（附肾着）
腰痛主湿热、肾虚、瘀血、挫闪、有痰积。脉大者肾虚，杜仲、龟板、黄柏、知母、
五味之类为末，猪脊髓丸服；脉涩者瘀血，用补阴丸加桃仁、红花；脉缓者湿热，苍术、杜
仲、黄柏、川芎之类；痰积作痛者，二陈加南星、半夏。腰曲不能伸者，针人中。凡诸痛皆
属火，寒凉药不可峻用，必用温散之药。诸痛不可用参，补气则疼愈甚。人有痛，面上忽见红点者，多死。
戴云∶湿热腰疼者，遇天阴或久坐而发者是也；肾虚者，疼之不已者是也；瘀血者，日
轻夜重者是也。
入方∶治湿痰腰痛，大便泄。
龟板（一两，炙） 苍术 椿皮 滑石（半两） 白芍（酒炒） 香附（各四钱）
上为末，酒糊丸。如内伤，白术、山楂汤下。
又方 治腰腿湿痛。
龟板（酒炙） 黄柏（酒炙） 苍术 苍耳 威灵仙（酒浸，各一两） 扁柏（半两）
上为末，酒糊丸。每用黑豆汁煎四物汤加陈皮、甘草，生姜煎汤下。久腰痛，必用官桂
以开之，方止。腹胁痛亦可。
又方
龟板（酒炙，一两半） 炒柏 白芍（一两） 陈皮 威灵仙 知母 苍术 苍耳
上为末。调服。
又方
龟板（酒炙，半两） 酒炒柏（四钱） 青皮（三钱） 生甘草（一钱半）
上为末。姜一大片，同前药末一钱研匀，以苍耳汁荡起，煎令沸服之。
摩腰膏 治老人虚人腰痛，并妇人白带。
附子尖 乌头尖 南星（各二钱半） 雄黄（一钱） 樟脑 丁香 干姜 吴茱
萸（各一钱半） 朱砂（一钱） 麝香（五粒大者）
上为末，蜜丸如龙眼大。每用一丸，姜汁化开如粥浓，火上炖热，置掌中，摩腰上。候
药尽粘腰上，烘绵衣包缚定，随即觉热如火，日易一次。
〔附录〕腰者，肾之外候，一身所恃以转移阖辟者也。盖诸经皆贯于肾而络于腰脊，肾气
虚，凡冲寒、受湿、伤冷、蓄热、血涩气滞、水积堕伤，与失志、作劳，种种腰疼，叠见而
层出矣。脉若弦而沉者为虚，沉者为滞，涩者瘀血，缓者为湿，滑与伏者是痰。
气痛，一身腔子尽痛，皆用少许木香于药内行气。若寒湿腰痛，见热则减，见寒则增，
积散加吴茱萸半钱，杜仲一钱。若湿腰痛，如坐水中，或为风湿雨露所着，湿流入肾经，
致腰痛，宜渗湿汤；不效，宜肾着汤。肾虚腰痛，转侧不能，以大建中汤加川椒十粒，仍以
茴香盐炒为末，破开猪腰子，作薄片，勿令断，层层散药末，水纸裹煨，熟，细嚼，酒吃
下。闪挫腰痛，宜复元通气散，酒调服，或五积散加牵牛头末一钱，或桃仁七枚。
附方
青娥丸 治肾虚腰痛，益精助阳。
破故纸（四两，炒） 杜仲（四两，炒去丝） 生姜（二两半，炒干）
上为末，用胡桃肉三十个研膏，入蜜，丸桐子大。每服五十丸，盐酒下。
独活寄生汤 治肾气虚弱，为风湿所乘，流注腰膝；或挛拳掣痛，不得屈伸；或缓弱冷
独活（一两） 桑寄生（如无以续断代之） 细辛 牛膝 秦艽 茯苓 白芍 桂心 川芎
防风 人参 熟地黄 当归 杜仲（炒） 甘草（炙，各二两）
上锉。每服三钱，水煎，空心服。下利者，去地黄；血
滞于下，委中穴刺出血，妙。仍灸肾俞、昆仑，尤佳。
治腰疼
黑丑（四两，半生半炒）
上研细，取头末，水丸桐子大，硫黄为衣。每服三十丸，空心盐酒送下，四服即止。
补阴丸 见诸虚类。
五积散 见香港脚类。
大建中汤 见斑疹类。
复元通气散 见气类。
肾着为病，其体重，腰冷如冰，饮食如故，腹重如物在腰，治宜流湿，兼用温暖之药以
肾着汤 治肾虚伤湿，身重腰冷，如坐水中，不渴，小便自利。
干姜（炮） 茯苓（各四两） 甘草（炙） 白术（各二两）
上 咀。每服五钱，水煎，空心服。
渗湿汤 治寒湿所伤，身体重着，如坐水中。
苍术 白术 甘草（炙，各一两） 茯苓 干姜（炮，各一两） 橘红 丁香（各二钱半）
上每服五钱，水一钟，生姜三片，枣一枚，煎服。
（附注：肾着病）
腰痛主要由湿热、肾虚、瘀血、挫闪（外力损伤）、痰积引起。脉象大的是肾虚，用杜仲、龟板、黄柏、知母、五味子等药研成末，用猪脊髓做丸服用；脉象涩的是瘀血，用补阴丸加桃仁、红花；脉象缓的是湿热，用苍术、杜仲、黄柏、川芎等药；因痰积导致疼痛的，用二陈汤加天南星、半夏。腰部弯曲不能伸展的，针刺人中穴。凡是各种疼痛都归属于火，寒凉药物不可猛烈使用，必须用温散的药物。各种疼痛不可用人参，补气则疼痛会更加严重。有人出现疼痛，脸上忽然出现红点的，大多死亡。
戴元礼说：湿热腰痛，遇到阴天或久坐就发作的是；肾虚腰痛，疼痛不止的是；瘀血腰痛，白天轻晚上重的是。
入方：治疗湿痰腰痛，大便泄泻。
龟板（一两，炙烤） 苍术 椿皮 滑石（半两） 白芍（酒炒） 香附（各四钱）
以上药物研成末，用酒糊做丸。如果是内伤，用白术、山楂汤送服。
又一方：治疗腰腿湿痛。
龟板（酒炙） 黄柏（酒炙） 苍术 苍耳 威灵仙（酒浸，各一两） 侧柏叶（半两）
以上药物研成末，用酒糊做丸。每次用黑豆汁煎煮四物汤，加入陈皮、甘草，再用生姜煎汤送服。久治不愈的腰痛，必须用官桂来开通气机，疼痛才能停止。腹胁痛也可以这样治。
又一方：
龟板（酒炙，一两半） 炒黄柏 白芍（一两） 陈皮 威灵仙 知母 苍术 苍耳
以上药物研成末。调服。
又一方：
龟板（酒炙，半两） 酒炒黄柏（四钱） 青皮（三钱） 生甘草（一钱半）
以上药物研成末。取一大片生姜，与前药末一钱一起研匀，用苍耳汁荡起，煎至沸腾后服用。
摩腰膏：治疗老人及体虚者的腰痛，以及妇女白带。
附子尖 乌头尖 天南星（各二钱半） 雄黄（一钱） 樟脑 丁香 干姜 吴茱萸（各一钱半） 朱砂（一钱） 麝香（五粒大的）
以上药物研成末，蜂蜜做丸如龙眼大小。每次用一丸，用姜汁化开如粥的浓度，在火上炖热，放在手掌中，按摩腰部。等到药完全粘在腰上，用烘热的棉衣包裹缚紧，随即感觉热如火烧，每天更换一次。
〔附录〕腰部是肾脏的外候，是人体依靠它来转移和开阖的关键部位。大概所有经络都贯穿肾脏并联络于腰脊，肾气虚弱，凡是受寒、受湿、受冷、蓄热、血涩气滞、水积堕伤，以及情志失调、劳累过度，种种腰痛，层出不穷。脉象弦而沉的是虚证，沉的是气滞，涩的是瘀血，缓的是湿邪，滑与伏的是痰饮。
气痛，全身躯干都痛，都在药中加入少许木香以行气。如果是寒湿腰痛，遇热减轻，遇寒加重，积散方加吴茱萸半钱，杜仲一钱。如果是湿腰痛，像坐在水中，或被风湿雨露所侵，湿气流入肾经，导致腰痛，宜用渗湿汤；无效，宜用肾着汤。肾虚腰痛，转身侧卧困难，用大建中汤加川椒十粒，仍用茴香盐炒研成末，剖开猪腰子，切成薄片，不要切断，层层撒上药末，用水纸包裹煨熟，细嚼，酒后吞下。闪挫腰痛，宜用复元通气散，酒调服，或用五积散加牵牛子头末一钱，或桃仁七枚。
附方：
青娥丸：治疗肾虚腰痛，益精助阳。
破故纸（四两，炒） 杜仲（四两，炒去丝） 生姜（二两半，炒干）
以上药物研成末，用胡桃肉三十个研成膏，加入蜂蜜，做成梧桐子大小的丸。每次服用五十丸，盐酒送下。
独活寄生汤：治疗肾气虚弱，被风湿乘虚而入，流注于腰膝；或者拘挛拳曲掣痛，不能屈伸；或者弛缓软弱冷痛。
独活（一两） 桑寄生（如无可用续断代替） 细辛 牛膝 秦艽 茯苓 白芍 桂心 川芎 防风 人参 熟地黄 当归 杜仲（炒） 甘草（炙，各二两）
以上切碎。每次服三钱，水煎，空腹服用。腹泻者，去掉地黄；血滞于下部，委中穴刺出血，效果妙。再灸肾俞、昆仑穴，尤其好。
治疗腰痛：
黑丑（四两，半生半炒）
以上研细，取头末，水泛丸如梧桐子大，硫黄为衣。每次服三十丸，空腹盐酒送下，服四次即止。
补阴丸：见诸虚类。
五积散：见香港脚类。
大建中汤：见斑疹类。
复元通气散：见气类。
肾着病，身体沉重，腰部冷如冰，饮食正常，腹部沉重如物在腰，治疗宜利湿，兼用温暖药物。
肾着汤：治疗肾虚伤湿，身体沉重腰部冷，像坐在水中，口不渴，小便自利。
干姜（炮） 茯苓（各四两） 甘草（炙） 白术（各二两）
以上切碎。每次服五钱，水煎，空腹服用。
渗湿汤：治疗寒湿所伤，身体沉重，像坐在水中。
苍术 白术 甘草（炙，各一两） 茯苓 干姜（炮，各一两） 橘红 丁香（各二钱半）
以上每次服五钱，水一盏，生姜三片，枣一枚，煎服。
(Note: Shen Zhuo Disease)
Lumbago is primarily caused by damp-heat, Kidney deficiency, blood stasis, sprain/strain (external injury), and phlegm accumulation. A large pulse indicates Kidney deficiency; use powder of Duzhong (Eucommia Bark), Guiban (Tortoise Shell), Huangbai (Phellodendron Bark), Zhimu (Anemarrhena Rhizome), and Wuweizi (Schisandra Fruit), made into pills with pig spinal cord for administration. A choppy pulse indicates blood stasis; use Buyin Wan (Nourish Yin Pill) added with Taoren (Peach Kernel) and Honghua (Safflower). A slow pulse indicates damp-heat; use Cangzhu (Atractylodes Rhizome), Duzhong, Huangbai, and Chuanxiong (Sichuan Lovage Rhizome). Pain due to phlegm accumulation is treated with Erchen Tang (Two-Cured Decoction) added with Nanting (Arisaema Rhizome) and Banxia (Pinellia Tuber). For inability to straighten the waist, needle Renzhong (GV26). All pains belong to fire; cold-cooling medicines should not be used aggressively, but rather warm-dispersing medicines must be employed. Ginseng should not be used for various pains, as tonifying Qi will exacerbate the pain. If a person experiences pain and sudden red spots appear on the face, death is likely.
Dai Yuanli stated: Lumbago due to damp-heat occurs during cloudy weather or after prolonged sitting; lumbago due to Kidney deficiency is characterized by unceasing pain; lumbago due to blood stasis is lighter during the day and heavier at night.
Prescription: Treats lumbago due to damp-phlegm with loose stools.
Guiban (Tortoise Shell, 1 liang, roasted), Cangzhu (Atractylodes Rhizome), Chunpi (Toona Leaf Bark), Huashi (Talcum, 0.5 liang), Baishao (White Peony Root, wine-fried), Xiangfu (Cyperus Rhizome, each 4 qian).
Grind all into powder, make pills with wine paste. If due to internal injury, take with Baizhu (Atractylodes Macrocephala Rhizome) and Shanzha (Hawthorn Fruit) decoction.
Another prescription: Treats damp-pain in the waist and legs.
Guiban (Tortoise Shell, wine-roasted), Huangbai (Phellodendron Bark, wine-roasted), Cangzhu, Can'er (Xanthium Fruit), Weilingxian (Swallowwort Root, wine-soaked, each 1 liang), Bianbo (Biota Tops, 0.5 liang).
Grind all into powder, make pills with wine paste. Each time, decoct Siwu Tang (Four Substances Decoction) with black bean juice, add Chenpi (Tangerine Peel) and Gancao (Licorice Root), and take with ginger decoction. For chronic lumbago, Guigui (Cinnamon Twig) must be used to open the qi mechanism for the pain to cease. Abdominal and hypochondriac pain can also be treated this way.
Another prescription:
Guiban (Tortoise Shell, wine-roasted, 1.5 liang), Chao Bai (Stir-fried Phellodendron), Baishao (White Peony Root, 1 liang), Chenpi, Weilingxian, Zhimu, Cangzhu, Can'er.
Grind all into powder. Take with water.
Another prescription:
Guiban (Tortoise Shell, wine-roasted, 0.5 liang), Jiu Chao Bai (Wine-stir-fried Phellodendron, 4 qian), Qingpi (Green Tangerine Peel, 3 qian), Sheng Gancao (Raw Licorice Root, 1.5 qian).
Grind all into powder. Take one large slice of fresh ginger, grind evenly with one qian of the above powder, stir with juice from Can'er (Xanthium Fruit), boil until bubbling, and drink.
Yaomao Gao (Waist-Massaging Ointment): Treats lumbago in the elderly and deficient persons, and leukorrhea in women.
Fuzi Jian (Tip of Aconite Lateral Root), Wutou Jian (Tip of Aconite Main Root), Nanting (Arisaema Rhizome, each 2.5 qian), Xionghuang (Realgar, 1 qian), Zhangnao (Borneol), Dingxiang (Clove), Ganjiang (Dried Ginger), Wuzhuyu (Evodia Fruit, each 1.5 qian), Zhusha (Cinnabar, 1 qian), Shexiang (Musk, five large grains).
Grind all into powder, make pills with honey the size of a longan. Use one pill each time, dissolve in ginger juice to the consistency of porridge, heat over fire, place in palm, and massage the waist. When the medicine adheres completely to the waist, wrap tightly with heated cotton clothing; immediately feel heat like fire. Change once daily.
[Appendix] The waist is the external manifestation of the Kidney and is relied upon by the whole body for movement and opening/closing. Generally, all meridians pass through the Kidney and connect to the lumbar spine. When Kidney Qi is deficient, various causes such as exposure to cold, dampness, chill, heat retention, blood stagnation, qi obstruction, fluid accumulation, trauma, emotional frustration, and overwork lead to recurrent lumbago. A string-like and deep pulse indicates deficiency; a deep pulse indicates stagnation; a choppy pulse indicates blood stasis; a slow pulse indicates dampness; slippery and hidden pulses indicate phlegm.
Qi pain involves pain throughout the torso; add a small amount of Muxiang (Aucklandia Root) to the prescription to move Qi. For lumbago due to cold-dampness, which decreases with heat and increases with cold, add half a qian of Wuzhuyu and one qian of Duzhong to Jisan Powder. For lumbago due to dampness, feeling as if sitting in water, or contracted by wind-damp/rain/dew where dampness flows into the Kidney meridian causing lumbago, use Shen Shi Tang (Drain Dampness Decoction); if ineffective, use Shen Zhuo Tang. For lumbago due to Kidney deficiency with difficulty turning or lying sideways, use Da Jianzhong Tang (Great Construct the Middle Decoction) added with ten Sichuan Pepper grains. Also, stir-fry Fenhui (Fennel Seed) with salt, grind into powder, split a pig kidney thinly without cutting through, layer the powder inside, wrap in water paper, roast until cooked, chew finely, and swallow with wine. For sprain/strain lumbago, use Fuyuan Tongqi San (Restore Origin and Unblock Qi Powder) taken with wine, or Wujie San (Five Accumulations Powder) added with one qian of the first-end powder of Qianniu (Morning Glory Seed), or seven Taoren (Peach Kernels).
Attached Prescriptions:
Qing'e Wan (Blue Robe Pill): Treats lumbago due to Kidney deficiency, benefits essence and assists Yang.
Poguzhi (Cibotium Rhizome, 4 liang, stir-fried), Duzhong (Eucommia Bark, 4 liang, stir-fried to remove silk fibers), Shengjiang (Fresh Ginger, 2.5 liang, stir-fried dry).
Grind all into powder, mix with thirty walnuts ground into paste and honey, make pills the size of a paulownia seed. Take fifty pills each time with salted wine.
Duhuo Jisheng Tang (Angelica Pubescens and Parasitic Loranthus Decoction): Treats Kidney Qi deficiency allowing wind-damp to invade and flow into the waist and knees; or spasmodic curling pain preventing flexion and extension; or flaccidity, weakness, and coldness.
Duhuo (Angelica Pubescens Root, 1 liang), Sangjisheng (Taxillus Branch, substitute with Xu Duan if unavailable), Xixin (Asarum Root), Niuxi (Achyranthes Root), Qinjiao (Gentiana Macrophylla Root), Fuling (Poria), Baishao, Guixin (Cinnamon Heart), Chuanxiong, Fangfeng (Saposhnikovia Root), Renshen (Ginseng Root), Shudihuang (Prepared Rehmannia Root), Danggui (Angelica Sinensis Root), Duzhong (Eucommia Bark, stir-fried), Gancao (Licorice Root, roasted, each 2 liang).
Cut into pieces. Take three qian each time, decoct in water, take on an empty stomach. If diarrhea occurs, remove Shudihuang. For blood stagnation below, prick Weizhong (BL40) to bleed, which is excellent. Additionally, moxa Shenshu (BL23) and Kunlun (BL60), which is even better.
Treating Lumbago:
Heiqiu (Black Morning Glory Seed, 4 liang, half raw half stir-fried).
Grind finely, take the finest powder, make water pills the size of a paulownia seed, coat with Sulfur. Take thirty pills each time with salted wine on an empty stomach; stops after four doses.
Buyin Wan (Nourish Yin Pill): See category of Various Deficiencies.
Wujie San (Five Accumulations Powder): See category of Hong Kong Foot (Gout/Lower Limb Disorders).
Da Jianzhong Tang (Great Construct the Middle Decoction): See category of Macules and Papules.
Fuyuan Tongqi San (Restore Origin and Unblock Qi Powder): See category of Qi.
Shen Zhuo disease presents with heavy body, cold waist like ice, normal diet, and heavy abdomen as if something is in the waist. Treatment should drain dampness and use warm medicines.
Shen Zhuo Tang (Kidney Fixation Decoction): Treats Kidney deficiency with damp invasion, heavy body, cold waist, feeling as if sitting in water, no thirst, free urination.
Ganjiang (Dried Ginger, processed), Fuling (Poria, each 4 liang), Gancao (Licorice Root, roasted), Baizhu (Atractylodes Macrocephala Rhizome, each 2 liang).
Cut into pieces. Take five qian each time, decoct in water, take on an empty stomach.
Shen Shi Tang (Drain Dampness Decoction): Treats injury from cold-damp, heavy body, feeling as if sitting in water.
Cangzhu, Baizhu, Gancao (Licorice Root, roasted, each 1 liang), Fuling, Ganjiang (Dried Ginger, processed, each 1 liang), Juhong (Red Tangerine Pulp), Dingxiang (Clove, each 2.5 qian).
Take five qian each time, with one cup of water, three slices of fresh ginger, and one jujube, decoct and drink.