通气防风汤
通气太阳肩背痛，羌独 草蔓防芎，气滞加木陈香附，气虚升柴参 同，血虚当归
白芍药，血瘀姜黄五灵红，风加灵仙湿二术，研送白丸治痰凝。
【注】李杲羌活胜湿汤，又名通气防风汤，治太阳经风湿肩背痛，即羌活、独活、 本、
甘草、蔓荆子、防风、川芎也。兼气郁滞痛者，则常常作痛，加木香、陈皮、香附也。气
虚郁痛者，则时止时痛，加升麻、柴胡、人参、黄 也。血虚郁痛者，则夜甚时止，加
当归、白芍药也。血瘀郁痛者，则夜痛不止，加姜黄、五灵脂、红花也。风气郁盛者，痛
则项肩强，加威灵仙也。湿气郁甚者，痛则肩背重，加苍术、白术也。痰风凝郁者，痛
则呕眩，用本汤研送青州白丸子也。
心痛岐骨陷处痛，横满上胸下胃脘，当脐脾腹连腰肾，少腹小大肠胁肝。虫痛时止
吐清水，疰即中恶寒外干，悸分停饮与思虑，食即停食冷内寒，水停痰饮热胃火，气即气
滞血瘀缘，随证分门检方治，真心黑厥至节难。
【注】岐骨陷处痛，名心痛。横满连胸，名肺心痛；下连胃脘，名胃心痛；连脐，名
脾心痛；连腰，名肾心痛；连少腹，名大肠小肠痛；连胁，名肝心痛；时止吐清水，名
虫心痛；中恶腹痛，名疰痛；寒邪外干，名中寒痛；悸而痛，名悸心痛；水停心下，属
饮也。思虑伤心，属伤也。停食痛，停水痛，停痰痛，胃火痛，气滞痛，血瘀痛，皆不死
之证也，当分门施治。惟真心痛，面色黑，四肢逆冷至节，死证也。
化滞丸 清中汤
攻湿积热求化滞，攻寒积水备急丹，火痛二陈栀连蔻，虫用乌梅饮控涎。
【注】化滞丸，成方也。清中汤，即陈皮、半夏、茯苓、甘草、姜炒山栀、黄连、草豆
蔻也。
木香流气饮
七情郁结流气饮，思虑悸痛归脾汤，内寒理中外五积，疰痛备急血抵当。
小建中汤
木来乘土腹急痛，缓肝和脾小建中，血虚寒痛羊肉治，气虚理中加陈青。
【注】羊肉，谓羊肉汤也。
乌头栀子汤
劫诸郁痛乌栀子，劫而复痛入元明，已经吐下或虚久，急痛欲死求鸦鸣。
【注】诸郁，谓诸寒火郁而痛也。寒多炮川乌为主，热多姜炒栀子为主。元明，元明
粉也。鸦鸣，谓以真鸦片末，或加麝香少许，饭丸如桐子大，每服三五丸引。在本草，名
一粒金丹。
治疗太阳经引起的肩背疼痛，方剂组成包括羌活、独活、甘草、蔓荆子、防风、川芎。若伴有气滞，加入木香、陈皮、香附；若伴有气虚，加入升麻、柴胡、人参、黄芩（注：原文“黄”后缺字，结合语境及李杲原意多为黄芪或黄芩，此处依原文保留“黄”，但根据常见配伍及下文“气虚”逻辑，通常指黄芪，然古籍传抄常有脱漏，此处暂按原文“黄”处理，或理解为黄芪/黄芩之误，为严谨起见，翻译中保留“黄”并标注可能指代）同用；若伴有血虚，加入当归、白芍药；若伴有血瘀，加入姜黄、五灵脂、红花；若风邪偏盛，加入威灵仙；若湿邪偏盛，加入苍术、白术；若为痰凝所致，可用此方研末送服青州白丸子以治痰凝。
【注释】李杲的羌活胜湿汤，又名通气防风汤，用于治疗太阳经受风湿侵袭导致的肩背疼痛，其药物组成为羌活、独活、藁本、甘草、蔓荆子、防风、川芎。兼有气机郁滞而痛者，疼痛常持续不止，需加入木香、陈皮、香附。因气虚导致气机郁滞而痛者，疼痛时发时止，需加入升麻、柴胡、人参、黄芪（注：原文作“黄”，据理杲《脾胃论》及气虚补益常规，此处应指黄芪，但严格依原文译为“黄”）。因血虚导致气机郁滞而痛者，夜间疼痛加重且时发时止，需加入当归、白芍药。因血瘀导致气机郁滞而痛者，夜间疼痛不止，需加入姜黄、五灵脂、红花。风气郁盛者，疼痛伴有颈项和肩部僵硬，需加入威灵仙。湿气郁盛者，疼痛伴有肩背部沉重感，需加入苍术、白术。痰与风邪凝滞郁结者，疼痛伴有呕吐、眩晕，使用本方研末送服青州白丸子。
心痛位于歧骨陷处，疼痛可横向满布至胸部下方及胃脘部，也可连及肚脐、脾腹并牵连腰肾，或少腹、大小肠及胁肋部肝脏区域。虫痛表现为疼痛时作时止并吐出清水；疰痛即中恶，由寒邪外侵引起；悸痛分为水饮停聚和思虑伤神两类；食痛由停食或内寒引起；水停、痰饮、热证及胃火均可致痛；气痛源于气滞，血痛源于血瘀。应根据症状分类，查阅相应方剂进行治疗。真心痛表现为面色黑、四肢厥冷至关节，属于难治的死证。
【注释】在歧骨陷处的疼痛，称为心痛。疼痛横满连及胸部，称为肺心痛；向下连及胃脘，称为胃心痛；连及肚脐，称为脾心痛；连及腰部，称为肾心痛；连及少腹，称为大肠和小肠痛；连及胁肋，称为肝心痛；疼痛时作时止并吐出清水，称为虫心痛；中恶引起的腹痛，称为疰痛；寒邪外侵引起的疼痛，称为中寒痛；心悸伴疼痛，称为悸心痛；水饮停聚于心下，属于饮证。思虑过度伤心，属于情志损伤。停食痛、停水痛、停痰痛、胃火痛、气滞痛、血瘀痛，均不属于死证，应当分类施治。唯有真心痛，面色发黑，四肢逆冷直至关节，属于死证。
攻逐湿积热邪求用化滞丸，攻逐寒邪积水备急丹。火热疼痛用二陈汤加栀子、黄连、草豆蔻；虫痛用乌梅饮或控涎丹。
【注释】化滞丸是现成方剂。清中汤，由陈皮、半夏、茯苓、甘草、姜炒山栀、黄连、草豆蔻组成。
七情郁结所致疼痛用木香流气饮；思虑过度导致的心悸疼痛用归脾汤；内寒疼痛用理中汤，外寒疼痛用五积散；疰痛用备急丸，血瘀重症用抵当汤。
肝木乘脾土导致腹部急痛，需用小建中汤缓肝和脾；血虚寒痛可用羊肉汤治疗；气虚疼痛可在理中汤基础上加入陈皮、青皮。
【注释】羊肉，指的是羊肉汤。
劫除各种郁结疼痛用乌头栀子汤；若劫除后疼痛复发，加入元明粉；如果已经经过吐下法治疗或病程久虚，遇到急痛欲死者，寻求鸦鸣（鸦片）治疗。
【注释】诸郁，指各种寒热郁结导致的疼痛。寒邪多者，以炮制过的川乌为主药；热邪多者，以姜炒栀子为主药。元明，指元明粉。鸦鸣，指用真鸦片粉末，或加少许麝香，制成如梧桐子大小的药丸，每次服用三五丸作为引药。在本草中，名为一粒金丹。
Tongqi Fangfeng Decoction (Ventilation-Enhancing Saposhnikovia and Ligusticum Decoction)
For treating shoulder and back pain caused by the Taiyang channel (Taiyang channel disease), the formula consists of Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Manjingzi (Viticis Fructus), Fangfeng (Saposhnikoviae Radix), and Chuanxiong (Ligustici Chuanxiong Rhizoma). If accompanied by Qi stagnation, add Muxiang (Aucklandiae Radix), Chenpi (Citri Reticulatae Pericarpium), and Xiangfu (Cyperi Rhizoma). If accompanied by Qi deficiency, add Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Renshen (Ginseng Radix et Rhizoma), and Huang [likely Huangqi (Astragali Radix) or Huangqin (Scutellariae Radix)] together. If accompanied by Blood deficiency, add Danggui (Angelicae Sinensis Radix) and Baishao (Paeoniae Radix Alba). If accompanied by Blood stasis, add Jianghuang (Curcumae Longae Rhizoma), Wulingzhi (Trogopterori Faeces), and Honghua (Carthami Flos). If Wind pathogen is predominant, add Weilingxian (Syneilesidis Rhizoma). If Dampness pathogen is predominant, add Cangzhu (Atractylodis Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma). If caused by Phlegm coagulation, this decoction can be powdered and taken with Qingzhou Baiwanzi (Qingzhou White Pill) to treat Phlegm coagulation.
[Note] Li Gao's Qianghuo Shengshi Tang (Notopterygium Decoction for Overcoming Dampness), also known as Tongqi Fangfeng Tang, treats shoulder and back pain due to Wind-Dampness invading the Taiyang channel. Its ingredients are Qianghuo, Duhuo, Gaoben (Ligustici Rhizoma), Gancao, Manjingzi, Fangfeng, and Chuanxiong. For cases complicated by Qi stagnation causing pain, where pain is constant, add Muxiang, Chenpi, and Xiangfu. For cases where Qi deficiency causes Qi stagnation and pain, where pain comes and goes, add Shengma, Chaihu, Renshen, and Huang [Huangqi]. For cases where Blood deficiency causes Qi stagnation and pain, where pain is worse at night and intermittent, add Danggui and Baishao. For cases where Blood stasis causes Qi stagnation and pain, where pain persists at night, add Jianghuang, Wulingzhi, and Honghua. When Wind Qi is abundant and stagnant, pain is accompanied by stiffness in the neck and shoulders; add Weilingxian. When Dampness is abundant and stagnant, pain is accompanied by heaviness in the shoulders and back; add Cangzhu and Baizhu. When Phlegm and Wind are coagulated and stagnant, pain is accompanied by vomiting and dizziness; use this decoction powdered and administered with Qingzhou Baiwanzi.
Xintong (Heart Pain) located in the depression between the cartilaginous processes of the sternum (Qigu). The pain may spread horizontally across the chest down to the epigastrium, connect to the umbilicus and spleen/abdomen extending to the kidneys, or involve the lower abdomen, large/small intestines, and liver area of the hypochondrium. Worm pain presents as intermittent pain with vomiting of clear fluid. Zhu pain (pestilential pain) is caused by evil Qi invasion and external cold. Palpitation pain is divided into those caused by Fluid retention and those caused by overthinking. Food pain is caused by food stagnation or internal cold. Water retention, Phlegm-fluid, Heat syndrome, and Stomach Fire can all cause pain. Qi pain stems from Qi stagnation, and Blood pain stems from Blood stasis. Treatment should follow symptom classification and reference appropriate formulas. Zhenxin Tong (True Heart Pain) presents with a black complexion and cold limbs extending to the joints; it is a fatal condition.
[Note] Pain in the depression of Qigu is named Heart Pain. Pain spreading horizontally to the chest is named Lung Heart Pain. Pain connecting to the epigastrium is named Stomach Heart Pain. Pain connecting to the umbilicus is named Spleen Heart Pain. Pain connecting to the waist is named Kidney Heart Pain. Pain connecting to the lower abdomen is named Large Intestine and Small Intestine Pain. Pain connecting to the hypochondrium is named Liver Heart Pain. Intermittent pain with vomiting of clear fluid is named Worm Heart Pain. Abdominal pain caused by Zhuzhong (evil qi attack) is named Zhu Pain. Pain caused by external Cold Evil is named Zhonghan Pain. Palpitation with pain is named Jixin Tong. Water retention below the heart belongs to Yin (Fluid retention). Overthinking damaging the Heart belongs to emotional injury. Food stagnation pain, water retention pain, phlegm pain, Stomach Fire pain, Qi stagnation pain, and Blood stasis pain are all non-fatal conditions and should be treated according to their categories. Only True Heart Pain, characterized by a black face and cold limbs reaching the joints, is a fatal condition.
Huazhi Wan (Eliminate Stagnation Pill) and Qingzhong Tang (Clear the Middle Decoction)
To attack dampness, accumulation, and heat, seek Huazhi Wan. To attack cold and accumulate water, prepare Bijidan (Emergency Prepared Pill). For Fire pain, use Erchen Tang (Two-Cured Decoction) plus Zhizi (Gardeniae Fructus), Lianlian (Coptidis Rhizoma), and Doukou (Amomi Fructus Rotundus). For worm pain, use Wumei Yin (Mume Decoction) or Kongxian Dan (Control Phlegm Pill).
[Note] Huazhi Wan is a prepared formula. Qingzhong Tang consists of Chenpi, Banxia (Pinelliae Rhizoma), Fuling (Poria), Gancao, Jiangchao Shanzhi (Gardenia fried with ginger), Huanglian (Coptidis Rhizoma), and Caodoukou (Amomi Fructus).
Muxiang Liuqi Yin (Aucklandia Flowing-Qi Decoction)
For pain due to emotional stagnation, use Muxiang Liuqi Yin. For palpitation and pain due to overthinking, use Guipi Tang (Restore the Spleen Decoction). For internal cold, use Lizhong Tang (Regulate the Middle Decoction); for external cold, use Wuji San (Five Accumulations Powder). For Zhu pain, use Bijidan; for severe Blood stasis, use Didang Tang (Defend Against Stasis Decoction).
Xiao Jianzhong Tang (Minor Construct the Middle Decoction)
When Liver Wood overacts on Spleen Earth causing abdominal urgency and pain, use Xiao Jianzhong Tang to soothe the Liver and harmonize the Spleen. For Blood deficiency with Cold pain, treat with Yangrou Tang (Mutton Decoction). For Qi deficiency pain, add Chenpi and Qingpi (Citri Reticulatae Pericarpium Viride) to Lizhong Tang.
[Note] Yangrou refers to Yangrou Tang (Mutton Decoction).
Wutou Zhizi Tang (Aconite and Gardenia Decoction)
To forcibly resolve various stagnant pains, use Wutou Zhizi Tang. If pain recurs after resolution, add Yuanmingfen (Mirabilite). If the patient has already undergone emesis/purgation therapy or suffers from chronic deficiency, and experiences acute pain nearing death, seek Yaming (Opium) for treatment.
[Note] "Various stagnant" refers to pain caused by various Cold or Heat stagnations. When Cold predominates, processed Chuanwu (Aconiti Radix Preparata) is the main herb. When Heat predominates, Ginger-fried Zhizi (Gardeniae Fructus) is the main herb. Yuanming refers to Yuanmingfen (Mirabilite). Yaming refers to using real Opium powder, possibly with a small amount of Shexiang (Moschus), formed into pills the size of Torreya seeds, taken 3-5 pills per dose as a guide. In Materia Medica, this is named Yili Jindan (One-Pill Golden Pill).