背脊乃肾脉所贯。属太阳经。其所以作痛者。乃房劳过度。不惜劳力。脊虚髓空所致。
若为贼风乘虚而入。实时HT 强。不能屈伸也。
桂附汤 治脊痛筋挛急服。乃血受寒。
大附子 肉桂（各二钱） 川芎（五钱） 白芍 生地 当归 木瓜（各一钱五分） 水煎温服。
散湿饮 治脊内酸痛。
白术 苍术 防己 防风 茯苓（各一钱） 官桂 天麻 当归（各一钱五分）
水煎临服加酒一杯。
虎兔丸 治骨髓冷痛。背脊酸疼。神效。
虎骨（二两羊酥炙） 天门冬（去心） 麦门冬（去心） 破故纸（炒） 玄胡索（各一两五钱）
杜仲（盐水炒） 大附子（便制） 菟丝子（酒煮） 香附（醋炒） 广木香（各一两） 上为末。入雄
猪脊髓一条。同蜜捣丸。每服三钱。空心酒下。
干道成男。而坤道成女。故男为阳。而女为阴也。气属乎阳。而血属为阴。故男多气。
而女
多血也。阳轻清而阴重浊。故气无形。而血有形也。气惟无形。故充满于中而不露。血惟有
形。故流溢于外而可见也。然是血也。以其初而言之。即先天真一之水。女子十四天癸至。
则源泉之通。自此而始。其往来有信如潮汐之不愆其期。然后血脉调和。而病无由生。一失
其期。便能作疾。而生育之机。亦因以窒矣。故治女病者。以调经为先。而善调经者。以顺
气为主。气顺则经自调。经调则血常足。是以月事既正。新血一生。一交媾之间。而胚胎即
结。血少精多。则精裹血而成男。血多精少。则血裹精而成女。欲得子者。于月事初止之后。
三日之内。新血始生。而气犹清。交感而成胎者必男也。三日之外。新血渐多。而气已浊。
交感而成胎者。必女也。其有交感于三日之外。而亦生男者。必其平素血气不盛。而其来不
浊故也。其有交感于三日之内。而亦生女者。必其平素血气太盛。而其来不清故也。其有血
气未尝不足。而月事又调。宜乎成胎也。而久不生育者。何也。是必男子精气不稠。或精寒
不相交结故也。而非女子之病也。其有男子精气素充。而又无子者。是必女子子宫之寒。不
能摄精故也。而非男子之病也。然何以知子宫之寒哉。盖女子尺脉常盛。若沉细而迟。如无
所动。则子宫之寒可知矣。其有子宫不寒。而亦无子者。必其血不足。或痰有余故也。然果
何以知其血之不足。痰之有余哉。亦视其形之肥瘦而已。盖瘦人多血虚。血虚则不能凝精。
肥人多湿痰。湿痰流注于下焦。则痰与血混淆。而化气不清。故亦不能凝精也。其有瘦人肥
人。而亦未尝无子者。又何也。盖瘦人多血虚。道其常也。若月事既调。而无热症。则血常
滋润而不枯。是以能生育也。肥人多湿痰。亦道其常也。然或肌肉不甚浮。而色不甚白。饮
食无浓味。则湿痰亦少。而血气常清。是以亦能生育也。由是观之。则女子之血实。所以宰
生生化化之机也。方其未成胎也。则此血周流而不息。应期而至。及其既成胎也。则此血荣
养于内以护其胎。今妇人初有孕。即头眩恶心。或发呕吐多厌饮食。而常思酸者。乃足厥阴
肝经养胎也。肝主风。故头眩。肝有余。则恶心呕吐。肝胜脾。故多厌饮食。肝喜酸。故常
思酸也。过此则诸经轮次养胎。其七八月之间。两足浮肿者。足太阴脾经养胎也。脾注四肢
。
故两足浮肿也。两手不浮肿而独见于两足者何也。盖脾本足之阴经。况此时胎气已坠下。故
不能不见于两足也。每一月。则一经养之。十个月。则十经养之。十月满足而后产焉。其
余二经则又养于既产之后。而化血化乳汁矣。是乳汁亦血也面其色白者。何也。盖胸前部倍
属太阴肺经。乃西方庚辛金也。金色本白。血从阴分而来。故变赤而为白也。凡血去多。则
令人虚。今乳汁既为血。亦不宜去多也。然其来也。恒有余其出也。无尽止足。以饮小儿。
而其母不觉其虚者。何也。盖人身之血。皆资于饮食以生者也。饮食入胃。游溢精气。上输
于肺。从肺之部位而出。故成乳汁。妇人既产。而饮食倍于常日。既产之后。又属足阳明胃
经养之。乳傍属阳明。故乳汁多受于此处。胃能化饮食。饮食能生血。饮食既足。则血亦足
。血既足。则其化为乳汁也。自无穷尽矣。何至令人虚乎。甘属胃。故乳汁亦甘。白属肺。
故乳汁亦白。是以知既产之后。乃肺胃二经养之也。小儿二三岁。其母复有妊儿饮魃乳。即
黄瘦泄泻者。以乳汁味酸。正足厥阴肝经养胎之日。肝能克脾。故儿饮之即泻也。当此之时
。肺经失令。胃土无权则所以滋养乎血者。已无所籍。几何而不为儿之病哉。此特论胎前产
后之事。而原其本于血。归其功于十二经耳。若夫胎前产后之症。又各具于诸症条下。而不
及一一细论云。
背脊是肾脉贯穿之处，归属于足太阳膀胱经。背脊之所以疼痛，是因为房事过度、不惜劳力，导致脊虚髓空所致。
如果是贼风乘虚侵入，就会立即出现僵硬，不能屈伸。
桂附汤：治疗脊痛筋脉拘挛紧急，服用此方。这是因为血液受寒邪侵袭。
大附子、肉桂（各二钱）、川芎（五钱）、白芍、生地、当归、木瓜（各一钱五分）。水煎，温服。
散湿饮：治疗脊内酸痛。
白术、苍术、防己、防风、茯苓（各一钱）、官桂、天麻、当归（各一钱五分）。
水煎，临服用时加酒一杯。
虎兔丸：治疗骨髓冷痛、背脊酸疼，神效。
虎骨（用羊酥炙烤，二两）、天门冬（去心）、麦门冬（去心）、破故纸（炒）、玄胡索（各一两五钱）、杜仲（盐水炒）、大附子（便制）、菟丝子（酒煮）、香附（醋炒）、广木香（各一两）。以上药物研为细末，加入一条雄猪脊髓，同蜂蜜捣匀制成丸药。每次服用三钱，空腹时用酒送下。
男子禀受乾道而成男，女子禀受坤道而成女，所以男子属阳，女子属阴。气属于阳，血属于阴，所以男子多气，女子多血。阳气轻清而阴气重浊，所以气无形，血有形。气因为无形，所以充满于体内而不显露；血因为有形，所以流溢于外而可见。然而这血，从最初来说，就是先天真一之水。女子十四岁时天癸至，源泉通畅，从此开始。月经往来有信，像潮汐一样不违背时期，然后血脉调和，疾病无从产生。一旦失去其定期，就能致病，生育的机能也因此闭塞。所以治疗女子疾病，以调经为先，而善于调经的人，以顺气为主。气顺则经自调，经调则血常足。因此月经正常，新血一生，在交媾之间，胚胎即结。血少精多，则精裹血而成男；血多精少，则血裹精而成女。想要得子的人，在月经刚停止后的三天之内，新血始生，而气犹清，此时交感而成胎者必为男孩。三天之外，新血渐多，而气已浊，此时交感而成胎者，必为女孩。那些在三天之外交感而生男孩的，一定是平时血气不盛，且经血不清浊的缘故。那些在三天之内交感而生女孩的，一定是平时血气太盛，且经血不清净的缘故。那些血气未曾不足，且月经又调，理应成胎，却久不生育的，为什么呢？这一定是男子精气不稠密，或精寒不相交结的缘故，而不是女子的病。那些男子精气素来充足，却又无子的，这一定是女子子宫寒冷，不能摄精的缘故，而不是男子的病。然而怎么知道子宫寒冷呢？大概女子尺脉常盛，如果沉细而迟，好像没有动静，那么子宫寒冷就可以知道了。那些子宫不寒，却也无子的，一定是血不足，或痰有余的缘故。然而究竟怎么知道血之不足、痰之有余呢？也是看她的形体肥瘦罢了。大概瘦人多血虚，血虚则不能凝精；肥人多湿痰，湿痰流注于下焦，则痰与血混淆，而化气不清，所以也不能凝精。那些瘦人或肥人也未尝没有孩子的，又为什么呢？大概瘦人多血虚，这是常态。如果月经既调，而无热症，则血常滋润而不枯，所以能生育。肥人多湿痰，这也是常态。然而如果肌肉不甚浮肿，面色不甚白，饮食没有浓味，则湿痰也少，而血气常清，所以也能生育。由此看来，女子的血实在主宰着生化之机。当尚未成胎时，这血周流不息，应期而至；等到已经成胎后，这血荣养于内以护持胎儿。现在妇人初怀孕，就头眩恶心，或者发呕吐多厌饮食，而常思酸的，这是足厥阴肝经养胎的表现。肝主风，所以头眩；肝有余，则恶心呕吐；肝胜脾，故多厌饮食；肝喜酸，故常思酸。过了这个阶段，则诸经轮次养胎。在七八个月之间，两足浮肿的，是足太阴脾经养胎。脾注四肢，所以两足浮肿。两手不浮肿而独见于两足的，为什么呢？大概脾本是足部的阴经，况且此时胎气已坠下，所以不能不见于两足。每个月，有一经养之，十个月，则有十经养之。十月满足而后生产。其余二经则是产后养之，化血化乳汁了。这乳汁也是血，它的颜色为什么是白的呢？大概胸前部位倍属足太阴肺经，乃西方庚辛金。金色本白，血从阴分而来，所以变赤而为白。凡是失血过多，就会令人虚弱。现在乳汁既然也是血，也不宜流失过多。然而它来时，恒常有剩余；它出去时，无尽止，足以喂养小儿，而其母不觉其虚弱，为什么呢？大概人身之血，都是依靠饮食来生成的。饮食入胃，游溢精气，上输于肺，从肺的部位而出，所以成为乳汁。妇人既产之后，饮食倍于常日，既产之后，又属足阳明胃经养之。乳旁属阳明，所以乳汁多受于此处。胃能化饮食，饮食能生血，饮食既足，则血亦足。血既足，则其化为乳汁，自然无穷尽，何至于令人虚弱呢？甘味属胃，所以乳汁亦甘；白色属肺，所以乳汁亦白。因此知道既产之后，乃是肺胃二经养之。小儿二三岁，其母复有妊儿饮魃乳（注：原文“饮魃”疑为衍文或误字，结合语境指哺乳），即黄瘦泄泻的，是因为乳汁味酸，正是足厥阴肝经养胎之日，肝能克脾，所以儿饮之即泻。当此之时，肺经失令，胃土无权，则所以滋养乎血者，已无所籍，几何而不为儿之病哉。这特论胎前产后之事，而原其本于血，归其功于十二经耳。至于胎前产后之症，又各具于诸症条下，而不及一一细论云。
The back and spine are penetrated by the Kidney meridian and belong to the Taiyang (Greater Yang) meridian. The reason for pain here is due to excessive sexual activity and neglect of physical labor, resulting in an empty spine and depleted marrow.
If pathogenic wind invades while the body is deficient, stiffness will occur immediately, preventing flexion and extension.
Guifu Tang (Cinnamon Twig and Aconite Decoction): Treats spinal pain with tendon spasms and urgency. This is caused by blood affected by cold pathogens.
Ingredients: Da Fuzi (Prepared Aconiti Lateralis Radix), Rougui (Cinnamomi Cortex) (each 2 qian); Chuanxiong (Ligustici Chuanxiong Rhizoma) (5 qian); Baishao (Paeoniae Radix Alba), Shengdi (Rehmanniae Radix), Danggui (Angelicae Sinensis Radix), Mugua (Chaenomelis Fructus) (each 1.5 qian). Decoct in water and take warm.
San Shi Yin (Dampness-Dispersing Drink): Treats soreness and pain inside the spine.
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma), Cangzhu (Atractylodis Rhizoma), Fangji (Stephaniae Tetrandrae Radix), Fangfeng (Saposhnikoviae Radix), Fuling (Poria) (each 1 qian); Guanzi Gui (Cinnamomi Ramulus), Tianma (Gastrodiae Rhizoma), Danggui (Angelicae Sinensis Radix) (each 1.5 qian).
Decoct in water; add one cup of wine before taking.
Hutu Wan (Tiger-Rabbit Pill): Treats cold pain in the bone marrow and soreness in the back and spine; highly effective.
Ingredients: Hugu (Ossis Tigridis) (roasted with sheep suet, 2 liang); Tianmendong (Asparagi Radix, heart removed), Maimendong (Ophiopogonis Radix, heart removed), Pozhuzi (Arecae Semen Preparatum, stir-fried), Yanhusuo (Corydalis Rhizoma) (each 1.5 liang); Duzhong (Eucommiae Cortex, stir-fried with salt water), Da Fuzi (Prepared Aconiti Lateralis Radix, processed via urination method), Tusizi (Cuscutae Semen, boiled in wine), Xiangfu (Cyperi Rhizoma, stir-fried with vinegar), Guangmuxiang (Agastachis Herba) (each 1 liang). Grind the above into powder. Add one cord of male pig spinal cord. Mix with honey and form pills. Take 3 qian per dose, on an empty stomach with wine.
Men are formed according to the Qian (Heaven/Yang) principle, and women according to the Kun (Earth/Yin) principle. Thus, men are Yang and women are Yin. Qi belongs to Yang, and Blood belongs to Yin. Therefore, men have more Qi, and women have more Blood. Yang is light and clear, while Yin is heavy and turbid. Thus, Qi has no fixed form, whereas Blood has a fixed form. Because Qi is formless, it fills the interior without being visible; because Blood has form, it flows outward and is visible. However, this Blood, speaking from its origin, is the primordial True One Water. When a girl reaches fourteen years of age, Tian Gui (menstruation and reproductive essence) arrives, and the flow of her source begins. Its coming and going are punctual, like tides that do not miss their schedule. Then, the blood vessels harmonize, and disease has no opportunity to arise. If this schedule is lost, disease arises, and the mechanism of reproduction becomes blocked. Therefore, treating female diseases prioritizes regulating menstruation, and those skilled at regulating menstruation prioritize smoothing Qi. When Qi is smooth, menstruation regulates itself; when menstruation is regulated, Blood remains sufficient. Thus, after menstruation is regular and new Blood is generated, conception occurs during intercourse. If there is less Blood and more Essence, Essence wraps around Blood to form a male fetus; if there is more Blood and less Essence, Blood wraps around Essence to form a female fetus. Those desiring a son should conceive within three days after menstruation stops. At this time, new Blood has just begun to generate, and Qi is still pure; conception during this period will surely result in a male. After three days, new Blood increases, but Qi becomes turbid; conception during this period will surely result in a female. Those who conceive after three days and still bear a son must have had weak Blood and Qi normally, and their menstrual blood was not turbid. Those who conceive within three days and bear a daughter must have had overly abundant Blood and Qi normally, and their menstrual blood was not clear. For those whose Blood and Qi were never insufficient and whose menstruation was regular, yet they fail to conceive for a long time, why? It must be that the man's Essence is not dense, or his Essence is too cold to combine; this is not the woman's fault. For men whose Essence is naturally abundant but who have no children, it must be that the woman's uterus is cold and cannot retain Essence; this is not the man's fault. How do we know the uterus is cold? Generally, the Chi pulse (pulse position at the wrist corresponding to the Kidneys and Mingmen) in women is often vigorous. If it is deep, thin, and slow, appearing motionless, then uterine cold can be known. For those whose uterus is not cold but still have no children, it must be due to insufficient Blood or excess Phlegm. How do we know if Blood is insufficient or Phlegm is excessive? We look at the person's body shape. Thin people tend to have Blood deficiency; if Blood is deficient, it cannot condense Essence. Fat people tend to have Damp-Phlegm; if Damp-Phlegm flows downward to the Lower Jiao, Phlegm and Blood mix, and the transformed Qi is not clear, so it also cannot condense Essence. Why do both thin and fat people sometimes have children? Thin people having Blood deficiency is the norm. However, if menstruation is regular and there are no heat symptoms, Blood remains moist and not dry, allowing for reproduction. Fat people having Damp-Phlegm is also the norm. But if muscles are not very puffy, complexion is not very white, and diet lacks rich flavors, then Damp-Phlegm is minimal, and Blood and Qi remain clear, allowing for reproduction. From this, we see that Women's Blood actually governs the mechanism of generation and transformation. Before conception, this Blood circulates endlessly and arrives on schedule; after conception, this Blood nourishes internally to protect the fetus. Now, when a woman first becomes pregnant, she may experience dizziness, nausea, vomiting, aversion to food, and cravings for sour foods. This is the Foot-Jueyin Liver Meridian nourishing the fetus. The Liver governs Wind, hence dizziness; Liver excess causes nausea and vomiting; Liver overacting on Spleen causes aversion to food; the Liver prefers sour, hence cravings for sour things. After this stage, other meridians take turns nourishing the fetus. Between the seventh and eighth months, swelling in both feet indicates the Foot-Taiyin Spleen Meridian is nourishing the fetus. The Spleen governs the four limbs, hence foot swelling. Why do hands not swell, only feet? The Spleen is a Foot-Yin meridian, and at this time, fetal Qi has descended, so swelling appears in the feet. Each month, one meridian nourishes; ten months, ten meridians nourish. After ten months full term, birth occurs. The remaining two meridians nourish after birth, transforming into Blood and Milk. This milk is also Blood, but why is it white? The chest area specifically belongs to the Foot-Taiyin Lung Meridian, which corresponds to Metal in the West (Geng-Xin). Metal is inherently white. Blood comes from the Yin aspect, changing from red to white. Excessive loss of Blood causes deficiency. Since milk is Blood, it should not be lost excessively. Yet, milk production is often abundant, and discharge is endless to feed the infant, without the mother feeling deficient. Why? Human Blood is generated from dietary intake. Food enters the Stomach, extracts Jing-Qi, transports it upward to the Lung, and exits from the Lung's region to become milk. After childbirth, dietary intake doubles, and the Foot-Yangming Stomach Meridian nourishes the postpartum state. The area beside the breast belongs to the Yangming meridian, where milk is largely produced. The Stomach digests food, and food generates Blood. If food intake is sufficient, Blood is sufficient. If Blood is sufficient, its transformation into milk is inexhaustible, causing no deficiency. Sweet flavor belongs to the Stomach, so milk is sweet; White color belongs to the Lung, so milk is white. Thus, we know that after childbirth, the Lung and Stomach meridians provide nourishment. When infants are two or three years old, if the mother becomes pregnant again and continues breastfeeding, and the child suffers from yellow emaciation and diarrhea, it is because the milk tastes sour, corresponding to the time when the Foot-Jueyin Liver Meridian nourishes the fetus. The Liver controls the Spleen, so drinking this milk causes diarrhea. At this time, the Lung Meridian loses its command, and Stomach Earth lacks authority, so the means to nourish Blood have no basis. How can the child not suffer? This discussion focuses on pre- and post-natal matters, tracing the root to Blood and attributing merit to the Twelve Meridians. Symptoms specific to pre- and post-natal periods are listed under respective symptom categories and are not discussed in detail here.