臂痛虽小症而虚实宜分盖此等之症最难辨也实症若何其痛长长在于一处皮毛之外但觉苦
楚按
之痛更甚口渴便闭此实邪也用搜风散火祛痰之味自然有效苟若不然更添疼痛吾以外祛汤治之
一剂而痛轻两剂而痛减三剂而痛愈使邪从外入仍从外出也虚症若何其痛不定或走来而走去或
在左而移右捶之而痛减摩之而痛安或作 而现形或生瘢而见色口必不渴而痰结更深肠必干枯
而溺偏清白此真气之虚而痰气壅滞固结而然也若用祛风之剂而身原无风或用祛火之药而体非
实火即用消痰之剂而正气既虚痰亦难去必须用健脾补肾之药而后佐之去风去火去痰之品自
然手到病除也方用卫臂散此方全不去治臂痛而单去滋肝益肾水木有养自不去克脾脾气健旺自
能运动四肢何致有两臂之痛哉
外祛汤
白术（五钱） 防风（三钱） 炒栀子（三钱） 荆芥（三钱） 半夏（三钱） 乌药（三钱） 甘草（一
钱） 白芍（三钱） 水煎服
卫臂散
黄 （一两） 当归（五钱） 防风（一钱） 白芥子（三钱） 白芍（五钱） 茯苓（五钱） 熟地（五
钱） 枸杞子（三钱） 薏仁（三钱）水煎服
两足之痛亦有虚实其症与两臂相同而少有异者盖足居下流多感水湿之气实症之生必为水
肿按
之皮肉如泥者是也虚症之生虽感水气而不致肿胀之如泥骨中作酸时痛时止久之膝大而腿胀者
是也实症宜泻其水用牵牛甘遂各二钱煎汤服之实时获效正不必俟其大肿而后治之也虚症不可
泻水宜补其气而兼利湿温其火而带治其风之为得也方用顾足散此方之妙妙在用气分之药以壮
其气气壮而后利水则水自出而邪自难留也
顾足散
黄 （一两） 薏仁（一两） 芡实（五钱） 白术（一两） 车前子（五钱） 肉桂（五分） 防风（五
分） 茯苓（五钱） 白芥子（五钱） 水煎服
臂痛虽然是小病症，但虚实必须区分，因为这类病症最难辨别。实证是怎样的疼痛？疼痛长久固定在一处，位于皮毛之外，只感到痛苦，按压时疼痛加剧，伴有口渴、大便闭塞，这是实邪所致，使用搜风、散火、祛痰的药物自然会有效；如果不这样，反而会增加疼痛，我用外祛汤治疗它，一剂后疼痛减轻，两剂后疼痛减少，三剂后疼痛痊愈，使邪气从外侵入仍从外出。虚证是怎样的疼痛？疼痛不固定，有时走来走去，或在左边移到右边，捶打后疼痛减轻，抚摸后疼痛安宁，有时发作并出现形状，或产生瘢痕并显现颜色，口中一定不渴而痰结更深，肠道一定干枯而小便偏清白，这是真气虚弱而痰气壅滞固结造成的。如果使用祛风的药剂而身体原本无风，或使用祛火的药物而体质并非实火，即使用消痰的药剂而正气已经虚弱，痰也难以去除，必须使用健脾补肾的药物，然后辅助以去风、去火、去痰的物品，自然手到病除。方剂用卫臂散，这个方子完全不直接治疗臂痛，而是专门滋肝益肾，水木有滋养，自然不去克制脾土，脾气健旺，自然能运动四肢，怎么会引起两臂疼痛呢？
外祛汤
白术（五钱） 防风（三钱） 炒栀子（三钱） 荆芥（三钱） 半夏（三钱） 乌药（三钱） 甘草（一钱） 白芍（三钱），水煎服。
卫臂散
黄芪（一两） 当归（五钱） 防风（一钱） 白芥子（三钱） 白芍（五钱） 茯苓（五钱） 熟地黄（五钱） 枸杞子（三钱） 薏苡仁（三钱），水煎服。
两足疼痛也有虚实之分，其症状与两臂相同而略有不同，因为足部处于下方，多感受水湿之气。实证的产生必定伴随水肿，按压时皮肉如泥般凹陷的是实证。虚证的产生虽然感受水气但不致肿胀如泥，骨中作酸，时痛时止，久而久之膝盖变大而腿部胀大的是虚证。实证应当泻其水，用牵牛子、甘遂各二钱煎汤服用，实时获得效果，正不必等到其大肿后才治疗。虚证不可泻水，应当补气兼利湿，温其火而兼治其风，这才是得当的方法。方剂用顾足散，这个方子的妙处在于使用气分的药物来壮其气，气壮之后利水则水自然排出而邪气难以留存。
顾足散
黄芪（一两） 薏苡仁（一两） 芡实（五钱） 白术（一两） 车前子（五钱） 肉桂（五分） 防风（五分） 茯苓（五钱） 白芥子（五钱），水煎服。
Although arm pain is a minor condition, it is essential to distinguish between excess (Shi) and deficiency (Xu), as such conditions are the most difficult to differentiate. What does an excess pattern look like? The pain remains fixed in one location for a long time, situated outside the skin and hair follicles, causing suffering that worsens upon palpation, accompanied by thirst and constipation; this is caused by pathogenic factors. Using herbs that dispel wind, clear fire, and resolve phlegm will naturally be effective. If not treated thus, the pain may increase. I treat it with Waiqu Decoction: after one dose, the pain lightens; after two doses, it decreases; after three doses, it resolves, allowing the pathogen to exit from where it entered. What does a deficiency pattern look like? The pain is not fixed, wandering here and there or shifting from left to right; it alleviates with percussion and soothes with massage; sometimes it manifests with visible shapes or discoloration/scars; the mouth is certainly not thirsty, yet phlegm accumulation deepens; the intestines are certainly dry, yet urination is clear and copious; this results from the deficiency of true Qi and the stagnation and consolidation of phlegm-Qi. If one uses wind-dispelling formulas when there is no wind in the body, or fire-clearing medicines when the constitution lacks excess fire, or phlegm-resolving agents when the righteous Qi is already deficient, the phlegm will be difficult to remove. One must use herbs that strengthen the Spleen and tonify the Kidney, then assist them with items that dispel wind, clear fire, and resolve phlegm, achieving immediate results. The formula used is Wei Bi San. This formula does not directly treat arm pain but instead nourishes the Liver and benefits the Kidney. With Water and Wood nourished, they naturally do not overact upon Earth; with the Spleen Qi robust, it can naturally move the four limbs, so how could arm pain arise?
Waiqu Decoction
Atractylodis Macrocephalae Rhizoma (5 qian), Saposhnikoviae Radix (3 qian), Gardeniae Fructus Preparatus (3 qian), Schizonepetae Spica (3 qian), Pinelliae Tuber (3 qian), Linderae Radix (3 qian), Glycyrrhizae Radix et Rhizoma (1 qian), Paeoniae Radix Alba (3 qian). Decoct in water and take orally.
Wei Bi San
Astragali Radix (1 liang), Angelicae Sinensis Radix (5 qian), Saposhnikoviae Radix (1 qian), Brassicae Semen Album (3 qian), Paeoniae Radix Alba (5 qian), Poria (5 qian), Rehmanniae Radix Praeparata (5 qian), Lycii Fructus (3 qian), Coicis Semen (3 qian). Decoct in water and take orally.
Pain in both feet also has excess and deficiency patterns. The symptoms are similar to those of the arms but with slight differences, as the feet are located inferiorly and are prone to contracting dampness-water pathogens. The generation of an excess pattern necessarily involves edema; if pressing causes the skin and flesh to sink like mud, it is an excess pattern. The generation of a deficiency pattern involves contracting dampness-water without resulting in pitting edema; the bones feel sour, pain comes and goes, and over time the knees enlarge while the legs swell; this is a deficiency pattern. For an excess pattern, one should drain the water using Kansui Radix and Pharbitidis Semen, each 2 qian, decocted in water and taken orally, obtaining immediate effect; there is no need to wait for severe swelling before treating. For a deficiency pattern, one must not drain water but rather tonify Qi while promoting diuresis, warm the Fire while simultaneously treating Wind; this is the appropriate approach. The formula used is Gu Zu San. The brilliance of this formula lies in using Qi-regulating herbs to strengthen Qi; once Qi is strong, diuresis occurs naturally, expelling water and making it difficult for pathogens to remain.
Gu Zu San
Astragali Radix (1 liang), Coicis Semen (1 liang), Euryales Semen (5 qian), Atractylodis Macrocephalae Rhizoma (1 liang), Plantaginis Semen (5 qian), Cinnamomi Cortex (5 fen), Saposhnikoviae Radix (5 fen), Poria (5 qian), Brassicae Semen Album (5 qian). Decoct in water and take orally.