（见诸嗽门停饮伏痰证）
肩背痛。未辨何证。俱宜和气饮。每服加乌药半钱。
当肩背一片冷痛。背膂疼痛。古方用神保丸愈者。此有积气故也。
其人素有痰饮。流注肩背作痛。宜星香散。或导痰汤下。五套丸。更于呕吐门。停饮证
选药。
有肾气不循故道。气逆。挟背而上。致肩背作痛。宜和气饮。每服加炒茴香半钱炒水椒
十粒。
有本体虚。及病后心膈间痛。或牵引乳胁。或走注肩背。此乃元气上逆。当引使归元。
不可
复下疏刷之剂。愈刷愈痛。发汗太多。人患此者众。惟宜温补。拘于气无补法之说。误矣。
经云、汗者心之液。又曰、阳受气于胸中。汗过多则心液耗。阳气不足。故致疼也。
有近方得病者。有病得之已久。时发动者。不问诸证。并宜异攻散。香灵汤。仍佐以挝
脾汤。
若积冷而痛者。宜手粘散。酒调下。于内加官桂等分。仍以挝脾汤。铁刷汤佐之。或用
苏合香丸。姜汁和酒调开热服。前后心痛。亦可用。
若服温药不效者。痛愈甚。宜微利其大便。量虚实。先进神保丸。以利为度。继进加
味七气汤。若因饮食冷物而痛者。宜调气散。和挝脾汤。
若因蛔作痛。蛔攻啮心痛。有休止。其人吐蛔。或与之汤饮药饵。转入转吐。盖缘物入
则蛔动。蛔动则令人恶心而吐。用川椒十数粒。煎汤下乌梅丸。
有肾气逆上攻心。以致心痛。用生韭研汁。和五苓散为丸。空肚茴香汤下。
（参见诸嗽门停饮伏痰证）
肩背疼痛。尚未辨别具体证型时，均适宜使用和气饮。每服剂量中加入乌药半钱。
当出现肩背部一片冷痛、背部脊柱疼痛时，古方中使用神保丸治愈的案例，是因为体内有积滞之气所致。
患者平素素有痰饮，流注于肩背导致疼痛，适宜使用星香散，或者用导痰汤送服五套丸。更可在呕吐门的停饮证中选取药物配合治疗。
若因肾气不循常道，气机上逆，挟带背部向上冲逆，导致肩背作痛，适宜使用和气饮。每服剂量中加入炒茴香半钱、炒水椒十粒。
若患者体质虚弱，以及病后心膈之间疼痛，或牵引至乳房胁肋部，或游走窜痛至肩背，这是元气上逆所致。应当引导元气回归本源，不可再次使用下法疏泄刷荡的药剂，否则越疏泄疼痛越剧烈。发汗过多的人患此病者众多，只适宜温补。拘泥于“气无补法”的说法，是错误的。
经典记载：“汗是心的津液。”又说：“阳气受气于胸中。”汗出过多则心之津液耗损，阳气不足，因此导致疼痛。
近来有患病者，有的病程已久，时常发作的，不论各种症状表现，都适宜使用异攻散、香灵汤，并辅以挝脾汤。
若是因积冷而疼痛的，适宜使用手粘散，用酒调服。在内加入官桂等量，仍以挝脾汤、铁刷汤辅助治疗。或者使用苏合香丸，用姜汁和酒调开，温热服用。前后的心痛，也可以使用。
如果服用温药无效，疼痛更加严重，适宜轻微通利大便。根据虚实情况，先进服神保丸，以大便通畅为度。随后进服加味七气汤。如果是因饮食生冷食物而疼痛的，适宜使用调气散，配合挝脾汤。
如果是因蛔虫引起疼痛，蛔虫攻啮心胸部位，疼痛有间歇，患者吐蛔虫，或者给予汤剂、药物，反而转入转吐。这是因为食物进入则蛔虫扰动，蛔虫扰动则令人恶心而呕吐。可用川椒十余粒，煎汤送服乌梅丸。
若因肾气上逆攻心，以致心痛，可用生韭菜研取汁液，与五苓散混合制成丸剂，空腹时用茴香汤送服。
(See the section on "Stagnant Fluid and Hidden Phlegm in Various Coughs")
Pain in the shoulder and back. If the specific syndrome has not yet been differentiated, Heqi Yin (Harmonizing Qi Decoction) is generally suitable. Add Ban Qian (half a qian, approx. 2.5g) of Wuyao (Lindera Root) to each dose.
When there is a patch of cold pain across the shoulder and back, and pain in the dorsal spine, ancient formulas used Shenbao Wan (Divine Preservation Pill) for cure; this is due to accumulated stagnant Qi.
The patient habitually suffers from phlegm-fluid retention, which flows and pours into the shoulder and back causing pain. Xingxiang San (Star and Fragrance Powder) is suitable, or it can be taken with Daotan Tang (Phlegm-Expelling Decoction) followed by Wu Tao Wan (Five Rounds Pill). Further selection of herbs can be made from the Stagnant Fluid Syndrome section under Vomiting.
If Kidney Qi does not follow its normal pathway, Qi rebels upward, carrying along the back and ascending, resulting in shoulder and back pain. Heqi Yin (Harmonizing Qi Decoction) is suitable. Add Chao Huixiang (Stir-fried Fennel Fruit), half a qian, and Chao Shuijiao (Stir-fried Zanthoxylum Bungeanum), ten grains, to each dose.
If the constitution is deficient, or if there is pain between the heart and diaphragm after illness, radiating to the breasts and hypochondrium, or wandering to the shoulder and back, this is due to Yuan Qi (Primal Qi) rebelling upward. It should be guided to return to its origin. One must not again use purgative or draining agents; the more one drains, the worse the pain becomes. Many people suffer from this condition after excessive sweating. Only warming and tonifying methods are appropriate. Adhering to the theory that "Qi cannot be tonified" is erroneous.
The Classics state: "Sweat is the fluid of the Heart." It also says: "Yang receives Qi from the chest center." Excessive sweating depletes the Heart's fluids and causes Yang Qi deficiency, thus leading to pain.
Recently, some patients have fallen ill; some have had the disease for a long time with intermittent attacks. Regardless of various symptoms, Yigong San (Different Attack Powder), Xiangling Tang (Fragrant and Spirit Decoction) are suitable, assisted by Zhuapi Tang (Beating Spleen Decoction).
If the pain is due to accumulated cold, Shounian San (Hand-Sticking Powder) is suitable, mixed with wine for administration. Add Guanzi Gui (Cinnamon Bark) in equal proportion, still assisted by Zhuapi Tang (Beating Spleen Decoction) and Tieshua Tang (Iron Brush Decoction). Or use Suhexiang Wan (White Musk Pill), mixed with ginger juice and wine, taken warm. This can also be used for anterior and posterior heart pain.
If warming medicines are ineffective and pain worsens, slight purgation of the large intestine is suitable. Assess deficiency and excess; first administer Shenbao Wan (Divine Preservation Pill), stopping when bowel movement is achieved. Then administer Jiawei Qi Qi Tang (Modified Seven Qi Decoction). If the pain is caused by consuming cold food, Tiaoqi San (Regulating Qi Powder) combined with Zhuapi Tang (Beating Spleen Decoction) is suitable.
If the pain is caused by roundworms, with roundworms attacking and biting the heart region, pain having intervals, and the patient vomiting roundworms, or if administering decoctions or medicines leads to further vomiting, it is because food entry agitates the worms, and worm agitation causes nausea and vomiting. Use ten-plus grains of Chuanjiao (Sichuan Pepper), decocted in water, to send down Wumei Wan (Mume Pill).
If Kidney Qi rebels upward attacking the Heart, causing heart pain, fresh Chinese chive juice is ground and mixed with Wuling San (Five-Ingredient Powder with Poria) to make pills. Taken on an empty stomach with Huixiang Tang (Fennel Decoction).