答曰。臂痛有数证。有因寒而得之者。或因伏痰者。有形寒饮冷伤肺者。有汗出伤阻者。夫
肝主诸筋。肝经虚弱。风寒入伤。与气血相搏。筋寒则急。上连两臂俱痛。宜服醒风汤理
气
汤主之。若或左或右。痛不能举臂者。此繇伏痰在内。中脘停滞。脾气不能流行。止与气搏
。流伏于左则左痛。在右则右痛。若右臂痛深连于骨。如斧槌。其气自嗌已下至脐。左右气
不相通彻。其痛发时。气上奔急。令人闷绝。肌肉日消。浆粥不下。心中烦闷。此繇形寒饮
冷。肺被寒结留滞于右边。若无故一臂无力。痛不能举。袭袭似汗。偏阻一边。肌肉时复掣
痛。或有不仁。手不能近头。久成偏枯。宜服百风汤主之。百风汤。治四肢垂曳。骨节疼痛
。(又名省风汤)
独活(三钱) 芎 防风 当归 桂心(各二两) 茯苓 附子 细辛 天麻(一两) 干蝎(
炒) 甘草(一两)
上为 咀。每服三钱。水一盏半。姜五片。煎七分。去滓。食前稍热服。茯苓丸。治伏痰臂
痛。
茯苓(一两) 半夏(二两) 枳壳(去穣麸炒半两) 风化朴硝(一分)
上为细末。姜汁煮糊为丸。如桐子大。每服三十丸。食前姜汤下。
理气汤。治痰饮臂痛。
上为粗末。每服五钱。水二盏。姜五片。煎一盏。去滓食前服。
回答说：臂痛有多种证候。有的是因寒邪引起的，有的是因伏痰引起的，有的是因形体受寒、饮食生冷损伤肺脏引起的，有的是因出汗后感受风邪阻滞经络引起的。
肝脏主管全身的筋脉。如果肝经虚弱，风寒之邪侵入受伤，与气血相互搏结，导致筋脉寒冷而拘急，向上牵连至两臂，引起双侧手臂疼痛。适宜服用醒风汤或理气汤来主治。
如果是左侧或右侧单侧疼痛，且手臂无法抬起，这是由于体内有伏痰停滞在中脘部位，脾气不能正常流通运行，仅与气机相互搏结。痰气流伏于左侧则左侧疼痛，流伏于右侧则右侧疼痛。
如果右臂疼痛剧烈并深入连及骨骼，感觉像被斧头槌击一样，气机从咽喉向下延伸至脐部，左右两侧气机不通畅。疼痛发作时，气机上冲急促，令人感到昏闷欲绝，肌肉日渐消瘦，连浆粥都无法吞咽，心中烦闷不安。这是由于形体受寒、饮食生冷，导致肺气被寒邪凝结留滞于右侧所致。
如果无故出现单侧手臂无力，疼痛导致无法抬起，伴有阵阵类似出汗的感觉，偏侧经络阻滞，肌肉时常抽搐疼痛，或者出现麻木不仁，手不能举过头顶接近头部，日久可能发展为偏枯（半身不遂）。适宜服用百风汤来主治。百风汤，用于治疗四肢下垂拖曳、骨节疼痛。（又名省风汤）
独活（三钱），川芎、防风、当归、桂心（各二两），茯苓、附子、细辛、天麻（各一两），干蝎（炒制）、甘草（各一两）。
以上药物捣碎成粗末。每次服用三钱，加水一盏半，生姜五片，煎煮至七分水量，滤去药渣，在饭前稍温热时服用。
茯苓（一两），半夏（二两），枳壳（去除瓤，麸皮炒制半两），风化朴硝（一分）。
以上药物研为细末，用姜汁煮糊制成丸药，大小如梧桐子大。每次服用三十丸，饭前用姜汤送服。
以上药物（指前文提到的醒风汤或理气汤原方，此处原文省略具体组成，仅述用法）捣为粗末。每次服用五钱，加水二盏，生姜五片，煎煮至一盏水量，滤去药渣，饭前服用。
Answer: Arm pain presents with several syndromes. Some are caused by cold pathogen, some by latent phlegm, some by external cold and cold drinks injuring the Lung, and some by wind obstruction following sweating.
The Liver governs all sinews (tendons). If the Liver meridian is deficient, wind-cold invades and injures, contending with Qi and Blood. Cold in the sinews causes contraction, extending upward to connect with both arms, resulting in bilateral arm pain. It is appropriate to administer Xingfeng Tang (Revive Wind Decoction) or Liqi Tang (Regulate Qi Decoction) as the primary treatment.
If the pain occurs on either the left or right side, and the arm cannot be lifted, this arises from latent phlegm stagnating internally at Zhongwan (CV12), where Spleen Qi fails to circulate freely, contending only with Qi. When the flow of phlegm stagnates on the left, the left side hurts; when it stagnates on the right, the right side hurts.
If the right arm pain is severe, penetrating to the bone, feeling like being struck by an axe or mallet, with Qi obstructed from the throat down to the umbilicus, and Qi not flowing smoothly between left and right, then during pain attacks, Qi rushes upward urgently, causing suffocation and fainting. Muscles waste away daily, and even thin gruel cannot be swallowed. The heart feels restless and depressed. This results from external cold and cold drinks, causing Lung Qi to be congealed and stagnant on the right side.
If suddenly one arm becomes weak and painful, unable to lift, accompanied by intermittent sensations resembling sweating, unilateral channel obstruction, recurrent muscle twitching pain, or numbness where the hand cannot reach the head, prolonged illness may lead to hemiplegia (Biangu). It is appropriate to administer Baifeng Tang (Hundred Wind Decoction) as the primary treatment. Baifeng Tang treats flaccidity and dragging of the four limbs and joint pain. (Also known as Shengfeng Tang).
Du Huo (Radix Angelicae Pubescentis, 3 qian), Xiong (Rhizoma Chuanxiong), Fang Feng (Saposhnikoviae Radix), Dang Gui (Radix Angelicae Sinensis), Gui Xin (Cortex Cinnamomi, each 2 liang), Fu Ling (Poria, 1 liang), Fu Zi (Radix Aconiti Lateralis Preparata), Xi Xin (Herba Asari), Tian Ma (Rhizoma Gastrodiae, each 1 liang), Gan Xie (Scorpio, stir-fried), Gan Cao (Radix Glycyrrhizae, each 1 liang).
Crush the above herbs into coarse pieces. Take 3 qian per dose, add 1.5 zhan of water and 5 slices of fresh ginger, decoct until 0.7 zhan remains, strain, and take warm before meals.
Fuling Wan (Poria Pill) treats arm pain due to latent phlegm.
Fu Ling (Poria, 1 liang), Ban Xia (Rhizoma Pinelliae Preparata, 2 liang), Zhi Ke (Fructus Aurantii, de-albendo, bran-fried, 0.5 liang), Fenghua Puxiao (Natrii Sulfas Exsiccatus, 1 fen).
Grind the above into fine powder, use ginger juice to cook paste for pills, sized like paulownia seeds. Take 30 pills per dose, wash down with ginger soup before meals.
Liqi Tang (Regulate Qi Decoction) treats arm pain due to phlegm-fluid retention.
[Formula composition omitted in source text context, referring to previous mention] Grind into coarse powder. Take 5 qian per dose, add 2 zhan of water and 5 slices of fresh ginger, decoct until 1 zhan remains, strain, and take before meals.