳明燥粪。不大便。胁下坚满。
舌上胎滑。小柴胡汤。太阳病。咳嗽。干呕。微利。心下痞硬。引胁下痛。身凉汗出。或时
头疼。此为表解里有水。十枣汤下之。病者胁下痛。素有痞积在于脐旁。引小腹入阴筋俱作
痛。此为脏结。不治。
身疼浮紧太阳临。自利肝并肾带沉。中湿毒因与风湿。其余霍乱本条寻。
局方。大柴胡证云。邪结在里。大便秘涩。心腹痛硬者。可服。若身体疼痛。是表证未
解。不可与之。然则身体疼痛。不脉沉。不自利。太阳之表证明矣。其或自利。脉沉。此则
阴证之身痛。脏家之里病云。
身痛。大抵多是表证。太阳身痛。脉浮紧。无汗。麻黄汤以汗之。或只脉迟者。血不足
也。先用小建中汤以养之。俟其尺脉浮。即用麻黄汤。
病七八日。脉细恶寒。为阴阳俱虚。吐汗下并不可治。在其人素无热。可芍药甘草附子
汤。素有热。可黄 建中汤。厥阴、少阳身痛。其脉沉。必自利。四逆汤。真武汤。附子汤。
中湿一身尽痛。不可汗下。但利小便。有本条。阴毒身痛。如被杖。腹中绞痛。脉沉而疾。
有本条。风湿一身痛重。但微汗。不可大发汗。有本条。发汗后身痛。脉沉迟者。桂枝加芍
药人参汤。汗后身痛。为寒邪在表。脉沉迟。为在里。用芍药入荣人参。安和真气。或用黄
建中汤。又汗后霍乱。身痛不休。少与桂枝汤。
方
解肌汤 治伤寒往来寒热。有时肢节烦疼者。
恒山（二两） 柴胡（四两） 知母 甘草 青蒿子 桃枝（各一两） 桂 生姜（二两） 乌
梅（十二枚） 葱白 薤白（各三寸） 柳枝（一握） 鳖甲（醋炙去裙 二两） 上以水
一斗二
防风汤 治少阳病。筋牵急而疼痛。发作有时。此为痹也。
防风 甘草（各一两炙） 天南星 生姜（二两炙） 上以水四升。煮取二升。去滓。
温服
合。日三服。
六物解肌汤 治伤寒发热身痛。
葛根（四两） 茯苓（三两） 麻黄 牡蛎 生姜（各二两） 甘草（一两） 上 咀。
以水八
煮取三升。分三服。再
服得汗通。即止。古今录验。无生姜、甘草。忌酢物。
参苓散 治伤寒。治百节疼。一切虚劳气疾。并宜服之。
人参（二两） 茯苓（一两） 白术（二十两锉） 桔梗（十两去芦） 橘红（六两） 香
白芷
（二两去芦） 川芎（一两半） 半夏（一两汤洗七次） 浓朴（二两
桂（去皮
春
夏三两秋冬四两） 枳壳
（四两麸炒令黄同桂杵为末） 干姜（春
三两） 上件一处焙干。除官桂、
枳壳别杵
须是匀。
取出。以净纸衬。安板床上候冷。勿令侵尘土。入前枳壳、官桂、川芎。和匀。杵为细末。
每服一钱。水一盏。生姜三片。葱二寸。煎七分。通口服。不拘时候。
阳旦汤 治伤寒肢节疼痛。内寒外热。心下虚烦。
芍药 甘草（各二两） 干姜 黄芩（各三两） 桂心（四两） 大枣（十五枚） 上
咀。以
一斗。煮取五升。去滓。
温服一升。日三服。夜再服。令小汗出。瘥。
黄 建中汤 治伤寒身痛。尺脉迟。及汗后身痛。脉弱。
黄 桂（各一钱半） 白芍药（三钱） 甘草（一钱） 上以水二钱。姜五片。枣二
枚。煎
。去滓。入稠饧一大
匙。再煎尽。温服。旧有微溏。或呕者。不用饧。
人参顺气散 治丈夫妇人风虚气弱。荣卫不和。肢节疼痛。身体沉重。头目眩晕。
肩背拘急。手足冷麻。半身不遂。口眼歪斜。痰涎不利。言语謇涩。或脾胃不和。心腹
刺痛。胸膈痞满。倦怠少力。霍乱转筋。吐泻不止。胎前产后。并宜服之。
干姜 人参（各一两） 川芎（去芦头） 甘草（炙） 白术（去芦） 苦梗（去芦） 浓
朴（去
皮姜汁制） 陈皮（洗去白）
白芷 麻黄（去节） 干葛（去芦各四两） 上为细末。每服二
枚。
薄
荷五七叶。同煎八分。不
拘时候。如伤寒感风冷。头疼腰
Taiyang (Sun-Yang), Shaoyin (Lesser-Yin), and Jueyin (Terminal-Yin) meridians can all present with body pain. Differentiation should be made based on external manifestations and pulse conditions. In Taiyang syndrome, the exterior pathogen has not yet resolved; the pulse is floating and tight. According to the principles, body pain should occur, and Mahuang Tang (Ephedra Decoction) is appropriate to induce sweating for resolution.
(The pulse is floating and tight with body pain, suitable for resolution by sweating. If the chi (cun-kou) pulse is slow, sweating must not be induced. Why is this known? Because Ying (Nutrient) Qi cannot reach the exterior due to blood deficiency. For those with a slow chi pulse, Xiaojianzhong Tang (Minor Construct the Middle Decoction) should first be used to nourish. If the pulse is floating, Mahuang Tang is the primary formula.)
In Taiyang disease complicated by dampness, the entire body feels painful, accompanied by fever, yellowing of the skin, and difficult urination. When a patient contracts dampness and subsequently suffers from wind injury, wind-dampness combats each other, causing whole-body pain and swelling; this is named Wind-Dampness. One should seek treatment within the context of Wind-Dampness protocols.
(Mahuang Jia Zhu Tang [Ephedra plus Atractylodes Macrocephala Decoction] is indicated.)
If the pulse is deep, with spontaneous diarrhea and body pain, it is a Yin syndrome. Urgent rescue of the interior is required. Sini Tang (Four Counterflow Decoction), Fuzi Tang (Aconite Decoction), Zhenwu Tang (True Warrior Decoction), and similar warming formulas should be used.
(Generally, if stool is loose but body pain persists, rescue the interior first; if stool is normal but body pain exists, urgently rescue the exterior. This must not be ignored.)
Alternatively, if there is heaviness of the body, stiffness of the back, cramping abdominal pain, difficulty in the throat, and a sensation as if beaten by a club, treat as Yin Du (Yin Toxin). Another question arises: After sweating, if body pain persists with a deep and slow pulse, what medicine should be used? Zhang Zhongjing provided Guizhi Shaoyao Shengren Xinjia Tang (Cinnamon Twig, Peony, Ginseng, and Fresh Ginger Modified Decoction), which addresses this specific syndrome. Xiaojianzhong Tang also treats post-sweating body pain with a deep and slow pulse. If vomiting and diarrhea from Huoluan (Cholera-like disorder) cease but body pain continues, a small dose of Guizhi Tang (Cinnamon Twig Decoction) will bring recovery. The *Jin Gui Yao Lue* states: Even if a patient with sores experiences body pain, do not induce sweating; doing so leads to... (text missing, likely referring to spasms or complications). Another question: What causes body itching? A floating and slow pulse indicates "No Yang" (insufficient Yang Qi), inability to produce sweat, resulting in inevitable body itching. In Taiyang disease, after seven or eight days, if the pulse is faint and aversion to cold exists, it is due to deficiency of both Yin and Yang; further sweating, purging, or emesis are contraindicated.
(Xiaochaihu Tang [Minor Bupleurum Decoction] is indicated. If repeated improper sweating occurs, Qi deficiency results, inevitably leading to bilateral deafness. Shaoyao Gancao Fuzi Tang [Peony, Licorice, and Aconite Decoction] may be used. For those with inherent heat, Huangqi Jianzhong Tang [Astragalus and Middle-Constructing Decoction] is suitable.)
Facial redness with heat indicates the pathogen has not yet resolved. Because slight sweating cannot be achieved, the body will likely itch. Guizhi Mahuang Ge Ban Tang (Half-Guizhi Half-Mahuang Decoction) is appropriate.
The verse states: Hypochondriac pain mostly belongs to Shaoyang; dry feces involve Yangming and require Xiaochaihu Tang for harmonization. Interior water retention with hard痞 (mass) requires Shizao Tang (Ten Jujube Decoction) for purging. Pain radiating from hypochondriac regions due to Yin-cold indicates dysfunction of the Zang organs.
Hypochondriac pain and fullness indicate pathogenic factors between the exterior and interior. As the pathogen transmits inward, it is about to become excess; Qi stagnation prevents movement, requiring harmonization. However, if interior water retention causes hardness and pain, purgation is necessary. For Shaoyang syndrome with hypochondriac pain, deafness, alternating chills and fever, dry retching, or hardness/fullness under the hypochondrium, Xiaochaihu Tang is used to harmonize.
When Yangming syndrome resolves and transmits to Shaoyang, presenting with hardness/fullness under the hypochondrium and dry retching, use Xiaochaihu Tang. Additionally, in Yangming dry feces syndrome with constipation, hardness/fullness under the hypochondrium, and a slippery tongue coating, Xiaochaihu Tang is also used. In Taiyang syndrome with cough, dry retching, mild diarrhea, epigastric hardness radiating to the hypochondrium, cool body with sweating, or occasional headache, the exterior is resolved but interior water exists; Shizao Tang is used to purge. If a patient has hypochondriac pain, a pre-existing mass near the umbilicus radiating pain to the lower abdomen and genitalia, this is Zangjie (Zang Knotting), which is untreatable.
Body pain with a floating-tight pulse characterizes Taiyang presentation. Spontaneous diarrhea with a deep pulse involves Liver, Kidney, and Dai Mai (Girdle Vessel). Damp-toxin and Wind-Dampness cause body pain; refer to relevant sections for Huoluan.
According to the *Ju Fang*, regarding Dachaihu Tang syndrome: If pathogen is bound in the interior with constipation and hard abdominal pain, it may be taken. However, if body pain exists, the exterior syndrome is unresolved, and it must not be given. Thus, body pain without a deep pulse or spontaneous diarrhea confirms clear Taiyang exterior syndrome. If spontaneous diarrhea and deep pulse exist, it is Yin syndrome body pain, an internal Zang pathology.
Body pain is generally mostly an exterior syndrome. Taiyang body pain with floating-tight pulse and no sweating is treated with Mahuang Tang to induce sweat. If only the pulse is slow, indicating blood insufficiency, Xiaojianzhong Tang is used first to nourish. Once the chi pulse becomes floating, Mahuang Tang is then applied.
After seven or eight days of illness, if the pulse is fine and aversion to cold exists, it indicates deficiency of both Yin and Yang; emesis, sweating, and purging are all contraindicated. For those without inherent heat, Shaoyao Gancao Fuzi Tang is suitable. For those with inherent heat, Huangqi Jianzhong Tang is suitable. In Jueyin and Shaoyang body pain with deep pulse and spontaneous diarrhea, Sini Tang, Zhenwu Tang, and Fuzi Tang are used. For dampness causing whole-body pain, sweating and purging are forbidden; only promoting urination is allowed, as per specific clauses. For Yin Du body pain resembling being beaten, with cramping abdominal pain and rapid-deep pulse, refer to specific clauses. For Wind-Dampness causing heavy body pain, only slight sweating is allowed, not vigorous sweating, as per specific clauses. Post-sweating body pain with deep-slow pulse is treated with Guizhi Ji Shaoyao Renshen Xinjia Tang. Post-sweating body pain indicates cold pathogen in the exterior; deep-slow pulse indicates involvement of the interior; use Peony to enter Ying and Ginseng to harmonize True Qi. Alternatively, Huangqi Jianzhong Tang may be used. In post-sweating Huoluan with persistent body pain, a small dose of Guizhi Tang is given.
Formulas:
Jieji Tang (Release the Muscle Decoction): Treats Shanghan with alternating chills and fever, and occasional vexing pain in limbs and joints.
Heshan (2 liang), Chaihu (4 liang), Zhimu, Gancao, Qinghaozi, Taozhi (1 liang each), Guizhi, Shengjiang (2 liang), Wumei (12 pieces), Congbai, Xiebai (3 cun each), Liuzhi (1 handful), Biejia (vinegar-processed, remove skirt, 2 liang). Decoct in 1 dou 2 sheng of water.
Fangfeng Tang (Saposhnikovia Decoction): Treats Shaoyang syndrome with tendon pulling, urgency, and pain occurring at intervals. This is Bi syndrome.
Fangfeng, Gancao (1 liang each, honey-fried), Tiannanxing, Shengjiang (2 liang, fried). Decoct in 4 sheng of water to obtain 2 sheng, remove dregs, take warm. Combine and take three times daily.
Liuwu Jieji Tang (Six-Ingredient Release Muscle Decoction): Treats Shanghan with fever and body pain.
Gegen (4 liang), Fuling (3 liang), Mahuang, Muli, Shengjiang (2 liang each), Gancao (1 liang). Cut into pieces, decoct in 8 sheng of water to obtain 3 sheng, divide into three doses. Take again until sweat flows smoothly, then stop. Ancient records verify this formula without Shengjiang and Gancao; avoid vinegar products.
Shenling San (Ginseng and Poria Powder): Treats Shanghan, pain in all joints, and all deficiency-labor Qi disorders. Suitable for general use.
Renshen (2 liang), Fuling (1 liang), Baizhu (20 liang, chopped), Jiegeng (10 liang, remove rhizome), Juhong (6 liang), Xiangbaizhi (2 liang, remove rhizome), Chuanxiong (1.5 liang), Banxia (1 liang, washed seven times in hot water), Houpo (2 liang, ginger-juice processed), Rougui (peeled, 3 liang in spring/summer, 4 liang in autumn/winter), Zhike (4 liang, bran-fried until yellow, pounded together with Rougui into powder), Ganjiang (3 liang in spring/summer). Roast all ingredients together until dry. Remove Guanrougui and Zhike separately. Ensure uniformity. Take out, line with clean paper, place on board to cool, avoiding dust. Add previous Zhike, Guanrougui, and Chuanxiong, mix evenly, pound into fine powder. Take 1 qian per dose with 1 zhan of water, 3 slices of Shengjiang, 2 cun of Congbai, decoct to 7 fen, take orally. No time restriction.
Yangdan Tang (Yang Dawn Decoction): Treats Shanghan with limb/joint pain, internal cold with external heat, and epigastric emptiness/vexation.
Shaoyao, Gancao (2 liang each), Ganjiang, Huangqin (3 liang each), Guixin (4 liang), Dazao (15 pieces). Cut into pieces, decoct in 1 dou of water to obtain 5 sheng, remove dregs. Take 1 sheng warm, three times daily, twice at night. Induce slight sweating for recovery.
Huangqi Jianzhong Tang (Astragalus and Middle-Constructing Decoction): Treats Shanghan body pain, slow chi pulse, and post-sweating body pain with weak pulse.
Huangqi, Guizhi (1.5 qian each), Baishaoyao (3 qian), Gancao (1 qian). Decoct in 2 sheng of water with 5 slices of Shengjiang and 2 dates. Remove dregs, add 1 large spoon of thick maltose, boil until consumed, take warm. If previously having mild diarrhea or vomiting, omit maltose.
Renshen Shunqi San (Ginseng and Qi-Promoting Powder): Treats men and women with wind-deficiency and Qi weakness, Ying-Wei disharmony, limb/joint pain, heavy body, dizziness, shoulder/back stiffness, cold/numb hands/feet, hemiplegia, facial deviation, phlegm obstruction, speech difficulty, spleen-stomach disharmony, stabbing heart/abdominal pain, chest/diaphragm fullness, fatigue, Huoluan with muscle cramps, continuous vomiting/diarrhea, and pre/post-natal conditions. Suitable for all.
Ganjiang, Renshen (1 liang each), Chuanxiong (remove rhizome), Gancao (fried), Baizhu (remove rhizome), Kugeng (remove rhizome), Houpo (peel, ginger-juice process), Chenpi (wash remove white pith), Baizhi, Mahuang (remove nodes), Gange (remove rhizome, 4 liang each). Pound into fine powder. Take 2 qian per dose with 5-7 leaves of Bohe, decoct in 8 fen of water. No time restriction. For Shanghan contracting wind-cold with headache and waist...