[总诀]腰为肾窍宜补温,湿着血瘀皆令疼。亦有痛连肩背者,太阳经病讨根源。
腰间沉痛,如带五千钱重者,肾经受寒湿也。宜时方肾着汤。
干姜(三钱) 白本(三钱) 云苓(五钱) 甘草(二钱)
歌曰∶肾着腰疼若带钱,姜苓白术草梢连。
除寒利湿无他术,漫道时方力不全。
(伯未按∶《三因方》原注“如大便泄者,加苍术、陈皮、丁香”。)
腰痛难忍,有如刀锥刺割者,瘀血积腰际也。宜鹿角利腰汤。
鹿角(三钱) 归尾(三钱) 白芍(三钱) 丹皮(三钱) 红花(一钱) 牛膝(二钱) 续
断(三钱)
歌曰∶腰疼难忍似锥刀,归芍丹皮等分熬。
鹿角红花同续断,再加牛膝煮成膏。
腰痛软弱,或兼小便不利者,虚劳肾气弱也。宜金匮肾气丸。
熟地(四钱) 山药(三钱) 云苓(三钱) 附子(三钱) 安桂(一钱) 泽泻(三钱) 丹皮
(三钱) 山茱萸(三钱)
歌曰∶腰疼软弱肾元虚,桂附丹萸药笼储。
山药云苓兼泽泻,地黄滋补渐宽舒。
(伯未按∶可用陈酒煮猪腰子啖之,或加杜仲、续断亦佳。一方用核桃肉四两、补骨脂一两同捣,日食三
四钱。)
腰痛连背,或兼寒热头痛者,风寒袭太阳也。宜人参败毒散。
羌活(一钱) 独活(一钱) 柴胡(二钱) 前胡(二钱) 川芎(八分) 枳壳(一钱) 沙参
(二钱) 桔梗(二钱) 杏仁(三钱) 茯苓(三钱) 甘草(一钱) 生姜(三片) 大枣(二枚) 葛
根(三钱)
歌曰∶头疼腰痛总因风,药用人参败毒攻。
二活柴前芎枳桔,苓甘葛枣杏姜通。
腰痛溺赤,或兼曲而不伸者,阴虚筋骨缩也。宜加味补阴丸。
生地(三钱) 知母(二钱) 黄柏(二钱) 龟板(炙,三钱) 续断(三钱) 山茱萸(三钱) 丹
皮(二钱) 葳蕤(二钱) 竹茹(一钱) 牛膝(一钱) 鹿角屑(一钱)
歌曰∶腰痛缘何曲不伸,阴虚筋缩地宜生。
丹皮续断知萸柏,龟鹿茹蕤牛膝行。
【总诀】腰部是肾脏的外窍,适宜采用温补的方法;湿气滞留和血瘀都会导致疼痛。也有疼痛牵连到肩背的情况,这属于太阳经受邪的病证,需要探究其根源。
腰间感到沉重且疼痛,就像腰上挂着五千枚铜钱那样沉重,这是肾经受到寒湿侵袭所致。适宜使用时方中的肾着汤。
干姜(三钱) 白术(三钱) 茯苓(五钱) 甘草(二钱)
歌诀说:肾着腰痛如同带钱束,干姜、茯苓、白术与甘草梢相连。
除去寒邪、利除湿气没有其他办法,不要说时方的力量不足。
(伯安按语:《三因方》原注指出“如果大便泄泻的,加入苍术、陈皮、丁香”。)
腰痛难以忍受,像被刀锥刺割一样的感觉,这是瘀血积聚在腰部所致。适宜使用鹿角利腰汤。
鹿角(三钱) 当归尾(三钱) 白芍(三钱) 牡丹皮(三钱) 红花(一钱) 牛膝(二钱) 续断(三钱)
歌诀说:腰痛难忍似锥刀,当归、白芍、丹皮等分熬制。
鹿角、红花同续断一起,再加牛膝煮成膏状。
腰痛伴有软弱无力,或者兼有小便不利的症状,这是虚劳导致的肾气虚弱。适宜使用金匮肾气丸。
熟地黄(四钱) 山药(三钱) 茯苓(三钱) 附子(三钱) 肉桂(一钱) 泽泻(三钱) 牡丹皮(三钱) 山茱萸(三钱)
歌诀说:腰痛软弱肾元虚,肉桂、附子、丹皮、山茱萸、山药储备其中。
山药、茯苓兼加泽泻,地黄滋补逐渐使身体宽舒。
(伯安按语:可以用陈酒煮猪腰子食用,或者加入杜仲、续断也很好。另一方法是用核桃肉四两、补骨脂一两一同捣碎,每天吃三四钱。)
腰痛牵连背部,或者兼有寒热、头痛的症状,这是风寒侵袭太阳经所致。适宜使用人参败毒散。
羌活(一钱) 独活(一钱) 柴胡(二钱) 前胡(二钱) 川芎(八分) 枳壳(一钱) 沙参(二钱) 桔梗(二钱) 杏仁(三钱) 茯苓(三钱) 甘草(一钱) 生姜(三片) 大枣(二枚) 葛根(三钱)
歌诀说:头疼腰痛总因风,用药用人参败毒散攻治。
羌活、独活、柴胡、前胡、川芎、枳壳、桔梗,茯苓、甘草、葛根、大枣、杏仁、生姜共同疏通。
腰痛伴小便色赤,或者兼有关节弯曲而不能伸直的症状,这是阴虚导致的筋骨收缩。适宜使用加味补阴丸。
生地黄(三钱) 知母(二钱) 黄柏(二钱) 龟板(炙,三钱) 续断(三钱) 山茱萸(三钱) 牡丹皮(二钱) 葳蕤(二钱) 竹茹(一钱) 牛膝(一钱) 鹿角屑(一钱)
歌诀说:腰痛缘何曲不伸,阴虚筋缩宜用生地黄。
丹皮、续断、知母、山茱萸、黄柏,龟板、鹿角、竹茹、葳蕤、牛膝行用。
[General Principle] The lower back is the external orifice of the Kidney and is suitable for warming and tonifying treatments; stagnation of dampness and blood stasis both cause pain. There are also cases where pain radiates to the shoulders and back, which belong to diseases of the Taiyang (Greater Yang) meridian, requiring investigation into their root causes.
A sensation of heaviness and pain in the waist, as if carrying five thousand coins around the waist, indicates cold-dampness invading the Kidney meridian. It is appropriate to use the Shenzhuo Decoction (Kidney-Attaching Decoction) from contemporary formulas.
Ganjiang (Dried Ginger Rhizome, 3 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, 3 qian) Yunling (Poria, 5 qian) Gancao (Licorice Root, 2 qian)
The song states: For Shenzhuo lumbar pain resembling a weight of coins, connect Ganjiang, Ling, Baizhu, and Gancao tips.
There is no other method to dispel cold and promote diuresis; do not say that contemporary formulas lack efficacy.
(Ber An's Note: The original annotation in *San Yin Fang* states "If there is diarrhea, add Cangzhu, Chenpi, and Dingxiang".)
Lumbar pain that is unbearable, feeling like being pierced by knives or awls, indicates blood stasis accumulating at the waist. It is appropriate to use Lujiao Liyao Decoction (Deer-Horn Lumbar-Benefiting Decoction).
Lujiao (Deer Horn, 3 qian) Guiwei (Tail of Angelicae Sinensis Radix, 3 qian) Baishao (White Peony Root, 3 qian) Danpi (Moutan Cortex, 3 qian) Honghua (Carthami Flos, 1 qian) Niuxi (Achyranthis Bidentatae Radix, 2 qian) Xuduan (Dipsaci Radix, 3 qian)
The song states: Lumbar pain unbearable like awls and knives, boil Guishao, Danpi in equal parts.
Combine Lujiao, Honghua with Xuduan, then add Niuxi and boil into a paste.
Lumbar pain accompanied by weakness, or combined with difficulty in urination, indicates deficiency labor due to weak Kidney Qi. It is appropriate to use Jin Kui Shenqi Wan (Jin Gui Shenqi Pill).
Shudi (Prepared Rehmanniae Radix, 4 qian) Shanyao (Dioscoreae Rhizoma, 3 qian) Yunling (Poria, 3 qian) Fuzi (Aconiti Lateralis Radix Praeparata, 3 qian) Angui (Cinnamomi Ramulus, 1 qian) Zexie (Alismatis Rhizoma, 3 qian) Danpi (Moutan Cortex, 3 qian) Shanzhuyu (Corni Fructus, 3 qian)
The song states: Lumbar pain and weakness indicate empty Yuan of the Kidney, Gui and Fu, Dan and Yu are stored in the medicine cabinet.
Shanyao, Yunling, and Zexie are added, while Dihuang nourishes and gradually brings comfort.
(Ber An's Note: One may eat pork kidneys boiled with aged wine, or adding Duzhong and Xuduan is also good. Another method uses four liang of Walnut Meat and one liang of Buguzhi pounded together, taken three to four qian daily.)
Lumbar pain radiating to the back, or combined with chills, fever, and headache, indicates Wind-Cold attacking the Taiyang meridian. It is appropriate to use Renshen Baidu San (Ginseng Detoxification Powder).
Qianghuo (Notopterygii Rhizoma et Radix, 1 qian) Duohuo (Angelicae Pubescentis Radix, 1 qian) Chaihu (Bupleuri Radix, 2 qian) Qianhu (Peucedani Radix, 2 qian) Chuanxiong (Ligusticum Chuanxiong Rhizoma, 8 fen) Zhike (Aurantii Fructus Immaturus, 1 qian) Shashen (Glehniae Radix, 2 qian) Jiegeng (Platycodonis Radix, 2 qian) Xingren (Armeniacae Semen Amarum, 3 qian) Fuling (Poria, 3 qian) Gancao (Licorice Root, 1 qian) Shengjiang (Zingiberis Rhizoma Recens, 3 slices) Dazao (Jujubae Fructus, 2 pieces) Gegen (Puerariae Lobatae Radix, 3 qian)
The song states: Headache and lumbar pain are generally due to Wind, use Renshen Baidu to attack it.
Er Huo (Qianghuo, Duohuo), Chai, Qian, Xiong, Zhi, Jie, along with Ling, Gan, Ge, Zao, Xing, Jiang, and Tong (unblocking agents).
Lumbar pain with reddish urine, or combined with stiffness preventing bending and extension, indicates Yin deficiency causing contraction of tendons and bones. It is appropriate to use Jiawei Buyin Wan (Modified Nourishing-Yin Pill).
Shengdi (Rehmanniae Radix, 3 qian) Zhimu (Anemarrhenae Rhizoma, 2 qian) Huangbai (Phellodendri Cortex, 2 qian) Guiban (Testudinis Carapax et Plastrum, roasted, 3 qian) Xuduan (Dipsaci Radix, 3 qian) Shanzhuyu (Corni Fructus, 3 qian) Danpi (Moutan Cortex, 2 qian) Weirui (Polygonati Odorati Rhizoma, 2 qian) Zhuru (Bambusae Caulis in Taedia, 1 qian) Niuxi (Achyranthis Bidentatae Radix, 1 qian) Lujiaoxie (Deer Horn Dust, 1 qian)
The song states: Why does lumbar pain prevent bending and extending? Yin deficiency and tendon contraction make Shengdi suitable.
Danpi, Xuduan, Zhi, Yushu, Bai (Huangbai), while Gu, Lu, Ru, Rui, and Niuxi circulate.