脉 诸痛脉弦紧。痛甚则沉伏。兼浮者风。兼沉者气。兼数则热。兼迟则寒。两寸弦滑。头
痛。两寸浮紧。伤寒头痛。浮缓。伤风头痛。脉诀云∶头痛短涩应须死。浮滑风痰病易除。
仲景云∶头痛脉浮紧。属太阳。弦细属少阳。浮大而长。属阳明。沉属太阴。沉细属少阴。
沉缓属厥阴。东垣头痛论宜考。 阳微阴弦。短而数者。心痛。左寸弦紧胃脘当心而痛。右
寸滑而实。胃脘痰积而痛。两关弦大而芤者死血。沉细而迟者可治。浮大弦长者难治。 两
关脉弦为脾。疼痛必当心连于两胁。 腹痛脉多。细小紧急。阴弦则腹痛。尺脉弦急。小腹
痛。尺脉紧。脐下痛。两尺短涩属血虚。两尺沉微属气虚。弦为食。滑为痰。细为湿。数为
热。迟为寒。细小而迟者生。浮大而疾者死。 两手脉双弦者。肝气有余。两胁作痛。沉涩
属郁。细紧或弦者怒气。 腰痛之脉。多沉而弦。兼浮者风紧者寒。濡细为湿。实则挫闪。
左尺脉大为肾虚。涩为瘀血。滑疾为痰。 脉促上擎者。肩背痛。寸关洪而大。沉而滑者。
皆主肩背痛。
症 头痛之候。东垣论之详矣。按东垣云。东风生于春。病在肝。 在颈项。故春气者病在
头。又诸阳会于头面。夫风泛上受之。风寒伤于上。邪从外入。客于经络。令人振寒头痛
。身重恶寒。治在风池风府。调其阴阳。不足则补。有余则泻。汗之则愈。此伤寒头痛
也。头痛耳鸣。九窍不利者。肠胃之所生。气虚头痛也。心烦头痛者。病在耳。过在手。巨
阳少阴。乃湿热头痛也。如气上不下。头疾颠疾。下虚上实也。过在足少阳。巨阳甚则入肾
。此寒湿头痛也。如头半寒痛者。先取手少阳阳明。此偏头痛也。其真头痛者。甚则脑甚痛。
手足寒至节。死不治。有厥逆头痛者。所犯大寒。内至骨髓。髓者以脑为主。胸逆故令头痛。
齿亦痛。凡头痛皆以风药治之者。以风药能上行也。又有伤风头痛。或半边偏疼。皆因风冷
所伤。遇风冷即发。其脉浮。食积痛者。因胃中有阴冷宿食不化。上攻而疼。其脉右寸紧盛
气虚者。因下部气虚上攻。温温而痛。异乎邪毒所致。其脉浮。症各不同。宜详辨而治之。
丹溪云、心痛即胃脘痛。有热厥寒厥。大实死血食积痰虫之类。机要云∶热厥心痛。身热
足寒。甚则烦躁而吐。额自汗出。脉洪可汗。刺太溪昆仑寒厥。心痛手足逆。通身冷汗。便
溺清利。不渴。气脉微弱。可温。术附汤。厥逆心疼者。寒邪伤心包络也。良姜菖蒲辛热之
剂主之。大实心痛。卒然发痛。大便或秘。久而注闷。心腹高起。按之则痛。不能饮食。可
下。煮雄丸利之。属痛者。痛则懊 发作。肿聚往来。上下行痛。有休作。痛定即能食。时
作时止。涎出。呕清水。面色乍青乍白乍赤。是痰者。隐然痛。而小便不利。得辛热汤则暂
止也。戴氏又云。死血痛者。痛有常处。不动移者是食积痛者。痛甚欲大便。便后痛减者是
。宜详审之。 脾疼者。起于心口。连于两胁。呕吐不食。乃肝木火甚。乘于脾土也。亦有
挟痰与火者。大抵因七情所触者多。 腹痛丹溪云∶有沉寒积热。死血气滞。食积虫痰之异
。亦有风寒暑湿。冷热泻痢。香港脚五脏血气攻刺。积聚疝瘕淋秘。饮食客忤。等痛。必审虚
实而施治也。戴氏又云∶绵绵痛而无增减者寒也。时作时止者热也。脉微自汗。得食而略定
者虚也。宜补。脉弦实。大痛不休者实也。宜下。或上或下或往或来。痛无定处。喜温而恶
寒者气也。宜散其余。死血食积痰虫。皆与心痛相类。故不细录。宜详辨之。 胁痛左属肝
有余。右属肺不足。有余则乘脾土土虚则不能生金。金不足。则木无所制。而反欺土。故治
必以制肝为主。丹溪云∶有肝木气实火盛。有死血。有痰有郁。注云∶木气实火盛者。或因
怒气伤肝。肝气大逆。或风中于肝。皆使木气实生火。火盛则肝急而胁痛。死血者。因瘀血
恶血。血停留于肝。归于胁下。而痛多在左。其候则自汗而痛。按之益甚。痰者。因痰积流
注于厥阴之经。亦使胁下痛。肺病则咳而急引。胁下痛郁者。因谋不决。或因怒气逆于经络
而不散。亦令胸胁作痛。须详别之。 腰痛戴氏云∶久痛不已者。肾虚也。日轻夜重者。瘀
血也。遇天阴雨而痛。或久坐而痛者湿也。四肢缓。足寒逆。腰冷如冰。冷汗精滑扇痛。是
湿热也。大抵因于房室过伤而肾虚者为多。盖肾虚则火旺。火旺则阴愈消。不能营养。故作
痛也。久而不治。则成骨痿。盖腰者。肾之府。乃一身之大关节。故经曰转摇不能。肾将惫
矣。又或六气乘虚而外入。七情感触而内伤。如恣志伤肾。郁怒伤肝。或负重损伤或行走
脞闪。瘀血蓄而不行。皆使气停血滞。着而成病矣。 肩背痛因风热乘肺太阴经。肺气郁甚
不行。病则颊颔肿。颈项肩 肘臂外后 痛。汗出。小便数而欠者。皆风湿乘肺也。小便遗失
者。皆肺金虚也。痛不可回顾者。此太阳经气郁而不行。以风药散之。脊背项强。腰似折。项似
拔。此是太阳经不通。如身重沉沉然。此寒湿也。宜疏风
。胜湿。泻火。和血。顺气。若伤湿流于关节。遍身尽痛者。治如上法。
治 按东垣治法云∶头痛之候。惟多以风药治效者何。盖高巅之上。惟风可到。故味之薄者
。乃阴中之阳。自地升天者也。然亦有三阴三阳之异。故太阳头痛恶风。脉浮紧。川芎、羌
活、独活、麻黄为主。少阳经头痛。脉弦细往来寒热。小柴胡为主。阳明头痛。自汗。发
热恶寒。脉浮缓长实者。升麻、葛根、石膏、白芷为主。太阴头痛。必有痰体重。或腹痛
为痰癖。其脉沉缓。苍术、半夏、南星为主。少阴头痛。三阴三阳。经不流行而足寒气逆
而寒厥。其脉沉细。麻黄、附子、细辛为主。厥阳头项痛。或吐痰沫。厥冷。其脉浮缓。
吴茱汤主之。血虚头痛。川芎、当归为主。气虚头痛。人参、黄 为主。气
血俱虚。调中益气。少加川芎、蔓荆子、细辛、之类。又白术、半夏、天麻汤、治痰厥头
痛药也。清空膏、乃风热头药也。羌活附子汤、厥阴药也。如湿气在上者。以苦药吐之。全
在活法。不可执方而治。 心痛丹溪云∶须分新久。若明知身犯寒气。口食冷物。于初得之
时。便宜温散。如草豆蔻丸之类。稍久。则成郁热。原病式中论之详矣。若欲行温散。宁无
助火为病乎。故古方多以山栀为主。加热药为向导。则邪易伏。病易退。正气复而愈矣。以
二陈，加川芎、苍术、干姜、焙栀子、煎服。予曾试验极妙。大实心痛者。金花丸主之。
或煮雄丸下之。死血痛者。桃仁承气汤下。食积痛者。备急丸主之。痰者吐之。梨芦末一
钱、入暇汁半碗、探吐得痰尽为妙、属痛者。理中汤加乌梅主之。或苦楝根、锡灰、槟榔、鹤风
草之类。为丸治之。脾疼者。制肝扶脾为主。越鞠二陈汤。加海石丸服效。 腹痛属寒者
宜温。吴茱萸、干姜之类。甚者四逆汤。属热者。清痰降火。二陈、芩连山栀、白芍药、顺气。木香槟榔、枳壳、香附、
或越鞠丸，加木香、槟榔、
亦可。死血者行血。川芎、当归、桃仁、红花、木香、玄胡索、甚者。桃仁承气汤、下之。
食积痛。宜消导之。白术白芍药、木香、砂仁、青皮、煎汤吞下保和丸。甚者。木香槟榔丸
下之。痰者、二陈加枳实山栀。属痛者。苦楝根槟榔、鹤风之类。或理中汤。加乌梅亦佳。
其余风寒暑湿泻痢。时气。五脏攻刺。疝瘕淋秘等腹痛。自有本条。大抵腹痛宜分三阴部
而治。中脘太阴。脐腹少阴。小腹厥阴。初起必推荡之。虚与久病。宜升宜消。 胁痛肝木
气实火盛。白芍药、当归、山栀、川芎、龙胆草、柴胡、青皮、或泻青丸、死血宜行血为主。
润血为佐。桃仁、红花牡丹皮、川芎、当归、香附、青皮、玄明粉、大黄润而下之。痰者。
二陈，加南星、白芥子、枳实、香附、川芎郁。用越鞠丸，加青皮、咳而痛。二陈加青黛、
栝蒌、姜汁、右胁痛。二陈，加枳壳、片芩、贝母、两胁痛。发寒热者。小柴胡汤，加青皮
、诸胁痛。必以柴胡、枳壳、青皮为主。 腰痛肾虚者最多。大补阴丸。加杜仲、牛膝、
枸杞子、五味子、猪脊髓丸、服。或用青娥煨肾丸、房劳精不足者。斑龙丸、痰者行痰。香
附、半夏、贝母、湿者。燥湿。杜仲、苍术桑寄生、川独活、黄柏、之类。瘀血者。顺而消
之。当归、杜仲、木香、桃仁、郁怒忧思而痛者。当归、贝母、香附、侧柏叶、杜仲、黄柏
、大抵诸腰痛。不宜补气药。及寒凉药。亦有外感因虚而袭。如太阳少阴多中寒。阳明太阴
多燥湿。少阳厥阴多风热。临症尤宜详审。腰胯痛。多是湿痰流注经络。故气不和而痛。宜
苍术、黄柏、木瓜主之。肾着者。体重腰冷如冰。饮食如故。小便自利。此下伤寒湿所致
。宜渗湿。兼温散理中。去人参，加苍术、茯苓主之。 肩背痛或一身尽痛。皆风寒湿热
乘肺也。宜通经络。益元气。散风泻火。宜羌活胜湿汤。加附子、防己主之。或粘痛汤亦
好。
方 加味芎归汤治诸头痛。根据后加减。
川芎（一钱） 当归（一钱五分） 柴胡（一钱） 半夏（一钱五分） 甘草（三分） 防风（八分）
羌活（八分） 黄芩 黄连（各一钱酒浸炒）
上作一服。姜三片。煎。食后服。
太阳经头痛。加麻黄（一钱五分）、葱白（五根）、倍羌活，去黄连、少阳经头痛。倍柴胡，去
羌活、黄连。
阳明经头痛。加升麻（五分）、石膏（一钱五分）、白芷（八分）
太阴头痛。加苍术、白术（各一钱□分）、南星（一钱）、天麻（八分）
少阴头痛。加细辛（七分）、蔓荆子（一钱），去黄连。
厥阴头痛。加干姜（七分）、吴茱萸（八分），去羌活、芩连
血虚头痛。加天麻、白芍药、生地黄（各一钱），去羌活、柴胡、黄连
气虚头痛。加人参、黄 （各一钱），去羌活、柴胡、芩连
气血俱虚。加参 、白术、天麻（各一钱五分）、熟附（五分）、蔓荆子（八分）、细辛（五分）、
去羌活、柴胡黄连。
火盛头痛。根据本方。加石膏（二钱）、酒蒸大黄（三钱）。
痰厥头痛。加南星、石膏（各一钱五分）、倍半夏、甚者。吐法效。
诸头痛。加入川芎、 本、蔓荆子、白芷、细辛、并用此五味足矣。
又方 越鞠二陈汤治心痛。胃脘痛。脾疼。腹痛。胁痛。并宜加减用之。
川芎（一钱） 苍术（一钱二分） 香附（醋浸炒） 山栀（炒半黑各一钱五分） 半夏（一钱二分）
陈皮（一钱） 甘草（三分） 干姜（炒黑一钱）
上作一服。水一钟半。姜三片。煎。不拘时服。
属寒而痛者。加丁香、草豆蔻（各一钱）、甚者。再加熟附子（一钱）
属热而痛者。加吴萸（炒）、黄连（一钱）、酒炒黄芩（一钱）、甚者。宜加大黄（三钱）、白芍药、
（一钱五分）、桂枝、五分
属痰者。加枳实（一钱五分）、倍半夏、或用吐法。尤妙。
郁怒痛。加桂枝、青皮（各七分）、白芍药（一钱五分）。
食积痛。加枳实、山楂（各一钱五分）、萝卜子、砂仁（各八分）、神曲（一钱）。
气不顺而痛。加木香（七分）、槟榔、乌药（各一钱）。
死血痛。加枳壳、当归尾、桃仁（各一钱五分）、大黄（三钱）、浓朴（一钱），去川芎、半夏、陈
皮、干姜。
妇人产后痛。加桃仁、牡丹皮、当归（各一钱五分）红花、玄胡索（各八分）、木香（五分）
属痛。加槟榔、雷丸（各一钱）、或用苦楝丸、或理中汤加乌梅。
脾痛。加海石（一钱五分）、青皮（一钱）、桂（五分）、或丸或散皆可。
腹痛。亦宜分三阴部分加减。中脘属太阴。加浓朴、半夏、脐腹少阴。加桂、木香、玄胡索
、小腹厥阴。加吴茱萸、官桂、白芍药。各随症轻重。度而用之。
虚者理中汤。实者桂枝大黄汤。寒热相并。大痛脉沉。
细实者。附子理中汤。合大承气汤。温而下之。
其余寒热。气血。郁怒。食积。痰蠹。治法皆与心痛同。胁痛左属肝木盛。加白芍药、龙胆
草、柴胡（各一钱二分）、青皮（七分）。
右胁痛。属肺火与痰。加贝母、枳壳、白芥子（各一钱）。
咳而胁痛。加贝母、白茯苓（各一钱）、白芥子、青黛（各八分）、姜汁（半盏）。
瘀血攻注胁痛。桃仁承气汤。加桂枝芍药、青皮、润而下之。
气郁胁痛。加木香（七分）、枳壳、青皮（各一钱）。
胁前发寒热者。本方去干姜，加柴胡、黄芩（各一钱五分）、青皮（八分）。
又方 当归羌活汤诸腰痛胯痛。香港脚及肩背身体痛。并宜加减用之。
当归 羌活 独活 柴胡 防风 杜仲 桑寄生（各等分） 桂（减半）
上作一服。姜枣煎。食远服。
如卧寒湿地腰痛。恐是太阳少阴血络中有凝血。加当归尾、苍术、桃仁、牛膝、防己（各
等分）。
湿热腰痛。加黄柏、木瓜、苍术、川芎（各等分）。
Pulse: The pulse of various pains is mostly wiry and tight. When the pain is severe, the pulse may appear deep and hidden. If accompanied by a floating pulse, it indicates wind pathogen; if accompanied by a deep pulse, it indicates qi stagnation; if accompanied by a rapid pulse, it indicates heat syndrome; if accompanied by a slow pulse, it indicates cold syndrome. A wiry and slippery pulse at both Cun positions (Cun position, radial artery pulse point) indicates headache. A floating and tight pulse at both Cun positions indicates headache due to Cold Damage (Shanghan). A floating and moderate pulse indicates headache due to Wind Strike (Shangfeng). *Mai Jue* (Classic of Pulse Diagnosis) states: "Headache with short and choppy pulse should be considered fatal; headache with floating and slippery pulse indicates easy cure for wind-phlegm disease." Zhang Zhongjing stated: "Headache with floating and tight pulse belongs to Taiyang Disease; wiry and thin pulse belongs to Shaoyang Disease; floating, large, and long pulse belongs to Yangming Disease; deep pulse belongs to Taiyin Disease; deep and thin pulse belongs to Shaoyin Disease; deep and moderate pulse belongs to Jueyin Disease." Dong Yuan's *Treatise on Headache* is worth consulting. A pulse that is weak in Yang and wiry in Yin, or short and rapid, indicates Heart Pain. A wiry and tight pulse at the left Cun position indicates stomach epigastrium pain centered at the heart. A slippery and solid pulse at the right Cun position indicates stomach epigastrium pain due to phlegm accumulation. A wiry, large, and hollow pulse at both Guan positions (Guan position, radial artery pulse point) indicates fixed blood stasis (Dead Blood), with a poor prognosis; a deep, thin, and slow pulse is treatable. A wiry pulse at both Guan positions indicates Spleen disease, where pain must occur from the epigastrium radiating to both hypochondria. Abdominal pain pulses vary, often appearing small, fine, urgent, and tight. A Yin pulse being wiry indicates abdominal pain. A wiry and urgent Chi pulse (Chi position, radial artery pulse point) indicates lower abdominal pain. A tight Chi pulse indicates periumbilical pain. A short and choppy pulse at both Chi positions indicates Blood Deficiency; a deep and faint pulse at both Chi positions indicates Qi Deficiency. A wiry pulse indicates food retention; slippery indicates phlegm; fine indicates dampness; rapid indicates heat; slow indicates cold. A small, fine, and slow pulse suggests survival; a floating, large, and rapid pulse suggests death. Bilateral double-wiry pulses indicate Liver Qi excess, causing pain in both hypochondria. A deep and choppy pulse indicates Qi depression; a fine, tight, or wiry pulse indicates anger. The pulse of lumbar pain is mostly deep and wiry. Accompanied by floating indicates wind; accompanied by tight indicates cold; soggy and fine indicates dampness; excess indicates sprain/strain injury. An enlarged left Chi pulse indicates Kidney Deficiency; choppy indicates blood stasis; slippery and rapid indicates phlegm. A surging pulse lifting upwards indicates shoulder and back pain. A洪 (surging) and large pulse at Cun and Guan positions, deep and slippery, all indicate shoulder and back pain.
Symptoms: The symptoms of headache are discussed in detail by Li Dong Yuan. According to Li Dong Yuan: East wind arises in spring, affecting the Liver, manifesting in the neck and nape, so spring pathogens affect the head. Furthermore, all Yang meridians converge on the head and face. Wind pathogens ascend and invade; wind-cold damages the upper body, pathogens enter from outside and lodge in the collaterals, causing chills, headache, heavy body, and aversion to cold. Treatment should focus on Fengchi (GB20) and Fengfu (GV16) acupoints, harmonizing Yin and Yang, tonifying deficiency, reducing excess, and inducing sweating for recovery. This is headache due to Cold Damage. Headache with tinnitus and dysfunction of the nine orifices originates from the intestines and stomach, indicating Qi Deficiency headache. Heart vexation with headache involves the ears and hand meridians, belonging to the Taiyang (Greater Yang) and Shaoyin meridians, indicating Damp-Heat headache. If Qi rises but does not descend, leading to head disorders and mania, it is a Lower Deficiency and Upper Excess syndrome, involving the Foot Shaoyang meridian; when Taiyang is severe, it enters the Kidney, indicating Cold-Damp headache. For half-head cold pain, first treat Hand Shaoyang and Yangming meridians; this is hemi-cephalgia (migraine). True headache is severe, with intense brain pain and cold hands and feet extending to joints; it is a fatal untreatable condition. Jue Ni headache occurs after exposure to severe cold, with cold penetrating to the bone marrow; since marrow is governed by the brain, cold counterflow causes headache and toothache. All headaches treated with wind-dispelling herbs do so because these herbs ascend. Wind-strike headache or unilateral pain is caused by wind-cold invasion, occurring upon exposure, with a floating pulse. Food retention pain is caused by cold undigested food in the stomach attacking upwards, with a tight and full right Cun pulse. Qi Deficiency pain is caused by lower Qi deficiency attacking upwards, feeling warm and painful, distinct from toxic pathogens, with a floating pulse. Symptoms vary; treatment requires detailed differentiation. Zhu Dan Xi said: Heart pain is epigastric pain. There are Heat Jue, Cold Jue, as well as Excess, Blood Stasis, Food Retention, and Phlegm-Worm types. *Ji Yao* states: Heat Jue heart pain presents with hot body and cold feet, irritability, vomiting, forehead sweating, and a洪 pulse; sweating method can be used, needling Taixi (KI3) and Kunlun (BL60). Cold Jue heart pain presents with cold extremities, whole-body cold sweat, clear urination and defecation, no thirst, and weak pulse; warming method can be used, using Shu Fu Tang. Jue Ni heart pain is caused by cold pathogen damaging the Pericardium, treated with warm acrid herbs like Galangal Rhizome and Acorus. Acute Excess heart pain presents with sudden onset, constipation, distension, elevated heart/abdomen, tenderness, and inability to eat; purgative method can be used, using Zhu Xiong Wan. Roundworm pain presents with agonizing attacks, migratory swelling/pain, intermittent episodes, ability to eat when pain subsides, salivation, vomiting clear water, and fluctuating complexion (blue, white, red); this is Phlegm pain. Dull pain with difficult urination, temporarily relieved by warm acrid decoctions, also indicates phlegm. Dai Shi said: Fixed blood stasis pain has a constant location without movement; food retention pain worsens with urge to defecate and improves after defecation. Careful examination is required. Spleen pain starts at the epigastrium, radiates to both hypochondria, with vomiting and anorexia, caused by Liver Wood Fire overacting on Spleen Earth. It may also involve phlegm and fire, mostly triggered by emotional factors. Abdominal pain, Zhu Dan Xi said, includes Cold Accumulation, Heat Accumulation, Blood Stasis, Qi Stagnation, Food Retention, and Phlegm-Worm differences. It also includes wind-cold-damp-heat, cold-heat diarrhea/dysentery, podagra, five-zang Qi/Blood stabbing pain, accumulations, hernias, strangury, and dietary intolerance. Deficiency and excess must be differentiated for treatment. Dai Shi said: Continuous pain without change is Cold; intermittent pain is Heat; micro pulse with spontaneous sweating, slightly relieved by eating, is Deficiency (tonify); wiry and solid pulse with unceasing severe pain is Excess (purge). Migratory pain favoring warmth and fearing cold is Qi pain (disperse). Other types like blood stasis, food retention, and phlegm-worm resemble heart pain and are not detailed here; careful differentiation is needed. Hypochondriac pain on the left indicates Liver excess; on the right indicates Lung deficiency. Excess overacts on Spleen Earth; Earth deficiency fails to generate Metal; Metal deficiency fails to control Wood, which then bullies Earth. Thus, treatment must focus on subduing the Liver. Zhu Dan Xi said: Causes include Liver Qi excess with Fire Hyperactivity, blood stasis, phlegm, and depression. Note: Liver Qi excess and Fire Hyperactivity result from anger injuring the Liver causing Qi rebellion, or wind invading the Liver, generating Fire. Fire hyperactivity causes Liver tension and hypochondriac pain. Blood stasis results from stagnant blood lodging in the Liver and hypochondrium, usually left-sided, with spontaneous sweating and worsening upon pressure. Phlegm lodges in the Jueyin meridian causing hypochondriac pain. Lung disease causes cough and pulling pain in the hypochondrium. Depression results from indecision or angry Qi stagnating in collaterals, causing chest and hypochondriac pain. Differentiation is essential. Lumbar pain, Dai Shi said: Chronic pain indicates Kidney Deficiency; worse at night than day indicates blood stasis; pain during rainy days or after prolonged sitting indicates dampness. Flaccid limbs, cold feet, icy cold waist, cold sweat, seminal emission, and fan-like pain indicate Damp-Heat. Mostly caused by sexual excess leading to Kidney Deficiency. Kidney Deficiency leads to Fire Hyperactivity, consuming Yin, failing to nourish, causing pain. Untreated, it becomes Bone Withering. The waist is the mansion of the Kidney and a major joint; thus, the classics state: inability to twist and turn indicates impending Kidney exhaustion. External pathogens entering via deficiency or internal injuries from emotions (e.g., desire injuring Kidney, anger injuring Liver), physical trauma, or sprains cause Qi stagnation and Blood stasis, forming disease. Shoulder and back pain is caused by wind-heat invading the Lung Taiyin meridian, causing severe Lung Qi depression, cheek/jaw swelling, neck/nape/shoulder/elbow/arm outer-posterior pain, sweating, frequent but scant urination, all indicating wind-damp invading the Lung. Urinary incontinence indicates Lung Metal deficiency. Inability to look back indicates Taiyang meridian Qi depression, treated with wind-dispersing herbs. Spine/back stiffness, waist feeling like breaking, neck feeling like pulling, indicates Taiyang meridian blockage. Heavy body feeling indicates cold-damp. Treatment should dispel wind, overcome dampness, purge fire, harmonize blood, and regulate Qi. If dampness flows into joints causing whole-body pain, treat as above.
Treatment: According to Li Dong Yuan's methods: Why are wind-dispersing herbs effective for headache? Because high peaks can only be reached by wind; thus, light-flavored herbs are Yang within Yin, ascending from earth to heaven. However, there are differences among the Three Yin and Three Yang meridians. Taiyang headache with aversion to wind and floating-tight pulse uses Chuanxiong, Qianghuo, Duhuo, Ma Huang. Shaoyang meridian headache with wiry-thin pulse and alternating chills/fever uses Xiao Chai Hu Tang. Yangming headache with spontaneous sweating, fever, aversion to cold, and floating-moderate-long-solid pulse uses Shengma, Gegen, Shigao, Baizhi. Taiyin headache with phlegm, heavy body, or abdominal pain/phlegm-pi, and deep-moderate pulse uses Cangzhu, Banxia, Nanting. Shaoyin headache with non-flowing Three Yin/Yang meridians, cold feet/reversal, and deep-thin pulse uses Ma Huang, Fuzi, Xixin. Jue Yang head/neck pain with phlegm spitting, cold reversal, and floating-moderate pulse uses Wu Zhu Yu Tang. Blood deficiency headache uses Chuanxiong, Danggui. Qi deficiency headache uses Renshen, Huangqi. Combined Qi/Blood deficiency uses Tiao Zhong Yi Qi Tang with minor additions of Chuanxiong, Man Jing Zi, Xixin. Bai Zhu, Banxia, Tian Ma Tang treats Phlegm Jue headache. Qing Kong Gao treats wind-heat headache. Qianghuo Fuzi Tang treats Jueyin disease. For dampness above, use bitter emetics. Flexibility is key; do not stick to one formula. Heart pain, Zhu Dan Xi said: Distinguish new vs. old. If caused by cold exposure/diet initially, use warm dispersants like Caodoukou Wan. Later, it becomes depressed heat (*Yuan Bing Shi*). Warm dispersants might aid fire; thus, ancient formulas use Gardenia (Zhizi) as main herb with warm guides to subdue pathogens, restore Zheng Qi. Er Chen Tang plus Chuanxiong, Cangzhu, Ganjiang, roasted Zhizi is effective. Acute excess heart pain uses Jin Hua Wan or Zhu Xiong Wan. Blood stasis pain uses Tao Ren Cheng Qi Tang. Food retention pain uses Bei Ji Wan. Phlegm pain uses emesis (Li Lu powder + maltose juice). Roundworm pain uses Li Zhong Tang plus Wumei, or Kuan Pi Gen, Xi Hui, Bing Lang, She Wei Cao pills. Spleen pain focuses on subduing Liver and supporting Spleen, using Yue Ju Er Chen Tang plus Hai Shi pills. Abdominal pain due to Cold uses warming herbs like Wu Zhu Yu, Ganjiang; severe cases use Si Ni Tang. Heat uses clearing phlegm/fire (Er Chen Tang + Huang Qin, Lian Lian, Zhizi, Baishao) and regulating Qi (Mu Xiang Bin Lang Wan, Zhi Ke, Xiang Fu, or Yue Ju Wan + Mu Xiang, Bing Lang). Blood stasis uses moving blood (Chuanxiong, Danggui, Tao Ren, Hong Hua, Mu Xiang, Yan Hu Suo); severe cases use Tao Ren Cheng Qi Tang. Food retention uses digestion/promotion (Baizhu, Baishao, Mu Xiang, Sharen, Qingpi decoction swallowing Bao He Wan); severe cases use Mu Xiang Bin Lang Wan. Phlegm uses Er Chen Tang + Zhishi, Zhizi. Roundworm uses Kuan Pi Gen, Bing Lang, She Wei Cao, or Li Zhong Tang + Wumei. Other abdominal pains (wind-cold-damp-heat, dysentery, epidemic, organ stabbing, hernia, strangury) have specific sections. Generally, abdominal pain is treated by dividing into Three Yin zones: Zhongwan (Taiyin), Qifu (Shaoyin), Xiaofu (Jueyin). Early stage requires purging; deficiency/chronic cases require ascending and resolving. Hypochondriac pain due to Liver excess/fire uses Baishao, Danggui, Zhizi, Chuanxiong, Longdan Cao, Chaihu, Qingpi, or Xie Qing Wan. Blood stasis uses moving blood (Taoren, Honghua, Mudanpi, Chuanxiong, Danggui, Xiangfu, Qingpi, Xuanshengfen, Dahuang). Phlegm uses Er Chen Tang + Nanxing, Baijiezi, Zhishi, Xiangfu. Depression uses Yue Ju Wan + Qingpi. Cough with pain uses Er Chen Tang + Qingdai, Gualou, Jiangzhi. Right hypochondriac pain uses Er Chen Tang + Zhiqiao, Huangqin, Beimu. Bilateral hypochondriac pain with chills/fever uses Xiao Chai Hu Tang + Qingpi. All hypochondriac pain prioritizes Chaihu, Zhiqiao, Qingpi. Lumbar pain due to Kidney Deficiency is most common, using Da Bu Yin Wan + Duzhong, Niuxi, Gouqizi, Wuweizi, Pig Marrow Pills, or Qing'e Weishen Wan. Sexual exhaustion uses Banlong Wan. Phlegm uses Xiangfu, Banxia, Beimu. Dampness uses drying dampness (Duzhong, Cangzhu, Sangjisheng, Duhuo, Huangbai). Blood stasis uses moving/resolving (Danggui, Duzhong, Muxiang, Taoren). Emotional pain uses Danggui, Beimu, Xiangfu, Ce Baiye, Duzhong, Huangbai. Generally, lumbar pain avoids Qi-tonics and cold-cooling herbs. External pathogens invading via deficiency: Taiyang/Shaoyin often Cold; Yangming/Taiyin often Dry/Damp; Shaoyang/Jueyin often Wind-Heat. Careful diagnosis is crucial. Waist/hip pain is often damp-phlegm flowing into collaterals, causing Qi disharmony, treated with Cangzhu, Huangbai, Mugua. Kidney Fixation (Shenzhe) presents with heavy body, icy cold waist, normal diet, free urination, caused by lower jiao cold-damp, treated with draining dampness and warming/dispatching (Li Zhong Tang minus Renshen, plus Cangzhu, Fuling). Shoulder/back pain or whole-body pain is caused by wind-cold-damp-heat invading Lung, requiring collaterals unblocking, Qi boosting, wind-dispersing, fire-purging, using Qianghuo Shengshi Tang + Fuzi, Fangji, or Niantong Tang.
Formulas: Modified Xiong Gui Tang treats various headaches, modified as follows:
Chuanxiong (1 qian), Danggui (1.5 qian), Chaihu (1 qian), Banxia (1.5 qian), Gancao (0.3 qian), Fangfeng (0.8 fen), Qianghuo (0.8 fen), Huangqin & Huanglian (1 qian each, wine-fried stir-baked).
One dose, decoct with 3 slices of ginger, take after meals.
Taiyang meridian headache: Add Mahuang (1.5 qian), Congbai (5 roots), double Qianghuo, remove Huanglian.
Shaoyang meridian headache: Double Chaihu, remove Qianghuo, Huanglian.
Yangming meridian headache: Add Shengma (0.5 fen), Shigao (1.5 qian), Baizhi (0.8 fen).
Taiyin headache: Add Cangzhu, Baizhu (1.2 qian each), Nanting (1 qian), Tianma (0.8 fen).
Shaoyin headache: Add Xixin (0.7 fen), Manjingzi (1 qian), remove Huanglian.
Jueyin headache: Add Ganjiang (0.7 fen), Wuzhuyu (0.8 fen), remove Qianghuo, Huangqin/Huanglian.
Blood deficiency headache: Add Tianma, Baishao, Shengdihuang (1 qian each), remove Qianghuo, Chaihu, Huanglian.
Qi deficiency headache: Add Renshen, Huangqi (1 qian each), remove Qianghuo, Chaihu, Huangqin/Huanglian.
Combined Qi/Blood deficiency: Add Renshen, Baizhu, Tianma (1.5 qian each), Shufu (0.5 fen), Manjingzi (0.8 fen), Xixin (0.5 fen), remove Qianghuo, Chaihu, Huanglian.
Fire hyperactivity headache: Based on base formula, add Shigao (2 qian), Jiuzheng Dahuang (3 qian).
Phlegm Jue headache: Add Nanxing, Shigao (1.5 qian each), double Banxia; severe cases, emesis is effective.
Various headaches: Add Chuanxiong, Gaben, Manjingzi, Baizhi, Xixin; these five herbs suffice.
Another Formula: Yue Ju Er Chen Tang treats heart pain, epigastric pain, spleen pain, abdominal pain, hypochondriac pain, modified as needed.
Chuanxiong (1 qian), Cangzhu (1.2 qian), Xiangfu (vinegar-soaked stir-baked), Zhizi (roasted half-black, 1.5 qian each), Banxia (1.2 qian), Chenpi (1 qian), Gancao (0.3 qian), Ganjiang (roasted black, 1 qian).
One dose, decoct with 1.5 zhong water and 3 ginger slices, take anytime.
Cold pain: Add Dingxiang, Caodoukou (1 qian each); severe, add Shufu (1 qian).
Heat pain: Add Wuzhuyu (stir-fried), Huanglian (1 qian), Jiuchao Huangqin (1 qian); severe, add Dahuang (3 qian), Baishao (1.5 qian), Guizhi (0.5 fen).
Phlegm pain: Add Zhishi (1.5 qian), double Banxia; or use emesis, especially effective.
Depression/Anger pain: Add Guizhi, Qingpi (0.7 fen each), Baishao (1.5 qian).
Food retention pain: Add Zhishi, Shanzha (1.5 qian each), Luobozhi, Sharen (0.8 fen each), Shenqu (1 qian).
Qi stagnation pain: Add Muxiang (0.7 fen), Binglang, Wuyao (1 qian each).
Blood stasis pain: Add Zhiqiao, Dangguiwei, Taoren (1.5 qian each), Dahuang (3 qian), Houpo (1 qian), remove Chuanxiong, Banxia, Chenpi, Ganjiang.
Postpartum pain: Add Taoren, Mudanpi, Danggui (1.5 qian each), Honghua, Yanhusuo (0.8 fen each), Muxiang (0.5 fen).
Roundworm pain: Add Binglang, Leiwan (1 qian each), or Kuanpi Wan, or Li Zhong Tang + Wumei.
Spleen pain: Add Haishi (1.5 qian), Qingpi (1 qian), Rougui (0.5 fen); pills or powder acceptable.
Abdominal pain: Divide by Three Yin. Zhongwan (Taiyin): Add Houpo, Banxia. Qifu (Shaoyin): Add Guizhi, Muxiang, Yanhusuo. Xiaofu (Jueyin): Add Wuzhuyu, Guigui, Baishao. Dosage based on severity.
Deficiency: Li Zhong Tang. Excess: Guizhi Dahuang Tang. Cold-Heat combined, severe pain, deep/thin/solid pulse: Fuzi Li Zhong Tang combined with Da Chengqi Tang, warm and purge.
Other cold-heat, Qi-blood, depression, food retention, phlegm treatments are same as heart pain. Left hypochondriac pain (Liver excess): Add Baishao, Longdancao, Chaihu (1.2 qian each), Qingpi (0.7 fen). Right hypochondriac pain (Lung fire/phlegm): Add Beimu, Zhiqiao, Baijiezi (1 qian each). Cough with hypochondriac pain: Add Beimu, Baifuling (1 qian each), Baijiezi, Qingdai (0.8 fen each), Jiangzhi (0.5 zhong). Blood stasis invading hypochondriac pain: Tao Ren Cheng Qi Tang + Guizhi, Shaoyao, Qingpi, moisten and purge. Qi depression hypochondriac pain: Add Muxiang (0.7 fen), Zhiqiao, Qingpi (1 qian each). Hypochondriac front with chills/fever: Base formula minus Ganjiang, add Chaihu, Huangqin (1.5 qian each), Qingpi (0.8 fen).
Another Formula: Danggui Qianghuo Tang treats lumbar pain, hip pain, podagra, shoulder/back/body pain, modified as needed.
Danggui, Qianghuo, Duhuo, Chaihu, Fangfeng, Duzhong, Sangjisheng (equal parts), Rougui (half amount).
One dose, decoct with ginger and jujube, take far from meals.
Lumbar pain from lying on cold/damp ground, suspecting blood stasis in Taiyang/Shaoyin collaterals: Add Dangguiwei, Cangzhu, Taoren, Niuxi, Fangji (equal parts).
Damp-heat lumbar pain: Add Huangbai, Mugua, Cangzhu, Chuanxiong (equal parts).