【内伤腋痛之症】无外感之邪，但两腋下作痛，或见咳嗽气逆，此内伤腋痛之症也。
【内伤腋痛之因】或恼怒怫郁，肝火刑金；或膏粱积热，熏蒸肺气；或房劳不谨，肾
火上冲。皆成内伤腋痛之症。
【内伤腋痛之脉】寸口脉大，肺气有伤。右关洪数，膏粱积热。脉沉而结，肺气
【内伤腋痛之治】若恼怒伤肝，木火刑金，加味泻白散。膏粱积热，土中之火刑金，
加味清胃汤，倍川连、枳壳。房劳不谨，水中之火刑金，家秘天地煎，合黄芩泻白散、二母汤。
加味泻白散
桑白皮 地骨皮 甘草 黄芩 柴胡 钩藤 苏梗 桔梗 山栀
加味清胃汤
升麻 川连 甘草 葛根 石膏 桑白皮 枳壳 地骨皮
家秘天地煎
天冬 地黄 黄柏 知母 川贝母 甘草 麦冬 桑白皮 地骨皮
水煎三四次，冲玄武胶收。
黄芩泻白散 即泻白散加黄芩。
二母汤 即贝母、知母，二味同煎。
秦子曰∶《内经》云∶西风生于秋，病在肺， 在肩背。则肩背之痛，乃肺之分野；且
手阳明大肠之脉，循臂上廉，上肩出 骨之前廉，上出柱骨，下入缺盆络肺，其支别者
，从缺盆，上颈贯颊。又云∶手太阳小肠之脉，出肩解，绕肩胛，交肩上，入缺盆，其支别
者，从缺盆循颈，上颊。按此论之，则肩背肺俞之痛，乃肺与大小肠为患矣。故肺病则缺盆
中痛，肩背痛；大肠病，则耳后肩 肘臂皆痛；小肠病，则肩 肘臂肿痛。故凡背
部肺 作痛，要分别右左二 ，外感内伤，有余不足。若右肺 缺盆痛，此肺与大肠之症；
若左肺 缺盆痛，乃是肺与小肠症也，以左右而分大肠小肠。至肺 ，则左右皆属肺也。然
太阳膀胱之脉，亦在于背，但膀胱太阳之病，满背皆痛，不比肺痛，止在肺 缺盆也。
[Symptoms of Internal Injury Axillary Pain] Without external pathogenic factors, there is pain in both axillae, or accompanied by cough and rebellious qi; this constitutes the syndrome of internal injury axillary pain.
[Etiology of Internal Injury Axillary Pain] It may result from anger and depression, causing Liver Fire to insult Lung Metal (Wood insulting Metal); or from accumulation of heat due to rich and greasy diet, steaming and affecting Lung Qi; or from imprudence in sexual activity, causing Kidney Fire to rush upward. All these lead to the syndrome of internal injury axillary pain.
[Pulse Diagnosis of Internal Injury Axillary Pain] The pulse at Cun Kou (Radial Artery) is large, indicating injury to Lung Qi. The pulse at Right Guan (Radial Artery position corresponding to Spleen/Stomach) is surging and rapid, indicating heat accumulation from rich food. The pulse is deep and knotted, indicating [Lung Qi obstruction/injury - text incomplete].
[Treatment of Internal Injury Axillary Pain] If anger injures the Liver, with Wood Fire insulting Lung Metal, use Jia Wei Xie Bai San (Modified Draining White Powder). If heat accumulates from rich diet, with Earth Fire insulting Lung Metal, use Jia Wei Qing Wei Tang (Modified Stomach-Clearing Decoction), doubling the dosage of Chuan Lian (Coptis Rhizome) and Zhi Qiao (Aurantium Fructus). If imprudence in sexual activity causes Water Fire to insult Lung Metal, use Jia Mi Tian Di Jian (Secret Heaven-Earth Decoction), combined with Huang Qin Xie Bai San (Scutellaria Modified Draining White Powder) and Er Mu Tang (Two Mother Decoction).
Jia Wei Xie Bai San (Modified Draining White Powder)
Sang Bai Pi (Morus Alba Root Bark), Di Gu Pi (Lycium Bark), Gan Cao (Licorice Root), Huang Qin (Scutellaria Root), Chai Hu (Bupleurum Root), Gou Teng (Uncaria Ramulus Cum Uncis), Su Geng (Perilla Stem), Jie Geng (Platycodon Root), Shan Zhi (Gardenia Fruit).
Jia Wei Qing Wei Tang (Modified Stomach-Clearing Decoction)
Sheng Ma (Cimicifugae Rhizoma), Chuan Lian (Coptidis Rhizoma), Gan Cao (Licorice Root), Ge Gen (Puerariae Radix), Shi Gao (Gypsum Fibrosum), Sang Bai Pi (Mori Cortex), Zhi Qiao (Aurantii Fructus), Di Gu Pi (Lycii Cortex).
Jia Mi Tian Di Jian (Secret Heaven-Earth Decoction)
Tian Dong (Asparagi Radix), Di Huang (Rehmanniae Radix), Huang Bo (Phellodendri Cortex), Zhi Mu (Anemarrhenae Rhizoma), Chuan Bei Mu (Fritillariae Cirrhosae Bulbus), Gan Cao (Licorice Root), Mai Dong (Ophiopogonis Radix), Sang Bai Pi (Mori Cortex), Di Gu Pi (Lycii Cortex).
Decoct in water three to four times, and take with dissolved Xuan Wu Jiao (Testudinis Carapax et Plastrum / Tortoise Shell Glue).
Huang Qin Xie Bai San (Scutellaria Modified Draining White Powder) is Xie Bai San plus Huang Qin.
Er Mu Tang (Two Mother Decoction) consists of Bei Mu (Fritillariae Bulbus) and Zhi Mu (Anemarrhenae Rhizoma), decocted together.
Qin Zi stated: The *Nei Jing* (Inner Canon) says: "West wind arises in autumn, disease affects the Lung, manifesting in the shoulder and back." Therefore, pain in the shoulder and back belongs to the domain of the Lung. Furthermore, the Hand-Yangming Large Intestine Meridian follows the lateral aspect of the arm, ascends to the shoulder, emerges anterior to the humerus, ascends to the vertebral column, descends into the Supraclavicular Fossa (Que Pen), and connects with the Lung. Its branch from the Supraclavicular Fossa ascends the neck and penetrates the cheek. It also states: the Hand-Taiyang Small Intestine Meridian exits the shoulder joint, circles the scapula, intersects at the shoulder, enters the Supraclavicular Fossa. Its branch from the Supraclavicular Fossa follows the neck to the cheek. Based on this discussion, pain in the shoulder and back at the Lung Shu area is caused by disorders of the Lung, Large Intestine, and Small Intestine. Thus, Lung disease causes pain in the Supraclavicular Fossa and shoulder/back pain; Large Intestine disease causes pain behind the ear, shoulder, elbow, and arm; Small Intestine disease causes swelling and pain in the shoulder, elbow, and arm. Therefore, for pain in the back at the Lung area, one must distinguish between the right and left sides, and differentiate between external contraction and internal injury, excess and deficiency. If the right Lung area and Supraclavicular Fossa are painful, this is a syndrome of the Lung and Large Intestine; if the left Lung area and Supraclavicular Fossa are painful, it is a syndrome of the Lung and Small Intestine, distinguishing Large and Small Intestines by left and right. As for the Lung itself, both sides belong to the Lung. However, the Foot-Taiyang Bladder Meridian is also located in the back, but Bladder Taiyang disease involves pain across the entire back, unlike Lung pain which is confined to the Lung area and Supraclavicular Fossa.