【内伤腋痛之症】无外感之邪，但两腋下作痛，或见咳嗽气逆，此内伤腋痛之症也。
【内伤腋痛之因】或恼怒怫郁，肝火刑金；或膏粱积热，熏蒸肺气；或房劳不谨，肾
火上冲。皆成内伤腋痛之症。
【内伤腋痛之脉】寸口脉大，肺气有伤。右关洪数，膏粱积热。脉沉而结，肺气
【内伤腋痛之治】若恼怒伤肝，木火刑金，加味泻白散。膏粱积热，土中之火刑金，
加味清胃汤，倍川连、枳壳。房劳不谨，水中之火刑金，家秘天地煎，合黄芩泻白散、二母汤。
加味泻白散
桑白皮 地骨皮 甘草 黄芩 柴胡 钩藤 苏梗 桔梗 山栀
加味清胃汤
升麻 川连 甘草 葛根 石膏 桑白皮 枳壳 地骨皮
家秘天地煎
天冬 地黄 黄柏 知母 川贝母 甘草 麦冬 桑白皮 地骨皮
水煎三四次，冲玄武胶收。
黄芩泻白散 即泻白散加黄芩。
二母汤 即贝母、知母，二味同煎。
秦子曰∶《内经》云∶西风生于秋，病在肺， 在肩背。则肩背之痛，乃肺之分野；且
手阳明大肠之脉，循臂上廉，上肩出 骨之前廉，上出柱骨，下入缺盆络肺，其支别者
，从缺盆，上颈贯颊。又云∶手太阳小肠之脉，出肩解，绕肩胛，交肩上，入缺盆，其支别
者，从缺盆循颈，上颊。按此论之，则肩背肺俞之痛，乃肺与大小肠为患矣。故肺病则缺盆
中痛，肩背痛；大肠病，则耳后肩 肘臂皆痛；小肠病，则肩 肘臂肿痛。故凡背
部肺 作痛，要分别右左二 ，外感内伤，有余不足。若右肺 缺盆痛，此肺与大肠之症；
若左肺 缺盆痛，乃是肺与小肠症也，以左右而分大肠小肠。至肺 ，则左右皆属肺也。然
太阳膀胱之脉，亦在于背，但膀胱太阳之病，满背皆痛，不比肺痛，止在肺 缺盆也。
【内伤腋痛的症状】没有外感邪气，只是两侧腋下疼痛，或者出现咳嗽、气逆的症状，这就是内伤腋痛的病症。
【内伤腋痛的病因】有的因恼怒抑郁，导致肝火刑克肺金；有的因饮食肥甘厚味积热，熏蒸肺气；有的因房事不节制，肾火上冲。这些都形成了内伤腋痛的病症。
【内伤腋痛的脉象】寸口脉大，说明肺气受损。右关脉洪数，是饮食积热的表现。脉象沉而结滞，是肺气……（原文此处似有缺漏，依文意推测为肺气郁闭或不足等，但严格翻译需忠实原文，故译为：脉象沉而结滞，肺气[受阻/受损]）。
【内伤腋痛的治疗】如果是恼怒伤肝，木火刑克肺金，使用加味泻白散。如果是饮食积热，土中之火刑克肺金，使用加味清胃汤，加倍使用黄连和枳壳。如果是房劳不谨，水中之火刑克肺金，使用家秘天地煎，配合黄芩泻白散和二母汤。
加味泻白散
桑白皮 地骨皮 甘草 黄芩 柴胡 钩藤 苏梗 桔梗 山栀
加味清胃汤
升麻 川连 甘草 葛根 石膏 桑白皮 枳壳 地骨皮
家秘天地煎
天冬 地黄 黄柏 知母 川贝母 甘草 麦冬 桑白皮 地骨皮
用水煎煮三四次，冲服玄武胶（龟板胶）收功。
黄芩泻白散 即泻白散加入黄芩。
二母汤 即贝母、知母两味药同煎。
秦子说：《内经》中说：“西风生于秋季，病在肺，表现在肩背。”那么肩背部的疼痛，属于肺的领域；而且手阳明大肠经的经脉，沿着手臂上侧，上行至肩部，出于臂骨前缘，上行出柱骨，下行入缺盆联络肺，其分支从缺盆上行颈部贯穿面颊。又说：手太阳小肠经的经脉，出于肩关节，环绕肩胛，交会于肩上，入缺盆，其分支从缺盆沿颈部上行至面颊。根据这些论述，那么肩背部肺俞穴区域的疼痛，是由肺与大肠、小肠引起的病变。所以肺病会导致缺盆中疼痛、肩背痛；大肠病，会导致耳后、肩、肘、臂都疼痛；小肠病，会导致肩、肘、臂肿痛。所以凡是背部肺部区域疼痛，要分别左右两个部位，辨别是外感还是内伤，是实证还是虚证。如果右侧肺区及缺盆疼痛，这是肺与大肠的病症；如果左侧肺区及缺盆疼痛，乃是肺与小肠的病症，以此区分大肠和小肠。至于肺本身，则左右都属于肺。然而足太阳膀胱经的经脉，也在背部，但膀胱太阳经的病证，是整个背部都疼痛，不像肺痛那样，仅局限于肺区和缺盆。
[Symptoms of Internal Injury Axillary Pain] Without external pathogenic factors, there is pain in both axillae, or accompanied by cough and rebellious qi; this constitutes the syndrome of internal injury axillary pain.
[Etiology of Internal Injury Axillary Pain] It may result from anger and depression, causing Liver Fire to insult Lung Metal (Wood insulting Metal); or from accumulation of heat due to rich and greasy diet, steaming and affecting Lung Qi; or from imprudence in sexual activity, causing Kidney Fire to rush upward. All these lead to the syndrome of internal injury axillary pain.
[Pulse Diagnosis of Internal Injury Axillary Pain] The pulse at Cun Kou (Radial Artery) is large, indicating injury to Lung Qi. The pulse at Right Guan (Radial Artery position corresponding to Spleen/Stomach) is surging and rapid, indicating heat accumulation from rich food. The pulse is deep and knotted, indicating [Lung Qi obstruction/injury - text incomplete].
[Treatment of Internal Injury Axillary Pain] If anger injures the Liver, with Wood Fire insulting Lung Metal, use Jia Wei Xie Bai San (Modified Draining White Powder). If heat accumulates from rich diet, with Earth Fire insulting Lung Metal, use Jia Wei Qing Wei Tang (Modified Stomach-Clearing Decoction), doubling the dosage of Chuan Lian (Coptis Rhizome) and Zhi Qiao (Aurantium Fructus). If imprudence in sexual activity causes Water Fire to insult Lung Metal, use Jia Mi Tian Di Jian (Secret Heaven-Earth Decoction), combined with Huang Qin Xie Bai San (Scutellaria Modified Draining White Powder) and Er Mu Tang (Two Mother Decoction).
Jia Wei Xie Bai San (Modified Draining White Powder)
Sang Bai Pi (Morus Alba Root Bark), Di Gu Pi (Lycium Bark), Gan Cao (Licorice Root), Huang Qin (Scutellaria Root), Chai Hu (Bupleurum Root), Gou Teng (Uncaria Ramulus Cum Uncis), Su Geng (Perilla Stem), Jie Geng (Platycodon Root), Shan Zhi (Gardenia Fruit).
Jia Wei Qing Wei Tang (Modified Stomach-Clearing Decoction)
Sheng Ma (Cimicifugae Rhizoma), Chuan Lian (Coptidis Rhizoma), Gan Cao (Licorice Root), Ge Gen (Puerariae Radix), Shi Gao (Gypsum Fibrosum), Sang Bai Pi (Mori Cortex), Zhi Qiao (Aurantii Fructus), Di Gu Pi (Lycii Cortex).
Jia Mi Tian Di Jian (Secret Heaven-Earth Decoction)
Tian Dong (Asparagi Radix), Di Huang (Rehmanniae Radix), Huang Bo (Phellodendri Cortex), Zhi Mu (Anemarrhenae Rhizoma), Chuan Bei Mu (Fritillariae Cirrhosae Bulbus), Gan Cao (Licorice Root), Mai Dong (Ophiopogonis Radix), Sang Bai Pi (Mori Cortex), Di Gu Pi (Lycii Cortex).
Decoct in water three to four times, and take with dissolved Xuan Wu Jiao (Testudinis Carapax et Plastrum / Tortoise Shell Glue).
Huang Qin Xie Bai San (Scutellaria Modified Draining White Powder) is Xie Bai San plus Huang Qin.
Er Mu Tang (Two Mother Decoction) consists of Bei Mu (Fritillariae Bulbus) and Zhi Mu (Anemarrhenae Rhizoma), decocted together.
Qin Zi stated: The *Nei Jing* (Inner Canon) says: "West wind arises in autumn, disease affects the Lung, manifesting in the shoulder and back." Therefore, pain in the shoulder and back belongs to the domain of the Lung. Furthermore, the Hand-Yangming Large Intestine Meridian follows the lateral aspect of the arm, ascends to the shoulder, emerges anterior to the humerus, ascends to the vertebral column, descends into the Supraclavicular Fossa (Que Pen), and connects with the Lung. Its branch from the Supraclavicular Fossa ascends the neck and penetrates the cheek. It also states: the Hand-Taiyang Small Intestine Meridian exits the shoulder joint, circles the scapula, intersects at the shoulder, enters the Supraclavicular Fossa. Its branch from the Supraclavicular Fossa follows the neck to the cheek. Based on this discussion, pain in the shoulder and back at the Lung Shu area is caused by disorders of the Lung, Large Intestine, and Small Intestine. Thus, Lung disease causes pain in the Supraclavicular Fossa and shoulder/back pain; Large Intestine disease causes pain behind the ear, shoulder, elbow, and arm; Small Intestine disease causes swelling and pain in the shoulder, elbow, and arm. Therefore, for pain in the back at the Lung area, one must distinguish between the right and left sides, and differentiate between external contraction and internal injury, excess and deficiency. If the right Lung area and Supraclavicular Fossa are painful, this is a syndrome of the Lung and Large Intestine; if the left Lung area and Supraclavicular Fossa are painful, it is a syndrome of the Lung and Small Intestine, distinguishing Large and Small Intestines by left and right. As for the Lung itself, both sides belong to the Lung. However, the Foot-Taiyang Bladder Meridian is also located in the back, but Bladder Taiyang disease involves pain across the entire back, unlike Lung pain which is confined to the Lung area and Supraclavicular Fossa.