(腋肿)
臂痛有六道经络,究其痛在何经,以行本经药行其气血,气血通则愈矣。以两
手伸直,臂贴身垂下,大指居前,小指居后而定之。其臂 之前廉痛者,属阳明经,
以升麻、白芷、干葛行之。后廉痛者,属太阳经,以 本、羌活行之。外廉痛者,
属少阳经,以柴胡行之。内廉痛者,属厥阴经,以柴胡、青皮行之。内廉痛者,属
太阴经,以升麻、白芷、葱白行之。内后廉痛者,属少阴经,以细辛、独活行之,
并用针灸法。臂为风寒湿所搏,或饮液流入,或因提挈重物致痛,或肿或不肿,除
饮证外,其余并可五积散(见中寒),及乌药顺气散,(见中风。)或蠲痹汤(见痹)。
审知是湿,蠲
痹汤每服加苍术末三匙,防己四分。挈重伤筋者,琥珀散、劫劳散、或和气饮(见肿胀),
每服加白姜黄五分,以姜黄能入臂故也。(薄桂味淡,能横行手臂,引药至痛处,亦不
可少。)痰饮,臂酸痛软麻,导痰汤(见痰)。加木香、白姜黄各五分,重者控涎丹(见痰)。
加去油木鳖子一两,桂枝五钱,每服二十丸,加至三十丸。血虚不荣于筋者,蠲痹
汤、四物汤(见血)各半帖煎服。气血凝滞者,舒筋汤。
腋属心包经、肝经,腋前属肺经,腋后属心经,腋下属肝经。经气热则腋肿,
察其部位治之。
(腋肿)
手臂疼痛涉及六条经络,探究疼痛位于哪条经络,便使用本经的药物来疏通该经络的气血,气血通畅后疼痛即可痊愈。判断方法为:将双手伸直,手臂紧贴身体两侧自然下垂,大拇指朝前,小指朝后。如果手臂前侧疼痛,属于阳明经(手阳明大肠经),使用升麻、白芷、干葛(葛根)来引导药力。后侧疼痛,属于太阳经(手太阳小肠经),使用羌活、本(藁本)来引导药力。外侧疼痛,属于少阳经(手少阳三焦经),使用柴胡来引导药力。内侧疼痛,属于厥阴经(手厥阴心包经),使用柴胡、青皮来引导药力。另一处内侧疼痛,属于太阴经(手太阴肺经),使用升麻、白芷、葱白来引导药力。内侧后侧疼痛,属于少阴经(手少阴心经),使用细辛、独活来引导药力,并配合针灸疗法。手臂因风寒湿邪侵袭,或饮液流入经络,或因提举重物导致损伤而疼痛,无论肿胀与否,除水饮证外,其余情况均可使用五积散(见中寒章节)、乌药顺气散(见中风章节)或蠲痹汤(见痹证章节)。若确知是湿邪所致,蠲痹汤每服加苍术末三匙、防己四分。因提举重物导致筋伤的患者,可使用琥珀散、劫劳散或和气饮(见肿胀章节),每服加白姜黄五分,因为姜黄能入臂部。(薄桂即肉桂,气味淡薄,能横行于手臂,引药到达疼痛部位,也不可缺少。)痰饮导致的臂部酸痛、软弱麻木,使用导痰汤(见痰证章节),加木香、白姜黄各五分;病情重的使用控涎丹(见痰证章节),加去油木鳖子一两、桂枝五钱,每次服用二十丸,逐渐增加至三十丸。血虚不能濡养筋脉的,使用蠲痹汤、四物汤(见血证章节)各半帖煎服。气血凝滞的,使用舒筋汤。
腋下属于心包经、肝经,腋前属于肺经,腋后属于心经,腋下属肝经。经脉之气热盛则导致腋肿,观察其具体部位进行治疗。
(Axillary Swelling)
Arm pain involves six meridians. To determine which meridian is affected, administer herbs belonging to that specific meridian to promote the flow of Qi and Blood; once the flow is unobstructed, the condition will resolve. The diagnostic method is as follows: extend both arms straight down along the sides of the body with thumbs facing forward and little fingers facing backward. Pain on the anterior aspect of the arm indicates involvement of the Yangming Meridian (Hand-Yangming Large Intestine Meridian); use Shengma (Cimicifugae Rhizoma), Baizhi (Angelicae Dahuricae Radix), and Gange (Puerariae Lobatae Radix) to guide the action. Pain on the posterior aspect indicates involvement of the Taiyang Meridian (Hand-Taiyang Small Intestine Meridian); use Qianghuo (Notopterygii Rhizoma et Radix) and Ben (Ligustici Rhizoma et Radix). Pain on the lateral aspect indicates involvement of the Shaoyang Meridian (Hand-Shaoyang Sanjiao Meridian); use Chaihu (Bupleuri Radix). Pain on the medial aspect indicates involvement of the Jueyin Meridian (Hand-Jueyin Pericardium Meridian); use Chaihu (Bupleuri Radix) and Qingpi (Citri Reticulatae Pericarpium Viride). Another area of medial pain indicates involvement of the Taiyin Meridian (Hand-Taiyin Lung Meridian); use Shengma (Cimicifugae Rhizoma), Baizhi (Angelicae Dahuricae Radix), and Congbai (Allii Fistulosi Bulbus). Pain on the posteromedial aspect indicates involvement of the Shaoyin Meridian (Hand-Shaoyin Heart Meridian); use Xixin (Asari Radix et Rhizoma) and Duhuo (Angelicae Pubescentis Radix), combined with acupuncture and moxibustion therapy. Arm pain caused by invasion of Wind-Cold-Dampness, accumulation of fluid in the channels, or injury from lifting heavy objects, whether accompanied by swelling or not, can generally be treated with Wuji San (Five Accumulations Powder, see Cold Damage section), Wuyao Shunqi San (Aucklandia Qi-Regulating Powder, see Stroke section), or Juanbi Tang (Bi-Suppression Decoction, see Bi Syndrome section), excluding cases of fluid retention. If dampness is confirmed, add three spoons of Cangzhu powder and four fen of Fangji to each dose of Juanbi Tang. For injuries to sinews caused by lifting heavy objects, use Hupo San (Amber Powder), Jie Lao San (Labor-Exhaustion Suppression Powder), or Heqi Yin (Harmonizing Qi Decoction, see Distension section), adding five fen of Bai Jianghuang (Curcumae Longae Rhizoma) per dose, as Jianghuang enters the arm channels. (Bo Gui, thin cinnamon bark, has a mild flavor and travels horizontally through the arms, guiding herbs to the painful site; it should not be omitted.) For arm soreness, weakness, and numbness due to Phlegm-Fluids, use Daotan Tang (Phlegm-Guiding Decoction, see Phlegm section), adding five fen of Muxiang (Aucklandiae Radix) and five fen of Bai Jianghuang (Curcumae Longae Rhizoma); for severe cases, use Kongxian Dan (Saliva-and-Fluid Expelling Pill, see Phlegm section), adding one liang of Mu Biezi (Strychnos Nux-vomica Seed, oil removed) and five qian of Guizhi (Cinnamomi Ramulus), taking twenty pills per dose, gradually increasing to thirty pills. For blood deficiency failing to nourish the sinews, take half a dose each of Juanbi Tang (Bi-Suppression Decoction) and Siwu Tang (Four Substances Decoction, see Blood section) decocted together. For stagnation of Qi and Blood, use Shujin Tang (Sinew-Relaxing Decoction).
The axilla belongs to the Pericardium Meridian and Liver Meridian; the anterior axilla belongs to the Lung Meridian; the posterior axilla belongs to the Heart Meridian; the inferior axilla belongs to the Liver Meridian. Heat in the meridian Qi causes axillary swelling; treat according to the specific location observed.