辛亥岁，到义溪，有一妇人，产后一年，口渴不止。服药不效，予用四君子汤，加麦冬
、乌梅、生干姜。蜜丸弹子大。令其噙化，三日知，十日痊愈。方中妙在白术之苦燥，干姜
之辛热，所以鼓胃气而升其水液也。
玉泉散
治消渴
白甘葛 天花粉 麦冬 生地 五味子 甘草
各等分，水煎服。
还津丸
止渴生津。
酸梅 乌梅（各二十五枚，枚俱去核） 薄荷末（一两） 冰片（一分五厘） 硼砂（一钱五分）
共研极细末，为丸，每含一丸。
消渴润燥方
白蜜 人乳酥（各一斤）
上溶化一处，每日不拘时服。
缫丝汤
治消渴。
用缫丝汤饮之。
麻仁丸（方见《伤寒》）
肾气丸（方见《金匮》）
六味丸（方见《时方》）
炙甘草汤（方见《伤寒》） 三方俱见虚劳
《经》曰∶太阳所至为腰痛。太阳、膀胱也，主外感而言。如五积散及桂枝汤加白术附子之
类，皆可治之。又曰∶腰者肾之府，转摇不动，肾将惫矣。主内伤而言，水虚用六味丸，火
衰用八味丸，如牛膝、杜仲、鹿茸、羊肾、人参、当归、枸杞之类，无不可以随宜加入。此
恒法也，业医者无不共晓。用而不效，则束手无策，而不知肝脾胃及督脉带脉，皆有此病，
须当细心分别。《经》云∶肝，足厥阴也，是动则病腰痛，不可以俯仰，宜当归四逆汤治之。（方中细辛能
遂肝性，木通能通络脉，以久痛必入络。）又曰∶从腰以下者，足太阴阳明皆主之。病在腰者，取 中。
余遇此症，每以白术为君者，取之太阴；有时用苡仁为君，取之阳明，人第曰二药利
湿，湿去而重着遂已。孰知白术营运土气于肌肉，外通皮肤，内通经络，风寒湿三气为痹，
一药可以兼治；苡仁为阳明正药，明阳主润宗筋，宗筋主束骨而利机关，故二药分用合用，
或加一二味引经，辄收奇效。又有瘀血作痛，以一味鹿角为末，酒调服甚效。或因挫跌，外伤
肿痛，或败血凝滞而不去，痛止而又作者，以桃仁承气汤，加附子、穿山甲，甚效。至于督
脉为病，尺寸中央俱浮（三部俱浮），直上直下（弦长之象），主腰强痛；带脉为病，关部左右
弹，主腰溶溶如坐水中，须用针灸之法。《李濒湖奇经考》极有发明，宜熟读之。
当归四逆汤 桂枝汤（俱见《伤寒》）
六味丸 八味丸（俱见《时方》）
新定白术汤
治腰痛而重，诸药不效者。
白术（生用，五钱至一两） 杜仲（生用，五钱或一两） 附子（二三钱）
水煎，空心服。脉沉而微，口中和，加肉桂一钱；脉沉而数，口中热，去附子，加黄柏一钱。
新定薏仁汤
治腰痛筋挛，难以屈伸者。
薏仁（一两） 附子（一二钱） 木瓜（一钱五分） 牛膝（二三钱）
水煎，空心服。如脉洪重按有力，口中热，去附子，加白术五钱。
鹿角散
以鹿角切片，酒拌焙黄勿焦。研末，空心老黄酒送下三四钱。以此药入督脉，兼能拓散
瘀血也。
辛亥年，我来到义溪，遇到一位妇人，产后一年，口渴不止。服用其他药物无效，我用四君子汤（补气基础方），加入麦冬、乌梅、生干姜。制成蜜丸，大小如弹子。让她含服，三天见效，十天痊愈。方中的妙处在于白术的苦燥之性，以及干姜的辛热之性，能够鼓舞胃气并提升水液上承。
玉泉散
治疗消渴病。
白甘葛、天花粉、麦冬、生地、五味子、甘草
各等分，水煎后服用。
还津丸
止渴生津。
酸梅、乌梅（各二十五枚，均去核）、薄荷末（一两）、冰片（一分五厘）、硼砂（一钱五分）
共同研磨成极细粉末，制成丸剂，每次含服一丸。
消渴润燥方
白蜜、人乳酥（各一斤）
将上述材料融化混合在一起，每日不限时间服用。
麻仁丸（方剂见《伤寒论》）
肾气丸（方剂见《金匮要略》）
六味丸（方剂见《时方歌括》）
炙甘草汤（方剂见《伤寒论》） 以上三方均用于治疗虚劳病
《黄帝内经》说：太阳经气异常可导致腰痛。太阳经即膀胱经，主要论述外感病引起的腰痛。如使用五积散或桂枝汤加白术、附子之类，都可以治疗。又说：腰是肾的府邸，如果腰部转动困难，说明肾气即将衰竭。这是指内伤引起的腰痛。肾阴水虚用六味丸，肾阳火衰用八味丸，如牛膝、杜仲、鹿茸、羊肾、人参、当归、枸杞等药，没有不可以随证加入的。这是常规治法，行医之人无不知晓。如果使用这些方法无效，便束手无策，却不知道肝、脾、胃及督脉、带脉也会引起腰痛，必须细心辨别。《黄帝内经》说：肝属足厥阴经，经脉变动则病发腰痛，不能俯仰，适宜用当归四逆汤治疗。（方中细辛能顺应肝木之性，通草能疏通络脉，因为久痛必然入络。）又说：腰部以下的病症，足太阴脾经和足阳明胃经都主治。病在腰部的，取穴中脘等穴位。
我遇到这类病症，常以白术为君药，取其归于太阴脾经；有时用薏苡仁为君药，取其归于阳明胃经。人们只说这两味药利湿，湿气去除后沉重感就消失了。殊不知白术能在肌肉中运化土气，外通皮肤，内通经络，风寒湿三气导致的痹症，一味药可以兼治；薏苡仁是阳明经的正药，阳明经主滋润宗筋，宗筋主约束骨骼而利于关节运动，所以这两味药分开用或合用，或者加一二味引经药，往往收到奇效。又有瘀血作痛的情况，用一味鹿角研末，酒调服非常有效。如果是因挫伤跌打，外伤肿痛，或败血凝滞不去，痛止后又复发的，用桃仁承气汤，加附子、穿山甲，效果很好。至于督脉为病，寸关尺三部中央脉象皆浮（三部俱浮），脉形直上直下（弦长之象），主腰脊强痛；带脉为病，关部左右脉搏跳动如弹指，主腰部松软无力如坐水中，须用针灸的方法治疗。《李濒湖奇经考》对此有极深入的阐发，应当熟读。
当归四逆汤、桂枝汤（均见《伤寒论》）
六味丸、八味丸（均见《时方歌括》）
新定白术汤
治疗腰痛且身体沉重，其他药物无效者。
白术（生用，五钱至一两）、杜仲（生用，五钱或一两）、附子（二三钱）
水煎，空腹服用。若脉沉而微，口中平和，加肉桂一钱；若脉沉而数，口中发热，去掉附子，加黄柏一钱。
新定薏仁汤
治疗腰痛伴筋脉拘挛，难以屈伸者。
薏苡仁（一两）、附子（一二钱）、木瓜（一钱五分）、牛膝（二三钱）
水煎，空腹服用。若脉洪大重按有力，口中发热，去掉附子，加白术五钱。
In the year of Xinhai, I arrived at Yixi, where I encountered a woman who had been suffering from incessant thirst for one year postpartum. Other medications proved ineffective. I prescribed Sijunzi Tang (Four Gentlemen Decoction) with added Maidong (Ophiopogon Tuber), Wumei (Mume Fruit), and Sheng Ganjiang (Raw Dried Ginger). These were processed into honey pills the size of bullet seeds. She was instructed to hold them in her mouth to dissolve slowly. Symptoms improved within three days, and she recovered completely in ten days. The brilliance of this formula lies in the bitter-drying nature of Baizhu (Atractylodis Macrocephalae Rhizoma) and the pungent-hot nature of Ganjiang (Zingiberis Rhizoma), which together stimulate Stomach Qi and elevate fluids upward.
Yuquan San (Jade Spring Powder)
Indicated for Xiao Ke (Wasting-Thirst Syndrome).
Baigange (Puerariae Lobatae Radix), Tianhuafen (Trichosanthis Radix), Maidong (Ophiopogonis Tuber), Shengdi (Rehmanniae Radix), Wuweizi (Schisandrae Chinensis Fructus), Gancao (Glycyrrhizae Radix et Rhizoma)
Equal parts, decocted in water and taken orally.
Huanjin Wan (Saliva-Returning Pill)
Stops thirst and generates fluids.
Suanmei (Pruni Mume Fructus), Wumei (Pruni Mume Fructus) (25 pieces each, pits removed), Bohe Mo (Menthae Haplocalycis Herba powder) (1 liang), Bingpian (Borneolum Syntheticum) (1 fen 5 li), Pengsha (Borax) (1 qian 5 fen)
Grind all ingredients into an extremely fine powder, form into pills, and take one pill by holding it in the mouth at a time.
Xiaoke Runzao Fang (Wasting-Thirst Moistening-Dryness Formula)
Baimi (Mel) (1 jin), Renru Su (Human Milk Butter) (1 jin)
Melt and mix together; take at any time of day without restriction.
Saosi Tang (Silkworm-Reeling Soup)
Indicated for Xiao Ke (Wasting-Thirst Syndrome).
Drink Saosi Tang.
Maren Wan (Hemp Seed Pill) (Formula see *Shanghan Lun*)
Shenqi Wan (Kidney Qi Pill) (Formula see *Jinkui Yaolue*)
Liuwei Wan (Six-Ingredient Pill) (Formula see *Shifang Gekua*)
Zhigancao Tang (Roasted Licorice Decoction) (Formula see *Shanghan Lun*)
The above three formulas are indicated for Xu Lao (Deficiency Consumption).
The *Classic* states: "When Taiyang reaches its extreme, it manifests as lower back pain." Taiyang refers to the Bladder Meridian, primarily discussing exogenous pathogens. Formulas such as Wuji San (Five Accumulations Powder) or Guizhi Tang (Cinnamon Twig Decoction) with added Baizhu (Atractylodis Macrocephalae Rhizoma) and Fuzi (Aconiti Lateralis Radix Praeparata) can be used to treat this. It also states: "The waist is the mansion of the Kidneys; if turning and shaking become difficult, the Kidneys are about to fail." This refers to endogenous injuries. For Kidney Yin deficiency (Water deficiency), use Liuwei Wan (Six-Ingredient Pill); for Kidney Yang deficiency (Fire decline), use Bawei Wan (Eight-Ingredient Pill). Herbs such as Niuxi (Achyranthis Bidentatae Radix), Duzhong (Eucommiae Cortex), Lurong (Cornu Cervi Pantotrichum), Yangshen (Ovis/Capis Testis), Renshen (Ginseng Radix et Rhizoma), Danggui (Angelicae Sinensis Radix), and Gouqi (Lycii Fructus) may be added according to the pattern. This is a standard method known to all practitioners. If these methods fail, one might feel helpless, unaware that the Liver, Spleen, Stomach, Du Mai (Governing Vessel), and Dai Mai (Belt Vessel) can also cause lower back pain, requiring careful differentiation. The *Classic* says: "The Liver belongs to the Foot Jueyin Meridian; when the meridian moves abnormally, it causes lower back pain, making flexion and extension impossible. It should be treated with Danggui Sini Tang (Angelica Decoction for Cold Extremities)." (Within the formula, Xixin (Asari Radix et Rhizoma) follows the nature of Wood/Liver, and Mutong (Akebiae Caulis) unblocks collaterals, because chronic pain inevitably enters the collaterals.) It also states: "For diseases below the waist, both the Foot Taiyin (Spleen) and Foot Yangming (Stomach) meridians govern them. For disease in the waist, select points such as Zhongwan."
In my experience with this syndrome, I often use Baizhu (Atractylodis Macrocephalae Rhizoma) as the sovereign herb, targeting the Taiyin Spleen; sometimes I use Yiren (Coicis Semen) as the sovereign herb, targeting the Yangming Stomach. People merely say these two herbs drain dampness, and once dampness is removed, the sensation of heaviness disappears. They do not realize that Baizhu (Atractylodis Macrocephalae Rhizoma) circulates Earth Qi within the muscles, connecting externally to the skin and internally to the collaterals; thus, it can simultaneously treat Bi Syndrome caused by Wind, Cold, and Dampness. Yiren (Coicis Semen) is the principal herb of the Yangming channel; Yangming moistens Zongjin (Major Sinews), which bind bones and facilitate joint movement. Therefore, using these two herbs separately or together, possibly adding one or two guiding herbs, often yields miraculous effects. For pain caused by Blood Stasis, grinding a single ingredient, Lujiao (Cornu Cervi Nigrum), into powder and taking it with wine is very effective. For trauma or contusions causing swelling and pain, or for stagnant blood that fails to resolve, causing recurring pain after temporary relief, Taochengqi Tang (Peach Kernel and Rhubarb Decoction) with added Fuzi (Aconiti Lateralis Radix Praeparata) and Chansanjia (Manis Squama) is highly effective. Regarding Du Mai (Governing Vessel) pathology, the pulse at the Cun, Guan, and Chi positions in the center is floating (floating in all three positions), with a straight up-and-down shape (string-long image), indicating stiff and painful lower back. Regarding Dai Mai (Belt Vessel) pathology, the pulse at the Guan position rebounds on both sides like a plucked string, indicating a feeling of looseness in the waist as if sitting in water; acupuncture and moxibustion must be used. Li Binhu's *Qijing Kao* (Examination of the Extraordinary Vessels) provides profound insights and should be studied thoroughly.
Danggui Sini Tang (Angelica Decoction for Cold Extremities), Guizhi Tang (Cinnamon Twig Decoction) (Both see *Shanghan Lun*)
Liuwei Wan (Six-Ingredient Pill), Bawei Wan (Eight-Ingredient Pill) (Both see *Shifang Gekua*)
Xinding Baizhu Tang (Newly Formulated Atractylodes Decoction)
Indicated for lower back pain with heaviness, unresponsive to other medications.
Baizhu (Raw, 5 qian to 1 liang), Duzhong (Raw, 5 qian or 1 liang), Fuzi (Prepared Aconite Root, 2-3 qian)
Decoct in water and take on an empty stomach. If the pulse is deep and faint, and the mouth feels neutral, add Rougui (Cinnamomi Cortex) 1 qian. If the pulse is deep and rapid, and the mouth feels hot, remove Fuzi (Prepared Aconite Root) and add Huangbai (Phellodendri Cortex) 1 qian.
Xinding Yiren Tang (Newly Formulated Coix Seed Decoction)
Indicated for lower back pain with tendon spasms, making flexion and extension difficult.
Yiren (Coix Seed, 1 liang), Fuzi (Prepared Aconite Root, 1-2 qian), Mugua (Chaenomelis Fructus, 1 qian 5 fen), Niuxi (Achyranthis Bidentatae Radix, 2-3 qian)
Decoct in water and take on an empty stomach. If the pulse is surging and forceful upon heavy pressure, and the mouth feels hot, remove Fuzi (Prepared Aconite Root) and add Baizhu (Atractylodis Macrocephalae Rhizoma) 5 qian.
Lujiao San (Deer Horn Powder)
Slice Deer Horn, mix with wine, and roast until yellow but not burnt. Grind into powder. Take 3-4 qian on an empty stomach with aged yellow wine. This herb enters the Du Mai (Governing Vessel) and helps disperse Blood Stasis.