bubble_chart Concept

Generalized pain refers to pain throughout the body.

This symptom is recorded in the "Treatise on Cold Damage Diseases" with names such as "body pain" and "physical pain," and is generally referred to as "generalized pain" in later medical literature.

If the pain is caused by the combination of wind, cold, and dampness leading to bi syndrome, limited to joint pain in the limbs, or if it is localized due to other reasons, it does not fall within the scope of this discussion.

bubble_chart Pattern Analysis

1. External Contractionwind-cold︰Generalized joint pain, aversion to cold with fever, absence of sweating, nasal congestion with runny nose, itchy throat with cough, thin white tongue coating, and floating tight pulse. This is due to invasion of wind-cold pathogens, which is severe, and may also present with heavy limbs, difficulty in turning the body, a distended head as if wrapped, and a white greasy tongue coating. The treatment for these two syndromes also differs. For wind-cold fettering the exterior with body pain, the treatment should focus on dispersing wind-cold and inducing sweating to release the exterior. The recommended formula is Ephedra Decoction with modifications.
2. Dampness Adhering to the Body Surface︰Generalized pain, heavy limbs, distending headache as if wrapped, or aversion to cold with fever, absence of sweating, white and greasy tongue coating, soggy pulse. This is due to contraction of dampness pathogens. Wind nature is mobile, cold nature is constricting; when externally contracting wind-cold, defensive yang becomes depressed, hence generalized joint pain. Zhubing Yuanhou Lun·Various Wind Disorders states: "When wind is in the skin, it causes creeping and pricking sensations as if being drawn or stabbed, with generalized pain..." The key points for pattern differentiation of wind-cold body pain are: generalized pain, aversion to wind and cold, fever, absence of sweating, nasal discharge, etc. Dampness adhering to the exterior causing body pain results from exposure to rain, walking in morning mist or dew, etc., leading to contraction of dampness pathogens that adhere to the exterior. The congealing and stagnant nature of dampness obstructs the flow of qi and blood in the sinews and vessels, hence causing generalized pain. Zhubing Yuanhou Lun·Various Wind Disorders states: "For those with wind-induced body pain... it is due to the mutual contention of wind and dampness between the flesh, clashing against each other, hence causing pain. If the pulse is floating and tight, there will be body pain." Key points for pattern differentiation: Severe body pain. Treatment should focus on releasing the exterior and dispelling dampness. The formula of choice is Notopterygium Overcoming Dampness Decoction with modifications.
3. Blood Stasis Obstructing the Collaterals︰Generalized pain, as if pricked by needles, with difficulty in turning over, dark tongue with ecchymosis, and deep, choppy pulse. The disease arises from prolonged obstruction syndrome entering the collaterals, or from qi disease progressing to blood, or due to other chronic sexually transmitted diseases causing disharmony of qi and blood. Prolonged illness enters the blood, leading to stasis and obstruction in the collaterals, resulting in body pain. The key points of pattern identification are: body pain like pricking, generally fixed in location, tongue with ecchymosis, and choppy pulse. Treatment should promote blood circulation, expel stasis, and unblock collaterals. The recommended formula is General Pain Stasis-Expelling Decoction.

In summary, body pain can be categorized into internal damage and external contraction. Generally, sudden onset of body pain is often caused by external contraction of wind-cold or dampness, while chronic body pain is due to obstruction of the collaterals. External contraction is often accompanied by exterior symptoms, and obstruction, besides body pain, also presents with signs of static blood. The former is treated with methods to induce sweating and release the exterior, often resolving the pathogen through sweating and thereby relieving the body pain; the latter, in addition to invigorating the blood to unblock the collaterals, also requires the inclusion of qi-regulating substances and is not easily resolved quickly.

bubble_chart Documentation

1. Zhangshi Yitong: "Body pain refers to pain throughout the entire body. Cold-damage disease, cholera, summerheat stroke, yin toxin, fixed arthralgia, and agonizing arthralgia all involve body pain. However, it is distinguished by observing accompanying symptoms, inquiring about the cause, and diagnosing the pulse. ... Pain caused by cold, where the painful area often feels cold or damp, is treated with Liquorice and Aconite Decoction. Internal damage due to overstrain, combined with the mutual contention of wind and dampness, resulting in pain throughout the body, is treated with tonifying middle and replenishing qi, adding Qiang Fang, Chinese Lovage, and Atractylodes Rhizome. Dampness-heat conflict, causing heavy shoulders and back, upper body heat, chest and diaphragm discomfort, and heavy pain throughout the body, is treated with Angelica Pain-Relieving Decoction. ... Pain throughout the body accompanied by chills and fever, chest and rib stuffiness and discomfort, due to liver blood deficiency and stagnant fire, is treated with Peripatetic Powder plus Notopterygium and Cinnamon Twig. If there is difficulty in urination, add Gardenia and Moutan. In hot weather with thick clothing, the striae and interstice open and sweat comes out, and the evil stays between the muscles, causing pain, treat with Six Harmonizations Decoction plus Notopterygium. Pain throughout the body like labor symptoms is treated with Ten Complete Great Tonics, removing White Atractylodes Rhizome and Prepared Rehmannia Root, and adding Notopterygium and Aconite Lateral Root."