Arthralgia

Arthralgia

Numbness in the body and pain in the limbs are now known as gout, but in ancient times were referred to as arthralgia. Weak individuals exposed to external wind develop blood arthralgia, and Zhang Zhongjing used Huangqi Wuwu Tang, adding Gui Zhi to the blood circulation, which is the most effective way to dispel wind. In blood-related cases, since the blood vessels are already weak, exposure to external wind often leads to arthralgia, either migrating or remaining localized. In such cases, Huangqi Wuwu Tang should be supplemented with Danggui, Danpi, and Honghua. For those with blood deficiency and excessive fire, when wind combines with fire and external arthralgia appears along with internal symptoms such as short stools and frequent thirst, Gui Zhi’s pungent warmth should not be used; instead, Siwu Decoction combined with Fangfeng, Chuanxiong, Huangqin, Danpi, Xuetong, Qinjiao, Xuduan, Antelope Horn, Sangjisheng, Polygonatum, Mai Dong, and others should be used for treatment. Blood deficiency naturally generates wind, and Danggui, Honghua, and Jingjie are often used in alcohol-water decoctions. When blood stasis spreads to the limbs, it also causes pain, similar to blood arthralgia. However, the pain caused by blood stasis is often like a sharp needle prick, the pulse is not floating, and there is no urgency, which is slightly different; please refer to the section on blood stasis for more details.

There is also Zhoubi (1), a type of foot ailment caused by phlegm-dampness, which is considered a miscellaneous condition and will not be discussed here.

[Note] (1) Zhoubi: Also known as Yinbi or Fengbi. Clinically, it manifests as limb soreness and pain that migrates unpredictably.

[Commentary] Blood arthralgia is similar to modern medical peripheral nerve disorders. In blood-related cases, wind often arises due to blood deficiency (i.e., insufficient nourishment of the sinews), resulting in wandering numbness, pain, and heaviness. Huangqi Gui Zhi Wuwu Tang is used for treatment. If there is thirst, short stools, and rapid pulse, it indicates internal heat is intense, and clearing the internal heat is the top priority; in such cases, Antelope Horn, Huangqin, and Chuanxiong should be added to Siwu Decoction.