臂痛者,因湿痰横行经络也。
二术汤 治痰饮双臂痛者,又治手臂痛,是上焦湿痰横行经络中作痛也。
苍术(米泔浸炒一钱半) 白术(去芦) 南星 陈皮 茯苓(去皮) 香附 酒芩 威灵仙 羌活
甘草(各一钱) 半夏(姜制,二钱)
上锉一剂,生姜煎服。
臂痛者,因风寒湿所搏也。或睡后,手在被外,为寒邪
所袭,遂令臂痛及妇人以臂枕而伤于风寒而致臂痛,悉根据后三方选用。
五积散 治臂痛因于寒者(方见中寒。)
乌药顺气散 治臂痛因于风者(方见中风。)
蠲痹汤 治臂痛因于湿者,兼治风湿相搏,身体烦疼,手足冷痹,四肢沉重。
当归 赤芍 黄 羌活 姜黄 防风 甘草(炙。各等分)
上锉一剂,生姜三片,水煎服。
滋荣调中汤 治臂痛及腰酸,或有时作疼。陈皮(盐水洗去白,八分) 白茯苓(去皮)
白术(去芦。各一钱) 半夏 白芍 酒芩 酒柏 牛膝(酒洗,去芦。各七分) 木瓜(盐水炒,七分)
当归(酒洗,一钱) 川芎(盐汤浸,五分) 羌活(六分) 知母(酒炒,六分) 桂枝(三分) 防风
(去芦,五分)
上锉一剂,生姜三片,水煎,食远服。
脉∶经云∶洪而大脉促上紧者,肩背痛;沉而滑者,痰痛(方见后豁痰汤。)
背痛者,痰气之所聚也。
参合汤 治背心一点痛。
陈皮 半夏(姜汁炒) 茯苓(去皮) 乌药 枳壳(麸炒) 僵蚕(炒) 川芎 白芷 麻黄 桔梗
(去芦) 干姜(减半) 紫苏 香附 苍术(米泔浸) 羌活(各等分) 甘草(减半)
上锉剂,生姜煎服。
肩背痛,不能回顾者,太阳气郁而不行也。
通气防风汤 治肩背痛,用风药以散之。
本(一钱) 防风 羌活(二钱) 独活(二钱) 川芎(一钱) 蔓荆子
(六分) 甘草(六分)
上锉一剂,水煎服。如身重腰沉、经中有寒湿,加酒浸防己一钱,轻者炮附子、重者炮川乌各五分。
豁痰汤 治肩背疼痛。
半夏(制) 栀子(炒,各一钱) 陈皮 海桐皮 枳壳(各八分) 桔梗 赤芍 苍术(制) 香附
(各七分) 茯苓(去皮,六分) 川芎 姜黄(各五分) 甘草(二分)
上锉,生姜煎,食远热服。如痛甚,头剂加朴硝二钱。
二术汤:治疗因痰饮导致的双臂疼痛,也治疗手臂疼痛,这是上焦湿痰在经络中横行阻滞引起的疼痛。
药材:苍术(用米泔水浸泡后炒制,一钱半)、白术(去芦头)、南星、陈皮、茯苓(去皮)、香附、酒黄芩、威灵仙、羌活、甘草(各一钱)、半夏(姜汁制,二钱)。
用法:以上药材锉碎为一剂,加生姜煎煮后服用。
臂痛,是由于风寒湿邪搏结所致。或者睡觉时手露在被外,被寒邪侵袭,从而导致手臂疼痛;以及妇女将手臂当作枕头而受风寒损伤导致的臂痛,均根据以下三方选用。
五积散:治疗因寒邪导致的臂痛(方剂见“中寒”章节)。
乌药顺气散:治疗因风邪导致的臂痛(方剂见“中风”章节)。
蠲痹汤:治疗因湿邪导致的臂痛,兼治风湿相搏引起的身体重痛、手足冷痹、四肢沉重。
药材:当归、赤芍、黄芪、羌活、姜黄、防风、甘草(炙,各等分)。
用法:以上药材锉碎为一剂,加生姜三片,水煎后服用。
滋荣调中汤:治疗臂痛及腰酸,有时也会疼痛。
药材:陈皮(盐水洗去白瓤,八分)、白茯苓(去皮)、白术(去芦头,各一钱)、半夏、白芍、酒黄芩、酒黄柏、牛膝(酒洗去芦头,各七分)、木瓜(盐水炒,七分)、当归(酒洗,一钱)、川芎(盐汤浸,五分)、羌活(六分)、知母(酒炒,六分)、桂枝(三分)、防风(去芦头,五分)。
用法:以上药材锉碎为一剂,加生姜三片,水煎,饭后久服。
脉象:《内经》云:脉象洪大而急促且上部紧的,是肩背痛;脉象沉而滑的,是痰痛(方剂见后文“豁痰汤”)。
背痛,是痰气聚集所致。
参合汤:治疗背心某一点疼痛。
药材:陈皮、半夏(姜汁炒)、茯苓(去皮)、乌药、枳壳(麸炒)、僵蚕(炒)、川芎、白芷、麻黄、桔梗(去芦头)、干姜(减半)、紫苏、香附、苍术(米泔水浸)、羌活(各等分)、甘草(减半)。
用法:以上药材锉碎为一剂,加生姜煎煮后服用。
肩背痛,不能回头顾盼的,是太阳经气郁滞而不运行所致。
通气防风汤:治疗肩背痛,使用风药以疏散之。
药材:藁本(一钱)、防风、羌活(二钱)、独活(二钱)、川芎(一钱)、蔓荆子(六分)、甘草(六分)。
用法:以上药材锉碎为一剂,水煎后服用。如果身体沉重、腰部沉困、经络中有寒湿,加酒浸防己一钱;病情轻者加炮附子,重者加炮川乌,各五分。
豁痰汤:治疗肩背疼痛。
药材:半夏(制)、栀子(炒,各一钱)、陈皮、海桐皮、枳壳(各八分)、桔梗、赤芍、苍术(制)、香附(各七分)、茯苓(去皮,六分)、川芎、姜黄(各五分)、甘草(二分)。
用法:以上药材锉碎,加生姜煎煮,饭后稍久热服。如果疼痛剧烈,第一剂加朴硝二钱。
Arm pain is caused by damp-phlegm (Tan Yin) traversing and obstructing the meridians.
Er Zhu Tang (Two Atractylodes Decoction): Treats arm pain due to phlegm-fluid retention affecting both arms, as well as arm pain generally. This refers to pain caused by upper jiao damp-phlegm traversing and obstructing the meridians.
Ingredients: Cang Zhu (Rhizoma Atractylodis Macrocephalae, soaked in rice water and stir-fried, 1.5 qian), Bai Zhu (Rhizoma Atractylodis Macrocephalae, remove rhizome), Nan Xing (Rhizoma Arisaematis), Chen Pi (Pericarpium Citri Reticulatae), Fu Ling (Poria, remove bark), Xiang Fu (Rhizoma Cyperi), Jiu Qin (Radix Scutellariae prepared with wine), Wei Ling Xian (Radix Saposhnikoviae), Qiang Huo (Rhizoma et Radix Notopterygii), Gan Cao (Radix Glycyrrhizae, each 1 qian), Ban Xia (Rhizoma Pinelliae, processed with ginger juice, 2 qian).
Usage: Coarsely crush the above ingredients for one dose, decoct with fresh ginger, and take orally.
Arm pain can also be caused by the binding of wind-cold-dampness. For instance, if the hand is exposed outside the blanket during sleep and attacked by cold pathogenic factors, it leads to arm pain. Similarly, women may suffer arm pain from using their arm as a pillow and being injured by wind-cold. In all such cases, select from the following three formulas.
Wu Ji San (Five Accumulations Powder): Treats arm pain caused by cold pathogens (see formula under "Zhong Han" / Cold Damage).
Wu Yao Shun Qi San (Lindera Regulating Qi Powder): Treats arm pain caused by wind pathogens (see formula under "Zhong Feng" / Wind Stroke).
Juan Bi Tang (Dispelling Bi Syndrome Decoction): Treats arm pain caused by dampness; also treats bi syndrome caused by wind-dampness binding, characterized by general body pain, cold numbness of hands and feet, and heaviness of the four limbs.
Ingredients: Dang Gui (Radix Angelicae Sinensis), Chi Shao (Radix Paeoniae Rubra), Huang Qi (Radix Astragali), Qiang Huo (Rhizoma et Radix Notopterygii), Jiang Huang (Rhizoma Curcumae), Fang Feng (Radix Saposhnikoviae), Zhi Gan Cao (Radix Glycyrrhizae Preparata, equal parts).
Usage: Coarsely crush the above ingredients for one dose, add three slices of fresh ginger, decoct with water, and take orally.
Zi Rong Tiao Zhong Tang (Nourishing Blood and Regulating Middle Jiao Decoction): Treats arm pain accompanied by soreness and pain in the lower back, which may occur intermittently.
Ingredients: Chen Pi (Pericarpium Citri Reticulatae, washed with salt water to remove white pith, 8 fen), Bai Fu Ling (Poria, remove bark), Bai Zhu (Rhizoma Atractylodis Macrocephalae, remove rhizome, each 1 qian), Ban Xia (Rhizoma Pinelliae), Bai Shao (Radix Paeoniae Alba), Jiu Qin (Radix Scutellariae prepared with wine), Jiu Bai (Cortex Phellodendri prepared with wine), Niu Xi (Radix Achyranthis Bidentatae, washed with wine, remove rhizome, each 7 fen), Mu Gua (Fructus Chaenomelis, stir-fried with salt water, 7 fen), Dang Gui (Radix Angelicae Sinensis, washed with wine, 1 qian), Chuan Xiong (Rhizoma Chuanxiong, soaked in salt water, 5 fen), Qiang Huo (Rhizoma et Radix Notopterygii, 6 fen), Zhi Mu (Rhizoma Anemarrhenae, stir-fried with wine, 6 fen), Gui Zhi (Ramulus Cinnamomi, 3 fen), Fang Feng (Radix Saposhnikoviae, remove rhizome, 5 fen).
Usage: Coarsely crush the above ingredients for one dose, add three slices of fresh ginger, decoct with water, and take long after meals.
Pulse diagnosis: The classics state that a pulse that is surging, large, rapid, and tight at the upper position indicates shoulder and back pain; a pulse that is deep and slippery indicates pain due to phlegm (see formula "Huo Tan Tang" later).
Back pain is caused by the accumulation of phlegm and qi.
Shen He Tang (Ginseng Combination Decoction): Treats pain at a specific point on the back.
Ingredients: Chen Pi (Pericarpium Citri Reticulatae), Ban Xia (Rhizoma Pinelliae, stir-fried with ginger juice), Fu Ling (Poria, remove bark), Wu Yao (Fructus Linderae), Zhi Ke (Fructus Aurantii, bran-stir-fried), Jiang Can (Bombyx Batryticatus, stir-fried), Chuan Xiong (Rhizoma Chuanxiong), Bai Zhi (Radix Angelicae Dahuricae), Ma Huang (Herba Ephedrae), Jie Geng (Radix Platycodi, remove rhizome), Gan Jiang (Rhizoma Zingiberis, halved), Zi Su (Folium Perillae), Xiang Fu (Rhizoma Cyperi), Cang Zhu (Rhizoma Atractylodis, soaked in rice water), Qiang Huo (Rhizoma et Radix Notopterygii, equal parts), Gan Cao (Radix Glycyrrhizae, halved).
Usage: Coarsely crush the above ingredients for one dose, decoct with fresh ginger, and take orally.
Shoulder and back pain accompanied by an inability to turn the head backward is caused by stagnation and failure of circulation of Tai Yang (Greater Yang) qi.
Tong Qi Fang Feng Tang (Unblocking Qi and Fang Feng Decoction): Treats shoulder and back pain by using wind-dispelling herbs to scatter the pathogen.
Ingredients: Ben Cao (Rhizoma Ligustici, 1 qian), Fang Feng (Radix Saposhnikoviae), Qiang Huo (Rhizoma et Radix Notopterygii, 2 qian), Du Huo (Radix et Rhizoma Angelicae Pubescentis, 2 qian), Chuan Xiong (Rhizoma Chuanxiong, 1 qian), Man Jing Zi (Fructus Viticis, 6 fen), Gan Cao (Radix Glycyrrhizae, 6 fen).
Usage: Coarsely crush the above ingredients for one dose, decoct with water, and take orally. If there is bodily heaviness, waist sinking sensation, or cold-dampness in the meridians, add Fang Ji (Radix Stephaniae Tetrandrae) soaked in wine (1 qian). For mild cases, add Pao Fu Zi (Radix Aconiti Lateralis Preparata); for severe cases, add Pao Chuan Wu (Radix Aconiti Kusnezoffii Preparata), each 5 fen.
Huo Tan Tang (Expelling Phlegm Decoction): Treats shoulder and back pain.
Ingredients: Ban Xia (Rhizoma Pinelliae, processed), Zhi Zi (Fructus Gardeniae, stir-fried, each 1 qian), Chen Pi (Pericarpium Citri Reticulatae), Hai Tong Pi (Cortex Tibouchinae), Zhi Ke (Fructus Aurantii, each 8 fen), Jie Geng (Radix Platycodi), Chi Shao (Radix Paeoniae Rubra), Cang Zhu (Rhizoma Atractylodis, processed), Xiang Fu (Rhizoma Cyperi, each 7 fen), Fu Ling (Poria, remove bark, 6 fen), Chuan Xiong (Rhizoma Chuanxiong), Jiang Huang (Rhizoma Curcumae, each 5 fen), Gan Cao (Radix Glycyrrhizae, 2 fen).
Usage: Coarsely crush the above ingredients, decoct with fresh ginger, and take hot long after meals. If the pain is severe, add Po Xiao (Natrii Sulfas) 2 qian in the first dose.