The Hand chapter is the Donguibogam at its most orthopaedic. It opens with bone measurements and the naming of every segment from shoulder to wrist, then turns to the palm as a window onto the stomach, and settles into its real subject: the arm that hurts and will not lift. Two long sections divide that complaint by cause — wind, cold and damp on one side, phlegm-rheum on the other — and the differential between them is the chapter's central clinical teaching. Heo Jun closes with the nails as prognostic signs, whitlow, winter fissures, and the point selections for every segment of the upper limb.
The Palm Is Examined to Assess the Stomach 手掌以候胃
靈樞曰, 掌中熱者, 腹中熱, 掌中寒者, 腹中寒.
The Divine Pivot says: when there is heat in the palm, there is heat in the abdomen; when there is cold in the palm, there is cold in the abdomen.
Yeongchu 靈樞
魚上白肉有靑血脉者, 胃中有寒. 《靈樞》
When the white flesh above the fish (魚, the thenar eminence) shows green-blue blood vessels, there is cold in the stomach.
Yeongchu 靈樞
胃中寒, 則手魚際之絡多靑, 胃中有熱, 則魚際之絡赤. 其暴黑者, 久留痺也. 其有赤有黑有靑者, 寒熱氣也. 《靈樞》
When there is cold in the stomach, the network vessels at the fish border (魚際) are mostly green-blue; when there is heat in the stomach, the network vessels at the fish border are red. Where they are suddenly black, there is long-lodged impediment (痺). Where there is red and black and green-blue together, it is cold and heat Qi mixed.
Yeongchu 靈樞
大指本節後白肉際名曰魚, 以其形似魚也. 有穴名魚際. 《靈樞》
The border of white flesh behind the base joint of the thumb is called the fish (魚), because its shape resembles a fish. There is a point there named Eoje (魚際, Fish Border).
Yeongchu 靈樞
傷寒手心熱者, 邪在裏也. 手背熱者, 邪在表也. 手足溫者, 陽證也. 手足冷者, 陰證也. 《回春》
In cold damage, when the centre of the palm is hot, the evil is in the interior; when the back of the hand is hot, the evil is in the exterior. When the hands and feet are warm, it is a yang pattern; when the hands and feet are cold, it is a yin pattern.
Clinical note Palm hot versus dorsum hot is one of the fastest bedside discriminations in the classical repertoire, and it survives intact in modern practice — the patient who complains of burning palms and soles is describing an interior heat picture, typically yin vacuity, while heat felt on the back of the hands points outward to an exterior pattern. The thenar inspection above is a related but distinct examination: colour of the thenar network vessels reads the Stomach, and a sudden blackness there is read as chronic impediment rather than as an acute sign.
Hoechun 回春
The Four Limbs Do Not Function 四肢不用
黃帝曰, 脾病而四肢不用, 何也. 岐伯對曰, 四肢, 皆稟氣於胃, 而不得至經, 必因於脾, 乃得稟也. 今脾病, 不能爲胃行其津液, 四肢不得稟水穀氣, 氣日以衰, 脉道不利, 筋骨肌肉, 皆無氣以生, 故不用焉. 《內經》
The Yellow Emperor said: when the Spleen is diseased the four limbs do not function. Why is this? Qi Bo replied: the four limbs all receive their Qi from the Stomach, yet it cannot reach the channels on its own — it must go by way of the Spleen to be received. Now when the Spleen is diseased it cannot move the fluids on the Stomach's behalf, and the four limbs no longer receive the Qi of water and grain. That Qi declines day by day, the vessel pathways lose their free flow, and sinew, bone and flesh all have no Qi by which to live. Therefore they do not function.
Naegyeong 內經
四肢解墮者, 脾精之不行也. 《內經》
Slackening and dropping of the four limbs is the Spleen essence failing to move.
Naegyeong 內經
帝曰, 人之嚲者, 何氣使然. 岐伯曰, 胃不實, 則諸脉虛, 諸脉虛, 則筋脉解墮, 筋脉解墮, 則行陰用力, 氣不能復, 故爲嚲. 嚲謂手足嚲曳也. 《靈樞》
The Emperor said: when a person is slack-limbed (嚲), what Qi brings this about? Qi Bo said: when the Stomach is not replete, all the vessels are vacuous; when all the vessels are vacuous, the sinews and vessels slacken and drop; when the sinews and vessels slacken and drop, then exertion during yin activity exhausts the Qi so that it cannot return — hence slackness. 嚲 means the hands and feet hanging and dragging.
Yeongchu 靈樞
帝曰, 脾與胃以膜相連, 而能爲之行其津液, 何也. 岐伯曰, 足〔太〕陰者, 脾也. 爲之行氣於三陰. 陽明者, 胃也. 亦爲之行氣於三陽. 藏府各因其經, 而受氣於陽明. 故爲胃行其津液也. 《內經》
The Emperor said: the Spleen and Stomach are joined only by a membrane, yet the Spleen is able to move the Stomach's fluids on its behalf. How is this? Qi Bo said: the foot greater yin is the Spleen; it moves Qi for the Stomach through the three yin. The yang brightness is the Stomach; it likewise moves Qi through the three yang. The viscera and bowels each follow their own channel and receive Qi from the yang brightness. Thus the Spleen moves the Stomach's fluids on its behalf.
Clinical note The source printing drops one graph after 足 and carries a stray 大 in the margin; the reading is 太, giving 足太陰 (foot greater yin, the Spleen channel). Confirmed by the Suwen parallel and by the answering clause on yang brightness.
Naegyeong 內經
脾實, 則四肢不擧. 內經曰, 脾太過, 則令人四肢不擧, 是也. 此謂膏粱之疾, 其治宜瀉. 三化湯方見風門, 調胃承氣湯方見寒門, 選而用之. 若脾虛, 則四肢不用, 盖脾病不能與胃行其津液, 其治宜補. 十全大補湯方見虛勞, 去邪留正. 《保命》
When the Spleen is replete, the four limbs cannot be raised. The Inner Classic says that when the Spleen is excessive it causes a person to be unable to raise the four limbs — this is it. This is called a disease of rich food, and its treatment should drain: select and use Samhwa-tang 三化湯
formula in the Wind chapter or
Jowiseunggi-tang 調胃承氣湯 formula in the Cold chapter. If the Spleen is vacuous, then the four limbs do not function, for a diseased Spleen cannot move the fluids together with the Stomach; its treatment should supplement —
Sipjeondaebo-tang 十全大補湯 formula in the Vacuity Taxation chapter dispels the evil and retains the right.
Clinical note The replete/vacuous fork is the practical content of this section. Both present as a limb that will not work, and the whole treatment reverses depending on which it is: drain the surfeit of rich food, or supplement the failed transformation. 膏粱之疾 — the disease of fat meat and fine grain — is the classical name for the disorders of the overfed, and it reads uncomfortably well as a description of metabolic disease. **Modern correspondence: flaccid paresis of the limbs; the replete variant maps onto the limb weakness seen with metabolic and inflammatory burden, the vacuous onto deconditioning and malabsorptive weakness.**
Bomyeong 保命
Causes of Shoulder and Arm Disease 肩臂病因
靈樞曰, 肺心有邪, 其氣流于兩肘.
The Divine Pivot says: when there is evil in the Lung and Heart, its Qi flows into the two elbows.
Clinical note The Lung and Heart channels both traverse the medial elbow, which is the anatomical basis of the claim — and the reason a persistent medial elbow complaint is worth a chest inquiry rather than a purely local reading.
Yeongchu 靈樞
手屈而不伸者, 其病在筋, 伸而不屈者, 其病在骨, 在骨守骨, 在筋守筋. 《靈樞》
When the hand bends but will not straighten, the disease is in the sinews; when it straightens but will not bend, the disease is in the bone. What is in the bone, treat at the bone; what is in the sinew, treat at the sinew.
Clinical note A two-line examination that still holds. Loss of extension with preserved flexion points to contracture of the flexor soft tissue; loss of flexion with preserved extension points to the joint itself. The closing instruction — treat at the level where the lesion lies — governs needle depth as much as point selection.
Yeongchu 靈樞
酒家之癖, 多爲項腫臂痛. 盖熱在上焦, 不能淸利. 故醞釀日久, 生痰涎, 聚飮氣, 流走於項臂之間, 不腫則痛耳. 《直指》
The habitual drinker's affliction is commonly swelling of the nape and pain in the arm. Heat lies in the upper burner and cannot be cleared and disinhibited; so, fermenting over long days, it engenders phlegm-drool and gathers rheum Qi, which flows and runs between the nape and the arm — where it does not swell, it aches.
Clinical note The verb 醞釀, to ferment or brew, is doing deliberate work here: the drinker's shoulder is described as brewing its own pathology by the same process that made the wine. This passage is the bridge into the phlegm-rheum section that follows, and it identifies the patient population — the heavy drinker with neck and shoulder complaints — for whom the phlegm formulas outperform the wind-damp ones.
Jikji 直指
臂爲風寒濕所搏, 或睡後手在被外, 爲寒邪所襲, 遂令臂痛. 或乳婦以臂枕兒, 傷於風寒, 亦致臂痛. 寒痛, 宜五積散方見寒門, 風痛, 宜烏藥順氣散, 濕痛, 宜蠲痺湯幷見風門, 加蒼朮ㆍ酒防己. 《醫鑑》
The arm may be assailed by wind, cold and damp; or the hand may lie outside the bedding during sleep and be raided by cold evil, which then causes arm pain; or a nursing mother may pillow her child on her arm and be damaged by wind cold, likewise bringing on arm pain. For cold pain, use
Ojeok-san 五積散 formula in the Cold chapter; for wind pain,
Oyaksungi-san 烏藥順氣散; for damp pain, Gyeonbi-tang 蠲痺湯
both in the Wind chapter, adding black atractylodes and wine-processed stephania.
Clinical note Three aetiologies, each with a concrete scene. The arm left outside the covers and the nursing mother's pillowed arm are observational medicine of a high order — both describe a limb held immobile in a sustained position while cooling, which is a recognizable modern account of how a shoulder becomes painful overnight. The nursing-mother case is also a reminder that this chapter was written for a practice seeing ordinary domestic complaints.
Uigam 醫鑑
氣血凝滯臂痛, 宜薑黃散ㆍ舒經湯.
Uigam 醫鑑
風濕臂痛, 宜活絡湯.
Uigam 醫鑑
七情臂痛, 宜白芥子散.
Uigam 醫鑑
臂胛痛, 宜五靈脂散.
Uigam 醫鑑
折傷後, 手足痛, 宜應痛元.
Clinical note These five lines are the chapter's prescribing index for shoulder and arm pain, sorted by cause rather than by site: stagnation, wind-damp, emotion, scapular involvement, trauma. Taken with the phlegm-rheum section following, they give six discriminable causes for a single presenting complaint — which is the practical answer to why one patient's frozen shoulder responds to a formula that does nothing for the next.
Uigam 醫鑑
Phlegm-Rheum Is Often the Cause of Arm Pain 痰飮多爲臂痛
凡人忽患, 胸背手脚腰胯隱痛不可忍, 連筋骨牽引釣痛, 坐臥不寧, 時時走易不定, 意謂是風證, 或疑是癰疽, 皆非也. 此乃痰涎伏在心膈上下, 變爲此疾. 《集要》
When a person suddenly suffers a hidden pain in the chest, back, hands, feet, lumbus or hip that cannot be borne, dragging and hooking along the sinews and bones, unable to sit or lie in peace, shifting from time to time and never fixed — one supposes it is a wind pattern, or suspects a welling abscess. It is neither. This is phlegm-drool lying hidden above and below the heart and diaphragm, which has transformed into this disease.
Clinical note The three cardinal features are given plainly: severe pain out of proportion to findings, migration without fixed location, and inability to find a comfortable position. Together they define the phlegm-rheum presentation and separate it from both wind patterns and suppurative disease — a differential that mattered because the treatments diverge completely. A modern reader will recognize the picture of widespread migratory musculoskeletal pain in a patient who looks well on examination.
Jibyo 集要
治臂痛不能擧, 或左右時復轉移, 由伏痰在中脘停滯, 脾氣不得流行, 上與氣搏. 四肢屬脾, 滯而氣不升, 故上行攻臂, 其脉沈細者, 是也. 氣實者, 控涎丹方見痰門最效. 宜用半硝丸ㆍ消痰茯苓丸. 《入門》
To treat arm pain with inability to raise the arm, shifting from left to right and back again from time to time: it arises from hidden phlegm halting and stagnating in the centre duct, so that Spleen Qi cannot move freely and contends with the Qi above. The four limbs belong to the Spleen; when it is stagnant and the Qi does not bear upward, it travels up and assails the arm. A sunken and fine pulse confirms it. Where the Qi is replete, Gongyeon-dan 控涎丹
formula in the Phlegm chapter is most effective. Otherwise use
Bancho-hwan 半硝丸 or
Sodambokryeong-hwan 消痰茯苓丸.
Clinical note The pathomechanism is worth following because it explains an otherwise odd claim — that a shoulder problem originates in the epigastrium. Phlegm stalls in the centre duct, Spleen Qi cannot bear upward, and since the limbs are Spleen territory the obstructed Qi drives up into the arm instead. The sunken fine pulse is the confirming sign, and the alternation between arms is the feature no structural lesion can produce.
Immun 入門
痰飮臂痛, 宜加減茯苓丸ㆍ芎活湯ㆍ半夏芩朮湯.
Immun 入門
臂痛, 或麻木, 或戰掉, 皆痰飮所作, 二陳湯方見痰門, 呑下靑州白圓子方見痰門.
Arm pain, or numbness, or trembling and shaking — all are made by phlegm-rheum. Use
Ijin-tang 二陳湯 formula in the Phlegm chapter to swallow down Cheongjubaegwonja 靑州白元子
formula in the Phlegm chapter.
Clinical note Numbness and tremor are grouped with pain as expressions of one cause, which is why this section's formulas reappear later at 心虛手振 (1.16) and 十指麻木 (1.13). The delivery method — a decoction used to swallow a pill — is standard for getting a drying pill past the stomach with a moving, harmonizing escort.
Immun 入門
Dislocation of the Shoulder and Arm Bone 肩臂骨脫臼
兩肩頭冷疼, 尤不可〔忽〕, 屢見將中風人. 臂骨脫臼, 不與肩相連接, 多有治不愈者. 要之, 纔覺肩上冷疼, 必先灸肩髃等穴, 毋使至於此極可也. 《資生》
Cold aching at the crown of both shoulders must not be neglected. It has repeatedly been seen in those about to be struck by wind: the arm bone slips from its socket and no longer connects with the shoulder, and many such cases are treated without being cured. The essential point is this — as soon as cold aching is felt on the shoulder, one must first moxa Gyeonu (肩髃, LI15) and similar points, so as not to let it reach this extremity.
Clinical note One graph is lost after 不可 in the source printing; supplied as 忽 (to neglect), which the sentence requires and which the following clause confirms. The clinical content is a prevention argument: cold shoulder ache is treated as a prodrome, and the instruction is to moxa early rather than wait for the disabling stage. Whether the 臂骨脫臼 described is true dislocation or the profound loss of glenohumeral function seen after stroke is not resolvable from the text — the association with impending wind strike suggests the latter, and the observation that such cases often fail treatment fits post-stroke shoulder subluxation better than it fits traumatic dislocation.
Jasaeng 資生
留飮之證, 四肢歷節痛, 氣短脉沈, 久則令人骨節蹉跌. 宜導痰湯方見痰門加減用之. 《入門》
In the pattern of lodged rheum, there is pain running through the joints of the four limbs, shortness of breath, and a sunken pulse; over time it causes the bone joints to slip and give way. Use Dodam-tang 導痰湯 formula in the Phlegm chapter with additions and subtractions.
Clinical note A second mechanism for the failing shoulder, distinct from the first: not cold ache preceding wind strike but rheum lodged in the joints, with the breathlessness and sunken pulse that mark the phlegm patterns of 1.9. 蹉跌 — slipping and stumbling — describes joints that give way rather than joints that hurt, and it places this passage close to what would now be called joint instability.
Immun 入門
The Hands Pick at the Bedclothes and Grope at the Air 手循衣撮空摸床
傷寒熱病之極, 手循衣撮空摸床者, 凶. 産後血脫, 亦有此證. 《綱目》
At the height of cold damage heat disease, when the hands run along the clothing, pluck at the empty air and grope over the bed, the sign is inauspicious. After childbirth with blood collapse, this pattern also occurs.
Gangmok 綱目
病人手尋衣領, 及亂捻物者, 肝熱也. 手搯眉目鼻面者, 肺熱也. 《綱目》
When the patient's hand searches for the collar of the garment and fumbles at objects at random, it is Liver heat. When the hand picks at the brows, eyes, nose and face, it is Lung heat.
Gangmok 綱目
傷寒熱病, 尋衣撮空, 許學士說作肝熱, 風淫末疾. 此論雖然莫若斷之爲肺熱似爲愈矣. 其人必譫言妄語. 經曰, 肺邪入心爲譫語, 兼上焦有疾, 肺必主之. 手經者, 上焦也. 此肺之體, 肝之用. 肝主血, 血者, 陰物也. 陰不能自動. 盖肺主氣, 爲氣所鼓舞, 故靜者得動. 一者說肝之用, 一者說肺之體, 此天地互爲體用也. 《東垣》
In cold damage heat disease with searching at the clothes and plucking at the air, Scholar Heo explained it as Liver heat and as wind invading the extremities. Although this argument stands, it seems better to settle it as Lung heat. Such a person will certainly speak deliriously and talk wildly. The Classic says that when Lung evil enters the Heart there is delirious speech; and where there is disease in the upper burner besides, the Lung must govern it. The hand channels are the upper burner. This is the Lung's substance and the Liver's function. The Liver governs the Blood; Blood is a yin thing, and yin cannot move of itself. It is the Lung that governs Qi, and being drummed up by the Qi, what was still is able to move. The one account speaks of the Liver's function, the other of the Lung's substance — this is heaven and earth serving as substance and function to one another.
Clinical note Carphologia and floccillation — picking at the bedclothes and grasping at the air — are recognized in modern medicine as terminal delirium signs, and the Donguibogam reads them the same way: 凶, inauspicious. What is unusual here is the extended argument over which viscus is responsible, with Li Dongyuan conceding his opponent's reasoning and then reframing the disagreement as substance versus function rather than right versus wrong. The clinical takeaway survives the metaphysics intact: this sign appears at the extremity of febrile illness and after postpartum hemorrhage, and it is a sign of gravity rather than a symptom to be treated locally. **Modern correspondence: carphologia/floccillation in terminal delirium.**
Dongwon 東垣
Whitlow 代指
代指者, 指頭先腫, 焮熱掣痛, 然後於爪甲邊結膿潰破, 甚者, 爪甲俱脫. 《入門》
In whitlow (代指), the fingertip swells first with scorching heat and wrenching pain; afterwards pus binds at the edge of the nail and breaks open, and in severe cases the nail comes off entirely.
Clinical note A clean clinical description of acute paronychia: tumor, calor, dolor at the nail fold, progressing to a pointing abscess and, when neglected, to nail loss. **Modern correspondence: acute bacterial paronychia; the severe form is a felon (distal pulp space infection).**
Immun 入門
代指, 亦謂之天蛇頭瘡. 《綱目》
Whitlow is also called heaven-snake head sore (天蛇頭瘡).
Gangmok 綱目
天蛇頭瘡, 開口腫痛, 以雄黃, 雞子內, 以患指浸其中一宿, 次早, 更以蜈蚣燒烟, 熏病指一二次, 卽消. 《入門》
For heaven-snake head sore that has opened and is swollen and painful: put realgar inside a hen's egg, steep the affected finger in it overnight, and the next morning burn centipede for its smoke and fumigate the diseased finger once or twice — it will disperse.
Clinical note Realgar is arsenic sulphide and centipede is toxic; neither belongs on broken skin in contemporary practice. Recorded as documented.
Immun 入門
治代指, 蒲公英, 與蒼耳草等分爲末, 好醋濃煎, 浸洗卽愈. 《丹心》
To treat whitlow: powder dandelion and cocklebur herb in equal parts, decoct thickly in good vinegar, and soak and wash the finger — it will heal.
Dansim 丹心
蒲公英擣細, 水和去滓服之, 滓〔罨〕患處, 累效. 《丹心》
Pound dandelion fine, mix with water, strain off the dregs and drink it; apply the dregs as a compress over the affected place. Repeatedly effective.
Clinical note The source prints a rare graph here; read as 罨, to apply as a compress, which the sentence requires. Note the structure of the treatment — the strained liquid taken internally and the residue used topically, so nothing is wasted and the medicine works from both directions. Dandelion is the through-line of this section, appearing in three of the nine passages.
Dansim 丹心
手指忽腫痛, 名爲代指, 焰焇煎湯淋漬之. 又取烏梅核中仁爲末, 醋調成膏, 入指漬之, 自愈. 《本草》
When a finger suddenly swells and hurts, it is called whitlow. Decoct saltpetre and pour it over and steep the finger. Also: powder the kernel from within the mume plum stone, mix with vinegar into a paste, insert the finger and let it soak — it will heal of itself.
Boncho 本草
又猪脂和蚯蚓擣爛付之. 又田螺生擣碎付之. 《本草》
Also: pound lard together with earthworm to a pulp and apply. Also: pound a live rice-field snail to fragments and apply.
Boncho 本草
生雞卵開一孔, 將指浸之, 三箇卽愈. 《綱目》
Open a single hole in a raw hen's egg and steep the finger in it; after three eggs it heals.
Clinical note The egg appears twice in this section, once as a vehicle for realgar and once alone. Stripped of the mineral, what remains is a warm moist enclosed soak of the fingertip — which is, in mechanism, close to the warm soaks still recommended for early paronychia before it points.
Gangmok 綱目
手足觸木惡刺, 及狐尿刺腫痛, 蒲公英摘取白汁, 多塗, 立差. 《入門》
For hands and feet struck by wood splinters and malign thorns, and for the swelling and pain of fox-urine thorn, pick dandelion and take its white sap, apply generously — it resolves at once.
Clinical note 狐尿刺, fox-urine thorn, is the classical name for a thorn wound that becomes disproportionately inflamed — the belief being that a fox had urinated on the plant. What it names is the infected puncture wound, and grouping it with splinter injuries here is anatomically sensible: both are inoculation injuries of the hand, and both were the common route to the whitlow described at the head of this section.
Immun 入門
Chapping and Fissuring of the Hands and Feet 手足皸裂
冬月手足皸裂作痛, 宜用黃蠟膏ㆍ臘享膏方見雜方.
For painful chapping and fissuring of the hands and feet in the winter months, use
Hwangrap-go 黃蠟膏 or Naphyang-go 臘享膏
formula in the Miscellaneous chapter.
Donguibogam · Su
手足皸裂, 取生薑汁ㆍ紅糟ㆍ白鹽ㆍ臘猪脂同硏爛炒熱, 擦入皸內, 一時雖痛, 少頃卽安. 《綱目》
For chapped and fissured hands and feet: take fresh ginger juice, red rice lees, white salt and year-end lard, grind them together to a pulp, fry until hot, and rub it into the fissures. Though it hurts for a moment, shortly it settles.
Clinical note The warning that it will sting before it soothes is the honest part of this entry, and it is accurate — salt and ginger in an open fissure will burn. The formulation is nonetheless coherent: lard occludes, salt is antiseptic, and the fermented lees supply acid and moisture. A patient told in advance that the remedy stings is far more likely to complete the treatment.
Gangmok 綱目
冬月冒涉凌凍, 面目手足皸裂, 血出作痛, 猪腦髓, 着熱酒中以洗之, 差. 《本草》
For those who brave ice and frost in winter, with face, eyes, hands and feet chapped and split, bleeding and painful: put pig brain into hot wine and wash with it.
Boncho 本草
又兎腦髓生塗之, 雀腦髓亦可. 《本草》
Also: apply rabbit brain raw; sparrow brain will serve as well.
Boncho 本草
又百沸湯洗後, 油髮(灰)付之卽安. 白芨末, 水調塗之, 亦效. 《丹心》
Also: after washing in water brought to a hundred boils, apply the ash of oiled hair and it settles. Powdered bletilla mixed with water and applied is likewise effective.
Clinical note The brain preparations are lipid dressings — brain tissue is largely fat and phospholipid, so the underlying logic is occlusion, the same principle as the beeswax salve. Bletilla (白芨, a variant writing of 白及) is the entry that transfers directly to modern practice: it forms a mucilaginous film over the wound bed and is still used for exactly this purpose. The hundred-boils wash preceding application is the same wash-then-seal sequence prescribed with Hwangrap-go.
Dansim 丹心
Simple Medicinals 單方
凡十四種.
Fourteen kinds in all.
Donguibogam · Su
羌活. 治肢節痛. 煎湯服之. 《東垣》
Notopterygium (羌活): treats pain of the limbs and joints. Decoct and take.
Dongwon 東垣
防風. 治四肢拘攣. 煎湯服, 或丸服. 《本草》
Siler (防風): treats hypertonicity and cramping of the four limbs. Decoct and take, or take as pills.
Boncho 本草
細辛. 治手足拘急. 或煎服, 或末服皆佳. 《本草》
Asarum (細辛): treats tension and cramping of the hands and feet. Taken as a decoction or as a powder, either is good.
Boncho 本草
蒼耳子. 主四肢拘攣痛. 取三兩炒搗末, 水一升半煎至半, 去滓呷服. 《本草》
Cocklebur fruit (蒼耳子): governs painful hypertonicity of the four limbs. Take 3 nyang, dry-fry and pound to powder, decoct in 1.5 seung of water down to half, strain off the dregs and sip.
Boncho 本草
天麻. 主四肢拘攣. 水煎服, 或蒸熟食. 或生食幷佳. 《本草》
Gastrodia (天麻): governs hypertonicity of the four limbs. Decoct in water and take, or steam until done and eat, or eat it raw — all are good.
Boncho 本草
淫羊藿. 治四肢不仁. 水煎服, 或浸酒服幷佳. 《本草》
Epimedium (淫羊藿): treats insensitivity of the four limbs. Decoct in water and take, or steep in wine and take — both are good.
Boncho 本草
地膚草. 主手足煩疼. 水煮服, 日三. 《本草》
Kochia herb (地膚草): governs vexing pain of the hands and feet. Boil in water and take, three times daily.
Boncho 本草
桑枝茶. 療臂痛. 可常飮之. 有人療兩臂痛, 百藥不效, 服此卽愈. 《綱目》
Mulberry twig tea (桑枝茶): heals arm pain. It may be drunk regularly. There was a man treating pain in both arms whom a hundred medicines had failed; on taking this he was cured.
Clinical note The most useful entry in this section and the one still in daily use. Mulberry twig is specific for the upper limb, it is mild enough for indefinite administration, and the tea form makes it something a patient can genuinely maintain between visits. The case note — a hundred medicines failed, this one worked — is the same rhetorical shape as the Seogyeong-tang case at 1.8, and both mark formulas the compiler wanted remembered.
Gangmok 綱目
五倍子. 治手足皸裂. 搗爲末, 調牛腦髓塡封卽愈. 《得效》
Chinese gall (五倍子): treats chapped and fissured hands and feet. Pound to powder, mix with ox brain, and pack it into the fissures to seal them.
Deukhyo 得效
松脂. 療代指. 入蠟熔化, 候溫, 以籠指頭卽差. 《本草》
Pine resin (松脂): heals whitlow. Add wax and melt together; when it has cooled to warm, cage the fingertip in it and it resolves.
Boncho 本草
醬淸. 治手指掣痛. 和蜜溫漬之卽愈. 《本草》
Clear soy sauce (醬淸): treats wrenching pain of the fingers. Mix with honey, warm it, and steep the finger — it heals.
Boncho 本草
鹿髓脂. 主四肢不隨. 和酒服之, 佳. 《本草》
Deer marrow fat (鹿髓脂): governs the four limbs not following the will. Mix with wine and take.
Boncho 本草
馬糞. 治毒熱攻手足腫痛欲脫. 水煮馬糞, 取汁溫漬之. 《本草》
Horse dung (馬糞): treats toxic heat assaulting the hands and feet so that they swell and hurt as though about to come off. Boil horse dung in water, take the liquid, and steep the part while warm.
Clinical note The presentation described — a hand so swollen and painful it feels about to detach — is a limb-threatening infection, and this is a hot soak for it. The material is unusable, but the maneuver is not: warm immersion of a septic hand remains standard first-line care while definitive treatment is arranged.
Boncho 本草
虎骨酒. 治臂脛痛, 不計深淺皆效. 《本草》
Clinical note Full preparation on the formula page. Two of its three ingredients are prohibited under CITES and the US Endangered Species Act; recorded as a document of the classical materia medica, not as a prescription.
Boncho 本草
Acupuncture and Moxibustion Methods 鍼灸法
靈樞曰, 手陽明之脉病, 肩前臑痛, 大指次指痛不用.
The Divine Pivot says: in disease of the hand yang brightness vessel, there is pain at the front of the shoulder and in the upper arm, and the finger next to the thumb (the index) is painful and will not function.
Yeongchu 靈樞
手太陽之脉病, 肩似拔, 臑似折.
In disease of the hand greater yang vessel, the shoulder feels as though wrenched out and the upper arm as though snapped.
Yeongchu 靈樞
手少陽之脉病, 肩臑肘臂外皆痛, 小指次指不用.
In disease of the hand lesser yang vessel, the shoulder, upper arm, elbow and outer forearm all hurt, and the finger next to the little finger (the ring) will not function.
Yeongchu 靈樞
手厥陰之脉病, 手心熱, 肘臂攣急, 腋腫.
In disease of the hand reverting yin vessel, the centre of the palm is hot, the elbow and forearm are hypertonic and tense, and the axilla is swollen.
Yeongchu 靈樞
手太陰之脉病, 臑臂內前廉痛厥, 掌中熱.
In disease of the hand greater yin vessel, the inner-anterior edge of the upper arm and forearm is painful and reverting cold, and the centre of the palm is hot.
Yeongchu 靈樞
手少陰之脉病, 臑臂內後廉痛厥, 掌中熱痛, 隨其經鍼灸之.
In disease of the hand lesser yin vessel, the inner-posterior edge of the upper arm and forearm is painful and reverting cold, and the centre of the palm is hot and painful. Needle and moxa according to the channel involved.
Clinical note These six passages are the channel-by-channel presentation that 1.10 above taught the reader to localize. Read together they form a complete differential for upper limb pain, and the closing instruction — treat according to whichever channel it is — makes explicit that the point selections following are meant to be filtered through that diagnosis rather than applied as a fixed protocol.
Yeongchu 靈樞
肩髃, 係兩手之安否. 《資生》
Gyeonu (肩髃, LI15) governs whether the two arms are well or not.
Jasaeng 資生
五指拘攣, 取三間ㆍ前谷. 《綱目》
For hypertonicity and cramping of the five fingers, select Samgan (三間, LI3) and Jeongok (前谷, SI2).
Gangmok 綱目
五指皆痛, 取陽池ㆍ外關ㆍ合谷. 《綱目》
For pain in all five fingers, select Yangji (陽池, TE4), Oegwan (外關, TE5) and Hapgok (合谷, LI4).
Gangmok 綱目
兩手攣急偏枯, 取大陵. 《綱目》
For both hands hypertonic and tense with hemiplegic withering, select Daereung (大陵, PC7).
Gangmok 綱目
肘攣筋急, 取尺澤. 《綱目》
For a cramped elbow with tense sinews, select Cheoktaek (尺澤, LU5).
Gangmok 綱目
肩不可動, 臂不可擧, 取肩髃ㆍ巨骨ㆍ淸冷淵ㆍ關衝. 《東垣》
When the shoulder cannot be moved and the arm cannot be raised, select Gyeonu (肩髃, LI15), Geogol (巨骨, LI16), Cheongnaengyeon (淸冷淵, TE11) and Gwanchung (關衝, TE1).
Clinical note The point prescription for frozen shoulder, and the one to know from this section. Note the structure: two local points at the shoulder girdle, one on the upper arm, and a distal well point at the ring fingertip — local, adjacent and distal in a single prescription, which is the classical pattern for a joint that has lost range rather than merely hurting.
Dongwon 東垣
臂膊痛麻痺, 取肩髃ㆍ手三里ㆍ外關ㆍ肩井ㆍ曲池ㆍ手上廉ㆍ合谷. 《綱目》
For pain, numbness and impediment of the arm and upper arm, select Gyeonu (肩髃, LI15), Susamni (手三里, LI10), Oegwan (外關, TE5), Gyeonjeong (肩井, GB21), Gokji (曲池, LI11), Susangnyeom (手上廉, LI9) and Hapgok (合谷, LI4).
Gangmok 綱目
肘痛不可屈伸, 取天井ㆍ尺澤. 《綱目》
For elbow pain that cannot bend or straighten, select Cheonjeong (天井, TE10) and Cheoktaek (尺澤, LU5).
Gangmok 綱目
肘臂腕痛, 取前谷ㆍ液門ㆍ中渚. 《綱目》
For pain of the elbow, forearm and wrist, select Jeongok (前谷, SI2), Aengmun (液門, TE2) and Jungjeo (中渚, TE3).
Gangmok 綱目
臂痠攣, 取肘髎ㆍ竅陰ㆍ尺澤ㆍ前谷ㆍ後谿. 《綱目》
For an aching, cramping arm, select Juryo (肘髎, LI12), Gyoeum (竅陰), Cheoktaek (尺澤, LU5), Jeongok (前谷, SI2) and Hugye (後谿, SI3).
Clinical note 竅陰 is given without qualifier and could be either Dugyoeum (頭竅陰, GB11) or Jokgyoeum (足竅陰, GB44). In an arm prescription the foot point is the likelier reading, since distal well points of the lesser yang are used to free the whole channel; but the text does not settle it and the ambiguity is left standing here.
Gangmok 綱目
腕痛, 取陽谿ㆍ曲池ㆍ腕骨. 《綱目》
For wrist pain, select Yanggye (陽谿, LI5), Gokji (曲池, LI11) and Wangol (腕骨, SI4).
Gangmok 綱目
兩胛痛, 取肩井ㆍ支溝. 《綱目》
For pain in both scapulae, select Gyeonjeong (肩井, GB21) and Jigu (支溝, TE6).
Clinical note The chapter closes with the scapular pair that opened its formula section at 1.8 — Oryeongji-san was indicated for 臂胛痛, pain of arm and scapula, and here the needling counterpart is given in two points. Taken as a whole, the acupuncture section moves systematically from proximal to distal: shoulder, arm, elbow, wrist, fingers, and back to the scapula.
Gangmok 綱目