时疫初起腕痛者，乃风淫末疾也。初起解表，汗、下后益气养血，与肩臂痛同治。
项、背、腰、膝、胫、足、肩臂诸痛，已列于前，则周身之酸痛备矣。兹复列周身骨节酸痛者，以痛在一处，
邪有专注，痛在周身，邪有分布也。专注之邪，须通其凝泣；分布之邪，须解其缚束。故治周身酸痛，疏表其大法
也。而酸与痛亦有别∶酸轻而浅；痛重而深。酸痛与拘挛又有别∶酸痛举动如常，拘挛屈伸不利；酸痛病在营
卫，拘挛病在筋脉。合酸痛拘挛，又有上下、浅深、前后之不同∶在身半以上为末疾，浅而易解；在身半以下为
本病，深而难去。合上、下之酸痛、拘挛，在未经汗、下与已经汗、下者又有别∶未经汗、下属邪盛，宜宣伐；
已经汗、下属正虚，宜调补。明乎此，则酸痛在周身，在一处，按证施治，无不当矣。解表诸方∶人参败毒散、九
味羌活汤、六神通解散、大羌活汤。
时疫初起，发热身重者，湿胜于热也，苍术为主。二、三日至四、五日传变之后，汗出更热而身重者，热壅
其经脉也，白虎汤为主。传里，表无热而舌燥、便秘、腹痛拒按而身重者，内结而气不达于表也，三承气为主。
屡经汗、下，表热已退，身重不可移动，脉虚散而无根，舌上无苔，二便自通者，阴阳两亡，经脉枯竭也。审其阴
阳偏胜而治之。偏于亡阴多燥证，六味合四物为主；偏于亡阳多脾胃证，六君合生脉为主；阴阳俱竭，生脉合六味
为主。
时疫（流行性疫病）初起出现手腕疼痛的，属于风邪侵袭四肢末端所致的疾病。初期应当采用解表法治疗，在发汗或攻下之后，再采用益气养血的方法，其治疗原则与肩臂疼痛相同。
颈部、背部、腰部、膝部、小腿、足部以及肩臂等各处的疼痛，前面已经列举过了，那么周身酸痛的情况也就完备了。这里再次列出周身骨节酸痛的内容，是因为：疼痛局限于一处，说明病邪有专注点；疼痛遍布周身，说明病邪有分布。对于专注的病邪，必须疏通其凝滞；对于分布的病邪，必须解除其束缚。因此，治疗周身酸痛，疏解表邪是主要大法。而“酸”与“痛”也有区别：酸感较轻且病位浅；痛感较重且病位深。“酸痛”与“拘挛”又有区别：酸痛者活动如常，拘挛者屈伸不利；酸痛病在营卫（营气与卫气），拘挛病在筋脉（肌腱与脉络）。综合酸痛与拘挛，又有上下、浅深、前后的不同：在半身以上为末疾（轻浅之病），病位浅而易于解除；在半身以下为根本之病，病位深而难以去除。结合上、下的酸痛与拘挛，在未经过发汗、攻下治疗与已经过发汗、攻下治疗的情况又有所不同：未经汗、下治疗的，属于邪气盛实，宜用宣散攻伐之法；已经过汗、下治疗的，属于正气虚弱，宜用调理补益之法。明白了这些道理，那么无论是周身酸痛还是局部酸痛，都能根据证候施治，没有不恰当的。解表的各种方剂包括：人参败毒散、九味羌活汤、六神通解散、大羌活汤。
时疫初起，出现发热且身体沉重的，是湿邪胜过热邪所致，以苍术为主药。发病二、三天到四、五天传变之后，出汗后热度更高且身体沉重的，是热邪壅塞经脉所致，以白虎汤为主方。病邪传入里部，体表无热象但舌燥、便秘、腹痛拒按且身体沉重的，是内部结滞导致气机不能通达于体表所致，以三承气汤为主方。多次经过发汗、攻下治疗后，体表热象已退，身体沉重无法移动，脉象虚散无根，舌上没有苔垢，大小便自然通畅的，这是阴阳两亡、经脉枯竭的表现。审察其阴阳哪一方偏胜而进行治疗。偏于亡阴的多表现为燥证，以六味地黄丸合四物汤为主方；偏于亡阳的多表现为脾胃症状，以六君子汤合生脉散为主方；若阴阳俱竭，则以生脉散合六味地黄丸为主方。
When epidemic febrile disease (Shi Yi) begins with wrist pain, it is a disorder of the extremities caused by wind pathogen invading the limbs. In the initial stage, exterior-releasing methods should be used; after sweating or purging, qi-nourishing and blood-supplementing methods should be applied, treating it similarly to shoulder and arm pain.
Pains in the neck, back, waist, knees, shins, feet, shoulders, and arms have been listed previously, thus covering the condition of generalized body soreness. Here, generalized bone and joint soreness is listed again because: pain localized in one area indicates that the pathogen has a specific focus; pain distributed throughout the body indicates that the pathogen is dispersed. For focused pathogens, stagnation must be unblocked; for dispersed pathogens, binding must be released. Therefore, the primary principle for treating generalized soreness is to disperse the exterior. There is also a distinction between "sourness" (suan) and "pain" (tong): sourness is mild and superficial; pain is severe and deep. There is also a distinction between "soreness-pain" and "spasm/contracture": those with soreness-pain move normally, while those with contracture have difficulty flexing and extending; soreness-pain involves Ying and Wei (nutritive and defensive qi), whereas contracture involves sinews and vessels. Combining soreness-pain and contracture, there are differences in upper/lower, shallow/deep, and anterior/posterior locations: conditions above the midpoint of the body are minor disorders (wei ji), which are superficial and easy to resolve; conditions below the midpoint are fundamental diseases, which are deep and difficult to eliminate. Regarding soreness-pain and contracture in the upper and lower body, there is a difference between those who have not undergone sweating/purging and those who have: those who have not undergone sweating/purging have excess pathogenic factors and require dispersing and attacking methods; those who have undergone sweating/purging have deficient healthy qi and require regulating and tonifying methods. Understanding these principles allows for appropriate treatment based on symptoms, whether the soreness is generalized or localized. Exterior-releasing formulas include: Renshen Baidu San (Ginseng Decoction to Overcome Toxins), Jiwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction), Liushen Tongjie San (Six-Efficacy Unblocking Powder), and Da Qianghuo Tang (Major Notopterygium Decoction).
In the initial stage of epidemic febrile disease, fever accompanied by heavy sensation of the body indicates dampness exceeding heat, treated primarily with Cangzhu (Atractylodis Rhizoma). After transmission occurs from day two or three to day four or five, if sweating leads to higher fever and heavy sensation of the body, it indicates heat obstructing the meridians, treated primarily with Baihu Tang (White Tiger Decoction). If the pathogen transmits to the interior, with no heat on the exterior but dry tongue, constipation, abdominal pain with refusal to press, and heavy sensation of the body, it indicates internal accumulation preventing qi from reaching the exterior, treated primarily with the Three Chengqi Formulas (San Chengqi). After repeated sweating and purging, if exterior heat has subsided, the body is so heavy it cannot move, the pulse is deficient, scattered, and rootless, the tongue lacks coating, and urination and defecation occur naturally, this indicates exhaustion of both Yin and Yang and depletion of the meridians. Treatment should be determined by assessing which aspect of Yin or Yang is predominant. Predominant Yin exhaustion often presents with dryness syndromes, treated primarily with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) combined with Siwu Tang (Four-Substance Decoction); predominant Yang exhaustion often presents with Spleen-Stomach syndromes, treated primarily with Liujunzi Tang (Six-Gentleman Decoction) combined with Shengmai San (Generate the Pulse Powder); if both Yin and Yang are exhausted, Shengmai San is combined with Liuwei Dihuang Wan as the primary treatment.