Library

Although arm pain is a minor condition, it is essential to distinguish between excess (Shi) and deficiency (Xu), as such conditions are the most difficult to differentiate. What does an excess pattern look like? The pain remains fixed in one location for a long time, situated outside the skin and hair follicles, causing suffering that worsens upon palpation, accompanied by thirst and constipation; this is caused by pathogenic factors. Using herbs that dispel wind, clear fire, and resolve phlegm will naturally be effective. If not treated thus, the pain may increase. I treat it with Waiqu Decoction: after one dose, the pain lightens; after two doses, it decreases; after three doses, it resolves, allowing the pathogen to exit from where it entered. What does a deficiency pattern look like? The pain is not fixed, wandering here and there or shifting from left to right; it alleviates with percussion and soothes with massage; sometimes it manifests with visible shapes or discoloration/scars; the mouth is certainly not thirsty, yet phlegm accumulation deepens; the intestines are certainly dry, yet urination is clear and copious; this results from the deficiency of true Qi and the stagnation and consolidation of phlegm-Qi. If one uses wind-dispelling formulas when there is no wind in the body, or fire-clearing medicines when the constitution lacks excess fire, or phlegm-resolving agents when the righteous Qi is already deficient, the phlegm will be difficult to remove. One must use herbs that strengthen the Spleen and tonify the Kidney, then assist them with items that dispel wind, clear fire, and resolve phlegm, achieving immediate results. The formula used is Wei Bi San. This formula does not directly treat arm pain but instead nourishes the Liver and benefits the Kidney. With Water and Wood nourished, they naturally do not overact upon Earth; with the Spleen Qi robust, it can naturally move the four limbs, so how could arm pain arise?

Waiqu Decoction
Atractylodis Macrocephalae Rhizoma (5 qian), Saposhnikoviae Radix (3 qian), Gardeniae Fructus Preparatus (3 qian), Schizonepetae Spica (3 qian), Pinelliae Tuber (3 qian), Linderae Radix (3 qian), Glycyrrhizae Radix et Rhizoma (1 qian), Paeoniae Radix Alba (3 qian). Decoct in water and take orally.

Wei Bi San
Astragali Radix (1 liang), Angelicae Sinensis Radix (5 qian), Saposhnikoviae Radix (1 qian), Brassicae Semen Album (3 qian), Paeoniae Radix Alba (5 qian), Poria (5 qian), Rehmanniae Radix Praeparata (5 qian), Lycii Fructus (3 qian), Coicis Semen (3 qian). Decoct in water and take orally.

Pain in both feet also has excess and deficiency patterns. The symptoms are similar to those of the arms but with slight differences, as the feet are located inferiorly and are prone to contracting dampness-water pathogens. The generation of an excess pattern necessarily involves edema; if pressing causes the skin and flesh to sink like mud, it is an excess pattern. The generation of a deficiency pattern involves contracting dampness-water without resulting in pitting edema; the bones feel sour, pain comes and goes, and over time the knees enlarge while the legs swell; this is a deficiency pattern. For an excess pattern, one should drain the water using Kansui Radix and Pharbitidis Semen, each 2 qian, decocted in water and taken orally, obtaining immediate effect; there is no need to wait for severe swelling before treating. For a deficiency pattern, one must not drain water but rather tonify Qi while promoting diuresis, warm the Fire while simultaneously treating Wind; this is the appropriate approach. The formula used is Gu Zu San. The brilliance of this formula lies in using Qi-regulating herbs to strengthen Qi; once Qi is strong, diuresis occurs naturally, expelling water and making it difficult for pathogens to remain.

Gu Zu San
Astragali Radix (1 liang), Coicis Semen (1 liang), Euryales Semen (5 qian), Atractylodis Macrocephalae Rhizoma (1 liang), Plantaginis Semen (5 qian), Cinnamomi Cortex (5 fen), Saposhnikoviae Radix (5 fen), Poria (5 qian), Brassicae Semen Album (5 qian). Decoct in water and take orally.