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Body pain is a syndrome present in all six channels (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin), manifesting as both exterior and interior syndromes, cold and heat syndromes, wind and dampness pathogenic factors. For instance, body pain caused by impaired circulation of Ying blood (Nutritive Blood) due to Taiyang Cold Damage is suitable for treatment via diaphoresis (sweating method). If, after sweating, the pulse becomes deep and slow accompanied by body pain, warming therapy should be employed.

Li Zhongzi pointed out: Body pain belonging to Baihu Tang (White Tiger Decoction) syndrome (excess heat in Yangming) should be resolved with Baihu Tang. For body pain characterized by interior cold with exterior false heat, one must first rescue the interior cold before attacking the exterior pathogen. When cold pathogens are in the three Yin channels, the pulse is deep, and body pain feels like being blown by wind; when in the three Yang channels, there is vexatious pain in the limbs and joints. Must one not carefully examine before using formulas such as Sini Tang (Frigid Extremities Decoction) or Chaihu Tang (Bupleurum Decoction)?

In Taiyang disease, body pain presents merely with stiffness and tension. Body pain caused by dampness involves heaviness of the body, making it difficult to turn or change position. Body pain from Yin Du (Yin Toxin) presents with extreme heaviness, as if beaten by a staff; these distinctions serve to differentiate the conditions.

Taiyang Disease: Fever, aversion to cold, and body pain belong to Taiyang disease, treatable with Mahuang Tang (Ephedra Decoction) or Da Qinglong Tang (Major Green Dragon Decoction) (for formula discussions, see Taiyang Disease Fever section below). If accompanied by a sensation of support and knotting beneath the heart, use Chaihu Jia Guizhi Tang (Bupleurum plus Cinnamon Twig Decoction). If accompanied by diarrhea with undigested food and abdominal distension, first warm the interior with Sini Tang, then release the exterior with Guizhi Tang (Cinnamon Twig Decoction). If the cunian pulse (radial pulse at the chi position) is slow, indicating blood deficiency and insufficient Ying Qi, *Ren Shu* suggests first nourishing blood with Huangqi Jianzhong Tang (Astragalus Decoction for Building the Middle), and only after the chi pulse recovers, use Chaihu Tang etc. for harmonization.

**Huangqi Jianzhong Tang Formula:**
Huangqi (Astragali Radix), Guizhi (Cinnamomi Ramulus) (each 1.5 qian), Baishao Yao (Paeoniae Radix Alba) (3 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (1 qian). The above four ingredients are decocted in 1 zhong (approx. 200ml) of water with 5 slices of Shengjiang (Zingiberis Rhizoma Recens) and 2 dates (Jujubae Fructus) until reduced to 0.8 zhong. Strain, add 1 large spoonful of thick maltose (Chixi), and simmer again before taking. Do not use maltose if there is a history of mild loose stools or vomiting.

Commentary: In cases of more heat than cold with a slow chi pulse, Ying blood is deficient. Using Huangqi in Huangqi Jianzhong Tang for blood deficiency relies on its sweet flavor; combined with Gancao, it greatly generates blood. This is a subtle method of Zhang Zhongjing. Generally, the nature of grain cultivation is sweet, and sweetness tonifies the Stomach. The Stomach is the sea of Qi and Blood, from which they arise. As stated in *Neijing*: "Without Yang, Yin cannot be generated." Using sweetness to tonify the Stomach to generate blood is profound. Modern practitioners only know that Renshen (Ginseng Radix) and Huangqi are Qi-tonifying herbs and thus use them to release the exterior.

After diaphoresis, if body pain persists with a deep and slow pulse, treat with Guizhi Ji Shaoyao Shengjiang Renshen Xinjia Tang (Modified Cinnamon Twig Decoction with Added Paeonia, Ginger, and Ginseng).
Guizhi (Cinnamomi Ramulus), Renshen (Ginseng Radix) (each 1.5 liang), Shaoyao (Paeoniae Radix), Shengjiang (Zingiberis Rhizoma Recens) (each 2 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (1 liang), Dazao (Jujubae Fructus) (6 pieces). Crush the herbs. Take 5 qian per dose, decoct in water, and take warm.

Cheng Wuji commented: Body pain after sweating indicates residual pathogen; deep and slow pulse indicates deficient Ying blood. The classics state: "A deep pulse indicates weak Ying Qi" and "A slow pulse indicates deficient Ying blood." Due to blood deficiency, Guizhi Tang is used to resolve the residual pathogen, while Shaoyao, Shengjiang, and Renshen are added to replenish the deficient blood.

Zhang Yuansu said: Some argue that the classics state excess exterior pathogen leads to floating and tight pulses and body pain, suitable for diaphoresis. Since body pain relates to residual exterior pathogen, why add Renshen, Shaoyao, and Shengjiang to tonify blood? I reply: Excess exterior pathogen causes body pain; blood deficiency also causes body pain. A floating and tight pulse indicates excess pathogen; a deep and faint pulse indicates blood deficiency. Excess is cured by reducing it; deficiency is cured by tonifying it. Whenever Zhang Zhongjing mentions post-diaphoresis symptoms without exterior signs or interior heat, leaving only body pain, if the pulse is slightly floating and vigorous, the exterior pathogen is not fully resolved. Here, the deep and slow pulse indicates blood deficiency, hence the addition of Renshen, Shengjiang, and Shaoyao to tonify blood.

Disease (Warming Method): Fever, headache, but a surprisingly deep pulse. If unrelieved and body pain persists, rescue the interior with Sini Tang (discussion in Fever section). After 8-9 days of Cold Damage, if Wind-Dampness intertwines, causing vexatious body pain and inability to turn independently, without vomiting or thirst, and with a floating, deficient, and choppy pulse, treat with Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction). (Cheng Wuji commented: By day 7-8 of Cold Damage or Wind Strike, pathogens often move inward, so body pain is usually absent. Persistent vexatious pain and immobility indicate Wind-Dampness intertwining. Vexation is Wind; pain/immobility is Dampness. Classics say: "Wind yields floating and deficient pulses." Pulse classics say: "Choppy pulses indicate Cold-Dampness." No vomiting/thirst means no interior pathogen. Floating, deficient, choppy pulse with bone/joint pain confirms Wind-Dampness in the meridians. Guizhi Fuzi Tang disperses Wind-Dampness from the exterior.)

**Guizhi Fuzi Tang Formula:**
Guizhi (Cinnamomi Ramulus, remove bark, 4 liang), Fuzi (Aconiti Lateralis Radix Praeparata, 3 pieces, processed, peeled, broken into 8 pieces), Shengjiang (Zingiberis Rhizoma Recens, 3 liang, sliced), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 2 liang), Dazao (Jujubae Fructus, 12 pieces, split). Decoct the five ingredients in 6 sheng (approx. 1200ml) of water to obtain 2 sheng. Strain and divide into three warm doses. (Cheng Wuji commented: Wind in the exterior is dispersed by the acrid-sweet nature of Guizhi and Gancao; Dampness in the meridians is driven out by the acrid-hot nature of Fuzi. Ginger and Dates, acrid-sweet, circulate Ying and Wei, regulate fluids, and harmonize the exterior.) If the patient has hard stool and spontaneous urination, remove Guizhi and add Baizhu Tang (Atractylodes Macrocephala Decoction). (Cheng Wuji commented: Guizhi induces sweating and depletes fluids. Spontaneous urination and hard stool indicate fluid deficiency; thus, remove Guizhi and add Baizhu.) If Wind-Dampness intertwines, causing vexatious joint pain, pulling pain, inability to flex/extend, severe pain upon touch, sweating, shortness of breath, dysuria, aversion to wind, reluctance to remove clothes, or slight edema, treat with Gancao Fuzi Tang (Licorice and Aconite Decoction).
Gancao (Glycyrrhizae Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 1 liang), Guizhi (Cinnamomi Ramulus, 2 liang), Fuzi (Aconiti Lateralis Radix Praeparata, 1 piece, processed). Crush and divide into four doses. Decoct in water and take warm. (*Ren Shu* notes: Add Fangfeng (Saposhnikoviae Radix) 1 liang for edema; add Baifuling (Poria) 1.5 liang for palpitations and dysuria.)

Yangming Disease: The patient desires food, yet urination is obstructed, stool is normal, bone/joint pain occurs, there is a slight fever, sudden mania ensues, followed by continuous sweating and resolution. This indicates Water failing to overcome Grain Qi, which combines with sweat. If the pulse is tight, recovery occurs (use Guizhi Tang).

Taiyin Disease: Wind Strike presenting with vexatious limb pain. A pulse that is slightly micro, slightly choppy, yet long indicates impending recovery.

Shaoyin Disease: Body pain, cold extremities, joint pain, and deep pulse indicate use of Fuzi Tang (Aconite Decoction). If Shaoyin disease progresses to day 4-5 with abdominal pain, dysuria, heavy/painful limbs, and spontaneous diarrhea, this indicates Water-Qi retention; use Zhenwu Tang (True Warrior Decoction).

Jueyin Disease: Profuse sweating, persistent fever, internal cramping, limb pain, diarrhea, cold extremities, and aversion to cold indicate use of Sini Tang.

Body Pain with Diarrhea (see Diarrhea section for formula discussion). Body Pain with Vomiting/Diarrhea indicates Huoluan (Food Poisoning/Colera); see Vomiting/Diarrhea section. Body Pain with cold extremities and deep pulse, with drowsiness, indicates Fuzi Tang (see "Desire to Sleep" section). Profuse sweating, persistent fever, internal cramping, diarrhea, and aversion to cold indicate Sini Tang (see Diarrhea section). Summerheat stroke in summer with deficient pulse and thirst indicates Baihu Jia Renshen Tang (White Tiger plus Ginseng Decoction) (see Summerheat section). Body pain as if beaten, blue complexion, sore throat indicates Yin Du (Yin Toxin); use Shengma Biejia Tang (Polygoni Multiflori and Turtle Shell Decoction, removing Xionghuang and Shujiao) (see Yin Du section).

Li Gao stated: For Wind-Dampness causing whole-body pain, use Buzhong Yiqi Tang (Middle-Boosting Qi-Rescuing Decoction) plus Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Shengma (Cimicifugae Rhizoma), Bencao (Ligustici Wallichii Rhizoma et Radix), and Cangzhu (Atractylodis Rhizoma). Discontinue once the illness passes, as wind-dispersing herbs damage Yuan Qi and exacerbate the condition.

Zhu Danxi stated: Shenzhu Tang treats Wind-Dampness with aversion to cold, tight pulse, and anhidrosis; Baizhu Tang treats Wind-Dampness with aversion to wind, slow pulse, and hyperhidrosis (both see Fever in Cold Damage section).
These two Atractylodes-based decoctions for Wind-Dampness require modification based on symptoms; details are in the Spasm section and following the descriptions of Baizhu Tang and Shenzhu Tang.

Hua Tuo (attributed in text as 'Huo', likely referring to a specific lineage or editor note, traditionally associated with *Ren Shu* or similar compilations, here translated as per context of authorship attribution in source): Xingren Tang (Apricot Kernel Decoction) treats Wind-Dampness body pain, aversion to wind, and slight edema.
Guizhi (Cinnamomi Ramulus, 2 liang), Mahuang (Ephedrae Herba, removed nodes, boiled/dried), Shaoyao (Paeoniae Radix), Tianmendong (Asparagi Radix, removed heart) (each 1 liang), Shengjiang (Zingiberis Rhizoma Recens, 1.5 liang), Xingren (Armeniacae Semen Amarum, 25 kernels, peeled/spiked, stir-fried). Crush. Take 5 qian per dose, decoct in water, take warm.

Li Gao stated: Mahuang Fujian Tang (Double-Decoction Ephedra Decoction) treats sweating in dark rooms, lethargy, limb fatigue/heaviness, wandering pain, caused by latent fire in the Lower Jiao unable to extend, floating/restless heat, sweating, and whole-body pain due to Wind-Dampness intertwining. Use Mahuang to induce gradual sweating; even pathogens in meridians benefit from this. Especially in spring, with slow/deep pulses, sweating is indicated to dispel Wind-Damp, raise Yang, relieve fatigue, and promote Qi/Blood vitality.
Mahuang (Ephedrae Herba, removed nodes, boil in 5 bowls water until boiling, skim foam/residue, reduce to 3 bowls, then add other herbs), Huangqi (Astragali Radix) (each 2 qian), Baizhu (Atractylodis Macrocephalae Rhizoma), Renshen (Ginseng Radix), Chaihu Gen (Bupleuri Radix), Fangfeng (Saposhnikoviae Radix), Sheng Dihuang (Rehmanniae Radix Recens) (each 5 fen), Qianghuo (Notopterygii Rhizoma et Radix), Huangbai (Phellodendri Cortex) (each 1 qian), Gancao (Glycyrrhizae Radix et Rhizoma), Xingren (Armeniacae Semen Amarum, 3 kernels, peeled/spiked). Crush, make one dose. Add to the Mahuang decoction, boil to 1 bowl, take before bed, avoid full stomach.

Danggui Niantong Tang (Angelica Pain-Numbing Decoction) treats body pain due to Damp-Heat (see Miscellaneous Diseases: Body Pain section).