血家腹痛。多是瘀血。另详瘀血门。然亦有气痛者。以失血之人。气先不和。是以血不平而吐衄。但血家气
痛。与杂病气痛有别。杂病气痛。则痛之甚。血家气痛。不甚。但觉胸腹之中。不得和畅。有郁滞结聚之形。宜
逍遥散。加姜黄香附子槟榔天台乌药治之。再参瘀血痞满门更详。
身体不仁。四肢疼痛。今名痛风。古曰痹证。虚人感受外风。客于脉分。则为血痹。仲景用黄 五物汤。以桂
枝入血分。行风最效。失血家血脉既虚。往往感受外风。发为痹痛。或游走不定。或滞着一处。宜黄 五物
汤。重加当归丹皮红花。如血虚火旺之人。风中兼火。外见痹证。内见便短脉数口渴等证。则不宜桂枝之
辛温。宜四物汤加防风柴胡黄芩丹皮血通秦艽续断羚羊角桑寄生玉竹麦冬治之。血虚生风。往往而
然。当归红花荆芥。酒水煎服。瘀血窜走四肢。亦发疼痛。证似血痹。惟瘀血之痛。多如锥刺。脉不浮不拘急。
此略不同。另详瘀血门。
又有周痹香港脚。痰湿走注者。皆系杂证。此不具论。
痿者。足废不能行之谓。分五痿治之。心气热则脉痿。筋纵而不任地。天王补心丹。加丹皮治之。肝气热为
筋痿。则筋急而挛。四物汤加羚羊角续断山茱萸黄柏地骨皮治之。脾气热为肉痿。胃干而渴。肌肉不仁。
四物汤加人参山药黄芩黄柏泽泻云苓治之。肾气热则骨痿。腰脊不举。地黄汤。及大补阴丸治之。肺气
热则津痿。不能灌溉于足。疲乏不行。清燥救肺汤治之。以上治法。虽分五脏。而总系阴虚热灼。筋骨不用
之所致。欲热之退。莫如滋阴。欲阴之生。莫如独取阳明。阳明者。五脏六腑之海。主润宗筋。宗筋主束骨而
利机关。阳明虚则宗筋纵。带脉不引。故足痿不用也。宜琼玉膏。加玉竹 石膏石斛花粉珍珠竹茹治之。
玉女煎。加犀角亦治之。然痿废之原。虽在于胃。而其病之发见。则在于筋骨。凡虎骨龟板鹿筋猪脊髓牛
骨髓狗脊骨碎补牛膝苡仁枸杞子菟丝子续断。皆可加入。以为向导。
痿证与香港脚有异。切不可误用风药。
失血体质者出现腹痛，大多是由瘀血阻滞所致。这一点在“瘀血门”中有详细论述。然而，也有因气机不畅引起的疼痛。因为失血之人，气机首先不和顺，导致血液不安宁而引发吐血、衄血。但是，失血体质者的气痛，与一般杂病的气痛有所不同。杂病的气痛，疼痛程度剧烈；失血体质者的气痛，疼痛并不剧烈，只是感觉胸腹之中不舒畅，有郁结阻滞、聚结成形的感觉。适宜使用逍遥散，加入姜黄、香附子、槟榔、天台乌药来治疗。更详细的内容可参考“瘀血痞满门”。
身体麻木不仁，四肢疼痛，现在称为痛风，古代称为痹证。体虚之人感受外风，风邪客居在脉分之间，就会形成血痹。张仲景使用黄芪桂枝五物汤，利用桂枝进入血分，祛风效果极佳。失血体质者血脉本就虚弱，往往容易感受外风，发作成痹痛。有的疼痛游走不定，有的固定在一处。适宜使用黄芪桂枝五物汤，加重当归、丹皮、红花的用量。如果是血虚火旺的人，风中兼夹火邪，外在表现为痹证，内在表现为小便短赤、脉数、口渴等症状，则不宜使用桂枝的辛温之性，适宜使用四物汤，加入防风、柴胡、黄芩、丹皮、秦艽、续断、羚羊角、桑寄生、玉竹、麦冬来治疗。血虚生风的情况，往往是这样的。用当归、红花、荆芥，酒水煎服。瘀血窜走于四肢，也会引发疼痛，症状类似血痹。只有瘀血的疼痛，多像锥刺一样尖锐，脉象不浮也不拘急，这与血痹略有不同。详细内容另见“瘀血门”。
又有周痹和香港脚（足部肿痛），由痰湿流注引起，都属于杂证，此处不作详细论述。
痿证，是指双足废用不能行走的症状。分为五种痿证进行治疗。心气热会导致脉痿，筋脉弛纵而不能支撑身体站立，使用天王补心丹，加入丹皮治疗。肝气热会导致筋痿，筋脉拘急挛缩，使用四物汤，加入羚羊角、续断、山茱萸、黄柏、地骨皮治疗。脾气热会导致肉痿，胃中干燥而口渴，肌肉麻木不仁，使用四物汤，加入人参、山药、黄芩、黄柏、泽泻、云苓（茯苓）治疗。肾气热会导致骨痿，腰脊僵硬不能举动，使用地黄汤及大补阴丸治疗。肺气热会导致津痿，津液不能灌溉于足部，肢体疲乏不能行走，使用清燥救肺汤治疗。以上治疗方法，虽然分别针对五脏，但总归是由于阴虚热灼，导致筋骨功能丧失所引起的。想要退热，不如滋阴；想要生阴，不如专门调理阳明经。阳明经是五脏六腑气血的海源，主要滋润宗筋。宗筋主管约束骨骼并利于关节运动。阳明经虚弱则宗筋弛纵，带脉不能牵引，所以足部痿废不能使用。适宜使用琼玉膏，加入玉竹、石膏、石斛、花粉、珍珠、竹茹治疗。玉女煎，加入犀角也能治疗。然而，痿废的根本原因虽然在于胃，但其病症的表现则在于筋骨。凡是虎骨、龟板、鹿筋、猪脊髓、牛骨髓、狗脊、骨碎补、牛膝、薏苡仁、枸杞子、菟丝子、续断，都可以加入方中，作为引经向导。
Abdominal pain in patients with a history of bleeding is mostly caused by blood stasis. This is detailed in the chapter on Blood Stasis. However, there are also cases of Qi-related pain. In individuals who have lost blood, Qi becomes disordered first, leading to unstable blood and resulting in hematemesis or epistaxis. Nevertheless, Qi pain in these patients differs from Qi pain in miscellaneous diseases. Qi pain in miscellaneous diseases is severe, whereas Qi pain in bleeding-prone patients is not severe; it merely feels like a lack of smoothness in the chest and abdomen, with a sensation of stagnation and accumulation. Xiaoyao San (Free Wanderer Powder) should be used, added with Jianghuang (Turmeric Rhizome), Xiangfuzi (Cyperi Rhizoma), Binglang (Areca Seed), and Tiantai Wuyao (Linderae Radix). For more details, refer to the section on Blood Stasis and Fullness.
Numbness of the body and pain in the four limbs are now called gout, while in ancient times they were referred to as Bi syndrome (Obstruction Syndrome). When deficient individuals contract external wind, and the pathogen lodges in the vessel layers, it results in Blood Bi (Blood Obstruction). Zhang Zhongjing used Huangqi Guizhi Wuwu Tang (Astragalus and Cinnamon Twig Five-Ingredient Decoction), utilizing Guizhi (Cinnamon Twig) to enter the blood level, which is highly effective for expelling wind. Patients with a history of bleeding often have deficient blood vessels and are prone to contracting external wind, developing Bi pain. The pain may wander or remain fixed in one area. Huangqi Guizhi Wuwu Tang (Astragalus and Cinnamon Twig Five-Ingredient Decoction) is appropriate, with increased doses of Danggui (Angelicae Sinensis Radix), Danpi (Moutan Cortex), and Honghua (Carthami Flos). If the patient has blood deficiency with hyperactive fire, where wind combines with fire, presenting externally as Bi syndrome and internally with symptoms such as short urine, rapid pulse, and thirst, the acrid-warm nature of Guizhi (Cinnamon Twig) is unsuitable. Instead, Siwu Tang (Four-Substance Decoction) should be used, added with Fangfeng (Saposhnikoviae Radix), Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Danpi (Moutan Cortex), Qinjiao (Gentianae Macrophyllae Radix), Xuduan (Dipsaci Radix), Lingyangjiao (Saigae Tataricae Cornu), Sangjisheng (Taxilli Herba), Yuzhu (Polygonati Odorati Rhizoma), and Maidong (Ophiopogonis Radix). Wind generated from blood deficiency often occurs in this manner. Use Danggui (Angelicae Sinensis Radix), Honghua (Carthami Flos), and Jingjie (Schizonepetae Spica), decocted in wine and water. Blood stasis wandering into the four limbs can also cause pain, resembling Blood Bi. However, pain from blood stasis is often sharp like a needle prick, and the pulse is neither floating nor tense, which differs slightly. See the chapter on Blood Stasis for details.
Zhou Bi (General Bi) and Hongjiaojiao (Hong Kong Foot/Gouty Arthritis) caused by phlegm-dampness flowing and pouring belong to miscellaneous diseases and are not discussed here.
Wei syndrome refers to the inability to walk due to leg paralysis. It is treated according to five types. Heat in Heart Qi causes Mai Wei (Vessel Atrophy), characterized by flaccid tendons unable to support the body; Tianwang Buxin Dan (Emperor of Heaven's Tonic for the Heart Pill) added with Danpi (Moutan Cortex) is used. Heat in Liver Qi causes Jin Wei (Tendon Atrophy), characterized by tight and contracted tendons; Siwu Tang (Four-Substance Decoction) added with Lingyangjiao (Saigae Tataricae Cornu), Xuduan (Dipsaci Radix), Shanzhuyu (Corni Fructus), Huangbai (Phellodendri Cortex), and Digupi (Lycii Cortex) is used. Heat in Spleen Qi causes Rou Wei (Muscle Atrophy), characterized by a dry stomach with thirst and insensate muscles; Siwu Tang (Four-Substance Decoction) added with Renshen (Ginseng Radix), Shanyao (Dioscoreae Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), Zexie (Alismatis Rhizoma), and Yunling (Poria) is used. Heat in Kidney Qi causes Gu Wei (Bone Atrophy), characterized by an immobile lower back and spine; Dihuang Tang (Rehmannia Decoction) and Dabu Yin Wan (Great Tonify Yin Pill) are used. Heat in Lung Qi causes Jin Wei (Fluid Atrophy), where fluids cannot irrigate the feet, causing fatigue and immobility; Qingzao Jiufei Tang (Clear Dryness Rescue Lung Decoction) is used. Although the above treatments differentiate by the five zang organs, they all stem from yin deficiency and heat scorching, leading to dysfunction of the sinews and bones. To clear heat, nothing is better than nourishing yin; to generate yin, nothing is better than focusing on the Yangming channel. Yangming is the sea of the five zang and six fu organs, primarily moistening the Zongjin (Major Sinew). Zongjin binds the bones and facilitates joint movement. Deficiency of Yangming leads to flaccidity of Zongjin and failure of the Dai Mai (Girdle Vessel) to pull, resulting in foot atrophy and immobility. Qiongyu Gao (Jade Elixir Paste) added with Yuzhu (Polygonati Odorati Rhizoma), Shigao (Gypsum Fibrosum), Shihu (Dendrobii Caulis), Huafen (Trichosanthis Radix), Zhenzhu (Margarita), and Zhuru (Bambusae Caulis in Taenia) is appropriate. Yuni Jian (Jade Woman Decoction) added with Xijiao (Rhinocerotis Cornu) is also effective. However, although the root of Wei syndrome lies in the Stomach, its manifestation lies in the sinews and bones. All of the following can be added as guiding herbs: Hugu (Pantheris Os), Guiban (Testudinis Carapax et Plastrum), Lujin (Cervi Tendo), Zhujingsui (Porci Medulla Spinalis), Niujingsui (Bovis Medulla Spinalis), Gouji (Cantori Os), Gusuibu (Drynariae Rhizoma), Niu Xi (Achyranthis Bidentatae Radix), Yiren (Coicis Semen), Gouqizi (Lycii Fructus), Tusizi (Cuscutae Semen), and Xuduan (Dipsaci Radix).
Wei syndrome differs from Hongjiaojiao (Hong Kong Foot/Gouty Arthritis); wind-expelling drugs must never be mistakenly used.