证治诸说 夫臂痛者，其说有五∶若臂痛，筋脉挛急，
不得屈伸，遇寒则剧，由肝虚，为风寒邪气留于经络，故筋
挛干急而痛，脉紧而细者，宜以小续命汤，或以异功五积散，加全蝎、麝香煎，甚者以柏子仁丸（出《妇人
良方》引《指迷方》，凡十三味，系温养之剂）。若臂痛不能举，时复转移，或左或右，此由中脘伏痰，脾气
滞而不行，则上下不运而痛，其脉沉细，宜茯苓丸或控涎丹。若臂痛流走，上下无常，外连肌肉，牵引背胛，
时发时止，由荣卫之气循行失度，遂受风毒之气，行于血中，随血上下，新故相搏则痛，宜小续命汤兼麝香
丸（当考），甚者以白芥子散。若卒然一臂无力，痛不能举， 似汗，肌肉时复掣痛，手不及头，此寒
湿客搏而筋缓也，宜以异功五积散，加全蝎、麝香煎，甚者以四君子汤加芍药、附子、生姜煎服。若气
血凝滞，经络不行，臂痛不能举者，舒经汤。（《管见良方》）
臂为风寒湿所搏，或饮液流入，或因提挈重物，皆致臂痛，有肿者，有不肿者，除饮证外，其余诸痛，并
宜五积散及乌药顺气散（按∶《得效》治风证，《医鉴》治因于气者）或蠲痹汤。外有血虚一证，血不荣
于筋，或致臂痛，宜蠲痹汤、四物汤各半帖，和匀煎服。乳妇以臂枕儿，伤于风寒，多有臂痛，亦宜于此
选用。若坐卧为风湿所搏，或睡后手在被外，为寒邪所袭，遂令臂痛，宜五积散及蠲痹汤、乌
药顺气散。审知是湿，蠲痹汤，每服加苍术三匙，防己四分，或用五痹汤。曾因挈重伤筋，以致臂痛，
宜琥珀散（用芍、莪、牡、棱、刘寄奴、玄胡、乌药、归、地、桂）、劫劳散（《类方》用虚劳方，然当
是《和剂·伤寒》门中方）或和气饮（《类方》用升麻和气饮，然当是五积散加麻黄），每
服加白姜黄半钱，以姜黄能入臂故也。（《要诀》）
臂连肩背酸痛，两手软痹，由痰饮流入四肢也。偶提重
物忽痛，伤筋也。因搐臂筋痛，伤于寒也。臂痛不能举，或
痛无定处，由脾虚邪气相搏也。臂痛不能举物，气血凝滞也。（《尊生书》）
和血诸方 舒经汤，治臂痛，又名五痹汤，亦治腰下疾。
片子姜黄（四两） 甘草 羌活（各一两） 白术 海桐皮 当归 赤芍药（各二两）
上为粗末，每服三钱，水一盏半，煎至七分，去滓温服。如腰以下疾，空心服。腰以上疾，食后服。
（《妇人良方》）（按∶据《事证方后集》，此本王伯举方，其说颇详，宜参。）《管见良方》治气血凝滞，
经络不行，肩痛不能举。一方，加沉香、生姜煎。《叶氏》五痹汤，大治风痰饮攻作臂膊疼痛，于本方去海
桐皮、归、芍。（亦见《事证方后集》，有说。）《杨氏》蠲痹汤，于本方去白术、海桐皮，
加黄 。（详见《痹》门。《医鉴》臂痛因湿者。）《得效》活络汤，治风湿臂痛，诸药不效者，
于本方去姜黄、桐皮、芍药，加独活、川芎。
红花四物汤，治妇人臂疼，又如瘫痪。刘立之云∶是血证，四物汤加红花煎服见效。（《朱氏》）
白芥子散，治臂痛，外连肌肉，牵引背胛，时发时止，此由荣卫之气循行失度，留滞经络，
与正气相搏，其痛发则有似瘫痪。
真白芥子 木鳖子（各二两麸炒） 没药（别研） 桂心 木香（各半两）
上为细末，入研药令停，每服一钱，温酒调下。（《妇人良方》）
服桑枝法，桑枝一小升，细切炒香，以水三大升，煎取二升，一日服尽，无时。政和间，
予尝病两臂痛，服诸药不效，根据此作数剂，臂痛即愈。（《本事》）
利气方 流气饮子。（按∶此不举主治，当是治气滞臂
痛。《得效》列之白芥子散后，曰∶治同上。）
紫苏叶 青皮 桔梗 大黄（煨） 当归 芍药 乌药 茯苓 川芎 黄 枳壳
（去穣麸炒） 防风（各半两） 甘草 橘皮（各三分） 木香 皮连大腹（二两锉姜汁）
上 咀，每服五钱，水二盏，姜三片，枣一枚，煎一盏，去滓服。（《妇人良方》）《得效》去大黄。
温经诸方 拾味锉散，治臂痛，连筋及骨，举动艰难。此药亦益血养筋生力。
当归（一两去土洗净切焙干） 黄 （二两炙） 白芍药（二两） 芎
（一两半不见火） 防风（一两半） 附子（三两炮制去皮脐） 白
术（一两半） 茯苓（七钱半） 熟干地黄（七钱半略洗净用少酒熬令干焙之） 肉桂（一两去粗皮不见火）
上件并修制了毕，然后秤之， 咀，每服四钱重，水一大满盏，生姜七片。枣子三个掰开，同煎
至七分，去滓通口服，食后临卧日三服。须温覆浓衣，畏寒去处。（《叶氏》）
臂痛多日风，其脉濡而来反急，明其湿。用苍术、附子各等分，木香一分，姜煎，帛盖，屋上露
星一宿，次日重汤暖服愈。（《永类》引《续易简》）
消痰诸方 治痰，茯苓元，本治臂痛，具《指迷方》中。云有人臂痛不能举，手或左（《妇
人良方》此有“或”字）右，时复转移。由伏痰在内，中脘停滞，脾气不流行，上与
气搏。四肢属脾，滞而气不下，故上行攻臂，其脉沉细者是也。后人谓此臂痛，乃痰证也（方出《
痰涎》中）。累有人为痰所苦，夜间两臂常若有人抽牵，两手战灼，至于茶盏亦不能举，只以
此药治之，皆随服随愈。（《是斋》）
半夏汤，治肩臂痛。
半夏（二两洗七遍切作薄片） 白茯苓（二两锉）
上为细末，每服二钱，水二盏，煎至八分，入姜汁一哈 壳许，再煎至七分，食后温热服。（《叶氏》）
又小半夏汤，治痰饮头眩及臂痛，于本方加甘草、橘、姜，水煎。
痰饮流入四肢，肩臂酸疼，两臂软痹，导痰加木香、片子姜黄、姜制白术，若作风治误矣。（《医通》）
控涎丹，加去油木鳖子一两，桂五钱，治臂痛，每服二十丸，加五三十丸。（《纲目》）
芎活汤，治水饮停蓄，注于经络，发为臂痛，皆因脾土有亏，平日多饮水浆，不能传化所致。
川芎 半夏（汤洗） 白茯苓 川独活 陈皮 枳壳（去穣炒各半两） 白术 甘草（各一分）
上为散，每服三钱，水一盏半，生姜同煎，去滓，食后停少时温服。（《得效》）
凉热方 热证，防风通圣散。（《得效》）
【证治诸说】关于臂痛的论述，主要有五种说法：
第一种，如果手臂疼痛，筋脉拘挛紧急，不能屈伸，遇寒冷则病情加重，这是由于肝虚，风寒邪气滞留于经络，导致筋脉拘急而痛，脉象紧而细的，适宜用小续命汤，或者用异功五积散，加入全蝎、麝香煎服，病情严重的用柏子仁丸（出自《妇人良方》引用《指迷方》，共十三味药，属于温养性质的方剂）。
第二种，如果手臂疼痛且不能抬起，时常转移位置，或左或右，这是由中脘部潜伏的痰饮所致，脾气阻滞不能运行，导致上下气机不运而疼痛，脉象沉细的，适宜用茯苓丸或控涎丹。
第三种，如果手臂疼痛游走不定，上下无常，向外牵连肌肉，牵引背部肩胛，时发时止，这是由于营卫之气循行失去常度，于是受到风毒之气侵袭，风毒随血液上下运行，新旧气血相搏结而产生疼痛，适宜用小续命汤兼服麝香丸（应当考证），病情严重的用白芥子散。
第四种，如果突然一只手臂无力，疼痛不能抬起，似有汗出，肌肉时常抽搐疼痛，手举不到头顶，这是寒湿客居搏击导致筋脉弛缓，适宜用异功五积散，加入全蝎、麝香煎服，病情严重的用四君子汤加入芍药、附子、生姜煎服。
第五种，如果气血凝滞，经络不通，手臂疼痛不能抬起的，用舒经汤。（出自《管见良方》）
手臂被风寒湿邪所搏结，或者饮液流入经络，或者因为提举重物，都会导致手臂疼痛，有的肿胀，有的不肿胀，除了饮证之外，其余各种疼痛，都适宜用五积散及乌药顺气散（按：《得效方》治疗风证，《医鉴》治疗因气滞引起的疼痛）或者蠲痹汤。此外还有一种血虚证，血液不能濡养筋脉，可能导致手臂疼痛，适宜用蠲痹汤、四物汤各半帖，混合均匀煎服。哺乳期妇女如果用胳膊枕着孩子睡觉，受风寒损伤，多有手臂疼痛，也适宜在此类方剂中选择使用。如果是坐卧时被风湿所搏结，或者睡觉后手露在被外，被寒邪侵袭，从而导致手臂疼痛，适宜用五积散及蠲痹汤、乌药顺气散。如果明确知道是湿邪所致，用蠲痹汤，每服用量中加入苍术三匙、防己四分，或者使用五痹汤。曾经因为提举重物损伤筋脉，以致手臂疼痛，适宜用琥珀散（含有芍药、莪术、牡蛎、三棱、刘寄奴、玄胡索、乌药、当归、地黄、肉桂）、劫劳散（《类方》中使用的是虚劳方，但应当是《和剂局方·伤寒》门中的方子）或和气饮（《类方》中使用的是升麻和气饮，但应当是五积散加麻黄），每服用量中加入白姜黄半钱，因为姜黄能入臂部经络的缘故。（出自《要诀》）
手臂连带肩背酸痛，两手软弱麻木，是由于痰饮流入四肢所致。偶尔提举重物忽然疼痛，是伤筋。因为拉扯手臂导致筋脉疼痛，是受了寒邪。手臂疼痛不能抬起，或者疼痛没有固定位置，是由于脾虚与邪气相搏结。手臂疼痛不能举起物品，是气血凝滞。（出自《尊生书》）
【和血诸方】舒经汤，治疗手臂疼痛，又名五痹汤，也治疗腰部以下的疾病。
片子姜黄（四两） 甘草 羌活（各一两） 白术 海桐皮 当归 赤芍药（各二两）
以上药物捣成粗末，每次服用三钱，用水一盏半，煎至七分，去渣温服。如果是腰部以下的疾病，空腹服用。如果是腰部以上的疾病，饭后服用。（出自《妇人良方》）（按：据《事证方后集》，此方源自王伯举方，其解说颇为详细，宜参考。）《管见良方》治疗气血凝滞，经络不通，肩膀疼痛不能抬起。一方，加入沉香、生姜煎服。《叶氏》五痹汤，主要治疗风痰饮邪攻冲导致的臂膊疼痛，在本方中去掉海桐皮、当归、芍药。（也见于《事证方后集》，有相关解说。）《杨氏》蠲痹汤，在本方中去掉白术、海桐皮，加入黄芪。（详见《痹》门。《医鉴》认为臂痛因湿者适用。）《得效方》活络汤，治疗风湿臂痛，其他药物无效的，在本方中去掉姜黄、桐皮、芍药，加入独活、川芎。
红花四物汤，治疗妇人手臂疼痛，又如同瘫痪症状。刘立之说：这是血证，用四物汤加入红花煎服见效。（出自《朱氏》）
白芥子散，治疗手臂疼痛，向外牵连肌肉，牵引背部肩胛，时发时止，这是由于营卫之气循行失去常度，留滞于经络，与正气相搏结，其疼痛发作时类似瘫痪。
真白芥子 木鳖子（各二两麸炒） 没药（单独研细） 桂心 木香（各半两）
以上药物捣成细末，加入研好的没药搅拌均匀，每次服用一钱，用温酒调服。（出自《妇人良方》）
服用桑枝的方法：桑枝一小升，切碎炒香，用水三大升，煎取二升，一天内服完，不限时间。政和年间，我曾经患两臂疼痛，服用各种药物无效，按照这个方法制作了几剂，手臂疼痛随即痊愈。（出自《本事方》）
【利气方】流气饮子。（按：此处未列举主治病症，应当是治疗气滞引起的臂痛。《得效方》将其列在白芥子散之后，说：主治同上。）
紫苏叶 青皮 桔梗 大黄（煨制） 当归 芍药 乌药 茯苓 川芎 黄芪 枳壳（去掉瓤，麸炒） 防风（各半两） 甘草 橘皮（各三分） 木香 黄连 大腹皮（二两，锉碎，用姜汁处理）
以上药物切碎，每次服用五钱，水二盏，生姜三片，大枣一枚，煎至一盏，去渣服用。（出自《妇人良方》）《得效方》去掉大黄。
【温经诸方】拾味锉散，治疗手臂疼痛，连及筋骨，举动艰难。此药也能益血养筋生力。
当归（一两，去土洗净切焙干） 黄芪（二两，炙） 白芍药（二两） 川芎（一两半，不见火） 防风（一两半） 附子（三两，炮制去皮脐） 白术（一两半） 茯苓（七钱半） 熟干地黄（七钱半，略洗净，用少量酒熬令干焙之） 肉桂（一两，去粗皮，不见火）
以上药材都修制完毕后，然后称量，切碎，每次服用四钱重，水一大满盏，生姜七片，大枣三个掰开，同煎至七分，去渣通口服，饭后临睡前每日三次服用。必须温暖覆盖厚衣，注意畏寒之处保暖。（出自《叶氏》）
手臂疼痛多日伴有风邪，脉象濡软而来却反而急促，表明有湿邪。用苍术、附子各等分，木香一分，生姜煎服，用布覆盖，在屋顶露星一夜，第二天隔水加热温服即愈。（出自《永类方》引《续易简方》）
【消痰诸方】治疗痰饮，茯苓丸，原本治疗手臂疼痛，详载于《指迷方》中。记载有人手臂疼痛不能抬起，手有时向左（《妇人良方》中有“或”字）有时向右，时常转移位置。这是由于体内潜伏痰饮，停滞在中脘，脾气不流通，向上与气相搏结。四肢属脾，气机滞涩不能下行，反而上行攻击手臂，脉象沉细的就是这种情况。后人称这种臂痛为痰证（方剂出自《痰涎》门）。屡次有人被痰饮所苦，夜间两臂常常感觉像被人抽拉牵拽，两手颤抖灼热，以至于茶盏也不能举起，只用这个药治疗，都是随服随愈。（出自《是斋百一选方》）
半夏汤，治疗肩臂疼痛。
半夏（二两，洗七遍，切作薄片） 白茯苓（二两，锉碎）
以上药物捣成细末，每次服用二钱，水二盏，煎至八分，加入生姜汁约半个蛤壳量，再煎至七分，饭后温热服用。（出自《叶氏》）
又有小半夏汤，治疗痰饮头眩及手臂疼痛，在本方中加入甘草、橘皮、生姜，水煎服。
痰饮流入四肢，肩臂酸疼，两臂软弱麻木，用导痰汤加入木香、片子姜黄、姜制白术，如果当作风证治疗就错了。（出自《医宗金鉴·医学入门》简称《医通》）
控涎丹，加入去油木鳖子一两，桂心五钱，治疗手臂疼痛，每次服用二十丸，可加至五三十丸。（出自《本草纲目》）
芎活汤，治疗水饮停蓄，注于经络，引发手臂疼痛，都是因为脾土亏虚，平日多饮水浆，不能传化所致。
川芎 半夏（汤洗） 白茯苓 川独活 陈皮 枳壳（去瓤炒各半两） 白术 甘草（各一分）
以上药物捣成散剂，每次服用三钱，水一盏半，生姜同煎，去渣，饭后稍停片刻温服。（出自《得效方》）
【凉热方】热证，用防风通圣散。（出自《得效方》）
[Theories and Treatments for Arm Pain] Regarding the theories of arm pain, there are five main perspectives:
First, if the arm is painful, with tendons and vessels cramped and tight, unable to flex or extend, and worsening upon exposure to cold, this is due to Liver deficiency, where Wind-Cold pathogenic factors remain in the meridians, causing tendon cramping and pain. If the pulse is tight and fine, Xiao Xuming Tang (Minor Continuation of Life Decoction) is appropriate, or Yigong Wuji San (Yi-Gong Five Accumulations Powder) added with Quanjie (Scorpio) and Shexiang (Musk) decocted. For severe cases, Baizi Ren Wan (Biota Seed Pill) is indicated (from *Furen Liangfang* citing *Zhimifang*, consisting of thirteen ingredients, a warming and nourishing formula).
Second, if the arm is painful and cannot be raised, with the pain shifting position from time to time, either left or right, this is caused by latent phlegm-fluids in the Zhongwan region (CV12), where Spleen Qi stagnates and fails to circulate, leading to obstruction of upper and lower movement and pain. If the pulse is deep and fine, Fuling Wan (Poria Pill) or Kongxian Dan (Phlegm-Fluid Expelling Pellet) is indicated.
Third, if arm pain wanders without fixed location, moving up and down, extending outward to muscles, and pulling on the back and scapula, occurring intermittently, this is due to the abnormal circulation of Ying (Nutritive) and Wei (Defensive) Qi, allowing Wind-Toxicity to invade and travel within the blood, clashing with new and old blood to cause pain. Xiao Xuming Tang combined with Shexiang Wan (Musk Pill) [to be verified] is indicated; for severe cases, Baijiezi San (White Mustard Seed Powder) is used.
Fourth, if suddenly one arm becomes weak, painful and unable to be raised, with apparent sweating, muscle twitching and pain, and the hand unable to reach the head, this is due to Cold-Dampness lodging and attacking, causing flaccidity of the tendons. Yigong Wuji San added with Quanjie (Scorpio) and Shexiang (Musk) is indicated; for severe cases, Sijunzi Tang (Four Gentlemen Decoction) added with Shaoyao (Peony Root), Fuzi (Prepared Aconite Root), and Shengjiang (Fresh Ginger) is indicated.
Fifth, if Qi and Blood stagnate and meridians are blocked, causing arm pain and inability to raise the arm, Shujing Tang (Meridian-Relaxing Decoction) is used (from *Guanjian Liangfang*).
Arm pain can result from the attack of Wind-Cold-Dampness, fluid accumulation in the channels, or lifting heavy objects. It may present with swelling or without. Excluding fluid-patterns, other types of pain generally respond to Wuji San (Five Accumulations Powder), Wuyao Shunqi San (Lindera Regulating Qi Powder) [Note: *Dexiao Fang* treats wind patterns; *Yijian* treats patterns due to Qi stagnation], or Juanbi Tang (Dispelling Bi Decoction). Additionally, there is a Blood Deficiency pattern where Blood fails to nourish the tendons, potentially causing arm pain. Juanbi Tang and Siwu Tang (Four Substances Decoction) in equal halves, mixed and decocted together, are indicated. Lactating women who rest their arms on infants may suffer Wind-Cold injury, often resulting in arm pain; these formulas are also suitable. If sitting or lying exposes the body to Wind-Dampness, or sleeping with hands outside the covers invites Cold Evil, causing arm pain, Wuji San, Juanbi Tang, and Wuyao Shunqi San are indicated. If dampness is confirmed, Juanbi Tang with additional Cangzhu (Atractylodes Rhizome) and Fangji (Stephania Root), or Wubi Tang (Five Bi Decoction), is used. For arm pain due to previous heavy lifting injuring tendons, Hupo San (Amber Powder) [containing Shaoyao, Ezhu, Muli, Sanleng, Liu Jinu, Yuanhu, Wuyao, Danggui, Dihuang, Rougui], Jielao San (Exhaustion-Seizing Powder) [Note: *Leifang* cites a consumptive disease formula, but likely refers to one from *Heji Jufang* under Cold Damage], or Heqi Yin (Harmonizing Qi Drink) [Note: *Leifang* cites Shengma Heqi Yin, but likely refers to Wuji San plus Mahuang], each taken with Banqian (half a qian) of Bai Jianghuang (Turmeric Tuber) because Jianghuang enters the arm meridians, are indicated (from *Yaojue*).
Arm pain radiating to the shoulder and back with soreness, accompanied by soft numbness in both hands, is caused by phlegm-fluids flowing into the four limbs. Sudden pain after lifting heavy objects indicates tendon injury. Pain from pulling the arm indicates Cold injury. Arm pain with inability to raise the arm, or pain without fixed location, is due to Spleen deficiency clashing with pathogenic factors. Inability to lift objects indicates Qi and Blood stagnation (from *Zunsheng Shu*).
[Formulas for Harmonizing Blood] Shujing Tang treats arm pain and is also known as Wubi Tang; it also treats diseases below the waist.
Pianzi Jianghuang (4 liang), Gancao (Licorice Root), Qianghuo (Notopterygium Rhizome) (1 liang each), Baizhu (Atractylodes Macrocephala Rhizome), Haitongpi (Sassafras Cortex), Danggui (Angelica Sinensis Root), Chishaoyao (Red Peony Root) (2 liang each).
Grind into coarse powder. Take 3 qian per dose, decoct in 1.5 cups of water until 0.7 cup remains, strain, and take warm. For diseases below the waist, take on an empty stomach. For diseases above the waist, take after meals (from *Furen Liangfang*). [Note: According to *Shizheng Fanghouji*, this originates from Wang Boju's formula, with detailed explanations; refer to it.] *Guanjian Liangfang* uses it for Qi and Blood stagnation blocking meridians, causing shoulder pain and inability to raise the arm. One variation adds Chenxiang (Agarwood) and Shengjiang (Fresh Ginger). Ye Shi's Wubi Tang primarily treats arm pain caused by Wind-Phlegm-Fluid attacking; remove Haitongpi, Danggui, and Shaoyao from the base formula (also seen in *Shizheng Fanghouji*). Yang Shi's Juanbi Tang removes Baizhu and Haitongpi from the base formula and adds Huangqi (Astragalus Root) (See *Bi* section; *Yijian* applies it to dampness-induced arm pain). *Dexiao Fang*'e Huoluo Tang treats Wind-Damp arm pain unresponsive to other drugs; remove Jianghuang, Tongpi, and Shaoyao from the base formula and add Duhuo (Angelica Pubescens Root) and Chuanxiong (Ligusticum Rhizome).
Honghua Siwu Tang (Red Flower Four Substances Decoction) treats arm pain in women, resembling paralysis. Liu Lizhi states this is a Blood pattern; adding Honghua (Safflower) to Siwu Tang yields effective results (from *Zhu Shi*).
Baijiezi San (White Mustard Seed Powder) treats arm pain extending to muscles and pulling the back/scapula, intermittent in nature. This is due to abnormal circulation of Ying and Wei Qi, stagnating in meridians and clashing with Healthy Qi, causing pain that resembles paralysis.
Zhen Baijiezi (True White Mustard Seed), Mugua Zi (Momordica Seed) (2 liang each, stir-fried with bran), Moyao (Myrrh) (separately ground), Guixin (Cinnamon Twig Bark), Muxiang (Vladimiria Root) (0.5 liang each).
Grind into fine powder, mix with the ground Myrrh. Take 1 qian per dose, mix with warm wine (from *Furen Liangfang*).
Method for consuming Mulberry Branch: Take a small sheng of Mulberry Branch (Sangzhi), cut finely, stir-fry until fragrant. Decoct in 3 large cups of water until 2 cups remain. Consume throughout the day in divided doses. During the Zhenghe era, I suffered from bilateral arm pain; various medicines failed. Following this method for several doses cured my pain (from *Benshi Fang*).
[Formulas for Promoting Qi Flow] Liuqi Yinzi (Flowing Qi Drink). [Note: Indications not listed here, likely for Qi-stagnation arm pain. *Dexiao Fang* lists it after Baijiezi San, stating "Indications same as above."]
Zisu Ye (Perilla Leaf), Qingpi (Green Tangerine Peel), Jiegeng (Platycodon Root), Dahuang (Rhubarb Root, baked), Danggui, Shaoyao, Wuyao, Fuling, Chuanxiong, Huangqi, Zhike (Bitter Orange Fruit, pith removed, bran-fried), Fangfeng (0.5 liang each), Gancao, Jupi (Tangerine Peel) (0.3 liang each), Muxiang, Lianpi (Coptis Cortex), Dafupi (Areca Peel) (2 liang, cut, processed with ginger juice).
Cut into pieces. Take 5 qian per dose, decoct in 2 cups of water with 3 slices of ginger and 1 jujube until 1 cup remains, strain, and take (from *Furen Liangfang*). *Dexiao Fang* omits Dahuang.
[Formulas for Warming Meridians] Shiwei Cusan (Ten-Ingredient Cut Powder) treats arm pain extending to tendons and bones, making movement difficult. This formula also benefits Blood, nourishes tendons, and generates strength.
Danggui (1 liang, cleaned, cut, dried), Huangqi (2 liang, honey-fried), Baishaoyao (2 liang), Xiong (Chuanxiong) (1.5 liang, avoid direct fire), Fangfeng (1.5 liang), Fuzi (3 liang, processed, skin and umbilicus removed), Baizhu (1.5 liang), Fuling (0.75 liang), Shudihuang (Prepared Rehmannia Root) (0.75 liang, lightly cleaned, boiled with little wine until dry, then dried), Rougui (Cinnamon Bark) (1 liang, outer bark removed, avoid direct fire).
Process all ingredients, weigh them, cut into pieces. Take 4 qian per dose, decoct in one full cup of water with 7 slices of ginger and 3 cracked jujubes until 0.7 cup remains, strain, and take orally. Take three times daily after meals and before sleep. Keep warm with thick clothing, protecting areas sensitive to cold (from *Ye Shi*).
For chronic arm pain with Wind, where the pulse is soggy yet rapid/tight, indicating Dampness: Use Cangzhu and Fuzi in equal parts, plus 1 part Muxiang, decocted with ginger. Cover with cloth, expose to starlight on the roof overnight, and reheat in a double boiler the next day for warm consumption (from *Yonglei Fang* citing *Xu Yijian Fang*).
[Formulas for Resolving Phlegm] To treat Phlegm, Fuling Wan (Poria Pill) originally treats arm pain, detailed in *Zhimifang*. It records a case of arm pain with inability to raise the arm, shifting left or right, migrating positions. This is due to latent Phlegm-Fluids stagnating in Zhongvan, causing Spleen Qi to fail to circulate, clashing upward with Qi. The four limbs belong to the Spleen; when Qi stagnates and fails to descend, it attacks the arms upward. The pulse is deep and fine. Later physicians identified this arm pain as a Phlegm pattern (Formula from *Tanxian* section). Repeatedly, patients suffering from Phlegm experienced nightly sensations of being pulled in both arms, trembling and burning hands, unable to lift even a teacup. Treating only with this formula resulted in immediate recovery (from *Shizhai Ba Yi Xuanfang*).
Banxia Tang (Pinellia Decoction) treats shoulder and arm pain.
Banxia (Pinellia Tuber, washed seven times, sliced thinly) (2 liang), Baifuling (White Poria) (2 liang, cut).
Grind into fine powder. Take 2 qian per dose, decoct in 2 cups of water until 0.8 cup remains, add ginger juice equivalent to half a clam shell, decoct until 0.7 cup remains, and take warm after meals (from *Ye Shi*).
There is also Xiaobanxia Tang (Minor Pinellia Decoction) for Phlegm-Fluid dizziness and arm pain; add Gancao, Jupi, and Shengjiang to the base formula and decoct with water.
When Phlegm-Fluids flow into the four limbs causing shoulder/arm soreness and soft numbness, use Daotan Tang (Major Phlegm-Resolving Decoction) added with Muxiang, Pianzi Jianghuang, and ginger-processed Baizhu. Treating this as a Wind pattern would be an error (from *Yitong*).
Kongxian Dan (Phlegm-Fluid Expelling Pellet) added with 1 liang of defatted Mugua Zi and 0.5 liang of Guixin treats arm pain. Take 20 pills per dose, increasing to 50-30 pills (from *Bencao Gangmu*).
Xionghuo Tang (Ligusticum and Notopterygium Decoction) treats Water-Fluid retention pouring into meridians, causing arm pain. This is due to Spleen Earth deficiency and habitual excessive drinking of fluids, failing to transmit and transform.
Chuanxiong, Banxia (washed with hot water), Baifuling, Chuan Duhuo, Chenpi, Zhike (pith removed, fried, 0.5 liang each), Baizhu, Gancao (0.1 liang each).
Grind into powder. Take 3 qian per dose, decoct in 1.5 cups of water with ginger, strain, and take warm shortly after meals (from *Dexiao Fang*).
[Cooling and Heating Formulas] For Heat Patterns, use Fangfeng Tongsheng San (Wind-Protecting Universal Rescue Powder) (from *Dexiao Fang*).