(附腰髀痛)
【脉】 洪大,洪为热,大为风。脉促上击者,肩背痛。脉沉而滑者,背膂痛。
【因】 风湿乘肺手太阴经,脉气郁甚不行也。
【证】 病则颊颔肿,颈、肩、 、肘、臂外后 痛。汗出小便数而欠者,皆风
热乘肺也;小便遗溺者,皆肺金虚也。
【治】 宜通经益元气,散风泻火之药。
通气散 治风热乘肺,肩背痛。
防风 木 独活 羌活(以上通经血) 黄芩 黄连(以上降火) 人参 黄 (上二味
,虚则加之)
腰髀痛
【因】 小肠经气,小肠心痛及腑。外有肺风、肺寒、骨虚而致。
(附身体痛)
【脉】 双弦,是两手俱弦也。
【因】 肝木气实火盛,或因怒气大逆,肝气郁甚,谋虑不决,风中于肝。皆使
木气大实生
火,火盛则肝急,瘀血、恶血停留于肝,归于胁下而痛。病则自汗,痛甚,按之益甚。
【证】 痰积流注厥阴,亦使胁下痛。病则咳嗽。
外有肝中风,左胁偏痛;肝中寒,胁下挛急;饮水胁下鸣相逐,皆致胁痛,须详之。
辨非 血枯证。胸胁支满,络气不行,妨于食,肝脾伤,病至先闻腥臊臭,出清
液,肺叶伤也。四肢清,目眩,复后血,此年少脱血,或醉行房,肝伤气竭致之故也。
【证治】 木火盛,宜以辛散之,以苦泻之,当归龙荟丸、泻青丸主之。死血,
宜以破血为主,润血为佐,复元活血、当归导滞等主之。痰积,宜以去痰行气,二陈汤加南
星、青皮、香附、青黛等主之。
龙荟丸 治食积发热,木盛胁痛。
柴胡 甘草 青皮 黄连 大黄 当归 木香 草龙胆 芦荟 川芎
治水气实加之。
治血汤 治死血。
左金丸 治肝火。
黄连(六两) 茱萸(一两)
导痰汤 治痰注。诸痰皆生于热。
台芎(二两) 香附(八两) 陈皮 苏叶 干姜(一两)
贴痛 芥菜子(研,水敷) 茱萸(醋研,敷上大效)
熨痛 醋炒灰热,布裹熨之,葱艾炒亦可;韭汁亦可。
身体痛
【脉证】 伤寒,太阳经表证,六脉俱紧;阴毒伤寒,身如被打,脉沉紧;伤寒
,发汗后,
身体痛,气血未和,脉弦迟。伤湿,湿流关节,一身尽痛;风湿相搏,肢体重痛,不可转侧
,脉缓。虚劳之人,气血虚损,脉弦小。
(附:腰部和髋部疼痛)
【脉象】 脉象洪大,洪脉主热,大脉主风。脉搏急促且向上冲击的,是肩背疼痛。脉象沉而滑的,是背部脊柱疼痛。
【病因】 风湿之邪侵袭手太阴肺经,导致脉气郁结严重而不能运行。
【证候】 患病则面颊和下颌肿胀,颈部、肩部、腋下、肘部、手臂外侧后方疼痛。出汗且小便频数但排尿不畅的,都是风热侵袭肺脏所致;小便失禁的,都是肺金虚弱所致。
【治法】 适宜使用疏通经络、补益元气、疏散风邪、泻除火邪的药物。
通气散:治疗风热侵袭肺脏引起的肩背疼痛。
防风、木通、独活、羌活(以上药物用于疏通经络气血)、黄芩、黄连(以上药物用于降火)、人参、黄芪(后两味药,若属虚证则加入)。
腰部及髋部疼痛
【病因】 小肠经的气机阻滞,以及小肠心痛波及腑脏。此外还有因肺受风邪、肺受寒邪、骨骼虚弱而导致。
(附:身体疼痛)
【脉象】 双弦脉,是指两手脉象都呈现弦象。
【病因】 肝木之气实盛、火邪旺盛,或者因为大怒导致气机逆乱,肝气郁结严重,思虑不决,风邪中于肝脏。这些都使木气极度实盛而生火,火邪旺盛则导致肝筋拘急,瘀血、恶血停留在肝脏,汇聚于胁下而引起疼痛。患病则自汗,疼痛剧烈,按压时疼痛加重。
【证候】 痰积流注于厥阴经,也会导致胁下疼痛。患病则咳嗽。
此外还有肝中风,表现为左侧胁部偏痛;肝中寒,表现为胁下拘挛紧急;饮水后胁下有鸣响声音相继出现,都会导致胁痛,需要详细辨别。
鉴别非血枯证。胸胁支撑胀满,络脉气机不行,妨碍进食,肝脾受损,发病时先闻到腥臊臭味,流出清稀液体,这是肺叶受损的表现。四肢发凉,头晕目眩,排便后出血,这是年少时大量失血,或者醉酒后行房事,导致肝脏受伤、气竭所致的原因。
【证治】 木火旺盛,适宜用辛味药发散它,用苦味药泻除它,以当归龙荟丸、泻青丸为主方。死血(瘀血),适宜以破血为主,润血为辅,以复元活血汤、当归导滞汤等为主方。痰积,适宜以祛痰行气为主,以二陈汤加天南星、青皮、香附、青黛等为主方。
龙荟丸:治疗食积发热,木气盛导致的胁痛。
柴胡、甘草、青皮、黄连、大黄、当归、木香、草龙胆、芦荟、川芎。若水气实盛则加入。
治血汤:治疗死血(瘀血)。
左金丸:治疗肝火。
黄连(六两)、吴茱萸(一两)。
导痰汤:治疗痰饮流注。各种痰饮都生于热。
台芎(二两)、香附(八两)、陈皮、苏叶、干姜(一两)。
贴痛方:芥菜子(研碎,用水敷贴)、吴茱萸(用醋研碎,敷贴效果极大)。
熨痛法:将药物醋炒成灰后加热,用布包裹熨烫患处,葱和艾炒热也可;韭菜汁也可以。
身体疼痛
【脉证】 伤寒,属于太阳经表证,六脉都紧;阴毒伤寒,身体像被打过一样疼痛,脉象沉紧;伤寒,发汗后,身体疼痛,气血尚未调和,脉象弦迟。伤湿,湿气流注关节,全身都疼痛;风湿相搏,肢体沉重疼痛,不能转动侧身,脉象缓。虚劳之人,气血虚损,脉象弦小。
(Attached: Pain in the Waist and Thighs)
[Pulse] The pulse is surging and large (Hong Da). Surging indicates Heat, while large indicates Wind. A rapid and upward-impacting pulse indicates pain in the shoulder and back. A deep and slippery pulse indicates pain in the dorsal spine.
[Etiology] Wind-Dampness invades the Hand-Taiyin Lung Meridian, causing severe stagnation of pulse Qi preventing its circulation.
[Syndrome] The disease presents with swelling of the cheeks and mandible, and pain in the neck, shoulders, axillae, elbows, and the lateral posterior aspect of the arms. Sweating accompanied by frequent but difficult urination indicates Wind-Heat invading the Lungs; urinary incontinence indicates deficiency of Lung Metal.
[Treatment] It is appropriate to use herbs that unblock meridians, benefit Yuan Qi, disperse Wind, and drain Fire.
Tongqi San (Ventilation Powder): Treats shoulder and back pain caused by Wind-Heat invading the Lungs.
Fangfeng (Saposhnikiae Radix), Mutong (Akebiae Caulis), Duhuo (Angelicae Pubescentis Radix), Qianghuo (Notopterygii Rhizoma et Radix) [These four unblock meridian blood]; Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma) [These two drain Fire]; Renshen (Ginseng Radix), Huangqi (Astragali Radix) [Add these two if there is deficiency].
Pain in the Waist and Thighs
[Etiology] Stagnation of Qi in the Small Intestine Meridian, as well as Small Intestine Heart-Pain affecting the Fu organs. Additionally, it can be caused by Wind-Cold in the Lungs or Bone Deficiency.
(Attached: General Body Pain)
[Pulse] Double-wiry pulse (Shuang Xian), meaning both wrists present a wiry pulse.
[Etiology] Excess Liver Wood Qi and abundant Fire, or severe Liver Qi stagnation due to extreme anger and rebellion, indecisive planning, or Wind pathogen striking the Liver. All these cause Wood Qi to become excessively excess generating Fire. Abundant Fire leads to Liver tendon tension, with stasis blood and foul blood lingering in the Liver, gathering under the hypochondrium causing pain. The disease presents with spontaneous sweating, severe pain exacerbated by pressure.
[Syndrome] Phlegm accumulation flowing into the Jueyin Meridian also causes pain under the hypochondrium. The disease presents with coughing.
Additionally, Wind attacking the Liver manifests as unilateral left-sided hypochondriac pain; Cold attacking the Liver manifests as spasm and tightness under the hypochondrium; drinking water followed by gurgling sounds under the hypochondrium all lead to hypochondriac pain, requiring detailed differentiation.
Differentiation from Blood Depletion Syndrome: Chest and hypochondriac fullness and distension, obstruction of collateral Qi, difficulty eating, injury to Liver and Spleen, onset preceded by smelling fishy and rank odors, discharge of clear fluids, indicating damage to Lung lobes. Cold limbs, dizziness, hematochezia after defecation, this is due to young age blood loss or sexual intercourse while intoxicated, causing Liver injury and Qi exhaustion.
[Syndrome and Treatment] For excessive Wood and Fire, it is suitable to scatter with Acrid herbs and drain with Bitter herbs, primarily using Danggui Longhui Wan (Angelica Longda Pill) and Xieqing Wan (Draining Green Pill). For dead blood (stasis blood), it is suitable to primarily break blood and assist with moistening blood, primarily using Fuyuan Huoxue Tang (Restore Vitality and Invigorate Blood Decoction) and Danggui Daozhi Tang (Angelica Guiding Stasis Decoction). For phlegm accumulation, it is suitable to remove phlegm and move Qi, primarily using Erchen Tang (Two-Aged Decoction) added with Nanxing (Arisaematis Rhizoma), Qingpi (Citri Reticulatae Pericarpium Viride), Xiangfu (Cyperi Rhizoma), and Qingdai (Indigo Naturalis).
Longhui Wan: Treats food retention fever and hypochondriac pain due to excess Wood.
Chaihu (Bupleuri Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Qingpi (Citri Reticulatae Pericarpium Viride), Huanglian (Coptidis Rhizoma), Dahuang (Rhei Radix et Rhizoma), Danggui (Angelicae Sinensis Radix), Muxiang (Aucklandiae Radix), Caolongdan (Gentianae Macrophyllae Radix), Lvhui (Aloe), Chuanxiong (Ligustici Chuanxiong Rhizoma). Add if there is excess Water Qi.
Zhixue Tang (Blood Treating Decoction): Treats dead blood (stasis blood).
Zuojin Wan (Left Restoring Pill): Treats Liver Fire.
Huanglian (Coptidis Rhizoma, 6 liang), Zhuyu (Evodiae Fructus, 1 liang).
Daotan Tang (Phlegm-Guiding Decoction): Treats phlegm flow. All phlegms arise from Heat.
Taixiong (Ligusticum Wallichii, 2 liang), Xiangfu (Cyperi Rhizoma, 8 liang), Chenpi (Citri Reticulatae Pericarpium), Zuye (Perillae Folium), Jiangjiang (Zingiberis Rhizoma Recens, 1 liang).
Topical for Pain: Mustard seed (Jiecaizi, ground and applied with water); Evodia fruit (Zhuyu, ground with vinegar, highly effective when applied topically).
Hot Compress for Pain: Vinegar-fried ash heated and wrapped in cloth for compressing; fried scallion and mugwort are also acceptable; leek juice is also usable.
General Body Pain
[Pulse and Syndrome] Taiyang Exterior Syndrome of Shanghan (Cold Damage), where all six pulses are tight; Yin Du Shanghan (Yin Toxic Cold Damage), body feels as if beaten, pulse is deep and tight; After sweating treatment for Shanghan, body pain persists because Qi and Blood are not yet harmonized, pulse is wiry and slow. Injury from Dampness, Dampness flows into joints, whole body hurts; Wind-Dampness combing, limbs feel heavy and painful, unable to turn or side, pulse is moderate/slow. In persons with Xu Lao (Deficiency and Emaciation), Qi and Blood are deficient, pulse is wiry and small.