（《素问·刺腰痛论》全《骨空论》《灵枢·杂病篇》）
足太阳脉令人腰痛，引项脊尻背如重状，
（《素问·刺腰痛篇》全。足太阳之脉，下项循肩 内，挟脊抵腰中，故令人腰痛引项脊尻背如重状也。尻，开高切，
臀也。）刺其 中、太阳正经出血，春无见血。（ 中，委中也，一名血 。太阳正经，昆仑也。太阳合肾水，水王于冬
而衰于春，故刺太阳经者春无见血。 ，隙同。）
少阳令人腰痛，如以针刺其皮中，循循然不可以俯仰，不可以顾，（少阳之气应风木，阳分受之，故如以针刺其皮中。
循循然，迟滞貌，谓其举动不便也。足少阳之脉起于目锐 ，上抵头角，下耳后，循颈下胸中，循胁里下行身足之侧，
故身不可以俯仰，头不可以回顾。俯，俯同。）刺少阳成骨之端出血，成骨在膝外廉之骨独起者，夏无见血。（膝外侧之
高骨独起者，乃 骨之上端，所以成立其身，故曰成骨。其端则阳关穴也。少阳合肝木，木王于春而衰于夏，故刺少阳
经者，夏无见血。）
阳明令人腰痛不可以顾，顾如有见者，善悲，（足阳明之筋，上循胁属脊；足阳明之脉，循颐后下廉出大迎，其支别
者下人迎，循喉咙入缺盆，下循腹里至气街中而合，以下髀关，故令人腰痛不可以顾。顾如有见者，见鬼怪之谓也。善
悲者，神不足则悲也。阳明气衰而阴邪侮之，故证见如此。）刺阳明于 前三 ，上下和之出血，秋无见血。（ 前三 ，
即三里也。上下和之，兼上下巨虚而言也。秋时胃土退气，故刺阳明者秋无见血。 音杭，又形敬切。 音委。）
足少阴令人腰痛，痛引脊内廉，（足少阴之脉，贯脊内属肾也。按∶此前少足太阴腰痛一证，必古文之脱简也。）刺
少阴于内踝上二 ，春无见血，出血太多，不可复也。（内踝上二 ，足少阴之复溜也。春时木旺水衰，故刺足少阴者，
春无见血。若出血太多，则肾气不可复也。）
厥阴之脉令人腰痛，腰中如张弓弩弦，（王氏曰∶足厥阴之支者，与太阴少阳之脉，同结于腰踝下中 下 之间，故
令人腰痛。肝主筋，肝病则筋急，故令腰中如张弓弩弦。）刺厥阴之脉，在 踵鱼腹之外，循之累累然乃刺之，（ ，腿
肚也。踵，足跟也。鱼腹， 之形如鱼腹也。 踵之间，鱼腹之外，循之累累然者，即足厥阴之络，蠡沟穴也。 音篆。）
其病令人善言默默然，不慧，刺之三 。（善言默默然者，善于言语默默也，即不能发声之谓。肝病从风，人多昏冒，故
不爽慧。三 ，三刺其处也。）
解脉令人腰痛，痛而引肩，目KT KT 然，时遗溲，刺解脉，在膝筋肉分间 外廉之横脉出血，血变而止。（解脉，
足太阳经之散行脉也。其脉循肩 ，故痛而引肩。其起在目内 ，故目KT KT 然。其属膀胱，故令遗溲。当刺解脉
之在膝后者，即 中横文两筋间，弩肉高起之处，则 中之分，此足太阳之血 也。若 之外廉，有血络横见，盛满而
紫黑者，刺之当见黑血。必候其血色变赤，乃止其针，此亦足太阳经之腰痛也。KT 音荒。 ，隙同。）
解脉令人腰痛如引带，常如折腰状，善恐，刺解脉，在 中结络如黍米，刺之血射以黑，见赤血而已。（复言解脉者，
谓太阳支脉，从腰中下挟脊，贯臀入 中者也，故其痛如引带、如折腰也。太阳之脉络肾，肾志恐，故善恐。 中，即
委中穴也。上文言 外廉之横脉，此言 中结络，治稍不同耳。已，止针也。）
同阴之脉令人腰痛，痛如小锤居其中，怫然肿，（足少阳之别，络于厥阴，并经下络足跗，故曰同阴之脉。如小锤居
其中，痛而重也。怫然，怒意，言肿突如怒也。锤音槌。怫音佛。）刺同阴之脉，在外踝上绝骨之端，为三 。（即足少
阳阳辅穴也。）阳维之脉令人腰痛，痛上怫然肿，（阳维，奇经之一也，阳脉相维交会之脉，故曰阳维，）刺阳维之脉，脉
与太阳合 下间，去地一尺所。（阳维脉气所发，别于金门而上行，故与足太阳合于 下间，去地一尺所，即承山穴也。）
衡络之脉令人腰痛，不可以俯仰，仰则恐仆，得之举重伤腰，衡络绝，恶血归之，（衡，横也。足太阳之外络，自腰
中横出髀外后廉，而下合于 中，故曰衡络。若举重伤腰，则横络阻绝而恶血归之，乃为腰痛。）刺之在 阳，筋之间，
上数寸，衡居，为二 ，出血。（ 阳，即足太阳之委阳穴，在血 上外廉两筋间，故云上 数寸。衡居，并居也，即
殷门穴。二穴皆当出血。）
会阴之脉令人腰痛，痛上漯漯然汗出，汗干令人欲饮，饮已欲走，（会阴，任脉穴也，在大便前，小便后，任、冲、
督三脉所会，故曰会阴。任由此行腹，督由此行背，故令人腰痛。邪在阴分，故漯漯然汗出。汗干而液亡，故令人欲饮。
饮多则阴气下溢，故欲走也。漯音磊。）刺直阳之脉上三 ，在跷上 下，五寸横居，视其盛者出血。（直阳，谓足太阳
正经之脉，侠脊贯臀，下至 中，循 过外踝之后，径直而行者，故曰直阳。跷为阳跷，即申脉也。 ，即委中也。此
脉上之穴，在跷之上， 之下，相去约五寸而横居其中，则承筋穴也。或左或右，视其血络之盛者，刺出其血。）
飞阳之脉令人腰痛，痛上怫怫然，甚则悲以恐，（飞阳，足太阳之络穴，别走少阴者也，故为腰痛。痛上怫怫然，言
痛状如嗔愤也。足太阳之脉络肾，其别者当心入散，故甚则悲以恐，悲生于心，恐生于肾也。）刺飞阳之脉，在内踝上五
寸，少阴之前，与阴维之会。（在内踝上五寸、少阴之前者，即阴维之会，筑宾穴也。亦同治飞阳之腰痛者。）昌阳之脉，
令人腰痛，痛引膺，目KT KT 然，甚则反折，舌卷不能言，（昌阳，即足少阴之复溜也。少阴属肾，故为腰痛。肾脉
注胸中，故痛引于膺。肾之精为瞳子，故目KT KT 然。少阴合于太阳，故反折。肾脉循喉咙，故舌卷不能言。）刺内
筋为二 ，在内踝上，大筋前，太阴后，上踝二寸所。（内筋，筋之内也，即复溜穴，在足太阴经之后，内踝上二寸所，
此阴跷之 也。）
散脉令人腰痛而热，热甚生烦，腰下如有横木居其中，甚则遗溲，（散脉，足太阴之别也，散行而上，故以名焉。其
脉循股入腹，结于腰髁下骨空中，故病则腰下如有横木居其中，甚乃遗溲也。）刺散脉在膝前，骨肉分间，络外廉，束脉
为三 。（膝前，膝内侧之前也。骨肉分间，谓膝内辅骨下廉， 肉之两间也。络外廉者，太阴之络，色青而见者也。辅
骨之下，后有大筋退出膝 之骨，令其连属，取此系束之脉，三刺以去其病，故曰束脉为三 ，是即地机穴也。按∶此
节云膝前骨肉分间络外廉束脉，似指阳明经为散脉，而王氏释为太阴，若乎有疑；但本篇独缺太阴刺法，而下文有云上
热刺足太阴者，若与此相照应，及考之地机穴，主治腰痛，故今从王氏之注。）
肉里之脉令人腰痛，不可以咳，咳则筋急，（肉里，谓分肉之里，足少阳脉之所行，阳辅穴也，又名分肉。少阳者筋
其应，咳则相引而痛，故不可以咳，咳则筋缩急也。）刺肉里之脉为二 ，在太阳之外，少阳绝骨之后。（太阳经之外，
少阳绝骨穴之后，即阳辅穴也。）
腰痛侠脊而痛至头几几然，目KT KT ，欲僵仆，刺足太阳 中出血。（几几，凭伏貌。KT KT ，目乱不明也。
此皆太阳证，故当刺 中出血，即委中穴也。）
腰痛上寒，刺足太阳、阳明；上热，刺足厥阴；（上寒上热，皆以上体言也。寒刺阳经，去阳分之阴邪；热刺厥阴，
去阴中之风热也。）不可以俯仰，刺足少阳；（少阳脉行身之两侧，故俯仰不利者当刺之。）中热而喘，刺足少阴，刺 中
出血。（少阴主水，水病无以制火，故中热。少阴之脉贯肝膈入肺中，故喘。当刺足之少阴，涌泉、大钟悉主之。 中义
如前。）
腰痛上寒，不可顾，刺足阳明；上热，刺足太阴。（足阳明之脉挟喉咙，上络头项，足太阴合于阳明，上行结于咽，
故皆不可左右顾。王氏曰∶上寒，阴市主之。不可顾，三里主之。上热，地机主之。）中热而喘，刺足少阴。（重出。）大
便难，刺足少阴。（肾开窍于二阴也。王氏曰∶涌泉主之。）少腹满，刺足厥阴。（厥阴之脉抵少腹也。王氏曰∶太冲主之。）
如折不可以俯仰，不可举，刺足太阳。（足太阳之脉循腰背，故为此诸证。王氏曰∶如折，束骨主之。不可以俯仰，京骨、
昆仑悉主之。不可举，申脉、仆参悉主之。）引脊内廉，刺足少阴。（脊之内廉，肾脉之所行也，故当刺足少阴。王氏曰∶
复溜主之。）
腰痛引少腹控 ，不可以仰，刺腰尻交者，两髁胂上，以月生死为 数，发针立已，（此邪客太阴之络为腰痛也。控，
引也。 ，季胁下之空软处也。腰尻交者，按王氏云∶即下 穴，此足太阴、厥阴、少阳三脉，左右交结于中也。两髁
胂，谓腰髁骨下坚肉也。盖腰髁下尻骨两旁有四骨空，左右凡八穴，为之八 骨。此太阴腰痛者，当取第四空，即下醪
也。以月死生为 数，如《缪刺篇》曰∶月生一日一 ，二日二 ，渐多之，十五日十五 ，十六日十四 ，渐少之也。
按缪刺论曰∶邪客于足太阴之络，令人腰痛引少腹控 ，不可以仰息。即此节之义，详本类前三十。 音秒。髁，苦瓦
切。胂音申。）左取右，右取左。（因脉之左右交结，故宜缪刺如此也。）
腰痛不可以转摇，急引阴卵，刺八 与痛上，八 在腰尻分间。
（《素问·骨空论》。八 者，上 、次 、中 、下 ，左右共八 ，俱足太阳经穴，在腰之下，尻之上，筋肉分
间陷下处。 音辽。）
腰痛，痛上寒，取足太阳、阳明；痛上热，取足厥阴；不可以俯仰，取足少阳。
（《灵枢·杂病篇》。重出见上文。）
足太阳膀胱经的经脉使人发生腰痛，疼痛牵引项部、脊柱、尾骶部和背部，感觉像背负重物一样沉重。
（《素问·刺腰痛篇》全文。足太阳膀胱经的经脉，下行经过项部，沿着肩胛内侧，夹着脊柱到达腰中，所以使人腰痛并牵引项、脊、尻、背，感觉像背负重物一样。尻，读音为开高切，指臀部。）针刺委中穴和昆仑穴，使足太阳膀胱经的正经出血，春季不宜放血。（委中穴，又名血郄。昆仑穴是足太阳膀胱经的正经穴位。足太阳膀胱经与肾水相合，水气在冬季旺盛而在春季衰退，所以针刺足太阳膀胱经时，春季不宜放血。郄，同隙字。）
足少阳胆经使人发生腰痛，痛感如同针刺在皮肤中，行动迟缓滞涩，不能前后俯仰，也不能回头张望。（足少阳胆经的气机对应风木，阳分受邪，所以痛感如同针刺在皮肤中。循循然，形容迟滞的样子，指举动不便。足少阳胆经的经脉起于目外眦，向上到达头角，向下经过耳后，沿着颈部下行至胸中，沿着胁肋内部下行至身体和腿部的侧面，所以身体不能俯仰，头部不能回顾。俯，同俯字。）针刺膝外侧高骨独起处的成骨端出血，该处位于膝盖外侧高骨独起的地方，夏季不宜放血。（膝盖外侧高骨独起的地方，是腓骨的上端，因为它是支撑身体的骨骼，所以称为成骨。其末端即阳关穴。足少阳胆经与肝木相合，木气在春季旺盛而在夏季衰退，所以针刺足少阳胆经时，夏季不宜放血。）
足阳明胃经使人发生腰痛，不能回头张望，回头时好像看到了鬼怪，容易悲伤。（足阳明胃经的筋，向上沿着胁肋连属于脊柱；足阳明胃经的经脉，沿着下颌后下方出大迎穴，其分支从人迎穴下行，沿着喉咙进入缺盆，向下沿着腹部内部到达气街中会合，再向下经过髀关，所以使人腰痛不能回头。顾如有见者，指看到鬼怪。善悲，指神气不足就会悲伤。阳明经气衰弱而阴邪欺侮它，所以出现这样的证候。）针刺足阳明胃经的足三里穴及其上下巨虚穴，调和上下并使其出血，秋季不宜放血。（足前三里，即足三里穴。上下和之，兼指上巨虚和下巨虚而言。秋季胃土之气退却，所以针刺足阳明胃经时，秋季不宜放血。杭音，又读形敬切。委音。）
足少阴肾经使人发生腰痛，疼痛牵引脊柱内侧。（足少阴肾经的经脉，贯穿脊柱内连属于肾。按：此前关于足太阴脾经腰痛的一节，必定是古文脱简遗漏所致。）针刺足少阴肾经在内踝上二寸处，春季不宜放血，如果出血过多，肾气就无法恢复了。（内踝上二寸处，是足少阴肾经的复溜穴。春季木旺水衰，所以针刺足少阴肾经时，春季不宜放血。如果出血太多，肾气就不可恢复。）
足厥阴肝经的经脉使人发生腰痛，腰部中间像拉满弓弩的弦一样紧绷。（王冰注：足厥阴肝经的支脉，与足太阴脾经、足少阳胆经的经脉，共同结聚于腰踝下的中封、中都之间，所以使人腰痛。肝主筋，肝病则筋脉拘急，所以导致腰部中间像拉满弓弩的弦一样紧绷。）针刺足厥阴肝经的经脉，位置在小腿肚鱼腹形状之外，顺着摸上去有结节状隆起的地方进行针刺，（腨，指小腿肚。踵，指足跟。鱼腹，指腨的形状像鱼腹。腨踵之间，鱼腹之外，顺着摸上去有累累结节状的，就是足厥阴肝经的络穴蠡沟穴。篆音。）该病使人善于言语但神情沉默，神志不清爽慧，针刺三下。（善于言语但神情沉默，指虽然能说话但不能发声。肝病多兼风邪，人多昏冒，所以不爽慧。三剌，指三次针刺该处。）
解脉使人发生腰痛，疼痛牵引肩部，眼睛视物模糊不清，时常遗尿，针刺解脉，位置在膝后筋肉分界处外侧的横脉出血，血色由黑变红即可停止。（解脉，是足太阳膀胱经散行的脉络。其脉循行经过肩胛，所以疼痛牵引肩部。其脉起于目内眦，所以眼睛视物模糊不清。其脉属膀胱，所以导致遗尿。应当针刺解脉在膝后的部位，即委中穴横纹两筋间，肌肉高起之处，这是足太阳膀胱经的血郄穴。如果在委中外侧有横行的血络显现，颜色紫黑充盈，针刺时应放出黑血。必须等到血色变为红色，才停止针刺，这也是足太阳膀胱经引起的腰痛。荒音。隙同。）
解脉使人腰痛，痛感像被带子牵引，经常像腰折断一样的状态，容易恐惧，针刺解脉，位置在委中穴处有像黍米大小的结络，针刺时射出的血是黑色的，见到红色的血就停止。（再次提到解脉，是指太阳膀胱经的支脉，从腰中下行夹着脊柱，贯穿臀部进入委中穴，所以疼痛像被带子牵引、像腰折断一样。太阳膀胱经的脉络连属于肾，肾志为恐，所以容易恐惧。委中，即委中穴。上文说的是委中外侧的横脉，这里说的是委中处的结络，治疗方法稍有不同而已。已，指停止针刺。）
同阴之脉使人发生腰痛，痛感像有小锤子居住在其中，沉重且肿胀，（足少阳胆经的别络，联络于足厥阴肝经，并且经过下肢联络足背，所以称为同阴之脉。像小锤子居住在其中，指疼痛且沉重。怫然，指愤怒的样子，形容肿胀突起如愤怒一般。锤音槌。怫音佛。）针刺同阴之脉，位置在外踝上绝骨的末端，针刺三次。（即足少阳胆经的阳辅穴。）
阳维脉使人发生腰痛，疼痛部位肿胀，（阳维，是奇经八脉之一，是阳脉相互维系交会之脉，所以叫阳维，）针刺阳维脉，位置在与足太阳膀胱经会合的腨下间，距离地面一尺左右。（阳维脉气所发出的部位，从金门穴上行，所以与足太阳膀胱经会合于腨下间，距离地面一尺左右，即承山穴。）
衡络之脉使人发生腰痛，不能前后俯仰，仰身时恐怕跌倒，这是由于举重损伤腰部，导致横络断裂，恶血积聚所致，（衡，通横。足太阳膀胱经的外络，从腰中横向伸出到髀外后侧，然后向下会合于委中穴，所以叫衡络。如果举重损伤腰部，则横络阻绝而恶血归聚于此，从而形成腰痛。）针刺的位置在委阳穴，筋的间隙中，向上数寸，横向分布，取两个穴位出血。（委阳，即足太阳膀胱经的委阳穴，在血郄上方外侧两筋间，所以说在上数寸。横居，并排居住，即殷门穴。这两个穴位都应当放血。）
会阴之脉使人发生腰痛，疼痛部位漯漯然出汗，汗干后令人想喝水，喝完后又想走动，（会阴，是任脉的穴位，在大便前、小便后，任脉、冲脉、督脉三脉在此交会，所以叫会阴。任脉由此行于腹部，督脉由此行于背部，所以使人腰痛。邪气在阴分，所以漯漯然出汗。汗干而津液亡失，所以令人想喝水。饮水多则阴气下溢，所以想走动。磊音。）针刺直阳之脉向上三寸处，在阳跷之上、委中之下，五寸处横向分布，观察血络盛满者放血。（直阳，指足太阳膀胱经正经的经脉，夹着脊柱贯穿臀部，下到委中，经过腨过外踝之后，径直而行，所以叫直阳。跷为阳跷，即申脉穴。委中，即委中穴。此脉上的穴位，在跷之上，委中之下，相距约五寸而横居其中，即承筋穴。或左或右，观察其血络盛满者，刺出其血。）
飞阳之脉使人发生腰痛，疼痛部位怫怫然，严重时悲伤且恐惧，（飞阳，是足太阳膀胱经的络穴，别走足少阴肾经，所以引起腰痛。痛上怫怫然，形容疼痛状如嗔愤。足太阳膀胱经的脉络连属于肾，其别络当心入散，所以严重时悲伤且恐惧，悲生于心，恐生于肾。）针刺飞阳脉，位置在内踝上五寸，足少阴肾经之前，与阴维脉交会处。（在内踝上五寸、足少阴肾经之前的，即阴维脉交会处筑宾穴。也共同治疗飞阳经引起的腰痛。）
昌阳之脉使人发生腰痛，疼痛牵引胸部，眼睛视物模糊不清，严重时身体反折，舌头卷缩不能说话，（昌阳，即足少阴肾经的复溜穴。少阴属肾，所以引起腰痛。肾脉注入胸中，所以疼痛牵引到膺部。肾的精气表现为瞳子，所以眼睛视物模糊不清。少阴合于太阳，所以身体反折。肾脉循行喉咙，所以舌头卷缩不能说话。）针刺内筋处作为两个穴位，位置在内踝上，大筋之前，足太阴脾经之后，踝上二寸处。（内筋，指筋的内侧，即复溜穴，在足太阴脾经之后，内踝上二寸处，这是阴跷脉的血郄穴。）
散脉使人发生腰痛且发热，热甚则生烦躁，腰部以下好像有横木居住在其中，严重时遗尿，（散脉，是足太阴脾经的别络，散行而上，所以以此命名。其脉循行大腿进入腹部，结聚于腰髁下的骨空中，所以发病时腰部以下好像有横木居住在其中，严重时甚至遗尿。）针刺散脉在膝前，骨肉分界处，络脉外侧，束脉针刺三次。（膝前，指膝内侧的前方。骨肉分间，指膝内辅骨下廉，腨肉的两间。络外廉，指太阴脾经的络脉，颜色青而显现。辅骨之下，后方有大筋退出膝中的骨，令其连属，取此系束之脉，针刺三次以去除疾病，所以叫束脉为三剌，这就是地机穴。按：这一节说膝前骨肉分间络外廉束脉，似乎指阳明经为散脉，而王冰解释为太阴，似乎有疑问；但本篇唯独缺少太阴经的刺法，而下文有说向上热刺足太阴的，若与此相呼应，以及考证地机穴主治腰痛，所以现在遵从王冰的注释。）
肉里之脉使人发生腰痛，不能咳嗽，咳嗽则筋脉拘急，（肉里，指分肉的里面，是足少阳胆经脉气所行的地方，即阳辅穴，又名分肉。少阳胆经对应筋，咳嗽则相互牵引而痛，所以不能咳嗽，咳嗽则筋脉收缩紧急。）针刺肉里之脉作为两个穴位，位置在足太阳膀胱经之外，足少阳胆经绝骨穴之后。（足太阳膀胱经之外，足少阳胆经绝骨穴之后，即阳辅穴。）
腰痛夹着脊柱疼痛直到头部，颈部僵硬不舒，眼睛视物模糊不清，想要僵仆倒地，针刺足太阳膀胱经的委中穴出血。（几几，形容低头伏卧的样子。KT KT，指眼睛视物混乱不明。这些都是太阳经的证候，所以应当针刺委中穴出血，即委中穴。）
腰痛上部寒冷，针刺足太阳膀胱经、足阳明胃经；上部发热，针刺足厥阴肝经；（上寒上热，都是指上半身而言。寒证针刺阳经，去除阳分的阴邪；热证针刺厥阴，去除阴中的风热。）不能前后俯仰，针刺足少阳胆经；（少阳胆经的行走在身体两侧，所以俯仰不利者应当针刺它。）中部发热且气喘，针刺足少阴肾经，针刺委中穴出血。（少阴肾主水，水病无法制约火，所以中部发热。少阴肾经的经脉贯穿肝膈进入肺中，所以气喘。应当针刺足少阴肾经，涌泉、大钟穴都主治此症。委中的含义如前所述。）
腰痛上部寒冷，不能回头张望，针刺足阳明胃经；上部发热，针刺足太阴脾经。（足阳明胃经的经脉挟持喉咙，上行联络头项，足太阴脾经与足阳明胃经相合，上行结聚于咽喉，所以都不能左右回头。王冰注：上寒，阴市穴主治。不能回头，足三里穴主治。上热，地机穴主治。）中部发热且气喘，针刺足少阴肾经。（重复出现。）大便困难，针刺足少阴肾经。（肾开窍于二阴。王冰注：涌泉穴主治。）小腹胀满，针刺足厥阴肝经。（厥阴肝经的经脉抵少腹。王冰注：太冲穴主治。）像折断一样不能前后俯仰，不能抬举，针刺足太阳膀胱经。（足太阳膀胱经的经脉循行腰背，所以出现这些证候。王冰注：像折断，束骨穴主治。不能前后俯仰，京骨、昆仑穴都主治。不能抬举，申脉、仆参穴都主治。）疼痛牵引脊柱内侧，针刺足少阴肾经。（脊柱的内侧，是肾脉所行的地方，所以应当针刺足少阴肾经。王冰注：复溜穴主治。）
腰痛牵引少腹，牵引季胁下，不能仰身，针刺腰尻交结的部位，两髁骨下的肌肉上，根据月亮的盈亏来确定针刺的次数，发针后立刻痊愈，（这是邪气客居足太阴脾经的络脉引起的腰痛。控，牵引。 ，季胁下的空软处。腰尻交者，按王冰说：即下髎穴，这是足太阴脾经、足厥阴肝经、足少阳胆经三脉，左右交结于其中。两髁胂，指腰髁骨下坚硬的肌肉。大概腰髁下尻骨两旁有四骨空，左右共八个穴位，称为八髎骨。这是太阴经引起的腰痛，应当取第四个空，即下髎穴。以月死生为刺数，如《缪刺篇》所说：月亮生出一天刺一针，两天刺两针，逐渐增多，十五天刺十五针，十六天刺十四针，逐渐减少。按《缪刺论》说：邪气客居足太阴脾经的络脉，使人腰痛牵引少腹控 ，不能仰息。就是这一节的意义，详见本类第三十节。秒音。髁，苦瓦切。胂音申。）左病取右，右病取左。（因为经脉左右交结，所以适宜用缪刺法这样治疗。）
腰痛不能转摇，急迫牵引阴囊，针刺八髎穴和疼痛部位，八髎穴位于腰尻分界处。
（《素问·骨空论》。八髎，指上髎、次髎、中髎、下髎，左右共八个穴位，都属于足太阳膀胱经的穴位，在腰之下，尻之上，筋肉分间的陷下处。辽音。）
腰痛，疼痛部位上部寒冷，取足太阳膀胱经、足阳明胃经；疼痛部位上部发热，取足厥阴肝经；不能前后俯仰，取足少阳胆经。
（《灵枢·杂病篇》。与前文重复出现。）
(The full text of "Ci Yao Tong Lun" from *Suwen*, "Gu Kong Lun", and "Za Bing Pian" from *Linghu*)
The meridians of the Foot-Taiyang Bladder cause lower back pain, with pain radiating to the nape, spine, sacrum, and back, feeling as if bearing a heavy burden.
(The full text of "Ci Yao Tong Pian" in *Suwen*. The meridian of the Foot-Taiyang Bladder descends through the nape, runs along the medial side of the shoulder blade, flanks the spine, and reaches the middle of the waist; thus it causes lower back pain radiating to the nape, spine, sacrum, and back, feeling as if bearing a heavy burden. Kao [sacrum/coccyx], pronounced kai-gao qie, refers to the buttocks.) Puncture the Weizhong (BL-40) point and Kunlun (BL-60) point to bleed the regular meridians of the Foot-Taiyang Bladder. In spring, avoid bleeding. (Weizhong is also known as Xue Xi [Blood Gap]. Kunlun is a regular acupoint of the Foot-Taiyang Bladder Meridian. The Foot-Taiyang Bladder corresponds to Kidney Water. Water Qi is prosperous in winter and declines in spring; therefore, when puncturing the Foot-Taiyang Bladder Meridian, avoid bleeding in spring. Xi, same as Xi [gap].)
The meridians of the Foot-Shaoyang Gallbladder cause lower back pain, with a sensation as if needles are pricking the skin. Movements are sluggish and stiff; one cannot bend forward or backward, nor can one turn the head to look back. (The Qi of the Foot-Shaoyang Gallbladder corresponds to Wind-Wood. When the Yang aspect is affected, the pain feels like needles pricking the skin. Xun-xun-ran describes a state of slowness and stiffness, indicating difficulty in movement. The meridian of the Foot-Shaoyang Gallbladder originates at the outer canthus, ascends to the frontal angle, descends behind the ear, runs along the neck down to the chest, travels within the hypochondrium, and descends along the lateral aspects of the body and legs; thus the body cannot bend forward or backward, and the head cannot turn back. Fu, same as Fu [bend].) Puncture the end of the Chenggu bone at the prominent bone on the lateral side of the knee to induce bleeding. This prominent bone is located at the upper end of the fibula on the lateral side of the knee. In summer, avoid bleeding. (The prominent bone on the lateral side of the knee is the upper end of the fibula. Since it supports the body, it is called Chenggu [Establishing Bone]. Its end is the Yangguan (GB-33) point. The Foot-Shaoyang Gallbladder corresponds to Liver Wood. Wood Qi is prosperous in spring and declines in summer; therefore, when puncturing the Foot-Shaoyang Gallbladder Meridian, avoid bleeding in summer.)
The meridians of the Foot-Yangming Stomach cause lower back pain, with an inability to turn the head to look back. When turning, one may hallucinate seeing ghosts. There is a tendency toward sadness. (The sinews of the Foot-Yangming Stomach ascend along the hypochondrium and attach to the spine. The meridian of the Foot-Yangming Stomach follows the lower jaw, exits at Daying (ST-5), and its branch descends from Renying (ST-17), follows the throat, enters the Supraclavacular Fossa (Qimen, REN-22), descends along the interior of the abdomen to meet at Qichuan (ST-30), and then descends past Biguan (ST-31); thus it causes lower back pain preventing head turning. "Seeing ghosts when looking back" refers to visual hallucinations. Sadness arises from deficiency of Shen (Spirit). When Yangming Qi declines and Yin pathogens oppress it, such symptoms appear.) Puncture the Zusanli (ST-36) point and the Shangjuxu (ST-37) and Xiajuxu (ST-39) points of the Foot-Yangming Stomach, harmonize the upper and lower, and induce bleeding. In autumn, avoid bleeding. (Sanqian Sanli refers to Zusanli (ST-36). Harmonizing upper and lower refers to Shangjuxu and Xiajuxu. In autumn, the Earth Qi of the Stomach retreats; therefore, when puncturing the Foot-Yangming Stomach Meridian, avoid bleeding in autumn. Hang sound, also pronounced Xingjing qie. Wei sound.)
The meridians of the Foot-Shaoyin Kidney cause lower back pain, with pain radiating to the medial side of the spine. (The meridian of the Foot-Shaoyin Kidney penetrates the interior of the spine and attaches to the Kidney. Note: The preceding section on lower back pain due to the Foot-Taiyin Spleen is likely a lacuna in the ancient text.) Puncture the Fuliu (KI-7) point, located two cun above the medial malleolus, on the Foot-Shaoyin Kidney Meridian. In spring, avoid bleeding. If too much blood is lost, the Kidney Qi cannot recover. (Fuliu (KI-7) is located two cun above the medial malleolus on the Foot-Shaoyin Kidney Meridian. In spring, Wood is prosperous and Water is weak; therefore, when puncturing the Foot-Shaoyin Kidney Meridian, avoid bleeding in spring. If too much blood is lost, Kidney Qi cannot be restored.)
The meridians of the Foot-Jueyin Liver cause lower back pain, with the waist feeling tight like the string of a drawn bow. (Wang Bing's commentary: A branch of the Foot-Jueyin Liver Meridian joins with the meridians of the Foot-Taiyin Spleen and Foot-Shaoyang Gallbladder at Zhongfeng (LR-7) and Zhongdu (LR-6) below the ankle and waist; thus it causes lower back pain. The Liver governs tendons. Liver disease causes tendon tension, resulting in the waist feeling tight like a drawn bow.) Puncture the meridian of the Foot-Jueyin Liver at the location outside the gastrocnemius muscle belly. Feel for nodular elevations along the path and puncture there. (Shuan refers to the calf. Zhong refers to the heel. Yufu [Fish Belly] describes the shape of the calf. Between the Shuan and Zhong, outside the Yufu area, where nodular elevations are felt upon palpation, is the Luo-connecting point Ligou (LR-5) of the Foot-Jueyin Liver Meridian. Zhuan sound.) This condition causes the patient to speak but remain silent, and to lack mental clarity. Puncture three times. (Speaking silently refers to the ability to speak but inability to produce sound clearly. Liver diseases often involve Wind, causing dizziness and clouded mind, leading to lack of clarity. San-ci means puncturing the site three times.)
Jie Mai (Resolving Vessel) causes lower back pain, with pain radiating to the shoulder, blurred vision, and occasional urinary incontinence. Puncture Jie Mai at the transverse vessel on the lateral side of the intermuscular space behind the knee to induce bleeding. Stop when the blood color changes from dark to red. (Jie Mai refers to the scattered collaterals of the Foot-Taiyang Bladder Meridian. Its pathway passes through the scapula, hence pain radiates to the shoulder. It originates at the inner canthus, hence blurred vision. It connects to the Bladder, hence urinary incontinence. One should puncture Jie Mai behind the knee, specifically between the two tendons at the popliteal crease of Weizhong (BL-40), where the muscle is prominent. This is the Xue Xi [Blood Gap] of the Foot-Taiyang Bladder Meridian. If there are visible transverse blood vessels on the lateral side of Weizhong, appearing purple-black and full, puncture them to release black blood. Wait until the blood turns red before stopping the needle. This is also lower back pain caused by the Foot-Taiyang Bladder Meridian. Huang sound. Xi, same as gap.)
Jie Mai causes lower back pain, feeling as if pulled by a belt, often resembling a broken waist. There is a tendency toward fear. Puncture Jie Mai at the nodular collaterals in Weizhong (BL-40), which resemble millet seeds. Puncture until black blood shoots out, then stop when red blood appears. (Mentioning Jie Mai again refers to the branch of the Taiyang Bladder Meridian that descends from the waist, flanking the spine, passing through the buttocks into Weizhong (BL-40). Hence the pain feels like being pulled by a belt or a broken waist. The Taiyang Bladder Meridian connects to the Kidney. The emotion of the Kidney is Fear, hence the tendency toward fear. Weizhong is Weizhong (BL-40). The previous section mentioned the transverse vessel on the lateral side of Weizhong; this section mentions the nodular collaterals in Weizhong. The treatment differs slightly. Yi means to stop needling.)
Tongyin Mai causes lower back pain, with a sensation as if a small hammer is lodged inside, causing heaviness and swelling. (The collateral of the Foot-Shaoyang Gallbladder connects to the Foot-Jueyin Liver and traverses down to connect with the dorsum of the foot; thus it is called Tongyin Mai. "Like a small hammer lodged inside" indicates painful heaviness. Fur-ran describes an angry expression, referring to swelling that protrudes as if angry. Chui sounds like Chui [hammer]. Fu sounds like Fo [Buddha/angry].) Puncture Tongyin Mai at the end of the Juegu bone above the lateral malleolus. Puncture three times. (This is the Yangfu (GB-38) point of the Foot-Shaoyang Gallbladder Meridian.)
Yangwei Mai causes lower back pain, with swelling at the painful site. (Yangwei is one of the Eight Extraordinary Vessels. It is the vessel where Yang meridians intersect and link; thus it is called Yangwei.) Puncture Yangwei Mai at the intersection with the Foot-Taiyang Bladder Meridian in the gastrocnemius region, approximately one chi above the ground. (The emission point of Yangwei Qi ascends from Jinmen (BL-63); thus it intersects with the Foot-Taiyang Bladder Meridian in the gastrocnemius region, one chi above the ground, which is the Chengshan (BL-57) point.)
Hengluo Mai causes lower back pain, with an inability to bend forward or backward. Bending backward may cause fear of falling. This results from lifting heavy objects and injuring the waist, severing the Hengluo, causing evil blood to accumulate. (Heng means horizontal. The external collateral of the Foot-Taiyang Bladder Meridian extends horizontally from the waist to the posterior-lateral aspect of the thigh, then descends to join Weizhong (BL-40); thus it is called Hengluo. If heavy lifting injures the waist, the horizontal collaterals are obstructed, and evil blood accumulates, causing lower back pain.) Puncture at Weiyang (BL-39), in the intertendinous space, several cun upward. Take two horizontally arranged points to bleed. (Weiyang is the Weiyang (BL-39) point of the Foot-Taiyang Bladder Meridian, located laterally between two tendons above the Xue Xi of Weizhong (BL-40), hence "several cun upward". Hengju means arranged horizontally, referring to the Yinmen (BL-37) point. Both points should be bled.)
Huiyin Mai causes lower back pain, with profuse sweating at the painful site. After the sweat dries, the patient desires water. After drinking, the patient desires to move about. (Huiyin is an acupoint of the Ren Mai, located anterior to the anus and posterior to the urethra, where the Ren, Chong, and Du meridians converge; thus it is called Huiyin. The Ren Meridian runs along the abdomen from here, and the Du Meridian runs along the back from here; thus it causes lower back pain. Pathogens in the Yin aspect cause profuse sweating. Sweat loss leads to fluid depletion, causing thirst. Excessive drinking causes Yin Qi to overflow downward, leading to restlessness. Lei sound.) Puncture the Zhongyang Mai upward by three cun, located above the Yangqiao and below Weizhong (BL-40), arranged horizontally at five cun distance. Bleed the prominent blood vessels. (Zhongyang refers to the regular meridian of the Foot-Taiyang Bladder, which flanks the spine, passes through the buttocks, descends to Weizhong (BL-40), passes through the calf, goes behind the lateral malleolus, and proceeds straight; thus it is called Zhongyang. Qiao refers to Yangqiao, which is Shenmai (BL-62). Weizhong is Weizhong (BL-40). The acupoint on this meridian is above Qiao and below Weizhong, horizontally arranged at about five cun distance, which is the Chengjin (BL-56) point. On either the left or right side, observe the prominent blood vessels and puncture to bleed.)
Feiyang Mai causes lower back pain, with a feeling of oppression at the painful site. Severe cases involve sadness and fear. (Feiyang is the Luo-connecting point of the Foot-Taiyang Bladder Meridian, diverging to the Foot-Shaoyin Kidney Meridian; thus it causes lower back pain. "Fu-fu-ran at the painful site" describes pain resembling indignation. The Foot-Taiyang Bladder Meridian connects to the Kidney. Its branch enters the heart and disperses; thus severe cases involve sadness and fear. Sadness arises from the Heart, and fear arises from the Kidney.) Puncture Feiyang Mai at five cun above the medial malleolus, anterior to the Foot-Shaoyin Kidney Meridian, at the intersection with the Yinwei Mai. (Five cun above the medial malleolus, anterior to the Foot-Shaoyin Kidney Meridian, is the intersection with the Yinwei Mai, the Zhubin (KI-9) point. It also treats lower back pain caused by Feiyang.)
Changyang Mai causes lower back pain, with pain radiating to the chest, blurred vision, severe cases involving opisthotonos (body arching backward), tongue retraction, and inability to speak. (Changyang is the Fuliu (KI-7) point of the Foot-Shaoyin Kidney Meridian. Shaoyin belongs to the Kidney, hence lower back pain. The Kidney Meridian pours into the chest, hence pain radiates to the Ying [chest]. The essence of the Kidney manifests in the pupils, hence blurred vision. Shaoyin combines with Taiyang, hence opisthotonos. The Kidney Meridian follows the throat, hence tongue retraction and inability to speak.) Puncture the Neijin [inner tendon] area as two points, located above the medial malleolus, anterior to the large tendon, posterior to the Foot-Taiyin Spleen Meridian, at two cun above the ankle. (Neijin refers to the inner side of the tendon, i.e., Fuliu (KI-7), located posterior to the Foot-Taiyin Spleen Meridian and two cun above the medial malleolus. This is the Xue Xi of the Yinqiao Mai.)
San Mai causes lower back pain accompanied by heat. Severe heat causes irritability. The lower waist feels as if a horizontal piece of wood is lodged within. Severe cases involve urinary incontinence. (San Mai is the collateral of the Foot-Taiyin Spleen Meridian, scattering upward; thus named San [scattered]. Its meridian runs along the thigh into the abdomen, knotting in the hollow below the lumbar and iliac bones. Hence, when diseased, the lower waist feels as if a horizontal piece of wood is lodged within, and severe cases involve urinary incontinence.) Puncture San Mai at the front of the knee, in the intermuscular space, on the lateral side of the collateral. Bind the vessel and puncture three times. (Front of the knee refers to the anterior aspect of the medial knee. Intermuscular space between bone and flesh refers to the lower margin of the medial condyle of the tibia, between the muscles. Lateral side of the collateral refers to the visible blue-green collateral of the Spleen Meridian. Below the tibial condyle, there is a large tendon exiting the knee joint bone, connecting them. Take this binding vessel and puncture three times to remove the disease; thus it is called "Bind Vessel Three Punctures," which is the Diji (SP-8) point. Note: This section mentions "front of knee, intermuscular space, lateral collateral, bind vessel," which seems to refer to the Yangming Meridian as San Mai, while Wang Bing interprets it as Taiyin. There is some doubt; however, this chapter uniquely lacks the puncture method for Taiyin, and the following text mentions "upper heat puncture Foot-Taiyin," which corresponds to this. Also, Diji (SP-8) treats lower back pain. Therefore, we follow Wang Bing's annotation.)
Rouli Mai causes lower back pain, with an inability to cough. Coughing causes tendon tension. (Rouli refers to the interior of the muscle compartments, the pathway of the Foot-Shaoyang Gallbladder Meridian, i.e., Yangfu (GB-38), also known as Fenrou. Shaoyang corresponds to tendons. Coughing causes mutual traction and pain; thus one cannot cough, as coughing causes tendon contraction and tension.) Puncture Rouli Mai as two points, located lateral to the Foot-Taiyang Bladder Meridian and posterior to the Juegu point of the Foot-Shaoyang Gallbladder Meridian. (Lateral to the Foot-Taiyang Bladder Meridian and posterior to the Juegu point of the Foot-Shaoyang Gallbladder Meridian is the Yangfu (GB-38) point.)
Lower back pain flanking the spine, radiating to the head, with a stiff neck, blurred vision, and a desire to collapse. Puncture Weizhong (BL-40) of the Foot-Taiyang Bladder Meridian to bleed. (Ji-jin describes a posture of bowing or lying prone. Kuang-kuang refers to blurred and chaotic vision. These are all Taiyang syndromes; thus one should puncture Weizhong (BL-40) to bleed.)
Upper body coldness with lower back pain: Puncture Foot-Taiyang Bladder and Foot-Yangming Stomach meridians. Upper body heat with lower back pain: Puncture Foot-Jueyin Liver meridian. Inability to bend forward or backward: Puncture Foot-Shaoyang Gallbladder meridian. (Upper cold/heat refers to the upper body. Cold conditions are treated by puncturing Yang meridians to expel Yin pathogens from the Yang aspect. Heat conditions are treated by puncturing Jueyin to expel Wind-Heat from the Yin aspect.) Middle heat with panting: Puncture Foot-Shaoyin Kidney meridian and bleed at Weizhong (BL-40). (Shaoyin governs Water. Water disease fails to control Fire, causing middle heat. The Shaoyin Meridian passes through the Liver and Diaphragm into the Lung, causing panting. One should puncture the Foot-Shaoyin Kidney Meridian; Yongquan (KI-1) and Dazhong (KI-4) both treat this. Meaning of Weizhong as previously stated.)
Upper body coldness with lower back pain and inability to turn head: Puncture Foot-Yangming Stomach meridian. Upper body heat: Puncture Foot-Taiyin Spleen meridian. (The Foot-Yangming Stomach Meridian flanks the throat and ascends to connect with the head and neck. The Foot-Taiyin Spleen Meridian combines with the Foot-Yangming Stomach Meridian, ascends, and knots at the pharynx; thus neither can turn the head left or right. Wang Bing notes: Upper cold, Yinshi (ST-5) treats it. Inability to turn head, Zusanli (ST-36) treats it. Upper heat, Diji (SP-8) treats it.) Middle heat with panting: Puncture Foot-Shaoyin Kidney meridian. (Repeated.) Difficulty defecating: Puncture Foot-Shaoyin Kidney meridian. (The Kidney opens into the two orifices. Wang Bing notes: Yongquan (KI-1) treats it.) Fullness in the lower abdomen: Puncture Foot-Jueyin Liver meridian. (The Jueyin Meridian reaches the lower abdomen. Wang Bing notes: Taichong (LR-3) treats it.) Lower back pain feeling like a fracture, unable to bend forward/backward or lift: Puncture Foot-Taiyang Bladder meridian. (The Foot-Taiyang Bladder Meridian follows the back and waist, causing these symptoms. Wang Bing notes: Feeling like a fracture, Shugu (BL-65) treats it. Unable to bend forward/backward, Jinggu (BL-64) and Kunlun (BL-60) treat it. Unable to lift, Shenmai (BL-62) and Pusan (BL-59) treat it.) Pain radiating to the medial side of the spine: Puncture Foot-Shaoyin Kidney meridian. (The medial side of the spine is the pathway of the Kidney Meridian; thus one should puncture the Foot-Shaoyin Kidney Meridian. Wang Bing notes: Fuliu (KI-7) treats it.)
Lower back pain radiating to the lower abdomen and hypochondrium, with inability to extend the back: Puncture the crossing points of the lumbar and sacrum, on the muscles below the hip bones. Determine the number of punctures based on the waxing and waning of the moon. The effect is immediate upon releasing the needle. (This is lower back pain caused by pathogens lodging in the collateral of the Foot-Taiyin Spleen Meridian. Kong means radiate. , refers to the soft hollow below the costal margin. Lumbar-sacral crossing points: According to Wang Bing, this refers to the Xialiao (BL-32) points. The Foot-Taiyin Spleen, Foot-Jueyin Liver, and Foot-Shaoyang Gallbladder meridians intersect here on the left and right. Liangkeshen refers to the firm muscles below the hip bones. There are four bony hollows on each side of the sacrum below the hip bones, totaling eight acupoints, known as the Ba Liao [Eight Hollows]. For Taiyin lower back pain, take the fourth hollow, i.e., Xialiao (BL-32). The number of punctures is determined by the moon: As stated in "Miao Ci Pian," on the first day of the waxing moon, one puncture; second day, two punctures; increasing gradually to fifteen punctures on the fifteenth day. On the sixteenth day of the waning moon, fourteen punctures; decreasing gradually. Note: "Miao Ci Lun" states: Pathogens lodging in the collateral of the Foot-Taiyin Spleen Meridian cause lower back pain radiating to the lower abdomen and hypochondrium, with inability to breathe while extending the back. This is the meaning of this section. See Class 30 for details. Miao sound. Huo, kuwa qie. Shen sound.) Treat the left side by puncturing the right, and the right side by puncturing the left. (Because the meridians intersect on the left and right, Miao Ci [Mirror Needling] is appropriate.)
Lower back pain with inability to twist or turn, urgently radiating to the scrotum: Puncture the Ba Liao [Eight Hollows] and the painful site. The Ba Liao are located in the division between the lumbar and sacral regions.
(*Suwen: Gu Kong Lun*). The Ba Liao refer to Shangliao (BL-31), Ciliao (BL-32), Zhongliao (BL-33), and Xialiao (BL-32), totaling eight points on the left and right. They belong to the Foot-Taiyang Bladder Meridian, located below the waist and above the sacrum, in the depressions between muscle and flesh. Liao sound.
Lower back pain with upper coldness: Select Foot-Taiyang Bladder and Foot-Yangming Stomach meridians. Lower back pain with upper heat: Select Foot-Jueyin Liver meridian. Inability to bend forward or backward: Select Foot-Shaoyang Gallbladder meridian.
(*Linghu: Za Bing Pian*). Repeated from the above text.