温湿热蒸，阻流行之隧，宜宣通之
石膏 杏仁 生苡仁 威灵仙 滑石 防己 寒水石
足膝肿痛（久不止内热）
生虎骨 仙灵脾 淮牛膝 金狗脊 陕归身 川萆
右腿痛不肿，入夜势笃（此邪留于阴，治从肝经）
杜仲 小茴香 穿山甲 归须 北细辛 干地龙
足痛攻冲（吐涎，大拇指疼）
吴萸 独活 归身 附子 细辛 防己
两足皮膜抚之则痛（此厥阴犯阳明胃也）
川楝子 小青皮 归须 橘红 延胡索 炒山栀 桃仁 查肉
饱食则哕，两足骨髓皆痛，此阳明不克司束筋骨。
用转旋阳气法（苓桂术姜汤）
陈参曰∶腿足痛，外感者推寒湿、湿热、湿风之流经入络。《内经》云∶伤于湿者，下先受
之，以治湿为主，或佐温佐清佐散为宜。若内伤，不外肝脾肾三者之虚，或补中或填下或养肝为治。
背者胸中之府，肺俞为病，即肩背作痛。又背为阳明之府，而阳明为十二经之长，虚则
不能束筋骨利机关，即肩垂背曲而臂亦作痛矣。阳明脉衰，肩胛筋衰不举而痛楚也。
手臂因何作疼痛，经络血虚风湿中。二术（苍白）南（星）秦（艽）二活（羌独）防（风），寒
桂（枝）艾血芎归用。热芩痰芥气参 ，伤用威灵红桃送。背属太阳膀胱经，此经气郁痛不
禁。羌活胜湿汤最妙，一点冷痛痰二陈。劳役过度时时痛，十全大补应安平。
营虚脉络失养，风动筋急（痛绕耳后，仿李东垣舒筋法）
当归 川桂枝 防风根 生 生于术 片姜黄 另服化脉活络丹一丸
劳倦肩背疼
桂 术 五加皮 苡仁 防己 白蒺藜 茯苓
阳明虚肝风动（当用柔甘温养法）
首乌 杞子 柏子仁 甘菊炭 归身 胡麻 羚角片 海桐皮 煨天麻 童桑枝 白蒺藜
寒郁气隧胸引肩背皆痛
宗《内经》诸痛皆寒之义，以温药两通气血。
川桂枝 川椒目 熟附子 橘皮 乌药支 淡吴英 延胡索 制香附 苏梗 远志
肉炒于术 白茯苓 元红花
肝浊冲逆作痛
干姜 乌梅 炒白芍 川黄连 川柏 细辛 炒川楝
失血，胃络虚，肩背痛（宜填补阳明）
人参 炒枣仁 白芍 茯神 陕归身 炙甘草
督脉虚，肾气上逆
陈参曰∶肾气攻背，项强溺频，是督脉不摄。用奇经药以峻补真阳为主。
鹿角霜 归身 杜仲 沙苑子 青盐 鹿角胶 杞子 茯苓 菟丝子
陈参曰∶凡冲气攻痛，从背而上者，系督脉主病，治在少阴。从腹而上者，系冲脉主病，
治在厥阴。此治病之宗旨也。故肺俞之风用防风散，痰臂流背痛用指迷丸。
湿热之邪蒸腾，阻滞了气机运行的通道，适宜采用宣通的方法治疗。
石膏、杏仁、生薏苡仁、威灵仙、滑石、防己、寒水石。
足部和膝部肿痛（若久治不愈则伴有内热）。
生虎骨、淫羊藿、淮牛膝、金狗脊、当归身、川萆薢。
右腿疼痛但不肿胀，入夜后症状加重（这是邪气滞留于阴分，治疗应从肝经入手）。
杜仲、小茴香、穿山甲、当归须、北细辛、干地龙。
足部疼痛呈攻冲状（伴有吐涎沫，大拇指疼痛）。
吴茱萸、独活、当归身、附子、细辛、防己。
双脚皮肤及皮下组织触碰即痛（这是厥阴肝经侵犯阳明胃经所致）。
川楝子、小青皮、当归须、橘红、延胡索、炒栀子、桃仁、山楂肉。
饱食后发生呃逆，两足骨髓皆痛，这是因为阳明胃气虚弱，不能主持约束筋骨的功能。
采用转旋阳气的方法（使用苓桂术姜汤）。
陈修园说：腿足疼痛，外感因素多推究为寒湿、湿热、湿风等邪气流经并侵入络脉。《内经》说：被湿邪所伤，身体下部先受邪，因此以治疗湿邪为主，或辅以温法、清法、散法为宜。若是内伤引起的，不外乎肝、脾、肾三脏的虚损，治疗或补益中气，或填补下元，或滋养肝脏。
背部是胸中脏腑的外府，肺俞穴发病，就会引起肩背疼痛。另外，背部也是阳明经所主的区域，而阳明经是十二经脉之长，正气虚弱就不能约束筋骨、滑利关节，就会出现肩膀下垂、背部弯曲以及手臂疼痛的情况。阳明经脉衰退，肩胛部的筋脉衰弱不能抬举，从而产生疼痛。
手臂为什么会疼痛？是因为经络血虚，风湿之邪侵袭。用药可用苍术、白术、天南星、秦艽、羌活、独活、防风，若有寒象加桂枝、艾叶，血虚加川芎、当归；若有热象加黄芩，有痰加芥子，气滞加人参，外伤瘀血用威灵仙、红花、桃仁送服。背部属于太阳膀胱经，此经气机郁滞导致疼痛不止。羌活胜湿汤最为巧妙，若有一点冷痛且兼有痰湿，可用二陈汤。劳役过度导致的时时疼痛，十全大补汤应能使其平安。
营血虚弱，脉络失养，风动导致筋脉拘急（疼痛环绕耳后，仿照李东垣的舒筋方法）。
当归、川桂枝、防风根、生白术、片姜黄，另服用化脉活络丹一丸。
因劳累疲倦导致的肩背疼痛。
桂枝、白术、五加皮、薏苡仁、防己、白蒺藜、茯苓。
阳明虚弱，肝风内动（应当使用柔润甘缓、温养的方法）。
何首乌、枸杞子、柏子仁、甘菊炭、当归身、胡麻仁、羚羊角片、海桐皮、煨天麻、桑枝、白蒺藜。
寒邪郁结在气机通道，牵引胸部和肩背都疼痛。
遵循《内经》“各种疼痛大多由寒邪引起”的道理，使用温药来同时疏通气血。
川桂枝、川椒目、熟附子、橘皮、乌药、淡吴茱萸、延胡索、制香附、苏梗、远志、肉炒白术、白茯苓、红花。
肝气浊逆上冲导致疼痛。
干姜、乌梅、炒白芍、川黄连、川黄柏、细辛、炒川楝子。
失血后，胃络虚弱，导致肩背痛（适宜填补阳明经气）。
人参、炒酸枣仁、白芍、茯神、当归身、炙甘草。
督脉虚弱，肾气上逆。
陈修园说：肾气攻冲背部，颈部僵硬、小便频繁，这是督脉不能固摄的表现。使用奇经药物以峻补真阳为主。
鹿角霜、当归身、杜仲、沙苑子、青盐、鹿角胶、枸杞子、茯苓、菟丝子。
陈修园说：凡是冲气攻痛，从背部向上走的，属于督脉主病，治疗重点在少阴肾经。从腹部向上走的，属于冲脉主病，治疗重点在厥阴肝经。这是治病的基本原则。所以肺俞受风用防风散，痰湿流注导致的臂背痛用指迷丸。
Damp-heat steaming obstructs the pathways of Qi circulation; it is appropriate to use methods that promote free flow.
Shigao (Gypsum Fibrosum), Xingren (Armeniacae Semen Amarum), Sheng Yiyiren (Coicis Semen), Weilingxian (Clematidis Radix et Rhizoma), Huashi (Talcum), Fangji (Stephaniae Tetrandrae Radix), Hanshuishi (Calcitrum).
Swelling and pain in the feet and knees (if persistent, internal heat develops).
Sheng Hugu (Ossis Tigridis), Xianlingpi (Epimedii Folium), Huai Niuxi (Achyranthis Bidentatae Radix), Jin Gouji (Drynariae Rhizoma), Gui Shen (Angelicae Sinensis Radix), Chuan Bi (Dioscoreae Hypoglaucae Rhizoma).
Pain in the right leg without swelling, worsening at night (this indicates pathogenic factors lingering in the Yin aspect; treatment should target the Liver meridian).
Duzhong (Eucommiae Cortex), Xiaohuixiang (Foeniculi Fructus), Chuanshanjia (Manis Squama), Guixu (Angelicae Sinensis Radix), Beixixin (Asari Radix et Rhizoma), Gandilong (Eelworm).
Attacking pain in the feet (accompanied by salivation and pain in the big toe).
Wuyu (Evodiae Fructus), Duhuo (Angelicae Pubescentis Radix), Guishen (Angelicae Sinensis Radix), Fuzi (Aconiti Lateralis Radix Preparata), Xixin (Asari Radix et Rhizoma), Fangji (Stephaniae Tetrandrae Radix).
Pain upon touching the skin and subcutaneous tissue of both feet (this indicates the Jueyin Liver meridian invading the Yangming Stomach meridian).
Chuanlianzi (Meliae Fructus), Xiao Qingpi (Citri Reticulatae Pericarpium Viride), Guixu (Angelicae Sinensis Radix), Juhong (Citri Reticulatae Pericarpium Rubrum), Yanhusuo (Corydalis Rhizoma), Chao Zhizi (Gardeniae Fructus), Taoren (Persicae Semen), Zharou (Crataegi Fructus).
Regurgitation after full meals, pain in the marrow of both legs, indicating Yangming deficiency failing to bind sinews and bones.
Use the method of rotating Yang Qi (Ling Gui Zhu Gan Tang modified with Ginger).
Chen Xiuyuan stated: Leg and foot pain caused by external pathogens is primarily attributed to Cold-Damp, Damp-Heat, or Damp-Wind pathogens entering the collaterals. The *Neijing* states: "When injured by dampness, the lower part of the body is affected first." Therefore, treatment focuses on resolving dampness, assisted by warming, clearing, or dispersing methods if necessary. If caused by internal injury, it involves deficiency of the Liver, Spleen, or Kidney; treatment may involve tonifying the Middle Jiao, filling the Lower Jiao, or nourishing the Liver.
The back is the mansion of the chest organs. Disease affecting the Feishu (BL13) acupoint causes shoulder and back pain. Furthermore, the back is governed by the Yangming meridians, which are the leaders of the twelve meridians. Deficiency leads to an inability to bind sinews and bones and facilitate joint movement, resulting in drooping shoulders, curved back, and arm pain. Decline of the Yangming pulse leads to weakness of the scapular tendons, causing immobility and pain.
Why do arms hurt? Due to blood deficiency in the meridians and invasion of Wind-Damp. Use Baizhu (Atractylodis Macrocephalae Rhizoma), Baizhu (Atractylodis Rhizoma), Nanxing (Arisaematis Rhizoma), Qinjiao (Gentianae Macrophyllae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Fangfeng (Saposhnikoviae Radix). For cold, add Guizhi (Cinnamomi Ramulus) and Aiye (Artemisiae Argyi Folium); for blood deficiency, add Xiong (Chuanxiong Rhizoma) and Gui (Angelicae Sinensis Radix). For heat, add Huangqin (Scutellariae Radix); for phlegm, add Jiezi (Sinapis Semen); for Qi stagnation, add Renshen (Ginseng Radix et Rhizoma). For trauma/stasis, send down with Weilingxian (Clematidis Radix et Rhizoma), Honghua (Carthami Flos), and Taoren (Persicae Semen). The back belongs to the Taiyang Bladder meridian; Qi stagnation here causes unendurable pain. Qianghuo Shengshi Tang is excellent. For slight cold pain with phlegm, use Erchen Tang. For pain due to overexertion, Shiquan Dabu Tang ensures peace.
Ying (Nutritive) blood deficiency fails to nourish the collaterals; Wind stirring causes tendon tension (pain circling behind the ear, imitating Li Dongyuan's tendon-soothing method).
Danggui (Angelicae Sinensis Radix), Chuan Guizhi (Cinnamomi Ramulus), Fangfenggen (Saposhnikoviae Radix), Sheng Baizhu (Atractylodis Macrocephalae Rhizoma), Pian Jianghuang (Curcumae Longae Rhizoma). Take one pill of Huamai Huoluo Dan separately.
Shoulder and back pain due to fatigue and exhaustion.
Guizhi (Cinnamomi Ramulus), Baizhu (Atractylodis Rhizoma), Wujiaopi (Acanthopanacis Cortex), Yiyiren (Coicis Semen), Fangji (Stephaniae Tetrandrae Radix), Baijili (Tribuli Fructus), Fuling (Poria).
Yangming deficiency with Liver Wind stirring (use a method of softening, sweetening, warming, and nourishing).
Shouwu (Polygoni Multiflori Radix), Qizi (Lycii Fructus), Baiziren (Biotae Semen), Ganju Tan (Chrysanthemi Indici Flos Carbonized), Guishen (Angelicae Sinensis Radix), Huma (Sesami Fructus), Lingjiao Pian (Saigae Tataricae Cornu), Haitongpi (Saposhnikoviae Radix), Wei Tianma (Gastrodiae Rhizoma), Tong Sangzhi (Mori Ramulus), Baijili (Tribuli Fructus).
Cold stagnation in the Qi pathways drawing pain from the chest to the shoulder and back.
Following the *Neijing* principle that "all pains are due to cold," use warm herbs to simultaneously unblock Qi and Blood.
Chuan Guizhi (Cinnamomi Ramulus), Chuan Jiaomu (Zanthoxyli Fructus), Shu Fuzi (Aconiti Lateralis Radix Preparata), Ju Pi (Citri Reticulatae Pericarpium), Wuyao (Linderae Radix), Dan Wuying (Evodiae Fructus), Yanhusuo (Corydalis Rhizoma), Zhi Xiangfu (Cyperi Rhizoma), Sugeng (Perillae Caulis), Yuanzhi (Polygalae Radix), Rou Chao Baizhu (Atractylodis Macrocephalae Rhizoma), Bai Fuling (Poria), Honghua (Carthami Flos).
Liver turbidity rushing upward causing pain.
Ganjiang (Zingiberis Rhizoma), Wumei (Mume Fructus), Chao Baishao (Paeoniae Radix Alba), Chuan Huanglian (Coptidis Rhizoma), Chuan Huangbai (Phellodendri Chinensis Cortex), Xixin (Asari Radix et Rhizoma), Chuan Chuanlian (Meliae Fructus).
After blood loss, deficiency of the Stomach collaterals causes shoulder and back pain (appropriate to tonify the Yangming).
Renshen (Ginseng Radix et Rhizoma), Chao Zaoren (Ziziphi Spinosae Semen), Baishao (Paeoniae Radix Alba), Fushen (Poria cum Radix), Sheng Guishen (Angelicae Sinensis Radix), Zhi Gancao (Glycyrrhizae Radix et Rhizoma Preparata).
Du Mai (Governor Vessel) deficiency with rebellious Kidney Qi.
Chen Xiuyuan stated: When Kidney Qi attacks the back, accompanied by neck stiffness and frequent urination, it is because the Du Mai fails to secure. Use extraordinary vessel herbs to vigorously tonify True Yang.
Lujiaoshuang (Cornu Cervi Degelatinatum), Guishen (Angelicae Sinensis Radix), Duzhong (Eucommiae Cortex), Shayuanzi (Astragali Complanati Semen), Qingyan (Sal), Lujiaojiao (Cornu Cervi Colla Gelatinum), Qizi (Lycii Fructus), Fuling (Poria), Tusizi (Cuscutae Semen).
Chen Xiuyuan stated: Whenever rebellious Qi attacks with pain moving upward from the back, it is a disease of the Du Mai, treated via the Shaoyin (Kidney) meridian. When moving upward from the abdomen, it is a disease of the Chong Mai (Penetrating Vessel), treated via the Jueyin (Liver) meridian. This is the fundamental principle of treatment. Thus, Wind affecting Feishu uses Fangfeng San; Phlegm flowing into arms and back uses Zhimi Wan.