《脉要精微论》曰∶“腰者，肾之府，转移不能，肾将惫矣。”《经脉篇》曰∶“足少阴之别，名曰大钟，
实则闭癃，虚则腰痛。”《刺腰痛篇》曰∶足太阳脉，令人腰痛。《刺疟论》曰∶“足太阳之疟，令人腰痛。”
细考《内景传图》，腰为肾经所居之地，膀胱经所过之区，腰痛止此二经。彼足厥阴、足阳明、足少阳经，本不
行腰，而言腰痛者，牵引而痛也。方书所辨，未尝分别其经；世医所治，止及肾虚一语。夫肾与膀胱，一表一
里，邪之自外来者，尽属太阳之腑；痛之自内生者，总归少阴一经。诊其脉之沉细者，而知其痛在少阴焉。时
痛时止者，房劳耗其精也（熟地、淮药、枣皮、泽泻、粉丹、茯苓、杜仲、牛膝）枕衾灿烂，心迷解语之花（
唐《天宝遗事》，大液池千叶莲盛开，帝与妃子共赏，谓左右曰∶“争似此解语花”），云雨苍茫，神醉游仙
之梦（《高唐赋∶“昔者，先王尝游高唐，怠而昼寝，梦见一妇人曰∶“外家巫山之女也，为高唐之客，闻君
游高唐，愿荐枕席”）。时痛时热者，浓味熬其水也（熟地、淮药、枣皮、茯苓、泽泻、丹皮、黄柏、知母），
山笋湖蒲，总无下箸之处（《晋书》何曾日食万钱，对案尚无下箸处）；脍鲤 鳖，翻为适口之资。痛着不
移者，闪挫竭其力也（经验方∶熟地、丹皮、秦归、杜仲、续断、淮膝、桃仁）。重举千钧，自诩扛鼎之力（
《汉书》项羽力能打鼎）；奇经百验，空传刮骨之文（见华佗注）。填骨髓而补真阴，为少阴之主药，厥惟地
黄，调和补泻，燮理阴
阳，实为护国之臣。诊其脉之浮紧者，而知其痛在太阳焉。刺痛背肉者，风淫于肾俞穴也（经验方∶麻黄、独
活、细辛、防风、秦归、酒芍、生地）。伛偻而行，偏铭考父之鼎（《左传》正考父之鼎名曰∶“一命而伛，
再命而偻，三命而俯，循墙而走”）； 在望，也承丈人之蜩（《庄子》仲尼适楚，出于林中，见 者，
承蜩犹掇之也，顾谓弟子曰∶“用志不分，乃凝于神，其 丈人之谓乎。”注∶ ，曲背；承蜩，以竽粘
蜩）。郁痛畏冷者，寒客于气海俞也（经验方∶麻黄、附子、细辛、秦归、炙草）。闲坐凄凉，滥厕楚宫之女
（楚王爱细腰，宫女多有不食以求瘦其腰者）；幽居 冷，空披齐国之纨（梁简文帝启鲁缟齐纨，藉新香而受
彩。梁元帝谢 锦，启鲜洁齐纨，声高赵毂）。病重难移者，湿着于藏精所也（经验方∶麻黄、苍术、杜仲、淮
膝、焦术、秦归、茯苓、苡米、炙草）。举止维艰，已作支离之态。《庄子》支离疏者，颐隐于齐（脐），肩
高于项，会撮指天，五管（官）在上，两脾在胁。”注∶支离，驼子；疏，人名，会撮，发髻；屈伸莫遂，
且无辗转之嫌。调血脉而通关窍，为太阳之主药，实为麻黄，驱逐客邪，通行经络，允推先锋之将。少阴不轻痛，
太阳之痛居多，所以《内经》麻黄之症特详。今人所治，动曰地黄症，盍取《内经》而细玩之也乎？
《素问·脉要精微论》说：“腰是肾的府库，如果腰部转动困难，说明肾气将要衰竭了。”《灵枢·经脉篇》说：“足少阴肾经的别络，名叫大钟穴，实证时会出现小便不通，虚证时则出现腰痛。”《素问·刺腰痛篇》说：足太阳膀胱经的病变，会导致人腰痛。《素问·刺疟论》说：“足太阳经的疟疾，使人腰痛。”
仔细考察《内景图》，腰部是足少阴肾经所居之地，也是足太阳膀胱经经过的区域，腰痛只涉及这两条经络。至于足厥阴肝经、足阳明胃经、足少阳胆经，原本并不行经于腰部，文中提到它们引起腰痛，是指疼痛由其他部位牵引至腰部所致。医书中对此辨析不够，未曾明确区分所属经络；世俗医生治疗腰痛，往往只归结为“肾虚”这一句话。
肾与膀胱，一里一表，外邪从外部侵入的，都属于太阳腑病；疼痛从内部产生的，总归属于少阴一经。诊察其脉象沉细的，就知道疼痛在少阴经。（可用方药：熟地黄、山药、山茱萸、泽泻、牡丹皮、茯苓、杜仲、牛膝。）
如果是时时作痛、时止时发，这是因为房事过度耗伤了肾精。（可用方药：熟地黄、山药、山茱萸、泽泻、牡丹皮、茯苓、杜仲、牛膝。）这就像唐玄宗在《天宝遗事》中所述，大液池千叶莲盛开，皇帝与妃子共赏，对左右侍臣说：“谁能比得上这朵解语花呢？”又如云雨之事苍茫不定，神魂沉醉于游仙之梦（出自《高唐赋》：“昔日先王曾游历高唐，疲倦而昼寝，梦见一妇人说：‘我是巫山之女，为高唐之客，听说君王游历高唐，愿荐枕席以侍奉。’”）。
如果是时时作痛且伴有发热感，这是因为厚味饮食煎熬了肾水。（可用方药：熟地黄、山药、山茱萸、茯苓、泽泻、牡丹皮、黄柏、知母。）这就好比晋代何曾每日饮食花费万钱，面对美食却仍觉得没有下筷子的地方；而那些脍鲤、鳖等美味，反而成了适口的资粮。
如果疼痛固定不移，这是因为闪挫劳损耗竭了体力。（经验方：熟地黄、牡丹皮、当归、杜仲、续断、怀牛膝、桃仁。）这如同重举千钧重物，自夸有扛鼎之力（《汉书》记载项羽力能扛鼎）；又似奇经百验，空传华佗刮骨疗毒的文章（见华佗注）。
填补骨髓而补益真阴，是治疗少阴病的主药，唯有地黄。它能调和补泻，燮理阴阳，实为护国的重臣。
诊察其脉象浮紧的，就知道疼痛在太阳经。刺痛背部肌肉的，是风邪淫溢于肾俞穴所致。（经验方：麻黄、独活、细辛、防风、当归、酒白芍、生地黄。）
弯腰曲背而行，正如正考父鼎上的铭文所说：“一命而伛，再命而偻，三命而俯，循墙而走”；又像庄子中所述，孔子去楚国，经过树林，看见痀偻丈人粘蝉，就像拾取东西一样容易，回头对弟子说：“用心专一，精神凝聚，说的就是这位痀偻丈人啊！”（注：痀偻，驼背；承蜩，用竿粘蝉）。
郁结疼痛且怕冷的，是寒邪客居于气海俞穴所致。（经验方：麻黄、附子、细辛、当归、炙甘草。）这如同闲坐时的凄凉，滥竽充数于楚宫之女（楚王喜爱细腰，宫女多有不吃饭以求腰身瘦小者）；幽居清冷，空披齐国的纨素（梁简文帝启奏鲁缟齐纨，藉新香而受彩。梁元帝谢赠锦缎，启奏鲜洁齐纨，声高赵毂）。
病情沉重难以移动的，是湿邪留着于藏精之所。（经验方：麻黄、苍术、杜仲、怀牛膝、焦白术、当归、茯苓、薏苡仁、炙甘草。）举止艰难，已呈现出支离破碎的状态。《庄子》中的支离疏，下巴隐藏在肚脐处，肩膀高于头顶，发髻指向天空，五脏六腑的位置倒置，两胁位于侧面。注解说：支离，指驼背的人；疏，是人名；会撮，指发髻。屈伸不能顺遂，而且没有辗转反侧的嫌疑。
调和血脉而通关窍，是治疗太阳病的主药，实为麻黄。它能驱逐客邪，通行经络，确实可推为先锋之将。
少阴经不轻易发生疼痛，太阳经的疼痛居多，所以《内经》中关于麻黄证的论述特别详细。今人治疗，动不动就说是地黄证（肾虚），何不取《内经》来细细研读呢？
As stated in *Su Wen: Mai Yao Jing Wei Lun* (Basic Questions: Essential and Subtle Aspects of Pulse Diagnosis): "The waist is the mansion of the Kidney. If one cannot turn or move it, the Kidney Qi is about to be exhausted." In *Ling Shu: Jing Mai Pian* (Spiritual Pivot: Chapter on Meridians): "The divergent channel of Foot-Shaoyin [Kidney] is named Dazhong (KI4). In excess conditions, there is urinary retention; in deficiency conditions, there is lower back pain." In *Su Wen: Ci Yao Tong Pian* (Basic Questions: Chapter on Acupuncture for Lower Back Pain): "The pathology of Foot-Taiyang [Bladder] meridian causes lower back pain." In *Su Wen: Ci Nie Lun* (Basic Questions: Chapter on Acupuncture for Malaria): "Malaria affecting Foot-Taiyang [Bladder] causes lower back pain."
Upon careful examination of the *Nei Jing Chuan Tu* (Illustrations of Internal Organs), the waist is the residence of the Foot-Shaoyin [Kidney] meridian and the pathway of the Foot-Taiyang [Bladder] meridian; thus, lower back pain involves only these two meridians. The Foot-Jueyin [Liver], Foot-Yangming [Stomach], and Foot-Shaoyang [Gallbladder] meridians do not originally traverse the waist. When they are said to cause lower back pain, it refers to referred pain. Medical texts have not clearly distinguished the affected meridians; worldly physicians treating lower back pain often merely attribute it to "Kidney Deficiency" (Shen Xu, Kidney Deficiency Syndrome).
The Kidney and Bladder are interior-exterior paired organs. Pathogenic factors entering from the exterior belong to the Foot-Taiyang [Bladder] Fu organ; pain originating from within generally belongs to the Foot-Shaoyin [Kidney] Zang organ. If the pulse is deep and fine (Chen Xi, Deep and Fine Pulse), the pain is located in the Foot-Shaoyin [Kidney]. (Formula ingredients: Prepared Rehmannia Root [Shu Di Huang], Chinese Yam [Huai Shan], Cornus Fruit [Zao Pi], Alisma Rhizome [Ze Xie], Moutan Cortex [Fen Dan Pi], Poria [Fu Ling], Eucommia Bark [Du Zhong], Achyranthes Root [Niu Xi]).
If the pain comes and goes intermittently, it is due to the depletion of essence through excessive sexual activity. (Formula ingredients: Prepared Rehmannia Root [Shu Di Huang], Chinese Yam [Huai Shan], Cornus Fruit [Zao Pi], Alisma Rhizome [Ze Xie], Moutan Cortex [Fen Dan Pi], Poria [Fu Ling], Eucommia Bark [Du Zhong], Achyranthes Root [Niu Xi]). This is likened to the story in Tang Dynasty's *Tian Bao Yi Shi*: when the thousand-petal lotuses bloomed in the Daye Pool, the Emperor admired them with his consort and said to his attendants, "Who compares to this speaking flower?" It is also like the vague cloud-and-rain encounters, where the spirit is intoxicated by dreams of wandering immortals (from *Gao Tang Fu*: "Formerly, the former King traveled to Gao Tang, grew tired, and slept during the day. He dreamed of a woman who said: 'I am the daughter of the Witch of Wu Mountain. I am a guest of Gao Tang. Hearing that Your Majesty travels to Gao Tang, I wish to offer my pillow.'").
If the pain is intermittent accompanied by heat sensation, it is due to rich flavors boiling down the body's fluids. (Formula ingredients: Prepared Rehmannia Root [Shu Di Huang], Chinese Yam [Huai Shan], Cornus Fruit [Zao Pi], Poria [Fu Ling], Alisma Rhizome [Ze Xie], Moutan Cortex [Dan Pi], Phellodendron Bark [Huang Bo], Anemarrhena Rhizome [Zhi Mu]). This is like He Zeng of the Jin Dynasty, who spent ten thousand coins daily on food yet still felt he had no place to put his chopsticks; whereas delicacies like sliced carp and turtle become suitable nourishment.
If the pain is fixed and does not move, it is due to strain and trauma exhausting physical strength. (Empirical Formula: Prepared Rehmannia Root [Shu Di Huang], Moutan Cortex [Dan Pi], Angelica Sinensis [Qin Gui - Note: likely Dang Gui contextually but text says Qin Gui, usually implies Angelica or similar blood-invigorating herb, here treated as given], Eucommia Bark [Du Zhong], Drynaria Rhizome [Xu Duan], Huai Niu Xi, Peach Kernel [Tao Ren]). This is like lifting heavy weights, boasting of the strength to carry a tripod (as recorded in *Han Shu* regarding Xiang Yu); or like the miraculous cures, empty tales of Hua Tuo scraping bone to remove poison.
To fill the marrow and tonify True Yin, the primary medicine for Foot-Shaoyin [Kidney] is Rehmannia Root (Di Huang). It harmonizes tonification and purgation, and regulates Yin and Yang, truly serving as a minister protecting the state.
If the pulse is floating and tight (Fu Jin, Floating and Tight Pulse), the pain is located in the Foot-Taiyang [Bladder]. Stabbing pain in the back muscles indicates Wind pathogen overflowing into the Shenshu (BL23) acupoint. (Empirical Formula: Ephedra Herb [Ma Huang], Angelica Pubescens [Du Huo], Asarum [Xi Xin], Saposhnikovia Root [Fang Feng], Angelica Sinensis [Qin Gui], Wine-processed White Peony Root [Jiu Shao], Raw Rehmannia Root [Sheng Di]).
Bending forward while walking is like the inscription on the tripod of Zheng Kaofu: "At first appointment, I bowed; at second, I stooped; at third, I leaned forward; following the wall, I walked." It is also like the story in *Zhuangzi*, where Confucius went to Chu, passed through a forest, and saw a hunchbacked old man catching cicadas as easily as picking them up. He told his disciples, "When purpose is undivided, spirit condenses. This refers to the hunchbacked old man!" (Note: Hunchbacked, Qu Bei; Catching Cicadas, Cheng Tiao).
Depressed pain with aversion to cold indicates Cold pathogen lodging in the Qihai Shu (BL24) acupoint. (Empirical Formula: Ephedra Herb [Ma Huang], Aconite Root [Fu Zi], Asarum [Xi Xin], Angelica Sinensis [Qin Gui], Honey-fried Licorice Root [Zhi Cao]). This is like sitting idly in desolation, akin to the women of the Chu Palace (King of Chu loved slender waists, so many palace women fasted to slim their waists); dwelling in seclusion and cold, wearing plain silk of Qi in vain.
Heavy illness difficult to move indicates Dampness lodging in the storehouse of Essence. (Empirical Formula: Ephedra Herb [Ma Huang], Atractylodes Rhizome [Cang Zhu], Eucommia Bark [Du Zhong], Huai Niu Xi, Charred Atractylodes Rhizome [Jiao Zhu], Angelica Sinensis [Qin Gui], Poria [Fu Ling], Coix Seed [Yi Mi], Honey-fried Licorice Root [Zhi Cao]). Movement is arduous, presenting a disjointed posture. In *Zhuangzi*, Zhi Li Shu had his chin hidden in his navel, shoulders higher than his neck, hair bun pointing to the sky, five viscera positioned above, and two flanks on the ribs. Note: Zhi Li means hunchback; Shu is a person's name; Hui Cuo is the hair bun. Flexion and extension are unsmooth, without any suspicion of turning over in bed.
To harmonize blood vessels and open orifices, the primary medicine for Foot-Taiyang [Bladder] is Ephedra Herb (Ma Huang). It expels external pathogens and unblocks meridians, truly deserving the title of vanguard general.
Foot-Shaoyin [Kidney] rarely experiences pain; Foot-Taiyang [Bladder] pain is more common. Therefore, *Nei Jing* details symptoms requiring Ephedra particularly thoroughly. Today's physicians often immediately diagnose "Rehmannia Syndrome" (Kidney Deficiency). Why not take *Nei Jing* and study it carefully?