治冷气心痛，及疝气心腹疼痛。
玄胡索（炒） 胡椒（各等分）
上为细末，每服二钱，食前用温酒调服。
良姜（四两。切碎，分作四分，一两用陈壁土半两，同炒，黄色，去土。一两用斑蝥三
十四个，同炒黄色，去斑蝥。一两用巴豆三十四个，去壳，同炒黄色，去豆。一两用陈仓米
半
上将茱萸同四色炒过良姜，再同炒令干，碾为细末，用浸茱萸酒煮面糊和丸，如梧桐子
大，每服五十丸，更看病患腹中冷热加减，空心用生姜汤送下。
治心掣，胸中忿气，不欲饮食。
赤茯苓（去黑皮） 当归（切碎） 干姜（炮） 人参 白术（以上各二两） 官桂
（去粗皮，
上锉如麻豆大，每服五钱，水一盏半，煎至八分，去滓稍热服，日二夜二。
《六元正纪论》曰∶太阳所至为腰痛。又曰∶巨阳即太阳也，虚则腰背头项痛。夫肾肝
为病，则腰滞而痛。故经云∶腰乃肾之腑，转摇不能，肾将惫矣。盖诸经皆贯于肾，而终于
腰脊，肾气一虚，邪气易入，或风寒暑湿客之，或血凝气滞，郁郁闷闷而不伸，积水沉重，
则小肠不得宣通，其证遂作。《素问·刺腰痛论》云∶分六经之病，且如太阳腰痛，引项脊
尻背如重状；阳明腰痛不可以顾，顾则如有所见者善悲；少阳腰痛如针刺皮，循循然不可俯
仰，不可以顾；太阴腰痛，令人而熟，热甚则劳，腰下如有横木居其中，甚则遗溲；少阴腰
痛，痛引脊内廉；厥阳腰痛，如张弓弩弦，善言嘿嘿然不慧，解脉是足太阳之别脉，令人腰
痛，引肩 然，时遗溲。又云∶痛如引带，常苦折腰状，善恐，同阴之脉，是足少阳之别
络也，令人腰痛，痛若小锤居其中，怫然肿。阳维之脉，是太阳之所生，奇脉也，令人腰痛
，痛上怫然肿。衡络之脉，是太阳之外络，令人腰痛，不可俯仰恐仆，得之举重伤腰，衡络
绝，恶血归之。会阴之脉，是足太阳之中经也，令人腰痛，痛上漯漯然汗出，汗干令人欲饮
，饮以欲走。飞扬之脉，是阴维之脉也，令人腰痛，痛上怫怫然，甚则悲恐。昌阳之脉，是
阴跷脉也，令人腰痛，痛引膺目 然，甚则反折舌卷不能言。肉里之脉，是少阳所生，则
阳维之脉所发也，令人腰痛，不可以咳，咳则筋缩，急挟脊而痛，至头几几然，目 欲僵
仆，刺足太阳，腰痛上寒，刺足太阳，阳明上热，刺足厥阴，不可俯仰，刺足少阳，中热而
喘，刺足少阴，少腹满刺足少阴，腰痛引少腹控 不可俯仰，刺腰尻交者两髁胛上。《刺热
篇》云∶脾热病者，热争则腰痛，不可俯仰，腹满涩；肾热病者，先腰疼， 酸舌渴，且人
之腰者，乃一身之大关节，六经所系，支络其经，多虚少实，或房劳之过度，或四气之所袭
，因虚则邪相搏，以为痛也。巢氏与《千金方》二家之论，腰痛有五，所感不同∶一曰阳气
不足，少阴肾衰，是以腰痛；二曰风痹，风寒湿着腰而痛；三曰肾虚，劳役伤肾而痛；四曰
弯腰作实伤腰而痛；五曰寝卧湿地而痛。此论受病各因。陈无择云∶又有三因而分之，盖太
阳少阴多中寒，少阳厥阴多中风，阳明太阴多中燥湿。若此六经腰痛者，为外之所因也。若
失志伤肾，郁怒伤肝，忧思伤脾，若此腰痛，为内之所因也。大抵此病，未尝不由肾虚，而
或以《内经》推足三阴三阳，十二经八脉，有贯络于腰肾而痛者，则经中各有刺法治之，或
风寒湿蓄热，与失志房劳，及坠伤闪肭，气滞血滞而痛者，当于五种三因而推之，不过发其
所由，用汗下补泻之法以疗之。若脉浮弦为风，弦紧为寒，沉细为湿，沉实为热，沉涩为气
与血也。治法识六经五种三因之病，则心胸了然，用药收十全之功，岂不美欤！
治疗冷气引起的心痛，以及疝气导致的心腹疼痛。
玄胡索（炒制） 胡椒（各取等量）
将上述药材研成细末，每次服用二钱，饭前用温酒调服。
良姜（四两。切碎，分成四份：一份一两用陈壁土半两，同炒至黄色，去掉土；一份一两用斑蝥三十四个，同炒至黄色，去掉斑蝥；一份一两用巴豆三十四个，去掉壳，同炒至黄色，去掉豆；一份一两用吴茱萸半两，同炒）。
将经过上述四种方法炒制过的良姜，再与剩下的吴茱萸一同炒干，碾成细末，用浸泡过吴茱萸的酒煮面糊和丸，制成梧桐子大小的药丸，每次服用五十丸，并根据患者腹中寒热情况酌情增减剂量，空腹时用生姜汤送服。
治疗心掣（心脏牵引性疼痛），胸中郁愤之气，不想进食。
赤茯苓（去掉黑皮） 当归（切碎） 干姜（炮制） 人参 白术（以上各二两） 官桂（去掉粗皮，锉碎如麻豆大小）。
将上述药材锉碎，每次服用五钱，加水一盏半，煎至八分，去渣，稍热时服用，每天早晚各一次。
《六元正纪论》说：太阳经气所至，表现为腰痛。又说：巨阳就是太阳经，虚损时会出现腰、背、头项疼痛。肾肝发生病变，会导致腰部滞重而痛。所以医经说：腰是肾的外府，如果转动摇动困难，说明肾气将要衰竭了。大概各条经脉都贯通于肾，并终结于腰脊，肾气一旦虚损，邪气就容易侵入，或是风寒暑湿客居体内，或是血凝气滞，郁闷不舒而不能伸展，积水沉重，导致小肠不得宣通，病症于是发作。《素问·刺腰痛论》说：区分六经的腰痛病证，比如太阳经腰痛，牵引项部、脊背、尻部及背部，感觉像有重物压着；阳明经腰痛，不能回顾，回顾时好像看到了什么幻象，且容易悲伤；少阳经腰痛，像针刺皮肤一样，行动迟缓，不能俯仰，也不能回顾；太阴经腰痛，使人感到腰部发热，热甚则疲劳，腰部下面好像横着一块木头在其中，严重时甚至遗尿；少阴经腰痛，疼痛牵引脊骨内侧；厥阴经腰痛，像张开的弓弩弦一样紧绷，喜欢说话却沉默不语，神志不清。解脉是足太阳膀胱经的别络，令人腰痛，牵引肩部，时常遗尿。又說：疼痛像被带子牵引，常常痛苦得弯腰折身，容易恐惧。同阴之脉，是足少阳胆经的别络，令人腰痛，疼痛好像有小锤子在里面，局部浮肿。阳维之脉，是由太阳经所生，属于奇经，令人腰痛，疼痛部位浮肿。衡络之脉，是太阳经的外络，令人腰痛，不能俯仰，害怕跌倒，这是由于举重损伤腰部，衡络断裂，恶血归聚于此所致。会阴之脉，是足太阳膀胱经的中经，令人腰痛，疼痛部位漯漯然出汗，汗干后想喝水，喝了水又想走动。飞扬之脉，是阴维之脉，令人腰痛，疼痛部位怫怫然不适，严重时悲伤恐惧。昌阳之脉，是阴跷脉，令人腰痛，疼痛牵引胸部和眼睛，严重时身体反折，舌卷缩不能说话。肉里之脉，由少阳经所生，也是阳维之脉的发源地，令人腰痛，不能咳嗽，一咳嗽就筋脉收缩紧急，挟持脊背而痛，直到头部僵硬，眼睛发直想要跌倒，应针刺足太阳经。腰痛上部寒冷，针刺足太阳经；上部发热，针刺足阳明经；不能俯仰，针刺足少阳经；内热而喘，针刺足少阴经；小腹胀满，针刺足少阴经；腰痛牵引少腹，控引睾丸，不能俯仰，针刺腰尻交会处的两髁胛上。《刺热篇》说：脾热病患者，热邪相争则腰痛，不能俯仰，腹部胀满涩滞；肾热病患者，先出现腰痛，伴有酸软、舌干口渴。而且人的腰，是一身的大关节，六经所系，支络其经，多虚少实，或者是房劳过度，或者是四气侵袭，因为虚则邪气相搏，从而产生疼痛。巢元方与《千金方》两家论述腰痛有五种，感受病因不同：一是阳气不足，少阴肾衰，因此腰痛；二是风痹，风寒湿附着于腰而痛；三是肾虚，劳役伤肾而痛；四是弯腰劳作造成实证伤腰而痛；五是睡卧湿地而痛。这些论述受病原因各不相同。陈无择说：又有三因来分类，大概太阳、少阴多中寒，少阳、厥阴多中风，阳明、太阴多中燥湿。如果是这六经腰痛，属于外因。如果是失志伤肾，郁怒伤肝，忧思伤脾，这样的腰痛，属于内因。大抵这个病，未尝不是因为肾虚，或者根据《内经》推究足三阴三阳、十二经八脉，有贯络于腰肾而痛的，则经文中各有刺法治之；或者是风寒湿蓄热，以及失志房劳，以及坠伤闪肭，气滞血滞而痛的，应当从五种三因来推究，不过是发掘其根源，用汗、下、补、泻的方法治疗。如果脉浮弦为风，弦紧为寒，沉细为湿，沉实为热，沉涩为气与血。掌握了六经、五种、三因的腰痛病证，则心中了然，用药能收到十全的效果，难道不美吗！
Treats heart pain caused by cold qi, as well as heart and abdominal pain due to hernia qi.
*Curcumae Radix* (Chou Xu Su, 延胡索) (stir-fried) *Piperis Fructus* (Hu Jiao, 胡椒) (equal parts).
Grind the above into a fine powder. Take two qian per dose, mixed with warm wine before meals.
*Alpiniae Officinarum Rhizoma* (Liang Jiang, 良姜) (four liang. Cut into pieces, divided into four parts: one part of one liang is stir-fried with half a liang of old wall soil until yellow, then the soil is removed; one part of one liang is stir-fried with thirty-four *Mylabris* (Ban Mao, 斑蝥) until yellow, then the insects are removed; one part of one liang is stir-fried with thirty-four shelled *Crotonis Fructus* (Ba Dou, 巴豆) until yellow, then the beans are removed; one part of one liang is stir-fried with half a liang of *Evodiae Fructus* (Zhu Yu, 吴茱萸)).
The *Alpiniae Officinarum Rhizoma* processed by the above four methods is further stir-fried dry together with the remaining *Evodiae Fructus*, ground into a fine powder, and made into pills the size of paulownia seeds using a wheat paste boiled in wine infused with *Evodiae Fructus*. Take fifty pills per dose, adjusting according to the patient's abdominal cold or heat condition. Take on an empty stomach with ginger decoction.
Treats heart pulling pain (Xin Che), oppressive qi in the chest, and loss of appetite.
*Poria* (Chi Fu Ling, 赤茯苓) (remove black skin) *Angelicae Sinensis Radix* (Dang Gui, 当归) (cut into pieces) *Zingiberis Rhizoma* (Gan Jiang, 干姜) (processed) *Ginseng Radix* (Ren Shen, 人参) *Atractodis Macrocephalae Rhizoma* (Bai Zhu, 白术) (two liang each for the above) *Cinnamomi Ramulus* (Guan Gui, 官桂) (remove rough bark, cut into sizes similar to hemp seeds).
Cut the above herbs. Take five qian per dose, add one and a half lamps of water, boil down to eight-tenths, remove dregs, and take slightly warm twice daily (morning and night).
The *Liu Yuan Zheng Ji Lun* states: "When Taiyang qi arrives, it manifests as lower back pain." It also states: "Ju Yang is Taiyang; when deficient, it causes pain in the lower back, back, head, and neck." When Kidney and Liver diseases occur, the lower back becomes stagnant and painful. Thus, the classics say: "The lower back is the mansion of the Kidney; if turning and shaking become difficult, the Kidney Qi is about to fail." Generally, all meridians penetrate the Kidney and terminate at the lumbar spine. Once Kidney Qi is deficient, pathogenic factors easily invade. This may be due to Wind, Cold, Summer-heat, or Dampness lodging in the body, or blood stasis and qi stagnation causing depression and inability to extend. Heavy accumulation of fluid obstructs the Small Intestine's unobstructed flow, leading to the manifestation of symptoms. The *Su Wen: Ci Yao Tong Lun* states: "Differentiate the lower back pain of the Six Meridians. For example, Taiyang lower back pain radiates to the neck, spine, sacrum, and back, feeling heavy; Yangming lower back pain prevents looking back, and looking back induces visual hallucinations and sadness; Shaoyang lower back pain feels like needle pricks to the skin, with slow movement, inability to bend or straighten, or look back; Taiyin lower back pain causes heat sensation in the waist, fatigue when heat is severe, a sensation of a horizontal wood block in the lower waist, and even urinary incontinence in severe cases; Shaoyin lower back pain radiates pain to the inner aspect of the spine; Jueyin lower back pain feels tight like a drawn bowstring, with speechlessness and mental confusion." Xie Mai (Resolving Vessel) is an extra vessel of the Foot-Taiyang Bladder Meridian, causing lower back pain radiating to the shoulder and occasional urinary incontinence. It also says: "Pain feels like being pulled by a strap, often suffering from bent waist, and fear." Tong Yin Zhi Mai (Same Yin Vessel) is an extra vessel of the Foot-Shaoyang Gallbladder Meridian, causing lower back pain with a sensation of a small hammer inside and local swelling. Yang Wei Zhi Mai (Yang Linking Vessel) originates from Taiyang and belongs to the Extraordinary Vessels, causing lower back pain with swelling at the painful site. Heng Luo Zhi Mai (Horizontal Collateral Vessel) is an external collateral of Taiyang, causing lower back pain with inability to bend/straighten and fear of falling, resulting from heavy lifting injuring the waist, breaking the Heng Luo, and evil blood gathering there. Hui Yin Zhi Mai (Hui Yin Vessel) is the central meridian of Foot-Taiyang, causing lower back pain with profuse sweating at the painful site; after sweat dries, thirst arises, and drinking leads to a desire to walk. Fei Yang Zhi Mai (Flying Yang Vessel) is the Yin Linking Vessel, causing lower back pain with discomfort at the painful site, and severe cases involve sadness and fear. Chang Yang Zhi Mai (Chang Yang Vessel) is the Yin Qiao Vessel, causing lower back pain radiating to the chest and eyes, with severe cases involving opisthotonos, tongue retraction, and inability to speak. Rou Li Zhi Mai (Flesh Interior Vessel) originates from Shaoyang and is where Yang Wei Zhi Mai emerges, causing lower back pain that worsens with coughing, leading to tendon contraction and spasm along the spine up to the head, with stiffness and a desire to fall; treat by needling Foot-Taiyang. For upper back coldness in lower back pain, needle Foot-Taiyang; for upper heat, needle Foot-Yangming; for inability to bend/straighten, needle Foot-Shaoyang; for internal heat and panting, needle Foot-Shaoyin; for lower abdominal fullness, needle Foot-Shaoyin; for lower back pain radiating to the lower abdomen and testicles with inability to bend/straighten, needle the intersection of the lumbar and sacral regions above the malleoli. The *Ci Re Pian* states: "In Spleen Heat Disease, when heat struggles, lower back pain occurs with inability to bend/straighten and abdominal fullness/stagnation; in Kidney Heat Disease, lower back pain appears first, accompanied by soreness, dry tongue, and thirst." Moreover, the human waist is the major joint of the body, connected to the Six Meridians, with collateral branches, mostly deficient rather than excess. Causes include excessive sexual activity or invasion by the Four Qi. Deficiency allows pathogens to clash, causing pain. Chao Yuanfang and the *Qian Jin Fang* discuss five types of lower back pain with different etiologies: 1. Insufficient Yang Qi and decline of Shaoyin Kidney; 2. Wind-Bi, where Wind-Cold-Dampness adheres to the waist; 3. Kidney deficiency from overwork; 4. Waist injury from bending labor (excess type); 5. Sleeping on damp ground. These describe different causes. Chen Wuyue states: "There are three categories based on etiology: Taiyang and Shaoyin often suffer from Cold; Shaoyang and Jueyin often suffer from Wind; Yangming and Taiyin often suffer from Dryness/Dampness." If these six meridian lower back pains are involved, they are external causes. If caused by emotional distress injuring the Kidney, anger injuring the Liver, or worry injuring the Spleen, these are internal causes. Generally, this disease stems from Kidney deficiency. Based on the *Nei Jing*, analyzing the Foot-San Yin and San Yang, Twelve Meridians, and Eight Extraordinary Vessels which connect to the waist and Kidney, each has specific acupuncture treatments. For Cold-Wind-Dampness accumulation, heat retention, emotional trauma, sexual excess, falls, sprains, qi stagnation, or blood stasis causing pain, one should deduce from the Five Types and Three Causes. The goal is to identify the root cause and use sweating, purging, tonifying, or reducing methods. A floating-wiry pulse indicates Wind; wiry-tight indicates Cold; deep-thin indicates Dampness; deep-solid indicates Heat; deep-choppy indicates Qi and Blood issues. Understanding the Six Meridians, Five Types, and Three Causes of lower back pain clarifies the mind, allowing medication to achieve perfect results, which is indeed admirable!